Mapping maternal and newborn healthcare access in West African Countries

Abstract Background: The Sustainable Development Goal (SDG) three emphasizes the need to improve maternal and newborn health, and reduce global maternal mortality ratio to less than 70 per 100 000 live births by 2030. Achieving the SDG goal 3.1 target will require evidence based data on concealed inequities in the distribution of maternal and child health outcomes and their linkage to healthcare access. The objectives of this study were to estimate the number of women of reproductive age, pregnancies and live births at subnational level using high resolution maps and to quantify the number of pregnancies within user-defined distances or travel times of a health facility in three poor resource West African countries: Mali, Guinea and Liberia. Methods: The maternal and newborn health outcomes were estimated and mapped for the purpose of visualization using geospatial analytic tools. Buffer analysis was then performed to assess the proximity of pregnancies to health facilities with the aim of identifying pregnancies with inadequate access (beyond 50km) to a health facility. Results: Results showed wide variations in the distribution of maternal and newborn health outcomes across the countries of interest and districts of each of the countries. There was also clustering of health outcomes and health facilities at the urban capital cities of Bamako, Conakry, and Greater Monrovia. Conclusion: To bridge the gap in inequity in healthcare access, and improve maternal and newborn health in the study countries, there is need for equitable distribution of human resources and infrastructure within and across the various districts.

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Mapping maternal and newborn healthcare access in West African Countries

10.21203/rs.2.11583/v1 ◽

2019 ◽

Author(s):

Dorothy Ononokpono ◽

Bernard Baffour ◽

Alice Richardson

Keyword(s):

Health Outcomes ◽

Health Facility ◽

Healthcare Access ◽

Newborn Health ◽

West African ◽

Health Facilities ◽

Maternal And Newborn Health ◽

African Countries ◽

Live Births ◽

Maternal And Newborn

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Assessment of Women’s Experience of Care during Childbirth for Quality Improvement at Level 5 Health Facilities in Bungoma County, Kenya

East African Journal of Health and Science ◽

10.37284/eajhs.5.1.521 ◽

2022 ◽

Vol 5 (1) ◽

pp. 1-18

Author(s):

Lucy Natecho Namusonge ◽

Maximilla N. Wanzala ◽

Edwin K. Wamukoya

Keyword(s):

Maternity Care ◽

Newborn Health ◽

Health Facilities ◽

Respectful Maternity Care ◽

Maternal And Newborn Health ◽

Disrespect And Abuse ◽

Live Births ◽

Experience Of Care ◽

Maternal And Newborn

High maternal and newborn mortality is a pressing problem in developing countries. Poor treatment during childbirth contributes directly and indirectly to this problem. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya, 20% of women report having experienced some form of disrespect and abuse (D&A). Bungoma County is among the 15 counties with the worst maternal and newborn health statistics in Kenya. The maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births, while skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&A, limited formal research on respectful maternity care. The study aimed at assessing women’s experience of care during childbirth at Level 5 health facilities in Bungoma County. The specific objectives were to determine the women’s experiences of care during childbirth, to determine factors contributing to disrespect and abuse during childbirth and to identify strategies for addressing issues affecting respectful maternity care for promoting quality of maternal and newborn care. A cross-sectional descriptive study design was used. It involved 360 mothers. Analysis of quantitative data was done using SPSS. Descriptive statistics were presented in graphs, tables, frequencies and percentages. Qualitative data was analysed thematically. The prevalence of D&A was 42.2%, younger age and lower education aggravated D&A. Autonomy, privacy and confidentiality, and absence of birth companionship were major aspects of D&A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationships were factors leading to D&A. It was concluded that there is a need for increased incorporation of Respectful Maternity Care (RMC) in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritising policy actions for improving the quality of maternal and newborn health outcomes and indicators.

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The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study

10.21203/rs.3.rs-27919/v3 ◽

2020 ◽

Author(s):

Duncan Ndombi Shikuku ◽

Geofrey Tanui ◽

Mercy Wabomba ◽

Dennis Wanjala ◽

Josephine Friday ◽

...

Keyword(s):

Health Service ◽

Health Service Utilization ◽

Newborn Health ◽

Significant Decline ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Monthly Average ◽

Quasi Experimental ◽

Time Periods ◽

Maternal And Newborn

Abstract Background: Poor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers' strikes in rural Kenya. Methods: The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods: December 2016-February 2017 when doctors were on strike (P1), March-May 2017 when no healthcare providers were on strike (P2), and June-October 2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies/means of maternal and newborn health service utilization data across the three periods. Results: The monthly average number of clients obtaining services from CMs across the three time periods was: first antenatal care (ANC) (P1-1.8, P2-2.3, P3-9.9), fourth ANC (P1-1.4, P2-1.0, P3-7.1), skilled birth (P1-1.5, P2-1.7, P3-13.1) and the differences in means were statistically significant (p<0.05). Over the period, the monthly average number of clients obtaining services from health facilities was: first ANC (P1-55.7, P2-70.8, P3-4.0), fourth ANC (P1-29.6, P2-38.1, P3-1.2) and skilled birth (P1-63.1, P2-87.4, P3-5.6), p<0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p>0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3 accompanied by a statistically significant decline in the average number of clients obtaining services from health facilities (p<0.05). First ANC increased by 68%, fourth ANC by 75%, skilled births by 68%, and postnatal care by 33% in P3 (p<0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3. Conclusions: The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.

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Quality of Maternal and Newborn Health Care in Ethiopia: A Cross-Sectional Study

10.21203/rs.3.rs-141660/v1 ◽

2021 ◽

Author(s):

Abera Biadgo ◽

Aynalem Legesse ◽

Abiy Seifu ◽

Kavita Singh ◽

Zewdie Mulissa ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Newborn Health ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Neonatal Health ◽

Input Process ◽

Maternal And Neonatal Health ◽

Maternal And Newborn

Abstract Background: Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia.Methodology: This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Microsoft Excel and exported to STATA for analysis. Descriptive analysis results are presented in texts, tables and graphs. Quality of maternal and neonatal health care was measured by input, process and outputs components. The components were developed by computing scores using standards used to measure the three components of the quality of maternal and neonatal health care.Result: The study was done in a total of 32 health facilities: 5 hospitals and 27 health centers in four regions. The study revealed that the average value of the quality of the maternal and neonatal health care input component among health facilities was 62%, while the quality of the process component was 43%. The quality of the maternal and neonatal health output component was 48%. According to the standard cut-off point for MNH quality of care, only 5 (15.6%), 3 (9.3%) and 3 (10.7%) of health facilities met the expected input, process and output maternal and neonatal health care quality standards, respectively.Conclusion: This study revealed that the majority of health facilities did not meet the national MNH quality of care standards. Focus should be directed towards improving the input, process and output standards of the maternal and neonatal health care quality, with the strongest focus on process improvement.

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Training Needs Assessment of Health Care Professionals in Reproductive, Maternal and Newborn Health in a Low-Income Setting in Tanzania

10.21203/rs.3.rs-115748/v2 ◽

2021 ◽

Author(s):

Columba Mbekenga ◽

Eunice Pallangyo ◽

Tumbwene E. Mwansisya ◽

Kahabi Isangula ◽

Loveluck Mwasha ◽

...

Keyword(s):

Health Care ◽

Needs Assessment ◽

Low Income ◽

Newborn Health ◽

Training Needs ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Training Needs Assessment ◽

Low Income Setting ◽

Maternal And Newborn

Abstract Background: Healthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular. However, under-investment in adequate training and capacity development among health care workers (HCWs) is reported worldwide and contributes to the critical shortages, and lack of adequate knowledge and skills among HCWs. The aim of this study was to assess the training needs among HCWs of RMNH care in selected health facilities of Mwanza, Tanzania. Methods: A cross-sectional descriptive and analytic survey using a self- administered questionnaire was conducted in 36 out of 80 health care facilities included in Improving Access to Reproductive, Maternal and Newborn Health in Mwanza, Tanzania (IMPACT) project within the 8 councils of Mwanza region in Tanzania. The training needs assessment (TNA) tool adapted from the Hennessy-Hicks’ Training Needs Assessment Questionnaire (TNAQ) was used for data collection. The HCWs rated on the importance of their task and their current performance of the task. The differences in scores were calculated to identify the greatest training needs.Results: Out of 153 HCWs who responded to the TNA questionnaire, majority were registered (n=62) and enrolled (n=43) nurses. Ninety percent (n= 137) were from government-owned health facilities, mostly from hospitals 68 (45%). Training needs were high in 16 areas (out of 49) including cervical cancer screening and care; accessing research resources; basic and comprehensive emergency obstetric and newborn care; and sexual and gender-based violence. The overall perceived importance of the training needs was significantly associated with perceived performance of tasks related to RMNH services (Pearson Correlation (r) = .256; p <001).Conclusions: The study highlights 16 (out of 49) training gaps as perceived by HCWs in RMNH in Tanzania. The utilization of findings from the TNA has great potential to facilitate designing of effective trainings for local RMNH services delivery hence improve the overall quality of care.

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Correction: Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries

PLoS ONE ◽

10.1371/journal.pone.0164519 ◽

2016 ◽

Vol 11 (10) ◽

pp. e0164519 ◽

Cited By ~ 2

Author(s):

Corrine W. Ruktanonchai ◽

Nick W. Ruktanonchai ◽

Andrea Nove ◽

Sofia Lopes ◽

Carla Pezzulo ◽

...

Keyword(s):

Newborn Health ◽

Maternal And Newborn Health ◽

East African ◽

African Countries ◽

Geographic Disparities ◽

Maternal And Newborn

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Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan

Health Research Policy and Systems ◽

10.1186/s12961-015-0041-8 ◽

2015 ◽

Vol 13 (S1) ◽

Cited By ~ 6

Author(s):

Shehla Zaidi ◽

Atif Riaz ◽

Fauziah Rabbani ◽

Syed Iqbal Azam ◽

Syeda Nida Imran ◽

...

Keyword(s):

Health Services ◽

Newborn Health ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Improve Access ◽

Maternal And Newborn

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Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzw083 ◽

2016 ◽

Vol 28 (5) ◽

pp. 566-572 ◽

Cited By ~ 3

Author(s):

Ibrahim Kabo ◽

Emmanuel Otolorin ◽

Emma Williams ◽

Nosa Orobaton ◽

Hannatu Abdullahi ◽

...

Keyword(s):

Quality Improvement ◽

Health Outcomes ◽

Newborn Health ◽

Quality Improvement Intervention ◽

Maternal And Newborn Health ◽

Improvement Intervention ◽

Maternal And Newborn

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Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries

PLoS ONE ◽

10.1371/journal.pone.0162006 ◽

2016 ◽

Vol 11 (8) ◽

pp. e0162006 ◽

Cited By ~ 23

Author(s):

Corrine W. Ruktanonchai ◽

Nick W. Ruktanonchai ◽

Andrea Nove ◽

Sofia Lopes ◽

Carla Pezzulo ◽

...

Keyword(s):

Newborn Health ◽

Maternal And Newborn Health ◽

East African ◽

African Countries ◽

Geographic Disparities ◽

Maternal And Newborn

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Quality of maternal and newborn health care in Ethiopia: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06680-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abera Biadgo ◽

Aynalem Legesse ◽

Abiy Seifu Estifanos ◽

Kavita Singh ◽

Zewdie Mulissa ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Newborn Health ◽

Health Facilities ◽

Maternal And Newborn Health ◽

Neonatal Health ◽

Input Process ◽

Maternal And Neonatal Health ◽

Maternal And Newborn

Abstract Background Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia. Methodology This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Microsoft Excel and exported to STATA for analysis. Descriptive analysis results are presented in texts, tables and graphs. Quality of maternal and neonatal health care was measured by input, process and outputs components. The components were developed by computing scores using standards used to measure the three components of the quality of maternal and neonatal health care. Result The study was done in a total of 32 health facilities: 5 hospitals and 27 health centers in four regions. The study revealed that the average value of the quality of the maternal and neonatal health care input component among health facilities was 62%, while the quality of the process component was 43%. The quality of the maternal and neonatal health output component was 48%. According to the standard cut-off point for MNH quality of care, only 5 (15.6%), 3 (9.3%) and 3 (10.7%) of health facilities met the expected input, process and output maternal and neonatal health care quality standards, respectively. Conclusion This study revealed that the majority of health facilities did not meet the national MNH quality of care standards. Focus should be directed towards improving the input, process and output standards of the maternal and neonatal health care quality, with the strongest focus on process improvement.

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