Accountability for women’s, children’s and adolescents’ health in the Sustainable Development Goal era

Barroso, Carmen; Lichuma, Winfred; Mason, Elizabeth; Lehohla, Pali; Paul, Vinod K.; Pkhakadze, Giorgi; Wickremarathne, Dakshitha; Yamin, Alicia

doi:10.1186/s12889-016-3399-9

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…There are also existing global initiatives, such as the ENAP ,3 the Global Strategy for Women's, Children's and Adolescents' Health 40 and the Mother-Baby Friendly Birthing Facilities Initiative ,41 as well as new initiatives to encourage government accountability; these are not limited to increasing supply and demand for care but also focus on ensuring equitable care, an often neglected yet a critical objective of accountability 42. These initiatives provide frameworks for countries to assess gaps in their maternal, newborn and child health policies; service guidelines; and implementation plans, and to examine how they help health workers acquire, maintain and use their competencies.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

et al. 2017

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ObjectiveTo present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills.DesignCross-sectional observational health facility assessment.SettingEthiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania.ParticipantsHealth workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed.Main outcome measuresIndicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation.ResultsSterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly.ConclusionsThe findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have the necessary equipment, supplies, knowledge and skills that are critical to save newborn lives.

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Section: Discussionmentioning

confidence: 99%

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

et al. 2017

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“…As a result, countries with high neonatal death are advised to scale up child survival programs in line with their cause-specific deaths [1,16,26]. Yet, countries, particularly in sub-Saharan Africa including Ethiopia, have limitations for timing and cause-specific death analysis [16].…”

Section: Introductionmentioning

confidence: 99%

When Do Newborns Die? Timing and Cause-Specific Neonatal Death in Neonatal Intensive Care Unit at Referral Hospital in Gedeo Zone: A Prospective Cohort Study

Eshete

Abiy

2020

International Journal of Pediatrics

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Background. Maternal, newborn, and child health have a high stake in the global health agenda, however, neonates’ risk of dying is unacceptable in the world. Ethiopia is one of the countries with high burden of neonatal morbidity and mortality. Yet, timing and cause-specific neonatal death are under-investigated. The present study aimed to determine the timing and cause-specific neonatal death. Methods. We conducted a prospective cohort study at Dilla University Referral Hospital Neonatal Care Unit from November 2016 to January 2018. All admitted neonates to the neonatal care unit were followed from cohort entry up to the occurrence of an event (death) or end of follow-up. We generated descriptive statistics to determine the timing of neonatal death and the cause of deaths. Results. Overall, 11.6% of neonates died during the follow-up. We found that 34.0% and 64.3% of deaths occurred during the first and second weeks of neonatal life, respectively. Neonatal sepsis and low birth weight were the main causes of death and hospital admission. Jaundices and low birth weight were the most common causes of death during the early neonatal period, whereas birth asphyxia, low birth weight, and sepsis were during late neonatal life. However, for other causes of death, the slight difference was seen between the death patterns in early and late neonatal periods. Conclusions. The timing and cause-specific neonatal deaths were varying among different time of the neonatal periods that needs to design context-based policy and interventions.

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“…The highest-burden countries, particularly, should link these metrics to strategies to improve the quality of available RMNCH services. Additionally, such monitoring supports recommended efforts to increase global and national accountability related to reducing maternal and child mortality [ 30 ]. Creating reliable pharmaceutical systems is essential to achieving SDG3, and it will require taking a holistic look beyond just product availability and logistics and toward strengthening other system components that affect access to both products and services [ 31 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

How to assure access of essential RMNCH medicines by looking at policy and systems factors: an analysis of countdown to 2015 countries

Briggs¹,

Embrey²,

Maliqi³

et al. 2018

BMC Health Serv Res

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BackgroundIn 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. To reach the new Sustainable Development Goals by 2030, information is needed to address policy and systems factors to improve access to lifesaving commodities.MethodsWe compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We mapped commodity information from four datasets from the World Health Organization and the United Nation’s Commission on Life Saving Commodities creating a stoplight dashboard to illustrate countries’ environment to assure access. We also developed a dashboard for policy and systems indicators for select countries.ResultsThe commodities we identified as having the fewest barriers to access had been in use longer, including oral rehydration solution and oxytocin injection. Looking across the different systems and policy determinants of access, only Zimbabwe had all 15 commodities on both its essential medicines list and in its standard treatment guidelines, and only Cameroon and Zambia had at least one product registered for each commodity. Senegal alone procured all tracer commodities centrally in the previous year, and 70% of responding countries had costed plans for maternal, newborn, and child health. No country reported recent stock-outs of all the 15 commodities at the central level—countries always had some of the 15 commodities available; however, products with frequent stock-outs included misoprostol, calcium gluconate, penicillin injections, ceftriaxone, and amoxicillin dispersible tablets.ConclusionsThis analysis highlights country deficiencies in policies and systems, such as incoherent policy guidelines, problems in product registration, lack of logistics data, and central-level stock-outs that may affect access to essential RMNCH commodities. To tackle these deficiencies, countries need to integrate commodity-related indicators into other health monitoring activities to improve service quality.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3766-6) contains supplementary material, which is available to authorized users.

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Accountability for women’s, children’s and adolescents’ health in the Sustainable Development Goal era

Cited by 4 publications

References 9 publications

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

When Do Newborns Die? Timing and Cause-Specific Neonatal Death in Neonatal Intensive Care Unit at Referral Hospital in Gedeo Zone: A Prospective Cohort Study

How to assure access of essential RMNCH medicines by looking at policy and systems factors: an analysis of countdown to 2015 countries

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