scholarly journals A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Maria Persson ◽  
Elin C. Larsson ◽  
Noor Pappu Islam ◽  
Kristina Gemzell-Danielsson ◽  
Marie Klingberg-Allvin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Provision ◽  
Care Providers ◽  
Personal Beliefs ◽  
Menstrual Regulation ◽  
Humanitarian Settings ◽  
Abortion Care ◽  
Regulation Policy ◽  
Comprehensive Abortion Care

Abstract Background Humanitarian settings are characterised by limited access to comprehensive abortion care. At the same time, humanitarian settings can increase the vulnerability of women and girls to unintended pregnancies and unsafe abortions. Humanitarian actors and health care providers can play important roles in ensuring the availability and accessibility of abortion-related care. This study explores health care providers’ perceptions and experiences of providing comprehensive abortion care in a humanitarian setting in Cox’s Bazar, Bangladesh and identifies barriers and facilitators in service provision. Method In-depth interviews (n = 24) were conducted with health care providers (n = 19) providing comprehensive abortion care to Rohingya refugee women and with key informants (n = 5), who were employed by an organisation involved in the humanitarian response. Data were analysed using an inductive content analysis approach. Results The national menstrual regulation policy provided a favourable legal environment and facilitated the provision of comprehensive abortion care, while the Mexico City policy created organisational barriers since it made organisations unable or unwilling to provide the full comprehensive abortion care package. Supplies were available, but a lack of space created a barrier to service provision. Although training from organisations had made the health care providers confident and competent and had facilitated the provision of services, their knowledge of the national abortion law and menstrual regulation policy was limited and created a barrier to comprehensive abortion services. Even though the health care providers were willing to provide comprehensive abortion care and had acquired skills and applied strategies to communicate with and provide care to Rohingya women, their personal beliefs and their perceptions of Rohingya women influenced their provision of care. Conclusion The availability and accessibility of comprehensive abortion care was limited by unfavourable abortion policies, a lack of privacy, a lack of knowledge of abortion laws and policies, health care providers’ personal beliefs and a lack of cultural safety. To ensure the accessibility and availability of quality services, a comprehensive approach to sexual and reproductive health and rights is needed. Organisations must ensure that health care providers have knowledge of abortion policies and the ability to provide quality care that is woman-centred and non-judgmental.

Organisational impact of the National Disability Insurance Scheme transition on mental health care providers: the experience in the Australian Capital Territory

2018 ◽  
Vol 26 (6) ◽  
pp. 590-594 ◽  
Author(s):  
Mary Anne Furst ◽  
Jose A Salinas-Perez ◽  
Luis Salvador-Carulla
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Service Provision ◽  
Care Providers ◽  
Australian Capital Territory ◽  
Insurance Scheme ◽  
Mental Health Care Providers ◽  
The Impact

Objectives: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. Methods: All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Results: Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. Conclusions: The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.

scholarly journals Reproductive awareness and recognition of unintended pregnancy: young women, key informants and health care providers perspectives in South Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oluwaseyi Dolapo Somefun ◽  
Jane Harries ◽  
Deborah Constant
Keyword(s):  
South Africa ◽  
Health Care ◽  
Unintended Pregnancy ◽  
Health Care Providers ◽  
Signs And Symptoms ◽  
Second Trimester ◽  
Care Providers ◽  
Policy Makers ◽  
Abortion Care ◽  
Pregnancy Status

Abstract Background South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women’s experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers’ and policy makers’ ideas for public sector strategies to facilitate prompt confirmation of pregnancy. Methods We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis. Results Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible. Conclusion Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.

scholarly journals “Beyond Personal Beliefs”

SAGE Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. 215824401667271 ◽  
Author(s):  
Maria Giulia Olivari ◽  
Gaia Cuccì ◽  
Emanuela Confalonieri
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Health ◽  
Job Attitudes ◽  
Main Theme ◽  
Care Providers ◽  
Personal Beliefs ◽  
Structured Interviews ◽  
Adolescent Patients

Using a qualitative method, our study aims to explore, identify, and describe Italian health care providers’ reflections on the contraceptive behaviors of adolescents attending family health centers, and health care providers’ self-perception of their own job attitudes toward these adolescent patients. Semi-structured interviews with 46 Italian health care providers were conducted and analyzed using thematic analysis. Two main themes emerged from the thematic data analysis regarding Italian health care providers’ self-perceptions and reflections. The first main theme was labeled “adolescents’ contraceptive behavior” and included two subthemes: “adolescents are confused and unprepared” and “contraception is a girls’ responsibility.” The second theme was labeled “job attitudes with adolescents,” and included three subthemes: “to inform and to educate,” “to build trustful relationships,” and “to go beyond personal beliefs.” The findings of this study showed that Italian health care providers perceive themselves as nonjudgmental and they interpret their own behavior as an attempt to answer adolescents’ sexual and reproductive health (SRH) needs in an open-minded way. Their work with adolescent patients with relation to contraceptive behaviors is led by the desire to educate through building a significant and long-term relationship that could sustain these patients.

scholarly journals Emotional Responses And Perceived Stressors Of Frontline Medical Staffs In Case Of Addis Ababa Covid-19 Treatment Centers And Obstetrics Emergency And Abortion Care Clinic, Ethiopia; Analytical Cross Sectional Study

2020 ◽  
Author(s):  
Mebratu Kebede ◽  
Dereje Demissie ◽  
Dessalegn Guddu ◽  
Michael Haile ◽  
Zebenay Bitew ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Emotional Response ◽  
Addis Ababa ◽  
Emotional Responses ◽  
Care Providers ◽  
Front Line ◽  
Care Clinic ◽  
Abortion Care

Abstract Background: the rapid spread of COVID-19, its lethality in severe cases and the absence of specific medicine poses a huge threat to human life and health, as well as huge impact on the mental health. Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms including emotional disturbance.Objective: the aim of this study will be to assess the current state of emotional responses and perceived stressors of frontline medical staffs in case of Addis Ababa COVID-19 Treatment Centers and obstetrics emergency and abortion care, Ethiopia 2020Methods: Hospital based comparative cross-section study design was conducted by using self-administered questionnaire survey from June 1st to 30th of 2020 among 133 and 266 frontline medical staffs from obstetric emergency and abortion care clinic and COVID-19 treatment centers respectively. The data were collected after getting written consent from each participant and it entered into the computer using Epi-data version 7, then exported to SPSS version 20 for further analysis. Descriptive analysis was done using frequencies & percent. All independent determinants with P-value <0.05 were used to identify important predictors of emotional responses and perceived stressors. Result; A total of 399 frontline medical staffs were included in the study. The mean age of the respondents of those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD=3.46) years and it was 28.12 (SD=4.09) years for the other groups. This study revealed that, 72.9% and 5.6% of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had a positive emotional response, respectively. Factors such as having a low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), being a nurse (AOR 10.53, 95% CI (1.31, 85.26)) and working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with negative emotional response.Conclusion; The current study revealed that a high proportion of front line a negative emotional responses had negative emotional response. Further, almost all of the medical staffs working in COVID-19 treatment centers and at obstetrics emergency and abortion care unit had perceived the outbreak related stressors. So, providing comprehensive psychological support is warranted for health care providers working in such kinds of department or units.

scholarly journals Recovered Voices: Experiences of Borderline Personality Disorder

2016 ◽  
Author(s):  
Carla Chugani
Keyword(s):  
Health Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Health Care Providers ◽  
Service Provision ◽  
Lived Experiences ◽  
Healthcare Providers ◽  
Borderline Personality ◽  
Care Providers ◽  
Clinical Issues

The purpose of this article is to use poetic analysis to present evocative accounts of the lived experiences of individuals who have recovered from Borderline Personality Disorder (BPD). Individuals with BPD suffer from a complex set of clinical issues that may be worsened by stigmatization encountered in their general lives as well as from health care providers. I argue that one method of enhancing clinical service provision to individuals with BPD is to view their behavior within the context that it originally developed. Viewing behavior in context may enhance healthcare providers’ abilities to respond empathically and/or to assist clients in generating meaningful solutions to problems associated with BPD. The poems offered here represent six individual stories of the experience of BPD. These poems may serve as a reminder of the painful and often tragic circumstances in which “borderline” behaviors can develop. They may also be useful as tools to assist trainees in developing better understanding of how to work with individuals with BPD effectively and compassionately.

scholarly journals Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness

2021 ◽  
pp. 1-19
Author(s):  
Nicole Mancini ◽  
Rachel Campbell ◽  
Hannah Yaphe ◽  
Tadios Tibebu ◽  
Eshleen Grewal ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Service Provision ◽  
Allied Health ◽  
Primary Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Allied Health Professionals ◽  
Patients With Diabetes

Introduction: Health care providers face a multitude of challenges in providing care to patients with diabetes who are experiencing homelessness. Considering the unique circumstance faced by this population, mainstream services must be adapted and tailored to meet patients’ needs. The objective of this study was to explore both the barriers faced by providers and programs in offering comprehensive diabetes care to these patients, and their suggested areas for improvement. Methods: We conducted semi-structured interviews with providers who care for patients who have diabetes and/or who experience homelessness. Participants included primary care providers, specialist physicians, dietitians, shelter staff, outreach workers, and diabetes educators in five Canadian centres (n=96). Responses were analyzed using qualitative thematic analysis. Results: Barriers most frequently cited by providers were a lack of resources for staff. Other challenges included policy barriers (restrictions on billing codes, care professionals’ scope of practice, and the structure of financial support for this population), duplication of services, and alternative priorities of care. Participants identified several strategies to improve care, which targeted the following spheres: location of service provision and coordination of care, policy changes, and extending funding and resources for staff, such as augmented funding to hire allied health professionals in outpatient settings and increasing outreach capabilities. Conclusion: Programs that strive to address the unique needs of clients experiencing homelessness face numerous challenges. Unique potential solutions to these barriers, such as service provision in a convenient location involving social and health services, incorporating allied health care providers in care to a greater extent, and updating policies to reflect the social complexity of the population can improve diabetes care.

scholarly journals Emotional responses and perceived stressors of frontline medical staffs in case of COVID-19 treatment centers and obstetrics emergency in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mebratu Abraha Kebede ◽  
Dereje Bayissa Demissie ◽  
Dessalegn Kenay Guddu ◽  
Michael Temane Haile ◽  
Zebenay Workneh Bitew ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Emotional Response ◽  
Addis Ababa ◽  
Emotional Responses ◽  
Care Providers ◽  
Front Line ◽  
Care Clinic ◽  
Abortion Care

Abstract Background the rapid spread of COVID-19, its lethality in severe cases and the absence of specific medicine poses a huge threat to human life and health, as well as huge impact on the mental health. Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms including emotional disturbance. Objective the aim of this study will be to assess the current state of emotional responses and perceived stressors of frontline medical staffs in case of Addis Ababa COVID-19 Treatment Centers and obstetrics emergency and abortion care, Ethiopia 2020. Methods Hospital based comparative cross-section study design was conducted by using self-administered questionnaire survey from June 1st to 30th of 2020 among 133 and 266 frontline medical staffs from obstetric emergency and abortion care clinic and COVID-19 treatment centers respectively. The data were collected after getting written consent from each participant and it entered into the computer using Epi-data version 7, then exported to SPSS version 20 for further analysis. Descriptive analysis was done using frequencies & percent. All independent determinants with P-value < 0.05 were used to identify important predictors of emotional responses and perceived stressors. Result A total of 399 frontline medical staffs were included in the study. The mean age of the respondents of those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD, 3.46) years and it was 28.12 (SD, 4.09) years for the other groups. This study revealed that, 72.9 and 5.6% of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had a positive emotional response, respectively. Factors such as having a low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), being a nurse (AOR 10.53, 95% CI (1.31, 85.26)) and working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with negative emotional response. Conclusion The current study revealed that a high proportion of front line a negative emotional responses had negative emotional response. Further, almost all of the medical staffs working in COVID-19 treatment centers and at obstetrics emergency and abortion care unit had perceived the outbreak related stressors. So, providing comprehensive psychological support is warranted for health care providers working in such kinds of department or units.

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