scholarly journals Grief reaction and psychosocial impacts of child death and stillbirth on bereaved North Indian parents: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0240270
Author(s):  
Manoja Kumar Das ◽  
Narendra Kumar Arora ◽  
Harsha Gaikwad ◽  
Harish Chellani ◽  
Pradeep Debata ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Economic Impacts ◽  
Child Death ◽  
Healthcare Providers ◽  
Financial Strain ◽  
Traumatic Experience ◽  
Community Members ◽  
Group Discussions ◽  
Psychological Disturbances ◽  
And Coping

Background Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child death. Methods This exploratory qualitative study in Delhi (India) included in-depth interviews with parents (50 mothers and 49 fathers), who had stillbirth or child death, their family members (n = 41) and community representatives (n = 12). Eight focus group discussions were done with community members (n = 72). Inductive data analysis included thematic content analysis. Perinatal Grief Scale was used to document the mother’s grief severity after 6–9 months of loss. Results The four themes emerged were grief anticipation and expression, impact of the bereavement, coping mechanism, and sociocultural norms and practices. The parents suffered from disbelief, severe pain and helplessness. Mothers expressed severe grief openly and some fainted. Fathers also had severe grief, but didn’t express openly. Some parents shared self-guilt and blamed the hospital/healthcare providers, themselves or family. Majority had no/positive change in couple relationship, but few faced marital disharmony. Majority experienced sleep, eating and psychological disturbances for several weeks. Mothers coped through engaging in household work, caring other child(ren) and spiritual activities. Fathers coped through avoiding discussion and work and professional engagement. Fathers resumed work after 5–20 days and mothers took 2–6 weeks to resume household chores. Unanticipated loss, limited family support and financial strain affected the severity and duration of grief. 57.5% of all mothers and 80% mothers with stillbirth had severe grief after 6–9 months. Conclusions Stillbirth and child death have lasting psychosomatic, social and economic impacts on parents, which are usually ignored. Sociocultural and religion appropriate bereavement support for the parents are needed to reduce the impacts.

scholarly journals Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

2020 ◽  
Author(s):  
Sarah Saleem ◽  
Narjis Rizvi ◽  
Anam Feroz ◽  
Sayyeda Reza ◽  
Saleem Jessani ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Contraceptive Use ◽  
Health Workers ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Qualitative Assessment ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was been conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs(Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

scholarly journals Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4736
Author(s):  
Uzma Rahim Khan ◽  
Naveed Ahmed ◽  
Rubaba Naeem ◽  
Umerdad Khudadad ◽  
Sarwat Masud ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Health Workers ◽  
Heat Waves ◽  
Healthcare Providers ◽  
Community Members ◽  
Home Based ◽  
Facility Level ◽  
Training Community ◽  
Access And Quality

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.

scholarly journals “Our culture prohibits some things”: Qualitative inquiry into how sociocultural context influences the scale up of community-based injectable contraceptives in Nigeria

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Scale Up ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Injectable Contraceptives ◽  
Depth Interviews

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.

scholarly journals “We have to learn to cooperate with each other”: a qualitative study to explore integration of traditional healers into the provision of HIV self-testing and tuberculosis screening in Eswatini

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernadette Schausberger ◽  
Nqobile Mmema ◽  
Velibanti Dlamini ◽  
Lenhle Dube ◽  
Aung Aung ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Workers ◽  
Traditional Healers ◽  
Health Facilities ◽  
Cultural Literacy ◽  
Health Seeking ◽  
Community Members ◽  
Group Discussions ◽  
Self Testing ◽  
Self Test

Abstract Background Traditional healing plays an important role in healthcare in Eswatini, and innovative collaborations with traditional healers may enable hard-to-reach men to access HIV and tuberculosis diagnostic services. This study explored attitudes towards integration of traditional healers into the provision of HIV self-testing kits and sputum collection containers. Methods A qualitative study was conducted in 2019–2020 in Shiselweni region, Eswatini. Eight male traditional healers were trained on HIV and tuberculosis care including distribution of HIV self-testing kits and sputum collection containers. Attitudes towards the intervention were elicited through in-depth interviews with the eight traditional healers, ten clients, five healthcare workers and seven focus group discussions with community members. Interviews and group discussions were conducted in SiSwati, audio-recorded, translated and transcribed into English. Data were coded inductively and analysed thematically. Results 81 HIV self-testing kits and 24 sputum collection containers were distributed by the healers to 99 clients, with 14% of participants reporting a reactive HIV self-test result. The distribution of sputum containers did not result in any tuberculosis diagnoses, as samples were refused at health centres. Traditional healers perceived themselves as important healthcare providers, and after training, were willing and able to distribute HIV self-test kits and sputum containers to clients. Many saw themselves as peers who could address barriers to health-seeking among Swazi men that reflected hegemonic masculinities and patriarchal attitudes. Traditional healers were considered to provide services that were private, flexible, efficient and non-judgemental, although some clients and community members expressed concerns over confidentiality breaches. Attitudes among health workers were mixed, with some calling for greater collaboration with traditional healers and others expressing doubts about their potential role in promoting HIV and tuberculosis services. Specifically, many health workers did not accept sputum samples collected outside health facilities. Conclusions Offering HIV self-testing kits and sputum containers through traditional healers led to high HIV yields, but no TB diagnoses. The intervention was appreciated by healers’ clients, due to the cultural literacy of traditional healers and practical considerations. Scaling-up this approach could bridge testing gaps if traditional healers are supported, but procedures for receiving sputum samples at health facilities need further strengthening.

scholarly journals Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

2020 ◽  
Author(s):  
Sarah Saleem ◽  
Narjis Rizvi ◽  
Anam Feroz ◽  
Sayyeda Reza ◽  
Saleem Jessani ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Contraceptive Use ◽  
Health Workers ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Qualitative Assessment ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs (Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

scholarly journals A qualitative study to explore the experience of parents of newborns admitted to neonatal care unit in rural Rwanda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0252776
Author(s):  
Samuel Byiringiro ◽  
Rex Wong ◽  
Jenae Logan ◽  
Deogratias Kaneza ◽  
Joseph Gitera ◽  
...  
Keyword(s):  
Qualitative Study ◽  
District Hospital ◽  
Healthcare Providers ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
Traumatic Experience ◽  
Environment Interaction ◽  
Care Services ◽  
Sub Saharan ◽  
Neonatal Care Unit

Background Neonatal Care Units (NCUs) provide special care to sick and small newborns and help reduce neonatal mortality. For parents, having a hospitalized newborn can be a traumatic experience. In sub-Saharan Africa, there is limited literature about the parents’ experience in NCUs. Objective Our study aimed to explore the experience of parents in the NCU of a rural district hospital in Rwanda. Methods A qualitative study was conducted with parents whose newborns were hospitalized in the Ruli District Hospital NCU from September 2018 to January 2019. Interviews were conducted using a semi-structured guide in the participants’ homes by trained data collectors. Data were transcribed, translated, and then coded using a structured code book. All data were organized using Dedoose software for analysis. Results Twenty-one interviews were conducted primarily with mothers (90.5%, n = 19) among newborns who were most often discharged home alive (90.5%, n = 19). Four themes emerged from the interviews. These were the parental adaptation to having a sick neonate in NCU, adaptation to the NCU environment, interaction with people (healthcare providers and fellow parents) in the NCU, and financial stressors. Conclusion The admission of a newborn to the NCU is a source of stress for parents and caregivers in rural Rwanda, however, there were several positive aspects which helped mothers adapt to the NCU. The experience in the NCU can be improved when healthcare providers communicate and explain the newborn’s status to the parents and actively involve them in the care of their newborn. Expanding the NCU access for families, encouraging peer support, and ensuring financial accessibility for neonatal care services could contribute to improved experiences for parents and families in general.

scholarly journals Applying the Three Delays Model to understand emergency care seeking and delivery in rural Bangladesh: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042690
Author(s):  
Bansari Shah ◽  
Nandita Krishnan ◽  
Stephen R. Kodish ◽  
Gayane Yenokyan ◽  
Kaniz Fatema ◽  
...  
Keyword(s):  
Focus Group ◽  
Emergency Care ◽  
Healthcare Providers ◽  
Care Seeking ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Rural Bangladesh ◽  
Three Delays ◽  
Depth Interviews

ObjectivesThe Three Delays Model has been commonly used to understand and prevent maternal mortality but has not been systematically applied to emergency medical conditions more generally. The objective of this study was to identify delays in emergency medical care seeking and delivery in rural Bangladesh and factors contributing to these delays by using the Three Delays Model as a framework.DesignA qualitative approach was used. Data were collected through focus group discussions and in-depth interviews using semistructured guides. Two analysts jointly developed a codebook iteratively and conducted a thematic analysis to triangulate results.SettingSix unions in Raiganj subdistrict of Bangladesh.ParticipantsEight focus group discussions with community members (n=59) and eight in-depth interviews with healthcare providers.ResultsDelays in the decision to seek care and timely receipt of care on reaching a health facility were most prominent. The main factors influencing care-seeking decisions included ability to recognise symptoms and decision-making power. Staff and resource shortages and lack of training contributed to delays in receiving care. Delay in reaching care was not perceived as a salient barrier. Both community members and healthcare providers expressed interest in receiving training to improve management of emergency conditions.ConclusionsThe Three Delays Model is a practical framework that can be useful for understanding barriers to emergency care and developing more tailored interventions. In rural Bangladesh, training community members and healthcare providers to recognise symptoms and manage acute conditions can reduce delays in care seeking and receiving adequate care at health facilities.

scholarly journals Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Virginia M. Tran ◽  
Laila Fozouni ◽  
Jana K. Denkinger ◽  
Caroline Rometsch ◽  
Florian Junne ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Traumatic Experience ◽  
Theory Approach ◽  
Islamic State ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Utilization Of Healthcare ◽  
The Impact

Abstract Background Ensuring adequate utilization of healthcare services for displaced populations is critical, yet there are well-documented treatment gaps. Yazidi women captured by the Islamic State (IS) were subjected to extreme trauma and violence. This study aims to understand perceptions of healthcare providers and utilization of these services among women who experienced extreme trauma. Methods This is a qualitative study with voluntary participation offered to approximately 400 women resettled through the Special Quota Program. An empirical approach was used to collect data and a grounded theory approach was used for content analysis. Participants ranked their interactions with providers on a Likert scale. Posttraumatic stress disorder (PTSD) symptoms were assessed using the impact of event scale-revised questionnaire. Results A total of 116 Yazidi women participated in this study. The women experienced an average of 6.8 months of captivity by IS and 93% met criteria for probable PTSD. Eighty-three percent of the women interacted with a physician; 80% found this interaction helpful. Sixty-nine percent interacted with psychologists; 61% found this interaction helpful. Six themes emerged: “reminders of trauma” and “hopelessness” in relation to the traumatic experience; “immediate relief” and “healing through pharmaceutical treatment” in relation to provider interventions, and “support” and “cultural differences” in relation to interactions with providers. Conclusions There exist major barriers to care for Yazidi women who experienced extreme trauma, particularly in regards to psychiatric care. Perceptions of healthcare providers and perceived effectiveness of therapy are critical factors that must be taken into consideration to improve healthcare utilization and outcomes.

scholarly journals Villagers are not affraid to die : qualitative study of community cohesion on pictorial warning on cigarette packaging with Grounded Theory approach in Yogyakarta

2018 ◽  
Vol 32 (8) ◽  
pp. 263
Author(s):  
Dhiya Urrahman ◽  
Fatwa Sari Tetra Dewi ◽  
Fuad Hamsyah
Keyword(s):  
Grounded Theory ◽  
Qualitative Study ◽  
Smoking Behavior ◽  
Theory Approach ◽  
Adaptation Period ◽  
Group Discussions ◽  
Community Cohesion ◽  
Health Warning ◽  
And Coping ◽  
Grounded Theory Approach

“Villagers are not afraid to die”: a qualitative study of community cohesion on pictorial warning on cigarette packaging with grounded theory approach in YogyakartaPurposeThe purpose of this study was to explore community's coping with a pictorial health warning on cigarette packaging. MethodsA qualitative study was conducted using grounded theory design. The study was conducted in the rural area of Sambirejo, Prambanan sub-district, Sleman, Yogyakarta. Data were collected by in-depth interviews and focus group discussions (FGD). Subjects were selected purposively with a maximum variation technique. ResultsThe perceptions, beliefs, coping, adaptation period, and smoking behavior remained mostly unchanged after seeing pictorial warnings on cigarette packaging. ConclusionsCoping was influenced by perceptions, beliefs, and the period of adaptation to pictorial health warnings. The period of adaptation changed some feelings and coping prior to the pictorial health warning, while pictorial health warning on cigarette packs appeared to make non-smokers increasingly want to smoke.

scholarly journals A cross-country qualitative study on contraceptive method mix: contraceptive decisionmaking among youth

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lynette Ouma ◽  
Burcu Bozkurt ◽  
Jill Chanley ◽  
Christine Power ◽  
Ronald Kakonge ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Contraceptive Method ◽  
Full Range ◽  
Sub Saharan Africa ◽  
Community Members ◽  
Group Discussions ◽  
Full Spectrum ◽  
Key Stakeholders ◽  
Sub Saharan ◽  
Method Mix

Abstract Background Youth ages 15 to 24, who comprise a large portion of sub-Saharan Africa, face a higher burden of unmet contraceptive need than adults. Despite increased international and national commitments to improving young people’s access to contraception, significant barriers impede their access to a full range of methods. To further explore these barriers among youth in Kenya, Nigeria, and Uganda, we conducted a qualitative study to capture the challenges that affect contraceptive method decisionmaking and complicate youth access to the full method mix. Methods To understand factors that impact young people’s contraceptive decisionmaking process across all three countries, we conducted a total of 35 focus group discussions with 171 youth ages 15 to 24 and 130 in-depth interviews with key stakeholders working in youth family planning. Questionnaires aligned with the High Impact Practices in Family Planning’s elements of adolescent-friendly contraceptive services. Data were coded with MAXQDA and analyzed using a framework for contraceptive decisionmaking to identify relevant patterns and themes. Results In all three countries, youth reported that condoms are the most commonly sought contraceptive method because they are easiest to access and because youth have limited knowledge of other methods. Youth from diverse settings shared uncertainty and concern about the safety and side effects of many methods other than condoms, complicating their ability to take full advantage of other available methods. While most youth in Kenya, Nigeria, and Uganda reported at least moderate confidence in obtaining the information needed to help choose a method, and only a few youth reported that they are completely unable to access contraceptives, other barriers still present a major deterrent for youth, including cost, inconvenient facility hours and long wait times, and stigma from family, community members, and providers. Conclusions Young people’s ability to fully exercise their method choice remains limited despite availability of services, leading them to take the path of least resistance. Program implementers and policymakers should consider the diverse and often interconnected barriers that youth face in attempting to enjoy the benefits of a full spectrum of contraceptive methods and design multi-level interventions to mitigate such barriers.

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