Maternal and Child Wellbeing

Maternal and Child Wellbeing Unit

The Center has documented shockingly high levels of childhood malnutrition among poor urban populations, largely driven by poor feeding practices in the first year of life. We have also generated evidence on how to improve feeding
practices for infants, specifically by promoting breastfeeding at household, community and workplace levels, as well as in health facilities. We must go deeper, however, to improve understanding of the contextual and relevant
influences on mothers regarding child nutrition, especially in the first 1,000 days of life, and how to promote and sustain good breastfeeding practices.

The Center has also initiated research to develop and test models of service delivery for maternal, newborn and child health within urban slum populations. These models have not yet been tested at scale and their utility in other marginalized communities is unknown. The overarching goal of this Unit is to understand the social and physical determinants of maternal health and child survival and potential to thrive, in order to develop effective intervention strategies for their promotion as part of the global push for improved maternal and child health outcomes. Three programmatic areas will define this agenda:

The signature issue for this Unit will be breastfeeding optimization. Situated within a broader Maternal, Infant and Young Child Nutrition research agenda, this program aims to understand multiple influences of, and strategies to optimize, early nutrition, including but not limited to the magnitude of visible and hidden maternal and child malnutrition, and the impacts of preconception nutrition and nutrition during the first 1,000 days of life on long-term health and human capital trajectories. The program will continue its work on developing and assessing interventions to optimize nutrition, specifically breastfeeding. At the macro level, the program will aim to characterize the nutrition transition in the African context and its influence on maternal and child nutrition and health.

The second program of work will be Early Childhood Development (ECD), to understand and promote contextual strategies to optimize early childhood development and understand the factors, interactions and pathways that
shape child health, development and early learning.

The Unit will also contribute to broader Maternal, Newborn and Child Health issues by monitoring MNCH health outcomes and influences in different contexts, including obstacles to access for MNCH services for vulnerable populations.

Featured Project

The role of a decision-support smartphone application in enhancing community health volunteers’ effectiveness to improve maternal and newborn outcomes in Nairobi, Kenya

Program: Maternal and Child Wellbeing

This study seeks to develop and validate a decision-support algorithm within an m-Health application to improve Maternal and Newborn Health (MNH) outcomes in the urban informal settlements within Kamukunji Sub-County in Nairobi. In order to assess the added value of using a CHV decision-support module of mobile partnership for maternal, newborn and child health (mPAMANECH) in reducing prenatal and postnatal maternal complications and newborn deaths, three specific research objectives were identified, namely, feasibility, acceptability and effects of the intervention.

The mobile application was developed as an integrated data capture tool with selected CHV reporting tools i.e. MOH 100, MOH 513 and MOH 514, and a decision support tool. The system was connected to selected health facilities in an attempt to improve CHV decision-making and referral mechanisms for mothers and newborns. Following a year of implementation, we explored the experiences of CHVs, health workers and members of sub-county health management teams with respect to improving maternal and newborn health outcomes in Kamukunji.

The findings reveal the necessity in considering the information and communication technology (ICT) readiness of users as well as the political and sociocultural environment. They also emphasize the importance of users in the development of such solutions. The study also demonstrates the feasibility and acceptability of this type of research in a previously under-researched sub-population. It serves as a basis for future work that could highlight opportunities to respond to the persistent challenges surrounding m-Health implementation in low-resource settings.

As more healthcare delivery models are developed, harnessing the potential of digital technologies to strengthen health systems is critical, as this provides a foundation for further innovation. Furthermore, the integration of new solutions into existing ones has the potential to improve use.

PROJECT PERIOD

  • Start date: May 2016
  • End date: May 2018

PROJECT FUNDER/S

  • County Innovation Challenge Fund (CICF) with Funds from the UK Department for International Development (DFID)

PROJECT TEAM

  • Dr. Pauline Bakibinga: Associate Research Scientist/Project Manager
  • Ms. Eva Kamande: Research Officer
  • Ms. Milka Omuya: Field Supervisor
  • Ms. Lyagamula Kisia: Field Supervisor

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