Maternal And Child Health Research Articles

Strengthening the role of community health assistants in delivering primary health care: the case of maternal health services in Zambia

IntroductionMany low-and middle-income countries, including Zambia experience a huge deficit of human resource for health, which affects the delivery of primary health care services such as maternal and child health (MCH), nutrition, HIV and gender-based services. The Clinton Health Access Initiative in collaboration with the Zambian Ministry of Health implemented a community health systems (CHS) strengthening project to enhance the capacity of community health assistants (CHA) to provide MCH services from 2019 to 2021. The project activities included capacity building in supervision, provision of financial incentives and logistics. This study explores how these interventions strengthened the role of the CHAs in delivering MCH services.MethodologyThis was a qualitative study consisting of 189 KIIs and IDIs as well as 20 FGDs conducted in all the 10 provinces of Zambia with the CHAs, and their supervisors, health workers, neighbourhood health committees and community members. Data were analysed using thematic analysis.ResultsThe CHS strengthening interventions including provision of training manuals, streamlined recruitment and deployment policies, capacity building of CHA supervisors, provision of transport and monthly remuneration contributed to improved delivery and acceptability of MCH services. Further, the leveraging of community networks, linkages and partnerships when delivering these services, including the traditional and religious leaders contributed to improved coverage and acceptability of MCH services. Meanwhile, health systems barriers such as limited supplies in some health facilities, shortage of health workers, persistent transportation challenges and failure to fully abide by the CHA recruitment and selection criteria affected delivery and acceptability of MCH services.ConclusionThis study builds on existing evidence on the importance of building a stronger community–based primary health care to effectively address maternal and child health related issues. We emphasize the need to integrate strategies such as provision of training manuals, enhanced recruitment and deployment policies, capacity building of supervisors, provision of transport and remuneration within the CHA program to enhance the provision and acceptability of health services.

Gambaran Surveilans Kesehatan Ibu dan Anak (KIA) sebagai Upaya Mengurangi Angka Kematian Ibu dan Anak di Kota Palembang

Maternal and Child Health (MCH) surveillance plays a critical role in reducing maternal and infant mortality rates in Palembang City. This study aims to provide a comprehensive overview of the implementation of MCH surveillance at the Padang Selasa Health Center in Palembang, focusing on the health conditions of mothers and children from 2022 to 2024. Using secondary data from annual and monthly reports, the study found that anemia and Chronic Energy Deficiency (KEK) in pregnant women remain significant health concerns. Furthermore, while the exclusive breastfeeding program and Vitamin A distribution showed positive outcomes, immunization coverage has declined in 2024, highlighting potential gaps in access and outreach. The study emphasizes the need for improved healthcare access, more effective nutritional education for pregnant women, and enhancements in the distribution and awareness of immunization programs to reduce maternal and child health risks.

THE DESCRIPTION OF ANXIETY SCORES IN POSTPARTUM MOTHERS DURING THE BREASTFEEDING PROCESS AFTER BEING EDUCATED WITH VIDEO AND MATERNAL AND CHILD HEALTH BOOK (MCH)

Anxiety is a common issue experienced by postpartum mothers, and it can interfere with the lactation process. During the postpartum adaptation period, many mothers face psychological challenges, including heightened anxiety. This emotional state can disrupt the hormonal regulation of prolactin and oxytocin—two key hormones responsible for breast milk production—thereby slowing the milk release and making breastfeeding more difficult. A preliminary observation conducted at Independent Midwifery Practice (IMP) Purwanti involving five postpartum mothers found that three mothers who experienced mild anxiety had delayed milk production, while the two mothers without anxiety had faster milk flow. This study aimed to assess changes in anxiety levels among postpartum mothers after receiving breastfeeding education through two different methods: animated videos and the Maternal and Child Health (MCH) book. The descriptive-analytic study was conducted from February to April 2023, involving all postpartum mothers on day five at IMP Purwanti, totaling 32 participants. The participants were divided equally into two intervention groups. Group one received health education via animated videos, while group two received education through the MCH book, with 16 mothers in each group. The results showed that in the animated video group, all 16 mothers (100.0%) reported no anxiety after the intervention. In the MCH book group, 15 mothers (93.8%) reported no anxiety, and only 1 mother (6.3%) experienced mild anxiety. None experienced severe anxiety. These findings suggest that both animated videos and MCH books are effective educational tools for reducing postpartum anxiety. Health services should consider integrating innovative educational strategies into routine postpartum care. Keywords: Postpartum anxiety, Breastfeeding education video, Maternal and child health book

Highlighting maternal healthcare utilization in five scheduled tribes of Assam, North-East India: Determinants and strategies for improvement

ABSTRACT According to World Health Organization, “maternal health is the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the healthcare dimensions of family planning, preconception, prenatal and postnatal care in order to ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases.” The most vital importance of maternal and child health (MCH) care services is to improve the outcome of both mother and child by preventing maternal and child mortality. Utilization of maternal healthcare services plays a critical role in reducing maternal, infant and child mortality along with the improvement in reproductive health of women. This paper attempts to provide an in-depth analysis of the determinants of maternal healthcare services utilization among the five tribes of Assam, India. The study is significant as it highlighted the major determinants of maternal healthcare service utilization in tribal context. The data were collected from Lakhimpur, Dibrugarh, Dhemaji, Sivsagar and Tinsukia districts through primary survey conducted among the Mishings, Sonowal Kacharis, Deoris and the Hajongs. Data are collected from July 2023-January 2024. The findings reveal that women’s autonomy in decision making on taking care of her health is an important factor in getting access to healthcare services. We observed that mother’s role in financial autonomy (Taking decision on spending money on treatment), choice of delivery, preference for doctor, or the nature of treatment has an influence on her access to healthcare services.

Fifty Years of Maternal and Child Health Nursing: Milestones Achieved and Future Horizons.

Maternal and child health (MCH) nursing has undergone significant transformations over the past five decades. This transformation is characterised by huge advancements in clinical practices, policy reforms and technological innovations. The aim of this commentary is to reflect on pivotal developments that have shaped MCH nursing and explore emerging challenges and opportunities that will define the next half-century. This commentary includes integration of holistic care models, the role of midwifery, technological integration and also address health disparities over the last 50 years.

The effect of the COVID-19 pandemic on the baby-friendly community initiative and maternal infant and young child nutrition in Kenya

BackgroundThe COVID-19 pandemic led to decline in access and utilization of the baby-friendly community initiative (BFCI) which is being implemented in Kenya. The impact of the pandemic on the BFCI and on maternal and child health and nutrition has not been documented. We undertook a qualitative study that assessed the effect of the COVID-19 pandemic on the baby-friendly community initiative (BFCI) activities, maternal and child health (MCH) services and maternal, infant and young child nutrition (MIYCN) practices in Kenya.MethodsData on the impact of the pandemic on the BFCI activities, provision and access to MCH services and MIYCN practices were collected using key informant interviews (n = 57), in-depth interviews (n = 31), and focus group discussions (n = 15) with government officials, civil society organizations and community members in BFCI implementing and non-implementing urban and rural areas.ResultsOur study found that BFCI activities, such as home visits, support group meetings and MCH services such as nutrition counselling, growth monitoring and vaccination were interrupted by the pandemic due to fear of contracting the virus, lack of personal protective equipment (PPEs) and movement restrictions. This meant that mothers did not have access to basic community and health services. Food insecurity attributed to financial difficulties resulted in coping strategies such as skipping meals and negatively affected MIYCN practices. Positive measures to prevent COVID-19 spread such as remote working enabled some mothers to adequately feed their children because they were better able to balance working and the demands of feeding young children from home.ConclusionOn balance, the pandemic negatively impacted the BFCI, MCH services and MIYCN practices in Kenya. In such a context, there is a need for innovative approaches to ensure continued provision of and access to facilities and community health services in the future if the country finds itself in a similar position with the challenges of a pandemic. The pandemic revealed that remote working support policies could have the potential to improve breastfeeding and complementary feeding for working women but further evidence is needed to fully evaluate this.

Facilitators, barriers and service availability for delivering integrated care for the triple elimination of HIV, syphilis and hepatitis B vertical transmission in Uganda: a multi-site explanatory mixed methods study

BackgroundElimination of vertical transmission of HIV, syphilis and hepatitis B is part of the global aspiration to end the three infections as public health threats by 2030. Whereas global and national policy guidelines recommend integration of screening, prevention and treatment for the three infections in maternal and child health (MCH) service delivery points, progress has been slow. We aimed to explore the health system factors that facilitate and hinder optimal integration of triple elimination services within the MCH platforms.MethodsThis was a cross-sectional, explanatory mixed methods multi-site study implemented in two regions of Uganda, conducted in July – August 2024. Firstly, we used an observation checklist to assess for the availability of services and commodities required for provision of triple elimination care at 20 health facilities (two regional referral hospitals, two general hospitals, two specialized outpatient TASO clinics, five HCIVs, eight HCIIIs and one HCII), and computed a percentage service and commodity availability score for each site, and average for the sites. We then used findings from this assessment to guide open-ended probing during key informant interviews and focus group discussions among ten key informants and 43 focus group discussion participants. Interviews and discussions were recorded, transcribed verbatim, and then analysed manually. We categorized responses as either facilitators or barriers and extracted quotes, by theme, based on the World Health Organization’s health systems building blocks framework.ResultsThe average percentage score of service and commodity availability was 61.8% (range: 46.4–78.6%) in Acholi region and 66.1% (range: 53.6–78.6%) in Teso region. We found that presence of trained focal persons, district accountability fora, routine data collection and utilization, and availability of motivated community health workers facilitated triple elimination service integration. Key barriers included limited district health team engagement, frequent stock-outs of diagnostic and treatment commodities, health personnel shortages and high reporting burden.ConclusionsHealth facility service readiness and availability percentage scores differed across facilities and between the two regions. Several health system factors facilitate integrated service provision for elimination of HIV, syphilis and hepatitis B vertical transmission. This integration is, however, constrained by a number of health system barriers. Further implementation research could contribute to addressing the various health system constraints and adoption of strategies for service integration tailored to site contexts.

The Effect of the Marmet Technique on Breast Milk Production in Postpartum Mothers

Background: The common challenge faced by mothers after childbirth is the difficulty in breastfeeding, particularly when milk production is not smooth. Issues such as delayed milk production at the beginning of breastfeeding are frequently encountered. One approach to address this is to manually express or pump breast milk until the baby is able to nurse. A preliminary survey conducted by the Maternal and Child Health (MCH) program at the Gorontalo Health Center, covering the period from May to July 2024, found that out of 199 postpartum mothers at the Limboto Health Center, 6 out of 10 experienced breastfeeding problems, including complaints of insufficient milk production and failure to clean the nipple after breastfeeding. Additionally, many mothers were unaware of the importance of breastfeeding. The purpose of this study is to analyze the impact of the Marmet technique on the smoothness of breast milk production in postpartum mothersMethod: The research design uses a quantitative quasi-experimental method. The subjects of this study were 15 postpartum mothers who met the inclusion criteria, selected using purposive sampling technique, and applying evidence-based nursing practice.Result:The Marmet technique has a significant impact on the smoothness of breast milk production after intervention on the first, third, and seventh days.Conclusion: The Marmet technique is essential in providing nursing care to postpartum mothers to improve the smoothness of breast milk production.

Maternal Factors Influencing Low Birth Weight in Newborns: A Retrospective Study

Background: Birth weight is a critical indicator of an infant's health. Research conducted in Indonesia has identified low birth weight (LBW) as a leading cause of neonatal mortality, accounting for approximately 35% of all cases. This study aims to determine the factors influencing the incidence of LBW.Method: The study used a retrospective design and included 83 respondents selected through quota sampling. Data were collected from the Maternal and Child Health (MCH) handbooks at Manggis Integrated Service Post (posyandu). Univariate analysis was performed to calculate frequency and percentage values. Bivariate analysis was carried out using the chi-squared test to examine relationships between variables. Multivariate analysis was conducted using the logistic regression test to assess the influence of multiple variables.Result: Maternal age at pregnancy (p=0.037) and maternal mid-upper arm circumference (MUAC) (p=0.034) were significantly associated with the occurrence of LBW in newborns. The odds ratio (OR) analysis revealed MUAC as the primary factor influencing LBW (OR=4.278), followed by maternal age during pregnancy (OR = 3.750). In comparison, haemoglobin levels (p = 0.500), maternal height (p = 0.408), and gestational age (p=0.118) were not significantly associated with the occurrence of LBW. MUAC was found to influence the occurrence of LBW in Kemuning Lor Village (p = 0.027). The MUAC variable accounted for 16.9% of the variance in LBW cases (R2 = 0.169). Improving the nutritional status of adolescent girls is imperative to ensure optimal health outcomes in future pregnancies.

USAID's Role in Saving Children's Lives: Past Legacy and Future Directions.

For more than 60 years, the United States Agency for International Development (USAID) has been a major funder of efforts to improve maternal and child health (MCH) across many low- and middle-income countries (LMICs). From 2000 to 2022, the global under-five mortality rate declined from 76 to 37 deaths per 1000 live births.1. Though this progress stemmed from the cumulative efforts of many organizations, governments, and health care workers, a 2022 causal analysis by Weiss et al. (the most recent analysis available), demonstrated that from 2000 to 2016, high USAID funding for MCH and malaria independently reduced under-five mortality by more than 20 deaths per 1000 live births compared with control regions.2.

Barriers to Effective Health Coverage in Low- and Middle-income Countries: A Systematic Scoping Review of Literature

The low- and middle-income countries (LMICs) are characterised by the highest burden of diseases and resource constraints. Thus, reforms imperative for responsive healthcare systems must be supported by context-appropriate evidence. However, lacunae persist with respect to the gap in terms of knowledge related to the level, barriers and inequities associated with effective healthcare coverage. The study was, thus, conducted to identify, describe, appraise and synthesise various bottlenecks impeding the trajectory towards effective coverage in LMICs. The study employed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A search of published articles was conducted on six electronic databases along with a manual and bibliographic search of grey literature. A gamut of peer-reviewed articles and technical reports evaluating the measure of—and barriers to—effective coverage in LMICs was included using an exhaustive set of inclusion criteria. A quality assessment of included studies was conducted using a standardised checklist adopted from the Joanna Briggs Institute. Further, selected studies were transcribed using data extraction and assessment templates adapted from the Cochrane Review Group, and a content analysis was performed within the Tanahashi framework of effective coverage. The search strategy retrieved 736 articles from the database, out of which 65 met the eligibility criterion. The majority of studies were characterised by cross-sectional and quantitative design, maternal and child health (MCH) interventions and availability/accessibility barriers. Analogously, most of the studies were conducted in the Sub-Saharan African region and were representative at the multi-country/national level. Conversely, the evidence on socio-economic determinants associated with effective health coverage was exiguous. The literature underscores supply-side constraints such as health workforce shortage, suboptimal structural quality and inefficient fund allocation as the most pronounced bottlenecks. Demand-side barriers, such as negative attitudes towards providers, lack of knowledge and community engagement, were also unravelled to exert an adverse impact on coverage. The study divulged that most of the literature on effective health coverage is underpinned by skewed representation. An evidence gap was found with respect to the studies from South-East Asian, Latin American and Caribbean LMICs and disaggregated administrative levels. Methodological deficiencies were also found in measurement metrics with respect to the assessment of a comprehensive package of services, equity, quality and robustness checks.

The impact of health education videos on the level of knowledge and attitudes of pregnant women about danger signs in pregnancy

Introduction: Complications of pregnancy can cause morbidity and mortality. Pregnant women should know about these complications so that they can immediately get intervention. Some of these complications are referred to as danger signs of pregnancy. The aim of the paper to know the effect of health education videos on the level of knowledge and attitudes about danger signs in pregnancy.Methods: This quasi-experimental study used a nonequivalent pretest-posttest with control group design. This research was conducted at Jetis Public Health Center (PHC) (intervention group) and Pajangan PHC (control group). The number of respondents was 64 pregnant women. The control group received education with the Maternal and Child Health (MCH) handbook while the intervention group also received education using MCH handbook and education using videos about the danger signs of pregnancy. An educational video with a duration of 10 minutes 19 seconds contains about danger signs of pregnancy and actions that must be taken to overcome these problems. Educational videos were given to respondents via Android phones that can be watched repeatedly. data analysis has been carried out with the t test.Results: Based on the homogeneity test on the characteristic data between the intervention and control group were homogeneous. Comparison between the difference the knowledge of the pre-posttest in the intervention group compared to the difference the pre-posttest knowledge of the control group (8.59 vs. 0.31) with p value = 0.311, meaning that there is no effect of providing education with video on knowledge. Comparison between the difference in pre-posttest attitudes of the intervention group compared with the difference in pre-posttest attitudes of the control group (1.71 vs -1.21) p value = 0.001, meaning that there is an effect of providing education with video on attitudes.Conclusion: Health education videos can improve the attitude about the danger signs of pregnancy.

Effectiveness of a multi-component facility-based intervention on HIV-related infant and maternal outcomes: results from the IMPROVE clustered randomized study.

Even in the context of widespread access to prevention of vertical HIV transmission (PVT) services, health system challenges compromise health outcomes for women living with HIV and their children. The "Integrated Management Team to Improve Maternal-Child Outcomes" (IMPROVE) study measured the effect of a package of facility-based interventions on PVT and maternal and child health (MCH) outcomes in Lesotho. This cluster-randomized study included six facilities randomized to the standard-of-care and six to the IMPROVE intervention. The intervention included multidisciplinary teams of health care and community workers providing MCH support, training in patient-centered care, and additional home support. Pregnant women with and without HIV were enrolled at their first antenatal visit and followed through 12-24 months postpartum with their infants. Data were collected through participant interviews and routine medical record abstraction. Primary outcomes included viral suppression and adherence to antiretroviral therapy (ART) for women with HIV and repeat HIV testing for women without HIV. Analysis utilized generalized estimating equations (GEE) adjusted for intra-site correlation. Between July 2016 and February 2017, 614 pregnant women with HIV and 390 without HIV were enrolled. At 12 months postpartum, over 90% of women with HIV with viral load (VL) testing had a VL < 1,000 copies/mL; the intervention arm had a trend toward higher proportion with undetectable VL (< 50 copies/mL) compared to the control arm [83% versus 72%, OR 1.9 (95% CI 0.86-4.14)]. Women with HIV in the intervention arm had significantly higher odds of consistent adherence to ART [OR 1.81 (95% CI 1.03-3.18)], and women without HIV in the intervention arm had significantly higher odds of being re-tested for HIV prior to delivery [OR 1.95 (95% CI 1.23-3.08)]. Sites that implemented the IMPROVE intervention documented better PVT and MCH outcomes than sites implementing standard-of-care. This package of facility-based interventions is a promising and easily scalable model for improving coordination, quality, and uptake of services within the existing health system.

Factors associated with obstetric ultrasound screening behavior during antenatal care at public health centers in Palu City

Antenatal screening by general practitioners in primary care using basic obstetric ultrasound aims to identify suspected pathological cases early. Early detection allows for timely intervention, potentially preventing complications. This study analyzed factors related to the knowledge, attitudes, and practices of pregnant women utilizing ultrasound for antenatal care in Palu City. A mixed-methods study with a quantitative approach was conducted on 380 pregnant women from 14 public health centers in Palu City using proportional random sampling with pregnant women and Maternal and Child Health (MCH) program officers at the Palu Health Office. Quantitative data were collected using a structured questionnaire that was adapted and modified from existing literature. Researchers visited mothers’ homes to obtain information on socio-demographic factors, obstetric history, and knowledge and attitudes towards obstetric ultrasound scans. For the qualitative study, researchers conducted observations and in-depth interviews to explore sources of information about ultrasound, as well as knowledge, attitudes, practices, and barriers related to obstetric ultrasound during antenatal care. Bivariate and multivariate logistic regression were used to identify associated factors. The study found that 70.8% of pregnant women had good knowledge about obstetric ultrasound, and 77% had positive attitudes. Ultrasound was accessed by 55.4% of women on their first visit (K1) and 57.0% on their fifth visit (K5). Significant factors associated with knowledge included having a bachelor’s degree or higher (AOR 2.70; 95% CI 0.21-35.23), being a government employee (AOR 3.901; 95% CI 1.92-7.90), and previous exposure to ultrasound (AOR 1.966; 95% CI 1.24-3.12). Factors significantly associated with the practice of ultrasound screening were higher education (AOR 3.17; 95% CI 0.54-21.20), government employment (AOR 4.53; 95% CI 1.17-15.18), good knowledge (AOR 3.71; 95% CI 1.71-11.23), and positive attitudes (AOR 11.07; 95% CI 2.09-17.20). Educational level, occupation, and previous exposure to ultrasound significantly influenced knowledge about obstetric ultrasound. The practice of ultrasound screening was significantly associated with education level, occupation, knowledge, and attitudes.

Hubungan Kunjungan Antenatal Care dan BBLR dengan Kejadian Stunting pada Balita Usia 24-59 Bulan

Stunting is a condition where a child fails to grow properly due to chronic malnutrition, resulting in a shorter stature compared to other children of the same age. This research aims to analyze the correlation between antenatal care visits and low birth weight (LBW) history with the incidence of stunting in children aged 24 to 59 months.The research uses an analytical observational method with a cross-sectional approach. The population consists of mothers and children aged 24 to 59 months at Balas Klumprik Health Center, totaling 841 toddlers. The sample includes 89 mothers and stunted toddlers, selected through simple random sampling. The independent variables are antenatal care visits and LBW history, while the dependent variable is stunting. The instrument used in this study is the analysis using the Maternal and Child Health (MCH) book. The correlation is analyzed using the Chi-Square test. The results show that almost all respondents (77.5%) comply with antenatal care. Nearly all respondents (95.5%) are not stunted. The Chi-Square test results show a P-Value of 0.000, where p &lt; α 0.05, indicating a correlation between antenatal care visits and the incidence of stunting in children aged 24 to 59 months. The Chi-Square test results also show a P-Value of 0.001, where p &lt; α 0.05, indicating a correlation between LBW history and the incidence of stunting in children aged 24 to 59 months in the Balas Klumprik Health Center area. The conclusion of this research is that there is a correlation between antenatal care visits and LBW history with the incidence of stunting. The recommendation for the Balas Klumprik Health Center is to conduct socialization for pregnant women about the importance of antenatal care during pregnancy. For the community, it is hoped that there will be an increased awareness of the importance of nutritional needs for toddlers.

A Malaysian Non-Governmental Organizations (NGO) Experience in Organizing the Maternal and Child Health (MCH) Outreach Clinics for Malaysia’s Interior Indigenous Tribes

Malaysia’s interior indigenous tribes, residing in remote areas of the tropical rainforest, face significant health disparities. This paper examines the role of medical non-governmental organization (NGO) such as Islamic Medical Association of Malaysia Response and Relief Team (IMARET) in aiding the Ministry of Health mobile teams to enhance the reach and frequency of maternal and child health (MCH) services. From 2015 to 2023, IMARET conducted 60 missions to remote indigenous communities, providing medical services to 10,832 patients. Starting in 2021, IMARET included antenatal and child immunization services as part of its outreach efforts, attending to 170 pregnant ladies and vaccinating 246 children. This expansion reflects IMARET’s commitment to addressing the specific needs of expectant mothers and children in these underserved communities. This paper also explores the challenges encountered, including maintaining proper records, lack of proper facility, cold chain management, demographic of the villages, off-road terrain conditions, adverse weather conditions, availability of knowledgeable volunteer doctors, communication barriers with villagers, and funding constraints. Effective collaboration between IMARET and government agencies is critical for improving maternal and child health outcomes in these communities.International Journal of Human and Health Sciences Supplementary Issue 01: 2025 Page: S36

Volunteerism Beyond Dentistry: Malaysian Dentists’ Contribution During the COVID-19 Pandemic

Malaysia’s interior indigenous tribes, residing in remote areas of the tropical rainforest, face significant health disparities. This paper examines the role of medical non-governmental organization (NGO) such as Islamic Medical Association of Malaysia Response and Relief Team (IMARET) in aiding the Ministry of Health mobile teams to enhance the reach and frequency of maternal and child health (MCH) services. From 2015 to 2023, IMARET conducted 60 missions to remote indigenous communities, providing medical services to 10,832 patients. Starting in 2021, IMARET included antenatal and child immunization services as part of its outreach efforts, attending to 170 pregnant ladies and vaccinating 246 children. This expansion reflects IMARET’s commitment to addressing the specific needs of expectant mothers and children in these underserved communities. This paper also explores the challenges encountered, including maintaining proper records, lack of proper facility, cold chain management, demographic of the villages, off-road terrain conditions, adverse weather conditions, availability of knowledgeable volunteer doctors, communication barriers with villagers, and funding constraints. Effective collaboration between IMARET and government agencies is critical for improving maternal and child health outcomes in these communities.International Journal of Human and Health Sciences Supplementary Issue 01: 2025 Page: S35

The impact of perinatal mental health training on knowledge and practice of primary care physicians: a systems strengthening initiative in Telangana, India

BackgroundIn India, despite the high prevalence of perinatal mental health (PMH) conditions most primary care physicians (PCPs) have inadequate knowledge and skills to identify and provide appropriate interventions. The Health and Family Welfare Department of Telangana, India, partnered with the United Nations Children's Fund (UNICEF) and the Perinatal Mental Health service of the National Institute of Mental Health and Neurosciences to address this gap. The initial step in integrating PMH into the Maternal and child health (MCH) program involved training PCPs. This study aimed to outline the knowledge improvements regarding PMH among PCPs after the training.MethodsThe training, conducted from June to January 2023–2024 across 30 districts, employed various interactive and reflective educational methods. Pre and post-training assessments evaluated knowledge enhancement and skill development, focusing on identifying perinatal anxiety and depression, assessing severity, recognizing risk factors, identifying the need for referrals, and rational psychopharmacology. This study aimed to assess the impact of training on improving knowledge and skills among PCPs which would influence perinatal mental health service delivery in Telangana.ResultsOut of 863 PCPs in the 30 districts, 465 (53.8%) were able to complete the one-day training. Valid pre and post-training responses were available for 374 PCPs. A comparison of pre and post-training scores showed improvement in knowledge in a mean number of risk factors identified (pre: 3.05, post: 5.4; p < 0.001), ability to recognize depression (pre: 2.75, post: 4.33; p < 0.001) and anxiety symptoms (pre: 4.16, post: 6.08; p < 0.001), assess the severity of depression (pre: 0.46, post: 0.85; p < 0.001) and anxiety (pre: 0.57, post: 0.98, p < 0.001), safe medication use during pregnancy (pre: 0.89, post: 2.18;p < 0.001), and during breastfeeding (pre: 1.07, post: 2.13; p < 0.001) and identifying the need for referral to a psychiatrist (pre: 1.90, post: 3.13; p = 0.003).ConclusionThe one-day training for PCPs enhanced knowledge across various PMH domains. However, studies with follow-up data are necessary to assess the retention of this knowledge and skills related to case identification and referrals. Such studies will provide a more comprehensive evaluation of the effectiveness of the training program.

Strategies to improve uptake of the RTS, S malaria vaccine in a malaria endemic area of Western Kenya

Background: The World Health Organization (WHO) recommended the first malaria vaccine, RTS, S in October 2021 to prevent malaria in children in sub-Saharan Africa. However, sub-optimal vaccine uptake, especially the 3rd and 4th doses has been reported. This study engaged key stakeholders involved in vaccine delivery in Muhoroni sub-county of western Kenya to evaluate strategies that can improve vaccine uptake. Methods: A purposive sampling method was used to select participants for focus group discussions (FGDs) and key informant interviews (KIIs). Four FGDs were conducted with caretakers whose children either completed or did not complete the recommended 4 doses of the vaccine or did not take any dose, and 1 FGD with 11 community health volunteers (CHVs). The KIIs involved 11 nurses in charge of maternal and child health (MCH) clinics. Interview guides were used for the FGDs and KIIs. Data was analyzed thematically using NVIVO software version 12. Results: Majority of the participants suggested engaging CHVs, community outreaches, community dialogues, sending reminders through short message services (SMSs) and use of local radios and/or television as possible strategies to improve vaccine uptake. Conclusions: Strategies such as enhanced CHV engagement, adoption of technology and improved communications were regarded as suitable ways of improving the uptake of RTS, S malaria vaccine.

Predictors of institutional delivery service utilization in Ethiopia: an umbrella review

IntroductionOne of the global health’s top priorities is improving maternal health. There is a high maternal mortality ratio, despite its major progress in the past two decades. Many countries in Sub-Saharan Africa, including Ethiopia, have not yet reached the sustainable development goal target. The majority of women die of labor and delivery-related complications, which are preventable if they had access to maternal health service utilization, particularly institutional delivery services. The low institutional delivery services utilization in Ethiopia was related to several factors. There are literature disagreements on these predictors and systematic review and meta-analysis (SRMA) studies reported different contributing factors. Therefore, this umbrella review aimed to identify pooled predictors of institutional delivery service utilization in Ethiopia.MethodPubMed, Web of Science, Embase, CINAHL, Scopus, Google Scholar and Cochrane were searched for SRMA studies on the predictors of institutional delivery service utilization in Ethiopia. All SRMA studies selected for potential inclusion in the umbrella review were subjected to a rigorous, independent appraisal by two critical reviewers using the Assessment of Multiple Systematic Reviews tool. Authors selected SRMA studies and abstracted data independently, and discrepancies were resolved through discussion or a third author intervened. A random-effects meta-analysis model was used to pool estimates of the included SRMA studies. Studies’ heterogeneity and risk of bias were assessed using I2 and Egger tests, respectively.ResultThe umbrella review revealed that institutional delivery services utilization in Ethiopia was 24% (95% confidence interval, CI: 14 to 34). Further, women education (odds ratio, OR = 3.54, 95% CI: 3.04, 4.12), attitude of the women toward maternal and child health (MCH) service (OR = 2.20, 95% CI: 1.30, 3.74), place of residence (OR = 3.29, 95% CI: 2.02, 5.34), live less than 5 km away from the nearest health facilities (OR = 3.48, 95% CI: 2.58, 4.71) and having at least one antenatal care follow-up (OR = 3.62, 95% CI: 3.03, 4.33) were significantly associated with institutional delivery service utilization.ConclusionThe proportion of pregnant women using institutional delivery services is low in Ethiopia. The findings highlight women’s education, tailored intervention in the attitude of women toward maternal and child health services, supporting rural communities, improving access and availability of health facilities and promoting antenatal care (ANC) follow-up play a crucial role in enhancing facility childbirth, thereby reducing maternal and neonatal mortality and achieving sustainable development goal 3.1 and 3.2.