Perspectives of beneficiaries, health service providers, and community members on a maternal and child health conditional cash transfer pilot programme in Nigeria

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Chioma Oduenyi ◽  
Victor Ordu ◽  
Ugo Okoli
Keyword(s):  
Child Health ◽  
Health Service ◽  
Maternal And Child Health ◽  
Service Providers ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Community Members ◽  
Pilot Programme ◽  
Health Service Providers ◽  
And Child Health

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2021 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background: Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods: A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results: Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation. Conclusions: Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

scholarly journals What mechanisms drive uptake of family planning when integrated with childhood immunisation in Ethiopia? A realist evaluation

2020 ◽  
Author(s):  
Shari Krishnaratne ◽  
Jessie K. Hamon ◽  
Jenna Hoyt ◽  
Tracey Chantler ◽  
Justine Landegger ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Realist Evaluation ◽  
Religious Leaders ◽  
Community Members ◽  
Theoretical Frameworks ◽  
Programme Theory ◽  
Integrated Delivery ◽  
And Child Health

Abstract Background:Maternal and child health are key priorities among the Sustainable Development Goals, which include a particular focus on reducing morbidity and mortality among women of reproductive age, newborns, and children under the age of five. Two components of maternal and child health are family planning (FP) and immunisation. Providing these services through an integrated delivery system could increase the uptake of vaccines and modern contraceptive methods (MCMs) particularly during the post-partum period. Methods:A realist evaluation was conducted in two woredas in Ethiopia to determine the key mechanisms and their triggers that drive successful implementation and service uptake of an intervention of integrated delivery of immunisations and FP. The methodological approach included the development of an initial programme theory and the selection of relevant, published implementation related theoretical frameworks to aid organisation and cumulation of findings. Data from 23 semi-structured interviews were then analysed to determine key empirical mechanisms and drivers and to test the initial programme theory. These mechanisms were mapped against published theoretical frameworks and a revised programme theory comprised of context-mechanism-outcome configurations was developed. A critique of theoretical frameworks for abstracting empirical mechanisms was also conducted. Results:Key contextual factors identified were: the use of trained Health Extension Workers (HEWs) to deliver FP services; a strong belief in values that challenged FP among religious leaders and community members; and a lack of support for FP from male partners based on religious values. Within these contexts, empirical mechanisms of acceptability, access, and adoption of innovations that drove decision making and intervention outcomes among health workers, religious leaders, and community members were identified to describe intervention implementation.Conclusions:Linking context and intervention components to the mechanisms they triggered helped explain the intervention outcomes, and more broadly how and for whom the intervention worked. Linking empirical mechanisms to constructs of implementation related theoretical frameworks provided a level of abstraction through which findings could be cumulated across time, space, and conditions by theorising middle-range mechanisms.

Human Milk in Premature Infant Feeding: Summary of a Workshop

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 741-743
Keyword(s):  
Child Health ◽  
Health Service ◽  
Human Milk ◽  
Community Health ◽  
Premature Infants ◽  
Maternal And Child Health ◽  
National Research Council ◽  
The United States ◽  
National Academy Of Sciences ◽  
And Child Health

Increasing interest in the utilization of human milk for the feeding of premature infants has been evident in the United States in the past few years and in the Scandinavian countries and several other parts of Europe for a longer time. Because premature infants exhibit even greater limitations of gastrointestinal and digestive functions and of immunologic status than do full-term infants, human milk may offer particular advantages. Such advantages include ready digestibility and absence of foreign proteins; in addition, it is possible that feeding of human milk may protect against enteric infections. In view of current interest in human milk for feeding premature infants, it seemed desirable to consider the possible associated benefits and risks. Such a consideration was undertaken on December 2 and 3, 1975, in Chevy Chase, Maryland, under the sponsorship of the Office for Maternal and Child Health, Bureau of Community Health Services, Health Service Administration, Department of Health, Education and Welfare. The meeting was attended by individuals believed knowledgeable about one or another area related to possible benefits and risks of feeding fresh or processed human milk by bottle or gavage to premature infants in hospitals. Participants in the workshop included representatives of two com- mittees of the American Academy of Pediatrics, two committees of the National Academy of Sciences-National Research Council, and representatives of the American College of Obstetricians and Gynecologists, the American Nursing Association, the Center for Disease Control, and the National Institute of Child Health and Human Development. Several representatives of the Office for Maternal and Child Health and of the Division of Clinical Services, Bureau of Community Health Service were also present.

No effects of pilot performance-based intervention implementation and withdrawal on the coverage of maternal and child health services in the Koulikoro region, Mali: an interrupted time series analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 379-387
Author(s):  
David Zombré ◽  
Manuela De Allegri ◽  
Valéry Ridde
Keyword(s):  
Time Series ◽  
Child Health ◽  
Health Service ◽  
Maternal And Child Health ◽  
Interrupted Time Series ◽  
Child Health Services ◽  
Child Health Service ◽  
Health Centres ◽  
The Impact ◽  
And Child Health

Abstract Performance-based financing (PBF) has been promoted and increasingly implemented across low- and middle-income countries to increase the utilization and quality of primary health care. However, the evidence of the impact of PBF is mixed and varies substantially across settings. Thus, further rigorous investigation is needed to be able to draw broader conclusions about the effects of this health financing reform. We examined the effects of the implementation and subsequent withdrawal of the PBF pilot programme in the Koulikoro region of Mali on a range of relevant maternal and child health indicators targeted by the programme. We relied on a control interrupted time series design to examine the trend in maternal and child health service utilization rates prior to the PBF intervention, during its implementation and after its withdrawal in 26 intervention health centres. The results for these 26 intervention centres were compared with those for 95 control health centres, with an observation window that covered 27 quarters. Using a mixed-effects negative binomial model combined with a linear spline regression model and covariates adjustment, we found that neither the introduction nor the withdrawal of the pilot PBF programme bore a significant impact in the trend of maternal and child health service use indicators in the Koulikoro region of Mali. The absence of significant effects in the health facilities could be explained by the context, by the weaknesses in the intervention design and by the causal hypothesis and implementation. Further inquiry is required in order to provide policymakers and practitioners with vital information about the lack of effects detected by our quantitative analysis.

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