Publications by authors named "Mark van der Graaf"
The COVID-19 pandemic has painfully exposed the constraints of fragile health systems in low- and middle-income countries, where global containment measures largely set by high-income countries resulted in disproportionate collateral damage. In Africa, a shift is urgently needed from emergency response to structural health systems strengthening efforts, which requires coordinated interventions to increase access, efficiency, quality, transparency, equity, and flexibility of health services. We postulate that rapid digitalization of health interventions is a key way forward to increase resilience of African health systems to epidemic challenges.
View Article and Find Full Text PDFMaternal and neonatal mortality rates in many low- and middle-income countries (LMICs) are still far above the targets of the United Nations Sustainable Development Goal 3. Value-based healthcare (VBHC) has the potential to outperform traditional supply-driven approaches in changing this dismal situation, and significantly improve maternal, neonatal and child health (MNCH) outcomes. We developed a theory of change and used a cohort-based implementation approach to create short and long learning cycles along which different components of the VBHC framework were introduced and evaluated in Kenya.
View Article and Find Full Text PDFIn Kenya, early coronavirus disease (COVID-19) modeling studies predicted that disruptions in antenatal care and hospital services could increase indirect maternal and neonatal deaths and stillbirths. As the Kenyan government enforced lockdowns and a curfew, many mothers-to-be were unable to safely reach hospital facilities, especially at night. Fear of contracting COVID-19, increasing costs of accessing care, stigma, and falling incomes forced many expectant mothers to give birth at home.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to identify key factors that influence maternal care, focusing on the interconnectedness of enrollment in antenatal care (ANC), frequency of ANC visits, and the use of skilled birth attendance (SBA).
- Conducted across 25 health facilities in Kenya, the research involved 5,879 low-income pregnant women and utilized various regression models to analyze the data, revealing that delayed ANC enrollment reduces visit frequency and that more visits correlate with increased likelihood of skilled care during birth.
- The findings suggest a chain reaction effect in maternal care where timely enrollment boosts ANC visits, which in turn supports the use of skilled assistance during childbirth, emphasizing the need to improve overall maternal healthcare access and early engagement for better outcomes.