scholarly journals Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255193
Author(s):  
Yoshiko Kawaguchi ◽  
Ahmad M. Sayed ◽  
Alliya Shafi ◽  
Sengchanh Kounnavong ◽  
Tiengkham Pongvongsa ◽  
...  
Keyword(s):  
Ecological Model ◽  
Lao Pdr ◽  
Labour Pain ◽  
Home Delivery ◽  
Health Facilities ◽  
Birth Preparedness ◽  
Factors Affecting ◽  
Medical Needs ◽  
Delivery Place ◽  
Delivery Policy

Background Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities. Methods A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model. Results Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD. Conclusions Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy.

scholarly journals Utilization of rural maternity delivery services in Nawalparasi and Kapilvastu District: A Qualitative Study

1970 ◽  
Vol 6 (3) ◽  
pp. 29-36 ◽  
Author(s):  
M Ahmed ◽  
B Devkota ◽  
B Sathian ◽  
SB Dixit
Keyword(s):  
Health Facility ◽  
Home Delivery ◽  
Health Facilities ◽  
Health Staff ◽  
Health Providers ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Dalit Women ◽  
Key Factor ◽  
Delivery Services

Increasing the proportion of births attended by skilled health providers is likely the key factor in reducing maternal and perinatal morbidity and mortality. Study objectives were to identify key factors influencing the utilization delivery services and stakeholders’ perceptions about these services. The study utilized focus group discussions and in-depth interviews with a diversity of community members users and nonusers , dalit women and health facility staffs to gain insights about the factors influencing use of trained attendants. Field researchers were trained to use FGD guides and interview schedules, and then gathered information on the perspectives of the women and their families and health staff. In Nawalparasi and Kapilvwastu we conducted a comparative study to compare on factors affecting the volume of delivery services.In Nawalparasi the deliveries in the pervious six months was relatively large number from hospital and PHCC whereas in Kapilvastu the delivery was in smaller number. The vast majority of women planned to have a home delivery attended by relatives and/or a Trained Birth Attendants and to reserve attendance at a health facility as a back-up plan in case of prolonged labor and complications. Ritual pollution considerations interfere with a decision to seek delivery in a facility, especially in the Western Hills. The cost recovery scheme ("incentives") deals with a major factor which inhibits use of health facilities. TBAs can encourage clients to deliver in health facilities. Staff feel that the large number of vacant positions inhibits availability of services and requires strenuous efforts on their part to cover for vacancies. Key Words: Maternity; delivery; health staff DOI: 10.3126/jcmsn.v6i3.4072Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.29-36

scholarly journals A Qualitative Exploration of the “Critical Window”: Factors Affecting Australian Children’s After-School Physical Activity

2013 ◽  
Vol 10 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Rebecca Megan Stanley ◽  
Kobie Boshoff ◽  
James Dollman
Keyword(s):  
Physical Activity ◽  
Peer Influence ◽  
Ecological Model ◽  
After School ◽  
Critical Window ◽  
Factors Affecting ◽  
Children's Perceptions ◽  
Children’S Perceptions ◽  
Children’S Voices ◽  
School Period

Background:The after-school period is potentially a “critical window” for promoting physical activity in children. The purpose of this study was to qualitatively explore children’s perceptions of the factors influencing their engagement in physical activity during the after-school period as the first phase in the development of a questionnaire.Methods:Fifty-four South Australian children age 10−13 years participated in same gender focus groups. Transcripts, field notes, and activity documents were analyzed using content analysis. Through an inductive thematic approach, data were coded and categorized into perceived barriers and facilitators according to a social ecological model.Results:Children identified a number of factors, including safety in the neighborhood and home settings, distance to and from places, weather, availability of time, perceived competence, enjoyment of physical activity, peer influence, and parent influence. New insights into bullying and teasing by peers and fear of dangerous animals and objects were revealed by the children.Conclusions:In this study, hearing children’s voices allowed the emergence of factors which may not be exposed using existing surveys. These findings are grounded in children’s perceptions and therefore serve as a valuable contribution to the existing literature, potentially leading to improved intervention and questionnaire design.

Meconium-stained liquor and low birth weight increases the odds of low fifth-minute apgar scores in public health facilities of arba minch town, southern Ethiopia: a cross-sectional study

2020 ◽  
Vol 10 (3) ◽  
pp. 86-90
Author(s):  
Abera Mersha ◽  
Shitaye Shibiru ◽  
Agegnehu Bante
Keyword(s):  
Public Health ◽  
Birth Weight ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Southern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Apgar Scores ◽  
Factors Affecting ◽  
Public Health Facilities

Background: Low Apgar scores in the childbirth period increased risk globally and significantly contributes to both newborn morbidity and mortality. Hence, it is very essential to update information on the status of low fifth-minute Apgar scores and factors affecting. Some studies were conducted, but most are retrospective and record reviews. Besides, there is limited study in country-Ethiopia. Therefore, this study aimed to assess the recent status of low fifth-minute Apgar scores and factors affecting in the study setting. Methods: A facility-based cross-sectional study was conducted among 286 newborns in public health facilities of Arba Minch town, southern Ethiopia from February 6 to March 9, 2019. Study participants were selected using a systematic random sampling method. Pre-tested interviewer-administered questionnaires and checklist were used to collect the data. Data were entered into Epi data version 3.1 and exported to Stata version 15 for analysis. A crude and adjusted odds ratio was computed in the binary logistic regression model. In this study, P-value, < 0.05 was considered to declare factors as a statistically significant association. Results: In this study, 17.8% (95%CI: 13.8%, 22.7%) of neonates had low fifth-minute Apgar scores. Condition of labor (induced/augmented) (AOR=3.33, 95%CI: 1.24, 8.90), meconium-stained liquor (AOR=3.37, 95%CI: 1.17, 9.74), and birth weight (AOR=3.48, 95%CI: 1.23, 9.86) were significantly associated with neonate’s low fifth-minute Apgar scores. Conclusions: This study indicated that a significant number of newborns resulted in low fifth-minute Apgar scores. Strengthen the provision of health information during antenatal care; avoid delay in screening high-risk mothers during pregnancy and delivery, and give immediate interventions should be recommended.

Barriers of Antenatal Care Service Utilization in Somali Regional State Using Social Ecological Framework, Eastern Ethiopia, Ethiopia: a Qualitative Study

2020 ◽  
Author(s):  
Abdurehman Mohammed ◽  
Alula Teklu ◽  
Senait Beyene ◽  
Abdiwahab Hashi ◽  
Zerihun Abebe ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Service Utilization ◽  
Ecological Model ◽  
Care Service ◽  
Structured Interview ◽  
Organizational Level ◽  
Enabling Factors ◽  
Eastern Ethiopia ◽  
Factors Affecting ◽  
Regional State

Abstract Background: A good Antenatal Care during pregnancy is important to ensure the health of the mother and the healthy development of the fetus. In 2016, at Ethiopian Somali region (43.6 %) of pregnant mothers had an Antenatal Care (ANC) visit at least once during their last pregnancy and only (11.8%) had a history of four or more visits for Antenatal Care, which are the lowest rates among all regions in Ethiopia.Objective: The objective of the study was to explore the barriers and determine enabling factors affecting Antenatal Care service utilization in Somali Regional state.Methods: A qualitative exploration was conducted from February 18 to March 11, 2017. A pre-tested semi-structured interview guides, and facility abstractions with checklists were used to collect the data. A total of 31 individual interviews, 12 focus group discussions, and 21 facility abstractions were collected. The population of the region were stratified into three areas based on their settlement characteristics as agro-pastoralist, pastoralist, and urban. Two districts were selected from each category based on their performance. The data was entered, coded, categorized, and analyzed by utilizing Nvivo version 11software. A thematic analysis was conducted using themes that were developed based on the constructs of the socio-ecological model.Results: According to the study, economic constraints, place of residence, mothers’ being lack of awareness, preference of female health care provider, husband’s disapproval, lack of acceptance by the community, absence of full ANC services packages related with shortage of manpower, medical supply in majority of the health facilities and lack of perceived benefits from ANC service were the main barriers of ANC service utilization. Conclusion: Individual, interpersonal, and organizational level factors were the most dominant barriers for ANC service utilization. Therefore, FMOH, regional, zonal and district level health administrators and other stakeholders should design effective IEC, community mobilization and work on supply-related problems to .increase ANC utilization in the region.

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Status of Home Delivery and Its Associated Factors among Women Who Gave Birth within the Last 12 Months in East Badawacho District, Hadiya Zone, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Deneke Delibo ◽  
Melake Damena ◽  
Tesfaye Gobena ◽  
Bahailu Balcha
Keyword(s):  
Maternal Education ◽  
Skilled Birth Attendance ◽  
Home Delivery ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
Birth Preparedness ◽  
Cross Sectional ◽  
Place Of Delivery ◽  
Birth Plan ◽  
Birth Attendance

Background. Home delivery is responsible to maternal mortality due to obstetric complication like hemorrhage, hypertensive disorders, and sepsis. The prevalence of home delivery is remained very high both nationally (73%) and regionally (SNNPR) with 74.5%. Efforts were made to increase institutional delivery through skilled birth attendance. But women still prefer home as a place of delivery. This study was done to determine whether home preference has association with home delivery or not and the reason why they prefer home delivery Method. A community-based cross-sectional study was conducted in East Badawacho District from January 26 to February 25/2018. A total of 552 participants were selected by systematic sampling. Data were collected using both quantitative and qualitative methods. Bivariate and multivariable analyses were carried out to identify factors associated with home delivery. Qualitative data was analyzed thematically, and results were triangulated with the data. Associations were determined by using OR at 95% CI and p value at 0.05. Result. Home delivery is found to be 73.6% (95% CI, 69.9%-77.2%). Lack of written birth plan for birth preparedness and readiness (AOR=14.965, 95% CI: 4.488-49.899), incomplete number of ANC visits (1-3)(AOR=4.455, 95% CI: 1.942-10.221), and home preference as a place of delivery (AOR=4.039, 95% CI: 1.545-10.558) were independent predictors of home delivery. Conclusion. Home delivery was high in the district. The independent factors significantly associated with home were lack of written birth plan for preparedness and readiness, incomplete number of ANC visits (1-3), and home preference as place of delivery. Actions targeting maternal education, encouraging number of ANC visits, and avoiding barriers for ID utilization were the crucial areas to tackle the problem.

Factors affecting utilization of youth friendly health services in Lagos State, Nigeria

2017 ◽  
Vol 31 (2) ◽  
Author(s):  
Toriola Temitope Femi-Adebayo ◽  
Yetunde Kuyinu ◽  
Olusola Adedeji Adejumo ◽  
Olayinka Goodman
Keyword(s):  
Health Services ◽  
School Attendance ◽  
Health Facilities ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Lagos State ◽  
The Mean ◽  
The Government ◽  
Youth Friendly ◽  
Youth Friendly Services

AbstractBackgroundYouth friendly health services (YFHS) are services that attract, respond to the needs of and retain young people for continuing care. This study was conducted to determine the factors affecting utilization of government (GYFF) and non-governmental youth friendly facilities (NGYFF) in Lagos state, Nigeria.MethodsA descriptive cross-sectional study was conducted. A total of 543 adolescents aged 15–24 years, between August 1, 2014 and October 31, 2014 were consecutively recruited from 10 (five government and five non-governmental) youth friendly health facilities that had been in operation for at least 6 months prior to the study. Logistic regression was used to determine predictors of utilization of youth friendly health facilities.ResultsOverall, the mean age of respondents was 17.9 ± 2.8. However, the mean age of respondents at GYFF (18.5 ± 3.0) was significantly higher than those at NGYFF (17.1 ± 2.5) (p < 0.001). Of the 567 youths enrolled, 196 (34.6%) had good utilization of youth friendly facilities (YFF) (34% from the GYFF and 35.2% from the NGYFF). Marital status, school attendance, having a baby, satisfaction with visit, perception that information shared was kept confidential and accessibility of the youth friendly services were associated with utilization of YFF (p < 0.05). Confidentiality and access to facilities were predictors of utilization of YFF.ConclusionThere is poor utilization of both government and non-governmental youth friendly services in Lagos, Nigeria. There is a need for both the government and private sector to harmonize resources aimed at encouraging utilization of YFF in Lagos, Nigeria.

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