A5004358688- Global Maternal and Child Health
- Maternal and Perinatal Health Interventions
- Healthcare Systems and Reforms
- Global Health Care Issues
- Mobile Health and mHealth Applications
- Adolescent Sexual and Reproductive Health
- Electronic Health Records Systems
- Maternal and fetal healthcare
- Maternal Mental Health During Pregnancy and Postpartum
- Gender, Labor, and Family Dynamics
- COVID-19 Impact on Reproduction
- Emergency and Acute Care Studies
- Healthcare Systems and Technology
- Healthcare Policy and Management
- Reproductive Health and Contraception
- Global Health Workforce Issues
- Primary Care and Health Outcomes
- Insurance and Financial Risk Management
- Medical Coding and Health Information
- Intergenerational Family Dynamics and Caregiving
- HIV/AIDS Impact and Responses
- Technology Use by Older Adults
- Child Nutrition and Water Access
- Health and Conflict Studies
- Health disparities and outcomes
London School of Hygiene & Tropical Medicine
2017-2025
University of London
2017-2020
Introduction The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the services and health outcomes. objective this study was to prospectively document experiences frontline maternal newborn healthcare providers. Methods We conducted a global, cross-sectional professionals via an online survey disseminated through professional networks social media in 12 languages. Information collected between 24...
<h3>Introduction:</h3> Electronic decision-support systems (EDSSs) aim to improve the quality of antenatal care (ANC) through adherence evidence-based guidelines. We assessed potential mHealth integrated model hypertension, diabetes, and ANC EDSS World Health Organization in primary-level health facilities Nepal. <h3>Methods:</h3> From December 2021 January 2023, we conducted a mixed-methods evaluation 19 Bagmati Province, Implementation was from March 2022 August 2022. facility survey,...
PurposeDespite efforts to expand contraceptive access for young people, few studies have considered where women (age 15–24) in low- and middle-income countries obtain modern contraceptives how the capacity content of care sources used compares with older users.MethodsWe examined first source respondents' current method using most recent Demographic Health Survey since 2000 33 sub-Saharan African countries. We classified providers according sector (public/private) provide a range short-...
Abstract Background Healthcare interventions are shaped by the resources needed to implement them, including staff time. This study, part of a process evaluation, aims compare time spent on antenatal care (ANC) and related recordkeeping in two rural primary-level health facilities Nepal, before after implementation an electronic decision support system intervention improve ANC quality that required additional documentation. Methods The study is before-and-after, observational time-motion...
Postpartum care has the potential to avert a substantial proportion of maternal and perinatal mortality morbidity. There is crucial gap in understanding quality postpartum for women giving birth health facilities low- middle-income settings. This particularly case sub-Saharan Africa (SSA), where levels neonatal are highest globally despite rapid increases facility-based childbirth. study estimated percentage receiving check following childbirth facility SSA examined determinants such...
Despite efforts to make contraceptive services more "youth friendly," unmet need for contraception among young women in sub-Saharan Africa remains high. For health systems effectively respond the reproductive needs of a growing youth population, it is imperative understand their and service seeking practices. This paper describes changes over time need, use, sources care four East African countries. We used three rounds DHS data from Kenya, Rwanda, Tanzania, Uganda examine trends 1999 2015...
Objective To assess the impact of introducing electronic decision support systems (EDSS)—electronic data entry implemented alongside existing paper-based antenatal care (ANC) records—on completeness and agreement ANC records. Design Two-phase cross-sectional (before after) substudy mobile health integrated model hypertension, diabetes (mIRA project) process evaluation. Setting Four rural districts in Bagmati Province, Nepal, 19 primary healthcare facilities. Participants records from...
Africa, and sub-Saharan Africa in particular, remains one of the regions with modest improvements to maternal newborn survival morbidity. Good quality intrapartum early postpartum care a health facility as well delivery under supervision trained personnel is associated improved outcomes decreased mortality. We describe contrast recent time trends scale socio-economic inequalities facility-based private childbirth Africa.We used Demographic Health Surveys two periods (2000-2007 2008-2016)...
Abstract Objective To prospectively document experiences of frontline maternal and newborn healthcare providers during the COVID-19 pandemic. Design Cross-sectional study via an online survey disseminated through professional networks social media in 12 languages. We analysed responses using descriptive statistics qualitative thematic analysis disaggregating by low- middle-income countries (LMICs) high-income (HICs). Setting 81 countries, between March 24 April 10, 2020. Participants 714...
Out-of-pocket (OOP) payment for modern contraception is an understudied component of healthcare financing in countries like Kenya, where wealth gradients met need have prompted efforts to expand access free contraception. This study aims examine whether, among public sector providers, the poor are more likely receive and compare how OOP injectables implants-two popular methods-differs by public/private provider type user's sociodemographic characteristics.Secondary analyses nationally...
In 2014, Egypt's Demographic and Health Survey (EDHS) documented an increase in the total fertility rate (TFR) to 3.5, up from a low of 3.0 recorded by 2008 EDHS. The has been anecdotally attributed social upheaval following January 2011 revolution, but little is known about when first began among which sub-groups women. Using birth histories seven rounds EDHS (1992-2014), this study reconstructed rates for single years 1990-2013 examined patterns childbearing five-year cohorts We found that...
The objective of this article is to assess the extent and determinants switching delivery location between women's first second deliveries. We used Demographic Health Survey data from 39 low- middle-income countries on locations >30 000 women who had their two deliveries in 5-year survey recall period. Each was characterized as occurring at home or a health facility, facilities were classified public- private-sector. estimated for each country, region overall. Multivariable logistic...
To describe trends in caesarean sections and facilities performing caesareans over time Tanzania examine the readiness of such terms infrastructure, equipment staffing. Nationally representative, repeated cross-sectional surveys women health facilities. Tanzania. Women reproductive age facility staff. Population-based rate, absolute annual number caesareans, percentage reporting to perform three indicators for safe care: availability consistent electricity, 24 hour schedule anaesthesia...
<h3>Key Messages</h3> Networks of Care (NOCs) can improve quality care, continuity and maternal newborn outcomes. They focus on relational elements that are key to health system functioning context specific. NOCs creating intentional connections between people services strengthening the functional aspects systems while incorporating emphasizing core aspects. also be used strengthen referral systems, thus promoting care. With momentum interest gathering around NOC approach, it could an...
Abstract Background India contributes 15% of the total global maternal mortality burden. An increasing proportion these deaths are due to Pregnancy Induced Hypertension (PIH), Gestational Diabetes Mellitus (GDM), and anaemia. This study aims evaluate effectiveness a tablet-based electronic decision-support system (EDSS) enhance routine antenatal care (ANC) improve screening management PIH, GDM, anaemia in pregnancy primary healthcare facilities Telangana, India. The EDSS will work at two...
Abstract Background Egypt has achieved important reductions in maternal and neonatal mortality experienced increases the proportion of births attended by skilled professionals. However, substandard care been highlighted as one avoidable causes behind persisting deaths. This paper describes changes over time use childbirth Egypt, focusing on location sector provision (public versus private) content immediate postpartum care. Methods We used five Demographic Health Surveys conducted between...
Cambodia has achieved significant progress in maternal health, yet remains the group of countries with highest mortality ratio South-East Asia. Extra efforts are needed to improve health through assessing coverage services as a continuum care (CoC) and identifying gaps. Our study aims explore level Optimal CoC by (1) measuring continuity optimal antenatal (ANC), skilled birth attendance (SBA) post-natal (PNC), (2) determinants dropping out from one service another (3) not achieving complete...
In Nigeria, the provision of public and private healthcare vary geographically, contributing to variations in one's surroundings across space. Facility-based delivery (FBD) is also spatially heterogeneous. Levels FBD are significantly lower for women certain south-eastern northern regions. The potential influence childbirth services frequented by community on individual's barriers utilization under-studied, possibly due lack suitable data. Using individual-level data, we present a novel...
The highest risk of maternal and perinatal deaths occurs during shortly after childbirth is preventable if functional referral systems enable women to reach appropriate health services when obstetric complications occur. Rising numbers deliveries in facilities, including high mortality settings like Nigeria, require formalised coordination across the system ensure that newborns get right level care, at time. This study describes critically assesses extent which its components can be captured...
In Nigeria, 59% of pregnant women deliver at home, despite evidence about the benefits childbirth in health facilities. While different modes transport can be used to access care, motorised guarantees quicker transfer compared non-motorised forms. Our study uses 2018 Nigeria Demographic and Health Survey (NDHS) describe pathways care determinants using reach this care. The most recent live birth 15–49 years within five preceding NDHS were included. main outcome was use childbirth....
Abstract Background Understanding implementation fidelity, or adherence to the intervention-as-intended, is essential interpreting results of evaluations. In this paper, we propose a longitudinal, explanatory approach fidelity through realist evaluation lens. We apply mixed-method assessment an electronic decision support system intervention improve quality antenatal care in Nepal. Methods The tablet-based was implemented 19 primary facilities As part project’s process evaluation, used four...
A strong focus on sexual and reproductive health of female adolescents is a key to achieving sustainable development goals, due the large size current cohort in low-income middle-income countries (LMICs) adolescents' biological social vulnerability. Several indicators fertility among are wide use, but contribution adolescent births all poorly understood. We propose calculate package three capturing births, stratified by parity (first second/higher).We used Demographic Health Survey data for...
Introduction Increases in facility deliveries sub-Saharan Africa have not yielded expected declines maternal mortality, raising concerns about the quality of care provided facilities. The readiness facilities at different health system levels to provide both emergency obstetric and newborn (EmONC) as well referral is unknown. We describe this combined by level region Senegal. Methods For cross-sectional study, we used data from nine Demographic Health Surveys between 1992 2017 Senegal trends...