scholarly journals Evaluation Of The Integrated Care Model: Child Morbidity Reduction In Mashonaland East, Zimbabwe

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Maxwell Mhlanga
Keyword(s):  
Maternal Health ◽  
Child Health ◽  
Community Health ◽  
Integrated Care ◽  
Incidence Rate ◽  
Maternal And Child Health ◽  
Care Model ◽  
Child Morbidity ◽  
Care Practices ◽  
And Child Health

Zimbabwe has one of the highest prevalence rates on preventable child morbidity in the world. This is mainly attributable to the absence of an effective community health mobilisation structure that reaches all targeted households with correct and consistent social behaviour change interventions for better child and maternal health. To address this, a cluster randomised controlled trial was conducted to assess the effectiveness of a developed integrated community intervention approach in reducing child morbidity and improving maternal health outcomes. A total of 765 mother-child pairs (413 in the intervention and 352 in the control) from 2 districts in Mashonaland East province were recruited and followed up for 12 months. Only women with children aged 0 - 48 months at the beginning of the study were selected. Participants were selected (and recruited) through stratified random sampling from 30 villages/clusters (16 in the control and 14 in the intervention) out of the total of 43 villages in the 2 districts. The intervention arm received education on maternal and child health through an Integrated Care Model mobilisation system whereas participants in the control arm were mobilized and educated using the conventional mobilisation system. Baseline and end-line surveys were done to assess and compare baseline characteristics and secondary study outcomes. The primary outcome was child morbidity in the follow-up period of 12 months. The mean age of participating mothers was 28 years (SD = 6.8) and that of participating children was 18.2 months (SD = 4.0). The risk of child morbidity was 37.5% in the control and 22.0% in the intervention representing a relative risk of 1.7 [95% C.I (1.4-2.1)]. The incidence rate of child morbidity was 0.043 and 0.022 episodes per child year in the control and intervention arm respectively giving an incidence rate ratio of 2.0(p<0.001). This ratio meant that the chance of being a disease case in the control was double that in the intervention arm. Women in the intervention arm had statistically significant (p<0.001) higher knowledge about maternal and child health and better child care practices at the end of the study. There was strong evidence that the Integrated Care Model did not only reduce child morbidity but also improved maternal knowledge, health-seeking behaviour and care practices. Accordingly, governments in developing countries and countries in poor resource settings could strengthen their community health delivery systems by implementing this low-cost, sustainable and high-impact approach.

Human Milk in Premature Infant Feeding: Summary of a Workshop

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 741-743
Keyword(s):  
Child Health ◽  
Health Service ◽  
Human Milk ◽  
Community Health ◽  
Premature Infants ◽  
Maternal And Child Health ◽  
National Research Council ◽  
The United States ◽  
National Academy Of Sciences ◽  
And Child Health

Increasing interest in the utilization of human milk for the feeding of premature infants has been evident in the United States in the past few years and in the Scandinavian countries and several other parts of Europe for a longer time. Because premature infants exhibit even greater limitations of gastrointestinal and digestive functions and of immunologic status than do full-term infants, human milk may offer particular advantages. Such advantages include ready digestibility and absence of foreign proteins; in addition, it is possible that feeding of human milk may protect against enteric infections. In view of current interest in human milk for feeding premature infants, it seemed desirable to consider the possible associated benefits and risks. Such a consideration was undertaken on December 2 and 3, 1975, in Chevy Chase, Maryland, under the sponsorship of the Office for Maternal and Child Health, Bureau of Community Health Services, Health Service Administration, Department of Health, Education and Welfare. The meeting was attended by individuals believed knowledgeable about one or another area related to possible benefits and risks of feeding fresh or processed human milk by bottle or gavage to premature infants in hospitals. Participants in the workshop included representatives of two com- mittees of the American Academy of Pediatrics, two committees of the National Academy of Sciences-National Research Council, and representatives of the American College of Obstetricians and Gynecologists, the American Nursing Association, the Center for Disease Control, and the National Institute of Child Health and Human Development. Several representatives of the Office for Maternal and Child Health and of the Division of Clinical Services, Bureau of Community Health Service were also present.

Promoting Antenatal Care: Identifying Policy Levers in Indian Context

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Singh
Keyword(s):  
Health Care ◽  
Child Health ◽  
Antenatal Care ◽  
Community Health ◽  
Maternal And Child Health ◽  
Nutrition Support ◽  
Child Health Care ◽  
Support Programme ◽  
Indian Context ◽  
And Child Health

Abstract Background The growing body of literature associates Antenatal Care (ANC) with early detection and prevention of maternal complications which in turn reduce the likelihood of maternal and infant death. Studies report that only about 40% of pregnant women in developing countries have attended four ANC visits. This situation mandates identifying policy levers for promoting ANC visits. Methods The study uses data from the Demographic and Health Survey (DHS) India (2015-16). We analyze a sample of about 100,000 women in the age group of 15-49 years who gave birth in three years preceding the survey. Using the theory of health seeking behaviour we propose a conceptual model to understand the a) Predisposing factors; b) Enabling factors and c) Need factors affecting the ANC visits in Indian context. Results 17 % women in our sample never went for ANC. 46 % women in our sample went for at least four ANC visits. SEM analysis suggests that our structural model fits well with the sample data (RMSEA: 0.05; TFI: 0.93; SRMR: 0.038). Higher age, lower parity, higher awareness and higher levels of education significantly predisposes women to go for ANC visits. The significant (95% CI) enablers include higher socio-economic status, meeting with Community Health Worker (CHW) and enrolment in government sponsored nutrition support program. While health system barriers and personal barriers act as disablers. Bad obstetric history and health issues during pregnancy are significant need factors. Our analysis suggests that meeting CHWs increases ANC visits by 1.8 units and enrolment in nutrition support programme increases ANC visits by 1.4 units. Conclusions CHW and nutrition support programme are significant policy levers to promote ANC care and reduce maternal and child morbidity and mortality. Antenatal care services must be included under universal health coverage domain to reduce financial barriers for women of low socio-economic strata Key messages Involvement of Community Health workers in the promotion of maternal and child health care is a cost-effective strategy. Nutrition support programmes through Anganwadi centres help advance maternal and child health care by promoting ANC care.

scholarly journals Community Radio Supporting Maternal and Child Health and Preventing obstetric Fistula in an area impacted by climate change

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Selim Shahriar ◽  
Abdullah Al Mahmood ◽  
Nitta Biswas ◽  
Sk Nazmul Huda ◽  
Radio Nalta ◽  
...  
Keyword(s):  
Climate Change ◽  
Maternal Health ◽  
Child Health ◽  
Maternal And Child Health ◽  
Obstetric Fistula ◽  
Radio Station ◽  
Community Radio ◽  
Development Partner ◽  
Radio News ◽  
And Child Health

Aims: To describe how a community radio station and its allied resources have supported maternal and child health promotion and prevention of fistula in hard to reach and climate change-affected areas in Bangladesh. Methods:  The volunteers and operators of Radio Nalta were provided training on maternal health and fistula communication by a development partner. Information packs were made available through different institutions. Results: We produced and broadcast public service announcements on maternal health and fistula, integrated maternal health and fistula related messages radio plays and prioritized maternal health and fistula coverage in community radio news. We aired 11 talk shows on fistula, eight in observation to International day to end obstetric fistula. We reached 600,000 people with fistula information. Conclusions: Community radio can help in reaching out populations in hard to reach areas with information and education for promoting maternal health and prevention of fistula. Coastal areas are impacted by climate change and the community radio can effectively communicate with communities there. 

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