scholarly journals Health Facility Capacity to Provide Maternal and Newborn Healthcare Services in Unguja

2019 ◽  
Vol 11 (10) ◽  
pp. 120
Author(s):  
Rukia Rajab Bakar ◽  
Rachel N Manongi ◽  
Blandina T. Mmbaga
Keyword(s):  
Child Health ◽  
Staff Training ◽  
Assessment Tool ◽  
Neonatal Care ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
And Child Health

Globally, every year 529,000 maternal deaths occur, 99% of which in developing countries with majority being in Sub-Saharan Africa. Maternal, Newborn and Child Health (MNCH) services depend on the accessibility, availability and quality of antenatal care (ANC), delivery and postnatal services. The aim of this study was to assess the health facilities’ capacity and readiness to provide MNCH services in Unguja Island, Zanzibar. A facility-based cross-sectional survey was conducted from May to June 2015 at public health facilities providing MNCH services. Data was collected by using the modified Service Availability and Readiness Assessment tool. Eighteen health facilities were assessed, two-thirds (66.7%, n = 12) of which were offering both maternity and reproductive and child health (RCH) services, 4 (22.2%) RCH services only, and 2 (11.1%) maternity services only. Readiness score for ANC services was 66% with high readiness scores in diagnostics services (89%) and equipment (69%). Overall, 14% offered all seven signal functions. Overall, delivery service readiness score was 48%. Overall readiness for comprehensive emergency obstetric and neonatal care services was 13%. Staff training and guidelines readiness score was 11%, while medicine and commodities score was 9%. The health facilities’ readiness in providing MNCH services remains inadequate in Unguja Island. Readiness in providing services was low for delivery and emergency obstetric and neonatal care services. Basic and advanced delivery services need to be improved in parallel with provision of necessary equipment, medicines and commodities and staff training for better MNCH service delivery.

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 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.

Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

Cross-sectional study of the quality of neonatal care services in Armenia

2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Quality Assessment ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Neonatal Deaths ◽  
Live Births ◽  
Care Services

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

scholarly journals Characteristics of successful integrated family planning and maternal and child health services: Findings from a mixed-method, descriptive evaluation

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 229
Author(s):  
Anne Pfitzer ◽  
Christina Maly ◽  
Hannah Tappis ◽  
Mark Kabue ◽  
Devon Mackenzie ◽  
...  
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Health Care Providers ◽  
Mixed Method ◽  
Physical Space ◽  
Health Facilities ◽  
Child Health Services ◽  
Care Providers ◽  
Cross Sectional ◽  
And Child Health

Background: Most postpartum women in low- and middle-income countries want to delay or avoid future pregnancies but are not using modern contraception. One promising strategy for increasing the use of postpartum family planning (PPFP) is integration with maternal, newborn and child health (MNCH) services. However, there is limited evidence on effective service integration strategies. We examine facilitators of and barriers to effective PPFP integration in MNCH services in Kenya and India.   Methods: We conducted a cross-sectional, mixed-method study in two counties in Kenya and two states in India. Data collection included surveying 215 MNCH clients and surveying or interviewing 82 health care providers and managers in 15 health facilities across the four sites. We analyzed data from each country separately. First, we analyzed quantitative data to assess the extent to which PPFP was integrated within MNCH services at each facility. Then we analyzed qualitative data and synthesized findings from both data sources to identify characteristics of well and poorly integrated facilities. Results: PPFP integration success varied by service delivery area, health facility, and country. Issues influencing the extent of integration included availability of physical space for PPFP services, health workforce composition and capacity, family planning commodities availability, duration and nature of support provided. Conclusions: Although integration level varied between health facilities, factors enabling and hindering PPFP integration were similar in India and Kenya. Better measures are needed to verify whether services are integrated as prescribed by national policies.

Soil-transmitted helminthiasis among mothers and their pre-school children on Unguja Island, Zanzibar with emphasis upon ascariasis

Parasitology ◽  
2008 ◽  
Vol 135 (12) ◽  
pp. 1447-1455 ◽  
Author(s):  
J. R. STOTHARD ◽  
E. IMISON ◽  
M. D. FRENCH ◽  
J. C. SOUSA-FIGUEIREDO ◽  
I. S. KHAMIS ◽  
...  
Keyword(s):  
Child Health ◽  
School Children ◽  
Negative Relationship ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
The North ◽  
Sub Saharan ◽  
And Child Health ◽  
Soil Transmitted Helminthiasis

SUMMARYSoil-transmitted helminthiasis (STH) is a scourge to the health and well-being of infants and pre-schoolchildren throughout many parts of sub-Saharan Africa. To improve maternal and child health, regular de-worming is recommended and often delivered from mother and child health (MCH) clinics, yet there have been few studies monitoring the progress and impact of interventions on local levels of disease. A cross-sectional parasitological survey, supplemented with questionnaires, was therefore conducted across 10 Ungujan villages examining mothers (n=322) and their pre-school children (n=359). Within children, mean prevalence of ascariasis, trichuriasis and hookworm was 8·6% (95% CI 5·5–11·8), 18·9% (95% CI 14·5–23·4) and 1·7% (95% CI 0·2–3·5) while in mothers mean prevalence was 6·7% (95% CI 3·7–9·7), 11·9% (95% CI 8·0–15·8) and 1·9% (95% CI 0·2–3·5), respectively. There was, however, significant spatial heterogeneity of STH by village, 2 villages having much elevated levels of infection, although general access to anthelminthics and utilization of village MCH clinics was good. Levels of parasite aggregation (k) were determined and a multilevel logistic regression model identified access to a household latrine [OR=0·56 (95% CI 0·32–0·99)] and having an infected household member [OR=3·72 (95% CI 2·22–6·26)] as observed risk factors. To further investigate worm burdens of Ascaris lumbricoides, adult worms were expelled using Combantrin® and measured. A negative relationship between mean worm burden and mean worm mass was found. Villages in the north of Unguja represent locations where there is elevated prevalence of both ascariasis and trichuriasis and it appears that local factors are particularly favourable for transmission of these helminths. From a perspective of control, in such locations, intervention efforts should be stepped up and greater efforts placed upon improving household sanitation.

scholarly journals Housing and child health in sub-Saharan Africa: A cross-sectional analysis

PLoS Medicine ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. e1003055 ◽  
Author(s):  
Lucy S. Tusting ◽  
Peter W. Gething ◽  
Harry S. Gibson ◽  
Brian Greenwood ◽  
Jakob Knudsen ◽  
...  
Keyword(s):  
Child Health ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sub Saharan ◽  
Sectional Analysis ◽  
And Child Health

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 Assessment of Utilization of HBCP Services for Children Diagnosed with Chronic and Terminal Illnesses Aged between 1-14 Years in Meru County, Kenya

2021 ◽  
pp. 29-45
Author(s):  
P. K. Kubai ◽  
A. M. Mutema ◽  
M. R. Kei
Keyword(s):  
Health Care ◽  
Care Program ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Home Based ◽  
Terminal Illnesses ◽  
Home Based Care

Introduction: Worldwide, 57 million people died in 2008 from Chronic Illnesses, an estimated 40 million were in need of HBCP services with 6.6 - 10.8 million Children and adolescents dying [1,2]. 98% of Children with Chronic and Terminal illnesses (CI/TI) are found in low and middle-income Countries. Chronic and Terminal illnesses in Children are on the rise in Sub Saharan Africa. Kenya has lagged in implementation of Home Based Care to mitigate effects of CI/TI [3]. According to WHO, 2017 and Ministry of Health-Kenya 2013, millions of Children are affected by these Illnesses such as Tuberculosis, Asthma, Congenital abnormalities, HIV/AIDS and Cancer among others [4,5]. These illnesses have made families’ to suffer emotional, psychosocial and economic hardships [6,7]. Evaluation of utilization of Home Based Care Program (EHBCP) services is significant in assessing effectiveness and quality delivery of HBCP [8,9].  Aims: To assess usage of minimum essential package required in provision of Home Based Care program services for Children aged between 1-14 years diagnosed with selected Chronic and Terminal illnesses in Meru County Kenya. Study Design:  A descriptive Cross Sectional Survey. Place and Duration of Study: Conducted in Meru County Kenya Health facilities between June 2018 and Dec 2019. Methodology: Descriptive Cross Sectional Survey of 245 Health Care Providers and Caregivers of Children diagnosed with selected by proportionate to size sampling and simple random sampling from different health facilities across Meru County was utilized. Results: Utilization, delivery of quality and effective Home Based Care program was positively associated with age, experience of Health Care Workers (HCWs) 4.8 [95% CI = 1.06 – 21.68, P = 0.041]. HCWs profession, gender and years of work were positively related to utilization and delivery of HBCP services 3.03 [95%CI = 1.64 – 5.59, P<0.001]. Conclusion: Current study concludes that utilization of Minimum HBCP essential package by participants was not effective and the quality delivery of minimum HBCP essential services was inadequate, which agrees with Sips et al., 2014 study that poor service delivery leads to inadequate utilization, it concludes that restructuring HBCP services would meet individual needs for ill Children.

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