scholarly journals Community-level impacts of sanitation coverage on maternal and neonatal health: a retrospective cohort of survey data

2021 ◽  
Vol 6 (10) ◽  
pp. e005674
Author(s):  
Brittany L Kmush ◽  
Bhavneet Walia ◽  
Anushruta Neupane ◽  
Carolina Frances ◽  
Idris Ahmed Mohamed ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Logit Model ◽  
Retrospective Cohort ◽  
Community Level ◽  
The Other ◽  
Demographic And Health Surveys ◽  
Birth Size ◽  
Neonatal Health ◽  
Live Births ◽  
Maternal And Neonatal Health

IntroductionAccess to sanitation facilities (toilets or latrines) greatly improves human health. Low community sanitation coverage may lead to increased exposure to pathogens for households both with and without a sanitation facility.MethodsWe created a retrospective cohort using Demographic and Health Surveys from 1990 through 2018. Using regression with matched women as a random intercept, we assessed the association between community-level sanitation coverage and neonatal mortality (Poisson model, n=1 254 862 live births, 187 datasets), small birth size (logit model, n=1 058 843 live births, 187 datasets) and anaemia (logit model, n=1 304 626 women, 75 datasets).ResultsAmong women with household sanitation, the incidence of neonatal death (incidence rate ratio: 0.85, 95% CI 0.77 to 0.93), the odds of small birth size (OR: 0.81, 95% CI 0.76 to 0.87) and anaemia (OR: 0.82, 95% CI 0.79 to 0.85) were lower for women in communities with 100% sanitation coverage compared with 1%–30% (p≤0.001 for all). There was no difference in neonatal deaths between women in communities with 31%–99% sanitation coverage compared with 1%–30% (p≥0.05). Among women without household sanitation, there were no differences in neonatal mortality by community sanitation (p≥0.05). The odds of small birth size were decreased (OR: 0.91, 95% CI 0.87 to 0.97, p=0.003) for women in communities with 61%–99% sanitation coverage compared with 1%–30%; there was no association with the other community sanitation categories (p≥0.05). The odds of anaemia were increased (OR: 1.08, 95% CI 1.06 to 1.11, p<0.001) for women living in communities with 0% sanitation coverage compared with 1%–30%, but no association with the other community sanitation categories (p≥0.05).ConclusionCommunity sanitation coverage is associated with improved maternal and neonatal outcomes, particularly among women with household sanitation. This suggests that the impact of sanitation coverage on maternal and neonatal health is underestimated unless the community-level effects are considered.

scholarly journals 1498Community-level risk factors for birth size of child in selected developing countries (1992-2018): multilevel analysis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rahul Bawankule ◽  
Abhishek Singh
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Significant Risk ◽  
Binary Logistic Regression ◽  
Community Level ◽  
Demographic And Health Surveys ◽  
Birth Size ◽  
Level Variation ◽  
Logistic Regression Models ◽  
Individual Level

Abstract Background We aimed to identify emerging community-level risk factors for birth size in the last two decades in developing countries, particularly in Bangladesh, India, Indonesia, and Nigeria, having the highest burden of low birth weight (LBW) births globally. Methods We used data from multiple rounds of the Demographic and Health Surveys (DHS) conducted throughout the last two decades in the selected countries. We applied multilevel binary logistic regression models and estimated the intra-correlation coefficient (ICC) and median odds ratio (MOR) with a 95% confidence interval (CI) to analyze community-level variation in the birth size of child. Results The odds of having a smaller than average size birth increased by 1.28 times (95% CI: 1.11-1.79) in Bangladesh (2014), 3.03 times (95% CI: 2.90-3.18) in India (2015-16), 1.40 times (95% CI: 1.28-1.58) in Indonesia (2017) and 2.32 times (95% CI: 2.15-2.53) in Nigeria (2018) when women moved from low-risk to high-risk communities. The children residing in communities with a higher level of female illiteracy, higher level of inadequate antenatal care visits (ANC), higher use of unimproved toilet facilities were more likely to born with smaller than average birth size during 1992-2018. Conclusions The study confirms a significant community-level variation in smaller than average birth size among all analysed countries. Community with higher levels of female illiteracy, inadequate ANC visits, use of unimproved toilet facilities emerged as significant risk factors throughout the last two decades. Key messages The community-level risk factors have an independent association with the birth size of child regardless of individual-level characteristics of women and children.

scholarly journals Effect of the Iranian Health Sector Evolution Plan Implementation Focused on the Type of Delivery on Maternal and Neonatal Health Indicators in Selected Hospitals of East Azerbaijan Province

2021 ◽  
Author(s):  
Hossein Jabbari Bayrami ◽  
Mobin Sokhanvar ◽  
Elahe Navvabi ◽  
Salahaddin Asadi
Keyword(s):  
Neonatal Mortality ◽  
Data Extraction ◽  
Health Sector ◽  
Health Indicators ◽  
Mortality Rates ◽  
Neonatal Health ◽  
Natural Childbirth ◽  
Maternal And Neonatal Health ◽  
East Azerbaijan ◽  
Type Of Delivery

Background: Health systems are making reforms to ensure and promote public health. Measuring the effects of reform is one way to determine its effectiveness and consequences. Objectives: This study was aimed at investigating the effect of the Iranian Health Sector Evolution Plan (HSEP) implementation with a focus on the type of delivery on maternal and neonatal health indicators in East-Azerbaijan Province. Methods: This descriptive-analytical study was conducted in 2017. The data of 800 patients were randomly selected through the dataset of eight hospitals equally in the two time periods of before and after the HSEP implementation. A researcher-made checklist was used for data extraction. Data were analyzed by SPSS version 22 using descriptive statistics, t-test, and chi-square. Results: The mean age of the mothers in both periods was 27 years. Most of the participants did not have a previous delivery and had a diploma or a lower level of education. The rate of natural childbirth increased from 34.5% (before the HSEP) to 44.2% (after the HSEP) (P < 0.05). Maternal and neonatal mortality rates decreased from 0.3 and 0.8% to 0.0 and 0.5%, respectively. Maternal and neonatal mortality and stillbirth rates were not significantly different based on the study period and type of delivery (P > 0.05). Conclusions: The findings indicated a significant increase in the rate of natural childbirth after the HSEP implementation. Maternal and neonatal mortality rates had also decreased. These results can guide policymakers in deciding whether to continue or review the reform.

scholarly journals Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010–2016

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Urban Areas ◽  
Economic Status ◽  
Statistical Significance ◽  
Population Attributable Risk ◽  
Population Attributable Fraction ◽  
Demographic And Health Surveys ◽  
Live Births ◽  
Urban Rural ◽  
Over Time

Abstract Background Programmatic and research agendas surrounding neonatal mortality are important to help countries attain the child health related 2030 Sustainable Development Goal (SDG). In Burundi, the Neonatal Mortality Rate (NMR) is 25 per 1000 live births. However, high quality evidence on the over time evolution of inequality in NMR is lacking. This study aims to address the knowledge gap by systematically and comprehensively investigating inequalities in NMR in Burundi with the intent to help the country attain SDG 3.2 which aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030. Methods The Burundi Demographic and Health Survey (BDHS) data for the periods of 2010 and 2016 were used for the analyses. The analyses were carried out using the WHO’s HEAT version 3.1 software. Five equity stratifiers: economic status, education, residence, sex and subnational region were used as benchmark for measuring NMR inequality with time over 6 years. To understand inequalities from a broader perspective, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, and Population Attributable Fraction (PAF) were calculated. Statistical significance was measured by computing corresponding 95% Confidence Intervals (CIs). Results NMR in Burundi in 2010 and 2016 were 36.7 and 25.0 deaths per 1000 live births, respectively. We recorded large wealth-driven (PAR = -3.99, 95% CI; − 5.11, − 2.87, PAF = -15.95, 95% CI; − 20.42, − 11.48), education related (PAF = -6.64, 95% CI; − 13.27, − 0.02), sex based (PAR = -1.74, 95% CI; − 2.27, − 1.21, PAF = -6.97, 95% CI; − 9.09, − 4.86), urban-rural (D = 15.44, 95% CI; 7.59, 23.29, PAF = -38.78, 95% CI; − 45.24, − 32.32) and regional (PAR = -12.60, 95% CI; − 14.30, − 10.90, R = 3.05, 95% CI; 1.30, 4.80) disparity in NMR in both survey years, except that urban-rural disparity was not detected in 2016. We found both absolute and relative inequalities and significant reduction in these inequalities over time - except at the regional level, where the disparity remained constant during the study period. Conclusion Large survival advantage remains to neonates of women who are rich, educated, residents of urban areas and some regions. Females had higher chance of surviving their 28th birthday than male neonates. More extensive work is required to battle the NMR gap between different subgroups in the country.

scholarly journals Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries?

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Aleha Aziz ◽  
Sarah Saleem ◽  
Tracy L. Nolen ◽  
Nousheen Akber Pradhan ◽  
Elizabeth M. McClure ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neonatal Mortality ◽  
Pregnancy Outcomes ◽  
Low Birthweight ◽  
The Other ◽  
Middle Income ◽  
Live Births ◽  
Low Resource ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences. Methods The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after delivery and at 42 days to ascertain delivery, neonatal, and maternal outcomes. We analyzed the maternal mortality ratios (MMR), neonatal mortality rates (NMR), stillbirth rates, and potential explanatory factors from 2010 to 2018 across the GN sites. Results From 2010 to 2018, there were 91,076 births in Pakistan and 456,276 births in the other GN sites combined. The MMR in Pakistan was 319 per 100,000 live births compared to an average of 124 in the other sites, while the Pakistan NMR was 49.4 per 1,000 live births compared to 20.4 in the other sites. The stillbirth rate in Pakistan was 53.5 per 1000 births compared to 23.2 for the other sites. Preterm birth and low birthweight rates were also substantially higher than the other sites combined. Within weight ranges, the Pakistani site generally had significantly higher rates of stillbirth and neonatal mortality than the other sites combined, with differences increasing as birthweights increased. By nearly every measure, medical care for pregnant women and their newborns in the Pakistan sites was worse than at the other sites combined. Conclusion The Pakistani pregnancy outcomes are much worse than those in the other GN sites. Reasons for these poorer outcomes likely include that the Pakistani sites' reproductive-aged women are largely poorly educated, undernourished, anemic, and deliver a high percentage of preterm and low-birthweight babies in settings of often inadequate maternal and newborn care. By addressing the issues highlighted in this paper there appears to be substantial room for improvements in Pakistan’s pregnancy outcomes.

scholarly journals Effectiveness of Cadres Training in Improving Maternal and Neonatal Health in Soreang Subdistrict

2019 ◽  
Vol 7 (3) ◽  
Author(s):  
Merry Wijaya ◽  
Fardila Elba ◽  
Ariyati Mandiri ◽  
Wenny Friska ◽  
Balkis Fitriani Faozi ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Infant Health ◽  
Health Workers ◽  
Healthcare Services ◽  
Neonatal Health ◽  
Health Counseling ◽  
Knowledge And Skills ◽  
Quasi Experimental ◽  
Maternal And Neonatal Health

The high maternal mortality rate (MMR) and neonatal mortality rate (NMR) are indicators of low health quality in society. Most maternal and neonatal mortality cases prevented through early detection and quick and accurate responses. Other factors that contribute to maternal and neonatal mortality are the quality of health care, the uneven distribution of health workers, and the inadequate health-supporting facilities. The government’s efforts in improving fair health workers distribution and quality of healthcare services by involving integrated health service post (pos pelayanan terpadu/posyandu) cadres, as the front-liners of health care programs (especially concerning maternal and neonatal health), should be able to provide better healthcare services to the people. Hence, cadres training is crucial for improving the cadres’ knowledge and skills in healthcare services. This study aims to analyze the effect of cadres training implementation on the development of cadres’ knowledge and skills in giving maternal and neonatal (infant) health counseling. This study used a quasi-experimental pretest-posttest design conducted from July to November 2017. The sample consists of 32 active cadres from 12 villages in Soreang sub-district who satisfy the inclusion criteria. Data is collected through questionnaires to measure knowledge improvement and checklists to measure cadres’ skills development. The findings show that cadres training implementation can improve cadres’ knowledge and skills in maternal and neonatal (infant) health counseling. EFEKTIVITAS PELATIHAN KADER DALAM MENINGKATKAN KESEHATAN IBU DAN BAYI DI KECAMATAN SOREANGAngka kematian ibu (AKI) dan angka kematian bayi (AKB) yang tinggi menjadi indikator status kesehatan masyarakat yang rendah. Sebagian besar kasus kematian ibu dan bayi dapat dicegah melalui deteksi dini dan penanganan yang cepat dan tepat. Faktor lain yang memengaruhi kematian ibu dan bayi adalah kualitas pelayanan kesehatan, distribusi tenaga kesehatan belum merata, dan sarana pendukung pelayanan kesehatan yang belum memadai. Upaya pemerintah dalam meningkatkan pemerataan tenaga kesehatan dan pelayanan kesehatan dengan melibatkan kader pos pelayanan terpadu (posyandu) sebagai ujung tombak program kesehatan, khususnya ibu dan anak, seyogianya mampu memberikan pelayanan kesehatan yang baik kepada masyarakat. Oleh karena itu, pelatihan kader untuk meningkatkan pengetahuan dan keterampilan dalam penanganan kesehatan mutlak diperlukan. Penelitian ini bertujuan menganalisis pengaruh implementasi pelatihan kader terhadap peningkatan pengetahuan dan keterampilan dalam melakukan penyuluhan kesehatan ibu dan anak. Penelitian ini menggunakan desain quasi-experimental pretest-posttest yang dilakukan dari Juli hingga November 2017. Sampel penelitian adalah 32 kader aktif dari 12 desa di Kecamatan Soreang yang memenuhi kriteria inklusi. Pengumpulan data menggunakan kuesioner untuk menilai perubahan pengetahuan dan daftar tilik untuk mengukur perubahan keterampilan kader. Hasil penelitian menunjukkan bahwa implementasi pelatihan kader mampu meningkatkan pengetahuan dan keterampilan kader dalam melakukan penyuluhan kesehatan ibu dan anak.

scholarly journals Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings

Lab on a Chip ◽  
2017 ◽  
Vol 17 (20) ◽  
pp. 3351-3387 ◽  
Author(s):  
Catherine E. Majors ◽  
Chelsey A. Smith ◽  
Mary E. Natoli ◽  
Kathryn A. Kundrod ◽  
Rebecca Richards-Kortum
Keyword(s):  
Neonatal Mortality ◽  
Point Of Care ◽  
Neonatal Health ◽  
Low Resource Settings ◽  
Low Resource ◽  
Point Of Care Diagnostics ◽  
Maternal And Neonatal Health ◽  
Diagnostic Technologies

We present diagnostic technologies available to detect the leading causes of maternal and neonatal mortality, highlighting key gaps in development.

scholarly journals Geospatial analysis of determinants of neonatal mortality in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Reproductive Age ◽  
Multiple Births ◽  
Demographic And Health Surveys ◽  
Neonatal Deaths ◽  
The Impact

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.

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