scholarly journals Pro-poor policies and improvements in maternal health outcomes in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Bhatia ◽  
L. K. Dwivedi ◽  
K. Banerjee ◽  
A. Bansal ◽  
M. Ranjan ◽  
...  
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Health Workers ◽  
Household Wealth ◽  
Supply Side ◽  
Wealth Status ◽  
Financial Barriers ◽  
Maternal Health Outcomes ◽  
Eag States

Abstract Background Since 2005, India has experienced an impressive 77% reduction in maternal mortality compared to the global average of 43%. What explains this impressive performance in terms of reduction in maternal mortality and improvement in maternal health outcomes? This paper evaluates the effect of household wealth status on maternal mortality in India, and also separates out the performance of the Empowered Action Group (EAG) states and the Southern states of India. The results are discussed in the light of various pro-poor programmes and policies designed to reduce maternal mortality and the existing supply side gaps in the healthcare system of India. Using multiple sources of data, this study aims to understand the trends in maternal mortality (1997–2017) between EAG and non EAG states in India and explore various household, economic and policy factors that may explain reduction in maternal mortality and improvement in maternal health outcomes in India. Methods This study triangulates data from different rounds of Sample Registration Systems to assess the trend in maternal mortality in India. It further analysed the National Family Health Surveys (NFHS). NFHS-4, 2015–16 has gathered information on maternal mortality and pregnancy-related deaths from 601,509 households. Using logistic regression, we estimate the association of various socio-economic variables on maternal deaths in the various states of India. Results On an average, wealth status of the households did not have a statistically significant association with maternal mortality in India. However, our disaggregate analysis reveals, the gains in terms of maternal mortality have been unevenly distributed. Although the rich-poor gap in maternal mortality has reduced in EAG states such as Bihar, Odisha, Assam, Rajasthan, the maternal mortality has remained above the national average for many of these states. The EAG states also experience supply side shortfalls in terms of availability of PHC and PHC doctors; and availability of specialist doctors. Conclusions The novel contribution of the present paper is that the association of household wealth status and place of residence with maternal mortality is statistically not significant implying financial barriers to access maternal health services have been minimised. This result, and India’s impressive performance with respect to maternal health outcomes, can be attributed to the various pro-poor policies and cash incentive schemes successfully launched in recent years. Community-level involvement with pivotal role played by community health workers has been one of the major reasons for the success of many ongoing policies. Policy makers need to prioritise the underperforming states and socio-economic groups within the states by addressing both demand-side and supply-side measures simultaneously mediated by contextual factors.

scholarly journals Understanding variation in maternal health service coverage and maternal health outcomes among districts in Rwanda

2019 ◽  
Author(s):  
Felix Sayinzoga ◽  
Tetui Moses ◽  
Koos van der Velden ◽  
Jeroen van Dillen ◽  
Leon Bijlmakers
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Outcomes ◽  
Health Workers ◽  
Text Messages ◽  
Maternal Health Service ◽  
Poor People ◽  
District Hospitals ◽  
Maternal Health Outcomes ◽  
Service Coverage

AbstractObjectiveTo identify factors that explain variations between districts in maternal health service coverage and maternal health outcomes.MethodsIndividual key informant interviews and focus group discussions using structured topic lists were conducted in May 2015 in four purposively selected districts.ResultsThe solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization. Geographical factors, in particular location close to borders with mobile populations and migrants, and large populations with sparsely distributed health infrastructure, exacerbated by hilly topography and muddy roads were identified as barriers. Shortages of skilled health providers at the level of district hospitals were cited as contributing to poor maternal health outcomes.ConclusionThere is a need to take into account disparities between districts when allocating staff and financial resources in order to achieve universal coverage for high-quality maternal health services and better outcomes. Local innovations such as the use of SMS and WhatsApp text messages by health workers and financial protection schemes for poor patients improve solidarity and are worth to be scaled up.

scholarly journals A Systematic Review of Racial and Ethnic Disparities in Maternal Health Outcomes among Asians/Pacific Islanders

2020 ◽  
Vol 5 (3) ◽  
pp. 139-152
Author(s):  
Janice Hata ◽  
Adam Burke
Keyword(s):  
Health Disparities ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Maternal Mortality Ratio ◽  
Ethnic Disparities ◽  
Obstetric Outcomes ◽  
Racial And Ethnic Disparities ◽  
The Us ◽  
Maternal Health Outcomes

Efforts to improve women’s health and to reduce maternal mortality worldwide have led to a notable reduction in the global maternal mortality ratio (MMR) over the past two decades. However, it is clear that maternal health outcomes are not equitable, especially when analyzing the scope of maternal health disparities across “developed” and “underdeveloped” nations. This study evaluates recent MMR scholarship with a particular focus on the racial and ethnic divisions that impact on maternal health outcomes. The study contributes to MMR research by analyzing the racial and ethnic disparities that exist in the US, especially among Asian and Pacific Islander (API) subgroups. The study applies exclusionary criteria to 710 articles and subsequently identified various maternal health issues that disproportionately affect API women living in the US. In applying PRISMA review guidelines, the study produced 22 peer-reviewed articles that met inclusionary and exclusionary criteria for this review. The data analysis identified several maternal health foci: obstetric outcomes, environmental exposure, obstetric care and quality measures, and pregnancy-related measures. Only eight of the 22 reviewed studies disaggregated API populations by focusing on specific subgroups of APIs, which signals a need to re-conceptualize marginalized API communities’ inclusion in health care systems, to promote their equitable access to care, and to dissolve health disparities among racial and ethnic divides. Several short- and long-term initiatives are recommended to develop and implement targeted health interventions for API groups, and thus provide the groundwork for future empirically driven research among specific API subgroups in the US.

scholarly journals Factors Influencing the Utilisation of Maternal Health Services: The Perspective of Rural Women in Ghana

2013 ◽  
Vol 3 (2) ◽  
pp. 121 ◽  
Author(s):  
Anita Anima Daniels ◽  
Albert Ahenkan ◽  
Kwabena Adu Poku
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Health Services ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
Maternal Health Outcomes

Maternal mortality is a global issue and WHO recommends the use of maternal health services to help improve the health of women and babies during pregnancy and childbirth. Considering global and national interest in improving maternal health and the fact that Ghana is still battling with reducing maternal mortality, understanding the factors affecting the use of maternal services in rural areas is crucial as the women are seen as more vulnerable due to inequity issues. This study sets to examine the factors that influence the utilisation of antenatal and delivery services among rural women in Ghana, focusing on individual and area factors. A descriptive cross sectional study was carried out in three rural communities using Akuapim North District of Ghana as a case study.. The study adopted the quantitative approach. Structured interviews were used in data collection with the help of interview schedules. Two hundred and ninety-six (296) respondents were sampled using both probability and non probability techniques. Findings reveal that the use of the MHS is inadequate in relation to the WHO standards. Individual characteristics such as age, marital status and family size and the cost and time taken to a health facility were significantly associated with all the maternal health outcomes. Poor access to vehicles hindered women from delivery in a health institution and getting assistance from trained medical personnels. However, no significant association was established between education of respondents and the maternal health outcomes. It is recommended that the Ministry of Health engages in inter-sectoral collaboration to help ensure health equity.Effective integration of TBAs in providing care is needed to help improve utilisation of maternal services in rural areas

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

scholarly journals P10 Realist review linking political exposures to child and maternal health outcomes

2021 ◽  
Author(s):  
Maxwell Barnish ◽  
Si Ying Tan ◽  
Araz Taeihagh ◽  
Michelle Tørnes ◽  
Rebecca Nelson-Horne ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Outcomes ◽  
Realist Review ◽  
Maternal Health Outcomes ◽  
Child And Maternal Health
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