Maternal And Child Health Programs Research Articles

Assessing the Impact of the COVID-19 Pandemic on Maternal and Child Health Services: A Comprehensive Analysis of Government Initiatives in Northern India.

The coronavirus disease (COVID-19) pandemic has significantly impacted healthcare services globally, with particular challenges observed in maternal and child health (MCH) care. This study aimed to assess the impact of the pandemic on MCH services in northern India, focusing on key government programs. Data were collected from four major MCH programs in India: Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the Universal Immunization Program (UIP). The study compared MCH service utilization and outcomes during the pandemic period (March-September 2020) with the same period in 2019. Preliminary findings indicated a significant reduction in the utilization of MCH services during the pandemic, with a decrease observed in institutional deliveries, antenatal care visits, and immunization coverage. For instance, institutional deliveries declined by 30% compared with the previous year, with a similar decrease observed in antenatal care visits. Immunization coverage also decreased by approximately 25%, indicating a substantial decline in preventive care services. Challenges in accessing essential treatments for sick infants have also been reported, with a 40% decrease in the utilization of free treatment services under the JSSK program. The COVID-19 pandemic has substantially impacted MCH services in northern India, highlighting the vulnerability of these essential health programs during public health emergencies. Addressing the challenges identified in this study is crucial to ensuring the continuity and resilience of MCH services in similar settings.

Integration of a tobacco cessation program into a rural community-based maternal and child health program in India: A stakeholders' perspective on task shifting.

According to the Global Adult Tobacco Survey-2, India, 7.5% of pregnant women are tobacco users with a high prevalence of smokeless tobacco use in rural India. Although pregnant women may receive advice to quit tobacco, lack of knowledge on providing cessation support among healthcare workers results in missed opportunities. Community Health Workers (CHWs) play a significant role in maternal and child health (MCH) programs. Thus, task-shifting for providing cessation support by CHWs was planned and the perceptions and attitudes of concerned stakeholders were explored. A pre-implementation qualitative study was conducted in four states of India within existing rural, community-based MCH program settings. Implementation research frameworks were used to develop data collection tools and for inductive and deductive thematic analysis. In-depth interviews were conducted with stakeholders (n=28) like coordinators, pregnant women and village functionaries of the government health system. Four focus groups were conducted with female CHWs (n=24). Stakeholders intended to adopt the intervention as objectives of the cessation intervention were aligned with the aims of the MCH program. CHWs related to their role in task-shifting and understood the context for implementing the intervention within the MCH program. Pregnant women expressed openness to receiving cessation support from CHWs acting as a facilitator for task-shifting. Barriers anticipated were the additional workload and time required for CHWs to implement the intervention. Task-shifting to female CHWs for screening tobacco users, providing brief advice and cessation support within the MCH program was perceived to be acceptable, adoptable and feasible. The study builds insight into the process of developing a grounded approach for the integration of tobacco cessation intervention into a rural, community-based antenatal care setting by task shifting to female community health workers for providing cessation support to pregnant women. The study fills gaps in the literature related to establishing tobacco cessation interventions for pregnant women. The delineated efforts in integration of the intervention and task shifting can be replicated in other developing countries, especially in rural communities within South Asian and Southeast Asian regions having cultural practices, community-based healthcare structures and tobacco consumption patterns that are comparable to India.

Maternal and Child Health (MCH) Programs: A Comprehensive Review of Interventions Policies and Community Impact

Maternal and Child Health (MCH) programs are pivotal in global public health, focusing on the well-being of mothers and children from conception to adolescence. This comprehensive review critically examines MCH interventions and policies, emphasizing accessibility, affordability, and cultural sensitivity. The impact of MCH programs on communities, including contributions to development, socio-economic stability, and healthcare equity, is explored. Challenges, such as resource constraints and cultural barriers, are discussed, along with opportunities for innovation and improvement, including technological advancements and interdisciplinary collaboration. Looking forward, the abstract outlines future directions, advocating for adaptability, evidencebased practices, increased research investment, and preventative measures. The review underscores the transformative potential of MCH programs in shaping the health and well-being of current and future generations.

Centers for Disease Control and Prevention Harvard Program Evaluation Practicum: 10 Years of Partnership in Public Health Program Evaluation.

The Centers for Disease Control and Prevention (CDC)'s Division of Reproductive Health and Harvard T.H. Chan School of Public Health (HSPH) Program Evaluation Practicum (CDC/HSPH Practicum) is a mutually beneficial workforce development partnership formed to provide state, local, and tribal public health organizations with an evaluation plan for a maternal and child health (MCH) program. State, local, and tribal public health organizations submit an MCH program in need of evaluation for inclusion consideration. Student pairs are matched with the selected programs in a 3-week practical field-based experience. This Practicum provides didactic training for both program staff and students followed by field work at the public health organizations. Students provide organizations with comprehensive evaluation plans, complete with logic model, methodology, and indicators. Since the Practicum's inception in 2013, 104 HSPH graduate students have been trained and 30 states and 1 territory have participated and received evaluation plans for their MCH programs. The utility and importance of the CDC/HSPH Practicum is evidenced by program staff and student feedback. Multiple states have implemented the plans designed by the students, with some evaluations leading to program enhancements. The CDC/HSPH Practicum prepares students for the workforce and adds much needed capacity to public health organizations by providing them with evaluation knowledge and skills, and usable evaluation plans to improve MCH-a win-win for all.

Development of contextual learning models through collaboration between lecturers, students, and village governments in nursing education.

This study aims to develop a contextual learning model through a collaboration between lecturers, students, and the village government for nursing education. This study used a qualitative design. The process of collecting the data was done through focus group discussions with 12 informants representing four stakeholders. There were four focus groups, namely universities, village governments, community health centers, and students. The discussion used open-ended questions that were developed through two parameters, the learning outcomes and learning activities. The data analysis undertaken used thematic analysis specifically. There were 11 grouped concepts found in this study which were able to be divided into three categories. The learning outcome category was formed of four concepts, including attitudes, mastery of knowledge, skills, and values. The learning process category was formed of five concepts, namely learning resources, learning methods and forms, learning media, learning time, and learning subjects. The main sources of contextual learning were found to be programs and maternal and child health (MCH) issues in the village. Techniques and instruments were the two concepts in the assessment category. A collaboration between lecturers and the village government to help students and to provide learning resources in the village integrates the program (MCH) with the learning outcomes. These concepts are the initial framework to help the head of the study program to integrate the MCH programs and cases in the curriculum and to facilitate the contextualization of the knowledge from the nursing students.

Literature Review: Model Edukasi Menyusui Untuk Suami

Breastfeeding can prevent annual deaths in children, including having a positive impact on the country's economy and even at the family level. Men are often forced to be involved in breastfeeding and caregiving, but the approach of the Maternal and Child Health (MCH) program is too girly, which often makes men feel alienated. Breastfeeding education for men is not impossible. This paper tries to describe several models that have been shown to have a positive impact on breastfeeding success using the literature review method. The results show that some face-to-face models for 2-3 hours can be done with several sessions for 2-3 weeks. Other models without face-to-face can also be done, for example by providing flyers, booklets, and disseminating information through mass media including education through Facebook and WhatsApp groups and smartphone applications. The government and health services should start seeing men as subjects in the MCH program and start developing breastfeeding education activities for fathers, even if breastfeeding education activities are combined with mothers, they should use a gender-free approach.

A Call to Transform Maternal and Child Health Mentorship to Build Inclusivity, Honor Diversity of Experiences, and Tackle the Root of Health Disparities

IntroductionMentorship should be a transformative experience that propels mentees from one point in their career to another and drives personal growth. Within the field of maternal and child health (MCH), it is considered a critical professional duty. However, MCH has yet to explicitly embrace mentorship practice as a means to address workforce challenges including turnover, knowledge loss, and undue burden on the part of historically oppressed individuals and communities to overturn oppressive systems.Call to ActionWe advocate for public calls for diversity and equity to be met with strategic enhancement of the practice of MCH mentorship. Transformative MCH mentorship should be used to promote positive identity formation, understanding of self in context, efficacy, and sustained commitment to working with MCH populations in ways that are inclusive and prevent the perpetration of the problematic power dynamics that lead to inequitable outcomes.RecommendationsWe present recommendations to strengthen MCH mentorship practice. At the individual level, there should be a refreshment of norms and expectations, where mentorship is seen as a uniquely flexible opportunity for mutual learning. At the organizational level, embedding mentorship in all aspects of practice helps establish and sustain a culture of belonging. This transformative organizational culture can attract and retain future generations of professionals that are not only more representative of the populations that MCH programs support but are prepared to authentically elevate the needs and strengths of those populations. These suggestions incorporate best practices from other fields and include ideas for the MCH field in particular.

Factors Affecting the Performance of Management Officers of Maternal and Child Health Programs at the Jayawijaya Community Health Center

The achievement of the Minimum Service Standard target in the Maternal and Child Health (MCH) program at the Jayawijaya District Health Center is still low. The purpose of this study was to analyze the factors that influence the performance of the officers managing the Maternal and Child Health Program at the Jayawijaya District Health Center. This research method is qualitative research with a case study approach, with 12 informants. The study was conducted in October 2020. The results showed that the provision of training related to MCH was still lacking so that the ability and skills of MCH program officers were mostly still low, the allocation of funds by the government was right on target, the supervision of the MCH program had been carried out regularly and periodically and program planning in the form of an annual Work Plan for Regional Apparatus Units (SKPD) has not been prepared. It is recommended to the head of the Jayawijaya district health office to hold training to increase the capacity and skills of health workers, make budget planning in accordance with existing technical guidelines, provide advocacy to the regional government budget team, form an integrated supervision team, form a MCH program planning team. , as well as planning the MCH program budget.

Utilizing Principles of Private Enterprise to Improve Maternal and Child Health Programs.

ABSTRACTHigh quality maternal and child health (MCH) programs are needed to meet the global Sustainable Development Goals 1, 2, 3, and 10. Yet, the vast majority of MCH programs are small, lack capacity and personnel, and are judged based on their relationships with funders, rather than their performance in the field. Adopting principles common among private enterprise could have a significant impact on shifting MCH to focus on implementing larger, higher quality programs and to routinely evaluate MCH as meeting/not meeting their primary mission. For example, focusing on recruiting personnel who have excellent social skills and are pragmatic problem-solvers reflects a principle of Hire the Best Staff. Similar principles such as Leadership Matters and Create a Culture of Discipline are guideposts that can improve the quality of MCH programs over time. This commentary outlines criteria which could both guide MCH organizational development and funders’ evaluations of MCH.

MCH Workforce Capacity: Maximizing Opportunities Afforded by a Changing Public Health System

Objectives A skilled workforce is essential to advancing maternal and child health (MCH) in a rapidly changing public health system. Little is known about the MCH workforce’s existing capacity to maximize opportunities afforded by ongoing change. We assessed MCH workforce capacity in three areas: Systems Integration, Evidence-Based Decision-Making, and Change Management/Adaptive Leadership. We then examined associations between workforce capacity and modifiable workforce development strategies/resources. Methods Data are from the Public Health Workforce Interests and Needs Survey (PH WINS). The present study was limited to employees working in MCH programs (weighted N = 3062). Workforce capacity was operationalized as self-reported awareness of public health trends and proficiency to perform related skills in the three areas. Survey-weighted generalized estimating equations were used to fit logistic regression models accounting for employee clustering within states. Results While awareness of public health trends was low, the majority of employees (> 70% in each area) reported proficiency to perform skills related to these trends. Capacity was lowest in Systems Integration. Employee engagement in academic partnerships and higher state contributions to MCH program budgets were the strategies/resources most consistently associated with higher capacity. Workplace support was the strongest correlate of capacity in Change Management/Adaptive Leadership. Conclusions for Practice Although employees lacked familiarity with specific public health trends, they were proficient in skills needed to engage in related work. Still, areas for improvement remain. Results provide a baseline against which future training efforts can be evaluated. Academic partnerships and MCH program funding may be useful to prioritize in the context of health transformation.

Is Abortion Included in Maternal and Child Health Curricula in the United States?

Purpose The purpose of this study is to assess whether Maternal and Child Health (MCH) graduate programs address abortion content in their programs' foundational courses, elective courses, and general curricula. Description Between January and March 2017, we conducted a descriptive study with faculty from the 13 Centers of Excellence in Maternal and Child Health Education, Science and Practice (COEs). We reviewed syllabi and discussed foundational and elective course content via email and key informant interviews with COE faculty. We categorized abortion coverage in foundational courses as "transparent" or "tangential" depending on inclusion of the word "abortion" in course syllabi. We identified electives addressing abortion as "electives including abortion" and courses that focus on abortion as "abortion-specific electives." Assessment Evidence demonstrated that most programs do not transparently address abortion in required course curricula. Only one of 13 COEs transparently addresses abortion in the foundational course(s); seven COEs tangentially include abortion in foundational courses; and all programs address abortion in some capacity though no standard exists to ensure its inclusion. Despite barriers, including avoidance of controversy and fear of losing funding, COEs could address abortion by establishing shared curricular standards, facilitating values clarification and attitude transformation activities, utilizing information-sharing networks, strengthening relationships between MCH programs and abortion-related organizations, and using professional societies. The scope of our study does not allow us to conclude why abortion content is lacking nor the quality of current content. Conclusion MCH programs should transparently incorporate abortion content in foundational and electives courses to educate students on how to engage with complex and sometimes stigmatized public health issues.

Strengthening maternal and child health in China: Lessons from transforming policy proposals into action.

China has made impressive achievements in improving maternal and child health (MCH) over the past few decades. This paper uses a policy lens to examine reasons for these achievements as well as barriers to further success. We found that strong governmental commitment and leadership, effective coordination, proactive participation of different stakeholders, and the provision of adequate resources were associated with China's success in improving MCH outcomes. Other low- and middle-income countries can learn valuable lessons from China's experience. These lessons include i) prioritizing MCH on the national development agenda, ii) keeping national ownership over health development cooperation, and iii) establishing effective monitoring, evaluation and accountability mechanisms for MCH programs.

Factors Driving Local Health Departments' Partnerships With Other Organizations in Maternal and Child Health, Communicable Disease Prevention, and Chronic Disease Control.

To describe levels of partnership between local health departments (LHDs) and other community organizations in maternal and child health (MCH), communicable disease prevention, and chronic disease control and to assess LHD organizational characteristics and community factors that contribute to partnerships. Data were drawn from the National Association of County & City Health Officials' 2013 National Profile Study (Profile Study) and the Area Health Resources File. LHDs that received module 1 of the Profile Study were asked to describe the level of partnership in MCH, communicable disease prevention, and chronic disease control. Levels of partnership included "not involved," "networking," "coordinating," "cooperating," and "collaborating," with "collaborating" as the highest level of partnership. Covariates included both LHD organizational and community factors. Data analyses were conducted using Stata 13 SVY procedures to account for the Profile Study's survey design. About 82%, 92%, and 80% of LHDs partnered with other organizations in MCH, communicable disease prevention, and chronic disease control programs, respectively. LHDs having a public health physician on staff were more likely to partner in chronic disease control programs (adjusted odds ratio [AOR] = 2.33; 95% confidence interval [CI], 1.03-5.25). Larger per capita expenditure was also associated with partnerships in MCH (AOR = 2.43; 95% CI, 1.22-4.86) and chronic disease prevention programs (AOR = 1.76; 95% CI, 1.09-2.86). Completion of a community health assessment was associated with partnership in MCH (AOR = 7.26; 95% CI, 2.90-18.18), and chronic disease prevention (AOR = 5.10; 95% CI, 2.28-11.39). About 1 in 5 LHDs did not have any partnerships in chronic disease control. LHD partnerships should be promoted to improve care coordination and utilization of limited health care resources. Factors that might promote LHDs' partnerships include having a public health physician on staff, higher per capita expenditure, and completion of a community health assessment. Community context likely influences types and levels of partnerships. A better understanding of these contextual factors may lead to more complete and effective LHD partnerships.

SIAPA YANG MENGAMBIL MANFAAT DARI PELAYANAN KIA DI INDONESIA TIMUR? ANALISIS DATA SDH 1991*

Maternaland Child Health (MCH) program has been an important national policy measure to prevent child death and to promote child health. In consideration of government restricted budget, the size of and spreadity of Indonesian population, government has provided at least one health center for every subdistrict and has promoted community participation through community based health post to reach the out reach population. This study seeks to explore community's utilization of this program and assesses whether the program has reached the priotity target groups such as the children with uneducated mothers and lower economic status. The 1991 Indonesian Demographic and Health Survey data is used and sampel of 860 children of 12-23 month old from eastern Indonesiaisthe focus of analysis. Logistic regression is used as multivariate analysis. The resultshows that the MCH program seems to have solved accessibility problem of economic constraint, however, contrary to the high priority groups being targeted, lower educated mothers use less services than those of more educated. This may be associated with lack of appropriate local conceptual framework in understanding preventive health behaviour among uneducated mothers and less progressive efforts in enforcing the need for social participation from the uneducated mothers.

Mapping the use of research to support strategies tackling maternal and child health inequities: evidence from six countries in Africa and Latin America.

BackgroundStriving to foster collaboration among countries suffering from maternal and child health (MCH) inequities, the MASCOT project mapped and analyzed the use of research in strategies tackling them in 11 low- and middle-income countries. This article aims to present the way in which research influenced MCH policies and programs in six of these countries – three in Africa and three in Latin America.MethodsQualitative research using a thematic synthesis narrative process was used to identify and describe who is producing what kind of research, how research is funded, how inequities are approached by research and policies, the countries’ research capacities, and the type of evidence base that MCH policies and programs use. Four tools were designed for these purposes: an online survey for researchers, a semi-structured interview with decision makers, and two content analysis guides: one for policy and programs documents and one for scientific articles.ResultsThree modalities of research utilization were observed in the strategies tackling MCH inequities in the six included countries – instrumental, conceptual and symbolic. Instrumental utilization directly relates the formulation and contents of the strategies with research results, and is the least used within the analyzed policies and programs. Even though research is considered as an important input to support decision making and most of the analyzed countries count five or six relevant MCH research initiatives, in most cases, the actual impact of research is not clearly identifiable.ConclusionsWhile MCH research is increasing in low- and middle-income countries, the impact of its outcomes on policy formulation is low. We did not identify a direct relationship between the nature of the financial support organizations and the kind of evidence utilization within the policy process. There is still a visible gap between researchers and policymakers regarding their different intentions to link evidence and decision making processes.

From Theory to Measurement: Recommended State MCH Life Course Indicators.

PurposeIn May 2012, the Association of Maternal and Child Health (MCH) Programs initiated a project to develop indicators for use at a state or community level to assess, monitor, and evaluate the application of life course principles to public health.DescriptionUsing a developmental framework established by a national expert panel, teams of program leaders, epidemiologists, and academicians from seven states proposed indicators for initial consideration. More than 400 indicators were initially proposed, 102 were selected for full assessment and review, and 59 were selected for final recommendation as Maternal and Child Health (MCH) life course indicators.AssessmentEach indicator was assessed on five core features of a life course approach: equity, resource realignment, impact, intergenerational wellness, and life course evidence. Indicators were also assessed on three data criteria: quality, availability, and simplicity.ConclusionThese indicators represent a major step toward the translation of the life course perspective from theory to application. MCH programs implementing program and policy changes guided by the life course framework can use these initial measures to assess and influence their approaches.

Pregnancy Risk Assessment Monitoring System and the W.K. Kellogg Foundation joint project to enhance maternal and child health surveillance: focus on collaboration.

Maternal and child health (MCH) surveillance data are important for understanding gaps in services and disparities in burden of disease, access to care, risk behaviors, and health outcomes. However, national and state surveillance systems are not always designed to gather sufficient data for calculating reliable estimates of the health conditions among high-risk or underrepresented population subgroups living in smaller geographic areas. The Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) has conducted surveillance for over 25 years in collaboration with state and city health departments. In 2012, PRAMS embarked on a multiyear collaboration with the W.K. Kellogg Foundation (WKKF) to include oversampling of minority and low-income women in selected geographic areas in four states (Louisiana, Michigan, Mississippi, and New Mexico) where the WKKF funded extensive place-based initiatives are located. The PRAMS-WKKF collaboration has broad implications for promoting meaningful collaboration between public, private, local, state, and federal organizations to address MCH data gaps on disparities, and for improving the availability of information needed for MCH programs, policy makers, and women.

How well do birth records serve maternal and child health programs? Birth registration system evaluation, New York City, 2008-2011.

National birth registration guidelines were revised in 2003 to improve data quality; however, few studies have evaluated the impact on local jurisdictions and their data users. In New York City (NYC), approximately 125,000 births are registered annually with the NYC Department of Health and Mental Hygiene, and data are used routinely by the department's maternal and child health (MCH) programs. In order to better meet MCH program needs, we used Centers for Disease Control and Prevention guidelines to assess birth data usefulness, simplicity, data quality, timeliness and representativeness. We interviewed birth registration and MCH program staff, reviewed a 2009 survey of birth registrars (n = 39), and analyzed 2008-2011 birth records for timeliness and completeness (n = 502,274). Thirteen MCH programs use birth registration data for eligibility determination, needs assessment, program evaluation, and surveillance. Demographic variables are used frequently, nearly 100 % complete, and considered the gold standard by programs; in contrast, medical variables' use and validity varies widely. Seventy-seven percent of surveyed birth registrars reported ≥1 problematic items in the system; 64.1 % requested further training. During 2008-2011, the median interval between birth and registration was 5 days (range 0-260 days); 11/13 programs were satisfied with timeliness. The NYC birth registration system provides local MCH programs useful, timely, and representative data. However, some medical items are difficult to collect, of low quality, and rarely used. We recommend enhancing training for birth registrars, continuing quality improvement efforts, increasing collaboration with program users, and removing consistently low-quality and low-use variables.

Family leaders and workforce leadership development.

Family members can become leaders who are a voice not only for their own family, but also as part of a collective voice to advocate for changes in services, programs, policies, and organizations that benefit all families. Family leadership is important because family leaders can keep the focus on the family experience, providing their own and other family stories, experiences, and perspectives to provide first hand feedback on the best ways of meeting the needs of families and the barriers and challenges that families face along the way. Strong family leaders not only have an impact on Maternal and Child Health (MCH) leadership, they represent a vital part of the MCH workforce. In the past, family leaders ‘‘emerged,’’ either by their own initiative and efforts or from other sectors such as education and early childhood program spheres (special education, Head Start, etc.). Family leaders are a valuable resource to MCH; therefore, as MCH identifies strategies for building the leadership capacity of the current workforce and developing the next generation of leaders, it is essential that the role of family and family leaders be infused in all aspects of MCH leadership development. In addition to family leaders, youth and young adults acting as self-advocates play an important role in MCH programs and policy development. Family leaders have become a vital part of the workforce and will be integral in providing a family-driven response to the changing environment, opportunities and realities that MCH will face in the future. This will require that MCH directors recognize the need to ensure family leaders have the knowledge, skills, confidence, and experience to represent the family perspective. Further, MCH as a field will need to cultivate an environment within programs and practices that embraces family leaders and youth/young adult self-advocates as vital members within the MCH workforce.

Using the Principles of Complex Systems Thinking and Implementation Science to Enhance Maternal and Child Health Program Planning and Delivery

Traditionally, epidemiologic methodologies have focused on measurement of exposures, outcomes, and program impact through reductionistic, yet complex statistical modeling. Although not new to the field of epidemiology, two frameworks that provide epidemiologists with a foundation for understanding the complex contexts in which programs and policies are implemented were presented to maternal and child health (MCH) professionals at the 2012 co-hosted 18th Annual MCH Epidemiology Conference and 22nd CityMatCH Urban Leadership Conference. The complex systems approach offers researchers in MCH the opportunity to understand the functioning of social, medical, environmental, and behavioral factors within the context of implemented public health programs. Implementation science provides researchers with a framework to translate the evidence-based program interventions into practices and policies that impact health outcomes. Both approaches offer MCH epidemiologists conceptual frameworks with which to re-envision how programs are implemented, monitored, evaluated, and reported to the larger public health audience. By using these approaches, researchers can begin to understand and measure the broader public health context, account for the dynamic interplay of the social environment, and ultimately, develop more effective MCH programs and policies.