Errors in estimated gestational ages reduce the likelihood of health facility deliveries: Results from an observational cohort study in Zanzibar
Background: Most maternal health programs in low- and middle- income countries estimate gestational age to provide appropriate antenatal care at the correct times throughout the pregnancy. Although various gestational dating methods have been validated in research studies, the performance of these methods has not been evaluated on a larger scale, such as within health systems. […]
Intended and unintended effects: Community perspectives on a performance-based financing programme in Malawi
Background Several performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members’ perspectives of Support for Service Delivery Integration – Performance-Based Incentives (‘SSDI-PBI’), a PBF intervention in Malawi, and explored some of the unintended effects that emerged amid implementation. […]
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia
Background: Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 deaths per 100,000 live births. Our study aimed to assess the relationship between MWH quality […]
Obstetric hemorrhage and shock management: Using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities
Background: Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings.Methods: This study employed a pre-intervention/intervention design in […]
Community health workers can improve child growth of antenatally-depressed, South African mothers: A cluster randomized controlled trial
Background: Maternal antenatal depression has long-term consequences for children’s health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed. Methods: A cluster randomized controlled trial of all pregnant, neighbourhood women in Cape Town, South Africa. Almost all pregnant women (98 %, N […]
Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: A prospective observational study
Objectives To assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS). Design A prospective observational study of MCH services. Setting Pujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017. […]
Maternal, social and abiotic environmental effects on growth vary across life stages in a cooperative mammal
Resource availability plays a key role in driving variation in somatic growth and body condition, and the factors determining access to resources vary considerably across life stages. Parents and carers may exert important influences in early life, when individuals are nutritionally dependent, with abiotic environmental effects having stronger influences later in development as individuals forage […]
Effects of a four-year health systems intervention on the use of maternal and infant health services: results from a programme evaluation in two districts of rural Chad
Background: Attendance of maternal and infant care services in rural Chad are consistently low. Our study aimed to assess the use of antenatal (ANC) and postnatal care (PNC) services, health facility delivery and infant health services after 4 years of a health systems intervention for improving the infrastructure, supplies, training and sensitization for maternal and […]
Parental Bacillus Calmette-Guérin vaccine scars decrease infant mortality in the first six weeks of life: A retrospective cohort study
Background: Live attenuated vaccines have been observed to have particularly beneficial effects for child survival when given in the presence of maternally transferred immunity (priming). We aimed to test this finding and furthermore explore the role of paternal priming. Methods: In an exploratory, retrospective cohort study in 2017, parental Bacillus Calmette-Guérin (BCG) scars were assessed […]
Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: A pragmatic effectiveness-implementation study protocol
Background: Over the past decade, prevalence of maternal and child morbidity and mortality in Togo, particularly in the northern regions, has remained high despite global progress. The causes of under-five child mortality in Togo are diseases with effective and low-cost prevention and/or treatment strategies, including malaria, acute lower respiratory infections, and diarrheal diseases. While Togo […]
