scholarly journals “He lets me go although he does not go with me.”: Rwandan women’s perceptions of men’s roles in maternal health

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Germaine Tuyisenge ◽  
Valorie A. Crooks ◽  
Nicole S. Berry
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Critical Time ◽  
Maternal Health Services ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Maternal Health Outcomes ◽  
Men’S Involvement

Abstract Background Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services. Methods We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care. Results Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions. Conclusion Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.

scholarly journals Factors Influencing the Utilisation of Maternal Health Services: The Perspective of Rural Women in Ghana

2013 ◽  
Vol 3 (2) ◽  
pp. 121 ◽  
Author(s):  
Anita Anima Daniels ◽  
Albert Ahenkan ◽  
Kwabena Adu Poku
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Health Services ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
Maternal Health Outcomes

Maternal mortality is a global issue and WHO recommends the use of maternal health services to help improve the health of women and babies during pregnancy and childbirth. Considering global and national interest in improving maternal health and the fact that Ghana is still battling with reducing maternal mortality, understanding the factors affecting the use of maternal services in rural areas is crucial as the women are seen as more vulnerable due to inequity issues. This study sets to examine the factors that influence the utilisation of antenatal and delivery services among rural women in Ghana, focusing on individual and area factors. A descriptive cross sectional study was carried out in three rural communities using Akuapim North District of Ghana as a case study.. The study adopted the quantitative approach. Structured interviews were used in data collection with the help of interview schedules. Two hundred and ninety-six (296) respondents were sampled using both probability and non probability techniques. Findings reveal that the use of the MHS is inadequate in relation to the WHO standards. Individual characteristics such as age, marital status and family size and the cost and time taken to a health facility were significantly associated with all the maternal health outcomes. Poor access to vehicles hindered women from delivery in a health institution and getting assistance from trained medical personnels. However, no significant association was established between education of respondents and the maternal health outcomes. It is recommended that the Ministry of Health engages in inter-sectoral collaboration to help ensure health equity.Effective integration of TBAs in providing care is needed to help improve utilisation of maternal services in rural areas

scholarly journals Unlocking community capabilities for addressing social norms/practices: Behavioural change intervention study to improve birth preparedness and complication readiness among pregnant women in rural Nigeria

2020 ◽  
Author(s):  
Irene Ifeyinwa Eze ◽  
Chinyere Ojiugo Mbachu ◽  
Edmund Ndudi Ossai ◽  
Celestina Adaeze Nweze ◽  
Chigozie Jesse Uneke
Keyword(s):  
Health Services ◽  
Pregnant Women ◽  
Intervention Study ◽  
Statistical Tests ◽  
Behavioural Change ◽  
Male Partner ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Danger Signs ◽  
Rural Nigeria

Abstract Background Maternal mortality is attributed to combination of contextual factors that cause delay in seeking care, leading to poor utilization of skilled health services. Community participation is one of the acknowledged strategies to improve health services utilization amongst the poor and rural communities. The study aimed at assessing the potentials of improving birth preparedness and complication readiness (BP/CR) using community-driven behavioural change intervention among pregnant women in rural Nigeria. Methods A pre-post intervention study was conducted from June 2018 to October 2019 on 158 pregnant women selected through multi-stage sampling technique from 10 villages. Data on knowledge and practices of birth preparedness and utilization of facility health services were collected through interviewer-administered pre-tested structured questionnaire. Behavioural change intervention comprising of stakeholders’ engagement, health education, facilitation of emergency transport and fund saving system, and distribution of educational leaflets/posters were delivered by twenty trained volunteer community health workers. The intervention activities focused on sensitization on danger signs of pregnancy, birth preparedness and complication readiness practices and emergency response. Means, standard deviations, and percentages were calculated for descriptive statistics; and T-test and Chi square statistical tests were carried out to determine associations between variables. Statistical significance was set at p-value < 0.05 Results The result showed that after the intervention, mean knowledge score of danger signs of pregnancy increased by 0.37 from baseline value of 3.94 (p < 0.001), and BP/CR elements increased by 0.27 from baseline value of 4.00 (p < 0.001). Mean score for BP/CR practices increased significantly by 0.22 for saving money. The proportion that attended ANC (76.6%) and had facility delivery (60.0%) increased significantly by 8.2% and 8.3% respectively. Participation in Community-related BP/CR activities increased by 11.6% (p = 0.012). Conclusion With the improvements recorded in the community-participatory intervention, birth preparedness and complication readiness should be promoted through community, household and male-partner inclusive strategies. Further evaluation will be required to ascertain the sustainability and impact of the programme.

Artificial Intelligence guided citizen-centric approach to enhance uptake of maternal health services among pregnant women living in urban slum settings in India. (Preprint)

2021 ◽  
Author(s):  
Rahul Shrivastava ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Resource Planning ◽  
Urban Slum ◽  
Maternal Health Services ◽  
Urban Slums

BACKGROUND Pregnant women are considered to be a “high risk” group with limited access to health facilities in urban slums. Barriers to utilization of health services may lead to maternal and child mortality, morbidity, low birth weight, and children with stunted growth. Application of artificial intelligence (AI) can provide substantial improvements in all areas of healthcare from diagnostics to treatment. There have been several technological advances within the field of AI, however, AI not merely driven by what is technically feasible, but by what is humanly desirable is the need of the hour. OBJECTIVE The objective of our study is to develop and evaluate the AI guided citizen centric platform to enhance the uptake of maternal health services (antenatal care) amongst the pregnant women living in urban slum settings. METHODS A cross-sectional mixed method approach employed to collect data among pregnant women, aged 18-44 years, living in urban slums of South Delhi. A convenience sampling used to recruit 225 participants at the Anganwadi centres (AWC) after obtaining consent from the eligible participants. Inclusion criteria includes pregnant individuals residing in urban slums for more than 3 months, having smartphones, visiting AWC for seeking antenatal care. Quantitative and qualitative data will be collected electronically using Open Data Kit (ODK) based opensource tool from eligible participants. Data will be collected on clinical as well as socio-demographic parameters (based on existing literature). We aim to develop an innovative AI guided citizen centric decision support platform to effectively manage pregnancy and its outcomes among urban poor populations. The proposed research will help policymakers to prioritize resource planning, resource allocation and development of programs and policies to enhance maternal health outcomes. RESULTS The AI guided citizen centric decision support platform will be designed, developed, implemented and evaluated using principles of human centred design and findings of the study will be reported to diverse stakeholders. The tested and revised platform will be deployed for use across various stakeholders such as pregnant women, healthcare professionals, frontline workers, and policymakers. CONCLUSIONS With the understanding, use and adoption of emerging and innovative technologies such as AI, maternal health informatics can be at the forefront to help pregnant women in crisis. The proposed platform will potentially be scaled up to different geographic locations for adoption for similar and other health conditions.

scholarly journals Access to Maternal Health Services during COVID-19

2020 ◽  
Vol 2 (2) ◽  
pp. 48-52 ◽  
Author(s):  
Smriti Pant ◽  
Saugat Koirala ◽  
Madhusudan Subedi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Pregnant Women ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Maternal Health Services ◽  
Global Scale ◽  
Health Care Facilities ◽  
Movement Restriction

Most causes of maternal morbidity and mortality can be prevented by giving prompt, suitable treatment to the women by qualified health practitioners. Maternal health services (MHS), which include antenatal care, delivery care, and postnatal care, can play a crucial role in preventing maternal health problems. The recent coronavirus disease (COVID-19) pandemic has had a disastrous effect on the health care delivery system of people of all ages, on a global scale but pregnant women face particular challenges. The aim of this review is to assess the effect of COVID-19 on access to MHS. For writing this narrative review, national and international reports on maternal health services during COVID-19, along with journal articles on the related topic were reviewed. Due to this pandemic, women worldwide are facing more barriers to accessing maternal health care, including restrictions, transport challenges, and anxiety over possibly being exposed to coronavirus. Many women preferred not to seek healthcare due to the fear of themselves being infected with the virus or transmitting it to their unborn babies. Additionally, movement restriction has made it difficult for many pregnant women to reach health care facilities. Even those who managed to reach health facilities have reported not receiving timely care. As a result, a considerable rise in maternal mortality globally has been estimated over the next six months. Despite the circumstances, efforts have been made to boost maternal health in both developed and developing countries. This pandemic has highlighted the importance of health preparedness with special attention given to vulnerable people like pregnant women and newborns while planning for such events. Keywords: Childbirth, COVID19, Maternal Health, Pandemic, Pregnancy, Women’s health

scholarly journals A Mobile Phone-based Multimedia Application Could Improve Maternal Health in Rural Southwestern Uganda: Mixed Methods Study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Angella Musiimenta ◽  
Wilson Tumuhimbise ◽  
Godfrey Mugyenyi ◽  
Jane Katusiime ◽  
Esther Atukunda ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Mobile Phone ◽  
Pregnant Women ◽  
Maternal Health Services ◽  
Multimedia Application ◽  
Transport Cost ◽  
Time Saving ◽  
Health Technologies ◽  
Video And Audio

Background: Reducing maternal and infant mortality rates remains challenging. Illiteracy, lack of reliable information, long distances to health centers continue to limit access to quality maternal healthcare in Uganda. Mobile health technologies could be promising affordable strategies for enhancing access to maternal health services. However, there is lack of studies assessing the experiences of illiterate rural pregnant women regarding these technologies. Objective: To explore how illiterate pregnant women perceive a maternal health mobile application composed of tailored video and audio messages, appointment reminders and calling function. Methods: We purposively sampled illiterate pregnant women initiating antenatal care at Mbarara Regional Referral Hospital. We carried out three focus group discussions with 14 women to elicit information on perceptions of the proposed mobile phone based multimedia application. We used STATA 13 to describe study participants and their preferences. Results: Pregnant women anticipated that intervention would enhance maternal health by reminding them to attend antenatal appointments, enabling transport cost and time saving, providing tailored information that is easy to understand, and recall. However, financial constraints and phone sharing would limit the functionality.Conclusion: Mhealth application may provide acceptable and affordable alternative approaches to providing maternal health services, especially in settings where face-to-face approaches are challenging.

scholarly journals Male partners' participation in birth preparedness and complication readiness in global south: systematic review and meta-analysis

2020 ◽  
Author(s):  
Minyahil Tadesse Boltena ◽  
Abraham Sahlemichael Kebede ◽  
Ziad El-Khatib ◽  
Benedict Oppong Asamoah ◽  
Andualem Tadesse Boltena ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Random Effect ◽  
Global South ◽  
Birth Preparedness ◽  
Male Partners ◽  
Complication Readiness ◽  
Nursing Mothers

Abstract Background: The lower priority given for involving male partners in birth preparedness and complication readiness contributes to the poor maternal and neonatal health outcomes. Male partners in low- and middle-income countries determine women’s access to and affordability of health services and directly influence their health outcomes. This systematic review and meta-analysis determine the pooled magnitude of the male partner’s participation in birth preparedness and complication readiness in the global south.Methods: Literature published in the English language from 2004 to 2019 was retrieved using appropriate search terms on Google Scholar, PubMed/MEDLINE, CINHAL, Scopus, and Embase. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. A pooled statistical meta-analysis was conducted using STATA Version 14.0 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test, respectively. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis. The Random effects model was used to estimate the summary prevalence of BPCR and the corresponding 95% confidence intervals (CI). Results: 12 studies and 4210 participants were included. The overall pooled result showed 52.3% of male partners of pregnant women and nursing mothers were prepared for birth and its complications. Forty-nine percent of male partners saved money for delivery and 40.5% of them identified skilled birth attendants, and 55% of male partners saved money for birth or its complication. Only 42.1% of male partners arranged transportation and 59.8% of them identified the place of birth. Only 18.9% of male partners identified a potential blood donor for emergency cases of childbirth and postpartum complication.Conclusions: A low proportion of male partners of pregnant women and nursing mothers were prepared for childbirth and its complications. Countries in the global south region should review their health care policies and design strategies to improve the birth preparedness and complication readiness practice among male partners of pregnant women and nursing mothers.

scholarly journals How Costly is the First Prenatal Clinic Visit? Analysis of Out-of-Pocket Expenditure in Rural Sri Lanka - A Country With Free Maternal Health Care

2021 ◽  
Author(s):  
Sajaan Praveena Gunarathne ◽  
Nuwan Darshana Wickramasinghe ◽  
Thilini Chanchala Agampodi ◽  
Indika Ruwan Prasanna ◽  
Suneth Buddhika Agampodi
Keyword(s):  
Sri Lanka ◽  
Maternal Health ◽  
Health Services ◽  
Pregnant Women ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Cross Sectional ◽  
The Mean ◽  
Study Setting

Abstract Background: This study aimed to determine the magnitude of and factors associated with out-of-pocket expenditure (OOPE) during the first prenatal clinic visit among pregnant women in Anuradhapura district, Sri Lanka, which provides free maternal healthcare. Methods: The study design was a cross-sectional study, and the study setting was 22 Medical Officers of Health areas in Anuradhapura District, Sri Lanka. Data of 1,389 pregnant women were analyzed using descriptive statistics and non-parametric tests. Results: The mean OOPE of the first prenatal clinic visit was USD 8.12, which accounted for 2.9% and 4.5% of the household income and expenditure, respectively. Pregnant women who used only government-free health services had an OOPE of USD 3.49. A significant correlation was recorded between household expenditure (rs=0.095, p=0.002) and the number of pregnancies (rs=-0.155, p<0.001) with OOPE. Conclusion: Despite having free maternal services, the OOPE of the first prenatal clinic visit is high in rural Sri Lanka. One-fifth of pregnant women utilize private health services, and pregnant women who used only government-free maternal health services also spend a direct medical cost.

scholarly journals Access to Formal Maternal Health Services and Informal Supports for Resettled Refugee Mothers in the Postnatal Period: A Scoping Review Protocol

2020 ◽  
Author(s):  
Emma Stirling Cameron ◽  
Benjamin DuPlessis ◽  
Megan Aston ◽  
Howard Ramos ◽  
Lois Jackson
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Scoping Review ◽  
Critical Time ◽  
Maternal Health Services ◽  
Postnatal Period ◽  
Refugee Women ◽  
Scoping Reviews ◽  
Review Protocol ◽  
Informal Supports

Abstract Background: The postnatal period is a critical time when women may need access to formal maternal health services (e.g., family physicians) and informal supports (e.g., family, friends). Resettled refugee women often encounter a myriad of barriers and challenges when attempting to access these services and supports in resettlement countries, including language and communication differences, socioeconomic constraints, challenges navigating foreign healthcare systems, and reduced social support networks. This has contributed to health inequities among postnatal resettled refugee women, including low self-reported health, five-times higher rates of postpartum depression, and social isolation. The purpose of this review is to understand access to formal maternal health services and informal supports for resettled refugee women during the postnatal period. Methods: This review will be conducted in accordance with JBI methodology for scoping reviews. A comprehensive search strategy, developed with a librarian scientist, will be used to identify relevant sources. Titles, abstracts, and full texts will be evaluated against inclusion criteria. Evidence from peer-reviewed and gray literature published after 2003 will be included. This review will focus only on studies conducted in middle- and high-income resettlement countries. Information will be extracted by two independent reviewers using a screening tool. Data will be synthesized and presented narratively, with tables and figures where appropriate. Discussion: This scoping review will provide an overview of resettled refugee women’s experiences during the postnatal period, with a focus on understanding access to health services and the availability and use of informal supports. It is expected that this review will outline both the barriers and facilitators affecting resettled refugee women seeking formal and informal care during the postnatal period. Findings will help to inform policy direction and future interventions seeking to improve postnatal care for resettled refugee women.Systematic Review Registration: This scoping review protocol has been registered with the Open Science Framework database, https://osf.io/rkqj6.

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