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Book part
Publication date: 12 November 2018

Nidhi Vij Mali

Information communication technologies can serve as a crucial missing link toward tacking wicked problems of social welfare policy implementation through collaborative…

Abstract

Information communication technologies can serve as a crucial missing link toward tacking wicked problems of social welfare policy implementation through collaborative governance. Using a mixed methods approach, a pre- and postanalyses were used to investigate whether and how cell phones can increase awareness of pregnant women about different cash and service benefits of maternal health benefit policies of 82 pregnant women in a remote tribal community in Melghat forest of Maharashtra, India. Pregnant women received customized prerecorded bilingual audio calls on their mobile phones about maternal health benefit policies. The author then traced whether those audio messages increased the claiming of policy benefits and public engagement. The key contribution of this research is that contrary to the optimism about digital governance, findings suggest that cell phones are not a “silver bullet” for increasing receipt of maternal health benefits. This book chapter concludes with the prescription that the impact of mobile phones and other information technologies will be marginal as long as there are administrative deficiencies in policy implementation and a misalignment in state and federal policy designs.

Article
Publication date: 16 July 2019

Naresh Kumar and Ritu Rani

The purpose of this paper is to examine the regional variations in maternal and child health all over India. The Maternal and Child Health Index (MCHI) is constructed to…

Abstract

Purpose

The purpose of this paper is to examine the regional variations in maternal and child health all over India. The Maternal and Child Health Index (MCHI) is constructed to find the extent of variations in maternal and child health status for the States and Union Territories (UTs) of India.

Design/methodology/approach

The Wroclow taxonomic technique was used to construct the MCHI for the States and UTs of India. In all, 29 variables were selected for the construction of MCHI. All the variables were taken from National Family Health Survey-4 (NFHS, 2017) of India.

Findings

The findings suggest that there are wide variations in MCHI all over India. In India, Kerala topped in terms of MCHI followed by Jammu & Kashmir. Nagaland is on the bottom of the list followed by Bihar and Uttar Pradesh. High values of MCHI (> 0.4) are posing a serious concern for all States/UTs in India.

Social implications

The existence of inequality in MCHI for India is truly posing a serious inquiry regarding the healthcare system in India. The outcome of the study demands that time has come to adopt a human rights approach to the right to health in India. The findings of the study could be used by the health policy makers in India.

Originality/value

This study shows the existence of wide variations in the quality of maternal and child health all over India. The quantification of the quality of maternal and child health is needed to improve the health of the population in India. Little research has been done on the issue of quality of maternal and child health in India. This study is an important contribution to the current knowledge of quality of maternal and child health in India.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 11 February 2019

Ama Pokuaa Fenny, Derek Asuman, Aba Obrumah Crentsil and Doreen Nyarko Anyamesem Odame

The purpose of this paper is to assess the trends of socioeconomic-related inequalities in maternal healthcare utilization in Ghana between 2003 and 2014 and examine the…

Abstract

Purpose

The purpose of this paper is to assess the trends of socioeconomic-related inequalities in maternal healthcare utilization in Ghana between 2003 and 2014 and examine the causes of inequalities in maternal healthcare utilization in Ghana.

Design/methodology/approach

Data are drawn from three rounds of the Ghana Demographic and Health Survey collected in 2003, 2008 and 2014, respectively. The authors employ two alternative measures of socioeconomic inequalities in health – the Wagstaff and Erreygers indices – to examine the trends of socioeconomic inequalities in maternal healthcare utilization. The authors proceed to decompose the causes of inequalities in maternal healthcare by applying a recently developed generalized decomposition technique based on recentered influence function regressions.

Findings

The study finds substantial pro-rich inequalities in maternal healthcare utilization in Ghana. The degree of inequalities has been decreasing since 2003. The elimination of user fees for maternal healthcare has contributed to achieving equity and inclusion in utilization. The decomposition analysis reveals significant contributions of individual, household and locational characteristics to inequalities in maternal healthcare. The authors find that educational attainment, urban residence and challenges with physical access to healthcare facilities increase the socioeconomic gap in maternal healthcare utilization.

Originality/value

There is a need to target vulnerable women who are unlikely to utilize maternal healthcare services. In addition to the elimination of user fees, there is a need to reduce inequalities in the distribution and quality of maternal health services to achieve universal coverage in Ghana.

Details

International Journal of Social Economics, vol. 46 no. 2
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 15 September 2014

Caroline J Gatrell

The purpose of this paper is to compare public health discourses on the importance of motherhood with organizational attitudes towards childbearing. It shows how pregnancy…

Abstract

Purpose

The purpose of this paper is to compare public health discourses on the importance of motherhood with organizational attitudes towards childbearing. It shows how pregnancy and the nurturing of infant children are valorized within public health discourses, which treat pregnancy and new maternity as a miraculous “project”, encouraging mothers to position maternity as central to their lives. By contrast, the paper shows how employers treat pregnancy and new motherhood as inconvenient and messy: as monstrous, at work.

Design/methodology/approach

The paper draws upon a database of qualitative netnographic (or internet-based) research. It analyses netnographic interactions between pregnant and newly maternal women. These virtual data are afforded the same validity as face-to-face research.

Findings

The paper demonstrates how maternal responsibilities for nurturing pregnancy and infant children, and the bio-medical properties of the maternal body, are central to public health discourses. By contrast, the maternal body is treated within organizations as alien, or monstrous.

Originality/value

The paper compares and contrasts public health valorizations of motherhood, with organizational tendencies to treat pregnancy/newly maternal bodies as monstrous. It highlights dichotomies faced by employed mothers. A continuing chasm between the social organization of maternity, and the attitudes of employers towards children and maternal bodies, is identified.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 33 no. 7
Type: Research Article
ISSN: 2040-7149

Keywords

Article
Publication date: 3 October 2019

Farah Shroff, Jasmit S. Minhas and Christian Laugen

Many low- and middle-income countries (LMICs) are struggling to reduce maternal mortality rates, despite increased efforts by the United Nations through the implementation…

Abstract

Purpose

Many low- and middle-income countries (LMICs) are struggling to reduce maternal mortality rates, despite increased efforts by the United Nations through the implementation of their Millennium Development Goals program. Industrialized nations, such as Canada, have a collaborative role to play in raising the global maternal health standards. The purpose of this paper is to propose policy approaches for Canadians and other Organization of Economic Cooperation and Development (OECD) nations who wish to assist in reducing maternal mortality rates.

Design/methodology/approach

Ten Canadian health experts with experience in global maternal health were interviewed. Using qualitative analytical methods, the authors coded and themed their responses and paired them with peer-reviewed literature in this area to establish a model for improving global maternal health and survival rates.

Findings

Findings from this study indicated that maternal health may be improved by establishing a collaborative approach between interdisciplinary teams of health professionals (e.g. midwives, family physicians, OB/GYNs and nurses), literacy teachers, agriculturalists and community development professionals (e.g. humanitarians with diverse linguistic and cultural backgrounds). From this, a conceptual approach was devised for elevating the standard of maternal health. This approach includes specifications by which maternal health may be improved, such as gender justice, women’s literacy, freedom from violence against women, food and water security and healthcare accessibility. This model is based on community health center (CHC) models that integrate upstream changes with downstream services may be utilized by Canada and other OECD nations in efforts to enhance maternal health at home and abroad.

Research limitations/implications

Maternal mortality may be reduced by the adoption of a CHC model, an approach well suited for all nations regardless of economic status. Establishing such a model in LMICs would ideally establish long-term relationships between countries, such as Canada and the LMICs, where teams from supporting nations would collaborate with local Ministries of Health, non-government organizations as well as traditional birth attendants and healthcare professionals to reduce maternal mortality.

Practical implications

All OECD Nations ought to donate 0.7 percent of their GDP toward international community development. These funds should break the tradition of “tied aid”, thereby removing profit motives, and genuinely contribute to the wellbeing of people in LMICs, particularly women, children and others who are vulnerable. The power of partnerships between people whose aims are genuinely focused on caring is truly transformative.

Social implications

Canada is not a driver of global maternal mortality reduction work but has a responsibility to work in partnership with countries or regions in a humble and supportive role. Applying a comprehensive and interdisciplinary approach to reducing maternal mortality in the Global South includes adopting a CHC model: a community development approach to address social determinants of health and integrating various systems of evidence-informed healthcare with a commitment to social justice. Interdisciplinary teams would include literacy professionals, researchers, midwives, nurses, family physicians, OB/GYNs and community development professionals who specialize in anti-poverty work, mediation/dialogue and education campaigns that emphasize the value of all people regardless of their gender, ethnicity, religion and income. Diasporic Canadians are invaluable members of these teams due to their linguistic and cultural knowledge as well as their enthusiasm for working with their countries of origin. Establishment of long-term partnerships of 5–10 years between a Canadian team and a region or nation in the Global South that is dedicated to reducing maternal mortality and improving women’s health are valuable. Canada’s midwifery education programs are rated as world leaders so connecting midwives from Canada with those of the Global South will facilitate essential transfer of knowledge such as using birth plans and other evidence-based practices. Skilled attendants at the birth place will save women’s lives; in most cases, trained midwives are the most appropriate attendants. Video link to a primer about this paper by Dr Farah Shroff: https://maa.med.ubc.ca/videos-and-media/.

Originality/value

There are virtually no retrievable articles that document why OECD nations ought to work with nations in the LMICs to improve maternal health. This paper outlines the reasons why it is important and explains how to do it well.

Article
Publication date: 7 June 2011

Patience Aseweh Abor, Gordon Abekah‐Nkrumah, Kojo Sakyi, Charles K.D. Adjasi and Joshua Abor

The study aims to examine the socio‐economic determinants of maternal health services utilization in Ghana.

3839

Abstract

Purpose

The study aims to examine the socio‐economic determinants of maternal health services utilization in Ghana.

Design/methodology/approach

Probit and ordered probit models are employed in this study.

Findings

The results generally indicate that most women in Ghana undertake the required visits for antenatal services and also take both doses of the tetanus toxoid vaccine as required by World Health Organization. However, the results show low levels of usage in terms of the other maternal health care services (i.e. prenatal care, delivery at a health facility, and postnatal care). There is clearly an urgent need to develop innovative strategies that will help upscale intervention especially for improvement in the use of these services by women in Ghana. The regression results reveal that utilization of maternal health services and intensity of use of antenatal services are influenced by age of mother, type of birth, education of mother, ethnicity, economic status, geographic location, residence, and religious affiliation. Obviously, this suggests that more than medical factors are responsible for the differences in the use of maternal health services by women in Ghana as well as the decision on the number of visits to undertake with respect to antenatal visits.

Originality/value

The findings of this study have important implications for health policy formulation targeted at improving maternal health care service utilization.

Details

International Journal of Social Economics, vol. 38 no. 7
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 9 May 2016

Joses M Kirigia, Germano M Mwabu, Juliet N Orem and Rosenabi Karimi Muthuri

The purpose of this paper is to estimate discounted value of potential non-health gross domestic product (GDP) losses attributable to the 167,913 maternal deaths that…

Abstract

Purpose

The purpose of this paper is to estimate discounted value of potential non-health gross domestic product (GDP) losses attributable to the 167,913 maternal deaths that occurred among 45 countries in the WHO African Region in 2013.

Design/methodology/approach

A cost-of-illness method was used to estimate non-health GDP losses related to maternal deaths. Future non-health GDP losses were discounted at 3 per cent. The analysis was undertaken for countries categorized under three income groups.

Findings

The discounted value of future non-health GDP loss due to maternal deaths in 2013 is in the order of Int$5.53 billion. About 17.6 per cent of that occurred in countries in the high and upper income group, 45.7 per cent in the middle income group and 36.7 per cent in the lower middle income group, and the average non-health GDP loss per maternal death was Int$136,799, Int$43,304 and Int$19,822, respectively.

Research limitations/implications

This study omitted costs related to direct health care, direct non-health care treatment, patient time for treatment, informal caregivers’ time, intangible costs such as pain and grief, lost output due to morbidity, and negative externalities on the family and community.

Social implications

The study demonstrated that maternal deaths have a sizable negative effect on non-health GDP of the region, implying that maternal mortality is not only a human rights concern but also an economic issue and that universal coverage of maternal health interventions ought to be an imperative goal in all countries.

Originality/value

This paper provides new evidence on the impact of maternal deaths on non-health GDP of 45 countries in the WHO African Region.

Details

International Journal of Social Economics, vol. 43 no. 5
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 22 March 2013

Dipty Nawal and Srinivas Goli

The purpose of this paper is to quantify inequalities in utilization of maternal health care services and measure the relative contribution of different factors affecting…

Abstract

Purpose

The purpose of this paper is to quantify inequalities in utilization of maternal health care services and measure the relative contribution of different factors affecting it in the context of Nepal.

Design/methodology/approach

The paper uses data from the latest round of the Nepal Demographic and Health Survey. Two stages of stratified cluster samplings were used. A total of 13,200 women aged 15-49 were interviewed.

Findings

Results of concentration index estimates in three selected indicators suggest considerable inequalities in maternal health care utilization. The decomposition analyses indicate that the critical factors contributing to inequalities in <3 antenatal care visits are poor economic status of households (32 percent) and women (23 percent) and their partners’ illiteracy (23 percent). However, in case of no institutional delivery, apart from the poor economic status of household (51 percent) and women's illiteracy (16 percent), the rural place of residence (21 percent) has emerged as critical factors contributing to inequalities. In case of no postnatal care within a day, birth order (21 percent) becomes a significant factor, next to the poor economic status of the household (41 percent) in terms of the relative contribution to total inequalities.

Practical implications

Policies and program targeting maternal health interventions need to consider equity with efficiency in utilization of maternal health care services, and further to achieve the targets of millennium development goal 5 in Nepal.

Originality/value

This study is an innovative effort to estimate inequalities in maternal health care services in the context of Nepal by using inequality decomposition model. For the first time, this study estimates the relative contribution of different socioeconomic factors contributing to inequalities in maternal health care services in Nepal.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 6 no. 1
Type: Research Article
ISSN: 1757-0980

Keywords

Article
Publication date: 4 October 2011

Gordon Abekah‐Nkrumah, Patience Aseweh Abor, Joshua Abor and Charles K.D. Adjasi

This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA).

2010

Abstract

Purpose

This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA).

Design/methodology/approach

The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro‐financing.

Findings

It is found that improved access to micro‐finance by women, combined with education may enhance maternal health service uptake.

Research limitations/implications

The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries.

Social implications

It is important to empower women by facilitating their access to education and micro‐finance. This has implications for improving maternal healthcare utilization in SSA.

Originality/value

The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 15 June 2020

Uche Abamba Osakede

This paper aims to analyze the relationship between public health spending and health outcome using time series data in Nigeria over the period 1980 to 2017, taking into…

Abstract

Purpose

This paper aims to analyze the relationship between public health spending and health outcome using time series data in Nigeria over the period 1980 to 2017, taking into account the role of governance by assessing how the quality of governance directly affects health status and indirectly as a mediator for the effectiveness of public health spending.

Design/methodology/approach

Using the Hausman statistical tests to check for the existence of endogeneity, the proper method for estimating the model for this study is the two-stage least square regression model. The two-stage least squares regression model addresses the problem of endogeneity using instrumental variables. The mediating role of governance on the effectiveness of public health spending on health was considered by an interaction of governance indicators with public health spending.

Findings

The results showed that public health spending had no significant effect on health outcome except when interacted with governance quality. The interaction of government health spending with governance effectiveness as well as that for control of corruption improved health by inducing a fall in maternal deaths, whereas government health expenditure interacted with rule of law raised maternal mortality. Public health spending interacted with regulatory quality improved life expectancy while that for political stability with public health spending induced a fall in life expectancy, poor maternal and infant health. Political stability and the control of corruption had direct influence on maternal health.

Practical implications

Given the predominance of public health spending in promoting access to health care and population health status for developing economies, the effectiveness of such spending should be top priority in policy makers’ agenda. This again is important because for developing economies, government revenue is generated from a small tax base due to their highly informal nature. To improve health status from public intervention in the health sector, there is indeed need for improvement in the overall state of governance in Nigeria.

Originality/value

This paper is one of the few country case studies which uses time series data to examine the role of governance on the efficacy of public health spending with extension of findings to maternal health and covering more measures of governance quality. The results fundamentally illuminate the importance of governance in fostering development in health and consequently enhancing economic development and growth.

Details

International Journal of Development Issues, vol. 20 no. 1
Type: Research Article
ISSN: 1446-8956

Keywords

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