scholarly journals Inferring antenatal care visit timing in low- and middle-income countries: Methods to inform potential maternal vaccine coverage

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237718
Author(s):  
Ranju Baral ◽  
Jessica Fleming ◽  
Sadaf Khan ◽  
Deborah Higgins ◽  
Nathaniel Hendrix ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Vaccine Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Low And Middle Income

scholarly journals Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jessica L. Watterson ◽  
Julia Walsh ◽  
Isheeta Madeka
Keyword(s):  
Systematic Review ◽  
Behavior Change ◽  
Antenatal Care ◽  
Postnatal Care ◽  
Health Workers ◽  
Review Of The Literature ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Mobile health (mHealth) technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients’, caretakers’, or health workers’ behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC), postnatal care (PNC), and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%,n=8) and most were conducted in African countries (80%,n=8). All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

scholarly journals Inequalities in Antenatal Care Coverage and Quality: an Analysis From 63 Low and Middle-income Countries Using the ANCq Content-qualified Coverage Indicator

2020 ◽  
Author(s):  
Luisa Arroyave ◽  
Ghada E Saad ◽  
Cesar G Victora ◽  
Aluisio J D Barros
Keyword(s):  
Antenatal Care ◽  
Urban Areas ◽  
Global Analysis ◽  
Socioeconomic Inequalities ◽  
Middle Income ◽  
National Surveys ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Difference ◽  
Low And Middle Income

Abstract Background: Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs.Methods: ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results: We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.Conclusions: Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

scholarly journals Identification of factors associated with stillbirth in Zimbabwe – a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kushupika Dube ◽  
Tina Lavender ◽  
Kieran Blaikie ◽  
Christopher J. Sutton ◽  
Alexander E. P. Heazell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Cross Sectional Study ◽  
Model Specification ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Low And Middle Income

Abstract Introduction 98% of the 2.6 million stillbirths per annum occur in low and middle income countries. However, understanding of risk factors for stillbirth in these settings is incomplete, hampering efforts to develop effective strategies to prevent deaths. Methods A cross-sectional study of eligible women on the postnatal ward at Mpilo Hospital, Zimbabwe was undertaken between 01/08/2018 and 31/03/2019 (n = 1779). Data were collected from birth records for maternal characteristics, obstetric and past medical history, antenatal care and pregnancy outcome. A directed acyclic graph was constructed with multivariable logistic regression performed to fit the corresponding model specification to data comprising singleton pregnancies, excluding neonatal deaths (n = 1734), using multiple imputation for missing data. Where possible, findings were validated against all women with births recorded in the hospital birth register (n = 1847). Results Risk factors for stillbirth included: previous stillbirth (29/1691 (2%) of livebirths and 39/43 (91%) of stillbirths, adjusted Odds Ratio (aOR) 2628.9, 95% CI 342.8 to 20,163.0), antenatal care (aOR 44.49 no antenatal care vs. > 4 antenatal care visits, 95% CI 6.80 to 291.19), maternal medical complications (aOR 7.33, 95% CI 1.99 to 26.92) and season of birth (Cold season vs. Mild aOR 14.29, 95% CI 3.09 to 66.08; Hot season vs. Mild aOR 3.39, 95% CI 0.86 to 13.27). Women who had recurrent stillbirth had a lower educational and health status (18.2% had no education vs. 10.0%) and were less likely to receive antenatal care (20.5% had no antenatal care vs. 6.6%) than women without recurrent stillbirth. Conclusion The increased risk in women who have a history of stillbirth is a novel finding in Low and Middle Income Countries (LMICs) and is in agreement with findings from High Income Countries (HICs), although the estimated effect size is much greater (OR in HICs ~ 5). Developing antenatal care for this group of women offers an important opportunity for stillbirth prevention.

scholarly journals Association of the quality of antenatal care with neonatal mortality: meta-analysis of individual participant data from 60 low- and middle-income countries

2019 ◽  
Vol 11 (6) ◽  
pp. 596-604 ◽  
Author(s):  
Subas Neupane ◽  
David Teye Doku
Keyword(s):  
Antenatal Care ◽  
Neonatal Mortality ◽  
Lower Risk ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractBackgroundWe investigated the quality of antenatal care (ANC) and its effect on neonatal mortality in 60 low- and middle-income countries (LMICs).MethodsWe used pooled comparable cross-sectional surveys from 60 LMICs (n=651 681). Cox proportional hazards multivariable regression models and meta-regression analysis were used to assess the effect of the quality of ANC on the risk of neonatal mortality. Kaplan–Meier survival curves were used to describe the time-to-event patterns of neonatal survival in each region.ResultsPooled estimates from meta-analysis showed a 34% lower risk of neonatal mortality for children of women who were attended to at ANC by skilled personnel. Sufficient ANC advice lowered the risk of neonatal mortality by 20%. Similarly, children of women who had adequate ANC had a 39% lower risk of neonatal mortality. The pooled multivariable model showed an association of neonatal mortality with the ANC quality index (HR 0.85, 95% CI 0.77 to 0.93).ConclusionsImprovement in the quality of ANC can reduce the risk of neonatal mortality substantially. Pursuing sustainable development goal 3, which aims to reduce neonatal mortality to 12 per 1000 live births by 2030, should improve the quality of ANC women receive in LMICs.

scholarly journals Cost-effectiveness of COVID-19 vaccination in low- and middle-income countries

2021 ◽  
Author(s):  
Mark J. Siedner ◽  
Christopher Alba ◽  
Kieran P. Fitzmaurice ◽  
Rebecca F. Gilbert ◽  
Justine A. Scott ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vaccine Coverage ◽  
Economic Benefits ◽  
Middle Income ◽  
Vaccination Programs ◽  
Middle Income Countries ◽  
One Year ◽  
The Cost ◽  
Benefits And Costs ◽  
Low And Middle Income

Despite the advent of safe and highly effective COVID-19 vaccines, pervasive inequities in global distribution persist. In response, multinational partners have proposed programs to allocate vaccines to low- and middle-income countries (LMICs). Yet, there remains a substantial funding gap for such programs. Further, the optimal vaccine supply is unknown and the cost-effectiveness of investments into global vaccination programs has not been described. We used a validated COVID-19 simulation model8 to project the health benefits and costs of reaching 20%-70% vaccine coverage in 91 LMICs. We show that funding 20% vaccine coverage over one year among 91 LMICs would prevent 294 million infections and 2 million deaths, with 26 million years of life saved at a cost of US$6.4 billion, for an incremental cost effectiveness ratio (ICER) of US$250/year of life saved (YLS). Increasing vaccine coverage up to 50% would prevent millions more infections and save hundreds of thousands of additional lives, with ICERs below US$8,000/YLS. Results were robust to variations in vaccine efficacy and hesitancy, but were more sensitive to assumptions about epidemic pace and vaccination costs. These results support efforts to fund vaccination programs in LMICs and complement arguments about health equity, economic benefits, and pandemic control11.

Sign in / Sign up

Export Citation Format

Share Document