Table 2.
Outcomes for 34 indicators comparing baseline knowledge, practice and coverage (KPC) results with endline results in Areas A and B of the Curamericas/Guatemala Maternal and Child Health Project, 2011–2015, with difference-in-differences analysis of changes from baseline to endline to test the hypothesis of whether the improvements in coverage were greater in Area A than in Area B
| Outcome Indicator | Area A | Area B | Difference in differences (Area A difference minus Area B difference) |
p-value for difference in differences | Hypothesis supported ** | ||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline percentage (numerator/denominator) (95% CI) |
Endline percentage (numerator/denominator) (95% CI) |
Percentage difference A (endline minus baseline) (95% CI) p value |
Baseline percentage (numerator/denominator) (95%CI) |
Endline percentage (numerator/denominator) (95% CI) |
Percentage difference B (endline minus baseline) (95% CI) p value |
||||
| Antenatal care | |||||||||
| *At least 4 quality antenatal care checks by a skilled provider (doctor, nurse, nurse-midwife) during most recent pregnancy |
13.4% (40/299) (9.5, 17.3%) |
65.0% (195/300) (59.5, 70.5%) |
51.6% (44.8, 58.4%) < 0.001 |
6.3% (19/300) (3.5, 9.1%) |
53.3% (160/300) (47.6, 59.1%) |
47.0% (40.6, 53.4%) < 0.001 |
+ 4.6% | 0.321 | No |
| *Tetanus toxoid immunization during most recent pregnancy |
63.2% (189/299) (57.6, 68.8%) |
67.7% (203/300) (62.3, 73.1%) |
4.5% (−3.3, 12.2%) 0.25 |
63.0% (189/300) (55.7, 67.0%) |
62.3% (187/300) (56.7, 67.9%) |
−.07% (−6.9, 8.9%) 0.80 |
+ 5.2% | 0.355 | No |
| *Iron/folate for at least 90 days during most recent pregnancy |
21.7% (65/299) (17.0, 26.5%) |
64.3% (193/300) (58.8, 69.9%) |
42.6% (35.3, 49.9%) < 0.001 |
10.0% (30/300) (6.5, 13.5%) |
26.3% (79/300) (21.2, 31.4%) |
16.3% (10,2, 22.5%) < 0.001 |
+ 26.3% | < 0.001 | Yes |
| Knowledge of at least 2 danger signs during pregnancy |
22.1% (66/299) (17.3, 26.9%) |
78.3% (235/300) (73.6, 83.1%) |
56.2% (49.5, 63.0%) < 0.001 |
21.3% (64/300) (16.6, 26.1%) |
66.3% (199/300) (60.9, 71.8%) |
45.0% (37.8%, 52..2%) < 0.001 |
+ 11.2% | 0.023 | Yes |
| Delivery care | |||||||||
| Knowledge of at least 2 danger signs during delivery |
13.4% (40/299) (9.5, 17.3%) |
66.3% (199/300) (60.9, 71.8%) |
53.0% (46.2, 59.7%) < 0.001 |
13.3% (40/300) (9.4, 17.3%) |
53.7% (161/300) (47.9, 59.4%) |
40.3% (33.4, 47.3%) < 0.001 |
+ 12.5% | 0.009 | Yes |
| Mothers of children 0- < 24 months of age who reported that their community had in place an emergency response transport plana |
29.4% (88/299) (24.2, 34.7%) |
44.7% (134/300) (38.9, 50.4%) |
15.2% (7.4, 23.0%) < 0.001 |
37.0% (111/300) (31.4, 42.6%) |
52.7% (158/300) (46.9, 58.4%) |
15.7% (7.6 23.7%) < 0.001 |
−0.4% | 1.0 | No |
| Children 0- < 24 months of age whose births were attended by a skilled health worker (doctor, nurse, nurse-midwife) |
15.4% (46/299) (11.2, 19.6%) |
29.3% (88/300) (24.1, 34.6%) |
14.0% (7.2, 20.7%) < 0.001 |
6.0% (18/300) (3.3, 8.7%) |
13.7% (41/300) (9.7, 17.6%) |
7.7% (2.8, 12.5%) 0.001 |
+ 6.2% | 0.12 | No |
| Births among children 0- < 24 months of age attended by a comadrona at home |
77.6% 232/299 (72.8, 82.4%) |
71.3% 214/300 (66.1, 76.6%) |
−6.3% (−13.4, 0.8%) 0.078 |
85.3% 256/300 (81.2, 89.4%) |
71.3% 214/300 (66.1, 76.6%) |
−14.0% (−20.6, −7.4%) < 0.001 |
+ 7.7% | 0.11 | No |
| Births that took place in a health facility (hospital, clinic, or Birthing Center) |
16.4% (49/299) (12.1, 20.7%) |
28.7% (86/300) (23.4, 33.9%) |
12.3% (5.5, 19.0%) < 0.001 |
6.7% (20/300) (3.8%, 9,5%) |
13.0% (39/300) (9.1, 16.9%) |
6.3% (1.5, 11.2%) 0.009 |
+ 6.0% | 0.152 | No |
| Births receiving active management of third stage of labor (AMTSL) during the most recent deliveryb |
9.4% (28/299) (6.0, 12.7%) |
20.0% (60/300) (15.4, 24.6%) |
10.6% (4.9, 16.4%) < 0.001 |
7.0% (21/300) (4.0, 9.9%) |
11.0% (33/300) (7.4, 14.6%) |
4.0% (−0.7, 8.7%) 0.086 |
+ 6.6% | 0.072 | No |
| Women with a child 0- < 24 months of age whose previous delivery was by cesarean section | N/A |
8.7% (26/300) (5.3, 12.1%) |
N/A | N/A |
2.3% (7/300) (0.4, 4.2%) |
N/A | N/A | N/A | N/A |
| Postpartum care | |||||||||
| Knowledge of at least 2 postpartum danger signs |
17.1% (51/299) (12.7, 21.4%) |
66.3% (199/300) (60.9, 71.8%) |
49.3% (42.3, 56.3%) < 0.001 |
18.7% (56/300) (14.2, 23.2%) |
54.3% (163/300) (48.6, 60.1%) |
35.7% (28.4, 43.0%) < 0.001 |
+ 13.6% | 0.007 | Yes |
| Postpartum visit for the mother and newborn within 48 hours after delivery |
22.4% (67/299) (17.6, 27.2%) |
39.0% (117/300) (33.4, 44.6%) |
16.6% (9.2, 24.0%) < 0.001 |
16.0% (48/300) (11.8, 20.2%) |
18.3% (55/300) (13.9, 22.8%) |
2.3% (−3.8, 8.5%) 0.448 |
+ 14.3% | 0.003 | Yes |
| *Percentage of mothers of children 0- < 24 months who received vitamin A supplementation within 2 months postpartum (card verified or maternal recall) |
22.1% (66/299) (17.3, 26.9%) |
47.7% (143/300) (41.9, 54.4%) |
25.6% (18.1, 33.1%) < 0.001 |
17.0% (51/300) (12.7, 21.3%) |
26.7% (80/300) (21.6, 31.8%) |
9.7% (3.0, 16.4%) 0.004 |
+ 15.9% | 0.002 | Yes |
| Newborn care | |||||||||
| Knowledge of at least 2 neonatal danger signs |
27.4% (82/299) (22.3, 32.6%) |
64.7% (194/300) (59.1, 70.2%) |
37.3% (29.7, 44.8%) < 0.001 |
29.7% (89/300) (24.4, 34.9%) |
58.7% (176/300) (53.0, 64.4%) |
29.0% (21.2, 36.8%) < 0.001 |
+ 8.3% | 0.128 | No |
| Essential Newborn Care during the most recent deliveryc |
6.0% (18/299) (3.3, 8.8%) |
39.0% (117/300) (33.4, 44.6%) |
33.0% (26.7, 39.2%) < 0.001 |
5.0% (15/300) (2.5, 7.5%) |
31.0% (93/300) (25.7, 36.3%) |
26.0% (20;1, 31.9%) < 0.001 |
+ 7.0% | 0.105 | No |
| Birth spacing and family planning | |||||||||
| Knowledge of at least 2 risks associated with pregnancy intervals < 24 months |
6.4% (19/299) (3.5, 9.2%) |
46.7% (140/300) (40.9, 52.4%) |
40.3% (33.9, 46.7%) < 0.001 |
12.0% (36/300) (8.2, 15.8%) |
33.7% (101/300) (28.2, 39.1%) |
21.7% (15.0, 28.3%) < 0.001 |
+ 18.6% | < 0.001 | Yes |
| *Current modern contraceptive use among non-pregnant women |
40.0% (107/267) (34.2, 46.0%) |
40.0% (102/255) (33.9, 46.3%) |
0.0% (−8.7, 8.9%) 1.000 |
32.0% (81/265) (25.1, 36.5%) |
29.6% (75/253) (24.1, 35.7%) |
− 2.4% (−7.4, 9.2%) 0.848 |
+ 2.4% | 0.886 | No |
| *Birth interval < 24 m between most recent 2 deliveries |
32.7% (75/299) (26.9, 39.0%) |
24.7% (56/226) (19.2, 30.9%) |
− 8.0% (− 28.1, 16.3%) 0.097 |
33.5% (77/230) (27.6, 38.7%) |
35.9% (75/209) (29.6, 42.5%) |
2.4% (−11.4, 7.9%) 0.392 |
−5.7% | 1.000 | No |
| Child nutrition | |||||||||
| Exclusive breastfeeding (children 0- < 6 months of age) in previous 24 hours |
75.0% (63/84) (65.5, 84.4%) |
82.0% (73/89) (73.9, 90.2%) |
7.0% (5.4, 19.5%) 0.260 |
79.2% (57/72) (69.6, 88.7%) |
71.6% (58/81) (61.6, 81.6%) |
− 7.6% (− 21.4, 6.3%) 0.275 |
+ 14.6% | 0.002 | Yes |
| Proper infant and young child feeding (children 6- < 24 months of age) |
53.0% (114/215) (46.2, 59.8%) |
74.3% (156,210) (68.3, 80.3%) |
21.3% (12.2, 30.4%) < 0.001 |
56.1% (128/228) (49.6, 62.7%) |
65.3% (143/219) (58.9%, 71.7% |
9.2% (0.0, 18.4%) 0.046 |
+ 12.1% | 0.028 | Yes |
| *Vitamin A supplementation for child 6- < 24 months in last 6 months |
79.1% (170/215) (73.5, 84.6%) |
74.3% (156/210) (68.3, 80.3%) |
−4.8% (−13.0, 3.4%) 0.243 |
73.7% (168/228) (67.9, 79.5%) |
67.1% (147/219) (69.8, 73.5%) |
− 6.6% (−15.2, 2.1%) 0.128 |
+ 1.8% | 0.732 | No |
| Childhood pneumonia | |||||||||
| Appropriate care seeking for child with symptoms of pneumonia |
26.1% (20/77) (16.0, 36.0%) |
51.6% (32/62) (38.9, 64.3%) |
25.6% (9.5, 41.8%) 0.002 |
20.5% (16/78) (11.4, 29.7%) |
46.6% (27/58) (33.5, 59.7%) |
26.0% (10.1, 42.0%) 0.001 |
−0.5% | 1.000 | No |
| Childhood diarrhea | |||||||||
| Use of oral rehydration therapy (or a recommended home fluid) during the most recent diarrheal episode |
28.3% (34/120) (20.1, 36.6%) |
40.8% (42/103) (31.1, 50.5%) |
12.4% (−0.3, 25.2%) 0.05 |
30.5% (36/118) (22.0, 39.0%) |
40.2% (47/117) (31.1, 49.2%) |
9.7% (−2.7%), 22.1%) 0.119 |
+ 2.8% | 0.638 | No |
| Increased fluid intake during the most recent diarrheal episode |
7.5% (9/120) (2.7%, 12.3%) |
18.5% (19/103) (10.8, 26.1%) |
11.0% (1.9, 20.0%) 0.015 |
7.6% (9/118) (2.7%, 12.5%), |
16.2% (19/117) (9.4%, 23.1%) |
8.6% (0.2, 17.0%) 0.040 |
+ 2.3% | 0.540 | No |
| Same/increased food intake during the most recent diarrheal episode |
0.0% (0/120) (0.0, 2.5%) |
0.0% (0/103) (0.0, 2.9%) |
0.0% (0.0, 0.0%) N/A |
2.5% (3/118) (0.0, 5.4%) |
5.1% (6/117) (1.0, 9.2%) |
2.6% (−2.4, 7.6%) 0.301 |
−2.6% | 1.000 | No |
| *Zinc treatment for the most recent diarrheal episode |
6.7% (8/120) (2.1, 11.2%) |
10.7% (11/103) (4.6, 16.8%) |
4.0% (−3.6, 1.6%) 0.291 |
1.7% (2/118) (0.0, 4.1%) |
10.3% (12/117) (4.6%, 15/9%) |
8.6% (2.5, 14.7%) 0.005 |
−4.6% | 1.000 | No |
| Childhood immunization | |||||||||
| *Measles Immunization children 12- < 24 months |
79.3% (96/121) (72.0, 86.7%) |
64.8% (79/122) (56.1, 73.4%) |
−14.5% (−25.9, −3.2%) 0.010 |
78.9% (116/147) (72.2, 85.6%) |
55.5% (66/119) (46.4, 64.6%) |
− 23.5% (− 34.8, −12.1%) < 0.001 |
+ 8.9% | 0.092 | No |
| *Complete vaccination coverage children 12- < 24 months (BCG, PENTA 1–3, polio 1–3, measles) |
73.6% (89/121) (65.5, 81.6%) |
56.6% (69/122) (47.6, 65.5%) |
−17.0% (− 29.0, −5.0%) 0.005 |
68.7% (101/147) (61.1, 76.4%) |
50.4% (60/119) (41.3, 59.6%) |
−18.3% (− 30.2, −6.3%) 0.002 |
+ 1.3% | 0.796 | No |
| WASH (wáter, sanitation and hygiene) | |||||||||
| Regular point-of-use water treatment |
66.6% (199/299) (61.1, 72.0%) |
97.7% (293/300) (95.9, 99.4%) |
31.1% (25.4, 36.8%) < 0.001 |
58.3% (175/300) (52.6, 64.0%) |
97.7% (293/300) (95.9, 99.4%) |
39.4% (33.4, 45.3%) < 0.001 |
−8.3% | 1.000 | No |
| Safe water storage |
11.7% (35/299) (8.0, 15.4%) |
28.0% (84/300) (22.8, 33.2%) |
16.3% (9.9, 22.7%) < 0.001 |
10.3% (31/300) (6.8, 13.8%) |
26.0% (78/300) (20.9, 31.1%) |
15.7% (9.5, 21.8%) < 0.001 |
+ 0.6% | 0.888 | No |
| Safe disposal of child’s feces the last time s/he defecated |
43.1% (129/299) (37.4, 48.9%) |
45.0% (135/300) (39.3, 50.7%) |
1.9% (−6.3, 10.0% 0.647 |
38.7% (116/300) (33.0, 44.3%) |
52.0% (156/300) (46.2, 57.8%) |
13.3% (5.3, 21.4%) < 0.001 |
−11.4% | 1.000 | No |
| Appropriate hand washing station in home (with water, soap, and soap recipient) |
2.3% (7/299) (0.6, 4.1%) |
44.7% (134/300) (38.9, 50.4%) |
42.3% (36.3, 48.3%) < 0.001 |
2.3% (7/300) (0.6, 4.1%) |
44.0% (132/300) (38.3, 49.7%) |
41.7% (35.7, 47.7%) < 0.001 |
+ 0.7% | 0.877 | No |
| Knowledge of the 4 critical times when hands should be washing (after defecating, before preparing food, after cleaning a child who has defecated, before feeding a child) |
1.3% (4/299) (0.0, 2.7%) |
34.0% (102/300) (28.5, 39.5%) |
32.7% (27.0, 38.3%) < 0.001 |
1.7% (5/300) (0.2, 3.1%) |
28.7% (86/300) (23.4, 33.9%) |
27.0% (21.6, 32.4%) (< 0.001) |
−5.7% | 0.148 | No |
NA not assessed, CI confidence interval
*Denotes indicators (n=10) that were tracked by the Project but depended on services delivered through the government-run PEC Program and therefore considered outside of the Project’s control
**The difference in differences is positive and statistically significant
aA plan that would provide transport for the mother and/or her newborn to the nearest health facility in the event of (1) a difficult delivery or (2) danger signs in pregnancy or during the postpartum period
bAMTSL: active management of the third stage of labor (controlled cord traction, uterine massage, and administration of a uterotonic drug)
cEssential Newborn Care: clean umbilical cord care, immediate breastfeeding, thermal care