scholarly journals The knowledge of danger signs of obstetric complications among women in rural India: evaluating an integrated microfinance and health literacy program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Danish Ahmad ◽  
Itismita Mohanty ◽  
Avishek Hazra ◽  
Theo Niyonsenga
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Maternal Health ◽  
Health System ◽  
Uttar Pradesh ◽  
Obstetric Complications ◽  
Rural India ◽  
Danger Signs ◽  
Knowledge Of Danger Signs ◽  
The Impact

Abstract Background Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results SHG member women receiving health literacy were 27% more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.

scholarly journals The Knowledge of Danger Signs of Obstetric Complications among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy  Program

2020 ◽  
Author(s):  
Danish Ahmad ◽  
Itismita Mohanty ◽  
Avishek Hazra ◽  
Theo Niyonsenga
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Maternal Health ◽  
Health System ◽  
Uttar Pradesh ◽  
Obstetric Complications ◽  
Rural India ◽  
Danger Signs ◽  
Knowledge Of Danger Signs ◽  
The Impact

Abstract Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods: Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.

scholarly journals The Knowledge of Danger Signs of Obstetric Complications Among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program

2020 ◽  
Author(s):  
Danish Ahmad ◽  
Itismita Mohanty ◽  
Avishek Hazra ◽  
Theo Niyonsenga
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Maternal Health ◽  
Health System ◽  
Uttar Pradesh ◽  
Obstetric Complications ◽  
Rural India ◽  
Danger Signs ◽  
Knowledge Of Danger Signs ◽  
The Impact

Abstract Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IHLMF) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages.Methods: Secondary data from the IHLMF program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level.Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics.Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.

scholarly journals The Knowledge of Danger Signs of Obstetric Complications among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program

2021 ◽  
Author(s):  
Danish Ahmad ◽  
Itismita Mohanty ◽  
Avishek Hazra ◽  
Theo Niyonsenga
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Maternal Health ◽  
Health System ◽  
Uttar Pradesh ◽  
Obstetric Complications ◽  
Rural India ◽  
Danger Signs ◽  
Knowledge Of Danger Signs ◽  
The Impact

Abstract Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods: Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.

scholarly journals Improving Birth Preparedness and Complication Readiness Through an Integrated Microfinance and Health Literacy Program:Evidence From Rural India

2020 ◽  
Author(s):  
Danish Ahmad ◽  
Itismita Mohanty ◽  
Theo Niyonsenga
Keyword(s):  
Health Literacy ◽  
Maternal Health ◽  
Uttar Pradesh ◽  
Wealth Quintile ◽  
Literacy Intervention ◽  
Rural India ◽  
Birth Preparedness ◽  
Diffusion Effect ◽  
Complication Readiness ◽  
The Impact

Abstract Background:Despite maternal mortality rate almost halving over the past two decades, approximately 295,000 deaths occurred annually in 2017 globally. They occur in high burden regions where most preventable deaths are precipitated by delays in maternal care provision. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. We evaluated the impact of the IMFHL program on BPCR practice by women in one of India’s poorest states-Uttar Pradesh, adjusting for community, household and individual variables. We also investigated if there is a diffusion of knowledge of BPCR from SHG members receiving the health literacy intervention to non-members in program villages.Method: Using secondary survey data from the IMFHL project, we analysed data from 17,244 women across SHG and non-member households in Uttar Pradesh. We performed multivariable logistic regressions to estimate adjusted IMFHL program’s effects on maternal BPCR practice.Results: Membership in SHG alone is positively associated with BPCR practice with 17 percent higher odds compared to women in villages without the programs. Furthermore, the odds of practising complete BPCR increases by almost fifty percent when a maternal health literacy component is added to the SHGs. A diffusion effect was found for BPCR practice from SHG members to non-members only when an added health literacy component was integrated into the SHG model. The main effect of the IMFHL program on BPCR practice remained stable in the presence of confounders suggesting that the delivery of health messages is undiluted by other non-programmatic factors at the individual, household and community level. Among confounders, only the poorest households as captured by the wealth quintile were significantly negatively associated with BPCR practice.Conclusion: The public health literature promotes the adoption of BPCR practices to improve maternal health outcomes. This study shows that SHGs exert both a dissemination effect of planned health behaviour within members, as well as facilitate a diffusion effect of the natural transfer of BPCR from members to non-members when SHGs are enriched with a health literacy component

scholarly journals A review of the impact of financing mechanisms on maternal health care in Australia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Haylee Fox ◽  
Stephanie M. Topp ◽  
Emily Callander ◽  
Daniel Lindsay
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health System ◽  
Search Engine ◽  
Grey Literature ◽  
Maternal Health Care ◽  
World Health ◽  
Google Search ◽  
The Impact ◽  
Out Of Pocket Costs

Abstract Background The World Health Organization states there are three interrelated domains that are fundamental to achieving and maintaining universal access to care - raising sufficient funds for health care, reducing financial barriers to access by pooling funds in a way that prevents out-of-pocket costs, and allocating funds in a way that promotes quality, efficiency and equity. In Australia, a comprehensive account of the mechanisms for financing the health system have not been synthesised elsewhere. Therefore, to understand how the maternal health system is financed, this review aims to examine the mechanisms for funding, pooling and purchasing maternal health care and the influence these financing mechanisms have on the delivery of maternal health services in Australia. Methods We conducted a scoping review and interpretative synthesis of the financing mechanisms and their impact on Australia’s maternal health system. Due to the nature of the study question, the review had a major focus on grey literature. The search was undertaken in three stages including; searching (1) Google search engine (2) targeted websites and (3) academic databases. Executive summaries and table of contents were screened for grey literature documents and Titles and Abstracts were screened for journal articles. Screening of publications’ full-text followed. Data relating to either funding, pooling, or purchasing of maternal health care were extracted for synthesis. Results A total of 69 manuscripts were included in the synthesis, with 52 of those from the Google search engine and targeted website (grey literature) search. A total of 17 articles we included in the synthesis from the database search. Conclusion Our study provides a critical review of the mechanisms by which revenues are raised, funds are pooled and their impact on the way health care services are purchased for mothers and babies in Australia. Australia’s maternal health system is financed via both public and private sources, which consequentially creates a two-tiered system. Mothers who can afford private health insurance – typically wealthier, urban and non-First Nations women - therefore receive additional benefits of private care, which further exacerbates inequity between these groups of mothers and babies. The increasing out of pocket costs associated with obstetric care may create a financial burden for women to access necessary care or it may cause them to skip care altogether if the costs are too great.

scholarly journals A cross-sectional study of the role of men and the knowledge of danger signs during pregnancy in southern Mozambique

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Galle ◽  
Malica De Melo ◽  
Sally Griffin ◽  
Nafissa Osman ◽  
Kristien Roelens ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Antenatal Care ◽  
Financial Support ◽  
Maternal Health Care ◽  
Cross Sectional ◽  
Men And Women ◽  
Danger Signs ◽  
Knowledge Of Danger Signs

Abstract Background The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. Qualitative research has highlighted that women depend on others to access high quality maternity care. Currently little is known about these factors in relation to maternal health in Mozambique. Methods A cross sectional household survey was conducted with men and women in southern Mozambique about decision making, financial support and knowledge of danger signs. A multivariable logistic model was used to identify factors associated with knowledge of danger signs and Cohen’s kappa for agreement among couples. Results A total of 775 men and women from Marracuene and Manhica districts were interviewed. Maternal health care decisions were frequently made jointly by the couple (32–49%) and financial support was mainly provided by the man (46–80%). Parental and parent-in-law involvement in decision making and financial support was minimal (0–3%). The average number of danger signs respondents knew was 2.05 and no significant difference (p = 0.294) was found between men and women. Communication with the partner was a significant predictor for higher knowledge of danger signs for both men (p = 0.01) and women (p = 0.03). There was very low agreement within couples regarding decision making (p = 0.04), financial support (p = 0.01) and presence at antenatal care consultations (p = 0.001). Results suggest women and men have a high willingness for more male participation in antenatal care, although their understanding of what constitutes this participation is not clear. Conclusion The study findings highlight the important role men play in decision making and financial support for maternal health care issues. Strengthening male involvement in antenatal care services, by investing in counselling and receiving couples, could help accelerate gains in maternal health in Mozambique. Maternal health care studies should collect more data from men directly as men and women often report different views and behavior regarding maternal health care issues and male involvement.

scholarly journals Correction to: Inequalities in the utilisation of maternal health Care in Rural India: Evidences from National Family Health Survey III & IV

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Survey ◽  
Family Health ◽  
Maternal Health Care ◽  
Rural India ◽  
National Family Health Survey ◽  
National Family

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Maternal Health Services ◽  
Policy Formulation ◽  
Social Accountability ◽  
The Social ◽  
The Government ◽  
The Impact

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.

scholarly journals Intervention Time Series Modeling of Infant Mortality: Impact of Free Maternal Health Care

2020 ◽  
pp. 38-47
Author(s):  
J. Kisabuli ◽  
J. Ong'ala ◽  
E. Odero
Keyword(s):  
Health Care ◽  
Time Series ◽  
Maternal Health ◽  
Infant Mortality ◽  
Moving Average ◽  
Maternal Health Care ◽  
The Sustainable Development ◽  
Infant Deaths ◽  
Moving Average Model ◽  
The Impact

Infant mortality is an important marker of the overall society health. The 3rd goal of the Sustainable Development Goals aims at reducing infant deaths that occur due to preventable causes by 2030. Due to increased infant mortality the Kenyan government introduced Free Maternal Health Care as an intervention towards reducing infant mortality through elimination of the cost burden of accessing medical care by the mother and the infant. The study examines the impact of Free Maternal Health Care on infant mortality using Intervention time series analysis particularly the intervention Box Jenkins ARIMA (Autoregressive Integrated Moving Average) model. There was significant support that Free Maternal Health Care had a significant impact on infant mortality which was estimated to be a decrease of 10.15% in infant deaths per month.

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