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Vicki Flenady, Aleena M Wojcieszek, Ingvild Fjeldheim, Ingrid K Friberg, Victoria Nankabirwa, Jagrati V Jani, Sonja Myhre, Philippa Middleton, Caroline Crowther, David Ellwood, David Tudehope, Robert Pattinson, Jacqueline Ho, Jiji Matthews, Aurora Bermudez Ortega, Mahima Venkateswaran, Doris Chou, Lale Say, Garret Mehl, J Frederik Frøen
BACKGROUND: Electronic health registries - eRegistries - can systematically collect relevant information at the point of care for reproductive, maternal, newborn and child health (RMNCH). However, a suite of process and outcome indicators is needed for RMNCH to monitor care and to ensure comparability between settings. Here we report on the assessment of current global indicators and the development of a suite of indicators for the WHO Essential Interventions for use at various levels of health care systems nationally and globally...
September 30, 2016: BMC Pregnancy and Childbirth
Nadia Akseer, Zaid Bhatti, Arjumand Rizvi, Ahmad S Salehi, Taufiq Mashal, Zulfiqar A Bhutta
BACKGROUND: Afghanistan has made considerable gains in improving maternal and child health and survival since 2001. However, socioeconomic and regional inequities may pose a threat to reaching universal coverage of health interventions and further health progress. We explored coverage and socioeconomic inequalities in key life-saving reproductive, maternal, newborn and child health (RMNCH) interventions at the national level and by region in Afghanistan. We also assessed gains in child survival through scaling up effective community-based interventions across wealth groups...
2016: BMC Public Health
Carlyn Mann, Courtney Ng, Nadia Akseer, Zulfiqar A Bhutta, Josephine Borghi, Tim Colbourn, Patricia Hernández-Peña, Luis Huicho, Muhammad Ashar Malik, Melisa Martinez-Alvarez, Spy Munthali, Ahmad Shah Salehi, Mekonnen Tadesse, Mohammed Yassin, Peter Berman
BACKGROUND: Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies. METHODS: This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed...
2016: BMC Public Health
Neha S Singh, Luis Huicho, Hoviyeh Afnan-Holmes, Theopista John, Allisyn C Moran, Tim Colbourn, Chris Grundy, Zoe Matthews, Blerta Maliqi, Matthews Mathai, Bernadette Daelmans, Jennifer Requejo, Joy E Lawn
BACKGROUND: Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons...
2016: BMC Public Health
Corrina Moucheraud, Helen Owen, Neha S Singh, Courtney Kuonin Ng, Jennifer Requejo, Joy E Lawn, Peter Berman
BACKGROUND: Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress...
2016: BMC Public Health
Chandana Maitra, Andrew Hodge, Eliana Jimenez Soto
Growing evidence suggests that early life investments in health are associated with improved human capital and economic outcomes. Various recent global studies have simulated the expected economic returns from alternative packages of interventions in reproductive, maternal, newborn and child health (RMNCH). However, very little is known about the comparability of estimates of the economic returns of RMNCH interventions across studies in low and middle income countries. Our study aims to fill this gap. We performed a comprehensive scoping review of the recent literature (2000-2013) on the economic returns (i...
July 1, 2016: Health Policy and Planning
Robert E Black, Carol Levin, Neff Walker, Doris Chou, Li Liu, Marleen Temmerman
As part of Disease Control Priorities 3rd Edition, the World Bank will publish a volume on Reproductive, Maternal, Newborn, and Child Health that identifies essential cost-effective health interventions that can be scaled up to reduce maternal, newborn, and child deaths, and stillbirths. This Review summarises the volume's key findings and estimates the effect and cost of expanded implementation of these interventions. Recognising that a continuum of care from the adolescent girl, woman, or mother to child is needed, the volume includes details of preventive and therapeutic health interventions in integrated packages: Maternal and Newborn Health and Child Health (along with folic acid supplementation, a key reproductive health intervention)...
April 8, 2016: Lancet
Paul M Pronyk, Bennett Nemser, Blerta Maliqi, Nora Springstubb, Diana Sera, Rouslan Karimov, Elizabeth Katwan, Benedicte Walter, Pascal Bijleveld
BACKGROUND: In September, 2012, the UN Commission on Life Saving Commodities (UNCoLSC) outlined a plan to expand availability and access to 13 life saving commodities. We profile global and country progress against these recommendations between 2012 and 2015. METHODS: For 12 countries in sub-Saharan Africa that were off-track to achieve the Millennium Development Goals for maternal and child survival, we reviewed key documents and reference data, and conducted interviews with ministry staff and partners to assess the status of the UNCoLSC recommendations...
April 2016: Lancet Global Health
Cyril M Engmann, Sadaf Khan, Cheryl A Moyer, Patricia S Coffey, Zulfiqar A Bhutta
As part of the "Grand Convergence: Aligning Technologies and Realities in Global Health" Collection, Cyril Engmann and colleagues discuss promising innovations that have the potential to move the RMNCH agenda forward.
March 2016: PLoS Medicine
Sara J Elazan, Ariel E Higgins-Steele, Jean Christophe Fotso, Mila H Rosenthal, Dharitri Rout
BACKGROUND: Male community health workers (CHWs) have rarely been studied as an addition to the female community health workforce to improve access and care for reproductive, maternal, newborn, and child health (RMNCH). OBJECTIVE: To examine how male health activists (MHAs) coordinated RMNCH responsibilities with existing female health workers in an Indian context. MATERIALS AND METHODS: Interviews from male and female CHWs were coded around community-based engagement, outreach services, and links to facility-based care...
January 2016: Indian Journal of Community Medicine
Selena J An, Asha S George, Amnesty E LeFevre, Rose Mpembeni, Idda Mosha, Diwakar Mohan, Ann Yang, Joy Chebet, Chrisostom Lipingu, Abdullah H Baqui, Japhet Killewo, Peter J Winch, Charles Kilewo
BACKGROUND: Integration of HIV into RMNCH (reproductive, maternal, newborn and child health) services is an important process addressing the disproportionate burden of HIV among mothers and children in sub-Saharan Africa. We assess the structural inputs and processes of care that support HIV testing and counselling in routine antenatal care to understand supply-side dynamics critical to scaling up further integration of HIV into RMNCH services prior to recent changes in HIV policy in Tanzania...
2015: BMC Health Services Research
Janine Barden-O'Fallon, Mamadou Alimou Barry, Paul Brodish, Jack Hazerjian
INTRODUCTION:   Since March 2014, Guinea has been in the midst of the largest, longest, and deadliest outbreak of Ebola Virus Disease ever recorded. Due to sub-optimal health conditions prior to the outbreak, Guinean women and children may have been especially vulnerable to worsening health care conditions. A rapid assessment was conducted to better understand how the delivery and utilization of routine RMNCH services may have been affected by the extraordinary strain placed on the health system and its client population by the Ebola outbreak in Guinea...
2015: PLoS Currents
Kelsey Vaughan, Maryse C Kok, Sophie Witter, Marjolein Dieleman
OBJECTIVE: This study sought to synthesize and critically review evidence on costs and cost-effectiveness of community health worker (CHW) programmes in low- and middle-income countries (LMICs) to inform policy dialogue around their role in health systems. METHODS: From a larger systematic review on effectiveness and factors influencing performance of close-to-community providers, complemented by a supplementary search in PubMed, we did an exploratory review of a subset of papers (32 published primary studies and 4 reviews from the period January 2003-July 2015) about the costs and cost-effectiveness of CHWs...
2015: Human Resources for Health
Fiona M Dickinson, Thidar Pyone, Nynke van den Broek
BACKGROUND: Humanitarian emergencies can disproportionately affect women of reproductive age, and children. Good data on reproductive maternal, newborn and child health (RMNCH) are vital to plan and deliver programmes to address RMNCH needs. There is currently a lack of information regarding the availability, use and applicability of data collection tools. METHODS: Key informant interviews (KII) were conducted with participants with experience of data collection in humanitarian settings, identified from relevant publications...
February 2016: International Health
Leonardo Arregoces, Felicity Daly, Catherine Pitt, Justine Hsu, Melisa Martinez-Alvarez, Giulia Greco, Anne Mills, Peter Berman, Josephine Borghi
BACKGROUND: Tracking of aid resources to reproductive, maternal, newborn, and child health (RMNCH) provides timely and crucial information to hold donors accountable. For the first time, we examine flows in official development assistance (ODA) and grants from the Bill & Melinda Gates Foundation (collectively termed ODA+) in relation to the continuum of care for RMNCH and assess progress since 2003. METHODS: We coded and analysed financial disbursements for maternal, newborn, and child health (MNCH) and for reproductive health (R*) to all recipient countries worldwide from all donors reporting to the creditor reporting system database for the years 2011-12...
July 2015: Lancet Global Health
Nafisa Halim, Kathryn Spielman, Bruce Larson
BACKGROUND: Globally, 25% of children aged 0 to 4 years and more than 10% of women aged 15 to 49 years suffer from malnutrition. A range of interventions, promising for improving maternal and child nutrition, may also improve physical and intellectual capacity, and, thereby, future productivity and earnings. METHODS: We conducted a systematic literature review and summarized economic impacts of 23 reproductive, maternal, newborn and child health (RMNCH) interventions, published in 29 empirical studies between 2000 and 2013, using data from 13 low- and middle-income countries...
2015: BMC Women's Health
Geetanjli Kalyan, Manju Vatsa
Nurses comprise a key component to maternal and newborn health care delivery, including the care of 'at-risk' or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education...
November 2014: Indian Journal of Pediatrics
Zohra S Lassi, Rohail Kumar, Tarab Mansoor, Rehana A Salam, Jai K Das, Zulfiqar A Bhutta
In an effort to accelerate progress towards achieving Millennium Development Goal (MDG) 4 and 5, provision of essential reproductive, maternal, newborn and child health (RMNCH) interventions is being considered. Not only should a state-of-the-art approach be taken for services delivered to the mother, neonate and to the child, but services must also be deployed across the household to hospital continuum of care approach and in the form of packages. The paper proposed several packages for improved maternal, newborn and child health that can be delivered across RMNCH continuum of care...
2014: Reproductive Health
Rajesh Kumar Rai
The Continuum of Reproductive, Maternal, Newborn, and Child Healthcare (RMNCH) model is suggested to be an effective tool to improve maternal and child health. This short dispatch proposes that if India pursues the continuum of care model, a well-designed follow-up strategy to track prospective mothers and their children is imperative.
September 2014: Journal of Epidemiology and Global Health
Gary L Darmstadt, Mary V Kinney, Mickey Chopra, Simon Cousens, Lily Kak, Vinod K Paul, Jose Martines, Zulfiqar A Bhutta, Joy E Lawn
Nearly a decade ago, The Lancet published the Neonatal Survival Series, with an ambitious call for integration of newborn care across the continuum of reproductive, maternal, newborn, and child health and nutrition (RMNCH). In this first of five papers in the Every Newborn Series, we consider what has changed during this decade, assessing progress on the basis of a systematic policy heuristic including agenda-setting, policy formulation and adoption, leadership and partnership, implementation, and evaluation of effect...
July 12, 2014: Lancet
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