Impact of Scale-up of Maternal and Delivery Care on Reductions in Neonatal Mortality in USAID MCH Priority Countries, 2000–2010

Winter, Rebecca; Pullum, Thomas W.; Florey, Lia; Hodgins, Steve

doi:10.1007/978-3-319-43688-3_16

Cited by 9 publications

(11 citation statements)

References 12 publications

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“…We also found gaps in appropriate care and wealth-based inequities in coverage for facility births, similar to a study of facility-births showing gaps in care, particularly for women with less education, and single women [ 36 ]. While facility birth and skilled attendance at birth are important steps to early newborn care, this alone may not lead to reduction in neonatal mortality [ 37 ]. Recent training on any aspect of essential childbirth care and availability of relevant guidelines at facilities in LMICs is limited and service availability, service readiness, and coverage of obstetric care services are low [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Equity in newborn care, evidence from national surveys in low- and middle-income countries

Peven

Mallick

Taylor

et al. 2021

Int J Equity Health

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Background High coverage of care is essential to improving newborn survival; however, gaps exist in access to timely and appropriate newborn care between and within countries. In high mortality burden settings, health inequities due to social and economic factors may also impact on newborn outcomes. This study aimed to examine equity in co-coverage of newborn care interventions in low- and low middle-income countries in sub-Saharan Africa and South Asia. Methods We analysed secondary data from recent Demographic and Health Surveys in 16 countries. We created a co-coverage index of five newborn care interventions. We examined differences in coverage and co-coverage of newborn care interventions by country, place of birth, and wealth quintile. Using multilevel logistic regression, we examined the association between high co-coverage of newborn care (4 or 5 interventions) and social determinants of health. Results Coverage and co-coverage of newborn care showed large between- and within-country gaps for home and facility births, with important inequities based on individual, family, contextual, and structural factors. Wealth-based inequities were smaller amongst facility births compared to non-facility births. Conclusion This analysis underlines the importance of facility birth for improved and more equitable newborn care. Shifting births to facilities, improving facility-based care, and community-based or pro-poor interventions are important to mitigate wealth-based inequities in newborn care, particularly in countries with large differences between the poorest and richest families and in countries with very low coverage of care.

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Section: Discussionmentioning

confidence: 99%

Equity in newborn care, evidence from national surveys in low- and middle-income countries

Peven

Mallick

Taylor

et al. 2021

Int J Equity Health

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“…Even a competent provider may not be able to provide high quality care if necessary supplies and other aspects of the enabling environment are inadequate [ 24 , 25 ]. When possible, self-reported data should be triangulated with other data sources, such as stock-outs of essential medicines [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Measuring progress in maternal and newborn health care in Mexico: validating indicators of health system contact and quality of care

Blanc

Díaz²,

McCarthy

et al. 2016

BMC Pregnancy Childbirth

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BackgroundThe majority of births in Mexico take place in a health facility and are attended by a skilled birth attendant, yet maternal mortality has not declined to anticipated levels. Coverage estimates of skilled attendance and other maternal and newborn interventions often rely on women’s self-report through a population-based survey, the accuracy of which is not well established.MethodsWe used a facility-based design to validate women’s report of skilled birth attendance, as well as other key elements of maternal, newborn intrapartum, and immediate postnatal care. Women’s reports of labor and delivery care were collected by exit interview prior to hospital discharge and were compared against direct observation by a trained third party in a Mexican public hospital (n = 597). For each indicator, validity was assessed at the individual level using the area under the receiver operating curve (AUC) and at the population level using the inflation factor (IF).ResultsFive of 47 indicators met both validation criteria (AUC > 0.60 and 0.75 < IF < 1.25): urine sample screen, injection or IV medication received during labor, before the birth of the baby (i.e., uterotonic for either induction or augmentation of labor), episiotomy, excessive bleeding, and receipt of blood products. An additional 9 indicators met criteria for the AUC and 18 met criteria for the IF. A skilled attendant indicator had high sensitivity (90.1 %: 95 % CI: 87.1–92.5 %), low specificity (14.0 %: 95 % CI: 5.8–26.7 %) and was suitable for population-level estimation only.ConclusionWomen are able to give valid reports on some aspects of the content of care, although questions regarding the indication for interventions are less likely to be known. Questions that include technical terms or refer to specific time periods tended to have lower response levels. A key aspect of efforts to improve maternal and newborn health requires valid measurement of women’s access to maternal and newborn health interventions and the quality of such services. Additional work on improving measurement of population coverage indicators is warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1047-0) contains supplementary material, which is available to authorized users.

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“…Adjusted models controlled for known predictors of newborn mortality, including mother’s sociodemographic characteristics, care-related and care-seeking behaviors, and birth characteristics. Sociodemographic characteristics of the mother that have been found to be associated with newborn mortality are: place of residence, wealth, education, religion [44], maternal age at birth [45, 46], preceding birth interval [47], previous child under age 5 died [8], receipt of ANC [48], tetanus toxoid vaccine coverage [19], size at birth as a proxy for premature birth [46], gender of child, skilled attendance at birth, and postnatal care (PNC) [49]. Tetanus was included only in the adjusted models in India since it was not assessed in the Bangladesh 2014 survey.…”

Section: Methodsmentioning

confidence: 99%

“…The low impact of SBAs may be attributable to selection bias: women with higher-risk pregnancies seeking out facility delivery where most births are attended by SBAs [6, 7]. These newborns have lower odds of surviving, offsetting the hoped-for reduction in mortality [8]. Even though the benefit of delivering in a health facility is well-known, and facility birth is encouraged through national policies, women continue to deliver at home.…”

Section: Introductionmentioning

confidence: 99%

Trends, determinants, and newborn mortality related to thermal care and umbilical cord care practices in South Asia

2019

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Background Although child mortality has decreased over the last several decades, neonatal mortality has declined less substantially. In South Asia, neonatal deaths account for the majority of all under-five deaths, calling for further study on newborn care practices. We assessed five key practices: immediate drying and wrapping, delayed bathing, immediate skin-to-skin contact after birth, cutting the umbilical cord with a clean instrument, and substances placed on the cord. Methods Using data from Demographic and Health Surveys conducted in Bangladesh, India, and Nepal between 2005 and 2016, we examined trends in coverage of key practices and used multivariable logistic regression to analyze predictors of thermal care and hygienic cord care practices and their associations with neonatal mortality among home births. The analysis excluded deaths on the first day of life to ensure that the exposure to newborn care practices would have preceded the outcome. Given limited neonatal mortality events in Bangladesh and Nepal, we pooled data from these countries. Results We found that antenatal care and skilled birth attendance was associated with an increase in the odds of infants' receipt of the recommended practices among home births. Hygienic cord care was significantly associated with newborn survival. After controlling for other known predictors of newborn mortality in Bangladesh and Nepal, antiseptic cord care was associated with an 80% reduction in the odds of dying compared with dry cord care. As expected, skilled care during pregnancy and birth was also associated with newborn survival. Missing responses regarding care practices were common for newborns that died, suggesting that recall or report of details surrounding the traumatic event of a loss of a child may be incomplete. Conclusions This study highlights the importance of maternal and newborn care and services for newborn survival in South Asia, particularly antenatal care, skilled birth attendance, and antiseptic cord care. Electronic supplementary material The online version of this article (10.1186/s12887-019-1616-2) contains supplementary material, which is available to authorized users.

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Impact of Scale-up of Maternal and Delivery Care on Reductions in Neonatal Mortality in USAID MCH Priority Countries, 2000–2010

Cited by 9 publications

References 12 publications

Equity in newborn care, evidence from national surveys in low- and middle-income countries

Equity in newborn care, evidence from national surveys in low- and middle-income countries

Measuring progress in maternal and newborn health care in Mexico: validating indicators of health system contact and quality of care

Trends, determinants, and newborn mortality related to thermal care and umbilical cord care practices in South Asia

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