scholarly journals Assessment of the Effects of the Free Maternal Health Policy on Maternal Health: A Case Study of New Juaben Municipality, Koforidua, Ghana.

2016 ◽  
Vol 6 (7) ◽  
pp. 51
Author(s):  
Nicholas Apreh Siaw ◽  
Samuel Kwofie

<p>The main objective of the study was to verify the effect of the free maternal care policy on maternal health in the New Juaben Municipality, Ghana. The population for the study encompassed women of the child bearing age (10-49) in the New Juaben Municipality. Both primary and secondary sources of data were employed for this study. Purposive and accidental sampling procedures were used to select the respondents. The sample size was two hundred (200). This study used trend analysis as its main approach of analyzing the available data. The findings show that antenatal attendance has been increasing over the years. This is attributed to the introduction of the free maternal health policy. However, quality of care remains a problem due to the enormous attendance. It was also recommended that there is still a great need to introduce other measures to reduce maternal mortality in the municipality. It was also recommended that quality of care must be addressed and also more efforts should be made in the services that have provided to the patients. It was concluded that, although the policy has not eradicated maternal mortality completely yet it has contributed to its significant reduction in the region.</p>

Author(s):  
Philip Ayizem Dalinjong ◽  
Alex Y Wang ◽  
Caroline SE Homer

Introduction: Ghana introduced a maternal health policy in July 2008 to provide free of cost health services to women. However, the utilization of services does not depend on affordability alone but acceptability as well. Acceptability includes attitudes and behaviors of providers and satisfaction with the quality of care. The study explored women’s views and perceptions about attitudes and behaviors of providers and satisfaction with the quality of services under the free maternal health policy in Ghana. In addition, the views and perceptions of providers were examined. Methods: A convergent parallel mixed-methods study was conducted. The study was carried out in the Kassena-Nankana Municipality in Ghana. A structured questionnaire was distributed among women (n=406) who utilized health facilities during pregnancy. Further, focus group discussions (FGDs) with women (n=10) and in-depth interviews with midwives and nurses (n=25) were held. Quantitative data were analyzed using descriptive statistics, while the qualitative data were recorded, transcribed, read, and coded thematically. Results: Women perceived facilities to be clean, especially the smaller ones. Ninety-eight percent of women (n=313/320) perceived providers to be respectful or friendly, and this was mostly confirmed in the FGDs. More than two-thirds of the women (74%, n=300) were also very satisfied or satisfied with the quality of care due to the respect accorded them by providers. Equally, midwives and nurses were satisfied with the quality of care they provided. Nonetheless, providers believed that the unavailability of drugs and supplies, laboratory services, accommodation, and transportation for emergencies reduced women’s satisfaction with services and the quality of care they could provide. Conclusion: The services provided to women during pregnancy were acceptable under the free maternal health policy. There remain challenges in addressing a lack of infrastructure and commodities that affects the quality of care.


2020 ◽  
Author(s):  
Jackline Akinyi Oluoch-Aridi ◽  
Francis Wafula ◽  
Gilbert O Kokwaro ◽  
Mary B Adam

Abstract Background Maternal mortality still remains a big health system challenge in Kenya. Free maternity policy resulted in an increase in Facility-based delivery. However, this has not been accompanied with a reduction in maternal mortality. This research aims at establishing women’s experiences and perceptions with regard to the quality of maternal health services received at health facilities during delivery. This contextual knowledge will assist policy makers to better understand patterns of health system utilization critical for forging strategies for reducing inequities and providing high quality maternal care.Methods Women aged between 18 and 49 who had recently delivered and were attending six-week immunization clinics were purposively selected at six different health facilities and focus group discussions were conducted with the women. The data was analyzed using thematic content analysis. Verbatim excerpts from the women were provided to illustrate the themes identified. The WHO vision for quality of care was used to assess the themes on experiences of care described by the womenResults Six themes were identified as facilitators to access maternal health services 1) Perceived quality of delivery services 2) Financial access to delivery services 3) Referrals to public tertiary health facilities 4) Social influence 5) operation times at public primary health facilities 6) Distance to the health facility. A few barriers were identified under the perceived quality of services most prominent been the mistreatment of women by night-shift nurses and the operation time at the primary health facilitiesConclusion The findings suggest that the rural women tend to prefer tertiary maternity health facility and there are a number of factors related to quality of care based on their experiences that predispose their choices. Most prominent was the availability of equipment such as theatres for obstetric complications. Another emerging issue was respectful care during maternity services. Auxiliary costs still present a challenge despite the free maternity services. Future studies need to focus on ensuring in depth contextual understanding of women’s perceptions of the experience of care with regard to patient-centered care. Understanding these aspects will help in forging strategies to reduce inequities that are leading to high maternal mortality


2020 ◽  
Vol 1 ◽  
Author(s):  
Jackline Oluoch-Aridi ◽  
Tecla Chelagat ◽  
Mary M. Nyikuri ◽  
Joseph Onyango ◽  
Danice Guzman ◽  
...  

Introduction: Maternal mortality continues to be one of the biggest challenges of the health system in Kenya. Informal settlements in Kenya have been known to have higher rates of maternal mortality and also receive maternity services of varied quality. Data assessing progress on key maternal health indicators within informal settlements are also often scarce. The COVID-19 pandemic hit Kenya in March this year and so far, the impact of the pandemic on access to maternal health has not been established. This study aims to add to the body of knowledge by investigating the effects of the COVID-19 pandemic and mitigation strategies on access to health care services in informal settlements.Methods: Qualitative methods using in-depth interviews were used to assess women's experiences of maternity care during the COVID-19 era and the impact of proposed mitigation strategies such as the lockdown and the curfew. Other aspects of the maternity experience such as women's knowledge of COVID-19, their perceived risk of infection, access to health facilities, perceived quality of care were assessed. Challenges that women facing as a result of the lockdown and curfew with respect to maternal health access and quality were also assessed.Results: Our findings illustrate that there was a high awareness of the symptoms and preventative measures for COVID-19 amongst women in informal settlements. Our findings also show that women's perception of risk to themselves was high, whereas risk to family and friends, and in their neighborhood was perceived as low. Less than half of women reported reduced access due to fear of contracting Coronavirus, Deprioritization of health services, economic constraints, and psychosocial effects were reported due to the imposed lockdown and curfew. Most respondents perceived improvements in quality of care due to short-waiting times, hygiene measures, and responsive health personnel. However, this was only reported for the outpatient services and not in-patient services.Conclusion: The most important recommendation was for the Government to provide food followed by financial support and other basic amenities. This has implications for the Government's mitigation measures that are focused on public health measures and lack social safety-net approaches for the most vulnerable communities.


Author(s):  
Margaret E. MacDonald

AbstractIn this chapter, I tell the story of the waxing and waning of the status of the traditional birth attendant (TBA) in global maternal health policy from the launch of the Safe Motherhood Initiative in 1987 to the present. Once promoted as part of the solution to reducing maternal mortality, the training and integration of TBAs into formal healthcare systems in the global south was deemed a failure and side-lined in the late 1990s in favour of ‘a skilled attendant at every birth’. This shift in policy has been one of the core debates in the history of the global maternal health movement and TBAs continue to be regarded with deep ambivalence by many health providers, researchers and policymakers at the national and global levels. In this chapter, I take a critical global heath perspective that scrutinises the knowledge, policy and practice of global health in order to make visible the broader social, cultural and political context of its making. In this chapter, I offer a series of critiques of global maternal health policy regarding TBAs: one, that the evidence cited to underpin the policy shift was weak and inconclusive; two, that the original TBA component itself was flawed; three, that the political and economic context of the first decade of the SMI was not taken into account to explain the failure of TBAs to reduce maternal mortality; and four, that the reorganisation of the Safe Motherhood movement at the global level demanded a new humanitarian logic that had no room for the figure of the traditional birth attendant. I close the chapter by looking at the return of TBAs in global level policy, which, I argue, is bolstered by a growing evidence base, and also by the trends towards ‘self-care’ and point-of-use technologies in global health.


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