Assessing individual factors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya.

Background: Globally, about 295,000 maternal deaths occurred in 2017 with Sub-Saharan Africa and Asia accounting for 86%. Sub-Saharan Africa alone accounted for nearly two-thirds. The rate of skilled birth attendant in Sub-African region stood at 59%. Three quarters of neonatal and maternal deaths occur outside hospital settings. Currently, the rate of maternal mortality in Kenya stands at 362 per 100,000 live births. Despite the deliberate government interventions to increase hospital deliveries, still a significant number of women deliver at home. The objective of this study was to assess the individual actors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya. Methods: This was a cross-sectional descriptive study adopting both quantitative and qualitative data collection methods. A total of 416 postnatal women were systematically sampled from households at a predetermined interval of four. Key informants interviews and focused group discussions provided additional qualitative data.Results: Approximately 56.7% of postnatal women in Marsabit County delivered in health facilities. Most individual factors such as decision maker (p=0.031), myths and misconceptions (p=0.025), reduction of complications (p=0.001), hospital delivery time consuming (p=0.023) and possession of medical insurance (p=0.001) were significantly associated with choice of place of delivery. Conclusions: Approximately 6 out 10 deliveries occur at health facilities in Marsabit County. Individual factors significantly influenced choice of place of delivery. There is need for the ministry of health, County Government of Marsabit and relevant stakeholders to demystify myths and misconceptions about hospital deliveries, scale up awareness on availability of Linda Mama medical cover for pregnant women to ensure easy access of hospital delivery services.

Download Full-text

Maintaining paediatric cardiac services during the COVID-19 pandemic in a developing country in sub-Saharan Africa: guidelines for a “scale up” in the face of a global “scale down”

Cardiology in the Young ◽

10.1017/s1047951120003650 ◽

2020 ◽

Vol 30 (11) ◽

pp. 1588-1594

Author(s):

Ogochukwu J. Sokunbi ◽

Ogadinma Mgbajah ◽

Augustine Olugbemi ◽

Bassey O. Udom ◽

Ariyo Idowu ◽

...

Keyword(s):

Scale Up ◽

Global Scale ◽

International Travel ◽

Sub Saharan Africa ◽

African Continent ◽

Tertiary Centre ◽

The Face ◽

Scale Down ◽

Sub Saharan ◽

International Experts

AbstractThe COVID-19 pandemic is currently ravaging the globe and the African continent is not left out. While the direct effects of the pandemic in regard to morbidity and mortality appear to be more significant in the developed world, the indirect harmful effects on already insufficient healthcare infrastructure on the African continent would in the long term be more detrimental to the populace. Women and children form a significant vulnerable population in underserved areas such as the sub-Saharan region, and expectedly will experience the disadvantages of limited healthcare coverage which is a major fall out of the pandemic. Paediatric cardiac services that are already sparse in various sub-Saharan countries are not left out of this downsizing. Restrictions on international travel for patients out of the continent to seek medical care and for international experts into the continent for regular mission programmes leave few options for children with cardiac defects to get the much-needed care.There is a need for a region-adapted guideline to scale-up services to cater for more children with congenital heart disease (CHD) while providing a safe environment for healthcare workers, patients, and their caregivers. This article outlines measures adapted to maintain paediatric cardiac care in a sub-Saharan tertiary centre in Nigeria during the COVID-19 pandemic and will serve as a guide for other institutions in the region who will inadvertently need to provide these services as the demand increases.

Download Full-text

Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

Global Implementation Research and Applications ◽

10.1007/s43477-021-00013-4 ◽

2021 ◽

Author(s):

Laura Ghiron ◽

Eric Ramirez-Ferrero ◽

Rita Badiani ◽

Regina Benevides ◽

Alexis Ntabona ◽

...

Keyword(s):

Family Planning ◽

Scale Up ◽

Scaling Up ◽

Sub Saharan Africa ◽

Health System Strengthening ◽

Country Level ◽

Look Ahead ◽

Republic Of The Congo ◽

Sub Saharan ◽

Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

Download Full-text

Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review

Journal of Diabetes Research ◽

10.1155/2018/9262395 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Bernardo Nuche-Berenguer ◽

Linda E. Kupfer

Keyword(s):

Systematic Review ◽

Health Systems ◽

Diabetes Care ◽

Healthcare Workers ◽

Scale Up ◽

Sub Saharan Africa ◽

Diagnostic Tools ◽

Inclusion Criteria ◽

Care Health ◽

Sub Saharan

Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA). Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed) to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

Download Full-text