scholarly journals Birth Spacing and Family Planning: Implementation of enhanced education and training for Community Health Coaches

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Alexandra Jostes, BS BA ◽  
Wilma Griffin, MS ◽  
Paige Dechant, BS ◽  
Carolina Otero, BA ◽  
Kathleen Sobiech, PhD ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
High Risk ◽  
Infant Mortality ◽  
Community Health ◽  
Low Income ◽  
Father Involvement ◽  
Birth Spacing ◽  
Extensive Literature ◽  
Health Coaches

  Background: Indiana is ranked 43/50 for infant mortality in America. WeCare employs lay Community Health Coaches (CHCs) to promote positive behavioral changes in pregnant, postpartum and women of child-bearing age living in low-income, high-risk communities in order to reduce the risk of infant mortality. Infant mortality can be reduced in communities where birth spacing and family planning education are available.   Project Methods: The goal was to address the knowledge gaps in patient handouts and CHC training regarding birth spacing and family planning. Through extensive literature searches, case conferences with CHCs, and review of current training materials, five gaps in training were identified: (1) comprehensive knowledge of rapid repeat pregnancies (2) resources regarding contraceptive methods (3) contraceptive counseling in the antenatal and postpartum periods (4) joint decision-making models and (5) father involvement in family planning.  Results: With comprehensive literature reviews and collaboration with fellow WeCare members, the gaps in training were appropriately filled. The WeCare training manual for CHCs is updated with information regarding birth spacing and family planning, as well as with counseling techniques for contraceptive method decision-making. A gap in existing literature regarding father involvement in family planning was identified.   Conclusion and Potential Impact: By enhancing CHC education on birth spacing, family planning, and counseling techniques, we may begin to close the knowledge gap for women in low-income, high-risk populations. This has the potential to reduce the rate of rapid repeat pregnancies and unintended pregnancies. We have also opened a new avenue of research about father involvement in family planning in the US.

scholarly journals A survey study of the impact of COVID-19 on women at high risk for infant mortality in Central Indiana

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Tanvi Asthana ◽  
Qing Tang ◽  
Matt Hodges ◽  
Debra Litzelman
Keyword(s):  
High Risk ◽  
Infant Mortality ◽  
Food Insecurity ◽  
Community Health ◽  
Health Workers ◽  
Survey Study ◽  
Chi Square ◽  
Daily Lives ◽  
High Risk Women ◽  
The Impact

Background/Objective: The WeCare program aims to reduce infant mortality through the community health worker model by assisting high risk women of child-bearing age. The COVID-19 pandemic introduced additional challenges for women already at high risk factor for infant mortality (IM). The aim of this survey study is to assess the impact of the COVID-19 pandemic in this population. Methods: Enrolled WeCare participants were given an optional COVID-19 phone survey (modified from the IeDEA survey*) between August 2020 and May 2021 to assess the impact of COVID-19 on their daily lives, income, food security, and mental health. Trained research assistants and community health workers administered surveys. Verbal consent was obtained over the phone.  Data was entered into REDCap.  From REDCap, data was exported to SAS version 9.4 to calculate descriptive statistics and chi square tests. Results:  Fifty-six primarily women of color (68%) completed the survey. Sixty-two percent of women lived in high-risk zip codes for infant mortality in Central Indiana. Fifty-seven percent of women worked prior to the outbreak. Forty-eight percent of the working women lost income, and seventy percent of women worked jobs requiring interaction with the public.  These women experienced greater food insecurity (38%), depression (24%), and anxiety (31%) compared to before the pandemic (p<0.001). Conclusion/Discussion: The demographics and residence of those interviewed were representative of the WeCare cohort (NS differences in race/ethnicity/age). In comparing the prevalence of food insecurity, depression and anxiety between the survey sampled during covid and prior to covid, all factors were significantly increased. These vulnerable women (many pregnant or postpartum), often major breadwinners in their household, held jobs putting them at high risk for covid infections, and lost these high-risk jobs at an alarming rate.  These data confirm the detrimental impact of COVID-19, especially on a population already at high risk for IM.   Acknowledgement of original authors of the *IeDEA survey: Suzanne Goodrich, Michael Scanlon, Leslie Enane, Kara Wools-Kaloustian 

scholarly journals Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1652 ◽  
Author(s):  
Muluneh Yigzaw Mossie ◽  
Anne Pfitzer ◽  
Yousra Yusuf ◽  
China Wondimu ◽  
Eva Bazant ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Continuum Of Care ◽  
Low Income Countries ◽  
Health Extension Workers ◽  
Pregnancy Risk ◽  
The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

Evaluation of human papillomavirus self-collection offered by community health workers at home visits among under-screened women in Brazil

2020 ◽  
pp. 096914132094105
Author(s):  
Naitielle de Paula Pantano ◽  
José H Fregnani ◽  
Júlio CP Resende ◽  
Luiz C Zeferino ◽  
Bruno de Oliveira Fonseca ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Pap Smear ◽  
Health Workers ◽  
Major Public Health Problem ◽  
Adult Women

Objective To explore the acceptability of high-risk human papillomavirus self-testing, involving community health workers, for never/under-screened Brazilian women. Cervical cancer is the most common cause of cancer-related death among adult women in a large number of low-income and lower-middle-income countries, where it remains a major public health problem. High-risk human papillomavirus persistence is required for the development of cervical neoplasia. Methods The target population was all women aged 30+ from the list of families available in healthcare centre data, who had never been screened or were not screened in the previous 3 years (under-screened women), and who were living in the 17 cities included in this study. Results Of the 377 women included, 16.9% ( n = 64) had never had a pap smear. Of all samples included in the study, 97.1% ( n = 366) were considered adequate for evaluation, as 2.9% ( n = 11) were considered invalid for all high-risk human papillomavirus types. Analysing these 366 samples, 9.6% ( n = 35) of the women were infected by at least one high-risk human papillomavirus type and 90.4% ( n = 331) had no infection with any high-risk type of the virus. Conclusions Vaginal self-sampling is an adequate strategy to improve the effectiveness of the cervical cancer program by increasing screening in a high-risk group.

scholarly journals ASUHAN KEBIDANAN CONTINUITY OF CARE PADA NY.K MASA HAMIL SAMPAI DENGAN KELUARGA BERENCANA DI KLINIK PANGESTU POLOREJO 2

2018 ◽  
Vol 2 (2) ◽  
pp. 83
Author(s):  
Siti Qomariyah ◽  
Suharti Suharti ◽  
Inna Sholicha Fitriani
Keyword(s):  
Family Planning ◽  
High Risk ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Continuity Of Care ◽  
Postpartum Period ◽  
Risk Group ◽  
Home Visits ◽  
High Risk Group ◽  
Midwifery Care

AbstractOne effort to reduce maternal mortality (MMR) and infant mortality (IMR) is by placing one midwife in each village with the responsibility of 1000 people in the region. Another way to deal with MMR and IMR problems is to provide comprehensive (comprehensive) midwifery care or care on a continuity of care basis starting from pregnancy, childbirth, childbirth, newborns and family planning.The care provided to Ny.K G3P20002 at 38 years of age has been conducted for pregnancy examinations 2 times at 39 4/7 weeks. From the results of the study, the mother complained of having fake her, constipation, hypertension and anxiety. Mother underwent delivery process at 41 41/7 weeks through surgery (SC) with indications postdate. PNC visits were carried out 3 times with normal examination results (including ttv, lokhea, involution, and lactation) on a 6-week visit, the mother complained of constipation. Babies are born through the SC process on March 1, 2018 weighing 3000 grams and on the last visit BB infants became 3900 grams. Babies experience physiological jaundice during the 6th day visit. Mother has participated in MOW after the SC action and home visits were made on the 20th day of March 20, 2018.Overall, mothers are included in the high risk group (HRG) with a score of 10 KSPR. In the postpartum period, in newborns and family planning there are no problems that can endanger both and are still classified as physiological.Keywords: Care provided, continuity of care, pregnancy periode, family planning Abstrak Salah satu upaya dalam menekan angka kematian ibu (AKI) dan angka kematian bayi (AKI) adalah dengan cara penempatan 1 bidan di setiap desa dengan tanggung jawab 1000 masyarakat di wilayah tersebut. Cara lain dalam menangani masalah AKI dan AKB adalah dengan cara memberikan asuhan kebidanan yang menyeluruh (komprehensif) atau asuhan secara continuity of care dimulai dari masa hamil, bersalin, nifas, bayi baru lahir serta KB.Asuhan yang diberikan pada Ny.K G3P20002 usia 38 tahun telah dilakukan pemeriksaan kehamilan sebanyak 2 kali saat uk 39 4/7 minggu. Dari hasil pengkajian ibu mengeluh mengalami his palsu, konstipasi, hipertensi serta cemas. Ibu menjalani proses persalinan saat uk 41 4/7 minggu melalui tindakan operasi (SC) dengan indikasi postdate. Kunjungan PNC dilakukan 3x dengan hasil pemeriksaan normal (meliputi ttv, lokhea, involusi, dan laktasi) pada kunjungan 6 minggu ibu mengeluh konstipasi. Bayi lahir melalui proses SC pada tanggal 1 Maret 2018 dengan berat 3000 gram dan pada kunjungan terakhir BB bayi menjadi 3900 gram. Bayi mengalami ikterusfisiologis pada saat kunjungan hari ke-6. Ibu telah berpartisipasi dalam KB MOW pasca tindakan SC dan dilakukan kunjungan rumah pada hari ke-20 tanggal 20 Maret 2018.Secara menyeluruh ibu termasuk dalam kelompok resiko tinggi (KRT) dengan skor KSPR 10. Dalam masa nifas, pada bayi baru lahir serta KB tidak ada masalah yang dapat membahayakan keduanya dan masih tergolong dalam fisiologis.Kata kunci: Asuhan kebidanan, continuity of care, masa hamil, keluarga berencana

Decision-Making in the Prescription of Orthotics and Prosthetics for Partial-Foot Amputees

2019 ◽  
Author(s):  
Pratima Saravanan ◽  
Charity Hipple ◽  
Jingxin Wang ◽  
Christopher McComb ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Low Income Countries ◽  
Extensive Literature ◽  
Proposed Model ◽  
Decision Making Model ◽  
Future Work ◽  
Automated Methods

Abstract Prosthetists face a daunting number of decisions that directly affect an amputee’s ability to walk and indirectly affect the overall quality of life of that amputee. In addition, the lack of resources in low-income countries provides a barrier to receive care after an amputation, and approximately 80% of amputees in low-income countries lack appropriate prosthetic care. In this research, we are motivated to understand what factors affect the decision-making strategies of prosthetists and podiatrists when prescribing prosthetics and orthotics to partial foot amputees. This work establishes a decision-making framework as a step towards automated methods that may reduce the complexities and decision-making burden of prosthetic prescription, ultimately increasing the efficiency of prosthetic prescription in low-resourced areas. A decision-making model is proposed based on an extensive literature review of over 100 papers. The proposed model is compared to qualitative data regarding decision-making strategies during prosthetic or orthotic prescription collected from nine prosthetists, surgeons, and other healthcare professionals directly involved in amputee care. Changes to the proposed model are described and future work exploring the role of automated methods to support decision-making in the context of prosthetics is discussed.

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