The contribution of poor and rural populations to national trends in reproductive, maternal, newborn, and child health coverage: analyses of cross-sectional surveys from 64 countries

IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.

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mHealth Series: Measuring maternal newborn and child health coverage by text messaging – a county–level model for China

Journal of Global Health ◽

10.7189/jogh.03.020402 ◽

2013 ◽

Vol 3 (2) ◽

Cited By ~ 12

Author(s):

Yanfeng Zhang ◽

Li Chen ◽

Michelle H. M. M. T. van Velthoven ◽

Wei Wang ◽

Li Liu ◽

...

Keyword(s):

Child Health ◽

Text Messaging ◽

County Level ◽

Health Coverage ◽

Newborn And Child Health ◽

Level Model ◽

And Child Health

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Socio-economic and demographic factors associated with reproductive and child health preventive care in Mozambique: a cross-sectional study

International Journal for Equity in Health ◽

10.1186/s12939-020-01303-3 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Chanvo Daca ◽

Miguel San Sebastian ◽

Carlos Arnaldo ◽

Barbara Schumann

Keyword(s):

Health Care ◽

Child Health ◽

Cross Sectional Study ◽

Health Coverage ◽

Sectional Study ◽

Cross Sectional ◽

Modern Contraceptives ◽

Reproductive And Child Health ◽

Universal Health ◽

And Child Health

Abstract Background Reproductive and child health interventions are essential to improving population health in Africa. In Mozambique, although some progress on reproductive and child health has been made, knowledge of social inequalities in health and health care is lacking. Objective To investigate socio-economic and demographic inequalities in reproductive and child preventive health care as a way to monitor progress towards universal health coverage. Methods A cross-sectional study was conducted, using data collected from the 2015 Immunization, AIDS and Malaria Indicators Survey (IMASIDA) in Mozambique. The sample included 6946 women aged 15 to 49 years. Outcomes variables were the use of insecticide treated nets (ITN) for children under 5 years, full child immunization and modern contraception use, while independent variables included age, marital status, place of residence, region, education, occupation, and household wealth index. Prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship between the socio-economic and demographic characteristics and the three outcomes of interest. Results The percentage of mothers with at least one child under 5 years that did not use ITN was 51.01, 46.25% of women had children aged 1 to 4 years who were not fully immunized, and 74.28% of women were not using modern contraceptives. Non-educated mothers (PR = 1.33; 95% CI: 1.16–1.51) and those living in the Southern region (PR = 1.36; 95% CI: 1.17–1.59) had higher risk of not using ITN, while the poorest quintile (PR = 1.34; 95% CI: 1.04–1.71) was more likely to have children who were not fully immunized. Similarly, non-educated women (PR = 1.17; 95% CI: 1.10–1.25), non-working women (PR = 1.09; 95% CI: 1.04–1.16), and those in the poorest quintile (PR = 1.13; 95% CI: 1.04–1.24) had a higher risk of not using modern contraceptives. Conclusion Our study showed a low rate of ITN utilization, immunization coverage of children, and modern contraceptive use among women of reproductive age. Several socio-economic and demographics factors (region, education, occupation, and wealth) were associated with these preventive measures. We recommend an equity-oriented resource allocation across regions, knowledge dissemination on the importance of ITN and contraceptives use, and an expansion of immunization services to reach socio-economically disadvantaged families in order to achieve universal health coverage in Mozambique.

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Measuring universal health coverage in reproductive, maternal, newborn and child health: An update of the composite coverage index

PLoS ONE ◽

10.1371/journal.pone.0232350 ◽

2020 ◽

Vol 15 (4) ◽

pp. e0232350 ◽

Cited By ~ 2

Author(s):

Fernando C. Wehrmeister ◽

Aluisio J. D. Barros ◽

Ahmad Reza Hosseinpoor ◽

Ties Boerma ◽

Cesar G. Victora

Keyword(s):

Child Health ◽

Universal Health Coverage ◽

Health Coverage ◽

Newborn And Child Health ◽

Universal Health ◽

And Child Health

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Local Dynamics of Collaboration for Maternal, Newborn and Child Health: A Social Network Analysis of Healthcare Providers and Their Managers in Gert Sibande District, South Africa

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2021.106 ◽

2021 ◽

Author(s):

Fidele Kanyimbu Mukinda ◽

Sara Van Belle ◽

Helen Schneider

Keyword(s):

Social Network ◽

Social Network Analysis ◽

Network Analysis ◽

Child Health ◽

Healthcare Providers ◽

Cross Sectional Survey ◽

Collaborative Relationships ◽

Cross Sectional ◽

Newborn And Child Health ◽

And Child Health

Background: Accountability for maternal, newborn and child health (MNCH) is a collaborative endeavour and documenting collaboration dynamics may be key to understanding variations in the performance of MNCH services. This study explored the dynamics of collaboration among frontline health professionals participating in two MNCH coordination structures in a rural South African district. It examined the role and position of actors, the nature of their relationships, and the overall structure of the collaborative network in two sub-districts. Methods: Cross-sectional survey using a social network analysis (SNA) methodology of 42 district and sub district actors involved in MNCH coordination structures. Different domains of collaboration (eg, communication, professional support, innovation) were surveyed at key interfaces (district-sub-district, across service delivery levels, and within teams). Results: The overall network structure reflected a predominantly hierarchical mode of clustering of organisational relationships around hospitals and their referring primary healthcare (PHC) facilities. Clusters were linked through (and dependent on) a combination of district MNCH programme and line managers, identified as central connectors or boundary spanners. Overall network density remained low suggesting potential for strengthening collaborative relationships. Within cluster collaborative patterns (inter-professional and across levels) varied, highlighting the significance of small units in district functioning. Conclusion: SNA provides a mechanism to uncover the nature of relationships and key actors in collaborative dynamics which could point to system strengths and weaknesses. It offers insights on the level of fragmentation within and across small units, and the need to strengthen cohesion and improve collaborative relationships, and ultimately, the delivery of health services.

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