scholarly journals Does interviewer gender influence a mother’s response to household surveys about maternal and child health in traditional settings? A qualitative study in Bihar, India

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252120
Author(s):  
Nancy Vollmer ◽  
Mansha Singh ◽  
Navika Harshe ◽  
Joseph J. Valadez
Keyword(s):  
Child Health ◽  
Health Workers ◽  
Sampling Error ◽  
Survey Methods ◽  
Transmitted Disease ◽  
Rural Setting ◽  
Birth Preparedness ◽  
Household Surveys ◽  
Survey Question ◽  
Lower Castes

Background Two probability surveys, conducted in the same districts of Bihar, India (Aurangabad and Gopalganj) at approximately the same time in 2016 using identical questionnaires and similar survey methods, produced significantly different responses for 37.2% (58/156) of the indicator comparisons. Interviewers for one survey were men while for the other they were women. Respondents were mothers of children aged 0–59 months living in a traditional rural setting. We examined the influence of interviewer gender on mothers’ survey responses and their implications for interpreting survey results. Methods We used qualitative methods including 10 focus group discussions (FGDs) and 33 in-depth interviews (IDIs) in the same locations as the 2016 surveys. FGD participants were purposefully selected mothers with children 0–59 months, husbands and other in-law family members. IDIs were carried out with frontline health-workers, enumerators and supervisors from the two previous household surveys. Results Findings revealed a preference for female interviewers for household surveys in study districts as they facilitated access to mothers and reduced their discomfort as survey participants. However, this gender preference was related to the survey question. Regardless of age, caste and educational level, most mothers were not permitted to communicate with men (aside from husbands) about female-specific health topics, including birth preparedness, delivery, menstrual cycles, contraception, breastfeeding, sexual behaviour, sexually transmitted disease, and domestic violence. Mothers in higher castes perceived these social restrictions more acutely than mothers in lower castes. There was no systematic direction of the resulting error. Mothers were willing to discuss child health issues with interviewers of either gender. Conclusions Interviewer gender is an important consideration when designing survey protocols for maternal and reproductive health studies and when selecting and training enumerators. Female interviewers are optimal for traditional settings in Bihar as they are more likely to obtain accurate data on sensitive topics and reduce the potential for non-sampling error due to their reduced social distance with maternal respondents.

Mapping of Household Surveys to Measure Barriers to Access to Maternal and Child Health Services in India

2021 ◽  
Vol 23 (1) ◽  
pp. 10-19
Author(s):  
Shivam Gupta ◽  
Priyanka Das ◽  
Siddhartha Kumar ◽  
Arindam Das ◽  
P. R. Sodani
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Survey ◽  
Maternal And Child Health ◽  
Household Surveys ◽  
Access Barriers ◽  
Health Service Provision ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
And Child Health

Objective: To map the range of access barrier indicators for which data can be derived from the three most common health related household surveys in India. Methods: A mapping review study was conducted to identify access dimensions and indicators of access barriers for maternal and child health (MCH) services included in three household surveys in India: National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS) and Annual Health Survey (AHS). Results: The Tanahashi framework for effective coverage of health services was used in this study, and 12 types of access barriers were identified, from which 23 indicators could be generated. These indicators measure self-reported access barriers for unmet healthcare needs through delayed care, as well as forgone care, and unsatisfactory experiences during health service provision. Multiple barriers could be identified, although there was marked heterogeneity in variables included and how barriers were measured. Conclusions: This study identified tracer indicators that could be used in India to monitor the population that experiences healthcare needs but fails to seek and obtain appropriate healthcare, and determine what the main barriers are. The surveys identified are well validated and allow the disaggregation of these indicators by equity stratifiers. Given the variability of the frequency and methodologies used in these surveys, comparability could be limited.

scholarly journals Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. K. Okemo ◽  
D. Kamya ◽  
A. M. Mwaniki ◽  
M. Temmerman
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Preconception Care ◽  
Healthcare Providers ◽  
Preventive Health Care ◽  
Structured Interview ◽  
University Hospital ◽  
Rural Setting ◽  
Rural Settings ◽  
And Child Health

Abstract Background Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya. Methods A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota sampling, at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The interviews were thereafter transcribed verbatim and analyzed thematically. Findings A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. The twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy. The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC. Conclusion From this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of the later.

scholarly journals The effect of community dialogues and sensitization on patient reporting of adverse events in rural Uganda: uncontrolled before-after study

2018 ◽  
Author(s):  
Helen Byomire Ndagije ◽  
Leonard Manirakiza ◽  
Dan Kajungu ◽  
Edward Galiwango ◽  
Donna Kusemererwa ◽  
...  
Keyword(s):  
Adverse Events ◽  
Community Engagement ◽  
Adverse Drug Events ◽  
Health Workers ◽  
Household Survey ◽  
Rural Setting ◽  
Health Issues ◽  
Community Members ◽  
Cross Sectional ◽  
Before And After

AbstractBackgroundThe patients that experience adverse events are in the best position to report them, only if they were empowered to do so. Systematic community engagement and support to patients in a rural setting to monitor any potential harm from medicines should provide evidence for patient safety.MethodsThis paper describes an uncontrolled before and after study aimed at assessing the effect of a community engagement strategy, the Community Dialogues and Sensitization (CDS) intervention between January and April 2017, on the knowledge, attitude and practice of reporting adverse drug events by community members in the two eastern Ugandan districts. A representative cross-sectional baseline household survey was done prior to the intervention in September 2016 (n=1034) and the end-line survey (n=827) in July 2017.ResultsAfter implementation of the CDS intervention, there was an overall 20% (95% CI=16- 25) increase in awareness about adverse drug events in the community. The young people (15- 24 years) demonstrated a 41% (95% CI =31-52) increase and the un-educated showed a 50% (95% CI=37-63) increase in awareness about adverse drug events. The attitudes towards reporting increased overall by 5% in response to whether there was a need to report ADEs (95% CI =3-7). An overall 115% (95% CI =137-217) increase in the population that had ever experienced ADEs was also reported.ConclusionOur evaluation shows that the CDS intervention increases knowledge, improves attitudes by catalyzing discussions among community members and health workers on health issues and monitoring safety of medicines.

scholarly journals Determinants of Preconception care among Pregnant Women In an Urban and a Rural Health Facility In Kenya: A Qualitative Study

2021 ◽  
Author(s):  
Joan Khavugwi Okemo ◽  
Dorothy Kamya ◽  
Abraham Mukaindo Mwaniki ◽  
Marleen Temmerman
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Preconception Care ◽  
Healthcare Providers ◽  
Preventive Health Care ◽  
Structured Interview ◽  
University Hospital ◽  
Rural Setting ◽  
Rural Settings ◽  
And Child Health

Abstract BACKGROUNDPreconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in the rural areas. Little is known regarding PCC use in Kenya that could help in bridging this gap. This study aimed to assess the determinants of PCC in urban and rural settings in Kenya.METHODSSelected pregnant women seeking antenatal care (ANC) were recruited by purposive sampling at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed thematically.RESULTS A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH).Transcription, coding and thematic analysis of the IDIs yielded 12 main themes. Eleven of the main themes were identified as determinants of PCC while the twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.CONCLUSIONFrom this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of nurses and doctors.

scholarly journals Assessing coverage of essential maternal and child health interventions using health-facility data in Uganda

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Elizabeth M. Simmons ◽  
Kavita Singh ◽  
Jamiru Mpiima ◽  
Manish Kumar ◽  
William Weiss
Keyword(s):  
Child Health ◽  
Health Facility ◽  
Maternal And Child Health ◽  
Gold Standard ◽  
Health Interventions ◽  
Household Surveys ◽  
Skilled Delivery ◽  
Improve Accuracy ◽  
Nationally Representative ◽  
And Child Health

Abstract Background Nationally representative household surveys are the gold standard for tracking progress in coverage of life-saving maternal and child interventions, but often do not provide timely information on coverage at the local and health facility level. Electronic routine health information system (RHIS) data could help provide this information, but there are currently concerns about data quality. This analysis seeks to improve the usability of and confidence in electronic RHIS data by using adjustments to calculate more accurate numerators and denominators for essential interventions. Methods Data from three sources (Ugandan Demographic and Health (UDHS) survey, electronic RHIS, and census) were used to provide estimates of essential maternal (> 4 antenatal care visits (ANC), skilled delivery, and postnatal care visit (PNC)) and child health interventions (diphtheria, pertussis, tetanus, and hepatitis B and Haemophilus influenzae type b and polio vaccination series, measles vaccination, and vitamin A). Electronic RHIS data was checked for quality and both numerators and denominators were adjusted to improve accuracy. Estimates were compared between the three sources. Results Estimates of maternal health interventions from adjusted electronic RHIS data were lower than those of the UDHS, while child intervention estimates were typically higher. Adjustment of electronic RHIS data generally improved accuracy compared with no adjustment. There was considerable agreement between estimates from adjusted, electronic RHIS data, and UDHS for skilled delivery and first dose of childhood vaccination series, but lesser agreement for ANC visits and second and third doses of childhood vaccinations. Conclusions Nationally representative household surveys will likely continue being the gold standard of coverage estimates of maternal and child health interventions, but this analysis shows that current approaches to adjusting health facility estimate works better for some indications than others. Further efforts to improve accuracy of estimates from RHIS sources are needed.

Sign in / Sign up

Export Citation Format

Share Document