The Care for Life Family Preservation Program: Outcome Evaluation of a Holistic Community Development Program in Mozambique

2019 ◽  
Vol 30 (1) ◽  
pp. 84-96
Author(s):  
Angelea Panos ◽  
Patrick Panos ◽  
Ruth Gerritsen-McKane ◽  
Tiago Tendai
Keyword(s):  
Infant Mortality ◽  
Maternal Mortality ◽  
Odds Ratio ◽  
International Association ◽  
Development Program ◽  
Outcome Evaluation ◽  
Family Preservation ◽  
Live Births ◽  
Comparison Groups ◽  
Family Preservation Program

Objective: In 2016, Mozambique ranked 13th worldwide in infant mortality (67.9 deaths/1,000 live births) and 20th worldwide in maternal mortality (489 deaths/100,000 live births). This study’s objective was to determine whether a comprehensive program, incorporating the International Association for Community Development’s recommended holistic elements was effective in a country such as Mozambique. Method: Over a 5-year period (2012–2017), an independent, randomized between-group outcome study was conducted to determine whether the holistic Care for Life ( CFL) Family Preservation Program was effective in reducing infant mortality ratios (IMRs) and maternal mortality ratios (MMRs) in Mozambique. Results: At preintervention assessment, intervention and comparison villages were statistically equivalent in both IMR and MMR. After 5 years, intervention villages were significantly below the comparison villages in both IMR (odds ratio = 2.3) and MMR (odds ratio = 4.6). Conclusion: The use of comparison groups demonstrated the CFL program comprehensive, holistic, and sustainable approach is effective.

scholarly journals The Relationship Of Pregnant Women's Knowledge And Attitude To The Implementation Of Delivery Planning And Complication Prevention (P4k) Program

2021 ◽  
Vol 1 (1) ◽  
pp. 13-21
Author(s):  
Ratih Ruhayati
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Significant Relationship ◽  
Infant Mortality Rate ◽  
P Value ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
The Relationship

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are indicators to assess the health status of the community. Based on the Indonesian Demographic and Health Survey 2017 IDHS, the maternal mortality rate in Indonesia is still high at 302 per 100,000 live births, while the infant mortality rate is 24 per 1000 live births. The decline in MMR and IMR cannot be separated from the role of community empowerment, one of which is carried out through the implementation of the Childbirth Planning and Complications Prevention Program (P4K). Most mothers, husbands, and families have less active role in the implementation of P4K, even though there is an effect of implementing P4K on neonatal mortality. This happens because the mother's knowledge about P4K is still lacking, so her attitude is still not positive. The purpose of this study was to determine the relationship between knowledge and attitudes of pregnant women towards the implementation of the Childbirth Planning and Complications Prevention (P4K) Program. The research design used "analytic descriptive" cross-sectional, with a total population of 126 pregnant women, while the sample was taken using purposive sampling technique, with a total sample of 96 respondents. The results of statistical analysis with the Chi-Square test showed that for the knowledge variable, the results of the P value = 0.005 concluded that there was a significant relationship between the level of knowledge and the implementation of P4K, while for the attitude variable the P value = 0.001 concluded that there was a significant relationship between attitudes with the implementation of P4K.

scholarly journals HUBUNGAN MOTIVASI BIDAN TENTANG P4K DENGAN PENERAPAN PROGRAM STIKER P4K PADA IBU HAMIL DI RUMAH SAKIT IMELDA MEDAN

2021 ◽  
Vol 7 (1) ◽  
pp. 19-23
Author(s):  
Khairani
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Health Indicators ◽  
Infant Mortality Rate ◽  
P Value ◽  
Demographic Health Survey ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Delivery Planning

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are health indicators of a country. Data of the 2012 Demographic Health Survey of Indonesia (DHSI) indicates that the maternal mortality rate increased by 359 deaths per 100,000 live births. Such rate was higher than the data of 2015DHSI, i.e. 228 deaths per 100,000 live births. The 2012 DHSI indicates IMR of 32 deaths  ​​per 1,000 live births, slightly lower than the 2007 DHSI indicating 34 deaths per 1,000 live births. One of the efforts to reduce MMR and IMR is through the Delivery Planning and Complication Prevention Program (PCPP). Midwives’ motivation about PCPP belonged to the category of moderate motivation (79.4%). The implementation of PCPP sticker program was mostly as planned (74.6%). There was a correlation between midwives’ motivation about PCPP and the implementation of PCPP sticker for pregnant women in the Imelda Hospital in 2020 with p-value = 0.013

Impact of National Health Mission of India on Infant and Maternal Mortality: A Logical Framework Analysis

2021 ◽  
pp. 097206342199498
Author(s):  
Rajesh Kumar
Keyword(s):  
Maternal Mortality ◽  
Health System ◽  
National Health ◽  
Maternal Mortality Ratio ◽  
Evaluation Framework ◽  
Infant Mortality Rate ◽  
Series Data ◽  
Health Management Information System ◽  
Live Births ◽  
Fund Allocation

Background: Since independence, life expectancy has increased substantially in India, but the goal of health-for-all has not been achieved yet. Hence, National Rural Health Mission was launched in 2005, and several strategies were implemented to strengthen the health system. Impact evaluation of the mission was done to learn lessons for future health planning. Materials and Methods: Logical evaluation framework was used to examine input, output and impact indicators systematically using time series data from Health Management Information System, National Family Health Surveys, National Sample Surveys and Sample Registration Scheme. Findings: After launch of the mission, fund allocation has increased nearly five times. The number of auxiliary nurse midwives has doubled, and the number of nurses has trebled. The number of accredited social health activists has increased to about one million. Institutional deliveries have increased from 38.7% in 2005–2006 to 78.9% in 2015–2016. Full immunisation coverage has increased from 43.5% to 62%. Oral rehydration solution (ORS) use in childhood diarrhoea has increased from 26% to 51%. Infant mortality rate has declined from 58 in 2005 to 33 per 1,000 live births in 2017 and maternal mortality ratio has also registered a decline from 254 in 2004–2006 to 122/100000 live births in 2015–2017. However, out-of-pocket health expenditure continues to be fairly high (69.3% of the total expenditure on health). Conclusions: Though National Health Mission has made a significant impact, the goal of universal care coverage is not yet fully achieved. Hence, capacity of health system needs to be trebled by a substantial increase in fund allocation.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Determinants of neonatal, postneonatal and maternal mortality on models of primary health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Public Policies ◽  
Family Health ◽  
Mortality Rates ◽  
Sao Paulo ◽  
The State ◽  
Care Organization ◽  
São Paulo

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

scholarly journals Associations between Red Blood Cell and Platelet Transfusions and Retinopathy of Prematurity

Neonatology ◽  
2020 ◽  
pp. 1-7
Author(s):  
Tobias Hengartner ◽  
Mark Adams ◽  
Riccardo E. Pfister ◽  
Diane Snyers ◽  
Jane McDougall ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Same Sex ◽  
Live Births ◽  
Adjusted Logistic Regression ◽  
Control Study

<b><i>Aim:</i></b> The aim of this study is to examine possible associations between the transfusion of RBC or platelets (PLTs) and the development of retinopathy of prematurity (ROP) in infants. <b><i>Methods:</i></b> This retrospective, national, case-control study included all live births in Switzerland between 2013 and 2018. We investigated preterm infants at a gestational age of &#x3c;28 weeks, who developed higher stage ROP (≥stage 2, <i>n</i> = 178). Each case infant was matched to another of the same sex who did not develop ROP (<i>n</i> = 178, control group). <b><i>Results:</i></b> When compared with the control group, we observed higher numbers of RBC transfusions per infant and higher percentages of infants receiving PLT transfusions in the case group. An adjusted logistic regression analysis revealed that both RBC (odds ratio [OR] 1.081, 95% confidence interval [CI] 1.020–1.146) and PLT transfusions (OR = 2.502, 95% CI 1.566–3.998) numbers were associated with ROP development. <b><i>Conclusions:</i></b> Multiple RBC and PLT transfusions are associated with higher stage ROP development. Prospective studies are required to determine their potential as risk factors.

Social Dimensions of Genetic Disorders

1992 ◽  
Vol 14 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Joan Ablon
Keyword(s):  
Health Education ◽  
Infant Mortality ◽  
Genetic Disease ◽  
Genetic Factors ◽  
Genetic Disorders ◽  
Genetic Defects ◽  
Social Dimensions ◽  
Live Births ◽  
Department Of Health ◽  
Recessive Genes

Each of us carries between 4-8 recessive genes for serious genetic defects, and, hence, stands a statistical chance of passing on a serious or lethal condition to each child… 12 million Americans carry true genetic disease due wholly or partly to defective genes or chromosomes…40 percent or more of all infant mortality results from genetic factors…4.8 to 5 percent of all live births have genetic defects. (U.S. Department of Health, Education, and Welfare. "What are the Facts About Genetic Disease?" National Inst. of Gen. Med. Scs., P.H.S., N.I.H. DHEW Pub. No. (NIH), 75-370, 1975.)

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