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

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.

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

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.

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

2021 ◽  
Vol 6 (2) ◽  
pp. e004575 ◽  
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.

scholarly journals Intersectional (in) equities in contact coverage of maternal and newborn health services in Nepal: insights from a nationwide cross-sectional household survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Resham B. Khatri ◽  
Yibeltal Alemu ◽  
Melinda M. Protani ◽  
Rajendra Karkee ◽  
Jo Durham
Keyword(s):  
Institutional Delivery ◽  
Secondary Analysis ◽  
Newborn Health ◽  
Household Survey ◽  
Universal Coverage ◽  
Maternal And Newborn Health ◽  
Multiple Forms ◽  
Wealth Status ◽  
Cross Sectional ◽  
Maternal And Newborn

Abstract Background Persistent inequities in coverage of maternal and newborn health (MNH) services continue to pose a major challenge to the health-care system in Nepal. This paper uses a novel composite indicator of intersectional (dis) advantages to examine how different (in) equity markers intersect to create (in) equities in contact coverage of MNH services across the continuum of care (CoC) in Nepal. Methods A secondary analysis was conducted among 1978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The three outcome variables included were 1) at least four antenatal care (4ANC) visits, 2) institutional delivery, and 3) postnatal care (PNC) consult for newborns and mothers within 48 h of childbirth. Independent variables were wealth status, education, ethnicity, languages, residence, and marginalisation status. Intersectional (dis) advantages were created using three socioeconomic variables (wealth status, level of education and ethnicity of women). Binomial logistic regression analysis was employed to identify the patterns of (in) equities in contact coverage of MNH services across the CoC. Results The contact coverage of 4ANC visits, institutional delivery, and PNC visit was 72, 64, and 51% respectively. Relative to women with triple disadvantage, the odds of contact coverage of 4ANC visits was more than five-fold higher (Adjusted Odds Ratio (aOR) = 5.51; 95% CI: 2.85, 10.64) among women with triple forms of advantages (literate and advantaged ethnicity and higher wealth status). Women with triple advantages were seven-fold more likely to give birth in a health institution (aOR = 7.32; 95% CI: 3.66, 14.63). They were also four times more likely (aOR = 4.18; 95% CI: 2.40, 7.28) to receive PNC visit compared to their triple disadvantaged counterparts. Conclusions The contact coverage of routine MNH visits was low among women with social disadvantages and lowest among women with multiple forms of socioeconomic disadvantages. Tracking health service coverage among women with multiple forms of (dis) advantage can provide crucial information for designing contextual and targeted approaches to actions towards universal coverage of MNH services and improving health equity.

scholarly journals Protocol for PMA-Ethiopia: A new data source for cross-sectional and longitudinal data of reproductive, maternal, and newborn health

2020 ◽  
Vol 4 ◽  
pp. 126
Author(s):  
Linnea Zimmerman ◽  
Selam Desta ◽  
Mahari Yihdego ◽  
Ann Rogers ◽  
Ayanaw Amogne ◽  
...  
Keyword(s):  
Data Collection ◽  
Longitudinal Data ◽  
Newborn Health ◽  
Quality Data ◽  
Maternal And Newborn Health ◽  
Unique Contribution ◽  
Cross Sectional ◽  
Data Source ◽  
The Impact ◽  
Maternal And Newborn

Background: Performance Monitoring for Action Ethiopia (PMA-Ethiopia) is a survey project that builds on the PMA2020 and PMA Maternal and Newborn Health projects to generate timely and actionable data on a range of reproductive, maternal, and newborn health (RMNH) indicators using a combination of cross-sectional and longitudinal data collection.  Objectives: This manuscript 1) describes the protocol for PMA- Ethiopia, and 2) describes the measures included in PMA Ethiopia and research areas that may be of interest to RMNH stakeholders. Methods: Annual data on family planning are gathered from a nationally representative, cross-sectional survey of women age 15-49. Data on maternal and newborn health are gathered from a cohort of women who were pregnant or recently postpartum at the time of enrollment. Women are followed at 6-weeks, 6-months, and 1-year to understand health seeking behavior, utilization, and quality. Data from service delivery points (SDPs) are gathered annually to assess service quality and availability.  Households and SDPs can be linked at the enumeration area level to improve estimates of effective coverage. Discussion: Data from PMA-Ethiopia will be available at www.pmadata.org.  PMA-Ethiopia is a unique data source that includes multiple, simultaneously fielded data collection activities.  Data are available partner dynamics, experience with contraceptive use, unintended pregnancy, empowerment, and detailed information on components of services that are not available from other large-scale surveys. Additionally, we highlight the unique contribution of PMA Ethiopia data in assessing the impact of coronavirus disease 2019 (COVID-19) on RMNH.

scholarly journals Continuity of care and its determinants of routine maternal and newborn health visits in Nepal: Evidence from a nationally representative household survey

2021 ◽  
Author(s):  
Resham Bahadur Khatri ◽  
Rajendra Karkee ◽  
Jo Durham ◽  
Yibeltal Assefa
Keyword(s):  
Continuity Of Care ◽  
Agricultural Sector ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Newborn Health ◽  
Outcome Variable ◽  
Maternal And Newborn Health ◽  
Health Management Information System ◽  
Neonatal Deaths ◽  
Maternal And Newborn

Abstract Background Maternal and newborn health (MNH) is a priority health issue in Nepal, has high maternal and neonatal deaths. Maternal and neonatal deaths can be prevented through uptake of essential antenatal, intrapartum, and postnatal interventions received during routine MNH visits. Not all women, however, receive all recommended routine visits across the MNH Continuum of Care (CoC) in Nepal. This study examined the patterns and determinants of (dis)continuity of care across the MNH continuum. Methods The study included 1,978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The outcome variable was (dis)continuity of care at different stages of MNH visits (at least four antenatal care (4ANC) visits, institutional delivery, and postnatal care (PNC) visit). Several structural, intermediary and health system explanatory variables were included in the analysis. Multinomial logistic regression analysis was conducted, and the magnitude of (dis)continuity of care was reported as relative risk ratios (RR) with 95% confidence intervals (CIs). The statistical significance level was set p<0.05. Results More than two-in-five (41%) women in Nepal received all three MNH visits across the CoC. There was high risk of discontinuity of care during months or weeks prior to childbirth or around childbirth. Higher risk of discontinuation across the CoC was reported among women of disadvantaged ethnic groups, lower wealth status and illiterate. Similarly, women who speak Bhojpuri, provinces six and seven, who had higher birth order (≥4), who involved in agricultural sector, had unwanted last birth had higher risk of discontinuation of MNH visits. Women did not complete all MNH visits if they had poor awareness on health mother groups and if they perceived problem of not having female healthcare providers. Conclusions Women had poor completion of all routine MNH visits. High discontinuation was observed among disadvantaged groups across the COC. Regular monitoring using the composite indicator of continuity of care through routine health management information system is required. Program approaches should focus on disadvantaged women to improve the completion of routine MNH visits and uptake of essential interventions.

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