Potential for reducing child and maternal mortality through reproductive and child health intervention programmes: An illustrative case study from India

2007 ◽  
Vol 21 (1) ◽  
pp. 13-44 ◽  
Author(s):  
Minja Kim Choe ◽  
Jiajian Chen
Author(s):  
Muhammad Atif Habib ◽  
Kirsten I. Black ◽  
Camille Raynes Greenow ◽  
Mushtaq Mirani ◽  
Sajid Muhammad ◽  
...  

Background: Pakistan is among the countries which have the highest maternal, neonatal and child mortality rates. Immediate efforts are required to enable Pakistan to achieve the health related sustainable development goals. The continuum of care interventions can substantially reduce the mortality burden, however local evidence to implement them is lacking in Pakistan. We implemented the maternal, neonatal and child health intervention package comprised of health facility strengthening, capacity building, continuum of care interventions and community mobilization and evaluated its effectiveness on maternal, neonatal and child health care practices and neonatal mortality.Methods: The intervention package was delivered through existing public health system in a rural district of Pakistan. We used a quasi-experimental design to assess the impact of interventions. Baseline and end line surveys were conducted and neonatal mortality was considered as the primary outcome measure. Data were analysed using bivariate and difference and difference analysis techniques.Results: We found a reduced risk of neonatal mortality (RR 0.704; 95% CI 0.557-0.889; p=0.0033), in intervention areas compared to control area. For secondary outcomes; including mortality for infants and under five children, antenatal care, skilled birth attendance, institutional deliveries, postnatal care, delayed bathing, inappropriate cord care practices, birth asphyxia, exclusive breastfeeding and immunization a significant difference (p<0.001) was observed in the intervention area compared to control area.Conclusions: This study provides local evidence from Pakistan that effective methods for delivering MNCH interventions within the existing health infrastructure can improve the MNCH outcomes especially in the rural areas.


Author(s):  
Andrea Felicetti

Resilient socioeconomic unsustainability poses a threat to democracy whose importance has yet to be fully acknowledged. As the prospect of sustainability transition wanes, so does perceived legitimacy of institutions. This further limits representative institutions’ ability to take action, making democratic deepening all the more urgent. I investigate this argument through an illustrative case study, the 2017 People’s Climate March. In a context of resilient unsustainability, protesters have little expectation that institutions might address the ecological crisis and this view is likely to spread. New ways of thinking about this problem and a new research agenda are needed.


Relay Journal ◽  
2020 ◽  
pp. 80-99
Author(s):  
Naoya Shibata

Although teaching reflection diaries (TRDs) are prevalent tools for teacher training, TRDs are rarely used in Japanese secondary educational settings. In order to delve into the effects of TRDs on teaching development, this illustrative case study was conducted with two female teachers (one novice, and one experienced) at a Japanese private senior high school. The research findings demonstrated that both in-service teachers perceived TRDs as beneficial tools for understanding their strengths and weaknesses. TRDs and class observations illustrated that the novice teacher raised their self-confidence in teaching and gradually changed their teaching activities. On the other hand, the experienced teacher held firm teaching beliefs based on their successful teaching experiences and were sometimes less willing to experiment with different approaches. However, they changed their teaching approaches when they lost balance between their class preparation and other duties. Accordingly, although teachers’ firm beliefs and successful experiences may sometimes become possible hindrances from using TRDs effectively, TRDs can be useful tools to train and help teachers realise their strengths and weaknesses.


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