Usability and feasibility of a mobile health system to provide comprehensive antenatal care in low-income countries: PANDA mHealth pilot study in Madagascar

2016 ◽  
Vol 23 (5) ◽  
pp. 536-543 ◽  
Author(s):  
Anne Caroline Benski ◽  
Giovanna Stancanelli ◽  
Stefano Scaringella ◽  
Josea Léa Herinainasolo ◽  
Jéromine Jinoro ◽  
...  
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Mobile Health ◽  
Medical Data ◽  
Patient Records ◽  
Electronic Patient Records ◽  
High Quality

Background Madagascar’s maternal health mortality ratio in 2013 was 478 deaths per 100,000 live births. Most deaths are related to direct complications during pregnancy and childbirth and could be reduced by providing comprehensive antenatal care (ANC). Objective The objective of the study was to assess the usability and feasibility of a mobile health system (mHealth) to provide high-quality ANC, according to World Health Organization (WHO) recommendations. Methods PANDA (Pregnancy And Newborn Diagnostic Assessment) is an easy-to-use mHealth system that uses affordable communications technology to support diagnosis and health care worker decision-making regarding ANC. From January to March 2015, a cross-sectional pilot study was conducted in Ambanja District, Madagascar, in which ANC using PANDA was provided to 100 pregnant women. The collected data were transmitted to a database in the referral hospital to create individual electronic patient records. Accuracy and completeness of the data were closely controlled. The PANDA software was assessed and the number of abnormal results, treatments performed, and participants requiring referral to health care facilities were monitored. Results The PANDA system facilitated creation of individual electronic patient records that included socio-demographic and medical data for 100 participants. Duration of ANC visits averaged 29.6 min. Health care providers were able to collect all variables (100%) describing personal and medical data. No major technical problems were encountered and no data were lost. During 17 ANC visits (17%), an alert function was generated to highlight abnormal clinical results requiring therapy or referral to an affiliated hospital. Participants’ acceptability of the system was very high. Conclusion This pilot study proved the usability and feasibility of the PANDA mHealth system to conduct complete and standardised ANC visits according to WHO guidelines, thus providing a promising solution to increase access to high-quality and standardised ANC for pregnant women in remote areas.

scholarly journals Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Saidi Mgata ◽  
Stephen Oswald Maluka
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Cultural Beliefs ◽  
Dar Es Salaam ◽  
World Health ◽  
Health Providers ◽  
Care Workers

Abstract Background Antenatal care (ANC) provided by a trained health care provider is important for monitoring pregnancy thereby reducing potential risks for the mother and child during pregnancy and delivery. The World Health Organization (WHO) recommends at least four ANC visits to all pregnant women. While the proportion of women who attend at least one ANC in low-income countries is high, most pregnant women start their first ANC attendance very late. In Tanzania only 24% of pregnant women start their first ANC attendance before the fourth month of pregnancy. While factors for the utilization of antenatal care in general have been widely studied, there is paucity of studies on the factors affecting timing of the first ANC attendance. This study aimed to understand individual, community, and health system factors that lead to the delay in seeking ANC services among pregnant women in Ilala Municipal in Dar es Salaam region, Tanzania. Methods A qualitative exploratory study, using in-depth interviews with 20 pregnant women and five health care workers was conducted in three different health facilities in Dar es Salaam Tanzania. Thematic analysis approach was used to analyse the data. Results Individual perceptions of antenatal care, past experience with pregnancy, fear of pregnancy disclosure, and socio-cultural beliefs were the key individual and social factors for late ANC attendance. Shortage of trained health care workers, lack of spouse’s escort and health providers’ disrespect to pregnant women were the main health system barriers to early ANC attendance. Conclusions This study concludes that community members should be sensitized about the importance of early ANC attendance. Additionally, while spouse’s escort policy is important for promoting PMTCT, the interpretation of the policy should not solely be left to the health providers. District and regional health officials should provide correct interpretation of this policy.

Issues of co-financing of drug provision for the population: international and Russian practice

2020 ◽  
pp. 49-56
Author(s):  
Vasiliy Ryazhenov ◽  
Victoriya Andreyeva ◽  
Elena Zakharochkina
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health System ◽  
Health Care System ◽  
Russian Federation ◽  
High Quality ◽  
Russian President ◽  
The Russian Federation ◽  
Vladimir Putin ◽  
Drug Provision

Russian President Vladimir Putin defined increase in life expectancy from 72.7 to 78 years by 2024 as a national aim in the Decree № 204 of May 7, 2018. Achievement of this aim depends on drug provision system among other factors. Strategy of drug provision for the population of the Russian Federation for the period until 2025 sets the goal of increasing availability of high quality, effective and safe medicines to meet needs of the population and the health system based on the formation of a rational and balanced system of drug provision for the population of the country with available resources. The health care system should expand the possibilities of using modern and effective mechanisms to ensure the financing of drug provision for the population.

scholarly journals A mixed reception: perceptions of pregnant adolescents’ experiences with health care workers in Cape Town, South Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ronel Sewpaul ◽  
Rik Crutzen ◽  
Natisha Dukhi ◽  
Derrick Sekgala ◽  
Priscilla Reddy
Keyword(s):  
South Africa ◽  
Health Care ◽  
Antenatal Care ◽  
Health Care Workers ◽  
Cape Town ◽  
Pregnant Adolescents ◽  
High Quality ◽  
Care Workers ◽  
Antenatal Clinics ◽  
Antenatal Services

Abstract Background Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. Methods Pregnant girls aged 13–19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. Results Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. Conclusions There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.

scholarly journals Exploring COVID-19 Related Factors Influencing Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Southwest Ethiopia

2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Care Service ◽  
Maternal Health Service ◽  
Related Factors ◽  
Factors Influencing

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.

scholarly journals Attitudes of Pregnant Women Towards Antenatal Care Services Provided in Primary Health Care Facilities of Mbombela Municipality, Mpumalanga Province, South Africa

2020 ◽  
Vol 13 (1) ◽  
pp. 569-575
Author(s):  
Lucia Drigo ◽  
Masane Luvhengo ◽  
Rachel T. Lebese ◽  
Lufuno Makhado
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Health Care Facilities ◽  
Care Services ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.

scholarly journals TINGKAT KECEMASAN IBU HAMIL TERHADAP KUNJUNGAN ANTENATAL CARE DI MASA PANDEMI COVID-19

2021 ◽  
Vol 13 (01) ◽  
pp. 96
Author(s):  
Nining Sulistyowati ◽  
Yeti Trisnawati
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Personality Inventory ◽  
Health Care Facilities ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Pregnancy Anxiety ◽  
Care Facilities

ABSTRAKLatar belakang: Pandemi Covid-19 menyebabkan banyak pembatasan hampir ke semua layanan rutin termasuk pelayanan kesehatan maternal dan neonatal. Ibu hamil menjadi enggan ke puskesmas atau fasiltas pelayanan kesehatan karena takut tertular, adanya anjuran menunda pemeriksaan kehamilan dan kelas ibu hamil Kurangnya kunjungan ANC ini bisa menyebabkan bahaya bagi ibu maupun janin seperti terjadinya perdarahan saat masa kehamilan karena tidak terdeteksinya tanda bahaya. Tujuan penelitian: Untuk menganalisis kecemasan ibu hamil terhadap kunjungan antenatal care di masa pandemic covid-19. Metode: Penelitian analitik dengan rancangan cross sectional. Penelitian dilakukan di Praktik Mandiri Bidan di Kota Tanjungpinang dari bulan Januari – Februari 2021. Populasi seluruh ibu hamil TM III yang terdata di Praktik Mandiri Bidan di Kota Tanjungpinang dengan sampel sebanyak 32 responden. Teknik purposive sampling dengan kriteria antara lain ibu hamil dengan usia kehamilan trimester III, mampu mengungkapkan perasaan dan kecemasannya, mempunyai handphone dan nomor whatsapp, memiliki Buku KIA serta skor L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) <10. Hasil penelitian: Hasil uji statistik chi square diperoleh nilai p 0,016 (p<0,05) disimpulkan ada hubungan antara tingkat kecemasan ibu hamil dengan kunjungan antenatal care ke fasilitas pelayanan kesehatan di masa pandemi Covid-19. Simpulan: Hasil penelitian menunjukkan bahwa kunjungan ANC ibu hamil ke fasilitas pelayanan kesehatan pada masa pandemi covid-19 sebagian besar melakukan kunjungan ANC teratur 22 ibu hamil (68,8%), ibu hamil tidak mengalami kecemasan 9 (28,1%). Ibu hamil yang mengalami kecemasan dan tidak teratur melakukan kunjungan ANC sebanyak 12 ibu hamil (37,5%). Ibu hamil yang tidak mengalami cemas seluruhnya melakukan kunjungan ANC secara teratur yaitu 9 responden.Kata kunci: umur, Pendidikan, pekerjaan, kehamilan, kecemasan, frekuensi antenatal carePREGNANT MOTHER'S ANXIETY LEVELS ON ANTENATAL CARE VISITS DURING THE COVID-19 PANDEMICABSTRACTBackground: The Covid-19 pandemic has caused many restrictions on almost all routine services, including maternal and neonatal health services. Pregnant women are reluctant to go to the puskesmas or health service facilities for fear of contracting it, there are recommendations to postpone pregnancy checks and classes for pregnant women. This lack of ANC visits can cause danger to the mother and fetus, such as bleeding during pregnancy because no danger signs are detected. The purpose of the study: To analyze the anxiety of pregnant women regarding antenatal care visits during the covid-19 pandemic. Methods: Analytical research with cross sectional design. The study was conducted at the Independent Midwife Practice in Tanjungpinang City from January - February 2021. The population of all TM III pregnant women recorded at the Midwife Independent Practice in Tanjungpinang City with a sample of 32 respondents. Purposive sampling technique with criteria including pregnant women with the third trimester of pregnancy, being able to express their feelings and anxieties, having a cellphone and whatsapp number, having a KIA Book and an L-MMPI (Lie-Score Minnesota Multiphase Personality Inventory) score <10. Research results: The results of the chi square statistical test obtained a p value of 0.016 (p <0.05) it was concluded that there was a relationship between the level of anxiety of pregnant women and antenatal care visits to health care facilities during the Covid-19 pandemic. Conclusion: The results showed that ANC visits of pregnant women to health care facilities during the covid-19 pandemic mostly carried out regular ANC visits 22 pregnant women (68.8%), pregnant women did not experience anxiety 9 (28.1%). Pregnant women who experience anxiety and do not regularly visit ANC as many as 12 pregnant women (37.5%). Pregnant women who do not experience anxiety all make regular ANC visits, namely 9 respondents.Keywords: age, education, occupation, pregnancy, anxiety, antenatal care frequency.

scholarly journals Health care seeking behaviour of women during pregnancy in rural south India: a qualitative study

2017 ◽  
Vol 4 (10) ◽  
pp. 3636 ◽  
Author(s):  
Antony Vincent ◽  
K. Keerthana ◽  
Damotharan K. ◽  
Ariarathinam Newtonraj ◽  
Joy Bazroy ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Rural Area ◽  
South India ◽  
Care Seeking ◽  
Important Indicator ◽  
Good Opportunity ◽  
Study Population

Background: Antenatal care is an important indicator in any health system. Through our study we intended to assess the perception of pregnant women regarding health seeking behaviour and awareness about complications during pregnancy. Methods: A qualitative study was carried out in August 2016, among the 41 pregnant women over 27 weeks of gestation in a rural area of south India. Women were selected randomly from the routine surveillance system maintained by Pondicherry Institute of Medical Sciences – Rural Health Training Centre, Chunampet, Kancheepuram District. Interviews audio recorded. After verbatim, manual coding and analysis was done based on pre decided eight themes. Results: In general all the antenatal women aware of the importance of regular antenatal check up. Knowledge regarding complications and danger sign was not adequate. Most of the women in rural area seek care in government facility due to its availability, accessibility and affordability. Decision making in health care is mostly taken by their husbands. Transportation has been identified as a barrier in seeking health care. Conclusions: Although few of the antenatal mothers in the study population were aware about some complications of pregnancy, but in general knowledge among most of the women was inadequate. There is a need for creating awareness among the antenatal mothers about common complications in pregnancy. On the other hand, the notion of routine care seeking during the antenatal period seems to be well rooted among the study population which is a very good sign. It is a good opportunity and is foundational to all other interventions relating to betterment of antenatal care in the community. 

scholarly journals Do the quality of health care services provided at personal health care institutions of Kaunas city and access to it meet expectations of pregnant women

Medicina ◽  
2009 ◽  
Vol 45 (8) ◽  
pp. 652 ◽  
Author(s):  
Virginija Vanagienė ◽  
Birutė Žilaitienė ◽  
Tadas Vanagas
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Quality Of Health Care ◽  
Response Rate ◽  
Care Facility ◽  
Family Physicians ◽  
Personal Health ◽  
Health Care Institutions

Objectives. To evaluate if the quality of services provided by family physicians and obstetricians/gynecologists at primary personal health care institutions of Kaunas city and access to it meet the needs and expectations of pregnant women. Material and methods. Pregnant women visiting the selected health care institutions at their third trimester of pregnancy were asked to fill in the anonymous questionnaire. The study was conducted at two randomly selected maternity centers of Kaunas city and two family practices of Kaunas city where antenatal care was provided by family physicians. The questionnaires were given to 106 patients visiting family physicians (response rate was 88.7%) and to 202 patients visiting obstetricians/ gynecologists (response rate was 81.7%). Results. Health services provided by family physicians and obstetricians/gynecologists met the expectations of pregnant women in respect of providing with information and communication. The patients of obstetricians/gynecologists significantly more often stated that they were very satisfied with patient-physician communication (P<0.05), they significantly more often understood explanations given by the physician (P<0.001) and claimed having sufficient knowledge about pregnancy (P<0.05), while the patients of family physicians significantly more often asserted that the physician helped them in preparation for childbirth (P<0.05). The patients of obstetricians/gynecologists significantly more often did not face any problems with access to services as compared to the patients of family physicians (z=3.0). Most of pregnant women stated that they were satisfied or very satisfied with the quality of health care at the health care facility providing them with antenatal care irrespective of the physician’s specialty. Conclusions. The quality of antenatal health care provided by both family physicians and obstetricians/gynecologists and access to it satisfied the needs and expectations of the surveyed women. Correction of the limitations noticed, e.g., closer communication, more understandable explanations, more attention to preparation for childbirth, better work planning, could improve the quality of antenatal care provided by the family physicians.

Sign in / Sign up

Export Citation Format

Share Document