Maternal and Child Health (MCH) / Santé maternelle et infantile (MCH)

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    Social and cultural factors perpetuating early marriage in rural Gambia : an exploratory mixed methods study
    (2020-01-24) Lowe, Mat; Joof, Mamsamba; Rojas, Bomar Mendez
    Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. This study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex. The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.
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    Comprendre les normes et prévenir la pratique du mariage des enfants pour promouvoir la santé reproductive des adolescents au Niger
    (2023-05) GRADE Africa; SOS Femmes et Enfants Victimes de Violence Familiale; Réseau des Jeunes Ambassadeurs pour la SR/PF
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    Positive masculinity programs, gender attitudes and practices, and health behaviors among men and boys in poor urban settlements in the Democratic Republic of Congo, Nigeria, and Rwanda
    (2023) Izugbara, Chimaraoke; Ugwu, Chidi; Emina, Jacques; Rutayisire, Fidèle; Atama, Chiemezie; Busgacalia, Ilaria
    Positive masculinity (PM) interventions provide a critical opportunity for challenging gender norms and masculine ideals obstructing sexual and reproductive health (SRH) and perpetuating gender inequality in poor urban sub-Saharan African (SSA) communities. While PM program implementers in Africa claim that their work relies on evidence on what works to promote male engagement for gender equality and improved SRHR, little systematic research exists on whether participation in PM interventions is associated with positive gender and health attitudes and practices. The current study sought to generate evidence regarding the relationship between progressive gender- and health-related attitudes, norms, and practices among men and boys, and participation in PM efforts in poor urban SSA communities.
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    Understanding and addressing the SRH needs and challenges of young women and girls in humanitarian settings in Nigeria and Uganda
    (2023-03) Izugbara, Chimaraoke; Esiet, Nike; Kanaahe, Brian
    This research project sought to gather and use evidence to improve the design and delivery of sexual and reproductive health and rights (SRHR) services among adolescent and young women in Muna El Badawe Internally Displaced Persons (IDP) Camp in Maiduguri, Nigeria and Nakivale Refugee Settlement Camp in Isingiro, Uganda. Following quantitative and qualitative research, the study found that use of contraception and other SRHR services is low. The data indicates this may be linked to low decision-making power, stigma, and lack of awareness. The study further found differences between the two locations that may help to inform and tailor future SRHR services across humanitarian settings, including around how concentrated cultural norms in an IDP camp impact decision-making and stigma differently than the more diverse population of the refugee camp.
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    SRHR needs and challenges of refugee and internally displaced women and girls in sub-Saharan Africa : evidence highlights
    (2023) Izugbara, Chimaraoke; Esiet, Nike; Kanaahe, Brian; International Center for Research on Women
    In 2019, more than 134 million people in 42 countries needed humanitarian due to wars, internal conflicts, natural disasters, or extreme poverty. Over 25 million of these people lived as refugees or internally displaced persons (IDPs). More than half of them were aged 18 years or less. Sub-Saharan Africa (SSA) hosts 26 % of the world’s current refugee population, a figure that is expected to rise due to ongoing and new conflicts in many parts of the subregion. Compounding this situation is the continuing influx of Yemeni refugees into the volatile Horn of Africa. We conducted a rapid scoping review of the literature on the sexual and reproductive health and rights (SRHR) challenges of young women and girls in refugee and IDPs camps as well as promising solutions and best practices to address these challenges.
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    Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators : a qualitative study
    (Springer Nature, 2023-01-14) Muhumuza, Albert; Najjuma, Josephine Nambi; MacIntosh, Heather; Sharma, Nishan; Singhal, Nalini
    Introduction: There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators. Methods We used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique. Results We conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators. Conclusion In the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.
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    Sexual and reproductive health needs and challenges of adolescent girls and young women in humanitarian settings in Nigeria and Uganda : a quantitative report
    (2023) Izugbara, Chimaraoke; Esiet, Adenike; Kanaahe, Brian
    To better address Sexual and reproductive health and rights (SRHR) care access needs for young women and adolescent girls in humanitarian settings, greater insight is required on the needs and experiences of this population. Focusing on young women and adolescent girls in an Internally displaced persons camp in Maiduguri, Nigeria, and a refugee camp in Isingiro, Uganda, this report provides greater insight into their sexual and reproductive health needs and challenges. It specifically focuses on living conditions in the camp; contraceptives, pregnancy, and abortion; use of sexual and reproductive health services; intimate partner violence; and gender-based violence. The report is part of a larger project to generate evidence to improve the design and delivery of SRHR services to girls and young women in humanitarian contexts.
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    Examining ethnic differences in age at sexual debut among adolescent girls in the Gambia
    (Women's Health and Action Research Centre (WHARC), 2021-06) Lowe, Mat; Rojas, Bomar Mendez
    Whether age at sexual debut is influenced by adolescents’ ethnicity has not been examined in the Gambia. The aim of this study was to assess ethnic differences in age at sexual debut among girls in 24 rural Gambian settlements. A cross-sectional household survey of 181 respondents aged (10-19 years) was conducted among girls belonging to the three main ethnic groups (Mandinka, Fula and Wolof). Descriptive statistics and ordinal logistic regression were used to show the onset of sexual intercourse and describe the patterns of sexual debut by ethnic group among respondents. All the analyses were conducted in Stata 12.0. The study findings showed that the lowest median age at sexual debut is among Mandinka and Wolof girls (14 years). The results of ordinal logistic regression indicate that girls in the Mandinka and Wolof ethnic groups are approximately 20% less likely to initiate sex at an early age than girls in the Fula ethnic group. On the other hand, girls with more than 1 year of education are less likely to initiate sex at an early age than those with less than 1 year of education. It was also found that girls who live with their mothers are 71% less likely to have an early sexual debut than those who do not. These findings suggest ethnic differences in age at sexual debut among girls in the Gambia. The findings also highlight the importance of female education and living with a mother in reducing the chances of early sexual debut among adolescent girls.
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    Maternal and child health implementation research in Mozambique : effective community interventions to promote sexual and reproductive health
    (2021) Pires, PHNM; Mupueleque M,; Zakus D,; Mucufo J,; Abdirazak A
    The article/study assesses the impact of community participation on improving sexual and reproductive health. Comparing changes between 2016 and 2019, the number of health committees operating in Natikiri (Nampula, Mozambique) rose from 7 to 20. Population access to contraceptives was facilitated, rising from 42% to 91% in women and 65% to 90% in men. At Marrere General Hospital (Nampula) maternity deliveries rose by 60%. The article reviews a baseline study, strategies designed to improve health services, and empowerment in sexual and reproductive health and rights, as well as enhancing maternal and child health.
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    Promoting evidence informed policy making in Nigeria : a review of the maternal, newborn and child health policy development process
    (2017-09-26) Uneke, Chigozie Jesse; Sombie, Issiaka; Keita, Namoudou; Lokossou, Virgil; Johnson, Ermel
    The study reviewed policy documents on maternal, newborn and child health (MNCH) in Nigeria to assess the application of evidence-informed mechanisms in the policy formulation process. From a literature review, policy documents indicate that a consultative process of collection of inputs involving multiple stakeholders was employed, but there was no rigorous scientific process of assessing, adaptation and application of scientific evidence acknowledged in the policy development process. The policy documents neither reported the process of production of evidence used in their development nor indicated the mechanisms in place for knowledge transfer and use of health research findings.
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    Nigerian research days for MNCH : 1st edition, 11-13 July 2018, Abuja Nigeria
    (2018) WAHO; Ovuoraye, John; Danchua, Abdullahi Ali
    This one-page report provides a synopsis of the Abiye Program facet of the innovating for maternal, newborn and child health (IMNCH) project in Ondo State, Nigeria. The main objective of the research days is to move MNCH research into policy and practice by sharing findings among researchers and policy makers. Results of the project to this point (2018) show impact: between 2009 and 2016 there has been a reduction in maternal mortality from 545/100,000 women to 171/100,000; a reduction of over 70%.
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    Application of equitable impact sensitive tool (EQUIST) in evidence informed policymaking to improve maternal and child health outcomes in Burkina Faso
    (2018-03-28) Uneke, C. Jesse; Sombie, Issiaka; Uro-Chukwu, Henry; Johnson, Ermel
    This brief puts forward policy options and strategies towards improved health equity and access to health care services in Benin. The concept of health equity is a critical component that requires strengthening to improve maternal, newborn and child health (MNCH) outcomes in Burkina Faso. UNICEF has designed the EQUitable Impact Sensitive Tool (EQUIST) to enable the global health community to improve equity in MNCH and to reduce health disparities. The brief reviews findings from a study using the EQUIST Situation Analysis of maternal and child health outcomes in Benin by sub-national categorization, wealth, and residence.
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    Communiqué issued at the end of a 3-day stakeholders’ meeting on the second edition of Nigeria research days for maternal newborn and child health with the theme “Integration of mental health into reproductive and community health : community mobilisation and engagement” - Wuse II Abuja, Nigeria, 24th to 26th September, 2019
    (2019) Taylor, Tinuola; James, Femi; Brooks, Godwin; Iloh, Kenechukwu
    This second workshop promoted by the West African Health Organization (WAHO) shared research findings from three IMCHA projects in Maternal, Newborn, Child and Adolescent Health plus Nutrition (MNCAH+N) in Nigeria, and discussed the use of research in decision making in MNCH. It also enhanced the capacity of stakeholders to use the regional evidence-based policy making guidance tool. The report briefly outlines workshop activities along with concluding recommendations.
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    Policy dialogue to support maternal newborn child health evidence use in policymaking : the lessons learnt from the Nigeria research days first edition
    (2020) Johnson, Ermel A. K.; Sombié, Issiaka; Uzochukwu, Benjamin S. C.; Uneke, Jesse C.; Amadou, Moukaïla
    The Department of Family Health (Federal Ministry of Health, Nigeria) initiated and organized the first Nigeria Research Days (NRD) as a platform for exchange between researchers and policymakers towards improving maternal, new-born and child health (IMNCH). Participants supported the content and format of the meeting and were willing to implement recommendations of the final communiqué. To enhance the translation of research to policy, policy dialogue appears to be an effective mechanism for researcher-policymaker collaboration. This paper describes the conceptualization, implementation and facilitation of the first edition of "Nigeria Research Days,” including a guide for panel discussions.
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    “Kunika women are always sick” : views from community focus groups on short birth interval (kunika) in Bauchi state, northern Nigeria
    (BMC, 2020-05-24) Ansari, Umaira; Pimentel, Juan; Omer, Khalid; Gidado, Yagana; Baba, Muhd Chadi
    The word kunika in the Hausa language describes a woman becoming pregnant before weaning her last child (pregnant while breast feeding). In support of culturally safe child spacing in Bauchi State, North East Nigeria, the study explores local perspectives about kunika and its consequences. Family size in this area is large, and polygamy is common. Some 57% of women in Bauchi have no education, compared with 36% nationally. Use of contraception is minimal. In the Bauchi context men continue to dominate decision-making about reproductive health (and ill-health) and sexual activity.
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    Nigerian trial shows how universal home visits can help reduce maternal risks
    (2019-04-09) Cockcroft, Anne; Andersson, Neil
    This study tested the impact of universal home visits carried out by trained female and male “home visitors” in Bauchi State in northern Nigeria. Through follow-up questionnaires, findings show that this focused type of home visits produced clear benefits. The style of home visit was highly successful in transferring knowledge to all participants; home visitors provided pregnant women and their spouses with information about the risk factors and what could be done to avoid them, allowing them to reduce the risks themselves. The visitors shared information either through conversations or short video clips, in the style of locally popular soap operas. The programme is being upscaled.
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    Quality of perinatal depression care in primary care setting in Nigeria
    (BMC, 2018-11-22) Ayinde, Olatunde O.; Oladeji, Bibilola D.; Abdulmalik, Jibril; Jordan, Keely; Kola, Lola; Gureje, Oye
    There are major inadequacies in the organisational and administrative profile of primary maternal care facilities that militate against the provision of quality care. Emerging themes from study interviews include severe manpower shortages, and absence of administrative and clinical support for manpower training and care provision. Findings from this detailed research build on previous evidence which suggests that capacity to respond to common perinatal mental disorders is virtually non-existent in primary care settings in Nigeria. Perinatal depression is associated with short and long term adverse maternal and child outcomes.
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    Why rural women do not use primary health centres for pregnancy care : evidence from a qualitative study in Nigeria
    (BMC, 2019-08-05) Ntoimo, Lorretta Favour C.; Okonofua, Friday E.; Igboin, Brian; Ekwo, Chioma; Imongan, Wilson; Yaya, Sanni
    Pregnant women in rural communities in Nigeria often do not use Primary Health Care Centres. Through focus group discussions, the study found four broad categories of reasons underlying non-use: 1) accessibility factors – poor roads and transportation, long distances, and facility not always open; 2) perceptions relating to poor quality of care, inadequate drugs, abusive care by health providers, long wait times, and inappropriate referrals; 3) costs of services, including inability to pay for services even when costs are not excessive; the introduction of informal payments by staff; and 4) partner support (or lack thereof), and misinterpretation of signs of pregnancy complications.