scholarly journals Associations in the continuum of care for maternal, newborn and child health: a population-based study of 12 sub-Saharan Africa countries

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Patrick Opiyo Owili ◽  
Miriam Adoyo Muga ◽  
Yiing-Jenq Chou ◽  
Yi-Hsin Elsa Hsu ◽  
Nicole Huang ◽  
...  
Keyword(s):  
Child Health ◽  
Continuum Of Care ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Population Based Study ◽  
Newborn And Child Health ◽  
Sub Saharan ◽  
And Child Health ◽  
The Continuum

scholarly journals The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana

2018 ◽  
Vol 3 (4) ◽  
pp. e000786 ◽  
Author(s):  
Akira Shibanuma ◽  
Francis Yeji ◽  
Sumiyo Okawa ◽  
Emmanuel Mahama ◽  
Kimiyo Kikuchi ◽  
...  
Keyword(s):  
Child Health ◽  
Continuum Of Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Newborn And Child Health ◽  
Care Services ◽  
Women And Children ◽  
And Child Health ◽  
The Continuum

IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.

scholarly journals Large and persistent subnational inequalities in reproductive, maternal, newborn and child health intervention coverage in sub-Saharan Africa

2020 ◽  
Vol 5 (1) ◽  
pp. e002232 ◽  
Author(s):  
Cheikh Mbacké Faye ◽  
Fernando C Wehrmeister ◽  
Dessalegn Y Melesse ◽  
Martin Kavao Kavao Mutua ◽  
Abdoulaye Maïga ◽  
...  
Keyword(s):  
Child Health ◽  
Health Planning ◽  
Capital City ◽  
Sub Saharan Africa ◽  
High Coverage ◽  
Newborn And Child Health ◽  
Essential Interventions ◽  
Wide Range ◽  
Sub Saharan ◽  
And Child Health

Subnational inequalities have received limited attention in the monitoring of progress towards national and global health targets during the past two decades. Yet, such data are often a critical basis for health planning and monitoring in countries, in support of efforts to reach all with essential interventions. Household surveys provide a rich basis for interventions coverage indicators on reproductive, maternal, newborn and child health (RMNCH) at the country first administrative level (regions or provinces). In this paper, we show the large subnational inequalities that exist in RMNCH coverage within 39 countries in sub-Saharan Africa, using a composite coverage index which has been used extensively by Countdown to 2030 for Women’s, Children’s and Adolescent’s Health. The analyses show the wide range of subnational inequality patterns such as low overall national coverage with very large top inequality involving the capital city, intermediate national coverage with bottom inequality in disadvantaged regions, and high coverage in all regions with little inequality. Even though nearly half of the 34 countries with surveys around 2004 and again around 2015 appear to have been successful in reducing subnational inequalities in RMNCH coverage, the general picture shows persistence of large inequalities between subnational units within many countries. Poor governance and conflict settings were identified as potential contributing factors. Major efforts to reduce within-country inequalities are required to reach all women and children with essential interventions.

scholarly journals Level of completion along continuum of care for maternal, newborn and child health services and factors associated with it among women in India: a population-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ajinkya Kothavale ◽  
Trupti Meher
Keyword(s):  
Child Health ◽  
Neonatal Mortality ◽  
Maternal And Child Health ◽  
Continuum Of Care ◽  
Major Barrier ◽  
Newborn And Child Health ◽  
Factors Associated ◽  
Women In India ◽  
And Child Health ◽  
The Continuum

Abstract Background India, being a developing country, presents a disquiet picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal mortality could be avoided if the continuum of care (CoC) is provided in a structured pathway from pregnancy to the postpartum period. Therefore, this article attempted to address the following research questions: What is the level of completion along CoC for MNCH services? At which stage of care do women discontinue taking services? and what are the factors affecting the continuation in receiving maternal, newborn and child health (MNCH) services among women in India? Methods The study utilized the data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. The analysis was limited to 107,016 women aged 15–49 who had given a live birth in the last 5 years preceding the survey and whose children had completed 1 year. Four sequential fixed effect logit regression models were fitted to identify the predictors of completion of CoC. Results Nearly 39% of women in India had completed CoC for maternal and child health by receiving all four types of service (antenatal care, institutional delivery, post-natal care and full immunization of their child), with substantial regional variation ranging from 12 to 81%. The highest number of dropouts in CoC were observed at the first stage with a loss of nearly 38%. Further, education, wealth index, and health insurance coverage emerged as significant factors associated with CoC completion. Conclusion The major barrier in achieving CoC for maternal and child health is the low utilization of ANC services in the first stage of the continuum and hence should be addressed for increasing CoC completion rate in the country. The gaps across all the levels of CoC indicate a need for increased focus on the CoC approach in India. A strategy should be developed that will connect all the components of MNCH avoiding dropouts and the MNCH provision should be standardized to provide services to every woman and child.

scholarly journals Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?

2019 ◽  
Vol 4 (Suppl 4) ◽  
pp. e001300 ◽  
Author(s):  
Ties Boerma ◽  
Hannah Tappis ◽  
Ghada Saad-Haddad ◽  
Jai Das ◽  
Dessalegn Y Melesse ◽  
...  
Keyword(s):  
Child Health ◽  
Child Growth ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Newborn And Child Health ◽  
National Surveys ◽  
Sub Saharan ◽  
National Trends ◽  
The Impact ◽  
And Child Health

Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990–2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality in children under 5 years in comparison with subregional trends. The surveys provide substantive evidence of a negative association between levels and trends in national indicators of RMNCH service coverage, child growth and under-5 mortality with armed conflict, with some notable exceptions. National surveys are an important source of data to assess the longer term national consequences of conflicts for RMNCH in most countries, despite limitations due to sampling and timing of the surveys.

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