Effect of healthcare spending on the relationship between the Human Development Index and maternal and neonatal mortality

Nuhu, Kaamel; McDaniel, Justin T.; Alorbi, Genevieve; Ruiz, Juan Ignacio

doi:10.1093/inthealth/ihx053

Cited by 15 publications

(12 citation statements)

References 22 publications

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“…Author details 1 Population Council, Dhaka 1212, Bangladesh. 2 Mirpur Government Bangla College, University of Dhaka, Dhaka 1216, Bangladesh.…”

Section: Supplementary Informationmentioning

confidence: 99%

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Effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia

Roy¹,

Khatun

2022

Health Econ Rev

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Background Maternal and neonatal mortality is high in South Asia. Recent studies have identified factors such as adolescent female fertility, healthcare spending is reducing maternal and neonatal mortality. The objective of this study is to examine the effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in South Asian countries. Methods A retrospective panel study design was used, a total of 8 South Asian countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) data from World development indicator 1990–2020 considered for analysis. Descriptive statistical method was used for summary. The effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality were analysed using fixed and random effect regression with multiple imputation. Findings Adolescent female fertility, maternal, and neonatal mortality is very high in the aforementioned countries, and considerably varies among countries. A significant relationship between the maternal mortality and healthcare spending, neonatal mortality and adolescent female fertility was observed. We found neonatal and maternal mortality are more likely to decrease depends on healthcare spending. Healthcare spending has a significantly negative effect on neonatal mortality (− 0.182, 95% CI: [− 0.295 to −.069]; P-value < 0.01) and maternal mortality (− 0.169, 95% CI: [− 0.243 to − 0.028]; P-value < 0.05). A change in 1 % increases in healthcare spending should decrease by 0.182 neonatal mortality per 1000 live births and maternal mortality by 0.169 per 100,000 live births. Conclusions In south Asian countries, increasing healthcare spending and decreasing adolescent female fertility may contribute to reduce maternal and neonatal mortality. In addition, number of service providers such as physicians supplied contributed to the decline of neonatal mortality. These findings have important implications for future improvement of healthcare spending in maternal and neonatal health programs.

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“…Author details 1 Population Council, Dhaka 1212, Bangladesh. 2 Mirpur Government Bangla College, University of Dhaka, Dhaka 1216, Bangladesh.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…Maternal and neonatal mortality in Asian countries has been decreasing over time [ 1 ]. Healthcare spending strongly influences both neonatal and maternal mortality [ 2 ]. Healthcare spending and adolescent female fertility are key policy instruments that are expected to decrease neonatal and maternal mortality.…”

Section: Introductionmentioning

confidence: 99%

Effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia

Roy¹,

Khatun

2022

Health Econ Rev

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“…Care quality and availability, health systems challenges, and socioeconomic determinants of health make up a multi-layered context where signi cant change is needed to continue to advance progress. Over 99% of maternal deaths occur in low-and middle-income countries and disparities within countries show a concentration of maternal morbidity and mortality among the poor (4,5). Furthermore, costs associated with maternal health services can be prohibitive for those in the lowest socio-economic quintiles, and lead to delays in seeking, and avoidance of, care.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Professional Midwives and Mentoring on the Quality and Availability of Maternity Care in Rural Government Hospitals in Bangladesh

Anderson¹,

Williams²,

Jess

et al. 2022

Preprint

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Background This study examined whether the introduction of professional midwives with and without facility mentorship improved care quality and availability in sub-district hospitals in Bangladesh. It also analysed the experiences of non-midwife maternity care providers and managers. Methods Using mixed-methods, differences between hospitals without midwives, with midwives, and with mentorship were explored. Quantitative analysis comprised observations of facility readiness and clinical care to assess implementation of World Health Organization maternity care guidelines. Participants also completed a survey on their knowledge, perceptions, and utilization of the guidelines. Focus groups and interviews explored midwives’ experiences of their roles, and the experiences of the maternity staff and managers in relation to the midwives and the improved care practices they introduced. Logistic regression was used to identify differences between hospital types following the deployment of midwives and also mentoring. Results There were 641 clinical observations, 237 completed surveys, 18 interviews and five focus groups. The analysis found facilities without midwives to be the least likely to implement quality care practices, and those with midwives and facility mentoring to be the most likely. Of the eight quality practices, hospitals with midwives but no mentors were significantly more likely than hospitals without midwives to use four: partograph (56% vs. 14%; p < 0.001), upright labour (94% vs. 63%; p = 0.001), delayed cord clamping (88% vs. 11%; p < 0.001), skin-to-skin (94% vs. 13%; p < 0.001). Hospitals with mentors were significantly more likely to use six: ANC card (84% vs. 52%; p < 0.001), partograph (97% vs. 14%; p < 0.001), upright positioning for labour (95% vs. 63%; p = 0.001), delayed cord clamping (98% vs. 11%; p < 0.001), skin-to-skin contact following birth (93% vs. 13%; p < 0.001), and upright positioning for birthing (86% vs. 26%; p < 0.001). In addition, attitudes among the other maternity staff and managers toward midwives’ capabilities and improving quality of care were found to be more positive with mentoring. Conclusion Facilities with professional midwives had better availability and quality of maternity care across multiple components of the health system. Care quality further improved with facility mentors who created enabling environments, provided training, and facilitated supportive relationships between existing maternity staff and managers and the newly deployed midwives.

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“…According to the latest report published by the UN, Iran ranks 60th among the 189 countries assessed, with a score of 0.798 [9]. Recent studies have stated that the HDI is not only a good indicator of a country’s socioeconomic development, but can also serve as a predictor of some health indicators, including maternal and infant death [10,11], pre-pregnancy and pregnancy outcomes [12], preterm delivery [13], quality of life associated with children’s health [14], and under-5 death [15]. Therefore, we examined the associations between the selected indicators in this study using the HDI.…”

Section: Introductionmentioning

confidence: 99%

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?

et al. 2019

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OBJECTIVESSince many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.METHODSThis study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.RESULTSIran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.CONCLUSIONSOverall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.

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Effect of healthcare spending on the relationship between the Human Development Index and maternal and neonatal mortality

Abstract: Given that healthcare spending can mediate the relationship between HDI and NM and MM, increases in healthcare spending among countries with low HDI could improve NM and MM outcomes.

Cited by 15 publications

References 22 publications

Effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia

Effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia

The Impact of Professional Midwives and Mentoring on the Quality and Availability of Maternity Care in Rural Government Hospitals in Bangladesh

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?

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