Maternal Health Programs Research Articles

Monitoring continuity of maternal and child health services, Indonesia.

ObjectiveTo implement an online system to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on maternal and child health and nutrition essential health services in Indonesia.MethodsWe developed an electronic monitoring and evaluation system to assist district health offices in making rapid assessments of the impact of COVID-19 on maternal and child health and nutrition programmes in their area and in developing policy and programme responses. This implementation research was conducted from September to December 2020 in 304 districts. The strategies consisted of technical assistance for district offices by 21 partner universities and development of an online dashboard for rapid situation analyses and reporting. We collected qualitative data on feasibility and adherence to the intervention, as well as quantitative data from routine health databases to analyse the impact of COVID-19 on maternal and child health and nutrition indicators.FindingsIn the majority of districts key maternal and child health and nutrition services were moderately or severely affected by the pandemic, particularly child growth monitoring and antenatal care services. Adherence to the protocol of the intervention varied across districts but the system is a feasible approach to be scaled up to other regions and health programmes. High uptake by the health ministry, district office and university partners provided the platform with collaborative efforts for health-systems strengthening.ConclusionThe electronic monitoring and evaluation system could be implemented and completed with several modifications to accommodate district offices and universities. There is a potential to scale up the intervention with better implementation planning and training.

Scoping review of maternal and newborn health interventions and programmes in Nigeria

ObjectiveTo systematically scope and map research regarding interventions, programmes or strategies to improve maternal and newborn health (MNH) in Nigeria.DesignScoping review.Data sources and eligibility criteriaSystematic searches were conducted from 1...

Village health worker motivation for better performance in a maternal and child health programme in Nigeria: A realist evaluation.

BackgroundCommunity health workers play an important role in linking communities with formal health service providers, thereby improving access to and utilization of health care. A novel cadre of community health workers known as village health workers (VHWs) were recruited to create demand for maternal health services in the Nigerian Subsidy Reinvestment Programme (SURE-P/MCH). In this study, we investigated the role of contextual factors and underlying mechanisms motivating VHWs.MethodsWe used realist evaluation to understand the impact of a multi-intervention maternal and child health programme on VHW motivation using Anambra State as a case study. Initial working theories and logic maps were developed through literature review and stakeholder engagement; programme theories were developed and tested using focus group discussions and in-depth interviews with various stakeholder groups. Interview transcripts were analysed through an integrated approach of Context, Mechanism and Outcomes (CMO) categorisation and connecting, and matching of patterns of CMO configurations. Motivation theories were used to explain factors that influence VHW motivation. Explanatory configurations are reported in line with RAMESES reporting standards.ResultsThe performance of VHWs in the SURE-P maternal and child health programme was linked to four main mechanisms of motivation: feelings of confidence, sense of identity or feeling of acceptance, feeling of happiness and hopefulness/expectation of valued outcome. These mechanisms were triggered by interactions of programme-specific contexts and resources such as training and supervision of VHWs by skilled health workers, provision of first aid kits and uniforms, and payments of a monthly stipend. The monthly payment was considered to be the most important motivational factor by VHWs. VHWs used a combination of innovative approaches to create demand for maternity services among pregnant women, and their performance was influenced by health system factors such as organisational capacity and culture, and societal factors such as relationship with the community and community support.ConclusionThis paper highlights important contextual factors and mechanisms for VHW motivation that can be applied to other interventions that seek to strengthen community engagement and demand creation in primary health care. Future research on how to sustain VHW motivation is also required.

The characteristics of Australian Maternal and Child Health home visiting nurses undertaking family violence work: An interpretive description study.

To explore the family violence practice of home visiting nurses and identify the personal and professional characteristics of nurses undertaking family violence work. A qualitative research design using interpretive description. The family violence nursing practice and characteristics of home visiting nurses in Victoria, Australia, were explored by analysing semi-structured interviews (n=37) conducted over 4months in 2019-2020. Twenty-five nurses and 12 nurse managers worked in urban, regional city and rural/remote settings. The data were analysed using reflexive thematic analysis. We categorized the characteristics of home visiting nurses into two broad themes with sub-themes: 'Things you can learn'; and 'You just bring yourself'. By researching the characteristics of home visiting nurses undertaking family violence work, this study has identified the personal characteristics managers should consider when recruiting nurses to this specialist role. Identifying the personal and professional skills required will improve nurses' working experience by reducing the risk of a potential skill/role mismatch. These insights may enhance the effectiveness of home visiting nurses so that the Enhanced Maternal and Child Health program contributes effectively to the support of women experiencing family violence. Interviewing home visiting nurses and their managers has enabled a clearer insight into this specialist practitioner's previously unexplored work. Identifying the nurses' personal, professional, and clinical characteristics should inform the development of position roles and identify nurses who are best suited for this role. This knowledge will ensure that the Maternal and Child Health program effectively supports women experiencing family violence.

Estimating the impact of donor programs on child mortality in low- and middle-income countries: a synthetic control analysis of child health programs funded by the United States Agency for International Development

BackgroundSignificant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the USA and the UK. Direct attribution of impact to large-scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes.MethodsThis study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016.ResultsIn the study period (2000–16), countries with above average USAID funding had an under-five mortality rate lower than the synthetic control by an average of 29 deaths per 1000 live births (year-to-year range of − 2 to − 38). This finding was consistent with several sensitivity analyses.ConclusionsThe synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.

Effect of checklist based box system interventions on improving institutional delivery among reproductive age women in Northwest Ethiopia: generalized structural equation modeling

BackgroundPrevious studies have shown that there is low utilization of institutional delivery in Ethiopia, as well as various factors contributing to this low utilization. Notably, there is paucity around interventions to improve institutional delivery. Hence, this study examines the effectiveness of checklist-based box system intervention on improving institutional delivery and to investigate the association through which the intervention is linked to institutional delivery.MethodThe study used data from a larger trial, on the effectiveness of checklist-based box system intervention on improving maternal health service utilization. In the intervention arm, mothers received regular community-level pregnancy screening and referral, service utilization monitoring boxes, drop-out tracing mechanisms, regular communication between health centers and health posts, and person-centered health education for mothers. This study used the existing government-led maternal health program as a control arm. A total of 1062 mothers who gave birth one-year before the survey were included in the final analysis. A difference-in-difference estimator was used to test the effectiveness of the intervention. Generalized structural equation modeling was used to examine the direct and/ indirect associations between the intervention and institutional delivery.ResultAmong participants, 403 (79.5%) mothers from intervention and 323 (58.2%) mothers from control clusters gave birth at health facilities. The result of the study revealed a 19% increase in institutional delivery in the intervention arm (19, 95%CI: 11.4-27.3%). In this study the pathway from checklist-based box system intervention to institutional delivery was mainly direct - (AOR = 3.32, 95%CI: 2.36-4.66), however, 33% of the effect was partially mediated by attendance of antenatal care four visits (AOR = 1.39, 95%CI: 1.02-1.92). The influence of significant others (AOR = 0.25, 95%CI: 0.15-0.43) and age (AOR = 0.03, 95%CI: 0.01- 0.09) had an inverse relation with institutional delivery.ConclusionThe implementation of a checklist-based box system significantly increased institutional delivery utilization, both directly and indirectly by improving antenatal care four attendance. A larger-scale implementation of the intervention was recommended, taking the continuum of care approach into account.Trial registrationClinicalTrials.gov, NCT03891030, Retrospectively registered on 26 March, 2019.

Knowledge, attitude, and practice of medical students regarding immunization and National Maternal and Child Health program in India

Background: There are gaps in knowledge, attitude, and practice (KAP) regarding immunization and National Maternal and Child Health program among health care workers. Aims and Objectives: This study aims to study the KAP gaps related with immunization among medical students at a teaching institute. Materials and Methods: A total of 321 medical students were evaluated using a 54-item pre-validated inventory containing 36 items on knowledge, 8 on attitude, and 10 on practice with total possible scores of 55, 8, and 17, respectively. Details regarding type of student (undergraduates, intern, and postgraduates), sex, age, and marital status were noted. For illustrative purposes, the domain scores were transformed to percentages. Data were analyzed using SPSS 21.0 Software. Kruskal–Wallis, Mann–Whitney U tests, and Pearson correlation coefficient were employed for statistical analysis. Results: Maximum were final year MBBS (n=146) followed by interns (n=106) and 1st year postgraduate students (n=69). Majority were female (55.8%), aged 22–25 years (74.8%), and unmarried (91.9%). Mean percentage scores for knowledge and attitude were 51.44±13.35% and 65.54±31.05%. For immunization subdomain of knowledge, attitude, and practice, these were 58.45±16.15%, 72.20±32.59%, and 36.74±13.10%, respectively. Knowledge and practice scores showed a significant association with type of student. Attitude scores did not show a significant association with demographic profile of student. Maximum scores for all the domains were observed among postgraduates. Overall practice scores were much lower than knowledge and attitude. A significant correlationwas observed between knowledge, attitude, and practice scores. Conclusion: The study identifies wide gaps in KAP of medical students that indicate need for strategic interventions.

The Impact of the COVID-19 Pandemic in Prenatal Care Clinics; Late Diagnosis?

Objective: Coronavirus Disease 2019 (COVID-19) pandemic has an effect on the healthcare system and prenatal care units as well. Our goal is to identify the points where antenatal care was interrupted during the COVID-19 pandemic, as well as the reasons for disruption, and to discuss possible measures in this regard.
 Methods: This study is a retrospective cross-sectional study which compiles cases who presented to our perinatology clinic for a period of 6 months after the COVID-19 infection was first detected in our country and were diagnosed late, despite the fact that they could have been diagnosed earlier based on their condition.
 Results: The study included 22 cases of delayed diagnosis. When the reasons for missing the antenatal follow-ups of the cases were examined, nine of them (40.9%) were afraid of being infected in the hospital environment, eight of them (36.3%) could not follow the procedures due to long-distance travel restrictions, four of them (18.1) were on the contact list during the antenatal follow-up period, and one of them (4.5%) escaped the follow-up to because their doctor was infected.
 Conclusion: COVID-19 outbreak has been found to drastically minimize the number of face-to-face visits. Prenatal care facilities were also found to be underutilized during the pandemic, possibly due to travel limitations, fear of infection, and contaminated healthcare staff. As a result, efforts to improve maternal health programs are suggested. A variety of information, education, and communication materials can be created to raise awareness about the care of pregnant women during COVID-19 pandemic.

Pregnancy with Tuberculosis: What’s New!

Pregnancy with Tuberculosis (TB) can adversely affect the health of the gravida, foetus, and neonate with a spectrum of short and long-term implications. Prevention, diagnosis, and management with a multi-disciplinary team (MDT) approach of TB in pregnancy can improve maternal and perinatal outcomes. Tuberculosis preventive therapy (TPT) can prevent active disease progression and improve the outcome. More recently, active steps to enhance the collaborative activities between maternal health programmes and the National Tuberculosis Elimination Programme (NTEP) have been proposed to ensure early detection and timely management of TB cases in pregnant women in India. This includes antenatal screening for tuberculosis infection and disease at every visit and universal drug sensitivity testing in positive cases. We present a review on tuberculosis in pregnancy with recent updates in its management.

Community mobilization to strengthen support for appropriate and timely use of antenatal and postnatal care: A review of reviews

BackgroundAntenatal care (ANC) and postnatal care (PNC) are critical opportunities for women, babies and parents/families to receive quality care and support from health services. Community-based interventions may improve the accessibility, availability, and acceptance of this vital care. For example, community mobilization strategies have been used to involve and collaborate with women, families and communities to improve maternal and newborn health.ObjectiveTo synthesize existing reviews of evidence on community mobilization strategies that strengthen support for appropriate and timely use of ANC and PNC.MethodsSix databases (MEDLINE, Embase, CINAHL, PsychINFO, Cochrane Library, PROSPERO) were searched for published reviews that describe community mobilization related strategies for ANC and/or PNC. Reviews were eligible for inclusion if they described any initiatives or strategies targeting the promotion of ANC and/or PNC uptake that included an element of community mobilization in a low- or middle-income country (LMIC), published after 2000. Included reviews were critically appraised according to the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Evidence Syntheses. This review of reviews was conducted following JBI guidelines for undertaking and reporting umbrella reviews.ResultsIn total 23 papers, representing 22 reviews were included. While all 22 reviews contained some description of community mobilization and ANC/PNC, 13 presented more in-depth details on the community mobilization processes and relevant outcomes. Seventeen reviews focused on ANC, four considered both ANC and PNC, and only one focused on PNC. Overall, 16 reviews reported at least one positive association between community mobilization activities and ANC/PNC uptake, while five reviews presented primary studies with no statistically significant change in ANC uptake and one included a primary study with a decrease in use of antenatal facilities. The community mobilization activities described by the reviews ranged from informative, passive communication to more active, participatory approaches that included engaging individuals or consulting local leaders and community members to develop priorities and action plans.ConclusionsWhile there is considerable momentum around incorporating community mobilization activities in maternal and newborn health programs, such as improving community support for the uptake of ANC and PNC, there is limited evidence on the processes used. Furthermore, the spectrum of terminology and variation in definitions should be harmonized to guide the implementation and evaluation efforts.

Maternal and child health and nutrition (MCHN) policies and programs in Sri Lanka: a paradigm for public health in Asia

Sri Lanka Journal of Medicine is the official journal of the Kandy Society of Medicine. It is a peer-reviewed journal currently published biannually. Original articles, reviews, brief reports, case reports, points of view, and letters to the editor, in all fields of medical science and practice are accepted for publication.The Sri Lanka Journal of Medicine is now indexed in DOAJ

Understanding global health policy engagements with qualitative research: Qualitative evidence syntheses and the OptimizeMNH guidelines

Systematic reviews of qualitative evidence—or ‘qualitative evidence syntheses’ (QES)—have recently become an important form of knowledge production within the broader projects of ‘evidence-based medicine’ (EBM) and ‘evidence-informed policymaking’ in global health. Proponents of QES argue that these reviews offer a way to promote ‘health systems thinking’ and build a better understanding of local process and context in global health policy- and decision-making. EBM's detailed technical procedures for evidence synthesis, however, do not necessarily fit well with conventional qualitative research paradigms and there are concerns that subjecting qualitative research to EBM's logics and practices might fatally compromise both its epistemological integrity and political impact. This article addresses these concerns via a reflective case study of the use of qualitative evidence in the World Health Organization's (WHO) OptimizeMNH guidelines for task shifting in maternal and newborn health programs. When I first joined the team developing the evidence base for these health systems-oriented guidelines, I wondered whether the inclusion of qualitative research would result in a broadening of the forms of reason, experience and judgment that informed global health policy, or instead, be another disheartening example of how modern bureaucratic systems coopt, standardize, and complexity-reduce the alternative logics they encounter. While the integration of qualitative evidence did come at some cost to the depth and critical insights of the evidence we were reviewing, there were also important ways in which the technical procedures of evidence-based medicine were open to adaptation and transformation. The formal inclusion of qualitative evidence syntheses in these global guidelines did not represent—or produce—a dramatic about-turn in global health policy's hegemonic discourses and practices. It did reveal, however, that powerful systems of health governance like the WHO and evidence-based medicine are not inevitably closed, but in fact open to change, in often unpredictable ways.

BELUM TERCAPAINYA INDIKATOR STANDAR PELAYANAN MINIMAL PROGRAM KESEHATAN IBU DAN ANAK (KIA) Studi Kualitatif di Puskesmas Sei Rampah, Kabupaten Serdang Bedagai, Tahun 2021)

The purpose of this research is to explore more deeply about all matters related to the lack Minimum Service Standards (MSS) indicators for Maternal and Child Health Program (KIA) at Sei Rampah Public Health Center, Serdang Bedagai Regency. This research is a qualitative research. The research instrument is the researcher himself who is subjective, so the data obtained is checked for validity using the triangulation technique, namely by extending the time ,source triangulation and triangulation of data collection methods. The informant is the head of the public health center, Coordinator midwives, implementing midwives, nurses and pregnant mother. Data analysis was carried out using the Miles and Hubberman method. The results of research showed the indicators for the Minimum Service Standards for the Maternal and Child Health Program (KIA) at the Sei Rampah Health Center had not reached the 100% target and the lowest indicator coverage was the Indicator Detection of Risk Factors and Complications 17,3%. The reason for not achieveing the SPM for KIA program because the People are hesitant to check their health at the Public health center during the Covic-19 pandemic. The efforts made by the Public health centre management are by increasing the number of midwives, doing home-care, providing information to the community, either by banners or leaflet about the implementation of health services at the puskesmas, carrying out health shipping in accordance with the Covid 19 health protocol procedures. This study produces a Theoritical Framework based on results of data collection, processing and analysis.

Role of trust in sustaining provision and uptake of maternal and child healthcare: Evidence from a national programme in Nigeria

Despite increasing attention to implementation research in global health, evidence from low- and middle-income countries (LMICs) using realist evaluations, in understanding how complex health programmes work remains limited. This paper contributes to bridging this knowledge gap by reporting how, why and in what circumstances, the implementation and subsequent termination of a maternal and child health programme affected the trust of service users and healthcare providers in Nigeria. Key documents were reviewed, and initial programme theories of how context triggers mechanisms to produce intended and unintended outcomes were developed. These were tested, consolidated and refined through iterative cycles of data collection and analysis. Testing and validation of the trust theory utilized eight in-depth interviews with health workers, four focus group discussions with service users and a household survey of 713 pregnant women and analysed retroductively. The conceptual framework adopted Hurley's perspective on ‘decision to trust’ and Straten et al.‘s framework on public trust and social capital theory. Incentives offered by the programme triggered confidence and satisfaction among service users, contributing to their trust in healthcare providers, increased service uptake, motivated healthcare providers to have a positive attitude to work, and facilitated their trust in the health system. Termination of the programme led to most service users' dissatisfaction, and distrust reflected in the reduction in utilization of MCH services, increased staff workloads leading to their decreased performance although residual trust remained. Understanding the role of trust in a programme's short and long-term outcomes can help policymakers and other key actors in the planning and implementation of sustainable and effective health programmes. We call for more theory-driven approaches such as realist evaluation to advance understanding of the implementation of health programmes in LMICs.

Institutional procedural discrimination, institutional racism, and other institutional discrimination: A nursing research example.

Institutional discrimination matters. The purpose of this longitudinal community‐based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community‐based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less “[when] different cultural ways of doing things were shared, the project did not support my way” from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed‐rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems.

Factors associated with the timely initiation of antenatal care: findings from a cross-sectional study in Northern Bangladesh

ObjectiveThis paper explored the factors that influence the timely initiation of antenatal care (ANC) in Bangladesh.DesignThis was a cross-sectional survey.SettingThis study conducted in two rural subdistricts and one urban area...

Joint spatio-temporal modelling of adverse pregnancy outcomes sharing common risk factors at sub-county level in Kenya, 2016\u20132019

BackgroundAdverse pregnancy outcomes jointly account for a high proportion of mortality and morbidity among pregnant women and their infants. Furthermore, the burden attributed to adverse pregnancy outcomes remains high and inadequately characterised due to the intricate interplay of its etiology and shared set of important risk factors. This study sought to quantify and map the underlying risk of multiple adverse pregnancy outcomes in Kenya at sub-county level using a shared component space-time modelling framework.MethodsReported sub-county level adverse pregnancy outcomes count from January 2016 – December 2019 were obtained from the Kenyan District Health Information System. A Bayesian hierarchical spatio-temporal model was used to estimate the joint burden of adverse pregnancy outcomes in space (sub-county) and time (year). To improve the precision of our estimates over time and space, information across the outcomes were combined via the shared and the outcome-specific components using a shared component model with spatio-temporal interactions.ResultsOverall, the total number of adverse outcomes in pregnancy increased by 14.2% (95% UI: 14.0–14.5) from 88,816 cases in 2016 to 101,455 cases in 2019. Between 2016 and 2019, the estimated low birth weight rate and the pre-term birth rate were 4.5 (95% UI: 4.4–4.7) and 2.3 (95% UI: 2.2–2.5) per 100 live births. The stillbirth and neonatal death rates were estimated to be 18.7 (95% UI: 18.0–19.4) and 6.9 (95% UI: 6.4–7.4) per 1000 live births. The magnitude of the spatio-temporal variation attributed to shared risk was high for pre-term births, low birth weight, neonatal deaths, stillbirths and neonatal deaths, respectively. The shared risk patterns were dominant in sub-counties located along the Indian ocean coastline, central and western Kenya.ConclusionsThis study demonstrates the usefulness of a Bayesian joint spatio-temporal shared component model in exploiting specific and shared risk of adverse pregnancy outcomes sub-nationally. By identifying sub-counties with elevated risks and data gaps, our estimates not only assert the need for bolstering maternal health programs in the identified high-risk sub-counties but also provides a baseline against which to assess the progress towards the attainment of Sustainable Development Goals.

The Humanitarian Lives Saved Tool: An evidence-based approach for reproductive, maternal, newborn, and child health program planning in humanitarian settings.

The Humanitarian Lives Saved Tool: An evidence-based approach for reproductive, maternal, newborn, and child health program planning in humanitarian settings.

Perspective: Opportunities and Scope for Expanded Deworming Programs for Soil-Transmitted Helminths in India

The current deworming strategy for soil-transmitted helminthiases (STH) focuses on pre-school and school-aged children and women in the reproductive age to eliminate morbidity. However, mathematical modeling and meta-analysis show that STH could be eliminated if the entire population, including adults, were treated. The Government of India (GOI) has been deworming children through various maternal and child health programs and school health programs. One of the largest initiatives is the school-based biannual deworming program for children aged 1-19 years in the ‘National Deworming Day’ since 2015. Women of the reproductive age have the opportunity to get dewormed under the Anemia Free India program. Adult men and women have the opportunity to receive Albendazole in the lymphatic filariasis (LF) endemic districts. The gaps in deworming are women above the age of 49 and adult men above 19 years, living in non-LF endemic areas. Understanding gaps in deworming will help plan policy changes and program strategies for STH elimination in India, which has 21% of the global STH burden, as well as in other STH endemic countries.

Integrated management of neonatal and childhood illness strategy in Zimbabwe: An evaluation.

More than five million children under the age of five die each year worldwide, primarily from preventable and treatable causes. In response, the World Health Organization's Integrated Management of Childhood Illnesses (IMNCI) strategy has been adopted in more than 95 low- and middle-income countries, 41 of them from Africa. Despite IMNCI's widespread implementation, evidence on its impact on child mortality and institutional deliveries is limited. This study examined the effect of IMNCI strategy in the context of Zimbabwe, where neonatal and infant mortality rates are among the highest in the world. We used binary logistic regression to analyze cross-sectional data from the 2015 Zimbabwe Demographic and Health Survey. Zimbabwe implemented the IMNCI strategy in 2012. Our empirical strategy involved comparing neonatal and infant mortality and institutional deliveries within the same geographic area before and after IMNCI implementation in a nationally representative sample of children born between 2010 and 2015. Exposure to IMNCI was significantly associated with a reduction in neonatal mortality (adjusted odds ratio (95% CI): 0.70 (0.50, 0.98)) and infant mortality (adjusted odds ratio (95% CI): 0.69 (0.54, 0.91)). The strategy also helped increase institutional deliveries significantly (adjusted odds ratio (95% CI): 1.95 (1.67, 2.28)). Further analyses revealed that these associations were concentrated among educated women and in rural areas.The IMNCI strategy in Zimbabwe seems to be successful in delivering its intended goals. Future programmatic and policy efforts should target women with low education and those residing in urban areas. Furthermore, sustaining the positive impact and achieving the child health-related Sustainable Development Goals will require continued political will in raising domestic financial investments to ensure the sustainability of maternal and child health programs.