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  1. Article ; Online: Child and adolescent deaths: a call for strengthening mortality surveillance systems.

    Fadel, Shaza A / Amouzou, Agbessi

    The Lancet. Global health

    2022  Volume 10, Issue 3, Page(s) e299–e300

    MeSH term(s) Adolescent ; Cause of Death ; Child ; Family ; Humans ; Population Surveillance
    Language English
    Publishing date 2022-02-18
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2723488-5
    ISSN 2214-109X ; 2214-109X
    ISSN (online) 2214-109X
    ISSN 2214-109X
    DOI 10.1016/S2214-109X(22)00009-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: There is no right time for accountability for women's, children's and adolescents' health.

    Amouzou, Agbessi / Walker, Neff

    Global health action

    2022  Volume 15, Issue sup1, Page(s) 2067399

    MeSH term(s) Adolescent ; Adolescent Health ; Child ; Female ; Humans ; Social Responsibility
    Language English
    Publishing date 2022-09-28
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2540569-X
    ISSN 1654-9880 ; 1654-9880
    ISSN (online) 1654-9880
    ISSN 1654-9880
    DOI 10.1080/16549716.2022.2067399
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Is there a prospect for mass drug administration of azithromycin to reduce child mortality in sub-Saharan Africa?

    Amouzou, Agbessi

    BMJ evidence-based medicine

    2019  Volume 24, Issue 5, Page(s) e7–e8

    MeSH term(s) Child, Preschool ; Humans ; Infant ; Africa South of the Sahara ; Azithromycin/administration & dosage ; Child Mortality ; Infant Mortality ; Mass Drug Administration
    Chemical Substances Azithromycin (83905-01-5)
    Language English
    Publishing date 2019-01-03
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2515-4478
    ISSN (online) 2515-4478
    DOI 10.1136/bmjebm-2018-111135
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  4. Article ; Online: Delays in accessing high-quality care for newborns in East Africa: An analysis of survey data in Malawi, Mozambique, and Tanzania.

    Niehaus, Lori / Sheffel, Ashley / Kalter, Henry D / Amouzou, Agbessi / Koffi, Alain K / Munos, Melinda K

    Journal of global health

    2024  Volume 14, Page(s) 4022

    Abstract: Background: Despite the existence of evidence-based interventions, substantial progress in reducing neonatal mortality is lagging, indicating that small and sick newborns (SSNs) are likely not receiving the care they require to survive and thrive. The ' ... ...

    Abstract Background: Despite the existence of evidence-based interventions, substantial progress in reducing neonatal mortality is lagging, indicating that small and sick newborns (SSNs) are likely not receiving the care they require to survive and thrive. The 'three delays model' provides a framework for understanding the challenges in accessing care for SSNs. However, the extent to which each delay impacts access to care for SSNs is not well understood. To fill this evidence gap, we explored the impact of each of the three delays on access to care for SSNs in Malawi, Mozambique, and Tanzania.
    Methods: Secondary analyses of data from three different surveys served as the foundation of this study. To understand the impact of delays in the decision to seek care (delay 1) and the ability to reach an appropriate point of care (delay 2), we investigated time trends in place of birth disaggregated by facility type. We also explored care-seeking behaviours for newborns who died. To understand the impact of delays in accessing high-quality care after reaching a facility (delay 3), we measured facility readiness to manage care for SSNs. We used this measure to adjust institutional delivery coverage for SSN care readiness.
    Results: Coverage of institutional deliveries was substantially lower after adjusting for facility readiness to manage SSN care, with decreases of 30 percentage points (pp) in Malawi, 14 pp in Mozambique, and 24 pp in Tanzania. While trends suggest more SSNs are born in facilities, substantial gaps remain in facilities' capacities to provide lifesaving interventions. In addition, exploration of care-seeking pathways revealed that a substantial proportion of newborn deaths occurred outside of health facilities, indicating barriers in the decision to seek care or the ability to reach an appropriate source of care may also prevent SSNs from receiving these interventions.
    Conclusions: Investments are needed to overcome delays in accessing high-quality care for the most vulnerable newborns, those who are born small or sick. As more mothers and newborns access health services in low- and middle-income countries, ensuring that life-saving interventions for SSNs are available at the locations where newborns are born and seek care after birth is critical.
    MeSH term(s) Female ; Infant, Newborn ; Humans ; Tanzania ; Malawi ; Mozambique ; Patient Acceptance of Health Care ; Health Services Accessibility
    Language English
    Publishing date 2024-02-09
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 2741629-X
    ISSN 2047-2986 ; 2047-2986
    ISSN (online) 2047-2986
    ISSN 2047-2986
    DOI 10.7189/jogh.14.04022
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  5. Article ; Online: The importance of improving intervention coverage measurement for ensuring all women, children and adolescents are reached with the health care services they need.

    Requejo, Jennifer / Amouzou, Agbessi

    Journal of global health

    2020  Volume 10, Issue 1, Page(s) 10102

    MeSH term(s) Adolescent ; Child ; Child Health Services ; Child Mortality/trends ; Female ; Global Health ; Health Services Accessibility ; Humans ; Maternal Mortality/trends ; Prenatal Care ; Sustainable Development
    Language English
    Publishing date 2020-03-31
    Publishing country Scotland
    Document type Editorial
    ZDB-ID 2741629-X
    ISSN 2047-2986 ; 2047-2986
    ISSN (online) 2047-2986
    ISSN 2047-2986
    DOI 10.7189/jogh.10.010102
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  6. Article ; Online: Strengthening routine health information systems for analysis and data use: a tipping point.

    Amouzou, Agbessi / Faye, Cheikh / Wyss, Kaspar / Boerma, Ties

    BMC health services research

    2021  Volume 21, Issue Suppl 1, Page(s) 618

    MeSH term(s) Health Information Systems ; Humans ; Models, Biological
    Language English
    Publishing date 2021-09-13
    Publishing country England
    Document type Editorial
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-021-06648-1
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  7. Article ; Online: Strengthening effectiveness evaluations to improve programs for women, children and adolescents.

    Amouzou, Agbessi / Bryce, Jennifer / Walker, Neff

    Global health action

    2022  Volume 15, Issue sup1, Page(s) 2006423

    Abstract: A full understanding of the pathways from efficacious interventions to population impact requires rigorous effectiveness evaluations conducted under realistic scale-up conditions at country level. In this paper, we introduce a deductive framework that ... ...

    Abstract A full understanding of the pathways from efficacious interventions to population impact requires rigorous effectiveness evaluations conducted under realistic scale-up conditions at country level. In this paper, we introduce a deductive framework that underpins effectiveness evaluations. This framework forms the theoretical and conceptual basis for the 'Real Accountability: Data Analysis for Results' (RADAR) project, intended to address gaps in guidance and tools for the evaluation of projects being implemented at scale to reduce mortality among women and children. These gaps include needs for a framework to guide decisions about evaluations and practical measurement tools, as well as increased capacity in evaluation practice among donors and program planners at global, national and project levels. RADAR aimed to improve the evidence base for program and policy decisions in reproductive, maternal, newborn and child health and nutrition (RMNCH&N). We focus on five linked methodological steps - presented as core evaluation questions - for designing and implementing effectiveness evaluation of large-scale programs that support both the needs of program managers to improve their programs and the needs of donors to meet their accountability responsibilities. RADAR has operationalized each step with a tool to facilitate its application. We also describe cross-cutting methodological issues and broader contextual factors that affect the planning and implementation of such evaluations. We conclude with proposals for how the global RMNCH&N community can support rigorous program evaluations and make better use of the resulting evidence.
    MeSH term(s) Adolescent ; Child ; Female ; Global Health ; Humans ; Infant, Newborn ; Nutritional Status ; Program Evaluation/methods
    Language English
    Publishing date 2022-09-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2540569-X
    ISSN 1654-9880 ; 1654-9880
    ISSN (online) 1654-9880
    ISSN 1654-9880
    DOI 10.1080/16549716.2021.2006423
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  8. Article ; Online: Strengthening routine health information systems for analysis and data use

    Agbessi Amouzou / Cheikh Faye / Kaspar Wyss / Ties Boerma

    BMC Health Services Research, Vol 21, Iss S1, Pp 1-

    a tipping point

    2021  Volume 4

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Implementing the Countrywide Mortality Surveillance in Action in Mozambique: How Much Did It Cost?

    Jiwani, Safia S / Mavie, Victor Américo / Williams, Emma / Kante, Almamy Malick / Amouzou, Agbessi

    The American journal of tropical medicine and hygiene

    2023  Volume 108, Issue 5_Suppl, Page(s) 40–46

    Abstract: Complete sample registration systems are almost inexistent in sub-Saharan Africa. The Countrywide Mortality Surveillance in Action (COMSA) project in Mozambique, a national mortality and cause of death surveillance system, was launched in January 2017, ... ...

    Abstract Complete sample registration systems are almost inexistent in sub-Saharan Africa. The Countrywide Mortality Surveillance in Action (COMSA) project in Mozambique, a national mortality and cause of death surveillance system, was launched in January 2017, began data collection in March 2018, and covers over 800,000 population. The objectives of this analysis are to quantify the costs of establishing and maintaining the project between 2017 and 2020 and to assess the cost per output of the surveillance system using data from financial reports produced by the National Institute of Health in Mozambique. The program cost analysis consists of start-up (fixed) costs and average annual operating costs covering the period of maximum implementation in 700 clusters. The cost per output analysis quantifies the annual operating cost of surveillance outputs during the same period. Approximately two million dollars were spent on setting up the system, with infrastructure, technological investments, and training making up over 80% of these start-up costs. The average annual operating costs of maintaining COMSA was $984,771 per year, of which 66% were spent on wages and data collection incentives. The cost per output analysis indicates costs of $37-$42 per vital event captured in the surveillance system (deaths, pregnancies, pregnancy outcomes), $303-$340 per verbal and social autopsy conducted on a reported death, and a per capita cost of $1-$1.3. In conclusion, establishing COMSA required large costs associated with infrastructure and technological investments. However, the system offers long-term benefits for real-time data generation and informing government decision-making for health.
    MeSH term(s) Pregnancy ; Female ; Humans ; Mozambique/epidemiology ; Costs and Cost Analysis ; Data Collection ; Rural Population
    Language English
    Publishing date 2023-04-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.22-0438
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  10. Article ; Online: The impact of the COVID-19 pandemic on trends in stillbirths, under-5 and maternal mortality in Brazil: Excess deaths and regional inequalities.

    Xavier, Mariana Otero / Amouzou, Agbessi / Maïga, Abdoulaye / Akseer, Nadia / Huicho, Luis / Matijasevich, Alicia

    Journal of global health

    2023  Volume 13, Page(s) 6040

    Abstract: Background: Despite the proliferation of studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic, there is less evidence on the indirect death toll compared to the health system and service provision disruptions. We assessed the impact ...

    Abstract Background: Despite the proliferation of studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic, there is less evidence on the indirect death toll compared to the health system and service provision disruptions. We assessed the impact of the COVID-19 pandemic on national and regional trends and differences in stillbirths, under-5 and maternal deaths in Brazil.
    Methods: We used the nationwide routine health information system data from January 2017 to December 2021, to which we applied descriptive and advanced mixed effects ordinary least squared regression models to measure the percent change in mortality levels during the COVID-19 pandemic (March 2020 to December 2021). We carried out counterfactual analyses comparing the observed and expected mortality levels for each type of mortality at national and regional levels.
    Results: Stillbirths increased 4.8% (3.1% in 2020 and 6.2% in 2021) and most noticeably maternal deaths increased 71.6% (35.3% in 2020 and 103.3% in 2021) over the COVID-19 period. An opposite pattern was observed in under-5 mortality, which dropped -10.2% (-12.5% in 2020 and -8.1% in 2021). We identified regional disparities, with a higher percent increase in stillbirths observed in the Central-West region and in maternal deaths in the South region.
    Discussion: Based on pre-pandemic trends and expected number of deaths in the absence of the COVID-19, we observed increases in stillbirths and maternal deaths and reductions in under-5 deaths during the pandemic. The months with the highest number of deaths (stillbirths and maternal deaths) coincided with the months with the highest mortality from COVID-19. The increase in deaths may also have resulted from indirect effects of the pandemic, such as unavailability of health services or even reluctance to go to the hospital when necessary due to fear of contagion.
    Conclusions: In Brazil, the COVID-19 outbreak and subsequent restrictions had a detrimental impact on stillbirths and maternal deaths. Even before the pandemic, mortality trends highlighted pre-existing regional inequalities in the country's health care system. Although there were some variations, increases were observed in all regions, indicating potential weaknesses in the health system and inadequate management during the pandemic, particularly concerning pregnant and postpartum women.
    MeSH term(s) Pregnancy ; Humans ; Female ; COVID-19/epidemiology ; Stillbirth/epidemiology ; Maternal Mortality ; Pandemics ; Maternal Death ; Brazil/epidemiology
    Language English
    Publishing date 2023-09-30
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 2741629-X
    ISSN 2047-2986 ; 2047-2986
    ISSN (online) 2047-2986
    ISSN 2047-2986
    DOI 10.7189/jogh.13.06040
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