Grand Challenges Canada Saving Brains Program.

Objective To determine if the Expanding Maternal and Neonatal Survival (EMAS) program was associated with improved effectiveness of the referral system in Indonesia to facilitate timely and effective management of complications experienced by women and newborns. Methods Poisson regression using longitudinal monitoring data was used to assess the impact of the EMAS program on stabilization practices prior to referral. Data from a nonrandomized quasi‐experimental pre‐post evaluation study were used to assess the impact of the EMAS program along the referral pathway using χ2 analysis. Results Monitoring data demonstrated improvements in intervention areas for stabilization of pre‐eclampsia/eclampsia (24% vs 61%, incidence rate ratio [IRR] 2.4; 95% confidence interval [CI], 2.3–2.6) and treatment of newborns with suspected severe infection (30% vs 54%, IRR 2.0; 95% CI, 1.6–2.4) prior to referral. The EMAS program was associated with significantly higher levels of communication, advanced notification, back referral, and hospital emergency readiness and staff preparedness compared with the comparison arm. Conclusion The EMAS program contributed to improvements in the management of obstetric and newborn complications, including communication, transportation, and preparation of pregnant mothers in need of referral and hospital emergency readiness and staff preparedness.

Objective To assess whether the Expanding Maternal and Neonatal Survival (EMAS) program was associated with improved care provided during hospital‐based childbirth. Methods A quasi‐experimental study with two rounds of data collection examined whether EMAS interventions improved facility‐based labor and childbirth care. Direct clinical observations were conducted for 1208 deliveries across 13 hospitals in 12 districts. Primary outcome measures included implementation of standard practices to reduce the risk of complications during labor and childbirth for both women and newborns. Results Adjusted difference‐in‐difference analysis compared the mean difference in quality scores between EMAS intervention hospitals and comparison sites and consistently found significantly better performance in EMAS sites: 14 points higher for labor monitoring (β‐coefficient 14.1; 95% confidence interval [CI], 7.1–21.0); 38 points higher for newborn resuscitation readiness (β‐coefficient 38.1; 95% CI, 31.1–45.2); and 33 points higher for infection prevention practices (β‐coefficient 32.6; 95% CI, 28.5–36.8). Conclusion EMAS approaches emphasizing facility readiness and adherence to performance standards significantly improved labor monitoring and complication prevention practices during childbirth.

Many micronutrients, including zinc, iodine, and B‐vitamins, are needed for the rapid brain development that occurs during gestation and infancy, laying a foundation for lifelong brain function. Few studies have examined the long‐term cognitive effects of maternal multiple micronutrient (MMN) supplements, compared to the current practice in many countries of iron and folic acid (IFA) supplementation. In 2001‐2004, in the SUMMIT trial, midwives in Indonesia were randomly assigned to distribute daily IFA or MMN from pregnancy through three months postpartum. We tested 3687 children of SUMMIT participants at 9‐12 years of age. Adjusting for midwife cluster, data collector, child age and gender, and home environment, children of mothers given MMN scored higher in visual attention (B=0.11, p < .01) and arithmetic (B=0.10, p=.05) compared to IFA. We observed positive effects on verbal ability (B=0.17, p=.02) in children of mothers who were undernourished at enrollment and on sustained attention (B=0.10, p=.04) and letter/word recognition (B=0.23, p=.04) in children of mothers who were anemic, consistent with previously observed effects on pre‐school cognition in these groups. We found positive effects on speed of sentence reading in children of well‐nourished mothers (B=0.11, p = .04), consistent with effects on birth weight in this group. No effects were found on fine motor ability, socio‐emotional scores, or several measures of executive function.Funded by Grand Challenges Canada

Purpose: The objective of this study was to explore why Muslim millennials in Indonesia prefer to invest in Islamic stocks on the Indonesia Stock Exchange (IDX).   Theoretical framework:  Muslim millennials prefer stock investments that align with religion and align with the consistency and moral integrity upheld by the Muslim community, including investing.   Design/methodology/approach: This study was a qualitative research method with a case study approach. Data were collected through in-depth interviews with ten millennial Muslim investors who invest in Islamic stocks in the IDX. Data analysis was carried out using thematic descriptive analysis.   Findings: The findings of this study suggest that millennial Muslim investors in Indonesia prefer to invest in Islamic stocks for the following reasons: adherence to Islamic values and beliefs, ethical investment, risk management, diversification, and the potential for better returns.   Research, Practical & Social implications:  We suggest further studies to include a case study of a more specific group of Muslim millennials to determine the influence of previous investment experiences, personal characteristics, and financial situation on their preferences in investing in Islamic stocks. In addition, it can also conduct comparative studies among several different countries or cultures to identify the factors that influence sharia stock investment decisions to provide a broader and representative picture.   Originality/value: This study provides insights into the factors that drive millennial Muslim investors in Indonesia to invest in Islamic stocks. This study's findings could benefit investors, the capital market industry, and policymakers in developing targeted strategies to attract millennial investors. Additionally, this study contributes to the literature on the Islamic capital market and investment behavior in emerging markets