The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Kimiyo Kikuchi - One of the best experts on this subject based on the ideXlab platform.
-
Postnatal Care could be the key to improving the continuum of Care in maternal and child health in ratanakiri cambodia
PLOS ONE, 2018Co-Authors: Kimiyo Kikuchi, Junko Yasuoka, Keiko Nanishi, Ashir Ahmed, Yasunobu Nohara, Mariko Nishikitani, Fumihiko Yokota, Tetsuya Mizutani, Naoki NakashimaAbstract:In South-East Asia, the maternal and child mortality rate has declined over the past decades; however, it varies among and within the countries in the region, including Cambodia. The continuum of Care is an integrated series of Care that women and children are required to avail continuously from pregnancy to the child/motherhood period. This study aimed to assess the completion rate of the continuum of Care and examine the factors associated with the continuum of Care in Ratanakiri, Cambodia. A cross-sectional study was conducted in Ratanakiri. Overall, 377 women were included, and data were collected via face-to-face interviews using a semi-structured questionnaire. Among them, 5.0% completed the continuum of Care (antenatal Care at least four times, delivery by skilled birth attendant, and Postnatal Care at least once). Meanwhile, 18.8% did not receive any Care during pregnancy, delivery, and after birth. The highest discontinuation rate was at the Postnatal Care stage (73.6%). Not receiving any perinatal Care was associated with neonatal complications at 6 weeks after birth (adjusted odds ratio [AOR]: 3.075; 95% confidence interval [CI]: 1.310-7.215). Furthermore, a long distance to the health center was negatively associated with completion of the continuum of Care (AOR: 0.877; 95% CI: 0.791-0.972). This study indicates the need for efforts to reduce the number of women who discontinue from the continuum of Care, as well as who do not receive any Care to avoid neonatal complications. Since the discontinuation rate was highest at the Postnatal Care, Postnatal Care needs to be promoted more through the antenatal Care and delivery services. Furthermore, given that long distance to health facilities was a barrier for receiving the Care continuously, our findings suggest the need for a village-based health Care system that can provide the basic continuum of Care in remote areas.
-
continuum of Care in a maternal newborn and child health program in ghana low completion rate and multiple obstacle factors
PLOS ONE, 2015Co-Authors: Francis Yeji, Akira Shibanuma, Abraham Oduro, Cornelius Debpuur, Kimiyo Kikuchi, Seth Owusuagei, Margaret Gyapong, Sumiyo Okawa, Evelyn K Ansah, Gloria Quansah AsareAbstract:Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of Care (at least four antenatal visits; skilled birth attendance; Postnatal Care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of Care (CoC) completion among Ghanaian women aged 15–49. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and Postnatal Care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and Postnatal Care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received Postnatal Care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.13–0.39), marital status (OR = 0.45; CI 0.22–0.95), education (OR = 2.71; CI 1.11–6.57), transportation (OR = 1.97; CI 1.07–3.62), and beliefs about childhood illnesses (OR = 0.34; CI0.21–0.61). Conclusion The continuum of Care completion rate is low in the study site. Efforts should focus on increasing Postnatal Care within 48 hours and overcoming the known obstacles to increasing the continuum of Care completion rate.
-
effective linkages of continuum of Care for improving neonatal perinatal and maternal mortality a systematic review and meta analysis
PLOS ONE, 2015Co-Authors: Kimiyo Kikuchi, Akira Shibanuma, Margaret Gyapong, Sumiyo Okawa, Evelyn K Ansah, Junko Yasuoka, Keiko Nanishi, Seth Owusuagyei, Yeetey Enuameh, Abraham OduroAbstract:Background Continuum of Care has the potential to improve maternal, newborn, and child health (MNCH) by ensuring Care for mothers and children. Continuum of Care in MNCH is widely accepted as comprising sequential time (from pre-pregnancy to motherhood and childhood) and space dimensions (from community-family Care to clinical Care). However, it is unclear which linkages of Care could have a greater effect on MNCH outcomes. The objective of the present study is to assess the effectiveness of different continuum of Care linkages for reducing neonatal, perinatal, and maternal mortality in low- and middle-income countries. Methods We searched for randomized and quasi-randomized controlled trials that addressed two or more linkages of continuum of Care and attempted to increase mothers’ uptake of antenatal Care, skilled birth attendance, and Postnatal Care. The outcome variables were neonatal, perinatal, and maternal mortality. Results Out of the 7,142 retrieved articles, we selected 19 as eligible for the final analysis. Of these studies, 13 used packages of intervention that linked antenatal Care, skilled birth attendance, and Postnatal Care. One study each used packages that linked antenatal Care and skilled birth attendance or skilled birth attendance and Postnatal Care. Four studies used an intervention package that linked antenatal Care and Postnatal Care. Among the packages that linked antenatal Care, skilled birth attendance, and Postnatal Care, a significant reduction was observed in combined neonatal, perinatal, and maternal mortality risks (RR 0.83; 95% CI 0.77 to 0.89, I2 79%). Furthermore, this linkage reduced combined neonatal, perinatal, and maternal mortality when integrating the continuum of Care space dimension (RR 0.85; 95% CI 0.77 to 0.93, I2 81%). Conclusions Our review suggests that continuous uptake of antenatal Care, skilled birth attendance, and Postnatal Care is necessary to improve MNCH outcomes in low- and middle-income countries. The review was conclusive for the reduction of neonatal and perinatal deaths. Although maternal deaths were not significantly reduced, composite measures of all mortality were. Thus, the evidence is sufficient to scale up this intervention package for the improvement of MNCH outcomes.
-
high incidence of neonatal danger signs and its implications for Postnatal Care in ghana a cross sectional study
PLOS ONE, 2015Co-Authors: Sumiyo Okawa, Akira Shibanuma, Kimiyo Kikuchi, Margaret Gyapong, Evelyn K Ansah, Junko Yasuoka, Keiko Nanishi, Seth Owusuagyei, Yeetey Enuameh, Abraham OduroAbstract:BACKGROUND: Reducing neonatal mortality is a major public health priority in sub-Saharan Africa. Numerous studies have examined the determinants of neonatal mortality but few have explored neonatal danger signs which potentially cause morbidity. This study assessed danger signs observed in neonates at birth determined the correlations of multiple danger signs and complications between neonates and their mothers and identified factors associated with neonatal danger signs. METHODS: A cross-sectional study was conducted in three sites across Ghana between July and September in 2013. Using two-stage random sampling we recruited 1500 pairs of neonates and their mothers who had given birth within the preceding two years. We collected data on their socio-demographic characteristics utilization of maternal and neonatal health services and experiences with neonatal danger signs and maternal complications. We calculated the correlations of multiple danger signs and complications between neonates and their mothers and performed multiple logistic regression analysis to identify factors associated with neonatal danger signs. RESULTS: More than 25% of the neonates were born with danger signs. At-birth danger signs in neonates were correlated with maternal delivery complications (r = 0.20 p < 0.001) and neonatal complications within the first six weeks of life (r = 0.19 p < 0.001). However only 29.1% of neonates with danger signs received Postnatal Care in the first two days and 52.4% at two weeks of life. In addition to maternal complications during delivery maternal age less than 20 years maternal education level lower than secondary school and fewer than four antenatal Care visits significantly predicted neonatal danger signs. CONCLUSIONS: Over a quarter of neonates are born with danger signs. Maternal factors can be used to predict neonatal health condition at birth. Management of maternal health and close medical attention to high-risk neonates are crucial to reduce neonatal morbidity in Ghana.
Abraham Oduro - One of the best experts on this subject based on the ideXlab platform.
-
continuum of Care in a maternal newborn and child health program in ghana low completion rate and multiple obstacle factors
PLOS ONE, 2015Co-Authors: Francis Yeji, Akira Shibanuma, Abraham Oduro, Cornelius Debpuur, Kimiyo Kikuchi, Seth Owusuagei, Margaret Gyapong, Sumiyo Okawa, Evelyn K Ansah, Gloria Quansah AsareAbstract:Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of Care (at least four antenatal visits; skilled birth attendance; Postnatal Care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of Care (CoC) completion among Ghanaian women aged 15–49. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and Postnatal Care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and Postnatal Care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received Postnatal Care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.13–0.39), marital status (OR = 0.45; CI 0.22–0.95), education (OR = 2.71; CI 1.11–6.57), transportation (OR = 1.97; CI 1.07–3.62), and beliefs about childhood illnesses (OR = 0.34; CI0.21–0.61). Conclusion The continuum of Care completion rate is low in the study site. Efforts should focus on increasing Postnatal Care within 48 hours and overcoming the known obstacles to increasing the continuum of Care completion rate.
-
effective linkages of continuum of Care for improving neonatal perinatal and maternal mortality a systematic review and meta analysis
PLOS ONE, 2015Co-Authors: Kimiyo Kikuchi, Akira Shibanuma, Margaret Gyapong, Sumiyo Okawa, Evelyn K Ansah, Junko Yasuoka, Keiko Nanishi, Seth Owusuagyei, Yeetey Enuameh, Abraham OduroAbstract:Background Continuum of Care has the potential to improve maternal, newborn, and child health (MNCH) by ensuring Care for mothers and children. Continuum of Care in MNCH is widely accepted as comprising sequential time (from pre-pregnancy to motherhood and childhood) and space dimensions (from community-family Care to clinical Care). However, it is unclear which linkages of Care could have a greater effect on MNCH outcomes. The objective of the present study is to assess the effectiveness of different continuum of Care linkages for reducing neonatal, perinatal, and maternal mortality in low- and middle-income countries. Methods We searched for randomized and quasi-randomized controlled trials that addressed two or more linkages of continuum of Care and attempted to increase mothers’ uptake of antenatal Care, skilled birth attendance, and Postnatal Care. The outcome variables were neonatal, perinatal, and maternal mortality. Results Out of the 7,142 retrieved articles, we selected 19 as eligible for the final analysis. Of these studies, 13 used packages of intervention that linked antenatal Care, skilled birth attendance, and Postnatal Care. One study each used packages that linked antenatal Care and skilled birth attendance or skilled birth attendance and Postnatal Care. Four studies used an intervention package that linked antenatal Care and Postnatal Care. Among the packages that linked antenatal Care, skilled birth attendance, and Postnatal Care, a significant reduction was observed in combined neonatal, perinatal, and maternal mortality risks (RR 0.83; 95% CI 0.77 to 0.89, I2 79%). Furthermore, this linkage reduced combined neonatal, perinatal, and maternal mortality when integrating the continuum of Care space dimension (RR 0.85; 95% CI 0.77 to 0.93, I2 81%). Conclusions Our review suggests that continuous uptake of antenatal Care, skilled birth attendance, and Postnatal Care is necessary to improve MNCH outcomes in low- and middle-income countries. The review was conclusive for the reduction of neonatal and perinatal deaths. Although maternal deaths were not significantly reduced, composite measures of all mortality were. Thus, the evidence is sufficient to scale up this intervention package for the improvement of MNCH outcomes.
-
high incidence of neonatal danger signs and its implications for Postnatal Care in ghana a cross sectional study
PLOS ONE, 2015Co-Authors: Sumiyo Okawa, Akira Shibanuma, Kimiyo Kikuchi, Margaret Gyapong, Evelyn K Ansah, Junko Yasuoka, Keiko Nanishi, Seth Owusuagyei, Yeetey Enuameh, Abraham OduroAbstract:BACKGROUND: Reducing neonatal mortality is a major public health priority in sub-Saharan Africa. Numerous studies have examined the determinants of neonatal mortality but few have explored neonatal danger signs which potentially cause morbidity. This study assessed danger signs observed in neonates at birth determined the correlations of multiple danger signs and complications between neonates and their mothers and identified factors associated with neonatal danger signs. METHODS: A cross-sectional study was conducted in three sites across Ghana between July and September in 2013. Using two-stage random sampling we recruited 1500 pairs of neonates and their mothers who had given birth within the preceding two years. We collected data on their socio-demographic characteristics utilization of maternal and neonatal health services and experiences with neonatal danger signs and maternal complications. We calculated the correlations of multiple danger signs and complications between neonates and their mothers and performed multiple logistic regression analysis to identify factors associated with neonatal danger signs. RESULTS: More than 25% of the neonates were born with danger signs. At-birth danger signs in neonates were correlated with maternal delivery complications (r = 0.20 p < 0.001) and neonatal complications within the first six weeks of life (r = 0.19 p < 0.001). However only 29.1% of neonates with danger signs received Postnatal Care in the first two days and 52.4% at two weeks of life. In addition to maternal complications during delivery maternal age less than 20 years maternal education level lower than secondary school and fewer than four antenatal Care visits significantly predicted neonatal danger signs. CONCLUSIONS: Over a quarter of neonates are born with danger signs. Maternal factors can be used to predict neonatal health condition at birth. Management of maternal health and close medical attention to high-risk neonates are crucial to reduce neonatal morbidity in Ghana.
David Schellenberg - One of the best experts on this subject based on the ideXlab platform.
-
the use of antenatal and Postnatal Care perspectives and experiences of women and health Care providers in rural southern tanzania
BMC Pregnancy and Childbirth, 2009Co-Authors: Mwifadhi Mrisho, Brigit Obrist, Joanna Schellenberg, Rachel A Haws, Adiel K Mushi, Hassan Mshinda, Marcel Tanner, David SchellenbergAbstract:Although antenatal Care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of Postnatal Care, by which we mean the Care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health Care providers on the use of antenatal and Postnatal services. From March 2007 to January 2008, we conducted in-depth interviews with health Care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and Postnatal services, perceptions of the rationale and importance of antenatal and Postnatal Care, barriers to utilisation and suggestions for improvement. Women were generally positive about both antenatal and Postnatal Care. Among common reasons mentioned for late initiation of antenatal Care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum Care-seeking from hospitals. Despite the perceived benefits of Postnatal Care for children, there was a total lack of Postnatal Care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community. Efforts to improve antenatal and Postnatal Care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and Postnatal Care can offer important opportunities for linking the health system and the community by encouraging women to deliver with a skilled attendant. Addressing staff shortages through expanding training opportunities and incentives to health Care providers and developing Postnatal Care guidelines are key steps to improve maternal and newborn health.
-
the use of antenatal and Postnatal Care perspectives and experiences of women and health Care providers in rural southern tanzania
BMC Pregnancy and Childbirth, 2009Co-Authors: Mwifadhi Mrisho, Brigit Obrist, Joanna Schellenberg, Rachel A Haws, Adiel K Mushi, Hassan Mshinda, Marcel Tanner, David SchellenbergAbstract:Background Although antenatal Care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of Postnatal Care, by which we mean the Care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health Care providers on the use of antenatal and Postnatal services.
Jody R Lori - One of the best experts on this subject based on the ideXlab platform.
-
how maternity waiting home use influences attendance of antenatal and Postnatal Care
PLOS ONE, 2021Co-Authors: Julie M Buser, Michelle L Munrokramer, Philip Veliz, Xingyu Zhang, Nancy Lockhart, Godfrey Biemba, Thandiwe Ngoma, Nancy A Scott, Jody R LoriAbstract:As highlighted in the International Year of the Nurse and the Midwife, access to quality nursing and midwifery Care is essential to promote maternal-newborn health and improve survival. One intervention aimed at improving maternal-newborn health and reducing underutilization of pregnancy services is the construction of maternity waiting homes (MWHs). The purpose of this study was to assess whether there was a significant change in antenatal Care (ANC) and Postnatal Care (PNC) attendance, family planning use, and vaccination rates before and after implementation of the Core MWH Model in rural Zambia. A quasi-experimental controlled before-and-after design was used to evaluate the impact of the Core MWH Model by assessing associations between ANC and PNC attendance, family planning use, and vaccination rates for mothers who gave birth to a child in the past 13 months. Twenty health Care facilities received the Core MWH Model and 20 were identified as comparison facilities. Before-and-after community surveys were carried out. Multivariable logistic regression were used to assess the association between Core MWH Model use and ANC and PNC attendance. The total sample includes 4711 mothers. Mothers who used the Core MWH Model had better ANC and PNC attendance, family planning use, and vaccination rates than mothers who did not use a MWH. All mothers appeared to fare better across these outcomes at endline. We found an association between Core MWH Model use and better ANC and PNC attendance, family planning use, and newborn vaccination outcomes. Maternity waiting homes may serve as a catalyst to improve use of facility services for vulnerable mothers.
-
how maternity waiting home use influences attendance of antenatal and Postnatal Care
Social Science Research Network, 2020Co-Authors: Julie M Buser, Michelle L Munrokramer, Philip Veliz, Xingyu Zhang, Nancy Lockhart, Godfrey Biemba, Thandiwe Ngoma, Nancy A Scott, Jody R LoriAbstract:Background: In this International Year of the Nurse and the Midwife, access to quality midwifery Care is essential to promote maternal-newborn health and improve survival. One intervention aimed at improving maternal-newborn health and reducing underutilization of pregnancy services is the construction of maternity waiting homes (MWHs). The purpose of this study was to assess whether there was a significant change in antenatal Care (ANC) and Postnatal Care (PNC) attendance, family planning (FP) use, and vaccination rates before and after implementation of the Core MWH Model in rural Zambia. Methods: A quasi-experimental controlled before-and-after design was used to evaluate the impact of the Core MWH Model by assessing associations between ANC and PNC attendance, FP use, and vaccination rates for mothers who delivered a child in the past 13 months. Twenty health Care facilities received the Core MWH Model and 20 were identified as comparison facilities. Multivariable logistic regression were used to assess the association between MWH use and ANC and PNC attendance. Findings: The total sample include 4711 mothers. Mothers who used a MWH had better ANC and PNC attendance, FP use, and vaccination rates than mothers who did not use a MWH. All mothers appeared to fare better across these outcomes at endline. Interpretation: We found an association between MWHs and better ANC and PNC attendance, FP use, and newborn vaccination outcomes. Maternity waiting homes may serve as a catalyst to improve use of facility services for vulnerable mothers, especially those living the farthest from services. Funding Statement: The study program was developed and is being implemented in collaboration with Merck for Mothers, Merck’s 10-year, $500 million initiative to help create a world where no woman dies giving life. Merck for Mothers is known as MSD for Mothers outside the United States and Canada (MRK 1846-06500.COL). The development of the study article was additionally supported in part by the Bill & Melinda Gates Foundation (OPP1130334) https://www.gatesfoundation.org/How-We-Work/Quick-Links/Grants-Database/Grants/2015/06/OPP1130334 and The ELMA Foundation (ELMA-15-F0010) http://www.elmaphilanthropies.org/the-elma-foundation. Declaration of Interests: The authors have no conflict of interest. Ethics Approval Statement: Institutional review board (IRB) ethical approval was obtained from the University of Michigan, Boston University, and the ERES Converge IRB in Zambia.
Adiel K Mushi - One of the best experts on this subject based on the ideXlab platform.
-
the use of antenatal and Postnatal Care perspectives and experiences of women and health Care providers in rural southern tanzania
BMC Pregnancy and Childbirth, 2009Co-Authors: Mwifadhi Mrisho, Brigit Obrist, Joanna Schellenberg, Rachel A Haws, Adiel K Mushi, Hassan Mshinda, Marcel Tanner, David SchellenbergAbstract:Although antenatal Care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of Postnatal Care, by which we mean the Care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health Care providers on the use of antenatal and Postnatal services. From March 2007 to January 2008, we conducted in-depth interviews with health Care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and Postnatal services, perceptions of the rationale and importance of antenatal and Postnatal Care, barriers to utilisation and suggestions for improvement. Women were generally positive about both antenatal and Postnatal Care. Among common reasons mentioned for late initiation of antenatal Care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum Care-seeking from hospitals. Despite the perceived benefits of Postnatal Care for children, there was a total lack of Postnatal Care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community. Efforts to improve antenatal and Postnatal Care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and Postnatal Care can offer important opportunities for linking the health system and the community by encouraging women to deliver with a skilled attendant. Addressing staff shortages through expanding training opportunities and incentives to health Care providers and developing Postnatal Care guidelines are key steps to improve maternal and newborn health.
-
the use of antenatal and Postnatal Care perspectives and experiences of women and health Care providers in rural southern tanzania
BMC Pregnancy and Childbirth, 2009Co-Authors: Mwifadhi Mrisho, Brigit Obrist, Joanna Schellenberg, Rachel A Haws, Adiel K Mushi, Hassan Mshinda, Marcel Tanner, David SchellenbergAbstract:Background Although antenatal Care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of Postnatal Care, by which we mean the Care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health Care providers on the use of antenatal and Postnatal services.