scholarly journals Contextual factors influencing a training intervention aimed at improved maternal and newborn healthcare in a health zone of the Democratic Republic of Congo

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260153
Author(s):  
Malin Bogren ◽  
Sylvie Nabintu Mwambali ◽  
Marie Berg

Background Maternal and neonatal mortality and morbidity in the Democratic Republic of Congo (DRC) are among the highest worldwide. As part of a quality improvement programme in a health zone in the DRC aimed at contributing to reduced maternal and neonatal mortality and morbidity, a three-pillar training intervention around childbirth was developed and implemented in collaboration between Swedish and Congolese researchers and healthcare professionals. The aim of this study is to explore contextual factors influencing this intervention. Methods A qualitative research design was used, with data collected through focus group discussions (n = 7) with healthcare professionals involved in the intervention before and at the end (n = 9). Transcribed discussions were inductively analysed using content analysis. Results Three generic categories describe the contextual factors influencing the intervention: i) Incentives motivated participants’ efforts to begin a training programme; ii) Involving the local health authorities was important; and (iii) Having physical space, electricity, and equipment in place was crucial. Conclusions This study and similar ones highlight that incentives of various types are crucial contextual factors that influence training interventions, and have to be considered already in the planning of such interventions. One such factor is expectations of monetary incentives. To meet this in a small research project like ours would require a reduction of the scale and thus limit the implementation of new evidence-based knowledge into practice aimed at reducing maternal mortality and morbidity.

OALib ◽  
2017 ◽  
Vol 04 (04) ◽  
pp. 1-11
Author(s):  
Cibangu Kazadi Richard ◽  
Bilonda Mpiana Alphonsine ◽  
Kabengele Mpinga Emmanuel ◽  
Mulewu Ngandu Hippolyte ◽  
Ciamala Mukendi Paul ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dalau Mukadi Nkamba ◽  
Gilbert Wembodinga ◽  
Pierre Bernard ◽  
John Ditekemena ◽  
Annie Robert

Abstract Background Poor awareness of obstetric danger signs is a major contributing factor to delays in seeking obstetric care and hence to high maternal mortality and morbidity worldwide. We conducted the current study to assess the level of agreement on receipt of counseling on obstetric danger signs between direct observations of antenatal care (ANC) consultation and women’s recall in the exit interview. We also identified factors associated with pregnant women’s awareness of obstetric danger signs during pregnancy in the Democratic Republic of Congo (DRC) Methods We used data from the 2017–2018 DRC Service Provision Assessment survey. Agreement between the observation and woman’s recall was measured using Cohen’s kappa statistic and percent agreement. Multivariable Zero-Inflated Poisson (ZIP) regression was used to identify factors associated with the number of danger signs during pregnancy the woman knew. Results On average, women were aware of 1.5 ± 1.34 danger signs in pregnancy (range: 0 to 8). Agreement between observation and woman’s recall was 70.7%, with a positive agreement of 16.9% at the country level but ranging from 2.1% in Bandundu to 39.7% in Sud Kivu. Using multivariable ZIP analysis, the number of obstetric danger signs the women mentioned was significantly higher in multigravida women (Adj.IRR = 1.38; 95% CI: 1.23–1.55), in women attending a private facility (Adj.IRR = 1.15; 95% CI: 1.01–1.31), in women attending a subsequent ANC visit (Adj.IRR = 1.11; 95% CI: 1.01–1.21), and in women counseled on danger signs during the ANC visit (Adj.IRR = 1.19; 95% CI: 1.05–1.35). There was a regional variation in the awareness of danger signs, with the least mentioned signs in the middle and the most in the eastern provinces. Conclusions Our findings indicated poor agreement between directly observed counseling and women’s reports that counseling on obstetric danger signs occurred during the current ANC visit. We found that province of residence, provision of counseling on obstetric danger signs, facility ownership, gravidity and the number of ANC visits were predictors of the awareness of obstetric danger signs among pregnant women. These factors should be considered when developing strategies aim at improving women’s awareness about obstetric danger signs in the DRC


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