Nutrition-sensitive agricultural interventions, agricultural diversity, food access and child dietary diversity: Evidence from rural Zambia

We study a nutrition-sensitive agricultural program in low-income rural Zambia between 2011 and 2015. Using a pre-post design with a control group, we measure program effects along established pathways connecting agriculture to nutrition: diversity of agricultural production, crop sales, household food access and child and maternal diets. The program increased diversity in crops grown and […]

Home birth attendants in low income countries: who are they and what do they do?

Background: Nearly half the world’s babies are born at home. We sought to evaluate the training, knowledge, skills, and access to medical equipment and testing for home birth attendants across 7 international sites.Methods: Face-to-face interviews were done by trained interviewers to assess level of training, knowledge and practices regarding care during the antenatal, intrapartum and […]

Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia

There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambia’s Child Grant Program on a range of maternal health utilization outcomes using […]

Maternal health care in five sub-Saharan African countries

This paper examines inequalities in access to maternal health care services and identifies demographic and socio-economic factors associated with poor maternal health outcomes using data from five Demographic and Health Surveys conducted in Ghana (2003), Kenya (2003), Nigeria (2003), Uganda (2000-2001) and Zambia (2001-2002). The six maternal health care indicators show that rural women are […]

Determinants of access to health care among women in East African countries: A multilevel analysis of recent demographic and health surveys from 2008 to 2017

Background: Access to essential health care is one of the major factors associated with maternal mortality. In developing countries, improving women’s access to health care has significantly reduced maternal death. Therefore, this study aimed to identify the determinants of access to health care among women in East African countries based on 2008 to 2017 Demographic […]

Tracking progress towards safe motherhood: Meeting the benchmark yet missing the goal? An appeal for better use of health-system output indicators with evidence from Zambia and Sri Lanka

Objectives Indicators of health-system outputs, such as Emergency Obstetric Care (EmOC) density, have been proposed for monitoring progress towards reducing maternal mortality, but are currently underused. We seek to promote them by demonstrating their use at subnational level, evaluating whether they differentiate between a high-maternal-mortality country (Zambia) and a low-maternal-mortality country (Sri Lanka) and assessing […]

Looking at the bigger picture: Effect of performance-based contracting of district health services on equity of access to maternal health services in Zambia

Zambia has been using output-based approaches for over two decades to finance whole or part of the public health system. Between 1996 and 2006, performance-based contracting (PBC) was implemented countrywide with the Central Board of Health (CBoH) as the provider of health services. This study reviews the association between PBC and equity of access to […]

Removing financial barriers to access reproductive, maternal and newborn health services: The challenges and policy implications for human resources for health

Background: The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies […]

Access factors linked to maternal deaths in Lundazi district, Eastern Province of Zambia: A case control study analysing maternal death reviews

Background: Access factors associated with maternal death are important to understand because they are considered to be an essential measure of women’s health and indicative of the performance of health care systems in any community globally. This study aimed to analyse the access risk factors linked to maternal deaths in Lundazi district of the Eastern […]

Access barriers to maternal healthcare services in selected hard-to-reach areas of zambia: A mixed methods design

Introduction: poor access to maternal health services is a one of the major contributing factors to maternal deaths in low-resource settings, and understanding access barriers to maternal services is an important step for targeting interventions aimed at promoting institutional delivery and improving maternal health. This study explored access barriers to maternal and antenatal services in […]