scholarly journals Mobile Money Use and Healthcare Utilization: Evidence from Rural Uganda

2020 ◽  
Vol 12 (9) ◽  
pp. 3741
Author(s):  
Hiroyuki Egami ◽  
Tomoya Matsumoto
Keyword(s):  
Antenatal Care ◽  
Fixed Effects ◽  
Developed Countries ◽  
Health Facilities ◽  
Care Utilization ◽  
Skilled Birth Attendants ◽  
Mobile Money ◽  
Birth Attendants ◽  
Heterogeneity Analysis ◽  
The Impact

Lack of cash on hand is a significant obstacle in accessing healthcare services in developing countries. Many expectant mothers in the least developed countries do not receive sufficient care during pregnancy due to financial constraints. If such hurdles in accessing healthcare can be overcome, it will contribute to reduction in maternal and newborn mortality, which is a key target of Sustainable Development Goal 3. This study reports the first assessment of the impact of mobile money services on maternal care utilization. We hypothesize that mobile money adoption would motivate rural Ugandan women to receive antenatal care and to deliver their children at health facilities or with skilled birth attendants. By receiving remittances utilizing mobile money, poor rural households may obtain more cash in hand, which might change women’s health-seeking behavior. We apply community- and mother-fixed effects models with heterogeneity analysis to longitudinal panel data (the RePEAT [Research on Poverty, Environment, and Agricultural Technology] survey) of three waves (2009, 2012, and 2015). The analysis uses pregnancy reports of 2007–2015 from 586 rural Ugandan households. We find suggestive evidence that mobile money adoption positively affects the take-up of antenatal care. Heterogeneity analysis indicates that mobile money brings a larger benefit to geographically challenged households by easing their liquidity constraint as they face higher cost of traveling to distant health facilities. The models failed to reject the null hypothesis of no mobile money effect on the delivery-related outcome variables. This study suggests that promoting financial inclusion by means of mobile money motivates women in rural and remote areas to make antenatal care visits while the evidence of such effect is not found for take-up of facility delivery or delivery with skilled birth attendants.

Globalization and health: An empirical investigation

2019 ◽  
Vol 19 (3) ◽  
pp. 207-224 ◽  
Author(s):  
Vishalkumar J Jani ◽  
Nisarg A Joshi ◽  
Dhyani J Mehta
Keyword(s):  
Health Status ◽  
Panel Data ◽  
Fixed Effects ◽  
Panel Data Analysis ◽  
Health Indicators ◽  
Developed Countries ◽  
Social Dimension ◽  
Three Dimensions ◽  
Infant Mortality Rate ◽  
The Impact

This article empirically examines the impact of globalization on the health status of countries by using panel data. Unlike previous studies, it has attempted to use three different dimensions of globalization and estimate their impact on health status measured by infant mortality rate and life expectancy. It also introduces an initial level of development status as an explanatory variable and found that it has an important role. The fixed effects panel data analysis shows that globalization has a positive impact on the health indicators. Out of the three dimensions of globalization, namely, economic, social and political, the first one has the highest influence on health for the less developed countries. However, as one moves up the ladder of development, social dimension becomes more important. Moreover, the pace of improvement in health indicators is faster in developed countries, indicating a divergence between the developed and the underdeveloped world.

scholarly journals Understanding Barriers and Facilitators of Maternal Health Care Utilization in Central Myanmar

2020 ◽  
Vol 17 (5) ◽  
pp. 1464
Author(s):  
Maja Aleksandra Milkowska-Shibata ◽  
Thin Thin Aye ◽  
San Myint Yi ◽  
Khin Thein Oo ◽  
Kyi Khaing ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
Traditional Birth Attendants ◽  
Barriers And Facilitators ◽  
Care Utilization ◽  
Study Objective ◽  
Birth Attendants

The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation (p ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery (p < 0.01). Utilization of postnatal care services was irregular (47.9%–70.9%) and strongly associated with women’s places of delivery (p < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.

scholarly journals The Prevalence of Skilled Birth Attendant Utilization and Its Correlates in North West Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Mulunesh Alemayehu ◽  
Wubegzier Mekonnen
Keyword(s):  
Skilled Birth Attendant ◽  
Skilled Birth Attendance ◽  
Northwest Ethiopia ◽  
Health Facilities ◽  
Health Centers ◽  
Skilled Birth Attendants ◽  
Urban Residence ◽  
North West ◽  
Birth Attendants ◽  
Birth Attendance

The low utilization of skilled birth attendants sustained high maternal mortality. The aim of this study was to assess its magnitude and correlates in Northwest Ethiopia. A study was conducted on 373 randomly selected women who gave birth in the 12 months preceding the survey. Correlates were identified using binary logistic regression. Skilled birth attendance was 18.8%. Inability to perform cultural practices in health facilities (65.5%), expecting smooth delivery (63.4%), and far distance (62%) were the main barriers. Women with urban residence (AOR = 5.46: 95% CI[2.21–13.49]), primary (AOR = 2.10: 95% CI[0.71–6.16]) and secondary-plus (AOR = 6.12:[1.39–26.92]) educational level, four-plus ANC visits (AOR = 17.33: 95% CI[4.22–71.29]), and proximity to health centers (AOR = 5.67: 95% CI[1.47–25.67]) had higher odds of using skilled birth attendants though women with no labor complications had lower odds (AOR = 0.02: 95% CI[0.01–0.05]). Skilled birth attendance use was low. Urban residence, primary-plus level of education, frequent ANC visits, living nearby the health centers, and a problem during labor were positively correlated with skilled birth attendance utilization. Stakeholders should enhance girls’ education beyond primary level and ANC services and shorten distances to health facilities.

scholarly journals Determinants of Disparity between Antenatal Bookings and Institutional Deliveries in Port Harcourt, Southern Nigeria

2020 ◽  
pp. 21-30
Author(s):  
Terhemen Kasso ◽  
Ojimah Chibianotu ◽  
Rosemary Ogu
Keyword(s):  
Qualitative Study ◽  
Antenatal Care ◽  
Health Workers ◽  
Structured Interview ◽  
Cost Of Care ◽  
Skilled Birth Attendants ◽  
Mortality And Morbidity ◽  
Birth Attendants ◽  
Port Harcourt ◽  
Depth Interviews

Aim: To determine the reasons why women deliver outside institutions where they register for antenatal care. Study Design: Qualitative study. Place and Duration of Study: Antenatal clinic of the University of Port Harcourt Teaching Hospital in February 2018. Methodology: A qualitative study using in-depth interviews (IDIs) was conducted in Port Harcourt, Nigeria to collect information on various reasons why women do not deliver where they received antenatal care (ANC) or with skilled birth attendants (SBAs). This was done using structured interview guides. Specifically, we asked 30 pregnant women to elucidate the circumstances that lead women to deliver in places other than where they had received antenatal care, and recommendations to enhance the number of women delivering with skilled birth attendants. All in-depth interviews were audio-taped, transcribed and content-analyzed. Results: Thirty IDIs were carried out. The women were all pregnant; aged 20 to 43 years old with mean age of 32.9 ± 5.5 years. The broad themes that emerged from their responses: Cost/financial reasons relating to inability to afford the cost of care in the hospitals, personal reasons such as fear of Caesarean section, and hospital-related reasons such as health workers’ strike action. Conclusion:  Evidence from our study indicates that pregnant women’s non-use of skilled birth attendants during childbirth even when they received antenatal care in the hospital is mainly due to financial, personal and hospital-related reasons. These factors are modifiable and should be targeted to increase delivery with skilled attendants, a key strategy for the reduction of maternal and neonatal mortality and morbidity.

Health Care Cost Growth

2011 ◽  
pp. 307-328 ◽  
Author(s):  
Michael E. Chernew ◽  
Dustin May
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Population Aging ◽  
Health Care Systems ◽  
Developed Countries ◽  
The United States ◽  
Care Utilization ◽  
Care Plans ◽  
Cost Growth ◽  
The Impact

Health care cost growth is among the most important issues facing the United States and other developed countries. This article describes the rapid growth in expenditure in most developed countries, and discusses the factors that have driven this growth, such as population aging, general economic growth, and the adoption and use of new medical technologies. The public financing aspect of health care spending adds an additional dimension to assessing the impact of rapid health care cost growth. The article considers a range of strategies for slowing cost growth, including economic evaluation of technologies. Most health care systems employ some method of cost sharing as a means to reduce health care utilization. This article also discusses managed care plans that integrate the financing and delivery of care. However, as costs grow, pressures to control spending will grow and distributional issues will become even more salient.

scholarly journals Exploring antenatal care utilization and intimate partner violence in Benin - are lives at stake?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dina Idriss-Wheeler ◽  
Sanni Yaya
Keyword(s):  
Intimate Partner Violence ◽  
Maternal Health ◽  
Antenatal Care ◽  
Partner Violence ◽  
Service Providers ◽  
Multivariate Logistic Regression Analysis ◽  
Intimate Partner ◽  
Care Utilization ◽  
Positive Health ◽  
The Impact

Abstract Background The republic of Benin ranks in the bottom third of countries recently assessed for ANC coverage and its Ministry of Family and National Solidarity (2009) reported close to 70% of Beninese women suffered abuse at least once in their lifetime. Utilization of antenatal care (ANC) services is key to positive health outcomes for both mother and infant. This study examined the impact of intimate partner violence (IPV) on the utilization of ANC services in Benin using both the basic 4 visit model (ANC-4) and the updated WHO recommended 8-visit model (ANC-8). Methods Data used for this study were collected from the nationally representative 2017–2018 Benin Demographic Health Survey (BDHS) on ever-partnered women aged 15–49 who had completed both reproductive maternal health and domestic violence modules of the survey. Descriptive statistics and multivariate logistic regression analysis were performed to determine significant factors associated with ANC utilization in Benin. Results Over 40% of the women (n = 3084) reported experience of IPV in their lifetime. Findings revealed that women who ever experienced IPV (OR 0.753, 95% CI: 0.628–0.901; p = 0.002) had 25% less odds of accessing the basic four ANC visits. IPV was not found to be a factor in accessing at least eight ANC visits. With increasing number of children, there was less likelihood of accessing at least four and at least eight visits. Being in the richest quintile (OR 5.490, 95% CI 3.907–7.714; p < 0.000 for ANC-4; OR, 5.781, 95% CI: 3.208–10.41; p < 0.000), making decisions on household and health care (OR 1.279, 95% CI: 1.042–1.569 for ANC-4; OR, 1.724; 95% CI: 1.170–2.540; p = 0.006 for ANC-8), and getting paid cash for work increased the chances of utilizing ANC-four (OR 1.451, 95% CI: 1.122–1.876; 0.005) but not for ANC-eight. Belonging to the Muslim faith decreased the odds of ANC utilization compared to all other religions. Conclusion This work revealed key areas for maternal health policy makers and service providers in Benin to appropriately plan effective policies (i.e., alleviate poverty; equitable health services access; cultural sensitivity) and necessary interventions (i.e. ANC education, IPV prevention, paid employment, alcohol cessation) to increase utilization of ANC.

scholarly journals Impact of Covid-19 Pandemic on Anc Clinic Visits and Deliveries by Skill Birth Attendant: A Retrospective Analysis in Kaduna State

2021 ◽  
pp. 1-5
Author(s):  
Abiola Clementina Ajibola ◽  
◽  
Saude Sagir ◽  
Keyword(s):  
Pregnant Women ◽  
Infection Prevention ◽  
Clinic Visit ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Significant Difference ◽  
Antenatal Attendance ◽  
The Impact ◽  
One Way Anova

COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) was first discovered in December 2019 in Wuhan, China and later declared a pandemic on March 11, 2020 by the WHO. This study was conducted to assess the impact of COVID -19 pandemic and its attendant infection prevention of lockdown on ANC utilization and deliveries by skilled birth attendants in Kaduna State. It is a retrospective data review of 18 months data on ANC clinic visit and skill birth delivery from 1,722 health facilities. October 2019 to March 2021 data was extracted from the DHIS 2. The analysis was carried out on SPSS using One Way ANOVA. A decline of 13.5% antenatal attendance for first booking compared to pre-COVID-19 was recorded. There was a slight increase of 3.5% Post-COVID-19. There was also a reduction of 4.1% in the number of pregnant women who had the four recommended ANC visits during the COVID-19 compared to pre-COVID-19 period. However, there was a reduction of 10.2% of pregnant women returning post COVID-19 lockdown. The study revealed increased number of pregnant women that delivered during and post COVID-19. There was an increase of 2, 753 and 1,699 during and post-COVID-19, respectively. At 95% confidence interval using significance value is 0.610 (i.e., p = .610), the significance is more than 0.05. Therefore, there is no statistically significant difference in the ANC utilization and skill birth attendance before, during and after the Covid-19 pandemic. Therefore Covid-19 did not affect ANC and skill birth deliveries.

scholarly journals Role of Central Bank Independence in Banking and Financial Stability Ensuring

2020 ◽  
Vol 4 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Victoria Dudchenko
Keyword(s):  
Developing Countries ◽  
Central Bank ◽  
Financial Stability ◽  
Fixed Effects ◽  
Developed Countries ◽  
Central Bank Independence ◽  
Stage Of Development ◽  
Banking Stability ◽  
The Impact

This paper is devoted to defining the role of the central bank in ensuring banking and financial stability. The main purpose of the study is to assess the direction and strength of the impact of central bank independence in terms of its individual aspects on the parameters of banking and financial stability for different groups of countries. Systematization of literature sources and the results of existing empirical research has shown that the expected effects of increasing the independence of the central bank are to improve banking and financial stability. For the study, a sample of statistical data for 10 developed and 10 developing countries for the period 1991-2012 was formed. The methodological basis of the study were the tools of panel regression modeling with fixed effects with Stata software use. The article presents the results of empirical analysis, which showed that the independence of the central bank is an important factor in ensuring banking stability. At the same time, the impact on financial stability has not been conclusively confirmed. The study empirically confirms and theoretically proves that the stage of development of the country determines the strength of such influence. Thus, developed countries generally show closer links between central bank independence and banking and financial stability, which in most cases are directly dependent, while developing countries have less lasting effects. The results of the analysis of the links between certain aspects of central bank independence and the level of banking and financial stability are of great practical value. The results of the study create a scientific basis for substantiating the sequence of actions aimed at strengthening the independence of the central bank. Thus, in developing countries, the focus should be on defining and prioritizing central bank goals, while developed countries should take a deeper approach to this issue and ensure the independence of monetary policy and financial independence of the central bank. Keywords: central bank, independence, banking stability, financial stability, Z-score, non-performing loans, capitalization, developed countries, developing countries, panel data.

scholarly journals The 4MOTHERS trial of the impact of a mobile money-based intervention on maternal and neonatal health outcomes in Madagascar: study protocol of a cluster-randomized hybrid effectiveness-implementation trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Etienne Lacroze ◽  
Till Bärnighausen ◽  
Jan Walter De Neve ◽  
Sebastian Vollmer ◽  
Rolland Marie Ratsimbazafy ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Outcomes ◽  
Sub Saharan Africa ◽  
Trial Registration ◽  
World Health ◽  
Neonatal Health ◽  
Mobile Money ◽  
Maternal And Neonatal Health ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Mobile money—a service enabling users to receive, store, and send electronic money using mobile phones—has been widely adopted across low- and middle-income economies to pay for a variety of services, including healthcare. However, evidence on its effects on healthcare access and health outcomes are scarce and the possible implications of using mobile money for financing and payment of maternal healthcare services—which generally require large one-time out-of-pocket payments—have not yet been systematically assessed in low-resource settings. The aim of this study is to determine the impact on health outcomes, cost-effectiveness, feasibility, acceptability, and usefulness of mobile phone-based savings and payment service, the Mobile Maternal Health Wallet (MMHW), for skilled healthcare during pregnancy and delivery among women in Madagascar. Methods This is a hybrid effectiveness-implementation type-1 trial, determining the effectiveness of the intervention while evaluating the context of its implementation in Madagascar’s Analamanga region, containing the capital, Antananarivo. Using a stratified cluster randomized design, 61 public-sector primary-care health facilities were randomized within 6 strata to either receive the intervention or not (29 intervention vs. 32 control facilities). The strata were defined by a health facility’s antenatal care visit volume and its capacity to offer facility-based deliveries. The registered pre-specified primary outcomes are (i) delivery at a health facility, (ii) antenatal care visits, and (iii) total healthcare expenditure during pregnancy, delivery, and neonatal period. The registered pre-specified secondary outcomes include additional health outcomes, economic outcomes, and measurements of user experience and satisfaction. Our estimated enrolment number is 4600 women, who completed their pregnancy between July 1, 2020, and December 31, 2021. A series of nested mixed-methods studies will elucidate client and provider perceptions on feasibility, acceptability, and usefulness of the intervention to inform future implementation efforts. Discussion A cluster-randomized, hybrid effectiveness-implementation design allows for a robust approach to determine whether the MMHW is a feasible and beneficial intervention in a resource-restricted public healthcare environment. We expect the results of our study to guide future initiatives and health policy decisions related to maternal and neonatal health and universal healthcare coverage through technology in Madagascar and other countries in sub-Saharan Africa. Trial registration This trial was registered on March 12, 2021: Deutsches Register Klinischer Studien (German Clinical Trials Register), identifier: DRKS00014928. For World Health Organization Trial Registration Data Set see Additional file 1.

Sign in / Sign up

Export Citation Format

Share Document