PLOS Global Public Health

Out-of-school adolescents (OSY) in urban slums face layered vulnerabilities and are often excluded from mainstream reproductive health services. The Youth-Powered Ecosystem to Advance Urban Adolescent Health (YPE4AH) project in Nigeria implemented a multi-sectoral, safe-space-centered model to improve access to family planning (FP) for this group. The project, implemented across Lagos and Kano States from 2021 to 2024, utilized a hub-and-spoke model, combining youth-designed safe spaces (Youth H...

Antenatal care (ANC) plays a crucial role in preventing and detecting pregnancy risks, facilitating prompt treatment, and disseminating essential information to expectant mothers. This role is particularly vital in developing countries, where a 4.65% rise in maternal mortality rate was observed in 2022, with 800 maternal and 7,700 perinatal deaths reported. The study aims to analyse the predictors and geospatial trends of the number of visits and timing of antenatal care in Zambia from 1992 to 2...

Many adolescents face barriers to accessing reproductive health care even though quality reproductive health care is a fundamental human right. This qualitative analysis describes quality reproductive health requests among adolescent high school girls in Kenya. We conducted a secondary analysis of qualitative data from a sub-sample of adolescent girls in Kenya who participated in the What Women Want global campaign. The campaign utilized one open-ended survey question. We also analyzed interview...

BackgroundCommunity health workers (CHWs) are central to primary health care delivery in Madagascar, yet their perspectives on what enables effective work are rarely centered in programme design and implementation. Evidence is needed on the support CHWs receive in practice and the priorities they identify to strengthen effectiveness and equity. MethodsWe conducted a qualitative study nested within the formative phase of a participatory action research initiative aimed at strengthening Madagasca...

IntroductionWith one of the highest rates of maternal mortality in the world, improving antenatal care for the poorest communities is a high priority in Nigeria. In 2022, Project HOPE partnered with the Nigerian Ministry of Health to implement a group antenatal care project in Niger State. Government managers and Project HOPE aligned policy documents and budgets, and conducted a baseline assessment. Project staff then trained health care workers on group antenatal care. The project also connect...

BackgroundKnowledge and use of sexual reproductive health and human immunodeficiency virus (SRH and HIV) services are crucial for the prevention of pregnancy and sexually transmitted infections (STIs) among adolescent girls and young women (AGYW). This study aims to assess the knowledge and perceptions of AGYW about the SRH and HIV services offered in health facilities in Maputo, Mozambique. Material and methodsA cross-sectional descriptive study was conducted based on exit surveys with AGYW he...

BackgroundDespite investments by the Nigerian government and international organizations in childhood immunization to combat child mortality, coverage in many northern states remains below the national average, thereby increasing the risk of vaccine-preventable diseases. This study describes the barriers to immunization in six states in Northeast and Northwest Nigeria, which have the lowest vaccination coverage rates in the country. MethodThe socioecological framework informed the design of foc...

BackgroundMaternal and neonatal mortality remains a public health burden around the globe most especially in developing countries. A well utilized antenatal care (ANC) is however among the identified interventions to reduce this burden of maternal and neonatal mortality rates. A lot of factors therefore predispose, enable and cause mothers to identify the need to utilize this service (ANC). Aims/objectivesThe aim of this study was to determine factors associated with the utilization of ANC serv...

BackgroundIn 2014, Uganda launched the National Male Involvement Strategy in Maternal and Child Health. In 2020, the District Health Management Information System report for Lamwo district, where Palabek Refugee Settlement is located, indicated a 10% male involvement in antenatal care (ANC). We investigated determinants of male involvement in ANC in Palabek Refugee Settlement to inform programs on improvement of male involvement in ANC in a refugee setting. MethodologyWe conducted a community-b...

BackgroundIncreasing access to and utilization of skilled care during pregnancy and child birth can significantly reduce maternal and infant morbidity and mortality. Male involvement can positively influence utilization but resource limited settings like Cameroon encounter obstacles in engaging men in maternal and child health services. The aim of our study was to identify contextually relevant barriers to male involvement in antenatal care attendance to inform the development of an intervention...

The COVID-19 pandemic exposed vulnerabilities in health systems abilities to detect, report, and respond to threats. Inadequate preparedness led to healthcare worker infections (HCW), essential service disruptions, and impacts on communities. Primary health care (PHC) is often overlooked in health security initiatives. Epidemic Ready Primary Health Care (ERPHC) is an initiative that strengthens PHC facilities to prevent, detect and respond to outbreaks, while maintaining essential services. ICA...

BackgroundThe COVID-19 global pandemic is expected to result in 8.3-38.6% additional maternal deaths in many low-income countries. The objective of this paper was to determine the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in Kenya. MethodsData for the first four months (March-June) of the pandemic and the equivalent period in 2019 were extracted from Kenya Health Information System. Two-sample test of proportions for ho...

BackgroundAdolescent sexual and reproductive health and rights (SRHR) remains a critical public health issue in low- and middle-income countries, with adverse health, educational, and economic consequences. Uganda faces significant challenges with high rates of unintended pregnancies among adolescents. This study investigated the factors associated with unintended pregnancies among unmarried adolescents in Eastern Uganda and explored the potential of using mobile money vendors to provide SRHR se...

BackgroundMaternal and newborn studies in Uganda have primarily focused on measuring coverage of facility-based birth. However, this is inadequate and tends to overestimate the benefits of services provided to women and newborns if the quality of care in the facilities is not considered. Effective coverage of care addresses this limitation and adjusts for the quality of services. This study aimed to assess the effective coverage of maternal and newborn care in Uganda. MethodsWe analyzed the 202...

BackgroundThe COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. This study aimed to compare the volumes of in-person visits and to explore the experiences of healthcare providers and users regarding the continuity of healthcare in the maternity ward of a Health and Social Promotion Center (HSPC) before, during and after the lockdown during the COVID-19 pandemic in Ouagadougou, Burkina Faso. MethodsWe conducted a multimethod, cross-sectional explorato...

Despite intensive international efforts to extend the coverage of primary healthcare services for women, pregnancy and childbirth still represent a high-risk period for both mother and child, particularly in low- and middle-income countries. Lack of access to antenatal care and its inadequate use during pregnancy contribute to maternal mortality. This study aimed to establish the factors associated with late start of antenatal care (ANC) in Muramvya health district, Burundi. A cross- sectional s...

Contraceptive use among adolescents in Ghana is low. Factors influencing adolescent contraceptive use in Techiman Municipality have not been investigated. This study aimed to determine factors influencing contraceptive use among adolescents in Techiman Municipality. An analytical cross-sectional community-based study was conducted from January-March, 2018 among adolescents between the ages of 16 and 19 years whoever had sex. Respondents were selected through multi-stage sampling. Data was colle...

The incidence of child marriage (CM) and intimate partner violence (IPV) are high in Uganda. The study sought to assess the association between child marriage and IPV across two waves of the Ugandan Demographic and Health Survey (UDHS). The evidence is important to inform policy implementation strategies aimed at curbing child marriages and IPV. We analyzed data from UDHS 2011 and 2016. The analysis was restricted to women who have ever cohabited. Simple and multiple logistic regression models ...

Northern Ghana faces a significant shortage of family planning (FP) services, leading to high rates of unplanned pregnancies and unsafe abortions that contribute to regional maternal mortality. Through the Academic Model Providing Access to Healthcare (AMPATH) Ghana, a partnership between Tamale Teaching Hospital (TTH), the University for Development Studies School of Medicine (UDS-SoM), and New York University Grossman School of Medicine (NYUGSOM), key stakeholders began strengthening regional ...

BackgroundSkilled birth attendants (SBAs) are vital for reducing maternal and newborn morbidity and mortality, yet their use remains below national and global targets, particularly in low--and middle-income countries like Tanzania. This study aimed to assess trends and determinants of SBA use among women of reproductive age (WRA) in Tanzania. MethodsThis was an analytical cross-sectional study among WRA in Tanzania, using data from the current Demographic and Health Surveys (DHS) 2004/05, 2010,...