Design and implementation of a health systems strengthening approach to improve health and nutrition of pregnant women and newborns in Ethiopia, Kenya, Niger, and Senegal
Maternal and neonatal mortality are unacceptably high in developing countries. Essential nutrition interventions contribute to reducing this mortality burden, although nutrition is poorly integrated into health systems. Universal health coverage is an essential prerequisite to decreasing mortality indices. However, provision and utilization of nutrition and health services for pregnant women and their newborns are poor […]
Interrupted time series analysis of free maternity services policy in Nyamira County, Western Kenya
Introduction The Government of Kenya instituted the free maternity services (FMS) policy to improve utilization of maternal healthcare services and thus improve maternal health. The aim of this study was to evaluate the effect of the FMS policy on the uptake of maternal health services in Nyamira County in western Kenya. Methods An interrupted time […]
Impact of the community healthcare plan and the free maternity services programme on maternal and child healthcare utilisation in rural Kenya: A dairy farmer population-based study
Background: Access to and utilisation of quality maternal and child healthcare services is generally recognized as the best way to reduce maternal and child mortality. Objectives: We evaluated whether the introduction of a voluntary family health insurance programme, combined with quality improvement of healthcare facilities [The Community Health Plan (TCHP)], and the introduction of free […]
Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia
Background: Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods: A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to […]
Improving health care facility birth rates in Rorya District, Tanzania: a multiple baseline trial
Background: Rates of maternal mortality and morbidity in Africa remain unacceptably high, as many women deliver at home, without access to skilled birth attendants and life-saving medications. In rural Tanzania, women face significant barriers accessing health care facilities for their deliveries. Methods: From January 2017 to February 2019 we conducted a multiple baseline (interrupted time […]
Design of an impact evaluation using a mixed methods model – An explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi
Background: In this article we present a study design to evaluate the causal impact of providing supply-side performance-based financing incentives in combination with a demand-side cash transfer component on equitable access to and quality of maternal and neonatal healthcare services. This intervention is introduced to selected emergency obstetric care facilities and catchment area populations in […]
Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia
Background: Cost of delivering reproductive health services to low income populations will always require total or partial subsidization by government and/or development partners. Broadly termed “demand-side financing” or “output-based aid”, these strategies include a range of interventions that channel government or donor subsidies to the user rather than the service provider. Initial pilot assessments of […]
Effect of a participatory multisectoral maternal and newborn intervention on maternal health service utilization and newborn care practices: A quasi-experimental study in three rural Ugandan districts
Background: The MANIFEST study in eastern Uganda employed a participatory multisectoral approach to reduce barriers to access to maternal and newborn care services. Objectives: This study analyses the effect of the intervention on the utilization of maternal and newborn services and care practices. Methods: The quasi-experimental pre- and post-comparison design had two main components: community […]
Maternal near-miss and mortality associated with hypertensive disorders of pregnancy remote from term: a multicenter observational study in Ghana
BACKGROUND: Maternal death rates remain high in many low- and middle-income countries. Hypertensive disorders of pregnancy account for 18% of maternal mortality in Ghana. The maternal near-miss approach was designed to evaluate severe (acute) complications in pregnancy, which is useful to detect potential areas for clinical care improvement. OBJECTIVE: This study aimed (1) to determine […]
Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter?
Introduction: The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of […]
