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This article provides an overview of the use of digitally enabled programmes to support perinatal mental healthcare in the NHS in Scotland, focusing on the Perinatal Wellbeing Programme from SilverCloud®. This follow up to a previous article published in the British Journal of Midwifery considers the experiences of using this programme in a Scottish context, examining feedback from users of the intervention. [ABSTRACT FROM AUTHOR]

Background: QUALMAT project aimed at improving quality of maternal and newborn care in selected health care facilities in three African countries. An electronic clinical decision support system was implemented to support providers comply with established standards in antenatal and childbirth care. Given that health care resources are limited and interventions differ in their potential impact on health and costs (efficiency), this study aimed at assessing cost-effectiveness of the system in Tanzania.Methods: This was a quantitative pre- and post- intervention study involving 6 health centres in rural Tanzania. Cost information was collected from health provider's perspective. Outcome information was collected through observation of the process of maternal care. Incremental cost-effectiveness ratios for antenatal and childbirth care were calculated with testing of four models where the system was compared to the conventional paper-based approach to care. One-way sensitivity analysis was conducted to determine whether changes in process quality score and cost would impact on cost-effectiveness ratios.Results: Economic cost of implementation was 167,318 USD, equivalent to 27,886 USD per health center and 43 USD per contact. The system improved antenatal process quality by 4.5% and childbirth care process quality by 23.3% however these improvements were not statistically significant. Base-case incremental cost-effectiveness ratios of the system were 2469 USD and 338 USD per 1% change in process quality for antenatal and childbirth care respectively. Cost-effectiveness of the system was sensitive to assumptions made on costs and outcomes.Conclusions: Although the system managed to marginally improve individual process quality variables, it did not have significant improvement effect on the overall process quality of care in the short-term. A longer duration of usage of the electronic clinical decision support system and retention of staff are critical to the efficiency of the system and can reduce the invested resources. Realization of gains from the system requires effective implementation and an enabling healthcare system.Trial Registration: Registered clinical trial at www.clinicaltrials.gov ( NCT01409824 ). Registered May 2009. [ABSTRACT FROM AUTHOR]

Janani Suraksha Yojana (JSY) is more often than not recognized only as a cash transfer scheme for institutional deliveries. Since its pan India introduction in 2005, the scheme has passed through various stages which affected its implementation in multiple ways. The scheme, however, could not earn the reputation of an intervention which affected maternal health in any phenomenal way other than increasing institutional deliveries. After five years of its implementation, the present paper attempts to highlight the areas where JSY has positively contributed; if not directly, indirectly in affecting maternal health and the psyche of the community. The article provides evidence from primary data collected from 424 women who delivered during April 2010–March 2011 in selected villages of four districts of Rajasthan, India. Findings from other population-based studies conducted in the state of Rajasthan since the launch of JSY have also been considered to support the findings of the current study presented in the paper. It attempts to show that though JSY incentives were contingent on institutional delivery alone; it led to improvement of other services which have positively affected maternal and child health in terms of health seeking behaviour of the community. Chi square test was employed and it shows health behaviour of those who availed JSY benefits to be significantly associated with registration of pregnancy (p < 0.01), antenatal checkups (p < 0.05), duration of stay at the institution post-delivery (p < 0.01), initiation of breastfeeding (p < 0.5) and postnatal checkup (p < 0.01). [ABSTRACT FROM PUBLISHER]

This article discusses the implications of new evidence from recently published research on maternity services across England. The Birthplace in England Research Programme was commissioned in 2007 to address key gaps in the evidence and inform those who plan, deliver, and use maternity services. These included the pattern of current services and availability of different models of care; the ways in which maternal and infant outcomes differ between settings; their comparative cost-effectiveness; and the organizational features of maternity care systems that might affect the quality and safety of care. [ABSTRACT FROM AUTHOR]