scholarly journals Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Taposh Kumar Biswas ◽  
Hasnat Sujon ◽  
M. Hafizur Rahman ◽  
Henry B. Perry ◽  
Mahbub Elahi Chowdhury
Keyword(s):  
Public Health ◽  
Service Delivery ◽  
Healthcare Service ◽  
Infection Prevention ◽  
Health Facilities ◽  
Quality Monitoring ◽  
Public Health Facilities ◽  
Care Services ◽  
Maternal And Newborn

Abstract Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. Methods The study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (> 80%), moderate (50 to 80%), and low (< 50%). Results Overall QoC scores were moderate for each DH (54.8%), and MCWC (56.1%). In DH, the QoC score was high for blood transfusion (80.3%); moderate for maternal complications management (77.0%), caesarean section (CS) (65.6%), infection prevention (64.3%), sick newborn care (54.1%), and normal vaginal delivery (NVD) (52.6%); and low for antenatal care (ANC) (25.6%) and postnatal care (PNC) (19.0%). In MCWC, the QoC scores were high for infection prevention (83.0%); moderate for CS (76.5%) and NVD (59.8%); and low for ANC (36.9%) and PNC (24.5%). Conclusions In the study facilities, the QoC for MNH services is found to be unsatisfactory, particularly for ANC and PNC. Urgent initiative needs to be taken by introducing contextualized quality monitoring tools at health facilities, along with training of the care providers and introducing a quality monitoring system.

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

Quality of Routine Health Information System Data and Associated Factors Among Departments in Public Health Facilities of Harari Region, Ethiopia

2021 ◽  
Author(s):  
Adisu Tafari Shama ◽  
Hirbo Shore Roba ◽  
Admas Abera ◽  
Negga Baraki
Keyword(s):  
Public Health ◽  
Information System ◽  
Data Quality ◽  
Health Information ◽  
Health Information System ◽  
Health Facilities ◽  
Quality Data ◽  
Public Health Facilities ◽  
System Data

Abstract Background: Despite the improvements in the knowledge and understanding of the role of health information in the global health system, the quality of data generated by a routine health information system is still very poor in low and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, this study was aimed to assess the quality of routine health information system data and associated factors in public health facilities of Harari region, Ethiopia.Methods: A cross-sectional study was conducted in all public health facilities in Harari region of Ethiopia. The department-level data were collected from respective department heads through document reviews, interviews, and observation check-lists. Descriptive statistics were used to data quality and multivariate logistic regression was run to identify factors influencing data quality. The level of significance was declared at P-value <0.05. Result: The study found a good quality data in 51.35% (95% CI, 44.6-58.1) of the departments in public health facilities in Harari Region. Departments found in the health centers were 2.5 times more likely to have good quality data as compared to departments found in the health posts. The presence of trained staffs able to fill reporting formats (AOR=2.474; 95%CI: 1.124-5.445) and provision of feedback (AOR=3.083; 95%CI: 1.549-6.135) were also significantly associated with data quality. Conclusion: The level of good data quality in the public health facilities was less than the expected national level. Training should be provided to increase the knowledge and skills of the health workers.

scholarly journals Infection prevention preparedness and practices for female sterilization services within primary care facilities in Northern India

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Abhishek Kumar ◽  
Abhishek Gautam ◽  
Arnab Dey ◽  
Ruhi Saith ◽  
Uttamacharya ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Prevention ◽  
Uttar Pradesh ◽  
Health Facilities ◽  
Female Sterilization ◽  
Provider Attitudes ◽  
Public Health Facilities ◽  
Northern India ◽  
Provider Adherence ◽  
Facility Readiness

Abstract Background In 2014, 16 women died following female sterilization operations in Bilaspur, a district in central India. In addition to those 16 deaths, 70 women were hospitalized for critical conditions (Sharma, Lancet 384,2014). Although the government of India’s guidelines for female sterilization mandate infection prevention practices, little is known about the extent of infection prevention preparedness and practice during sterilization procedures that are part of the country’s primary health care services. This study assesses facility readiness for infection prevention and adherence to infection prevention practices during female sterilization procedures in rural northern India. Method The data for this study were collected in 2016–2017 as part of a family planning quality of care survey in selected public health facilities in Bihar (n = 100), and public (n = 120) and private health facilities (n = 97) in Uttar Pradesh. Descriptive analysis examined the extent of facility readiness for infection prevention (availability of handwashing facilities, new or sterilized gloves, antiseptic lotion, and equipment for sterilization). Correlation and multivariate statistical methods were used to examine the role of facility readiness and provider behaviors on infection prevention practices during female sterilization. Result Across the three health sectors, 62% of facilities featured all four infection prevention components. Sterilized equipment was lacking in all three health sectors. In facilities with all four components, provider adherence to infection prevention practices occurred in only 68% of female sterilization procedures. In Bihar, 76% of public health facilities evinced all four components of infection prevention, and in those facilities provider’s adherence to infection prevention practices was almost universal. In Uttar Pradesh, where only 55% of public health facilities had all four components, provider adherence to infection prevention practices occurred in only 43% of female sterilization procedures. Conclusion The findings suggest that facility preparedness for infection prevention does play an important role in provider adherence to infection prevention practices. This phenomenon is not universal, however. Not all doctors from facilities prepared for infection prevention adhere to the practices, highlighting the need to change provider attitudes. Unprepared facilities need to procure required equipment and supplies to ensure the universal practice of infection prevention.

scholarly journals Healthcare Expenditure on Childbirth in India: Two Part Model Analysis

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Sumit Kumar ◽  
Mandeep Kaur
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Diagnostic Tests ◽  
Healthcare Expenditure ◽  
Economic Status ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Status Occupation ◽  
Part Model

The aim of the study is to estimate the extent and determinants of healthcare expenditure of inpatients on childbirth in India. The study is based on sample of 14510 women who gave birth to a child (whether live or still-birth, vaginal or caesarean). To estimate the determinants two-part models has been utilised. The results indicate that women spent on average around INR 9103 per childbirth in hospitals. There are also wide variations in the spending pattern of women on childbirth. Household size, economic status, occupation, religion, and caste impact the expenditure on childbirth in hospitals. There are also wide variations in the spending of women belonging to different geo-graphical locations of India. Surgeries/caesarean or utilisation of facilities like special room and diagnostic tests etc. also significantly increase the expenditure. Women opting for public health facilities or having insurance spend less as compared to others. Government of India should increase investment in health to strengthen its current infrastructure. There is dire need to improve the quality of public health facilities, to reduce the regional imbalances in health facilities, to improve the coverage of health insurance in India for equitable and pro-people health facilities.

scholarly journals Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Kiros Fenta Ajemu ◽  
Alem Desta
Keyword(s):  
Public Health ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Output Quality

Abstract Background Substantial improvements have been observed in coverage and access to maternal health services in Ethiopia. However, quality of care has been lagging behind. Therefore, the aim of the study was to assess quality of OptionB + in Mekelle Zone, Northern Ethiopia.Methods Facility based cross-sectional study involving both quantitative and qualitative methods was conducted from December 2016- January 2017. The quality of service delivery was assessed in 11 public health facilities in Mekelle. Data collection was conducted using facility audit, observation, and client exit interview check list to assess (Input-Process–Output) quality components. Similarly in-depth interview guide was used to gather qualitative data. Data were analyzed using SPSS version 21 software. Descriptive statistics were computed to summarize the study findings and triangulation was made with qualitative findings.Results Overall, 2 (16.7%) of study health facilities full filled all the three quality components but none in 3(25%). The input quality component was better than the others in which 4(33.3%) facilities were rated as good. The process and output quality components were judged as good in 3(25%) study health facilities.Conclusion Only 16.7% of facilities studied were achieved good quality with respect to the three predetermined quality components. Since, assessed items in each quality component were potentially easy to intervene; strengthening program monitoring needed by program managers at each level of the health facilities.

scholarly journals Quality of Antenatal Care in Selected Public Health Facilities of West Ethiopia

2021 ◽  
Author(s):  
Markos Desalegn Beyene ◽  
Amanuel Nemomsa ◽  
Desalegn Wirtu ◽  
Motuma Getachew ◽  
Gemechu Kejela ◽  
...  
Keyword(s):  
Public Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Urine Sample ◽  
Client Satisfaction ◽  
Health Facilities ◽  
Outcome Variable ◽  
P Value ◽  
Public Health Facilities

Abstract Background: Ante natal care is a key entry point for a pregnant woman to receive abroad range of promotion and preventive health services. Objective: was to assess the quality of antenatal care services at public health facilities of western Ethiopia. Methods: Facility-based cross-sectional study was conducted from May 30th to June 30th, 2016. All public health facilities in the zone were audited, 316 medical records were reviewed, and 316 pregnant women were interviewed. The data was entered using EPI Data version 3.1 and analyzed using SPSS version 20.0. Descriptive statistics, binary, and multiple logistic regressions were conducted. Variables with a P-value of <0.05 were considered as statistically significant predictors of the outcome variable.Results: A total of 316 pregnant women were enrolled in the study. All facilities were categorized as “good” by the possession of necessary equipment, 3/4 by basic amenities and 87.34% by general and gynecologic examination. The information was provided for 222(86.21%), which is categorized as poor.252 (79.7%) of the women were satisfied with ANC. A urine sample taken during ANC visit AOR 3.36(1.70, 6.61) and counseling on food eaten during pregnancy AOR 2.27(1.16, 4.45) were predictors of client satisfaction on ANC. Conclusions: The majority of pregnant women were satisfied with the ANC they received. A urine sample taken during the ANC visits and being counseled on the types of food eaten during pregnancy were predictors for client satisfaction on ANC. Concerned bodies need to improve laboratory tests and information provision.

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