Pregnancy Intentions May Not be a Useful Measure for Research on Maternal and Child Health Outcomes

Abstract Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that the low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfers (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. In 2014 we conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visits, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers' knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of rural health facilities.

Download Full-text

Breastfeeding: Insights for improving malaria, family planning, and maternal and child health outcomes in northwestern Nigeria through social and behavior change research

10.31899/rh14.1106 ◽

2020 ◽

Keyword(s):

Family Planning ◽

Child Health ◽

Behavior Change ◽

Health Outcomes ◽

Maternal And Child Health ◽

Child Health Outcomes ◽

And Behavior ◽

And Child Health

Download Full-text

COVID-19 and Health Sector Development Plans in Africa: The Impact on Maternal and Child Health Outcomes in Uganda

Risk Management and Healthcare Policy ◽

10.2147/rmhp.s328004 ◽

2021 ◽

Vol Volume 14 ◽

pp. 4353-4360

Author(s):

Mary Gorret Atim ◽

Violet Dismas Kajogoo ◽

Demeke Amare ◽

Bibie Said ◽

Melka Geleta ◽

...

Keyword(s):

Child Health ◽

Health Outcomes ◽

Maternal And Child Health ◽

Health Sector ◽

Child Health Outcomes ◽

Development Plans ◽

The Impact ◽

And Child Health

Download Full-text

Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study

BMC Public Health ◽

10.1186/s12889-020-09468-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Karl W. le Roux ◽

Ellen Almirol ◽

Panteha Hayati Rezvan ◽

Ingrid M. le Roux ◽

Nokwanele Mbewu ◽

...

Keyword(s):

Child Health ◽

Health Outcomes ◽

Maternal And Child Health ◽

Home Visiting ◽

Health Workers ◽

Group Comparison ◽

Comparison Study ◽

Child Health Outcomes ◽

The Impact ◽

And Child Health

Abstract Background Home visits by paraprofessional community health workers (CHWs) has been shown to improve maternal and child health outcomes in research studies in many countries. Yet, when these are scaled or replicated, efficacy disappears. An effective CHW home visiting program in peri-urban Cape Town found maternal and child health benefits over the 5 years point but this study examines if these benefits occur in deeply rural communities. Methods A non-randomized, two-group comparison study evaluated the impact of CHW in the rural Eastern Cape from August 2014 to May 2017, with 1310 mother-infant pairs recruited in pregnancy and 89% were reassessed at 6 months post-birth. Results Home visiting had limited, but important effects on child health, maternal wellbeing and health behaviors. Mothers reported fewer depressive symptoms, attended more antenatal visits and had better baby-feeding practices. Intervention mothers were significantly more likely to exclusively breastfeed for 6 months (OR: 1.8; 95% CI: 1.1, 2.9), had lower odds of mixing formula with baby porridge (regarded as detrimental) (OR: 0.4; 95% CI: 0.2, 0.8) and were less likely to consult traditional healers. Mothers living with HIV were more adherent with co-trimoxazole prophylaxis (p < 0.01). Intervention-group children were significantly less likely to be wasted (OR: 0.5; 95% CI 0.3–0.9) and had significantly fewer symptoms of common childhood illnesses in the preceding two weeks (OR: 0.8; 95% CI: 0.7,0.9). Conclusion The impact of CHWs in a rural area was less pronounced than in peri-urban areas. CHWs are likely to need enhanced support and supervision in the challenging rural context.

Download Full-text