Management of covid-19: a practical guideline for maternal and newborn health care providers in Sub-Saharan Africa

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities. While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

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Advancing People-Centered Maternal and Newborn Health Care through Birth Preparedness and Complication Readiness in Rural Bangladesh

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v7i2.639 ◽

2018 ◽

Vol 7 (2) ◽

pp. 107-117

Author(s):

Tapas Mazumder ◽

Ahmed Ehsanur Rahman ◽

Emdadul Hoque ◽

Md. Al Mahmud ◽

Md. Abu Bakkar Siddique ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Local Level ◽

Newborn Health ◽

Local Context ◽

Maternal And Newborn Health ◽

Birth Preparedness ◽

Care Providers ◽

Complication Readiness ◽

Maternal And Newborn

Background: In Bangladesh, women and newborns continue to face elevated risks around the time of pregnancy, birth and postpartum. Applying a people-centered approach to maternal and newborn (MNH) services is a priority in such contexts to increase appropriate use of services and improve the health of women and newborns. In 2009, Enfants du Monde and PARI Development Trust began supporting the Ministry of Health at local level to implement birth preparedness and complication readiness (BPCR) for improving MNH in Netrokona district, Bangladesh. Objective: To assess the contribution of the BPCR intervention in advancing people-centered MNH care in Netrokona district, Bangladesh. Methods:We conducted 15 in-depth interviews (IDIs), one focus group discussion (FGD) and four group discussions with different stakeholders. In addition, a household survey was conducted with 725 women (intervention n=444, control n=281) and 317 of their husbands (intervention n=178, control n=139) at baseline and with 737 women (intervention n=442, control n=295) and 732 husbands at endline.Results: The BPCR intervention was co-designed through a consultative process with national and local stakeholders, ensuring the reflection of local context. Training health care providers to improve their counseling skills allowed them to apply effective BPCR counseling during ANC visits and be responsive to women’s situations and individual needs. In addition, discussion on BPCR in households and courtyard meetings provoked families’ and communities’ engagement in MNH. Consequently. there was significant increase across most indicators related to BPCR practice among women and husbands’ involvement between baseline and endline.Discussion: The BPCR intervention was successful in advancing people-centered MNH care by empowering women and increasing the engagement of men, families and communities in MNH care. Our study findings are coherent with the findings of studies conducted in similar settings. Conclusions: Carefully co-designed BPCR interventions should be further expanded within Bangladesh and beyond in order to advance people-centered care and progress toward the Sustainable Development Goals (SDGs).

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Assessment of quality of care in maternal and newborn health services available in public health care facilities in Bangladesh

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v35i2.3044 ◽

2009 ◽

Vol 35 (2) ◽

pp. 53-56 ◽

Cited By ~ 9

Author(s):

Sameena Chowdhury ◽

Syed Akram Hossain ◽

Abdul Halim

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Care Providers ◽

Information Exchange ◽

Newborn Health ◽

Health Care Facilities ◽

Maternal And Newborn Health ◽

Care Providers ◽

Maternal And Newborn

The study was conducted using the exit interview with patients (n=120), in depth interview with health care providers (n=87) and focus group discussion (n=16) with stakeholders to assess the perceived level of quality of care in maternal and newborn health at public facilities in Bangladesh. Both clients and providers expressed dissatisfaction for inadequate quality of care represented by poor cleanliness, long waiting time with less consultation time, poor compassion by providers, inadequate supply of drugs and unnoticed cost for services varied by level of facilities. Inadequacy in human resource and absenteeism and poor laboratory service were reported to worsen the condition especially at lower level of service delivery. Thus this study explored some important factors like poor quality of care, inadequate technical competencies, information exchange and follow-up services. A deficit in supplies and logistics are strong barrier in regards to quality of care at various levels which needs to be addressed immediately.Keywords: Bangladesh; Maternal health; Newborn health; Quality of careOnline: 13 August 2009DOI: 10.3329/bmrcb.v35i2.3044Bangladesh Med Res Counc Bull 2009; 35: 53-56

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Predictors of job satisfaction and intention to stay in the job among health-care providers in Uganda and Zambia

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzab128 ◽

2021 ◽

Vol 33 (3) ◽

Author(s):

min kyung kim ◽

catherine arsenault ◽

Lynn m Atuyambe ◽

Margaret e Kruk

Keyword(s):

Job Satisfaction ◽

Health Care ◽

Health Care Providers ◽

Obstetric Care ◽

Sub Saharan Africa ◽

Maternal And Newborn Health ◽

Care Providers ◽

Intention To Stay ◽

Quality Health ◽

Sub Saharan

Abstract Background A shortage of competent health-care providers is a major contributor to poor quality health care in sub-Saharan Africa. To increase the retention of skilled health-care providers, we need to understand which factors make them feel satisfied with their work and want to stay in their job. This study investigates the relative contribution of provider, facility and contextual factors to job satisfaction and intention to stay on the job among health-care providers who performed obstetric care in Uganda and Zambia. Methods This study was a secondary analysis of data from a maternal and newborn health program implementation evaluation in Uganda and Zambia. Using a Likert scale, providers rated their job satisfaction and intention to stay in their job. Predictors included gender, cadre, satisfaction with various facility resources and country. We used the Shapley and Owen decomposition of R2 method to estimate the variance explained by individual factors and groups of factors, adjusting for covariates at the facility and provider levels. Results Of the 1134 providers included in the study, 68.3% were female, 32.4% were nurses and 77.1% worked in the public sector. Slightly more than half (52.3%) of providers were strongly satisfied with their job and 42.8% strongly agreed that they would continue to work at their facility for some time. A group of variables related to facility management explained most of the variance in both job satisfaction (37.6%) and intention to stay (43.1%). Among these, the most important individual variables were satisfaction with pay (20.57%) for job satisfaction and opinions being respected in the workplace (17.52%) for intention to stay. Doctors reported lower intention to stay than nurses. Provider demographics and facility level and ownership (public/private) were not associated with either outcome. There were also differences in job satisfaction and intention to stay between Ugandan and Zambian health-care providers. Conclusion Our study suggests that managers play a crucial role in retaining a sufficient number of satisfied health-care providers providing obstetric care in two sub-Saharan African countries, Uganda and Zambia. Prioritizing and investing in health management systems and health managers are essential foundations for high-quality health systems.

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SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2789 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1279.1-1279

Author(s):

Z. Rutter-Locher ◽

J. Galloway ◽

H. Lempp

Keyword(s):

Rheumatoid Arthritis ◽

Health Care ◽

Health Care Providers ◽

Unmet Need ◽

Primary Care Providers ◽

Sub Saharan Africa ◽

Care Providers ◽

Specialist Care ◽

Sub Saharan ◽

The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

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Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.879 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Galle ◽

H Cossa ◽

N Osman ◽

K Roelens ◽

S Griffin ◽

...

Keyword(s):

Health Care ◽

Maternal Health ◽

Hiv Prevention ◽

Health Care Providers ◽

Male Involvement ◽

Sub Saharan Africa ◽

Care Providers ◽

Pregnancy And Childbirth ◽

Policy Level ◽

Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

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Shared Decision-making in Maternal and Newborn Health in Burkina Faso

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v5i2.526 ◽

2015 ◽

Vol 5 (2) ◽

pp. 68-73

Author(s):

Janet Perkins ◽

Cecilia Capello ◽

Aminata Bargo ◽

Carlo Santarelli

Keyword(s):

Health Care ◽

Decision Making ◽

Burkina Faso ◽

Health Sector ◽

Newborn Health ◽

Maternal And Newborn Health ◽

Birth Preparedness ◽

Care Providers ◽

Complication Readiness ◽

Maternal And Newborn

Community participation in decision-making within the health sector is an essential component in advancing efforts toward primary health care (PHC). Since 2006, Enfants du Monde, a Swiss non-governmental organization (NGO), in collaboration with the local NGO Fondation pour le Développement Communautaire/Burkina Faso (FDC/BF), has been supporting the Ministry of Health (MoH) to include communities in decision-making related to maternal and newborn health (MNH) services. Notably, participatory community assessments (PCA) are conducted to provide a platform for community members to discuss MNH needs and be involved in the decision-making within the health sector. During the PCAs, participants identify and prioritize needs and propose solutions to improve MNH, solutions which are then integrated in the annual district health action plan. Integrated interventions include: promotion of birth preparedness and complication readiness; training health care providers in counselling skills; building awareness of men on MNH issues and their capacity to support women; and strengthening community bodies to manage obstetrical and neonatal complications. The inclusion of these interventions has contributed to the advancement of PHC in three regions in Burkina Faso.

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