Association Between Maternal and Child Health Handbook and Quality of Antenatal Care Services in Palestine

Abstract

Objectives The Maternal and Child Health (MCH) handbook is an integrated home-based record allowing clients to keep records on the continuum of care for mothers and children. This study aimed to assess associations between MCH handbook ownership and receipt of selected content of antenatal care services in Palestine. Methods Distribution of the MCH handbook in Palestine was launched in 2008. We used an anonymous data set of the Palestinian Family Survey 2010 and analyzed the data of 2026 women who had live births within the past 12 months. Descriptive statistical analysis was conducted to assess differences between MCH handbook holders and non-holders. Multivariable logistic regression models were used to estimate adjusted odds ratios of the effects of MCH handbook use according to proxy indicators of antenatal care quality. Results Accounting for about 60% (n = 1202) of study participants, handbook holders were more likely to be primipara, live in the Gaza Strip, live in refugee camps, and live within a 30-min distance to antenatal care facilities; however, household wealth levels for handbook holders were lower compared with non-holders. Handbook users had significantly higher odds of receiving all three kinds of medical tests and receiving information on five or more health education topics as part of antenatal care. The higher odds remained after adjusting for possible confounding variables, such as household wealth, region, residential area, birth order of the child, frequency of antenatal care, and time required to reach antenatal care facilities. Conclusions for Practice Use of the handbook as a portable checklist possibly promoted providers' higher adherence to the national guideline.

Visitas domiciliares inovadoras e a saúde materno‑infantil

“…Todos os dados positivos da presente pesquisa também corroboraram os achados da literatura, que indicam o uso de materiais educativos, manuais de orientações e intervenções educacionais nos serviços de saúde como fontes tecnicamente confiáveis para garantir condições de saúde materno-infantil adequadas, melhorar o uso dos métodos contraceptivos, melhorar a prática da amamentação exclusiva e também a qualidade da alimentação complementar das crianças (27)(28)(29)(30)(31)(32)(33)(34)(35)(36) .…”

Accountability strategies for sexual and reproductive health and reproductive rights in humanitarian settings: a scoping review

“…Three of the 14 papers examine the implementation and monitoring of standards. Kitabayashi describes the use of personal Maternal and Child Health (MCH) Handbooks, a client-held record intended to promote the continuum of care among women who may see multiple providers, as MCH care is fragmented and client mobility is curtailed by curfews and other limitations [92]. The handbook increased service utilization and promoted higher provider compliance with procedures, as the handbook functioned as a checklist [92].…”

“…Kitabayashi describes the use of personal Maternal and Child Health (MCH) Handbooks, a client-held record intended to promote the continuum of care among women who may see multiple providers, as MCH care is fragmented and client mobility is curtailed by curfews and other limitations [92]. The handbook increased service utilization and promoted higher provider compliance with procedures, as the handbook functioned as a checklist [92]. Howard (2012) examined how SRH services contracted to nonstate actors performed against predetermined benchmarks set out in the Basic Package of Health Services (BPHS); the use of these performance targets reportedly led to increased provisionand thus coverageof reproductive health services [93].…”

“…The extent to which these efforts are embedded in larger institutional frameworks for training and supervision was key to their success [48,83,91]; interviewees also emphasized this finding. Institutional commitment, expressed in part through transparency about the program and manager (rather than just clinician) engagement in the project, facilitated success [48,90,94] as did awareness of the standards among those tasked with ensuring their implementation [83,92,93]. Both the MCH handbooks and the BPHS programs included activities to promote awareness and buy-in.…”

“…Both the MCH handbooks and the BPHS programs included activities to promote awareness and buy-in. Staff from different agencies were trained to complete the MCH handbooks [92] and accomplishment of the SRH components of the BPHS was incentivized through performance-based payments [93].…”