scholarly journals Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000–2019

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003810
Author(s):  
Mohammed Jawad ◽  
Thomas Hone ◽  
Eszter P. Vamos ◽  
Valeria Cetorelli ◽  
Christopher Millett
Keyword(s):  
Child Health ◽  
Vaccination Coverage ◽  
Maternal And Child Health ◽  
Armed Conflict ◽  
Skilled Birth Attendant ◽  
Live Births ◽  
Measles Vaccination ◽  
And Child Health ◽  
Excess Deaths ◽  
Measles Vaccination Coverage

Background Armed conflicts have major indirect health impacts in addition to the direct harms from violence. They create enduring political instability, destabilise health systems, and foster negative socioeconomic and environmental conditions—all of which constrain efforts to reduce maternal and child mortality. The detrimental impacts of conflict on global maternal and child health are not robustly quantified. This study assesses the association between conflict and maternal and child health globally. Methods and findings Data for 181 countries (2000–2019) from the Uppsala Conflict Data Program and World Bank were analysed using panel regression models. Primary outcomes were maternal, under-5, infant, and neonatal mortality rates. Secondary outcomes were delivery by a skilled birth attendant and diphtheria, pertussis, and tetanus (DPT) and measles vaccination coverage. Models were adjusted for 10 confounders, country and year fixed effects, and conflict lagged by 1 year. Further lagged associations up to 10 years post-conflict were tested. The number of excess deaths due to conflict was estimated. Out of 3,718 country–year observations, 522 (14.0%) had minor conflicts and 148 (4.0%) had wars. In adjusted models, conflicts classified as wars were associated with an increase in maternal mortality of 36.9 maternal deaths per 100,000 live births (95% CI 1.9–72.0; 0.3 million excess deaths [95% CI 0.2 million–0.4 million] over the study period), an increase in infant mortality of 2.8 per 1,000 live births (95% CI 0.1–5.5; 2.0 million excess deaths [95% CI 1.6 million–2.5 million]), a decrease in DPT vaccination coverage of 4.9% (95% CI 1.5%–8.3%), and a decrease in measles vaccination coverage of 7.3% (95% CI 2.7%–11.8%). The long-term impacts of war were demonstrated by associated increases in maternal mortality observed for up to 7 years, in under-5 mortality for 3–5 years, in infant mortality for up to 8 years, in DPT vaccination coverage for up to 3 years, and in measles vaccination coverage for up to 2 years. No evidence of association between armed conflict and neonatal mortality or delivery by a skilled birth attendant was found. Study limitations include the ecological study design, which may mask sub-national variation in conflict intensity, and the quality of the underlying data. Conclusions Our analysis indicates that armed conflict is associated with substantial and persistent excess maternal and child deaths globally, and with reductions in key measures that indicate reduced availability of organised healthcare. These findings highlight the importance of protecting women and children from the indirect harms of conflict, including those relating to health system deterioration and worsening socioeconomic conditions.

scholarly journals Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010

2018 ◽  
Vol 3 (2) ◽  
pp. e000674 ◽  
Author(s):  
Dana R Thomson ◽  
Cheryl Amoroso ◽  
Sidney Atwood ◽  
Matthew H Bonds ◽  
Felix Cyamatare Rwabukwisi ◽  
...  
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Health System ◽  
Population Health ◽  
Maternal And Child Health ◽  
Rural Areas ◽  
Health System Strengthening ◽  
Live Births ◽  
Intervention Area ◽  
And Child Health

IntroductionAlthough Rwanda’s health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.MethodsCombining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.ResultsOverall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.ConclusionWe observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.

High coverage of vitamin A supplementation and measles vaccination during an integrated Maternal and Child Health Week in Sierra Leone

2014 ◽  
Vol 7 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Fatmata F. Sesay ◽  
Mary H. Hodges ◽  
Habib I. Kamara ◽  
Mohamed Turay ◽  
Adam Wolfe ◽  
...  
Keyword(s):  
Child Health ◽  
Vitamin A ◽  
Sierra Leone ◽  
Maternal And Child Health ◽  
High Coverage ◽  
Vitamin A Supplementation ◽  
Measles Vaccination ◽  
And Child Health

scholarly journals Analysis of Maternal and Child Health Indicators in an Area at Paraná State, Brazil

2013 ◽  
Vol 2013 ◽  
pp. 1-9
Author(s):  
Emiliana Cristina Melo ◽  
Ana Beatriz Guedes Ribeiro ◽  
Rosana Rosseto de Oliveira ◽  
Robsmeire Calvo Melo Zurita ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Skin Color ◽  
Health Indicators ◽  
Infant Mortality Rate ◽  
Live Births ◽  
Pregnancy And Delivery ◽  
The Mean ◽  
Information Database ◽  
And Child Health

The aim of this study was to analyze maternal and child health indicators and infant mortality rate (IMR) at the cities located at the 18th Health Division (HD) in Parana State, Brazil. In this ecological study we analyzed all live births and infant deaths which occurred from 2000 to 2009 at the 18th HD, collecting data from the Mortality Information Database and the Live Births Information Database. The variables assessed were grouped into maternal, pregnancy and delivery, and neonatal variables. The analysis was conducted using the mean percentage of each variable and the IMR calculated for both periods: from 2000 to 2004 and from 2005 to 2009. The IMR was reduced considerably, following Brazil's and Paraná State's trend. Maternal indicators went down regarding the mean percentage of teenage mothers and low education, whereas they went up regarding mother with 35 years old or older and mothers without a partner. Pregnancy indicators showed increased prematurity and cesarean birth. Neonatal indicators raised in black/brown skin color and low birth weights percentages. This study provides a better understanding of maternal and child health in the cities located at the 18th HD, supplying grounds to plan actions regarding the real needs of each specific city.

scholarly journals 1421Effects of the Colombian armed conflict on reproductive, maternal and child health

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Isabel Garcés-palacio ◽  
Mary Salazar-Barrientos ◽  
Edison Bedoya Bedoya ◽  
Ana Langer
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Maternal And Child Health ◽  
Armed Conflict ◽  
Maternal Mortality Ratio ◽  
Secondary Analysis ◽  
Health Indicators ◽  
Internally Displaced ◽  
And Child Health ◽  
Victimization Rates

Abstract Background Colombia has been affected by internal armed conflict for 70 years. About 7.3 million people have been internally displaced and nearly 50% of them were women. In conflict-afflicted areas, pregnant women and newborns have higher rates of adverse health outcomes. Methods Secondary analysis of public databases. We examined sixteen indicators from the Countdown to 2030 initiative, for which data from Colombia were available and reliable between 1998 and 2016. We also constructed a variable (victimization rate) to measure the intensity of the conflict for each municipality/year and grouped them into quintiles. We compared relative differences and confidence intervals using the Rothman and Greenland method. Results Across time, most indicators improved in all municipalities. However, four indicators were significantly different between municipalities with high versus low victimization rates. The maternal mortality ratio was higher in the municipalities with higher victimization rates in the periods 1998-2004, 2005-2011 and 2012-2016. The percentages of caesarean births and women who received four or more antenatal care visits were lower in settings with highest levels of victimization (1998-2000,) while the fertility rate among women 15-19 years old was higher in those municipalities between 2012 and 2016. Conclusions In Colombia, several maternal and child health indicators have improved during the years of the conflict; however, municipalities most affected by the armed conflict had poorer reproductive and maternal health outcomes. Key messages Maternal and reproductive health were negatively affected by protracted armed conflict in Colombia.

scholarly journals The Availability of Health Resources on the Performance of Maternal and Child Health Policy Implementation in East Nusa Tenggara

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Florentianus Tat ◽  
Irfan Irfan ◽  
Maria Magdalena Bait
Keyword(s):  
Health Policy ◽  
Child Health ◽  
Policy Implementation ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Health Resources ◽  
Live Births ◽  
Child Health Policy ◽  
Health Policy Implementation ◽  
And Child Health

Maternal and child health problems continue to be priority health issues in Indonesia, especially in East Nusa Tenggara (NTT). The maternal mortality rate in NTT has reached 159/100,000 live births, while infant and under-five mortality rates have reached 32/1000 live births and 40/1,000 live births, respectively above the national value of 23/1000 live births and 32/1,000 live births. It indicates that the health and maternal and child health policies in NTT have not been maximally implemented. One of the causes is the lack of available health worker resources that provide health services. The research objective is to identify the effect of health resources' availability on the performance of maternal and child health policy implementation in NTT. A quantitative research method for data collection was carried out in 11 districts in NTT and 104 public health centers (pusat kesehatan masyarakat, puskesmas) towards 235 health workers from August to December 2019. The results show that the health workers were categorized as insufficient/not available (mean value of 2.64), and puskemas did not have doctors, midwives, and nurses conforming to standards. There was also inadequacy in some aspects such as budget (average value of 2.45), medical devices (average value of 2.75), medicines and medical supplies, buildings, and transport. A correlation was found between resources and the performance of maternal and child health policies (p=0.00) with a coefficient correlation of 0.546. It indicates a strong and positive correlation, which means that if there is an increase in resources, maternal and child health policy implementation will also. Partial linear regression tests showed t arithmetic=13.304 >t table 1.97, which means that H0 was rejected. It suggests a significant effect between resources and the performance of maternal and child health policy implementation in NTT. In conclusion, resources had a positively significant impact on the performance of maternal and child health policy in NTT. PENGARUH KETERSEDIAAN SUMBER DAYA KESEHATAN TERHADAP KINERJA IMPLEMENTASI KEBIJAKAN KESEHATAN IBU DAN ANAK DI NUSA TENGGARA TIMURPermasalahan kesehatan ibu dan anak (KIA) terus menjadi prioritas masalah kesehatan di Indonesia khususnya di Nusa Tenggara Timur (NTT). Angka kematian ibu di NTT mencapai 159/100.000 kelahiran hidup (KH), sedangkan angka kematian bayi dan balita mencapai 32/1.000 KH dan 40/1.000 KH yang masing-masing di atas nilai nasional, yaitu 23/1.000 KH dan 32/1.000 KH. Kondisi tersebut mengindikasikan bahwa penerapan kebijakan KIA di NTT belum dilaksanakan secara maksimal. Salah satu penyebabnya adalah sumber daya manusia kesehatan yang memberikan pelayanan kesehatan kurang tersedia. Tujuan penelitian adalah mengidentifikasi pengaruh ketersediaan sumber daya manusia kesehatan terhadap kinerja penerapan kebijakan KIA di NTT. Metode penelitian adalah kuantitatif. Pengumpulan data dilakukan di 11 kabupaten dan 104 pusat kesehatan masyarakat (puskesmas) pada 235 tenaga kesehatan dari bulan Agustus hingga Desember 2019. Hasil penelitian menunjukkan bahwa tenaga kesehatan dikategorikan tidak cukup/tidak tersedia (nilai rerata 2,64) dan puskesmas tidak memiliki dokter, bidan, dan perawat sesuai standar. Selain itu, terdapat juga kekurangan di beberapa aspek seperti anggaran biaya (nilai rerata 2,45), alat kesehatan (nilai rerata 2,75), obat dan perbekalan kesehatan, alat medis, bangunan, serta alat transportasi. Korelasi ditemukan antara sumber daya dan kinerja penerapan kebijakan KIA (p=0,00) dengan koefisien korelasi 0,546. Hal ini berarti korelasi cukup kuat dan positif, artinya jika sumber daya ditingkatkan maka kinerja implementasi kebijakan KIA juga meningkat. Uji regresi linier parsial menunjukkan t hitung=13,304 >t tabel 1,97 yang bermakna H0 ditolak. Hal ini menunjukkan pengaruh yang signifikan antara sumber daya dan kinerja penerapan kebijakan KIA di Provinsi NTT. Simpulan, sumber daya berpengaruh signifikan positif terhadap kinerja penerapan kebijakan KIA di NTT.

scholarly journals Association of maternal and child health related variables with decline in infant mortality rate in Punjab, India

2017 ◽  
Vol 4 (12) ◽  
pp. 4558
Author(s):  
Harjot Kaur ◽  
Tarundeep Singh ◽  
PVM Lakshmi
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Infant Mortality ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Infant Mortality Rate ◽  
Rapid Decline ◽  
Live Births ◽  
Children Ever Born ◽  
And Child Health

Background: Infant mortality rate (IMR) is a sensitive indicator for monitoring child health and survival. Punjab state in North India is performing better than most of the other states in various health indicators. Punjab’s IMR has shown a rapid decline from 38/1000 live births in 2008 (Sample registration system (SRS) 2008) to 24/1000 live births in 2014 (SRS 2014). This study was planned to assess which of the maternal and child health services is associated with rapid decline in infant mortality rate. Methods: Association between various components of prenatal care, intranatal care and postnatal care, and child healthcare and socio demographic variables (taken from secondary data of District Level Household Surveys) and Infant Mortality Rate (taken from SRS) of Punjab was studied. Spearman correlation coefficient was calculated to measure the association between the variables. Results: Total fertility rate (TFR), women who had institutional deliveries, safe deliveries and mean children ever born are statistically significantly associated with decline in infant mortality rate. Conclusions: In Punjab, maternal and child health indicators are directly or indirectly associated with decline in infant mortality rate. Findings of the study demonstrate that the recent rapid decline in IMR of Punjab is strongly associated with increase in institutional deliveries and decline in TFR and the mean number of children ever born. 

scholarly journals Comparison of Maternal and Child Health Statistics between South and North Korea

2020 ◽  
Vol 24 (3) ◽  
pp. 170-180
Author(s):  
Jeong Min Lee ◽  
Chae Young Kim ◽  
Sung-Hoon Chung ◽  
Yong-Sung Choi ◽  
Chong-Woo Bae
Keyword(s):  
Health Status ◽  
Child Health ◽  
United Nations ◽  
Maternal And Child Health ◽  
North Korea ◽  
Mortality Rates ◽  
Female Population ◽  
Live Births ◽  
The Impact ◽  
And Child Health

Purpose: This study aimed to investigate the extent of the difference in health status between South Korea (SK) and North Korea (NK) by comparing indicators relevant to maternal and child health.Methods: The maternal and child health status of SK and NK considering population, birth, and mortality was reviewed using 2 Korean statistics, United Nations Children’s Fund, and United Nations databases from 1950 to 2017.Results: The annual number of total live births in SK had decreased from 1,006,600 in 1970 to 326,900 in 2018, and that in NK had declined from 530,000 in 1970 to 360,000 in 2015. The percentage of children among the total population was higher in NK than in SK, and the decrease in the percentage of children in SK is remarkable, which is related to a low fertility rate in the last few decades. However, the mortality rates related to children were higher in NK than in SK. In 2017, neonatal mortality rates (per 1,000 live births) in SK and NK were 1.5 and 9.0, respectively. The fertile female population of SK and NK in 2015 was 50.2% and 52.0%, respectively, and SK and NK’s aging index (%) in 2017 was 107.3 and 46.1, respectively.Conclusion: This study shows the different population distributions and maternal and child health statuses between SK and NK, which may have a negative impact on social integration after reunification. Therefore, it is important to understand the indicators of maternal and child health to become the powerbase of efficient healthcare system integration by minimizing the impact at the beginning of the reunification.

scholarly journals Scoping review protocol on maternal, newborn and child health research in Ethiopia

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e034307
Author(s):  
Grace J Chan ◽  
Misrak Getnet ◽  
Ronke Olowojesiku ◽  
Thein Min-Swe ◽  
Bezawit Hunegnaw ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Maternal And Child Health ◽  
Scoping Review ◽  
Health Research ◽  
Newborn And Child Health ◽  
Live Births ◽  
Review Protocol ◽  
Child Health Research ◽  
And Child Health

IntroductionThere has been a tremendous reduction in maternal and child mortality in the last decade. However, a significant number of deaths still occur disproportionately in low-income country settings. Ethiopia is the second-most populous nation in sub-Saharan Africa with a high maternal mortality rate of 412 deaths per 100 000 live births and an under-five mortality rate of 55 per 1000 live births. This study presents a scoping review protocol to describe the current knowledge of maternal and child health in Ethiopia to identify gaps for prioritisation of future maternal, newborn and child health research.Methods and analysesA search strategy will be conducted in PubMed/MEDLINE, EMBASE and the WHO African Index Medicus. Researchers will independently screen title and abstracts followed by full texts for inclusion. Study characteristics, research topics, exposures and outcomes will be abstracted from articles meeting inclusion criteria using standardised forms. Descriptive analysis of abstracted data will be conducted.Ethics and disseminationData will be abstracted from published manuscripts and no additional ethical approval is required. The results of the review will be shared with maternal and child health experts in Ethiopia through stakeholder meetings to prioritise research questions. Findings will be submitted to a peer-reviewed journal for publication, in addition to national-level and global-level disseminations.

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