To improve maternal and child health, the Nigerian government introduced the Midwives Service Scheme (MSS), a program to increase access to skilled care in rural areas. Experts evaluated the impact of MSS and found that initial improvements were not sustained.
Nigeria is the world's second-largest contributor to under-five and maternal mortality. To address low rates of use of maternal and child health services, the government deployed midwives to work in rural communities. How effective has this program been?
RAND Labor and Population conducts research related to children and families, including childhood health and access to health care, children's success in early childhood programs such as child care and preschool, and government assistance programs for low-income families.
The Better Obstetrics in Rural Nigeria (BORN) Study examines the effectiveness of the MSS. A nested qualitative study led by RAND Europe evaluated nine primary care clinics that appeared to be having differing success in terms of recruitment/retention of midwives and uptake of services.
RAND is conducting a "natural experiment" in Malawi, where the government banned TBAs in 2007. The study is estimating whether the ban succeeded in shifting women into health facilities, and what impacts the ban had on newborn deaths.
Our finding that the rate of major obstetrical complications varies markedly across US hospitals should prompt clinicians and policy makers to develop comprehensive quality metrics for obstetrical care and focus on improving obstetrical outcomes.
Home visiting programs can deliver much-needed health care to vulnerable children and their families. However, program implementation efforts in New Mexico have been thwarted by funding delays, insufficient resources, and poor execution of crucial capacity-building tools.
In an observational study using a difference-in-differences design, the relationship between the Chiranjeevi Yojana programme and the probability of delivery in health-care institutions, the probability of obstetric complications and mean household expenditure for deliveries was subsequently examined.
Inadequate numbers of Nurse Practitioners (NPs) trained in Sexual and Reproductive Health (SRH) and expanding health insurance coverage from health care reform will create a gap in NPs to meet SRH needs. Policy options that could help close this gap are examined.
To learn how hospital labor and delivery units can achieve effective and sustainable teamwork practices and how much such practices affect staff experiences and patient outcomes, RAND researchers studied five units as they implemented improvements.
The Guatemalan Survey of Family Health was designed to examine the way in which rural Guatemalan families and individuals cope with childhood illness and pregnancy, and the role of ethnicity, poverty, social support, and health beliefs in this process.
Results suggest a policy strategy focused first on enacting laws that would encourage a patient-centered approach, by developing and using hospital protocols to implement state policy, and then on educating physicians about the actual legal environment.