scholarly journals Assessment of integration of emergency obstetric and newborn care in maternal and newborn care in healthcare facilities in Osun State, Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249334
Author(s):  
Abiola Olubusola Komolafe ◽  
Adekemi Eunice Olowokere ◽  
Omolola Oladunni Irinoye
Keyword(s):  
Statistical Significance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Median Score ◽  
Cross Sectional ◽  
Significance Level ◽  
Healthcare Facilities ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

The integration of emergency obstetric and newborn care (EmONC) into maternal and newborn care is essential for its effectiveness to avert preventable maternal and newborn deaths in healthcare facilities. This study used a theory-oriented quantitative approach to document the reported extent of EmONC integration, and its relationship with EmONC training, guidelines availability and level of healthcare facility. A descriptive cross-sectional study was conducted among five hundred and five (505) healthcare providers and facility managers across the three levels of healthcare delivery. An adapted questionnaire from NoMad instrument was used to collect data on the integration of EmONC from the study participants. Ethical approval was obtained and informed consents taken from the participants. Both descriptive (frequency, percentage, mean and median) and inferential analyses (Kruskal Wallis and Mann Whitney tests) were done with statistical significance level of p<0.05 using STATA 14. The mean age of respondents was 38.68±8.27. The results showed that the EmONC integration median score at the three levels of healthcare delivery was high (77 (IQR = 83–71)). The EmONC integration median score were 76 (IQR = 84–70), 76 (IQR = 80–68) and 78 (IQR = 84–74) in the primary, secondary and tertiary healthcare facilities respectively. Integration of EmONC was highest (83 (IQR = 87–78)) among healthcare providers who had EmONC training and also had EmONC guidelines made available to them. There were significant differences in EmONC integration at the three levels of healthcare delivery (p = 0.046), among healthcare providers who had EmONC training and those with EmONC guidelines available in their maternity units (p = 0.001). EmONC integration was reportedly high and significantly associated with EmONC training and availability of guidelines. However, the congruence of reported and actual extent of integration of EmONC at the three levels of healthcare delivery still need validation as such would account for the implementation success and maternal-neonatal outcomes.

scholarly journals A study on knowledge regarding different aspects of injection safety among injection providers at different levels of health care

2017 ◽  
Vol 4 (5) ◽  
pp. 1737
Author(s):  
Uroosa Farooq Allaqband ◽  
Anjum B. Fazili ◽  
Rohul Jabeen Shah ◽  
Ab. Majid Ganai ◽  
Walied K. Balwan ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Healthcare Providers ◽  
P Value ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Definition Of ◽  
Unsafe Injection ◽  
Exposure Prophylaxis ◽  
Age Range ◽  
Injection Safety

Background: Estimates suggest that at least 50% of the world’s injections administered each year are unsafe, particularly in developing countries. Unsafe injection practices put patients and healthcare providers at risk of infectious and non-infectious adverse events, sound knowledge of healthcare providers is vital to break the chain of blood borne diseases transmission caused by unsafe injection practices.Methods: Cross sectional observational questionnaire based study was carried out amongst 152 injection providers of 40 healthcare facilities of two districts of Kashmir valley (one rural and one urban) selected purposively. Results are summarised and presented in the form of tables and chi (x2) test was used for test of association with statistical significance set at p-value of less than 0.05.Results: In this study out of 152 injection providers, majority (81.57%) were in the age range of 21-40 years and 74.3% were females. 43.4% of the participants were FMPHWs, 30.9% were nurses and 13.8% pharmacists. Overall 65.8% and 67.1% of injection providers had correct knowledge regarding WHO definition of safe injection and infections transmitted by unsafe injections respectively. Majority (90.8%) were aware about the biomedical waste management rules.Conclusions: We conclude that over all the knowledge of different aspects of injection safety was good among the participants except the poor knowledge ofpost exposure prophylaxis and disposal of injection related waste despite the use of color coded bags at the sites of waste generation. 

scholarly journals Nursing knowledge of essential maternal and newborn care in a high‐mortality urban African setting: A cross‐sectional study

2018 ◽  
Vol 28 (5-6) ◽  
pp. 882-893 ◽  
Author(s):  
Georgina A. V. Murphy ◽  
David Gathara ◽  
Ann Mwaniki ◽  
Grace Nabea ◽  
Jacintah Mwachiro ◽  
...  
Keyword(s):  
High Mortality ◽  
Newborn Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nursing Knowledge ◽  
Maternal And Newborn Care ◽  
African Setting ◽  
Maternal And Newborn

scholarly journals Smoking behaviour among adult patients presenting to health facilities in four provinces of Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wan-Chun Huang ◽  
Ngoc Yen Pham ◽  
Thu Anh Nguyen ◽  
Van Giap Vu ◽  
Quy Chau Ngo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Smoking Behaviour ◽  
Health Facilities ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
District Hospitals ◽  
Quit Attempts

Abstract Background Attendance at healthcare facilities provides an opportunity for smoking cessation interventions. However, the smoking behaviours of patients seeking healthcare in Vietnam are not well-understood. We aimed to evaluate behaviours related to smoking among patients presenting to health facilities in Vietnam. Methods We conducted a cross-sectional study in 4 provinces of Vietnam. Consecutive patients aged ≥15 years presenting to 46 health facilities were assessed. Current smokers were randomly selected to complete a full survey about smoking behaviour, quit attempts, and preparedness to quit. Results Among 11,245 patients who sought healthcare, the prevalence of current smoking was 18.6% (95% CI: 17.8–19.4%) overall, 34.6% (95% CI: 33.2–36.0%) among men and 1.1% (95% CI: 0.8–1.3%) among women. Current smokers who were asked about smoking by healthcare providers in the last 12 months were more likely to make quit attempts than those not asked (40.6% vs 31.8%, p = 0.017). Current smokers who attempted to quit in the past 12 months made limited use of cessation aids: counselling (1.9%) and nicotine replacement therapy (10%). A higher proportion of patients wanted to quit in the next month at national/provincial hospitals (30.3%) than those visiting district hospitals (11.3%, p < 0.001) and commune health centres (11.1%, p = 0.004). Conclusions Smoking is common among male patients presenting to healthcare facilities in Vietnam. Formal smoking cessation supports are generally not used or offered. This population is likely to benefit from routine smoking cessation interventions that are integrated within the routine healthcare delivery system.

scholarly journals Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

2020 ◽  
Author(s):  
Aline Semaan ◽  
Constance Audet ◽  
Elise Huysmans ◽  
Bosede B Afolabi ◽  
Bouchra Assarag ◽  
...  
Keyword(s):  
Health Professionals ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Evidence Based ◽  
List Type ◽  
Care Services ◽  
Care Processes ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

AbstractObjectiveTo prospectively document experiences of frontline maternal and newborn healthcare providers during the COVID-19 pandemic.DesignCross-sectional study via an online survey disseminated through professional networks and social media in 12 languages. We analysed responses using descriptive statistics and qualitative thematic analysis disaggregating by low- and middle-income countries (LMICs) and high-income countries (HICs).Setting81 countries, between March 24 and April 10, 2020.Participants714 maternal and newborn healthcare providers.Main outcome measuresPreparedness for and response to COVID-19, experiences of health workers providing care to women and newborns, and adaptations to 17 outpatient and inpatient care processes during the pandemic.ResultsOnly one third of respondents received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, only 47% of participants in LMICs, and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing, and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based.ConclusionsSubstantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations, and support rapid development of effective responses.Key MessagesWhat is already knownIn addition to lack of healthcare worker protection, staffing shortages, heightened risk of nosocomial transmission and decreased healthcare use described in previous infectious disease outbreaks, maternal and newborn care during the COVID-19 pandemic has also been affected by large-scale lockdowns/curfews.The two studies assessing the indirect effects of COVID-19 on maternal and child health have used models to estimate mortality impacts.Experiences of frontline health professionals providing maternal and newborn care during the COVID-19 pandemic have not been empirically documented to date.What this study addsRespondents in high-income countries more commonly reported available/updated guidelines, access to COVID-19 testing, and dedicated isolation rooms for confirmed/suspected COVID-19 maternity patients.Levels of stress increased among health professionals globally, including due to changed working hours, difficulties in reaching health facilities, and staff shortages.Healthcare providers were worried about the impact of rapidly changing care practices on health outcomes: reduced access to antenatal care, fewer outpatient visits, shorter length-of-stay in facilities after birth, banning birth companions, separating newborns from COVID-19 positive mothers, and postponing routine immunisations.COVID-19 illustrates the susceptibility of maternity care services to emergencies, including by reversing hard-won gains in healthcare utilisation and use of evidence-based practices. These rapid findings can inform countries of the main issues emerging and help develop effective responses.

scholarly journals Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

2020 ◽  
Author(s):  
Yolisa Nalule ◽  
Helen Buxton ◽  
Erin Flynn ◽  
Olutunde Oluyinka ◽  
Stephen Sara ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Newborn Care ◽  
Maternal Caregivers ◽  
Healthcare Facilities ◽  
Hygiene Practices ◽  
Post Natal Care ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn ◽  
Natal Care

Abstract Background Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care. Methods This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first six hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge. Results Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn. Conclusions In this setting, hand hygiene practices during post-natal care and the first six hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.

scholarly journals Lay and healthcare providers’ experiences to inform future of respectful maternal and newborn care in Tanzania and Malawi: an Appreciative Inquiry

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046248
Author(s):  
Paschal Mdoe ◽  
Tracey A Mills ◽  
Robert Chasweka ◽  
Livuka Nsemwa ◽  
Chisomo Petross ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Appreciative Inquiry ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Skilled Birth Attendance ◽  
Birth Attendance ◽  
The Government ◽  
Maternal And Newborn Care ◽  
Respectful Care ◽  
Maternal And Newborn

ObjectivesDisrespectful care, which remains prevalent in low and middle-income countries (LMICs), acts as a barrier to women accessing skilled birth attendance, compromising care when services are available. Building on what was positive in facilities, we aimed to explore lay and healthcare providers’ experience of respectful care to inform future interventions.SettingFive maternity facilities in Mwanza Tanzania and Lilongwe Malawi.Participants94 participants in Malawi (N=46) and Tanzania (N=48) including 24 women birthing live baby within the previous 12 months; 22 family members and 48 healthcare providers who regularly provided maternity care in the included facilitiesDesignThe study was guided by Appreciative Inquiry (AI). Semistructured, one-to-one interviews were conducted between January and December 2019. Interviews were audio-recorded, translated where necessary, transcribed verbatim, and analysed using the framework approach.ResultsFour main themes describing participants positive experience and their vision of respectful care were identified: (1) empathic healthcare provider–woman interactions including friendly welcome and courteous language, well-timed appropriate care and information sharing, (2) an enabling environment, characterised by improvement of physical environment, the use of screens, curtains and wall partitions for privacy, availability of equipment and provision of incentives to staff, (3) supportive leadership demonstrated by the commitment of the government and facility leaders to provision of respectful care, ensuring availability of guidelines and policies, supportive supervision, reflective discussion and paying staff salaries timely, (4) providers’ attitudes and behaviours characterised by professional values through readiness, compassionate communication and commitment.ConclusionThe positive experiences of service users, families and healthcare providers provided insight into key drivers of respectful care in facilities in Tanzania and Malawi. Interventions targeting improved environment and privacy, healthcare provider communication and developing positive leadership structures in facilities could provide the basis for sustained improvement in respectful and dignified maternal and newborn care in LMICs.

scholarly journals Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yolisa Nalule ◽  
Helen Buxton ◽  
Erin Flynn ◽  
Olutunde Oluyinka ◽  
Stephen Sara ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Newborn Care ◽  
Maternal Caregivers ◽  
Healthcare Facilities ◽  
Hygiene Practices ◽  
Post Natal Care ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn ◽  
Natal Care

Abstract Background Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care. Methods This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first 6 hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge. Results Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn. Conclusions In this setting, hand hygiene practices during post-natal care and the first 6 hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.

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