Impact of Community Health Interventions on Maternal and Child Health Indicators in the Upper East Region of Ghana

2021 ◽  
Author(s):  
Evelyn Sakeah ◽  
Ayaga A Bawah ◽  
Patrick Asuming ◽  
Cornelius Debpuur ◽  
Paul Welaga ◽  
...  
Keyword(s):  
Child Health ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Health System Strengthening ◽  
Transport Systems ◽  
Health Delivery ◽  
East Region ◽  
Upper East Region ◽  
And Child Health

Abstract BackgroundThis paper reports on results of a health system strengthening programme implementation research in the Upper East region of northern Ghana where critical interventions to accelerate and strengthen the health delivery were implemented. Transformative interventions implemented included empowering community leaders and actors to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, provision of basic medical equipment to community clinics, and improving the skills of critical health staff training. MethodsA mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. For these analyses a pre-and-post randomized cluster design was used. For the qualitative data focused group and individual indepth interviews were employed to gauge the views of different stakeholders associated with the implementation process. ResultsSignificant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage (ANC and PNC) were observed. Similarly, there were significant increases in delivering of children in a health facilities and deliveries assisted by skilled health personnel after the intervention compared to before intervention situation in the region. There has also been increased uptake of women providing oral rehydration salts (ORS) for treatment of diarrhoea, as well as marked reductions in upper respiratory infections (URI). Conclusions Results from a pre-and post-evaluation impact assessment of interventions implemented in these health deprived parts of Ghana show that the programme had a strong positive impact on the functioning of Ghana’s health delivery system known as Community-based Health Planning and Services programme and induced visible changes in key indicators of health system performance.

scholarly journals Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010

2018 ◽  
Vol 3 (2) ◽  
pp. e000674 ◽  
Author(s):  
Dana R Thomson ◽  
Cheryl Amoroso ◽  
Sidney Atwood ◽  
Matthew H Bonds ◽  
Felix Cyamatare Rwabukwisi ◽  
...  
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Health System ◽  
Population Health ◽  
Maternal And Child Health ◽  
Rural Areas ◽  
Health System Strengthening ◽  
Live Births ◽  
Intervention Area ◽  
And Child Health

IntroductionAlthough Rwanda’s health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.MethodsCombining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.ResultsOverall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.ConclusionWe observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.

scholarly journals Effects of The Leadership, Management And Governance Intervention On Maternal And Child Health Service Performances In Ethiopia: A Propensity Score Matched Analysis

2021 ◽  
Author(s):  
Mesele Damte Argaw ◽  
Binyam Fekadu Desta ◽  
Sualiha Abdlkader Muktar ◽  
Wondwosen Shiferaw Abera ◽  
Ismael Ali Beshir ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Maternal And Child Health ◽  
Work Climate ◽  
Exposed Group ◽  
Health System Strengthening ◽  
Primary Health ◽  
New Challenges ◽  
And Child Health

Abstract Background: The maternal, neonatal and child mortality rates in Ethiopia are among the reported highest in Africa. Despite the reported alarming mortality rates, there are proven public health interventions in place to avoid preventable maternal and child deaths. Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing the work climate, and creating responsive health systems. Hence, the Ethiopian Ministry of Health with the support of the USAID Transform: Primary Health Care Activity has been implementing LMG interventions to improve performance of primary health care entities. The LMG interventions include a six-day classroom training with an additional six to nine months of leadership project implementation, supplemented with three to four onsite coaching sessions. The purpose of this evaluation was to measure the effects of LMG interventions on maternal and child health service performances and on the overall health system strengthening measurement results of primary health care entities. Methods: The study used a cross-sectional study design with propensity matched score analysis and was conducted from August 28, 2017, to September 30, 2018, in Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and Peoples’ (SNNP) regions. Data collection took place through interviewer and self-administered questionnaires among 227 LMG intervention exposed and 227 non-exposed health workers. Propensity score matched analysis was used to estimate the average treatment effects of LMG interventions on contraceptive acceptance rates, antenatal care, skilled birth attendance, postnatal care, full immunization services, growth monitoring services, management system, work climate and capacity to respond to new challenges. Results: The mean overall maternal and child health key performance indicator score with standard deviation (SD) for the LMG intervention exposed group was 63.86 ± 13.16 (SD) and 57.02 ± 13.71 (SD) for the non-exposed group. The overall health system strengthening score for the LMG intervention exposed group (mean rank =269.31) and non-exposed group (mean rank = 158.69) had statistically significant differences (U=10.145, z= -11.175, p=0.001). The average treatment effects of 3.54, 3.51, 2.64, 3.00, 1.073.34 percentage-points were observed for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. In addition, with regards to health system strengthening measurements, we found an average treatment effect (ATE) of 12.46, 4.79 and 4.88 percentage points for strengthening management system, enhancing work climate and capacity to respond to new challenges, respectively. Conclusion: We found positive evidence of effects of the LMG intervention on increased maternal and child health services performances at primary healthcare entities. Moreover, health facilities with LMG intervention exposed health workers had a higher and statistically significant difference in management systems, work climate and readiness to face new challenges. Therefore, this study generates evidence for integrating LMG interventions to improve the performance of primary healthcare entities and maternal and child service uptake of community members, which contributes to the reduction maternal and child deaths.

scholarly journals The Maternal and Child Health Handbook for Improving the Continuum of Care and Other Maternal and Child Health Indicators in Angola: An Implementation Study Protocol

2021 ◽  
Vol 2 ◽  
Author(s):  
Ai Aoki ◽  
Keiji Mochida ◽  
Michiru Kuramata ◽  
Toru Sadamori ◽  
Helga Reis Freitas ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Intervention Group ◽  
Health Indicators ◽  
Continuum Of Care ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Implementation Status ◽  
And Child Health

Background: Reducing maternal, neonatal, and infant mortality tops the health targets of sustainable development goals. Many lifesaving interventions are being introduced in antenatal, delivery, and postnatal care. However, many low- and middle-income countries (LMICs) have not reached maternal and child health targets. The Maternal and Child Health Handbook (MCH-HB) is recommended as a home-based record to promote a continuum of care from pregnancy to early childhood, and is gaining increasing attention among LMICs. Several countries have adopted it as national health policy. To effectively utilize the MCH-HB in LMICs, implementation needs to be considered. Angola is an LIMC in Sub-Saharan Africa, where maternal and child health indicators are among the poorest. The Angolan Ministry of Health adopted the MCH-HB program in its national health policy and is currently conducting a cluster randomized controlled trial (MCH-HB RCT) to evaluate its impact on the continuum of care. This study aimed to evaluate implementation status, and barriers and facilitators of MCH-HB program implementation in Angola.Methods: To evaluate implementation status comprehensively, the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework will be used. Four components other than effectiveness will be investigated. A cross-sectional survey will be conducted targeting all health facilities and officers in charge of the MCH-HB at the municipality health office in the intervention group after the MCH-HB RCT. Data from the cross-sectional survey, secondary MCH-HB RCT data, and operational MCH-HB RCT records will be analyzed. Health facilities will be classified into good-implementation and poor-implementation groups using RE-AIM indicators. To identify barriers to and facilitators of MCH-HB implementation, semi-structured interviews/focus group discussions will be conducted among health workers at a sub-sample of health facilities and all municipality health officers in charge of MCH-HB in the intervention group. The Consolidated Framework for Implementation Research will be adopted to develop interview items. Thematic analysis will be performed. By comparing good-implementation and poor-implementation health facilities, factors that differ between groups that contribute to successful implementation can be identified.Discussion: This study's findings are expected to inform MCH-HB implementation policy and guidelines in Angola and in other countries that plan to adopt the MCH-HB program.

Contribution of the results‐based financing strategy to improving maternal and child health indicators in Burkina Faso

2018 ◽  
Vol 34 (1) ◽  
pp. 111-129 ◽  
Author(s):  
Zawora Rita Zizien ◽  
Catherine Korachais ◽  
Philippe Compaoré ◽  
Valéry Ridde ◽  
Vincent De Brouwere
Keyword(s):  
Child Health ◽  
Burkina Faso ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Financing Strategy ◽  
And Child Health ◽  
Results Based Financing

Health System Impacts on Maternal and Child Health

2009 ◽  
pp. 83-97 ◽  
Author(s):  
Nancy Gerein ◽  
Andrew Green ◽  
Tolib Mirzoev ◽  
Stephen Pearson
Keyword(s):  
Child Health ◽  
Health System ◽  
Maternal And Child Health ◽  
And Child Health
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