scholarly journals Lessons for responding to COVID-19, from Exemplars in Under-five Mortality Reduction

2020 ◽  
Vol 4 ◽  
pp. 120
Author(s):  
Lisa R Hirschhorn ◽  
Nathaniel Gerthe ◽  
David E Phillips ◽  
Oliver Rothschild ◽  
Manpreet Singh ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Data Systems ◽  
Under Five ◽  
Success Stories ◽  
And Child Health

COVID-19 may not have the same direct effects on children as it does on older adults, but its indirect effects still pose a threat to child health, by disrupting delivery of routine health services like immunizations. This has happened during previous crises, and early indications point towards similar disruptions due to the coronavirus pandemic. To mitigate this, countries need to build resilient health systems capable of maintaining essential maternal and child health interventions, while also responding to COVID. How can this be accomplished? To find some answers, we can learn from countries in the past who improved health outcomes in the face of challenging circumstances. Specific to child health, countries with positive-outlier performance in reducing under-five mortality provide helpful strategies. These lessons include a clear national plan that drives rapid response, leveraging existing data systems to inform decision-making, engaging communities via community health workers, and focusing on equity. Today, countries around the world are facing the challenge of responding to the pandemic while building resilient health systems that continue to deliver invaluable maternal and child health services. Studying lessons from previous success stories can help inform the road ahead.

scholarly journals Pengaruh Pendidikan Kesehatan Tentang Deteksi Dini Perkembangan Anak Usia Balita Terhadap Peningkatan Pengetahuan dan Ketrampilan Ibu Dalam Melakukan Deteksi Dini Perkembangan Anak di Pusat Kesehatan Masyarakat Sikumana, Kota Kupang

2017 ◽  
Vol 15 (1) ◽  
pp. 1-13
Author(s):  
Agustina Agustina ◽  
Mariana Oni Betan
Keyword(s):  
Child Development ◽  
Health Education ◽  
Child Health ◽  
Early Detection ◽  
Health Services ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Children Under Five ◽  
Under Five ◽  
And Child Health

Early childhood is the "golden period" of child development, the window of opportunity and the critical period. This period is a sensitive period, a period of rapid and important growth and development. If there is a drift of growth and not detected early then it will affect the growth of the next flower (Siswanto, 2010). Based on data from East Nusa Tenggara Health Profile (2010), early detection in children under five in Kupang City was 1,506 children (9.3%) of 16,121 children under five. Research Ina A., 2014, in Kota Kupang, found 19 respondents experiencing development deviations. Existing phenomenon in the field rarely found early detection activities of child development in Maternal and Child Health Services. Assessment of progress with KPSP is easy to do as long as you know how. This study aims to analyze the influence of health education on early detection of the child under five development of children towards improving mother's knowledge and skill in early detection of child development, at Maternal and Child Health Services, health center of Sikumana, Kupang City ". This type of research is experimental with one group design pre-test and post-test design. The sample size was 44 people, ie 22 treatment and 22 no treatment. Random sampling. The results of this study indicate that there is an effect of health education on early detection of the development of children under five on improving mother's knowledge and skills in early detection of child development, in Maternal and Child Health Services Sikumana Health Center, Kupang City "with p = 0,000, for knowledge and p = 0,000 for skills.

scholarly journals Pelaksanaan Permainan Ular Tangga dalam Kelas Ibu Hamil

2020 ◽  
Vol 1 (1) ◽  
pp. 23-28
Author(s):  
Lisda Widianti Longgupa ◽  
Nurfatimah Nurfatimah ◽  
Nilda Yulita Siregar
Keyword(s):  
Child Health ◽  
Health Services ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Flip Chart ◽  
Post Test ◽  
And Child Health

The efforts to reduce maternal and infant mortality can be done by increasing the coverage and quality of maternal and child health services. One effort is made to bring health services closer to the community through the pregnant mothers class program. Pregnant woman class is a study group of pregnant women with gestational age between 4 weeks to 36 weeks with a maximum number of 10 participants. In this class, pregnant women will learn together, discuss and exchange experiences on overal maternal and child health, facilitated by midwives or health workers by using the class package for pregnant women, namely flip chart, guidelines for implementing classes of pregnant women,  class facilitator’s handbook pregnant women, exercise books for pregnant women  and books on maternal and child health (MCH). Based on the results of community service activities with participants of 40 pregnant women there was an increase in correct answers to all participants after participating in class activities for snakes ladderss of pregnant women. From the pre-test result it turns out that most of the results obtained were less than 60. This shows that the knowledge ability of pregnant women is still lacking. However, after holding the snakes ladder pregnant class, there was an increase in the knowledge of pregnant women with an increase in the post-test score point in the range between 21-30 (47.5%).

scholarly journals Assessment of gaps of knowledge and practices of frontline community workers in Chandragiri Mandal, Chittoor district, Andhra Pradesh: maternal and child health services

2021 ◽  
Vol 8 (3) ◽  
pp. 1299
Author(s):  
Shankar Reddy Dudala ◽  
Sathyendra Nath Ponna ◽  
Venkata Prasad Upadrasta ◽  
Hemalatha Bathina ◽  
Renuka Sadasivuni ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Vitamin A ◽  
Community Health ◽  
Maternal And Child Health ◽  
Andhra Pradesh ◽  
Health Workers ◽  
Child Health Services ◽  
Frontline Workers ◽  
And Child Health

Background: The undernutrition status among the vulnerable groups in rural areas still persists, despite provision of Anganwadi services in villages. Assessment knowledge and practices about maternal and child health services of frontline workers, will identify knowledge and implementation gaps. Objective was to assess the knowledge, attitude and practices of community health workers of maternal and child health services for identifying gaps for designing and implementing intervention.Methods: In this community based prospective, pre and post intervention-based study, Knowledge, Attitude and Practices (KAP) of the community health workers, in 16 villages and 13 Anganwadi centres of Chandragiri Mandal, Chittoor district, Andhra Pradesh about maternal and child health services were collected. The basic infrastructure of the anganwadis and health centres of Auxiliary nurse midwifes were assessed using a prevalidated survey instrument. Descriptive analysis was used.Results: The knowledge of antenatal and postnatal care was least among Anganwadi workers. Awareness regarding need of colostrum feeding was high in AWW compared to ASHA. ANM and AWW had lesser knowledge about duration of the exclusive breast feeding to the infant. Only 57.1% of ANM had sufficient knowledge about protein energy malnutrition consequences. AWW, ASHA did not have knowledge of vitamin A deficiency signs and symptoms although providing massive dose of vitamin A to children. ASHAs did not have awareness about anaemia and the knowledge was below 50% in ANMs.Conclusions: The study emphasizes the need for proper training with interactive sessions to these frontline workers, which will enhance their knowledge and skills for provision of quality services.

scholarly journals Barriers in utilization of maternal and child health services among Musahar in Dudhauli Municipality of Sindhuli district, Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Laxmi Gautam ◽  
Jwala Subedi
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Quantitative Methods ◽  
Health Workers ◽  
Child Health Services ◽  
Health Concern ◽  
P Value ◽  
And Child Health

Background: Maternal and Child Health remains a public health challenge in Nepal. This study explored information regarding barriers in the utilization of Maternal and Child Health services among women of Musahar community.Methods: A cross-sectional study was carried out in Dudhauli Municipality, Sindhuli using qualitative and quantitative methods. Qualitative data were obtained from, In Depth Interview among health workers and a Focus Group Discussion among FCHVs of Musahar community. Interview was carried out using questionnaire for quantitative study among 121 mothers of under 5 children. The data was analyzed using SPSS software version 21. Chi Square test was applied to test the associations while p value <0.05 was considered significant.Results: The average age and age at marriage of respondents were 24.6±5.7 years and 16.22±2.8 respectively, 76% were illiterate, 93.2% lies below poverty line and 73.6% were home maker. Among them, 29.8 did not have ANC while 47.1 had 4 or more ANC visits, 64.5% institutional delivery and 29.8% PNC visit. Social barriers and lack of information are major barriers contributing to more than half of no ANC visit and which contribute to >60% in case of PNC. Home delivery for first child was 56.2% while for last child was 33.9%. Almost 1/5th of the children were not vaccinated. Qualitative study identified social factors like negligence, family pressure, shyness, and unhealthy financial decisions as important barriers.Conclusions: Utilization of maternal and child health services was poor among Musahar mothers and children which indicates a serious public health concern.

scholarly journals Trust of community health workers influences the acceptance of community-based maternal and child health services

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Merridy Grant ◽  
Aurene Wilford ◽  
Lyn Haskins ◽  
Sifiso Phakathi ◽  
Ntokozo Mntambo ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Community Members ◽  
Community Based ◽  
Complex Relationships ◽  
And Child Health

Background: Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings.Aim: To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves.Setting: Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa.Methods: A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing.Results: Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW’s role; if they appeared to question the CHW’s competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community.Conclusion: Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

scholarly journals A retrospective study of the impact of health worker strikes on maternal and child health care utilization in western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael L. Scanlon ◽  
Lauren Y. Maldonado ◽  
Justus E. Ikemeri ◽  
Anjellah Jumah ◽  
Getrude Anusu ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Control Group ◽  
Western Kenya ◽  
The Impact ◽  
And Child Health ◽  
Risk Ratios

Abstract Background There have been dozens of strikes by health workers in Kenya in the past decade, but there are few studies of their impact on maternal and child health services and outcomes. We conducted a retrospective survey study to assess the impact of nationwide strikes by health workers in 2017 on utilization of maternal and child health services in western Kenya. Methods We utilized a parent study to enroll women who were pregnant in 2017 when there were prolonged strikes by health workers (“strike group”) and women who were pregnant in 2018 when there were no major strikes (“control group”). Trained research assistants administered a close-ended survey to retrospectively collect demographic and pregnancy-related health utilization and outcomes data. Data were collected between March and July 2019. The primary outcomes of interest were antenatal care (ANC) visits, delivery location, and early child immunizations. Generalized estimating equations were used to estimate risk ratios between the strike and control groups, adjusting for socioeconomic status, health insurance status, and clustering. Adjusted risk ratios (ARR) were calculated with 95% confidence intervals (95%CI). Results Of 1341 women recruited in the parent study in 2017 (strike group), we re-consented 843 women (63%) to participate. Of 924 women recruited in the control arm of the parent study in 2018 (control group), we re-consented 728 women (79%). Women in the strike group were 17% less likely to attend at least four ANC visits during their pregnancy (ARR 0.83, 95%CI 0.74, 0.94) and 16% less likely to deliver in a health facility (ARR 0.84, 95%CI 0.76, 0.92) compared to women in the control group. Whether a child received their first oral polio vaccine did not differ significantly between groups, but children of women in the strike group received their vaccine significantly longer after birth (13 days versus 7 days, p = 0.002). Conclusion We found that women who were pregnant during nationwide strikes by health workers in 2017 were less likely to receive WHO-recommended maternal child health services. Strategies to maintain these services during strikes are urgently needed.

scholarly journals Assessment of Maternal and Child Health Care Services Performance in The Context of COVID-19 Pandemic in Addis Ababa, Ethiopia: Evidence From Routine Service Data

2021 ◽  
Author(s):  
Senedu Bekele Gebreegziabher ◽  
Solomon Sisay Marrye ◽  
Tsegaye Hailu Kumssa ◽  
Kassa Haile Merga ◽  
Alemu Kibret Feleke ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Addis Ababa ◽  
Child Health Services ◽  
P Value ◽  
Health Management Information System ◽  
Under Five ◽  
And Child Health

Abstract Background In many settings, health care service provision has been modified to managing COVID-19 cases, and this has been affecting the provision of maternal and child health services. The aim of this study was to assess trends in selected maternal and child health services performance in the context of COVID-19 pandemic. Methods A cross-sectional data review was conducted in Addis Ababa, Ethiopia from April to May 2021. Routine health management information system database was reviewed from Addis Ababa Health Bureau for the period from July 2019 to March 2021 across all quarters. Proportions and mean with standard deviations were computed. T-test was used to assess statistically significant differences in services mean performance. Results PNC visit, new contraceptives accepters, safe abortion care and number of under-five years old children treated for pneumonia significantly decreased by 9.3% (p-value 0.04), 20.3% (p-value 0.004), 23.7% (p-value 0.01) and 77.2% (P-value < 0.001), respectively during the first eight months of the COVID-19 pandemic compared to the previous eight months’ average performance. The trends in ANC first visit, new contraceptive accepters, pentavalent-3 vaccination and under-five children treated for pneumonia began to decline between January-March 2020 when the COVID-19 pandemic began; with accelerated declines between April-June 2020 following national lockdown. The trends for the stated services began to increase during July-September 2020, during the last quarter of national lockdown. Contraceptive accepters and pentavalent-1 vaccination continued to decline and showed no recovery until January-March 2021when this study was completed. Conclusions Most of the maternal and child health services performance declined following the onset of COVID-19 pandemic and national lockdown, and most of the services began recovering during July-September 2020, the last quarter of national lockdown. However, new and repeat contraceptive accepters and pentavalent-1 recipients continue to decline and show no recovery during end of the study period. Implementing COVID-19 prevention measures and assuring the community about the safety of service delivery is imperative to ensure continuity of the maternal and child health services. Regular monitoring and evaluation of services performance is required to identify slowly recovering services and respond to potentially volatile changes during the COVID-19 pandemic.

scholarly journals The Effect of Accessibility on Performance of Maternal and Child Health Policy Implementation in East Nusa Tenggara Province, Indonesia

2019 ◽  
Vol 11 (11) ◽  
pp. 180
Author(s):  
Tat Florentianus ◽  
Bait M. Maria
Keyword(s):  
Child Health ◽  
Health Service ◽  
Health Services ◽  
Policy Implementation ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Service Accessibility ◽  
The Government ◽  
And Child Health

BACKGROUND: The fact shows that the performance of health service policy implementation from the output aspect (out put) and the outcome (out comes) policy has not been in line with expectations. This condition will also have a direct influence on the Human Development Index in East Nusa Tenggara Province, where the position of East Nusa Tenggara is still in the order of 32 out of 34 provinces in Indonesia, which ranges from 68.77. The main purpose of this study was to identify the health service accessibility in East Nusa Tenggara. Furthermore, this study also intended to find out the performance of policy implementation and was to identify the effect of accessibility of health sevices on the performance of policy implementation on mothers and children in East Nusa Tenggara. SUBJECT &amp; METHOD: This research is a quantitative study, conducted in 11 districts, 104 community healths services, and has 235 health workers as respondents in East Nusa Tenggara Province of Indonesia. RESULT: The results of the study on conditions of accessibility and networking in maternal and child health services in East Nusa Tenggara Province are still lacking (mean 2.7), meaning that conditions of accessibility in East Nusa Tenggara Province do not support the implementation of MCH policies. The performance of MCH policy implementation in East Nusa Tenggara Province is in the 3.36 category, meaning that the targets of MCH services that have been made have not been maximally realized. There is a correlation between accessibility conditions and the performance of MCH policy implementation (p = 0.00), the correlation coefficient of 0.429 shows that this correlation is quite strong, although not very strong. This correlation shows a positive relationship which means that if the accessibility conditions are easier, it will improve the performance of MCH policy implementation. The effect of accessibility on policy performance has been carried out partial linear regression test (t test), found t count = 19.0115 &gt; t table 1.97 means that there is a significant influence on the condition of accessibility to the performance of MCH policies in East Nusa Tenggara Province. CONCLUSION: Accessibility to health services in East Nusa Tenggara Province is still lacking, the policy implementation performance is good and there is a significant and positive influence between service accessibility and policy implementation performance. RECOMENDATION: The government is expected to be more serious in efforts to open the accessibility of health services and set more realistic targets that could be achieved.

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