Maternal Health Practices Research Articles

Clinical teaching practices in maternal mental health care: An integrated review.

WHAT IS KNOWN ABOUT THE TOPIC?: Mental health-related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice. Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. WHAT ARE THE IMPLICATIONS FOR EDUCATION?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. ABSTRACT: Introduction Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion Clinical teaching is an important aspect of midwifery education. Utilizing student-centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives.

The relationship between postpartum pain and mother-infant bonding: A prospective observational study

IntroductionPostpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding. MethodsParticipants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0−10) and classified as non-severe (<8) or severe pain (≥8). Maternal-infant bonding was evaluated using the Post-Partum Bonding Questionnaire (PBQ; 0–125), with a score > 5 defining impaired bonding. Demographic data included age, BMI, parity, education level, economic status, partnership, prior history of depression, familial history of depression, desire to breastfeed, epidural analgesia during labor, rooming in, and Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using 2 separate multivariable logistic regression models for vaginal and cesarean deliveries, where maximum postpartum pain was the independent variable and impaired postpartum bonding was the dependent variable and controlled for the other factors collected. ResultsSevere postpartum pain (VNS ≥ 8) showed no significant relationship with impaired bonding when controlling for confounding variables. In vaginal deliveries, there was an association between a history of depression and impaired bonding (Odds Ratio 2.2 [1.07–4.65], p = 0.04) and EPDS > 10 and impaired bonding (OR 11.5 [3.2–73.6], p < 0.001). For cesarean deliveries, rooming in with the baby had a protective effect (OR 11.5 [3.2–73.6], p < 0.001). ConclusionsContrary to expectations, severe postpartum pain did not influence maternal-infant binding in the cohort of patients with vaginal and cesarean deliveries. Instead, factors such as maternal mental health and rooming-in practices appeared to exert more significant influence. Clinical trial registrationNCT05206552.

Factors affecting practices of recently delivered women on maternal and neonatal health care in selected rural areas of Bangladesh

Bangladesh has made laudable progress in maternal and child health (MCH). Maternal and child mortalities have reduced substantially accompanied by stellar rise in immunization and contraceptive prevalence rate (CPR). However, such success is distributed unevenly throughout and the country is among one of the top ten countries with highest number of neonatal and under-five children mortalities. Rural Bangladesh is home to more than half of the country’s total population. Yet, disparity in access to healthcare services and information are overt in these areas. Utilization of maternal health services (MHS) is low whereas maternal and child mortalities are high in the rural areas. Thus, this cluster randomized cross sectional study was conducted with the aim to observe the practices that rural women followed in regards to maternal and child health and factors that affected these practices. Primary data was collected from 550 respondents using a structured questionnaire within the time period September—October 2019. All our participants were recently delivered women (RDW), defined in our study as women of reproductive age (15–49 years) who had delivered a child recently, i.e. 12 months prior (September 2018 – August 2019) the data collection. We conducted logistic regression and multivariate analysis to analyze data. Results from this study depict that while 96.3% of RDW opted for ANC visits and 99.1% fed colostrum to their newborn, fewer have had institutional deliveries and the number of RDW who had PNC was only 64.7%. Education was found to be the most prominent factor that affected practices employed by RDW. The more educated a respondent was, the greater the chance was of her engaging in appropriate maternal and child health practices. The RDW preferred and visited private facilities the most to obtain healthcare services with private medical doctors being one of the prime sources of healthcare information for the respondents. On the contrary, monthly expenditure exerted no statistically significant impact on the aforementioned practices. Thus, results of our study imply that interventions enhancing education and health knowledge of women and engaging private sector be designed for improving maternal and neonatal health care in rural areas of Bangladesh.

Exploring Maternal Health and Pregnancy Practices: A Comprehensive Study Among Pregnant Women

Maternal health and pregnancy practices are critical to ensuring the well-being of both expectant mothers and their unborn children. Women undergo significant physiological and emotional changes during pregnancy, making adopting appropriate nutrition and healthcare practices essential. Objective: To explore maternal health and pregnancy practices. Methods: This cross-sectional study was conducted in the Rural Community of Karachi, Pakistan, from August 2022 to January 2023. A total of 100 pregnant women were part of the study. Results: The study shows that around 36% of participants follow a balanced diet during pregnancy, and 47% take prenatal vitamins or iron supplements as recommended. Moreover, 29% prefer home delivery, 81% prefer healthcare facility delivery, and 75% believe home delivery has more complications than healthcare facility delivery. Conclusions: The study reveals that numerous expectant mothers follow advice on a balanced diet and prenatal care. However, a significant number still face challenges in accessing healthcare. Despite a preference for home remedies, most opt for healthcare facility deliveries, showcasing trust in professional assistance. Enhancing healthcare access, prenatal services, and nutritional education could enhance the well-being of both mothers and babies.

Maternal mental health is associated with children's frequency of family meals at 12 and 24 months of age.

Diet during the child's first years is important for growth and development. In toddlerhood, higher diet quality is reported among children eating meals together with family. Although previous literature has documented several associations between maternal mental health and early child feeding practices, less is known about the relationship between maternal mental health and child frequency of shared family meals. This study explores associations between maternal symptoms of anxiety and depression, measured by The Hopkins Symptoms Checklist (SCL-8), and toddler participation in family meals. We used cross-sectional data from the Norwegian study Early Food for Future Health, in which participants responded to questionnaires at child age 12 (n = 455) and 24 months (n = 295). Logistic regression was used to explore associations between maternal mental health and child having regular (≥5 per week) or irregular (<5 per week) family meals (breakfast and dinner), adjusting for relevant child and maternal confounding variables. Children of mothers with higher scores of anxiety and depression had higher odds of Irregular family meals at both timepoints; (OR: 2.067, p = 0.015) and (OR: 2.444, p = 0.023). This is one of few studies exploring associations between maternal mental health and child frequency of shared family meals in early childhood, a period where the foundation for life-long health is shaped. Given the high prevalence of mental ailments and disorders, these findings are important and may inform future public health interventions. Further exploration of this relation is needed, including longitudinal research to test predictive associations and qualitative studies to increase insight and understanding.

Change in marijuana use from adolescence to young adulthood and its relation to gestational alcohol and marijuana exposure

IntroductionMany studies have examined changes in marijuana use across adolescence, but few have examined factors associated with transitions from adolescence to young adulthood. We examined prenatal exposures to alcohol and marijuana and adolescent risk and protective factors that best distinguished among abstinence, continuity, or cessation of marijuana use from 16 to 22 years. MethodData were from the Maternal Health Practices and Child Development Project at the prenatal and 16- and 22-year follow-up phases. The offspring were of lower socioeconomic status with an average of 12.8 years of education at 22 years. Participants' frequency and quantity of marijuana use over the past year were used to determine change in use. A discriminant analysis was applied to distinguish among the identified groups. The risk factors considered included prenatal substance exposures and age 16 demographics, behavior, and home environment. ResultFour categories of transitions were defined based on marijuana use from 16 to 22 years: non-users (n = 193), stop/decrease (n = 81), continue at same level/increase (n = 125), and initiation after the 16-year phase (n = 122). The factors that best distinguished among these groups were peers' marijuana use, delinquency, caregivers' financial strain, prenatal exposure to alcohol and marijuana, and race. ConclusionPrenatal alcohol and marijuana exposure were significantly related to transitions of marijuana use from adolescence to young adulthood, controlling for peers' use, behavior problems, and home environment. While gestational marijuana exposure was associated with early initiation/increasing use, alcohol exposure was related to later initiation. The findings emphasize the long-term effects of prenatal exposure to alcohol and marijuana.

Household Vulnerability and Childhood Immunization Status in Nigeria

Immunization is considered one of the most cost-effective public health interventions for reducing childhood morbidity, mortality, and disability globally. However, while global achievement of over 70% coverage rates was sustained in 1990s, wide variations exist between and within countries. In some developing countries, immunization rates increased substantially, but in sub-Saharan Africa, immunization rates plummeted, leaving millions of children vulnerable to life-threatening diseases. In Nigeria, coverage rates for routine immunization for all antigens still fall below 50%. The study examined the overall influence of household vulnerability dimensions, maternal health practices on childhood immunization status in Nigeria. The study used secondary data from 2013 Nigeria Demographic and Health Surveys (NDHS). The analytical weighted sample size was 5,824women of reproductive ages (15–49 years) with a live birth in the past 3 years, whose children were within age 12 to 23 months at the time of the survey. The data was analyzed using frequency distribution, chi-square test, and binary logistic regression. The results showed a decreasing regional variation in the proportion of fully immunized children from high of 23.6% in South-West, to a low of 9.1% in North-East. The overall household vulnerability status showed that children in more and most vulnerable households were 62% (OR = 0.38; p &lt; .001; CI [0.32-0.46]) and 89%less likely (OR = 0.11; p &lt; .001; CI [0.08-0.14]) to receive full vaccination compared with their counterpart in non-vulnerable households. The study revealed significant relationship between mothers’: (i) number of antenatal visits (OR = 1.66; p &lt; .05; CI [0.25-1.77]); (ii) quality of antenatal care (OR = 2.61; p &lt; .05; CI [1.45-4.67]); (iii) place of delivery (OR = 0.62; p &lt; .05; CI [0.45-0.86]); (iv) assistance during delivery (OR = 0.41; p &lt; .001; CI [0.28-0.57]); (v) time of postnatal check (OR = 1.81; p &lt; .001; CI [1.49-2.19]) and full childhood immunization status.

P07-066-23 Maternal Mental Health and Infant Complementary Feeding Practices

P07-066-23 Maternal Mental Health and Infant Complementary Feeding Practices

Profiling Maternal and Child Health Care in the Tribal Communities of Telangana State: An Anthropological Enquiry

Sexual and reproductive health aspects of tribal communities have been a matter of concern for various scholars. The present study, conducted among the tribals in one of the Integrated Tribal Development Agency areas (Mannanoor ITDA) in the state of Telangana, is primarily set to enrich the existing knowledge concerning reproductive health. The article particularly focuses on the antenatal/prenatal care, intranatal care, and reproductive outcomes among the tribal communities. The article attempts to look into the age of these women at marriage and various conceptions, the spacing between conceptions, and the outcome of the conceptions. Besides this, efforts have been made to gather data on the place of delivery, antenatal care, and birth weights of infants. The study could identify that about a quarter were low-birth-weight babies. The study also showed that overall reproductive wastage is quite significant in the tribal communities in the study area, even though the women in the area were found to be avoiding marriages at a very young age. By and large, the study reveals that maternal and child health practices are relatively satisfactory in the tribal communities in the study area.

Perspectives of stakeholders regarding the value of maternal and newborn health interventions and practices supported by UNICEF and other partners in the West Nile region of Uganda: a qualitative study

IntroductionUganda has high maternal, neonatal, and under-five mortality rates. This study documents stakeholder perspectives on best practices in a maternal and newborn health (MNH) quality-improvement programme implemented in the West Nile region of Uganda to improve delivery and utilisation of MNH services.MethodsThis exploratory cross-sectional qualitative study, conducted at the end of 2021, captured the perspectives of stakeholders representing the different levels of the healthcare system. Data were collected in four districts through: interviews with key informants working at all levels of the health system; focus group discussions with parents and caretakers and with community health workers; and interviews with individual community members whose lives had been impacted by the MNH programme. The initial content analysis was followed by a deductive synthesis pitched according to the different levels of the health system and the health-systems building blocks.ResultsThe findings are summarised according to the health-systems building blocks and an account is given of three of the interventions most valued by participants: (1) data use for evidence-based decision making (with regard to human resources, essential reproductive health commodities, and financing); (2) establishment of special newborn care units and high-dependency maternity units at district hospitals and training of the health workforce (also with reference to other infrastructural improvements such as the provision of water, sanitation and hygiene facilities at health facilities); and (3) community referral of pregnant women through a commercial motorcycle voucher referral system.ConclusionThe MNH programme in the West Nile region adopted a holistic and system-wide approach to addressing the key bottlenecks in the planning, delivery, and monitoring of quality MNH services. There was general stakeholder appreciation across the board that the interventions had the potential to improve quality of care and newborn and maternal health outcomes. However, as the funding was largely donor-driven, questions about government ownership and sustainability in the context of limited resources remain.

Sociocultural practices and beliefs during pregnancy, childbirth, and postpartum among indigenous pastoralist women of reproductive age in Manyara, Tanzania: a descriptive qualitative study

BackgroundDespite interventions improving maternal and newborn morbidity and mortality, progress has been sluggish, especially in hard-to-reach indigenous communities. Sociocultural beliefs in these communities more often influence the adoption of particular behaviors throughout pregnancy, childbirth, and postpartum. Therefore, this study identified sociocultural beliefs and practices during pregnancy, childbirth, and postpartum among indigenous pastoralist women of reproductive age in the Manyara region, Tanzania.MethodsThe study was a descriptive qualitative design. We used purposive sampling to select twelve participants among community members who were indigenous women of Manyara who had ever experienced pregnancy. In-depth interviews were audio-recorded and transcribed verbatim, and organized manually. We used manual coding and inductive-deductive thematic analysis.ResultsThe study’s findings showed that sociocultural beliefs and practices are widespread, covering antenatal through childbirth to the postnatal period. Both harmful and harmless practices were identified. For example, the use of herbal preparations to augment labor was reported. Previously, most women preferred home delivery; however, the practice is changing because of increased knowledge of home delivery complications and the accessibility of the facilities. Nevertheless, women still practice hazardous behaviors like applying strange things in the birth canal after delivery, increasing the risk of puerperal infection.ConclusionsSociocultural practices are predominant and widely applied throughout the peripartum period. These beliefs encourage adopting specific behaviors, most harmful to both mother and fetus. These sociocultural practices tend to affect the utilization of some essential maternal and child health practices. Eliminating unsafe peripartum practices will increase the use of medical services and ultimately improve outcomes for both mothers and their newborns. Public health interventions must recognize the cultural context informing these cultural practices in marginalized indigenous communities. Healthcare providers should routinely take the history of commonly traditional practices during the peripartum period to guide them in providing quality care to women by correcting all harmful practices.

Household Vulnerability Dimensions, Maternal Health Practices and Childhood Immunization Status in Nigeria

Immunisation is considered one of the most cost-effective public health interventions for reducing childhood morbidity, mortality, and disability globally. However, while global achievement of over 70% coverage rates was sustained in the 1990s, wide variations exist between and within countries. In some developing countries, immunisation rates increased substantially, but in sub-Saharan Africa, immunisation rates plummeted, leaving millions of children vulnerable to life-threatening diseases. In Nigeria, coverage rates for routine immunisation of all antigens still fall below 50%. The study examined the overall influence of household vulnerability dimensions, maternal health practices on childhood immunization status in Nigeria. The study used secondary data from the 2013 Nigeria Demographic and Health Surveys (NDHS). The analytical weighted sample size was 5,824 women of reproductive ages (15-49 years) with a live birth in the past three years, whose children were within age 12-23 months at the time of the survey. The data were analyzed using frequency distribution, chi-square test and binary logistic regression. The results showed a decreasing regional variation in the proportion of fully immunized children from a high of 23.6% in the South-West, to a low of 9.1% in the North-East. The overall household vulnerability status showed that children in more and most vulnerable households were 62% (OR = 0.38; p &lt; 0.001; CI: 0.32-0.46) and 89% less likely (OR = 0.11; p &lt; 0.001; CI: 0.08-0.14) to receive full vaccination compared with their counterpart in non-vulnerable households. The study revealed a significant relationship between mothers’: i) Number of antenatal visits (OR = 1.66; p &lt; 0.05; CI: 0.25-23 1.77); ii) Quality of antenatal care (OR = 2.61; p &lt; 0.05; CI: 1.45-4.67); iii) Place of delivery (OR = 0.62; p &lt; 0.05; CI: 0.45-0.86); iv) Assistance during delivery (OR = 0.41; p &lt; 0.001; CI: 0.28-0.57); v) Time of postnatal check (OR = 1.81; p &lt; 0.001; CI: 1.49-2.19) and full childhood immunisation status. The study concluded that different dimensions of household vulnerability and maternal health-seeking behavior are key underlying factors of childhood immunization in Nigeria.

Testing theory of change assumptions of health behavior change interventions: A blended approach exploring local contexts

This paper used a blended approach that involves multiple techniques to, first, test a set of assumptions around a health behavior change communication intervention theory of change (ToC) and, second, surface some unidentified assumptions involving the local context. The intervention was integrated with women’s self-help groups (SHGs) in Uttar Pradesh, India. The key assumption tested in this paper was the linkage between SHG membership, program exposure, and maternal, newborn, and child health practices. Learnings were substantiated through empirical investigations, including structural equation modeling and mediation analysis, as well as ‘co-learning’ workshops within the community. The workshops aimed to capture and interpret the heterogeneity of local contexts through deep dialogs with the community and program implementers at various levels. Statistical analyses indicated a significant association between the amount of women’s program exposure and their health practices. SHG membership was shown to affect maternal health practices; however, it did not have a direct effect on neonatal or child health practices. The ‘co-learning’ workshops revealed crucial aspects, such as prevailing socio-cultural norms, which prevented pregnant or recently delivered women from participating in SHG meetings. This paper encourages evaluators to work with the community to interpret and co-construct meaning in unpacking the contextual forces that seldom appear in the program ToC.

Is the maternal health voucher scheme associated with increasing routine immunization coverage? Experience from Bangladesh.

Bangladesh initiated the Maternal Health Voucher Scheme (MHVS) in 2007 to improve maternal and child health practices and bring equity to the mainstream of health systems by reducing financial and institutional barriers. In this study, we investigated whether the MHVS has an association with immunization coverage in a rural area of Bangladesh. Between 30 October 2016 and 15 June 2017, we carried out a cross-sectional survey in two low performing areas in terms of immunization coverage- Chattogram (erstwhile Chittagong division) and Sylhet division of Bangladesh. We calculated the coverage of fully immunized children (FIC) for 1151 children aged 12-23 months of age. We compared the coverage of FIC between children whose mothers enrolled in MHVS and children whose mother did not. We analyzed immunization coverage using crude odds ratio (OR) and adjusted OR (aOR) from binary logistic regression models. The overall coverage of FIC was 86%. Ninety-three percent children whose mothers were MHVS members were fully immunized whereas the percentage was 84% for the children of mothers who were not enrolled in MHVS. Multivariate analysis also shows that FIC coverage was higher for children whose mothers enrolled in MHVS compared to those children whose mothers did not; the aOR was 2.03 (95% confidence interval 1.11-3.71). MHVS provides a window for non-targeted benefits of childhood vaccination. Providing health education to pregnant mothers during prenatal care may motivate them to immunize their children. Programmes targeted for mothers during pregnancy, childbirth and post-natal may further increase utilization of priority health services such as childhood immunization.

Interruptions in contraception and unintended pregnancy during the COVID-19 pandemic: A protocol for systematic review and meta-analysis.

The COVID-19 pandemic has impacted access to and use of maternal, newborn, and child health services. Due to lockdowns and travel restrictions implemented during the first wave of the pandemic, the provision of essential maternal health services such as family planning was critically affected. Unlike most healthcare, contraception-related services are impractical for virtual care provision as women need to attend the clinic in person. Therefore, most women across the world might have been left with an unmet need for contraception during the lockdown period. Interruptions in contraception services have led to an increased number of unintended pregnancies. With the emergence of several pocket studies, it is essential to pool the available evidence reporting the effects of COVID-19 on contraception to inform maternal health policy and practice. The aims of this review are (1) to determine the effects of the COVID-19 pandemic on access to contraceptives among sexually active women and (2) to identify the magnitude of unintended pregnancy linked to interruptions of contraceptives due to the COVID-19 pandemic. The protocol for this systematic review was registered in PROSPERO (CRD42021267077). Electronic databases such as MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and Google Scholar will be searched for articles using appropriate key terms. The identified articles will be assessed against the eligibility criteria. Two reviewers (A.B. and T.B.) will independently screen titles and abstracts of all retrieved articles followed by a full-text review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The quality of the papers will be assessed by using the Risk of Bias Assessment tool for Non-Randomized Studies. Quantitative findings will be pooled using a random-effects model meta-analysis, while qualitative findings will be presented using a narrative synthesis. Ethical approval is not required. The findings will be disseminated through conference presentations and peer-reviewed publications. This systematic review will present current data needed to design evidence-based programmes for improving access to contraception and preventing unintended pregnancy during the COVID-19 pandemic and future emergencies. PROSPERO CRD42021267077.

African Immigrant Women's Maternal Health Experiences in Clarkston, Georgia: A Qualitative Study.

The maternal health experiences of African immigrant women, their utilization of health care services, and the effects on maternal health have received limited attention in research. This research explored the maternal health experiences of African immigrant women residing in Clarkston, Georgia, and their use of health services. Fourteen African immigrant women responded to semistructured interviews. An adapted version of the Andersen health care utilization model explained the predisposing factors, enabling factors, and need factors, which influence the use of maternal health care for African immigrant women. Findings were presented according to the Andersen health care utilization model. Analysis of the interviews resulted in 11 themes. The themes were as follows: (1) Community social structure, (2) community health beliefs, (3) health organization concerning the use of women, infants, and children, (4) social support at the individual level, (5) limited English proficiency, (6) need for better health education, (7) perception of care, (8) health financing, (9) long wait times and lack of transportation, (10) fear of medication and obstetrical interventions, and (11) impact of Female Genital Mutilation/Cutting. Maternal health practices of African immigrant women are impacted by environmental and cultural factors. Public health interventions should be implemented to advance African immigrant women's health care utilization practices through required health education and tailored care, which will translate to positive maternal health experiences.

A mobile health app may improve maternal and child health knowledge and practices among rural women with limited education in Uganda: a pilot randomized controlled trial.

ObjectiveThis article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education.Materials and methodsPregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatHealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assessing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices.ResultsOf the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P = .19), 3.6 (P = .14), and 6.4 (P = .25), respectively higher odds of knowing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, compared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic.Discussion and conclusionThe app increased knowledge and practices although not reaching statistical significance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes.

Care in the time of COVID: An interpretative phenomenological analysis of the impact of COVID-19 control measures on post-partum mothers' experiences of pregnancy, birth and the health system.

BackgroundFindings suggest pandemic control measures have modified maternal health practices, compromising the quality of care provided to new and expectant mothers and interfering with their birthing experiences. For this reason, this study explored the lived experiences of post-partum Victorian mothers during the pandemic as well as the potential influence of control measures over their perceptions regarding the health system.MethodsThis study used a qualitative approach. Recruitment was conducted between May and June 2021, using both the Australian Breastfeeding Association’s social media pages and snowball recruitment. Interviews were semi-structured using open-ended questions relating to key themes. Seven Victorian post-partum mothers were identified and their transcripts analysed using Interpretative Phenomenological Analysis.ResultsMothers described how unexpected changes to maternal care exacerbated feelings of uncertainty regarding pregnancy and birth. Mothers also differentiated between impacts by the health system and the role healthcare professionals played in moderating these effects. Whilst visitor restrictions provided some benefit, restrictions to familial and social support left many of the mothers feeling alone during their pregnancy and interfered with their immediate post-partum experience.ConclusionThis study illustrates the importance of evidence-based practice in maternal care and provides insights for both health professionals and policy analysts in developing new or modifying existing guidelines that better balance the needs of expectant and post-partum mothers with pandemic control measures.

Community Health Educators and Maternal Health: Experimental Evidence from Northern Nigeria

The slow pace of improvement in service delivery and health outcomes for pregnant women and newborns in developing countries has been a major concern for policy makers in recent decades. This paper presents the results from a randomized controlled trial of a community health worker program designed to enhance uptake of child and maternal health services in Northern Nigeria. Three interventions were evaluated: the deployment of community health educators, health educators with the provision of safe birth kits, and health educators with community dramas. The results suggest that the interventions increased utilization of antenatal, postnatal, and infant care. Maternal and newborn health practices improved as well as health knowledge. In addition, the community health worker program was more effective when supplemented with additional program components.

Explore the Role of Homoeopathy in Maternal Health Care Practices in UP and India

On 13th December 1986, the famous actor of Indian cinema Mrs. Smita Patil died of child birth complications technically known as puerperal sepsis (HT, 13th Dec, 1986). 36 years later, in 2022, Dr. Archana of Dausa, Rajasthan died by suicide as she was arrested after a pregnant woman died of Post Partum Haemorrhage (PPH) in her private hospital (TNN. March 30th 2022). This clearly reflects the challenge that maternal health throws at the health fraternity. A woman’s struggle in the stage of pregnancy is full of turbulents. The struggle of mothers continues in India even today and that too in the state of UP even on a large scale. The current Maternal Mortality Ratio in India is 103 per 10000 live births &amp; for the state of UP, it is 167 (SRS, 2019). Similarly, the Maternal Mortality Rate of India is 6.5 per 100,000 pregnant women in the age group of 15-49 years where as in UP, it is 14.7 per 100,000 pregnant women in the age group of 15-49 years. The high Maternal Mortality both in India and UP stand as a testimony to this fact as reducing this indicator is a priority. The target of achieving the SDG target of 70 per one lakh live births is a long way. The current article focuses on the initiatives of the role of homoeopathy in public health system to address maternal mortality. Basically, there are three approaches to reduce maternal mortality. These are addressing the three crucial delays related to the maternal mortality. The article focuses exclusively on these approaches while relating to homoeopathy. There are three objectives of the article. The first is to find out the current status of Homoeopathy in the maternal health practices, the second is to find out the details of the current &amp; past implementation strategies in the homoeopathic context and the third is to find out the link between Homoeopathy &amp; maternal health practices. The study uses secondary data. The gap that the article worked on is to explore a link between Homoeopathy &amp; maternal health &amp; its modalities. It deciphers whether there is a functional link currently or not &amp; suggests future strategies based on the functionality of the link. It will be a step in the right direction to fulfill the plans to achieve the maternal health target of SDG by 2030 especially for maternal mortality related goals. For the benefit of the readers, the article includes its expected outcome, relevance to society &amp; policy making through the context of the identified issues &amp; the research gap. Through all these sections, the current article puts an effort to fulfill the three cited objectives of the current study related to incorporation of homoeopathy in maternal care.