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Neonatal mortality rate is 24 deaths per 1,000 live births in Bangladesh and most of them die during early neonatal period. The purpose of this paper is to assess the knowledge and attitude of neonatal care practices among postnatal mothers in a tertiary care hospital in order to provide a basis for the development of strategies to improve further.

A cross-sectional study was carried out in the Dhaka Medical College Hospital, Bangladesh using a convenient sampling technique. In total 211 postnatal mothers were interviewed using a structured questionnaire and χ² test was used to analyze the data.

Among mothers, 37.9 percent were aged between 16–20 years; 16.1 percent had no institutional education; 55 percent were primipara and only 26.5 percent had attended antenatal visit for more than four times. Mothers had apparently good knowledge and attitude about thermoregulation, early initiation of breast-feeding, importance of providing colostrum to the newborn, exclusive breast-feeding (EBF) up to six months of age and immunization at birth. However, this study identified knowledge gap about cord care, eye care, first bathing and hygiene practices. Overall, only a small proportion of respondents had good level of knowledge (37 percent) and attitude (47.4 percent) on newborn care. Highly significant statistical association was found between the knowledge, attitude level and socio-demographic characteristics of respondents. Knowledge and attitude were strongly associated as well.

There is scope for improvement by providing health education to antenatal and postnatal mothers. Therefore, implementation of the guidelines outlined in the Maternal and Child Handbook (MCH) is highly recommended.

There is scope for improvement by providing health education to antenatal and postnatal mothers. Therefore, implementation of the guidelines outlined in the MCH is highly recommended to enhance the knowledge and attitude on newborn care among postnatal mothers.

This study aims to explore whether there is an association between women's empowerment and the utilization of maternal healthcare facilities.

This study considered four indices for measuring women's empowerment – labor force participation index (LFPI), decision-making power index (DMPI), attitude toward partner’s violence index (ATPVI) and knowledge level index (KLI) – and three healthcare facilities – number of antenatal visits, delivery with healthcare facilities and postnatal checkup after delivery. Data extracted for this study were from the Bangladesh Demographic and Health Survey 2011 and 2014. A chi-square test was used for bivariate analysis, and a three-level logistic regression model was applied for multivariate analysis.

An increment was observed in the practice of all considered healthcare facilities, and the percentage of highly empowered women in DMPI decreased from 2011 to 2014. This study found that higher empowerment of women in DMPI, KLI and ATPVI significantly (p-value < 0.05) increases the utilization of healthcare facilities. High empowerment of mothers in LFPI was found negatively associated with facility delivery and positively associated with the postnatal checkup.

Women's empowerment was found significantly associated with the utilization of maternal healthcare facilities. This study is seeking the attention of corresponding authority to come up with a more effective intervention program to empower women to utilize maternal healthcare facilities.

This paper aims to investigate infant sensory patterns and their associations with previous perinatal loss, maternal-foetal attachment and postnatal maternal sensory patterns.

In a prospective cohort study, women with and without perinatal loss (N = 57) were recruited from an Australian public hospital. Participants were surveyed during pregnancy (maternal-foetal attachment, loss) and again postnatally (maternal/infant sensory patterns). Chi-square tests and logistic regression analyses controlling for previous perinatal loss were conducted with infant sensory patterns as outcome variables.

“More than typical” infant low registration was associated with poorer quality of maternal-foetal attachment. “More than typical” infant sensory seeking was associated with previous perinatal loss and higher levels of maternal sensory seeking. “More than typical” infant sensory sensitivity was linked with previous perinatal loss, poorer quality of maternal-foetal attachment and higher maternal low registration. “More than typical” infant sensory avoidance was associated with poorer quality of maternal-foetal attachment and higher levels of maternal sensory sensitivity.

To support more typical infant sensory patterns, results point to the potential benefit of occupational therapists supporting pregnant women with previous perinatal loss; facilitating favourable maternal-foetal attachment; and educating new mothers on how their sensory patterns impact on interactions with their infant. Sensory modulation strategies that consider the sensory patterns of both mother and infant may be beneficial to promote engagement in co-occupations.

These findings are the first to suggest that previous perinatal loss, poorer quality of maternal-foetal attachment and higher levels of maternal postnatal sensory patterns represent risk factors for infant sensory patterns that are “more than typical.”

This study aimed to analyze the role of community health workers (CHWs) called accredited social health activists (ASHAs) in improving maternal health outcomes in the rural community of Punjab, India. The study also examined the expectations of these workers from the community and identified the problems faced by them in carrying out their roles.

Using multistage sampling, a total of 28 villages were selected from seven districts of Punjab, and from these selected villages, a total of 57 ASHAs working as the interface between the rural community and the public health system and 420 women who had delivered a baby were interviewed.

Desire to earn money was the most prominent reason for joining the community work program, but ASHAs felt overburdened and underpaid compared to their work commitments. Not only was the incentive paid to these workers was insufficient and irregular but they also suffered at the hands of medical staff at public hospitals.

While exploring the problems experienced by the CHWs, this study recommends opting for a mix of monetary and nonmonetary incentives for acknowledging the work of CHWs. The study is the first of its kind for the state of Punjab battling with a worsening maternal mortality rate (MMR).

The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

Corporate social responsibility (CSR) in India includes education, environment, healthcare and rural development. In post-liberalized India, the healthcare sector (services and facilities) has grown in leaps and bounds over last two decades. The purpose of this paper is to reveal and explain the CSR profile of select healthcare companies of India and reveal gaps and scope of healthcare activities with a special consideration towards maternal health.

Primary data are collected from seven listed companies of Goa state which were willing to participate in the study. In total, 67 companies constituting the Healthcare Sector Index of Standard & Poor of the Bombay Stock Exchange are considered as secondary source. Data of 59 companies that come within the threshold of Companies Act, 2013, are studied. CSR guidelines (with a turnover of Rs 10bn or a market capitalization of Rs 5bn or a net profit of Rs 50m) are taken as an initial frame of reference.

In total, 89.83 per cent of these companies have initiatives related to health care. Structured companies (contribute to the company’s overall mission and goals) with CSR policy have committee size varying from three to five directors with an independent director. During 2016–2017, they were mandated to spend Rs 4.2613bn out of which only 74.59 per cent was spent. Geographical spread of CSR initiatives is skewed, with majority of companies focussing on the states of Maharashtra and Gujarat, whereas the states of Odisha and North-Eastern being neglected. The focus areas of CSR are education, healthcare and rural development. The variation of MMR in different states of India is an indicator for corporate as to which state needs more attention. The corporate sector in India needs to focus on SDG3 target of MMR and move towards a newer dimension and direction.

The originality of this paper lies in the recognition of the initiative of Government of India of weaning out CSR activities outside the purview of business sense and towards instilling a social sense in company behaviour. This is a dimensional and directional change in the evolution of CSR practices in companies and countries. To this end, 59 healthcare sector companies under the threshold of Companies Act 2013 were studied and results were outlined.

The aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.

The data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.

The results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, received no advice about the delivery place, no pregnancy complications, decision about health care, and prior plan for home delivery were identified as significant predictors of home delivery. Cost of services, cultural practices and attitude towards health facility, lack of a female delivery assistant, perceived fear of caesarian section, poor quality of services, and lack of knowledge about maternity services appeared as important barriers for institutional delivery.

Based on primary data from a rural area, this study would help understand reasons and factors affecting home delivery and developing an appropriate strategy for the improvement of institutional delivery and maternity care services in Bangladesh.

The purpose of this study was to examine adverse outcomes associated with cesarean deliveries and to assess potential confounding factors.

A hospital-based cross-sectional study was conducted from September 1−30, 2019 using mixed methods of data collection. Multistage sampling was used to draw the eligible study participants. The sample size was calculated using the single population proportion formula. A systematic random sampling technique was used to draw the sample size. 180 original medical records were excluded because of having missed information, leaving 1,618 women as the study population. We used the questionnaire adapted from the Ethiopian Demographic and Health Survey to collect quantitative data and analyzed using SPSS version 22, while thematic analysis for qualitative measures was used to generate themes regarding associated perspectives of participants from a community.

More than 383 women delivered by cesarean section. 20% of the mothers with the mean age at birth of 26.1 ± 4.8 experienced adverse outcomes. Adjusted odds ratio (AOR) was used to measure the association of determinants and was 2.95 (95% CI 1.19–7.29) for nonuse of antenatal care, 3.18 (95% CI 1.43–6.94) for nonuse of prophylaxis, 4.28 (95% CI 1.58−11.61) for history of medical illness and 7.09 (95% CI 1.19−45.59) for use of substandard operation set up compared with their counterparts.

Strengths of the study include the finding of the study are reliably reported in mixed study methods examining hospital-based institutional and personal risk factors and exploring the whole community's perspectives. However, the important limitations of the study indicate that the study poses a number of challenges related to studying design, therefore there was not sufficient evidence of causality to draw conclusions from the findings. In addition, the study was conducted at a single hospital so that it is not convenient to generalize the findings of the study for setting different in social and economic status.

Based on the findings, attention has been drawn to healthcare personnel to provide training and consultation services for pregnant women and for health care administration to ensure standard set up for operation.

This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters.

A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software.

BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed.

Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.