scholarly journals Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Rejina Gurung ◽  
◽  
Harriet Ruysen ◽  
Avinash K. Sunny ◽  
Louise T. Day ◽  
...  
Keyword(s):  
Newborn Care ◽  
Verbal Abuse ◽  
Standards Of Care ◽  
Skin Contact ◽  
Mode Of Birth ◽  
Survey Interviews ◽  
Maternal And Newborn Care ◽  
Poor Care ◽  
Respectful Care ◽  
Maternal And Newborn

Abstract Background Respectful maternal and newborn care (RMNC) is an important component of high-quality care but progress is impeded by critical measurement gaps for women and newborns. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study was an observational study with mixed methods assessing measurement validity for coverage and quality of maternal and newborn indicators. This paper reports results regarding the measurement of respectful care for women and newborns. Methods At one EN-BIRTH study site in Pokhara, Nepal, we included additional questions during exit-survey interviews with women about their experiences (July 2017–July 2018). The questionnaire was based on seven mistreatment typologies: Physical; Sexual; or Verbal abuse; Stigma/discrimination; Failure to meet professional standards of care; Poor rapport between women and providers; and Health care denied due to inability to pay. We calculated associations between these typologies and potential determinants of health – ethnicity, age, sex, mode of birth – as possible predictors for reporting poor care. Results Among 4296 women interviewed, none reported physical, sexual, or verbal abuse. 15.7% of women were dissatisfied with privacy, and 13.0% of women reported their birth experience did not meet their religious and cultural needs. In descriptive analysis, adjusted odds ratios and multivariate analysis showed primiparous women were less likely to report respectful care (β = 0.23, p-value < 0.0001). Women from Madeshi (a disadvantaged ethnic group) were more likely to report poor care (β = − 0.34; p-value 0.037) than women identifying as Chettri/Brahmin. Women who had caesarean section were less likely to report poor care during childbirth (β = − 0.42; p-value < 0.0001) than women with a vaginal birth. However, babies born by caesarean had a 98% decrease in the odds (aOR = 0.02, 95% CI, 0.01–0.05) of receiving skin-to-skin contact than those with vaginal births. Conclusions Measurement of respectful care at exit interview after hospital birth is challenging, and women generally reported 100% respectful care for themselves and their baby. Specific questions, with stratification by mode of birth, women’s age and ethnicity, are important to identify those mistreated during care and to prioritise action. More research is needed to develop evidence-based measures to track experience of care, including zero separation for the mother-newborn pair, and to improve monitoring.

scholarly journals Lay and healthcare providers’ experiences to inform future of respectful maternal and newborn care in Tanzania and Malawi: an Appreciative Inquiry

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046248
Author(s):  
Paschal Mdoe ◽  
Tracey A Mills ◽  
Robert Chasweka ◽  
Livuka Nsemwa ◽  
Chisomo Petross ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Appreciative Inquiry ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Skilled Birth Attendance ◽  
Birth Attendance ◽  
The Government ◽  
Maternal And Newborn Care ◽  
Respectful Care ◽  
Maternal And Newborn

ObjectivesDisrespectful care, which remains prevalent in low and middle-income countries (LMICs), acts as a barrier to women accessing skilled birth attendance, compromising care when services are available. Building on what was positive in facilities, we aimed to explore lay and healthcare providers’ experience of respectful care to inform future interventions.SettingFive maternity facilities in Mwanza Tanzania and Lilongwe Malawi.Participants94 participants in Malawi (N=46) and Tanzania (N=48) including 24 women birthing live baby within the previous 12 months; 22 family members and 48 healthcare providers who regularly provided maternity care in the included facilitiesDesignThe study was guided by Appreciative Inquiry (AI). Semistructured, one-to-one interviews were conducted between January and December 2019. Interviews were audio-recorded, translated where necessary, transcribed verbatim, and analysed using the framework approach.ResultsFour main themes describing participants positive experience and their vision of respectful care were identified: (1) empathic healthcare provider–woman interactions including friendly welcome and courteous language, well-timed appropriate care and information sharing, (2) an enabling environment, characterised by improvement of physical environment, the use of screens, curtains and wall partitions for privacy, availability of equipment and provision of incentives to staff, (3) supportive leadership demonstrated by the commitment of the government and facility leaders to provision of respectful care, ensuring availability of guidelines and policies, supportive supervision, reflective discussion and paying staff salaries timely, (4) providers’ attitudes and behaviours characterised by professional values through readiness, compassionate communication and commitment.ConclusionThe positive experiences of service users, families and healthcare providers provided insight into key drivers of respectful care in facilities in Tanzania and Malawi. Interventions targeting improved environment and privacy, healthcare provider communication and developing positive leadership structures in facilities could provide the basis for sustained improvement in respectful and dignified maternal and newborn care in LMICs.

scholarly journals Implementation of a referral and expert advice call Center for Maternal and Newborn Care in the resource constrained health system context of the Greater Accra region of Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ebenezer Oduro-Mensah ◽  
Irene Akua Agyepong ◽  
Edith Frimpong ◽  
Marjolein Zweekhorst ◽  
Linda Amarkai Vanotoo
Keyword(s):  
Decision Making ◽  
Call Center ◽  
Clinical Decision Making ◽  
Newborn Care ◽  
Clinical Decision ◽  
Series Data ◽  
Maternal And Newborn Care ◽  
Greater Accra Region ◽  
Maternal And Newborn ◽  
Decision Making Support

Abstract Background Referral and clinical decision-making support are important for reducing delays in reaching and receiving appropriate and quality care. This paper presents analysis of the use of a pilot referral and decision making support call center for mothers and newborns in the Greater Accra region of Ghana, and challenges encountered in implementing such an intervention. Methods We analyzed longitudinal time series data from routine records of the call center over the first 33 months of its operation in Excel. Results During the first seventeen months of operation, the Information Communication Technology (ICT) platform was provided by the private telecommunication network MTN. The focus of the referral system was on maternal and newborn care. In this first phase, a total of 372 calls were handled by the center. 93% of the calls were requests for referral assistance (87% obstetric and 6% neonatal). The most frequent clinical reasons for maternal referral were prolonged labor (25%), hypertensive diseases in pregnancy (17%) and post-partum hemorrhage (7%). Birth asphyxia (58%) was the most common reason for neonatal referral. Inadequate bed space in referral facilities resulted in only 81% of referrals securing beds. The national ambulance service was able to handle only 61% of the requests for assistance with transportation because of its resource challenges. Resources could only be mobilized for the recurrent cost of running the center for 12 h (8.00 pm – 8.00 am) daily. During the second phase of the intervention we switched the use of the ICT platform to a free government platform operated by the National Security. In the next sixteen-month period when the focus was expanded to include all clinical cases, 390 calls were received with 51% being for medical emergency referrals and 30% for obstetrics and gynaecology emergencies. Request for bed space was honoured in 69% of cases. Conclusions The call center is a potentially useful and viable M-Health intervention to support referral and clinical decision making in the LMIC context of this study. However, health systems challenges such inadequacy of human resources, unavailability of referral beds, poor health infrastructure, lack of recurrent financing and emergency transportation need to be addressed for optimal functioning.

scholarly journals Building a Maternal and Newborn Care Training Programme for Health-Care Professionals in Guinea-Bissau

2017 ◽  
Vol 30 (10) ◽  
pp. 734 ◽  
Author(s):  
Ana Reynolds ◽  
Ahmed Zaky ◽  
Joana Moreira-Barros ◽  
João Bernardes
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Newborn Care ◽  
Training Programme ◽  
Guinea Bissau ◽  
Care Training ◽  
Multiple Choice Questionnaire ◽  
Training Programmes ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Introduction: The Integrated Programme of Maternal and Child Health aims to reduce maternal and child mortality in Guinea-Bissau. The purpose of this article is to share our experience in building a training programme on maternal and newborn care for health-care professionals in Guinea-Bissau.Material and Methods: Regional directors of the four target areas chose a group of staff who provide prenatal and childbirth care to attend the course (12 to 15 trainees per region). In each region, 15 highly interactive and practical sessions were scheduled over eight weeks. The trainees’ summative and reactive assessment was obtained using a multiple choice questionnaire (final test) and an anonymous survey, respectively.Results: Attendees included 25 nurses, 17 midwives and 14 doctors. About two thirds had five years’ practice or less. Test median scores were higher among trainees with two to nine years of practice (54.4% to 60.9%), as compared to those with a year or less (47.8%) or 10 or more years (45.7%). Pedagogical variables were rated as ‘good’ or ‘very good’ by 91% to 95% of the attendees.Discussion: Use of an interactive and practical pedagogical methodology produced positive results and was crucial to tailoring the training to local needs. However, adapting the syllabus according to professional categories and experiences should be considered.Conclusion: Our results warrant further development and evaluation of training programmes on maternal and neonatal care in Guinea-Bissau.

scholarly journals Ready to deliver maternal and newborn care? Health providers’ perceptions of their work context in rural Mozambique

2018 ◽  
Vol 11 (1) ◽  
pp. 1532631 ◽  
Author(s):  
Sibone Mocumbi ◽  
Kevin McKee ◽  
Khátia Munguambe ◽  
Rogério Chiau ◽  
Ulf Högberg ◽  
...  
Keyword(s):  
Newborn Care ◽  
Health Providers ◽  
Work Context ◽  
Care Health ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

scholarly journals Assessment of Critical Knowledge on Maternal and Newborn care Services among Primary Level Nurse Mid-wives in Kapilvastu District of Nepal

2017 ◽  
Vol 13 (4) ◽  
pp. 351-356 ◽  
Author(s):  
D. Acharya ◽  
R. Paudel
Keyword(s):  
Newborn Care ◽  
Neonatal Health ◽  
Poor Knowledge ◽  
Primary Level ◽  
Critical Knowledge ◽  
Care Services ◽  
Maternal And Neonatal Health ◽  
Nurse Midwives ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background Despite greater emphasis on maternal and neonatal health through policy and programming in Nepal, maternal and neonatal health is still not impressive. Health care providers’ knowledge assessment on maternal and neonatal care has been well documented elsewhere, but it is very little understood in Nepal.Objective The primary objective of this study was to assess the critical knowledge of primary level nurse- midwives on maternal and newborn care in Kapilvastu District of Nepal.Method This was an Institution based cross-sectional study, conducted in Kapilvastu district, Nepal among sixty eight nurse-midwives. The participants were selected using simple random sampling technique. For collecting the data, health institutions were visited by enumerators for a month from 1st October to 1st November 2012. Data were entered into Microsoft Excel, cleaned and analyzed using SPSS version 17.0.Result More than 3/4th of the nurse-midwives had 10-20 years of experience. Majority of them (89.7%) had poor knowledge in taking action to prevent mother to child transmission for HIV positive women. More than half of them (54.4%) had some knowledge in performing the active management of third stage of labor whereas almost half (51.5%) had poor knowledge to actions needed on post-partum haemorrhage (PPH). Similarly, more than two third (69.1%) had poor knowledge in newborn care.Conclusion Majority of the nurse-midwives were found to have either poor or some level of knowledge in most of the components of maternal and newborn care services. So, greater emphasis should be given to upgrade the knowledge of nurse mid-wives.

scholarly journals Bolivia programme evaluation of a package to reach an underserved population: Community-based maternal and newborn care economic analysis

2017 ◽  
Vol 32 (suppl_1) ◽  
pp. i75-i83 ◽  
Author(s):  
Diana Barger ◽  
Bertha Pooley ◽  
Julien Roger Dupuy ◽  
Norma Amparo Cardenas ◽  
Steve Wall ◽  
...  
Keyword(s):  
Economic Analysis ◽  
Newborn Care ◽  
Programme Evaluation ◽  
Underserved Population ◽  
Community Based ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

scholarly journals Community-based maternal and newborn care: A concept analysis

Curationis ◽  
2018 ◽  
Vol 41 (1) ◽  
Author(s):  
Yonas R. Guta ◽  
Patrone R. Risenga ◽  
Mary M. Moleki ◽  
Merertu T. Alemu
Keyword(s):  
Low Income ◽  
Newborn Care ◽  
Newborn Health ◽  
Concept Analysis ◽  
Low Income Countries ◽  
Maternal And Newborn Health ◽  
Community Based ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background: Community-based care can serve as a valuable programme in the provision of essential maternal and newborn care, specifically in communities in low-income countries. However, its application in maternal and newborn care is not clearly documented in relation to the rendering of services by skilled birth attendants.Objectives: The purpose of the analysis was to clarify the meaning of the concept ‘community-based maternal and newborn care and its relationship to maternal and newborn health’.Method: Walker and Avant’s and Rodgers and Knafl’s as well as Chin and Kramer’s approaches to concept analysis were followed to analyse community-based maternal and newborn care.Results: The attributes of community-based care in maternal and newborn health include (1) the provision of home- and/or community-level skilled care, (2) linkages of health services and (3) community participation and mobilisation. These attributes are influenced by antecedents as well as consequences.Conclusion: The provision of good maternal and newborn care to all clients is a crucial aspect in provision of maternal and newborn services. In order for low-income countries to promote maternal and newborn health, community-based care services are the best option to follow.

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