scholarly journals 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

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.

scholarly journals The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana

2018 ◽  
Vol 3 (4) ◽  
pp. e000786 ◽  
Author(s):  
Akira Shibanuma ◽  
Francis Yeji ◽  
Sumiyo Okawa ◽  
Emmanuel Mahama ◽  
Kimiyo Kikuchi ◽  
...  
Keyword(s):  
Child Health ◽  
Continuum Of Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Newborn And Child Health ◽  
Care Services ◽  
Women And Children ◽  
And Child Health ◽  
The Continuum

IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.

scholarly journals Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan: a secondary analysis of cross-sectional survey data

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028922 ◽  
Author(s):  
Jin-Won Noh ◽  
Young-mi Kim ◽  
Nabeel Akram ◽  
Ki Bong Yoo ◽  
Jooyoung Cheon ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Program ◽  
Time Window ◽  
Tracking System ◽  
Childhood Vaccination ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sindh Province ◽  
And Child Health

ObjectiveUntimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan.DesignCross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys.SettingCommunity-based maternal and child health surveys.ParticipantsAmong 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included.OutcomesAt the participants’ home, an interviewer asked mothers to show their children’s vaccination cards, which contained information regarding vaccinations. Children’s vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth’s penalised likelihood was performed to identify factors associated with timeliness of vaccinations.Results238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child’s age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate.ConclusionsHome-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old.

scholarly journals FACILITY ASSESSMENT FOR MATERNAL AND CHILD HEALTH SERVICES IN BANGLADESH USING SERVICE AVAILABILITY AND READINESS ASSESSMENT (SARA) TOOL: A CROSS-SECTIONAL PILOT STUDY

2017 ◽  
Vol 3 (3) ◽  
pp. 77-88
Author(s):  
Afzal Aftab ◽  
Mehedi Hasan ◽  
Rahmatul Bari ◽  
Mohammad Didar Hossain ◽  
Mehadi Hasan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Health Facilities ◽  
Child Health Services ◽  
Service Availability ◽  
Readiness Assessment ◽  
Cross Sectional ◽  
And Child Health

Background: To initiate journey towards the Universal Health Coverage (UHC) it is essential to assess the health facilities. Unfortunately, no health facility assessment has been conducted in Bangladesh so far using “Service Availability and Readiness Assessment (SARA)” tool. Therefore, we aimed to conduct a pilot study to assess health facilities for maternal and child health services using SARA tool so that we can scale-up this assessment throughout the country later.Aim: We aimed to assess the health facilities for maternal and child health services in Tangail, Bangladesh using service availability and readiness assessment (SARA) tool.Methods: A cross-sectional pilot study was conducted in Bashail and Shokhipur Upazilla of Tangail district. A sample of 14 health facilities was assessed purposefully for data collection using a modified version of the SARA tool. Data was collected from November 01 to November 15, 2013, using paper-based questionnaire. Finally, following data collection, data were documented into Microsoft Excel by data collectors. Data were analyzed using Microsoft Excel, version 2010.Results: General service readiness has been segregated into five domains and their readiness scores were basic amenities (53.06%), basic equipment (83.33%), standard precautions for infection prevention (55.56%), and basic equipment (58.93%) for included health facilities. Similarly, specific service readiness includes family planning (48.15%), child immunization (67.71%), preventive and curative care (71.43%), and basic surgery (93.33%).Conclusion: Since we are moving towards UHC, it is essential to know the current scenario of health facilities. This pilot study reveals the strength and weakness of the health facilities in providing the maternal and child health services. These findings will help us to resolve all the identified gaps through proper planning and action.

scholarly journals Burnout among obstetricians and paediatricians: a cross-sectional study from China

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024205 ◽  
Author(s):  
Junying Ye ◽  
Huan Wang ◽  
Hao Wu ◽  
Liaosha Ye ◽  
Qi Li ◽  
...  
Keyword(s):  
Child Health ◽  
Family Support ◽  
Maternal And Child Health ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Occupational Burnout ◽  
Cross Sectional ◽  
Professional Efficacy ◽  
Patient Relationships ◽  
And Child Health

ObjectivesHospitals devoted to maternal and child health represent unique healthcare institutions in China. Healthcare professionals in these hospitals attend to health services for women and children, and also provide technical services and support for district maternal and children’s healthcare as well as family planning. However, few studies have examined occupational burnout among doctors employed in these hospitals. This research addresses the gap in the literature.MethodsA cross-sectional survey of obstetricians and paediatricians from 11 maternal and child health hospitals across China was conducted May through June 2017. A total of 678 people completed a self-administered questionnaire. The survey included questions about demographics, doctor–patient relationships and networks of support as well as characteristics designed to capture the occurrence of burnout, such as emotional exhaustion, cynicism and professional efficacy. T-test, variance and multiple regression analyses were used to examine the data.ResultsThe research revealed that 56.6% of obstetricians and paediatricians exhibited signs of occupational burnout. Poor doctor–patient relationships and high average number of weekly hours worked contributed to burnout. Additionally, low family support corresponded to physicians’ low sense of professional efficacy.ConclusionsSeveral factors have contributed to occupational burnout among paediatricians and obstetricians at maternal and child health hospitals in China, including lack of family support, poor doctor–patient relationships and heavy workloads.

Maternal and Child Health in Urban Sabah, Malaysia: A Comparison of Citizens and Migrants

1994 ◽  
Vol 7 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Siti Norazah Zulkifli ◽  
Khin Maw U ◽  
Khairuddin Yusof ◽  
Wong Yut Lin
Keyword(s):  
Child Health ◽  
Infant Mortality ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Cross Sectional Study ◽  
Infant Mortality Rate ◽  
Cross Sectional ◽  
Multi Stage ◽  
Pregnancy Wastage ◽  
And Child Health

This paper describes selected maternal and child health indicators based on a cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of 1, 515 women were interviewed from a multi-stage random sample of households in eight urban centers. Among the 1, 411 women in the sample who had experienced a pregnancy before, 76% were local citizens and 24% were migrants. There were statistically significant differences between citizens and migrants in ethnicity, religion, education, household income, and access to treated water supply and sanitary toilet facilities. Significantly fewer migrants practiced any form of contraception and obtained any antenatal care during any pregnancy. Furthermore, citizens tended to initiate care as early as three months but migrants as late as seven months. Despite these differences, only the infant mortality rate, and not pregnancy wastage, was statistically significantly higher among migrants. Pregnancy interval was also similar between the two groups. The influence of several socioeconomic factors on pregnancy wastage and infant mortality was explored. Asia Pac J Public Health1994;7(3):151-8.

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