scholarly journals Health facility preparedness of maternal and neonatal health services: a survey in Jumla, Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pasang Tamang ◽  
Padam Simkhada ◽  
Paul Bissell ◽  
Edwin van Teijlingen ◽  
Rose Khatri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Essential Medicine ◽  
Essential Medicines ◽  
Neonatal Health ◽  
Cross Sectional ◽  
The Past ◽  
Ambulance Transport ◽  
Emergency Ambulance ◽  
Maternal And Neonatal Health

Abstract Background Over the past 20 years, Nepal has seen major improvements in childhood and maternal survival. In 2015, the Nepalese government introduced a new federal political structure. It is unclear how this has affected the health system, and particularly, maternal and child health care. Hence, this study aims to describe and analyse health facility preparedness in the light of the federalization process with regards to providing appropriate and timely maternal and neonatal health services. Methods A descriptive cross-sectional study was conducted in Jumla district, Nepal in 2019 covering all 31 state health facilities (HF) to assess the availability of maternal and neonatal health services including appropriate workforce and access to essential medicines. Tests of association between demographic factors and the probability of a facility experiencing a shortage of essential medicine within the last 3 months were also conducted as exploratory procedures. Results Out ot 31 HFs, more than 90% of them had all their staff positions filled. Most facilities (n = 21) had experienced shortages of essential medicines within the past 3 months. The most common out of stock medicine were: Amoxicillin (n = 10); paracetamol (n = 10); Vitamin A (n = 7); and Metronidazole (n = 5). Twenty-two HFs had referred maternal and newborn cases to a higher centre within the past 12 months. However, more worryingly, twenty HFs or their catchment communities did not have emergency ambulance transport for women and newborns. Conclusion HFs reported better staffing levels than levels of available drugs. HFs should be supported to meet required minimal standards such as availability of essential medicines and the provision of emergency ambulance transport for women and newborns.

scholarly journals Correction to: Health facility preparedness of maternal and neonatal health services: a survey in Jumla, Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pasang Tamang ◽  
Padam Simkhada ◽  
Paul Bissell ◽  
Edwin van Teijlingen ◽  
Rose Khatri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Neonatal Health ◽  
Maternal And Neonatal Health

scholarly journals Utilization of Health Facility–Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Demisu Zenbaba ◽  
Biniyam Sahiledengle ◽  
Diriba Dibaba ◽  
Mitiku Bonsa
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Facility ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Delivery Service ◽  
The Past ◽  
Southeast Ethiopia ◽  
Delivery Services

Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility–based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility–based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility–based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.

scholarly journals Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021223 ◽  
Author(s):  
Joshua Sumankuuro ◽  
Judith Crockett ◽  
Shaoyu Wang
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Newborn Health ◽  
Essential Medicines ◽  
Maternal And Newborn Health ◽  
Neonatal Health ◽  
Community Members ◽  
West Region ◽  
Maternal And Neonatal Health ◽  
Maternal And Newborn

ObjectivesIn considering explanations for poor maternal and newborn health outcomes, many investigations have focused on the decision-making patterns and actions of expectant mothers and families, as opposed to exploring the ‘supply side’ (health service provider) barriers. Thus, we examined the health system factors impacting on access to and delivery of quality maternal and newborn healthcare in rural settings.DesignA semistructured qualitative study using face-to-face in-depth interviews with health professionals, and focus group sessions with community members, in eight project sites in two districts of Upper West Region, Ghana, was employed. Participants were purposively selected to generate relevant data to help address the study objective. The survey was guided by WHO standard procedures and Ghana Health Ministry’s operational work plan for maternal and newborn care.SettingNadowli–Kaleo and Daffiama–Bussie–Issa districts in Upper West Region, Ghana.ParticipantsTwo hundred and fifty-three participants were engaged in the study through convenient and purposive sampling: healthcare professionals (pharmacist, medical doctor, two district directors of health services, midwives, community health and enrolled nurses) (n=13) and community members comprising opinion leaders, youth leaders and adult non-pregnant women (n=240 in 24 units of focus groups).ResultsResults show significant barriers affecting the quality and appropriateness of maternal and neonatal health services in the rural communities and the Nadowli District Hospital. The obstacles were inadequate medical equipment and essential medicines, infrastructural challenges, shortage of skilled staff, high informal costs of essential medicines and general limited capacities to provide care.ConclusionImplementation of the birth preparedness and complication readiness strategy is in its infancy at the health facility level in the study areas. Increasing the resources at the health provider level is essential to achieving international targets for maternal and neonatal health outcomes and for bridging inequities in access to essential maternal and newborn healthcare.

scholarly journals The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania

2020 ◽  
Vol 35 (3) ◽  
pp. 323-333 ◽  
Author(s):  
August Kuwawenaruwa ◽  
Kaspar Wyss ◽  
Karin Wiedenmayer ◽  
Emmy Metta ◽  
Fabrizio Tediosi
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Healthcare Utilization ◽  
Low Income ◽  
Essential Medicines ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Catchment Areas ◽  
Medicine Availability

Abstract Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.

scholarly journals Maternal and neonatal health expenditure in mumbai slums (India): A cross sectional study

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Jolene Skordis-Worrall ◽  
Noemi Pace ◽  
Ujwala Bapat ◽  
Sushmita Das ◽  
Neena S More ◽  
...  
Keyword(s):  
Health Expenditure ◽  
Cross Sectional Study ◽  
Neonatal Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternal And Neonatal Health

scholarly journals Essential Medicine and Equipment for Emergency Obstetric and Newborn Care in Zanzibar: Situation at a Glance

2019 ◽  
pp. 1-7
Author(s):  
Andrea B. Pembe ◽  
Bruno Sunguya ◽  
Stella Mushy ◽  
Sebalda Leshabari ◽  
George Kiwango ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Essential Medicine ◽  
Newborn Care ◽  
Newborn Health ◽  
Structure Interview ◽  
Essential Medicines ◽  
Maternal And Newborn Health ◽  
Cross Sectional ◽  
Live Births ◽  
Delivery Services

Background:Maternal and neonatal mortality are unacceptably high in Zanzibar. Maternal mortality and neonatal mortality ratio stand at 350 per 100,000 live births and 29 per 1,000 live births respectively as of 2018. Addressing challenges facing maternal and newborn health requires among others, the assurance of essential medicine and equipment to deliver evidence based interventions. This paper reports evidence gathered on the availability of essential medicines and equipment in providing Emergency Obstetric and Newborn Care (EmoNC) services in Zanzibar. Methods:A cross-sectional mixed methods study design was used to collect information on the availability of drugs and equipment from all health facilities providing delivery services in Zanzibar. Semi-structure interview guide was used to carry in-depth interviews (IDIs) with health facility in-charges while observation on availability of essential medicine and equipment for EmONC was carried using standard observation guide as adopted from Averting Maternal Death and Disability program.

scholarly journals Assessing variation among the national essential medicines lists of 21 high-income countries: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045262
Author(s):  
Michael Sergio Taglione ◽  
Nav Persaud
Keyword(s):  
Low Income ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
High Income ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Income Status ◽  
Essential Medicines Lists

ObjectiveEssential medicines lists have been created and used globally in countries that range from low-income to high-income status. The aim of this paper is to compare the essential medicines list of high-income countries with each other, the WHO’s Model List of Essential Medicines and the lists of countries of other income statuses.DesignHigh-income countries were defined by World Bank classification. High-income essential medicines lists were assessed for medicine inclusion and were compared with the subset of high-income countries, the WHO’s Model List and 137 national essential medicines lists. Medicine lists were obtained from the Global Essential Medicines database. Countries were subdivided by income status, and the groups’ most common medicines were compared. Select medicines and medicine classes were assessed for inclusion among high-income country lists.ResultsThe 21 high-income countries identified were most like each other when compared with other lists. They were more like upper middle-income countries and least like low-income countries. There was significant variability in the number of medicines on each list. Less than half (48%) of high-income countries included a newer diabetes medicines in their list. Most countries (71%) included naloxone while every country including at least one opioid medicine. More than half of the lists (52%) included a medicine that has been globally withdrawn or banned.ConclusionEssential medicines lists of high-income countries are similar to each other, but significant variations in essential medicine list composition and specifically the number of medications included were noted. Effective medicines were left off several countries’ lists, and globally recalled medicines were included on over half the lists. Comparing the essential medicines lists of countries within the same income status category can provide a useful subset of lists for policymakers and essential medicine list creators to use when creating or maintaining their lists.

scholarly journals Influencing factors of physicians’ prescription behavior in selecting essential medicines: a cross-sectional survey in Chinese county hospitals

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xin Zhou ◽  
Xueting Zhang ◽  
Linsheng Yang ◽  
Xu Hu ◽  
Aizong Shen ◽  
...  
Keyword(s):  
Health Care ◽  
Structural Equation Model ◽  
Influencing Factors ◽  
Structural Equation ◽  
Essential Medicine ◽  
Equation Model ◽  
Essential Medicines ◽  
Actual Behavior ◽  
Cross Sectional ◽  
Factors Affecting

Abstract Background To explore the key factors affecting prescription practices of essential medicines in Chinese county hospital. National essential medicine policy (NEMP) plays important roles in health care system, especially in developing countries. As a fundamental component in the Chinese health system reform, NEMP was implemented in primary health care institutions during the first stage of reform. As it is rolled out, priority usage and zero-mark-up policy of essential medicines are to be applied in every government-run healthcare institution. However, the intention and influence factors of physicians on priority selecting essential medicine remains unclear. Methods Based on the theory of planned behavior, a cross-sectional questionnaire survey was conducted to analyze physicians’ intention, attitude, subjective norms (SNs) and perceived behavioral control (PBC) on prescrictions and their actual behavior on selection of essential medicines. Results Two hundred eighty-two physicians participated in the structural questionnaire interview. The final structural equation model reflected influencing factors affecting physicians’ prescribing behavior (χ2/df = 1.32, GFI = 0.99, IFI = 0.99). Structural equation model analysis showed that attitude, other influencers and institutional environment, and PBC significantly affected behavioral intention. However, the control extent of cognition behavior of physicians prescribing had no significant positive effect on the priority usage of essential medicines. Conclusion Investigation results demonstrate physicians are unaware of NEMP design and implementation plans. To help enhance rational use of essential medicines we suggest educating physicians on the value of NEMP, and integrating the drug shortage report into the essential medicine (EM) bidding system seamless communication with pharmaceutical manufacturers’ credit information system.

scholarly journals Indicators related to the rational use of medicines and its associated factors

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Marina Guimarães Lima ◽  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Ediná Alves Costa ◽  
Ione Aquemi Guibu ◽  
...  
Keyword(s):  
Health Services ◽  
Associated Factors ◽  
National Level ◽  
Essential Medicines ◽  
Correct Identification ◽  
Cross Sectional ◽  
Rational Use ◽  
Basic Health ◽  
Rational Use Of Medicines ◽  
Basic Health Units

OBJECTIVE: To evaluate indicators related to the rational use of medicines and its associated factors in Basic Health Units. METHOD: This is a cross-sectional study carried out in a representative sample of Brazilian cities included in the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The data were collected by interviews with users, medicine dispensing professionals, and prescribers; and described by prescription, dispensing, and health services indicators. We analyzed the association between human resources characteristics of pharmaceutical services and dispensing indicators. RESULTS: At national level, the average number of medicines prescribed was 2.4. Among the users, 5.8% had antibiotic prescription, 74.8% received guidance on how to use the medicines at the pharmacy and, for 45.1% of users, all prescribed medicines were from the national list of essential medicines. All the indicators presented statistically significant differences between the regions of Brazil. The dispensing professionals that reported the presence of a pharmacist in the unit with a working load of 40 hours or more per week presented 1.82 more chance of transmitting information on the way of using the medicines in the dispensing process. CONCLUSION: The analysis of prescription, dispensing, and health services indicators in the basic health units showed an unsatisfactory proportion of essential medicines prescription and limitations in the correct identification of the medicine, orientation to the patients on medicines, and availability of therapeutic protocols in the health services

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