scholarly journals Effect and feasibility of district level scale up of maternal, newborn and child health interventions in Pakistan: a quasi-experimental study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036293
Author(s):  
Zahid Ali Memon ◽  
Shah Muhammad ◽  
Sajid Soofi ◽  
Nimra Khan ◽  
Nadia Akseer ◽  
...  
Keyword(s):  
Child Health ◽  
Scale Up ◽  
Case Fatality ◽  
Population Level ◽  
Evidence Based ◽  
High Burden ◽  
Newborn And Child Health ◽  
The Impact ◽  
And Child Health

IntroductionPakistan has a high burden of maternal, newborn and child morbidity and mortality. Several factors including weak scale-up of evidence-based interventions within the existing health system; lack of community awareness regarding health conditions; and poverty contribute to poor outcomes. Deaths and morbidity are largely preventable if a combination of community and facility-based interventions are rolled out at scale.Methods and analysisUmeed-e-Nau (UeN) (New Hope) project aims is to improve maternal, newborn and child health (MNCH) in eight high-burden districts of Pakistan by scaling up of evidence-based interventions. The project will assess interventions focused on, first, improving the quality of MNCH care at primary level and secondary level. Second, interventions targeting demand generation such as community mobilisation, creating awareness of healthy practices and expanding coverage of outreach services will be evaluated. Third, we will also evaluate interventions targeting the improvement in quality of routine health information and promotion of use of the data for decision-making. Hypothesis of the project is that roll out of evidence-based interventions at scale will lead to at least 20% reduction in perinatal mortality and 30% decrease in diarrhoea and pneumonia case fatality in the target districts whereas two intervention groups will serve as internal controls. Monitoring and evaluation of the programme will be undertaken through conducting periodical population level surveys and quality of care assessments. Descriptive and multivariate analytical methods will be used for assessing the association between different factors, and difference in difference estimates will be used to assess the impact of the intervention on outcomes.Ethics and disseminationThe ethics approval was obtained from the Aga Khan University Ethics Review Committee. The findings of the project will be shared with relevant stakeholders and disseminated through open access peer-reviewed journal articles.Trial registration numberNCT04184544; Pre-results.

scholarly journals Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview

BMJ Open ◽  
2014 ◽  
Vol 4 (5) ◽  
pp. e004749 ◽  
Author(s):  
Manisha Nair ◽  
Sachiyo Yoshida ◽  
Thierry Lambrechts ◽  
Cynthia Boschi-Pinto ◽  
Krishna Bose ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Child Health ◽  
Situational Analysis ◽  
Newborn And Child Health ◽  
Facilitators And Barriers ◽  
And Child Health

scholarly journals Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

2020 ◽  
Author(s):  
Lauren Yu-Lien Maldonado ◽  
Julia J. Songok ◽  
John W. Snelgrove ◽  
Christian B. Ochieng ◽  
Sheilah Chelagat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Education ◽  
Child Health ◽  
Health Behaviors ◽  
Pregnant Women ◽  
Evidence Based ◽  
Matched Cohort ◽  
Western Kenya ◽  
Newborn And Child Health ◽  
And Child Health

Abstract Background: We launched Chamas for Change (Chamas), a group-based health education and microfinance program for pregnant women and their infants, to address inequities contributing to high rates of maternal and neonatal mortality in western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and uptake of evidence-based, maternal, newborn and child health (MNCH) behaviors. Methods: We prospectively compared the uptake of MNCH behaviors between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at health facilities in Busia County to participate in Chamas . Women enrolled in Chamas agreed to attend bi-monthly group health education and optional microfinance sessions for 12 months. We collected baseline sociodemographic data at study enrollment for each cohort. We used descriptive analyses and adjusted multivariable logistic regression models to compare outcomes across cohorts at 6-12 months postpartum, with α set to 0.05. Results: Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a facility with a skilled birth attendant (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In our adjusted models, Chamas participants were nearly five times as likely as controls to deliver in a health facility (OR 5.07, 95% CI 2.74-9.36, p<0.001). Though not statistically significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Our sensitivity analyses revealed no significant difference in the odds of facility delivery based on microfinance participation. Conclusions: Chamas participation was associated with increased practice of evidence-based MNCH health behaviors among pregnant women in western Kenya. Our findings demonstrate this program’s potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect.

scholarly journals The effect of enhanced public–private partnerships on Maternal, Newborn and child Health Services and outcomes in Nairobi–Kenya: the PAMANECH quasi-experimental research protocol

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006608 ◽  
Author(s):  
Pauline Bakibinga ◽  
Remare Ettarh ◽  
Abdhalah K Ziraba ◽  
Catherine Kyobutungi ◽  
Eva Kamande ◽  
...  
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Health Facilities ◽  
Public Private Partnerships ◽  
Quality Healthcare ◽  
Newborn And Child Health ◽  
Quasi Experimental ◽  
The Impact ◽  
And Child Health

IntroductionRapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The ‘Partnership for Maternal, Newborn and Child Health’ (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public–private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya.Methods and analysisThis is a quasi-experimental study; our approach is to support private as well as public health providers and the community to enhance access to and demand for quality healthcare services. Key activities include: infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for healthcare providers as well as the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end-line survey will be conducted at least 1 year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference.Ethics and disseminationEthical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and academic publications to facilitate uptake by policymakers.Protocol registration numberKEMRI- NON-SSC-PROTOCOL No. 393.

scholarly journals Impact of COVID-19 on utilization of maternal, newborn and child health services in Nigeria: protocol for a country-level mixed-methods study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1106
Author(s):  
Godwin Akaba ◽  
Osasuyi Dirisu ◽  
Kehinde Okunade ◽  
Eseoghene Adams ◽  
Jane Ohioghame ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Study Design ◽  
Qualitative Data ◽  
Health Care Facilities ◽  
Mixed Methods Study ◽  
Child Health Services ◽  
Newborn And Child Health ◽  
The Impact ◽  
And Child Health

Background: Battling with COVID-19 and providing essential services along the continuum of care could be challenging. This study will evaluate the impact of COVID-19 on utilization of maternal, newborn and child health (MNCH) services in Nigeria and explore the barriers being experienced by women and their families in getting access to MNCH services, as well as other contextual factors that may have shaped the utilization of MNCH services during the COVID-19 pandemic. Methods and analysis: The study will adopt an observational mixed-methods study design involving 18 health care facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria. We will retrieve longitudinal data on MNCH services from all selected hospitals three months before and after the first recorded case of COVID-19 in Nigeria. Qualitative data will be collected using in-depth interviews conducted via mobile phones or ZOOM meeting platforms among stakeholder participants (users of MNCH services, health workers and policymakers) to ascertain their perceptions on how COVID-19 has shaped the utilization of MNCH services. We will triangulate quantitative and qualitative data to better understand the impact of COVID-19 on the utilization of MNCH services in Nigeria. Ethics and dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. Our findings will provide the first evidence from an African setting on the impact of COVID-19 on the utilization of MNCH services using a mixed-methods study design for policy formulation towards sustained MNCH service delivery.

scholarly journals Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?

2019 ◽  
Vol 4 (Suppl 4) ◽  
pp. e001300 ◽  
Author(s):  
Ties Boerma ◽  
Hannah Tappis ◽  
Ghada Saad-Haddad ◽  
Jai Das ◽  
Dessalegn Y Melesse ◽  
...  
Keyword(s):  
Child Health ◽  
Child Growth ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Newborn And Child Health ◽  
National Surveys ◽  
Sub Saharan ◽  
National Trends ◽  
The Impact ◽  
And Child Health

Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990–2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality in children under 5 years in comparison with subregional trends. The surveys provide substantive evidence of a negative association between levels and trends in national indicators of RMNCH service coverage, child growth and under-5 mortality with armed conflict, with some notable exceptions. National surveys are an important source of data to assess the longer term national consequences of conflicts for RMNCH in most countries, despite limitations due to sampling and timing of the surveys.

scholarly journals Impact of COVID-19 on utilization of maternal, newborn and child health services in Nigeria: protocol for a country-level mixed-methods study

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1106
Author(s):  
Godwin Akaba ◽  
Osasuyi Dirisu ◽  
Kehinde Okunade ◽  
Eseoghene Adams ◽  
Jane Ohioghame ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Study Design ◽  
Qualitative Data ◽  
Health Care Facilities ◽  
Mixed Methods Study ◽  
Child Health Services ◽  
Newborn And Child Health ◽  
The Impact ◽  
And Child Health

Background: Battling with COVID-19 and providing essential services along the continuum of care could be challenging. This study will evaluate the impact of COVID-19 on utilization of maternal, newborn and child health (MNCH) services in Nigeria and explore the barriers being experienced by women and their families in getting access to MNCH services, as well as other contextual factors that may have shaped the utilization of MNCH services during the COVID-19 pandemic. Methods and analysis: The study will adopt an observational mixed-methods study design involving 18 health care facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria. We will retrieve longitudinal data on MNCH services from all selected hospitals six months before and after the first recorded case of COVID-19 in Nigeria. Qualitative data will be collected using in-depth interviews conducted via mobile phones or ZOOM meeting platforms among stakeholder participants (users of MNCH services, health workers and policymakers) to ascertain their perceptions on how COVID-19 has shaped the utilization of MNCH services. We will triangulate quantitative and qualitative data to better understand the impact of COVID-19 on the utilization of MNCH services in Nigeria. Ethics and dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. Our findings will provide the first evidence from an African setting on the impact of COVID-19 on the utilization of MNCH services using a mixed-methods study design for policy formulation towards sustained MNCH service delivery.

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