Health system and community level interventions for improving antenatal care coverage and health outcomes

Abstract

Health system and community level interventions for improving antenatal care coverage and health outcomes.

Peer‐pressure and overuse: The effect of a multimodal approach on variation in benzodiazepine prescriptions in a network of public hospitals

“…With the aim of improving the quality of care, healthcare systems increase their efforts in reducing variations in diagnostic and therapeutic prescriptions . Large variations in healthcare delivery could in fact lead to worse patient outcomes and to unfavourable economic consequences …”

One Size Does Not Fit All: The Importance of Contextually Sensitive mHealth Strategies for Frontline Female Health Workers

“…One distinguishing characteristic of this frontline workforce is its ability to provide healthcare services while being sensitive to the culture and context of host communities (Bhatia, 2014;Maes et al, 2015;Mbuagbaw et al, 2015;Mumtaz et al, 2013). This characteristic is part of the minimum guidelines for CHW selection set by the World Health Organization: "CHWs should be members of the communities where they work, should be selected by the communities, should be answerable to the communities for their activities, should be supported by the health system but not necessarily a part of its organization, and have shorter training than professional workers" .…”

“…As recognized by Maryse et al in their recent systematic review, retention and performance is better in programs where selected CHWs are trusted members of the community and better reflect the linguistic and cultural diversity of the population served (Kok et al, 2015). This contextually sensitive healthcare service provided by frontline female workers is particularly beneficial for maternal care in conservative communities of the developing world (Hurt, Walker, Campbell, & Egede, 2016;Mbuagbaw et al, 2015;Mumtaz et al, 2013). Female healthcare workers-as they belong to the same community-have a comfort level with their patients, which is not possible to establish for a healthcare professional from outside the community.…”

Social and biological determinants of growth and development in underprivileged societies

“…4 Níveis elevados de estresse psicossocial não estão associados apenas ao baixo peso ao nascer, mas também a um número menor de consultas pré-natais. 19 A Organização Mundial de Saúde (OMS) recomenda pelo menos quatro consultas pré-natais, uma durante o primeiro trimestre, a segunda entre a 24 a e 28 a semanas de gestação e a terceira e quarta na 32 a e 36 a semanas de gestação. Atualmente, não apenas o retardo do crescimento está relacionado a condições sociais desfavorecidas, mas também o sobrepeso, associado ao baixo nível de escolaridade dos pais, grandes famílias e situação socioeconômica mais baixa.…”

“…5 Curiosamente, o estudo de da Rocha Neves et al 1 relatou que nenhuma das crianças era magra, ao passo que o sobrepeso ocorria em 4,4% das crianças. 19 Os fatores que impedem que as mulheres obtenham o número correto de consultas pré-natais são pobreza, falta de informações, distância até o serviço de cuidado pré-natal, serviços inadequados e práticas culturais. 6 Além disso, evidências cada vez maiores sugerem que tanto o retardo do crescimento no início da vida quanto o sobrepeso na infância aumentam o risco de a criança apresentar doença cardiovascular na vida adulta.…”