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2 results

  • Equity effect of a community-based primary healthcare program on the incidence of childhood morbidity in rural Northern Ghana

  • Edmund Wedam Kanmiki, Abdullah A. Mamun, James F. Phillips, Martin O’Flaherty
  • Journal:
    Primary Health Care Research & Development / Volume 26 / 2025
    Published online by Cambridge University Press:
    28 February 2025, e23
    • Article
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  • Background:

    Childhood morbidity is a precursor and contributor to under-five child mortality. Community-based primary healthcare programs are culturally responsive and low-cost strategies for delivering maternal and child health services in rural communities.

    Aim:

    To evaluate the equity effect of the Ghana Essential Health Intervention Program (GEHIP) – a five-year community-based primary healthcare program – on childhood morbidity.

    Methods:

    GEHIP was implemented in the Upper East region of Northern Ghana. Household baseline and end line surveys conducted in 2010/2011 and 2014/2015, respectively, from both intervention and comparison districts were used to assess three childhood morbidity conditions: maternal recall of neonatal illness, the incidence of diarrhoea, and fever. Difference-in-differences analysis, mean comparison test, and multivariate logistic regressions are used to assess the effect of GEHIP exposure on these three childhood morbidity conditions.

    Results:

    Baseline sample data of 2,911 women and end line sample of 2,829 women were included in this analysis. There was generally more reduction in all three childhood morbidity conditions in intervention communities relative to comparison communities. Diarrhoea and fever had a statistically significant treatment effect (AOR = 0.95, p-value<0.01 and AOR = 0.94, p-value<0.001). Results of equity analysis indicate significant mean reductions for both the poor and non-poor for neonatal illness and diarrhea, while only the intervention group had a significant reduction for both poor and non-poor for fever. Regression analysis shows no significant equity/inequity effects of GEHIP on the incidence of diarrhoea and fever. Neonatal illness, however, shows significant effects of wealth within the intervention group.

    Conclusion:

    This study shows that GEHIP contributed significantly to childhood morbidity reduction. This implies that community-based strategies have the potential to improve child health and contribute to the attainment of the United Nations sustainable development goal related to child health. Specific targeted measures are recommended to ensure both the poor and relatively better-off benefit from interventions.

  • Chapter 12 - What Do We Know about the Children of Women over 40 and What Can Older Mothers Do to Optimize Their Children’s Development?

  • from Section 7 - Children of Older Parents
  • Edited by Dimitrios S. Nikolaou, David B. Seifer
  • Book:
    Optimizing the Management of Fertility in Women over 40
    Published online:
    15 September 2022
    Print publication:
    06 October 2022, pp 141-152

  • Summary

    Advancing maternal age impacts the risk of poor perinatal outcomes in women who conceived naturally to a greater extent than those who conceived by ART. Less is known about very advanced maternal age (>45) with use of ART compared with spontaneous conceptions due to the small numbers available for such analysis. Generally, there is no significant increase in adverse perinatal outcomes in pregnancies over 40, regardless of the mode of conception. Using donor oocytes to conceive at any age has increased adverse perinatal and neonatal outcomes compared to using IVF/ICSI with autologous oocytes or spontaneous conception. Single embryo transfer can minimize these associated risks with donor oocyte cycles. With advancing maternal age, there is an associated increased risk of childhood cancers. There is sparse data on this topic; however, there is evidence that an increased risk of childhood morbidity not requiring hospitalization is associated with advanced maternal age. Being an older mother shows to positively affect their children’s behavior and cognitive abilities, though age alone cannot explain all these observations. There is a well-documented increased risk of ASD associated with both increasing maternal and paternal age.