Peter M Macharia
Datos Biográficos
| ID | 6651817 |
|---|---|
| NOMBRE | Peter M Macharia |
| NOMBRES | Peter M |
| APELLIDO | Macharia |
| FIRMA | MACHARIA P M |
| AFILIACIONES | Kenya Medical Research Institute |
| ORCID | 0000-0003-3410-1881 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 24 |
| TOTAL DE CITAS | 1 |
| TOTAL COMO AUTOR | 24 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2017 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 1 |
Dialysis deserts in the Philippines
BACKGROUND: In the Philippines, dialysis facilities are clustered in urban centers, leaving patients with Kidney Failure (KF) in rural and geographically isolated regions severely underserved. Despite a national peritoneal dialysis (PD)-first policy since 2014, a decade of implementation has not closed this gap, and no national analysis has examined whether the existing organization of dialysis services drives geographic inequities or how integra…
Spatial distribution, integration and determinants of family planning service provision in Lubumbashi, DRC
Universal access to family planning (FP) services is essential for safeguarding sexual and reproductive health and rights. Integration of FP and routine maternal and child health (MCH) services has been associated with increased uptake of long-acting reversible contraceptives and contributes to reduced unintended pregnancies, unsafe abortions and complications associated with short interpregnancy intervals. In the DRC, FP use remains limited desp…
Levels of in-facility maternal mortality, obstetric complications and stillbirths in three urban referral hospitals in Guinea
INTRODUCTION: Despite global efforts to reduce maternal mortality, progress has stalled, particularly in sub-Saharan Africa, where the maternal mortality ratio remains high. This study aims to assess in-facility maternal mortality, maternal and foetal complications, and stillbirths in referral hospitals at different levels of the health system in Guinea. METHODS: This was a cross-sectional study conducted at three urban referral hospitals in Guin…
The richness of urban health realities lost in measurement monocultures
box Standardised measurement approaches obscure urban diversity and marginalise locally relevant insights
Impact of travel time to health facilities on perinatal outcomes
Background: Evidence-based global guidance on safe travel time for small or sick newborns who require transfer to health facilities after birth is lacking. A two-hour threshold is frequently cited in low- and middle-income countries (LMICs), while 30 minutes is commonly used in high-income countries (HICs). Although these thresholds are widely referenced, their empirical basis and consistency across levels of newborn care and journey types have n…
Beyond facility-based births
Maternal and newborn studies in Uganda have primarily focused on measuring contact coverage, such as the proportion of facility-based births. However, this is inadequate and may overestimate the benefits of services provided to women and newborns if the quality of care in the facilities is not considered. Effective coverage of care addresses this limitation and adjusts for the quality of services. This study assessed the effective coverage of mat…
Modeling Geographical Accessibility and Inequalities to Childbirth Services in the Grand Nokoué Metropolitan Area, Benin
Timely access to comprehensive , high-quality emergency obstetric and neonatal care can prevent maternal and neonatal mortality but remains challenging in Benin. We examine geographic accessibility to childbirth care (CBC) in Grand Nokoué, the largest conurbation in Benin. We gathered data on boundaries, health facilities, road network, elevation, land cover, relative wealth, urbanicity, and geo-traced travel speeds over 45 days during the rainy …
Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi
Objective: To establish the prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among mother–child pairs in Malawi and explore their geographical distribution and associated multilevel factors. Design: Cross-sectional study using secondary data from the 2015–2016 Malawi Demographic and Health Survey using a mixed effects binomial model to identify multilevel factors associated with DBM and TBM. Georeferenced …
Exploring the urban gradient in population health
The demographic, ecological and socioeconomic changes associated with urbanisation are linked to changes in disease incidence, health service provision and mortality. These effects are heterogeneous between and within urban areas, yet without a clear definition of what constitutes an ‘urban’ area, their measurement and comparison are constrained. The definitions used vary between countries and over time hindering analyses of the relationship betw…
Neonatal and perinatal mortality in the urban continuum
INTRODUCTION: Recent studies suggest that the urban advantage of lower neonatal mortality in urban compared with rural areas may be reversing, but methodological challenges include misclassification of neonatal deaths and stillbirths, and oversimplification of the variation in urban environments. We address these challenges and assess the association between urban residence and neonatal/perinatal mortality in Tanzania. METHODS: The Tanzania Demog…
Geographic accessibility to public and private health facilities in Kenya in 2021
Objectives: To achieve universal health coverage, adequate geographic access to quality healthcare services is vital and should be characterized periodically to support planning. However, in Kenya, previous assessments of geographic accessibility have relied on public health facility lists only, assembled several years ago. Here, for the first time we assemble a geocoded list of public and private health facilities in 2021 and make use of this up…
Leveraging big data for improving the estimation of close to reality travel time to obstetric emergency services in urban low- and middle-income settings
Maternal and perinatal mortality remain huge challenges globally, particularly in low- and middle-income countries (LMICs) where >98% of these deaths occur. Emergency obstetric care (EmOC) provided by skilled health personnel is an evidence-based package of interventions effective in reducing these deaths associated with pregnancy and childbirth. Until recently, pregnant women residing in urban areas have been considered to have good access to ca…
Comparing modelled with self-reported travel time and the used versus the nearest facility
INTRODUCTION: Geographic access to family planning (FP) services has been characterised through a variety of proximity metrics. However, there is little evidence on the validity of women's self-reported compared with modelled travel time to an FP outlet, or between different distance measures. METHODS: We used data from four urban sites in Kenya. A longitudinal FP outlet census was directly linked with data from cross-sectional FP user surveys. W…
Progress towards achieving child survival goals in Kenya after devolution
Subnational projections of under-5 mortality (U5M) have increasingly become an essential planning tool to support Sustainable Development Goals (SDGs) agenda and strategies for improving child survival. To support child health policy, planning, and tracking child development goals in Kenya, we projected U5M at units of health decision making. County-specific annual U5M were estimated using a multivariable Bayesian space-time hierarchical model ba…
Modelling geographic access and school catchment areas across public primary schools to support subnational planning in Kenya
Understanding the location of schools relative to the population they serve is important to contextualise the time, students must travel and to define school catchment areas (SCAs) for planning. We assembled a spatio-temporal database of public primary schools (PPS), population density of school-going children (SGC), and factors affecting travel in 2009 and 2020 in Kenya. We combined the assembled datasets within cost distance and cost allocation…
Subnational estimates of factors associated with under-five mortality in Kenya
BACKGROUND: To improve child survival, it is necessary to describe and understand the spatial and temporal variation of factors associated with child survival beyond national aggregates, anchored at decentralised health planning units. Therefore, we aimed to provide subnational estimates of factors associated with child survival while elucidating areas of progress, stagnation and decline in Kenya. METHODS: Twenty household surveys and three popul…
Defining service catchment areas in low-resource settings
Defining an accurate, representative service catchment area is important for computing population denominators for disease mapping and efficient public planning, including health, education and social care.\n \nThe growth in population settlement modelling techniques and provision of geocoded service databases has fuelled an increase in local and regional service access mapping to examine coverage and equity in much of sub-Saharan African countri…
Plasmodium falciparum parasite prevalence in East Africa
The High Burden High Impact (HBHI) strategy for malaria encourages countries to use multiple sources of available data to define the sub-national vulnerabilities to malaria risk, including parasite prevalence. Here, a modelled estimate of Plasmodium falciparum from an updated assembly of community parasite survey data in Kenya, mainland Tanzania, and Uganda is presented and used to provide a more contemporary understanding of the sub-national mal…
Spatial and spatio-temporal methods for mapping malaria risk
A vulnerability index for Covid-19
BACKGROUND: Response to the coronavirus disease 2019 (COVID-19) pandemic calls for precision public health reflecting our improved understanding of who is the most vulnerable and their geographical location. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya. METHODS: Geospatial indicators were assembled to create three vulnerabi…
Spatial access inequities and childhood immunisation uptake in Kenya
Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya
Sub national variation and inequalities in under-five mortality in Kenya since 1965
Kenya has made huge progress in child survival since independence. However, U5M remains high and heterogeneous with substantial differences between counties. Better use of the current resources through focused allocation is required to achieve further reductions, reduce inequalities and increase the likelihood of achieving Sustainable Development Goal 3·2 on U5M by 2030
Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015
Background Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with foc…
Coverage of routine reporting on malaria parasitological testing in Kenya, 2015–2016
BACKGROUND: Following the launch of District Health Information System 2 across facilities in Kenya, more health facilities are now capable of carrying out malaria parasitological testing and reporting data as part of routine health information systems, improving the potential value of routine data for accurate and timely tracking of rapidly changing disease epidemiology at fine spatial resolutions. OBJECTIVES: This study evaluates the current co…
Modelling geographic access and school catchment areas across public primary schools to support subnational planning in Kenya
Understanding the location of schools relative to the population they serve is important to contextualise the time, students must travel and to define school catchment areas (SCAs) for planning. We assembled a spatio-temporal database of public primary schools (PPS), population density of school-going children (SGC), and factors affecting travel in 2009 and 2020 in Kenya. We combined the assembled datasets within cost distance and cost allocation…
Coverage of routine reporting on malaria parasitological testing in Kenya, 2015–2016
BACKGROUND: Following the launch of District Health Information System 2 across facilities in Kenya, more health facilities are now capable of carrying out malaria parasitological testing and reporting data as part of routine health information systems, improving the potential value of routine data for accurate and timely tracking of rapidly changing disease epidemiology at fine spatial resolutions. OBJECTIVES: This study evaluates the current co…
Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015
Background Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with foc…
Sub national variation and inequalities in under-five mortality in Kenya since 1965
Kenya has made huge progress in child survival since independence. However, U5M remains high and heterogeneous with substantial differences between counties. Better use of the current resources through focused allocation is required to achieve further reductions, reduce inequalities and increase the likelihood of achieving Sustainable Development Goal 3·2 on U5M by 2030
Spatial and spatio-temporal methods for mapping malaria risk
A vulnerability index for Covid-19
BACKGROUND: Response to the coronavirus disease 2019 (COVID-19) pandemic calls for precision public health reflecting our improved understanding of who is the most vulnerable and their geographical location. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya. METHODS: Geospatial indicators were assembled to create three vulnerabi…
Spatial access inequities and childhood immunisation uptake in Kenya
Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya
Subnational estimates of factors associated with under-five mortality in Kenya
BACKGROUND: To improve child survival, it is necessary to describe and understand the spatial and temporal variation of factors associated with child survival beyond national aggregates, anchored at decentralised health planning units. Therefore, we aimed to provide subnational estimates of factors associated with child survival while elucidating areas of progress, stagnation and decline in Kenya. METHODS: Twenty household surveys and three popul…
Defining service catchment areas in low-resource settings
Defining an accurate, representative service catchment area is important for computing population denominators for disease mapping and efficient public planning, including health, education and social care.\n \nThe growth in population settlement modelling techniques and provision of geocoded service databases has fuelled an increase in local and regional service access mapping to examine coverage and equity in much of sub-Saharan African countri…
Plasmodium falciparum parasite prevalence in East Africa
The High Burden High Impact (HBHI) strategy for malaria encourages countries to use multiple sources of available data to define the sub-national vulnerabilities to malaria risk, including parasite prevalence. Here, a modelled estimate of Plasmodium falciparum from an updated assembly of community parasite survey data in Kenya, mainland Tanzania, and Uganda is presented and used to provide a more contemporary understanding of the sub-national mal…
Geographic accessibility to public and private health facilities in Kenya in 2021
Objectives: To achieve universal health coverage, adequate geographic access to quality healthcare services is vital and should be characterized periodically to support planning. However, in Kenya, previous assessments of geographic accessibility have relied on public health facility lists only, assembled several years ago. Here, for the first time we assemble a geocoded list of public and private health facilities in 2021 and make use of this up…
Leveraging big data for improving the estimation of close to reality travel time to obstetric emergency services in urban low- and middle-income settings
Maternal and perinatal mortality remain huge challenges globally, particularly in low- and middle-income countries (LMICs) where >98% of these deaths occur. Emergency obstetric care (EmOC) provided by skilled health personnel is an evidence-based package of interventions effective in reducing these deaths associated with pregnancy and childbirth. Until recently, pregnant women residing in urban areas have been considered to have good access to ca…
Comparing modelled with self-reported travel time and the used versus the nearest facility
INTRODUCTION: Geographic access to family planning (FP) services has been characterised through a variety of proximity metrics. However, there is little evidence on the validity of women's self-reported compared with modelled travel time to an FP outlet, or between different distance measures. METHODS: We used data from four urban sites in Kenya. A longitudinal FP outlet census was directly linked with data from cross-sectional FP user surveys. W…
Progress towards achieving child survival goals in Kenya after devolution
Subnational projections of under-5 mortality (U5M) have increasingly become an essential planning tool to support Sustainable Development Goals (SDGs) agenda and strategies for improving child survival. To support child health policy, planning, and tracking child development goals in Kenya, we projected U5M at units of health decision making. County-specific annual U5M were estimated using a multivariable Bayesian space-time hierarchical model ba…
Modelling geographic access and school catchment areas across public primary schools to support subnational planning in Kenya
Understanding the location of schools relative to the population they serve is important to contextualise the time, students must travel and to define school catchment areas (SCAs) for planning. We assembled a spatio-temporal database of public primary schools (PPS), population density of school-going children (SGC), and factors affecting travel in 2009 and 2020 in Kenya. We combined the assembled datasets within cost distance and cost allocation…
Exploring the urban gradient in population health
The demographic, ecological and socioeconomic changes associated with urbanisation are linked to changes in disease incidence, health service provision and mortality. These effects are heterogeneous between and within urban areas, yet without a clear definition of what constitutes an ‘urban’ area, their measurement and comparison are constrained. The definitions used vary between countries and over time hindering analyses of the relationship betw…
Neonatal and perinatal mortality in the urban continuum
INTRODUCTION: Recent studies suggest that the urban advantage of lower neonatal mortality in urban compared with rural areas may be reversing, but methodological challenges include misclassification of neonatal deaths and stillbirths, and oversimplification of the variation in urban environments. We address these challenges and assess the association between urban residence and neonatal/perinatal mortality in Tanzania. METHODS: The Tanzania Demog…
Prevalence and determinants of double and triple burden of malnutrition among mother–child pairs in Malawi
Objective: To establish the prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among mother–child pairs in Malawi and explore their geographical distribution and associated multilevel factors. Design: Cross-sectional study using secondary data from the 2015–2016 Malawi Demographic and Health Survey using a mixed effects binomial model to identify multilevel factors associated with DBM and TBM. Georeferenced …
Beyond facility-based births
Maternal and newborn studies in Uganda have primarily focused on measuring contact coverage, such as the proportion of facility-based births. However, this is inadequate and may overestimate the benefits of services provided to women and newborns if the quality of care in the facilities is not considered. Effective coverage of care addresses this limitation and adjusts for the quality of services. This study assessed the effective coverage of mat…
Modeling Geographical Accessibility and Inequalities to Childbirth Services in the Grand Nokoué Metropolitan Area, Benin
Timely access to comprehensive , high-quality emergency obstetric and neonatal care can prevent maternal and neonatal mortality but remains challenging in Benin. We examine geographic accessibility to childbirth care (CBC) in Grand Nokoué, the largest conurbation in Benin. We gathered data on boundaries, health facilities, road network, elevation, land cover, relative wealth, urbanicity, and geo-traced travel speeds over 45 days during the rainy …
Dialysis deserts in the Philippines
BACKGROUND: In the Philippines, dialysis facilities are clustered in urban centers, leaving patients with Kidney Failure (KF) in rural and geographically isolated regions severely underserved. Despite a national peritoneal dialysis (PD)-first policy since 2014, a decade of implementation has not closed this gap, and no national analysis has examined whether the existing organization of dialysis services drives geographic inequities or how integra…
Spatial distribution, integration and determinants of family planning service provision in Lubumbashi, DRC
Universal access to family planning (FP) services is essential for safeguarding sexual and reproductive health and rights. Integration of FP and routine maternal and child health (MCH) services has been associated with increased uptake of long-acting reversible contraceptives and contributes to reduced unintended pregnancies, unsafe abortions and complications associated with short interpregnancy intervals. In the DRC, FP use remains limited desp…
Levels of in-facility maternal mortality, obstetric complications and stillbirths in three urban referral hospitals in Guinea
INTRODUCTION: Despite global efforts to reduce maternal mortality, progress has stalled, particularly in sub-Saharan Africa, where the maternal mortality ratio remains high. This study aims to assess in-facility maternal mortality, maternal and foetal complications, and stillbirths in referral hospitals at different levels of the health system in Guinea. METHODS: This was a cross-sectional study conducted at three urban referral hospitals in Guin…
The richness of urban health realities lost in measurement monocultures
box Standardised measurement approaches obscure urban diversity and marginalise locally relevant insights
Impact of travel time to health facilities on perinatal outcomes
Background: Evidence-based global guidance on safe travel time for small or sick newborns who require transfer to health facilities after birth is lacking. A two-hour threshold is frequently cited in low- and middle-income countries (LMICs), while 30 minutes is commonly used in high-income countries (HICs). Although these thresholds are widely referenced, their empirical basis and consistency across levels of newborn care and journey types have n…
Global Maternal and Child Health (17 obras) · Geography (14 obras) · Medicine (14 obras) · Environmental health (12 obras) · Population (12 obras) · Public health (9 obras) · Demography (7 obras) · Cartography (6 obras) · Business (5 obras) · Child Nutrition and Water Access (5 obras)