Task shifting in maternal and child health care: An evidence brief for Uganda

2011 ◽  
Vol 27 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Harriet Nabudere ◽  
Delius Asiimwe ◽  
Rhona Mijumbi
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Professionals ◽  
Health Workers ◽  
Perinatal Outcomes ◽  
Implementation Strategies ◽  
Cost Effective ◽  
Task Shifting ◽  
Care Seeking ◽  
And Child Health

The Problem: There is a shortage and maldistribution of medically trained health professionals to deliver cost-effective maternal and child health (MCH) services. Hence, cost-effective MCH services are not available to over half the population of Uganda and progress toward the Millennium Development Goals for MCH is slow. Optimizing the roles of less specialized health workers (“task shifting”) is one strategy to address the shortage and maldistribution of more specialized health professionals.Policy Options: (i) Lay health workers (community health workers) may reduce morbidity and mortality in children under five and neonates; and training for traditional birth attendants may improve perinatal outcomes and appropriate referrals. (ii) Nursing assistants in facilities might increase the time available from nurses, midwives, and doctors to provide care that requires more training. (iii) Nurses and midwives to deliver cost-effective MCH interventions in areas where there is a shortage of doctors. (iv) Drug dispensers to promote and deliver cost-effective MCH interventions and improve the quality of the services they provide. The costs and cost-effectiveness of all four options are uncertain. Given the limitations of the currently available evidence, rigorous evaluation and monitoring of resource use and activities is warranted for all four options.Implementation Strategies: A clear policy on optimizing health worker roles. Community mobilization and reduction of out-of-pocket costs to improve mothers’ knowledge and care-seeking behaviors, continuing education, and incentives to ensure health workers are competent and motivated, and community referral and transport schemes for MCH care are needed.

scholarly journals Humanization of childbirth: meanings and perceptions of nurses

2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Andrêssa Batista Possati ◽  
Lisie Alende Prates ◽  
Luiza Cremonese ◽  
Juliane Scarton ◽  
Camila Neumaier Alves ◽  
...  
Keyword(s):  
Child Health ◽  
Professional Practice ◽  
Teaching Hospital ◽  
Maternal And Child Health ◽  
Health Professionals ◽  
Descriptive Study ◽  
Southern Brazil ◽  
Qualitative Descriptive ◽  
And Child Health

Abstract Objective: To know the meanings attributed to humanized childbirth by nurses of an obstetric center. Method: A qualitative descriptive study was carried out with nurses from a teaching hospital, located in southern Brazil. An operational proposal was used. The participants were six nurses who worked in the service. Results: The humanization of childbirth was understood as a set of practices and attitudes based on dialogue, empathy and embracement; the provision of guidelines; the appreciation of parturients' singularities; the performance of procedures proven to be beneficial to maternal and child health and continuous professional updating. Conclusion: The humanization of birth is still a challenge in professional practice. The role of women, the respect for their rights and the commitment of health professionals are the foundation of the humanization of childbirth.

scholarly journals Impact of measles supplementary immunisation activities on utilisation of maternal and child health services in low-income and middle-income countries

2018 ◽  
Vol 3 (3) ◽  
pp. e000466 ◽  
Author(s):  
Iryna Postolovska ◽  
Stéphane Helleringer ◽  
Margaret E Kruk ◽  
Stéphane Verguet
Keyword(s):  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Low Income ◽  
Child Health Services ◽  
Demographic And Health Surveys ◽  
Care Seeking ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Child Health

BackgroundMeasles supplementary immunisation activities (SIAs) are an integral component of measles elimination in low-income and middle-income countries (LMICs). Despite their success in increasing vaccination coverage, there are concerns about their negative consequences on routine services. Few studies have conducted quantitative assessments of SIA impact on utilisation of health services.MethodsWe analysed the impact of SIAs on utilisation of selected maternal and child health services using Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 28 LMICs, where at least one SIA occurred over 2000–2014. Logistic regressions were conducted to investigate the association between SIAs and utilisation of the following services: facility delivery, postnatal care and outpatient sick child care (for fever, diarrhoea, cough).ResultsSIAs do not appear to significantly impact utilisation of maternal and child services. We find a reduction in care-seeking for treatment of child cough (OR 0.67; 95% CI 0.48 to 0.95); and a few significant effects at the country level, suggesting the need for further investigation of the idiosyncratic effects of SIAs in each country.ConclusionThe paper contributes to the debate on vertical versus horizontal programmes to ensure universal access to vaccination. Measles SIAs do not seem to affect care-seeking for critical conditions.

scholarly journals Analisis Kebutuhan dan Pemanfaatan Buku Serta Pedoman Pelayanan KIA di Puskesmas: Studi Kualitatif

2020 ◽  
Vol 23 (2) ◽  
pp. 99-107
Author(s):  
Diyan Ermawan Effendi ◽  
Arief Priyo Nugroho ◽  
Suharmiati Suharmiati ◽  
Lestari Handayani
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Health Centers ◽  
High Rate ◽  
Needs Analysis ◽  
Primary Health ◽  
Expectant Mothers ◽  
Ease Of Access ◽  
And Child Health

The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Care Providers ◽  
And Child Health

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

Sign in / Sign up

Export Citation Format

Share Document