scholarly journals Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences

2021 ◽  
Vol 6 (3) ◽  
pp. e004347
Author(s):  
Suman P N Rao ◽  
Nicole Minckas ◽  
Melissa M Medvedev ◽  
David Gathara ◽  
Prashantha Y N ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Personnel ◽  
Online Survey ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Mitigation Strategies ◽  
Care Seeking ◽  
Care Providers ◽  
Middle Income ◽  
Sick Newborn

IntroductionThe COVID-19 pandemic is disrupting health systems globally. Maternity care disruptions have been surveyed, but not those related to vulnerable small newborns. We aimed to survey reported disruptions to small and sick newborn care worldwide and undertake thematic analysis of healthcare providers’ experiences and proposed mitigation strategies.MethodsUsing a widely disseminated online survey in three languages, we reached out to neonatal healthcare providers. We collected data on COVID-19 preparedness, effects on health personnel and on newborn care services, including kangaroo mother care (KMC), as well as disruptors and solutions.ResultsWe analysed 1120 responses from 62 countries, mainly low and middle-income countries (LMICs). Preparedness for COVID-19 was suboptimal in terms of guidelines and availability of personal protective equipment. One-third reported routine testing of all pregnant women, but 13% had no testing capacity at all. More than 85% of health personnel feared for their own health and 89% had increased stress. Newborn care practices were disrupted both due to reduced care-seeking and a compromised workforce. More than half reported that evidence-based interventions such as KMC were discontinued or discouraged. Separation of the mother–baby dyad was reported for both COVID-positive mothers (50%) and those with unknown status (16%). Follow-up care was disrupted primarily due to families’ fear of visiting hospitals (~73%).ConclusionNewborn care providers are stressed and there is lack clarity and guidelines regarding care of small newborns during the pandemic. There is an urgent need to protect life-saving interventions, such as KMC, threatened by the pandemic, and to be ready to recover and build back better.

scholarly journals Training programs to improve identification of sick newborns and care-seeking from a health facility in low- and middle-income countries: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alastair Fung ◽  
Elisabeth Hamilton ◽  
Elsabé Du Plessis ◽  
Nicole Askin ◽  
Lisa Avery ◽  
...  
Keyword(s):  
Health Facility ◽  
Scoping Review ◽  
Training Programs ◽  
Health Workers ◽  
Newborn Care ◽  
Care Seeking ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Care Training

Abstract Background Most neonatal deaths occur in low- and middle-income countries (LMICs). Limited recommendations are available on the optimal personnel and training required to improve identification of sick newborns and care-seeking from a health facility. We conducted a scoping review to map the key components required to design an effective newborn care training program for community-based health workers (CBHWs) to improve identification of sick newborns and care-seeking from a health facility in LMICs. Methods We searched multiple databases from 1990 to March 2020. Employing iterative scoping review methodology, we narrowed our inclusion criteria as we became more familiar with the evidence base. We initially included any manuscripts that captured the concepts of “postnatal care providers,” “neonates” and “LMICs.” We subsequently included articles that investigated the effectiveness of newborn care provision by CBHWs, defined as non-professional paid or volunteer health workers based in communities, and their training programs in improving identification of newborns with serious illness and care-seeking from a health facility in LMICs. Results Of 11,647 articles identified, 635 met initial inclusion criteria. Among these initial results, 35 studies met the revised inclusion criteria. Studies represented 11 different types of newborn care providers in 11 countries. The most commonly studied providers were community health workers. Key outcomes to be measured when designing a training program and intervention to increase appropriate assessment of sick newborns at a health facility include high newborn care provider and caregiver knowledge of newborn danger signs, accurate provider and caregiver identification of sick newborns and appropriate care-seeking from a health facility either through caregiver referral compliance or caregivers seeking care themselves. Key components to consider to achieve these outcomes include facilitators: sufficient duration of training, refresher training, supervision and community engagement; barriers: context-specific perceptions of newborn illness and gender roles that may deter care-seeking; and components with unclear benefit: qualifications prior to training and incentives and remuneration. Conclusion Evidence regarding key components and outcomes of newborn care training programs to improve CBHW identification of sick newborns and care-seeking can inform future newborn care training design in LMICs. These training components must be adapted to country-specific contexts.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

scholarly journals Managing Sexual Dysfunction For Women With Breast Cancer: The Perspective Of Health Care Providers In North East Malaysia.

2021 ◽  
Author(s):  
Siti Balqis Chanmekun ◽  
Maryam Mohd Zulkifli ◽  
Rosediani Muhamad ◽  
Norhasmah Mohd Zain ◽  
Wah Yun Low ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Dysfunction ◽  
Sexual Health ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Phenomenological Approach ◽  
Care Providers ◽  
North East ◽  
East Malaysia

Abstract Purpose: Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers’ (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using phenomenological approach. Methods: This qualitative study was conducted using a face-to-face interview method to HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis. Results: Three key barriers were identified through the thematic analysis: a scarcity of related knowledge; the influence of socio-cultural ideas about sex; and the speciality-centric nature of the healthcare system. Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that is, both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients. Conclusion: Therefore, interventions to empower the knowledge, break the sociocultural barriers and improve the clinic settings are crucial for HCPs in managing FSD confidently.

Palliative care transitions from acute care to community-based care: A qualitative systematic review of the experiences and perspectives of health care providers

2020 ◽  
Vol 34 (10) ◽  
pp. 1316-1331 ◽  
Author(s):  
Tieghan Killackey ◽  
Emily Lovrics ◽  
Stephanie Saunders ◽  
Sarina R. Isenberg
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Discharge Process ◽  
Care Providers ◽  
Community Based ◽  
Qualitative Systematic Review

Background: Transitioning from the hospital to community is a vulnerable point in patients’ care trajectory, yet little is known about this experience within the context of palliative care. While some studies have examined the patient and caregiver experience, no study to date has synthesized the literature on the healthcare provider’s perspective on their role and experience facilitating these transitions. Aim: The purpose of this systematic review was to understand the experience and perspective of healthcare providers who support the transition of patients receiving palliative care as they move from acute care to community settings. Design: A qualitative systematic review of studies using thematic analysis as outlined by Thomas and Harden. PROSPERO: ID # CRD42018109662. Data Sources: We searched four databases: MEDLINE, Embase, ProQuest and CINAHL for studies published in English from 1995 until May 22, 2020. Four reviewers screened records using the following selection criteria: (1) peer-reviewed empirical study, (2) adult sample, (3) qualitative study design, (4) perspective of healthcare providers, and (5) included a component of transitions between acute to community-based palliative care. Study findings were analyzed using thematic analysis which entailed: (1) grouping the findings into recurring themes; (2) iteratively referring back to the articles to obtain nuances of the theme and quotations; and (3) defining and solidifying the themes. Results: Overall 1,791 studies were identified and 15 met inclusion criteria. Studies were published recently (>2015, n = 12, 80%) and used a range of qualitative methods including semi-structured interviews, focus groups, and field interviews. Three core themes related to the role and experience of healthcare providers were identified: (1) assessing and preparing for transition; (2) organizing and facilitating the logistics of transition; and (3) coordinating and collaborating transitional care across sectors. The majority of studies focused on the discharge process from acute care; there was a lack of studies exploring the experiences of healthcare providers in the community who receive patients from acute care and provide them with palliative care at home. Conclusion: This review identified studies from a range of relatively high-income countries that included a diverse sample of healthcare providers. The results indicate that healthcare providers experience multiple complex roles during the transition facilitation process, and future research should examine how to better assist clinicians in supporting these transitions within the context of palliative care provision.

Primary healthcare providers' attitudes and beliefs about the menopause-related care needs of women who have migrated from low- and middle-income countries to Australia

2020 ◽  
Vol 26 (1) ◽  
pp. 88
Author(s):  
Karin A. Stanzel ◽  
Karin Hammarberg ◽  
Jane Fisher
Keyword(s):  
Primary Healthcare ◽  
Online Survey ◽  
Healthcare Providers ◽  
Migrant Women ◽  
Care Needs ◽  
Middle Income ◽  
Structural Support ◽  
Middle Income Countries ◽  
Primary Healthcare Providers ◽  
Low And Middle Income

Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.

scholarly journals Intensive Care Unit design; from advance to basic

2019 ◽  
pp. S17-S20
Author(s):  
Mohsin Nazir Butt ◽  
Muhammad Faisal Khan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Health ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Care Providers ◽  
Middle Income ◽  
Adequate Knowledge ◽  
Unit Design ◽  
Information Technologists

Optimum ICU design has pivotal role in critical care delivery that has major impact on physical and psychological health of the patients, physicians and other related staff. Its structure formation is complex and demands the dedicated involvement of not only care providers but also a trained and multi-professional team of architect, engineer and information technologists, etc. This paper tracks the journey from traditional design to recent advances in building the intensive care unit. The limitations in ICU design observed in the lower to middle income countries will also be discussed in this review. Specialist hospital architects are scarce in these countries and the ordinary civil engineering does not impart adequate coaching on matters related to lay-out plans as well as the various minute details about fittings and provisions. Hence, it becomes imperative for the anesthesiologists and other healthcare providers to come to guide and assistance to the architects involved in designing the blue prints. It may only be possible if they have adequate knowledge and professional experience.Citation: Butt MN, Khan MF. Intensive Care Unit design; from advance to basic. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S17-S20

scholarly journals Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

2021 ◽  
Vol 4 ◽  
pp. 19
Author(s):  
Subhash Chander ◽  
Ines Gonzalez-Casanova ◽  
Sandra S. Chaves ◽  
Nancy A. Otieno ◽  
Marc-Alain Widdowson ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Critical Role ◽  
Healthcare Providers ◽  
Attitudes And Beliefs ◽  
Care Providers ◽  
Middle Income ◽  
Maternal Immunization ◽  
Maternal Vaccination ◽  
Vaccine Recommendations ◽  
And Behavior

Background: Maternal immunization is known to be one of the best strategies to protect both mothers and their infants from infectious diseases. Studies have shown that healthcare providers play a critical role in implementation of maternal immunization. However, little is known about providers’ attitudes and beliefs towards vaccination that can influence their vaccine recommendations, specifically in low to middle income countries (LMIC). Methods: A self-administrated knowledge, attitude and behavior (KAB) survey was provided to 150 antenatal care providers across four different regions (Nairobi, Mombasa, Marsabit, and Siaya counties) of Kenya. The research staff visited the 150 clinics and hospitals and distributed a quantitative KAB survey. Results: Nearly all of the antenatal care providers (99%) recommended tetanus maternal vaccination. Similarly, 99% of the providers agreed that they would agree to provide additional vaccinations for pregnant women and reported that they always advise their patients to get vaccinated. Between 80 and 90% of the providers reported that religious beliefs, ethnicity, cultural background and political leaders do not affect their attitude or beliefs towards recommending vaccines. Conclusions: Considering the positive responses of healthcare providers towards vaccine acceptance and recommendation, these results highlight an opportunity to work in partnership with these providers to improve coverage of maternal vaccination and to introduce additional vaccines (such as influenza). In order to achieve this, logistical barriers that have affected the coverage of the currently recommended vaccines, should be addressed as part of this partnership.

scholarly journals Assessment of Facility based newborn care at various health care facilities in Rajkot district

2017 ◽  
Vol 4 (4) ◽  
pp. 1125
Author(s):  
Jasmin R. Oza ◽  
Ashutosh D. Jogia ◽  
Bhavesh R. Kanabar ◽  
Dhara V. Thakrar
Keyword(s):  
Health Care ◽  
Health Personnel ◽  
Newborn Care ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Centers ◽  
Care Providers ◽  
Digital Thermometer ◽  
Neonatal Deaths ◽  
District Hospitals

Background: India carries the single largest share (around 25-30%) of neonatal deaths in the world. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively with high coverage.Methods: A cross-sectional observational study was conducted at various health facilities of Rajkot district where facility based newborn care are created as per the guidelines under NRHM. It was conducted during August 2013 to October, 2013. The data entry was done in Microsoft Office Excel 2007 and analyzed in Epi info software from CDC Atlanta. Results: This study included total 32 health facilities including 10 Primary Health Centers (PHC) (24X7), 15 Community Health Centers (CHC), 5 Sub District Hospitals (SDH), one District Hospital (DH) and one Medical College (MC). There are a total of 36 facilities of different level available in government set up for newborn care starting from NBCC to SNCU. All (100%) of the health centers visited were equipped with NBCC for newborn care, while NBSU and SNCU for newborn care were created at only 2 (6.2%) centers respectively. Only 2 out of 10 PHC had all required equipments for NBCC. All the required equipments were available at 3 CHCs out of total 15 CHCs. All the SDH were having adequate equipment for NBCC except resuscitator & separate Digital Thermometer were not available at 2 SDH. At DH, except for Digital thermometer, all equipments were adequate. Only 1 SDH has been established for NBSU and it did not have adequate no. of radiant warmer and resuscitator. DH is lacking in all the required equipment for SNCU except for resuscitator (250 ml) and refrigerator. Out of total 101 health personnel, 68 (67.3%) have been trained for NSSK.  From total 68 trained health personnel, 12 (17.7%) got the score above the cut off for resuscitation skill. Out of the trained respondents, 29 (42.7%) acquired score above cut off for routine care.Conclusion: All the PHCs, CHCs, SDHs and DH were deficient in equipments. NBSU was created in only one SDH. SNBU was created at DH and MC, but equipments were not sufficient at both centers. Health care providers involved in facility based newborn care units had poor knowledge regarding routine newborn care and also not properly trained in resuscitation.

scholarly journals Just-in-time postnatal education programees to improve newborn care practices: needs and opportunities in low-resource settings

2020 ◽  
Vol 5 (7) ◽  
pp. e002660
Author(s):  
Laura Subramanian ◽  
Seema Murthy ◽  
Prasad Bogam ◽  
Shirley D Yan ◽  
Megan Marx Delaney ◽  
...  
Keyword(s):  
Survey Data ◽  
Newborn Care ◽  
Just In Time ◽  
Evidence Based ◽  
Care Seeking ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Education Model ◽  
Care Practices

Worldwide, many newborns die in the first month of life, with most deaths happening in low/middle-income countries (LMICs). Families’ use of evidence-based newborn care practices in the home and timely care-seeking for illness can save newborn lives. Postnatal education is an important investment to improve families’ use of evidence-based newborn care practices, yet there are gaps in the literature on postnatal education programees that have been evaluated to date. Recent findings from a 13 000+ person survey in 3 states in India show opportunities for improvement in postnatal education for mothers and families and their use of newborn care practices in the home. Our survey data and the literature suggest the need to incorporate the following strategies into future postnatal education programming: implement structured predischarge education with postdischarge reinforcement, using a multipronged teaching approach to reach whole families with education on multiple newborn care practices. Researchers need to conduct robust evaluation on postnatal education models incorporating these programee elements in the LMIC context, as well as explore whether this type of education model can work for other health areas that are critical for families to survive and thrive.

scholarly journals High Neonatal Mortality Rates in Rural India: What Options to Explore?

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Ravi Prakash Upadhyay ◽  
Palanivel Chinnakali ◽  
Oluwakemi Odukoya ◽  
Kapil Yadav ◽  
Smita Sinha ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Rural Areas ◽  
Relevant Literature ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Neonatal Care ◽  
Standards Of Care ◽  
Neonatal Health ◽  
Middle Income ◽  
Trained Manpower

The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as “m-health” and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.

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