Maternal and Child Health Commons^™

Increasing Access To Magnesium Sulphate In Nigeria, Population Council

Reproductive Health

The World Health Organization recommends magnesium sulphate (MgSO4) as the most effective, safe, and low-cost drug for treating pre-eclampsia and eclampsia. To increase access to and use of MgSO4 in Kano State, Nigeria the Population Council trained lower-cadre healthcare providers in antenatal clinics to detect pre-eclampsia early and institute timely and appropriate management by administering the loading dose of MgSO4 and referring for follow-up care. This brief reports that the intervention, which was supported by the John D. and Catherine T. MacArthur Foundation, reduced the maternal mortality rate due to PE/E by 40 percent in project sites. Moving forward, the …

Landscape Analysis Report On Pre-Eclampsia And Eclampsia In Pakistan, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Karen Kirk, Amy Dempsey, Charlotte E. Warren

Reproductive Health

This report presents the findings of a landscape analysis of the policy, programming, and service environment around prevention and treatment of pre-eclampsia and eclampsia (PE/E) in Pakistan. The primary aim of the landscape analysis was to identify the policy and program level of activities, as well as gaps and challenges around prevention and treatment of PE/E and the use of magnesium sulphate at the provincial and district levels in Pakistan. The study was carried out by the Population Council in 2016, with the support of the United States Agency for International Development (USAID) as part of the Project entitled “Ending …

Promoting Respectful Maternity Care Resource Package: Community Flipchart, Population Council

Reproductive Health

Progress toward the reduction of maternal and newborn morbidity and mortality has been slow because improvements require overcoming financial and geographical barriers to accessing skilled care, as well as the poor quality of care in maternity units. A little-understood component of the poor quality of care experienced by women during facility-based childbirth is the disrespectful and abusive behavior of healthcare providers and other facility staff. Acknowledgment of these behaviors by policymakers, program staff, civil society groups, and community members indicates the problem is widespread. This is a teaching aid for community health workers and other community-level resource persons to conduct …

Formative Research On Assessing Barriers To Fistula Care And Treatment In Nigeria, Charlotte E. Warren, Rachel Agbonkhese, Salisu Mohammed Ishaku

Reproductive Health

This report documents results of a systematic study of peer-reviewed and “grey” literature which identified studies relevant for understanding barriers to accessing obstetric fistula (OF) care in developing countries. To more comprehensively and holistically understand these barriers in Nigeria and potential enabling factors for alleviation, this study explored the perspectives of those involved in both identifying fistula and accessing care, such as family members and other community stakeholders including patriarchs, matriarchs, community leaders, and other opinion leaders. It also examines the cultural patterns, myths, and perspectives related to OF and how they influence women’s willingness and capacities to access surgical …

Barriers To Fistula Repair In Uganda: A Formative Study, Population Council

Reproductive Health

This brief describes a formative research study conducted in Uganda by the Population Council, building on the results of a systematic review, to better understand the barriers and enabling factors for fistula repair care delivery and access. Understanding how Ugandan women living with fistula decide to seek care, identify and reach medical centers, and receive adequate and appropriate care is integral and continues to influence the design of a larger implementation pilot. This study focuses on Fistula Care Plus project-supported treatment facilities where fistula camps are routinely held. Results show that while it is difficult to measure the relative influence …

Fact Sheet—How Does Quality Of Care Relate To A Rights-Based Approach To Family Planning Programs?, Jan Kumar

Reproductive Health

Because policymakers are challenged by numerous, overlapping definitions of quality of care, with uncertainty about which to adopt, there is a need for common understanding of each construct and its contribution to family planning (FP). This factsheet describes several definitions of quality in health care that are widely accepted. It concludes that improving and assuring quality of care is a legal, ethical, and practical imperative, and is instrumental in achieving outcomes that benefit women, children, and programs. If donors embrace, fund, and hold governments accountable to the fullness of a rights-based approach for FP with an explicit focus on assuring …

Measuring Quality Of Care: A Review Of Previously Used Methodologies And Indicators, Katherine Tumlinson

Reproductive Health

Despite successful efforts to increase financial and geographic access to family planning services in many parts of the developing world, large numbers of women with a desire to delay or limit future pregnancies are not using contraceptive methods. Several multi-country, large-scale facility surveys incorporate indicators for measuring the quality of family planning service delivery. These facility surveys use data collection tools such as facility audits, provider and client questionnaires, and third party observation guides. A limited body of research indicates that the validity of these tools is low, however, while large variations in analytical approaches inhibit use of existing literature …

Fact Sheet—Measuring Quality Of Care: A Review Of Methodologies And Indicators, Katherine Tumlinson

Reproductive Health

Broad support for the promotion of high-quality service delivery in family planning (FP) programs is rooted in the publication in 1990 of a formal framework outlining its essential elements. This framework, developed by Judith Bruce of the Population Council, defines FP service delivery quality through six critical elements: choice of methods, information provided to clients, interpersonal relations, provider competence, follow-up mechanisms, and appropriate range of services offered. This factsheet argues that despite widespread endorsement of the Bruce framework and development of standardized data collection instruments, obstacles to accurate measures of quality of care remain. It concludes that further discussion within …

Evaluation De La Mise En Oeuvre Et Des Réalisations De L’Approche 3d Au Sein Du Plan D’Action National De Planification Familiale (Panpf) Au Sénégal—Technical Brief, Population Council

Reproductive Health

Leader dans le domaine de la Planification Familiale (PF) en Afrique de l’Ouest francophone, le Sénégal a entrepris diverses initiatives pour atteindre ses objectifs, dont l’élaboration du Plan d’Action National de Planification Familiale (PANPF) 2012–15, basé sur l’Approche 3D (Démocratisation, Démédicalisation, Décentralisation). Au moment où il arrivait à terme, et que l’élaboration d’un nouveau plan était envisagée, il était nécessaire de documenter l’approche, sa mise en œuvre, et ses réalisations. Le Population Council a mené cette étude en collaboration avec la Direction de la Santé de la Reproduction et de la Survie de l’Enfant du Ministère de la Santé et …

A Model For Providing 24-Hour Normal Delivery Services At Union Health And Family Welfare Centers In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan, Forhana Rahman Noor, Afsana Fatema Noor

Reproductive Health

In rural areas of Bangladesh, emergency obstetric care services are available at the upazila level and above. At lower levels, Union Health and Family Welfare Centers (UHFWCs) located in the proximity of women’s homes provide normal delivery services. Recently, the Directorate General of Family Planning (DGFP) undertook an initiative to provide 24-hour normal delivery services in newly upgraded UHFWCs. The Population Council, with financial support from UKaid is providing technical assistance to the DGFP to implement an operations research study to test the effectiveness of this model. This brief presents an overview of the project, describes the implementation of project …

Evaluation Of The Impact Of Strengthening Union Health And Family Welfare Centers For Providing 24/7 Normal Delivery Services In Bangladesh, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan, Mohammed Sharif, Forhana Rahman Noor, Surojit Kundu, Shongkour Roy, Afsana Fatema Noor, Ubaidur Rob

Reproductive Health

In Bangladesh, the majority of the infant deliveries in rural areas take place at homes where there is a higher risk of morbidity and mortality. Most Union Health and Family Welfare Centers (UHFWCs) are unable to provide 24-hour normal delivery services in close proximity to most rural women. With this point of view, the Population Council has provided technical assistance to the Directorate General of Family Planning to implement an operations research (OR) study in 24 UHFWCs to test the effectiveness of a model to strengthen UHFWCs so that they can provide such services. This report presents the findings of, …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Districts Haripur And Nowshera, Khyber Pakhtunkhwa, Population Council

Reproductive Health

Through its Reproductive Maternal and Neonatal Child Health project, GIZ Pakistan is assisting the Government of Pakistan in strengthening its health system’s capacities for ensuring effective, efficient, client-oriented, and affordable reproductive, maternal, newborn, and adolescent health care. GIZ engaged with senior national and provincial government officials who indicated their interest in applying the innovative Made-In/Made-For (Maternal Death, from Informants/Maternal Death, Follow On Review) methodology, a cost-effective alternative for generating reliable estimates of maternal mortality through community-based informant networks. This Population Council study in two pilot districts identified specific areas that need strong policy and programmatic interventions to improve maternal health …

Using The Community Informant-Based (Made-In And Made-For) Methodology To Estimate The Neonatal Mortality Rate (Nmr) In Nowshera, Khyber Pakhtunkhwa: A Feasibility Study, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, Rehan M. Niazi

Reproductive Health

Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Maternal Mortality Ratio (Mmr) In Khyber Pakhtunkhwa, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

This report documents a study by the Population Council estimating the maternal mortality ratio of Khyber Pakhtunkhwa (KP) province in Pakistan using an innovative community informant–based method, known as the “Made-In/Made-For” (MIMF) technique, to collect data on maternal deaths. The report confirms that maternal mortality persists as a major public health issue in KP, and the problem may be much larger than assumed. The study’s success in identifying causes of death through verbal autopsies and their subsequent disaggregation into direct and indirect causes is important from policy and programmatic perspectives. Interventions need to focus both on direct and indirect causes …

Success Of Bubble Cpap In Treatment Of Respiratory Distress Syndrome In Preterm Infants, Tufail Soomro, Shiyam Sunder Tikmani

Community Health Sciences

Background: To observe the survival of preterm infants with respiratory distress syndrome treated with bubble CPAP in a tertiary care hospital.
Methods: This prospective observational study was conducted in the NICU of Civil hospital Sukkur from 1st July 2013 to 18th August 2015. All consecutively born preterm neonates with gestational age between 27 weeks to 36 weeks of gestation, admitted to the neonatal intensive care unit with respiratory distress are included in the study.These neonates were managed by Bubble continuous positive airway pressure (bCPAP) in combination with surfactant (bovine derivative) via intubation, Surfactant replacement, extubation (INSURE) protocol Success was considered …

Improving Access To Primary Care For Aboriginal Babies In Western Australia: Study Protocol For A Randomized Controlled Trial, Dan Mcaullay, Kimberley Mcauley, Rhonda Marriott, Glenn Pearson, Peter Jacoby, Chantal Ferguson, Elizabeth Geelhoed, Juli Coffin, Charmaine Green, Selina Sibosado, Barbara Henry, Dorota Doherty, Karen Edmond

Research outputs 2014 to 2021

Background:

Despite a decade of substantial investments in programs to improve access to primary care for Aboriginal mothers and infants, more than 50 % of Western Australian Aboriginal babies are still not receiving primary and preventative care in the early months of life. Western Australian hospitals now input birth data into the Western Australian electronic clinical management system within 48 hours of birth. However, difficulties have arisen in ensuring that the appropriate primary care providers receive birth notification and clinical information by the time babies are discharged from the hospital. No consistent process exists to ensure that choices about primary …

Is There A Trade-Off? Infant Health Outcomes And Managed Care Competition, Shana L. Moore

Theses and Dissertations--Public Policy and Administration

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to …

Data Management And Data Facilitation In Multi-Center Large Cohort Health Care Studies, Wei Wang

Dissertations, Master's Theses and Master's Reports

Data management and data facilitation is the foundation and a critical part for scientific investigations, especially with large cohort studies on health care, which may have multiple components collected from different institutes or different areas due to efficiency, cost, enrollment considerations. In this thesis, I consider how to design and to implement data management with multi-center health care research data. The research project that I joined focuses mainly on environmental health science, and the primary goal is to investigate the impact of nutritional and toxicant exposures in environment during fetal and early postnatal life on individual’s health outcomes over the …

Enteric Fever: A Slow Response To An Old Plague, Carlos Franco- Paredes, M. Imran Khan, Esteban Gonzalez- Diaz, Jose I. Santos- Preciado, Alfonso J. Rodriguez Morales, Eduardo Gotuzzo

Centre of Excellence in Women and Child Health

Man is irremediably embedded in nature with complex interactions with all living organisms. Historically, the establishment of contemporary human societies has been influenced by our coexistence with other microorganisms living in highly interconnected habitats and ecologies. As a result, with the progression from unicellular to multicellular life, bacteria have coexisted with humans. In this biological journey, while there are important benefits provided by bacterial guests to the human host living in complex relationships and becoming part of their microbiome, some organisms are able to cause a wide spectrum of diseases. Among the large Enterobacteriaceae family, the genus Salmonella, a …

Status Of Paratyphoid Fever Vaccine Research And Development, Laura B. Martin, Raphael Simon, Calman A. Maclennan, Sharon M. Tennant, Sushant Sahastrabuddhe, M. Imran Khan

Centre of Excellence in Women and Child Health

Salmonella enterica serovars Typhi and Paratyphi (S. Paratyphi) A and B cause enteric fever in humans. Of the paratyphoid group, S. Paratyphi A is the most common serovar. In 2000, there were an estimated 5.4 million cases of S. Paratyphi A worldwide. More recently paratyphoid fever has accounted for an increasing fraction of all cases of enteric fever. Although vaccines for typhoid fever have been developed and in use for decades, vaccines for paratyphoid fever have not yet been licensed. Several S. Paratyphi A vaccines, however, are in development and based on either whole cell …