scholarly journals Determinants of practice of preconception care among women of reproductive age group in southern Ethiopia, 2020: content analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aklilu Habte ◽  
Samuel Dessu ◽  
Dereje Haile
Keyword(s):  
Decision Making ◽  
Linear Regression ◽  
Low Income ◽  
Psychological Health ◽  
Preconception Care ◽  
Household Wealth ◽  
Low Income Countries ◽  
Southern Ethiopia ◽  
Care Practice ◽  
Generalized Linear Regression

Abstract Background Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for desired outcomes. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to assess the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. Methods A community-based cross-sectional study was conducted from February 1 to 30, 2020. A total of 600 mothers who have given birth in the last 12 months have been randomly selected. A two-stage sampling technique was employed. For data collection, a pre-tested, semi-structured questionnaire was used. The data was encoded and entered into Epi-Data version 3.1 and exported for analysis to SPSS version 23. Household wealth status was determined through the application of principal component analysis(PCA). The practice PCC was considered as a count variable and measured as a minimum score of 0 and a maximum of 10. A bivariable statistical analysis was performed through analysis of variance (ANOVA) and independent t-tests and variables with a p-value of < 0.05 were eligible for the generalized linear regression model. To see the weight of each explanatory variable on PCC utilization, generalized linear regression with a Poisson link was done. Results Of the sampled 600 participants, 591 took part in the study, which yielded a response rate of 98.8%.The mean (± SD) score of the practice of PCC was 3.94 (± 1.98) with minimum and maximum scores of 0 and 10 respectively. Only 6.4% (95%CI: 4.6, 8.6) of mothers received all selected items of PCC services. Thecommonest item received by 67.2% of mothers was Folic acid supplementation, while 16.1% of mothers received the least item of optimizing psychological health. Education status of mother[AOR 0.74, 95%CI 0.63, 0.97], time spent to access nearby health facilities [AOR 0.69, 95%CI 0.58, 0.83], availability of PCC unit [AOR 1.46; 95%CI 1.17, 1.67], mother’s knowledge on PCC [AOR 1.34, 95%CI 1.13, 1.65], being a model household [AOR 1.31, 95%CI 1.18, 1.52] and women’s autonomy in decision making [AOR 0.75, 95%CI 0.64, 0.96] were identified as significant predictors of practice of PCC. Conclusion The uptake of WHO-recommended PCC service elements in the current study area was found to be unsatisfactory. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice. Plain language summary Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for better endings. The main goal of the PCC is to improve maternal and child health outcomes, by-promoting wellness and providing preventive care. It can also be seen as an earlier chance for teenage girls, mothers, and children to live a better and longer-term healthy life. Pieces of PCC service packages suggested by the World Health Organization(WHO) are, micronutrient supplementation (Folate supplementation), infectious disease (STI/HIV) screening and testing, chronic disease screening and management, healthy diet therapy, vaccination, prevention of substance use (cessation of cigarette smoking and too much alcohol consumption), optimizing psychological health, counseling on the importance of exercise and reproductive health planning and implementation. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to evaluate the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. Mothers who have given birth in the last 12 months have been randomly selected Household wealth status was determined through the application of principal component analysis(PCA). To see the weight of each explanatory variable on PCC, generalized linear regression with a Poisson type was done. Accordingly, the Education status of the mother, time spent to access nearby health facilities, availability of PCC unit, mother’s knowledge on PCC, being a model household, and women’s autonomy in decision making were identified as significant predictors of practice of PCC. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

scholarly journals Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Milimo ◽  
J. M. Zulu ◽  
J. Svanemyr ◽  
E. Munsaka ◽  
O. Mweemba ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomised Controlled Trial ◽  
Low Income ◽  
Controlled Trial ◽  
Community Support ◽  
Female Adolescents ◽  
Low Income Countries ◽  
Sexual Decision Making ◽  
Economic Support ◽  
Randomised Controlled

Abstract Background The importance of educating female adolescents has been recognized as critical to the development of any country. However, in low income countries like Zambia they often drop out of school due to poverty, early pregnancy and early marriages. Some studies indicate that economic support such as Social Cash Transfers (SCTs) can mitigate the effects of poverty on female adolescents by improving their school participation and helping postpone pregnancy and marriage. This study aimed to explore the role of economic support in influencing education and sexual decision making among female adolescents in a randomised controlled trial in Zambia. Methods The study adopted a qualitative approach. It utilized purposive and convenient sampling. Data were collected from 6 schools using 18 in-depth interviews (IDIs) and 4 focus group discussions (FGDs) comprising 48 school-going female adolescents in grade 8 aged 14 to 17. All participants received economic support in form of SCTs and payment of school fees as part of the Research Initiative to Support the Empowerment of Girls (RISE), a Cluster Randomised Controlled Trial. Data were analyzed using thematic analysis. Results Findings suggested several benefits of the economic support for the female adolescents such as economic independence and empowerment; increased assertiveness and autonomy; reduced desire for sexual relationships with boys in exchange for cash and gifts; increased motivation for school; enhanced parental and community support for female adolescents’ education and; reduced school dropouts. However, they also experienced jealousy from those who did not benefit from the economic support. Conclusion Economic support played a significant role in influencing both educational and sexual decision making among female adolescents. Trial registration ISRCTN Registry: ISRCTN12727868, (4 March 2016).

Effects of social media motivations on women’s psychological well-being in Pakistan

First Monday ◽  
2020 ◽  
Author(s):  
Iffat Ali Aksar ◽  
Mahmoud Danaee ◽  
Huma Maqsood ◽  
Amira Firdaus
Keyword(s):  
Social Media ◽  
Low Income ◽  
Psychological Health ◽  
Online Survey ◽  
Media Use ◽  
Sampling Technique ◽  
Well Being ◽  
Low Income Countries ◽  
Social Media Use ◽  
Psychological Well Being

Social media use has been increasing apace regardless of geographical and economic boundaries. In particular, its penetration has occurred more rapidly in developing and low-income countries with abounding health and psychological disadvantages. Given the understanding that women are more prone to psychological disorders than men, the current research is an effort to examine social media motives and subsequent effects on the psychological well-being of women social media users in Pakistan. The study is based on an online survey conducted to ascertain as to what extent social media use contributes to women’s psychological well-being or otherwise. The survey recorded responses of 240 women selected through purposive sampling technique. SEM-PLS analysis of the collected data revealed that social media usage plays a meaningful role in women’s psychological health. However, results exposed that Pakistani women, under the traditional patriarchal social pressure, not only have to observe cultural norms in online practices but are also forced to adhere to socially constructed gender roles in online spaces. The mixed results suggest conducting extensive research for a deeper insight into the role of social media in psychological well-being of women in other low-income countries.

scholarly journals Reversible Long Term Contraceptives Utilization among Married Women of Reproductive Age Group in Areka Town, Southern Ethiopia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Samson Kastro Dake ◽  
Temesgen Lera Abiso
Keyword(s):  
Low Income ◽  
Statistical Significance ◽  
Married Women ◽  
Reproductive Age ◽  
Low Income Countries ◽  
Southern Ethiopia ◽  
Age Group ◽  
Women Of Reproductive Age ◽  
Reproductive Age Group

BACKGROUND፡ In low income countries, bearing many children is the main factor affecting maternal health. This study aimed to estimate the prevalence of reversible long term contraceptives utilization and identify factors associated with it among married women of child bearing age in Areka District in South EthiopiaMETHODS: We conducted a community-based cross-sectional survey involving systematically recruited 346 married women of reproductive age group. Data was collected using a structured interviewer-administered questionnaire on May 2019. We used SPSS version 25 for data entry and analyses. Bivariate logistic regression analysis was used to select exposure variables with crude association. Multivariate analysis was done to control for potential confounders and identify predictors of the outcome. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI)was reported, and statistical significance was declared at p<0.05.RESULTS: The prevalence of reversible long term contraceptives utilization among married women of reproductive age group was 134(38.7%). Utilization of Reversible Long Term Contraceptives (RLTCs) was positively associated with being protestant Christian religion follower, advanced educational status, history of abortion, and having a better attitude towards reversible long term contraceptives. In other words, being housewife, being daily laborer, having no radio in the household and making fertility decisions alone were negatively associated.CONCLUSION: The prevalence of RLTCs in the study area was high. Women should be empowered educationally through other alternative opportunities to formal school. In addition to electronic media, different community events and community conversations should be used to convey messages on contraceptives particularly RLTCs. Behavioral change communications would benefit women in shaping their attitudestowards RLTCs.

scholarly journals Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1652 ◽  
Author(s):  
Muluneh Yigzaw Mossie ◽  
Anne Pfitzer ◽  
Yousra Yusuf ◽  
China Wondimu ◽  
Eva Bazant ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Continuum Of Care ◽  
Low Income Countries ◽  
Health Extension Workers ◽  
Pregnancy Risk ◽  
The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

scholarly journals Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi

2020 ◽  
Author(s):  
Sarah C Masefield ◽  
Alan Msosa ◽  
Jean Grugel
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
National Health ◽  
Low Income ◽  
Service Providers ◽  
Health Sector ◽  
National Health System ◽  
Low Income Countries ◽  
Health Coverage

Abstract BackgroundAll countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access and quality in Malawi. Its health sector is highly dependent on donor contributions, and recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve more effective cooperation with stakeholders. This study explores health sector stakeholders’ perceptions of the challenges to improving governance in Malawi’s national health system within the post-2017 context of government attempts to articulate a way forward.MethodsA qualitative study design was used. Interviews were conducted with 22 representatives of major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. Content relating to healthcare governance was identified in the transcripts and field notes and analysed using inductive content analysis.ResultsStakeholders view governance challenges as a significant barrier to achieving a more effective and equitable health system. Three categories were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).ConclusionsHealth sector stakeholders see serious political, structural, and financial challenges to improving governance in the national health system in Malawi which will impact the government’s goal of achieving UHC by 2030. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the policy documents, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC. The difficulties stakeholders perceive in relation to building equitable and effective healthcare governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.

scholarly journals Participatory Design and Process Testing to Optimize Utility, Usability, and Acceptability of a Mobile Game for Promoting Evidence-Driven Public Health Decision-Making in Resource-Constrained Settings

2022 ◽  
Vol 3 ◽  
Author(s):  
James Douglas Sinnatwah ◽  
Hajah Kenneh ◽  
Alvan A. Coker ◽  
Wahdae-Mai Harmon-Gray ◽  
Joelyn Zankah ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Low Income ◽  
Participatory Design ◽  
End Users ◽  
Low Income Countries ◽  
Design Team ◽  
Training Methods ◽  
Design Development ◽  
Mobile Game

Innovative game-based training methods that leverage the ubiquity of cellphones and familiarity with phone-based interfaces have the potential to transform the training of public health practitioners in low-income countries such as Liberia. This article describes the design, development, and testing of a prototype of the Figure It Out mobile game. The prototype game uses a disease outbreak scenario to promote evidence-based decision-making in determining the causative agent and prescribing intervention measures to minimize epidemiological and logistical burdens in resource-limited settings. An initial prototype of the game developed by the US team was playtested and evaluated by focus groups with 20 University of Liberia Masters of Public Health (UL MPH) students. Results demonstrate that the learning objectives—improving search skills for identifying scientific evidence and considering evidence before decision-making during a public health emergency—were considered relevant and important in a setting that has repeatedly and recently experienced severe threats to public health. However, some of the game mechanics that were thought to enhance engagement such as trial-and-error and choose-your-own-path gameplay, were perceived by the target audience as distracting or too time-consuming, particularly in the context of a realistic emergency scenario. Gameplay metrics that mimicked real-world situations around lives lost, money spent, and time constraints during public health outbreaks were identified as relatable and necessary considerations. Our findings reflect cultural differences between the game development team and end users that have emphasized the need for end users to have an integral part of the design team; this formative evaluation has critically informed next steps in the iterative development process. Our multidisciplinary, cross-cultural and cross-national design team will be guided by Liberia-based public health students and faculty, as well as community members who represent our end user population in terms of experience and needs. These stakeholders will make key decisions regarding game objectives and mechanics, to be vetted and implemented by game design experts, epidemiologists, and software developers.

Developing Training Tools for Clinicians in LICs: Using Hidden Markov Modeling to Study the Decision-Making Strategies of Expert and Novice Prosthetists

2020 ◽  
Author(s):  
Pratima Saravanan ◽  
Michael Walker ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Low Income ◽  
Decision Support Tool ◽  
Low Income Countries ◽  
Controlled Study ◽  
Clear Understanding ◽  
Care Providers ◽  
Support Tool ◽  
Expert And Novice

Abstract Approximately, 40 million amputees reside in the rural parts of Low-Income Countries (LICs), and 95% of this population do not have proper access to prosthetic devices and rehabilitation services. A proper prosthetic prescription requires a clear understanding of the patient’s ambulation, goals, cultural and societal norms, locally available prosthetic materials, etc., which can be accomplished only by a local prosthetist. However, due to the lack of prosthetic schools and training centers in LICs, the rural parts lack well-trained amputee care providers. Hence there is a need to educate the prosthetists and prosthetic technicians in the LIC, specifically in the rural regions. To accomplish this, the current research proposes a decision-support tool to aid decision-making during prescription and educate prosthetists. A controlled study was conducted with expert and novice prosthetists to compare effective decision-making strategies. Results suggest that experts leverage distinct decision-making strategies when prescribing prosthetic and orthotic devices; in comparison, novices exhibited less consistent patterns of decision-making tendencies. By modeling the decision-making strategies of expert prosthetists, this work lays the foundation to develop an automated decision support tool to support decision-making for prosthetists in LICs, improving overall amputee care.

scholarly journals Scaling up Dietary Data for Decision-Making in Low-Income Countries: New Technological Frontiers

2017 ◽  
Vol 8 (6) ◽  
pp. 916-932 ◽  
Author(s):  
Winnie Bell ◽  
Brooke A Colaiezzi ◽  
Cathleen S Prata ◽  
Jennifer C Coates
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Scaling Up ◽  
Low Income Countries ◽  
Dietary Data

Association Between Maternal Education and Childhood Mortalities in Myanmar

2019 ◽  
Vol 31 (8) ◽  
pp. 689-700 ◽  
Author(s):  
Khaing Soe ◽  
Paula Holland ◽  
Ceu Mateus
Keyword(s):  
Low Income ◽  
Maternal Education ◽  
Secondary Level ◽  
Household Wealth ◽  
Social Determinant ◽  
Low Income Countries ◽  
Independent Effect ◽  
Comprehensive Health ◽  
Health Survey Data ◽  
Context Specific

Maternal education is widely regarded as a core social determinant of child mortality in low-income countries. In Myanmar, the evidence related to context-specific social determinants of health including maternal education is scarce, limiting grounds to advocate for a comprehensive health policy. Employing multivariate methods, the study analyzed the 2015-2016 Demographic Health Survey data exploring independent effect of maternal education on neonatal, infant, and under-5 mortality. The study found that maternal education was not significantly associated with neonatal mortality as its effect was confounded by household wealth and geographic residence; however, it had independent effect on infant and under-5 mortality. Mothers with primary education had 23% reduction in the odds of under-5 mortality ( P < .001); those with secondary level had 40% reduction ( P < .001); and those at higher level had 62% reduction ( P < .001). The study concluded that maternal education is a critical social determinant of childhood mortalities in Myanmar.

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