Health System Impacts on Maternal and Child Health

2009 ◽  
pp. 83-97 ◽  
Author(s):  
Nancy Gerein ◽  
Andrew Green ◽  
Tolib Mirzoev ◽  
Stephen Pearson
Keyword(s):  
Child Health ◽  
Health System ◽  
Maternal And Child Health ◽  
And Child Health

scholarly journals Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010

2018 ◽  
Vol 3 (2) ◽  
pp. e000674 ◽  
Author(s):  
Dana R Thomson ◽  
Cheryl Amoroso ◽  
Sidney Atwood ◽  
Matthew H Bonds ◽  
Felix Cyamatare Rwabukwisi ◽  
...  
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Health System ◽  
Population Health ◽  
Maternal And Child Health ◽  
Rural Areas ◽  
Health System Strengthening ◽  
Live Births ◽  
Intervention Area ◽  
And Child Health

IntroductionAlthough Rwanda’s health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.MethodsCombining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.ResultsOverall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.ConclusionWe observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A realist synthesis

2020 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health System ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Care ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

Abstract Background: Despite the growing global application of mobile health (mHealth) technology in maternal and child health, contextual factors, and mechanisms by which interventional outcomes are generated, have not been subjected to a systematic examination. In this study, we sought to uncover context, mechanisms, and outcome elements of various mHealth interventions based on implementation and evaluation studies to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and mothers.Method: We undertook a realist synthesis. An electronic search of six online databases (Medline, PubMed, Google Scholar, Scopus, Academic Search Premier, and Health Systems Evidence) was performed. Using appropriate Boolean phrases terms and selection procedures, 32 articles were identified. A theory-driven approach, narrative synthesis, was applied to synthesize the data. Thematic content analysis was used to delineate elements of the intervention, including its context, actors, mechanisms, and outcomes. Abduction and retroduction were applied using a realist evaluation heuristic tool to formulate generative theories.Results: We formulated two configurational models illustrating how and why mHealth impacts the implementation and uptake of maternal and child care services. Implementation-related mechanisms include buy-in from health care providers, perceived support of health care providers’ motivation, and perceived ease of use and usefulness. These mechanisms were influenced by adaptive health system conditions including organization, resource availability, policy implementation dynamics, experience with technology, network infrastructure, and connectivity. For pregnant women and mothers, mechanisms that trigger mHealth use and consequently uptake of maternal and child health care include perceived satisfaction, motivation, and positive psychological support. Information overload was identified as a potential negative mechanism impacting the uptake of maternal and child health care. These mechanisms were influenced by health system conditions, socio-cultural characteristics, socio-economic and demographics characteristics, network infrastructure and connectivity, and awareness.Conclusion: Models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how and why they impact maternal and child health care in low- and middle-income countries. These models provide a foundation for the ‘white box’ of theory-driven evaluation of mHealth interventions and can improve rollout and implementation where required.

scholarly journals Overcoming the challenges of community-engaged emergency referrals in a rural district of Pakistan

2021 ◽  
pp. 1-10
Author(s):  
Imran Naeem Abbasi ◽  
Sameen Siddiqi
Keyword(s):  
Child Health ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Department ◽  
Referral System ◽  
Health Issues ◽  
District Health ◽  
Community Volunteers ◽  
Depth Interviews ◽  
And Child Health

A functional referral system for addressing maternal and child health issues requires coordinated efforts by health system stakeholders and community. Using Rural Health Program (RHP) Thatta as platform provided by an academic institution, district health system stakeholders and community of Mirpur Sakro taluka of Thatta were engaged to strengthen the emergency referral system for maternal and child health emergencies through active community engagement. Through combined consultation, referral system plan for maternal and child health emergencies was developed. Community volunteers from each village liaised for transportation, referring patients to health facilities and maintaining referral documentation. An ambulance service under contract with health department and private transporters were taken on-board to facilitate patients’ transportation. Community’s experiences of referral system were assessed through qualitative in-depth interviews. Patients’ experiences of referral system improved but faced structural challenges including out of pocket transport expenses, direct self-referrals, Continuous...

Impact of Community Health Interventions on Maternal and Child Health Indicators in the Upper East Region of Ghana

2021 ◽  
Author(s):  
Evelyn Sakeah ◽  
Ayaga A Bawah ◽  
Patrick Asuming ◽  
Cornelius Debpuur ◽  
Paul Welaga ◽  
...  
Keyword(s):  
Child Health ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Health System Strengthening ◽  
Transport Systems ◽  
Health Delivery ◽  
East Region ◽  
Upper East Region ◽  
And Child Health

Abstract BackgroundThis paper reports on results of a health system strengthening programme implementation research in the Upper East region of northern Ghana where critical interventions to accelerate and strengthen the health delivery were implemented. Transformative interventions implemented included empowering community leaders and actors to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, provision of basic medical equipment to community clinics, and improving the skills of critical health staff training. MethodsA mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. For these analyses a pre-and-post randomized cluster design was used. For the qualitative data focused group and individual indepth interviews were employed to gauge the views of different stakeholders associated with the implementation process. ResultsSignificant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage (ANC and PNC) were observed. Similarly, there were significant increases in delivering of children in a health facilities and deliveries assisted by skilled health personnel after the intervention compared to before intervention situation in the region. There has also been increased uptake of women providing oral rehydration salts (ORS) for treatment of diarrhoea, as well as marked reductions in upper respiratory infections (URI). Conclusions Results from a pre-and post-evaluation impact assessment of interventions implemented in these health deprived parts of Ghana show that the programme had a strong positive impact on the functioning of Ghana’s health delivery system known as Community-based Health Planning and Services programme and induced visible changes in key indicators of health system performance.

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