Experiences of a new cadre of midwives in Bangladesh: findings from a mixed method study

Abstract Background Bangladesh did not have dedicated professional midwives in public sector health facilities until recently, when the country started a nation-wide programme to educate and deploy diploma midwives. The objective of the findings presented in this paper, which is part of a larger study, was to better understand the experience of the midwives of their education programme and first posting as a qualified midwife and to assess their midwifery knowledge and skills. Methods We applied a mixed method approach, which included interviewing 329 midwives and conducting 6 focus group discussions with 43 midwives and midwifery students. Sampling weights were used to generate representative statistics for the entire cohort of the midwives deployed in the public sector health facilities. Results Most of the midwives were satisfied with different dimensions of their education programme, with the exception of the level of exposure they had to the rural communities during their programme. Out of 329 midwives, 50% received tuition fee waivers, while 46% received funding for educational materials and 40% received free accommodation. The satisfaction with the various aspects of the current posting was high and nearly all midwives reported that a desire to work in the public sector in the long run. However, a significant proportion of the midwives expressed concerns with equipment, accommodation, transport and prospect of transfers. The scores on the knowledge test and self-reported skill levels were varied but reasonably high. Conclusion While the midwives are highly motivated, satisfied with many aspects of their current jobs and have adequate knowledge and skills, there are some bottlenecks and concerns that, if unaddressed, may derail the success of this programme. To capture the career progress of these midwives, additional research, including a follow-up study with the same cohort of midwives, would be beneficial to this programme.

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The role of the public and private health sectors on factors associated with early essential newborn care practices among institutional deliveries in Ghana

BMC Health Services Research ◽

10.1186/s12913-021-06665-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maxwell Tii Kumbeni ◽

Paschal Awingura Apanga ◽

Mary-Ann Wepiamo Chanase ◽

John Ndebugri Alem ◽

Nana Mireku-Gyimah

Keyword(s):

Health Insurance ◽

Public Sector ◽

Private Sector ◽

Newborn Care ◽

Health Facilities ◽

Essential Newborn Care ◽

Public And Private ◽

The Public ◽

Factors Associated ◽

Public Sector Health

Abstract Background Early essential newborn care is one of the important interventions developed by the World Health Organization to reduce morbidities and mortalities in neonates. This study investigated the role of the public and private sector health facilities on factors associated with early essential newborn care practices following institutional delivery in Ghana. Methods We used data from the 2017/2018 multiple indicator cluster survey for our analysis. A total of 2749 mothers aged 15–49 years were included in the study. Logistic regression analysis was used to assess the factors associated with early essential newborn care in both public and private health sectors. Results The prevalence of good early essential newborn care in the public sector health facilities was 26.4 % (95 % CI: 23.55, 29.30) whiles that of the private sector health facilities was 19.9 % (95 % CI: 13.55, 26.30). Mothers who had a Caesarean section in the public sector health facilities had 67 % lower odds of early essential newborn care compared to mothers who had a vaginal delivery [adjusted prevalence odds ratios (aPOR) = 0.33, 95 % CI: 0.20, 0.53]. Mothers without a health insurance in the public sector health facilities had 26 % lower odds of early essential newborn care compared to mothers with a health insurance (aPOR = 0.74, 95 % CI: 0.56, 0.97). However, these associations were not observed in the private sector health facilities. Conclusions The findings suggest that the prevalence of good early essential newborn care in the public sector health facilities was higher than that reported in the private sector health facilities. Child health programs on early essential newborn care needs to be prioritized in the private healthcare sector. The Government of Ghana may also need to increase the coverage of the national health insurance scheme for women in reproductive age.

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Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

Journal of the Pakistan Medical Association ◽

10.47391/jpma.0003 ◽

2021 ◽

pp. 16-21

Author(s):

Syed Sharaf Ali Shah ◽

Safdar Pasha ◽

Nikhat Iftikar ◽

Altaf Ahmed Soomro ◽

Nazia Farrukh ◽

...

Keyword(s):

Public Sector ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Health Facilities ◽

Cross Sectional ◽

Injection Equipment ◽

Public And Private ◽

Healthcare Facilities ◽

The Public ◽

Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

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Health Characteristics and Utilization of Public Sector Health Facilities Among Migrant Agricultural Workers in Orange County, New York

Journal of Health & Social Policy ◽

10.1300/j045v04n01_06 ◽

1992 ◽

Vol 4 (1) ◽

pp. 57-75 ◽

Cited By ~ 8

Author(s):

Shelley I White-Means

Keyword(s):

New York ◽

Public Sector ◽

Orange County ◽

Health Facilities ◽

Agricultural Workers ◽

Public Sector Health ◽

Characteristics And Utilization

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Capacity of Ugandan public sector health facilities to prevent and control non-communicable diseases: an assessment based upon WHO-PEN standards

BMC Health Services Research ◽

10.1186/s12913-018-3426-x ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 12

Author(s):

Hilary E. Rogers ◽

Ann R. Akiteng ◽

Gerald Mutungi ◽

Adrienne S. Ettinger ◽

Jeremy I. Schwartz

Keyword(s):

Public Sector ◽

Communicable Diseases ◽

Health Facilities ◽

Non Communicable Diseases ◽

Public Sector Health ◽

And Control

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Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria

Health Policy and Planning ◽

10.1093/heapol/czy032 ◽

2018 ◽

Vol 33 (5) ◽

pp. 666-674 ◽

Cited By ~ 2

Author(s):

Atsumi Hirose ◽

Ibrahim O Yisa ◽

Amina Aminu ◽

Nathanael Afolabi ◽

Makinde Olasunmbo ◽

...

Keyword(s):

Public Sector ◽

Health Facilities ◽

Delivery Care ◽

Technical Quality ◽

Quality Of Delivery ◽

Private And Public ◽

Public Sector Health

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District health information systems in the public sector: health centres in Korea

VINE ◽

10.1108/vine.2003.28733dae.003 ◽

2003 ◽

Vol 33 (4) ◽

Keyword(s):

Information Systems ◽

Public Sector ◽

Health Information ◽

Health Information Systems ◽

District Health ◽

The Public ◽

Health Centres ◽

Public Sector Health

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Public procurement performance and the challenge of service complexity – the case of pre-hospital healthcare

Journal of Public Procurement ◽

10.1108/jopp-01-2020-0002 ◽

2020 ◽

Vol 20 (4) ◽

pp. 403-421

Author(s):

Inger Johanne Pettersen ◽

Kari Nyland ◽

Geraldine Robbins

Keyword(s):

Health Care ◽

Public Sector ◽

Health Care Services ◽

Practical Implication ◽

Public Procurement ◽

Content Type ◽

Procurement Process ◽

The Public ◽

Social Controls ◽

Public Sector Health

Purpose The purpose of this paper is to study the links between contextual changes, contract arrangements and resultant problems when changes in outsourcing regulatory requirements are applied to complex pre-hospital services previously characterized by relational contracting. Design/methodology/approach The study deployed a qualitative design based on interviews with key informants and extensive studies of documents. It is a longitudinal study of a procurement process taking place in a regional health authority covering the period 2006 to 2017. Findings A complex and longitudinal public procurement process where pre-hospital (ambulance) services are transformed from relational and outsourced governance to more formal arrangements based on legal and transactional controls, is described in detail. After several years, the process collapsed due to challenges following public scrutiny, legal actions and administrative staff resignations. The public body lacked procurement competencies and the learning process following the regulations was lengthy. In the end, the services were in-sourced. Research limitations/implications This study is based on one case and it should, therefore, not be generalized without limitations. Practical implications One practical implication of this study is that transactional contracts are not optimal when core and complex services are produced in inter-organizational settings. In public sector health-care contexts, the role of informal and social controls based on relational exchanges are particularly applicable. Social implications Acute health-care services essential to citizens’ security and health imply high asset specificity, frequency and uncertainty. Such transactions should according to theory be produced in-house because of high agency costs in the procurement process. Originality/value The paper contributes to the understanding of how the public procurement process can itself be complex, as managerial challenges and solutions vary along several dimensions and are contingent upon external factors. In particular, the study increases knowledge of why the design and implementation of outsourcing models may create problems that impede and obstruct control in a particular public sector context.

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Factors Contributing to Low Tuberculosis Detection Rates among Children Accessing Health Services in Selected Public Sector Health Facilities in Zimbabwe

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.08.04.art002 ◽

2020 ◽

Vol 8 (4) ◽

pp. 8-17

Author(s):

Emmanuel Tachiwenyika

Keyword(s):

Public Sector ◽

Cross Sectional Study ◽

Health Facilities ◽

African Countries ◽

Cross Sectional ◽

Detection Rates ◽

Ethical Approval ◽

Childhood Tb ◽

Pediatric Tb ◽

Public Sector Health

Introduction: Zimbabwe is one of 8 African countries with high per capita incidence of TB, TB/HIV and multi-drug resistant TB. Zimbabwe experienced a proportionate decline in childhood TB contribution to all notifications from 9% in 2011 to 5% in 2017. Methodology: Analytical cross-sectional study was conducted in 20 public sector health facilities. Data were collected from healthcare workers (HCWs) using structured questionnaires, interview guide for health managers and data abstraction tool for childhood TB data in registers. Protocol received ethical approval and written informed consent was obtained from participants. Results: Eighty-one HCWs and 18 managers were interviewed; data for 21,791 children were abstracted. About 3.1% of children were screened for TB, and 63.2% of presumptive TB children had TB diagnostic tests. A majority (71.9%) of TB tests were conducted on the Gen Xpert MTB Rif platform. Thirty-one out of 335 children with TB tests were diagnosed with TB, and 93.5% were initiated on treatment. Seven facilities offered TB testing, 5 had TB guidelines and 5 had pediatric TB job aides. Five out of 7 microscopes and 4/7 GeneXpert machines were functional. About 64.1% of HCWs had childhood TB training, 51% had ever received mentorship on childhood TB management, 53.1% had ever collected childhood TB diagnosis specimen and 23.3% had ever initiated children on TB treatment. Discussion: Childhood TB screening and diagnosis was suboptimal, and this was a result of low healthcare worker capacity, shortage and breakdown of TB diagnostic machines and weak TB diagnostic sample transportation system.

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