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 […]

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 […]

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 […]

Missed opportunities for institutional delivery and associated factors among urban resident pregnant women in South Tigray Zone, Ethiopia: A community-based follow-up study

Background: Every pregnant woman is considered to be at risk and some risks may not always be foreseeable or detectable. Therefore, the presence of a skilled birth attendant at every delivery is considered to be the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia, the proportion of births attended by skilled personnel […]

Magnitude of Child Food Insecurity, Its Association with Child Immunization and Huosehold wealth Status, and Coping Strategies in Dabat Demographic and Surveillance System North West Ethiopia

Background. The magnitude of food insecurity in Ethiopia ranges from 38.7% to 82.3% among the general population. Children under the age of five years were more prone to food insecurity and its serious consequences like anemia, low bone density, frequent episodes of common cold, stomachache, poor educational performance, and dental carries in developing countries like […]

Client Satisfaction with Delivery Care Service and Associated Factors in the Public Health Facilities of Gamo Gofa Zone, Southwest Ethiopia: In a Resource Limited Setting

Background. Ensuring patient satisfaction is an important means of secondary prevention of maternal mortality. This study presents findings from a multidimensional study of client satisfaction from the Gamo Gofa Zone in Southwest Ethiopia. Methods. A facility based cross-sectional study using exit interviews was conducted from 2014. Client satisfaction was measured using a survey adopted from […]