scholarly journals Characteristics of successful integrated family planning and maternal and child health services: Findings from a mixed-method, descriptive evaluation

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 229
Author(s):  
Anne Pfitzer ◽  
Christina Maly ◽  
Hannah Tappis ◽  
Mark Kabue ◽  
Devon Mackenzie ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Health Care Providers ◽  
Mixed Method ◽  
Physical Space ◽  
Health Facilities ◽  
Child Health Services ◽  
Care Providers ◽  
Cross Sectional ◽  
And Child Health

Background: Most postpartum women in low- and middle-income countries want to delay or avoid future pregnancies but are not using modern contraception. One promising strategy for increasing the use of postpartum family planning (PPFP) is integration with maternal, newborn and child health (MNCH) services. However, there is limited evidence on effective service integration strategies. We examine facilitators of and barriers to effective PPFP integration in MNCH services in Kenya and India.   Methods: We conducted a cross-sectional, mixed-method study in two counties in Kenya and two states in India. Data collection included surveying 215 MNCH clients and surveying or interviewing 82 health care providers and managers in 15 health facilities across the four sites. We analyzed data from each country separately. First, we analyzed quantitative data to assess the extent to which PPFP was integrated within MNCH services at each facility. Then we analyzed qualitative data and synthesized findings from both data sources to identify characteristics of well and poorly integrated facilities. Results: PPFP integration success varied by service delivery area, health facility, and country. Issues influencing the extent of integration included availability of physical space for PPFP services, health workforce composition and capacity, family planning commodities availability, duration and nature of support provided. Conclusions: Although integration level varied between health facilities, factors enabling and hindering PPFP integration were similar in India and Kenya. Better measures are needed to verify whether services are integrated as prescribed by national policies.

scholarly journals Characteristics of successful integrated family planning and maternal and child health services: Findings from a mixed-method, descriptive evaluation

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 229
Author(s):  
Anne Pfitzer ◽  
Christina Maly ◽  
Hannah Tappis ◽  
Mark Kabue ◽  
Devon Mackenzie ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Health Care Providers ◽  
Mixed Method ◽  
Physical Space ◽  
Health Facilities ◽  
Child Health Services ◽  
Care Providers ◽  
Cross Sectional ◽  
And Child Health

Background: Most postpartum women in low- and middle-income countries want to delay or avoid future pregnancies but are not using modern contraception. One promising strategy for increasing the use of postpartum family planning (PPFP) is integration with maternal, newborn and child health (MNCH) services. However, there is limited evidence on effective service integration strategies. We examine facilitators of and barriers to effective PPFP integration in MNCH services in Kenya and India.   Methods: We conducted a cross-sectional, mixed-method study in two counties in Kenya and two states in India. Data collection included surveying 215 MNCH clients and surveying or interviewing 82 health care providers and managers in 15 health facilities across the four sites. We analyzed data from each country separately. First, we analyzed quantitative data to assess the extent to which PPFP was integrated within MNCH services at each facility. Then we analyzed qualitative data and synthesized findings from both data sources to identify characteristics of well and poorly integrated facilities. Results: PPFP integration success varied by service delivery area, health facility, and country. Issues influencing the extent of integration included availability of physical space for PPFP services, health workforce composition and capacity, family planning commodities availability, duration and nature of support provided. Conclusions: Although integration level varied between health facilities, factors enabling and hindering PPFP integration were similar in India and Kenya. Better measures are needed to verify whether services are integrated as prescribed by national policies.

scholarly journals Impact of COVID-19 Pandemic on Utilization of Facility-Based Essential Maternal and Child Health Services in North Shewa Zone, Ethiopia

2022 ◽  
Author(s):  
Chalachew Bekele ◽  
Delayehu Bekele ◽  
Bezawit Hunegnaw ◽  
Kimiko Van Wickle ◽  
Fanos Ashenafi ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Child Health ◽  
Service Utilization ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Care Providers ◽  
New Family ◽  
And Child Health

Introduction: Ethiopia registered its first case of COVID-19 on March 13, 2020. We aimed to assess maternal, newborn, and child health care (MNCH) utilization during the first six months of the COVID-19 pandemic, as well as potential barriers and enablers of service utilization from health care providers and clients. Methods: Mixed study design was conducted as part of the Birhan Health and Demographic Surveillance System in Ethiopia. The trend of service utilization during the first six months of COVID-19 was compared to corresponding time and data points of the preceding year. Result: Service utilization of new family planning visits (43.2 to 28.5/month, p = 0.014) and sick under five child visits (225.0 to 139.8/month, P = 007) declined during the initial six months of the pandemic compared to the same period in the preceding year. Antenatal and postnatal care visits, facility delivery rates, and child routine immunization visits also decreased although this did not reach statistical significance. Interviews with health care providers and clients highlighted several barriers to service utilization during COVID-19, including fear of disease transmission, economic hardship, and transport service disruptions and restrictions. Enablers of service utilization included communities' decreased fear of COVID-19, and awareness-raising activities. Conclusion: Provision of essential MNCH services is crucial to ascertain favorable maternal and child health outcomes. In low- and middle-income country settings like Ethiopia, health systems might be fragile to withstand the caseloads and priority setting due to the pandemic. Our study presents early findings on the utilization of MNCH services that were maintained except sick child and new family planning visits. Government leaders, policy makers, and clinicians who wish to improve the resilience of their health system will need to continuously monitor service utilization and clients' evolving concerns during the pandemic to prevent increases in maternal and child morbidity and mortality.

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 Status of maternal and child health services amongst migrants in Ludhiana slums – how far from the MDG targets?

2017 ◽  
Vol 4 (4) ◽  
pp. 1188 ◽  
Author(s):  
Paramita Sengupta ◽  
Anoop I. Benjamin ◽  
Bontha V. Babu
Keyword(s):  
Health Care ◽  
Child Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Rural Areas ◽  
Immunization Coverage ◽  
Child Health Services ◽  
Care Providers ◽  
Cross Sectional ◽  
Pregnancy And Childbirth

Background: It is essential to monitor the coverage of health interventions in subgroups of populations, especially the marginalized and those at higher risk, because national averages can hide important inequalities. This study was carried out to find out the utilization and coverage of MCH services among migrants in the slums of Ludhiana, Punjab.Methods: Cross-sectional sample study.  370 women, who had childbirth within two years prior to the survey, were randomly selected from the 3947 newer migrant households in 30 slum settlements in Ludhiana surveyed for provision of health care, and information obtained from them with regard to MCH services availed by them for their last pregnancy and childbirth. Their children 12-23 months old, 195 in number, were studied for child health services.Results: Antenatal care (ANC) was availed by 44.0% of the women, with 24.6% of them going for minimum 4 antenatal visits and 29.1% having an institutional delivery but only 35.9% by trained health personnel. Place of delivery was found to be a significant predictor of antenatal care. Women staying in Ludhiana availed the least ANC. Complete immunization coverage in the 12-23 month olds was 37.4%. Government health worker visited 7.8% of the homes.Conclusions: Despite the relative proximity and concentration of health centers in urban compared to rural areas, migrant slum-dwellers are still not able to access quality MCH care. The problem of non-availability of essential healthcare and uneven distribution of skilled health care providers is the central challenge in meeting our health goals. 

scholarly journals FACILITY ASSESSMENT FOR MATERNAL AND CHILD HEALTH SERVICES IN BANGLADESH USING SERVICE AVAILABILITY AND READINESS ASSESSMENT (SARA) TOOL: A CROSS-SECTIONAL PILOT STUDY

2017 ◽  
Vol 3 (3) ◽  
pp. 77-88
Author(s):  
Afzal Aftab ◽  
Mehedi Hasan ◽  
Rahmatul Bari ◽  
Mohammad Didar Hossain ◽  
Mehadi Hasan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Health Facilities ◽  
Child Health Services ◽  
Service Availability ◽  
Readiness Assessment ◽  
Cross Sectional ◽  
And Child Health

Background: To initiate journey towards the Universal Health Coverage (UHC) it is essential to assess the health facilities. Unfortunately, no health facility assessment has been conducted in Bangladesh so far using “Service Availability and Readiness Assessment (SARA)” tool. Therefore, we aimed to conduct a pilot study to assess health facilities for maternal and child health services using SARA tool so that we can scale-up this assessment throughout the country later.Aim: We aimed to assess the health facilities for maternal and child health services in Tangail, Bangladesh using service availability and readiness assessment (SARA) tool.Methods: A cross-sectional pilot study was conducted in Bashail and Shokhipur Upazilla of Tangail district. A sample of 14 health facilities was assessed purposefully for data collection using a modified version of the SARA tool. Data was collected from November 01 to November 15, 2013, using paper-based questionnaire. Finally, following data collection, data were documented into Microsoft Excel by data collectors. Data were analyzed using Microsoft Excel, version 2010.Results: General service readiness has been segregated into five domains and their readiness scores were basic amenities (53.06%), basic equipment (83.33%), standard precautions for infection prevention (55.56%), and basic equipment (58.93%) for included health facilities. Similarly, specific service readiness includes family planning (48.15%), child immunization (67.71%), preventive and curative care (71.43%), and basic surgery (93.33%).Conclusion: Since we are moving towards UHC, it is essential to know the current scenario of health facilities. This pilot study reveals the strength and weakness of the health facilities in providing the maternal and child health services. These findings will help us to resolve all the identified gaps through proper planning and action.

scholarly journals Provision and Utilization of Health and Nutrition Services During the COVID-19 Pandemic in Urban Bangladesh

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 690-690
Author(s):  
Celeste Sununtnasuk ◽  
Phuong Nguyen ◽  
Anjali Pant ◽  
Lan Mai Tran ◽  
Shivani Kachwaha ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Care Providers ◽  
Health And Nutrition ◽  
Gates Foundation ◽  
And Child Health

Abstract Objectives The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake. Methods We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children < 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Results Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children). Conclusions Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute; and Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI Solutions.

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