Use of healthcare services at time of delivery: a prospective community based study in Madagascar

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Pourette ◽  
T V Andrianantoandro ◽  
F M J Rakotoarimanana ◽  
M Razakamanana ◽  
O Rakotomalala ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Facility ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Binary Logistic Regression ◽  
Healthcare Services ◽  
Traditional Healers ◽  
June July ◽  
A Prospective Study ◽  
Close Family

Abstract Background Maternal mortality remains high in Madagascar (478 deaths per 100,000 live births) and more than 60% of birth are not assisted by professional health workers. This study aimed to determine factors that influence choices of delivery place in two municipalities of Vakinakaratra region. Methods This was a prospective study. 245 pregnant women in the 2nd and 3rd trimester of pregnancy were included and surveyed during Oct-Nov 2016. The same women were re-surveyed 3 months or more after their respective deliveries (June-July 2017). Binary logistic regression was used and the analysis were supported by qualitative interviews conducted with 35 women from the sample, 7 community health workers, 5 professionals health workers and 15 traditional healers and traditional births attendants or 'reninjaza'. Results Overall, 91.8 % of women intended to give birth at health facilities. The reasons given are the quality of services and the medical support in case of complications, the registration of birth and the referrals and encouragement from reninjaza. However, out of 229 mothers interviewed after delivery, only 60.7% gave birth in a health facility. Educated mothers were ORa=6.6 (p < 0.001) times more likely to deliver at health facility and mothers with at least 4 births are ORa=0.17 (p < 0.01) times less likely to do it. The qualitative analysis highlights the cost (logistics and care) as well as the fear of caesarean sections as a brake on childbirth in a health facility. The distance from the health center and the lack of preparation to travel there were also identified. Decisions at the time of childbirth come under the close family. Conclusions Use of maternity services remains low. The implementation of free delivery care policies, formalizing the collaboration between reninjaza and health workers and raising awareness among close family should improve the access to healthcare. Key messages Collaborations between health workers and traditional healers should be formalized. The close family of pregnant women (spouse, mother, mother-in-law) should be the target of awareness raising strategies.

scholarly journals Factors Influencing Pregnant Women's Participation in Prenatal Classes in Magetan Regency, Indonesia

2021 ◽  
Author(s):  
Rofiatul Uzza ◽  
Sapto Adi ◽  
Suci Puspita Ratih
Keyword(s):  
Pregnant Women ◽  
Infant Health ◽  
Health Workers ◽  
Binary Logistic Regression ◽  
Study Data ◽  
Health Promotion Program ◽  
P Value ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Women's Participation

Prenatal classes in Indonesia are government’s effort to improve the knowledge and skills of pregnant women. Several factors influence the participation of pregnant women in these classes. This research aimed to identify the factors that correlate with pregnant women’s participation in prenatal classes in several rural villages of Magetan Regency, Indonesia. This observational analytical research was performed quantitatively using a cross-sectional design. Seventy-eight pregnant women meeting the research criteria were included in this study. Data were collected through a questionnaire that has been tested through validity and reliability tests. A binary logistic regression was employed to conduct a statistical analysis. Results showed that supports from family (OR 32.40, p-value < 0.01, 95% CI 4.55–230.64) and from health workers (OR 22.53, p-value < 0.001, 95% CI 3.96–128.19) were significantly associated with the respondent’s participation in prenatal classes after controlling the potential confounding factors such as knowledge, attitudes and information availability. Keywords: maternal health, health promotion program, pregnancy, infant health

scholarly journals Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

2021 ◽  
Vol 13 (4(J)) ◽  
pp. 17-30
Author(s):  
Ruth Atuhaire ◽  
Robert Wamala ◽  
Leonard. K. Atuhaire ◽  
Elizabeth Nansubuga
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Health Facility ◽  
Maternal Education ◽  
Health Workers ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Care Health

This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

scholarly journals Community Preparedness and Practices for Prevention and Control of COVID-19 (COP-COVID): An assessment from rural northern India

2021 ◽  
pp. 1-19
Author(s):  
Aravind Gandhi P ◽  
Tanveer Rehman ◽  
Divya Ilanchoorian ◽  
Soundappan Kathirvel
Keyword(s):  
Health Workers ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Change Communication ◽  
Northern India ◽  
Community Preparedness ◽  
June July ◽  
And Control

Abstract Objectives The study assessed the community preparedness to manage the COVID-19 and access to healthcare services during the lockdown of 2020 in a rural health block of northern India. Methods A cross-sectional study was conducted during June-July, 2020 in 25 villages and five wards of a rural administrative block of Haryana. A pre-tested, semi-structured investigator administered checklist was used to assess the community preparedness and practices for COVID-19 prevention/control and healthcare access through direct observations and interviewing community health workers and beneficiaries. Results Active surveillance for influenza-like illness was carried out in 86.7% of the study units, though the frequency was once a month. There was poor adherence (adherence: 0-3%) to COVID-19 infection prevention & control (IPC) measures such as physical distancing and use of face masks. Rural beneficiaries reported difficulty accessing essential healthcare services than their urban counterparts. Conclusion A qualitative study to understand the facilitators and barriers for the non-adherence to IPCs measures by the study population and formulating behaviour change communication strategies for improving the IPCs is needed. Repeat, cross-sectional surveys at regular intervals may be planned to gauge the change and effect of the interventions on the community preparedness and practices.

scholarly journals Influence of Cultural and Religious Practices on the Management of Pregnancy at Mbombela Municipality, South Africa: An Explorative Study

2021 ◽  
Vol 15 (1) ◽  
pp. 130-135
Author(s):  
Lucia Drigo ◽  
Lufuno Makhado ◽  
Rachel Tsakani Lebese ◽  
Maphuti Judas Chueng
Keyword(s):  
Pregnant Women ◽  
Cultural Practices ◽  
Healthcare Services ◽  
Traditional Healers ◽  
Care Plan ◽  
Religious Practices ◽  
Mpumalanga Province ◽  
Active Involvement ◽  
Health Care Clinics ◽  
Data Saturation

Background: Cultural norms bring substantial weight in women’s decision-making, especially concerning the choice of the birth location. Cultural and religious practices may influence how pregnant women respond to Antenatal Care (ANC) services, feel confident about which questions to ask, or participate in the discussions about their care plan or birth options. Purpose: The study aimed to explore and describe the influence of cultural practices on the management of pregnancy in the Mbombela Municipality of Mpumalanga Province. Methods: Using a qualitative approach, pregnant women who failed to completely attend ANC services were purposively sampled, and individual unstructured in-depth interviews were employed to collect data. The study consisted of a sample size of 18 pregnant women, and data saturation was reached. Tech’s method of analysis was followed for data analysis. Results: Study findings revealed a significant theme: cultural practices and pregnancy management, encompassing three sub-themes: cultural practices in pregnancy, cultural medication taken by pregnant women, and the effects of cultural practices on pregnancy management. Conclusion: It is recommended that women should be given health education concerning ANC services every day while they wait in primary health care clinics. Accordingly, the healthcare professionals should encourage the active involvement of all pregnant women in health promotion gatherings and offer chances for clarity seeking. Despite the availability of free maternal healthcare services in primary healthcare clinics, women still consult traditional healers during pregnancy and believe in cultural practices. It is therefore important that programs developed for maternal services be congruent to the cultural practices of women to be serviced.

Are anemia, gastrointestinal disorders, and pregnancy outcome associated with pica behavior?

2020 ◽  
Vol 13 (4) ◽  
pp. 521-527
Author(s):  
Elham Sadeghi ◽  
Atefeh Yas ◽  
Soheila Rabiepoor ◽  
Hojjat Sayyadi
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Significant Relationship ◽  
Health Care Professionals ◽  
Healthcare Services ◽  
Gastrointestinal Disorders ◽  
Cluster Sampling ◽  
Significance Level ◽  
A Prospective Study

OBJECTIVE: This study was conducted to determine the relationship between pica and anemia, gastrointestinal disorders, as well as pregnancy outcomes in pregnant women. METHODOLOGY: This study was a prospective study carried out between January 2016 and June 2017 and was performed on 226 pregnant women who attended four different health care centers to receive routine prenatal care. Sampling was done considering the inclusion criteria, in two steps: cluster sampling and random sampling. Data collection was done using a researcher-made checklist. The significance level was set at p = 0.05. RESULTS: The average age of the participants was 26.10±6.27. The prevalence of pica in pregnant women in the first, second, and third trimesters was 9.3, 8, and 2.1%, respectively. The most common pica craving among pregnant women was for ice and frozen materials (68.2%). There was a statistically significant relationship between gastrointestinal disorders and anemia with pica (p < 0.001). There was also a significant relationship between birth weights of babies born to mothers with pica and those without pica (p = 0.005). CONCLUSION: Pica in pregnant women had a significant relationship with gastrointestinal disorders and anemia during pregnancy and pregnancy outcomes. Thus, in addition to providing healthcare services, health care professionals should consider patients’ pica practices and make the necessary interventions.

scholarly journals Strengthen iron folate supplementation of pregnant women in Ntchisi District, Malawi

2018 ◽  
Vol 9 (3) ◽  
pp. 254-260 ◽  
Author(s):  
Tendai Mary Museka-Saidi ◽  
Trust Takudzwa Mlambo ◽  
Nancy Aburto ◽  
Regina Susan Keith
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Consumer Demand ◽  
Health Workers ◽  
Building Blocks ◽  
Health Facilities ◽  
Reproductive Age ◽  
Care Group ◽  
Folate Supplementation

While an estimated 45% of pregnant women in Malawi are anaemic, only 33% take iron tablets for a minimum of 90 days during pregnancy. The study explored the capacity of health facilities and communities to strengthen antenatal iron folate supplementation in Ntchisi, to support the achievement of Malawi’s nutrition target on halving anaemia in women of reproductive age by 2025. This qualitative study employed systematic random and purposeful sampling. Eight Focus Group Discussions with mothers of children 0-23 months, eight with Care Group volunteers and eight in-depth interviews with Village Health Workers (Health Surveillance Assistants) were conducted in each village falling within the catchment area of each of 8 health facilities. Health facilities had been sampled each from the 7 Traditional Authorities with the district hospital and direct observations had been conducted at each for antenatal care service delivery. 10 key informants from the health facilities and the District Health Office were interviewed. Thus a total of 16 FGDs, 8 HSA interviews, and 10 key informant interviews provided the data analysed in this paper.  Data were analysed manually using thematic framework analysis. Poor access to and follow up of antenatal care at the health facility has limited access to iron folate supplements, as the health facility is the main source of Iron folates. Recurrent depletion of stock of iron folate were reported by mothers at most health facilities. Consumer demand for the tablets was low due to side effects, poor acceptability, associated myths, forgetfulness and frustration from having to take a daily medication. There was limited training and education materials at the health facility and community with inadequate support given to women. The absence of clear policies and guidelines on iron folate supplementation resulted in inconsistencies in messaging. Uptake and adherence were not routinely monitored. There is a need to improve the main building blocks of the iron folate programme, including the: delivery system, tablet supply, patient education, consumer demand, monitoring and evaluation and policy.

The prevalence of Trichomonas vaginalis and Candida albicans infection in the lower genital tracts of antenatal patients in Abakaliki, Southeastern Nigeria

1970 ◽  
Vol 4 (1) ◽  
pp. 11-14 ◽  
Author(s):  
IM Sunday-Adeoye ◽  
JOK Adeoye ◽  
OUJ Umeora ◽  
PI Okonta
Keyword(s):  
Candida Albicans ◽  
Pregnancy Outcomes ◽  
Trichomonas Vaginalis ◽  
Dropout Rate ◽  
Antenatal Clinic ◽  
Southeastern Nigeria ◽  
High Dropout Rate ◽  
Adverse Pregnancy ◽  
June July ◽  
A Prospective Study

Aims: To determine the prevalence of Trichomonas vaginalis and Candida albican infection among anasymptomatic pregnant population and to document their pregnancy outcomes.Methods: This was a prospective study involving antenatal clinic attendees at the Ebonyi State UniversityTeaching Hospital, Abakaliki, Nigeria. They were randomly recruited and informed consent obtained. Vaginalspecimens were collected from them and analyzed in the laboratory. They were followed up till delivery andpregnancy outcomes documented.Results: Two hundred expectant mothers were recruited. The prevalence rate of Trichomonas vaginalis andCandida albicans were 0.5% and 27.5% respectively. Due to the high dropout rate in the study, it wasimpossible to make any reasonable inference about the pregnancy outcomes associated with these conditions.Conclusion: There is probably the need for the use of more sophisticated methods for the detection ofTrichomonas vaginalis. The existing methods in most laboratories in the country may not be adequate. Thereis also probably the need for a larger sample size and a stricter follow up of the patients in order to documentany adverse pregnancy outcomes associated with these conditions.Keywords: Prevalence; Trichomonas vaginalis; Candida albicans; antenatal careDOI: 10.3126/njog.v4i1.3325Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 11-14

STUDI KUALITATIF : KEBUTUHAN IBU HAMIL DENGAN DIABETES MELITUS GESTASIONAL DI KABUPATEN KARANGANYAR JAWA TENGAH

2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Health Center ◽  
Blood Sugar ◽  
Interpretative Phenomenological Analysis ◽  
Health Workers ◽  
Phenomenological Analysis ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Diabetes Melitus

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  

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