1,778 research outputs found
Investigating the role of health care at birth on inequalities in neonatal survival: evidence from Bangladesh
No full textIntroduction: In countries such as Bangladesh many women may only seek skilled care at birth when complications become evident. This often results in higher neonatal mortality for women delivering in institutions. However, we hypothesise that the apparent increase in mortality is concentrated in less advantaged women. The aim of this paper is to examine the association between place of delivery and neonatal mortality in Bangladesh, and how this varies by socio-economic status. Methodology: The study is based on data from three pooled Bangladesh Demographic and Household Surveys, and uses bivariate analysis and binomial multivariate logistic regression. It creates composite variable combining place of delivery with indicators of socio-economic status to examine the relationship between these two factors on neonatal mortality.Results: Women from poorer socio-economic groups who give birth in institutions have worse outcomes than those who give birth at home. This difference is much less marked for more wealthy women. There is a much stronger socio-economic gradient for neonatal mortality for women who give birth in institutions than those who delivery at home.Conclusion: In Bangladesh babies from lower socio-economic groups have very poor outcomes if born in a facility, suggesting that services are particularly failing to meet the needs of poorer and less educated women
Historical Fiction Author Don Neal Discusses Cold War Activities in Alaska
No full textDuring the Cold War, the USA was concerned that Russia would invade Alaska and American intelligence officers created the Stay Behind Agent Program to counter. At this event, Don Neal, author of the Ben Hunnicutt series that includes Cross Kill, Warhead, and washtub Gold, discusses the Nike missile system, the top-secret anti-espionage campaign Operation Washtub, and other Cold War activities in Alaska
""Forget-me-not"" card
No full textA Christmas card sent to Nora Neal of Seaford, Delaware, from May Matthews
Climbing the ladder to equitable access for mothers and children: health system transitions to universal coverage in urban and rural settings
No full text""Forget-me-not"" card
No full textA Christmas card sent to Nora Neal of Seaford, Delaware, from May Matthews
Material Spirituality with Neal DeRoo Pt. I
No full textIs spirituality one part of our lives that we experience in worship? Or does it permeate our whole being? Are we able to pull spirituality and religion apart? What would happen if we considered how our spirituality is embodied, deeply, in our world? In this inaugural episode of Critical Faith, Neal DeRoo explores these questions in his lecture "Toward a Material Spirituality: Religion and Phenomenological Expression." The recording is the first of three parts, all from a Scripture, Faith, and Scholarship Seminar hosted at the Institute for Christian Studies.
Neal DeRoo is Canada Research Chair in Phenomenology and Philosophy of Religion and Associate Professor of Philosophy at The King's University in Edmonton, Alberta, and the author of Futurity in Phenomenology: Promise and Method in Husserl, Levinas, and Derrida (Fordham: 2013)
Examining the "Urban Advantage'' in Maternal Health Care in Developing Countries
No full textAs the global urban population surpasses the rural, continuing growth in most developing countries means an inevitable increase in urban births. The majority of births in many countries will not be in remote rural areas, but in towns and cities [1]. Far from being good news for the twin Millennium Development Goals (MDGs) of maternal and child health—neither of which is currently on track for success [2]—high levels of urbanisation are likely to be associated with increased exclusion from care for many mothers in poor countries, and continued high maternal and newborn mortality among the urban poor. Health and social services in urban areas have not kept pace with urban population growth [3,4]. Women in slum communities can find care difficult to access even though a well-functioning health infrastructure is located nearby, and in some cases the urban poor have less access to services than people who live in rural areas [5–7]
Gaps in maternity care data: A policy brief for England
No full textThe monitoring of maternal-newborn health and health services in the UK is important for identifying trends over time that could cause concern or require action to protect patients at national, regional or individual Trust level. Accountability at international level can also raise flags for patient safety tracking national progress towards international goals2, as recently seen in the highlighting of continued rise and inequalities in maternal mortality in the USA3. Monitoring has been particularly important during the COVID-19 pandemic, as ongoing policy-making has needed to become very responsive to changing circumstances as successive waves and different strains of COVID-19 have unrolled. Monitoring our core maternity system, whether during a pandemic or not, should be comprehensive, fully include all Trusts, and be based on current agreed policy tenets. Comparing maternity provision and outcomes between different Trusts can be fraught with difficulty, as each Trust has its own characteristics and different caseloads, but its only by monitoring and comparing Trusts with care that we can identify good performers, share best practice, and draw lessons for policy and practice.In England, individual Trusts are responsible for collecting, cleaning and using data for their own management given their own particular characteristics. But quality of data, data collection and expertise in analysis varies from Trust to Trust, causing problems for nationwide data systems that inform overall or regional strategies and policy development. During COVID-19, data collection and monitoring has become even more challenged, while at the same time more urgent, with a growing public understanding of health statistics and policy responses in real time. The ASPIRE study investigated the use of quantitative data for monitoring maternity services throughout the pandemic. Available data were examined across the COVID-19 pandemic starting from one year before its onset in English Trusts. The study focussed on seven Trusts, but data from all English Trusts have been assessed in order to see each case study Trust in the context of nationwide variations. This policy brief presents findings on the data available to monitor maternity services, the quality of that data and identifies the strengths and shortcomings of the data for responsive policy-making in a pandemic. Recommendations from the study are pandemic-specific, as well as more wide reaching and universal, using COVID-19 as an example of a crisis
Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis
No full textObjectives: Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population.Setting: Women's experience of user fees in 5 African countries.Primary and secondary outcome measures: Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities’ births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries’ choice.Participants: We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria).Results: User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana.Conclusions: Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care.<br/
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