Providing respectful maternity care in northern Ghana: A mixed-methods study with maternity care providers

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

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The development of the WHO Labour Care Guide: an international survey of maternity care providers

Reproductive Health ◽

10.1186/s12978-021-01074-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Veronica Pingray ◽

Mercedes Bonet ◽

Mabel Berrueta ◽

Agustina Mazzoni ◽

María Belizán ◽

...

Keyword(s):

Decision Making ◽

Maternity Care ◽

Health Personnel ◽

Clinical Decision Making ◽

Clinical Decision ◽

Research Network ◽

Respectful Maternity Care ◽

Care Providers ◽

Skilled Health Personnel ◽

Skilled Health

Abstract Background The partograph is the most commonly used labour monitoring tool in the world. However, it has been used incorrectly or inconsistently in many settings. In 2018, a WHO expert group reviewed and revised the design of the partograph in light of emerging evidence, and they developed the first version of the Labour Care Guide (LCG). The objective of this study was to explore opinions of skilled health personnel on the first version of the WHO Labour Care Guide. Methods Skilled health personnel (including obstetricians, midwives and general practitioners) of any gender from Africa, Asia, Europe and Latin America were identified through a large global research network. Country coordinators from the network invited 5 to 10 mid-level and senior skilled health personnel who had worked in labour wards anytime in the last 5 years. A self-administered, anonymous, structured, online questionnaire including closed and open-ended questions was designed to assess the clarity, relevance, appropriateness of the frequency of recording, and the completeness of the sections and variables on the LCG. Results A total of 110 participants from 23 countries completed the survey between December 2018 and January 2019. Variables included in the LCG were generally considered clear, relevant and to have been recorded at the appropriate frequency. Most sections of the LCG were considered complete. Participants agreed or strongly agreed with the overall design, structure of the LCG, and the usefulness of reference thresholds to trigger further assessment and actions. They also agreed that LCG could potentially have a positive impact on clinical decision-making and respectful maternity care. Participants disagreed with the value of some variables, including coping, urine, and neonatal status. Conclusions Future end-users of WHO Labour Care Guide considered the variables to be clear, relevant and appropriate, and, with minor improvements, to have the potential to positively impact clinical decision-making and respectful maternity care.

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Engaging patients and primary care providers in the design of novel opinion leader based interventions for acute asthma in the emergency department: a mixed methods study

BMC Health Services Research ◽

10.1186/s12913-018-3587-7 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Cristina Villa-Roel ◽

Maria Ospina ◽

Sumit R Majumdar ◽

Stephanie Couperthwaite ◽

Erin Rawe ◽

...

Keyword(s):

Primary Care ◽

Emergency Department ◽

Mixed Methods ◽

Acute Asthma ◽

Opinion Leader ◽

Primary Care Providers ◽

Mixed Methods Study ◽

Care Providers

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Health Care Providers’ Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study

JMIR Cancer ◽

10.2196/cancer.7345 ◽

2017 ◽

Vol 3 (2) ◽

pp. e12 ◽

Cited By ~ 9

Author(s):

Echo L Warner ◽

Qian Ding ◽

Lisa Pappas ◽

Julia Bodson ◽

Brynn Fowler ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Mixed Methods Study ◽

Care Providers ◽

Vaccination Barriers

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In pursuit of a cure: The plural therapeutic landscape of onchocerciasis-associated epilepsy in Cameroon – A mixed methods study

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009206 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009206

Author(s):

Maya Ronse ◽

Julia Irani ◽

Charlotte Gryseels ◽

Tom Smekens ◽

Serge Ekukole ◽

...

Keyword(s):

Mixed Methods ◽

Health Care Providers ◽

Economic Status ◽

Health Service Delivery ◽

Mixed Methods Study ◽

Faith Healing ◽

Care Providers ◽

Therapeutic Landscape ◽

Populations At Risk ◽

Important Health

Background A high prevalence of epilepsy has been observed in several onchocerciasis-endemic villages in the Sanaga River basin, Cameroon. Recent studies suggest that ivermectin, a drug that is distributed annually with the aim of eliminating onchocerciasis, may have a protective effect against acquiring onchocerciasis-associated epilepsy (OAE). This study, therefore, provides an in-depth understanding of both the complex therapeutic landscape for epilepsy as well as the experiences related to the ‘community-directed treatment with ivermectin’ (CDTI) campaign in order to identify a more trenchant path forward in the fight against epilepsy. Methodology/Principal findings Based on a mixed methods study combining a qualitative strand with a quantitative survey, we found that epilepsy was perceived to have had an epidemic emergence in the past and was still considered an important health issue in the study area. Socio-economic status, availability and accessibility of drugs and practitioners, as well as perceived aetiology shaped therapeutic itineraries for epilepsy, which included frequenting (in)formal biomedical health care providers, indigenous and/or faith healing practitioners. Ivermectin uptake for onchocerciasis was generally well known and well regarded. The CDTI faced structural and logistical bottlenecks undermining equal access and optimal adherence to the drug. Conclusions/Significance Uninterrupted, sustainable and comprehensive health-service delivery is essential to help alleviate the epilepsy burden on afflicted households. Addressing structural challenges of CDTI and communicating the potential link with epilepsy to local populations at risk could optimize the uptake of this potentially significant tool in OAE prevention.

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Disrespect and Abuse During Facility‐Based Childbirth in North Showa Zone, Ethiopia

10.21203/rs.3.rs-72775/v1 ◽

2020 ◽

Author(s):

Yohannes Mehretie Adinew ◽

Helen Hall ◽

Amy Marshall ◽

Janet Kelly

Keyword(s):

Maternity Care ◽

Positive Association ◽

Cross Sectional Study ◽

Public Health Facility ◽

Respectful Maternity Care ◽

P Value ◽

Disrespect And Abuse ◽

Structural Factors ◽

Care Providers ◽

Cross Sectional

Abstract Background: Respectful maternity care is a fundamental human right, and an important component of quality maternity care that every childbearing woman should receive. Disrespect and abuse during childbirth is not only a violation of a women’s rights, it is associated with a reduction in the number of women accessing professional maternity services and increases the risk of maternal mortality. This study investigated women’s experience of disrespect and abuse during facility-based childbirth in Ethiopia. Methods: A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous twelve months in North showa zone of Ethiopia. A structured, researcher administered questionnaire was used with data collected using digital, tablet-based tools. Participants’ experiences were measured using the seven categories and verification criteria of disrespect and abuse identified by White Ribbon Alliance. Multivariable logistic regression was used to identify the association between experience of disrespect and abuse and interpersonal and structural factors at p-value < 0.05 and OR values with 95% conﬁdence interval. Results: All participants reported at least one form of disrespect and abuse during childbirth. Types of disrespect and abuse experienced by participants were; physical abuse 435(100%), non-consented care 423(97.2%), non-confidential care 288 (66.2%), abandonment/ neglect (34.7%), non-dignified care 126(29%), discriminatory care 99(22.8%) and detention 24(5.5%). Hospital birth [AOR: 3.04, 95% CI: 1.75, 5.27], rural residence [AOR: 1.44, 95% CI: 0.76, 2.71], monthly household income less than 1,644 Birr (USD 57) [AOR: 2.26, 95% CI: 1.20, 4.26], being attended by female providers [AOR: 1.74, 95% CI: 1.06, 2.86] and midwifery nurses [AOR: 2.23, 95% CI: 1.13, 4.39] showed positive association with experience of disrespect and abuse. Conclusion: The level of disrespect and abuse is high and its drivers and enablers include both structural and interpersonal factors. Expanding the size and skill mix of professionals in the preferred facilities (hospitals), and sensitizing care providers and health managers regarding the magnitude and consequences of D&A are strategies that could possibly promote more dignified and respectful maternity care.

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