scholarly journals Why don't some women attend antenatal and postnatal care services?: a qualitative study of community members' perspectives in Garut, Sukabumi and Ciamis districts of West Java Province, Indonesia

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Christiana R Titaley ◽  
Cynthia L Hunter ◽  
Peter Heywood ◽  
Michael J Dibley
Author(s):  
Amber Mehmood ◽  
Shirin Wadhwaniya ◽  
Esther Bayiga Zziwa ◽  
Olive C Kobusingye

Abstract Background Emergency care services in low-and middle-income countries (LMICs) have traditionally received less attention in the dominant culture favouring vertical health programs. The unmet needs of pre-hospital and hospital-based emergency services are high but the barriers to accessing safe and quality emergency medical services (EMS) remain largely unaddressed. Few studies in Sub-Saharan Africa have qualitatively investigated barriers to EMS use, and quality of pre-hospital services from the providers and community perspective. We conducted a qualitative study to describe the patient-centred approach to emergency care in Kampala, Uganda, with specific attention to access to EMS.Methods The data collection was comprised of Key Informant Interviews (KII) and Focus Group Discussions (FGDs) with the community members. KII participants were selected using maximum purposive sampling based on expert knowledge of emergency care systems, and service delivery. FGDs were conducted to understand perceptions and experiences towards access to pre-hospital care, and to explore barriers to utilization of EMS. The respondents of ten KII and seven FGDs included pre-hospital EMS (PEMS) administrators, policy makers, police, health workers and community members. We conducted a directed content analysis to identify key themes and triangulate findings across different informant groups.Results Key themes emerged across interviews and discussions concerning: (1) lack of funds, (2) lack of standards, (3) need for upfront payments for emergency transport and care, 4) corruption, 5) poor quality pre-hospital emergency service, 6) poor quality hospital emergency care, and 7) delay in seeking treatment.Conclusions Patient-centred emergency care should be an integral part of comprehensive health care services. As Uganda and other LMICs continue to strive for universal health coverage, it is critical to prioritize and integrate emergency care within health systems owing to its cross-cutting nature. Community perceptions around access and quality of PEMS should be addressed in national policies covering affordable and safe EMS.


Author(s):  
Neelima Singh ◽  
Satyendra Nath Ponna ◽  
Venkata Prasad Upadrasta ◽  
Shankar Reddy Dudala ◽  
Renuka Sadasivuni

Background: Variation exists in utilization of antenatal and postnatal care services in public health facilities of developing countries. Provision of antenatal and postnatal care services is the major function of public health delivery system of India to improve maternal health outcomes. The objective of this study is to estimate the determinants of utilization of antenatal and postnatal care services stratified by geographical region in Telangana.Methods: It is a cross-sectional study of District Level Health and Facility Survey-4 of the state of Telangana. Multistage, stratified, probability proportional to size sample with replacement was used. 3065 women, who delivered after the year 2008, were considered for analysis. Descriptive analysis of components of antenatal and postnatal care services stratified by geographical region was carried out. Binomial logistic regression was carried out to determine association of demographic, system level variables with adequate antenatal care.Results: Study reveals variation exists across four regions of Telangana in utilization of maternal health services. Reception of adequate antenatal care is low in South region (20.6%) and high in East region (31.5%). Pregnant women with secondary education were 66% more likely to receive adequate antenatal care services compared to illiterate.Conclusions: Short term and long-term goals to be adopted and implemented by government to address the demand-supply imbalance such as public health infrastructure and quality of services in underperforming districts of Telangana to increase utilization of maternal health services by training health staff and engaging local communities to seek health care services.


2016 ◽  
Vol 13 (1) ◽  
Author(s):  
Sharon Eva Ahumuza ◽  
Joseph Rujumba ◽  
Abdallah Nkoyooyo ◽  
Raymond Byaruhanga ◽  
Rhoda K. Wanyenze

1970 ◽  
Vol 2 (2) ◽  
Author(s):  
Mayumi Mizutani ◽  
Junko Tashiro ◽  
Nia Damiati ◽  
Uswatun Khasanah

This study aimed to explore perceptions about a healthy-eating lifestyle and reasons to practice a healthy-eating lifestyle of women with type 2 diabetes in a city of West Java by using a case study design. Six female patients, with type 2 diabetes, ages 47–63 from a hospital were interviewed guided by the health promotion model. Their healthy-eating lifestyle included currently practicing or not practicing a healthy-eating lifestyle. Reasons to practice were: beliefs for health and for physical energy to work for family, definition of multidimensional health and self-efficacy increased by: support from God, support from family, support from health professionals and improved or deteriorated health status by prior experience. Reasons not to practice were: difficulty in arranging diet, rejecting eating, controlling appetite, and accessing health care services. Related difficulties were interpersonal relations with family and social situation such as social events, expensive medical fee, and distance to the hospital. These findings suggest that women with type 2 diabetes in Indonesia need to be supported with the reasons to practice a healthy-eating lifestyle.Key words:Diet, health promotion, Indonesia, type 2 diabetes, women AbstrakTujuan dari penelitian ini adalah untuk mengeksplorasi persepsi tentang gaya hidup mengonsumsi makanan sehat dan alasan untuk mempraktikkan gaya hidup memakan makanan sehat pada wanita penderita diabetes tipe 2 di satu kota di Jawa Barat dengan menggunakan desain penelitian studi kasus. Enam pasien wanita penderita diabetes tipe 2 berumur antara 47–63 tahun. Penelitian ini dilakukan di sebuah rumah sakit. Pasien diwawancara secara terbimbing menggunakan model promosi kesehatan. Gaya hidup partisipan dalam mengonsumsi makanan sehat dinilai dalam penelitian ini, termasuk yang sedang dipraktikkan atau tidak sedang dipraktikkan. Hasil penelitian menunjukkan alasan partisipan untuk mengonsumsi makanan sehat adalah: keyakinan untuk sehat dan kekuatan fisik untuk bekerja bagi keluarga, definisi kesehatan multidimensi dan efikasi diri meningkat oleh dukungan Tuhan, dukungan dari keluarga, dukungan dari petugas kesehatan, dan meningkatnya atau menurunnya status kesehatan oleh pengalaman sebelumnya. Alasan untuk tidak mengonsumsi makanan sehat adalah kesulitan dalam: mengatur diet, menolak makan, mengontrol nafsu makan, dan kesulitan mengakses pelayanan kesehatan. Kesulitan-kesulitan yang terkait dengan masalah ini adalah hubungan interpersonal dengan keluarga dan situasi sosial seperti acara-acara sosial, biaya medis yang mahal, dan jarak ke rumah sakit. Penelitian ini menyarankan peningkatan dukungan bagi wanita penderita diabetes tipe 2 di Indonesia agar mempraktikkan gaya hidup memakan makanan yang sehat.Kata kunci:Diabetes tipe 2, Indonesia, makanan, promosi kesehatan, wanita


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.


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