48 research outputs found
Effectiveness and cost-effectiveness of home-based postpartum care on neonatal mortality and exclusive breastfeeding practice in low-and-middle-income countries: a systematic review and meta-analysis
No full textBackground:
Early postpartum facility discharge negatively impacts mothers’ proper and effective use postnatal care. Cognizant of these facts, home-based postnatal care practices have been promoted to complement facility-based care to reduce neonatal mortality. This systematic review evaluated the effectiveness and cost-effectiveness of home-based postnatal care on exclusive breastfeeding practice and neonatal mortality in low-and-middle-income countries.
Methods:
Randomized trials and quasi-experimental studies were searched from electronic databases including PubMed, Popline, Cochrane Central Register of Controlled Trials and National Health Service Economic Evaluation databases. Random-effects meta-analysis model was used to pool the estimates of the outcomes accounting for the variability among studies.
Results:
We identified 14 trials implementing intervention packages that included preventive and promotive newborn care services, home-based treatment for sick neonates, and community mobilization activities. The pooled analysis indicates that home-based postpartum care reduced neonatal mortally by 24% (risk ratio 0.76; 95% confidence interval 0.62–0.92; 9 trials; n = 93,083; heterogeneity p < .01) with no evidence of publication bias (Egger’s test: Coef. = − 1.263; p = .130). The subgroup analysis suggested that frequent home visits, home visits by community health workers, and community mobilization efforts with home visits, to had better neonatal survival. Likewise, the odds of mothers who exclusively breastfed from the home visit group were about three times higher than the mothers who were in the routine care group (odds ratio: 2.88; 95% confidence interval: 1.57–5.29; 6 trials; n = 20,624 mothers; heterogeneity p < .01), with low possibility of publication bias (Coef. = − 7.870; p = .164).
According to the World Health Organization’s Choosing Interventions that are Cost-Effective project recommendations, home-based neonatal care strategy was found to be cost-effective.
Conclusions:
Home visits and community mobilization activities to promote neonatal care practices by community health workers is associated with reduced neonatal mortality, increased practice of exclusive breastfeeding, and cost-effective in improving newborn health outcomes for low-and-middle-income countries. However, a well-designed evaluation study is required to formulate the optimal package and optimal timing of home visits to standardize home-based postnatal interventions
Blood transfusion service readiness and its associated factors in health facilities providing blood transfusion services across Ethiopia: A secondary analysis of the 2018 Service Availability and Readiness Assessment (SARA) survey.
No full textIntroductionTimely and safe blood transfusion services are crucial for saving lives in emergencies. Previous studies have focused on hospital inpatient care access but have overlooked blood transfusion service readiness. This study examined the readiness of blood transfusion services in health facilities across Ethiopia and its determinants.MethodsThis study used Service Availability and Readiness Assessment (SARA) 2018 data from 632 facilities. Readiness was measured based on seven components: the presence of at least one trained staff for appropriate use of blood and safe transfusion; guidelines for appropriate use and transfusion; blood storage refrigerator; blood typing; cross-match typing; blood supply safety; and blood supply sufficiency. Data were analyzed using descriptive and inferential statistics. Facility characteristics were summarized using frequency tables and summary statistics. Bivariate and multivariable linear regression analyses examined the predictors of service readiness.ResultsFacilities offering blood transfusion services had a mean readiness score of 4.5 (out of 7), with only 5% having all items. Most facilities performed blood typing, but less than one-third conducted cross-match testing, and over half lacked guidelines and trained staff. Service readiness varied significantly across regions. Facilities in Oromia (Coef.: -0.74; 95% CI: [-1.32, -0.15]) and Somali (Coef.: -1.26; 95% CI: [-2.21, -0.31]) had lower readiness scores compared to Addis Ababa. Increased availability of medical equipment corresponded to a 49% increase in readiness scores (Coef.: 0.49; 95% CI: [0.19, 0.79]).ConclusionThe study highlights deficiencies in blood transfusion service readiness and regional disparities, emphasizing the need for targeted support to enhance readiness across regions
Maternal Anthropometric Measurements Do Not Have Effect on Birth Weight of Term, Single, and Live Births in Addis Ababa City, Ethiopia
No full textLow birth weight is a global public health problem for mortality and morbidity in any age group. The objective of this study is to investigate the effect of maternal anthropometric measurements on birth weight. A cross-sectional study was conducted from Nov 25, 2012, to Feb 25, 2013, in maternity public hospitals in Addis Ababa city, Ethiopia. The effect is investigated using correlation, linear regression, independent sample T-test, one-way ANOVA, and finally multivariate linear regression analysis. A total of 605 women and their newborns took part in this study and prevalence of low birth weight is 8.3%. On adjusted multivariate linear regression analysis, maternal anthropometric measurements did not have an effect on birth weight. Since maternal mid-upper arm circumference ≤ 20 cm and body mass index ≤18.5kg/m2 are almost nil in this study, generalization is difficult to general population where undernourished women are common in the rural Ethiopia and similar study is recommended in those areas. Antenatal care visits, gestational age, and female sex of newborn had statistically significant effect in determining the risk of low birth weight. Women who were living with large family members had a heavier newborn than counterparts. This might be due to the fact that pregnant women have better care and social support in Ethiopian context, so advising pregnant women to live with family members should be considered to enhance social support during pregnancy in Ethiopia. Maternal anthropometric measurements have no significant effect in determining birth weight in the city and we recommend similar studies where undernourished women are common
Effective treatment coverage for sick young infants with possible serious bacterial infection when referral not feasible in low-and middle-income countries: systematic review and meta-analysis
No full textHealth post readiness and its influence on mothers’ care-seeking practice for their sick children in Ethiopia
No full textIntroductionInfection accounts for about half of all neonatal deaths and it contributes to 37% of neonatal deaths in Sub-Saharan Africa where there is low health facility readiness and the quality of service given at health facilities is low. In this study, we assessed the influence of health posts’ readiness on the care-seeking behavior of mothers of sick young children.MethodThis study analyzed data from a community-based implementation survey conducted by JSI in the two districts of Ethiopia from April 2021 to July 2022. In this study, we enrolled 4,262 and 4,081 mothers with children < 15 months at the baseline and end-line surveys, respectively, of which 508 and 359 infants were diagnosed for illness at 66 and 64 health posts at the baseline and end-line surveys. We used the Service Availability and Readiness Assessment tool to compute the facility readiness score. We used independent sample t-test and logistic regression to see the contributions of facility readiness for care-seeking practices of mothers. AOR at 95% CI and p-value < 0.05 is used to declare a statistically significant association between variables and to control the confounding.ResultsIn the end-line survey about 359 sick young infants were identified. And in the baseline survey, 508 young infants were ill. Most of 88.0% sick young infants sought care in the end line compared to 57.3% at the baseline (p < 0.001). The overall summated mean facility readiness score was 69.6%, equivalent to 49.0% of the standardized mean score. This study also highlights rich households (AOR = 2.02; 95% CI: 1.1–3.9), reaching out to health posts (HPs) equipped with materials and supplies (AOR = 1.52; 95% CI: 1.2–1.9), and ANC use (AOR = 2.35; 95%CI: 1.2–4.7) were positively associated with care seeking practice compared to their counterparts.ConclusionThe study reveals a moderate level of health post-readiness that needs improvement. Health posts readiness, ANC use, parity, and wealth status influenced the care-seeking behavior of mothers for their sick children
Effectiveness of participatory community solutions strategy on improving household and provider health care behaviors and practices: A mixed-method evaluation
No full textIntroductionWe implemented a participatory quality improvement strategy in eight primary health care units of Ethiopia to improve use and quality of maternal and newborn health services.MethodsWe evaluated the effects of this strategy using mixed-methods research. We used before-and-after (March 2016 and November 2017) cross-sectional surveys of women who had children 0–11 months to compare changes in maternal and newborn health care indicators in the 39 communities that received the intervention and the 148 communities that did not. We used propensity scores to match the intervention with the comparison communities at baseline and difference-in-difference analyses to estimate intervention effects. The qualitative method included 51 in-depth interviews of community volunteers, health extension workers, health center directors and staff, and project specialists.ResultsThe difference-in-difference analyses indicated that 7.9 percentage points (95% confidence interval [CI]: 1.8–13.9%) increase in receiving skilled delivery care between baseline and follow-up surveys in the intervention area that is attributable to the strategy. The intervention effect on postnatal care in 48 hours of the mother was 15.3% (95% CI: 7.4–23.2). However, there was no evidence that the strategy affected the seven other maternal and newborn health care indicators considered. Interview participants said that the participatory design and implementation strategy helped them to realize gaps, identify real problems, and design appropriate solutions, and created a sense of ownership and shared responsibility for implementing interventions.ConclusionsCommunity participation in planning and monitoring maternal and newborn health service delivery improves use of some high-impact maternal and newborn health services. The study supports the notion that participatory community strategies should be considered to foster community-responsive health systems.</div
Outline of participants for qualitative research.
No full textOutline of participants for qualitative research.</p
Sample characteristics, by study arm and survey period.
No full textSample characteristics, by study arm and survey period.</p
Definition of MNH care and facility readiness and performance indicators.
No full textDefinition of MNH care and facility readiness and performance indicators.</p
Survey dataset.
No full textThis is survey data with variables and their values we used for the analysis. (XLS)</p
