scholarly journals Barriers and facilitators to breastfeeding during the immediate and one month postpartum periods, among Mexican women: a mixed methods approach

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sonia Hernández-Cordero ◽  
Ana Lilia Lozada-Tequeanes ◽  
Ana Cecilia Fernández-Gaxiola ◽  
Teresa Shamah-Levy ◽  
Matthias Sachse ◽  
...  
Keyword(s):  
Infant Formula ◽  
Exclusive Breastfeeding ◽  
Mexican Women ◽  
Timely Initiation ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
Hospital Practices ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Evidence suggests that inadequate hospital practices, as well as sociocultural and community factors have detrimental effects on timely initiation as the first breastfeed within first hour after birth, and exclusive breastfeeding. The purpose of the study was to examine the factors that influence timely initiation of breastfeeding and exclusive breastfeeding at birth and 1 month postpartum in Mexican women delivering in public and private hospitals. Methods Mixed methods were conducted between May and July 2017, including surveys (n = 543) and semi-structured interviews (n = 60) in the immediate (7 h) and intermediate (30 days) postpartum periods. Participants were women aged 15–49 years, in public and private hospitals, of urban and rural municipalities of Chihuahua and Puebla, Mexico. Results Timely initiation was reported by 49.4% of mothers, and 34.7% reported that their children received infant formula at the hospital. Only 44.8% of women reported exclusive breastfeeding at 1 month postpartum. Timely initiation of breastfeeding was higher in women with vaginal delivery (62.1 vs 35.5%; p < 0.05) and those who received information during pregnancy (OR 1.07; p = 0.018). Exclusive breastfeeding at 1 month postpartum was related to older maternal age (OR 1.05; p < 0.001) and the fact that the mothers had received more information about breastfeeding during pregnancy (OR 1.13; p = 0.0001). Infant formula use was less associated with timely initiation (OR 0.46; p = 0.001). Participants in qualitative data identified the emotional, physical and economic benefits of breastfeeding, however, the perception about insufficient production of human milk, and the belief that infant formula is recommended, persists. Conclusions Modification of hospital practices, such as decreasing the number of cesarean and the use of infant formula, as well as the support of the initiation and continuation of exclusive breastfeeding by health personnel and family members, could help increase breastfeeding practices in Mexican women.

scholarly journals A Review of the Factors Associated With the Timely Initiation of Breastfeeding and Exclusive Breastfeeding in the Middle East

2017 ◽  
Vol 11 ◽  
pp. 117955651774891 ◽  
Author(s):  
Riyadh A Alzaheb
Keyword(s):  
Middle East ◽  
Exclusive Breastfeeding ◽  
Maternal Employment ◽  
Middle Eastern ◽  
World Health ◽  
Delivery Mode ◽  
Breastfeeding Initiation ◽  
Timely Initiation ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Background: Breastfeeding supplies all the nutrients that infants need for their healthy development. Breastfeeding practice is multifactorial, and numerous variables influence mothers’ decisions and ability to breastfeed. This review identifies the factors potentially affecting the timely initiation of breastfeeding within an hour after birth and exclusive breastfeeding in the first 6 months in Middle Eastern countries. Methods: The Medline, ScienceDirect, and Web of Science databases were keyword-searched for primary studies meeting the following inclusion criteria: (1) publication in the English language between January 2001 and May 2017, (2) original research articles reporting primary data on the factors influencing the timely initiation of breastfeeding and/or exclusive breastfeeding, (3) the use of World Health Organization definitions, and (4) Middle Eastern research contexts. A random effect model was used to establish the average prevalence of the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. Results: The review identified 19 studies conducted in Saudi Arabia (7), Iran (3), Egypt (2), Turkey (2), Kuwait (1), the United Arab Emirates (1), Qatar (1), Lebanon (1), and Syria (1). The meta-analysis established that 34.3% (confidence interval [CI]: 20.2%-51.9%) of Middle Eastern newborns received breastfeeding initiated within an hour of birth, and only 20.5% (CI: 14.5%-28.2%) were fed only breast milk for the first 6 months. The 8 studies exploring breastfeeding initiation most commonly associated it with the following: delivery mode, maternal employment, rooming-in, and prelacteal feeding. The 17 studies investigating exclusive breastfeeding most frequently linked it to the following: maternal age, maternal education, maternal employment, and delivery mode. Conclusions: Middle Eastern health care organizations should fully understand all the determinants of breastfeeding identified by this review to provide suitable practical guidance and advice to help new mothers to overcome barriers where possible and to contribute to improving infant and maternal health in the region.

scholarly journals Influence of pharmaceutical marketing mix strategies on physicians’ prescribing behaviors in public and private hospitals, Dessie, Ethiopia: a mixed study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abel Demerew Hailu ◽  
Birhanu Demeke Workneh ◽  
Mesfin Haile Kahissay
Keyword(s):  
Study Design ◽  
Marketing Mix ◽  
Pharmaceutical Marketing ◽  
Depth Information ◽  
Second Phase ◽  
Private Hospitals ◽  
Public And Private ◽  
Qualitative Design ◽  
Prescribing Behavior ◽  
Public And Private Hospitals

Abstract Background Prescription drugs constitute the primary source of revenue for the pharmaceutical industry. Most pharmaceutical companies commit a great deal of time and money to market in hopes of convincing physicians about their products. The objective of this study is to assess perceived influence of pharmaceutical marketing mix strategies on physicians’ prescribing behaviors in hospitals, Dessie, Ethiopia. Methods Mixed methods sequential explanatory design was employed in two public and three private hospitals. A cross-sectional study design was employed by including (136) physicians working in public and private hospitals. Percentage, mean, standard deviation, and multiple linear regressions were computed using Statistical Package for Social Science. In the second phase, the phenomenological design was employed to fully explore in-depth information. Purposive sampling was used to select key informants and 14 in-depth interviews were conducted by the principal investigator. Content analysis was performed using Nvivo 11 plus and interpretation by narrative strategies. Results The overall perceived influence of pharmaceutical marketing mix strategies in physicians’ prescribing behavior was 55.9%. The influence of promotion, product, place and price strategy perceived by physicians in their prescribing behavior was 83 (61%), 71(52.2%), 71 (52.2%), 80 (58.8%) respectively. There was a statistically significant difference among marketing mix strategies (β = 0.08, p = < 0.001). Determinants on the influence of physicians’ prescribing behavior were specialty (p = 0.01) and working areas (p = 0.04). The qualitative design also generates additional insights into the influence of pharmaceutical marketing mix strategies on physician prescribing behavior. Conclusions More than half of physicians perceived that pharmaceutical marketing mix strategies influence their prescribing behavior. The qualitative design also revealed that pharmaceutical marketing mix strategies influenced physicians prescribing behavior. Strengthening the regulation and maintaining ethical practice would help to rationalize the physicians’ prescribing practice.

scholarly journals THE CO-PRODUCTION OF INNOVATION: A CASE STUDY IN A REHABILITATION HOSPITAL

2016 ◽  
Vol 17 (4) ◽  
pp. 109-129
Author(s):  
REGIS SILAS CARDOSO ◽  
ANTONIO ISIDRO DA SILVA FILHO ◽  
LEAR VALADARES VIEIRA
Keyword(s):  
Private Hospitals ◽  
Public And Private ◽  
Production Studies ◽  
Rehabilitation Hospital ◽  
Innovative Process ◽  
Innovation Capacity ◽  
Public And Private Hospitals ◽  
Methodological Aspects ◽  
Research Analysis

ABSTRACT Purpose: Understand how the user, the provider/supplier and the decision maker interact in the innovative process, as well as identify how the co-production occurs. Originality/gap/relevance/implications: There is evidence that the innovation derives among other factors from elements that characterize the co-production. Studies involving co-production of innovation are scarce. This study contributes to increase the theoretical knowledge in innovation in hospitals, mainly regarding co-production of innovation. Key methodological aspects: It is a qualitative study with case study strategy. Data collection through interviews and documentary research. Analysis of the data by technique of content analysis. Summary of key results: The logic of product development is still applied in the development of technological solutions for the hospital, against the logic of services, involving the interaction of customer with supplier. The results also suggest the possibility of relationship between innovation capacity and occurrence of innovation, pointing out the need to test this relationship in future works. Key considerations/conclusions: It is necessary to understand and investigate the mechanisms that allow the interaction of users, from design to implementation of innovation. It is also important to investigate whether the elements that characterize the co-production are relevant to explain innovation in hospitals, because elements were identified related to the concept of innovation that deserves to be better understood, including in contexts of public and private hospitals.

scholarly journals Client Satisfaction on Antenatal Care Service by Pregnant Women in Public and Private Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Comparative Descriptive Study

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Waiting Time ◽  
Client Satisfaction ◽  
Addis Ababa ◽  
Care Service ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals

Background: Antenatal care (ANC) is an important health care service which is intended to potentially reduce maternal morbidity and mortality particularly in areas where the general health status of women is presumed poor, choice of facilities is limited and the service delivery compromised by geography (terrain, transport), socio-demographic factors, financial capability and awareness. Though improving the quality of health care is one of the targeted strategies in the Health Sector Development Program IV (HSDP IV) of Ethiopia, little is known about the quality of antenatal care service and client satisfaction at the different hospitals in Addis Ababa, the capital city of Ethiopia. Objective: To determine satisfaction of ANC services among pregnant women at the public teaching and private hospitals in Addis Ababa, Ethiopia. Methods: Health institution-based comparative cross-sectional study was conducted from February to June, 2019 in public and private hospitals, in Addis Ababa, using sample size determination for comparisons of proportion between the two populations. All participants who fulfilled the inclusion criteria were enrolled based on the flow of pregnant women to the ANC clinics at the selected hospitals. Data were entered and cleaned using EPI-info version 3.5.1 and analysis was performed by SPSS version 21. Association of independent variables with the client satisfaction was done using binary and multivariate logistic regression. Significant association of variables with outcome was determined using adjusted odds ratio (AOR) together with 95 % confidence interval. Level of significance was set at P-value of ≤ 0.05. Results: Five hundred seventy one pregnant women attending Antenatal Care at private (281) and public (290) hospitals were included with response rates of 94.1 and 91.2% for public and private hospitals, respectively. The age distribution of the participants was between 17 and 43 years with a mean age of 27.3±5.1 years. Most of the clients, 249 (88.7%) at private and 276 (95.2%) at public hospitals were between the ages of 20 and 34 years. One hundred fourteen (39.3%) of the clients at public and 113 (40.2%) at private hospitals were nulliparous. The clients overall satisfaction with antenatal care was mostly positive both at the private and public hospitals and two hundred twenty eight (81.1%) of the private and 174 (60%) of the public hospitals were satisfied with the services provided. Having ANC follow up at the private hospitals had statistically significant difference in client satisfaction compared to those in public hospitals with P value of 0.019, (AOR 2.97, 95% CI:1.19 -7.74). Clients’ satisfaction with the cleanliness of the environment was 11.1 times more likely to be satisfied with the general ANC service, P<0.05, (AOR 12.18 95% CI: 7.45-19.91). Having more than 4 ANC visits was positively associated with client overall satisfaction, P= 0.021, (AOR 2.41, 95% CI: 1.12-5.24,) while long waiting time is negatively associated with client satisfaction. Conclusions: The study showed significant difference in client satisfaction rate between the selected private and public facilities. Private facilities outperformed public facilities with regards to structural features (privacy, waiting time, space, and neatness). We recommend concerted effort to improve ANC visits and pay due attention to the privacy, waiting time, and the neatness of the facilities in public hospitals.

scholarly journals Fostering the practice of rooming-in in newborn care

2013 ◽  
Vol 3 (2) ◽  
pp. 177-178
Author(s):  
Saurabh R. Shrivastava ◽  
Prateek S. Shrivastava ◽  
Jegadeesh Ramasamy
Keyword(s):  
Institutional Delivery ◽  
Newborn Care ◽  
Cost Effective ◽  
Timely Initiation ◽  
Cost Effective Approach ◽  
Health Related ◽  
And Child Health ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding ◽  
Universal Application

Practice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge. Adoption of rooming-in offers multiple benefits to the newborn, mother, and mother-child as a unit. It is a cost-effective approach wherefewer instruments are required and spares additional manpower. Rooming-in endeavors the opportunity to contribute signifi cantly in the child’s growth, development and survival by assisting in timely initiation of breastfeeding. To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of healthcare professionals. Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative; inculcating a sense of ownership among health professionals, can be strategically enforced for better maternal and child health related outcomes.

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