Sixty Second Science: Maternal and Child Health
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A new cadre of community health worker for sanitation and hygiene promotion in rural Zimbabwe Key findings: - Mothers value CHWs as accessible, affordable source of health information - CHWs build trust through regular home visits and personalized care - CHWs help address social determinants through referrals and follow up - CHWs play a key role in health education and behavior change Implications: - Invest in regular supportive supervision and refresher training for CHWs - Consider incentives to motivate and retain CHWs - Strengthen CHW linkages to formal health facilities for referrals - Involve communities in CHW selection to build trust and ownership Presented by:
Sixty Second Science: Maternal and Child Health
- 1. SIXTY SECOND SCIENCE! Maternal and Child Health
- 2. Title: Faith Leaders Advocate for Increased Healthy Timing and Spacing of Pregnancy/Family Planning Use and Stronger Maternal and Child Health Outcomes Research Team: World Vision (WV) Ghana and Kenya Teams Location: WV Ghana-Northern Region-West Gonja & Zabzugu Districts, Population: 105,000, Research Sample: 1182; ------------------WV Kenya-Isiolo & Marsabit County, Population-435,000, Research Sample: 986, Mixed religion in both countries Key Findings - Anticipated: I. Knowledge: Increase in knowledge and awareness of faith leaders regarding Pregnancy Spacing and Family Planning, II. Use: Willingness to promote use of available FP and MCH services during church, in mosques, the standard days method/cycle beads to educate couples and to refer women and spouses to clinics for FP services, III. Advocacy: Willingness to serve as change agents and mentor other faith/religious leaders in HTSP/FP and MCH. Future programming: Faith leader engagement is critical and should be part of every program/project. They need to be seen as partners - in promoting understanding and linkages of how timing and spacing of pregnancy, use of family planning methods and other high impact practices affect the health of mothers and children. Presented by: Susan Otchere, MOMENT Project Director, World Vision US.
- 3. “Armenia “Go Baby Go”:A quasi-experimental intervention- control study ResearchTeam: Alfonso Rosales, Karine Abelyan,Arax Hovhannesyan,Viktoria Sargsyan, Mishadi Perera, Rhonda Holloway, Dennis Cherian Study Location/ Population: Gavar andVardenis regions of Gegharkunik province (administrative division) in the Republic of Armenia. All children living in the 43 target communities aged 0 to 24 months (born between February 1st, 2013 and February 15th, 2015) were recruited into the study and were followed over a period of 14 months. Key findings: • Children at the intervention site were 22% more likely to receive minimum dietary diversity and increased support for learning and discipline practices compared with the controls arm. • Children in the intervention site had 83% higher total composite score (cognitive, motor, and language) than children in the control arm. • There were no significant differences on stunting prevalence among both groups. Implications on future programming: • Delivery of ECD services via community based delivery platform is feasible • Linkages with formal health system is necessary to provide adequate ECD services • Further research needs to be done to properly assess the long term effects of chronic malnutrition (stunting)
- 4. Recognition of and care-seeking for newborn complications in Jayawijaya District, Papua Province, Indonesia:A qualitative study ResearchTeam:Alfonso Rosales, CandraWijaya,Lila K. Hairani,Meita Ilyana,Oktarinda Miko,Sigit Sulistyo,Emily Gifford, Rhonda Holloway,Micheal Bantung Kristina Pabate,Dennis Cherian Study Location/Population: The study population consisted of ten sub districts in Jayawijaya District, Papua Province, Indonesia. Illness narratives were conducted with five cases of newborn illness and four cases of newborn death. Key findings: Implications on future programming: • This study demonstrates a simple qualitative approach that might be useful to gain contextual information for the design of interventions to transform behavior patterns, facilitate access to care, and improve early identification of illness.
- 5. • 900+ pregnant women Malava sub-county, Kenya • Adherence partner (AP):Family member or friend women ask to support supplement adherence • Key findings – Feasible: 80% women counseled and 91% received AP poster – Acceptable: 89% of women had an AP – Impact: (1) women with APs reported significantly more adherence support, and (2) more support was significantly associated with high calcium adherence • Programmatic implications – Women appreciated and benefited from adherence support from family members – AP strategy is simple and low cost and could be delivered through antenatal care or CHWs Funding support from Micronutrient Initiative and Sackler Institute for Nutrition Science at the New York Academy of Sciences Stephanie Martin, Lanre Omotayo, Gretel Pelto, Gina Chapleau, Rebecca Stoltzfus, Kate Dickin Feasibility, acceptability, and impact of adherence partners to support prenatal micronutrient supplementation
- 6. Initiative to halve PPH Mortality in Niger within 2 Yrs – Pop 20.8 million Dr. Anders Seim Among 65,396 births we have info on thru Oct. 4 • PPH Incidence 2.04 % (1,337 women) vs Expected 18% having PPH & 10.5% w/ severe PPH PPH Mortality 13.2 % of deaths (50 women) vs Expected 25% - 35% of deaths Next: Others can replicate Niger’s initiative, Baseline Survey etc., Nigeria is using its own funds.
- 8. CRSAssessments on the role of indigenousAfrican plant foods in resiliency and dietary diversity AlexandraTowns,AnaMariaFerrazdeCampos,ErinBaldridge,AngelaTavares,MariaNakayiza,EverlynMatiri KEY FINDINGS: • Diverse indigenous micronutrient-rich foods consumed year-round • Sale of indigenous leafy vegetables contribute to women’s livelihoods • Stigma & nutrient loss need to be addressed IMPLEMENTATION RECOMMENDATIONS • Engage agricultural & nutrition sectors to encourage cultivation, conservation & consumption LOCATION/POPULATION: Mothers & fathers in: • Eastern Zambia • Southern Malawi • Northern Uganda
- 9. Barrieranalyses on maternal,child health & nutrition behaviors in the Syrian refugee crisis: Findings from Lebanon, Jordan,Turkey • 6-year Crisis: 4,806,762 Syrian refugees • Trends Across Settings: • The outcomes of the study will help agencies to inform program design and advocacy (ex: peer-support groups, mobile clinics or shared transport, MHPSS referrals/ activities, micro-gardening & voucher adjustments and referrals) Extra meal AC Iron-rich Extra meal Stress EBF Limited Money or Food Voucher ANC Distance, transport, traffic Access (across multiple behaviors)
- 10. Cost of the Diet study in Azraq Camp, Jordan Esther Busquet, Amelia Reese-Masterson, Patricia Moghames • Azraq camp: 37,659 Syrian refugees; camp in Jordan desert • Key findings: – A nutritious diet is available and affordable for many households, but not for all with the 20 JOD food voucher and free bread – A food habits diet is available, but not affordable for majority of households • The outcomes of the study will help agencies working in Azraq to inform program design and advocacy
- 11. Assessment of Adolescent Girl Nutrition, Dietary Practices, and Roles in Zimbabwe Amelia Reese-Masterson, Pamela Murakwani, Zothile Mlobane Population: Adolescent girls 13-19 years (n=692) Design: Cross-sectional, representative survey Key Findings: • 47% food insecurity, 66% poor dietary diversity • Stunting 7% (18% in pre-menarche), thinness 6% • Low decision-making power regarding food, yet high involvement in food preparation • Pregnancy common, yet low knowledge of nutrition during pregnancy Recommendations: Integrated nutrition & reproductive health behavior change activities for adolescent girls Food security interventions with incentives built in for adolescent girl nutrition and school attendance
- 12. Calorie sources in traditional & modern rural Nicaragua Corn, plaintains 45 Beans 20 Vegetables 10 Fruit 10 Meat, fish, eggs, dairy 10 Sugar, oil 5 White Rice, Bread 33 Sugar* 15 Oil* 15 Beans 9 Corn, Plaintains 9 Meat, fish, eggs, dairy 7 Processed Foods 7
- 13. SIXTY SECOND SCIENCE! Community Health Approaches, Vector-Borne Disease and Humanitarian Response
- 14. Dashboards for Performance Management of CHWs Jill Shah • Jointly by Muso & Medic Mobile • Yirimadjo, Mali with 150 CHWs • Supervisory meetings conducted with all the CHWs • Half (75) of the group’s meetings were supplemented with a paper-dashboard showing key performance indicators • Anticipated findings: the experimental group is able to work more effectively, correct more error, with addition of paper visualizations. • Full results coming in Dec 2016
- 15. Zika virus knowledge, attitudes, and practices among the population of four municipalities in Honduras: A cross-sectional survey in Honduras A study by Alfonso Rosales, Adriana Yepes-Mayorga, Fabiano Franz, Maya Haynes, Alejandro Arias, Ramón Jeremías Soto, Jamo Huddle, Dennis Cherian, Monica Prado and Joanne Thomas Objective: To determine the impact of the national communication strategy on the Honduran population’s knowledge, attitudes and practices (KAP) since the inception of the Zika virus response. Method: • Conducted a community- based KAP survey in four municipalities (Choluteca, Danli, El Progreso and San Matias) of Honduras in July 2016. • The study used a 2-stage, 30-cluster sampling method targeting adult males, adult females and adolescents. Key findings: 1. Almost 8 out of 10 Hondurans knew that Zika can be transmitted by mosquito bite; however only 2 out of 10 (0.1%) were aware that Zika can be spread by sexual and vertical transmission. 2. Less than half of all participants had any knowledge of the causal relationship between Zika infection with microcephaly and Guillain-Barré syndrome. 3. Overall, 50% of respondents said they did not have enough information about the infection and expressed their need for more information on prevention. Recommendations: • The existing risk communication process has mainly focused on vector control. • Our findings identify information priority gaps that urgently need to be addressed by national stakeholders to protect the most vulnerable from Zika infection and its complications. • Information on Zika complications and transmission routes need to be tailored in particular to target populations such as men and adolescents.
- 16. • Interviewed 20 SHINE mothers • Explored perspectives on CHW health service delivery Community health worker health (CHW) service delivery in rural Zimbabwe: Client perspectives about community health workers and implications for programs The Sanitation Hygiene and Infant Nutrition Efficacy (SHINE) Trial Team Client confidentiality Teaching styles Availability Respect Key Findings • Women articulated specific skill sets, attitudes, characteristics Client confidentiality Respectful treatment Availability Teaching strategies & styles Implications for programs • Align client-identified skills and competencies with CHW trainings, supervision and support • Creating stronger responsive health systems requires understanding what aspects of health service delivery matter to clients and the community “if you do not ask whether people have understood…it defeats the purpose” “if they are harsh in responding to us, that is what determines whether we will cease to be open with them” “I can approach her at her house when she is busy…and she will …help without showing annoyance” “maintains confidentiality” Funding support: Bill & Melinda Gates Foundation (BMGF); UK Department for International Development
- 17. Dr. Pierre Paul Health System Strengthening: PIH’s approach for Emergency Preparedness Hôpital Universitaire de Mirebalais -205 000 sq feet -300 beds -1200 employees -6 ORs -1500 visits/day -2/3 visits outside typical catchment area • Silent Disaster Response: Medical Resident Strike • Post Hurricane Matthew Response