Medicine and Health Sciences Commons^™

Birth Preparedness And Complication Readiness Among Women Of Reproductive Age In Kenya And Tanzania: A Community-Based Cross-Sectional Survey, James Orwa, Samwel Gatimu, Michaela Mantel, Stanley Luchters, Micheal Mugerwa, Sharon Brownie, Leonard Subi, Secilia Mrema, Lucy Nyaga, Grace Edwards, Loveluck Mwasha, Kahabi Isangula, Edna Selestine, Sofia Jadavji, Rachel Pell, Columba Mbekenga, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.

Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was …

Trends In And Predictors Of Pregnancy Termination Among 15–24 Year-Old Women In Nigeria: A Multi-Level Analysis Of Demographic And Health Surveys 2003–2018, Franklin I. Onukwugha, Monica A. Magadi, Ahmed Sarki, Lesley Smith

School of Nursing & Midwifery, East Africa

Background: Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. …

Determinants Of Health Care Seeking Behaviors In Puerperal Sepsis In Rural Sindh, Pakistan: A Qualitative Study, Shabina Ariff, Fatima Mir, Farhana Tabassum, Farrukh Raza, Atif Habib, Ali Turab, Amnesty Lefevre, Linda A. Bartlett, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essential to managing PS, but numerous social, cultural and technical barriers prevent or delay access to care and necessary medical attention. Through this qualitative study, we identified barriers to care seeking for puerperal sepsis among recently delivered women in Matiari, Pakistan.
Methods: We conducted 20 in-depth interviews among recently delivered women with and without sepsis and their family members in September 2012. Key informant interviews were conducted with 14 healthcare providers and traditional …

Delivering Water, Sanitation And Hygiene Interventions To Women And Children In Conflict Settings: A Systematic Review, Daina Als, Sarah Meteke, Marianne Stefopulos, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Shailja Shah, Reena P. Jain, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.
Methods: We conducted a systematic search for publications indexed in four databases, and grey literature …

Impact Of Conflict On Maternal And Child Health Service Delivery: A Country Case Study Of Afghanistan, Mohammed Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Since decades, the health system of Afghanistan has been in disarray due to ongoing conflict. We aimed to explore the direct effects of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing these services.
Method: We conducted a quantitative analysis of secondary data on RMNCAH&N indicators and undertook a supportive qualitative study to help understand processes and contextual factors. For quantitative analysis, we stratified the various provinces of Afghanistan into minimal-, moderate- and severe conflict categories based on battle-related deaths from Uppsala Conflict Data Program (UCDP) and …

Maternal Health Challenges During Covid-19 And Way Forward, Muskaan Dosani, Salima Muhammad Farooq, Shahnaz Shahid Ali

Journal of Asian Midwives (JAM)

The COVID-19 pandemic has affected nearly every country around the globe. Although every individual is at risk of getting the virus, maternal, fetal and newborn clients face specific and potentially unknown challenges which can make them highly compromised. The purpose of this paper is to discuss the maternal health challenges faced by women during COVID-19 and to propose possible strategies using the socio-ecological model (SEM) to promote the physical, social, and mental well-being of women and their infants during the perinatal period. SEM can be used as a framework to plan and implement strategies focusing on health promotion and disease …

Understanding The Factors Affecting The Humanitarian Health And Nutrition Response For Women And Children In Somalia Since 2000: A Case Study, Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar Ahmed Bhutta, Abdirisak A. Dalmar

Woman and Child Health

Background: Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country's infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors has sought to provide basic services, including health services for women and children, throughout the conflict. This study aimed to better understand the humanitarian health response for women and children in Somalia since 2000.
Methods: The study utilized a mixed-methods design. We collated intervention coverage data from publically available large-scale household surveys and we conducted 32 interviews with representatives from government, UN agencies, NGOs, and health facility …

Impact Of Conflict On Maternal And Child Health Service Delivery - How And How Not: A Country Case Study Of Conflict Affected Areas Of Pakistan, Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing the prioritization and implementation in conflict affected areas of Pakistan (Balochistan and FATA).
Method: We conducted a secondary quantitative and a primary qualitative analysis. For the quantitative analysis, we stratified the various districts/agencies of Balochistan and FATA into the conflict categories of minimal-, moderate- and severe based on …

Religious, Socio-Cultural Norms And Gender Stereotypes Influence Uptake And Utilization Of Maternal Health Services Among The Digo Community In Kwale, Kenya: A Qualitative Study, Vernon Mochache, George Wanje, Lucy Nyaga, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, Peter Gichangi

Obstetrics and Gynaecology, East Africa

Background: Maternal health outcomes in resource-limited settings are typically influenced by supply-side factors affecting the provision of quality health services. The extent to which demand-side factors contribute to this influence is unclear. We aimed to explore how individual and community-wide factors influenced uptake and utilization of maternal health services among the Digo community residing in Kwale County of coastal Kenya.

Methods: Between March and December 2015, we conducted 5 focus group discussions (FGDs) and 15 in-depth interviews (IDIs) with members of the Digo community predominant in Kwale county, Kenya. Respondents were sampled purposively and included female (pregnant and …

Delivering Infectious Disease Interventions To Women And Children In Conflict Settings: A Systematic Review, Sarah Meteke, Marianne Stefopulos, Daina Als, Michelle Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Mariella Munyuzangabo, Reena P. Jain, Shailja Shah, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Conflict has played a role in the large-scale deterioration of health systems in low-income and middle-income countries (LMICs) and increased risk of infections and outbreaks. This systematic review aimed to synthesise the literature on mechanisms of delivery for a range of infectious disease-related interventions provided to conflict-affected women, children and adolescents.
Methods: We searched Medline, Embase, CINAHL and PsychINFO databases for literature published in English from January 1990 to March 2018. Eligible publications reported on conflict-affected neonates, children, adolescents or women in LMICs who received an infectious disease intervention. We extracted and synthesised information on delivery characteristics, including delivery …

Delivering Non-Communicable Disease Interventions To Women And Children In Conflict Settings: A Systematic Review, Shailja Shah, Mariella Munyuzangabo, Michelle F. Gaffey, Mahdis Kamali, Reena P. Jain, Daina Als, Sarah Meteke, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).
Methods: A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD …