Multisectoral approaches to addressing global urban maternal and perinatal health inequities

Babajide, Opeyemi; Beňová, Lenka; Abejirinde, Ibukun-Oluwa Omolade; Steegers, Eric A.P.; Waiswa, Peter; Galea, Sandro; Abdalla, Salma M

doi:10.1080/23748834.2022.2097829

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…This was consistent with the existing literature [ 26 , 27 ]. Leveraging multisectoral approaches in urban contexts could help improve overall service delivery and quality [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review

et al. 2023

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Introduction: As the world continues to urbanize, particularly in low- and middle-income countries, understanding the barriers and effective interventions to improve urban immunization equity is critical to achieving both Immunization Agenda 2030 targets and the Sustainable Development Goals. Approximately 25 million children missed one or more doses of the diphtheria, tetanus and pertussis (DTP3) vaccine in 2021 and it is estimated that close to 30% of the world’s children missing the first dose of DTP, known as zero-dose, live in urban and peri-urban settings. Methods: The aim of this research is to improve understanding of urban immunization equity through a qualitative review of mixed method studies, urban immunization strategies and funding proposals across more than 70 urban areas developed between 2016 and 2020, supported by Gavi, the Vaccine Alliance. These research studies and strategies created a body of evidence regarding the barriers to vaccination in urban settings and potential interventions relevant to low- and middle-income countries (LMICs) with a focus on the vaccination of urban poor, populations of concern and residents of informal settlements. Through the document review we identified common challenges to achieving equitable coverage in urban areas and mapped proposed interventions. Results: We identified 70 documents as part of the review and categorized results across (1) social determinants of health, (2) immunization service-delivery barriers and (3) quality of services. Barriers and solutions identified in the documents were categorized in these thematic areas, drawing information from results in more than 21 countries. Conclusion: Populations of concern such as migrants, refugees, residents of informal settlements and the urban poor face barriers to accessing care which include poor availability and quality of service. Example solutions proposed to these challenges include tailored delivery strategies, improved use of digital data collection and child-friendly services. More research is required on the efficacy of the proposed interventions identified and on gender-specific dynamics in urban poor areas affecting equitable immunization coverage.

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“…This was consistent with the existing literature [ 26 , 27 ]. Leveraging multisectoral approaches in urban contexts could help improve overall service delivery and quality [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review

et al. 2023

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“…According to Modigliani and Miller (1958), creditors impose severe conditions on capital structure, which limits the flexibility and prerogatives of senior management (Gelpern et al, 2023). As a result of these covenants, business owners are now concerned about losing control (Babajide et al, 2023).Despite this, a large proportion of company failures can be linked to poor financing choices, such as undercapitalization and improper capital structures, like the wrong ratio of debt to equity financing (Kramoliš & Dobeš, 2020).…”

Section: Family Controlmentioning

confidence: 99%

Capital Structure Construct and Family Control as Stimulus on Family Business Performance: Evidence From Indonesia

Yulianty,

Amani,

Purnomo

et al. 2024

MAKSIMUM

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The aim of this study is to find out and reproduce how the decision-making process of the capital structure in a family-owned company, and how the family control task serves as a kind of mediation in order to improve the business performance of the company. The target population of this research is the entire family company especially SMEs that is located in Bandung, whose company age is 1 to more than 30 years. Sampling techniques using probability techniques. The total respondents used were 140 respondents who were CEOs or directors and representatives of the family business. The analysis used is using track analysis using Partial Least Square (PLS) The findings of this study show that the process of improving the business performance of a family company is heavily influenced by the accuracy of decision-making in the capital structure and control of the family members themselves.

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“…This points to the need for wellcoordinated planning and management of intersectoral collaboration if such interventions are to succeed when translated into routine services [28]. It also highlights an important revelation that addressing the stillbirth burden thrives well in a multisectoral approach just like any other maternal and child health intervention [29]. Elsewhere, the value of a multisectoral approach towards addressing public health challenges has been emphasised [28].…”

Section: Inputsmentioning

confidence: 99%

National-level key stakeholders’ perspectives regarding intervention progression and emerging challenges within the national stillbirth reduction response in Uganda

Ssegujja

Andipatin

2023

PLoS ONE

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Introduction Implementation of evidence-based interventions was adopted to respond to the stillbirth burden from the global campaigns. However, new challenges emerge in the process of rolling out such interventions into routine services more so in the context of resource-limited settings. Since the scale-up of policy recommendations to address stillbirth in Uganda, the health system response has seldom been explored. This study was conducted among national-level key stakeholders to elicit their perspectives regarding intervention progression and challenges emerging from the implementation of the national stillbirth reduction strategies in Uganda. Methods The study adopted an exploratory qualitative design with interviews conducted among a purposively selected sample of national-level actors drawn from the maternal and Child Health (MCH) policy networks. Respondents were primed with ongoing national-level stillbirth reduction strategies as a case and later asked for their opinions regarding intervention progression and emerging challenges. All interviews were conducted in English and transcribed verbatim. Atlas. ti was used to facilitate the coding processes which used a pre-determined codebook developed a priori based on the applied framework. A thematic analysis technique was used. Results Human resources as reflected in the slow recruitment of essential staff, motivation and attitudes of the available human resource, on and off-drug stockouts, and equipment interruptions posed challenges to the effective implementation of interventions to address the stillbirth burden. The policy translation process was sometimes faced with deviations from the recommended practice. Deviations from guideline implementation, inadequate managerial skills of the health workers and managers in stewarding the implementation processes, inadequate implementation feedback, loops in communication and working with a passive community also posed process-dependent bottlenecks. Outcome expectation challenges stemmed from the inability to deliver stillbirth reduction interventions along the Reproductive Maternal New born Child and Adolescent Health (RMNCAH) continuum of care and the overconcentration of facility-level intervention with less focus on community/demand side interventions. Conclusion In this exploratory study, national-level stakeholders perceive the adopted stillbirth reduction strategies as having the potential to address the burden. They, however, highlight potential challenges along the input-process-outcome continuum which ought to be addressed and opportunities to explore potential solutions befitting the national-level context.

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Multisectoral approaches to addressing global urban maternal and perinatal health inequities

Cited by 4 publications

References 12 publications

Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review

Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review

Capital Structure Construct and Family Control as Stimulus on Family Business Performance: Evidence From Indonesia

National-level key stakeholders’ perspectives regarding intervention progression and emerging challenges within the national stillbirth reduction response in Uganda

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