What the Government of Ghana Could do to Allay the Fears on Maternal Health

2014 ◽  
Author(s):  
Joshua Sumankuuro
Keyword(s):  
Maternal Health ◽  
The Government

scholarly journals Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Maternal Health Services ◽  
Policy Formulation ◽  
Social Accountability ◽  
The Social ◽  
The Government ◽  
The Impact

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.

scholarly journals Impact of socio-economic inequity in access to maternal health benefits in India: Evidence from Janani Suraksha Yojana using NFHS data

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247935
Author(s):  
Prem Shankar Mishra ◽  
Karthick Veerapandian ◽  
Prashant Kumar Choudhary
Keyword(s):  
Maternal Health ◽  
Social Groups ◽  
National Level ◽  
Health Benefits ◽  
Indian Society ◽  
Positive Sign ◽  
Social Discrimination ◽  
Data Set ◽  
Janani Suraksha Yojana ◽  
The Government

Background Caste plays a significant role in Indian society and it influences women to health care access in the community. The implementation of the maternal health benefits scheme in India is biased due to caste identity. In this context, the paper investigates access to Janani Suraksha Yojana (JSY) among social groups to establish that caste still plays a pivotal role in Indian society. Also, this paper aims to quantify the discrimination against Scheduled Castes/Scheduled Tribes (SCs/STs) in accessing JSY. Methods This paper uses a national-level data set of both NFHS-3 (2005–06) and NFHS-4 (2015–16). Both descriptive statistics and the Fairlie decomposition econometric model have been used to measure the explained and unexplained differences in access to JSY between SCs/STs and non-SCs/STs groups. Results Overall, the total coverage of JSY in India is still, 36.4%. Further, it is found that 72% of access to JSY is explained by endowment variables. The remaining unexplained percentage (28%) indicates that there is caste discrimination (inequity associated social-discrimination) against SCs/STs in access to JSY. The highest difference (54%) between SCs/STs and non-SCs/STs in access to JSY comes from the wealth quintile, with the positive sign indicating that the gap between the two social groups is widening. Discussion and conclusion It is necessary for the government to implement a better way to counter the caste-based discrimination in access to maternal health benefits scheme. In this regard, ASHA and Anganwadi workers must be trained to reduce the influence of dominant caste groups as well as they must be recruited from the same community to identify the right beneficiaries of JSY and in order to reduce inequity associated with social-discrimination.

scholarly journals Evaluating the impact of a maternal health voucher programme on service use before and after the introduction of free maternity services in Kenya: a quasi-experimental study

2018 ◽  
Vol 3 (2) ◽  
pp. e000726 ◽  
Author(s):  
Mardieh L Dennis ◽  
Timothy Abuya ◽  
Oona Maeve Renee Campbell ◽  
Lenka Benova ◽  
Angela Baschieri ◽  
...  
Keyword(s):  
Maternal Health ◽  
Private Sector ◽  
Maternal Health Services ◽  
Facility Delivery ◽  
Absolute Increase ◽  
Maternity Services ◽  
Poor Women ◽  
The Government ◽  
The Impact ◽  
The Continuum

IntroductionFrom 2006 to 2016, the Government of Kenya implemented a reproductive health voucher programme in select counties, providing poor women subsidised access to public and private sector care. In June 2013, the government introduced a policy calling for free maternity services to be provided in all public facilities. The concurrent implementation of these interventions presents an opportunity to provide new insights into how users adapt to a changing health financing and service provision landscape.MethodsWe used data from three cross-sectional surveys to assess changes over time in use of 4+ antenatal care visits, facility delivery, postnatal care and maternal healthcare across the continuum among a sample of predominantly poor women in six counties. We conducted a difference-in-differences analysis to estimate the impact of the voucher programme on these outcomes, and whether programme impact changed after free maternity services were introduced.ResultsBetween the preintervention/roll-out phase and full implementation, the voucher programme was associated with a 5.5% greater absolute increase in use of facility delivery and substantial increases in use of the private sector for all services. After free maternity services were introduced, the voucher programme was associated with a 5.7% higher absolute increase in use of the recommended package of maternal health services; however, disparities in access to facility births between voucher and comparison counties declined. Increased use of private sector services by women in voucher counties accounts for their greater access to care across the continuum.ConclusionsOur findings show that the voucher programme is associated with a modest increase in women’s use of the full continuum of maternal health services at the recommended timings after free maternity services were introduced. The greater use of private sector services in voucher counties also suggests that there is need to expand women’s access to acceptable and affordable providers.

scholarly journals Karakteristik Sosial Ekonomi dan Kesehatan Maternal

2011 ◽  
Vol 6 (3) ◽  
pp. 133
Author(s):  
Rindang Ekawati
Keyword(s):  
Maternal Health ◽  
Significant Relationship ◽  
Contraceptive Use ◽  
Place Of Residence ◽  
Chi Square ◽  
Level Of Education ◽  
Number Of Children ◽  
Birth Attendance ◽  
Chi Square Test ◽  
The Government

Kesehatan maternal yang tergolong tinggi di Indonesia merupakan indikator keberhasilan pembangunan pada Millenium Development Goals yang terus diupayakan untuk diperbaiki. Penelitian ini bertujuan mengetahui hubunganantara karakteristik sosial, demografi, dan ekonomi dengan tingkat kesehatan ibu. Penelitian yang menggunakan sumber data sekunder Survei Demografi Kesehatan di Jawa Barat yang mencakup 86 blok sensus yang meliputi 2.150 rumah tangga meliputi 1.100 rumah tangga di perkotaan dan 1.050 rumah tangga di pedesaan. Jumlah sampel terpilih adalah 1.720 wanita pernah kawin berumur 15 – 49 tahun. Analisis data dilakukan secara deskriptif analitik dan uji kai kuadrat. Terdapat hubungan signifikan antara umur ibu, pendidikan ibu, dan indeks kesejahteraan dengan pemilihan tenaga penolong persalinan oleh tenaga kesehatan. Juga terdapat hubunganyang signifikan antara kesertaan dalam program KeluargaBerencana dengan umur ibu, pendidikan, dan indeks kesejahteraan. Tidak ada hubungan yang signifikan antara kesertaan ber-KB dengan daerah tempat tinggal dan jumlah anak yang masih hidup. Terdapat hubungan signifikanantara tempat persalinan dengan daerah tempat tinggal, tingkat pendidikan ibu, indeks kesejahtaraan, serta jumlah anak yang masih hidup.Kata kunci: Sosial ekonomi, kesehatan maternal, pemakaian kontrasepsiAbstractHigh level of maternal health in Indonesia is one of Millenium Development Goal’s indicators, so that the government continually put this variable as priority to be improved. This study attempted to know the relationship between social, demographic, and economic characteristics with maternalhealth. Data source is obtained from Demographic and Health Survey 2007, West Java Province, which included 86 census blocks, 2.150 households. Among 2.150 households, 1.100 live in urban area, while 1.050 in rural area. Total selected sample is 1.720 ever married women aged between 15 – 49 years old. This research using chi-square test to observed whether thereis a significant relationship between age, level of education, and wealth indexes with birth attendance. There is also significant relationship between contraceptive use with women’s age, level of education, and level of wealth indexes. While, there is no significant relationship between contraceptiveuse with place of residence and number of children alive. According to the result, there is significant relationship beetween place of birth delivery with place of residence, level of education, wealth indexes, and number of children alive.Key words: Socioeconomic, maternal health, contraceptive use

scholarly journals DESAIN KELEMBAGAAN DALAM KOLABORASI PENCEGAHAN KEMATIAN IBU SAAT PERSALINAN

2021 ◽  
Vol 6 (2) ◽  
pp. 150
Author(s):  
Rininta Andriani ◽  
La Ode Syaiful Islamy
Keyword(s):  
Maternal Health ◽  
Maternal Death ◽  
Data Reduction ◽  
Qualitative Method ◽  
Phenomenological Approach ◽  
Health Facilities ◽  
Data Display ◽  
The Third ◽  
Appropriate Treatment ◽  
The Government

Efforts to prevent maternal death during childbirth have become a serious concern of the government and society. Many factors cause maternal death; one of the factors is the lack of access to good services for maternal health, especially the punctuality of emergencies caused by being late in making decisions to get treatment, the second is late arriving at health facilities, and the third is late in getting adequate and appropriate treatment. The efforts to prevent maternal death during childbirth can be made by collaborating to design institution collaborative of maternal death prevention at first. The purpose of this research was to describe the collaborative institution design of maternal death prevention during childbirth in South Buton Regency using a qualitative method with a phenomenological approach, data collected through observation, interviews, and document study and analyzed with the stages of data reduction, data display, and conclusion drawing/verification. The result showed that in designing the institution, this could be seen from society's large participation based on equality and sharing of understanding from the collaborative actors. The establishment of a limited forum resulted from discussions carried out, which was legitimated in terms of basic rules of collaboration supporter that combined between customary regulations and customs of ancestors and applicable statutory regulations.

scholarly journals Health Insurance Support on Maternal Health Care: Evidence from Survey Data in India

2020 ◽  
Author(s):  
Imtiyaz Ali ◽  
Saddaf Naaz Akhtar ◽  
Bal Govind Chauhan ◽  
Manzoor Ahmad Malik ◽  
Kapil Dev Singh
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Maternal Health ◽  
Policy Development ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Maternal Health Care ◽  
Long Run ◽  
Inclusive Policy ◽  
The Government

AbstractMaternal healthcare financing is key to the smooth functioning of maternal health systems in a country. In India, maternal healthcare persists as a significant public health issue. Adequate health insurance could transform the utilization of maternal health care services to prevent maternal consequences. This paper aims to examine the health insurance policies that cover maternal health and their performance in India. The unit-level social consumption data on health by the National Sample Survey Organizations (NSSO), conducted in India (2017-18), is used. Bi-variate analysis, logistic regression, and propensity scoring matching (PSM) are used to evaluate the coverage of health insurance coverage on women’s maternal health care utilization. Our findings suggest that spending on health insurance can benefit pregnant women, especially among the poor, without financial stress. The study has also minimized the financial burden and prevent high-risk pregnancy-related complications and consequences. Also, there is a need for proactive and inclusive policy development by the Government of India to promote more health insurance schemes in the public and private sectors. This can bring down the risk of maternal mortality and also boost the Indian economy in terms of a better quality of life in the long run, and the way towards more just and more egalitarian societies.HighlightsAround 14.1% of Indian women are covered with health insurance schemes.Muslim women have the lowest health insurance coverage in India.Women covered with health insurance schemes has showed significant contributor to the better utilization of full ANC and institutional delivery compared to uncovered women in India.A proactive and inclusive policy development is needed by the Government of India to promote more for health insurance schemes better quality of life in the long run.

scholarly journals GROUPING OF PROVINCES IN INDONESIA BASED ON MATERNAL HEALTH INDICATORS USING VARIABLE WEIGHTING K-MEANS AND FUZZY C-MEANS

2020 ◽  
Vol 9 (1) ◽  
pp. 44
Author(s):  
Elvira Mustikawati Putri Hermanto
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Health Workers ◽  
Post Partum ◽  
Immunization Coverage ◽  
Health Indicators ◽  
Fuzzy C Means ◽  
Variable Weighting ◽  
The Government ◽  
Very High

Maternal Mortality Rate (MMR) is an indicator used to assess maternal health as well as the health status of a country. MMR is a target that must be achieved by Indonesian Government in Sustainable Development Goals (SDGs) in 2030. The Government of Indonesia has made various efforts to reduce MMR. This study aims to determine the distribution pattern of indicators for improving maternal health by grouping provinces in Indonesia based on the characteristics of maternal health indicators. The variables used are indicators that affect maternal mortality, namely K4 coverage (x1), Td2+ immunization coverage (x2), maternity assisted by health workers in health facilities coverage (x3), post-partum check up coverage (x4), Puskesmas implementing pregnant classes (x5), Puskesmas implementing P4K (x6), participant of KB coverage (x7) in Indonesia in 2017. The grouping methods are Variable Weighting K-Means (VWKM) and Fuzzy C-Means (FCM). The selection of the best grouping results uses the Internal Cluster Dispersion Rate (icdrate). Based on the analysis results, the best grouping is generated by the FCM method. The icdrate value generated by FCM is 0.325 while the icdrate value generated by VWKM is 0.552. FCM produces five groups which can be categorized as groups with maternal health indicator characteristics with very low, low, medium, high, and very high scores. Provinces in a group tend to be geographically close. East Java and Bali are provinces included in the indicator group of very high maternal health. Papua and West Papua fall into the group for maternal health which is very low.

scholarly journals On Zero-Inflated Hierarchical Poisson Models with Application to Maternal Mortality Data

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Kassim Tawiah ◽  
Samuel Iddi ◽  
Anani Lotsi
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Health Planning ◽  
Health Sector ◽  
Generalized Linear Mixed Model ◽  
Mortality Data ◽  
Model Framework ◽  
The Government

Count outcomes are commonly encountered in health sector data. The occurrence of count outcomes that exhibit many zeros has necessitated the extension of the ubiquitous Poisson regression model to accommodate the zero inflation and overdispersion as a result of the extra dispersion. We explored different extensions of the Poisson model including mixed models within the generalized linear mixed model framework to account for the repeated measurement of outcomes. These models are applied to maternal mortality data from fifty-six health facilities in four regions of Ghana. The objective is to identify factors associated with maternal mortality. The best-fitting model, the zero-inflated Poisson generalized linear mixed model, revealed that maternal mortality in hospital facilities is influenced by the number of referrals (into and out) of the hospital facility, number of antenatal visits exceeding four, number of midwives, and number of medical doctors at the facility. To be able to achieve targeted results in reducing maternal mortality and achieve the Sustainable Development Goal 3, the government, together with the ministry of health, should provide adequate maternal health services, especially at the district and community level. Additionally, there is a need for increased investment in Community Health Planning Services and related healthcare infrastructure and systems within the context of the Ouagadougou Declaration, that is, improve the training of skilled birth workers (midwives and doctors) and employ them at clinics to deal with labour complications without referring them to major hospitals. Furthermore, a well-structured awareness campaign is needed with importance given to avoiding adolescent pregnancy and improving antenatal care attendance to, at least, four, the gold standard, before delivery. Also, we recommend quality assessment form an essential part of all services that are directed towards improving maternal health and that more emphasis is needed to be given on research with multiple allied partners.

scholarly journals Maternal Mortality and Maternal Health Care in Nigeria: Implications for Socio-Economic Development

2019 ◽  
Vol 7 (5) ◽  
pp. 849-855 ◽  
Author(s):  
Olawale Olonade ◽  
Tomike I. Olawande ◽  
Oluwatobi Joseph Alabi ◽  
David Imhonopi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Health Care System ◽  
Socioeconomic Development ◽  
Maternal Health Care ◽  
African Countries ◽  
Sub Saharan ◽  
The Government ◽  
Care System

BACKGROUND: Even though maternal mortality, which is a pregnancy-related death is preventable, it has continued to increase in many nations of the world, especially in the African countries of the sub-Saharan regions caused by factors which include a low level of socioeconomic development. AIM: This paper focuses on cogent issues affecting maternal mortality by unpacking its precipitating factors and examining the maternal health care system in Nigeria. METHODS: Contemporary works of literature were reviewed, and the functionalist perspective served as a theoretical guide to examine the interrelated functions of several sectors of the society to the outcome of maternal mortality. RESULTS: It was noted that apart from the medical related causes (direct and indirect) of maternal mortality, certain socio-cultural and socioeconomic factors influence the outcome of pregnancy. Also, a poor health care system, which is a consequent of weak social structure, is a contributing factor. CONCLUSION: As a result, maternal mortality has debilitating effects on the socioeconomic development of any nation. It is therefore pertinent for the government to improve maternal health and eradicate poverty to ensure sustainable development.

scholarly journals A Qualitative Study on the Pathways to Evidence-Based Antenatal Care in Periurban Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Jones Asafo Akowuah ◽  
Peter Agyei-Baffour ◽  
Benedict Osei Asibey
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Scale Up ◽  
Hospital Staff ◽  
Maternal Health Care ◽  
Sub Saharan Africa ◽  
Transport Cost ◽  
Health Staff ◽  
The Government

Maternal health care has become a major concern on international fora in the 21st century. Even though major interventions have been taken to scale up maternal health care locally, nationally, and globally, adequate utilisation has not been achieved due to system-induced setbacks, especially in sub-Saharan Africa. The study explored the facilitators and barriers to antenatal care use in periurban Ghana. Seventeen (17) respondents consisting of four mothers receiving ANC services, four mothers receiving postnatal care with their ANC experience, four midwives, and four nurses with the District Public Health Nurse were involved in the study. The exploratory case study design was used with respondents comprising two focus groups and interview participants. Using thematic analysis, the results revealed that restrictive factors like travel time, long waiting time, transport cost, service cost, quality of service, and attitude of hospital staff still act as constraining factors even after the introduction of free maternal health care. The study concludes that practices like focused ANC and routine monitoring to facilities among others have increased utilisation. The study therefore recommends that to ensure adequate utilisation, the government and other stakeholders should offer support to the less-privileged mothers. Again, services should be easily available at facilities to pregnant women even if they are to be bought. It is further recommended that antenatal care services should be reoriented and clinical psychologists should be placed at all health centres to empower health staff on the best attitude towards clients. Interventions if mainstreamed into the national maternal health policy could be useful.

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