Medical Decision Support Technology for Better Antenatal Care of the Mother, Under-Five Child Survival and Child Health in Rural India

2014 ◽  
Vol 03 (04) ◽  
Author(s):  
Seenivasan P Sujatha Shritharan
2019 ◽  
Vol 24 (S1) ◽  
pp. 22-30 ◽  
Author(s):  
Jeevan Thapa ◽  
Shyam Sundar Budhathoki ◽  
Rejina Gurung ◽  
Prajwal Paudel ◽  
Bijay Jha ◽  
...  

Abstract Introduction The third Sustainable Development Goal, focused on health, includes two targets related to the reduction in maternal, newborn and under-five childhood mortality. We found it imperative to examine the equity and coverage of reproductive, maternal, newborn and child health (RMNCH) interventions from 2001 to 2016 in Nepal; and the death aversion that will take place during the SDG period. Methods We used the datasets from the Nepal Demographic Health Surveys (NDHS) 2001, 2006, 2011 and 2016. We calculated the coverage and equity for RMNCH interventions and the composite coverage index (CCI). Based on the Annualized Rate of Change (ARC) in the coverage for selected RMNCH indicators, we projected the trend for the RMNCH interventions by 2030. We used the Lives Saved Tools (LiST) tool to estimate the maternal, newborn, under-five childhood deaths and stillbirths averted. We categorised the interventions into four different patterns based on coverage and inequity gap. Results Between 2001 and 2016, a significant improvement is seen in the overall RMNCH intervention coverage-CCI increasing from 46 to 75%. The ARC was highest for skilled attendance at birth (11.7%) followed by care seeking for pneumonia (8.2%) between the same period. In 2016, the highest inequity existed for utilization of the skilled birth attendance services (51%), followed by antenatal care (18%). The inequity gap for basic immunization services reduced significantly from 27.4% in 2001 to 5% in 2016. If the current ARC continues, then an additional 3783 maternal deaths, 36,443 neonatal deaths, 66,883 under-five childhood deaths and 24,024 stillbirths is expected to be averted by the year 2030. Conclusion Nepal has experienced an improvement in the coverage and equity in RMNCH interventions. Reducing inequities will improve coverage for skilled birth attendants and antenatal care. The current annual rate of change in RMNCH coverage will further reduce the maternal, neonatal, under-five childhood deaths and stillbirths.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.


2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 38-38
Author(s):  
Sorana D. Bolboacă ◽  
◽  
Adriana Elena Bulboacă ◽  
◽  
◽  
...  

"The Clinical Decision Support (CDS), a form of artificial intelligence (AI), consider physician expertise and cognitive function along with patient’s data as the input and case-specific medical decision as an output. The improvements in physician’s performances when using a CDS ranges from 13% to 68%. The AI applications are of large interest nowadays, and a lot of effort is also put in the development of IT applications in healthcare. Medical decision support systems for non-medical staff users (MDSS-NMSF) as phone applications are nowadays available on the market. A MDSS-NMSF app is generally not accompanied by a scientific evaluation of the performances, even if they are freely available or not. Two clinical scenarios were created, and Doctor31 retrieved the diagnosis decisions. First scenario: man, 29 years old, and three symptoms: dysphagia, weight loss (normal body mass index), and tiredness. Second scenario: women, 47 years old with L5-S1 disk herniation, abnormal anti-TPO antibodies, lower back pain (burning sensations), constipation, and tiredness. The outcome possible effects and implications, as well as vulnerabilities induced on the used, are highlighted and discussed. "


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