An assessment of health facility factors influencing male participation in utilization of antenatal care services among spouses in selected manufacturing industries in Nairobi County, Kenya

Background: Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern, 295 000 women died of pregnancy or childbirth related complications in 2017. Late initiation of Antenatal Care (ANC) services in most low-income countries like Tanzania has been reported as a major problem which increase maternal mortality rate (MMR). However, different factors for late initiation of antenatal care are not well identified. Therefore, this study aimed to identify factors for late initiation of antenatal care both individual factors and health policy factors as per pregnant women and health care providers opinions in Kahama Municipal, Tanzania. Broad Objective: The study focused on assessment of factors for late initiation of Antenatal Care (ANC) in Kahama Municipal, Tanzania. Materials and Methods: This study was conducted using a qualitative method with exploratory approach which was carried out to explore factors for late initiation of antenatal care in Kahama Municipal. An in-depth interview (IDI) and Focus Group Discussion (FGD) were methods used to collect data. The study comprised of 14 in-depth interviews (IDIs) with pregnant women with age range of 18 years to 49 years attending antenatal care clinics in two health facilities and 4 in-depth interviews (IDIs) with health care providers attending pregnant women during antenatal care clinic visit. Furthermore, two Focus Group Discussions (FGDs), one from each health facility with pregnant women were conducted. Data Analysis: Thematic analysis was conducted through use of inductive approach. The audio recordings were conducted using the Swahili language then transcribed and translated into the English language where themes were obtained after translation. Results: Findings obtained from this study were factors for late initiation of antenatal care as reported by both pregnant women and health care providers. Factors for late initiation of antenatal care were under guidance of Health Behavioral Modal (HBM): Factors mentioned by pregnant women included pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications, , unfriendly services and unequal gender power relation within a family. Factors mentioned by health care providers based on health policy and managerial factors such as Partner accompanying policy, distant allocation of health facility from people’s settlement and unfriendly services provided by health care providers. Conclusion: This study focused on assessing factors for late initiation of antenatal care in Kahama municipal council in Shinyanga, Tanzania. Different factors for late initiation of antenatal care were reported which included pregnant women and health care providers. Pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, and distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications. Health policy and managerial related factors were partner accompanying policy, unfriendly services, and allocation of health facility. Recommendation: However different improvement made on maternal health services in Tanzania but still some of pregnant women are not utilizing it efficiently because of different obstacles like distance from people’s settlement to the health facility, Partner accompanying policy and unfriendly services provided by health care providers. Through such obstacles as a policy maker, I would like to advice Government through Ministry of Health to allocate health facility nearby people’s settlement, providing outreach program to educate the community about antenatal care rather than relying on partner accompanying policy and lastly is provision of refresher training related to client’s rights during health care services provision to all staff.

Download Full-text

Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia

Women s Health ◽

10.1177/1745506520976017 ◽

2020 ◽

Vol 16 ◽

pp. 174550652097601

Author(s):

Daniel Adane ◽

Biresaw Wassihun

Keyword(s):

Antenatal Care ◽

Health Care Providers ◽

Postnatal Care ◽

Associated Factors ◽

Client Satisfaction ◽

Post Partum ◽

Care Providers ◽

Amhara Region ◽

Awi Zone

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

Download Full-text

Quality of antenatal care services in Rwanda: assessing practices of health care providers

BMC Health Services Research ◽

10.1186/s12913-018-3694-5 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Akashi Andrew Rurangirwa ◽

Ingrid Mogren ◽

Joseph Ntaganira ◽

Kaymarlin Govender ◽

Gunilla Krantz

Keyword(s):

Health Care ◽

Antenatal Care ◽

Health Care Providers ◽

Care Providers ◽

Care Services

Download Full-text

Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

10.21203/rs.2.12400/v4 ◽

2020 ◽

Author(s):

Bettina Utz ◽

Bouchra Assarag ◽

Touria Lekhal ◽

Wim Van Damme ◽

Vincent De Brouwere

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Gestational Diabetes ◽

Antenatal Care ◽

Health Care Providers ◽

Management Approach ◽

Care Providers ◽

Diabetes Screening ◽

Primary Level ◽

Care Services

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

Download Full-text

Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

10.21203/rs.2.12400/v1 ◽

2019 ◽

Author(s):

Bettina Utz ◽

Bouchra Assarag ◽

Touria Lekhal ◽

Wim Van Damme ◽

Vincent De Brouwere

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Gestational Diabetes ◽

Antenatal Care ◽

Health Care Providers ◽

Management Approach ◽

Care Providers ◽

Diabetes Screening ◽

Primary Level ◽

Care Services

Abstract Background Gestational diabetes mellitus (GDM) is associated with an increased risk for a future diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. Looking at the main themes screening, diagnosis, treatment and service organization, we thematically analyzed the data using a combined de- and inductive approach. Results The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. Lack of knowledge about gestational diabetes in the community but also by private health care providers demanded more time for counseling. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes and the ability to take decisions on follow-up. Conclusions Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

Download Full-text

Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

10.21203/rs.2.12400/v2 ◽

2020 ◽

Author(s):

Bettina Utz ◽

Bouchra Assarag ◽

Touria Lekhal ◽

Wim Van Damme ◽

Vincent De Brouwere

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Gestational Diabetes ◽

Antenatal Care ◽

Health Care Providers ◽

Management Approach ◽

Care Providers ◽

Diabetes Screening ◽

Primary Level ◽

Care Services

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

Download Full-text

Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

10.21203/rs.2.12400/v3 ◽

2020 ◽

Author(s):

Bettina Utz ◽

Bouchra Assarag ◽

Touria Lekhal ◽

Wim Van Damme ◽

Vincent De Brouwere

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Gestational Diabetes ◽

Antenatal Care ◽

Health Care Providers ◽

Management Approach ◽

Care Providers ◽

Diabetes Screening ◽

Primary Level ◽

Care Services

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

Download Full-text

Pregnancy Outcome between Booked and Unbooked Cases in A Tertiary Level Hospital

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v9i2.37261 ◽

2018 ◽

Vol 9 (2) ◽

pp. 43-48

Author(s):

Alpana Adhikary ◽

Anwara Begum ◽

Fahmida Sharmin Joty ◽

Nihar Ranjan Sarker ◽

Tahmina Akhter

Keyword(s):

Antenatal Care ◽

Pregnancy Outcome ◽

Health Care Providers ◽

Family Income ◽

Adverse Pregnancy Outcome ◽

Post Partum ◽

Age Difference ◽

Care Providers ◽

Cross Sectional ◽

Adverse Pregnancy

To achieve the Sustainable Development Goals (SDG’2030) with regards to maternal health, there is need for research on the local causes and factors influencing adverse maternal & foetal outcomes in health institutions. Antenatal care throughout the pregnancy can ensure better feto-maternal outcome. It also contributed to reduction of maternal and infant mortality. This study was an attempt to enable health care providers to know where to focus to overcome adverse maternal outcome.Objectives: To find out the difference in maternal and perinatal outcome and socio-demographic characteristics in booked and unbooked cases. Design: A Cross-sectional observational study.Place of study :Department of Obststrics and Gynaeology , Shaheed Suhrawardy Medical College Hospital.Study period: April’2015 to july’2015. Study population- All patients admitted for delivery and puerperium during study period.Results: Unbooked mothers constituted 39.1% of the 218 deliveries in the studied period. There was no mean age difference between booked mothers and unbooked mothers (26.05±5.5 and 25.44±5.4; P=0.667) .But unbooked cases had a lower educational status (P<0.0036). Majority of the unbooked cases were from low family income group. Unbooked mothers were about less likely to deliver by spontaneous vaginal delivery compared to booked mothers (28% to 39%; P<0.339) and more likely to be delivered by emergency caesarean section than booked mothers. Unbooked mothers were having low birth weight babies than booked mother (2.65±0.595 and 3.02±0.477, p<0.010). Referral to neonatal unit more common in unbooked cases (69.6% to 25.6%). Post partum complications in unbooked and booked cases were (44%and 20.5%).Conclusion: The study showed a positive correlation between socio –demographic factor and lack of proper antenatal care and adverse pregnancy outcome. Improving the availability and accessibility of quality antenatal and delivery care services in all our institutes will improve pregnancy outcome.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 43-48

Download Full-text

Repositioning post partum care in Kenya

10.31899/rh16.1013 ◽

2005 ◽

Author(s):

Keyword(s):

Health Care Providers ◽

Postpartum Period ◽

Service Providers ◽

Post Partum ◽

Cultural Beliefs ◽

Care Providers ◽

Skilled Attendant ◽

Maternal Deaths ◽

Early Postpartum Period ◽

Early Postpartum

In Kenya, although 45 percent of maternal deaths occur within the first 24 hours after childbirth and 65 percent of maternal deaths occur during the first week postpartum, health-care providers continue to advise on a first check-up six weeks after childbirth. The early postpartum period is also critical to newborn survival, with 50–70 percent of life-threatening newborn illnesses occurring in the first week. Yet most strategies to reduce maternal and perinatal morbidity and mortality have focused on pregnancy and birth. In addition to the heavy workload of providers who do not assess the mother post-delivery when she may bring her infant for immunization, lack of knowledge, poverty, cultural beliefs and practices perpetuate the problem. The only register that exists for mothers post-delivery is for family planning, thus perpetuating the lack of emphasis on the early postpartum period with no standardized register to record care given. To address this gap in service delivery, the Population Council defined the minimal services a mother and baby should receive from a skilled attendant after birth. As stated in this brief, the development of a standardized postpartum register is one step toward advocating for providing early postpartum care among health-service providers.

Download Full-text

Utilization of antenatal health care services and its impact on birth weight of newborn in rural area of Western Rajasthan, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20170739 ◽

2017 ◽

Vol 4 (3) ◽

pp. 680 ◽

Cited By ~ 2

Author(s):

Sandeep Kumar Uppadhaya ◽

Neha Agrawal ◽

Suman Bhansali ◽

Kapil Garg ◽

Mahendra Singh

Keyword(s):

Health Care ◽

Birth Weight ◽

Antenatal Care ◽

Rural Area ◽

Health Care Providers ◽

Health Care Services ◽

Nuclear Family ◽

Care Providers ◽

Care Services ◽

Antenatal Visits

Background: Antenatal care is an important component of reproductive and child health but has not been utilized to the full extent in India. The study is aimed to assess the utilization of antenatal health care services by mothers and its impact on birth weight of their newborn.Methods: A community based cross sectional study was conducted in a rural area of Jodhpur, Rajasthan. A total of 198 women of study area who have delivered between 1st July 2013 to 30thJune 2014 (12 months period) were interviewed by pre-designed and semi-structured questionnaire by door to door approach.Results: Present study showed that 100% of mothers registered their pregnancy in any health facility and 56.6% were registered in 2nd trimester. Only 32.8% mothers had received four or more antenatal visits. Only 26.26% mothers had utilized full antenatal care (minimum four antenatal visits, minimum one TT and minimum 100 IFA tablet taken) during pregnancy. The prevalence of low birth weight was 12.6%. Proportion of LBW babies was more (15.9%) in mothers who had not availed of full antenatal care. This difference was statistically significantly (P<0.05).Conclusions: The important factors related to low utilization of Antenatal services were lower socioeconomic status, lower literacy of mothers, working mothers, parity and nuclear family. The findings of this study may be utilized by the health managers and health care providers to address the problem of low ANC coverage.

Download Full-text