219427 Assessment of Integration of Postpartum/postnatal Care in Zambia

Wednesday, November 10, 2010

Kuhu Maitra, MBBS, DCH, MD , International Health, Abt Associates Inc, Bethesda, MD
Michelle T. Wallon, MA , Health Services and Systems Program (HSSP), Jhpiego - Zambia, Lusaka, Zambia
Judith Fullerton, PhD, CNM, FACNM , Independent Consultant: Reproductive/Maternal and Child Health, Research and Evaluation, U of CA San Diego (retired), San Diego, CA
Donna Vivio, MPH, MS, CNM , Reproductive Health, WHO Bangladesh, Dhaka, Bangladesh
Melinda Ojermark, MPH , International Health Division, Abt Associates, Bethesda, MD
Nanthalile Mugala, MMed, MBcHB , USAID funded NGO, Health services and systems programme, Lusaka, Zambia
Caroline Chibawe-Phiri, MPH, MBcHB , International Health, JHPIEGO, Lusaka, Zambia
Zambia's maternal mortality rate currently stands at 591/100,000, a significant decrease from 729/100,000 in 2002. The postpartum period has been identified as a key area in which substantial improvements must be made. More than half (51%) of postpartum women in Zambia receive no postnatal care. The Health Services and Systems Program undertook a qualitative case study in July of 2009, to determine whether the combined effects of health programming in child health and nutrition (CHN), integrated reproductive health (IRH), and systems strengthening resulted in the integrated delivery of postpartum and postnatal services at the health facility level.

Health facilities that had received systems strengthening, IRH, and CHN program inputs were selected as the nine study sites in three districts. The study sample was comprised of women of reproductive age, who had recently given birth or previously received services related to a prior pregnancy; fathers of infants; community representatives; health service managers and; health care providers. Ten research assistants conducted the 257 facility and community-based interviews/focus group discussions, using specifically developed interview guides. Key results: 1) IRH, CHN, and systems strengthening program inputs have made a positive difference in service delivery and; 2) trained providers have every intention to offer more and better integrated postpartum/postnatal services. .

Study conclusions address training reinforcement, facility configuration, and assuring inclusion of all WHO-recommended essential elements of postpartum and postnatal care services. The analysis can guide governments and partners in low-resource settings in the development of programs to achieve improved maternal and child health outcomes.

Learning Areas:
Planning of health education strategies, interventions, and programs
Program planning
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Participants will be able to identify the components of an integrated package of postpartum/postnatal care services 2. Participants will be able to describe how programming in reproductive health, child health, and systems strengthening can contribute to an integrated package of care 3. Participants will be able to describe the challenges to achieving an integrated package of postpartum/postnatal care in low-resource settings

Keywords: Access to Health Care, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the design and monitoring of the study. I am one of the authors of the study design.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.