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Journal articles on the topic 'Health Medicine Maternal health services Child health services Uzbekistan'

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Published: 4 June 2021
Last updated: 11 February 2022

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1

Phung, Hai, Lis Young, Mai Tran, Khin Than Win, Carole Alcock, and Ken Hillman. "Health Informatics and Health Information Management in Maternal and Child Health Services." Health Information Management 33, no. 2 (September 2004): 36–42. http://dx.doi.org/10.1177/183335830403300204.

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WILLIAMS, CICELY D. "MATERNAL AND CHILD HEALTH SERVICES IN DEVELOPING COUNTRIES*." Nutrition Reviews 31, no. 11 (April 27, 2009): 365–66. http://dx.doi.org/10.1111/j.1753-4887.1973.tb07053.x.

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3

Lansdown, Richard. "Learning from the Health Services of other Lands: Maternal and Child Health." Journal of the Royal Society of Medicine 82, no. 1 (January 1989): 57–58. http://dx.doi.org/10.1177/014107688908200128.

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4

Islam, M. Aminul, and C. C. Nielsen. "Maternal and child health services: Evaluating mothers' perceptions and participation." Public Health 107, no. 4 (July 1993): 243–49. http://dx.doi.org/10.1016/s0033-3506(05)80503-7.

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5

Mitayani and Zulmardi. "Maternal and child health services in Kuranji Padang City towards SDG's." Enfermería Clínica 29 (March 2019): 85–87. http://dx.doi.org/10.1016/j.enfcli.2018.11.027.

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Bakar, Rukia Rajab, Rachel N. Manongi, and Blandina T. Mmbaga. "Health Facility Capacity to Provide Maternal and Newborn Healthcare Services in Unguja." Global Journal of Health Science 11, no. 10 (August 20, 2019): 120. http://dx.doi.org/10.5539/gjhs.v11n10p120.

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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.
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ABBAS, ADNAN A., and GODFREY J. A. WALKER. "Determinants of the Utilization of Maternal and Child Health Services in Jordan." International Journal of Epidemiology 15, no. 3 (1986): 404–7. http://dx.doi.org/10.1093/ije/15.3.404.

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Zaidi, Shehla, Maryam Huda, Ammarah Ali, Xaher Gul, Rawshan Jabeen, and Mashal Murad Shah. "Pakistan’s Community-based Lady Health Workers (LHWs): Change Agents for Child Health?" Global Journal of Health Science 12, no. 11 (September 29, 2020): 177. http://dx.doi.org/10.5539/gjhs.v12n11p177.

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BACKGROUND: In Pakistan’s high child mortality context, a large-scale Lady Health Worker (LHW) Program raises the need to look at whether LHWs are delivering their key mandate as agents of change for child health. This study examines the quantity and quality of LHW interactions with mothers for child health and their impact on mothers' knowledge and child health practices. METHODS: 1,968 mothers of children <2 years (n=1,968) were interviewed through a cross-sectional survey in two rural districts of Pakistan focusing on immunization, nutrition, and early child illness. Data on frequency of LHW’s visits; services provided, specific services related to routine immunization (RI), nutrition and child illness, and maternal knowledge and practices were analyzed using median values for continuous variables and counts and percentages for categorical data. RESULTS: Monthly visits by LHW were reported by only 63% of LHW covered households. During LHW monthly encounters, Oral Polio drops administration was most frequently reported (77%), followed by RI (59%), breastfeeding counseling (20%), child illness management advice (18%), growth monitoring (9.5%), while none reported receiving hygiene counseling. Although LHWs were reported to be the main information source for child health; limited impact of LHW-mother interaction was seen on maternal knowledge and practices: 76% mothers reported receiving ORS packets from LHWs but only 27% knew of correct usage, only 34% washed hands before feeding children, less than a third could correctly recall early signs of pneumonia and awareness of Vaccine Preventable Diseases other than Polio ranged from 42%-9% only. CONCLUSION: Although LHWs are main information source for child health services but infrequent, poor quality household encounters indicate ineffective delivery on the key mandate of community-based child health. Policy debate instead of focusing on scaling up or downsizing the program, should prioritize quality and supervision to improve value for money of a critical community resource.
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Romsaiyud, Walisa, and Wichian Premchaiswadi. "Adaptive Multi-Services System for Maternal and Child Health Care on Mobile Application (AM-Care)." International Journal of Healthcare Information Systems and Informatics 5, no. 3 (July 2010): 27–43. http://dx.doi.org/10.4018/jhisi.2010070103.

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Addressing efforts towards the improvement of maternal and child health management can often prove to be problematic in context to successfully obtaining healthcare and medical treatment information from health care professionals. In this regard, the authors propose an adaptive multi-service system that contains fully integrated health care services, medical treatment services, and maternal and child health management. The system utilized both web-based and mobile technology for implementing the application. A practical framework for generating individual maternal and child health care is also presented from data repositories and fully integrated functional health care services to support an improved quality of life for both mother and children. The application, namely AM-Care, consists of the three main components, i.e., Control Centre Component, Web-based Components, and Mobile Components. Also, AM-Care has the important add-on features such as emergency services and warning services.
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10

Pandey, Achyut Raj, Biwesh Ojha, Niraj Shrestha, Jasmine Maskey, Dikshya Sharma, Peter Godwin, Binaya Chalise, and Krishna Kumar Aryal. "Progress in Reducing Inequalities in Reproductive, Maternal, Newborn and Child Health Services in Nepal." Journal of Nepal Health Research Council 19, no. 1 (April 23, 2021): 140–47. http://dx.doi.org/10.33314/jnhrc.v19i1.3375.

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Background: Equity has emerged as a cross-cutting theme in the health sector, and countries across the world are striving to ensure that all people have access to the health services they need without undue financial hardship and educational, social, cultural and geographical barriers. In this context, this analysis has attempted to analyse Nepal’s progress in reducing inequalities in reproductive, maternal, newborn and child health services based on economic status and place of residence.Methods: In this analysis, we have used data available from the web version of the Health Equity Assessment Toolkit, a data visualisation tool developed by the World Health Organisation. We have analysed the inequalities in terms of a composite coverage index which combines eight reproductive, maternal, newborn and child health interventions along the continuum of care.Results: Composite coverage of reproductive, maternal, newborn and child health services was 43% in 2001 which increased to 65% in 2016. The absolute difference in composite coverage of the services between the lowest and highest wealth quintiles decreased from 28-percentage points in 2001 to 8-percentage points in 2016. The difference in service coverage between the urban and rural settings reduced from 21-percentage points to six percentage points in the period. Among the eight various services, births attended by skilled birth attendants is the indicator with the highest scope for improvement. Conclusions: Inequalities based on wealth quintiles and residence places have narrowed from 2001 to 2016. Additional efforts in expanding skilled birth attendants and antenatal care service coverage among the poorest quintile and rural residents could further improve the coverage of the indicators at the national level and narrow down the inequalities.Keywords: Health services; inequality; maternal; Nepal; newborn and child health; reproductive health
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11

Singh, S., D. C. Jain, and R. C. Chaddha. "Evaluation of Maternal and Child Health Services at Block PHC Harduaganj, Aligarh, (UP)." International Journal of Infectious Diseases 12 (December 2008): e437-e438. http://dx.doi.org/10.1016/j.ijid.2008.05.1279.

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Lussier, Karine, Myriam Laventure, and Karine Bertrand. "Parenting and Maternal Substance Addiction: Factors Affecting Utilization of Child Protective Services." Substance Use & Misuse 45, no. 10 (June 1, 2010): 1572–88. http://dx.doi.org/10.3109/10826081003682123.

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13

Okafor, C. B. "Availability and use of services for maternal and child health care in rural Nigeria." International Journal of Gynecology & Obstetrics 34, no. 4 (April 1991): 331–46. http://dx.doi.org/10.1016/0020-7292(91)90602-2.

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14

Laar, A. S., E. Bekyieriya, S. Isang, and B. Baguune. "Assessment of mobile health technology for maternal and child health services in rural Upper West Region of Ghana." Public Health 168 (March 2019): 1–8. http://dx.doi.org/10.1016/j.puhe.2018.11.014.

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15

Sahoo, Krushna Chandra, Sapna Negi, Kripalini Patel, Bijaya Kumar Mishra, Subrata Kumar Palo, and Sanghamitra Pati. "Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review." Healthcare 9, no. 7 (June 30, 2021): 828. http://dx.doi.org/10.3390/healthcare9070828.

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Maternal and child health (MCH) has been a global priority for many decades and is an essential public health service. Ensuring seamless delivery is vital for desirable MCH outcomes. This systematic review outlined the challenges in accessing and continuing MCH services during public health emergencies—pandemics and disasters. A comprehensive search approach was built based on keywords and MeSH terms relevant to ‘MCH services’ and ‘pandemics/disasters’. The online repositories Medline, CINAHL, Psyc INFO, and Epistemonikos were searched for studies. We included twenty studies—seven were on the Ebola outbreak, two on the Zika virus, five related to COVID-19, five on disasters, and one related to conflict situations. The findings indicate the potential impact of emergencies on MCH services. Low utilization and access to services have been described as common challenges. The unavailability of personal safety equipment and fear of infection were primary factors that affected service delivery. The available evidence, though limited, indicates the significant effect of disasters and pandemics on MCH. However, more primary in-depth studies are needed to understand better the overall impact of emergencies, especially the COVID-19 pandemic, on MCH. Our synthesis offers valuable insights to policymakers on ensuring the uninterrupted provision of MCH services during an emergency.
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Sabo, Samantha, Matthew Butler, Kelly McCue, Patrick Wightman, Vern Pilling, Martín Celaya, and Sara Rumann. "Evaluation protocol to assess maternal and child health outcomes using administrative data: a community health worker home visiting programme." BMJ Open 9, no. 12 (December 2019): e031780. http://dx.doi.org/10.1136/bmjopen-2019-031780.

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IntroductionEmerging evidence suggests community health workers (CHWs) delivering preventive maternal and child health (MCH) interventions through home visiting improve several important health outcomes, including initiation of prenatal care, healthy birth weight and uptake of childhood immunisations.Methods and analysisThe Arizona Health Start Program is a behavioral-based home visiting intervention, which uses CHWs to improve MCH outcomes through health education, referral support, and advocacy services for at-risk pregnant and postpartum women with children up to 2 years of age. We aim to test our central hypothesis that mothers and children exposed to this intervention will experience positive health outcomes in the areas of (1) newborn health; (2) maternal health and healthcare utilisation; and (3) child health and development. This paper outlines our protocol to retrospectively evaluate Health Start Program administrative data from 2006 to 2015, equaling 15 576 enrollees. We will use propensity score matching to generate a statistically similar control group. Our analytic sample size is sufficient to detect meaningful programme effects from low-frequency events, including preterm births, low and very low birth weights, maternal morbidity, and differences in immunisation and hospitalisation rates.Ethics and disseminationThis work is supported through an inter-agency contract from the Arizona Department of Health Services and is approved by the University of Arizona Research Institutional Review Board (Protocol 1701128802, approved 25 January 2017). Evaluation of the three proposed outcome areas will be completed by June 2020.
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Charlton, Brittany M., Jessica A. Kahn, Vishnudas Sarda, Sabra L. Katz-Wise, Donna Spiegelman, Stacey A. Missmer, and S. Bryn Austin. "Maternal Attitudes/Relationship Quality and Daughter’s Receipt of Reproductive Health Care Services." Journal of Pediatric and Adolescent Gynecology 29, no. 2 (April 2016): 175. http://dx.doi.org/10.1016/j.jpag.2016.01.040.

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18

Al Nahedh, Nosa N. A. "Factors affecting the choice of maternal and child health services in a rural area of Saudi Arabia." Eastern Mediterranean Health Journal 1, no. 2 (August 30, 2021): 261–69. http://dx.doi.org/10.26719/1995.1.2.261.

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Thistudy examines factors affecting the choice of maternal and child health services in a rural area in Saudi Arabia. A house-to-house survey of 329 women in Al-Oyaynah village, north-west of Riyadh city, was carried out to determine the maternal factors associated with this choice. The variables examined included age, duration of marriage, education, occupation, income, parity and husband’s education. The analysis showed that distance from the health service, education of the mother and her age were the strongest determinants of the choice of maternal child health service used
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19

Kaoje, Aminu U., Sani Labaran, Aminu G. Magashi, and Jessica T. Ango. "Improving maternal and child health: a situational analysis of primary health care centres of Sokoto state, Nigeria." International Journal Of Community Medicine And Public Health 5, no. 12 (November 24, 2018): 5052. http://dx.doi.org/10.18203/2394-6040.ijcmph20184777.

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Background: Primary health care facilities constitute the first point of contacts of public with healthcare and form integral part of the country’s health system.Methods: A descriptive cross sectional study was conducted among 88 primary care facilities in the State. A simple random sampling technique was used to select the facilities. Federal Ministry of Health integrated supportive supervision tool was adapted for data collection and analysis done using SPSS Version 20.0. The variables were summarised with frequency and percentage and results presented in tables.Results: Almost two-thirds (65%) of the facilities provide 24 hours service coverage for both maternal and child care services. Only 16% of the facilities had medical officers, 12.5% had required number of nurse/midwife while 27% had no single nurse/midwife. With respect to trainings, one third of the facilities had personnel trained on medium and extended lifesaving skills, 20% had a trained staff on emergency obstetrics and newborn care while 61% had no single trained personnel on integrated management of childhood illnesses. A large proportion of the facilities provide maternal services such as focused ANC and delivery but none use partograph to monitor labour. A good number of facilities were lacking basic equipment and medicine supply with about two third of facilities lacking misoprostol and magnesium sulphate, and only 15% had functional DRF.Conclusions: Health resources and the level of service provision in its current form may not lead to a significant improvement in maternal and child health in the state to guarantee universal coverage.
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Sununtnasuk, Celeste, Phuong Nguyen, Anjali Pant, Lan Mai Tran, Shivani Kachwaha, Deborah Ash, Mohsin Ali, et al. "Provision and Utilization of Health and Nutrition Services During the COVID-19 Pandemic in Urban Bangladesh." Current Developments in Nutrition 5, Supplement_2 (June 2021): 690. http://dx.doi.org/10.1093/cdn/nzab045_072.

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Abstract Objectives The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake. Methods We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children < 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Results Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children). Conclusions Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute; and Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI Solutions.
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Talukder, Md Noorunnabi, and Ubaidur Rob. "Equity in Access to Maternal and Child Health Services in Five Developing Countries: What Works." International Quarterly of Community Health Education 31, no. 2 (April 2011): 119–31. http://dx.doi.org/10.2190/iq.31.2.b.

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22

Fauveau, V., B. Wojtyniak, J. Chakraborty, A. M. Sarder, and A. Briend. "The effect of maternal and child health and family planning services on mortality: is prevention enough?" BMJ 301, no. 6743 (July 14, 1990): 103–7. http://dx.doi.org/10.1136/bmj.301.6743.103.

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Fauveau, V., B. Wojtyniak, J. Chakraborty, AM Sarder, and A. Briend. "The effect of maternal and child health and family planning services on mortality: Is prevention enough?" International Journal of Gynecology & Obstetrics 34, no. 4 (April 1991): 389. http://dx.doi.org/10.1016/0020-7292(91)90610-h.

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Belemsaga, Danielle Yugbare, Seni Kouanda, Anne Goujon, Joel A. Kiendrebeogo, Els Duysburgh, Olivier Degomme, and Marleen Temmerman. "A review of factors associated with the utilization of healthcare services and strategies for improving postpartum care in Africa." Afrika Focus 28, no. 2 (February 26, 2015): 83–105. http://dx.doi.org/10.1163/2031356x-02802006.

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Reducing maternal mortality continues to be a major challenge for African countries. We conducted a literature review to identify the factors associated with the utilization of maternal and child healthcare services during the postpartum period and the strategies for strengthening postpartum healthcare in Africa. We carried out an electronic search in several databases of texts published between 1995 and 2012 related to maternal and child health. Seventy-five publications fitted the eligibility criteria. Our analysis shows that to a large extent the socio-economic context was dominant among the factors associated with the quality and utilization of postpartum services. The best interventions were those on immediate postpartum maternal care combining several intervention packages such as community mobilization and provision of services, community outreach services and health training. The integration within health facilities of mother and child clinics was shown to contribute significantly to improving the frequency of mothers’ postpartum visits.
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Avula, Rasmi, Phuong Nguyen, Sattvika Ashok, Sumati Bajaj, Shivani Kachwaha, Anjali Pant, Monika Walia, et al. "India's 2.42 Million Frontline Health Workers Enable Restoration of Health and Nutrition Service Delivery After Early COVID-19 Lockdowns." Current Developments in Nutrition 5, Supplement_2 (June 2021): 206. http://dx.doi.org/10.1093/cdn/nzab029_007.

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Abstract Objectives Modeling studies have estimated impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes, but little is known about actual delivery status. We studied disruptions and restorations of health and nutrition services by frontline workers (FLWs) in India during COVID-19. Methods We conducted phone surveys with 5500 FLWs in seven states between August–October 2020, asking about service delivery during April 2020 (T1) and in the August-October period (T2) and analyzed changes between T1 and T2. We also analyzed publicly available administrative data (AD) from 704 districts including the pre-pandemic period (T0) to examine disruptions and restoration of services. Results Phone surveys suggest, in T1, opening of village centers, fixed day events, growth monitoring, and immunization services was <50% in several states. In T2, restorations of center-based services were seen, with increases of >33% in >= 3 states. Food supplementation was least disrupted both in T1 and T2. AD highlights geographic variability both in disruptions in T1 compared to T0 and restorations in T2. FLWs’ adaptations to ensure service provision included home delivery (60 to 96%), ensuring physical distancing (33 to 86%), coordinating with other FLWs (7 to 49%), and using phone (∼2 to 65%). Challenges included personal fears, walking long distances, and beneficiaries’ non-cooperation. Conclusions Services to mothers and children were disrupted during lockdown and restored thereafter. Rapid policy guidance and local adaptations by a strong cadre of FLWs likely enabled service resumption. However, gaps remain, and more research is needed on use of services by clients. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.
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Li, Virginia Cheng. "Critical Public Health Problems Perceived by Urban Chinese Health Workers." International Quarterly of Community Health Education 6, no. 4 (January 1986): 297–308. http://dx.doi.org/10.2190/c3kb-tyd4-p0ah-k509.

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This study surveyed a cross section of urban Chinese health workers' perception of problems, needs and priorities in health care delivery. Eleven categories of problems were identified by the health workers. When asked to prioritize what they perceived as critical public health problems in China, more respondents (25.9%) cited family planning and maternal child health as the most critical problem. However, in terms of response frequency, family planning and maternal child health ranked fifth (10.7%) behind disease prevention (18.4%), health education of the public (15.4%), health services administration (13.1%), and environmental health (12.1%). Other critical problems identified were medical education (10.0%). industrial health (5.3%), research (4.5%), nutrition and food sanitation (4.5%), young adults (3.6%), and the elderly (3.6%). Apparently, family planning is perceived as the most critical societal health problem affecting the welfare of the state, but heart disease, cancer, dysentery, hepatitis, and others were perceived as personal health problems critical to the individual and the public. The delineation suggests a distinction of state versus individual priorities. The Chinese health workers saw solutions to these critical problems more often in combined measures of health education, policy regulation, and medical care, than in single measures. They recognized the importance of an enlightened public and felt that educating the public must undergrid all health measures to reach the goal of Health for All by the Year 2000.
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Yitbarek, Kiddus, Gelila Abraham, and Sudhakar Morankar. "Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence." BMJ Open 9, no. 5 (May 2019): e025937. http://dx.doi.org/10.1136/bmjopen-2018-025937.

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ObjectiveThe aim of this review was to identify, appraise and synthesise studies that reported on the contribution of women’s development army (WDA) to maternal and child health development.SettingStudies conducted in Ethiopia 2010 onwards and published in English were considered.Data sourcesEvidence were searched in MEDLINE, CINAHL and EBSCOhost from 25 March to 10 April 2018.Eligibility criteriaBoth quantitative and qualitative studies assessing the contribution of WDA to maternal and child health were considered.Data extraction and synthesisTwo independent reviewers have extracted data using pre-planned data extraction tool separately for each study design. Findings were synthesised using tables and narrative summary.OutcomeMaternal and child health services; maternal and child mortality.ResultsNine studies met the inclusion criteria and were used for synthesis. The results revealed that participation and membership in women’s development teams (WDTs) have a positive effect on minimising maternal death and improving child immunisation service use. Skilled delivery and antenatal care service use were higher in WDTs located within a radius of 2 km from health facilities. Women’s development teams were also the main sources of information for mothers to prepare themselves for birth and related complications. Moreover, well-established groups have strengthened the linkage of the health facility to the community so that delays in maternal health service use were minimised; health extension workers could effectively refer women to a health facility for birth and utilisation of skilled birth service was improved.ConclusionVoluntary health service intervention in Ethiopia has improved maternal and child health services’ outcome. A decrease in maternal deaths, increase in antenatal and delivery service use and improved child immunisation service uptake are attributable to this intervention. The linkage between community members and the primary healthcare system served as an effective and efficient mechanism to share information.
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Akaba, Godwin, Osasuyi Dirisu, Kehinde Okunade, Eseoghene Adams, Jane Ohioghame, Obioma Obikeze, Emmanuel Izuka, Maryam Sulieman, and Michael Edeh. "Impact of COVID-19 on utilization of maternal, newborn and child health services in Nigeria: protocol for a country-level mixed-methods study." F1000Research 9 (August 18, 2021): 1106. http://dx.doi.org/10.12688/f1000research.26283.2.

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Background: Battling with COVID-19 and providing essential services along the continuum of care could be challenging. This study will evaluate the impact of COVID-19 on utilization of maternal, newborn and child health (MNCH) services in Nigeria and explore the barriers being experienced by women and their families in getting access to MNCH services, as well as other contextual factors that may have shaped the utilization of MNCH services during the COVID-19 pandemic. Methods and analysis: The study will adopt an observational mixed-methods study design involving 18 health care facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria. We will retrieve longitudinal data on MNCH services from all selected hospitals six months before and after the first recorded case of COVID-19 in Nigeria. Qualitative data will be collected using in-depth interviews conducted via mobile phones or ZOOM meeting platforms among stakeholder participants (users of MNCH services, health workers and policymakers) to ascertain their perceptions on how COVID-19 has shaped the utilization of MNCH services. We will triangulate quantitative and qualitative data to better understand the impact of COVID-19 on the utilization of MNCH services in Nigeria. Ethics and dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. Our findings will provide the first evidence from an African setting on the impact of COVID-19 on the utilization of MNCH services using a mixed-methods study design for policy formulation towards sustained MNCH service delivery.
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Stein, Karen. "Using situation analysis to assess women's perceptions of quality of maternal-child health and family planning services." Reproductive Health Matters 6, no. 11 (January 1998): 45–54. http://dx.doi.org/10.1016/s0968-8080(98)90081-7.

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Florentianus, Tat, and Bait M. Maria. "The Effect of Accessibility on Performance of Maternal and Child Health Policy Implementation in East Nusa Tenggara Province, Indonesia." Global Journal of Health Science 11, no. 11 (September 30, 2019): 180. http://dx.doi.org/10.5539/gjhs.v11n11p180.

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BACKGROUND: The fact shows that the performance of health service policy implementation from the output aspect (out put) and the outcome (out comes) policy has not been in line with expectations. This condition will also have a direct influence on the Human Development Index in East Nusa Tenggara Province, where the position of East Nusa Tenggara is still in the order of 32 out of 34 provinces in Indonesia, which ranges from 68.77. The main purpose of this study was to identify the health service accessibility in East Nusa Tenggara. Furthermore, this study also intended to find out the performance of policy implementation and was to identify the effect of accessibility of health sevices on the performance of policy implementation on mothers and children in East Nusa Tenggara. SUBJECT & METHOD: This research is a quantitative study, conducted in 11 districts, 104 community healths services, and has 235 health workers as respondents in East Nusa Tenggara Province of Indonesia. RESULT: The results of the study on conditions of accessibility and networking in maternal and child health services in East Nusa Tenggara Province are still lacking (mean 2.7), meaning that conditions of accessibility in East Nusa Tenggara Province do not support the implementation of MCH policies. The performance of MCH policy implementation in East Nusa Tenggara Province is in the 3.36 category, meaning that the targets of MCH services that have been made have not been maximally realized. There is a correlation between accessibility conditions and the performance of MCH policy implementation (p = 0.00), the correlation coefficient of 0.429 shows that this correlation is quite strong, although not very strong. This correlation shows a positive relationship which means that if the accessibility conditions are easier, it will improve the performance of MCH policy implementation. The effect of accessibility on policy performance has been carried out partial linear regression test (t test), found t count = 19.0115 > t table 1.97 means that there is a significant influence on the condition of accessibility to the performance of MCH policies in East Nusa Tenggara Province. CONCLUSION: Accessibility to health services in East Nusa Tenggara Province is still lacking, the policy implementation performance is good and there is a significant and positive influence between service accessibility and policy implementation performance. RECOMENDATION: The government is expected to be more serious in efforts to open the accessibility of health services and set more realistic targets that could be achieved.
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Istafa, Mabda Novalia, Ferry Efendi, and Erna Dwi Wahyuni. "Maternal Healthcare Utilization among Mothers Aged 15-24 Years in Indonesia: a Literature Review." Indonesian Journal of Community Health Nursing 6, no. 1 (April 1, 2021): 1. http://dx.doi.org/10.20473/ijchn.v6i1.17754.

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Introduction: The use of health care services in mothers was a very important concern in developing countries because it was very beneficial in terms of declining maternal mortality rate, but the use of maternal health services in mothers aged 15-24 years In Indonesia was still not maximized. The purpose of this review was to analyze best practices in the use of maternal health services in mothers aged 15-24 years.Method: The systematic review of this search was done by the publication range was five years ago. Article criteria were articles reviewed by Bestari Partners, government documents and research locations in developing countries. Acquired 10 references that meet predefined criteria.Results: The analysis obtained was the use of maternal health services in mothers aged 15-24 years needs to be increased by looking at the factors that influence among them were seeing from the socio-demography of mothers and husbands, household factors, access to health services and regional factors.Conclusion: These recommendations are aimed at governments, health professionals and families that efforts to increase not only can be done by a single community line, but the whole must also be able to cooperate by the role in the efforts to increase the use of Health care services.
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Akseer, Nadia, Goutham Kandru, Emily C. Keats, and Zulfiqar A. Bhutta. "COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition." American Journal of Clinical Nutrition 112, no. 2 (June 19, 2020): 251–56. http://dx.doi.org/10.1093/ajcn/nqaa171.

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ABSTRACT Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.
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Lopez-Arana, Sandra, Mauricio Avendano, Frank J. van Lenthe, and Alex Burdorf. "The impact of a conditional cash transfer programme on determinants of child health: evidence from Colombia." Public Health Nutrition 19, no. 14 (February 26, 2016): 2629–42. http://dx.doi.org/10.1017/s1368980016000240.

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AbstractObjectiveConditional cash transfer (CCT) programmes provide income to low-income families in return for fulfilling specific behavioural conditions. CCT have been shown to improve child health, but there are few systematic studies of their impact on multiple determinants of child health. We examined the impact of a CCT programme in Colombia on: (i) use of preventive health services; (ii) food consumption and dietary diversity; (iii) mother’s knowledge, attitudes and practices about caregiving practices; (iv) maternal employment; and (v) women’s empowerment.DesignSecondary analysis of the quasi-experimental evaluation of theFamilias en Accionprogramme. Children and families were assessed in 2002, 2003 and 2005–06. We applied a difference-in-differences approach using logistic or linear regression, separately examining effects for urban and rural areas.SettingColombia.SubjectsChildren (n1450) and their families in thirty-one treatment municipalities were compared with children (n1851) from sixty-five matched control municipalities.ResultsFamilias en Accionwas associated with a significant increase in the probability of using preventive care services (OR=1·85, 95 % CI 1·03, 3·30) and growth and development check-ups (β=1·36, 95 % CI 0·76, 1·95). It had also a positive impact on dietary diversity and food consumption. No effect was observed on maternal employment, women’s empowerment, and knowledge, attitudes and practices about caregiving practices. Overall,Familias en Accion’s impact was more marked in rural areas.ConclusionCCT in Colombia increase contact with preventive care services and improve dietary diversity, but they are less effective in influencing mother’s employment decisions, empowerment and knowledge of caregiving practices.
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Sakuma, Saki, Junko Yasuoka, Khampheng Phongluxa, and Masamine Jimba. "Determinants of continuum of care for maternal, newborn, and child health services in rural Khammouane, Lao PDR." PLOS ONE 14, no. 4 (April 23, 2019): e0215635. http://dx.doi.org/10.1371/journal.pone.0215635.

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Mehata, Suresh, Yuba Raj Paudel, Maureen Dariang, Krishna Kumar Aryal, Bibek Kumar Lal, Mukti Nath Khanal, and Deborah Thomas. "Trends and Inequalities in Use of Maternal Health Care Services in Nepal: Strategy in the Search for Improvements." BioMed Research International 2017 (2017): 1–11. http://dx.doi.org/10.1155/2017/5079234.

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Background. Nepal has made significant progress against the Millennium Development Goals for maternal and child health over the past two decades. However, disparities in use of maternal health services persist along geographic, economic, and sociocultural lines. Methods. Trends and inequalities in the use of maternal health services in Nepal between 1994 and 2011 were examined using four Nepal Demographic and Health Surveys (NDHS), nationally representative cross-sectional surveys conducted by interviewing women who gave birth 3–5 years prior to the survey. Sociodemographic disparities in maternal health service utilization were measured. Rate difference, rate ratios, and concentration index were calculated to measure income inequalities. Findings. The percentage of mothers that received four antenatal care (ANC) consultations increased from 9% to 54%, the institutional delivery rate increased from 6% to 47%, and the cesarean section (C-section) rate increased from 1% in 1994 to 6% in 2011. The ratio of the richest and the poorest quintile mothers for use of four ANC, institutional delivery, and C-section delivery were 5.08 (95% CI: 3.82–6.76), 9.00 (95% CI: 6.55–12.37), and 9.37 (95% CI: 4.22–20.83), respectively. However, inequality is reducing over time; for the use of four ANC services, the concentration index fell from 0.60 (95% CI: 0.56–0.64) in 1994–1996 to 0.31 (95% CI: 0.29–0.33) in 2009–2011. For institutional delivery, the concentration index fell from 0.65 (95% CI: 0.62–0.70) to 0.40 (95% CI: 0.38–0.40) between 1994–1996 and 2009–2011. For C-section deliveries, an increase in concentration index was observed, 0.64 (95% CI: 0.51–0.77); 0.76 (95% CI: 0.64–0.88); 0.77 (95% CI: 0.71–0.84); and 0.66 (95% CI: 0.60–0.72) in the periods 1994–1996, 1999–2001, 2004–2006, and 2009–2011, respectively. All sociodemographic variables were significant predictors of use of maternal health services, out of which maternal education was the most powerful. Conclusion. To increase equitable use of maternal health services in Nepal there is a need to strengthen the health system to increase access to and utilization of services among poorer women, those with less education, and those living in remote areas. Beyond the health sector stronger efforts are needed to tackle the root causes of health inequality, reduce poverty, increase female education, eradicate caste/ethnicity based social discrimination, and invest in the development of remote areas.
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McCoy, D., K. Storeng, V. Filippi, C. Ronsmans, D. Osrin, B. Matthias, O. M. Campbell, et al. "Maternal, neonatal and child health interventions and services: moving from knowledge of what works to systems that deliver." International Health 2, no. 2 (June 2010): 87–98. http://dx.doi.org/10.1016/j.inhe.2010.03.005.

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Defar, Atkure, Yemisrach B. Okwaraji, Zemene Tigabu, Lars Åke Persson, and Kassahun Alemu. "Distance, difference in altitude and socioeconomic determinants of utilisation of maternal and child health services in Ethiopia: a geographic and multilevel modelling analysis." BMJ Open 11, no. 2 (February 2021): e042095. http://dx.doi.org/10.1136/bmjopen-2020-042095.

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ObjectiveWe assessed whether geographic distance and difference in altitude between home to health facility and household socioeconomic status were associated with utilisation of maternal and child health services in rural Ethiopia.DesignHousehold and health facility surveys were conducted from December 2018 to February 2019.SettingForty-six districts in the Ethiopian regions: Amhara, Oromia, Tigray and Southern Nations, Nationalities, and Peoples.ParticipantsA total of 11 877 women aged 13–49 years and 5786 children aged 2–59 months were included.Outcome measuresThe outcomes were four or more antenatal care visits, facility delivery, full child immunisation and utilisation of health services for sick children. A multilevel analysis was carried out with adjustments for potential confounding factors.ResultsOverall, 39% (95% CI: 35 to 42) women had attended four or more antenatal care visits, and 55% (95% CI: 51 to 58) women delivered at health facilities. One in three (36%, 95% CI: 33 to 39) of children had received full immunisations and 35% (95% CI: 31 to 39) of sick children used health services. A long distance (adjusted OR (AOR)=0.57; 95% CI: 0.34 to 0.96) and larger difference in altitude (AOR=0.34; 95% CI: 0.19 to 0.59) were associated with fewer facility deliveries. Larger difference in altitude was associated with a lower proportion of antenatal care visits (AOR=0.46; 95% CI: 0.29 to 0.74). A higher wealth index was associated with a higher proportion of antenatal care visits (AOR=1.67; 95% CI: 1.02 to 2.75) and health facility deliveries (AOR=2.11; 95% CI: 2.11 to 6.48). There was no association between distance, difference in altitude or wealth index and children being fully immunised or seeking care when they were sick.ConclusionAchieving universal access to maternal and child health services will require not only strategies to increase coverage but also targeted efforts to address the geographic and socioeconomic differentials in care utilisation, especially for maternal health.Trial registration numberISRCTN12040912.
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Natai, Clara C., Neema Gervas, Frybert M. Sikira, Beatrice J. Leyaro, Juma Mfanga, Mashavu H. Yussuf, and Sia E. Msuya. "Association between male involvement during antenatal care and use of maternal health services in Mwanza City, Northwestern Tanzania: a cross-sectional study." BMJ Open 10, no. 9 (September 2020): e036211. http://dx.doi.org/10.1136/bmjopen-2019-036211.

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BackgroundMale involvement in antenatal care (ANC) is among interventions to improve maternal health. Globally male involvement in ANC is low and varies in low-income and middle-income countries including Tanzania where most maternal deaths occur. In Sub-Sahara, men are chief decision makers and highly influence maternal health. In Tanzania information is limited regarding influence of male involvement during ANC on utilisation of maternal health services.ObjectivesTo determine the effect of male involvement during ANC on use of maternal health services in Mwanza, Tanzania.DesignA cross-sectional study conducted from June to July 2019.SettingThis study was conducted at seven randomly selected health facilities providing reproductive, maternal and child health (RCH) services in Mwanza City.ParticipantsIncluded 430 postpartum women who delivered 1 year prior to the study and attending for RCH services (growth monitoring, vaccination, postpartum care).Outcome measures4 or more ANC visits, skilled birth attendant (SBA) use during childbirth and postnatal care (PNC) utilisation 48 hours after delivery.MethodsInterviews and observation of the women’s ANC card were used to collect data. Data was entered, cleaned and analysed by SPSS.ResultsThe mean age of participants was 25.7 years. Of 430 women, 54.4% reported their partners attended ANC at least once, 69.7% reported they attended for four or more ANC visits during last pregnancy, 95% used SBAs during childbirth and 9.2% attended PNC within 48 hours after delivery. Male involvement during ANC was significantly associated with four or more ANC visits (Crude Odds Ratio (COR): 1.90; 95% CI: 1.08–3.35) but not with SBA use or PNC utilisation.ConclusionMale involvement in ANC is still low in Mwanza, as 46% of the partners had not attended with partners at ANC. Alternative strategies are needed to improve participation. Studies among men are required to explore the barriers of participation in overall RCH services.
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Nguyen, Phuong Hong, Long Quỳnh Khương, Priyanjana Pramanik, Sk Masum Billah, Purnima Menon, Ellen Piwoz, and Hannah H. Leslie. "Effective coverage of nutrition interventions across the continuum of care in Bangladesh: insights from nationwide cross-sectional household and health facility surveys." BMJ Open 11, no. 1 (January 2021): e040109. http://dx.doi.org/10.1136/bmjopen-2020-040109.

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IntroductionImproving the impact of nutrition interventions requires adequate measurement of both reach and quality of interventions, but limited evidence exists on advancing coverage measurement. We adjusted contact-based coverage estimates, taking into consideration the inputs required to deliver quality nutrition services, to calculate input-adjusted coverage of nutrition interventions across the continuum of care from pregnancy through early childhood in Bangladesh.MethodsWe used data from the 2014 Bangladesh Demographic and Health Surveys to assess use of maternal and child health services and the 2014 Service Provision Assessment to determine facility readiness to deliver nutrition interventions. Service readiness captured availability of nutrition-specific inputs (including human resources and training, equipment, diagnostics and medicines). Contact coverage was combined with service readiness to create a measure of input-adjusted coverage at the national and regional levels, across place of residence, and by maternal education and household socioeconomic quintiles.ResultsContact coverage varied from 28% for attending at least four ANC visits to 38% for institutional delivery, 35% for child growth monitoring and 81% for sick child care. Facilities demonstrated incomplete readiness for nutrition interventions, ranging from 48% to 51% across services. Nutrition input-adjusted coverage was suboptimal (18% for ANC, 23% for institutional delivery, 20% for child growth monitoring and 52% for sick child care) and varied between regions within the country. Inequalities in input-adjusted coverage were large during ANC and institutional delivery (14–17 percentage points (pp) between urban and rural areas, 15 pp between low and high education, and 28-34 pp between highest and lowest wealth quintiles) and less variable for sick child care (<2 pp).ConclusionNutrition input-adjusted coverage was suboptimal and varied subnationally and across the continuum of care in Bangladesh. Special efforts are needed to improve the reach as well as the quality of health and nutrition services to achieve the Sustainable Development Goals.
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McNamara, Bridgette, Lina Gubhaju, Louisa Jorm, David Preen, Jocelyn Jones, Grace Joshy, Carrington Shepherd, Daniel McAullay, and Sandra Eades. "Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)." BMJ Open 8, no. 3 (March 2018): e021236. http://dx.doi.org/10.1136/bmjopen-2017-021236.

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IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
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Nimmagadda, Sneha, Lakshmi Gopalakrishnan, Rasmi Avula, Diva Dhar, Nadia Diamond-Smith, Lia Fernald, Anoop Jain, et al. "Effects of an mHealth intervention for community health workers on maternal and child nutrition and health service delivery in India: protocol for a quasi-experimental mixed-methods evaluation." BMJ Open 9, no. 3 (March 2019): e025774. http://dx.doi.org/10.1136/bmjopen-2018-025774.

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IntroductionMillions of children in India still suffer from poor health and under-nutrition, despite substantial improvement over decades of public health programmes. The Anganwadi centres under the Integrated Child Development Scheme (ICDS) provide a range of health and nutrition services to pregnant women, children <6 years and their mothers. However, major gaps exist in ICDS service delivery. The government is currently strengthening ICDS through an mHealth intervention called Common Application Software (ICDS-CAS) installed on smart phones, with accompanying multilevel data dashboards. This system is intended to be a job aid for frontline workers, supervisors and managers, aims to ensure better service delivery and supervision, and enable real-time monitoring and data-based decision-making. However, there is little to no evidence on the effectiveness of such large-scale mHealth interventions integrated with public health programmes in resource-constrained settings on the service delivery and subsequent health and nutrition outcomes.Methods and analysisThis study uses a village-matched controlled design with repeated cross-sectional surveys to evaluate whether ICDS-CAS can enable more timely and appropriate services to pregnant women, children <12 months and their mothers, compared with the standard ICDS programme. The study will recruit approximately 1500 Anganwadi workers and 6000+ mother-child dyads from 400+ matched-pair villages in Bihar and Madhya Pradesh. The primary outcomes are the proportion of beneficiaries receiving (a) adequate number of home visits and (b) appropriate level of counselling by the Anganwadi workers. Secondary outcomes are related to improvements in other ICDS services, and knowledge and practices of the Anganwadi workers and beneficiaries.Ethics and disseminationEthical oversight is provided by the Committee for the Protection of Human Subjects at the University of California at Berkeley, and the Suraksha Independent Ethics Committee in India. The results will be published in peer-reviewed journals and analysis data will be made public.Trial registration numberISRCTN83902145
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Bchir, A. "[The birth register as an evaluation tool of maternal and child health activities at district level]." Eastern Mediterranean Health Journal 2, no. 3 (September 2, 2021): 418–24. http://dx.doi.org/10.26719/1996.2.3.418.

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Relevant epidemiological data are essential to improving management of maternal and child health services at district level. In public maternity hospitals of the health region of Monastir, Tunisia, a perinatal register has been established recording information related to pregnancy, childbirth and the condition of the newborn. During 1994, 7750 deliveries were registered, of which 46% took place in the university teaching hospital. Use of peripheral maternity hospitals varies according to the resources of the hospital;the university teaching hospital is highly attractive, especially for women from neighbouring districts. These findings raise the problem of the cost-effectiveness and relevance of opening new health facilities, particularly in times of economic crisis in the health care system
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Atake, E. H. "The impacts of migration on maternal and child health services utilisation in Sub-Saharan Africa: evidence from Togo." Public Health 162 (September 2018): 16–24. http://dx.doi.org/10.1016/j.puhe.2018.05.010.

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Kumar, C., P. K. Singh, and R. K. Rai. "Coverage gap in maternal and child health services in India: assessing trends and regional deprivation during 1992-2006." Journal of Public Health 35, no. 4 (January 27, 2013): 598–606. http://dx.doi.org/10.1093/pubmed/fds108.

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Chol, Chol, Joel Negin, Kingsley Emwinyore Agho, and Robert Graham Cumming. "Women’s autonomy and utilisation of maternal healthcare services in 31 Sub-Saharan African countries: results from the demographic and health surveys, 2010–2016." BMJ Open 9, no. 3 (March 2019): e023128. http://dx.doi.org/10.1136/bmjopen-2018-023128.

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ObjectivesTo examine the association between women’s autonomy and the utilisation of maternal healthcare services across 31 Sub-Saharan African countries.Design, setting and participantsWe analysed the Demographic and Health Survey (DHS) (2010–2016) data collected from married women aged 15–49 years. We used four DHS measures related to women’s autonomy: attitude towards domestic violence, attitude towards sexual violence, decision making on spending of household income made by the women solely or jointly with husbands and decision making on major household purchases made by the women solely or jointly with husbands. We used multiple logistic regression analyses to examine the association between women’s autonomy and the utilisation of maternal healthcare services adjusted for five potential confounders: place of residence, age at birth of the last child, household wealth, educational attainment and working status. Adjusted ORs (aORs) and 95% CI were used to produce the forest plots.Outcome measuresThe primary outcome measures were the utilisation of ≥4 antenatal care visits and delivery by skilled birth attendants (SBA).ResultsPooled results for all 31 countries (194 883 women) combined showed weak statistically significant associations between all four measures of women’s autonomy and utilisation of maternal healthcare services (aORs ranged from 1.07 to 1.15). The strongest associations were in the Southern African region. For example, the aOR for women who made decisions on household income solely or jointly with husbands in relation to the use of SBAs in the Southern African region was 1.44 (95% CI 1.21 to 1.70). Paradoxically, there were three countries where women with higher autonomy on some measures were less likely to use maternal healthcare services. For example, the aOR in Senegal for women who made decisions on major household purchases solely or jointly with husbands in relation to the use of SBAs (aOR=0.74 95% CI 0.59 to 0.94).ConclusionOur results revealed a weak relationship between women’s autonomy and the utilisation of maternal healthcare services. More research is needed to understand why these associations are not stronger.
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Jindal, S. "PMM.49 Overview of Maternal Medicine services at Milton Keynes Hospital, UK." Archives of Disease in Childhood - Fetal and Neonatal Edition 99, Suppl 1 (June 2014): A139.1—A139. http://dx.doi.org/10.1136/archdischild-2014-306576.405.

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Henning, Margaret J., Joseph M. Zulu, Charles Michelo, Stephanie Simmons Zuilkowski, and Candace Hubner. "Adolescent Mothers’ Experiences With Community Health Assistants in Rural Zambia." International Quarterly of Community Health Education 40, no. 4 (December 26, 2019): 353–61. http://dx.doi.org/10.1177/0272684x19896737.

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Adolescent health demands specific attention because adolescents have the lowest levels of health-care coverage of any age-group globally. The main objective as addressed in this article was to explore the lived experience of adolescent mothers and the services provided to them by community health assistants (CHAs) in rural Zambia. Because the number of adolescent mothers in rural Zambia is so high, it is even more critical to describe the lived experiences of health care among these young women with particular emphasis on primary health care as delivered by CHAs in rural Zambia. We used a mixed-methods design to address our research questions. Data were collected from nine focus groups, which were conducted with young mothers from four provinces and 10 districts ( n = 60). To support our effort to better understand the delivery of maternal and child health care in rural Zambia, key informant interviews were conducted with adolescent mothers ( n = 12). We also conducted surveys ( n = 44) and one-on-one interviews ( n = 22) with CHAs. To the best of our knowledge, this is the largest study focused on the intersection of adolescents, maternal child health, and CHA delivery of care in Zambia. The results of our study suggest opportunities for change to operational practices within the rural health-care setting and the need to develop structured and age-appropriate services that focus on adolescents. This work addresses the gap in research for adolescents in health care in rural Zambia and brings attention to the unique health-care needs of adolescent mothers within the rural health-care setting.
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Hasan, Md Mehedi, Ricardo J. Soares Magalhaes, Saifuddin Ahmed, Sayem Ahmed, Tuhin Biswas, Yaqoot Fatima, Md Saimul Islam, Md Shahadut Hossain, and Abdullah A. Mamun. "Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries." Global Health: Science and Practice 8, no. 4 (October 12, 2020): 654–65. http://dx.doi.org/10.9745/ghsp-d-20-00097.

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Wickramage, K., and R. Surentrikumaran. "(A194) “Displaced Voices”: Are those Displaced by War Satisfied with the Provision and Quality of Health Care they Received?" Prehospital and Disaster Medicine 26, S1 (May 2011): s54—s55. http://dx.doi.org/10.1017/s1049023x11001907.

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Research into how war-displaced communities value or prioritize aid response is limited. A clearer conceptualization of what affected populations seek from the international humanitarian response to their needs would be valuable in planning for emergencies.AimExploring internally displaced person's (IDP) experiences and perceptions of the humanitarian response, with a focus on health risks, resources, and health services received during their displacement.MethodA mixed-method approach using both quantitative and qualitative methods was used. This study assessed the perceptions of IDPs on provision of health and other services using an interviewer-administered-questionnaire (survey) using a sample frame that included the entire displaced population of 150,000 IDPs living in 97 camps. Findings from the survey were synthesized with the key themes that emerged through the qualitative methodology. In-depth interviews were conducted with health cluster actors. An innovative child-to-child (CTC) based research methodology was used to ascertain the insights and perceptions of displaced children and adolescents.ResultsThe survey revealed community satisfaction with health care services immediately after displacement (within IDP camps) improved considerably from 63% to 80% (6 months after the acute phase). Significant gains also were registered for shelter (54.2% to 81.4%), and sanitation (47.4% to 62%). Satisfaction of services rendered by primary healthcare workers also were high; 81.7% for public health midwife (who provided maternal and child health care), and 76.8% for public health inspectors (who provided environmental health and disease control). However, CTC workshops revealed inequalities in access to food based on ‘caste’ and occupation. Protection issues relating to violence from community and militant groups were reported.ConclusionsDespite IDP satisfaction with healthcare services, there were gaps in food security and violence/protection activities. Recognizing of the role/impact community health volunteers play in health care is an important factor in enhancing primary health care services in IDP camps.
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Maclean, Miriam Jennifer, Scott Anthony Sims, and Melissa O'Donnell. "Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study." BMJ Open 9, no. 7 (July 2019): e029675. http://dx.doi.org/10.1136/bmjopen-2019-029675.

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ObjectivesTo determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups.DesignA longitudinal, population-based record-linkage study.ParticipantsAll children in Western Australia (WA) with birth records between 1990 and 2009.Outcome measuresMental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013.ResultsCompared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders.ConclusionsYoung people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.
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