Relationship with Maternal Health and Infant Mortality

Relationship with spending on maternal health and infant mortality 

Introduction 

Maternal health and infant mortality are the two key healthcare issues exist in today’s dynamic world. On one hand we are witnessing inventions and discovery in field of science, medicine, astronomy, rise in economy condition and life style of people round the world, but on the other hand we are also facing 30/1000 infants death on average (as per WHO 2016 data). All over world millions of dollar are spent on healthcare still till date many countries are not able to bring that mortality rate even below 50. Government and non-government organizations like WHO, CMA, AMA, [WHO 2008] US health and human service department etc. are there who are putting continues efforts to reduce the infant mortality rate by identifying the root cause of this problem. Even financial assistance are given to have better medical facility to save the infants. 
Infant and Maternal health has a direct relationship. It is the women who give birth to a child thus the life expectancy of child in its initial years is highly dependent upon how is the health of mother is. According to Centre of Disease Control and Prevention (CDC) 2015 report, the major causes of infant deaths are birth defects, preterm birth, low birth weight, maternal pregnancy syndrome and injuries like suffocation. As per WHO data, almost $6.5 [USA] trillion is spent across the globe that means $948 per person on an average which is not a small amount but the spending is uneven across the world. 
In this report, expenditure on maternal health care and infant deaths are taken as research study where we would like to establish correlation existence between these two things. This research will highlight the impact of spending money on maternal health that can bring positive results to infant mortality rate. Is this the only way to reduce infant mortality? What are obstacles in spending money on maternal health? Caring women health can help to reduce infant mortality? These are some the key areas of this research study. 

Project Objective  

The purpose of this research is to establish relation between maternal health expenditure and its impact on infant mortality rate. 

Project Scope

This project is related to healthcare services expenditure on maternal health and infant mortality rate across the world. This project is carried over 65 days. For this study, study has done continent wise. All direct and indirect factors or variables are considered for establishing relationship using statistical measures. 

Literature Review  

According to WHO November 2016 factsheet, near about 830 women die from preventable causes related to childbirth and pregnancy. 99% of such deaths are occurring in developing countries. Rural and poorer community women are among the most affected. These figures are miserable if we take the healthcare services and facilities the world has now. Despite so much investment, the women mortality rate has not reduced significantly. More than half of maternal deaths are happening in fragile and humanitarian settings. This risk is higher in case of adolescent girls under 15 years of age. The major reasons of deaths are coming as severe bleeding, infections, high blood pressure during pregnancy, complication in delivery and unsafe abortion. This is impacting infant deaths as well. The recent figure given by WHO says that 2.7 million new-born died in 2015. The simple reason of deaths were health of their mothers, lack of education, care during pregnancy, unavailability of healthcare services, social taboos etc. (distance, poverty, lack of healthcare information, inadequate services, cultural practices as described by WHO). According to WHO survey, 40% of such deaths were from low income countries. Only 78% of mothers got skilled healthcare attendance during the birth of child. Despite having facilities, the women are dying during or after pregnancy. The Millennium Development Goal set by WHO has not been met yet (Target-75%). More socking fact that WHO brought is the GAP of mortality between high and low income country. In high income countries, the rate is less than 1%. [Fraser, A et.al 2018]
According to Saradiya Mukherjee [et.al 2013] report, the household expenditure on healthcare in urban area is 2 times to rural area. Poverty is one of the essential factor that is affecting accessibility and education of healthcare services. According to the study, if you save a mother’s life, it will help to save the infant life as well because without her the rate of mortality chance becomes 3-4 times. The study has proved that every pregnancy is wanted brings cost savings and concrete benefits to maternal and child health, poverty reduction and gender equality. 
According to a study done by WHO, it is found that investing in women’s healthcare will make each mother a better nourished mother. This will help household to spend less money on healthcare afterwards to manage economy. One of the major problem that investment in healthcare of women is family planning. Access to emergency obstetric care is limited in many parts of the world (especially African and South Asian region). The increase in cost of food grains caused especially lower income family women to face inadequate nutrient and this comes as mal nutrition for infants to survive against diseases. [Than, K. K.,et.al2018]
Does investing in maternal healthcare brings down mortality of infant? WHO has given evidences to this case. According to the source, [Nilsson, C., et.al2018] Sri Lanka’s maternal mortality rate was 500/100000 during 1950 with US$270 per capita. It managed to reach 100/100000 rate by 1970 mid and now it’s around 50. Though they had limited resources but their investment in maternal health gave this success. This they achieved through free healthcare services, development of emergency obstetric, skilled birth attendant availability. 
According to Sonalde Desai [et.al 1998], under the survey of 22 developing country, the examination were done on infant mortality, child height for age and immunization status. He found a strong relationship between maternal education and child health. With the reduction of 1% decreases in the healthcare spending, the excess of 90 deaths associated with maternity were witnessed. 
Justification 
The research study is on two important aspects of society i.e. health of women and children (infant). In this study the problem is basically to establish correlation between the expenditure on maternal health and how it reflecting decrease in infant mortality. In this research at first mother’s health and mortality rate [Jha, S. K.et.al2018] has been studied through scholarly research studies and articles. The root causes of healthcare problems of women during pregnancy and after pregnancy has been identified. These causes are linked to infant health to understand the mortality chances. Finally the research goes through investment opportunities that may/mayn’t bring reduction in infant mortality. Overall the research study is going to extend the studies on healthcare services and will provide scope for further research. 
Gap opportunities  
There has been a lot of research studies have done individually on maternal health and infant mortality. This research study is identifying the correlation between growths of investment in healthcare of women and the reduction of mortality rate of infants. This will fill the gap of earlier research like pointing out the constraints in investments, despite investments why there is a gap in urban and rural or high income and low income infant and maternal mortality rate. It will also try to find the prospects of investment outcome enhancement to increase women health and decline in mortality rate of child and women. 
Hypothesis 
There is a significant correlation existence between the investments in maternal care and reduction in infant mortality. 
H0- Correlation exists between expenditure on maternal health and infant mortality rate.
H1- There is no relation between maternal health and infant mortality rate. 
The hypothesis takes both positive and negative impact of social media. The level of significant is taken 0.05 [Eriksson, K.,et.al2017]
Research Questions 
Primary Research Question- 
Is there a positive or negative correlation between maternal health expenditure and infant mortality rate?
Secondary Research Questions- 
  1. What is the relevance of spending money on materiality healthcare?
  2. Does family income has influence over maternal health?
  3. Can financial and non-financial assistance from government and non-government organization on maternal expenditure improve the maternal healthcare and infant mortality reduction? 
  4. How improvement in maternal health will improve infant mortality reduction rate?

Research Design and Methodology 

The purpose of this study is to establish correlation between the two elements for which quantitative research is suitable. This is a descriptive research study where maternal healthcare and infant mortality characteristics are studied so that correlation establishment become possible. 
The steps under this quantitative research design-
Research problem- This signifies the primary question or the basic hypothesis we have taken under study. The correlation of mother health and infant mortality is the research problem.
Purpose of study- To understand how far the two aspects are related. This will help to understand expenditure on maternal health can reduce infant mortality to what extent.  
Literature Review- We took various research reports and journals to get some idea about the purpose of study and also it is going to help in carrying out sampling, data collection, analysis and testing hypothesis. [Pillay, T.,et.al2017]
Research design- The method of research we have taken is quantitative in nature. It is a correlational study between maternal healthcare expenditure and infant mortality thereon. 
Sampling- The population used for collecting relevant data for the purpose of study.
Collection of data- The methods adopted to collect relevant data under study. Here interviews, questionnaire and previous findings were used. The sources of data collection are mostly secondary in nature.
Analysis of data- The use of Statistical analysis for establishing the existence of correlation. 
Reporting- This research study is meant for both academic and social cause. 
Ethical consideration- The factor of confidentiality, reliability, safety etc. applied during research process. [Dowell, C. M et.al2018]
Research Instruments 
For this research study, both primary and secondary data collection method has been used. For the primary data, a structured questionnaire were given to the sample population. For secondary data, the published research reports and journals were collected from enumerators. 
Quantitative data analysis 
Data cleaning-
Any ambiguous data is kept out the research process to arrive at appropriate result. Content analysis will be done in order to capture open ended question’s information. 
Data coding- Numerical will be assigned to the responses of given population. Data classification will be done in order to put similar nature data at one place. 
Data presenting- Tables and charts will be used in order to summarize coding data. To analyse the data for interpretation, SPSS, ANOVA and Chi-square test will be used based on research design.
Data interpretation- Based on the data analysis, key finding will be interpreted as per researcher’s judgement.  
Sampling and Sample Size 
For the purpose of study, judgemental sampling is considered. The sample population will be 50 women who were selected from Arizona judicial district of USA. Apart from this, 4 healthcare organizations were also considered under sample study.
Questionnaire design 
The questionnaire is a structured questionnaire where some of the questions are open ended and close ended questions. For each questions, the options are given accordingly. For each question weightage is assigned from 1 to 5 that is 1 is the lowest and 5 is the highest rated questions.
Validity and Reliability Testing   
For validity- Repeated answers are clubbed into one. The responses and data collections were done during research process and their sources are recorded, to test the authenticity, we have verified the existence of data after data analysis.
Reliability- All responses were collected when the respondent is in sound mind. All secondary responses are collected from previous research reports and journals. 
Research Limitation 
Moreover the expenditure on healthcare of mothers varies due to currency and economy fluctuation thus what would be the exact expenditure determination is impossible. Most of the collected data are taken directly under study, especially the secondary data collected from [Callaghan, W. M.et.al 2017] WHO, CDC and UNICEF without cross checking of data validity and reliability. The sample population under study doesn’t represent the entire population thus there may be variation of results. The time limit and resources for conducting research is limited.
Research Schedule   
                                                 

Conclusion 

This study focused on two important aspects of healthcare which are women health and infant mortality. This study helped to identify the correlation existence between expenditure on women health and infant mortality rate.The collected data helped to extend the understanding and after analysing the data we come to know that if major proportion of expenditure is given towards women healthcare alongside government and non-government aids, the nutrition of mother can be maintained and this will help to reduce the chances of infant mortality. 

References   

Mukherjee, S., Singh, A., & Chandra, R. (2013). Maternity or catastrophe: a study of household expenditure on maternal health care in India. Health, 5(1), 109-118.
Desai, S., & Alva, S. (1998). Maternal education and child health: Is there a strong causal relationship?. Demography, 35(1), 71-81.
Than, K. K., Tin, K. N., La, T., Thant, K. S., Myint, T., Beeson, J. G., ... & Morgan, A. (2018). The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study. BMC public health, 18(1), 99.
Fraser, A., Catov, J. M., Lawlor, D. A., & Rich-Edwards, J. W. (2018). Pregnancy characteristics and women’s cardiovascular health. In Handbook of Life Course Health Development (pp. 145-165). Springer, Cham.
Nilsson, C., Hessman, E., Sjöblom, H., Dencker, A., Jangsten, E., Mollberg, M., ... & Begley, C. (2018). Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC pregnancy and childbirth, 18(1), 28.
WHO Commission on Social Determinants of Health, & World Health Organization. (2008). Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization.
Jha, S. K., & Singh, N. V. (2018). Assessing Burden of Infant Mortality on Socio-Economic Classes in North-Eastern India. In Issues on Health and Healthcare in India (pp. 241-253). Springer, Singapore.
Dowell, C. M., Mejia, G. C., Preen, D. B., & Segal, L. (2018). Maternal incarceration, child protection, and infant mortality: a descriptive study of infant children of women prisoners in Western Australia. Health & Justice, 6(1), 2.
Pillay, T., Porter, K., & Marson, S. (2017). Developing an early life Parent Education Programme in response to high infant mortality rates. Journal of Neonatal Nursing.
Callaghan, W. M., MacDorman, M. F., Shapiro-Mendoza, C. K., & Barfield, W. D. (2017). Explaining the recent decrease in US infant mortality rate, 2007–2013. American journal of obstetrics and gynecology, 216(1), 73-e1.
Eriksson, K., Niemesh, G. T., & Thomasson, M. (2017). Revising Infant Mortality Rates for the Early 20th Century United States (No. w23263). National Bureau of Economic Research.

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