Melinda Munos
Biographic Data
| ID | 3574489 |
|---|---|
| NAME | Melinda Munos |
| GIVEN NAMES | Melinda |
| FAMILY NAME | Munos |
| SIGNATURE | MUNOS M |
| AFFILIATIONS | Johns Hopkins University |
| ORCID | 0000-0002-1349-8026 |
| VERIFIED | Yes |
| TOTAL WORKS | 34 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 34 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Formative research in Ethiopia and Bangladesh
Background: As countries transition from implementing iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey questions, response options, and visual aids to measure coverage of prenatal micronutrient supplements. Methods: In phase I, we landscap…
WHO launches global network of institutes to strengthen capacity for health inequality monitoring
This article introduces the global WHO-managed Health Inequality Monitoring Network, which is dedicated to strengthening and expanding health inequality monitoring practices at global, regional and country levels. Launched in 2025, the Health Inequality Monitoring Network consists of 12 inaugural institutional members, represented by over 140 affiliated individuals spanning all world regions. The Network aims to: strengthen capacities for health …
Measuring and monitoring child health and well-being—an integral part of the climate change agenda
Climate change has far-reaching consequences for all aspects of human society (Romanello et al. 2023). Children are uniquely vulnerable to climate change for a multitude of physiological and developmental reasons as well as because of distinctive behaviors such as outdoor play that increase their exposure to climate-related stressors (EPA 2023). Several reviews have summarized the multiple direct and indirect pathways through which climate change…
Effective coverage for maternal health
Background: Efforts to improve maternal health have focused on measuring health and nutrition service coverage. Despite improvements in service coverage, maternal mortality rates remain high. This suggests that coverage indicators alone do not fully capture the quality of care and may overestimate the health benefits of a service. Effective coverage (EC) cascades have been proposed as an approach to capture service quality within population-based…
Inequities in effective coverage of family planning services in low- and middle-income countries
Background: Despite decades of family planning (FP) programme successes in low- and middle-income countries (LMICs), women still face an unmet need for contraceptives, as well as inequalities in coverage. Including elements of service readiness in FP intervention coverage measures will better inform population-level programme performance. Methods: We identified five LMICs that had health facility and household surveys conducted <5 years apart wit…
Advancing maternal and newborn healthcare measurement
Background: High-quality healthcare for pregnant women and newborns, particularly postnatal care (PNC) and small and/or sick newborn care (SSNC), is essential to reducing maternal and newborn morbidity and mortality in low- and middle-income countries (LMICs). Poor quality of care (QoC) is a major contributor to preventable morbidity and mortality, emphasising the need for its improvement in health service delivery through systematic measurement …
Challenges in reducing maternal and neonatal mortality in Niger
INTRODUCTION: Recent modelled estimates suggest that Niger made progress in maternal mortality since 2000. However, neonatal mortality has not declined since 2012 and maternal mortality estimates were based on limited data. We researched the drivers of progress and challenges. METHODS: We reviewed two decades of health policies, analysed mortality trends from United Nations data and six national household surveys between 1998 and 2021 and assesse…
Effective multi-sectoral approach for rapid reduction in maternal and neonatal mortality
BACKGROUND: Bangladesh experienced impressive reductions in maternal and neonatal mortality over the past several decades with annual rates of decline surpassing 4% since 2000. We comprehensively assessed health system and non-health factors that drove Bangladesh's success in mortality reduction. METHODS: We operationalised a comprehensive conceptual framework and analysed available household surveys for trends and inequalities in mortality, inte…
Delays in accessing high-quality care for newborns in East Africa
Background: Despite the existence of evidence-based interventions, substantial progress in reducing neonatal mortality is lagging, indicating that small and sick newborns (SSNs) are likely not receiving the care they require to survive and thrive. The 'three delays model' provides a framework for understanding the challenges in accessing care for SSNs. However, the extent to which each delay impacts access to care for SSNs is not well understood.…
Effects of the Covid-19 pandemic on maternal, newborn, and child health service coverage in Burkina Faso
Background: While countries' coronavirus disease 2019 (COVID-19) emergency contingency and response plans aimed to prevent and control the spread of the virus, they also caused major disruptions to health services. We assessed the effects of COVID-19 on coverage and inequalities in select maternal, newborn, and child health services in Burkina Faso. Methods: We analysed data from two cross-sectional household surveys conducted in two provinces, o…
Effective Coverage of Modern Contraceptive Use in Ethiopia
The increase in contraceptive prevalence rate (crude coverage) in Ethiopia over the past two decades does not necessarily reflect service quality, and although the proportion of women with unmet needs has decreased, it remains unacceptably high. Hence, this study aimed to estimate the effective coverage (EC) of modern contraceptive methods in Ethiopia, considering the quality of care. We used nationally representative surveys, such as health faci…
Exploring approaches to weighting estimates of facility readiness to provide health services used for estimating input-adjusted effective coverage
The ideal approach for calculating effective coverage of health services using ecological linking requires accounting for variability in facility readiness to provide health services and patient volume by incorporating adjustments for facility type into estimates of facility readiness and weighting facility readiness estimates by service-specific caseload. The aim of this study is to compare the ideal caseload-weighted facility readiness approach…
The Radar coverage tool
Population-based intervention coverage data are used to inform the design of projects, programs, and policies and to evaluate their impact. In low- and middle-income countries (LMICs), household surveys are the primary source of coverage data. Many coverage surveys are implemented by organizations with limited experience or resources in population-based data collection. We developed a streamlined survey and set of supporting materials to facilita…
Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal
Revitalizing child health
Essential health, education and other service disruptions arising from the COVID-19 pandemic risk reversing some of the hard-won gains in improving child survival over the past 40 years. Although children have milder symptoms of COVID-19 disease than adults, pandemic control measures in many countries have disrupted health, education and other services for children, often leaving them without access to birth and postnatal care, vaccinations and e…
Validation of maternal report of nutrition‐related interventions and counselling during antenatal care in southern Nepal
The delivery of nutrition-related interventions and counselling during antenatal care is critical for a healthy pregnancy for both mother and child. However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteri…
Advancing nutrition measurement
The health sector plays an important role in the delivery of high-quality nutrition interventions to women and children in low- and middle-income countries (LMICs). However, there are no standardized approaches to defining and measuring nutrition service quality in these contexts. This study aims to systematically develop quality of care indices for direct health systems nutrition interventions using a five-step process: (1) identify recommended …
Using cognitive interviewing to bridge the intent‐interpretation gap for nutrition coverage survey questions in India
Designing survey questions that clearly and precisely communicate the question's intent and elicit responses based on the intended interpretation is critical but often undervalued. We used cognitive interviewing to qualitatively assess respondents' interpretation of and responses to questions pertaining to maternal and child nutrition intervention coverage. We conducted interviews to cognitively test 25 survey questions with mothers (N = 21) with…
The role of gender power relations on women’s health outcomes
The association between decision-making and other gender domains with women's health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. Future studies should integrate and analyze gender-sensitive questions within coverage surveys
Understanding client and provider perspectives of antenatal care service quality
Methods for analysis of complex survey data
BACKGROUND: Low-income and middle-income countries (LMICs) seek to better utilize household and health facility survey data for monitoring and evaluation, as well as for health program planning. However, analysis of this complex survey data are complicated. In Tanzania, the National Evaluation Platform project sought to analyze Demographic and Health Survey (DHS) data and Service Provision Assessment (SPA) data as part of an evaluation of the nat…
A multi-institutional approach to data-driven decision-making
Evaluation of methods for linking household and health care provider data to estimate effective coverage of management of child illness
BACKGROUND: Existing population-based surveys have limited accuracy for estimating the coverage and quality of management of child illness. Linking household survey data with health care provider assessments has been proposed as a means of generating more informative population-level estimates of effective coverage, but methodological issues need to be addressed. METHODS: A 2016 survey estimated effective coverage of management of child illness i…
Linking household survey and health facility data for effective coverage measures
BACKGROUND: Population-based measures of intervention coverage are used in low- and middle-income countries for program planning, prioritization, and evaluation. There is increased interest in effective coverage, which integrates information about service quality or health outcomes. Approaches proposed for quality-adjusted effective coverage include linking data on need and service contact from population-based surveys with data on service qualit…
Validation studies for population-based intervention coverage indicators
BACKGROUND: Population-based intervention coverage indicators are widely used to track country and program progress in improving health and to evaluate health programs. Indicator validation studies that compare survey responses to a "gold standard" measure are useful to understand whether the indicator provides accurate information. The Improving Coverage Measurement (ICM) Core Group has developed and implemented a standard approach to validating…
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Using LiST to model potential reduction in under-five mortality in Burkina Faso
These findings suggest that significant reductions in under-five mortality may be achieved through the scale-up of the Acceleration. The Ministry of Health and its partners in Burkina Faso should continue their efforts to scale up these proven interventions to achieve and even exceed target levels for coverage
Linking household and facility data for better coverage measures in reproductive, maternal, newborn, and child health care
Improving coverage measurement for reproductive, maternal, neonatal and child health
BACKGROUND: Regular monitoring of coverage for reproductive, maternal, neonatal, and child health (RMNCH) is central to assessing progress toward health goals. The objectives of this review were to describe the current state of coverage measurement for RMNCH, assess the extent to which current approaches to coverage measurement cover the spectrum of RMNCH interventions, and prioritize interventions for a novel approach to coverage measurement lin…
Quality of antenatal care service provision in health facilities across sub–Saharan Africa
BACKGROUND: Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. METHODS: Using data from 20 nationally representative health…
Using the Lives Saved Tool to aid country planning in meeting mortality targets
This study revealed that achieving the coverage targets for the MNCH&N interventions in the 2014-23 PDDSS would likely not allow Mali to achieve its mortality targets. The NEP-Mali team was able to identify two packages of MNCH&N interventions (and targets) that achieved under-5 and neonatal mortality rates at, or very near, the PDDSS targets. The Malian Ministry of Health and Public Hygiene is using these results to revise its plans and strategi…
Evaluation of methods for linking household and health care provider data to estimate effective coverage of management of child illness
BACKGROUND: Existing population-based surveys have limited accuracy for estimating the coverage and quality of management of child illness. Linking household survey data with health care provider assessments has been proposed as a means of generating more informative population-level estimates of effective coverage, but methodological issues need to be addressed. METHODS: A 2016 survey estimated effective coverage of management of child illness i…
Linking household survey and health facility data for effective coverage measures
BACKGROUND: Population-based measures of intervention coverage are used in low- and middle-income countries for program planning, prioritization, and evaluation. There is increased interest in effective coverage, which integrates information about service quality or health outcomes. Approaches proposed for quality-adjusted effective coverage include linking data on need and service contact from population-based surveys with data on service qualit…
Validation studies for population-based intervention coverage indicators
BACKGROUND: Population-based intervention coverage indicators are widely used to track country and program progress in improving health and to evaluate health programs. Indicator validation studies that compare survey responses to a "gold standard" measure are useful to understand whether the indicator provides accurate information. The Improving Coverage Measurement (ICM) Core Group has developed and implemented a standard approach to validating…
Validity of maternal report of care-seeking for childhood illness
BACKGROUND: Accurate data on care-seeking for child illness are needed to improve public health programs and reduce child mortality. The accuracy of maternal report of care-seeking for child illness as collected through household surveys has not been validated. METHODS: A 2016 survey compared reported care-seeking against a gold-standard of health care provider documented care-seeking events among a random sample of mothers of children <5 years i…
Validation of maternal reports for low birthweight and preterm birth indicators in rural Nepal
BACKGROUND: Tracking progress towards global newborn health targets depends largely on maternal reported data collected through large, nationally representative surveys. We evaluated the validity, across a range of recall period lengths (1 to 24 months post-delivery), of maternal report of birthweight, birth size and length of pregnancy. METHODS: We compared maternal reports to reference standards of birthweights measured within 72 hours of deliv…
Linking data sources for measurement of effective coverage in maternal and newborn health
Linking data sources for measurement of effective coverage in maternal and newborn health: what do we learn from individual-vs ecological-linking methods
Why some mothers overestimate birth size and length of pregnancy in rural Nepal
BACKGROUND: Quantitative validation studies alone may not be able to distinguish between instances when participants did not accurately report an event vs when participants did not understand a question. We used an explanatory qualitative study design to acquire an in-depth understanding of why some mothers in rural Nepal overestimate birth size of their newborn and their length of pregnancy. METHODS: We conducted two focus group discussions (FGD…
Understanding client and provider perspectives of antenatal care service quality
Methods for analysis of complex survey data
BACKGROUND: Low-income and middle-income countries (LMICs) seek to better utilize household and health facility survey data for monitoring and evaluation, as well as for health program planning. However, analysis of this complex survey data are complicated. In Tanzania, the National Evaluation Platform project sought to analyze Demographic and Health Survey (DHS) data and Service Provision Assessment (SPA) data as part of an evaluation of the nat…
A multi-institutional approach to data-driven decision-making
Revitalizing child health
Essential health, education and other service disruptions arising from the COVID-19 pandemic risk reversing some of the hard-won gains in improving child survival over the past 40 years. Although children have milder symptoms of COVID-19 disease than adults, pandemic control measures in many countries have disrupted health, education and other services for children, often leaving them without access to birth and postnatal care, vaccinations and e…
Validation of maternal report of nutrition‐related interventions and counselling during antenatal care in southern Nepal
The delivery of nutrition-related interventions and counselling during antenatal care is critical for a healthy pregnancy for both mother and child. However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteri…
Advancing nutrition measurement
The health sector plays an important role in the delivery of high-quality nutrition interventions to women and children in low- and middle-income countries (LMICs). However, there are no standardized approaches to defining and measuring nutrition service quality in these contexts. This study aims to systematically develop quality of care indices for direct health systems nutrition interventions using a five-step process: (1) identify recommended …
Using cognitive interviewing to bridge the intent‐interpretation gap for nutrition coverage survey questions in India
Designing survey questions that clearly and precisely communicate the question's intent and elicit responses based on the intended interpretation is critical but often undervalued. We used cognitive interviewing to qualitatively assess respondents' interpretation of and responses to questions pertaining to maternal and child nutrition intervention coverage. We conducted interviews to cognitively test 25 survey questions with mothers (N = 21) with…
The role of gender power relations on women’s health outcomes
The association between decision-making and other gender domains with women's health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. Future studies should integrate and analyze gender-sensitive questions within coverage surveys
The Radar coverage tool
Population-based intervention coverage data are used to inform the design of projects, programs, and policies and to evaluate their impact. In low- and middle-income countries (LMICs), household surveys are the primary source of coverage data. Many coverage surveys are implemented by organizations with limited experience or resources in population-based data collection. We developed a streamlined survey and set of supporting materials to facilita…
Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal
Exploring approaches to weighting estimates of facility readiness to provide health services used for estimating input-adjusted effective coverage
The ideal approach for calculating effective coverage of health services using ecological linking requires accounting for variability in facility readiness to provide health services and patient volume by incorporating adjustments for facility type into estimates of facility readiness and weighting facility readiness estimates by service-specific caseload. The aim of this study is to compare the ideal caseload-weighted facility readiness approach…
Challenges in reducing maternal and neonatal mortality in Niger
INTRODUCTION: Recent modelled estimates suggest that Niger made progress in maternal mortality since 2000. However, neonatal mortality has not declined since 2012 and maternal mortality estimates were based on limited data. We researched the drivers of progress and challenges. METHODS: We reviewed two decades of health policies, analysed mortality trends from United Nations data and six national household surveys between 1998 and 2021 and assesse…
Effective multi-sectoral approach for rapid reduction in maternal and neonatal mortality
BACKGROUND: Bangladesh experienced impressive reductions in maternal and neonatal mortality over the past several decades with annual rates of decline surpassing 4% since 2000. We comprehensively assessed health system and non-health factors that drove Bangladesh's success in mortality reduction. METHODS: We operationalised a comprehensive conceptual framework and analysed available household surveys for trends and inequalities in mortality, inte…
Global Maternal and Child Health (28 works) · Medicine (27 works) · Environmental health (24 works) · Population (16 works) · Nursing (15 works) · Child Nutrition and Water Access (14 works) · Health care (14 works) · Economic growth (9 works) · Psychological intervention (9 works) · Public health (9 works)