scholarly journals Existing barriers to utilization of health services for maternal and newborn care in rural Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Ayodo ◽  
George O. Onyango ◽  
Salome Wawire ◽  
Nadia Diamond-Smith
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Western Kenya ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Understanding the existing barriers to utilization of maternal and newborn health care services can inform improvement of care services in the rural settings in sub-Saharan Africa. However, how unintended pregnancy relates to the uptake of antenatal care (ANC) services and also how gaps in the role of the community health workers and health facilities affect maternal and newborn care and referral services are poorly understood. Methods This was a formative ethnographic study design to determine barriers to the utilization of health care services for maternal and newborns in rural Western Kenya. We interviewed 45 respondents through in-depth interviews in rural Bondo Sub- County, Western Kenya: Mothers and Fathers with children under 5 years), 2 Focus Group Discussions (FGDs) with Traditional Birth Attendants (TBA), and 2 FGDs with Skilled Birth Attendants (SBAs). The data were analyzed using Atlas-ti. Results We found that unintended pregnancy results into poor uptake of antenatal care (ANC) services due to limited knowledge and poor support system. The respondents appreciated the role of community health workers but poor government infrastructure exists. Also, perceived harshness of the health care providers, poor management of high-risk pregnancies, and unavailability of supplies and equipment at the health facilities are of concern. Conclusions The findings of this study highlight barriers to the utilization of maternal and newborn services that if addressed can improve the quality of care within and outside health facilities.

scholarly journals The role of health services in encouraging disclosure of violence against women

2017 ◽  
Vol 56 (4) ◽  
pp. 220-226
Author(s):  
Vesna Leskošek ◽  
Miha Lučovnik ◽  
Lucija Pavše ◽  
Tanja Premru Sršen ◽  
Megie Krajnc ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Health Workers ◽  
Care Service ◽  
Health Care Service ◽  
Care Staff ◽  
Health Care Staff ◽  
Care Services

Abstract Introduction The aim of the survey was to assess the differences in disclosure by the type of violence to better plan the role of health services in identifying and disclosing violence. Methods A validated, anonymous screening questionnaire (NorAQ) for the identification of female victims of violence was offered to all postpartum women at a single maternity unit over a three-month period in 2014. Response rate was 80% (1018 respondents). Chi square test was used for statistical analysis (p<0.05 significant). Results There are differences in disclosure by type of violence. Nearly half (41.5%) of violence by health care services was not reported, compared to 33.7% physical, 23.4% psychological, and 32.5% sexual that was reported. The percentage of violence in intimate partnership reported to health care staff is low (9.3% to 20.8%), but almost half of the violence experienced by heath care services (44%) is reported. Intimate partnership violence is more often reported to the physician than to the psychologist or social worker. Violence in health care service is reported also to nurses. Conclusions Disclosure enables various institutions to start with the procedures aimed at protecting victims against violence. Health workers should continuously encourage women to speak about violence rather than asking about it only once. It is also important that such inquiries are made on different levels of health care system and by different health care professions, since there are differences to whom women are willing to disclose violence.

scholarly journals Women’s experiences of maternal and newborn health care services and support systems in Buikwe District, Uganda: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261414
Author(s):  
Marte Bodil Roed ◽  
Ingunn Marie Stadskleiv Engebretsen ◽  
Robert Mangeni ◽  
Irene Namata
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Health ◽  
Postnatal Period ◽  
Maternal And Newborn Health ◽  
Care Services ◽  
Professional Health ◽  
Maternal And Newborn

Background Uganda continues to have a high neonatal mortality rate, with 20 deaths per 1000 live births reported in 2018. A measure to reverse this trend is to fully implement the Uganda Clinical Guidelines on care for mothers and newborns during pregnancy, delivery and the postnatal period. This study aimed to describe women’s experiences of maternal and newborn health care services and support systems, focusing on antenatal care, delivery and the postnatal period. Methods We used triangulation of qualitative methods including participant observations, semi-structured interviews with key informants and focus group discussions with mothers. Audio-recorded data were transcribed word by word in the local language and translated into English. All collected data material were stored using two-level password protection or stored in a locked cabinet. Malterud’s Systematic text condensation was used for analysis, and NVivo software was used to structure the data. Findings Antenatal care was valued by mothers although not always accessible due to transport cost and distance. Mothers relied on professional health workers and traditional birth attendants for basic maternal services but expressed general discontentment with spousal support in maternal issues. Financial dependency, gender disparities, and lack of autonomy in decision making on maternal issues, prohibited women from receiving optimal help and support. Postnatal follow-ups were found unsatisfactory, with no scheduled follow-ups from professional health workers during the first six weeks. Conclusions Further focus on gender equity, involving women’s right to own decision making in maternity issues, higher recognition of male involvement in maternity care and improved postnatal follow-ups are suggestions to policy makers for improved maternal care and newborn health in Buikwe District, Uganda.

scholarly journals Moral Hazard on Free Health Care Services:A Study from Consumer's Side

2020 ◽  
Vol 10 (2) ◽  
pp. 1-5
Author(s):  
Sushila Baral ◽  
Sony Pandey ◽  
Rajesh kumar Yadav ◽  
Sudarshan Subedi
Keyword(s):  
Health Care ◽  
Moral Hazard ◽  
Health Care Services ◽  
Health Workers ◽  
Education Level ◽  
Health Facilities ◽  
Normal Behaviour ◽  
Care Services ◽  
Free Health Care ◽  
At Home

Free Health Service is a priority program and a boon to all citizens mostly for the poor and marginalized groups. It is a timely and exemplary program of government but some people have deviation in their normal behaviour as services have been provided free. A descriptive cross-sectional approach was done to assess moral hazard on free health care services by consumers. An interview schedule was used to collect quantitative data and in depth interview with health workers for qualitative data in selected eleven health facilities. The study showed the prevalence of moral hazards of free health care services by the consumers. Two-third (65%) respondents had medicines at home. Around one-third (33%) of respondent had self demanded for the medicines. Two-third (67.6%) doesn't seek for health services during health problems. One-fourth (23.6%) had poster at home for non IEC purpose. Age, education level, travelling time to health facility, occupation, and satisfaction towards services were significantly associated with availability of medicines at home. Age, education level, health workers behaviour were significantly associated with self demand of medicines. Peoples are misutilizing the services as, government bear the burden of cost. There was deviation in the normal behaviour of the peoples due to no registration fees and free drugs availability. Many people like to take medicines and have a notion that there is a pills for every ill as a result they self demand for the medicines and mostly don’t consume full dose which can develop drug resistance. Visit to health facilities to collect medicines at home have increase unnecessary burden to health facilities and also increase in morbidity status. The result can inform developing proper policy and safety measures to drop off moral hazard on free health care services.

Evaluation of Community Health Workers’ Upskilling Training in Maternal and Newborn Care at Mount Hagen in Western Highlands Province, Papua New Guinea

2018 ◽  
Vol 1 (7) ◽  
Author(s):  
Jolly Kulimbua
Keyword(s):  
Community Health ◽  
Papua New Guinea ◽  
Community Health Workers ◽  
Health Workers ◽  
Newborn Care ◽  
New Guinea ◽  
Health Facilities ◽  
Care Providers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background:   Community Health Workers (CHWs) in Western highlands Province were given a 6-month CHW upskilling training to enable them to provide essential maternal-newborn care, do timely referral of high risk clients and refer emergencies to hospital. Five trainings were conducted over the five year period. Forty seven (47) CHWs were upskilled over that five year period.   Aim:   To evaluate the effectiveness of the CHW Upskilling Training during 2012 – 2016.   Methods:    A post-training assessment was conducted by direct observations of the CHWs and the Officer in Charges (OICs) at their workplaces. Assessors observed the application of knowledge and skills and determined if there were improvements in the health facilities. Purposeful discussions were carried out to elicit qualitative feedback from CHWs OICs of the health facilities.   Findings:   The findings were impressive. The organisation of health facilities improved with specific schedules made for priority reproductive and maternal health services. The recording of maternal and newborn care services indicated great improvement. The ANC, family planning and labour ward registers indicated the kinds of services provided including management of life-threatening conditions. Records show reduced maternal and newborn deaths. Records also show reduced unnecessary referrals.   Conclusions:   The CHW Up skilling Training Program is an effective intervention to improve reproductive health and maternal-newborn services in remote areas of Papua New Guinea, particularly where there are no midwives, or higher category health care providers. It has contributed to improved maternal-newborn survival.   Recommendations:   The evaluation recommends that the CHW Upskilling Training should reach more CHWs to fill in gaps in health facilities where there are no midwives or doctor. In Papua New Guinea, the CHWs Upskilling program in maternal and newborn care is recommended for all CHWs.

scholarly journals Barriers to accessing maternal and newborn care: a qualitative study in district Thatta, Pakistan

2020 ◽  
Author(s):  
Muhammad Asim ◽  
Sarah Saleem ◽  
Zarak Hussain Ahmad ◽  
Imran Naeem ◽  
Farina Abrejo ◽  
...  
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Newborn Care ◽  
Structured Interview ◽  
Maternal And Newborn Health ◽  
Structural Level ◽  
Care Seeking ◽  
Structural Barriers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background: Accessibility and utilization of health care play a significant role in preventing complications during pregnancy, labor, and the early postnatal period. However, multiple barriers can prevent women from accessing pregnancy and neonatal care. The aim of this study was to explore the multifaceted barriers that inhibit women to seek maternal and newborn health care in Thatta, Sindh, Pakistan.Methods: This study employed an interpretive research design using purposive sampling approach. Pre-tested semi-structured interview guides were used for data collection. The data were collected through eight focus group discussions with men and women, and six in-depth interviews with lady health workers and analyzed through thematic analysis. Findings: The study identified individual, socio-cultural, and structural level barriers that inhibit women from seeking maternal and newborn care. Individual barriers included: mistrust towards public health facilities, and inadequate symptom recognition. The two identified socio-cultural barriers were: aversion to biomedical interventions, and gendered imbalances in decision making. The structural barriers included: prohibitively expensive transportation services, and ineffective referral systems. Conclusion and Suggestions: Increasing the coverage of healthcare service without addressing the multifaceted barriers that influence service utilization will not reduce the burden of maternal and neonatal mortality. As this study reveals, care seeking is influenced by a diverse array of barriers that are individual, sociocultural, and structural in nature. A combination of capacity development, health awareness, and structural interventions can address many if not all of these barriers.

scholarly journals Building a Maternal and Newborn Care Training Programme for Health-Care Professionals in Guinea-Bissau

2017 ◽  
Vol 30 (10) ◽  
pp. 734 ◽  
Author(s):  
Ana Reynolds ◽  
Ahmed Zaky ◽  
Joana Moreira-Barros ◽  
João Bernardes
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Newborn Care ◽  
Training Programme ◽  
Guinea Bissau ◽  
Care Training ◽  
Multiple Choice Questionnaire ◽  
Training Programmes ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Introduction: The Integrated Programme of Maternal and Child Health aims to reduce maternal and child mortality in Guinea-Bissau. The purpose of this article is to share our experience in building a training programme on maternal and newborn care for health-care professionals in Guinea-Bissau.Material and Methods: Regional directors of the four target areas chose a group of staff who provide prenatal and childbirth care to attend the course (12 to 15 trainees per region). In each region, 15 highly interactive and practical sessions were scheduled over eight weeks. The trainees’ summative and reactive assessment was obtained using a multiple choice questionnaire (final test) and an anonymous survey, respectively.Results: Attendees included 25 nurses, 17 midwives and 14 doctors. About two thirds had five years’ practice or less. Test median scores were higher among trainees with two to nine years of practice (54.4% to 60.9%), as compared to those with a year or less (47.8%) or 10 or more years (45.7%). Pedagogical variables were rated as ‘good’ or ‘very good’ by 91% to 95% of the attendees.Discussion: Use of an interactive and practical pedagogical methodology produced positive results and was crucial to tailoring the training to local needs. However, adapting the syllabus according to professional categories and experiences should be considered.Conclusion: Our results warrant further development and evaluation of training programmes on maternal and neonatal care in Guinea-Bissau.

Sign in / Sign up

Export Citation Format

Share Document