scholarly journals Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia

2019 ◽  
Author(s):  
Anbrasi Edward ◽  
Aparna Krishnan ◽  
Grace Ettyang ◽  
Younghee Jung ◽  
Henry B Perry ◽  
...  
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Rural Communities ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Social Accountability ◽  
Engagement Strategies ◽  
Birth Attendance ◽  
Quasi Experimental

Abstract Background Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on SBA. In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of community-oriented interventions including timed CHW services and SBA. Results Over 90% of the 3,037 women in Cambodia, 2,805 women in Kenya and 1,171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia and Kenya showed significantly higher odds of SBA (Cambodia, aOR=7.48; 95% CI: 3.87, 14.5, Kenya, aOR=0.60; 95% CI: 0.41, 0.85). The findings also indicated that older women (>24 years), in Cambodia, women with primary or secondary education in Cambodia and Kenya, women from higher wealth quintiles in Cambodia, and women with four or more ANC visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions (aOR=1.69; 95% CI: 0.92, 3.13 in Cambodia; aOR=2.12; 95% CI: 1.06, 4.26 in Kenya; aOR=6.78; 95% CI: 1.15, 13.9 in Zambia), follow up visits from the CHW following a referral or health facility visit (aOR=2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR=2.17; 95% CI 1.25, 3.75 in Kenya; aOR=1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA. Conclusions Enhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery and accelerating the sustainable development goals for maternal child and newborn health.

scholarly journals Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia

2020 ◽  
Author(s):  
Anbrasi Edward ◽  
Aparna Krishnan ◽  
Grace Ettyang ◽  
Younghee Jung ◽  
Henry B Perry ◽  
...  
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Secondary Education ◽  
Rural Communities ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Social Accountability ◽  
Birth Attendance ◽  
Quasi Experimental ◽  
Matched Comparison

Abstract Background Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on skilled birth attendance (SBA). In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two matched comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of timed CHW services and community-oriented interventions on SBA. Results Over 80% of the 3,037 women in Cambodia, 2,805 women in Kenya and 1,171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia showed significantly higher odds of SBA (aOR=7.48; 95% CI: 3.87, 14.5). The findings also indicated that women over the age of 24 in Cambodia, women with primary or secondary education in Cambodia and secondary education in Kenya, women from higher wealth quintiles in Cambodia, and women with four or more antenatal care (ANC) visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions in Kenya (aOR=2.12; 95% CI: 1.06, 4.26) and Zambia (aOR=6.78; 95% CI: 1.15, 13.9) and follow up CHW visits after a referral or health facility visit (aOR=2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR=2.17; 95% CI 1.25, 3.75 in Kenya; aOR=1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA.Conclusions Enhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery. These strategies can accelerate the achievement of the sustainable development goals for maternal child and newborn health.

scholarly journals Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia

2020 ◽  
Author(s):  
Anbrasi Edward ◽  
Aparna Krishnan ◽  
Grace Ettyang ◽  
Younghee Jung ◽  
Henry B Perry ◽  
...  
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Secondary Education ◽  
Rural Communities ◽  
Newborn Health ◽  
Skilled Birth Attendance ◽  
Social Accountability ◽  
Birth Attendance ◽  
Quasi Experimental ◽  
Matched Comparison

Abstract Background Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on skilled birth attendance (SBA). In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two matched comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of timed CHW services and community-oriented interventions on SBA. Results Over 80% of the 3,037 women in Cambodia, 2,805 women in Kenya and 1,171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia showed significantly higher odds of SBA (aOR=7.48; 95% CI: 3.87, 14.5). The findings also indicated that women over the age of 24 in Cambodia, women with primary or secondary education in Cambodia and secondary education in Kenya, women from higher wealth quintiles in Cambodia, and women with four or more antenatal care (ANC) visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions in Kenya (aOR=2.12; 95% CI: 1.06, 4.26) and Zambia (aOR=6.78; 95% CI: 1.15, 13.9) and follow up CHW visits after a referral or health facility visit (aOR=2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR=2.17; 95% CI 1.25, 3.75 in Kenya; aOR=1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA.Conclusions Enhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery. These strategies can accelerate the achievement of the sustainable development goals for maternal child and newborn health.

scholarly journals SCHOOL HEALTH PROMOTION: A QUASI-EXPERIMENTAL STUDY ON CLEAN AND HEALTHY LIVING BEHAVIOR AMONG ELEMENTARY STUDENTS IN JAYAPURA, PAPUA, INDONESIA

2020 ◽  
Vol 6 (6) ◽  
pp. 220-225
Author(s):  
Ellen Rosawita Veronica Purba ◽  
Lely Lusmilasari ◽  
Janatin Hastuti
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Elementary Students ◽  
School Health ◽  
Comparison Group ◽  
School Health Promotion ◽  
Healthy Living ◽  
Knowledge And Attitudes ◽  
Quasi Experimental ◽  
Experimental Group

Background: The Indonesian government has launched a clean and healthy living behavior program as one of the efforts for school health promotion. However, the healthy behaviors of the elementary students remain low. Objectives: This study aimed to examine the effect of audiovisual-based education on the knowledge and attitudes of clean and healthy behavior in elementary students.Methods: This was a quasi-experimental study with a pretest-posttest comparison group design conducted from 1 October to 17 October 2018. A total sample of 272 students was selected using purposive sampling, with 136 assigned in an experimental group (audiovisual group) and a comparison group (poster only group). Knowledge and attitudes of clean and healthy living behavior were measured using validated questionnaires. Data were analyzed using a paired t-test and independent t-test.Results: There was a significant effect of the interventions given in the experimental and comparison group on knowledge and attitude of clean and healthy living behavior (p<0.05). However, the experimental group showed a higher mean score compared to the comparison group in knowledge and attitudes, which indicated that the use of audiovisual-based education was more effective than the use of poster alone in improving the knowledge and attitudes of clean and healthy living behavior.Conclusion: The students who received audiovisual-based education had higher knowledge and attitudes of clean and healthy living behavior than those who only received poster-based education. This study provides input for pediatric and community nurses to provide better health education for the community, specifically for school health promotion.

scholarly journals Wealth-based equity in maternal, neonatal, and child health services utilization: a cross-sectional study from Ethiopia

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Alem Desta Wuneh ◽  
Araya Abrha Medhanyie ◽  
Afework Mulugeta Bezabih ◽  
Lars Åke Persson ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Maternal Health ◽  
Child Health ◽  
Health Services ◽  
Wealth Index ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Child Health Services ◽  
Services Utilization ◽  
Birth Attendance ◽  
And Child Health

Abstract Background Despite the pro-poor health policies in Ethiopia, the utilization of maternal, neonatal, and child health services remains a challenge for the country. Health equity became central in the post-2015 Sustainable Development Goals globally and is a priority for Ethiopia. The aim of this study was to assess equity in utilization of a range of maternal and child health services by applying absolute and relative equity indices. Methods Data on maternal and child health utilization emanated from a baseline survey conducted for a large project ‘Optimizing the Health Extension Program from December 2016 to February 2017 in four regions of Ethiopia. The utilization of four or more antenatal care visits; skilled birth attendance; postnatal care within 2 days after childbirth; immunization with BCG, polio 3, pentavalent 3, measles and full immunization of children aged 12–23 months; and vitamin A supplementation for 6–23 months old children were stratified by wealth quintiles. The socioeconomic status of the household was assessed by household assets and measured by constructing a wealth index using principal component analysis. Equity was assessed by applying two absolute inequity indices (Wealth index [quintile 5- quintile 1] and slope index of inequality) and two relative inequity indices (Wealth index [quintile5: quintile1] and concentration index). Results The maternal health services utilization was low and inequitably distributed favoring the better-off women. About 44, 71, and 18% of women from the better-off households had four or more antenatal visits, utilized skilled birth attendance and postnatal care within two days compared to 20, 29, and 8% of women from the poorest households, respectively. Skilled birth attendance was the most inequitably distributed maternal health service. All basic immunizations: BCG, polio 3, pentavalent 3, measles, and full immunization in children aged 12–23 months and vitamin A supplementation were equitably distributed. Conclusion Utilization of maternal health services was low, inequitable, and skewed against women from the poorest households. In contrast, preventive child health services were equitably distributed. Efforts to increase utilization and reinforcement of pro-poor and pro-rural strategies for maternal, newborn and immunization services in Ethiopia should be strengthened.

scholarly journals Has untargeted sexual health promotion for young people reached its limit? A quasi-experimental study

2013 ◽  
Vol 67 (5) ◽  
pp. 398-404 ◽  
Author(s):  
Lawrie Elliott ◽  
Marion Henderson ◽  
Catherine Nixon ◽  
Daniel Wight
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Young People ◽  
Sexual Health ◽  
Quasi Experimental

scholarly journals The Effects of Health Promotion Model on Preventive Behaviors of Osteoporosis during Premenopausal Period in Employed Women: A Quasi-experimental Study

2018 ◽  
Vol 7 (3) ◽  
pp. 324-330
Author(s):  
Mahsa Askarian ◽  
Iran Jahanbin ◽  
Fatemeh Vizeshfar ◽  
Zahra Yazdanpanahi ◽  
Hamideh Mohseni
Keyword(s):  
Experimental Study ◽  
Health Promotion ◽  
Block Size ◽  
Preventive Behaviors ◽  
Health Promotion Model ◽  
Wide Range ◽  
Quasi Experimental ◽  
The Mean ◽  
Pender's Health Promotion Model ◽  
Experimental Group

Objectives: Osteoporosis is one of the major problems of the healthcare system and is a common debilitating metabolic disease among women. Pender’s health promotion model which is a conceptual framework and describes a wide range of health behavior was selected to assess the behavioral changes in this study. Materials and Methods: A total of 122 women aged between 30 and 45 were selected to take part in this quasi-experimental study. The samples were split into experimental and control groups using the block randomization method (block size of 4). The educational program, based on Pender’s model, was performed weekly. Pender’s questionnaire on preventive behaviors of osteoporosis was filled out before and two months after interventions by both groups. SPSS software version 18.0 was used for data analysis. Results: In terms of qualitative and quantitative data (demographic characteristics), there was no meaningful difference between the two groups (P>0.05). The mean difference (MD) in the score of the perceived benefits and barriers, perceived self-efficacy, programming, competing demand, and their commitment to a plan of actions increased in the experimental group after the intervention (P<0.001). However, there was no significant increase in the mean score of social support in the experimental group after the intervention (P>0.05). Conclusions: It can be assumed that teaching preventive behaviors of osteoporosis through Pender’s health promotion model was effective. Considering the findings, it is obvious that continuing this program can maintain and consolidate the changes which have been made in behaviors.

scholarly journals Determinants of skilled birth attendants for delivery in Nepal

2012 ◽  
Vol 8 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Y R Baral ◽  
K Lyons ◽  
J Skinner ◽  
E R Van Teijlingen
Keyword(s):  
Qualitative Research ◽  
Maternal Health ◽  
Health Services ◽  
Quantitative Research ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Women's Role

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women’s role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women’s involvement in decision making; and women’s autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women’s role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6223 Kathmandu Univ Med J 2010;8(3):325-32 

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