Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa
Introduction The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite […]
Perceived barriers to maternal and newborn health services delivery: A qualitative study of health workers and community members in low and middle-income settings
Objectives In considering explanations for poor maternal and newborn health outcomes, many investigations have focused on the decision-making patterns and actions of expectant mothers and families, as opposed to exploring the â € supply side’ (health service provider) barriers. Thus, we examined the health system factors impacting on access to and delivery of quality maternal […]
Quality of antenatal care predicts retention in skilled birth attendance: A multilevel analysis of 28 African countries
Background: An effective continuum of maternal care ensures that mothers receive essential health packages from pre-pregnancy to delivery, and postnatally, reducing the risk of maternal death. However, across Africa, coverage of skilled birth attendance is lower than coverage for antenatal care, indicating mothers are not retained in the continuum between antenatal care and delivery. This […]
Bottleneck analysis at district level to illustrate gaps within the district health system in Uganda
Background: Poor quality of care and access to effective and affordable interventions have been attributed to constraints and bottlenecks within and outside the health system. However, there is limited understanding of health system barriers to utilization and delivery of appropriate, highimpact, and cost-effective interventions at the point of service delivery in districts and sub-districts in […]
Intergenerational impacts of maternal mortality: Qualitative findings from rural Malawi
Background: Maternal mortality, although largely preventable, remains unacceptably high in developing countries such as Malawi and creates a number of intergenerational impacts. Few studies have investigated the far-reaching impacts of maternal death beyond infant survival. This study demonstrates the short- and long-term impacts of maternal death on children, families, and the community in order to […]
Prevalence and Predictors of “Small Size” Babies in Ethiopia: In-depth Analysis of the Ethiopian Demographic and Health Survey, 2011
BACKGROUND: Low Birth Weight (LBW) babies account for nearly 80% of neonatal deaths globally. In Ethiopia, only 5% of them are weighed at birth. This study analyzes the prevalence and key proximate determinants of reported infant size, and its validity to use as a proxy indicator for low birth weight inthe Ethiopian context. Data source: […]
Care Decision Making of Frontline Providers of Maternal and Newborn Health Services in the Greater Accra Region of Ghana
Objectives: To explore the “how” and “why” of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes. Methods: A cross sectional and descriptive mixed method study involving a desk review of […]
Impact of inter-facility transport on maternal mortality in the free state province
Aim. In December 2011, having identified inter-facility transport as a problem in the maternity service, the Free State Department of Health procured and issued 48 vehicles including 18 dedicated to maternity care. Subsequently, a sustained reduction in mortality was observed. We probed the role of inter-facility transport in effecting this reduction in mortality. Methods. A […]
Monitoring Maternity Mortality in Botswana
This paper describes the maternity monitoring system in Botswana, developed in 1998, and the main methods used: maternal death and morbidity reviews at service delivery level, analysis by the National Maternal Mortality Audit Committee of data from the reviews as reported on two forms, perinatal reviews and surveys using process indicators. We carried out a […]
Pre-hospital care seeking behaviour for childhood acute respiratory infections in south-western Nigeria
WHO/UNICEF currently recommend that childhood malaria and pneumonia be managed together in the community; most African countries are in the process of developing this policy. We conducted a cross-sectional study to determine maternal awareness of general danger signs of childhood illnesses and the prevalence, determinants and sources of pre-hospital treatment by mothers during their child’s […]