Improving access to child health services at the community level in Zambia: a country case study on progress in child survival, 2000–2013
| Autor: | Marie A. Brault, Connie A. Haley, Penelope Kalesha-Masumbu, Aaron M. Kipp, Kasonde Mwinga, Phanuel Habimana, Mary Katepa-Bwalya, Sten H. Vermund, Margaret Maimbolwa |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Economic growth Urban Population Child Health Services Population Zambia Developing country Millennium Development Goals under-five mortality 03 medical and health sciences 0302 clinical medicine Health facility Pregnancy Infant Mortality parasitic diseases Humans Medicine Maternal Health Services 030212 general & internal medicine Healthcare Disparities education Health Education Community Health Workers 2. Zero hunger education.field_of_study business.industry 030503 health policy & services Health Policy Child Health Infant Newborn 1. No poverty Infant Original Articles Focus Groups maternal and child health 3. Good health Child mortality Child Preschool Child Mortality Community health Workforce Female Health education 0305 other medical science business qualitative research |
| Zdroj: | Health Policy and Planning |
| ISSN: | 1460-2237 0268-1080 |
| DOI: | 10.1093/heapol/czw141 |
| Popis: | Reductions in under-five mortality in Africa have not been sufficient to meet the Millennium Development Goal #4 (MDG#4) of reducing under-five mortality by two-thirds by 2015. Nevertheless, 12 African countries have met MDG#4. We undertook a four country study to examine barriers and facilitators of child survival prior to 2015, seeking to better understand variability in success across countries. The current analysis presents indicator, national document, and qualitative data from key informants and community women describing the factors that have enabled Zambia to successfully reduce under-five mortality over the last 15 years and achieve MDG#4. Results identified a Zambian national commitment to ongoing reform of national health strategic plans and efforts to ensure universal access to effective maternal, neonatal and child health (MNCH) interventions, creating an environment that has promoted child health. Zambia has also focused on bringing health services as close to the family as possible through specific community health strategies. This includes actively involving community health workers to provide health education, basic MNCH services, and linking women to health facilities, while supplementing community and health facility work with twice-yearly Child Health Weeks. External partners have contributed greatly to Zambia’s MNCH services, and their relationships with the government are generally positive. As government funding increases to sustain MNCH services, national health strategies/plans are being used to specify how partners can fill gaps in resources. Zambia’s continuing MNCH challenges include basic transportation, access-to-care, workforce shortages, and financing limitations. We highlight policies, programs, and implementation that facilitated reductions in under-five mortality in Zambia. These findings may inform how other countries in the African Region can increase progress in child survival in the post-MDG period. |
| Databáze: | OpenAIRE |
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