Prevention of Unintended Pregnancy and HIV/STIs Among Latinos in Rural Communities: Perspectives of Health Care Providers

2010 ◽  
Vol 31 (8) ◽  
pp. 718-736 ◽  
Author(s):  
Meredith Branch ◽  
S. Marie Harvey ◽  
Ann P. Zukoski ◽  
Jocelyn Warren
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Unintended Pregnancy ◽  
Health Care Providers ◽  
Care Providers

scholarly journals Reproductive awareness and recognition of unintended pregnancy: young women, key informants and health care providers perspectives in South Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oluwaseyi Dolapo Somefun ◽  
Jane Harries ◽  
Deborah Constant
Keyword(s):  
South Africa ◽  
Health Care ◽  
Unintended Pregnancy ◽  
Health Care Providers ◽  
Signs And Symptoms ◽  
Second Trimester ◽  
Care Providers ◽  
Policy Makers ◽  
Abortion Care ◽  
Pregnancy Status

Abstract Background South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women’s experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers’ and policy makers’ ideas for public sector strategies to facilitate prompt confirmation of pregnancy. Methods We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis. Results Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible. Conclusion Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.

scholarly journals Modern Desires, Knowledge Control, and Physician Resistance: Regulating Ayurvedic Medicine in Nepal

2008 ◽  
Vol 4 (1) ◽  
pp. 86-112 ◽  
Author(s):  
Mary Cameron
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Providers ◽  
Health Knowledge ◽  
Traditional Healers ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Certification ◽  
Traditional Practitioners ◽  
The Government

AbstractForms of medical regulation in Nepal are shown to limit health knowledge transmission in the name of protecting the people from health care providers both familiar and trusted. Within the last four years Nepal's Ministry of Health implemented controversial legislation requiring Ayurvedic medical practitioners to register with the government in order to practise medicine and to prepare plant-based medications. Traditional practitioners find the age and lineage requirements for those not holding medical certification in Ayurveda potentially devastating to their profession, and they have launched an active campaign resisting the new professionalisation requirements. These actions can be seen to result from the convergence of a rising modern Nepali state bureaucracy, the people's desire for a country free of high rates of morbidity and mortality, and the powerful ideology of Western-based health care modernisation guiding health development. I draw on recent research in Kathmandu and in two rural communities to summarise the role of Ayurveda in Nepal's health care, to analyse the politics behind the legislation and the traditional healers' response, and finally to suggest the legislation's impact on health care.

scholarly journals Insights for rural health care provider retention : a quantitative survey analysis

2021 ◽  
Author(s):  
◽  
Maria Kuhns
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Rural Health ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Rural Health Care ◽  
Care Providers ◽  
The Impact

Due to rural health disparities and an uneven distribution of health providers across the rural urban continuum, retaining the existing rural health care provider workforce may be an important strategy to maintain existing rural health care provision. While a large body of literature addresses how to recruit health care providers to rural areas, less is known about how to retain these providers. Even less literature has focused on the role of rural communities in health care provider retention. In this thesis, I examine the role of provider background and familial characteristics, workplace characteristics, and community characteristics that may impact a provider's likelihood to consider leaving a rural community. I use data from a survey of over 900 rural health care providers across nine states and a probit model to estimate the impact of these characteristics on a provider's propensity to consider leaving. I find that establishing social ties and integrating within the community through volunteering reduces providers' likelihood to consider leaving by 10 percent. Additionally, providers who engage in entrepreneurship by investing in part or all of their practice are 12 percent less likely to consider leaving, all else being equal. I also find that having unacceptable on-call responsibilities increases a provider's likelihood to consider leaving by 17 percent. This thesis contributes to the existing literature by estimating the effects of work-life balance, entrepreneurship, and the role of family and personal integration on provider retention. Furthermore, it emphasizes the role of communities in provider retention. These results offer insights to rural communities and decision-makers seeking to identify how to maintain their existing rural health care workforce.

scholarly journals Preserving traditional medical knowledge through modes of transmission: A post-positivist enquiry

2014 ◽  
Vol 16 (1) ◽  
Author(s):  
Janet Adekannbi ◽  
Wole M. Olatokun ◽  
Isola Ajiferuke
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Traditional Medicine ◽  
Health Care Providers ◽  
Horizontal Transmission ◽  
Healthcare Delivery ◽  
Medical Knowledge ◽  
Health Care Facilities ◽  
Care Providers ◽  
Medical Practitioners

Background: In Nigeria, most rural communities lack access to orthodox medical facilities despite an expansion of orthodox health care facilities and an increase in the number of orthodox health care providers. Over 90% of Nigerians in rural areas thus depend wholly or partly on traditional medicine. This situation has led to a call for the utilisation of Traditional medical practitioners in primary-healthcare delivery. Hence, the persistence of the knowledge of traditional medicine, especially in the rural communities where it is the only means of primary health care, has been a concern to information professionals.Objectives: This study investigated the role which the mode of transmission plays in the preservation of traditional medical knowledge.Method: A post-positivist methodology was adopted. A purposive sampling technique was used to select three communities from each of the six states in South-Western Nigeria. The snowball technique was used in selecting 228 traditional medical practitioners, whilst convenience sampling was adopted in selecting 529 apprentices and 120 children who were not learning the profession. A questionnaire with a five-point Likert scale, key-informant interviews and focus-group discussions were used to collect data. The quantitative data was analysed using descriptive statistics whilst qualitative data was analysed thematically.Results: The dominant mode of knowledge transmission was found to be oblique (66.5%) whilst vertical transmission (29.3%) and horizontal transmission (4.2%) occurred much less.Conclusion: Traditional medical knowledge is at risk of being lost in the study area because most of the apprentices were children from other parents, whereas most traditional medical practitioners preferred to transmit knowledge only to their children.

scholarly journals DETERMINANTS OF FAMILY PLANNING AMONG MYANMAR WOMEN: SYSTEMATIC REVIEW

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Nyein Moh Moh Myint ◽  
Sa Sa Aung
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Rural Communities ◽  
Health Care Providers ◽  
Care Providers ◽  
Affective Factors ◽  
Contraceptive Usage ◽  
Socio Demographic Factors ◽  
Living Children ◽  
Attitude And Motivation

Background: Family planning is achieved by using contraceptive methods and the treatment of involuntary infertility. In Myanmar, although the contraceptive prevalence rate is increasing, it still needs to reach 60% in family planning 2020 commitment. This review is aimed to explore the determinants that can improve or inhibit contraceptive usage among Myanmar women. Methods: 88 articles are found through searching in PubMed, Scopus, EBSCO and ProQuest. Nine articles which meet inclusion and exclusion criteria are selected. Results: Four main themes emerged. These are socio-demographic factors (age, level of education, marital duration, number of living children, religion, occupation, income), cognitive factors (knowledge), affective factors (attitude and motivation including support from health care providers, family, friend as well as husband and health education) and availability of service (distance form health care place, service available for 24 hours, cost). Conclusion: The findings will be supported to information about the needs and gaps in implementing family planning. It is recommended that knowledge on determinants of family planning is helpful to improve family planning program in both urban and rural communities.

scholarly journals An Electronic-Based Curriculum to Train Acute Care Providers in Rural Haiti and India

2019 ◽  
Vol 11 (4s) ◽  
pp. 152-157 ◽  
Author(s):  
Ayesha Khan ◽  
Stefanie S. Sebok-Syer ◽  
Hanna Linstadt ◽  
Megan Storm ◽  
Nadeem Modan ◽  
...  
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Acute Care ◽  
Health Care Providers ◽  
Clinical Care ◽  
World Health ◽  
Care Providers ◽  
Community Members ◽  
Electronic Learning ◽  
Health Organization

ABSTRACT Background Access to a trained, competent health care workforce remains a challenge globally, particularly in rural settings. To bridge this gap, the World Health Organization calls for innovations in electronic learning and task shifting. Yet, these approaches are underutilized due to cost, challenges associated with implementing technology, and a lack of suitably educated trainees. Objective We explored the feasibility of the Acute Care Providers Project (ACPP) to remotely train community members to be health care providers in 2 sites: Haiti and India. Methods The ACP program is an asynchronous curriculum that provides core health content and a structured approach to clinical care through an electronic curriculum. The curriculum is reinforced with case-based practice and hands-on workshops for procedural skills. ACPP was deployed in rural Haiti and India. Evaluation of the program included multiple-choice pretests and posttests, an objective structured clinical examination (OSCE), and direct observation of skills. Results Four Haitian and 55 Indian trainees completed the course. In Haiti, mean scores were 34.8% (SD 12.4) on the pretest and 78.0% (SD 6.5) on the posttest (P = .004). Trainees scored 100% on the OSCE and passed the skills checklist. In India, mean scores were 16.5% (SD 3.9) on the pretest and 81.7% (SD 9.0) on the posttest (P < .001). Trainees scored a median of 91.8% (SD 3.95) on the OSCE and all passed the skills checklist. Conclusions The ACPP offers a scalable, replicable asynchronous curriculum to train lay individuals to provide basic health care in rural communities.

scholarly journals Maternal Health Care Providers and the Challenges of Quality Services in Rural Communities of Kaduna State, Nigeria

2012 ◽  
Vol 10 (1) ◽  
Author(s):  
Godswill James ◽  
Ada Helen Ochi
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Maternal Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Maternal Health Care ◽  
Care Providers ◽  
Quality Health Care ◽  
Cross Sectional

It is widely assumed by maternal health care programmers and policy makers that expanding coverage of maternal health care services will improve reproductive health indices such as maternal mortality; this is without taking into account the quality of care especially in rural areas. Despite various attempts by Governments to increase the utilization of maternity service and improve maternal health, the progress made so far remains little in rural areas. This study examines the challenges faced by maternal health care providers in providing quality services in rural communities of Kaduna State. A community-based cross-sectional research design was adopted and data were obtained using both quantitative and qualitative methods. A survey of 300 women aged 15-49 years was carried out, using multi-stage sampling techniques involving Local Government Areas, wards, main streets, houses, households and individuals. Focus group discussions were conducted among women who delivered three months before the survey, and those who experienced acute morbidity and complications. In-depth interviews were conducted with maternal health care providers in the study communities. The study reveals inadequacy in equipment, number and quality of staff in the rural health facilities; younger women were more likely to have positive experience of care than older women. Care was discontinued if health care providers were perceived as unqualified, neglectful or too young. Many pregnant women were discouraged from taking their drugs due to the perception that the drugs increased the baby’s weight which makes delivery difficult. Engagement with political, religious leaders and community groups needs to be fostered through sensitization and sustained advocacy to remove constraints to accessibility of quality health care in rural areas.

scholarly journals Factors Influencing Family Physician Scope of Practice:

2018 ◽  
Vol 50 (4) ◽  
pp. 269-274
Author(s):  
Randall Reitz ◽  
Kyle Horst ◽  
Maura Davenport ◽  
Shiela Klemmetsen ◽  
Michael Clark
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Providers ◽  
Local Community ◽  
Scope Of Practice ◽  
Personal Factors ◽  
Care Providers ◽  
Rural Medicine ◽  
Full Spectrum ◽  
Developmental Factors

Background and Objectives: Despite the efforts of many organizations to increase the volume of rural health care providers, rural communities continue to experience a shortage of physicians. To address this shortage, more information is needed as to how specific factors contribute to family physicians’ choice to purse rural full-spectrum practice. Methods: Interviews with 21 key informants guided a grounded theory analysis around the question of “What factors contribute to the decision to, and maintenance of, practicing full-spectrum rural medicine?” Results: Analysis revealed two categories of factors that influenced choice of scope and maintenance of scope across a career: contextual and developmental factors. Contextual factors included the national health care landscape, the local setting, and personal factors. The developmental factors pertained to the point in the physician’s career, and include preprofessional envisioned scope, current scope, and ideal future scope of practice. Conclusions: Results describe how a rural physician’s scope of practice generally narrows as her/his career progresses. The results elaborate on how the larger health care landscape, local community, and personal factors all intersect to inform a physician’s decision to pursue and/or continue practice. Results of the study were consistent with preexisting literature, but provide additional depth and suggest a theoretical relationship among factors.

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