A Comparative Analysis of Healthcare Facilities: With and Without 24/7 Interventions.
DOI:
https://doi.org/10.61919/jhrr.v4i2.789Keywords:
24/7 healthcare, maternal health, neonatal health, public health, rural healthcare, healthcare accessibility, MNCH services, Tharparkar, maternal mortality, child health indicatorsAbstract
Background: Maternal and neonatal mortality remains disproportionately high in low and middle-income countries, particularly in remote areas with limited healthcare accessibility. The Tharparkar district of Sindh, Pakistan, exemplifies such challenges, with basic utilities and healthcare services notably lacking.
Objective: This study aimed to assess the impact of 24/7 availability of Maternal, Newborn, and Child Health (MNCH) services on healthcare delivery and patient outcomes in government healthcare facilities in the Tharparkar district.
Methods: This action research followed a cross-sectional study design. Data collection commenced after receiving ethical approval and written consent from the Government District Health Officer of Tharparkar. Longitudinal data were collected using District Health Information tools from six healthcare facilities, three of which operated 24/7 and the remaining three for six hours daily. Data included indicators such as general outpatient department (OPD) visits, non-vaginal deliveries (NVD), antenatal, postnatal care, family planning, immunization, neonatal deaths, stillbirths, and live births. Statistical analysis was conducted using SPSS version 25, and results were visualized using Tableau 2024.
Results: Facilities operating 24/7 reported a significant increase in healthcare utilization: general OPD attendance increased by 118.5% at THQ Kheeme Jo Par, 168.2% at GD Jese Jo Par, and 150.5% at GD Mehrna Vero. There were also notable improvements in NVD, antenatal, postnatal care, and family planning services. Immunization rates improved, stillbirths decreased, and there were zero neonatal deaths reported in these facilities following the intervention.
Conclusion: The implementation of 24/7 MNCH services in Tharparkar significantly enhanced healthcare service delivery and improved maternal and child health outcomes. Continuous healthcare availability is crucial for improving health indicators and achieving global health targets in underserved populations.
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References
Wignarajah S, Bhuiyan SU, Gugathasan A. The Maternal and Child Health (MCH) Handbook and Its Influence on Health Behaviors: A Literature Review. Eur J Environ Public Heal. 2022;6(1):1–10.
World Health Organization. Maternal Mortality [Internet]. 2023 [cited 2024 Apr 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
Asfaha BT, Gebremariam SH, Gebremariam GK, Weldemariam AG. Knowledge About Obstetric Danger Signs and Related Factors in Reproductive-Age Women in the Southeast Zone of Tigray, 2021: A Cross-Sectional Study. Int J Reprod Med. 2022;2022(7346618).
Rosa-Mangeret F, Benski AC, Golaz A, Zala PZ, Kyokan M, Wagner N, et al. 2.5 Million Annual Deaths—Are Neonates in Low-And Middle-Income Countries Too Small to Be Seen? A Bottom-Up Overview on Neonatal Morbi-Mortality. Trop Med Infect Dis. 2022;7(5):1–21.
Prater E. A Third of Women Suffer Long-Term Medical Consequences After Giving Birth. These 9 ‘Underreported’ Health Problems Are Impacting Millions [Internet]. 2023 [cited 2024 Apr 9].
Aziz A, Saleem S, Nolen TL, Pradhan NA, McClure EM, Jessani S, et al. Why Are the Pakistani Maternal, Fetal and Newborn Outcomes So Poor Compared to Other Low and Middle-Income Countries? Reprod Health [Internet]. 2020;17(3):1–13. Available from: https://doi.org/10.1186/s12978-020-01023-5
Shaeen SK, Tharwani ZH, Bilal W, Islam Z, Essar MY. Maternal Mortality in Pakistan: Challenges, Efforts, and Recommendations. Ann Med Surg. 2022;81:2019–21.
Knoema. Pakistan - Maternal Mortality Ratio (Modeled Estimate) [Internet]. [cited 2024 Apr 9]. Available from: https://knoema.com/atlas/Pakistan/topics/Health/Health-Status/Maternal-mortality-ratio
Agha S, Fitzgerald L, Fareed A, Rajbhandari P, Rahim S, Shahid F, et al. Quality of Labor and Birth Care in Sindh Province, Pakistan: Findings from Direct Observations at Health Facilities. PLoS One. 2019;14(10):e0223701.
Iqbal S, Maqsood S, Zakar R, Zakar MZ, Fischer F. Continuum of Care in Maternal, Newborn and Child Health in Pakistan: Analysis of Trends and Determinants from 2006 to 2012. BMC Health Serv Res. 2017;17(189).
Lassi ZS, Kumar R, Bhutta ZA. Community-Based Care to Improve Maternal, Newborn, and Child Health. In: Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities [Internet]. third. 2016.
Sahoo KC, Negi S, Patel K, Mishra BK, Palo SK, Pati S. Challenges in Maternal and Child Health Services Delivery and Access During Pandemics or Public Health Disasters in. Healthcare. 2021;9(828).
U.S. Department of Health & Human Services. The Surgeon General's Call to Action: To Improve Maternal Health [Internet]. 2018.
Malik MA, Rohm LR, Van Baal P, Van Doorslaer EVD. Improving Maternal and Child Health in Pakistan: A Programme Evaluation Using a Difference in Difference Analysis. BMJ Glob Heal. 2021;6(e006453).
Sharma BB, Pennell C, Sharma B, Smith R. Reducing Maternal Mortality in Low- and Middle-Income Countries: The Nepalese Approach of Helicopter Retrieval. Am J Obstet Gynecol [Internet]. 2024;1–4.
Rahaman M, Roy A, Chouhan P, Malik NI, Bashir S, Ahmed F, et al. Contextualizing the Standard Maternal Continuum of Care in Pakistan: An Application of Revised Recommendation of the World Health Organization. Front Public Heal. 2023;11(1261790).
Endehabtu BF, Angaw DA, Gonete TZ, Jisso M, Abera N, Alemayehu A, et al. Availability of Maternal, Newborn Care and Child Health Services at Primary Health Care Unit During COVID-19 Outbreak in Ethiopia. Ethiop J Health Sci. 2023;33(2):117–26.
Ahmed J, Schneider CH, Alam A, Raynes-Greenow C. An Analysis of the Impact of Newborn Survival Policies in Pakistan Using a Policy Triangle Framework. Heal Res Policy Syst [Internet]. 2021;19(1). Available from: https://doi.org/10.1186/s12961-021- 00735-9
Mishra UK, Jacobs SE, Doyle LW, Garland SM. Newer Approaches to the Diagnosis of Early Onset Neonatal Sepsis. Arch Dis Child Fetal Neonatal Ed. 2006;91(3):208–12.
Latunji OO, Akinyemi OO. Factors Influencing Health-Seeking Behaviour Among Civil Servants in Ibadan, Nigeria. Ann Ibadan Postgrad Med [Internet]. 2018;16(1):52–60.
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