Assessment on the knowledge and reported practices of women on maternal and child health care: a cross-sectional survey

Abstract Background: Maternal and child health care services are available in both public and private facilities in Nepal. No study has yet looked at trends in maternal and child health service use over time in Nepal. This paper assesses trends in and determinants of visiting private health facilities for maternal and child health needs using nationally representative data from the last three successive Nepal Demographic Health Surveys (NDHS). Methods: Data from the NDHS conducted in 2006, 2011, and 2016 were used. Maternal and child health-seeking was established using data on place of antenatal care (ANC), place of delivery, and place of treatment for child diarrhoea and fever/cough. Logistic regression models were fitted to identify trends in and determinants of health-seeking at private facilities. Results: The results indicate an increase in the use of private facilities for maternal and child health care over time. Across the three survey waves, women from the highest wealth quintile had the highest odds of accessing ANC services at private health facilities (AOR=6.0, CI= 3.78 -9.52 in 2006; AOR=5.6, CI= 3.51 – 8.81 in 2011; AOR=3.0, CI= 1.53 -5.91 in 2016). Women from the highest wealth quintile (AOR=8.3 CI= 3.97 – 17.42 in 2006; AOR=7.3, CI= 3.91 – 13.54 in 2011; AOR=3.3, CI= 1.54 – 7.09 in 2016) and women with more years of schooling (AOR=1.1, CI= 1.07 – 1.16 in 2006; AOR=1.1, CI= 1.04 – 1.14 in 2011; AOR=1.2, CI= 1.17 -1.27 in 2016) were more likely to deliver in private health facilities. Likewise, children belonging to the highest wealth quintile (AOR=6.4, CI= 1.59 – 25.85 in 2006; AOR=8.0, CI= 2.43 – 26.54 in 2016) were more likely to receive diarrhoea treatment in private health facilities.Conclusions: Women are increasingly visiting private health facilities for maternal and child health care in Nepal. Household wealth quintile, and the mother’s years of schooling were the major determinants for selecting private health facilities for these services. These trends indicate the importance of collaboration between private and public health facilities in Nepal to foster a public private partnership approach in the Nepalese health care sector.

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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

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.638766 ◽

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.

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