Lindsay Mallick

University of Maryland, College Park | UMD, UMCP, University of Maryland College Park · Department of Family Science

Measuring quality of care in family planning services is essential for policymakers and stakeholders. However, there is limited agreement on which mathematical approaches are best able to summarize quality of care. Our study used data from recent Service Provision Assessment surveys in Haiti, Malawi, and Tanzania to compare three methods commonly u...

Objective: Early breastfeeding has numerous benefits for both the mother and her baby. Previous research typically analyzes breastfeeding initiation in binary terms (within the first hour or day). Although delays are associated with cesarean delivery and skin-to-skin contact may facilitate early breastfeeding, a more nuanced understanding of these...

Infrastructure investments can contribute substantially to alleviating burdens of morbidity and mortality while also providing a positive return on investment in the long term.

Background Despite the tenets of rights‐based, person‐centered maternity care, racialized groups, low‐income people, and people who receive Medicaid insurance in the United States experience mistreatment, discrimination, and disrespectful care more often than people with higher income or who identify as white. This study aimed to explore the relati...

Article snippets: Reports of infant deaths and illness in 2021 and early 2022 from Cronobacter bacterial infections prompted a Food and Drug Administration investigation of an Abbott Nutrition plant that supplied up to 40% of the US market share of infant formula. Voluntary recalls and temporary closure of the Abbott plant in February 2022 resulte...

Introduction: Despite known benefits of breastfeeding, including prevention against infections for infants, in the presence of numerous barriers, less than half of infants in high-income countries breastfeed for 6 months. One potential barrier to breastfeeding is birth by cesarean section (C-Section), which can invoke long-term difficulties. Howeve...

The private sector plays a substantial role in the provision of family planning (FP) in low- and middle-income countries. Evidence shows varied levels of quality in the private sector, and there is limited information about the comparative quality of public versus private FP service delivery across settings. Under the USAID-funded MOMENTUM project,...

Background: Reliable measurement of newborn postnatal care is essential to understand gaps in coverage and quality and thereby improve outcomes. This study examined gaps in coverage and measurement of newborn postnatal care in the first 2 days of life. Methods: We analyzed Demographic and Health Survey data from 15 countries for 71,366 births to...

Despite the tenets of rights-based, person-centered maternity care, women of color, low-income women, and women who are Medicaid recipients in the U.S. are more likely to experience mistreatment, discrimination, and disrespectful care. The presence of a doula (a person who provides continuous support during childbirth) may mitigate these experience...

Background Malawi has halved the neonatal mortality rate between 1990–2018, however, is not on track to achieve the Sustainable Development Goal 12 per 1,000 live births. Despite a high facility birth rate (91%), mother-newborn dyads may not remain in facilities long enough to receive recommended care and quality of care improvements are needed to...

Background High coverage of care is essential to improving newborn survival; however, gaps exist in access to timely and appropriate newborn care between and within countries. In high mortality burden settings, health inequities due to social and economic factors may also impact on newborn outcomes. This study aimed to examine equity in co-coverage...

Intimate partner violence (IPV) may interfere with women's contraceptive use. This study analyzed IPV and discontinuation while still in need (DWSIN) using detailed contraceptive calendar data from the 2014 Kenya Demographic and Health Survey and measures of IPV experience in the same 12-month observation period. Using multivariable regression anal...

This report identifies a short list of indicators that measure readiness for and provision of highly effective healthcare interventions. The authors propose a quality of care index (QOCI) that spans reproductive, maternal, newborn, and child health and nutrition (RMNCHN) as well as water, sanitation, and hygiene (WASH).

Background: Iron-folic acid (IFA) supplementation during pregnancy is key to prevent maternal anemia. In Malawi and Haiti, consumption of IFA supplements remains suboptimal. This study examined the IFA-related services provided in health facilities and their association with women’s adherence to IFA supplementation during pregnancy. Methods: This s...

Background: Effective coverage research is increasing rapidly in global health and development, as researchers use a range of measures and combine data sources to adjust coverage for the quality of services received. However, most estimates of effective coverage that combine data sources are reported only as point estimates, which may be due to th...

Background: Early initiation of breastfeeding (within an hour of birth) has benefits for newborn health and survival. Optimal breastfeeding supports growth, health, and development. Health facilities provide essential pregnancy, maternal, and newborn care and offer support for early breastfeeding. We examined the relationship between the breastfee...

Population-based household surveys, such as those conducted through The Demographic and Health Surveys (DHS) Program, are generally considered one of the best sources for estimates of reproductive, maternal, newborn, and child health and nutrition (RMNCH+N) outcomes. However, questions sometimes surface about the validity of these estimates. The ex...

Background: Effective coverage research is increasing rapidly in global health and development, as researchers use a range of measures and combine data sources to adjust coverage for the quality of services received. However, most estimates of effective coverage that combine data sources are reported only as point estimates, which may be due to the...

Our study assessed the relationship between maternal health care-seeking and measures of empowerment among women in Pakistan in order to identify persistent disparities in the utilization of maternal health services.

These four research policy briefs rely largely on the findings of the nationally representative 2017 Ghana Maternal Health Survey (GMHS). This report is the product of the GMHS Analysis and Policy Brief Writing Workshop held in Big Ada, Ghana from 16-23 May 2019. The purpose of the workshop was 1) to build the capacity of workshop participants to u...

Early initiation of breastfeeding (within an hour of birth) has numerous benefits for newborn health and survival. Optimal breastfeeding supports child growth, health, and development. Health facilities provide essential pregnancy, maternal, and newborn care services and offer support for early breastfeeding. In this study, we examined the relation...

Background: Although child mortality has decreased over the last several decades, neonatal mortality has declined less substantially. In South Asia, neonatal deaths account for the majority of all under-five deaths, calling for further study on newborn care practices. We assessed five key practices: immediate drying and wrapping, delayed bathing,...

Introduction This study linked data from the 2012 Haiti Demographic and Health Survey (DHS) and the 2013 Haiti Service Provision Assessment (SPA) to estimate the extent to which women’s contraceptive use is associated with the method choices available in Haiti’s health facilities. Methods Using Global Positioning System (GPS) data for DHS clusters...

Background The persistence of preventable maternal and newborn deaths highlights the importance of quality of care as an essential element in coverage interventions. Moving beyond the conventional measurement of crude coverage, we estimated effective coverage of facility delivery by adjusting for facility preparedness to provide delivery services i...

Objectives: The height-for-age index, a useful marker of health, is not sensitive to recent nutritional insufficiencies but instead reflects cumulative growth deficiencies and linear growth retardation. Low height-for-age, known as stunting, reflects malnutrition over an extended period and can be affected by long-term or chronic morbidity. The we...

Objectives: Maternal anemia is a major public health problem in many low and middle income countries. In Malawi, consumption of iron folic acid supplements (IFA) has remained low and unchanged since 2004, even with the support of national policy and programs. To understand program implementation challenges, our study examined the relationship betw...

Background: Launched in 2012 in Uganda and Zambia, Saving Mothers, Giving Life (SMGL) was a five-year initiative that aimed to improve access to and use of maternal and newborn health care services, as well as to strengthen the quality of these services. Aim: This study compared the change in coverage of eight related maternal and child health (MC...

Aims: This study examined the association between self-reported female genital fistula symptoms and experience of gender-based violence (GBV) among women interviewed in Demographic and Health Surveys (DHS) surveys. Methods: This study pooled data from 13 recent DHS surveys with both fistula and domestic violence modules. Multivariable logistic regr...

Although child mortality has decreased considerably in the last several decades, newborn mortality has declined less substantially and its share of all under-five mortality consequently has grown. While lifesaving interventions such as skilled birth attendance and delivery in a health facility have increased, they have only contributed to a limited...

This report identifies 40 indicators of nutrition intervention readiness and delivery as part of antenatal care (ANC) and sick child care according to SPA surveys conducted in 10 countries.

Launched in 2012 in Uganda and Zambia, the Saving Mothers, Giving Life (SMGL) initiative aimed to improve access to and use of maternal and newborn health care as well as the quality of maternal and newborn health care services. This study compared the change in coverage of nine related maternal and child health (MCH) indicators between districts i...

This report examines the trends in maternal and child health over a 14-year period (2000-2014) in Cambodia. The analysis draws from four nationally representative household surveys conducted by The Demographic and Health Surveys Program in 2000, 2005, 2010, and 2014. We examined estimates of indicators of antenatal care, delivery, and postnatal car...

Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health fac...

Aims: To examine the association between alcohol consumption at last sex and unsafe sex in seven countries in sub-Saharan Africa. Design: Multivariable logistic regression of unsafe sex was performed using cross-sectional data with a stratified sample design from seven countries. Setting: The study uses data from the Demographic and Health Surveys...

Objective The Demographic and Health Surveys (DHS), which include standardized questions on female genital fistula symptoms, provide a unique opportunity to evaluate the epidemiology of fistula. This study sought to examine associations between self-reported fistula symptoms and experience of gender-based violence (GBV) among women interviewed in...

There is a growing demand for data on adolescents for planning, monitoring, and evaluating youth initiatives. Although Demographic and Health Surveys (DHS) typically interview women age 15-49, retrospective survey questions and comprehensive birth histories and contraceptive calendars provide data on the experience of adolescents of all ages from a...

There is a growing demand for data on adolescents for planning, monitoring, and evaluating youth initiatives. Although Demographic and Health Surveys (DHS) typically interview women age 15-49, retrospective survey questions and comprehensive birth histories and contraceptive calendars provide data on the experience of adolescents of all ages from a...

Researchers generally agree on a framework of domains and indicators of quality of care in family planning, although there is less consensus on methodological approaches for creating summary measures. This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare tradition...

Adolescence is a period of transition from childhood to adulthood when many behaviors and events set the stage for adult health. Demographic and Health Surveys (DHS) data are often used to describe adolescents age 15-19 but are infrequently used to examine younger adolescents age 10-14. This study employs retrospective data from women and men age 1...

Background High quality of care in family planning (FP) services has been found to be associated with increased and continued use of contraceptive methods. The interpersonal skills and technical competence of the provider is one of the main components of quality of care. To study the process component of quality of care, the distribution of the FP...

While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal h...

This study uses data from Demographic and Health Surveys (DHS) conducted in Nigeria in 2003, 2008, and 2013 to assess levels and trends in maternal health indicators. The analysis focuses on four areas of indicators directly related to the risk of maternal mortality and morbidity: antenatal care and its components; birth assistance and place of del...

This study explores the relationship between intimate partner violence (IPV) and contraceptive discontinuation using data from 11 Demographic and Health Surveys. The study uses detailed data in the reproductive calendars and the domestic violence module of the survey to co-locate contraceptive and IPV experience in the same 12-month observation per...

The disproportionate demand for services related to infectious diseases such as HIV/AIDS, tuberculosis, and malaria among pregnant women in sub-Saharan Africa, given limited health facility attendance, drives a need to integrate these services with antenatal care (ANC). This paper uses data from Service Provision Assessments in Kenya (2010), Malawi...

This investigation explored squad leaders’ perceptions of their roles managing subordinate soldiers’ behavioral health (BH) needs. The data were obtained through an anonymous survey of 458 squad leaders (i.e., small unit leaders who oversee 4–10 soldiers). More than 80% of squad leaders perceived management of soldier BH needs before, during, and a...

Long-acting reversible contraceptive (LARC) methods—intrauterine devices (IUDs), implants, and injectables—together comprise a growing share of contraceptive use in low-income countries. Using DHS contraceptive calendar data this paper examines married women’s adoption and discontinuation of LARCs, other modern methods, and traditional/folkloric me...

Access to and quality of health services are key determinants in utilization of health services and consequently, health outcomes. By linking DHS household data and health facility survey data, this paper explores the relationship between the service environment (service availability and readiness to provide a service) and utilization and quality o...

Over the past 30 years, the Demographic and Health Surveys (DHS) Program has conducted more than 300 household surveys in over 90 countries. As the number of countries with multiple surveys has risen, there is an increased opportunity for comparisons of health in relation to economic status over time. However, the DHS Wealth Index, which ranks rela...

In this article, authors review the recent literature in hearing conservation best practices to contribute to the Air Force Hearing Conservation Program (HCP) quality improvement measures. The cited research addresses HCP successes and deficits, revealing a need for increased health behavior theory-based training for workers, improved hearing prote...

When outbreaks of acute gastrointestinal illness occur in military or institutional settings, they can have significant impact on training and education. In July 2011, nearly 300 basic cadets, instructors, food service workers, and health care professionals were affected by a laboratory confirmed outbreak of Norovirus during field training exercise...

On 31 August 2011, the rabies-related death of a U.S. Army soldier prompted the Department of Defense to identify personnel who deployed since March 2010 and had indicated an animal exposure on their post-deployment health assessment. The USAF followed up on 701 airmen to ensure their animal exposure was properly assessed. An algorithm, based on re...

In July 2011, the U.S. Air Force School of Aerospace Medicine (USAFSAM) Epidemiology Consult Service investigated an ongoing outbreak of acute gastrointestinal (GI) illness--characterized by vomiting, nausea, diarrhea, and stomach cramps--that affected cadets and support personnel at a field training location at the U.S. Air Force Academy. Six outb...