03. Journals

2,963 items available

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http://hdl.handle.net/10986/2210

These are journal articles published in World Bank journals as well as externally by World Bank authors.

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Now showing 1 - 4 of 4

Quality of Clinical Assessment and Child Mortality: A Three-Country Cross-Sectional Study

(Oxford University Press, 2020-06) Perales, Nicole A. ; Wei, Dorothy ; Khadka, Aayush ; Leslie, Hannah H. ; Hamadou, Saidou ; Chamberlin Yama, Gervais ; Robyn, Paul Jacob ; Shapira, Gil ; Kruk, Margaret E. ; Fink, Gunther

This analysis describes specific gaps in the quality of health care in Central Africa and assesses the association between quality of clinical care and mortality at age 2–59 months. Regionally representative facility and household surveys for the Democratic Republic of the Congo, Cameroon and Central African Republic were collected between 2012 and 2016. These data are novel in linking facilities with households in their catchment area. Compliance with diagnostic and danger sign protocols during sick-child visits was observed by trained assessors. We computed facility- and district-level compliance indicators for patients aged 2–59 months and used multivariate multi-level logistic regression models to estimate the association between clinical assessment quality and mortality at age 2–59 months in the catchment areas of the observed facilities. A total of 13 618 live births were analysed and 1818 sick-child visits were directly observed and used to rate 643 facilities. Eight percent of observed visits complied with 80% of basic diagnostic protocols, and 13% of visits fully adhered to select general danger sign protocols. A 10% greater compliance with diagnostic protocols was associated with a 14.1% (adjusted odds ratio (aOR) 95% CI: 0.025–0.244) reduction in the odds of mortality at age 2–59 months; a 10% greater compliance with select general danger sign protocols was associated with a 15.3% (aOR 95% CI: 0.058–0.237) reduction in the same odds. The results of this article suggest that compliance with recommended clinical protocols remains poor in many settings and improvements in mortality at age 2–59 months could be possible if compliance were improved.
The Child Health Effects of Terrorism: Evidence from the Boko Haram Insurgency in Nigeria

(Taylor and Francis, 2018-08-25) Ekhator, Uche Eseosa ; Asfaw, Abraham Abebe

This study examines the effect of terrorism on height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, stunting, and wasting. Using the Boko Haram Insurgency, it compares outcomes in Boko Haram high-active and low-active areas. A difference-in-difference and regression model identifies the extensive and intensive margin effects respectively. The study uses data from the Nigeria Demographic and Health Survey and the Global Terrorism Database. The results suggest that the Boko Haram Insurgency reduces weight-for-age and weight-for-height z-scores and increases the probability of wasting. The evidence suggests that policies targeting healthcare services may mitigate the long-term impacts of the Boko Haram Insurgency on human capital production.
Pathways to High and Low Performance: Factors Differentiating Primary Care Facilities under Performance-Based Financing in Nigeria

(Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine, 2018-01) Mabuchi, Shunsuke ; Sesan, Temilade ; Bennett, Sara C.

The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centers (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices. We used a multiple case study where we compared two high-performing PHCCs and two low-performing PHCCs for each of the two PBF target states. Two teams of two trained local researchers spent 1 week at each PHCC and collected semi-structured interview, observation and documentary data. Data from interviews were transcribed, translated and coded using a framework approach. The data for each PHCC were synthesized to understand dynamic interactions of different elements in each case. We then compared the characteristics of high and low performers. The areas in which critical differences between high and low-performers emerged were: community engagement and support; and performance and staff management. We also found that (i) contextual and health system factors particularly staffing, access and competition with other providers; (ii) health center management including community engagement, performance management and staff management; and (iii) community leader support interacted and drove performance improvement among the PHCCs. Among them, we found that good health center management can overcome some contextual and health system barriers and enhance community leader support. This study findings suggest a strong need to select capable and motivated health center managers, provide long-term coaching in managerial skills, and motivate them to improve their practices. The study also highlights the need to position engagement with community leaders as a key management practice and a central element of interventions to improve PHCC performance.
'Once the delivery is done, they have finished': A Qualitative Study of Perspectives on Postnatal Care Referrals by Traditional Birth Attendants in Ebonyi State, Nigeria

(Springer Nature, 2017-12-19) Chukwuma, Adanna ; Mbachu, Chinyere ; Cohen, Jessica ; Bossert, Thomas ; McConnell, Margaret

While 79% of Nigerian mothers who deliver in facilities receive postnatal care within 48 h of delivery, this is only true for 16% of mothers who deliver outside facilities. Most maternal deaths can be prevented with access to timely and competent health care. Thus, the World Health Organization, International Confederation of Midwives, and International Federation of Gynecology and Obstetrics recommend that unskilled birth attendants be involved in advocacy for skilled care use among mothers. This study explores postnatal care referral behavior by TBAs in Nigeria, including the perceived factors that may deter or promote referrals to skilled health workers. Differences in TBA referral before, during, and after delivery appear to reflect the TBAs understanding of the added value of skilled care for the client and the TBA, as well as the TBA’s perception of the implications of referral for her credibility as a maternal care provider among her clients. We also found that there are opportunities to engage TBAs in routine postnatal care referrals to facilities in Nigeria by using incentives and promoting a cordial relationship between TBAs and skilled health workers. Thus, despite the potential negative consequences TBAs may face with postnatal care referrals, there are opportunities to promote these referrals using incentives and promoting a cordial relationship between TBAs and skilled health workers. Further research is needed on the interactions between postnatal maternal complications, TBA referral behavior, and maternal perception of TBA competence.