Individual- and Neighborhood-Level Factors of Measles Vaccination Coverage in Niamey, Niger: A Multilevel Analysis.

Vaccination is a proven equitable intervention if people take advantage of the opportunity to get vaccinated. Niger is a low-income country in West Africa, with a 76% measles 1 vaccination coverage rate in 2016. This study was conducted to identify individual- and neighborhood-level factors that could improve measles 1 vaccination coverage in Niamey, the capital. In October 2016, 460 mothers with children aged 12-23 months were surveyed. The outcome was to determine whether the mother's child had been vaccinated against measles 1 or not. For individual-level variables of measles 1 vaccination status, the following were included: mother's age group, mother tongue, maternal education level, husband's job, where the mother gave birth (at home or at a health center) and whether the mother discussed vaccination with friends. Neighborhood-level factors were access time to the health center, household access to electricity, and a grand-mean-centered wealth score. Multilevel logistic regression analysis was performed. At the individual-level, primary and secondary-educated mothers were more likely to vaccinate their children against measles 1 (aOR 1.97, 95% CI 1.11-3.51). At the neighborhood-level, no factors were identified. Therefore, a strengthened focus on equity-based, individual factors is recommended, including individual motivation, prompts and ability to access vaccination services.

Effects of the maternal and child health handbook and other home-based records on mothers' non-health outcomes: a systematic review.

OBJECTIVE: This review aimed to investigate the effects of the maternal and child health (MCH) handbook and other home-based records on mothers' non-health outcomes. DESIGN: Systematic review. DATA SOURCES: PubMed, Web of Science, CINAHL, Academic Search Complete, PsycArticles, PsycINFO, SocINDEX, CENTRAL, NHS EED, HTA, DARE, Ichuushi and J-STAGE through 26 March 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Original research articles examining home-based records and mothers' non-health outcomes published in English or Japanese across various study designs. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted relevant data and assessed the risk of bias. We assessed the certainty of evidence for each study using the Grading of Recommendations Assessment, Development, and Evaluation approach. Due to the heterogeneity of the included studies, we conducted a narrative synthesis of their findings. RESULTS: Of the 4199 articles identified, we included 47 articles (20 in Japanese) in the review. Among the different types of home-based records, only the MCH handbook provided essential information about the mother-child relationship, and its use facilitated the mother-child bonding process. Mothers reported generally feeling satisfied with the use of home-based records; although their satisfaction with health services was influenced by healthcare providers' level of commitment to using these records. While home-based records positively affected communication within the household, we observed mixed effects on communication between mothers/caregivers and healthcare providers. Barriers to effective communication included a lack of satisfactory explanations regarding the use of home-based records and personalised guidance from healthcare providers. These records were also inconsistently used across different health facilities and professionals. CONCLUSIONS: The MCH handbook fostered the mother-child bond. Mothers were generally satisfied with the use of home-based records, but their engagement depended on how these records were communicated and used by healthcare providers. Additional measures are necessary to ensure the implementation and effective use of home-based records. PROSPERO REGISTRATION NUMBER: CRD42020166545.

Roles of the Maternal and Child Health Handbook and Other Home-Based Records on Newborn and Child Health: A Systematic Review.

Home-based records are paper or electronic records retained and used by mothers or caregivers to document the health services received for maternal, newborn, and child health. Little has been studied about the roles of these records on newborn and child health outcomes. Hence, we collated and summarized evidence concerning the roles of home-based records in improving newborn and child health. We conducted a systematic search in several databases: MEDLINE, Web of Science, CINAHL, PsycINFO, PsycARTICLES, Academic Search Complete, SocINDEX, CENTRAL, DARE, NHS EED, HTA, J-STAGE, Ichushi, and gray literature. We included original research articles of all study designs published in English or Japanese until January 2020. Owing to heterogeneity across the outcomes of included studies, we conducted a narrative synthesis. We included 55 studies (23 in Japanese) among 14,017 identified articles. We identified the following roles of home-based records on newborn and child health: promoted newborn/childcare seeking, improved knowledge and practices of newborn/childcare, encouraged home care for childhood illnesses, reduced child mortality and morbidity, and facilitated continuum of care. We observed a mixed effect on age-appropriate immunization (e.g., DTP3 completion) and no effect on the practice of immediate breastfeeding and prevention of perinatal mortality and morbidity. The findings highlighted the effectiveness and usefulness of home-based records to improve newborn and child health outcomes. However, only a few studies were available for each outcome category, limiting the certainty of evidence provided in this review. Therefore, we recommend further studies to explore the benefits of home-based records on improving newborn and child health.

Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis.

METHODS: We searched for evidence regarding community-based peer support for mothers in databases, such as PubMed/MEDLINE, the Cochrane Library, CINAHL, Web of Science, SocINDEX, and PsycINFO. We selected three outcome variables for breastfeeding practices, namely, exclusive breastfeeding duration, breastfeeding within the first hour of life, and prelacteal feeding. We conducted meta-analyses of the included randomized controlled trials and quasi-experimental studies. RESULTS: For our review, we selected 47 articles for synthesis out of 1,855 retrieved articles. In low- and middle-income countries, compared to usual care, community-based peer support increased exclusive breastfeeding at 3 months (RR: 1.90, 95% CI: 1.62-2.22), at 5 months (RR: 9.55, 95% CI: 6.65-13.70) and at 6 months (RR: 3.53, 95% CI: 2.49-5.00). In high-income countries, compared to usual care, peer support increased exclusive breastfeeding at 3 months (RR: 2.61, 95% CI: 1.15-5.95). In low- and middle-income countries, compared to usual care, peer support increased the initiation of breastfeeding within the first hour of life (RR: 1.51, 95% CI: 1.04-2.21) and decreased the risk of prelacteal feeding (RR: 0.38, 95% CI: 0.33-0.45). CONCLUSIONS: Community-based peer support for mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3-6 months in low- and middle-income countries. Such support also encourages mothers to initiate breastfeeding early and prevents newborn prelacteal feeding.