The effect of community health volunteer activation on maternal and child health in Volta region, Ghana

2015 ◽  
Author(s):  
Gyuhong Lee ◽  
Yeonji Ma
Keyword(s):  
Child Health ◽  
Community Health ◽  
Maternal And Child Health ◽  
Health Volunteer ◽  
Community Health Volunteer ◽  
Volta Region ◽  
And Child Health

Human Milk in Premature Infant Feeding: Summary of a Workshop

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 741-743
Keyword(s):  
Child Health ◽  
Health Service ◽  
Human Milk ◽  
Community Health ◽  
Premature Infants ◽  
Maternal And Child Health ◽  
National Research Council ◽  
The United States ◽  
National Academy Of Sciences ◽  
And Child Health

Increasing interest in the utilization of human milk for the feeding of premature infants has been evident in the United States in the past few years and in the Scandinavian countries and several other parts of Europe for a longer time. Because premature infants exhibit even greater limitations of gastrointestinal and digestive functions and of immunologic status than do full-term infants, human milk may offer particular advantages. Such advantages include ready digestibility and absence of foreign proteins; in addition, it is possible that feeding of human milk may protect against enteric infections. In view of current interest in human milk for feeding premature infants, it seemed desirable to consider the possible associated benefits and risks. Such a consideration was undertaken on December 2 and 3, 1975, in Chevy Chase, Maryland, under the sponsorship of the Office for Maternal and Child Health, Bureau of Community Health Services, Health Service Administration, Department of Health, Education and Welfare. The meeting was attended by individuals believed knowledgeable about one or another area related to possible benefits and risks of feeding fresh or processed human milk by bottle or gavage to premature infants in hospitals. Participants in the workshop included representatives of two com- mittees of the American Academy of Pediatrics, two committees of the National Academy of Sciences-National Research Council, and representatives of the American College of Obstetricians and Gynecologists, the American Nursing Association, the Center for Disease Control, and the National Institute of Child Health and Human Development. Several representatives of the Office for Maternal and Child Health and of the Division of Clinical Services, Bureau of Community Health Service were also present.

Promoting Antenatal Care: Identifying Policy Levers in Indian Context

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Singh
Keyword(s):  
Health Care ◽  
Child Health ◽  
Antenatal Care ◽  
Community Health ◽  
Maternal And Child Health ◽  
Nutrition Support ◽  
Child Health Care ◽  
Support Programme ◽  
Indian Context ◽  
And Child Health

Abstract Background The growing body of literature associates Antenatal Care (ANC) with early detection and prevention of maternal complications which in turn reduce the likelihood of maternal and infant death. Studies report that only about 40% of pregnant women in developing countries have attended four ANC visits. This situation mandates identifying policy levers for promoting ANC visits. Methods The study uses data from the Demographic and Health Survey (DHS) India (2015-16). We analyze a sample of about 100,000 women in the age group of 15-49 years who gave birth in three years preceding the survey. Using the theory of health seeking behaviour we propose a conceptual model to understand the a) Predisposing factors; b) Enabling factors and c) Need factors affecting the ANC visits in Indian context. Results 17 % women in our sample never went for ANC. 46 % women in our sample went for at least four ANC visits. SEM analysis suggests that our structural model fits well with the sample data (RMSEA: 0.05; TFI: 0.93; SRMR: 0.038). Higher age, lower parity, higher awareness and higher levels of education significantly predisposes women to go for ANC visits. The significant (95% CI) enablers include higher socio-economic status, meeting with Community Health Worker (CHW) and enrolment in government sponsored nutrition support program. While health system barriers and personal barriers act as disablers. Bad obstetric history and health issues during pregnancy are significant need factors. Our analysis suggests that meeting CHWs increases ANC visits by 1.8 units and enrolment in nutrition support programme increases ANC visits by 1.4 units. Conclusions CHW and nutrition support programme are significant policy levers to promote ANC care and reduce maternal and child morbidity and mortality. Antenatal care services must be included under universal health coverage domain to reduce financial barriers for women of low socio-economic strata Key messages Involvement of Community Health workers in the promotion of maternal and child health care is a cost-effective strategy. Nutrition support programmes through Anganwadi centres help advance maternal and child health care by promoting ANC care.

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Care Providers ◽  
And Child Health

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

scholarly journals Evaluation Of The Integrated Care Model: Child Morbidity Reduction In Mashonaland East, Zimbabwe

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Maxwell Mhlanga
Keyword(s):  
Maternal Health ◽  
Child Health ◽  
Community Health ◽  
Integrated Care ◽  
Incidence Rate ◽  
Maternal And Child Health ◽  
Care Model ◽  
Child Morbidity ◽  
Care Practices ◽  
And Child Health

Zimbabwe has one of the highest prevalence rates on preventable child morbidity in the world. This is mainly attributable to the absence of an effective community health mobilisation structure that reaches all targeted households with correct and consistent social behaviour change interventions for better child and maternal health. To address this, a cluster randomised controlled trial was conducted to assess the effectiveness of a developed integrated community intervention approach in reducing child morbidity and improving maternal health outcomes. A total of 765 mother-child pairs (413 in the intervention and 352 in the control) from 2 districts in Mashonaland East province were recruited and followed up for 12 months. Only women with children aged 0 - 48 months at the beginning of the study were selected. Participants were selected (and recruited) through stratified random sampling from 30 villages/clusters (16 in the control and 14 in the intervention) out of the total of 43 villages in the 2 districts. The intervention arm received education on maternal and child health through an Integrated Care Model mobilisation system whereas participants in the control arm were mobilized and educated using the conventional mobilisation system. Baseline and end-line surveys were done to assess and compare baseline characteristics and secondary study outcomes. The primary outcome was child morbidity in the follow-up period of 12 months. The mean age of participating mothers was 28 years (SD = 6.8) and that of participating children was 18.2 months (SD = 4.0). The risk of child morbidity was 37.5% in the control and 22.0% in the intervention representing a relative risk of 1.7 [95% C.I (1.4-2.1)]. The incidence rate of child morbidity was 0.043 and 0.022 episodes per child year in the control and intervention arm respectively giving an incidence rate ratio of 2.0(p<0.001). This ratio meant that the chance of being a disease case in the control was double that in the intervention arm. Women in the intervention arm had statistically significant (p<0.001) higher knowledge about maternal and child health and better child care practices at the end of the study. There was strong evidence that the Integrated Care Model did not only reduce child morbidity but also improved maternal knowledge, health-seeking behaviour and care practices. Accordingly, governments in developing countries and countries in poor resource settings could strengthen their community health delivery systems by implementing this low-cost, sustainable and high-impact approach.

Sustainable high impact community health worker programs for low-income urban settings: Designing of ANCHUL (AnteNatal and Child Health Care in Urban sLums) intervention for Accredited Social Health Activist (ASHAs) in Delhi, India

2020 ◽  
Author(s):  
Suparna Ghosh-Jerath ◽  
Niveditha Devasenapathy ◽  
Monika Rana ◽  
Sanjay Zodpey ◽  
Anuraj Shankar
Keyword(s):  
Child Health ◽  
Community Health ◽  
Maternal And Child Health ◽  
Implementation Research ◽  
Urban Poor ◽  
Health Needs ◽  
Social Health ◽  
Design Phase ◽  
Decision Space ◽  
And Child Health

Abstract Background: Urbanization in India has led to increasing economic disparities and health inequalities with worse maternal and child health indicators among the urban poor. Community health workers (CHW) within the urban community health systems (UCHS) can play important role in addressing the health needs of urban poor. We present here a 3-stage process of development of a remodelled program for the existing CHWs called Accredited Social Health Activists (ASHAs) working in urban poor settlements of Delhi, India, in collaboration with Delhi State Health Mission (DSHM); the implementers of the program. The intervention was called ANCHUL (Antenatal and Child Health in Urban sLums) intervention and was designed in three phases; formative phase, design phase and evaluation phase. In this paper we discuss the formative and design phase.Methods: We used a mixed methods approach including surveys, qualitative enquires, desk reviews and consultations with key stakeholders (program implementers, decision makers in the health system, ASHAs, clients and healthcare providers) during the formative and design phase. The goal was to create a dynamic adaptive model for the urban ASHA program based on current evidence yet bound within the decision space and options of program implementers. Principles of implementation research was applied to design the ANCHUL intervention. A pragmatic quasi experimental design was used to evaluate this complex intervention.Results: The formative phase identified the current maternal and child health needs of the urban poor, the programmatic challenges of the ASHA program and helped in creating a conceptual framework for the intervention. The design phase formalised the key components of the ANCHUL intervention namely selection, training, monitoring and supervision, and execution of ASHAs' day to day activities; identify the standardized components and flexible functions, and list the process indicators for evaluating this intervention.Conclusion: Principles of implementation research was used for designing a context specific intervention directed towards ASHAs while engaging with a wide range of stakeholders. Such an approach may prove to be time consuming yet is feasible to address implementation challenges of an ongoing program and remodel it with evidence based components planned within the decision space of implementers.

Sign in / Sign up

Export Citation Format

Share Document