scholarly journals Communication between mothers and health workers is important for quality of newborn care: a qualitative study in neonatal units in district hospitals in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Silondile Luthuli ◽  
Neil McKerrow
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Health Workers ◽  
Newborn Care ◽  
Well Being ◽  
Structured Interview ◽  
Observation Data ◽  
Good Communication ◽  
District Hospitals

Abstract Background There is a high global burden of neonatal mortality, with many newborn babies dying of preventable and treatable conditions, particularly in low and middle-income countries. Improving quality of newborn care could save the lives of many thousands of babies. Quality of care (QoC) is a complex and multifaceted construct that is difficult to measure, but patients’ experiences of care are an important component in any measurement of QoC. We report the findings of a qualitative study exploring observations and experiences of health workers (HWs) and mothers of babies in neonatal units in South Africa. Methods A qualitative case study approach was adopted to explore care of newborn babies admitted to neonatal units in district hospitals. Observation data were collected by a registered nurse during working hours over a continuous five-day period. Doctors and nurses working in the neonatal unit and mothers of babies admitted during the observation period were interviewed using a semi-structured interview guide. All interviews were audio recorded. Observation data were transcribed from hand written notes. Audiotapes of interviews were transcribed verbatim and, where necessary, translated into English. A thematic content analysis was used to analyse the data. Results Observations and interviews were conducted in seven participating hospitals between November 2015 and May 2016. Our findings highlight the importance of information sharing between HWs and mothers of babies, contrasting the positive communication reported by many mothers which led to them feeling empowered and participating actively in the care of their babies, with incidents of poor communication. Poor communication, rudeness and disrespectful behaviour of HWs was frequently described by mothers, and led to mothers feeling anxious, unwilling to ask questions and excluded from their baby’s care. In some cases poor communication and misunderstandings led to serious mismanagement of babies with HWs delaying or withholding care, or to mothers putting their babies at risk by not following instructions. Conclusion Good communication between mothers and HWs is critical for building mothers’ confidence, promoting bonding and participation of mothers in the care of their baby and may have long term benefits for the health and well-being of the mother and her baby.

scholarly journals Older Portuguese And Mexican Adults And Sexual Well-Being? A Cross-Cultural Qualitative Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 909-909
Author(s):  
Sofia von Humboldt ◽  
Neyda Ma Mendoza-Ruvalcaba ◽  
José Alberto Ribeiro-Gonçalves ◽  
Gail Low ◽  
Isabel Leal
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Old Age ◽  
Demographic Data ◽  
Self Care ◽  
Well Being ◽  
Structured Interview ◽  
Cross Cultural ◽  
Community Dwelling

Abstract Objectives Sexual well-being (SWB) refers to the subjective emotional and cognitive evaluation of the quality of the individual's sexuality, it plays a relevant role in quality of life and health promotion on old age and has cross-cultural implications. The aim of this study is to analyse comparatively the perspectives of older adults on their SWB in Portugal and Mexico. Methods Data were collected from 86 Portuguese and 80 Mexican community-dwelling participants aged 65 years and older, using a semi-structured interview protocol. Older adults were inquired about their perceptions on what contributes to their sexual well-being. Socio-demographic data were also enquired. Content analysis was used to identify key themes. Results Outcomes indicated eight themes: eroticism, supportive relationship, positive self-concept, health and self-care, romance, active life, tenderness and care, and no pain and no pregnancy restrictions, for both samples. Eroticism was the most frequent theme reported by Portuguese participants (31.4%) and health and self-care were the most frequent theme reported by Mexican participants (26.5%). Conclusions The empirical results of this study indicated that SWB is strongly influenced by socio-cultural and psychosocial values. This cross-cultural comparison between Portugal and Mexico contributes to understand this concept in old age with different perspectives and place a scenario for future culture-adapted interventions and comprehensive policies. Keywords: Mexican, older adults; Portuguese; qualitative study; sexual well-being

scholarly journals First experiences of accrediting district hospitals for excellence in newborn care in KwaZulu-Natal, South Africa: Successes and challenges

2018 ◽  
Vol 7 (3) ◽  
pp. 25 ◽  
Author(s):  
Lyn Haskins ◽  
Dolly Nyasulu ◽  
Ruth Davidge ◽  
Neil McKerrow ◽  
Christiane Horwood
Keyword(s):  
South Africa ◽  
Health Care ◽  
Newborn Care ◽  
Health Facilities ◽  
Quality Health Care ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Quality Health ◽  
Successes And Challenges

Objective: Providing quality health care is what all health facilities seek to achieve. Accreditation of health services are used to assess and improve the quality of health care in different settings. This study describes experiences of developing and conducting accreditation for excellence in newborn care in district hospitals in KwaZulu-Natal (KZN), South Africa following a 3-year programme of support to all nurseries in KZN.Methods: A facility review was conducted in district hospitals in KZN to evaluate the quality of care provided to newborn babies to accredit hospitals in newborn care. Multiple tools were used to assess different components of care from different perspectives, including record reviews, assessment of staff skills and interviews with mothers. Awarding accreditation was based on scores achieved in various domains, which contributed to an overall score. Compliance with key priority indicators was required for accreditation to be awarded.Results: Overall scores for accreditation ranged between 57%-93%. Mothers reported high levels of satisfaction with care received. Record reviews identified shortfalls in care provided, and skills assessments showed poor resuscitation skills in labour wards in some hospitals. Of 39 district hospitals, eight were awarded silver and five were awarded gold accreditation status.Conclusions: This accreditation of newborn care provides a workable model for undertaking accreditation in district hospitals and can be used by managers to identify and address shortfalls in care. Regular accreditation would support ongoing quality improvement (QI) in neonatal care and such a process could be applied to other aspects of care in health facilities.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

scholarly journals Depression Survivors Among Emerging Adults: Their Healing Journey

2021 ◽  
Vol 7 (2) ◽  
pp. 47-65
Author(s):  
Wei Zhe Pui ◽  
Jamayah Saili
Keyword(s):  
Qualitative Study ◽  
Coping Strategies ◽  
Emerging Adults ◽  
Healing Process ◽  
Well Being ◽  
Building Blocks ◽  
Structured Interview ◽  
The Self ◽  
Healing Journey

This qualitative study explored the healing process of depression survivors among emerging adults with effective coping strategies utilised by them. A semi-structured interview was conducted on participants aged between 18-28 years old. A theme narrating the experience of the depression survivors were identified: The journey of healing - Crawling out of the quicksand. The survivors emphasised that to achieve healing, everything starts from within the self, and they had been putting in a lot of their extra efforts in helping themselves heal. They all went beyond recovery, where their efforts illustrated their focus on healing, thriving, and achieving optimal well-being upon recovery. Significantly, the relevance and applicability of the building blocks of Seligman’s PERMA model of well-being towards those efforts taken were revealed in the study. .

scholarly journals Health workers' views on factors affecting caregiver engagement with bubble CPAP

2020 ◽  
Author(s):  
Sangwani Salimu ◽  
Maggie Woo Kinshella ◽  
Marianne Vidler ◽  
Mwai Banda ◽  
Laura Newberry ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Health Management ◽  
Care Providers ◽  
District Health ◽  
Severe Respiratory Distress ◽  
Good Communication ◽  
District Hospitals ◽  
Bubble Cpap

Abstract Background Severe respiratory distress is a leading cause of mortality among neonates in Malawi. Despite evidence on the safety, cost effectiveness and efficacy of bubble continuous positive airway pressure (CPAP) in managing the condition, its use in Malawian health facilities is limited and little is known about caregivers' engagement with perspectives of bubble CPAP. The purpose of this study was to explore caregiver perspectives for bubble CPAP at both central and district hospitals and key factors that enable effective caregiver engagement in Malawi. Methods This was a descriptive qualitative study employing secondary analysis of 46 health care worker in-depth interviews. We interviewed the health workers about their thoughts on caregiver perspectives regarding use of bubble CPAP. We implemented the study at a tertiary facility and three district hospitals in southern Malawi. This was a part of a larger study to understand barriers and facilitators to implementing neonatal innovations in resource-constrained hospitals. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). Health workers were purposively selected to include nurses, clinicians and district health management involved in the use of bubble CPAP.Results Emerging issues included caregiver fears around bubble CPAP equipment as potentially harmful to their new-borns and how inadequate information provided to caregivers exacerbated knowledge gaps and was associated with refusal of care. However, good communication between health care providers and caregivers was associated with acceptance of care. Caregivers’ decision-making was influenced by relatives and peer advocates were helpful in supporting caregivers and alleviating fears or misconceptions about bubble CPAP.Conclusions Since caregivers turn to relatives and peers for support, there is need to ensure that both relatives and peers are counselled on bubble CPAP for improved understanding and uptake. Health workers need to provide simplified, accurate, up-to-date information on the intervention as per caregivers’ level of understanding. Notably, contextualised comprehensible information will help alleviate caregivers’ fear and anxieties about bubble CPAP.

Events as Sustainable Experience for Local Communities of a Tourist Destination

2021 ◽  
pp. 214-222
Author(s):  
Cecília Lopes Lobo ◽  
Rui Costa
Keyword(s):  
Word Of Mouth ◽  
Local Community ◽  
Sustainable Tourism ◽  
Well Being ◽  
Structured Interview ◽  
Qualitative Approach ◽  
Future Generations ◽  
Exploratory Research ◽  
Key Dimensions

There is an increasing concern for public stakeholders to develop sustainable tourism strategies, in order to satisfy the needs of today's society, without compromising future generations. Considering the key dimensions of sustainable tourism, this chapter aims to analyse the well-being of a destination's local community and its relationship with tourist events. This exploratory research used a qualitative approach by employing a semi-structured interview with the most relevant stakeholders of the destination. It is possible to conclude that local events can have different positive impacts on the quality of life of the residents. Greater support for local political strategies, better feedback, and word-of-mouth, translating into a positive and sustainable promotion of the destination by the local community are results that can be expected from organising events also designed for the residents of the destination, as a sustainable and inclusive experience.

scholarly journals Caregiving and Intervention Uptake, an Exploration of Women's Experiences with Nutrition- specific and Nutrition- sensitive Interventions in Rural Zimbabwe (P10-132-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dadirai Fundira ◽  
Gretel Pelto ◽  
Mduduzi Mbuya ◽  
Jean Humphrey ◽  
Rebecca Stoltzfus
Keyword(s):  
International Development ◽  
Family Involvement ◽  
Infant Nutrition ◽  
Health Workers ◽  
Mode Of Delivery ◽  
Well Being ◽  
Structured Interview ◽  
Intervention Delivery ◽  
Nutrition Sensitive ◽  
Intervention Uptake

Abstract Objectives To explore women's caregiving experiences, and identify motivators and barriers to the uptake, of interventions aimed at improving health and nutrition behaviors. Methods 40 in-depth interviews were conducted with a purposely selected sample of caregivers of infants (age 12 months to 18 months) using a semi structured interview guide. All participants in the interviews had received one or more interventions in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial, which included nutrition specific and nutrition sensitive messages delivered one on one by Village Health workers (VHWs) in the participant's household. All interviews were audio recorded, transcribed and translated, and then analyzed for themes and sub-themes, using standard text analysis coding procedures. Results Based on mothers’ narratives in response to broad, open-ended questions, the barriers and facilitators of reported appropriate child care practices and intervention uptake can be classified under four major themes: (1) caregiving environment (including sub themes around perceived child health and well-being, family involvement, social support, cultural/social norms, resources and husband involvement), (2) maternal capabilities (with sub themes around caregiver knowledge, self-efficacy and time, (3) intervention messages (with sub themes around perceived ease/complexity of intervention, mode of delivery and duration of intervention lessons), and (4) intervention delivery agent (with sub themes around perceived VHW knowledge, communication skills and reliability). Conclusions Our results show that in rural Zimbabwe caregiving decisions and hence intervention uptake is influenced by multiple factors, but the underlying dynamic can be characterized in terms of the interaction between caregiver actions and child feedback. Funding Sources Supported by the Bill & Melinda Gates Foundation, the UK Department for International Development and Borlaug LEAP.

scholarly journals Lessons from a Health Policy and Systems Research programme exploring the quality and coverage of newborn care in Kenya

2020 ◽  
Vol 5 (1) ◽  
pp. e001937
Author(s):  
Mike English ◽  
David Gathara ◽  
Jacinta Nzinga ◽  
Pratap Kumar ◽  
Fred Were ◽  
...  
Keyword(s):  
Health System ◽  
Low Income ◽  
Health Workers ◽  
Newborn Care ◽  
Well Being ◽  
Public Hospitals ◽  
Urban Setting ◽  
Health System Strengthening ◽  
Research Approach ◽  
Systems Research

There are global calls for research to support health system strengthening in low-income and middle-income countries (LMICs). To examine the nature and magnitude of gaps in access and quality of inpatient neonatal care provided to a largely poor urban population, we combined multiple epidemiological and health services methodologies. Conducting this work and generating findings was made possible through extensive formal and informal stakeholder engagement linked to flexibility in the research approach while keeping overall goals in mind. We learnt that 45% of sick newborns requiring hospital care in Nairobi probably do not access a suitable facility and that public hospitals provide 70% of care accessed with private sector care either poor quality or very expensive. Direct observations of care and ethnographic work show that critical nursing workforce shortages prevent delivery of high-quality care in high volume, low-cost facilities and likely threaten patient safety and nurses’ well-being. In these challenging settings, routines and norms have evolved as collective coping strategies so health professionals maintain some sense of achievement in the face of impossible demands. Thus, the health system sustains a functional veneer that belies the stresses undermining quality, compassionate care. No one intervention will dramatically reduce neonatal mortality in this urban setting. In the short term, a substantial increase in the number of health workers, especially nurses, is required. This must be combined with longer term investment to address coverage gaps through redesign of services around functional tiers with improved information systems that support effective governance of public, private and not-for-profit sectors.

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