District-level health system strengthening for universal health coverage: Evidence from a longitudinal cohort study in rural Madagascar, 2014-2018
Introduction Despite renewed commitment to universal health coverage and health system strengthening (HSS) to improve access to primary care, there is insufficient evidence to guide their design and implementation. To address this, we conducted an impact evaluation of an ongoing HSS initiative in rural Madagascar, combining data from a longitudinal cohort and primary health centres. […]
Association of Higher Educational Attainment on Antenatal Care Utilization Among Pregnant Women in East Africa Using Demographic and Health Surveys (DHS) from 2010 to 2018: A Multilevel Analysis
Introduction: The use of antenatal care (ANC) plays a major role in minimizing maternal and child mortality through effective and appropriate screening, preventive, or treatment intervention. Even though almost all pregnancy-related mortalities are largely preventable through adequate use of ANC, sub-Saharan Africa (SSA), particularly East African Countries, continues to share the largest share of global […]
Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries
Introduction: Globally, over 65% of maternal deaths occur during the first 42 days of postpartum while the same proportion of neonatal deaths occur during the first 7 days of life. In sab- Saharan Africa, 4.7 million mothers, newborns, and children die on annual basis. As to our knowledge, there is no study on postnatal care […]
The Collective Action Problem but Not Numerical Superiority Explains Success in Intergroup Encounters in Verreaux’s Sifaka (Propithecus verreauxi): Implications for Individual Participation and Free-Riding
Socioecological theory predicts that larger groups are able to gain better access to resources because of their numerical advantage in intergroup contests. Nevertheless, the numerical superiority hypothesis has received mixed support, perhaps due to the collective action problem and sex differences in strategies and payoffs. We tested the numerical superiority and the collective action problem […]
Factors associated with risk of developmental delay in preschool children in a setting with high rates of malnutrition: A cross-sectional analysis of data from the IHOPE study, Madagascar
Background: 50% of Malagasy children have moderate to severe stunting. In 2016, a new 10 year National Nutrition Action Plan (PNAN III) was initiated to help address stunting and developmental delay. We report factors associated with risk of developmental delay in 3 and 4 year olds in the rural district of Ifanadiana in southeastern Madagascar […]
Decomposing the gap in missed opportunities for vaccination between poor and non-poor in sub-Saharan Africa: A Multicountry Analyses
Understanding the gaps in missed opportunities for vaccination (MOV) in sub-Saharan Africa would inform interventions for improving immunisation coverage to achieving universal childhood immunisation. We aimed to conduct a multicountry analyses to decompose the gap in MOV between poor and non-poor in SSA. We used cross-sectional data from 35 Demographic and Health Surveys in SSA […]
Individual, maternal and household risk factors for anaemia among young children in sub-Saharan Africa: A cross-sectional study
Objective Anaemia affects the majority of children in sub-Saharan Africa (SSA). Previous studies of risk factors for anaemia have been limited by sample size, geography and the association of many risk factors with poverty. In order to measure the relative impact of individual, maternal and household risk factors for anaemia in young children, we analysed […]
Association between proximity to a health center and early childhood mortality in madagascar
Objective: To evaluate the association between proximity to a health center and early childhood mortality in Madagascar, and to assess the influence of household wealth, maternal educational attainment, and maternal health on the effects of distance. Methods: From birth records of subjects in the Demographic and Health Survey, we identified 12565 singleton births from January […]
Baseline population health conditions ahead of a health system strengthening program in rural Madagascar
Background: A model health district was initiated through a program of health system strengthening (HSS) in Ifanadiana District of southeastern Madagascar in 2014. We report population health indicators prior to initiation of the program. Methods: A representative household survey based on the Demographic Health Survey was conducted using a two-stage cluster sampling design in two […]
A mobile health wallet for pregnancy-related health care in madagascar: mixed-methods study on opportunities and challenges
Background: Mobile savings and payment systems have been widely adopted to store money and pay for a variety of services, including health care. However, the possible implications of these technologies on financing and payment for maternal health care services—which commonly require large 1-time out-of-pocket payments—have not yet been systematically assessed in low-resource settings. Objective: The […]
