A strategy for reducing maternal and newborn deaths by 2015 and beyond

Darmstadt, Gary L.; Marchant, Tanya; Claeson, Mariam; Brown, Win; Morris, Saul S.; Taylor, Mary; Ferguson, Rebecca M.; Voller, Shirine; Teela, Katherine C.; Makowiecka, Krystyna; Hill, Zelee; Mangham-Jefferies, Lindsay; Avan, Bilal Iqbal; Spicer, Neil; Engmann, Cyril; Twum-Danso, Nana A.Y.; Somers, Kate; Kraushaar, D; Schellenberg, Joanna

doi:10.1186/1471-2393-13-216

Cited by 40 publications

(44 citation statements)

References 24 publications

(24 reference statements)

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“…These factors were related to the intervention package, its distribution and buy-in from the local stakeholders. According to Darmstard et al [44], these three factors influence the effectiveness of a strategy.…”

Section: Discussionmentioning

confidence: 99%

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

Ekirapa-Kiracho

Kananura

Tetui

et al. 2017

Global Health Action

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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 mobilization and empowerment, and health provider capacity building. The primary outcomes were utilization of antenatal care (ANC), delivery and postnatal care, and newborn care practices. Baseline (n = 2237) and endline (n = 1946) data were collected from women of reproductive age. The data was analysed using difference in differences (DiD) analysis and logistic regression. Results: The DiD results revealed an 8% difference in early ANC attendance (p < 0.01) and facility delivery (p < 0.01). Facility delivery increased from 66% to 73% in the intervention area, but remained unchanged in the comparison area (64% vs 63%, p < 0.01). The DiD results also demonstrated a 20% difference in clean cord care (p < 0.001) and an 8% difference in delayed bathing (p < 0.001). The intervention elements that predicted facility delivery were attending ANC four times [adjusted odds ratio (aOR) 1.42, 95% confidence interval (CI) 1.17–1.74] and saving for maternal health (aOR 2.11, 95% CI 1.39–3.21). Facility delivery and village health team (VHT) home visits were key predictors for clean cord care and skin-to-skin care. Conclusions: The multisectoral approach had positive effects on early ANC attendance, facility deliveries and newborn care practices. Community resources such as VHTs and savings are crucial to maternal and newborn outcomes and should be supported. VHT-led health education should incorporate practical measures that enable families to save and access transport services to enhance adequate preparation for birth.

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Section: Discussionmentioning

confidence: 99%

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

Ekirapa-Kiracho

Kananura

Tetui

et al. 2017

Global Health Action

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“…The lifetime risk of pregnancy‐related death is 21 in 1,000 women (CSA & ICF International, ). Haemorrhage, abortion, anaemia, infection, unsafe abortion, prolonged labour, obstructed labour and eclampsia contribute to 80% of the maternal death (Darmstadt et al, ; Mageda & Mmbaga, ).…”

Section: Introductionmentioning

confidence: 99%

Institutional delivery service use and associated factors among women who delivered during the last 2 years in Dallocha town, SNNPR, Ethiopia

et al. 2019

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AimTo determine the institutional delivery service use and identify factors associated among women who delivered during the last two years in Dallocha town.DesignA community‐based cross‐sectional study.MethodsThe study was conducted from 10 March–10 April 2016. A total of 411 study participants were selected by using systematic sampling method. The source population was all reproductive age group mothers. Bivariate and multiple logistic regression was conducted.ResultsInstitutional delivery was 304 (74%). Factors associated with increased likelihood of institutional delivery were owning a radio or television, making more than four antenatal care visits, knowing at least one maternity service advantage. Not knowing about at least one benefit institutional delivery decreased the likelihood of institutional delivery.ConclusionThree‐quarters of the mothers delivered at the health institution. Accordingly, promotion of antenatal care follow‐up, in‐service training of health professionals and health education is recommended.

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“…Pregnancy- or childbirth-related complications lead to more than 380 preventable deaths of women per day in these countries 3 . Researchers have underscored the importance of improving the quality of labour and delivery care for continued reduction in preventable maternal and neonatal deaths 4 , 5 …”

Section: Introductionmentioning

confidence: 99%

Maternal and neonatal services in Ethiopia: measuring and improving quality

Canavan

Brault

Tatek

et al. 2017

Bull. World Health Organ.

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ProblemMaternal and neonatal mortality remains high in low- and middle-income countries, with poor quality of intrapartum care as a barrier to further progress.ApproachWe developed and tested a method of measuring the quality of maternal and neonatal care that could be embedded in a larger national performance management initiative. The tool used direct observations and medical record reviews to score quality in nine domains of intrapartum care. We piloted and evaluated the tool in visits to the 18 lead hospitals that have responsibility to promote and coordinate quality improvement efforts within a hospital cluster in Ethiopia. Between baseline and follow-up assessments, staff from a national quality collaborative alliance provided hospital-based training on labour and delivery services.Local settingEthiopia has invested in hospital quality improvement for more than a decade and this tool was integrated into existing quality improvement mechanisms within lead hospitals, with the potential for scale-up to all government hospitals.Relevant changesSignificant improvements in quality of intrapartum care were detected from baseline (June–July 2015) to follow-up (February–March 2016) in targeted hospitals. The overall mean quality score rose from 65.6 (standard deviation, SD: 10.5) to 91.2 (SD: 12.4) out of 110 items (P < 0.001).Lessons learntThe method was feasible, requiring a total of 3 days and two to three trained data collectors per hospital visit. It produced data that detected substantial changes made during 8 months of national hospital quality improvement efforts. With additional replication studies, this tool may be useful in other low- and middle-income countries.

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A strategy for reducing maternal and newborn deaths by 2015 and beyond

Cited by 40 publications

References 24 publications

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

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

Institutional delivery service use and associated factors among women who delivered during the last 2 years in Dallocha town, SNNPR, Ethiopia

Maternal and neonatal services in Ethiopia: measuring and improving quality

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