LIVIVO - Search results -

Search results

Result 1 - 10 of total 51

Search options

Article ; Online: Quality of antenatal care in 13 sub-Saharan African countries in the SDG era: evidence from Demographic and Health Surveys.

Ameyaw, Edward Kwabena / Baatiema, Linus / Naawa, Ambrose / Odame, Frederick / Koramah, Doris / Arthur-Holmes, Francis / Frimpong, Shadrack Osei / Hategeka, Celestin

BMC pregnancy and childbirth

2024 Volume 24, Issue 1, Page(s) 303

Abstract: Background: Maternal and neonatal mortality remains high in sub-Saharan Africa (SSA) with women having 1 in 36 lifetime risk. The WHO launched the new comprehensive recommendations/guidelines on antenatal care (ANC) in 2016, which stresses the essence ... ...

Abstract	Background: Maternal and neonatal mortality remains high in sub-Saharan Africa (SSA) with women having 1 in 36 lifetime risk. The WHO launched the new comprehensive recommendations/guidelines on antenatal care (ANC) in 2016, which stresses the essence of quality antenatal care. Consequently, the objective of this cross-sectional study is to investigate the quality of ANC in 13 SSA countries. Methods: This is a cross-sectional study that is premised on pre-existing secondary data, spanning 2015 to 2021. Data for the study was obtained from the Measure DHS Programme and included a total of 79,725 women aged 15-49 were included. The outcome variable was quality ANC and it was derived as a composite variable from four main ANC services: blood pressure taken, urine taken, receipt of iron supplementation and blood sample taken. Thirteen independent variables were included and broadly categorised into individual and community-level characteristics. Descriptive statistics were used to present the proportion of women who had quality ANC across the respective countries. A two-level multilevel regression analysis was conducted to ascertain the direction of association between quality ANC and the independent variables. Results: The overall average of women who had quality ANC was 53.8% [CI = 51.2,57.5] spanning from 82.3% [CI = 80.6,85.3] in Cameroon to 11% [CI = 10.0, 11.4] in Burundi. Women with secondary/higher education had higher odds of obtaining quality ANC compared with those without formal education [aOR = 1.23, Credible Interval [Crl] = 1.10,1.37]. Poorest women were more likely to have quality ANC relative to the richest women [aOR = 1.21, Crl = 1.14,1.27]. Married women were more likely to receive quality ANC relative to those cohabiting [aOR = 2.04, Crl = 1.94,3.05]. Women who had four or more ANC visits had higher odds of quality ANC [aOR = 2.21, Crl = 2.04,2.38]. Variation existed in receipt of quality ANC at the community-level [σ Conclusion: To achieve significant improvement in the coverage of quality ANC, the focus of maternal health interventions ought to prioritise uneducated women, those cohabiting, and those who are unable to have at least four ANCs. Further, ample recognition should be accorded to the existing and potential facilitators and barriers to quality ANC across and within countries.
MeSH term(s)	Humans ; Female ; Prenatal Care/statistics & numerical data ; Prenatal Care/standards ; Adult ; Africa South of the Sahara ; Cross-Sectional Studies ; Pregnancy ; Adolescent ; Young Adult ; Quality of Health Care ; Middle Aged ; Health Surveys ; Socioeconomic Factors
Language	English
Publishing date	2024-04-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-024-06459-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Article ; Online: Addressing missing values in routine health information system data: an evaluation of imputation methods using data from the Democratic Republic of the Congo during the COVID-19 pandemic.

Feng, Shuo / Hategeka, Celestin / Grépin, Karen Ann

Population health metrics

2021 Volume 19, Issue 1, Page(s) 44

Abstract: Background: Poor data quality is limiting the use of data sourced from routine health information systems (RHIS), especially in low- and middle-income countries. An important component of this data quality issue comes from missing values, where health ... ...

Abstract	Background: Poor data quality is limiting the use of data sourced from routine health information systems (RHIS), especially in low- and middle-income countries. An important component of this data quality issue comes from missing values, where health facilities, for a variety of reasons, fail to report to the central system. Methods: Using data from the health management information system in the Democratic Republic of the Congo and the advent of COVID-19 pandemic as an illustrative case study, we implemented seven commonly used imputation methods and evaluated their performance in terms of minimizing bias in imputed values and parameter estimates generated through subsequent analytical techniques, namely segmented regression, which is widely used in interrupted time series studies, and pre-post-comparisons through paired Wilcoxon rank-sum tests. We also examined the performance of these imputation methods under different missing mechanisms and tested their stability to changes in the data. Results: For regression analyses, there were no substantial differences found in the coefficient estimates generated from all methods except mean imputation and exclusion and interpolation when the data contained less than 20% missing values. However, as the missing proportion grew, k-NN started to produce biased estimates. Machine learning algorithms, i.e. missForest and k-NN, were also found to lack robustness to small changes in the data or consecutive missingness. On the other hand, multiple imputation methods generated the overall most unbiased estimates and were the most robust to all changes in data. They also produced smaller standard errors than single imputations. For pre-post-comparisons, all methods produced p values less than 0.01, regardless of the amount of missingness introduced, suggesting low sensitivity of Wilcoxon rank-sum tests to the imputation method used. Conclusions: We recommend the use of multiple imputation in addressing missing values in RHIS datasets and appropriate handling of data structure to minimize imputation standard errors. In cases where necessary computing resources are unavailable for multiple imputation, one may consider seasonal decomposition as the next best method. Mean imputation and exclusion and interpolation, however, always produced biased and misleading results in the subsequent analyses, and thus, their use in the handling of missing values should be discouraged.
MeSH term(s)	COVID-19 ; Democratic Republic of the Congo/epidemiology ; Health Information Systems ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-11-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2127230-X
ISSN	1478-7954 ; 2155-7772
ISSN (online)	1478-7954
ISSN	2155-7772
DOI	10.1186/s12963-021-00274-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Addressing missing values in routine health information system data

Shuo Feng / Celestin Hategeka / Karen Ann Grépin

Population Health Metrics, Vol 19, Iss 1, Pp 1-

an evaluation of imputation methods using data from the Democratic Republic of the Congo during the COVID-19 pandemic

2021 Volume 14

Abstract: Abstract Background Poor data quality is limiting the use of data sourced from routine health information systems (RHIS), especially in low- and middle-income countries. An important component of this data quality issue comes from missing values, where ... ...

Abstract	Abstract Background Poor data quality is limiting the use of data sourced from routine health information systems (RHIS), especially in low- and middle-income countries. An important component of this data quality issue comes from missing values, where health facilities, for a variety of reasons, fail to report to the central system. Methods Using data from the health management information system in the Democratic Republic of the Congo and the advent of COVID-19 pandemic as an illustrative case study, we implemented seven commonly used imputation methods and evaluated their performance in terms of minimizing bias in imputed values and parameter estimates generated through subsequent analytical techniques, namely segmented regression, which is widely used in interrupted time series studies, and pre–post-comparisons through paired Wilcoxon rank-sum tests. We also examined the performance of these imputation methods under different missing mechanisms and tested their stability to changes in the data. Results For regression analyses, there were no substantial differences found in the coefficient estimates generated from all methods except mean imputation and exclusion and interpolation when the data contained less than 20% missing values. However, as the missing proportion grew, k-NN started to produce biased estimates. Machine learning algorithms, i.e. missForest and k-NN, were also found to lack robustness to small changes in the data or consecutive missingness. On the other hand, multiple imputation methods generated the overall most unbiased estimates and were the most robust to all changes in data. They also produced smaller standard errors than single imputations. For pre–post-comparisons, all methods produced p values less than 0.01, regardless of the amount of missingness introduced, suggesting low sensitivity of Wilcoxon rank-sum tests to the imputation method used. Conclusions We recommend the use of multiple imputation in addressing missing values in RHIS datasets and appropriate handling of data ...
Keywords	Missing data ; Routine health information systems (RHIS) ; Health management information system (HMIS) ; Health services research ; Low- and middle-income countries (LMICs) ; Multiple imputation ; Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Subject code	310
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article: Temporal trends in coverage, quality and equity of maternal and child health services in Rwanda, 2000-2015.

Hategeka, Celestin / Arsenault, Catherine / Kruk, Margaret E

BMJ global health

2020 Volume 5, Issue 11

Abstract: Introduction: Achieving the maternal and child health (MCH)-related Sustainable Development Goals (SDG) will require equitable and effective (quality-adjusted) coverage of recommended health interventions in low- and middle-income countries. We assessed ...

Abstract	Introduction: Achieving the maternal and child health (MCH)-related Sustainable Development Goals (SDG) will require equitable and effective (quality-adjusted) coverage of recommended health interventions in low- and middle-income countries. We assessed effective coverage and equity of MCH services in Rwanda in the Millennium Development Goal (MDG) era to help guide policy decisions to improve equitable health gains in the SDG era and beyond. Methods: Using four rounds of Rwanda demographic and health surveys conducted from 2000 to 2015, we identified coverage and quality indicators for five MCH services: antenatal care (ANC), delivery care, and care for child diarrhoea, suspected pneumonia and fever. We calculated crude coverage and quality in each survey and used these to estimate effective coverage. The effective coverage should be regarded as an upper bound because there were few available quality measures. We also described equity in effective coverage of these five MCH services over time across the wealth index, area of residence and maternal education using equiplots. Results: A total of 48 910 women aged 15-49 years and 33 429 children under 5 years were included across the four survey rounds. In 2015, average effective coverage was 33.2% (range 19.9%-44.2%) across all five MCH services, 30.1% (range 19.9%-40.2%) for maternal health services (average of ANC and delivery) and 35.3% (range 27.3%-44.2%) for sick child care (diarrhoea, pneumonia and fever). This is in contrast to crude coverage which averaged 56.5% (range 43.6%-90.7%) across all five MCH services, 67.3% (range 43.9%-90.7%) for maternal health services and 49.2% (range 43.6%-53.9%) for sick child care. Between 2010 and 2015 effective coverage increased by 154.2% (range 127.3%-170.0%) for maternal health services and by 27.4% (range 4.2%-79.6%) for sick child care. These increases were associated with widening socioeconomic inequalities in effective coverage for maternal health services, and narrowing inequalities in effective coverage for sick child care. Conclusion: While effective coverage of common MCH services generally improved in the MDG era, it still lagged substantially behind crude coverage for the same services due to low-quality care. Overall, effective coverage of MCH services remained suboptimal and inequitable. Policies should focus on improving effective coverage of these services and reducing inequities.
MeSH term(s)	Child ; Child, Preschool ; Female ; Humans ; Maternal Health Services ; Maternal-Child Health Services ; Pregnancy ; Prenatal Care ; Rwanda/epidemiology ; Socioeconomic Factors
Language	English
Publishing date	2020-11-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2020-002768
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Health system adaptions to improve care for people living with non-communicable diseases during COVID-19 in low-middle income countries: A scoping review.

Baatiema, Leonard / Sanuade, Olutobi A / Allen, Luke N / Abimbola, Seye / Hategeka, Celestin / Koram, Kwadwo A / Kruk, Margaret E

Journal of global health

2023 Volume 13, Page(s) 6006

Abstract: Background: During the COVID-19 pandemic, access to health care for people living with non-communicable diseases (NCDs) has been significantly disrupted. Calls have been made to adapt health systems and innovate service delivery models to improve access ...

Abstract	Background: During the COVID-19 pandemic, access to health care for people living with non-communicable diseases (NCDs) has been significantly disrupted. Calls have been made to adapt health systems and innovate service delivery models to improve access to care. We identified and summarized the health systems adaptions and interventions implemented to improve NCD care and their potential impact on low- and middle-income countries (LMICs). Methods: We comprehensively searched Medline/PubMed, Embase, CINAHL, Global Health, PsycINFO, Global Literature on coronavirus disease, and Web of Science for relevant literature published between January 2020 and December 2021. While we targeted articles written in English, we also included papers published in French with abstracts written in English. Results: After screening 1313 records, we included 14 papers from six countries. We identified four unique health systems adaptations/interventions for restoring, maintaining, and ensuring continuity of care for people living with NCDs: telemedicine or teleconsultation strategies, NCD medicine drop-off points, decentralization of hypertension follow-up services and provision of free medication to peripheral health centers, and diabetic retinopathy screening with a handheld smartphone-based retinal camera. We found that the adaptations/interventions enhanced continuity of NCD care during the pandemic and helped bring health care closer to patients using technology and easing access to medicines and routine visits. Telephonic aftercare services appear to have saved a significant amount of patients' time and funds. Hypertensive patients recorded better blood pressure controls over the follow-up period. Conclusions: Although the identified measures and interventions for adapting health systems resulted in potential improvements in access to NCD care and better clinical outcomes, further exploration is needed to establish the feasibility of these adaptations/interventions in different settings given the importance of context in their successful implementation. Insights from such implementation studies are critical for ongoing health systems strengthening efforts to mitigate the impact of COVID-19 and future global health security threats for people living with NCDs.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Developing Countries ; Government Programs/organization & administration ; Government Programs/standards ; Hypertension/epidemiology ; Hypertension/therapy ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/therapy ; Pandemics ; Delivery of Health Care/organization & administration ; Delivery of Health Care/standards ; Health Services Accessibility/organization & administration ; Health Services Accessibility/standards ; Internationality
Language	English
Publishing date	2023-03-03
Publishing country	Scotland
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2986
ISSN (online)	2047-2986
ISSN	2047-2986
DOI	10.7189/iogh.13.06006
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Health related quality of life of patients undergoing in-centre hemodialysis in Rwanda: a cross sectional study.

Shumbusho, Gloria / Hategeka, Celestin / Vidler, Marianne / Kabahizi, Jules / McKnight, Marla

BMC nephrology

2022 Volume 23, Issue 1, Page(s) 345

Abstract: Background: There are few studies assessing the quality of life of patients with chronic and end stage kidney disease in sub-Saharan Africa. We aimed to describe the health-related quality of life (HRQOL) of patients undergoing in-centre maintenance ... ...

Abstract	Background: There are few studies assessing the quality of life of patients with chronic and end stage kidney disease in sub-Saharan Africa. We aimed to describe the health-related quality of life (HRQOL) of patients undergoing in-centre maintenance hemodialysis in Rwanda using the KDQOL™-36 and determine sociodemographic and clinical factors associated with their quality of life. Methods: We conducted a multicenter, cross-sectional study between September 2020 and July 2021. Patients over the age of 18 receiving maintenance in-centre hemodialysis for at least three months at the Rwandan tertiary hospitals were administered the KDQOL™-36 questionnaire to assess physical and mental health functioning, the effect, burden and symptoms and problem of kidney disease. Sociodemographic and clinical information was collected for all eligible patients. Using mixed effects linear regression models, we explored factors associated with overall KDQOL and its domains, while accounting for clustering of patients within hemodialysis centres. Results: Eighty-nine eligible patients were included in the study. The majority of participants were younger than 60 years old (69.7%), male (66.3%), had comorbidities (91%), and 71.6% were categorized as level 3 on a 4 tier in-country poverty scale. All participants had health insurance coverage, with 67.4% bearing no out of pocket payments for hemodialysis. The median (IQR) quality of life score was 45.1 (29.4) for overall HRQOL, 35.0 (17.9) for PCS and 41.7 (17.7) for MCS. Symptoms and problem of kidney disease, effect of kidney disease, and burden of kidney disease scored 58.3 (43.8), 56.3 (18.8) and 18.8 (37.5), respectively. A notable difference of KDQOL scores between hemodialysis centres was observed. Overall KDQOL was associated with male sex (adjusted ß coefficient [aß]: 8.5, 95% confidence interval [CI]: 2.8, 14.3); being employed (aß: 8.2, 95% CI: 2.2, 14.3); dialysis vintage of 13-24 months (aß: 10.5, 95% CI: 3.6, 17.6), hemoglobin of 10-11 g/dl (aß: 7.3, 95% CI: 0.7, 13.7) and comorbidities (e.g., ≥ 3 comorbidities vs. none) (aß: -29.8, 95% CI: -41.5, -18.3). Conclusion: Patients on in-centre hemodialysis in Rwanda have reduced KDQOL scores, particularly in the burden of kidney disease and physical composite summary domains. Higher overall KDQOL mean score was associated with male sex, being employed, and dialysis vintage of 13-24 months, hemoglobin of 10-11 g/dl and absence of comorbidities. The majority of patients receiving in-centre hemodialysis have higher socioeconomic status reflecting the social and financial constraints to access and maintain dialysis in resource limited settings.
MeSH term(s)	Adult ; Humans ; Male ; Middle Aged ; Cross-Sectional Studies ; Kidney Diseases/etiology ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/etiology ; Quality of Life/psychology ; Renal Dialysis/adverse effects ; Rwanda/epidemiology
Language	English
Publishing date	2022-10-27
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-022-02958-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Temporal trends in coverage, quality and equity of maternal and child health services in Rwanda, 2000–2015

Margaret E Kruk / Catherine Arsenault / Celestin Hategeka

BMJ Global Health, Vol 5, Iss

2020 Volume 11

Abstract: Introduction Achieving the maternal and child health (MCH)-related Sustainable Development Goals (SDG) will require equitable and effective (quality-adjusted) coverage of recommended health interventions in low- and middle-income countries. We assessed ... ...

Abstract	Introduction Achieving the maternal and child health (MCH)-related Sustainable Development Goals (SDG) will require equitable and effective (quality-adjusted) coverage of recommended health interventions in low- and middle-income countries. We assessed effective coverage and equity of MCH services in Rwanda in the Millennium Development Goal (MDG) era to help guide policy decisions to improve equitable health gains in the SDG era and beyond.Methods Using four rounds of Rwanda demographic and health surveys conducted from 2000 to 2015, we identified coverage and quality indicators for five MCH services: antenatal care (ANC), delivery care, and care for child diarrhoea, suspected pneumonia and fever. We calculated crude coverage and quality in each survey and used these to estimate effective coverage. The effective coverage should be regarded as an upper bound because there were few available quality measures. We also described equity in effective coverage of these five MCH services over time across the wealth index, area of residence and maternal education using equiplots.Results A total of 48 910 women aged 15–49 years and 33 429 children under 5 years were included across the four survey rounds. In 2015, average effective coverage was 33.2% (range 19.9%–44.2%) across all five MCH services, 30.1% (range 19.9%–40.2%) for maternal health services (average of ANC and delivery) and 35.3% (range 27.3%–44.2%) for sick child care (diarrhoea, pneumonia and fever). This is in contrast to crude coverage which averaged 56.5% (range 43.6%–90.7%) across all five MCH services, 67.3% (range 43.9%–90.7%) for maternal health services and 49.2% (range 43.6%–53.9%) for sick child care. Between 2010 and 2015 effective coverage increased by 154.2% (range 127.3%–170.0%) for maternal health services and by 27.4% (range 4.2%–79.6%) for sick child care. These increases were associated with widening socioeconomic inequalities in effective coverage for maternal health services, and narrowing inequalities in effective coverage for sick ...
Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
Subject code	360
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Burden of post-traumatic stress disorder acute exacerbations during the commemorations of the genocide against Tutsis in Rwanda: a cross-sectional study.

Kabakambira, Jean Damascene / Uwera, Gladys / Hategeka, Marthe / Kayitesi, Marie Louise / Malu, Célestin Kaputu Kalala / Hategeka, Celestin

The Pan African medical journal

2018 Volume 30, Page(s) 216

Abstract: Introduction: Following the 1994 genocide against Tutsis in Rwanda, the prevalence of post-traumatic stress disorder (PTSD) is high. In a period of seven days every year in April, Rwandans gather to mourn the victims of the genocide. During this ... ...

Abstract	Introduction: Following the 1994 genocide against Tutsis in Rwanda, the prevalence of post-traumatic stress disorder (PTSD) is high. In a period of seven days every year in April, Rwandans gather to mourn the victims of the genocide. During this commemoration period, survivors living with chronic PTSD experience PTSD acute exacerbations (PAE). We assessed factors associated with severe PAE during the annual commemoration period of the genocide against Tutsis in Rwanda. Methods: We carried out a retrospective cross-sectional study that included people who had PAE during the commemoration week in April 2011 across Huye District in Rwanda. Our outcome measure was PAE categorized into three levels: < 15 minutes, 15-30 minutes, and > 30 minutes. Ordinal logistic regression analyses were performed to identify factors associated with severe PAE. Results: We enrolled 383 people with PAE, of whom 71.8% were female and 53.5% were aged 20-45 years. All participants reported history of PAE, of which 59.8% had experienced more than two PAE during the previous commemoration periods. 33.2% had PAE that lasted > 30 minutes. History of PAE (> twice) (OR = 1.86; 95% CI = 1.27-2.75) and having lost a partner in genocide (OR = 2.19; 95% CI = 1.01-4.81) were associated with severe PAE, after adjusting for sex and age. Conclusion: Our findings suggest that PAE is frequent during the commemoration periods. People who reported having more prior PAE and being widow (er) were more likely to have severe PAE. While history of PAE and bereavement status are non-modifiable factors, our findings could help identify and target these people who are at risk for severe PAE.
MeSH term(s)	Acute Disease ; Adult ; Chronic Disease ; Cross-Sectional Studies ; Ethnicity/psychology ; Female ; Genocide/psychology ; Grief ; Humans ; Logistic Models ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Prevalence ; Retrospective Studies ; Rwanda/epidemiology ; Severity of Illness Index ; Stress Disorders, Post-Traumatic/epidemiology ; Survivors/psychology ; Young Adult
Language	English
Publishing date	2018-07-17
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2018.30.216.15663
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Effect of a community health worker mHealth monitoring system on uptake of maternal and newborn health services in Rwanda.

Hategeka, Celestin / Ruton, Hinda / Law, Michael R

Global health research and policy

2019 Volume 4, Page(s) 8

Abstract: Background: In an effort to improve access to proven maternal and newborn health interventions, Rwanda implemented a mobile phone (mHealth) monitoring system called RapidSMS. RapidSMS was scaled up across Rwanda in 2013. The objective of this study was ... ...

Abstract	Background: In an effort to improve access to proven maternal and newborn health interventions, Rwanda implemented a mobile phone (mHealth) monitoring system called RapidSMS. RapidSMS was scaled up across Rwanda in 2013. The objective of this study was to evaluate the impact of RapidSMS on the utilization of maternal and newborn health services in Rwanda. Methods: Using data from the 2014/15 Rwanda demographic and health survey, we identified a cohort of women aged 15-49 years who had a live birth that occurred between 2010 and 2014. Using interrupted time series design, we estimated the impact of RapidSMS on uptake of maternal and newborn health services including antenatal care (ANC), health facility delivery and vaccination coverage. Results: Overall, the coverage rate at baseline for ANC (at least one visit), health facility delivery and vaccination was very high (> 90%). The baseline rate was 50.30% for first ANC visit during the first trimester and 40.57% for at least four ANC visits. We found no evidence that implementing RapidSMS was associated with an immediate increase in ANC (level change: -1.00% (95% CI: -2.30 to 0.29) for ANC visit at least once, -1.69% (95% CI: -9.94 to 6.55) for ANC (at least 4 visits), -3.80% (95% CI: -13.66 to 6.05) for first ANC visit during the first trimester), health facility delivery (level change: -1.79, 95% CI: -6.16 to 2.58), and vaccination coverage (level change: 0.58% (95%CI: -0.38 to 1.55) for BCG, -0.75% (95% CI: -6.18 to 4.67) for polio 0). Moreover, there was no significant trend change across the outcomes studied. Conclusion: Based on survey data, the implementation of RapidSMS did not appear to increase uptake of the maternal and newborn health services we studied in Rwanda. In most instances, this was because the existing level of the indicators we studied was very high (ceiling effect), leaving little room for potential improvement. RapidSMS may work in contexts where improvement remains to be made, but not for indicators that are already very high. As such, further research is required to understand why RapidSMS had no impact on indicators where there was enough room for improvement.
Language	English
Publishing date	2019-03-22
Publishing country	England
Document type	Journal Article
ISSN	2397-0642
ISSN (online)	2397-0642
DOI	10.1186/s41256-019-0098-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Effects of scaling up various community-level interventions on child mortality in Burundi, Kenya, Rwanda, Uganda and Tanzania: a modeling study.

Hategeka, Celestin / Tuyisenge, Germaine / Bayingana, Christian / Tuyisenge, Lisine

Global health research and policy

2019 Volume 4, Page(s) 1

Abstract: Background: Improving child health remains one of the most significant health challenges in sub-Saharan Africa, a region that accounts for half of the global burden of under-five mortality despite having approximately 13% of the world population and 25% ...

Abstract	Background: Improving child health remains one of the most significant health challenges in sub-Saharan Africa, a region that accounts for half of the global burden of under-five mortality despite having approximately 13% of the world population and 25% of births globally. Improving access to evidence-based community-level interventions has increasingly been advocated to contribute to reducing child mortality and, thus, help low-and middle-income countries (LMICs) achieve the child health related Sustainable Development Goal (SDG) target. Nevertheless, the coverage of community-level interventions remains suboptimal. In this study, we estimated the potential impact of scaling up various community-level interventions on child mortality in five East African Community (EAC) countries (i.e., Burundi, Kenya, Rwanda, Uganda and the United Republic of Tanzania). Methods: We identified ten preventive and curative community-level interventions that have been reported to reduce child mortality: Breastfeeding promotion, complementary feeding, vitamin A supplementation, Zinc for treatment of diarrhea, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution (ORS), oral antibiotics for treatment of pneumonia, treatment for moderate acute malnutrition (MAM), and prevention of malaria using insecticide-treated nets and indoor residual spraying (ITN/IRS). Using the Lives Saved Tool, we modeled the impact on child mortality of scaling up these 10 interventions from baseline coverage (2016) to ideal coverage (99%) by 2030 (ideal scale-up scenario) relative to business as usual (BAU) scenario (forecasted coverage based on prior coverage trends). Our outcome measures include number of child deaths prevented. Results: Compared to BAU scenario, ideal scale-up of the 10 interventions could prevent approximately 74,200 (sensitivity bounds 59,068-88,611) child deaths by 2030 including 10,100 (8210-11,870) deaths in Burundi, 10,300 (7831-12,619) deaths in Kenya, 4350 (3678-4958) deaths in Rwanda, 20,600 (16049-25,162) deaths in Uganda, and 28,900 (23300-34,002) deaths in the United Republic of Tanzania. The top four interventions (oral antibiotics for pneumonia, ORS, hand washing with soap, and treatment for MAM) account for over 75.0% of all deaths prevented in each EAC country: 78.4% in Burundi, 76.0% in Kenya, 81.8% in Rwanda, 91.0% in Uganda and 88.5% in the United Republic of Tanzania. Conclusions: Scaling up interventions that can be delivered at community level by community health workers could contribute to substantial reduction of child mortality in EAC and could help the EAC region achieve child health-related SDG target. Our findings suggest that the top four community-level interventions could account for more than three-quarters of all deaths prevented across EAC countries. Going forward, costs of scaling up each intervention will be estimated to guide policy decisions including health resource allocations in EAC countries.
Language	English
Publishing date	2019-05-29
Publishing country	England
Document type	Journal Article
ISSN	2397-0642
ISSN (online)	2397-0642
DOI	10.1186/s41256-019-0106-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

To top

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

Inter-library loan at ZB MED