scholarly journals Separating Newborns from Mothers and Maternal Consent for Newborn Care and the Association with Health Care Satisfaction, Use and Breastfeeding: Findings from a longitudinal survey in Kenya

2020 ◽  
Author(s):  
Michelle K. Nakphong ◽  
Emma Sacks ◽  
James Opot ◽  
May Sudhinaraset
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Newborn Care ◽  
Health Facilities ◽  
Secondary Outcome ◽  
Satisfaction With Care ◽  
Postpartum Visit ◽  
Health Care Satisfaction ◽  
Care Satisfaction

AbstractObjectivesDisrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors, or associated outcomes. This study aimed to examine these practices and associations with health care satisfaction, use, and breastfeeding.DesignProspective cohort studySettingHealth facilities in Nairobi and Kiambu counties in KenyaParticipantsData were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1,014 women surveyed at baseline and at least one follow-up at 2-4 or 10 weeks postpartum.Primary and secondary outcome measures1) Outcomes related to satisfaction with care and care utilization, 2) Continuation of post-discharge newborn care practices such as breastfeeding.Results17.6% of women reported being separated from their newborns at the facility after delivery, of whom 71.9% were separated over 10 minutes. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 minutes) were 44% less likely to be exclusively breastfeeding at 2-4 weeks (aOR=0.56, 95%CI: 0.40, 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95%CI: 1.67, 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95%CI: 1.05, 4.41), and 33% greater likelihood of exclusive breastfeeding at 10 weeks (aOR=1.33, 95%CI: 1.10, 1.62).ConclusionsNewborns, mothers, and families have a right to high quality, respectful care, including the ability to stay together, be informed and have proper consent for care. The implications of these practices on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.Article SummaryStrengths and Limitations of the StudyThis is one of the first studies to include survey questions surrounding details of separation of newborns from mothers and maternal consent for care, including risk factors and reasons for separation.This study used longitudinal data collected over 10 weeks following delivery to assess associations with outcomes, including postpartum visit attendance and breastfeeding.Differences in participants who responded to the 2-4week and 10 week follow-up interviews may have introduced bias due to differences in composition, thus comparisons of associations with outcomes between these two points should be interpreted conservatively.Findings may have limited generalizability to other contexts, as the study sample included women who gave birth at facilities in Nairobi and Kiambu counties.

scholarly journals Association between newborn separation, maternal consent and health outcomes: findings from a longitudinal survey in Kenya

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045907
Author(s):  
Michelle Kao Nakphong ◽  
Emma Sacks ◽  
James Opot ◽  
May Sudhinaraset
Keyword(s):  
Health Outcomes ◽  
Breast Feeding ◽  
Post Partum ◽  
Health Centre ◽  
Newborn Care ◽  
Health Facilities ◽  
Public Hospitals ◽  
Secondary Outcome ◽  
Satisfaction With Care ◽  
Post Discharge

ObjectivesDisrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors or associated outcomes. This study examined these experiences and associations with healthcare satisfaction, use and breast feeding.DesignProspective cohort study.Setting3 public hospitals, 2 private hospitals, and 1 health centre/dispensary in Nairobi and Kiambu counties in Kenya.ParticipantsData were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1014 women surveyed at baseline and at least one follow-up at 2–4 or 10 weeks post partum.Primary and secondary outcome measures(1) Outcomes related to satisfaction with care and care utilisation; (2) continuation of post-discharge newborn care practices such as breast feeding.Results17.6% of women reported newborn separation at the facility, of whom 71.9% were separated over 10 min. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 min) were 44% less likely to be exclusively breast feeding at 2–4 weeks (adjusted OR (aOR)=0.56, 95% CI: 0.40 to 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95% CI: 1.67 to 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95% CI: 1.05 to 1.55), and 33% greater likelihood of exclusive breast feeding at 10 weeks (aOR=1.33, 95% CI: 1.10 to 1.62).ConclusionsNewborns, mothers and families have a right to high-quality, respectful care, including the ability to stay together, be informed and properly consent for care. The implications of these experiences on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.

Health Care Satisfaction in Relation to Gender Identity

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Katarina A. Ferrucci ◽  
Tubanji Walubita ◽  
Ariel L. Beccia ◽  
Eric Y. Ding ◽  
Bill M. Jesdale ◽  
...  
Keyword(s):  
Health Care ◽  
Gender Identity ◽  
Health Care Satisfaction ◽  
Care Satisfaction

scholarly journals Lost in Transition: Health Care Experiences of Adults Born Very Preterm—A Qualitative Approach

2020 ◽  
Vol 8 ◽  
Author(s):  
Anna Perez ◽  
Luise Thiede ◽  
Daniel Lüdecke ◽  
Chinedu Ulrich Ebenebe ◽  
Olaf von dem Knesebeck ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Adult Health ◽  
Care Providers ◽  
Very Preterm ◽  
Care Services ◽  
Health Care Satisfaction ◽  
Care Satisfaction ◽  
Adult Health Care

Introduction: Adults Born Very Preterm (ABP) are an underperceived but steadily increasing patient population. It has been shown that they face multiple physical, mental and emotional health problems as they age. Very little is known about their specific health care needs beyond childhood and adolescence. This article focuses on their personal perspectives: it explores how they feel embedded in established health care structures and points to health care-related barriers they face.Methods: We conducted 20 individual in-depth interviews with adults born preterm aged 20–54 years with a gestational age (GA) below 33 weeks at birth and birth weights ranging from 870–1,950 g. Qualitative content analysis of the narrative interview data was conducted to identify themes related to self-perceived health, health care satisfaction, and social well-being.Results: The majority (85%) of the study participants reported that their former prematurity is still of concern in their everyday lives as adults. The prevalence of self-reported physical (65%) and mental (45%) long-term sequelae of prematurity was high. Most participants expressed dissatisfaction with health care services regarding their former prematurity. Lack of consideration for their prematurity status by adult health care providers and the invisibility of the often subtle impairments they face were named as main barriers to receiving adequate health care. Age and burden of disease were important factors influencing participants' perception of their own health and their health care satisfaction. All participants expressed great interest in the provision of specialized, custom-tailored health-care services, taking the individual history of prematurity into account.Discussion: Adults born preterm are a patient population underperceived by the health care system. Longterm effects of very preterm birth, affecting various domains of life, may become a substantial burden of disease in a subgroup of formerly preterm individuals and should therefore be taken into consideration by adult health care providers.

scholarly journals Health care professionals’ adherence to partograph use in Ethiopia: analysis of 2016 national emergency obstetric and newborn care survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Solomon Weldemariam Gebrehiwot ◽  
Mulugeta Woldu Abrha ◽  
Haftom Gebrehiwot Weldearegay
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Multivariable Analysis ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Outcome Variable ◽  
Care Providers ◽  
Care Survey ◽  
National Emergency

Abstract Background The period around childbirth and the first 24 hours postpartum remains a perilous time for both mother and newborn. Health care providers’ compliance to the World Health Organization modified partogram across the active first stage of labor is a graphic representation of a mother’s condition that is used as a guide in providing quality obstetrics care. However, little evidence is documented on the health providers’ adherence to the use of the partograph in Ethiopia, which limits health care providers’ ability to improve quality care services. Therefore, this study assessed the adherence of partograph use and associated factors in Ethiopia. Methods Data from the Ethiopian 2016 National Emergency Obstetric and Newborn Care survey of 3,804 health facilities that provided maternity services were used. We extracted 2611 partograph charts over a 12 months period prior to the survey to review the proper recording of each component. Data analyses were performed using SPSS version 22.0 software. A logistic regression analyses was used to identify the association of explanatory variables with the outcome variable. A p-value of <0.05 was considered as cut off point to declare the significance association in the multivariable analysis. Results Of the total 2611 partographs reviewed, 561(21.5%) of them were fully recorded as per the WHO guideline. Particularly, molding in 50%, color of liquor in 70.5%, fetal heart beat in 93.3%, cervical dilation in 89.6%, descent in 63.2%, uterine contraction in 94.5%, blood pressure in 80.5%, pulse rate in 70.5%, and temperature in 53% were accurately recorded. The odds of adherence to partograph use were 1.4 in rural health facilities when compared to their counterparts (AOR=1.44; 95% CI: 1.15, 1.80, P- 0.002). Conclusion This study revealed a poor level of adherence in partograph use in Ethiopia. Molding, maternal temperature and decent were the least recorded parameters of the partograph. The odds of completion of partograph were high in rural facilities. Strong supporting supervision and mentoring the health workers to better record and use of partograph are needed mainly in urban health facilities. Moreover in the future, interventional research should be conducted to improve the current rate of adherence.

scholarly journals Going home with baby: innovative and comprehensive support for new mothers

2018 ◽  
Vol 20 ◽  
Author(s):  
Tonia Olson ◽  
Angela Bowen ◽  
Julie Smith-Fehr ◽  
Swagata Ghosh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Newborn Care ◽  
Community Services ◽  
Screening Tests ◽  
Physical And Mental Health ◽  
New Mothers ◽  
Care Clinic ◽  
Primary Health

AbstractShorter length of stay for postpartum mothers and their newborns necessitates careful community follow-up after hospital discharge. The vast amount of information given during the initial postpartum period can be overwhelming. New parents often need considerable support to understand the nuances of newborn care including newborn feeding. Primary health care and community services need to ensure there is a seamless continuum of care to support, empower, and educate new mothers and their families to prevent unnecessary hospital readmission and other negative health outcomes. The Healthy & Home postpartum community nursing program provides clinical communication and supports to bridge the gap between acute hospital and community follow-up care through home visits, a primary health care clinic, a breastfeeding center, a breastfeeding café, a postpartum anxiety and depression support group, bereavement support, and involvement in a Baby-Friendly Initiative™ coalition. Nurses working in the program have the acute care skills and resources to complete required health care assessments and screening tests. They are also international board-certified lactation consultants able to provide expert breastfeeding and lactation care. This paper describes how the Healthy & Home program has evolved over the past 25 years and offers suggestions to other organizations wanting to develop a postpartum program to meet the physical and mental health needs of postpartum families to promote maternal and infant wellbeing.

scholarly journals Exercise in a Healthy Heart Program: A Cohort Study

2013 ◽  
Vol 7 ◽  
pp. CMC.S12654 ◽  
Author(s):  
J. Meikle ◽  
A. Al-Sarraf ◽  
M. Li ◽  
K. Grierson ◽  
J. Frohlich
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Lipid Profile ◽  
Retrospective Chart Review ◽  
Secondary Outcome ◽  
The Mean ◽  
Group 2 ◽  
Prevention Clinic ◽  
Group 1

Objective To assess the effects of exercise on resting heart rate (RHR), weight, lipid profile, and blood pressure. We hypothesized that the participants who increased their physical activity would show improvement in their cardiovascular risk factors compared to those who did not. Design Retrospective chart review over the mean duration of 4.9 years of follow-up. Setting Healthy Heart Program Prevention Clinic at St. Paul's Hospital, Vancouver, British Columbia, Canada. Participants We reviewed 300 charts of patients randomly selected from those who attended the Prevention Clinic between 1984 and 2009. 248 (82.7%) patients were referred for primary prevention and 52 (17.3%) for secondary prevention. Primary and secondary outcome measures Weight, RHR, lipid profile, and blood pressure were recorded at the initial and last visit. Results During a mean of 4.9 years of follow-up, 55% of participants improved their exercise. The mean decrease in the RHR for these patients (group 1) was 5.9 beats per minute (bpm) versus the mean increase of 0.3 bpm for the “no change” group (group 2) ( P < 0.01). The mean net weight increase in group 1 was 0.06 kg/year versus 0.25 kg/year in group 2. Because of medications, all patients had a significant improvement in their lipid profiles. Furthermore, there was a statistically significant greater reduction in Framingham Risk Score (FRS) in group 1 versus group 2 (11.8% versus 15.1%, P < 0.01). Conclusion Participation in the program significantly reduces modifiable risk factors for cardiovascular disease. Improved exercise regimen results in lower RHR and greater reduction in FRS. However, even in a Prevention Program, despite strong advocacy of the importance of exercise, a significant percentage of participants does not improve their exercise habits.

Has brief counselling an impact on the risk factors for cardiovascular disease in 40-year-old men. A three-year follow-up study

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 300-307 ◽  
Author(s):  
Anita Näslindh-Ylispangar ◽  
Marja Sihvonen ◽  
Seppo Sarna ◽  
Hannu Vanhanen ◽  
Pertti Kekki
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Repeated Measures ◽  
Follow Up Study ◽  
The Metabolic Syndrome ◽  
Old Men ◽  
The Impact

AbstractThe metabolic syndrome presents a serious challenge to health professionals. The aim of the present study is to analyze the impact of a brief counselling on cardiovascular risk factors among 40-year-old men. Forty-six males living in north-eastern Helsinki voluntarily completed the follow-up study between 2001 and 2004, and were assessed for clinical risk factors. The mean differences were determined by a paired t-test, and the interaction between groups and time by the F-test with repeated measures ANOVA. After baseline assessment and in 2002, males received a 45 minute nurse-delivered counselling session with self-administered protocol. Cardiovascular risk factors improved significantly (p<0.05) from baseline within months. However, the final measurements obtained after three years showed that almost all risk factors, except the low and high density lipoprotein, tended to revert back to baseline. The profiles were similar in all predictor groups. Brief counselling had an impact on risk factors measured in 2002, but only a partial effect on them in 2004. Conclusive results lead to the idea thatmore collaboration is needed between private health care agencies and official primary health care for ensuring the continuity of improved health habits among middle-aged males.

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