Maternal and Newborn Health Research Roundup – September 2024

1.

Human resources for health and maternal mortality in Latin America and the Caribbean over the last three decades: a systemic-perspective reflections  

In a comprehensive study spanning three decades, researchers have shed light on the intricate relationship between healthcare workforce availability and maternal mortality rates in Latin America and the Caribbean. Despite concerted efforts and specific programs aligned with the Millennium Development Goals, the region has faced significant challenges in reducing maternal mortality rates satisfactorily. The study highlights the critical role of human resources in health systems and the complex process of aligning supply with demand. It reveals a stark heterogeneity in the regional health systems’ responses to maternal mortality, with some countries deploying effective strategies tailored to their populations’ needs. The findings underscore that while the provision of health personnel alone cannot explain the variations in maternal mortality rates, it is essential to explore new ways for health workers to integrate and synergize with other resources to enhance system capacity for delivering care tailored to each country’s conditions. (1 April 2024)  

2.

Effect of group antenatal care versus individualized antenatal care on birth preparedness and complication readiness: a cluster randomized controlled study among pregnant women in Eastern Region of Ghana 

A recent study from Ghana reveals that group antenatal care (G-ANC) significantly enhances birth preparedness and complication readiness (BPCR) compared to individualized antenatal care (I-ANC). Conducted across 14 health facilities, the trial involved 1,285 pregnant women who participated in either G-ANC or I-ANC. Findings indicate that women in the G-ANC group were better at recognizing pregnancy danger signs and more likely to arrange emergency transport and save money for transportation. Specifically, the mean increase in danger sign recognition was from 1.8 to 3.4 in the G-ANC group, compared to 1.7 to 2.2 in the I-ANC group. Additionally, the percentage of women arranging emergency transport rose from 2% to 41% in the G-ANC group, versus 1.5% to 11.5% in the I-ANC group. These results suggest that G-ANC is a more effective approach for improving maternal health outcomes in rural Ghana, warranting further implementation of this model. (16 August 2024) 

3.

Functional integration of services during the antenatal period can potentially improve childhood growth parameters beyond infancy: findings from a post-interventional follow-up study in West Bengal, India 

A recent study from India reveals that integrating enhanced antenatal care services significantly benefits childhood growth parameters beyond infancy. Conducted between 2018 and 2019, the study involved 809 mother-child pairs, with the intervention group receiving augmented antenatal care, including targeted dietary counseling, supervised supplementary nutrition intake, and iron-folic acid supplementation. Follow-up data collected in 2021 showed that children in the intervention group had a significantly reduced risk of stunting, wasting, and being underweight compared to the control group. Specifically, the risk of stunting was reduced by 35%, wasting by 43%, and underweight by 39%. These findings underscore the long-term benefits of comprehensive antenatal care, suggesting that such interventions can have lasting positive effects on child health and development. (15 August 2024) 

4.

Development of a Quality Assurance Assessment Tool to meet accreditation standards for midwifery education: A Delphi study  

A recent Delphi study has successfully created a robust framework for evaluating and enhancing the quality of midwifery education. Conducted with a panel of 55 experts from Bangladesh, India, and Sweden, the study underwent three rounds of tool development, field testing, and consensus building. The resulting Quality Assurance Assessment Tool demonstrated strong face and content validity, aligning with both global education standards and national accreditation requirements. Minor revisions were made to improve clarity and feasibility. This tool is poised to significantly aid countries in assessing and improving their midwifery education programs, ensuring they meet international benchmarks and ultimately enhancing the quality of maternal and newborn care. (September 2024)  

5.

Prevalence of group B Streptococcus colonisation in mother–newborn dyads in low-income and middle-income south Asian and African countries: a prospective, observational study

A prospective, observational study examined rectovaginal Group B Streptococcus (GBS) colonization in 6,922 pregnant women at the time of labor across nine low- and middle-income countries in Africa and South Asia. The findings report a high overall prevalence of maternal GBS colonization at 24.1%, with the highest rates in Mali and the lowest in Ethiopia. The study also reported a concerning 72.3% rate of vertical transmission from colonized mothers to their newborns, with Mozambique showing the highest transmission rates. The most common GBS serotypes identified were Ia, V, and III, although there was notable geographical variation in serotype distribution, with certain serotypes more prevalent in specific regions. These findings raise concerns about the current multivalent capsular-polysaccharide GBS vaccines, as serotypes not covered by these vaccines are common in some areas. The study underscores the need for vaccine efficacy and post-licensure effectiveness studies to consider the potential for non-vaccine serotype replacement and its impact on maternal GBS colonization. (20 August 2024)