scholarly journals Health workers' experiences of collaborative quality improvement for maternal and newborn care in rural Tanzanian health facilities: A process evaluation using the integrated 'Promoting Action on Research Implementation in Health Services' framework

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209092 ◽  
Author(s):  
Ulrika Baker ◽  
Arafumin Petro ◽  
Tanya Marchant ◽  
Stefan Peterson ◽  
Fatuma Manzi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Services ◽  
Process Evaluation ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Research Implementation ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

scholarly journals Existing barriers to utilization of health services for maternal and newborn care in rural Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Ayodo ◽  
George O. Onyango ◽  
Salome Wawire ◽  
Nadia Diamond-Smith
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Western Kenya ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Understanding the existing barriers to utilization of maternal and newborn health care services can inform improvement of care services in the rural settings in sub-Saharan Africa. However, how unintended pregnancy relates to the uptake of antenatal care (ANC) services and also how gaps in the role of the community health workers and health facilities affect maternal and newborn care and referral services are poorly understood. Methods This was a formative ethnographic study design to determine barriers to the utilization of health care services for maternal and newborns in rural Western Kenya. We interviewed 45 respondents through in-depth interviews in rural Bondo Sub- County, Western Kenya: Mothers and Fathers with children under 5 years), 2 Focus Group Discussions (FGDs) with Traditional Birth Attendants (TBA), and 2 FGDs with Skilled Birth Attendants (SBAs). The data were analyzed using Atlas-ti. Results We found that unintended pregnancy results into poor uptake of antenatal care (ANC) services due to limited knowledge and poor support system. The respondents appreciated the role of community health workers but poor government infrastructure exists. Also, perceived harshness of the health care providers, poor management of high-risk pregnancies, and unavailability of supplies and equipment at the health facilities are of concern. Conclusions The findings of this study highlight barriers to the utilization of maternal and newborn services that if addressed can improve the quality of care within and outside health facilities.

Evaluation of Community Health Workers’ Upskilling Training in Maternal and Newborn Care at Mount Hagen in Western Highlands Province, Papua New Guinea

2018 ◽  
Vol 1 (7) ◽  
Author(s):  
Jolly Kulimbua
Keyword(s):  
Community Health ◽  
Papua New Guinea ◽  
Community Health Workers ◽  
Health Workers ◽  
Newborn Care ◽  
New Guinea ◽  
Health Facilities ◽  
Care Providers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background:   Community Health Workers (CHWs) in Western highlands Province were given a 6-month CHW upskilling training to enable them to provide essential maternal-newborn care, do timely referral of high risk clients and refer emergencies to hospital. Five trainings were conducted over the five year period. Forty seven (47) CHWs were upskilled over that five year period.   Aim:   To evaluate the effectiveness of the CHW Upskilling Training during 2012 – 2016.   Methods:    A post-training assessment was conducted by direct observations of the CHWs and the Officer in Charges (OICs) at their workplaces. Assessors observed the application of knowledge and skills and determined if there were improvements in the health facilities. Purposeful discussions were carried out to elicit qualitative feedback from CHWs OICs of the health facilities.   Findings:   The findings were impressive. The organisation of health facilities improved with specific schedules made for priority reproductive and maternal health services. The recording of maternal and newborn care services indicated great improvement. The ANC, family planning and labour ward registers indicated the kinds of services provided including management of life-threatening conditions. Records show reduced maternal and newborn deaths. Records also show reduced unnecessary referrals.   Conclusions:   The CHW Up skilling Training Program is an effective intervention to improve reproductive health and maternal-newborn services in remote areas of Papua New Guinea, particularly where there are no midwives, or higher category health care providers. It has contributed to improved maternal-newborn survival.   Recommendations:   The evaluation recommends that the CHW Upskilling Training should reach more CHWs to fill in gaps in health facilities where there are no midwives or doctor. In Papua New Guinea, the CHWs Upskilling program in maternal and newborn care is recommended for all CHWs.

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2019 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Low Income ◽  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential for both mothers and infants, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality, to assess the quality of routine maternal and newborn care and the proportion of women delivering in facilities with a good standard of care. Surveys were conducted in 2012 and 2015 to assess changes in the quality of care over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. 166 and 305 primary care facilities were sampled in 2012 and 2015 respectively. In each year we assessed whether each facility could provide four “signal” functions of routine maternal and newborn care. From facility registers we counted the number of deliveries in the previous six months and calculated the proportion of women giving birth in facilities which could offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities which provided all four signal functions rose from 40% (95% CI 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh in 2012 an estimated 4% (95% CI 1-24) of facility deliveries occurred in facilities which provided all four signal functions, rising to 39% (95% CI 25-55) in 2015. In Nigeria these estimates were 25% (95% CI 6-66) and zero for 2012 and 2015 respectively. Improvements in signal functions in Ethiopia and Uttar Pradesh were led by improved supplies of commodities while Nigeria experienced declines in supplies of commodities and the number of Skilled Birth Attendants employed. Conclusions This study quantifies how health facilities can provide sub-optimal maternal and newborn care, and may help explain inconsistent outcomes of health facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of the capacity of facilities to provide such care. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon maternal and newborn care.

scholarly journals Engaging community health workers in maternal and newborn care in eastern Uganda

2015 ◽  
Vol 8 (1) ◽  
pp. 23968 ◽  
Author(s):  
Monica Okuga ◽  
Margaret Kemigisa ◽  
Sarah Namutamba ◽  
Gertrude Namazzi ◽  
Peter Waiswa
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Newborn Care ◽  
Maternal And Newborn Care ◽  
Eastern Uganda ◽  
Maternal And Newborn

scholarly journals We Won’t Go There: Barriers to Accessing Maternal and Newborn Care in District Thatta, Pakistan

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1314
Author(s):  
Muhammad Asim ◽  
Sarah Saleem ◽  
Zarak Husain Ahmed ◽  
Imran Naeem ◽  
Farina Abrejo ◽  
...  
Keyword(s):  
Health Workers ◽  
Newborn Care ◽  
Newborn Health ◽  
Structured Interview ◽  
Maternal And Newborn Health ◽  
Structural Level ◽  
Care Seeking ◽  
Structural Barriers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Accessibility and utilization of healthcare plays a significant role in preventing complications during pregnancy, labor, and the early postnatal period. However, multiple barriers can prevent women from accessing services. The aim of this study was to explore the multifaceted barriers that inhibit women from seeking maternal and newborn health care in Thatta, Sindh, Pakistan. This study employed an interpretive research design using a purposive sampling approach. Pre-tested, semi-structured interview guides were used for data collection. The data were collected through eight focus group discussions with men and women, and six in-depth interviews with lady health workers and analyzed through thematic analysis. The study identified individual, sociocultural, and structural-level barriers that inhibit women from seeking maternal and newborn care. Individual barriers included mistrust towards public health facilities and inadequate symptom recognition. The three identified sociocultural barriers were aversion to biomedical interventions, gendered imbalances in decision making, and women’s restricted mobility. The structural barriers included ineffective referral systems and prohibitively expensive transportation services. Increasing the coverage of healthcare service without addressing the multifaceted barriers that influence service utilization will not reduce the burden of maternal and neonatal mortality. As this study reveals, care seeking is influenced by a diverse array of barriers that are individual, sociocultural, and structural in nature. A combination of capacity development, health awareness, and structural interventions can address many if not all of these barriers.

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