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Introduction In many developing countries, the lack of access to quality maternal health care remains a concern in regard to improving maternal health. It has been argued that a lack [...], To report on the design and basic outcomes of three interventions aimed at improving the use and quality of maternity care in rural China: financial interventions, training in clinical skills, and training in health education. Community-based cluster randomized trials were carried out in one central and two western provinces between 2007 and 2009: (1) financial interventions covered part of women's costs for prenatal and postnatal care, (2) training of midwives in clinical skills was given by local maternity care experts in two- or three-group training courses, (3) health education training for midwives and village doctors were given by local experts in health education in two- or three-group training courses. A survey was conducted in a stratified random sample of women who had been pregnant in the study period. 73% of women (n = 3,673) were interviewed within 1-10 months of giving birth. Outcomes were compared by the different intervention and control groups. Adjusted odds ratios were calculated by logistic regression to adjust for varying maternal characteristics. Most of the differences found between the groups were small and some varied between provinces. The financial intervention did not influence the number of visits, but was associated with increased caesarean sections and a decrease in many ultrasound tests. The clinical intervention influenced some indicators of care content. There was no consistent finding for the health education intervention. Financial and training interventions have the potential to improve maternity care, but better implementation is required. Unintended consequences, including overuse of technology, are possible. Keywords Financial intervention * Educational intervention * Maternity care * Rural China * Cluster randomized trial

IN VITRO FERTILIZATION (IVF) (including intracytoplasmic sperm injections and frozen embryo transfers) is a common infertility treatment. In Finland, currently ~2.5% of infants are born as a result of IVF, [...], OBJECTIVE. The purpose of this study was to use nationwide registries to examine the health of children up to 4 years of age who were born as a result of in vitro fertilization. METHODS. Children born after in vitro fertilization (N = 4559) from 1996 to 1999 were monitored until 2003. Two control groups were selected from the Finnish Medical Birth Register as follows: all other children (excluding children born after ovulation induction) from the same period (N = 190 398, for study of perinatal health and hospitalizations) and a random sample of those children (n = 26 877, for study of health-related benefits). Mortality rates and odds ratios for perinatal outcomes, hospitalizations, health-related benefits, and long-term medication use were calculated. RESULTS. Although the health of most in vitro fertilization children was good, such children had more health problems than other children. A total of 35.7% of in vitro fertilization children and 2.2% of control children were multiple births, and the health of multiple births was worse than that of singletons. Perinatal outcomes of in vitro fertilization children were worse and hospital episodes were more common than among control children. Risks for cerebral palsy and psychological and developmental disorders were increased. Among in vitro fertilization singletons, worse results for perinatal outcomes and hospitalizations, but no increased risk for specific diseases, were found. The health of in vitro fertilization multiple births was comparable to the health of control multiple births. CONCLUSIONS. Reducing the number of transferred embryos would improve the health of in vitro fertilization children. Additional studies are needed to explain the poorer health of in vitro fertilization singletons, as well as follow-up studies to examine the health of in vitro fertilization children from 4 years onward. www.pediatrics.org/cgi/doi/10.1542/ peds.2006-0735 doi:10.1542/peds.2006-0735 Key Words in vitro fertilization, perinatal health, morbidity, multiplicity, registry-based study Abbreviations CP-- cerebral palsy IVF--in vitro fertilization HDR--Hospital Discharge Register MBR--Medical Birth Register SII--Social Insurance Institution OR--odds ratio CI-- confidence interval ICD- 10--International Classification of Diseases, 10th Revision

Knowledge about mothers' perceptions of the quality of Finnish maternity services is limited. The aim of this cross-sectional study was to describe mothers' perceptions of the quality of Finnish maternity services, and to identify background factors associated with them. The data were collected from 1,760 mothers in autumn 2016. Descriptive statistics were used. This study is reported in accordance with STROBE. Most mothers (84%) considered the quality of the maternity services good. The mean response values for the quality of patient education (3.9), staff knowledge and skills (4.3), and hospital environment (4.3) were good. Parity and mode of childbirth were associated with perceptions of the quality of maternity services. Based on the results, development of midwifery and nursing practices should focus on sufficient pain relief, adequate duration of skin-to-skin contact, breastfeeding counselling and opportunities for mothers to reflect on their birth experience afterwards. Moreover, the study results can be used for education. Challenges for future research are presented. [ABSTRACT FROM AUTHOR]

Abstract Background The collection of information on infertility treatments is important for the surveillance of potential health consequences and to monitor service provision. Study design We compared the coverage and outcomes of IVF children reported in aggregated IVF statistics, the Medical Birth Register (subsequently: MBR) and research data based on reimbursements for IVF treatments in Finland in 1996–1998. Results The number of newborns were nearly equal in the three data sources (N = 4331–4384), but the linkage between the MBR and the research data revealed that almost 40% of the reported IVF children were not the same individuals. The perinatal outcomes in the three data sources were similar, excluding the much lower incidence of major congenital anomalies in the IVF statistics (157/10 000 newborns) compared to other sources (409–422/10 000 newborns). Conclusion The differences in perinatal outcomes in the three data sets were in general minor, which suggests that the observed non-recording in the MBR is most likely unbiased.