How do women, men, and health providers perceive interventions to influence men's engagement in maternal and newborn health? A qualitative evidence synthesis

Abstract Background Maternal and newborn mortality continue to be major challenges in Nigeria. While greater participation of men in maternal and newborn health has been associated with positive outcomes in many settings, male involvement remains low. The objective of this analysis was to investigate male involvement in maternal and newborn health in Jigawa state, northern Nigeria. Methods This qualitative study included 40 event narratives conducted with families who had experienced a maternal or newborn complication or death, in-depth interviews with 10 husbands and four community leaders, and four focus group discussions with community health workers. The interviews focused on understanding illness recognition and care seeking as well as the role of husbands at each stage on the continuum of maternal and newborn health. Data were transcribed, translated to English, and coded and analyzed using Dedoose software and a codebook developed a priori. Results This paper reports low levels of knowledge of obstetric and newborn complications among men and limited male involvement during pregnancy, childbirth and the post-partum period in Jigawa state. Men are key decision-makers around the location of the delivery and other decisions linked to maternal and newborn health, and they provide crucial resources including nutritious foods and transportation. However, they generally do not accompany their wives to antenatal visits, are rarely present for deliveries, and do not make decisions about complications arising during delivery and the immediate post-partum period. These gendered roles are deeply ingrained, and men are often ridiculed for stepping outside of them. Additional barriers for male involvement include minimal engagement with health programs and challenges at health facilities including a poor attitude of health providers towards men and accompanying family members. Conclusion These findings suggest that male involvement is limited by low knowledge and barriers related to social norms and within health systems. Interventions engaging men in maternal and newborn health must take into account these obstacles while protecting women’s autonomy and avoiding reinforcement of gender inequitable roles and behaviors.

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Reproductive Maternal and Newborn Health Providers’ Assessment of Facility Preparedness and Its Determinants during the COVID-19 Pandemic in Lagos, Nigeria

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-1324 ◽

2021 ◽

Vol 104 (4) ◽

pp. 1495-1506

Author(s):

Charles Ameh ◽

Aduragbemi Banke-Thomas ◽

Mobolanle Balogun ◽

Christian Chigozie Makwe ◽

Bosede Bukola Afolabi

Keyword(s):

Service Delivery ◽

Online Survey ◽

Newborn Health ◽

Maternal And Newborn Health ◽

Health Providers ◽

Chi Square ◽

Cross Sectional ◽

Work Related ◽

Unit Increase ◽

Maternal And Newborn

ABSTRACTThe global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal, and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significantly predict this. An anonymous cross-sectional online survey of RMNH providers was conducted from to July 1–21, 2020 in Lagos State, Nigeria. We conducted a descriptive and ordinal regression analysis, with RMNH worker perception of HF preparedness for RMNH service delivery during the outbreak as the dependent variable. In all, 256 RMNH workers participated, 35.2% reported that RMNH services were unavailable at some time since March 2020, 87.1% felt work-related burnout, 97.7% were concerned about the availability of personal protective equipment (PPE) and related guidelines, and only 11.7% were satisfied with the preparedness of their HFs. Our final model was a statistically significant predictor of RMNH worker perception of HF preparedness explaining 54.7% of the variation observed. The most significant contribution to the model was communication by HF management (likelihood ratio chi-square [LRCS]: 87.94, P < 0.001) and the availability of PPE and COVID-19 guidelines (LRCS: 15.43, P < 0.001). A one-unit increase in the level of concern about the availability of PPE and COVID-19 guidelines would increase the odds of observing a higher category of satisfaction with HF COVID-19 preparedness. Adequate support of RMNH providers, particularly provision of PPE and guidelines, and appropriate communications about COVID-19 should be prioritized as part of HF preparedness.

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A double-edged sword—telemedicine for maternal care during COVID-19: findings from a global mixed-methods study of healthcare providers

BMJ Global Health ◽

10.1136/bmjgh-2020-004575 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004575 ◽

Cited By ~ 1

Author(s):

Anna Galle ◽

Aline Semaan ◽

Elise Huysmans ◽

Constance Audet ◽

Anteneh Asefa ◽

...

Keyword(s):

Health Professionals ◽

Online Survey ◽

Newborn Health ◽

Maternal And Newborn Health ◽

Birth Preparedness ◽

Care Provision ◽

Health Providers ◽

Psychosocial Counselling ◽

Maternal And Newborn

IntroductionThe COVID-19 pandemic has led to a rapid implementation of telemedicine for the provision of maternal and newborn healthcare. The objective of this study was to document the experiences with providing telemedicine for maternal and newborn healthcare during the pandemic among healthcare professionals globally.MethodsThe second round of a global online survey of maternal and newborn health professionals was conducted, disseminated in 11 languages. Data were collected between 5 July and 10 September 2020. The questionnaire included questions regarding background, preparedness and response to COVID-19, and experiences with providing telemedicine. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregated by country income level.ResultsResponses from 1060 maternal and newborn health professionals were analysed. Telemedicine was used by 58% of health professionals and two-fifths of them reported not receiving guidelines on the provision of telemedicine. Key telemedicine practices included online birth preparedness classes, antenatal and postnatal care by video/phone, a COVID-19 helpline and online psychosocial counselling. Challenges reported lack of infrastructure and technological literacy, limited monitoring, financial and language barriers, lack of non-verbal feedback and bonding, and distrust from patients. Telemedicine was considered as an important alternative to in-person consultations. However, health providers emphasised the lower quality of care and risk of increasing the already existing inequalities in access to healthcare.ConclusionsTelemedicine has been applied globally to address disruptions of care provision during the COVID-19 pandemic. However, some crucial aspects of maternal and newborn healthcare seem difficult to deliver by telemedicine. More research regarding the effectiveness, efficacy and quality of telemedicine for maternal healthcare in different contexts is needed before considering long-term adaptations in provision of care away from face-to-face interactions. Clear guidelines for care provision and approaches to minimising socioeconomic and technological inequalities in access to care are urgently needed.

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Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013274 ◽

2019 ◽

Cited By ~ 2

Author(s):

Bronwen Merner ◽

Sophie Hill ◽

Cinzia Colombo ◽

Vicki Xafis ◽

Carolyn M Gaulden ◽

...

Keyword(s):

Health Services ◽

Evidence Synthesis ◽

Qualitative Evidence Synthesis ◽

Health Providers ◽

Qualitative Evidence

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Reproductive Maternal and Newborn Health providers assessment of facility preparedness and its Determinants during the COVID-19 pandemic in Lagos, Nigeria

10.1101/2020.09.24.20201319 ◽

2020 ◽

Author(s):

Charles A Ameh ◽

Aduragbemi A Banke-Thomas ◽

Mobolanle Balogun ◽

Christian Chigozie Makwe ◽

Bosede Afolabi

Keyword(s):

Service Delivery ◽

Online Survey ◽

Newborn Health ◽

Outcome Variable ◽

Maternal And Newborn Health ◽

Health Providers ◽

Cross Sectional ◽

Work Related ◽

Unit Increase ◽

Maternal And Newborn

The global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significantly predict this. An anonymous cross-sectional online survey of RMNH providers was conducted from 1st to 21st July 2020 in Lagos state Nigeria. We conducted a descriptive and ordinal regression analysis, with RMNH worker perception of HF preparedness for RMNH service delivery during the outbreak as the dependent variable. Two hundred and fifty-six RMNH workers participated, 35.2% reported that RMNH services were unavailable at some time since March 2020, 39% felt moderate or extreme work-related burnout, 84% were moderately or extremely concerned about the availability of PPE and related guidelines, and only 11.7% were extremely satisfied with the preparedness of their HFs. Our final model was a statistically significant predictor of RMNH worker perception of HF preparedness explaining 54.7% of the variation in the outcome variable. A one-unit increase in the level of satisfaction with the communication from HF management and level of concern about the availability of PPE and COVID-19 guidelines would increase the odds of observing a higher category of satisfaction with HF COVID-19 preparedness (OR 0.79-2.92, p<0.001 and 0.02-0.15 p<0.001 respectively). Adequate support of RMNH providers particularly provision of PPE and guidelines, appropriate communications about COVID-19 should be prioritised as part of health system preparedness.

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