The effect of increases in the Syrian refugee population in Turkey on public maternal and child health outcomes

BackgroundWith the date for achieving the targets of the Millennium Development Goals (MDGs) approaching fast, there is a heightened concern about equity, as inequities hamper progress towards the MDGs. Equity-focused approaches have the potential to accelerate the progress towards achieving the health-related MDGs faster than the current pace in a more cost-effective and sustainable manner. Ghana's rate of progress towards MDGs 4 and 5 related to reducing child and maternal mortality respectively is less than what is required to achieve the targets. The objective of this paper is to examine the equity dimension of child and maternal health outcomes and interventions using Ghana as a case study.MethodsData from Ghana Demographic and Health Survey 2008 report is analyzed for inequities in selected maternal and child health outcomes and interventions using population-weighted, regression-based measures: slope index of inequality and relative index of inequality.ResultsNo statistically significant inequities are observed in infant and under-five mortality, perinatal mortality, wasting and acute respiratory infection in children. However, stunting, underweight in under-five children, anaemia in children and women, childhood diarrhoea and underweight in women (BMI < 18.5) show inequities that are to the disadvantage of the poorest. The rates significantly decrease among the wealthiest quintile as compared to the poorest. In contrast, overweight (BMI 25-29.9) and obesity (BMI ≥ 30) among women reveals a different trend - there are inequities in favour of the poorest. In other words, in Ghana overweight and obesity increase significantly among women in the wealthiest quintile compared to the poorest. With respect to interventions: treatment of diarrhoea in children, receiving all basic vaccines among children and sleeping under ITN (children and pregnant women) have no wealth-related gradient. Skilled care at birth, deliveries in a health facility (both public and private), caesarean section, use of modern contraceptives and intermittent preventive treatment for malaria during pregnancy all indicate gradients that are in favour of the wealthiest. The poorest use less of these interventions. Not unexpectedly, there is more use of home delivery among women of the poorest quintile.ConclusionSignificant Inequities are observed in many of the selected child and maternal health outcomes and interventions. Failure to address these inequities vigorously is likely to lead to non-achievement of the MDG targets related to improving child and maternal health (MDGs 4 and 5). The government should therefore give due attention to tackling inequities in health outcomes and use of interventions by implementing equity-enhancing measure both within and outside the health sector in line with the principles of Primary Health Care and the recommendations of the WHO Commission on Social Determinants of Health.

Addressing Gaps in Maternal, Neonatal, and Child Health for Achieving SDG 2030 in West Africa.

Climate-sensitive maternal and child health outcomes: A scoping review and policy implications for Kiribati.

BackgroundInequality in maternal and child health seriously hinders the overall improvement of health, which is a concern in both the United Nations Sustainable Development Goals (SDGs) and Healthy China 2030. However, research on the equality of maternal and child health is scarce. This study longitudinally assessed the equality trends in China’s maternal and child health outcomes from 2000 to 2013 based on place of residence and gender to improve the fairness of domestic maternal and child health.MethodsData on China’s maternal and child health monitoring reports were collected from 2000 to 2013. Horizontal and vertical monitoring were performed on the following maternal and child health outcome indicators: incidence of birth defects (IBD), maternal mortality rate (MMR), under 5 mortality rate (U5MR) and neonatal mortality rate (NMR). The newly developed HD*Calc software by the World Health Organization (WHO) was employed as a tool for the health inequality assessment. The between group variance (BGV) and the Theil index (T) were used to measure disparity between different population groups, and the Slope index was used to analyse the BGV and T trends.ResultsThe disparity in the MMR, U5MR and NMR for the different places of residence (urban and rural) improved over time. The BGV (Slope BGV = -32.24) and T (Slope T = -7.87) of MMR declined the fastest. The gender differences in the U5MR (Slope BGV = -0.06, Slope T = -0.21) and the NMR (Slope BGV = -0.01, Slope T = 0.23) were relatively stable, but the IBD disparity still showed an upward trend in both the place of residence and gender strata. A decline in urban-rural differences in the cause of maternal death was found for obstetric bleeding (Slope BGV = -14.61, Slope T = -20.84). Improvements were seen in the urban-rural disparity in premature birth and being underweight (PBU) in children under 5 years of age. Although diarrhoea and pneumonia decreased in the U5MR, no obvious gender-based trend in the causes of death was observed.ConclusionWe found improvement in the disparity of maternal and child health outcomes in China. However, the improvements still do not meet the requirements proposed by the Healthy China 2030 strategy, particularly regarding the rise in the IBD levels and the decline in equality. This study suggests starting with maternal and child health services and focusing on the disparity in the causes of death in both the place of residence and gender strata. Placing an emphasis on health services may encourage the recovery of the premarital check and measures such as prenatal and postnatal examinations to improve equality.

Mother-child pairs may separate during early life, yet the health impacts thereof are unclear. We explored the patterns and impact of separation among women living with HIV (WLHIV) and their children in South Africa. WLHIV who had initiated antiretroviral therapy (ART) during pregnancy received HIV viral load (VL) testing and completed a timeline questionnaire of mother-child separation since delivery at 3-5years post-partum. Health care usage was abstracted from routine medical records. We examined associations between separation and (a) maternal health outcomes (engagement in HIV care and HIV viral suppression, [VS]) and (b) child health outcomes (post-breastfeeding HIV testing and immunisation completion), using logistic regression. Of 346 mother-child pairs (median maternal age at antenatal ART initiation, 28years), 24% were ever separated (median time to first separation 20months, interquartile range [IQR] 9, 31). Most separated children were living with their grandmothers (65/83, 78%). Mothers who ever separated were younger, and more likely to be employed, and to reside in informal housing than those who never separated. Any separation reduced the odds of VS≤50 copies/mL at four years post-partum (odds ratio 0.57; 95% CI 0.34-0.93); associations were similar for VL≤1000 copies/mL and maternal engagement in care. No association was found between separation and child confirmatory HIV testing or immunisation completion. In this setting, mother-child separation is common in the first four years of life and appears associated with suboptimal maternal outcomes. Further research is required to understand the drivers and implications of mother-child separation.

Maternal and child health (MCH) outcomes remain a major public health concern in Pakistan, particularly in low- and middle-income areas where access to health services is limited. Objective: To assess the effectiveness of community-based interventions in improving maternal and child health outcomes in underserved areas of Pakistan. Methods: This cross-sectional analytical study was conducted at Services Hospital, Lahore, from November 2024 to April 2025. A total of 245 participants, including pregnant women, mothers of children under five years, and primary caregivers. Data were collected using a structured questionnaire on maternal health practices, child health indicators, and exposure to community-based interventions such as lady health worker visits, counseling sessions, and health education campaigns. Results: Among participants, 77.1% reported at least one ANC visit, while 51.4% completed four or more visits. Institutional deliveries were recorded in 61.6%, and PNC within 48 hours in 43.7%. Immunization coverage was 74.7%, and exclusive breastfeeding was practiced in 59.2% of cases. Exposure to CBIs was significantly associated with better outcomes: ≥4 ANC visits (64.8% vs. 34.1%, p &lt; 0.01), institutional delivery (71.2% vs. 46.8%, p &lt; 0.01), full immunization (82.1% vs. 61.9%, p &lt; 0.01), and exclusive breastfeeding (65.7% vs. 47.2%, p = 0.02). Logistic regression confirmed independent associations between CBI exposure and improved maternal and child health outcomes. Overall satisfaction with CBIs was high (72.6%), although some participants reported irregular visits and referral gaps. Conclusion: Community-based interventions significantly improve maternal and child health outcomes in low- and middle-income areas of Pakistan.

To report on the distribution of eye diseases, aetiologies of severe visual impairment/blindness (SVI/BL) and unmet eye care needs of the Syrian refugee population and the Lebanese host community. This retrospective study analysed the data of patients that were examined during the Ayounkon project -an eye health care project offering medical and surgical treatment for Syrian refugees and Lebanese host community in the Bekaa Valley in Lebanon. The project took place in three different primary health care centres and involved cooperation between several NGOs and ophthalmologists working on a voluntary basis. Data was analysed for distribution of eye diseases and aetiologies responsible for monocular and binocular SVI/BL. A total of 2067 patients were included, 677 were children < 18years. The most frequent pathologies were ocular allergy (10%), and cataract (7.4%). 158 patients (7.6%) were referred for surgery. Glasses were prescribed for 1103 patients (53.4%), of whom 242 (21.9%) were children of school age. SVI/BL was found in 276 patients (13%). The condition was bilateral in 116 patients (42%). SVI/BL was significantly more frequent in the Syrian population than in the Lebanese (186 patients, 14.8% versus 86 patients, 11.3%; p = 0.04). The main causes for SVI/BL were cataract, keratoconus/corneal decompensation and amblyopia. The Syrian refugee population and the Lebanese host community have a high prevalence of ophthalmic pathologies and SVI/BL. Visual impairment is more prevalent in the refugee population. Our findings underscore the importance of targeted interventions and access to eye care services for these populations.

Background: Family planning is a cornerstone of reproductive health, contributing significantly to improved maternal and child health outcomes. In Pakistan, where high population growth, limited healthcare infrastructure, and socio-cultural barriers persist, the role of family planning is pivotal in reducing maternal and infant mortality, enhancing birth spacing, and improving overall health indicators. Despite its importance, challenges such as gender inequality, socio-religious norms, and inadequate healthcare services limit its adoption and effectiveness. Objective: To evaluate the impact of family planning on maternal and child health outcomes in Pakistan, including contraceptive use, maternal and infant mortality, birth spacing, and childhood illnesses. Methods: A narrative review was conducted using electronic databases, including PubMed, Embase, Web of Science, and Scopus, alongside manual reference searches. Studies conducted in Pakistan, published in English, and focusing on family planning's impact on maternal and child health outcomes were included. Data extraction encompassed study characteristics, family planning interventions, maternal and child health outcomes, and key findings. Quality assessment tools such as the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool were employed to evaluate methodological rigor. Data synthesis was performed narratively, and meta-analysis was conducted where feasible to summarize quantitative findings. Results: Family planning interventions demonstrated significant benefits, including reductions in maternal and infant mortality, healthier birth spacing, and lower rates of childhood illnesses. Contraceptive use improved maternal health outcomes by preventing high-risk pregnancies and reducing complications. However, socio-cultural barriers, limited healthcare access, and unmet contraceptive needs were identified as persistent challenges. Conclusion: Family planning has a transformative impact on maternal and child health outcomes in Pakistan. Addressing socio-cultural and healthcare system barriers through integrated strategies and evidence-based policies can enhance its adoption, contributing to improved health and well-being for families nationwide.

Background: Maternal and child health disparities between rural and urban areas represent one of the most pressing public health challenges in the United States. While urban areas typically have better access to specialized care, both rural and urban high-risk communities face significant barriers to optimal maternal and child health outcomes. Objective: This study evaluates the comparative effectiveness and economic impact of different public finance mechanisms including Medicaid waivers, federal grants, and state-funded programs in supporting maternal and child health services across rural and urban high-risk areas. Methods: We conducted a comprehensive analysis of maternal and child health outcomes, healthcare utilization patterns, and economic impacts across different geographic and policy contexts using systematic literature review and secondary data analysis from 2016-2023. Results: Medicaid expansion significantly improved maternal health outcomes in both rural and urban areas, with rural areas showing greater relative improvement. State-funded doula programs demonstrated cost-effectiveness ratios of $1.2 million in savings per $1 million invested. Rural areas faced unique challenges including provider shortages and transportation barriers, while urban high-risk areas dealt with concentrated poverty and systemic access issues. Conclusions: Tailored policy approaches that address geographic-specific barriers while maintaining universal access principles show the greatest promise for improving maternal and child health outcomes. Integrated financing mechanisms combining federal, state, and local resources appear most effective in addressing complex rural-urban disparities.

Background: Father involvement has emerged as a critical but often overlooked determinant of maternal and child health (MCH) outcomes. While maternal engagement has traditionally been emphasized, growing evidence suggests that paternal participation during pregnancy, childbirth, and early infancy significantly enhances maternal emotional well-being, healthcare utilization, breastfeeding practices, child growth, and cognitive development. However, in many cultural settings—especially in India—fathers remain minimally involved due to social norms, gendered expectations, and lack of awareness. Understanding how father involvement influences MCH outcomes is essential for designing family-centered interventions. Methods: A cross-sectional mixed-method research design was used. Quantitative data were collected from mothers –father dyads with children aged 0–2 years using a structured questionnaire measuring paternal emotional support, decision-making participation, financial contribution, and caregiving activities. Maternal health outcomes included ANC attendance, place of delivery, postpartum depression scores, and breastfeeding practices. Child outcomes included immunization status, growth indicators, feeding patterns, and morbidity. Qualitative interviews were conducted with a subset of fathers to explore perceptions and barriers to involvement. Data were analyzed using descriptive statistics, chi-square tests, correlation analysis, and thematic analysis. Results: Higher levels of father involvement were significantly associated with improved maternal ANC completion, reduced postpartum depressive symptoms, higher exclusive breastfeeding rates, and increased institutional deliveries. Child outcomes showed that greater paternal participation correlated with better immunization coverage, lower frequency of illness episodes, and improved weight-for-age and height-for-age scores. Qualitative data highlighted cultural norms, work constraints, and limited health system engagement as major barriers to active father involvement. Supportive family environments, health education sessions, and flexible work hours facilitated positive participation. Conclusion: Father involvement plays a vital role in shaping both maternal and child health outcomes. Encouraging paternal engagement can reduce maternal burden, improve health-seeking behaviors, and enhance child growth and development. The findings demonstrate the need for healthcare systems—especially community health and nursing programs—to shift toward inclusive, family-centered strategies that actively involve fathers. Incorporating fathers into antenatal counseling, postpartum education, and community outreach may significantly strengthen MCH outcomes and contribute to achieving national and global health goals

Low-status women typically have poorer maternal and child health outcomes. In northern Nigeria, we piloted alternative models for engaging vulnerable women and facilitating an improvement in their maternal health outcomes. We assess the net impact of an integrated health system improvement model focusing on ensuring emergency obstetrical services for clusters of affiliated primary health care clinics, on the relative additional impact of alternative community engagement (CE) strategies. Analysis of baseline to endline survey data (2009-2013) showed that proportions of women making antenatal care (ANC) visits and who delivered with a skilled birth attendant doubled. Maternal and infant mortality also declined. Greater improvements with more ANC visits and skilled birth attendance were associated with being non-poor, owning a cell-phone, being less socially excluded, being satisfied with improvements in the clinic, and participating more in CE activities. Efforts to increase participation in CE activities can further enhance outcomes for the vulnerable women

This study examines the influence of institutional quality on maternal and child health outcomes in Nigeria between 1978 and 2023. The generalised method of moments (GMM) is used in this study. The study employs two institutional quality measures (democracy and corruption) and four maternal and child health measures (infant mortality rate, maternal mortality rate, contraceptive prevalence, and the number of neonatal deaths) to determine the specific role of institutional quality in producing maternal and child health outcomes in the country. A correlation matrix was used to examine the association between the research variables. Regression analysis was used to determine the functional relationship between institutional quality and maternal and child health outcomes. The results showed that institutional quality significantly influenced maternal and child health outcomes in Nigeria. The study concluded that the quality of institutions influences healthcare delivery in the country and recommended an improvement in the awareness of the institutional quality-healthcare delivery nexus in the country. The Nigerian government should establish effective mechanisms to support public health campaigns, thereby enhancing awareness of the connections between corruption and the poor maternal and child health outcomes in Nigeria. This study is the first to emphatically examine the influence of institutional quality on the maternal and child health outcomes nexus in Nigeria, using different measures of institutional quality and health outcomes.

This study aimed to assess the effectiveness of home visits conducted by public health workers (PHW), specifically public health nurses and midwives, in promoting maternal and child health in Naga City. The study utilized a descriptive research design with 45 purposively selected PHW (22 midwives and 23 nurses) as respondents. The majority of the 45 respondents were female (91.1\%), aged 28-57 years old, and had been serving for 1-10 years. Most of them (33.3\%) served up to 1,000 families, while only a small percentage served more than 3,000 families. Only one respondent fell within the youngest age group of 18-27. A survey questionnaire was used as the primary research instrument, which contained three parts: the respondents' profile, the effectiveness of home visits on maternal health, and the effectiveness of home visits on child health outcomes. The gathered data were analyzed using descriptive statistics, and the results showed that home visits by public health workers are perceived to be effective in improving maternal and child health outcomes across various domains. However, there is still room for improvement in addressing maternal mental health issues economic needs, and reducing delays in seeking medical care. The researcher proposed a needs assessment nursing intervention to identify the specific healthcare needs of Naga City women, improve the delivery of home visits by Public Health Nurses and Midwives, and eventually enhance maternal and child health outcomes in Naga City.

IntroductionThe first five years of life is an important developmental period that establishes the foundation for future health and well-being. Mothers play a primary role in providing emotional and physical nourishment during early childhood. This systematic review aims to explore the association between maternal health and child health in the first five years of the child’s life.Materials and methodsAs primary aims, we systematically synthesised published evidence relating to the first five years of life for associations between maternal health exposures (mental, physical and Health-Related Quality of Life (HRQoL) and child health outcomes (physical health, mental health, HRQoL and Health Service Use (HSU) /cost). As a secondary aim, we explored how the above associations vary between disadvantaged and non-disadvantaged populations. The search was limited to studies that published and collected data from 2010 to 2022. The systematic review was specific to countries with similar health systems to Australia. The search was conducted in MEDLINE, CINAHL, APA PsycINFO, GLOBAL HEALTH, and EMBASE databases. The quality of the included studies was assessed by The Effective Public Health Practice Project (EPHPP) tool.ResultsThirteen articles were included in the final synthesis from the identified 9439 articles in the primary search. Six (46%) explored the association between maternal mental health and child’s physical health, two (15%) explored maternal and child’s physical health, one (8%) explored maternal and child’s mental health, one (8%) explored maternal physical health and child’s HRQoL, and three (23%) explored maternal mental health and child’s HSU. We found an association between maternal health and child health (physical and mental) and HSU outcomes but no association between maternal health and child’s overall HRQoL. The results for disadvantaged communities did not show any difference from the general population.Discussion and conclusionOur review findings show that maternal health influences the child’s health in the first five years. However, the current evidence is limited, and the findings were primarily related to a specific maternal or child’s health condition. There was no evidence of associations of child health outcomes in healthy mothers. There is an extensive research gap investigating maternal health exposures and child outcomes in quality of life and overall health.

BackgroundConceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review.MethodsThe database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories.ResultsOut of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations.ConclusionWe present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.