scholarly journals Funding received from breastmilk substitute manufacturers and policy positions of national maternity care provider associations: an online cross-sectional review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050179
Author(s):  
Salma Qassin ◽  
Caroline S E Homer ◽  
Alyce N Wilson
Keyword(s):  
Care Provider ◽  
Maternity Care ◽  
Financial Support ◽  
Perinatal Care ◽  
Professional Associations ◽  
Secondary Outcome ◽  
Care Providers ◽  
Cross Sectional ◽  
Breast Feed ◽  
Breastmilk Substitute

ObjectivesMaternity care providers play an essential role in supporting women to breast feed. It is critical that their professional associations limit influence from breastmilk substitute (BMS) manufacturers. Aims of this study were (i) to examine whether maternity care provider associations had policy or positions statements addressing BMS marketing and (ii) to explore the type of funding received by these associations.DesignAn online cross-sectional review.SettingNational or regional maternity provider professional associations in Australia, New Zealand, the USA, Canada and the UK.ParticipantsTwenty-eight maternity care provider (obstetricians, midwives, nurses and others involved in perinatal care) professional association websites.InterventionsWebsites were examined from November 2019 to October 2020.Primary and secondary outcome measuresEvidence of BMS industry funding and policy or position statements addressing acceptance of funding from industries such as BMS.ResultsPolicies addressing the BMS industry were found for 14 associations (50%). UK-based associations (5/5, 100%) and perinatal associations (4/6, 67%) were most likely to have a policy. Six associations (6/28, 21%) received some form of BMS financial support. The highest rates of BMS support were seen in the form of event advertising (5/28, 18%); closely followed by event sponsorship (4/28, 14%). At a provider level, obstetric associations had the highest rates of BMS support (2/4, 50%). At a country level, US-based associations were most likely to receive BMS support (3/7, 43%).ConclusionsBMS industry financial support was received by one-fifth of maternity care provider associations. Half of these associations had policies addressing BMS marketing. BMS industry support can create conflicts of interest that can threaten efforts to support, protect and promote breast feeding. Healthcare provider associations should avoid BMS funding and at a minimum have policy or position statements addressing BMS marketing.

scholarly journals Person-Centered Maternity Care During Childbirth and Associated Factors at Selected Public Hospitals in Addis Ababa, Ethiopia, 2021: A Cross-Sectional Study

2021 ◽  
Author(s):  
Azezew Ambachew Tarekegne ◽  
Berhanu Wordofa Giru ◽  
Bazie Mekonnen
Keyword(s):  
Health Care Providers ◽  
Maternity Care ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Person-centered maternity care is respectful and responsive care to individual women’s preferences, needs, and values and ensuring that their values guide all clinical decisions during childbirth. It is recognized as a key dimension of the quality of maternity care that increases client satisfaction and institutional delivery. However, little research has been conducted about person-centered maternity care in Ethiopia. Objective: The aim of this study was to assess the status of person-centered maternity care and associated factors among mothers who gave birth at selected public hospitals in Addis Ababa city, Addis Ababa, Ethiopia, 2021.Method: A facility-based cross-sectional study was conducted at selected public hospitals in Addis Ababa city. A semi-structured questionnaire was used to collect data from post-natal mothers selected by systematic random sampling. The data was coded and entered using Epi-data version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable linear regression analysis was used to identify factors associated with person-centered maternity care. The strength of association between independent and dependent variables was reported by using unstandardized β at 95% CI and p-value < 0.05 were considered statistically significant.Results: In this study 384 mothers were participated with a response rate of 99.2%. The overall prevalence of person-centered maternity care was 65.8%. Respondents who had no ANC follow-up (β= -5.39, 95% CI: -10.52, -0.26), <4 ANC follow up (β= -3.99, 95% CI: -6.63, -1.36), night time delivery (β= -3.95, 95% CI: -5.91, -1.98) and complications during delivery (β= -3.18, 95% CI: -6.01, -0.35) were factors significantly associated with person-centered maternity care.Conclusion and Recommendations: The finding of this study showed that the proportion of person-centered maternity care among mothers who gave birth in public hospitals of Addis Ababa was high as compared to previous studies. The factors affecting person-centered maternity care are manageable to interventions. Therefore, Health care providers need to provide person-centered maternity care for all mothers.

scholarly journals Is quality maternal healthcare all about successful childbirth? Views of mothers in the Wa Municipality, Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257401
Author(s):  
Linus Baatiema ◽  
Augustine Tanle ◽  
Eugene Kofuor Maafo Darteh ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Service Delivery ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
West Region ◽  
Adverse Pregnancy ◽  
Wa Municipality

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.

Disrespect and Abuse During Facility‐Based Childbirth in North Showa Zone, Ethiopia

2020 ◽  
Author(s):  
Yohannes Mehretie Adinew ◽  
Helen Hall ◽  
Amy Marshall ◽  
Janet Kelly
Keyword(s):  
Maternity Care ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Public Health Facility ◽  
Respectful Maternity Care ◽  
P Value ◽  
Disrespect And Abuse ◽  
Structural Factors ◽  
Care Providers ◽  
Cross Sectional

Abstract Background: Respectful maternity care is a fundamental human right, and an important component of quality maternity care that every childbearing woman should receive. Disrespect and abuse during childbirth is not only a violation of a women’s rights, it is associated with a reduction in the number of women accessing professional maternity services and increases the risk of maternal mortality. This study investigated women’s experience of disrespect and abuse during facility-based childbirth in Ethiopia. Methods: A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous twelve months in North showa zone of Ethiopia. A structured, researcher administered questionnaire was used with data collected using digital, tablet-based tools. Participants’ experiences were measured using the seven categories and verification criteria of disrespect and abuse identified by White Ribbon Alliance. Multivariable logistic regression was used to identify the association between experience of disrespect and abuse and interpersonal and structural factors at p-value < 0.05 and OR values with 95% confidence interval. Results: All participants reported at least one form of disrespect and abuse during childbirth. Types of disrespect and abuse experienced by participants were; physical abuse 435(100%), non-consented care 423(97.2%), non-confidential care 288 (66.2%), abandonment/ neglect (34.7%), non-dignified care 126(29%), discriminatory care 99(22.8%) and detention 24(5.5%). Hospital birth [AOR: 3.04, 95% CI: 1.75, 5.27], rural residence [AOR: 1.44, 95% CI: 0.76, 2.71], monthly household income less than 1,644 Birr (USD 57) [AOR: 2.26, 95% CI: 1.20, 4.26], being attended by female providers [AOR: 1.74, 95% CI: 1.06, 2.86] and midwifery nurses [AOR: 2.23, 95% CI: 1.13, 4.39] showed positive association with experience of disrespect and abuse. Conclusion: The level of disrespect and abuse is high and its drivers and enablers include both structural and interpersonal factors. Expanding the size and skill mix of professionals in the preferred facilities (hospitals), and sensitizing care providers and health managers regarding the magnitude and consequences of D&A are strategies that could possibly promote more dignified and respectful maternity care.

scholarly journals Respectful maternity care delivered within health facilities in Bangladesh, Ghana and Tanzania: a cross-sectional assessment preceding a quality improvement intervention

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039616
Author(s):  
Alexander Manu ◽  
Nabila Zaka ◽  
Christina Bianchessi ◽  
Edward Maswanya ◽  
John Williams ◽  
...  
Keyword(s):  
Emotional Support ◽  
Maternity Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Social Scientists ◽  
Cross Sectional ◽  
Respectful Care

ObjectiveTo assess respectful maternity care (RMC) in health facilities.DesignCross-sectional study.SettingForty-three (43) facilities across 15 districts in Bangladesh, 16 in Ghana and 12 in Tanzania.ParticipantsFacility managers; 325 providers (nurses/midwives/doctors)—Bangladesh (158), Ghana (86) and Tanzania (81); and 849 recently delivered women—Bangladesh (295), Ghana (381) and Tanzania (173)—were interviewed. Observation of 641 client–provider interactions was conducted—Bangladesh (387), Ghana (134) and Tanzania (120).AssessmentTrained social scientists and clinicians assessed infrastructure, policies, provision and women’s experiences of RMC (emotional support, respectful care and communication).Primary outcomeRMC provided and/or experienced by women.ResultsThree (20%) facilities in Bangladesh, four (25%) in Ghana and three (25%) in Tanzania had no maternity clients’ toilets and one-half had no handwashing facilities. Policies for RMC such as identification of client abuses were available: 81% (Ghana), 73% (Bangladesh) and 50% (Tanzania), but response was poor. Ninety-four (60%) Bangladeshi, 26 (30%) Ghanaian and 20 (25%) Tanzanian providers were not RMC trained. They provided emotional support during labour care to 107 (80%) women in Ghana, 95 (79%) in Tanzania and 188 (48.5%) in Bangladesh, and were often courteous with them—236 (61%) in Bangladesh, 119 (89%) in Ghana and 108 (90%) in Tanzania. Due to structural challenges, 169 (44%) women in Bangladesh, 49 (36%) in Ghana and 77 (64%) in Tanzania had no privacy during labour. Care was refused to 13 (11%) Tanzanian and 2 Bangladeshi women who could not pay illegal charges. Twenty-five (7%) women in Ghana, nine (6%) in Bangladesh and eight (5%) in Tanzania were verbally abused during care. Providers in all countries highly rated their care provision (95%–100%), and 287 (97%) of Bangladeshi women, 368 (97%) Ghanaians and 152 (88%) Tanzanians reported ‘satisfaction’ with the care they received. However, based on their facility experiences, significant (p<0.001) percentages—20% (Ghana) to 57% (Bangladesh)—will not return to the same facilities for future childbirth.ConclusionsFacilities in Bangladesh, Ghana and Tanzania have foundational systems that facilitate RMC. Structural inadequacies and policy gaps pose challenges. Many women were, however, unwilling to return to the same facilities for future deliveries although they (and providers) highly rated these facilities.

scholarly journals A descriptive study to determine the knowledge and practices related to tobacco cessation among clinicians attached to dental colleges in Bangalore City, India

2014 ◽  
Vol 17 (4) ◽  
pp. 106
Author(s):  
Naveen Narasimha Murthy ◽  
N. Vanishree
Keyword(s):  
Health Care Providers ◽  
Tobacco Cessation ◽  
Control Policy ◽  
Knowledge Score ◽  
Professional Associations ◽  
Mean Value ◽  
Care Providers ◽  
Tobacco Use Cessation ◽  
Cross Sectional ◽  
Bangalore City

<p><strong>Objective:</strong> Tobacco use cessation is critical in reducing the effect of a major factor for both oral &amp; systemic diseases. Its use continues to be the leading cause of preventable death worldwide with India accounting for probably a large chunk of these, due to its acceptance, both culturally and traditionally. Smoke and smokeless form of tobacco has become steady companion of today’s youth in India. <strong>Material and </strong><strong>Methods:</strong> A descriptive cross-sectional study was conducted to assess the knowledge and practices related to tobacco cessation among practicing dentists a sample size of 366 with inclusion and exclusion criteria attached to various dental colleges in Bangalore city. <strong>Results:</strong> Comparison of knowledge and practice among qualifications revealed that the knowledge score was more among the MDS professionals with a mean value of 78.3±7.9 and the practice score was also higher among the same with a mean value of 33.3±9. Comparison based on duration of practice revealed that the knowledge score was higher in dentists with experience of 0-5 years by a mean value of 78.4±7.5 and a higher practice score was found in dentists with an experience of 6-8 years with a mean value of 33.5±8.4. <strong>Conclusion:</strong> Physicians and health care providers in association with their national medical and health professional associations must play a leading role in advocating for the implementation of a comprehensive tobacco control policy and implementation of tobacco cessation methods should be included in the dental curriculum.</p>

scholarly journals Knowledge, attitude and practice of mothers and prospective mothers in neonatal care and utilization of perinatal care services

2020 ◽  
Vol 7 (5) ◽  
pp. 1134
Author(s):  
Pawankalyani Pinnamaneni ◽  
Joshna Mutyala ◽  
Ravikumar Chodavarapu
Keyword(s):  
Urban Areas ◽  
Perinatal Care ◽  
Neonatal Infection ◽  
Neonatal Care ◽  
Cross Sectional ◽  
Care Services ◽  
Attitude And Practice ◽  
Lactating Mothers ◽  
Breast Feed ◽  
Knowledge Attitude And Practice

Background: The present study was done with the aim to study existing knowledge, attitude and practice (KAP) about neonatal care, perinatal care and its services, among mothers (pregnant and lactating mothers).Methods: This cross-sectional study was done among 624 pregnant women and in mothers of newborn in both rural and urban areas around Vijayawada during the period from October 2015 to November 2017. A structured questionnaire reflecting KAP about neonatal care and perinatal care services was used in the study. The collected data was placed in a proforma and analysed.Results: Rural (53.8%) and urban (46.2%) mothers are equally represented in the present study. There is a slight preponderance of lactating mothers (52.2%). Most of the mothers are homemakers (82.1%) and belong to nuclear families (90.1%). There is a considerable deficiency in the knowledge nearly 45% ad practices nearly 40%, related to the number of ANC’s. The proportion of mothers receiving baby’s immunization advice from obstetrician is 18.5% and from paediatrician is 26.4%. Neonatal infection prevention was not advised in 71.3% of mothers and 23.5% mothers receive advice from obstetrician and 19.1% from paediatrician. The practice of staring first breast feed within one hour is not implemented about 88% of mothers. Nearly 30% of the mothers are not keeping the baby warm and nearly 90% of the mothers are not aware of KMC.Conclusions: The findings of the study conclude that there is a need for systematic and planned health education by the paediatrician and obstetrician to increase the KAP among mothers about neonatal health care.

scholarly journals Self-reported provision of person-centred maternity care among providers in Kenya and Ghana: scale validation and examination of associated factors

2021 ◽  
Vol 6 (12) ◽  
pp. e007415
Author(s):  
Patience A Afulani ◽  
Raymond A Aborigo ◽  
Jerry John Nutor ◽  
Jaffer Okiring ◽  
Irene Kuwolamo ◽  
...  
Keyword(s):  
Construct Validity ◽  
Maternity Care ◽  
Scale Validation ◽  
Care Providers ◽  
Validity And Reliability ◽  
Contributing Factors ◽  
Cronbach’S Alpha ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cronbach's Alpha

IntroductionPerson-centred maternity care (PCMC), which refers to care that is respectful and responsive to women’s preferences needs, and values, is core to high-quality maternal and child health. Provider-reported PCMC provision is a potentially valid means of assessing the extent of PCMC and contributing factors. Our objectives are to assess the psychometric properties of a provider-reported PCMC scale, and to examine levels and factors associated with PCMC provision.MethodsWe used data from two cross-sectional surveys with 236 maternity care providers from Ghana (n=150) and Kenya (n=86). Analysis included factor analysis to assess construct validity and Cronbach’s alpha to assess internal consistency of the scale; descriptive analysis to assess extent of PCMC and bivariate and multivariable linear regression to examine factors associated with PCMC.FindingsThe 9-item provider-reported PCMC scale has high construct validity and reliability representing a unidimensional scale with a Cronbach’s alpha of 0.72. The average standardised PCMC score for the combined sample was 66.8 (SD: 14.7). PCMC decreased with increasing report of stress and burnout. Compared with providers with no burnout, providers with burnout had lower average PCMC scores (β: −7.30, 95% CI:−11.19 to –3.40 for low burnout and β: −10.86, 95% CI: −17.21 to –4.51 for high burnout). Burnout accounted for over half of the effect of perceived stress on PCMC.ConclusionThe provider PCMC scale is a valid and reliable measure of provider self-reported PCMC and highlights inadequate provision of PCMC in Kenya and Ghana. Provider burnout is a key driver of poor PCMC that needs to be addressed to improve PCMC.

scholarly journals “I fought my entire way”: Experiences of declining maternity care services in British Columbia

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252645
Author(s):  
P. Mimi Niles ◽  
Kathrin Stoll ◽  
Jessie J. Wang ◽  
Stéphanie Black ◽  
Saraswathi Vedam
Keyword(s):  
British Columbia ◽  
Care Provider ◽  
Maternity Care ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Medical Knowledge ◽  
Newborn Care ◽  
Disrespect And Abuse ◽  
Service Users ◽  
Care Providers

Background The 2016 WHO Standards for improving quality of maternal and newborn care in health facilities established patient experience of care as a core indicator of quality. Global health experts have described loss of autonomy and disrespect as mistreatment. Risk of disrespect and abuse is higher when patient and care provider opinions differ, but little is known about service users experiences when declining aspects of their maternity care. Methods To address this gap, we present a qualitative content analysis of 1540 written accounts from 892 service users declining or refusing care options throughout childbearing with a large, geographically representative sample (2900) of childbearing women in British Columbia who participated in an online survey with open-ended questions eliciting care experiences. Findings Four themes are presented: 1) Contentious interactions: “I fought my entire way”, describing interactions as fraught with tension and recounting stories of “fighting” for the right to refuse a procedure/intervention; 2) Knowledge as control or as power: “like I was a dim girl”, both for providers as keepers of medical knowledge and for clients when they felt knowledgeable about procedures/interventions; 3) Morbid threats: “do you want your baby to die?”, coercion or extreme pressure from providers when clients declined interventions; 4) Compliance as valued: “to be a ‘good client’”, recounting compliance or obedience to medical staff recommendations as valuable social capital but suppressing desire to ask questions or decline care. Conclusion We conclude that in situations where a pregnant person declines recommended treatment, or requests treatment that a care provider does not support, tension and strife may ensue. These situations deprioritize and decenter a woman’s autonomy and preferences, leading care providers and the culture of care away from the principles of respect and person-centred care.

La Crisis de la Atención de Maternidad: Experts’ Perspectives on the Syndemic of Poor Perinatal Health Outcomes in Puerto Rico

2021 ◽  
Vol 80 (1) ◽  
pp. 2-16
Author(s):  
Holly Horan ◽  
Melissa Cheyney ◽  
Yvette Piovanetti ◽  
Vanessa Caldari
Keyword(s):  
Puerto Rico ◽  
Health Outcomes ◽  
Puerto Rican ◽  
Maternity Care ◽  
Infant Health ◽  
Perinatal Care ◽  
Perinatal Health ◽  
Care Providers ◽  
Structured Interviews ◽  
Contributing Factors

The purpose of this study was to center the voices of maternal and infant health care (MIH) clinicians and public health experts to better understand factors associated with persistently high rates of poor perinatal health outcomes in Puerto Rico. Currently, Puerto Rican physicians, midwives, and other care providers’ perspectives are absent from the literature. Guided by a syndemics framework, data were collected during eighteen months of ethnographic fieldwork and through open-ended, semi-structured interviews (n=20). Three core themes emerged. The first two themes: (1) Los estresores diarios: poor nutrition, contaminated water, and psychosocial stress; and (2) Medicina defensiva: solo obstetrics and fear-based medicine, describe contributing factors to Puerto Rico’s high preterm and cesarean birth rates. The third theme: (3) Medicina integrada: midwives, doulas, and comprehensive re-education explores potential solutions to the island’s maternity care crisis that include improved integration of perinatal care services and educational initiatives for both patients and providers. Collectively, participants’ narratives expose a syndemic of poor perinatal health outcomes that emerges from the structural vulnerability generated by decades of colonial domination embedded in the daily lives of island residents and in the Puerto Rican maternity care system.

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