Evaluation of a maternal, neonatal and child health intervention package in a rural district of Pakistan: a quasi-experimental study

Abstract

Background: Pakistan is among the countries which have the highest maternal, neonatal and child mortality rates. Immediate efforts are required to enable Pakistan to achieve the health related sustainable development goals. The continuum of care interventions can substantially reduce the mortality burden, however local evidence to implement them is lacking in Pakistan. We implemented the maternal, neonatal and child health intervention package comprised of health facility strengthening, capacity building, continuum of care interventions and community mobilization and evaluated its effectiveness on maternal, neonatal and child health care practices and neonatal mortality.Methods: The intervention package was delivered through existing public health system in a rural district of Pakistan. We used a quasi-experimental design to assess the impact of interventions. Baseline and end line surveys were conducted and neonatal mortality was considered as the primary outcome measure. Data were analysed using bivariate and difference and difference analysis techniques.Results: We found a reduced risk of neonatal mortality (RR 0.704; 95% CI 0.557-0.889; p=0.0033), in intervention areas compared to control area. For secondary outcomes; including mortality for infants and under five children, antenatal care, skilled birth attendance, institutional deliveries, postnatal care, delayed bathing, inappropriate cord care practices, birth asphyxia, exclusive breastfeeding and immunization a significant difference (p<0.001) was observed in the intervention area compared to control area.Conclusions: This study provides local evidence from Pakistan that effective methods for delivering MNCH interventions within the existing health infrastructure can improve the MNCH outcomes especially in the rural areas.

Effect of health facility linkage with community using postnatal card on postnatal home visit coverage and newborn care practices in rural Ethiopia: A controlled quasi-experimental study design

“…Despite improvements observed in the essential newborn care practices, the absolute percentage changes were minimal due to probably the ingrained cultural practices and timing of counseling the mothers in the rural community. Similar findings were reported from maternal and newborn health related interventions [ 37 , 48 , 51 , 59 – 61 ].…”

“…Studies showed that neonatal and maternal morbidity and mortality can be significantly reduced with basic and low cost interventions if managed appropriately and with high coverage of PNHV [ 51 – 53 ].…”

Factors Affecting Delivery Health Service Satisfaction of Women and Fear of COVID− 19: Implications for Maternal and Child Health in Pakistan

“…The maternal mortality rate, neonatal mortality rate, and under five-year old child mortality rate for Pakistan are unsatisfactory (Alimohamadi et al, 2019 ; Habib et al, 2019 ). One of the reasons identified for the high mortality rates in developing regions is low levels of institutional deliveries with skilled providers (Randive et al, 2014 ; Yoseph et al, 2020 ).…”

Improving maternal and child health in Pakistan: a programme evaluation using a difference in difference analysis

“…The results show significant gains in wide-ranging MCH outcomes including service delivery (double difference of 33.1% and 30.5% in skilled birth attendance and institutional deliveries, respectively). 27 …”

“…The results show significant gains in wide-ranging MCH outcomes including service delivery (double difference of 33.1% and 30.5% in skilled birth attendance and institutional deliveries, respectively). 27 The voucher and contracting schemes seem to have had some success in improving the management of MCH interventions, by showing effects that were not observed in the other NPPI districts. Earlier research has claimed that the social mobilisation strategy and provision of in Rawalpindi on a rotational basis.…”