Analysis of Indonesia’s community health volunteers (kader) as maternal health promoters in the community integrated health service (Posyandu) following health promotion training

Background: Maternal health promotion is a task allocated to the kader (community health volunteers) in the community integrated health services called Posyandu. Yet, they are inadequately trained to perform this task. We present an analysis of the kader as maternal health promoters after their health promotion training with use of counselling card. Methods: Between March-April 2015, 14 participatory workshops were conducted and 188 kader in four villages in Ciranjang sub-district were trained. Data were collected through in-depth interviews and focus group discussions from community members, health care providers and policy makers in the four villages. A total of 44 interviews were conducted prior to health promotion training and 48 interviews post- training. In 46 Posyandu, kader were observed during their practice of health promotion within 3 consecutive months of post training. Data was transcribed and analysed in NVivo 10. Results: Most kader acknowledged that health promotion training improved their knowledge of maternal health and counselling skills and changed their attitude towards pregnant women at the Posyandu. They could confidently negotiate health messages and importance of health facility delivery with antenatal women. The kader also found the counselling cards helped pregnant women understand the health messages more clearly. The participatory training method involving role play and direct discussions boost kader confidence to deliver health promotion. As a result, the kader gained community appreciation which enhanced their motivation about their job. Conclusions: Appropriate health promotion training, provided the kader with adequate knowledge and skills to become resourceful maternal health promoters in the community.

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Exploring the lived experiences of pregnant women and community health care providers during the pandemic of COVID-19 in Bangladesh through a phenomenological analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04284-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sadika Akhter ◽

Feroza Akhter Kumkum ◽

Farzana Bashar ◽

Aminur Rahman

Keyword(s):

Health Care ◽

Pregnant Women ◽

Community Health ◽

Lived Experience ◽

Health Care Providers ◽

Health Workers ◽

Maternal And Newborn Health ◽

Community Health Care ◽

Care Providers ◽

The Government

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.

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Socio-cultural contextual factors that contribute to the uptake of a mobile health intervention to enhance maternal health care in rural Senegal

Reproductive Health ◽

10.1186/s12978-019-0800-z ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Margaret E. MacDonald ◽

Gorgui Sene Diallo

Keyword(s):

Health Care ◽

Maternal Health ◽

Maternal Mortality ◽

Community Health ◽

Health Care Providers ◽

Mobile Health ◽

Maternal Health Care ◽

Care Group ◽

Care Providers ◽

Mhealth Intervention

Abstract Background Although considerable progress has been made in reducing maternal mortality over the past 25 years in Senegal, the national maternal mortality ratio (MMR), at 315 deaths per 100,000 live births, is still unacceptably high. In recent years a mobile health (mHealth) intervention to enhance maternal health care has been introduced in rural and remote areas of the country. CommCare is an application that runs on cell phones distributed to community health workers known as matrones who enroll and track women throughout pregnancy, birth and the post-partum, offering health information, moral support, appointment reminders, and referrals to formal health care providers. Methods An ethnographic study of the CommCare intervention and the larger maternal health program into which it fits was conducted in order to identify key social and cultural contextual factors that contribute to the uptake and functioning of this mHealth intervention in Senegal. Ethnographic methods and semi-structured interviews were used with participants drawn from four categories: NGO field staff (n = 16), trained health care providers (including physicians, nurses, and midwives) (n = 19), community level health care providers (n = 13); and women belonging to a community intervention known as the Care Group (n = 14). Data were analyzed using interpretive analysis informed by critical medical anthropology theory. Results The study identified five socio-cultural factors that work in concert to encourage the uptake and use of CommCare: convening women in the community Care Group; a cultural mechanism for enabling pregnancy disclosure; constituting authoritative knowledge amongst women; harnessing the roles of older women; and adding value to community health worker roles. We argue that, while CommCare is a powerful tool of information, clinical support, surveillance, and data collection, it is also a social technology that connects and motivates people, transforming relationships in ways that can optimize its potential to improve maternal health care. Conclusions In Senegal, mHealth has the potential not only to bridge the gaps of distance and expertise, but to engage local people productively in the goal of enhancing maternal health care. Successful mHealth interventions do not work as ‘magic bullets’ but are part of ‘assemblages’ – people and things that are brought together to accomplish particular goals. Attention to the social and cultural elements of the global health assemblage within which CommCare functions is critically important to understand and develop this mHealth technology to its full potential.

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Health Literacy, Information Seeking Patterns and Perceived Outcomes among Pregnant Women in Two Districts of Tanzania

10.21203/rs.3.rs-156717/v1 ◽

2021 ◽

Author(s):

Columba Mbekenga ◽

Reuben Mutagaywa ◽

Edda Tandi Lwoga

Keyword(s):

Health Literacy ◽

Maternal Health ◽

Pregnant Women ◽

Health Information ◽

Health Care Providers ◽

Low Income ◽

Information Seeking ◽

Health Knowledge ◽

Care Providers ◽

High Level

Abstract BackgroundPregnant women that engage in information seeking process are more likely to have a high level of knowledge about their health, be confident to discuss their health concerns with their health care providers and report better health promotion activities than individuals who do not seek health information. However, health literacy influence pregnant women’s information seeking behaviours and consequently their health knowledge and health outcomes. Limited studies have explored the effects of health literacy on the outcomes associated with the information seeking among pregnant women in Tanzania. This study investigates the relationship between health literacy and information seeking patterns and its associated outcomes among pregnant women in Tanzania. MethodsA cross- sectional survey was conducted among 260 pregnant women aged 18 and above attending selected antenatal clinics (ANC) in Tanzania. Health literacy was assessed using a REALM-SF instrument while information seeking patterns while the associated outcomes were measured using three Likert scales. Descriptive and analytic analyzes were performed using the SPSS, version 24.ResultsAmong the demographic factors, level of education was significantly associated with the level of health literacy (p<0.001). The level of health literacy was better among married pregnant women than those who were not married, and among those who have high income more than those with low-income. The number of ANC visits, gestational age and parity were significantly associated with the level of health literacy (p<0.05). A significant relationship was found between health literacy with seeking health information from village leaders (p < 0.0001) and all online information sources (p < 0.05). Pregnant women with high level of health literacy strongly agree to confirm (from health professionals) the validity of health information they receive from different sources and to recommend the importance of searching health information to others (p<0.001).ConclusionHealth literacy has great influence on maternal health behaviors and the associated outcomes. Maternal health interventions targeting both individual women and the public to ensure high health literacy levels across communities are required. An integration of online/ web-based health information in ANC health educational packages would warrant pregnant women access to high quality health information.

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Reproduction and Language

The Oxford Handbook of Language and Sexuality ◽

10.1093/oxfordhb/9780190212926.013.52 ◽

2018 ◽

Cited By ~ 1

Author(s):

Sallie Han

Keyword(s):

Health Care ◽

Pregnant Women ◽

Health Care Providers ◽

Social Study ◽

Linguistic Anthropology ◽

Human Reproduction ◽

Care Providers ◽

Medical Health Care ◽

Medical Health

The aim of this chapter is to demonstrate the importance and necessity of bringing together the considerations of language and reproduction. While other topics of sexuality have aroused interest in sociolinguistics and linguistic anthropology, the ideas, practices, and experiences of human reproduction, notably pregnancy, remain understudied. At the same time, a discussion of language has been largely absent from the anthropology of reproduction, which has emerged in the last twenty years as an especially vibrant area of cultural and social study. The chapter examines the metaphors and discourses or the “talk about” reproduction; the interactions and “talk between” people, like pregnant women and medical health care providers, which shapes the ordinary experiences of reproduction; the “talk to” parties (specifically, fetuses and imagined children) who themselves become constituted through talk; and reproduction as literacy event or one that is mediated and experienced in relation to texts. It is asserted that language is a practice of reproduction.

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Benefits, Challenges, and Social Impact of Health Care Providers’ Adoption of Social Media

Social Science Computer Review ◽

10.1177/08944393211025758 ◽

2021 ◽

pp. 089443932110257

Author(s):

Md Irfanuzzaman Khan ◽

Jennifer (M.I.) Loh

Keyword(s):

Health Care ◽

Social Media ◽

Health Promotion ◽

Health Care Providers ◽

Health Care Professionals ◽

Community Support ◽

Care Providers ◽

Australian Health ◽

Actual Use ◽

Use Of Social Media

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.

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Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.879 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Galle ◽

H Cossa ◽

N Osman ◽

K Roelens ◽

S Griffin ◽

...

Keyword(s):

Health Care ◽

Maternal Health ◽

Hiv Prevention ◽

Health Care Providers ◽

Male Involvement ◽

Sub Saharan Africa ◽

Care Providers ◽

Pregnancy And Childbirth ◽

Policy Level ◽

Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

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Brazil’s Community Health Workers Practicing Narrative Medicine: Patients’ Perspectives

Journal of General Internal Medicine ◽

10.1007/s11606-021-06730-8 ◽

2021 ◽

Author(s):

Rogério Meireles Pinto ◽

Rahbel Rahman ◽

Margareth Santos Zanchetta ◽

W. Galhego-Garcia

Keyword(s):

Health Care ◽

Community Health ◽

Community Health Workers ◽

Health Care Providers ◽

Health Workers ◽

Hybrid Approach ◽

Narrative Medicine ◽

Structured Interview ◽

Patient Perspectives ◽

Care Providers

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.

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Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

BMC Psychiatry ◽

10.1186/s12888-021-03092-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Najmieh Saadati ◽

Poorandokht Afshari ◽

Hatam Boostani ◽

Maryam Beheshtinasab ◽

Parvin Abedi ◽

...

Keyword(s):

Pregnant Women ◽

Health Care Providers ◽

Health Anxiety ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Third Trimester ◽

Related Factors ◽

Cross Sectional ◽

The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

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Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis

International Urogynecology Journal ◽

10.1007/s00192-020-04636-3 ◽

2021 ◽

Author(s):

Heidi F. A. Moossdorff-Steinhauser ◽

Bary C. M. Berghmans ◽

Marc E. A. Spaanderman ◽

Esther M. J. Bols

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Pregnant Women ◽

Health Care Providers ◽

Meta Analysis ◽

Care Providers ◽

Case Definitions ◽

Monthly Basis ◽

Policy Makers ◽

In Pregnancy

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

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M-health for maternal health- bridging the gaps!!

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175822 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1

Author(s):

Sheeba Marwah ◽

Pratima Mittal

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Maternal Health ◽

Medical Care ◽

Health Care Providers ◽

Mobile Technology ◽

Clinical Applications ◽

Obstetrics And Gynecology ◽

Care Providers ◽

Effectiveness Data

This article reviews significance, potential and principles to consider when setting up a telemedicine (TM) program to provide care to women in the field of obstetrics and gynecology, essentially deploying mobile technology. There are various benefits of such TM clinical applications. The consensus among patients and health care providers is that this technology is convenient to provide needed subspecialty medical care, even when it is not available locally. Such innovations are clinically successful, but economic and cost-effectiveness data are lacking.

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