Mothers’ Experiences and Perceptions of Facility-based Delivery Care in Rural Ethiopia

In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care.

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Determinants of Disparity between Antenatal Bookings and Institutional Deliveries in Port Harcourt, Southern Nigeria

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i130346 ◽

2020 ◽

pp. 21-30

Author(s):

Terhemen Kasso ◽

Ojimah Chibianotu ◽

Rosemary Ogu

Keyword(s):

Qualitative Study ◽

Antenatal Care ◽

Health Workers ◽

Structured Interview ◽

Cost Of Care ◽

Skilled Birth Attendants ◽

Mortality And Morbidity ◽

Birth Attendants ◽

Port Harcourt ◽

Depth Interviews

Aim: To determine the reasons why women deliver outside institutions where they register for antenatal care. Study Design: Qualitative study. Place and Duration of Study: Antenatal clinic of the University of Port Harcourt Teaching Hospital in February 2018. Methodology: A qualitative study using in-depth interviews (IDIs) was conducted in Port Harcourt, Nigeria to collect information on various reasons why women do not deliver where they received antenatal care (ANC) or with skilled birth attendants (SBAs). This was done using structured interview guides. Specifically, we asked 30 pregnant women to elucidate the circumstances that lead women to deliver in places other than where they had received antenatal care, and recommendations to enhance the number of women delivering with skilled birth attendants. All in-depth interviews were audio-taped, transcribed and content-analyzed. Results: Thirty IDIs were carried out. The women were all pregnant; aged 20 to 43 years old with mean age of 32.9 ± 5.5 years. The broad themes that emerged from their responses: Cost/financial reasons relating to inability to afford the cost of care in the hospitals, personal reasons such as fear of Caesarean section, and hospital-related reasons such as health workers’ strike action. Conclusion: Evidence from our study indicates that pregnant women’s non-use of skilled birth attendants during childbirth even when they received antenatal care in the hospital is mainly due to financial, personal and hospital-related reasons. These factors are modifiable and should be targeted to increase delivery with skilled attendants, a key strategy for the reduction of maternal and neonatal mortality and morbidity.

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Experience of Facility Based Childbirth in Rural Ethiopia: An Exploratory Study of Women’s Perspective

Journal of Pregnancy ◽

10.1155/2017/7938371 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Yohannes Mehretie Adinew ◽

Netsanet Abera Assefa

Keyword(s):

Health Care ◽

Health Care Providers ◽

Home Delivery ◽

Care Providers ◽

Skilled Birth Attendants ◽

Group Discussions ◽

Rural Ethiopia ◽

Birth Attendants ◽

Skilled Attendance ◽

Study Participants

Background. In Ethiopia, majority (62%) of pregnant women attend antenatal care at least once, yet only 26% deliver with skilled birth attendants in the available health units. Thus, this study explored beliefs and behaviors related to labour and skilled attendance among the women, their perspectives on health care providers, and traditional birth attendants. Methods. Sixteen key informant interviews and eight focus group discussions were conducted among purposively selected women who had previous experience of facility based childbirth but gave birth to their most recent child without skilled attendance in the last 12 months. Thematic content analysis was used to elicit and assess the various perspectives of each group of participants interviewed. Findings. The study participants described a range of experiences they had during childbirth at health facilities that forced them to choose home delivery in their most recent delivery. Three themes and six subthemes emerging from women’s description were abusive and disrespectful treatment, unskilled care, poor client provider interaction, noncontinuous care, lack of privacy, and traditional practices. Conclusion. The abuse and disrespect from providers are deterring women from seeking skilled attendance at birth. Thus the health care providers need to improve client provider relationships.

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Development of healthcare facility standards for Thai female inmates

International Journal of Prisoner Health ◽

10.1108/ijph-07-2017-0032 ◽

2018 ◽

Vol 14 (3) ◽

pp. 163-174 ◽

Cited By ~ 1

Author(s):

Nantaga Sawasdipanich ◽

Supa Puektes ◽

Supaporn Wannasuntad ◽

Ankana Sriyaporn ◽

Chulepon Chawmathagit ◽

...

Keyword(s):

Healthcare Facility ◽

Healthcare Services ◽

Phase Iii ◽

Service Improvement ◽

Female Inmates ◽

Improvement Project ◽

Content Type ◽

Screening Programs ◽

Activity Promotion ◽

Depth Interviews

Purpose The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement. Design/methodology/approach This research and quality improvement project was comprised of three phases. Surveying healthcare facilities and in-depth interviews with female inmates as well as prison nurses were employed in Phase I. Expert reviews and public hearing meetings were used for developing the SHF-TFI in Phase II. Satisfaction questionnaires, focus group interviews of the female inmates, and in-depth interviews with nurses and prison wardens were utilized to evaluate feasibility and effectiveness of SHF-TFI implementation in Phase III. Findings The SHF-TFI was elaborated in order to be more specific to the context of the correctional institutes and correspond with healthcare as to the needs of female inmates. It was divided into three main aspects: administrative standards, health service standards and outcome standards. After implementation, nurses reflected on the feasibility and benefits of the SHF-TFI on the organizations, inmates and nurses. The female inmates perceived remarkable improvement in the healthcare services including physical activity promotion and screening programs for non-communicable diseases, the physical environment and sufficiency of medical equipment. Moreover, the pregnant inmates and incarcerated mothers with children shared their views on better antenatal and child developmental care, as well as availability of baby supplies. Originality/value The findings support the feasibility and effectiveness of the SHF-TFI for quality care improvement and applicability of the Bangkok Rules in women’s correctional institutes.

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The Children’s Hospital of the Future: A Vision That Meets All Needs

HERD Health Environments Research & Design Journal ◽

10.1177/19375867211058851 ◽

2021 ◽

pp. 193758672110588

Author(s):

Barbara Więckowska ◽

Katarzyna Byszek ◽

Maciej Malenda

Keyword(s):

Future Development ◽

Design Thinking ◽

Healthcare Facility ◽

Healthcare Services ◽

Model Driven ◽

Children's Hospital ◽

The Future ◽

Children’S Hospital ◽

Future Care ◽

Depth Interviews

Objectives: The objective of this article is twofold. First, to present a comprehensive internal assessment of the hospital by different groups of stakeholders and, second, to determine whether there are common needs and wishes that, if incorporated in the hospital vision, will enable future development. Background: The Children’s Memorial Health Center is the largest children’s hospital in Poland. The hospital began operations in 1977 with a vision to be a modern healthcare facility that provides comprehensive care for children. That vision has not changed over time but everything else did. Methods: Six design thinking sessions were conducted with 83 employees and 40 respondents who used health services in the hospital in the past, along with in-depth interviews with 25 representatives of management to gather data for the hospital assessment. Results: Sixty-three features influencing future development were identified. Seven groups of features were classified to be either transformation drivers (four groups) or enablers (three groups). We focused on features that were indicated by all groups of respondents to define a common vision for future development. Conclusions: Depending on the respondent’s role in the healthcare ecosystem, the list of variables within each of seven groups defining the “hospital of the future” was different while evaluating the healthcare services. Therefore, all stakeholders must be engaged in the ideation process to create a strategy for a future care model driven by innovation.

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ASSESSMENT OF SKILLED BIRTH ATTENDANTS REGARDING HELPING BABIES BREATH INTERVENTION TO IMPROVE NEWBORN CARE IN RURAL DISTRICT OF SINDH

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i1.24 ◽

1970 ◽

Vol 7 (1) ◽

pp. 48-53

Author(s):

Sheh Mureed ◽

Muhammad Hassan Gandro ◽

Walid Hassan

Keyword(s):

Newborn Care ◽

Cross Sectional Study ◽

Vital Role ◽

Skilled Birth Attendants ◽

Cross Sectional ◽

Neonatal Deaths ◽

Birth Attendants ◽

Study Results ◽

Knowledge And Practice ◽

Labour Room

Background: Globally, 3.1 million newborn deaths occur every year out of these estimated 400,000 neonatal deaths occur in Pakistan. All neonatal deaths 99% take place in poorest region and countries of the world, usually within hours of birth; mostly the cause of neonatal deaths is hypoxia. To access knowledge and practice of SBAs regarding HBB and to access the availability of equipments required for HBB. Methods: Descriptive Cross-Sectional Study on SBAs as trained in HBB. All 46 SBAs trained on HBB working in Labour room eight rural Health centers, four Taluka, One district Head Quarter Health Facilities and thirteen Mlbcs of the district, were included in the sample for study. All 41 SBAs were trained on HBB participated in the study. Results: Mean age of 30 years. Out of total 41 participants 25 were working in B-EmoNC (61%), 3in C-EmoNC (7.3%) and 13 in mid wife laid birth Centre (MLBC) or birth station (31.7%). About 92.7% of participants said that main purpose of HBB training is to decrease the NMR by improving newborn care. Drying of newborn is 82.7%, hand washing is 95.12% and 85.3% of the study participants said that they gave 30-40 breaths per minutes. Cord clamp and pair of ties was accessible to 85% of participants versus 14.3% who reported it's not accessible. Almost one quarter (34.1%) participants have low knowledge and practice. Knowledge and training had significant effect on the overall practices of the skilled birth attendants for skilled birth deliveries and reduce the neonatal deaths (P <0.001). Conclusion: Tools play a vital role for the implication of the knowledge into practices and tools were available almost to every participant. Although few barriers also identified for the less application of the helping hand babies trainings in the community.

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The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation

Children ◽

10.3390/children8060526 ◽

2021 ◽

Vol 8 (6) ◽

pp. 526

Author(s):

James Ditai ◽

Aisling Barry ◽

Kathy Burgoine ◽

Anthony K. Mbonye ◽

Julius N. Wandabwa ◽

...

Keyword(s):

Low Cost ◽

Neonatal Resuscitation ◽

Sub Saharan Africa ◽

Skilled Birth Attendants ◽

New Device ◽

Birth Attendants ◽

Premature Babies ◽

Sub Saharan ◽

The Uk ◽

The University

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

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A City Too Busy to Remember? Aging, Structural Violence, and the Politics of Forgetting in Atlanta’s Gentrification

Innovation in Aging ◽

10.1093/geroni/igaa057.1266 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 393-393

Author(s):

John Pothen ◽

Keland Yip ◽

Ellen Idler

Keyword(s):

Older Adults ◽

Structural Violence ◽

Aging In Place ◽

Healthcare Services ◽

The Past ◽

Critical Theories ◽

Property Owners ◽

Ongoing Development ◽

The City ◽

Depth Interviews

Abstract Can forgotten stories from the past inform a city’s future? As older adults continue to live longer and comprise more of the population than ever before, the suitability of gentrifying spaces for older adults aging in place is increasingly important. Critical theories of gentrification argue that remembering the experiences of older adults in this context - experiences of suffering, resilience, and structural violence - is essential to promote changes in support aging in place. In this study, we tell a story of individual experiences, structural violence, and aging in the ongoing gentrification of one neighborhood in southwest Atlanta. We construct this narrative through a qualitative analysis of 1,500 local newspaper articles from 1950 to the present day and 10 in-depth interviews with ex-residents of the neighborhood aged 65-87. Drawing on the theory of planetary rent gaps, we frame gentrification as a class struggle between property-owners and working class residents. We highlight the city government’s role as a facilitator for property-owners through projects including the Model City initiative, preparation for the 1996 Olympics, and ongoing development surrounding the Atlanta BeltLine. We show how these projects have affected the prospects for aging in place in general and, specifically, by affecting access to healthcare services. We share this story in an effort to combat the politics of forgetting and to inform a richer, more inclusive, and more equitable future for gentrifying spaces.

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Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

Nordic Journal of Nursing Research ◽

10.1177/2057158521994451 ◽

2021 ◽

pp. 205715852199445

Author(s):

Kristina Sundt Eriksen ◽

Sissel Iren Eikeland Husebø ◽

Hartwig Kørner ◽

Kirsten Lode

Keyword(s):

Colorectal Cancer ◽

Thematic Analysis ◽

Oldest Old ◽

Healthcare Services ◽

Hospital Data ◽

Colorectal Cancer Surgery ◽

Discharge From Hospital ◽

Depth Interviews ◽

Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

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