Home - Maternal/Fetal health during pregnancy

Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis

In response to the COVID-19 pandemic, the authors developed and implemented a new antenatal care schedule integrating telehealth across all models of pregnancy care and assessed the effectiveness and safety of telehealth in antenatal care. Findings from this study suggest that telehealth integrated antenatal care enabled the reduction of in-person consultations by 50% without compromising pregnancy outcomes. This care model can help to minimise in-person interactions during the COVID-19 pandemic, but should also be considered in post-pandemic health-care models.

Cost-effectiveness analysis of Baby-Friendly Hospital Initiative in promotion of breast-feeding and reduction of late neonatal infant mortality in Brazil

The objective of this study was to analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections.

Community-based Savings Groups, Women's Agency, and Maternal Health Service Utilisation: Evidence From Mozambique

This study, using data collected as part of an ongoing programme evaluation, investigates whether participation in Saving Groups (SGs)-a community-owned microfinance intervention focused on poor households - is associated with maternal health service utilisation, and whether this association is mediated by women's agency - as measured by self-efficacy and decision-making autonomy. This study suggests that the impact of SG membership on use of maternal health services goes beyond improvements in household income and may operate through women's agency by giving women the ability to realize their preference for quality health care.

Meeting the SDG challenge to end fistula and preventable childbirth-related morbidity and mortality

Lack of safe, affordable, medically indicated caesarean delivery is a primary contributor to global health inequity. In low-income and middle-income countries (LMICs), it perpetuates preventable morbidity and mortality caused by prolonged or obstructed labour.  Adequate intervention alone would avert 1 million disability-adjusted life-years (DALYs), with a median benefit-to-cost ratio of 6·0 at US$304 per DALY averted, reflecting an eradicable burden of disease that undermines sustainable development, economic growth, and human rights.

How much do conditional cash transfers increase the utilization of maternal and child health care services? New evidence from Janani Suraksha Yojana in India.

Janani Suraksha Yojana (safe motherhood scheme, or JSY) provides cash incentives to marginal pregnant women in India conditional on having mainly institutional delivery. Using the fourth round of district level household survey (DLHS-4), we have estimated its effects on both intended and unintended outcomes. Our estimates of average treatment effect on the treated (ATT) from propensity score matching are remarkably higher than those found in previous prominent studies using the second and third rounds of the survey (DLHS-2 and DLHS-3). When we apply fuzzy regression discontinuity design exploiting the second birth order, our estimates of local average treatment effect (LATE) are much higher than that of ATT. For example, due to JSY, institutional delivery increases by around 16 percentage points according to ATT estimate but about 23 percentage points according to LATE estimate.

The Effects of Ghana’s National Health Insurance Scheme on Maternal and Infant Health Care Utilization

The Ghanaian government implemented the National Health Insurance Scheme in 2004 and the aim of this study is to evaluate its early effects on maternal and infant healthcare use. The authors conclude that in the first years of operation, the National Health Insurance Scheme had a modest impact on the use of antenatal and delivery care. This is important for other African countries currently introducing or considering a national health insurance as a means towards universal health coverage.

Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit

Economic interventions are increasingly recognised as a mechanism to address perinatal health outcomes among disadvantaged groups. In the US, the earned income tax credit (EITC) is the largest poverty alleviation programme. Little is known about its effects on perinatal health among recipients and their children. The authors exploit quasi-random variation in the size of EITC payments to examine the effects of income on perinatal health. Findings suggest that EITC payment size is associated with better levels of several indicators of perinatal health. Instrumental variables analysis, however, does not reveal a causal association between household income and these health measures.