Maternal, Newborn, and Child Health
- Implementation Approaches for Introducing and Overcoming Barriers to Hepatitis B Birth-Dose Vaccine in sub-Saharan Africa
We discuss determinants of hepatitis B birth-dose vaccine uptake in sub-Saharan Africa countries at the policy, facility, and community levels and propose solutions to known barriers of hepatitis B vaccine introduction in low- and middle-income countries.
- Health System Redesign to Shift to Hospital Delivery for Maternal and Newborn Survival: Feasibility Assessment in Kakamega County, Kenya
Service delivery redesign is needed to accelerate progress toward improved health outcomes. Kakamega County, Kenya, demonstrates that there is a strong base of health system assets that would serve as a starting point to successfully implement maternal and newborn health service delivery redesign.
- Household Survey Measurement of Newborn Postnatal Care: Coverage, Quality Gaps, and Internal Inconsistencies in Responses
Reliable measurement of postnatal content of care is currently lacking despite the critical importance of care in this vulnerable period. We found that there is a large quality-coverage gap with missed opportunities for quality care as well as internal inconsistencies in responses to newborn questions.
- Projecting the Impact of Nutrition Policy to Improve Child Stunting: A Case Study in Guatemala Using the Lives Saved Tool
We projected the impact of a Scaling Up Nutrition intervention policy, the Great Crusade, and found that increasing intervention coverage is unlikely to improve child stunting outcomes in Guatemala to meet Sustainable Development Goals by 2030.
- Impact of Solar Light and Electricity on the Quality and Timeliness of Maternity Care: A Stepped-Wedge Cluster-Randomized Trial in Uganda
Lack of access to reliable energy is a major neglected health system challenge to maternal and child health. We found that installing a solar energy system intervention in rural Ugandan maternity facilities led to modest increases in the quality of maternity care and reductions in delays in care.
- Participation in a Community-Based Women's Health Education Program and At-Risk Child Development in Rural Kenya: Developmental Screening Questionnaire Results Analysis
A community-based intervention focused on women's health education may help protect against early childhood developmental delays in resource-limited settings.
- Accuracy of Using Mid-Upper Arm Circumference to Detect Wasting Among Children Aged 6–59 Months in Nepal
When comparing the sensitivity and specificity of mid-upper arm circumference (MUAC) versus weight-for-height z-scores (WHZ) to identify wasting in children aged 6–59 months in Nepal, our findings suggest that only using MUAC compared to WHZ to screen may exclude a large number of children who could be at risk of severe or moderate acute malnutrition.
- Negative Incentives for Noninstitutional Births Are Associated With a Higher Rate of Facility-Based Births in the Eastern Visaya Region, Philippines
Penalties imposed for noninstitutional deliveries by local government policies could motivate pregnant women to deliver at birthing facilities; however, local governments should address barriers to accessing a birthing facility in underserved areas before prohibiting noninstitutional deliveries.
- Readiness to Provide Antenatal Corticosteroids for Threatened Preterm Birth in Public Health Facilities in Northern India
In settings with limited resources that lack standards to ensure the quality of childbirth and newborn care, the use of antenatal corticosteroids is potentially harmful. Safe, effective use of antenatal corticosteroids requires providing standardized evidence-based practices and supportive supervision, training staff, and a facility-level actionable health information system.
- Care Around Birth Approach: A Training, Mentoring, and Quality Improvement Model to Optimize Intrapartum and Immediate Postpartum Quality of Care in India
The Care Around Birth approach provides an integrated implementation framework to improve the quality, equity, and dignity of care during the intrapartum and immediate postpartum periods, thereby addressing key drivers of maternal and newborn mortality.