scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

scholarly journals Health Facility Capacity to Provide Postabortion Care in Afghanistan: A Cross-Sectional Study

2019 ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
Skilled Birth Attendants ◽  
Public Health Facilities ◽  
Birth Attendants ◽  
Public Facilities ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Manual Vacuum Aspiration ◽  
Family Planning Counseling

Abstract Background: Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births, Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes. Contraceptive prevalence rate has fluctuated between 10–20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated health facilities’ capacity to provide postabortion care, and skilled birth attendants’ knowledge and perceptions. Methods: Accessible public health facilities with at least five births per day on average (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Data collection methods for provision included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions.Results: Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Seventy percent of public facilities expected to provide basic emergency obstetric and newborn care had functional manual vacuum aspiration supplies in the delivery room. More than 80% of public health facilities had male condoms, oral contraceptive pills, intrauterine devices, and injectables. Conclusions: This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, and availability of supplies.

scholarly journals Immediate Postpartum Modern Family Planning Utilization and Associated factors among women gave birth public Health facilities, Addis Ababa, Ethiopia

2021 ◽  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
Full Text ◽  
Associated Factors ◽  
Addis Ababa ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Modern Family ◽  
Modern Family Planning

Abstract The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.

scholarly journals Availability of emergency obstetric and newborn care services at public health facilities of Sindh province in Pakistan

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramesh Kumar ◽  
Jamil Ahmed ◽  
Fozia Anwar ◽  
Ratana Somrongthong
Keyword(s):  
Public Health ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Public Health Facilities ◽  
Care Services ◽  
Sindh Province

Abstract Background Basic and comprehensive emergency obstetric care services in Pakistan remain a challenge considering continued high burden of maternal and newborn mortality. This study aimed to assess the availability of emergency obstetric and newborn care in Sindh Province of Pakistan. Methods This cross-sectional survey was conducted in twelve districts of the Sindh province in Pakistan. The districts were selected based on the maternal neonatal and child health indicators. Data were collected from 63 public-sector health facilities including district, Taluka (subdistrict) headquarters hospitals and rural health centers. Basic and comprehensive emergency obstetric newborn care services were assessed through direct observations and interviews with the heads of the health facilities by using a World Health Organization pretested and validated data collection tool. Participants interviewed in this study included the managers and auxiliary staff and in health facilities. Results Availability of caesarean section (23, 95% C.I. 14.0–35.0) and blood transfusion services (57, 95% CI. 44.0–68.0), the two components of comprehensive emergency obstetric and newborn care, was poor in our study. However, assessment of the seven components of basic emergency obstetric and newborn services showed that 92% of the health facilities (95% C.I. 88.0–96.0) had parenteral antibiotics, 90%, (95% C.I. 80.0–95.0) had oxytocin, 92% (95% CI 88.0–96.0) had manual removal of the placenta service, 87% (95%, C.I. 76.0–93.0) of the facilities had staff who could remove retained products of conception, 82% (95% C.I. 71.0–89.0) had facilities for normal birth and 80% (95% C.I. 69.0–88.0) reported presence of neonatal resuscitation service. Conclusion Though the basic obstetric and newborn services were reasonably available, comprehensive obstetric and newborn services were not available as per the World Health Organization’s standards in the surveyed public health facilities. Ensuring the availability of caesarean section and blood transfusion services within these facilities may improve population’s access to these essential services around birth.

scholarly journals Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Taposh Kumar Biswas ◽  
Hasnat Sujon ◽  
M. Hafizur Rahman ◽  
Henry B. Perry ◽  
Mahbub Elahi Chowdhury
Keyword(s):  
Public Health ◽  
Service Delivery ◽  
Healthcare Service ◽  
Infection Prevention ◽  
Health Facilities ◽  
Quality Monitoring ◽  
Public Health Facilities ◽  
Care Services ◽  
Maternal And Newborn

Abstract Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. Methods The study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (> 80%), moderate (50 to 80%), and low (< 50%). Results Overall QoC scores were moderate for each DH (54.8%), and MCWC (56.1%). In DH, the QoC score was high for blood transfusion (80.3%); moderate for maternal complications management (77.0%), caesarean section (CS) (65.6%), infection prevention (64.3%), sick newborn care (54.1%), and normal vaginal delivery (NVD) (52.6%); and low for antenatal care (ANC) (25.6%) and postnatal care (PNC) (19.0%). In MCWC, the QoC scores were high for infection prevention (83.0%); moderate for CS (76.5%) and NVD (59.8%); and low for ANC (36.9%) and PNC (24.5%). Conclusions In the study facilities, the QoC for MNH services is found to be unsatisfactory, particularly for ANC and PNC. Urgent initiative needs to be taken by introducing contextualized quality monitoring tools at health facilities, along with training of the care providers and introducing a quality monitoring system.

scholarly journals Quality of essential newborn care and neonatal resuscitation at health facilities in Afghanistan: a cross-sectional assessment

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030496
Author(s):  
Faridullah Atiqzai ◽  
Partamin Manalai ◽  
Sher Shah Amin ◽  
Karen M Edmond ◽  
Malalai Naziri ◽  
...  
Keyword(s):  
Public Health ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
High Volume ◽  
Health Facilities ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Public Health Facilities ◽  
Skin Contact

ObjectiveTo assess readiness and quality of essential newborn care and neonatal resuscitation practices in public health facilities in Afghanistan.DesignCross-sectional assessment.Setting226 public health facilities in Afghanistan, including 77 public health facilities with at least five births per day (high-volume facilities) and 149 of 1736 public health facilities with fewer than five births per day (low-volume facilities).ParticipantsManagers of 226 public health facilities, 734 skilled birth attendants (SBAs) working at these facilities, and 643 women and their newborns observed during childbirth at 77 high-volume health facilities.Outcome measuresAvailability of knowledgeable SBAs, availability of supplies and compliance with global guidelines for essential newborn care and neonatal resuscitation practices.ResultsAt high-volume facilities, 569/636 (87.9%) of babies were dried immediately after birth, 313/636 (49.2%) were placed in skin-to-skin contact with their mother and 581/636 (89.7%) had their umbilical cord cut with a sterile blade or scissors. A total of 87 newborn resuscitation attempts were observed. Twenty-four of the 87 (27.5%) began to breath or cry after simply clearing the airway or on stimulation. In the remaining 63 (72.5%) cases, a healthcare worker began resuscitation with a bag and mask; however, only 54 (62%) used a correct size of mask and three babies died as their resuscitation with bag and mask was unsuccessful.ConclusionsThe study indicates room for improvement of the quality of neonatal resuscitation practices at public health facilities in Afghanistan, requiring only strengthening of the current best practices in newborn care. Certain basic and effective aspects of essential newborn care that can be improved on with little additional resources were also missing, such as skin-to-skin contact of the babies with their mother. Improvement of compliance with the standard newborn care practices must be ensured to reduce preventable newborn mortality and morbidity in Afghanistan.

scholarly journals Inventory management performance for family planning, maternal and child health medicines in public health facilities of West Wollega zone, Ethiopia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Oliyad Kebede ◽  
Gizachew Tilahun
Keyword(s):  
Public Health ◽  
Family Planning ◽  
Child Health ◽  
Inventory Management ◽  
Maternal And Child Health ◽  
Supply System ◽  
Health Facilities ◽  
Management Performance ◽  
Public Health Facilities ◽  
And Child Health

Abstract Background Inventory management is the heart of the supply system in improving availability of medicines, reducing the cost, and improving patient care quality. However, in the government facilities’ supply system, inventory management is poor. So, the purpose of this research is to assess inventory management performance for family planning, maternal and child health medicines in public health facilities of West Wollega zone, Oromia region, Ethiopia. Method Facility-based descriptive cross-sectional quantitative study was conducted using checklist, structured and semi-structured questionnaire, and triangulated with qualitative method. Quantitative data were coded and analyzed using SPSS Version 20 and Microsoft excel spreadsheet. Qualitative data were analyzed manually, using thematic analysis technique. Different indicators were used to measure variables. Results Among 23 health facilities assessed, availability of family planning/maternal and child health medicines ranged from 0 to 100%. Average availability of medicines was 14 (61.30%) with mean stock-out duration of 70.71 days. Bin cards were available for 559 (78.40%) of medicines, and 374 (52.45%) bin cards were accurate. Report submission rate was 116 (84.06%), with 47 (40.52%) report and resupply forms reported on time, 73 (62.93%) of them were complete and 69 (59.48%) were accurate. Supplier-related problem, lack of human resource, administrative problem, and lack of computer infrastructure were inventory management challenges identified. Conclusion Inventory management performance for Family planning/maternal and child health medicines was poor as indicated by low availability, high stock-out duration, and poor LMIS performance. Efforts should be undertaken by concerned bodies to improve it.

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