scholarly journals Health service utilization, perspectives, and health-seeking behavior for maternal and child health services in the Amazon of Peru, a mixed-methods study

Author(s):  
Christopher M. Westgard ◽  
Ally Rogers ◽  
Giselle Bello ◽  
Natalia Rivadeneyra

Abstract Background Various factors influence health service utilization at the community level. Research on the barriers to uptake of local health services is essential to reduce maternal and child mortality and morbidity. The Amazon region of Peru has some of the poorest health indicators in the country. The current study set out to better understand the health-seeking behavior and perspectives of mothers in Amazonian communities, exploring individual- and contextual-level barriers for seeking care at local health facilities for common maternal and child health issues. Methods The study employed a mixed-methods design by conducting 50 structured interviews with mothers of children under the age of 4. The study took place in 5 communities in Loreto, Peru. The quantitative data was analyzed with descriptive statistics to identify participants’ socio-demographic characteristics and reported utilization of health services. The qualitative data was analyzed in three rounds: inductive codebook development, application of the codebook, and thematic synthesis to contextualize the quantitative results and better understand the perspectives of the mothers regarding maternal and child health issues and the local health services. Results Overall, reported health service utilization among study participants was relatively high. However, the mothers identified several individual- and contextual-level factors that may affect their experiences and the health-seeking behaviors of other mothers in their communities: (i) embarrassment, fear, and trust, (ii) insufficient number and poor attitudes of health personnel, (iii) limited supply of basic medicines and materials in the health facility, and (iv) low demand for family planning services and limited awareness of adolescent-specific services. Conclusion Several findings in the current study reflect the reduced conditions of health services, while others display that many mothers maintain a positive outlook on the health services available to them and are proactive in the care of their child. The study provides valuable insight into the use of local health services and the common perspectives that are hindering further uptake at the community level in the Amazon of Peru, with important implications for health policy.

2021 ◽  
Vol 1 (2) ◽  
pp. 261-269
Author(s):  
Nosa N. A. Al Nahedh

Thistudy examines factors affecting the choice of maternal and child health services in a rural area in Saudi Arabia. A house-to-house survey of 329 women in Al-Oyaynah village, north-west of Riyadh city, was carried out to determine the maternal factors associated with this choice. The variables examined included age, duration of marriage, education, occupation, income, parity and husband’s education. The analysis showed that distance from the health service, education of the mother and her age were the strongest determinants of the choice of maternal child health service used


2019 ◽  
Vol 11 (11) ◽  
pp. 180
Author(s):  
Tat Florentianus ◽  
Bait M. Maria

BACKGROUND: The fact shows that the performance of health service policy implementation from the output aspect (out put) and the outcome (out comes) policy has not been in line with expectations. This condition will also have a direct influence on the Human Development Index in East Nusa Tenggara Province, where the position of East Nusa Tenggara is still in the order of 32 out of 34 provinces in Indonesia, which ranges from 68.77. The main purpose of this study was to identify the health service accessibility in East Nusa Tenggara. Furthermore, this study also intended to find out the performance of policy implementation and was to identify the effect of accessibility of health sevices on the performance of policy implementation on mothers and children in East Nusa Tenggara. SUBJECT & METHOD: This research is a quantitative study, conducted in 11 districts, 104 community healths services, and has 235 health workers as respondents in East Nusa Tenggara Province of Indonesia. RESULT: The results of the study on conditions of accessibility and networking in maternal and child health services in East Nusa Tenggara Province are still lacking (mean 2.7), meaning that conditions of accessibility in East Nusa Tenggara Province do not support the implementation of MCH policies. The performance of MCH policy implementation in East Nusa Tenggara Province is in the 3.36 category, meaning that the targets of MCH services that have been made have not been maximally realized. There is a correlation between accessibility conditions and the performance of MCH policy implementation (p = 0.00), the correlation coefficient of 0.429 shows that this correlation is quite strong, although not very strong. This correlation shows a positive relationship which means that if the accessibility conditions are easier, it will improve the performance of MCH policy implementation. The effect of accessibility on policy performance has been carried out partial linear regression test (t test), found t count = 19.0115 > t table 1.97 means that there is a significant influence on the condition of accessibility to the performance of MCH policies in East Nusa Tenggara Province. CONCLUSION: Accessibility to health services in East Nusa Tenggara Province is still lacking, the policy implementation performance is good and there is a significant and positive influence between service accessibility and policy implementation performance. RECOMENDATION: The government is expected to be more serious in efforts to open the accessibility of health services and set more realistic targets that could be achieved.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Nigatu Regassa Geda ◽  
Cindy Xin Feng ◽  
Carol J. Henry ◽  
Rein Lepnurm ◽  
Bonnie Janzen ◽  
...  

Abstract Background Despite progress made to improve access to child health services, mothers’ consistent utilization of these services has been constrained by several factors. This study is aimed at assessing the inequalities in key child health service utilization and assess the role of antenatal care (ANC) on subsequent service use. Method The analysis of the present study was based on the Ethiopian Demographic and Health Surveys, a nationally representative sample of 10,641 children. A health service utilization score was constructed from the affirmative responses of six key child health interventions associated with the most recent birth: ANC service, delivery of the last child at health facilities, postnatal care services, vitamin A intake, iron supplementation and intake of deworming pills by the index child. A mixed effect Poisson regression model was used to examine the predictors of health service utilization and three separate mixed effect logistic regression models for assessing the role of ANC for continued use of delivery and postnatal care services. Results The results of mixed effect Poisson regression indicate that the expected mean score of health service utilization was lower among non-first birth order children, older and high parity women, those living in polygamous families and women living in households with no access to radio. The score was higher for respondents with better education, women who had previous experience of terminated pregnancy, residing in more affluent households, and women with experiences of mild to high intimate partner violence. Further analysis of the three key health services (ANC, delivery, and postnatal care), using three models of mixed effect logistic regression, indicates consistent positive impacts of ANC on the continuum of utilizing delivery and postnatal care services. ANC had the strongest effects on both institutional delivery and postnatal care service utilization. Conclusion The findings implicated that maternal and child health services appear as continuum actions/behavior where utilization of one affects the likelihood of the next service types. The study indicated that promoting proper ANC services is very beneficial in increasing the likelihood of mothers utilizing subsequent services such as delivery and postnatal care services.


2021 ◽  
pp. 317-327
Author(s):  
Lutfan Lazuardi ◽  
Guardian Yoki Sanjaya ◽  
Pungkas Bahjuri Ali ◽  
Renova Glorya Montesori Siahaan ◽  
Lia Achmad ◽  
...  

: Introduction : Maternal and child health (MCH) is a global priority as health care innovation continues to evolve, including the use of information and communication technology. Studies showed that interoperable information systems can improve the quality of health services and at the same time facilitate the integration of data for the purpose of monitoring and evaluating the performance of health services, especially MCH. Aims : This study aims to identify various maternal and child health information systems used in Indonesia and opportunity of interoperability between systems to support continuum of care services. Methodology: Qualitative descriptive research was conducted in Yogyakarta Province from November to December 2020. This study assessed MCH applications that have been used in public and private primary health care, hospitals, health offices and in the community by identifying their functions and mapped data elements used by each application to assess potential interoperability between systems. The online focus group discussions with various application providers was conducted to explore the challenges of interoperability between digital systems. Results and Discussion : There were 18 maternal and child health information systems have been developed by the government (central and local), health facilities and private sector. The initiation of interoperability between systems has not yet occurred, except to support regular reporting at the health office and Ministry of Health level. Interoperability between information systems required efforts to improve information technology facilities and infrastructure, development of health data standards, strengthening governance and regulation and utilization of data as an effort to monitor, evaluation and continuity of interoperability between systems to support the digitalization of services and routine reporting. Conclusions and Recommendations : Digitalization of MCH services in Indonesia has the opportunity to support the continuum of care through an interoperable system. However, several enabler factors need to be prepared to support interoperability between information systems.


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