Health system governance following devolution: Comparing experiences of decentralisation in Kenya and Indonesia
Introduction Devolution reforms in Indonesia and Kenya have brought extensive changes to governance structures and mechanisms for financing and delivering healthcare. Community health approaches can contribute towards attaining many of devolution’s objectives, including community participation, responsiveness, accountability and improved equity. We set out to examine governance in two countries at different stages in the devolution […]
Effect of community-level intervention on antenatal care attendance: a quasi-experimental study among postpartum women in Eastern Uganda
Background: Early Initiation of antenatal care (ANC) and at least four visits during pregnancy allow screening and support for a healthy lifestyle and self-care during pregnancy however, community-directed interventions to improve access to these services are rarely explored. Objective: To assess the effect of community health worker (CHW) involvement on utilisation of antenatal services during […]
Not water, sanitation and hygiene practice, but timing of stunting is associated with recovery from stunting at 24 months: Results from a multi-country birth cohort study
Objectives: To measure the role of water, sanitation and hygiene (WASH) practices on recovery from stunting and assess the role of timing of stunting on the reversal of this phenomenon Design: Data from the MAL-ED multi-country birth cohort study was used for the current analysis. Generalised linear mixed-effects models were used to estimate the probability […]
Evaluation of the ethiopian millennium rural initiative: Impact on mortality and cost-effectiveness
Main Objective: Few studies have examined the long-term, impact of large-scale interventions to strengthen primary care services for women and children in rural, low-income settings. We evaluated the impact of the Ethiopian Millennium Rural Initiative (EMRI), an 18-month systems-based intervention to improve the performance of 30 primary health care units in rural areas of Ethiopia. […]
Implications of power imbalance in antenatal care seeking among pregnant adolescents in rural Tanzania: A qualitative study
Background Adolescent girls (10–19 years) are at increased risk of morbidity and mortality from pregnancy and childbirth complications, compared with older mothers. Low and middle-income countries, including Tanzania, bear the largest proportion of adolescent perinatal deaths. Few adolescent girls in Tanzania access antenatal care at health facilities, the reasons for which are poorly understood. Methods […]
Utilisation of private general practitioners to provide caesarean deliveries in five rural district public hospitals in South Africa: a mixed-methods study
Objective Researching how public-private engagements may promote universal access to safe obstetric care including caesarean delivery is essential. The aim of this research was to document the utilisation of private general practitioners (GPs) contracted to provide caesarean delivery services in five rural district hospitals in the Western Cape, the profile and outcomes of caesarean deliveries. […]
Individual and contextual factors associated with low childhood immunisation coverage in Sub-Saharan Africa: A multilevel analysis
Background: In 2010, more than six million children in sub-Saharan Africa did not receive the full series of three doses of the diphtheria-tetanus-pertussis vaccine by one year of age. An evidence-based approach to addressing this burden of un-immunised children requires accurate knowledge of the underlying factors. We therefore developed and tested a model of childhood […]
Direct and opportunity costs related to utilizing maternity waiting homes in rural Zambia
Aim: To assess the direct and opportunity costs involved in utilising maternity waiting homes. Method: A cross-sectional admission survey administered to women who used ten maternity waiting homes across two rural districts in Zambia. A total of 3,796 women participated in the survey. Descriptive analysis was conducted on three domains of the data: demographic characteristics […]
Predictors of Medical Students’ Views toward Research: Insights from a Cross-Cultural Study among Portuguese-Speaking Countries
Developing the skills and interest in scientific research of medical students is crucial to ensuring effective healthcare systems. As such, in this study, we aimed to assess Portuguese-speaking medical students’ attitudes and perceptions toward scientific research and clinical practice, and how they are influenced by individual characteristics and regional indicators. A total of 455 first-year […]
Travel time and perinatal mortality after emergency caesarean sections: An evaluation of the 2-hour proximity indicator in Sierra Leone
Introduction Longer travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance. Methods Women who delivered by caesarean section […]
