Table 1 Details of the study sites in the MNH registry
Location | Type | Community Setting | Human Development Index a |
|---|---|---|---|
South Asia | |||
India (Belgaum) – South West Karnataka | Semi-urban | The study area includes 24 primary health centers (clusters). Each is managed by a physician medical officer who works with nursing staff and auxiliary nurse midwives in associated sub-centers, the most peripheral outpost of the health care services. There are 3 tertiary care hospitals and eight secondary care hospitals serving the region as referral hospitals staffed by obstetricians, pediatricians and nurses. In addition to these public sector health facilities, there are several private sector maternity facilities within the site catchment area. | 0.508 |
India (Nagpur) – Eastern Maharashtra | Semi-urban and rural | The study area includes 20 primary health centers, each served by physician medical officers and nurses. These areas include 119 sub-centers where basic maternal and child care are provided. Referral care is provided in ten tertiary hospitals (2 public sector and 8 private sector), and 129 secondary hospitals (27 public sector hospitals and 102 private nursing homes). | 0.549 |
Pakistan – two of five sub districts in Thatta, Sindh province | Semi-urban and rural | The study area includes over 75 health facilities, both public sector and private fee-for-service, providing maternal and child health services. This includes 47 primary health clinics in 24 clusters, 25 secondary care facilities and 3 referral hospitals. Care in health clinics is typically provided by either paramedical staff, including nurses and lady health visitors, or non-specialist physicians. Obstetricians provide care in referral hospitals. | 0.595 |
Sub-Saharan Africa | |||
Kenya – western Kenya in Busia, Bungoma and Kakamega counties | Rural | The study area is served by 23 health facilities in 16 clusters, most operated by the government and staffed by nurse-midwives and clinical officers and a single medical officer. Three hospitals function as referral hospitals. Most physicians are generalists, with a small number of trained obstetricians and pediatricians. | 0.570 |
Zambia – Kafue and Chongwe districts, East Zambia | Rural | There are ten clusters, eight of which have health posts. Care is provided primarily by nurse midwives in the health posts and by traditional birth attendants for home births. There are 3 district hospitals and a referral hospital in Lusaka. Specialty physicians are available in the referral hospital only. | 0.465 |
Latin American Sites | |||
Argentina – Corrientes and Santiago del Estero Provinces, North Argentina | Semi-urban and rural | There are six clusters, three in each province. Each cluster corresponds to a department (municipality) in which the vast majority of the births occur at a publicly-funded secondary level hospital. Care is provided primarily by physicians and midwives. There are 2 Provincial referral hospitals located in provincial capital cities. | 0.828 |
Guatemala – Chimaltenago region, Western Highlands | Rural | There are 18 clusters served by one referral hospital, 30 health centers, and 42 health posts. Maternal and infant care in the hospital is provided mainly by obstetricians and general physicians, in health centers by physicians and nurses, and in health posts by auxiliary nurses | 0.679 |