Investing in Maternal Health in Malaysia and Sri Lanka

Pathmanathan, Indra; Liljestrand, Jerker; Martins, Jo. M.; Rajapaksa, Lalini C.; Lissner, Craig; Silva, Amala de; Selvaraju, Swarna; Singh, Prabha Joginder

doi:10.1596/0-8213-5362-4

Cited by 13 publications

(2 citation statements)

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Section: Resultsmentioning

confidence: 99%

“…The rapid expansion of mother and child health and family planning services through the collaboration with FRHAM and NPFDB, as well as the expansion of PHC clinics in rural areas, were major factors in lowering infant and maternal mortality rates across the country from 1960 to 1990. 46 “While we are doing this, we have a lot of resource support, nurses have been trained, we have public health nurses … they are the ones that manage the clinic actually … they know the SOPs, where you are doing, how you are doing, very connected with the community … ” (IV6, former health policy maker) The prioritisation of maternal care for all married Malaysian women played a key role in the significant reduction in MMR, but MMR has remained relatively stagnant over the last 20 years (C). 29 Teenage pregnancy remains a concern 29 and adolescents and unmarried women often face barriers, such as stigma and discrimination in accessing these services due to socio-cultural and religious norms and practices (C).…”

Section: Resultsmentioning

confidence: 99%

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Priority-setting to integrate sexual and reproductive health into universal health coverage: the case of Malaysia

Lim

Yap

Barmania

et al. 2020

Sexual and Reproductive Health Matters

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Despite increasing calls to integrate and prioritise sexual and reproductive health (SRH) services in universal health coverage (UHC) processes, several SRH services have remained a low priority in countries' UHC plans. This study aims to understand the priority-setting process of SRH interventions in the context of UHC, drawing on the Malaysian experience. A realist evaluation framework was adopted to examine the priority-setting process for three SRH tracer interventions: pregnancy, safe delivery and post-natal care; gender-based violence (GBV) services; and abortion-related services. The study used a qualitative multimethod design, including a literature and document review, and 20 in-depth key informant interviews, to explore the context-mechanism-outcome configurations that influenced and explained the priority-setting process. Four key advocacy strategies were identified for the effective prioritisation of SRH services, namely: (1) generating public demand and social support, (2) linking SRH issues with public agendas or international commitments, (3) engaging champions that are internal and external to the public health sector, and (4) reframing SRH issues as public health issues. While these strategies successfully triggered mechanisms, such as mutual understanding and increased buy-in of policymakers to prioritise SRH services, the level and extent of prioritisation was affected by both inner and outer contextual factors, in particular the socio-cultural and political context. Priority-setting is a political decision-making process that reflects societal values and norms. Efforts to integrate SRH services in UHC processes need both to make technical arguments and to find strategies to overcome barriers related to societal values (including certain socio-cultural and religious norms). This is particularly important for sensitive SRH services, like GBV and safe abortion, and for certain populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Priority-setting to integrate sexual and reproductive health into universal health coverage: the case of Malaysia

Lim

Yap

Barmania

et al. 2020

Sexual and Reproductive Health Matters

View full text Add to dashboard Cite

show abstract

Geographical access, transport and referral systems.

Munjanja¹,

Magure²,

Kandawasvika³

et al. 2012

Maternal and Perinatal Health in Developing Countries

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Poor access to emergency obstetric care is due to one of three delays: deciding to seek care, reaching a health facility and receiving appropriate treatment. Poor geographical access in itself is not the cause of the second delay, but the delay results from failure to bridge it with adequate referral interventions and systems. Geographical access can be defined using several dimensions, including distribution and density of services, distance and time. Poor physical access to health services contributes to urban-rural inequities in the utilization of services and in health outcomes. It also compounds the problem of availability of human resources for health in rural areas. Geographical access is mainly a problem of rural populations, especially the poor. The two-tiered model of primary health care and hospital-level care makes referral and referral systems essential. Referral can be hampered and delays caused by a poorly functioning system. Solutions to overcome the problems of physical access include communication, transport, educational, financial, infrastructural and technological interventions. The effects and the effectiveness of many of these interventions are poorly understood and more evidence is needed to aid decision making, especially for low resource settings.

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Women's preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery

Kruk

Paczkowski

Tegegn

et al. 2009

Journal of Epidemiology & Community Health

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Women in rural southwest Ethiopia who have limited personal experience with facility delivery nonetheless value health facility attributes that indicate high technical quality: availability of drugs and equipment and physician providers. Well-designed policy experiments that measure the contribution of quality improvements to facility delivery rates in Ethiopia and other countries with low health service utilisation and high maternal mortality may inform national efforts to reduce maternal mortality.

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Investing in Maternal Health in Malaysia and Sri Lanka

Cited by 13 publications

References 0 publications

Priority-setting to integrate sexual and reproductive health into universal health coverage: the case of Malaysia

Priority-setting to integrate sexual and reproductive health into universal health coverage: the case of Malaysia

Geographical access, transport and referral systems.

Women's preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery

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