The Humanitarian Lives Saved Tool: An evidence-based approach for reproductive, maternal, newborn, and child health program planning in humanitarian settings

Abstract Background: We launched Chamas for Change (Chamas), a group-based health education and microfinance program for pregnant women and their infants, to address inequities contributing to high rates of maternal and neonatal mortality in western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and uptake of evidence-based, maternal, newborn and child health (MNCH) behaviors. Methods: We prospectively compared the uptake of MNCH behaviors between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at health facilities in Busia County to participate in Chamas . Women enrolled in Chamas agreed to attend bi-monthly group health education and optional microfinance sessions for 12 months. We collected baseline sociodemographic data at study enrollment for each cohort. We used descriptive analyses and adjusted multivariable logistic regression models to compare outcomes across cohorts at 6-12 months postpartum, with α set to 0.05. Results: Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a facility with a skilled birth attendant (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In our adjusted models, Chamas participants were nearly five times as likely as controls to deliver in a health facility (OR 5.07, 95% CI 2.74-9.36, p<0.001). Though not statistically significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Our sensitivity analyses revealed no significant difference in the odds of facility delivery based on microfinance participation. Conclusions: Chamas participation was associated with increased practice of evidence-based MNCH health behaviors among pregnant women in western Kenya. Our findings demonstrate this program’s potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect.

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Factors influencing maternal nutrition practices in a large scale maternal, newborn and child health program in Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0179873 ◽

2017 ◽

Vol 12 (7) ◽

pp. e0179873 ◽

Cited By ~ 22

Author(s):

Phuong H. Nguyen ◽

Tina Sanghvi ◽

Sunny S. Kim ◽

Lan M. Tran ◽

Kaosar Afsana ◽

...

Keyword(s):

Child Health ◽

Large Scale ◽

Health Program ◽

Maternal Nutrition ◽

Newborn And Child Health ◽

Factors Influencing ◽

Nutrition Practices ◽

And Child Health

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Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors

PLoS ONE ◽

10.1371/journal.pone.0142849 ◽

2015 ◽

Vol 10 (12) ◽

pp. e0142849 ◽

Cited By ~ 28

Author(s):

Francis Yeji ◽

Akira Shibanuma ◽

Abraham Oduro ◽

Cornelius Debpuur ◽

Kimiyo Kikuchi ◽

...

Keyword(s):

Child Health ◽

Health Program ◽

Continuum Of Care ◽

Completion Rate ◽

Newborn And Child Health ◽

And Child Health

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Effect and feasibility of district level scale up of maternal, newborn and child health interventions in Pakistan: a quasi-experimental study

BMJ Open ◽

10.1136/bmjopen-2019-036293 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036293

Author(s):

Zahid Ali Memon ◽

Shah Muhammad ◽

Sajid Soofi ◽

Nimra Khan ◽

Nadia Akseer ◽

...

Keyword(s):

Child Health ◽

Scale Up ◽

Case Fatality ◽

Population Level ◽

Evidence Based ◽

High Burden ◽

Newborn And Child Health ◽

The Impact ◽

And Child Health

IntroductionPakistan has a high burden of maternal, newborn and child morbidity and mortality. Several factors including weak scale-up of evidence-based interventions within the existing health system; lack of community awareness regarding health conditions; and poverty contribute to poor outcomes. Deaths and morbidity are largely preventable if a combination of community and facility-based interventions are rolled out at scale.Methods and analysisUmeed-e-Nau (UeN) (New Hope) project aims is to improve maternal, newborn and child health (MNCH) in eight high-burden districts of Pakistan by scaling up of evidence-based interventions. The project will assess interventions focused on, first, improving the quality of MNCH care at primary level and secondary level. Second, interventions targeting demand generation such as community mobilisation, creating awareness of healthy practices and expanding coverage of outreach services will be evaluated. Third, we will also evaluate interventions targeting the improvement in quality of routine health information and promotion of use of the data for decision-making. Hypothesis of the project is that roll out of evidence-based interventions at scale will lead to at least 20% reduction in perinatal mortality and 30% decrease in diarrhoea and pneumonia case fatality in the target districts whereas two intervention groups will serve as internal controls. Monitoring and evaluation of the programme will be undertaken through conducting periodical population level surveys and quality of care assessments. Descriptive and multivariate analytical methods will be used for assessing the association between different factors, and difference in difference estimates will be used to assess the impact of the intervention on outcomes.Ethics and disseminationThe ethics approval was obtained from the Aga Khan University Ethics Review Committee. The findings of the project will be shared with relevant stakeholders and disseminated through open access peer-reviewed journal articles.Trial registration numberNCT04184544; Pre-results.

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Early results of an integrated maternal, newborn, and child health program, Northern Nigeria, 2009 to 2011

BMC Public Health ◽

10.1186/1471-2458-13-1034 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 11

Author(s):

Sally E Findley ◽

Omolara T Uwemedimo ◽

Henry V Doctor ◽

Cathy Green ◽

Fatima Adamu ◽

...

Keyword(s):

Child Health ◽

Health Program ◽

Northern Nigeria ◽

Newborn And Child Health ◽

Early Results ◽

And Child Health

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Baseline Socio-Demographic and Mortality Profile of a Peri-urban Coastal Community in Karachi, Pakistan Before the Introduction of a Comprehensive Maternal, Newborn and Child Health Intervention Package

10.21203/rs.3.rs-67851/v1 ◽

2021 ◽

Author(s):

Muhammad Ilyas ◽

Kanwal Nayani ◽

Ameer Muhammad ◽

Yasir Shafiq ◽

Benazir Baloch ◽

...

Keyword(s):

Mortality Rate ◽

Child Health ◽

Neonatal Mortality ◽

Child Mortality ◽

Mortality Rates ◽

Evidence Based ◽

Intervention Package ◽

Newborn And Child Health ◽

Live Births ◽

And Child Health

Abstract Objective Pakistan has the highest neonatal mortality rate and one of the highest under-5 mortality rates in the world, at 42 deaths and 74 deaths per thousand live births respectively. We undertook implementation of an evidence-based maternal, newborn and child health (MNCH) intervention package to reduce under-five mortality in Rehri Goth, a peri-urban coastal community on the outskirts of Karachi, Pakistan. This paper aims to present the socio-demographic and under-5 mortality profile of Rehri Goth prior to implementation of the intervention package. We conducted a detailed census of all households on socio-demographic variables. ResultsOver the course of the census period, 6,962 households were visited. The total population of Rehri Goth was found to be 42,980. The male to female ratio was 52:48. Among adults aged 15 years and above, 67.1% had no formal education. The neonatal mortality and under-five mortality rates were 59 and 109 deaths per 1,000 live births respectively. Rehri Goth has a baseline child mortality rate that is higher than the national average in Pakistan. This provides an opportunity to deliver an evidence-based, targeted MNCH package to reduce child mortality.

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