Policy Strategies to Improve Maternal Health Services Delivery and Outcomes in Anambra State, Nigeria

2014 ◽  
Vol 35 (7-9) ◽  
pp. 828-844 ◽  
Author(s):  
Mabel Ezeonwu
Inovasi ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 141-150
Author(s):  
Jonni Sitorus

The number of maternal deaths in North Sumatra in 2017 was recorded in Labuhanbatu Regency and Deli Serdang Regency as many as 15 deaths, Langkat Regency with 13 deaths, and Batubara Regency with 11 deaths. Efforts to accelerate the reduction of Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are carried out to ensure that every mother is able to access quality maternal health services, such as maternal health services, delivery assistance by trained health personnel in health care facilities, postpartum care for mothers and babies, special care and referrals if complications occur, the ease of obtaining maternity and childbirth leave and family planning services. Efforts to reduce MMR and IMR are not only the responsibility of one sector, but need the involvement and roles of other stakeholders to accelerate the reduction of MMR/IMR. This study aims to provide recommendations for the reduction of MMR/IMR through the role of stakeholders in North Sumatra. The study used a qualitative method with a phenomenological approach which was conducted from May to September 2019. The research locations were: Mandailing Natal Regency, Deli Serdang Regency, Simalungun Regency, and Sibolga City. The research subjects consisted of 3 (three) elements, namely: Government, Private and Community. Data collection was carried out through observation and through Focus Group Discussion (FGD). This study concludes that the model of efforts to reduce maternal and infant mortality rates must be carried out in a holistic and integrative manner with medical, social, and cultural approaches, starting from health services for adolescent girls, women of productive age, pregnant women, maternity, newborns and toddlers. Efforts to reduce MMR and IMR are the responsibility of all DPOs and elements of academia, business and community, whose programs and activities are integrated. Efforts to reduce MMR and IMR must be viewed from various perspectives, including from a medical, social and cultural perspective.


2020 ◽  
Vol 5 (1) ◽  
pp. e000233
Author(s):  
Willcliff K Thadeus ◽  
Lawrencia D Mushi

Objectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH). Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies. Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT. Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities.


2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.


Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.


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