scholarly journals Diffusion of Handwashing Knowledge and Water Treatment Practices From Mothers in an Antenatal Hygiene Promotion Program to Nonpregnant Friends and Relatives, Machinga District, Malawi

2018 ◽  
Vol 39 (1) ◽  
pp. 63-69
Author(s):  
Anu Rajasingham ◽  
Janell A. Routh ◽  
Anagha Loharikar ◽  
Elly Chemey ◽  
Tracy Ayers ◽  
...  
Keyword(s):  
Water Treatment ◽  
Maternal Health ◽  
Service Use ◽  
Free Water ◽  
Antenatal Clinic ◽  
Maternal Health Service ◽  
Middle Income ◽  
Treatment Practices ◽  
Hygiene Practices

Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases in low- and middle-income countries. Integrating water treatment and hygiene products into antenatal clinic care can motivate water treatment and handwashing among pregnant women. Free water hygiene kits (water storage containers, sodium hypochlorite water treatment solution, and soap) and refills of water treatment solution and soap were integrated into antenatal care and delivery services in Machinga District, Malawi, resulting in improved water treatment and hygiene practices in the home and increased maternal health service use. To determine whether water treatment and hygiene practices diffused from maternal health program participants to friends and relatives households in the same communities, we assessed the practices of 106 nonpregnant friends and relatives of these new mothers at baseline and 1-year follow-up. At follow-up, friends and relatives were more likely than at baseline to have water treatment products observable in the home (33.3% vs. 1.2%, p < 0.00001) and detectable free chlorine residual in their water, confirming water treatment (35.7% vs. 1.4%; p < 0.00001). Qualitative data from in-depth interviews also suggested that program participants helped motivate adoption of water treatment and hygiene behaviors among their friends and relatives.

scholarly journals Cost of maternal health services in low and middle-income countries: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027822 ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Oluwasola Banke-Thomas ◽  
Adamu Maikano ◽  
Charles Anawo Ameh
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Economic Evaluations ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries

IntroductionThere is substantial evidence that maternal health services across the continuum of care are effective in reducing morbidities and mortalities associated with pregnancy and childbirth. There is also consensus regarding the need to invest in the delivery of these services towards the global goal of achieving Universal Health Coverage in low/middle-income countries (LMICs). However, there is limited evidence on the costs of providing these services. This protocol describes the methods and analytical framework to be used in conducting a systematic review of costs of providing maternal health services in LMICs.MethodsAfrican Journal Online, CINAHL Plus, EconLit, Embase, Global Health Archive, Popline, PubMed and Scopus as well as grey literature databases will be searched for relevant articles which report primary cost data for maternal health service in LMICs published from January 2000 to June 2019. This search will be conducted without implementing any language restrictions. Two reviewers will independently search, screen and select articles that meet the inclusion criteria, with disagreements resolved by discussions with a third reviewer. Quality assessment of included articles will be conducted based on cost-focused criteria included in globally recommended checklists for economic evaluations. For comparability, where feasible, cost will be converted to international dollar equivalents using purchasing power parity conversion factors. Costs associated with providing each maternal health services will be systematically compared, using a subgroup analysis. Sensitivity analysis will also be conducted. Where heterogeneity is observed, a narrative synthesis will be used. Population contextual and intervention design characteristics that help achieve cost savings and improve efficiency of maternal health service provision in LMICs will be identified.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42018114124

scholarly journals Initiation and continuity of maternal healthcare: examining the role of vouchers and user-fee removal on maternal health service use in Kenya

2019 ◽  
Vol 34 (2) ◽  
pp. 120-131 ◽  
Author(s):  
Mardieh L Dennis ◽  
Lenka Benova ◽  
Timothy Abuya ◽  
Matteo Quartagno ◽  
Ben Bellows ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Service Use ◽  
Maternal Health Service ◽  
Health Service Use ◽  
Maternal Healthcare ◽  
User Fee

scholarly journals Spatial variability in factors influencing maternal health service use in Jimma Zone, Ethiopia: a geographically-weighted regression analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jaameeta Kurji ◽  
Charles Thickstun ◽  
Gebeyehu Bulcha ◽  
Monica Taljaard ◽  
Ziqi Li ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Spatial Variability ◽  
Postnatal Care ◽  
Service Use ◽  
Information Source ◽  
Maternal Health Service ◽  
Parameter Estimates ◽  
Explanatory Factors ◽  
Jimma Zone

Abstract Background Persisting within-country disparities in maternal health service access are significant barriers to attaining the Sustainable Development Goals aimed at reducing inequalities and ensuring good health for all. Sub-national decision-makers mandated to deliver health services play a central role in advancing equity but require appropriate evidence to craft effective responses. We use spatial analyses to identify locally-relevant barriers to access using sub-national data from rural areas in Jimma Zone, Ethiopia. Methods Cross-sectional data from 3727 households, in three districts, collected at baseline in a cluster randomized controlled trial were analysed using geographically-weighted regressions. These models help to quantify associations within women’s proximal contexts by generating local parameter estimates. Data subsets, representing an empirically-identified scale for neighbourhood, were used. Local associations between outcomes (antenatal, delivery, and postnatal care use) and potential explanatory factors at individual-level (ex: health information source), interpersonal-level (ex: companion support availability) and health service-levels (ex: nearby health facility type) were modelled. Statistically significant local odds ratios were mapped to demonstrate how relevance and magnitude of associations between various explanatory factors and service outcomes change depending on locality. Results Significant spatial variability in relationships between all services and their explanatory factors (p < 0.001) was detected, apart from the association between delivery care and women’s decision-making involvement (p = 0.124). Local models helped to pinpoint factors, such as danger sign awareness, that were relevant for some localities but not others. Among factors with more widespread influence, such as that of prior service use, variation in estimate magnitudes between localities was uncovered. Prominence of factors also differed between services; companion support, for example, had wider influence for delivery than postnatal care. No significant local associations with postnatal care use were detected for some factors, including wealth and decision involvement, at the selected neighbourhood scale. Conclusions Spatial variability in service use associations means that the relative importance of explanatory factors changes with locality. These differences have important implications for the design of equity-oriented and responsive health systems. Reductions in within-country disparities are also unlikely if uniform solutions are applied to heterogeneous contexts. Multi-scale models, accommodating factor-specific neighbourhood scaling, may help to improve estimated local associations.

scholarly journals Fistula Prevention Awareness Activities of Community Volunteerism Niger: A way to improve Access to Information and Care

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Souley Ibrahim ◽  
Ndeyi Altine Diop ◽  
Mounkaila ◽  
Habsatou Traore ◽  
Vandana Tripathi
Keyword(s):  
Maternal Health ◽  
Obstetric Fistula ◽  
Community Outreach ◽  
Safe Motherhood ◽  
Maternal Health Service ◽  
Access To Information ◽  
Community Monitoring ◽  
Fistula Prevention ◽  
Improve Access

Aims: To assess the effects of community volunteer (CV) activities on use of maternal and reproductive health services in Niger. The USAID-funded Fistula Care Plus Project (FC+) strengthens fistula prevention, detection, treatment and reintegration. In Niger, FC+ engaged CVs to increase facility delivery, promote pre- and post-natal care and to improve access to family planning (FP) in Tahoua and Maradi health districts. Methods: FC+identified CVs and trained them to explain obstetric fistula, identify pregnancy danger signs, promote safe motherhood, and discuss male involvement. CVs provide community monitoring through household visits and awareness activities. CVs collect data on pregnant women, follow up on antenatal (ANC)/post-natal (PNC) visits, and provide counseling on all FP methods. We used routine facility data to summarize maternal health service usage in Tahoua and Maradi. Results: 774 CVs were trained between March 2015 and April 2016; they held 9,999 community outreach events, reaching 98,654 individuals. The number of women completing their first ANC visit increased from 13,041 in 2015 to 14,978 in 2016 (15%). 12% and 25% increases were documented, respectively, for fourth ANC visit and PNC visit completion in 2016 relative to 2015.A 48% increase in new acceptors of long-acting FP methods also occurred. Data require standardization against population changes and triangulation with qualitative data from community stakeholders. Conclusions: Engaging community volunteers may improve access to information and services, resulting in increased use of FP and maternal health care. A follow-up system to ensure continued engagement among stakeholders could promote sustainability.

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