scholarly journals Reviewing implementation fidelity to leverage impact in a multi-country maternal and child health and nutrition study

2016 ◽  
Vol 82 (3) ◽  
pp. 519
Author(s):  
Anna Paden ◽  
Annette Ghee ◽  
Armen Martirosyan ◽  
Bridget Aidam ◽  
Jane Chege
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Implementation Fidelity ◽  
Health And Nutrition ◽  
Nutrition Study ◽  
And Child Health

scholarly journals Cohort profile: the Maternal and Child Health and Nutrition in Acre, Brazil, birth cohort study (MINA-Brazil)

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034513
Author(s):  
Marly A Cardoso ◽  
Alicia Matijasevich ◽  
Maira Barreto Malta ◽  
Barbara Hatzlhoffer Lourenco ◽  
Suely G A Gimeno ◽  
...  
Keyword(s):  
Child Health ◽  
Birth Cohort ◽  
Maternal And Child Health ◽  
Retention Rate ◽  
Epidemiological Data ◽  
Childhood Development ◽  
Birth Cohort Study ◽  
Health And Nutrition ◽  
And Child Health

PurposeMaternal and Child Health and Nutrition in Acre, Brazil (MINA-Brazil) is a longitudinal, prospective population-based birth cohort, set-up to understand the effects of early environmental exposures and maternal lifestyle choices on growth and development of the Amazonian children.ParticipantsMother–baby pairs (n=1246) were enrolled at delivery from July 2015 to June 2016 in Cruzeiro do Sul, Acre, Brazil. Mothers of 43.7% of the cohort were recruited in the study during pregnancy from February 2015 to January 2016. Study visits took place during pregnancy, delivery, at 1 month, 6 months, 1 year and 2 years after delivery. In addition to clinical and epidemiological data, samples collected by the MINA-Brazil study include plasma, serum and extracted DNA from blood and faeces, which are stored in a biobank.Findings to dateKey baseline reports found a high prevalence of gestational night blindness (11.5%; 95% CI 9.97% to 13.25%) and maternal anaemia (39.4%; 95% CI 36.84% to 41.95%) at delivery. Antenatal malaria episodes (74.6% ofPlasmodium vivax) were diagnosed in 8.0% of the women and were associated with an average reduction in birth weight z-scores of 0.35 (95% CI 0.14 to 0.57) and in birth length z-scores of 0.31 (95% CI 0.08 to 0.54), compared with malaria-free pregnancies. At 2-year follow-up, data collection strategies combined telephone calls, WhatsApp, social media community and home visits to minimise losses of follow-up (retention rate of 79.5%).Future plansA 5-year follow-up visit is planned in 2021 with similar interviews and biospecimens collection. The findings from this prospective cohort will provide novel insights into the roles of prenatal and postnatal factors in determining early childhood development in an Amazonian population.

scholarly journals Women's Stated Preferences for Conditional Cash Transfer Programs Focused on Maternal and Child Health and Nutrition in India (P22-012-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shivani Kachwaha ◽  
Krishna Rao ◽  
Avril Kaplan ◽  
David Bishai
Keyword(s):  
Child Health ◽  
Service Quality ◽  
Maternal And Child Health ◽  
Good Health ◽  
User Preferences ◽  
Cash Transfer ◽  
Growth Monitoring ◽  
Health And Nutrition ◽  
Number Of Visits ◽  
And Child Health

Abstract Objectives Conditional Cash Transfers (CCTs) are important national strategies to improve maternal and child health and nutrition. India recently began implementing a Maternity Benefit Program (MBP) to encourage health care use during pregnancy and early childhood; under discussion is to include child nutrition services within a CCT program. This paper aims to understand the preferences of mothers with young children for design features (cash transfer amount and conditionalities) of CCT programs. Methods We conducted a Discrete Choice Experiment in Uttar Pradesh, India where 405 mothers with children below three years of age were interviewed. Respondents were presented 18 hypothetical CCT program profiles defined by five attributes – cash transfer amount, number of ante-natal care visits, number of visits for child immunization/growth monitoring, time taken to complete a visit, and health benefit received (proxy for service quality). Conditional logit regression was used to analyze respondent choices. Results Mothers valued the amount of cash transfer, quality of services, and quicker health center visits. They did not have a strong preference for the number of visits required. Higher cash amounts are associated with greater probability of participation. For any given amount of cash amount, better service quality (produced better health) elicited greater participation. Mothers put high valuation on service quality; they were willing-to-pay (give up) INR 2858 ($41) for a program that produced good health. Without any cash transfer, only improving service quality from average to good would increase participation by 27%. A cash transfer amount of INR 6000 ($86, currently offered by MBP) combined with fair (good) quality services would increase participation by 78% (85%). Preference for CCT programs differed across sub-groups defined by prior users of government health services and socioeconomic status. Poor households valued a given cash transfer amount more than better-off households, while better-off households valued good health outcomes more than poorer households. Conclusions Aligning maternal and child health CCT programs with user preferences can increase program participation. This study provides guidance on incorporating user preferences in the CCT program design. Funding Sources Department of International Health, Johns Hopkins University.

scholarly journals PROCOMIDA, a Food-Assisted Maternal and Child Health and Nutrition Program, Contributes to Postpartum Weight Retention in Guatemala: A Cluster-Randomized Controlled Intervention Trial

2019 ◽  
Vol 149 (12) ◽  
pp. 2219-2227 ◽  
Author(s):  
Jef L Leroy ◽  
Deanna K Olney ◽  
Marie T Ruel
Keyword(s):  
Weight Gain ◽  
Child Health ◽  
Maternal And Child Health ◽  
Child Undernutrition ◽  
Randomized Controlled ◽  
Health And Nutrition ◽  
Postpartum Weight ◽  
Cluster Randomized ◽  
Unhealthy Weight ◽  
And Child Health

ABSTRACT Background Food-assisted maternal and child health and nutrition (FA-MCHN) programs are widely used to reduce household food insecurity and maternal and child undernutrition in low- and middle-income countries. These programs, however, may unintentionally lead to excessive energy intake and unhealthy weight gain, especially in food-secure populations. Objective We evaluated the impact of an FA-MCHN program implemented in Guatemala on maternal weight from pregnancy to 24 mo postpartum. The program was earlier shown to reduce stunting. Methods We used a longitudinal, cluster-randomized controlled trial with arms varying in family ration size [full (FFR), reduced (RFR), none (NFR)] and individual maternal ration type [corn–soy blend (CSB), lipid-based nutrient supplement (LNS), micronutrient powder (MNP)]: A: FFR + CSB; B: RFR + CSB; C: NFR + CSB; D: FFR + LNS; E: FFR + MNP; F: control. Weight was measured during pregnancy and at 1, 4, 6, 9, 12, 18, and 24 mo postpartum. We used linear mixed models controlling for pregnancy weight with random cluster and mother effects. Data on 3535 women were analyzed. Results Significant (P < 0.05) or marginally significant (P < 0.10) effects of 0.50–0.65 kg were found at all time points (except 9 mo) in arm A. Similar-sized effects were found in arms B (1, 4, 6, and 12 mo) and C (1 and 12 mo). Marginally significant effects (0.51–0.66 kg) were found in arm D (1, 6, 9, and 12 mo); in arm E, marginally significant effects (0.48–0.75 kg) were found from 6 to 24 mo. Conclusions The effect on maternal postpartum weight is of concern because of the high existing prevalence of overweight. Programs need to include “double-duty” objectives and actions, to ensure that addressing child undernutrition does not exacerbate the problem of unhealthy weight gain. This trial was registered at clinicaltrials.gov as NCT01072279.

scholarly journals Peran kepala dinas dalam inovasi program public health lokal di Daerah Istimewa Yogyakarta

2017 ◽  
Vol 33 (10) ◽  
pp. 501
Author(s):  
Febria Rahmi ◽  
Yodi Mahendradata ◽  
Mubasysyir Hasanbasri
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Department ◽  
Strategic Decision ◽  
Strategic Decisions ◽  
District Health Office ◽  
District Health ◽  
Health And Nutrition ◽  
Local Medium ◽  
And Child Health

Purpose: The study aimed to describe the strategic decision making by the heads of the DIY health departments concerning the issue of maternal and child health and nutrition.Methods: This qualitative research was an exploratory study.Results: The district health office for Yogyakarta city in the Special Region of Yogyakarta does not have many strategic decisions to solve problems about maternal and child health and nutrition. However, the decisions are always hampered by human resources. Only the Gunung Kidul District Health Office stated that there was no political involvement in decisions by the head of the health department.Conclusions: The decisions made by heads of health department are still limited to the strategic plan and local medium term development plan (RPJMD). Not many innovations are developed to overcome the problems of maternal and child health and nutrition.

scholarly journals Provision and Utilization of Health and Nutrition Services During the COVID-19 Pandemic in Urban Bangladesh

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 690-690
Author(s):  
Celeste Sununtnasuk ◽  
Phuong Nguyen ◽  
Anjali Pant ◽  
Lan Mai Tran ◽  
Shivani Kachwaha ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Care Providers ◽  
Health And Nutrition ◽  
Gates Foundation ◽  
And Child Health

Abstract Objectives The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake. Methods We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children &lt; 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Results Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children). Conclusions Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute; and Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI Solutions.

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