PMID- 26432978
OWN - NLM
STAT- MEDLINE
DCOM- 20160502
LR  - 20151228
IS  - 1365-3156 (Electronic)
IS  - 1360-2276 (Linking)
VI  - 20
IP  - 12
DP  - 2015 Dec
TI  - Finding the gap: revealing local disparities in coverage of maternal, newborn and 
      child health services in South Sudan using lot quality assurance sampling.
PG  - 1711-21
LID - 10.1111/tmi.12613 [doi]
AB  - OBJECTIVES: We adapted a rapid monitoring method to South Sudan, a new nation 
      with one of the world's highest maternal and child mortality rates, aiming to 
      assess coverage of maternal, neonatal and child health (MNCH) services at the 
      time of independence, and introducing a monitoring and evaluation system (M&E) 
      for equity-sensitive tracking of progress related to Millennium Development Goals 
      (MDG) 4 and 5 at national, state and county levels to detect local variability. 
      METHODS: We conducted a national cross-sectional household survey among women 
      from six client populations in all, but six of South Sudan's 79 counties. We used 
      lot quality assurance sampling (LQAS) to measure coverage with diverse MNCH 
      indicators to obtain information for national-, state- and county-level health 
      system management decision-making. RESULTS: National coverage of MNCH services 
      was low for all maternal and neonatal care, child immunisation, and child care 
      indicators. However, results varied across states and counties. Central Equatoria 
      State (CES), where the capital is located, showed the highest coverage for most 
      indicators (e.g. >/=4 antenatal care visits range: 4.5% in Jonglei to 40.1% in 
      CES). Urban counties often outperformed rural ones. CONCLUSIONS: This adaptation 
      of LQAS to South Sudan demonstrates how it can be used in the future as an M&E 
      system to track progress of MDGs at national, state and county levels to detect 
      local disparities. Overall, our data reveal a desperate need for improving MNCH 
      service coverage in all states.
CI  - (c) 2015 The Authors.Tropical Medicine & International Health Published by John 
      Wiley & Sons Ltd.
FAU - Valadez, Joseph J
AU  - Valadez JJ
AD  - Liverpool School of Tropical Medicine, International Public Health Department, 
      Liverpool, UK.
FAU - Berendes, Sima
AU  - Berendes S
AD  - Liverpool School of Tropical Medicine, International Public Health Department, 
      Liverpool, UK.
FAU - Lako, Richard
AU  - Lako R
AD  - Ministry of Health of the Republic of South Sudan, Directorate of Policy, 
      Planning, Budgeting and Research, Juba, South Sudan.
FAU - Gould, Simon
AU  - Gould S
AD  - Liverpool School of Tropical Medicine, International Public Health Department, 
      Liverpool, UK.
FAU - Vargas, William
AU  - Vargas W
AD  - Liverpool School of Tropical Medicine, International Public Health Department, 
      Liverpool, UK.
FAU - Milner, Susan
AU  - Milner S
AD  - Liverpool School of Tropical Medicine, International Public Health Department, 
      Liverpool, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151019
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
SB  - IM
MH  - Adult
MH  - Child
MH  - *Child Health
MH  - Child Health Services/standards
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - Female
MH  - Health Care Surveys
MH  - *Health Services Needs and Demand
MH  - *Healthcare Disparities
MH  - Humans
MH  - Infant
MH  - *Infant Health
MH  - Infant, Newborn
MH  - Lot Quality Assurance Sampling/methods
MH  - *Maternal Health
MH  - Maternal-Child Health Services/*standards
MH  - Mortality
MH  - Pregnancy
MH  - *Quality Assurance, Health Care
MH  - Socioeconomic Factors
MH  - South Sudan/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - Africa
OT  - South Sudan
OT  - equity
OT  - household survey
OT  - lot quality assurance sampling
OT  - millennium development goals
OT  - monitoring and evaluation
OT  - universal health coverage
EDAT- 2015/10/04 06:00
MHDA- 2016/05/03 06:00
CRDT- 2015/10/04 06:00
PHST- 2015/10/04 06:00 [entrez]
PHST- 2015/10/04 06:00 [pubmed]
PHST- 2016/05/03 06:00 [medline]
AID - 10.1111/tmi.12613 [doi]
PST - ppublish
SO  - Trop Med Int Health. 2015 Dec;20(12):1711-21. doi: 10.1111/tmi.12613. Epub 2015 
      Oct 19.