Women in resource constrained settings often fail to seek care because of inadequate money, even though they often belong to small financial social networks where they save to help each other during funerals, buy meat during festive days, and contribute to wedding preparations among many other things. The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study implemented in the districts of Kamuli, Kibuku and Pallisa exploited this opportunity by encouraging households to join existing financial social networks where households can save money, such as women’s saving groups, burial groups and financial circles, for maternal health. This Issue Brief outlines the key messages and recommendations from MANIFEST's experience.
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Reducing maternal and newborn deaths has been a key goal for the Government of Uganda. Focus has been put on increasing access to reproductive health services including antenatal care and skilled birth attendance. Reducing maternal and newborn deaths cannot be solely achieved through increasing access to reproductive health services and skilled birth attendance.
This brief shares key findings under the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study in both the intervention and control area. Integrated strategies were implemented to reduce maternal and newborn deaths in the districts of Kamuli, Kibuku and Pallisa, in Eastern Uganda.
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Recognising and rewarding the best performing health workers and facilities as a way of motivating them was one of the activities under the Health Systems Strengthening component of the MANIFEST Study. This Issues Brief shares the key lessons learned from the MANIFEST experience.
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Mentorship is deliberate pairing of a more skilled or experienced person with a lesser skilled or inexperienced one, with the agreed-upon goal of having the less experienced person to grow and develop specific competencies. Here, the more experienced (Mentor) guides the less experienced (Mentee) in the development of specific professional knowledge and skills which will promote personal and professional development of the mentee. This Brief is based on lessons learned from mentors and mentees following a one year mentorship exercise in three districts in Eastern Uganda.
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This MANIFEST Issue Brief shares lessons learned on how to enhance the commitment of district health teams, and presents the findings from quarterly district implementation committee review meeting minutes (four from each district), interviews with nine district health team members and observations made by the research team during the implementation of the project.
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Under the decentralized system of governance, health facilities are not only points of delivery but also hold resources that require management. The findings of this issue brief are based on 22 key informant interviews undertaken among health facility managers and select district health team members of three rural districts in Eastern Uganda. Pallisa, Kibuku and Kamuli were the districts in which Makerere University School of Public Health, through the MANIFEST study, intervened to improve management practices among health facility managers among other things.
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In order to enhance quality of maternal and newborn care, the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study team championed a support supervision programme in Kamuli, Kibuku and Pallisa Districts. This MANIFEST Issue Brief outlines the issue, the MANIFEST experience and the results.
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This MANIFEST Research brief presents some of the key results from the end line survey of the 4-year study which aimed at contributing to the reduction of maternal and neonatal deaths through the use of a participatory action research approach.
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This brief reflects upon the experience of FHS, a DFID funded RPC, with research capacity development. While FHS espoused a strong commitment to capacity development and put together a package of related strategies to support research capacity development among its partner organizations, these strategies met with varying degrees of success. We consider which types of capacity development strategies may work best for RPCs and under what circumstances.
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Throughout the duration of the Future Health Systems project (FHS), country teams have committed to undertaking systematic learning though implementation research and by bringing together key actors involved in service delivery. In this Key Message Brief, we share some examples of how FHS teams have embodied a “learning-by-doing” approach, and what the consequences of this approach have been.
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The concept of clinical mentorship is increasingly becoming important in order to improve the delivery of quality healthcare services. This MANIFEST Progress Brief is based on perspectives of mentors and mentees following a six month mentorship exercise in the districts of Kamuli, Kibuku and Pallisa in eastern Uganda. It outlines the issue, the approach taken, preliminary results, a summary of findings, improvements in clinical care, administrative improvements and challenges.
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This Progress Brief looks at the component of the MANIFEST study that aims to increase financial and physical access to maternal health services by promoting financial preparedness as well as availability of routine and referral transport. It outlines the approach taken, the preliminary findings, the challenges and the lessons learnt.
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This Progress Brief brief highlights implementation experiences from the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study using VHTs to stimulate demand for maternal and newborn health services. It outlines the approach taken, preliminary findings, challenges and lessons learnt.
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This MANIFEST Issue Brief looks at how to increase the use of Partographs to monitor the progress of labour. It explains what a partograph is, and provides practical tips for how to improve partograph use.
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The use of mHealth interventions within health systems research is increasing, with few taking into account the connections between gender and mHealth.
This policy brief attempts to fill this gap by exploring key connections between mHealth and gender that need to be taken into account when conducting or implementing mHealth research and interventions.
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Risks and adversities during early childhood majorly hamper this neurological development. They are also irreversible with long standing impact on the eventual productivity in life. Given the huge impact that deficits in the early years have in terms of human productivity and sustainable development, early childhood development needs serious attention. This research brief provides formative evidence on the gaps in the care practices needed for Early Childhood Development in the Sundarbans. It will begin by first gauging the status of child development, the gaps and challenges in key practices needed for it and it will conclude with key recommendations.
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Among the several determinants of child malnutrition – ranging from individual factors to societal ones – recent evidence indicates open defecation as an important determinant responsible for child malnutrition. This research brief explores the association between underweight children (0-6 years) and open defecation in the context of Indian Sundarbans, where low body weight is considered as an indicator of childhood malnutrition.
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In countries with high levels of poverty or instability and with poor health system management and governance, people are highly vulnerable to shocks associated with ill health, including major epidemics. An effective health system can help build their resilience by reducing exposure to infection and minimising the impact of sickness on livelihoods and economic development.
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Bangladesh has a serious shortage of physicians, paramedics, nurses, and midwives. The available qualified care providers are centred in urban areas, resulting in an inequitable access of the rural and disadvantaged sections of the population to healthcare. Under these circumstances, the use of mHealth meaning provision of healthcare services through mobile devices provides a new opportunity to ensure access to quality healthcare services for the population in general, and for people from poorer sections and hard-to-reach areas in particular. There are currently around 20 mHealth service initiatives in the country which are mostly telephone hotlines for consulting physicians and/or obtaining healthcare information. Effectiveness of these services depends on the evidence-informed development of appropriate programmes designed around people’s perceptions of mHealth and user feedback. To that end, FHS Bangladesh partner, ICDDR,B recently conducted a survey on mHealth in Chakaria, a rural area in the southeast coastal area of Bangladesh. This brief presents the findings from this survey.
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The health situation of children in the Indian Sundarbans couldn’t be more precarious. Facing chronic malnutrition as well as a high prevalence of easily preventable but highly communicable diseases, access for children to health services in the region is complicated by the rough terrain and the winding tidal rivers of the deltaic region.The key question is, what can be done to improve the health situation of children in the Sundarbans? This briefing answers that question by outlining the several methodologies employed in the study. It then considers both the demand and supply sides for child-centred health services in the block. It concludes with recommendations for beginning to repair the fractured health system there.
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