scholarly journals Armed Conflicts and National Trends in Reproductive, Maternal, Newborn and Child Health in Sub-Saharan Africa: What Can National Health Surveys Tell Us?

2018 ◽  
Author(s):  
Ties Boerma ◽  
Hannah Tappis ◽  
Ghada Saad-Haddad ◽  
Jai K Das ◽  
Dessalegn Y Melesse ◽  
...  
Keyword(s):  
Child Health ◽  
National Health ◽  
Health Surveys ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Newborn And Child Health ◽  
Sub Saharan ◽  
National Trends ◽  
And Child Health ◽  
National Health Surveys

scholarly journals Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?

2019 ◽  
Vol 4 (Suppl 4) ◽  
pp. e001300 ◽  
Author(s):  
Ties Boerma ◽  
Hannah Tappis ◽  
Ghada Saad-Haddad ◽  
Jai Das ◽  
Dessalegn Y Melesse ◽  
...  
Keyword(s):  
Child Health ◽  
Child Growth ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Newborn And Child Health ◽  
National Surveys ◽  
Sub Saharan ◽  
National Trends ◽  
The Impact ◽  
And Child Health

Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990–2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality in children under 5 years in comparison with subregional trends. The surveys provide substantive evidence of a negative association between levels and trends in national indicators of RMNCH service coverage, child growth and under-5 mortality with armed conflict, with some notable exceptions. National surveys are an important source of data to assess the longer term national consequences of conflicts for RMNCH in most countries, despite limitations due to sampling and timing of the surveys.

scholarly journals Large and persistent subnational inequalities in reproductive, maternal, newborn and child health intervention coverage in sub-Saharan Africa

2020 ◽  
Vol 5 (1) ◽  
pp. e002232 ◽  
Author(s):  
Cheikh Mbacké Faye ◽  
Fernando C Wehrmeister ◽  
Dessalegn Y Melesse ◽  
Martin Kavao Kavao Mutua ◽  
Abdoulaye Maïga ◽  
...  
Keyword(s):  
Child Health ◽  
Health Planning ◽  
Capital City ◽  
Sub Saharan Africa ◽  
High Coverage ◽  
Newborn And Child Health ◽  
Essential Interventions ◽  
Wide Range ◽  
Sub Saharan ◽  
And Child Health

Subnational inequalities have received limited attention in the monitoring of progress towards national and global health targets during the past two decades. Yet, such data are often a critical basis for health planning and monitoring in countries, in support of efforts to reach all with essential interventions. Household surveys provide a rich basis for interventions coverage indicators on reproductive, maternal, newborn and child health (RMNCH) at the country first administrative level (regions or provinces). In this paper, we show the large subnational inequalities that exist in RMNCH coverage within 39 countries in sub-Saharan Africa, using a composite coverage index which has been used extensively by Countdown to 2030 for Women’s, Children’s and Adolescent’s Health. The analyses show the wide range of subnational inequality patterns such as low overall national coverage with very large top inequality involving the capital city, intermediate national coverage with bottom inequality in disadvantaged regions, and high coverage in all regions with little inequality. Even though nearly half of the 34 countries with surveys around 2004 and again around 2015 appear to have been successful in reducing subnational inequalities in RMNCH coverage, the general picture shows persistence of large inequalities between subnational units within many countries. Poor governance and conflict settings were identified as potential contributing factors. Major efforts to reduce within-country inequalities are required to reach all women and children with essential interventions.

scholarly journals 1076Spatial modelling on maternal and child health: a scoping review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Leonardo Ferreira ◽  
Cauane Blumenberg ◽  
Fernando Hartwig ◽  
Aluisio Barros
Keyword(s):  
Child Health ◽  
National Health ◽  
Health Surveys ◽  
Small Area ◽  
Small Area Estimation ◽  
Spatial Modelling ◽  
Estimation Methods ◽  
Area Estimation ◽  
And Child Health ◽  
National Health Surveys

Abstract Background The Sustainable Development Goals brought attention to the lack of geographically disaggregated data in low- and middle-income (LMIC) countries as national health surveys are generally not designed to provide estimates beyond the first administrative level. Advances on small area estimation methods have allowed for more granular estimates which support targeting and implementation of local health interventions. This study aims to summarize literature on the advances in spatial modelling of reproductive, maternal, newborn and child health (RMNCH). Methods We carried out a comprehensive literature search in five databases to identify studies that: 1) performed small area estimation; 2) were carried out in LMIC settings; 2) focused on RMNCH outcomes; 3) were based on national health surveys. Studies modelling travel time were not considered. Results We included 70 out of 4266 studies. The state-of-art approach to small area estimation has been through a Bayesian framework with INLA for administrative level or up to 5x5 km estimates. Malaria and child mortality outcomes are predominant, closely followed by anthropometry, vaccination and contraceptives use. Conclusions Spatial modelling has become a suitable approach for local estimates where data at finer resolutions is not available. However, there is not a consensus on how to report and interpret uncertainties. Key messages Local estimates are essential to identify and act on the most disadvantaged areas. Properly communicating uncertainty is a big challenge for researchers and they must accompany estimates to avoid misinterpretation.

scholarly journals Cost-Effectiveness of Interventions to Improve Maternal, Newborn and Child Health Outcomes: A WHO-CHOICE Analysis for Eastern Sub-Saharan Africa and South-East Asia

2021 ◽  
Author(s):  
Karin Stenberg ◽  
Rory Watts ◽  
Melanie Y. Bertram ◽  
Kaia Engesveen ◽  
Blerta Maliqi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Child Health ◽  
Health Outcomes ◽  
East Asia ◽  
Sub Saharan Africa ◽  
World Health ◽  
South East Asia ◽  
Newborn And Child Health ◽  
Sub Saharan ◽  
And Child Health

Background: Information on cost-effectiveness allows policy-makers to evaluate if they are using currently available resources effectively and efficiently. Our objective is to examine the cost-effectiveness of health interventions to improve maternal, newborn and child health (MNCH) outcomes, to provide global evidence relative to the context of two geographic regions. Methods: We consider interventions across the life course from adolescence to pregnancy and for children up to 5 years old. Interventions included are those that fall within the areas of immunization, child healthcare, nutrition, reproductive health, and maternal/newborn health, and for which it is possible to model impact on MNCH mortality outcomes using the Lives Saved Tool (LiST). Generalized cost-effectiveness analysis (GCEA) was used to derive average cost-effectiveness ratios (ACERs) for individual interventions and combinations (packages). Costs were assessed from the health system perspective and reported in international dollars. Health outcomes were estimated and reported as the gain in healthy life years (HLYs) due to the specific intervention or combination. The model was run for 2 regions: Eastern sub-Saharan Africa (SSA-E) and South-East Asia (SEA). Results: The World Health Organization (WHO) recommended interventions to improve MNCH are generally considered cost-effective, with the majority of interventions demonstrating ACERs below I$100/HLY saved in the chosen settings (low-and middle-income countries [LMICs]). Best performing interventions are consistent across the two regions, and include family planning, neonatal resuscitation, management of pneumonia and neonatal infection, vitamin A supplementation, and measles vaccine. ACERs below I$100 can be found across all delivery platforms, from community to hospital level. The combination of interventions into packages (such as antenatal care) produces favorable ACERs. Conclusion: Within each region there are interventions which represent very good value for money. There are opportunities to gear investments towards high-impact interventions and packages for MNCH outcomes. Cost-effectiveness tools can be used at national level to inform investment cases and overall priority setting processes.

scholarly journals Community perspectives on maternal and child health during nutrition and economic transition in sub-Saharan Africa

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Daniella Watson ◽  
Sarah H Kehoe ◽  
Agnes Erzse ◽  
Adélaïde Compaoré ◽  
Cornelius Debpuur ◽  
...  
Keyword(s):  
Child Health ◽  
Nutritional Status ◽  
Maternal And Child Health ◽  
Child Nutrition ◽  
Economic Transition ◽  
Sub Saharan Africa ◽  
Men And Women ◽  
Maternal And Child Nutrition ◽  
Sub Saharan ◽  
And Child Health

Abstract Objective: To explore community perceptions on maternal and child nutrition issues in Sub-Saharan Africa. Design: Thirty focus groups with men and women from three communities facilitated by local researchers. Setting: One urban (Soweto, South Africa) and two rural settings (Navrongo, Ghana and Nanoro, Burkina Faso) at different stages of economic transition. Participants: Two hundred thirty-seven men and women aged 18–55 years, mostly subsistence farmers in Navrongo and Nanoro and low income in Soweto. Results: Differences in community concerns about maternal and child health and nutrition reflected the transitional stage of the country. Community priorities revolved around poor nutrition and hunger caused by poverty, lack of economic opportunity and traditional gender roles. Men and women felt they had limited control over food and other resources. Women wanted men to take more responsibility for domestic chores, including food provision, while men wanted more involvement in their families but felt unable to provide for them. Solutions suggested focusing on ways of increasing control over economic production, family life and domestic food supplies. Rural communities sought agricultural support, while the urban community wanted regulation of the food environment. Conclusions: To be acceptable and effective, interventions to improve maternal and child nutrition need to take account of communities’ perceptions of their needs and address wider determinants of nutritional status and differences in access to food reflecting the stage of the country’s economic transition. Findings suggest that education and knowledge are necessary but not sufficient to support improvements in women’s and children’s nutritional status.

Soil-transmitted helminthiasis among mothers and their pre-school children on Unguja Island, Zanzibar with emphasis upon ascariasis

Parasitology ◽  
2008 ◽  
Vol 135 (12) ◽  
pp. 1447-1455 ◽  
Author(s):  
J. R. STOTHARD ◽  
E. IMISON ◽  
M. D. FRENCH ◽  
J. C. SOUSA-FIGUEIREDO ◽  
I. S. KHAMIS ◽  
...  
Keyword(s):  
Child Health ◽  
School Children ◽  
Negative Relationship ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
The North ◽  
Sub Saharan ◽  
And Child Health ◽  
Soil Transmitted Helminthiasis

SUMMARYSoil-transmitted helminthiasis (STH) is a scourge to the health and well-being of infants and pre-schoolchildren throughout many parts of sub-Saharan Africa. To improve maternal and child health, regular de-worming is recommended and often delivered from mother and child health (MCH) clinics, yet there have been few studies monitoring the progress and impact of interventions on local levels of disease. A cross-sectional parasitological survey, supplemented with questionnaires, was therefore conducted across 10 Ungujan villages examining mothers (n=322) and their pre-school children (n=359). Within children, mean prevalence of ascariasis, trichuriasis and hookworm was 8·6% (95% CI 5·5–11·8), 18·9% (95% CI 14·5–23·4) and 1·7% (95% CI 0·2–3·5) while in mothers mean prevalence was 6·7% (95% CI 3·7–9·7), 11·9% (95% CI 8·0–15·8) and 1·9% (95% CI 0·2–3·5), respectively. There was, however, significant spatial heterogeneity of STH by village, 2 villages having much elevated levels of infection, although general access to anthelminthics and utilization of village MCH clinics was good. Levels of parasite aggregation (k) were determined and a multilevel logistic regression model identified access to a household latrine [OR=0·56 (95% CI 0·32–0·99)] and having an infected household member [OR=3·72 (95% CI 2·22–6·26)] as observed risk factors. To further investigate worm burdens of Ascaris lumbricoides, adult worms were expelled using Combantrin® and measured. A negative relationship between mean worm burden and mean worm mass was found. Villages in the north of Unguja represent locations where there is elevated prevalence of both ascariasis and trichuriasis and it appears that local factors are particularly favourable for transmission of these helminths. From a perspective of control, in such locations, intervention efforts should be stepped up and greater efforts placed upon improving household sanitation.

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