scholarly journals An innovative intervention to improve respectful maternity care in three Districts in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Birkety Mengistu ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Maternity Care ◽  
Regression Coefficient ◽  
Interrupted Time Series ◽  
The Other ◽  
Respectful Maternity Care ◽  
Experience Of Care ◽  
National Initiative ◽  
Care Training

Abstract Background Mistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from attending skilled birth. In Ethiopia, mistreatment occurs in up to 49.4% of mothers giving birth in health facilities. This study describes the development, implementation and results of interventions to improve respectful maternity care. As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed respectful maternity care training module with three core components: testimonial videos developed from key themes identified by staff as experiences of mothers, skills-building sessions on communication and onsite coaching. Respectful maternity care training was conducted in February 2017 in three districts within three regions. Methods Facility level solutions applied to enhance the experience of care were documented. Safe Childbirth Checklist data measuring privacy and birth companion offered during labor and childbirth were collected over 27 months from 17 health centers and three hospitals. Interrupted time series and regression analysis were conducted to assess significance of improvement using secondary routinely collected programmatic data. Results Significant improvement in the percentage of births with two elements of respectful maternal care—privacy and birth companionship offered— was noted in one district (with short and long-term regression coefficient of 18 and 27% respectively), while in the other two districts, results were mixed. The short-term regression coefficient in one of the districts was 26% which was not sustained in the long-term while in the other district the long-term coefficient was 77%. Testimonial videos helped providers to see their care from their clients’ perspectives, while quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions. This includes organizing tour to the birthing ward and allowing cultural celebrations. Conclusion This study demonstrated effective way of improving respectful maternity care. Use of a multipronged approach, where the respectful maternity care intervention was embedded in quality improvement approach helped in enhancing respectful maternity care in a comprehensive manner.

scholarly journals An Innovative Intervention to Improve Respectful Maternity Care in Three Districts in Ethiopia

2020 ◽  
Author(s):  
Birkety Mengistu Jembere ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Maternity Care ◽  
Interrupted Time Series ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Experience Of Care ◽  
National Initiative ◽  
Care Training ◽  
Facility Level ◽  
Birth Companion

Abstract Background: Mistreatment during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, mistreatment has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care and decrease mistreatment in three districts in Ethiopia. Methods: As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel respectful maternity care training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the respectful maternity care training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facility level solutions applied to enhance privacy and birth companion were documented. Results: Analysis of the effectiveness of integrating respectful maternity care using available programmatic data showed significant improvement following the respectful maternity care training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Conclusion: This study suggests that integrating the respectful maternity care training into the district-wide quality improvement collaborative is effective in improving respectful maternity care. Multi-pronged approach is especially helpful in enhancing respectful maternity care comprehensively. Use of testimonial videos helped providers to see their services from their clients’ perspective, the quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions.

scholarly journals An Innovative Intervention to Improve Respectful Maternity Care in Three Districts in Ethiopia

2020 ◽  
Author(s):  
Birkety Mengistu Jembere ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Maternity Care ◽  
Interrupted Time Series ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Training Module ◽  
Experience Of Care ◽  
National Initiative ◽  
Care Training ◽  
Birth Companion

Abstract Background: Mistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from accessing skilled delivery in health facilities. In Ethiopia, mistreatment has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care in Ethiopia. Methods: As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel respectful maternity care training module with three core components: testimonial videos, a skills-building session on communication, and onsite coaching. The respectful maternity care training was conducted in February 2017 in three districts within three regions of Ethiopia. Facility level solutions applied to enhance the experience of care for mothers as a result of the training module were documented. Safe Childbirth Checklist data measuring privacy maintained and birth companion offered during labor and delivery were collected over 27 months from 17 health centers and three hospitals in the three districts. Interrupted time series and a regression analysis were conducted to assess the significance of improvement. Results: Data analysis showed significant improvement in the percentage of births with two elements of respectful maternal care—privacy maintained and birth companionship offered—following the respectful maternity care training, which was sustained beyond the project intervention (regression coefficients ranging from 18% to 77% for births with privacy and with birth companion offered). About 23 local solutions were devised and implemented in the health facilities that improved the experience of care for mothers. Conclusion: This study suggests that integrating the respectful maternity care training into a district-wide quality improvement collaborative is effective in improving respectful maternity care. Use of a multi-pronged approach is especially helpful in enhancing respectful maternity care comprehensively. Testimonial videos helped providers to see their services from their clients’ perspective, while quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions.

scholarly journals An Innovative Intervention to Improve Respectful Maternity Care in Three Districts in Ethiopia

2019 ◽  
Author(s):  
Birkety Mengistu Jembere ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Maternity Care ◽  
Interrupted Time Series ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Experience Of Care

Abstract BackgroundDisrespect and abuse (D&A) during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, D&A has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care (RMC) and decrease D&A in three districts in Ethiopia.MethodsAs part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel RMC training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the RMC training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using STATA version 13 for interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facilitated discussions were conducted among health care providers to gauge the effectiveness of the videos. Facility level solutions applied to enhance RMC were documented. ResultsAn analysis of the effectiveness of integrating RMC using available programmatic data showed significant improvement following the RMC training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Facilitated discussions with health care providers participating in the RMC training showed improved understanding of patients’ perspectives and the psychosocial needs of their clients. ConclusionThis study suggests that integrating the RMC training into the district-wide quality improvement (QI) collaborative is effective in improving RMC. Use of testimonial videos are especially helpful as they remind providers of the need to treat mothers with dignity and helps them reflect on potential root causes for this type of treatment and develop effective solutions.

scholarly journals Assessment of Women’s Experience of Care during Childbirth for Quality Improvement at Level 5 Health Facilities in Bungoma County, Kenya

2022 ◽  
Vol 5 (1) ◽  
pp. 1-18
Author(s):  
Lucy Natecho Namusonge ◽  
Maximilla N. Wanzala ◽  
Edwin K. Wamukoya
Keyword(s):  
Maternity Care ◽  
Newborn Health ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Maternal And Newborn Health ◽  
Disrespect And Abuse ◽  
Live Births ◽  
Experience Of Care ◽  
Maternal And Newborn

High maternal and newborn mortality is a pressing problem in developing countries. Poor treatment during childbirth contributes directly and indirectly to this problem. Many women experience disrespectful and abusive treatment during childbirth worldwide which violates their rights. In Kenya, 20% of women report having experienced some form of disrespect and abuse (D&A). Bungoma County is among the 15 counties with the worst maternal and newborn health statistics in Kenya. The maternal mortality rate is 382 per 100,000 live births and newborn deaths 32 per 1,000 live births, while skilled birth attendance is 41.4%. This study was motivated by the poor maternal and newborn indicators, rising incidences of D&A, limited formal research on respectful maternity care. The study aimed at assessing women’s experience of care during childbirth at Level 5 health facilities in Bungoma County. The specific objectives were to determine the women’s experiences of care during childbirth, to determine factors contributing to disrespect and abuse during childbirth and to identify strategies for addressing issues affecting respectful maternity care for promoting quality of maternal and newborn care. A cross-sectional descriptive study design was used. It involved 360 mothers. Analysis of quantitative data was done using SPSS. Descriptive statistics were presented in graphs, tables, frequencies and percentages. Qualitative data was analysed thematically. The prevalence of D&A was 42.2%, younger age and lower education aggravated D&A. Autonomy, privacy and confidentiality, and absence of birth companionship were major aspects of D&A. Health workforce shortage, inadequate supervision, space and beds, poor provider-patient relationships were factors leading to D&A. It was concluded that there is a need for increased incorporation of Respectful Maternity Care (RMC) in routine care, deploy more staff, avail equipment and supplies, and enhance support supervision. The study information intends to assist stakeholders in prioritising policy actions for improving the quality of maternal and newborn health outcomes and indicators.

scholarly journals Experiences and perceptions of birth companions supporting women in labour at a District Hospital in Limpopo, South Africa

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Joy V. Summerton ◽  
Tsakani R. Mtileni ◽  
Maphei E. Moshabela
Keyword(s):  
South Africa ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Limpopo Province ◽  
Respectful Maternity Care ◽  
National Guidelines ◽  
Cross Sectional ◽  
Case Record ◽  
Experience Of Care ◽  
Birth Companion

Background: South Africa has included birth companions in its national guidelines for maternity care and the revised Maternity Case Record, in and effort to improve the quality and experience of care. However, reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward.Objectives: To document the experiences and perceptions of birth companions who supported women in labour in a rural hospital in Limpopo Province where a Respectful Maternity Care (RMC) project was piloted.Method: An institution-based cross-sectional study design was employed. Purposive sampling was employed where all birth companions who supported a woman during labour and birth were included in the study. The experiences and perceptions of birth companions were captured using a birth companion feedback book during the period of 1st April to 30th August 2019. Thematic analysis was used to analyse the data.Results: Seventy-one (71) of the 73 birth companions only had positive responses about the birthing experience and how both the birth companion and woman in labour were treated. Two birth companions were dissatisfied with the treatment provided by the midwife that supported the birth.Conclusion: It is important for healthcare providers to understand the far reaching emotional and psychological impact of their attitudes and behaviour on, not only women in labour but also on others who witness their (healthcare providers) behaviour. Mechanisms to obtain feedback from birth companions should be integrated into strategies to improve the quality and experience of care for women during childbirth.

Respectful maternity care and breastfeeding

2021 ◽  
pp. 175797592098421
Author(s):  
Humaira Ansari ◽  
Rajiv Yeravdekar
Keyword(s):  
Maternity Care ◽  
Fundamental Rights ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Short Term ◽  
Policies And Programs

Respectful maternity care and its effect on breastfeeding is not widely explored. Disrespect and abuse affect the health of the mother and the newborn, affect lactogenesis and negatively influence breastfeeding. This has serious short-term and long-term ill effects. Separation of the mother and the newborn result in failure to establish early breastfeeding. Interventions, policies and programs should be developed to address the issues pertaining to respectful maternity care. This will not only help in breastfeeding but will also safeguard the fundamental rights of the mother and the child.

Radioimmunotherapy for treatment of acute myeloid leukaemia and myelodysplastic syndrome

2005 ◽  
Vol 44 (03) ◽  
pp. 107-117
Author(s):  
R. G. Meyer ◽  
W. Herr ◽  
A. Helisch ◽  
P. Bartenstein ◽  
I. Buchmann
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Primary Tumour ◽  
The Other ◽  
Haematopoietic Stem Cell ◽  
Other Hand ◽  
Primary Reduction ◽  
The One ◽  
Acute Myeloid

SummaryThe prognosis of patients with acute myeloid leukaemia (AML) has improved considerably by introduction of aggressive consolidation chemotherapy and haematopoietic stem cell transplantation (SCT). Nevertheless, only 20-30% of patients with AML achieve long-term diseasefree survival after SCT. The most common cause of treatment failure is relapse. Additionally, mortality rates are significantly increased by therapy-related causes such as toxicity of chemotherapy and complications of SCT. Including radioimmunotherapies in the treatment of AML and myelodyplastic syndrome (MDS) allows for the achievement of a pronounced antileukaemic effect for the reduction of relapse rates on the one hand. On the other hand, no increase of acute toxicity and later complications should be induced. These effects are important for the primary reduction of tumour cells as well as for the myeloablative conditioning before SCT.This paper provides a systematic and critical review of the currently used radionuclides and immunoconjugates for the treatment of AML and MDS and summarizes the literature on primary tumour cell reductive radioimmunotherapies on the one hand and conditioning radioimmunotherapies before SCT on the other hand.

Hidden “holes” in the capital of banks and the supply of credit to the real sector of economy

2018 ◽  
pp. 49-68 ◽  
Author(s):  
M. E. Mamonov
Keyword(s):  
Credit Risk ◽  
The Other ◽  
Real Sector ◽  
Capital Management ◽  
Loan Loss ◽  
Short Term ◽  
The Real ◽  
Ex Post ◽  
The One

Our analysis documents that the existence of hidden “holes” in the capital of not yet failed banks - while creating intertemporal pressure on the actual level of capital - leads to changing of maturity of loans supplied rather than to contracting of their volume. Long-term loans decrease, whereas short-term loans rise - and, what is most remarkably, by approximately the same amounts. Standardly, the higher the maturity of loans the higher the credit risk and, thus, the more loan loss reserves (LLP) banks are forced to create, increasing the pressure on capital. Banks that already hide “holes” in the capital, but have not yet faced with license withdrawal, must possess strong incentives to shorten the maturity of supplied loans. On the one hand, it raises the turnovers of LLP and facilitates the flexibility of capital management; on the other hand, it allows increasing the speed of shifting of attracted deposits to loans to related parties in domestic or foreign jurisdictions. This enlarges the potential size of ex post revealed “hole” in the capital and, therefore, allows us to assume that not every loan might be viewed as a good for the economy: excessive short-term and insufficient long-term loans can produce the source for future losses.

Interrelationships between municipal spatial policy strategy and airport operation and development. Lodz Airport case study

2018 ◽  
Vol 59 (1) ◽  
pp. 65-79
Author(s):  
Katarzyna Nikorowicz-Zatorska
Keyword(s):  
Land Use ◽  
Urban Planning ◽  
Cultural Development ◽  
The Other ◽  
Local Authorities ◽  
Spatial Management ◽  
The One ◽  
Surrounding Areas

Abstract The present paper focuses on spatial management regulations in order to carry out investment in the field of airport facilities. The construction, upgrades, and maintenance of airports falls within the area of responsibility of local authorities. This task poses a great challenge in terms of organisation and finances. On the one hand, an active airport is a municipal landmark and drives local economic, social and cultural development, and on the other, the scale of investment often exceeds the capabilities of local authorities. The immediate environment of the airport determines its final use and prosperity. The objective of the paper is to review legislation that affects airports and the surrounding communities. The process of urban planning in Lodz and surrounding areas will be presented as a background to the problem of land use management in the vicinity of the airport. This paper seeks to address the following questions: if and how airports have affected urban planning in Lodz, does the land use around the airport prevent the development of Lodz Airport, and how has the situation changed over the time? It can be assumed that as a result of lack of experience, land resources and size of investments on one hand and legislative dissonance and peculiar practices on the other, aviation infrastructure in Lodz is designed to meet temporary needs and is characterised by achieving short-term goals. Cyclical problems are solved in an intermittent manner and involve all the municipal resources, so there’s little left to secure long-term investments.

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