Humanized Childbirth and Cultural Humility: Designing an Online Course for Maternal Health Providers in Limited-Resource Settings

2015 ◽  
Vol 5 (4) ◽  
pp. 188-199 ◽  
Author(s):  
Amita Sreenivas ◽  
Susanna Cohen ◽  
Laura Magaña-Valladares ◽  
Dilys Walker
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Care Professionals ◽  
Role Models ◽  
Professional Training ◽  
Health Workers ◽  
Cultural Humility ◽  
Online Course ◽  
Disrespect And Abuse ◽  
Health Providers

This article reviews the implications of disrespect and abuse in maternal health services, the growing movement to humanize childbirth and promote cultural humility, and one strategy to build an online course to address this issue among maternal health workers in Mexico. Reports of disrespect and abuse have been widely reported by women seeking health services, including maternity care, across the globe. Evidence indicates offenders are often health care professionals who do not consider their behavior inappropriate and believe they are acting in the interests of both mother and baby. These same providers are often overworked, underpaid, and have few role models who humanize childbirth and demonstrate cultural humility. Strategies which aim to foster competencies in humanized childbirth and cultural humility among health providers are lacking in current health professional training programs. Using the case of Mexico, the authors describe the template and justification for an online course for novice to expert health professionals to build competencies in humanized childbirth and cultural humility. Recommendations for future work are discussed.

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

scholarly journals Health Workers’ Perspectives on Infrastructure to Support Maternal Health Services in Rural Areas of Vietnam

2017 ◽  
Vol 12 (2) ◽  
pp. 55-61
Author(s):  
Thi Hoai Thu Nguyen ◽  
Fiona McDonald ◽  
Andrew Wilson
Keyword(s):  
Primary Care ◽  
Developing Countries ◽  
Maternal Health ◽  
Health Services ◽  
Rural Areas ◽  
Health Workers ◽  
Maternal Health Services ◽  
District Health ◽  
Health Centres ◽  
The Impact

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.

scholarly journals Community perceptions on demand-side incentives to promote institutional delivery in Oyam district, Uganda: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026851
Author(s):  
William Massavon ◽  
Calistus Wilunda ◽  
Maria Nannini ◽  
Caroline Agaro ◽  
Simon Amandi ◽  
...  
Keyword(s):  
Maternal Health ◽  
Qualitative Study ◽  
Health Services ◽  
Low Income ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
Community Support ◽  
Maternal Health Services ◽  
Health Seeking ◽  
Team Members

ObjectiveTo examine the perceptions of community members and other stakeholders on the use of baby kits and transport vouchers to improve the utilisation of childbirth services.DesignA qualitative study.SettingOyam district, Uganda.ParticipantsWe conducted 10 focus group discussions with 59 women and 55 men, and 18 key informant interviews with local leaders, village health team members, health facility staff and district health management team members. We analysed the data using qualitative content analysis.ResultsFive broad themes emerged: (1) context, (2) community support for the interventions, (3) health-seeking behaviours postintervention, (4) undesirable effects of the interventions and (5) implementation issues and lessons learnt. Context regarded perceived long distances to health facilities and high transport costs. Regarding community support for the interventions, the schemes were perceived to be acceptable and helpful particularly to the most vulnerable. Transport vouchers were preferred over baby kits, although both interventions were perceived to be necessary. Health-seeking behaviours entailed perceived increased utilisation of maternal health services and ‘bypassing’, promotion of collaboration between traditional birth attendants and formal health workers, stimulation of men’s involvement in maternal health, and increased community awareness of maternal health. Undesirable effects of the interventions included increased workload for health workers, sustainability concerns and perceived encouragement to reproduce and dependency. Implementation issues included information gaps leading to confusion, mistrust and discontent, transport voucher scheme design; implementation; and payment problems, poor attitude of some health workers and poor quality of care, insecurity, and a shortage of baby kits. Community involvement was key to solving the challenges.ConclusionsThe study provides further insights into the implementation of incentive schemes to improve maternal health services utilisation. The findings are relevant for planning and implementing similar schemes in low-income countries.

scholarly journals Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

2021 ◽  
Vol 9 (T4) ◽  
pp. 18-26
Author(s):  
Arlina Dewi ◽  
Sri Sundari ◽  
Nursetiawan Nursetiawan ◽  
Supriyatiningsih Supriyatiningsih ◽  
Dianita Sugiyo ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Urban Area ◽  
Urban Areas ◽  
Health Workers ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Integrated System

BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality. AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas. METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising. RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity. CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

scholarly journals Kasus-Kasus Maternal di Berita Online Menyangkut Hak Asasi yang Patut Menjadi Pelajaran dalam Pendidikan Bidan di Indonesia

2019 ◽  
pp. 140-152
Author(s):  
Mahindria Vici Virahayu ◽  
D. Dasuki ◽  
O. Emilia ◽  
M. Hasanbasri ◽  
M. Hakimi
Keyword(s):  
Human Rights ◽  
Maternal Health ◽  
Health Services ◽  
Low Income ◽  
Community Involvement ◽  
Health Workers ◽  
Professional Associations ◽  
Maternal Health Services ◽  
Online News ◽  
Scientific Publications

Abstrak Gerakan menghormati hak asasi manusia dalam pelayanan kesehatan maternal di berbagai negara mendorong petugas kesehatan bertindak lebih manusiawi. Perempuan selama ini diam karena tidak ingin memutus hubungan harmonis dengan bidan serta jarangnya isu ini diangkat dalam pertemuan profesi dan publikasi ilmiah menyebabkan perhatian yang rendah terhadap hak asasi manusia dalam pelayanan kesehatan maternal. Penelitian ini bertujuan untuk mengidentifikasi kegagalan dalam pemenuhan hak kesehatan ibu hamil dan bersalin serta mengeksplorasi alasan-alasan yang menyebabkan hal tersebut terjadi. Metode penelitian dilakukan dengan melakukan penelusuran berita online kompas.com, tribunnews.com, dan detiknews.com tahun 2016-2018 dengan kata kunci “malpraktik” dan “bidan”, tentang persoalan hak asasi manusia dalam pelayanan bidan. Kami mengikuti kasus dalam lebih dari satu media online, disertai perkembangan berita tentang kasus tersebut. Hasil penelitian menunjukkan bahwa dominasi bidan dalam pelayanan kesehatan maternal di Indonesia, berdampak pada pengabaian hak asasi perempuan dan keselamatan. Kejadian ini pada kelompok orang dengan pendapatan rendah dan kelompok yang mampu. Didapatkan praktik bidan di luar kewenangan, kemungkinan motivasi mendapatkan keuntungan, dominasi bidan, posisi sosial perempuan yang rendah dalam pelayanan kesehatan maternal, dan keterlibatan masyarakat yang rendah untuk mendukung perempuan yang mengalami ketidakadilan dalam layanan kesehatan. Kepercayaan dan ketergantungan perempuan pada bidan, berdampak pengabaian hak asasi dan keselamatan ibu, tindakan di luar kewenangan, untuk pencarian keuntungan dalam praktik pribadi. Organisasi profesi dan pendidik bidan harus memasukkan penerapan hak asasi manusia dalam praktik kebidanan melalui kasus-kasus dari berita online dalam pertemuan berkala asosiasi profesi, serta kurikulum pendidikan, untuk mencegah dampak buruk pengabaian hak asasi ibu di masa depan. Kata kunci: pengabaian hak asasi dalam layanan bidan, kasus malpraktik bidan, penguatan pendidikan bidan Abstract The movement to respect human rights in maternal health services in various countries encourages health workers to act more humanely. Low attention to human rights issue in maternal health services due to the silent of the victims-because women do not want to break the harmonious relationship with midwives, and this issue is rarely raised in professional meetings and scientific publications. This study aims to identify failures in fulfilling the health rights of pregnant women and childbirth and explore the reasons for this. The research method is done by searching online news kompas.com, tribunnews.com, and detiknews.com in 2016-2018 with the keywords “malpractice” and “midwife”, about human rights issues in midwifery services. We followed the case in more than one online media, accompanied by the case progress report. The results of the study show that the dominance of midwives in maternal health services in Indonesia has an impact on neglecting women’s human rights and safety. This event is in the group of people with low income and groups who are able. The practice of midwive’s out of authority, possible motivations for profit, dominance of midwives, low social position of women in maternal health services, and low community involvement in supporting women who experience inequality in maternal health services. Trust and dependence of women on midwives, impact on neglecting human rights and maternal safety, actions that are beyond authority, for seeking profit in private practice. Midwife professional organizations and educators must incorporate the application of human rights in midwifery practice through cases from online news in periodic meetings of professional associations, as well as educational curricula, to prevent the adverse effects of neglecting maternal rights in the future. Keywords: neglect of human rights in midwife services, midwife malpractice case, strengthening midwifery education

scholarly journals Maternal health services for pregnant adolescent girls in Uganda: Barriers and Opportunities

2020 ◽  
Author(s):  
Vivian Namuli ◽  
Gorgeous Sarah Chinkonono ◽  
Catherine Atuhaire ◽  
Betty Nyawira Christensen ◽  
Vitalis Pemunta ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Health Workers ◽  
Maternal Health Services ◽  
Sub Saharan Africa ◽  
Pregnant Adolescents ◽  
Care Services

Abstract Background: Globally, adolescent pregnancy is one of the major areas of concern. Over 16 million girls aged between 15-19 years give birth, while over 1 million become pregnant before 15 years, most of who are in Sub-Saharan Africa. Yet, very few adolescents access maternal health services. This study explored the available maternal health services, barriers in accessing them and possible strategies for improving accessibility to these services among pregnant adolescents, specifically in Uganda.Methods: The study was carried out at Naguru teenage information and health Centre (NTIHC), Nakawa division, Kampala district using a qualitative research approach. Data was obtained using in-depth face to face interviews from 31 independent pregnant adolescents and four health care providers. These participants were selected using convenient sampling technique. Data was manually analyzed and themes were extracted and used in the interpretation of results.Results: The study found out that adolescents use only antenatal health care services while the uptake of postpartum health services was side-lined much as they were found available in the health facilities. The dominant antenatal care services among adolescents include; testing and managing of STIs, measuring pressure, tetanus vaccine, measuring weight, counselling and guidance, peer education, and providing drugs. Adolescents also encountered challenges such as long distances, financial constraints, stigmatization, negative attitude of health workers and community expressed bias when accessing these services. It further revealed that through government intervention, community and health workers, accessibility to maternal health services would be improved. Specifically, increasing remuneration for health workers; sensitizing communities about adolescent pregnancy and rights; construction of labour suites; and health workers’ competence were highly emphasized.Conclusion: Advertising and promotion of maternal health services; sensitization of community members; and government involvement will be the key parameters for enhancing maternal health care among adolescent mothers.

scholarly journals Smoking as a method of coping for medical workers

2021 ◽  
Vol 64 (3) ◽  
pp. 16-24
Author(s):  
Lilia Grati ◽  
◽  
◽  
Keyword(s):  
Health Care ◽  
Harm Reduction ◽  
Perceived Stress ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Role Models ◽  
Health Workers ◽  
Action Plan ◽  
Entire Group ◽  
Care Providers

Background: This article analyzes the professional stress at healthcare professionals (HCP), related to their job. Health care providers can serve as role models in promoting healthy lifestyles; however, HCP commitment to help individuals to quit smoking may be influenced by their own smoking behavior. Material and methods: In order to determine the level of perceptual stress, the Perceived Stress Questionnaire (PSQ) was applied, PSQ developed by Levenstein et al. In order to determine the level of addiction to smoking, the Fagerstorm nicotine addiction test was applied. The research was attended by 210 subjects from 5 medical institutions: doctors, nurses, and resident doctors. Confidentiality is maintained. Results: The doctors accumulated 32% on the scale of severe dependence, 8% moderate dependence and only 9% mild dependence, after calculating the score and interpreting the data. The resident doctors have accumulated the maximum score on the scale of mild dependence, 7% moderate dependence and only 3% severe dependence, which speaks of the fact that they are the youngest category of medical workers at the beginning of their careers and still do not have good defense mechanisms. The nurses, who represent 9% of the entire group of subjects, accumulated 0% on the scale of severe dependence, 8% moderate dependence and 1% mild dependence. Conclusions: Comparative data on smoking dependence levels in doctors of 32% according to the perceived stress level 71% confirm this. Stressed health workers are more likely to smoke, have different social problems and are males. The results of research have shown that the prevalence of smokers among health care professionals is high (51%), implying the ineffectiveness of the current government anti-tobacco strategy. Introducing new pillar – Harm Reduction in National Antismoking Action Plan, along with prevention, cessation and protection from second-hand smoking, can improve current smoking situation in general. It would be helpful to implement training programs about Tobacco Harm Reduction for healthcare workers to improve their ability in smoking cessation counselling techniques to provide active support to their patients.

scholarly journals Who are the real community health workers in Tshopo Province, Democratic Republic of the Congo?

2019 ◽  
Vol 4 (4) ◽  
pp. e001529 ◽  
Author(s):  
Sarah L Dalglish ◽  
Sarah Straubinger ◽  
Justine A Kavle ◽  
Lacey Gibson ◽  
Evariste Mbombeshayi ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Community Health ◽  
Democratic Republic ◽  
Health Workers ◽  
Traditional Healers ◽  
Child Health Services ◽  
Health Providers ◽  
Community Members ◽  
Republic Of The Congo

Recent years have seen increasing momentum towards task shifting of basic health services, including using community health workers (CHW) to diagnose and treat common childhood illnesses. Yet few studies have examined the role of traditional healers in meeting families’ and communities’ health needs and liaising with the formal health system. We examine these issues in Tshopo Province in the Democratic Republic of the Congo, a country with high rates of child mortality (104 deaths per 1000 live births). We conducted 127 in-depth interviews and eight focus group discussions with a range of community members (mothers, fathers and grandmothers of children under 5 years of age) and health providers (CHWs, traditional healers, doctors and nurses) on topics related to care seeking and case management for childhood illness and malnutrition, and analysed them iteratively using thematic content analysis. We find significant divergence between biomedical descriptions of child illness and concepts held by community members, who distinguished between local illnesses and so-called ‘white man’s diseases.’ Traditional healers were far less costly and more geographically accessible to families than were biomedical health providers, and usually served as families’ first recourse after home care. Services provided by traditional healers were also more comprehensive than services provided by CHWs, as the traditional medicine sphere recognised and encompassed care for ‘modern’ diseases (but not vice versa). Meanwhile, CHWs did not receive adequate training, supervision or supplies to provide child health services. Considering their accessibility, acceptability, affordability and ability to recognise all domains of illness (biomedical and spiritual), traditional healers can be seen as the de facto CHWs in Tshopo Province. National and international health policymakers should account for and involve this cadre of health workers when planning child health services and seeking to implement policies and programmes that genuinely engage with community health systems.

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