Maternal, Newborn, and Child Health (MNCH) / la santé de la mère, du nouveau-né, et de l’enfant
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Item Sexual and reproductive health rights in times of conflict : the lived experiences of Syrian refugee women in Lebanon(2023-12) El Kak, Faysal; Abou Habib, Lina; Whaibeh, Emile; Al Fakhani, SohaylaItem Application of a qualitative rapid assessment approach to inform community-responsive information, education and communication activities(2018-02) Bergen, Nicole; Shifera, AsfawThe study examined the application of a qualitative rapid assessment approach to explore community perceptions and experiences related to health and health inequality, focusing on maternal and child health (MCH). Participants identified health inequalities within communities and attributed them to lack of knowledge, exclusion from social groups, and poverty. Health Extension Workers (HEWs), religious leaders and “development army” members are well-positioned to disseminate knowledge and influence health behaviours. The study generated a context-specific situational analysis to inform the design and delivery of information, education and communication (IEC) activities in Jimma Zone (Ethiopia).Item The impact of universal home visits with pregnant women and their spouses on maternal outcomes: a cluster randomised controlled trial in Bauchi State, Nigeria(BMJ Global Health, 2019-01-04) Cockcroft, Anne; Omer, Khalid; Gidado, Yagana; Chadi Baba, Muhammad; Aziz, Amar; Ansari, Umaira; Ibrahim Gamawa, Adamu; Yarima, Yahaya; Andersson, NeilIn Bauchi State (Nigeria) maternal morbidity is associated with domestic violence, heavy work in pregnancy, ignorance of danger signs, and lack of spousal communication. This cluster randomized controlled trial tested the impact of universal home visits where risk factors were discussed with pregnant women and their spouses, to precipitate household actions that protect pregnant women. Universal home visits which share evidence and provoke discussion between pregnant women and their husbands can reduce maternal morbidity without an increased load on facilities for antenatal and delivery care.Item Ne laisser personne pour compte : les systèmes ESEC, le genre et les ODD(LE CENTRE D’EXCELLENCE sur les systèmes ESEC, 2019-01) Buvinic, Mayra; Carey, EleanorLes inégalités entre les sexes contribuent à l’exclusion des filles et des femmes les plus désavantagées des systèmes d’enregistrement de l’état civil et des systèmes d’identité nationale, ce qui exacerbe ces inégalités. En fait, l’enregistrement de l’état civil et les documents d’identité contribuent à abolir les inégalités en aidant à protéger les femmes et les filles contre les mariages d’enfants, en garantissent leurs droits successoraux et un divorce équitable, et en facilitant leur accès à la participation politique et aux services financiers modernes. Ces avantages font en sorte que les systèmes d’ESEC et d’identité ont une plus grande valeur pour les femmes que pour les hommesItem How culture shapes the sexual and reproductive health practices among adolescent girls in Eastern Equatoria, South Sudan(South Sudan medical journal (SSMJ), 2018-08) Chowdhury, Reajul; McKague, KevinBRAC (Building Resources Across Communities) studied attitudes and practices relating to adolescent sexual reproductive health and related topics. This paper reports the findings from this qualitative study. South Sudan has one of the world’s youngest populations with 72 percent below 30 years of age; 26 percent of adolescent girls (15 to 19 years) are mothers. One participant stated, “If a girl does not get pregnant at early age, people think she is barren.” When asked how many children a woman should have, a majority of participants said that a woman should give birth to eight to twelve children and, therefore, should start giving birth early. The article starts on page 56.Item Innovating for maternal and child health in Africa : a mid-term formative evaluation(2018-10) Thorsteinsdottir, Halla; Bell, Jennifer Mary; Bandyopadhyay, NandineeIn this mid-term formative evaluation, the objective is to learn from the early years of IMCHA and identify strategies that can inform and strengthen IMCHA’s implementation until the end of the initiative, as well as speak to related future activities. The evaluation addresses a total of ten evaluation questions on four themes: 1. Integrity in the design of the IMCHA model: How has the IMCHA design been operationalized, relative to the purpose and objectives of the program? 2. Integration of gender/equity dimensions: How are the components of the IMCHA initiative addressing equity-sensitive and gender dimensions at the current state of implementation? 3. Innovation and scaling: How has the focus on innovation and scale been articulated in the research projects of IMCHA? 4. Program delivery: How is the implementation of IMCHA being facilitated by IDRC, relative to the purpose and objectives?Item Harnessing CRVS systems for the gender-related SDGs - opportunities and challenges(Knowledge Brief Series on Gender, 2019-02) Badiee, Shaida; Appel, DeirdreThis paper describes how CRVS data is not only critical for reporting on the SDGs, but for guiding and implementing policies necessary to achieve them. Doing so is contingent on the usability, openness and interoperability of data, which CRVS systems help produce. It is this symbiotic relationship between data and gender-related SDGs that underscores how well-functioning CRVS systems are needed for the international development community to achieve the SDGs by 2030.Item The costs and benefits of CRVS as a tool for women's empowerment(2019-01) Espey, JessicaThis paper complements the others’ contextual analysis by focusing on some of the practical barriers to the expansion of CRVS systems, namely costs, current levels of investment, and shortfall, while also highlighting the immense investment opportunity. The two other papers are : "Leave no one behind : CRVS, Gender and the SDGS" and "Harnessing CRVS data for the gender-related SDGs; opportunities and challenges".Item Leaving no one behind : CRVS, Gender and the SDGs(Centre d'excellence sur les systèmes ESEC, 2019-01) Buvinic, Mayra; Carey, EleanorGender inequalities contribute to the exclusion of the most disadvantaged women and girls from civil registration and national ID systems, exacerbating these inequalities. Civil registration and identity documents help to redress them by helping protect women and girls against child marriage, securing inheritance rights and fair divorce, and facilitating access to political participation and modern financial services. These benefits enhance the value of CRVS and ID for women when compared to men.Item Knowledge briefs on gender and civil registration and vital statistics (CRVS)(Centre of Excellence for CRVS Systems, 2019-01) Centre of Excellence for CRVS SystemsThe Centre of Excellence for Civil Registration and Vital Statistics (CRVS) Systems at the International Development Research Centre (IDRC) advocates for strong CRVS systems to monitor progress towards gender equality, support social protection, and empower women and girls. It has set out to inspire a global commitment to integrating gender analysis across activities to strengthen CRVS systems by discussing the status of the field, evaluating opportunities and challenges, as well as identifying priority areas of research and action to improve vital event registration for women and girls.Item Reason that I did not go - determinants of use of antenatal care services in South Africa two decades after the end of Apartheid(2012) Fried, J; Sunderji, A; Birch, S; Eyles, JItem Cultural influences on the assessment of children’s pain(2009) Finley, G A; Kristjánsdóttir, Ó; Forgeron, P ACulture is commonly regarded as a factor in pain behaviour and experience, but the meaning of the term is often unclear. There is little evidence that pain perception is modified by cultural or ethnic factors, but pain expression by children and interpretation by caregivers may be affected by the culture of the patient or the caregiver. The present paper examines some of the research regarding cultural influences on children’s pain assessment, and addresses directions for future research. A focus on cultural influences should not distract clinicians from the need to be sensitive to individual beliefs and attitudes.Item Gift of Agency: Sexual Exchange Scripts among Nigerian Youth(2010) Barnett, J P; Maticka-Tyndale, E; HP4RY TeamThis article examines the practice of directly exchanging goods for sexual intercourse using data from 36 focus-group discussions with youth living in rural southern Nigeria. Conceptualizing this practice as a sexual script, the authors conduct a deductive thematic analysis framed by the broader context in which sexual exchange occurs. Combining scripting theory with an analysis of the form of the payment, it was found that the cultural script of exchange supports girls’ agency. However, at the interpersonal level of practice, this script often loses out in conflict with the cultural scripting of male control. The shape of this practice is influenced by intrapsychic scripts (e.g., sexual violence is an option), interpersonal resources (e.g., family money), and cultural scripts (e.g., stuff and status bring friends). In the final analysis, sexual exchange is found to be a script that both enables and restricts agency. It is a power niche for those with limited social and economic power, enabling them to seek and access material goods, social status, and sexual experience. It is also a means of coercing unwanted sex via peer and parental pressure, poverty, and a context of gender inequality. Implications for HIV prevention are discussed.Item Low male-to-female sex ratio of children born in India: national survey of 1.1 million households(2006-01) Jha, P; Kumar, R; Vasa, P; Dhingra, N; Thiruchelvam, DBackground: Fewer girls than boys are born in India. Various hypotheses have been proposed to explain this low sex ratio. Our aim was to ascertain the contribution of prenatal sex determination and selective abortion as measured by previous birth sex. Methods: We analysed data obtained for the Special Fertility and Mortality Survey undertaken in 1998. Ever-married women living in 1.1 million households in 6671 nationally-representative units were asked questions about their fertility history and children born in 1997. Findings: For the 133 738 births studied for 1997, the adjusted sex ratio for the second birth when the preceding child was a girl was 759 per 1000 males (99% CI 731—787). The adjusted sex ratio for the third child was 719 (675—762) if the previous two children were girls. By contrast, adjusted sex ratios for second or third births if the previous children were boys were about equal (1102 and 1176, respectively). Mothers with grade 10 or higher education had a significantly lower adjusted sex ratio (683, 610—756) than did illiterate mothers (869, 820—917). Stillbirths and neonatal deaths were more commonly male, and the numbers of stillbirths were fewer than the numbers of missing births, suggesting that female infanticide does not account for the difference. Interpretation: Prenatal sex determination followed by selective abortion of female fetuses is the most plausible explanation for the low sex ratio at birth in India. Women most clearly at risk are those who already have one or two female children. Based on conservative assumptions, the practice accounts for about 0·5 million missing female births yearly, translating over the past 2 decades into the abortion of some 10 million female fetuses.Item Role of health extension workers in improving utilization of maternal health services in rural areas in Ethopia: a cross sectional study(2012) Abrha, A; Spigt, M; Tewelde, Y; Schaay, N; Sanders, DItem Multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy(2012-05) El-Jardali, Fadi; Ataya, Nour; Jamal, Diana; Jaafar, MahaSenior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in knowledge translation (KT) activities, there are windows of opportunity for moving towards more evidence informed policymaking. A recurring positive theme was the development of new national strategic plans. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers.Item Exploring inequalities in access to and use of maternal health services in South Africa(2012-05) Silal, Sheetal P; Penn-Kekana, Loveday; Harris, Bronwyn; Birch, Stephen; McIntyre, DianeWhile health system barriers to obstetric care have been well documented, “patient-oriented” barriers have been neglected. This article explores affordability, availability and acceptability barriers to obstetric care in South Africa. Rural women face the greatest barriers, including longest travel times, highest costs associated with delivery, and lowest levels of service acceptability. Negative provider-patient interactions include: staff inattentiveness, turning away women in early-labour, shouting at patients, and insensitivity towards those who had experienced stillbirths. To achieve its MDGs, South Africa must systematically address the access constraints as well as altering the attitudes and actions of health care providers.Item Pain as the neglected adverse event(2010-04) MacLaren Chorney, Jill; McGrath, Patrick; Finley, G AllenThe article advocates for eliminating medically caused pain as a goal for health systems. Treating excessive pain as an adverse event would ensure that best practices are followed, and obstacles to adequate pain management are identified and addressed. Best practice standards have been developed, such as those by the American Society of Anesthesiologists Task Force on Acute Pain Management, the Association of Paediatric Anaesthetists in the United Kingdom, the Canadian Paediatric Society, the American Academy of Pediatrics and others. Classifying pain as an adverse event would place accountability for management at a systemic rather than at an individual level.Item Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda(2011-11) Kabakyenga, Jerome K; Östergren, Per-Olof; Turyakira, Eleanor; Pettersson, Karen OThis research indicates that prevalence of recently delivered women who had knowledge of key danger signs, or those who were birth prepared was very low. Since the majority of women attend antenatal care sessions, the quality and methods of delivery of antenatal care education require review to improve effectiveness. Young age and high levels of education had a synergistic effect on the relationship between knowledge and birth preparedness. The study explores the association between knowledge of obstetric danger signs and birth preparedness among recently delivered women in south-western Uganda.Item Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda(2011-10) Kabakyenga, Jerome K; Östergren, Per-Olof; Turyakira, Eleanor; Mukasa, Peter K; Pettersson, Karen OdbergThe study investigated the role of individual and health facility factors on the risk of obstructed labour and its adverse outcomes in south-western Uganda. A review was performed on 12,463 obstetric records (2006) from six hospitals. It was found that the risk of obstructed labour was statistically significantly associated with residence in a particular district. Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcomes. The study provides baseline information for policy makers and implementers to improve safe motherhood programmes.