Academic literature on the topic 'Safe Motherhood Programme (Ghana)'

In the United States, the US Agency for International Development (USAID) has decided to fund project MotherCare, which is aimed at enhancing the services and educational programme that have a significant impact on maternal and neonatal health and nutrition. The work is being carried out by John Snow Incorporated in Washington DC and will include five projects in different countries to demonstrate the efficacy of various interventions, such as improvements in the nutrition of newborn babies, as well as the prevention and treatment of disorders known to be important to maternal and neonatal mortality and morbidity. The MotherCare project will also introduce research and training initiatives in a number of countries. For those interested in researching a practical approach to reducing maternal mortality, the Safe Motherhood Operational Research programme is offering funding for government and non-governmental organisations in developing countries.1

The safe motherhood programme is one of the priority programme of Nepal. Its primary goal is to reduce maternal and neonatal mortality. Safe pregnancy, safe delivery and safe birth of new born are the major components of safe motherhood. This can be accomplished through increased access to effective antenatal, delivery and postnatal care and a massive health awareness activity in local communities.Academic Voices, Vol. 3, No. 1, 2013, Pages 19-23 DOI: http://dx.doi.org/10.3126/av.v3i1.9981

Safe Motherhood is not only a Reproductive Right but also a basic human right. Provision of Safe Motherhood services like skilled attendants at birth reduces maternal deaths and morbidities. Bangladesh has reduced maternal deaths from 540/ 100,000 live births in the nineties to 194 in 2010. In a recent estimate by WHO, UNICEF, UNFPA, the World Bank and the United Nations Population Division, the Maternal Mortality Rate (MMR) has declined to 170 per 100,000 live births in Bangladesh.DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21535 Bangladesh Journal of Bioethics 2014; 5(3):26-27

Introduction: It has been two decades Nepal has initiated safe motherhood programme in 1998, since then there has been significant reduction in maternal mortality and improvement in newborn care. Western Regional Hospital is the government referral hospital in western Nepal and has large volume of patients utilizing the safe motherhood services. This study is a review of one year of different safe motherhood services provided by this hospital. Methods: The data from the hospital records section from Asoj 2073 (September - October 2016) to Bhadra 2074 (August - September 2017)has been extracted from the hospital record section and analyzed in terms to different services like antenatal visits, vaginal delivery, caesarean section, incomplete abortion and ectopic pregnancy. The obtained data was entered and analyzed using Microsoft Excel. Results: Total of 42,798 patients had utilized the safe motherhood services during the study periods, majority of them being antenatal visits followed by vaginal and caesarean delivery. Some of the vaginal deliveries 490 (5.3%) were complicated which included vacuum delivery, intrauterine fetal death, twins and breech delivery. Among the total delivery 2316(24.8%) were caesarean sections, of which more than halves were due to emergency indications. Conclusions: The safe motherhood program in Western Regional Hospital has positive impact on the maternal health in this region and further expansion of the services and facilities are recommended in coming days in scenario of increasing number of patients.

Maternal and infant mortality is a global health issue with a significant social and economic impact. Each year, over half a million women worldwide die due to complications related to pregnancy or childbirth, four million infants die in the first 28 days of life, and eight million infants die in the first year. Ninety-nine percent of maternal and infant deaths are in developing countries. Reducing maternal and infant mortality is among the key international development goals. In China, the national maternal mortality ratio and infant mortality rate were reduced greatly in the past two decades, yet a large discrepancy remains between urban and rural areas. To address this problem, a large-scale Safe Motherhood Programme was initiated in 2000. The programme was implemented in Guangxi in 2003. Interventions in the programme included both demand-side and supply side-interventions focusing on increasing health service use and improving birth outcomes. Little is known about the effects and economic outcomes of the Safe Motherhood Programme in Guangxi, although it has been implemented for seven years. The aim of this research is to estimate the effectiveness and cost-effectiveness of the interventions in the Safe Motherhood Programme in Guangxi, China. The objectives of this research include: 1. To evaluate whether the changes of health service use and birth outcomes are associated with the interventions in the Safe Motherhood Programme. 2. To estimate the cost-effectiveness of the interventions in the Safe Motherhood Programme and quantify the uncertainty surrounding the decision. 3. To assess the expected value of perfect information associated with both the whole decision and individual parameters, and interpret the findings to inform priority setting in further research and policy making in this area. A quasi-experimental study design was used in this research to assess the effectiveness of the programme in increasing health service use and improving birth outcomes. The study subjects were 51 intervention counties and 30 control counties. Data on the health service use, birth outcomes and socio-economic factors from 2001 to 2007 were collected from the programme database and statistical yearbooks. Based on the profile plots of the data, general linear mixed models were used to evaluate the effectiveness of the programme while controlling for the effects of baseline levels of the response variables, change of socio-economic factors over time and correlations among repeated measurements from the same county. Redundant multicollinear variables were deleted from the mixed model using the results of the multicollinearity diagnoses. For each response variable, the best covariance structure was selected from 15 alternatives according to the fit statistics including Akaike information criterion, Finite-population corrected Akaike information criterion, and Schwarz.s Bayesian information criterion. Residual diagnostics were used to validate the model assumptions. Statistical inferences were made to show the effect of the programme on health service use and birth outcomes. A decision analytic model was developed to evaluate the cost-effectiveness of the programme, quantify the decision uncertainty, and estimate the expected value of perfect information associated with the decision. The model was used to describe the transitions between health states for women and infants and reflect the change of both costs and health benefits associated with implementing the programme. Result gained from the mixed models and other relevant evidence identified were synthesised appropriately to inform the input parameters of the model. Incremental cost-effectiveness ratios of the programme were calculated for the two groups of intervention counties over time. Uncertainty surrounding the parameters was dealt with using probabilistic sensitivity analysis, and uncertainty relating to model assumptions was handled using scenario analysis. Finally the expected value of perfect information for both the whole model and individual parameters in the model were estimated to inform priority setting in further research in this area.The annual change rates of the antenatal care rate and the institutionalised delivery rate were improved significantly in the intervention counties after the programme was implemented. Significant improvements were also found in the annual change rates of the maternal mortality ratio, the infant mortality rate, the incidence rate of neonatal tetanus and the mortality rate of neonatal tetanus in the intervention counties after the implementation of the programme. The annual change rate of the neonatal mortality rate was also improved, although the improvement was only close to statistical significance. The influences of the socio-economic factors on the health service use indicators and birth outcomes were identified. The rural income per capita had a significant positive impact on the health service use indicators, and a significant negative impact on the birth outcomes. The number of beds in healthcare institutions per 1,000 population and the number of rural telephone subscribers per 1,000 were found to be positively significantly related to the institutionalised delivery rate. The length of highway per square kilometre negatively influenced the maternal mortality ratio. The percentage of employed persons in the primary industry had a significant negative impact on the institutionalised delivery rate, and a significant positive impact on the infant mortality rate and neonatal mortality rate. The incremental costs of implementing the programme over the existing practice were US $11.1 million from the societal perspective, and US $13.8 million from the perspective of the Ministry of Health. Overall, 28,711 life years were generated by the programme, producing an overall incremental cost-effectiveness ratio of US $386 from the societal perspective, and US $480 from the perspective of the Ministry of Health, both of which were below the threshold willingness-to-pay ratio of US $675. The expected net monetary benefit generated by the programme was US $8.3 million from the societal perspective, and US $5.5 million from the perspective of the Ministry of Health. The overall probability that the programme was cost-effective was 0.93 and 0.89 from the two perspectives, respectively. The incremental cost-effectiveness ratio of the programme was insensitive to the different estimates of the three parameters relating to the model assumptions. Further research could be conducted to reduce the uncertainty surrounding the decision, in which the upper limit of investment was US $0.6 million from the societal perspective, and US $1.3 million from the perspective of the Ministry of Health. It is also worthwhile to get a more precise estimate of the improvement of infant mortality rate. The population expected value of perfect information for individual parameters associated with this parameter was US $0.99 million from the societal perspective, and US $1.14 million from the perspective of the Ministry of Health. The findings from this study have shown that the interventions in the Safe Motherhood Programme were both effective and cost-effective in increasing health service use and improving birth outcomes in rural areas of Guangxi, China. Therefore, the programme represents a good public health investment and should be adopted and further expanded to an even broader area if possible. This research provides economic evidence to inform efficient decision making in improving maternal and infant health in developing countries.

Current knowledge on mortality rates for stillbirths, early and late neonatal deaths and perinatal deaths in South Asia is dependent on statistically modelled estimates. There is very little information on the contribution of intrapartum complications and preterm births to stillbirths and mortality in the first month of life in rural Bangladesh. First, I systematically reviewed studies and performed a meta-analysis to obtain reliable estimates for the above mentioned mortality rates in South Asia. Second, I examined the association between the presence of a programme increasing professional birth attendance, facility delivery and emergency care access and reductions in mortality levels in a retrospective cohort in Matlab, Bangladesh. Third, I examined the determinants of preterm birth and whether this programme was associated with preterm prevalence reduction. Fourth, I explored the contributions of intrapartum complications and preterm births to perinatal deaths in this cohort. The systematic review found that perinatal mortality levels were high in Afghanistan, Bangladesh, India, Nepal and Pakistan and low in Sri Lanka and Maldives. Stillbirths were underreported. The cohort study found that the presence of the Matlab Safe Motherhood Programme was strongly associated with greatly reduced stillbirths and very early (Day 0-2) neonatal deaths. This programme did not contribute to the neonatal mortality decline after Day 3 or to preterm birth trends. Preterm birth accounted for a third of stillbirths and deaths in the neonatal period. Against expectations, only two intrapartum complications (haemorrhage and multiple pregnancy) was associated with increased odds of perinatal mortality. Dystocia and hypertensive diseases of pregnancy showed no effect. Stillbirth and very early neonatal death reduction in Bangladesh can be achieved by improving access to facilities and emergency care. Focused antenatal care for women might possibly reduce preterm births but further research is needed to understand how the prevalence of preterm birth can be reduced.

Chapters 10 and 11 were about the methodology and results, respectively, on the system's impact on compliance of the healthcare providers with the maternal health guidelines. Chapter 12 now considers the broader consequences of the BACIS program study. First, a discussion of the results of the BACIS program study in relation to the safe motherhood programme is undertaken. This is followed by a discussion of the issue of non-utilisation of health services, which is an issue that impacts on outcomes and programme success. After this follows a section on the discussion of the results of the BACIS program study against other e-health interventions that are in use or have been proposed, then next against other public health interventions in general, not just e-health systems. The final section discusses the study's results against the backdrop of the broader topic of primary healthcare functioning.

Vaccination is a highly effective measure for ensuring child survival, and it is universally implemented by nations to administer specific vaccines, particularly targeting high-risk groups like pregnant women and newborns. In 1986, the Government of India elevated the program's status to that of a National Technology Mission, committing to achieving its objectives within the specified timeframe. The Child Survival and Safe Motherhood Programme (which included the Universal Immunisation Programme (UIP)) was merged into the Reproductive and Child Health (RCH) program in 1997. Collaborating with global and national entities such as WHO and UNICEF, the Indian government endeavors to ensure comprehensive childhood vaccination. However, a study titled "High Immunization Coverage but Delayed Immunization Reflects Gaps in Health Management Information System (HMIS) in District Kangra, Himachal Pradesh" revealed that only 29% of children in the district received immunization. According to immunisation statistics, 68% of youngsters had delays from the recommended schedule of at least 32 days. The use of mono-dose BCG vials, pre-call notifications to moms, and adjusting HMIS software to track each beneficiary's immunisation status and punctuality rather than depending on total numbers were among the recommendations [1].