Why some women fail to give birth at health facilities: a qualitative study of women’s perceptions of perinatal care from rural Southern Malawi

Abstract Background Perinatal care nurses are well positioned to provide the education and support new fathers need to navigate the transition to fatherhood and to encourage positive father involvement from the earliest hours of a child’s life. To effectively serve fathers in perinatal settings, it is important to understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage them, or alternatively alienate and discourage them. Methods This qualitative study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities. The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min. Data were analyzed using a qualitative descriptive approach. Results Overall, study participants held very positive subjective attitudes toward fathers and father involvement. Nevertheless, many of the nurses signaled normative beliefs based on race/ethnicity, gender, and culture that may moderate their intention to engage with fathers. Participants also indicated that their education as well as the culture of perinatal healthcare are focused almost entirely on the mother-baby dyad. In line with this focus on mothers, participants comments reflected a normative belief that fathers are secondary caregivers to their newborns, there to help when the mother is unavailable. Conclusions Nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them. Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care.

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Disclosure of Depression in Primary Care: A Qualitative Study of Women’s Perceptions

Women s Health Issues ◽

10.1016/j.whi.2016.07.002 ◽

2016 ◽

Vol 26 (5) ◽

pp. 529-536 ◽

Cited By ~ 9

Author(s):

Abiola O. Keller ◽

Carmen R. Valdez ◽

Rebecca J. Schwei ◽

Elizabeth A. Jacobs

Keyword(s):

Primary Care ◽

Qualitative Study ◽

Women’S Perceptions

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Acceptability of lifelong treatment among HIV-positive pregnant and breastfeeding women (Option B+) in selected health facilities in Zimbabwe: a qualitative study

BMC Public Health ◽

10.1186/s12889-017-4611-2 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 10

Author(s):

Addmore Chadambuka ◽

Leila Katirayi ◽

Auxilia Muchedzi ◽

Esther Tumbare ◽

Reuben Musarandega ◽

...

Keyword(s):

Qualitative Study ◽

Health Facilities ◽

Hiv Positive

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Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

10.52916/jogs214011 ◽

2021 ◽

pp. 1-9

Author(s):

Clara Opha Haruzivishe

Keyword(s):

Perinatal Care ◽

Neonatal Morbidity ◽

Health Facilities ◽

Sub Saharan Africa ◽

Morbidity And Mortality ◽

World Health ◽

Performance Standard ◽

Cross Sectional ◽

Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

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A qualitative study on factors that influence women’s choice of delivery in health facilities in Addis Ababa, Ethiopia

BMC Pregnancy and Childbirth ◽

10.1186/s12884-016-1105-7 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 14

Author(s):

Tigest Shifraw ◽

Yemane Berhane ◽

Hanna Gulema ◽

Tamil Kendall ◽

Anne Austin

Keyword(s):

Qualitative Study ◽

Addis Ababa ◽

Health Facilities

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Evaluation of Measles Surveillance Systems in Ginnir District, Bale Zone, Southeast Ethiopia: A Concurrent Embedded Mixed Quantitative/Qualitative Study

10.21203/rs.3.rs-115297/v1 ◽

2020 ◽

Author(s):

Falaho Sani ◽

Mohammed Hasen ◽

Mohammed Seid ◽

Nuriya Umer

Keyword(s):

Public Health ◽

Qualitative Study ◽

Surveillance System ◽

Public Health Surveillance ◽

Health Surveillance ◽

Health Facilities ◽

Surveillance Data ◽

Surveillance Systems ◽

Southeast Ethiopia ◽

Bale Zone

Abstract Background: Public health surveillance systems should be evaluated periodically to ensure that the problems of public health importance are being monitored efficiently and effectively. Despite the widespread measles outbreak in Ginnir district of Bale zone in 2019, evaluation of measles surveillance system has not been conducted. Therefore, we evaluated the performance of measles surveillance system and its key attributes in Ginnir district, Southeast Ethiopia.Methods: We conducted a concurrent embedded mixed quantitative/qualitative study in August 2019 among 15 health facilities/study units in Ginnir district. Health facilities are selected using lottery method. The qualitative study involved purposively selected 15 key informants. Data were collected using semi-structured questionnaire adapted from Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems through face-to-face interview and record review. The quantitative findings were analyzed using Microsoft Excel 2016 and summarized by frequency and proportion. The qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings.Results: The structure of surveillance data flow was from the community to the respective upper level. Emergency preparedness and response plan was available only at the district level. Completeness of weekly report was 95%, while timeliness was 87%. No regular analysis and interpretations of surveillance data, and the supportive supervision and feedback system was weak. The participation and willingness of surveillance stakeholders in implementation of the system was good. The surveillance system was found to be useful, easy to implement, representative and can accommodate and adapt to changing conditions. Report documentation and quality of data was poor at lower level health facilities. Stability of the system has been challenged by shortage of budget and logistics, staff turnover and lack of update trainings.Conclusions: The surveillance system was acceptable, useful, simple, flexible and representative. Data quality, timeliness and stability of the system were attributes that require improvement. The overall performance of measles surveillance system in the district was poor. Hence, regular analysis of data, preparation and dissemination of epidemiological bulletin, capacity building and regular supervision and feedback are recommended to enhance performance of the system.

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Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda

Malaria Journal ◽

10.1186/s12936-015-1020-9 ◽

2016 ◽

Vol 15 (1) ◽

Cited By ~ 18

Author(s):

Robin Altaras ◽

Anthony Nuwa ◽

Bosco Agaba ◽

Elizabeth Streat ◽

James K. Tibenderana ◽

...

Keyword(s):

Qualitative Study ◽

Rural Health ◽

Health Workers ◽

Rapid Test ◽

Health Facilities ◽

Test Results ◽

Western Uganda

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Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda

Reproductive Health ◽

10.1186/1742-4755-11-21 ◽

2014 ◽

Vol 11 (1) ◽

Cited By ~ 107

Author(s):

Allen Kabagenyi ◽

Larissa Jennings ◽

Alice Reid ◽

Gorette Nalwadda ◽

James Ntozi ◽

...

Keyword(s):

Reproductive Health ◽

Qualitative Study ◽

Health Services ◽

Male Involvement ◽

Reproductive Health Services ◽

Rural Districts ◽

Women’S Perceptions ◽

Contraceptive Uptake

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User Perception Towards mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Study (Preprint)

10.2196/preprints.28628 ◽

2021 ◽

Author(s):

Jane Li ◽

David Silvera-Tawil ◽

Marlien Varnfield ◽

M Sazzad Hussain ◽

Vanitha Math

Keyword(s):

Qualitative Study ◽

Pregnant Women ◽

Mobile Applications ◽

Data Privacy ◽

Perinatal Care ◽

Well Being ◽

Technical Solution ◽

Pregnancy Care ◽

Health And Well Being ◽

In Pregnancy

BACKGROUND Mobile Health (mHealth) technologies, such as wearable devices and mobile applications have become popular for lifestyle and healthcare support. They have the potential to be beneficial for pregnancy monitoring, in the form of health and well-being tools to facilitate the tracking of health status changes, risks and complications of pregnant women. However, research on understanding clinicians’ and pregnant women’s interests, preferences and requirements for mHealth solutions tailored to pregnancy care is limited. OBJECTIVE This qualitative study aimed to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth to support the monitoring of health and well-being during pregnancy. METHODS Semi-structured interviews were conducted with four pregnant women, four postnatal women, and thirteen clinicians working in perinatal care. RESULTS Clinicians perceived the potential benefit of mHealth in supporting different levels of health and wellbeing monitoring, risk assessment and care provision in pregnancy care. The majority of women participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians can monitor the data. While some pregnancy-related medical conditions can be suitable for an mHealth model of remote monitoring, there are clinical and technical challenges for introducing mHealth in pregnancy care. Incorporating appropriate health and well-being measures, intelligent detection of abnormalities and tailored information for pregnant women were considered critical. Usability and data privacy were among the concerns of participants. The challenges of getting pregnant women engaged in longitudinal mHealth monitoring, the extra work required for clinicians in monitoring data, and the need for an evidence-based technical solution were highlighted. CONCLUSIONS mHealth technologies, such as wearable sensors, smart health devices and mobile applications capable of supporting the pregnancy journey are emerging. Clinical, technical and practical factors associated with the use of mHealth technologies to monitor health and well-being, as well as strategies for motivating pregnant women and clinicians’ in the use of the technologies need to be carefully considered before the introduction of mHealth pregnancy care routine and practices.

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