SKILLED CARE AT BIRTH IN THE DEVELOPING WORLD: PROGRESS TO DATE AND STRATEGIES FOR EXPANDING COVERAGE

2006 ◽  
Vol 39 (1) ◽  
pp. 109-120 ◽  
Author(s):  
CYNTHIA STANTON ◽  
ANN K. BLANC ◽  
TREVOR CROFT ◽  
YOONJOUNG CHOI

Skilled attendance at delivery is one of the key indicators to reflect progress toward the Millennium Development Goal of improving maternal health. This paper assesses global progress in the use of skilled attendants at delivery and identifies factors that could assist in achieving Millennium Development Goals for maternal health. National data covering a substantial proportion of all developing country births were used for the estimation of trends and key differentials in skilled assistance at delivery. Between 1990 and 2000, the percentage of births with a skilled attendant increased from 45% to 54% in developing countries, primarily as a result of an increasing use of doctors. A substantial proportion of antenatal care users do not deliver with a skilled attendant. Delivery care use among antenatal care users is highly correlated with wealth. Women aged 35 and above, who are at greatest risk of maternal death, are the least likely to receive professional delivery care. Births in mid-level facilities appear to be a strategy that has been overlooked. More effective strategies are needed to promote skilled attendance at birth during antenatal care, particularly among poor women. Specific interventions are also needed to encourage older and high parity mothers to seek professional care at delivery.

Author(s):  
Tarun Bala

<div><p><em>Reducing maternal and child mortality is the most important goal of the National Rural Health Mission. Indian government has worked towards its commitment to achieve the Millennium Development Goals.  Huge investments are being made by Government of India to achieve these goals. A well framed roadmap is being developed for accelerating child survival and improving maternal health and 16 indicators is selected for this purpose. The improvement in these indicators shows the way towards the achievement of MDGs.  India has made considerable progress over the last few years since NRHM in the area of maternal and child health, which was further accelerated after introduction of RMNCHA+ () strategy which appropriately directs the states to focus their efforts on the most vulnerable and disadvantaged sections of the society in the country. Main focus is healthy mothers and child. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts. ‘Continuum care’ is required to have equal focus on various life stages.  Improvement in these indicators provide an understanding the importance of ‘continuum of care’ to ensure equal focus on various life stages. Some low performing districts had shown an improvement over period of time in its RMNCHA+ indicators.</em></p></div>


2017 ◽  
Vol 4 (01) ◽  
Author(s):  
Sonal Katyal

Despite being a relatively smaller state, Haryana’s per capita Gross State Domestic Product (GSDP) is quite high. However, the statistical data on the status of women has a different story to share. This study analyses the maternal healthcare situation in Haryana to examine the differences in utilisation of maternal health care service, i.e. delivery care on the basis of socio-economic and socio-demographic indicators such as women’s age at birth, birth order, education, residence, religion, wealth index and caste. The study uses the third round of the National Family Health Survey (NFHS) data which is similar to the Demographic and Health Surveys (DHS). The findings reveal that women who have taken antenatal care utilise these services much more than women who have not taken antenatal care services. The utilisation pattern is in conjugation with the hypotheses. The results demonstrate that several socio-economic and demographic factors affect the utilisation of delivery care services in Haryana. Efforts need to be taken at community and household level to improve utilisation the utilisation of these services.


2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.


2017 ◽  
Vol 10 (1) ◽  
pp. 30-32
Author(s):  
Sumedha Sharma

The 21st International Society of Hypertension in Pregnancy (ISSHP) meeting was held in São Paulo, Brazil from 23 to 26 October 2016. The discourse at this Congress brought global maternal health into the foray among basic science and clinical research. In concordance with the United Nations sustainable development goals which warrant an integrated view to health with investments in adolescence and childhood, the research at Congress focussed on a ‘life course’ approach to maternal health – examining intergenerational effects of maternal obesity and hypertension on the behavioral and physical developments of infants. Bringing in research from the Global South highlighted inequities in treatment and management of women with hypertensive disorders of pregnancy, in addition to the challenges in adoption of recommendations generated in Global North. The evidence shared can serve as platform for further discourse on global maternal health and in generating accountability to close the ‘evidence to policy’ gap.


2021 ◽  
Vol 7 ◽  
pp. 205520762110644
Author(s):  
Hasifah Kasujja Namatovu ◽  
Tonny Justus Oyana ◽  
Henk Gerard Sol

Current empirical evidence suggests that successful adoption of eHealth systems improves maternal health outcomes, yet there are still existing gaps in adopting such systems in Uganda. Service delivery in maternal health is operating in a spectrum of inadequacy, hence eHealth adoption cannot ensue. This study set out to explore the challenges that impede eHealth adoption in women's routine antenatal care practices in Uganda. A qualitative approach using semi-structured interviews was employed to document challenges. These challenges were classified based on a unified theory of acceptance and use of technology constructs. One hundred and fifteen expectant mothers, aged between 18 and 49 years, who spoke either English or Luganda were included in the study that took place between January to May 2019. Thematic analysis using template analysis was adopted to analyse qualitative responses. Challenges were categorised based on five principal unified theories of acceptance and use of technology constructs namely: performance expectancy, effort expectancy, social influence, facilitating conditions and behavioural intention. Facilitating conditions had more influence on technology acceptance and adoption than the other four constructs. Specifically, the lack of training prior to using the system, technical support, computers and smart phones had a downhill effect on adoption. Subsequently, the cost of data services, internet intermittency, and the lack of systems that bridge the gap between mothers and health providers further hindered technology uptake. In conclusion, strategies such as co-development, training end-users, garnering support at the national and hospital levels should be advocated to improve user acceptance of technology.


10.2196/15890 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15890
Author(s):  
Jessica L Watterson ◽  
Diego Castaneda ◽  
Caricia Catalani

Background Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. Objective This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. Methods This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. Results The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (P=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. Conclusions These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.


2018 ◽  
Vol 3 (1) ◽  
pp. 103
Author(s):  
Wira Meiriza ◽  
Aladin Aladin ◽  
Edison Edison

Infant Mortality Rate in West Sumatra still increased from 96 cases in 2015 becomes 111 cases in 2016. One of the contributors to this was the case of Low Birth Weight Babies (LBWB), wich is birth weight < 2500 grams. Causative factors of LBWB are derived from maternal factors because it is related to fetal growth, starting from the moment of conception until the baby is born. Maternal health is very influential towards the growth and development of the fetus. In addition, Antenatal Care is also require to monitor maternal health. Antenatal service care quality can detect the occurrence of risk in pregnancy. This study aims to determine the relationship of maternal factors based on maternal age, parity, distance of pregnancy, complications of pregnancy, economic status, nutritional status, anemia status, antenatal care implementation and the quality of antenatal care services with LBWB incidence on health facilities level 1 in Padang City.This study used a comparative cross-sectional design totalling 72 respondents consisting of a group of mothers who gave birth to babies with birth weight < 2500 grams and ≥ 2500 grams using consecutive sampling technique. Then conducted interviews and observations by using questionnaires as well as data processing were carried out using SPSS. The results showed there was a correlation between pregnancy complications (p = 0.033), anemia status (p = 0.016) and the implementation of antenatal care (p = 0.000) with the incidence of LBWB, while the unrelated were maternal age (p = 0.405), parity (p = 1,000), pregnancy distance (p = 1,000), economic status (p = 0.637), nutritional status (p = 0.326), and quality of antenatal care services (p = 0.812).The conclusion of this study is that there is no correlation between the quality of antenatal care services and the incidence of LBWB, and the implementation of antenatal care is the dominant factor related with the incidence of LBWB in Padang City.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.


2021 ◽  
Vol 13 (23) ◽  
pp. 13236
Author(s):  
Rui Meng ◽  
Lirong Zhang ◽  
Hongkuan Zang ◽  
Shichao Jin

Low-carbon energy technology is the most fundamental way to control carbon emissions. The Sanjiangyuan region in Qinghai Province must put environmental conservation in first place during development, because of its important function of national ecological protection. The comprehensive benefits of photovoltaic technology in this area need to be evaluated. In this paper, a new multicriteria decision model (MCDM) is established, with the four dimensions of “environment-society-economy-population”, and 16 specific indicators are developed by combining the coupling coordination degree (CCD) and the decision-making trial and evaluation laboratory (DEMATEL) method. MCDM can contribute to screening out key indicators that should be of high concern. The evaluation results show that the four dimensions of “environment-society-economy-population” in the Sanjiangyuan region are highly correlated, and the PPAT is creating a coordinated development; the elements of population and environment play a decisive role in the comprehensive benefits based on five key indicators and three indicative indicators. The paper provides suggestions for the local government to further implement the PV poverty alleviation industry, under the condition that the natural environmental capacity of the region and the natural ecosystem are fully respected and undisturbed.


2021 ◽  

This publication presents the latest key statistics on development issues for the economies of Asia and the Pacific. It sets out the region’s current status in relation to the Sustainable Development Goals, and provides economic, financial, social, and environmental indicators for the 49 regional members of the Asian Development Bank. It covers global value chains and also highlights initiatives of national statistics offices to provide timely data for planning and policymaking. A special supplement, Capturing the Digital Economy, sets out a framework for measuring the importance of the digital economy in national and global production processes.


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