Women's Lived Experiences of Giving Birth in Ghana: A Metasynthesis of the Literature

2020 ◽  
Vol 10 (3) ◽  
pp. 126-139
Author(s):  
Donna Lee Lorenze
Keyword(s):  
Health Policy ◽  
Health Services ◽  
Lived Experiences ◽  
Home Birth ◽  
Maternal Health Services ◽  
Poor Quality ◽  
Screening Criteria ◽  
Pregnancy And Childbirth ◽  
Quality Health ◽  
Skilled Attendants

BACKGROUNDThe purpose of this metasynthesis is to analyze women's lived experiences of giving birth in Ghana during and after the Millennium Development Goals (MDGs), when health policy in Ghana was changed to urge women to birth in health services with skilled attendants.METHODAn interpretive phenomenological framework guided the review of the literature. Three electronic databases were searched as well as reference lists and author searches. Articles that met the screening criteria for inclusion were coded and thematically analyzed, then drawn together to construct the essence of women's experiences of giving birth in Ghana.RESULTSSeven themes were constructed from the data and these were poor quality health services, maltreatment by midwives, mixed emotions about pregnancy and childbirth, supernatural fears, women wanting safe births with skilled birth attendants, uncertainty about reaching a health facility, and decision-making hierarchy. There were three counter themes and these were women wanting a home birth with a traditional midwife, defiance against dominant decision-makers by some women, and a belief that “not all nurses are bad.”CONCLUSIONGhanaian women have heeded the MDGs and health policy messages to birth with skilled attendants, but in reality, they are not always accessible, available, appropriate, or of high quality. Maternal health services still need much improvement including more resources such as staff, essential services, medicines, and quality assurance standards.

scholarly journals Healthcare Quality Management System in Pakistan

2019 ◽  
Vol 3 (2) ◽  
pp. 74-77
Author(s):  
Wajahat Hussain
Keyword(s):  
Quality Management ◽  
Health Services ◽  
Healthcare System ◽  
Planning Process ◽  
Quality Management System ◽  
International Health ◽  
Quality Of Healthcare ◽  
Poor Quality ◽  
Operational Planning ◽  
Quality Health

The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system.  Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust.

scholarly journals Health Equity and Universal Provision in Norway: A Case Study

2020 ◽  
Vol 11 (1) ◽  
pp. 39-65
Author(s):  
Lydia Mehrara ◽  
Susan Young
Keyword(s):  
Health Policy ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Service Access ◽  
Migrant Women ◽  
Policy And Practice ◽  
Policy Practice ◽  
Study Approach

This article reports on a qualitative study undertaken to explore the policy-practice nexus of health policy in Norway in relation to the provision and delivery of maternal health services to migrant women.  The research used a case study approach focusing on a particular programme which provided maternal health services to migrant women and collected data through review and analysis of policy documentation, observation of this programme, and discussions with people responsible for implementing health policy.  While Norway is well known for its universal policy principles, which in the main enable good access to services, the case study indicated that there are some limitations in policy and practice.  We use the principle of proportionate universalism to comment on and make recommendations for policy makers and practitioners in this area, to better attend to the principle of equity in service access and usage.  The article provides an overview of the Norwegian health policy systems, structures and provisions; describes the service provision from a specific programme providing maternal health services to migrant women in Stavanger, Norway; and concludes with some recommendations which emerge from the findings.

scholarly journals Conceptualizing "access" of maternal health services in lower-middle-income countries

2020 ◽  
Vol 11 (1) ◽  
pp. 108-111
Author(s):  
Bismah Jameel ◽  
Aeda Bhagaloo ◽  
Khadija Rashid ◽  
Umair Majid
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Political Factors ◽  
Middle Income ◽  
Pregnancy And Childbirth ◽  
Middle Income Countries ◽  
Health System Improvement ◽  
Barriers To Access ◽  
System Improvement

A considerable number of women die each year worldwide due to preventable causes during pregnancy and childbirth. The high mortality of women who die from pregnancy-related issues can be attributed to inadequate access of high-quality maternal health services. However, access is a nebulous concept with a compendium of conceptualizations and definitions. In this paper, we discuss the various conceptualizations of access to maternal health services in lower middle-income countries, and compare how issues related to access differ between high- and lower middle-income countries. This discussion informs two priorities that we suggest for researchers conducting health system improvement work in lower middle-income countries: 1) develop a robust understanding of the barriers to access that continue to persist due to cultural, socioeconomic, and political factors, and 2) formulate frameworks and theories specific to lower middle-income countries to guide research.

scholarly journals Empirical Analysis of Socio-Economic Determinants of Maternal Health Services Utilisation in Burundi

2021 ◽  
Author(s):  
Desire Habonimana ◽  
Neha Batura
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Professional ◽  
Maternal Health Services ◽  
Long Distance ◽  
Economic Determinants ◽  
Pregnancy And Childbirth ◽  
Point Of Use ◽  
Education Levels ◽  
Trained Health Professional

Abstract BackgroundTimely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distance to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite prenatal, childbirth and postanal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four antenatal care (ANC) visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi.MethodsWe use data from the 2017 Burundian Demographic and Health Survey (DHS) collected from 8,941 women who reported a live birth in the five years preceding the survey. We use multiple regression analysis to explore the factors that determine the likelihood of seeking ANC services from a trained health professional, the number of ANC visits made and the choice of assisted childbirth. ResultsOccupation, marital status and wealth increase the likelihood of seeking ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than others. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are assisted during childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth. ConclusionsIn Burundi, utilisation of maternal health services is low. There is inequality in services utilisation among women based on wealth, parity, religion, and occupation. ANC is an important determinant of subsequent delivery care. There is a gap between married and unmarried women. This has a strong health policy implication to improve access to maternal health services for unmarried women.

scholarly journals Poor-quality health services and lack of programme support leads to low uptake of HIV testing in rural Mozambique

2012 ◽  
Vol 11 (4) ◽  
pp. 327-335 ◽  
Author(s):  
Carolyn M Audet ◽  
Kate Groh ◽  
Troy D Moon ◽  
Sten H Vermund ◽  
Mohsin Sidat
Keyword(s):  
Health Services ◽  
Hiv Testing ◽  
Poor Quality ◽  
Quality Health ◽  
Quality Health Services

scholarly journals Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

2020 ◽  
Author(s):  
Emily White Johansson ◽  
Udochisom Anaba ◽  
Dele Abegunde ◽  
Mathew Okoh ◽  
Shittu Abdu-Aguye ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Behavior Change ◽  
Self Efficacy ◽  
Maternal Health Services ◽  
Facility Delivery ◽  
Cross Sectional ◽  
Pregnancy And Childbirth ◽  
Psychosocial Influences ◽  
And Behavior

Abstract BackgroundAntenatal care (ANC) and facility delivery are essential maternal health services, but uptake remains low in northwestern Nigeria. To increase service use, social and behavior change (SBC) programs target psychosocial influences across cognitive, emotional and social domains including knowledge, beliefs, self-efficacy, and social norms. Yet there remains limited research that measures and quantitatively examines the role of psychosocial influences on pregnancy and childbirth behaviors in Nigeria or elsewhere. MethodsA cross-sectional population-based survey of randomly sampled women with a child under two years was conducted in Kebbi, Sokoto and Zamfara states of northwestern Nigeria in September 2019. Women were asked about maternal health behaviors during their last pregnancy. New psychosocial metrics were developed using the Ideation Model of Strategic Communication and Behavior Change. Predicted probabilities for visiting ANC four or more times (ANC4+) and giving birth in a facility were derived using mixed-effects logistic regression models adjusted for ideational and sociodemographic variables.ResultsAmong 3,039 women, 23.6% (95% CI: 18.0%-30.3%) attended ANC4+ times and 15.5% (95% CI: 11.8%-20.1%) gave birth in a facility. Among women who did not attend ANC4+ times or have a facility-based delivery during their last pregnancies, the most commonly cited reasons were lack of perceived need (42% and 67%, respectively) and spousal opposition (25% and 27%, respectively). Women who knew any ANC benefit or the recommended number of ANC visits were 3.2- and 2.1-times more likely to attend ANC4+ times. Women who held positive views about health facilities for childbirth had 1.2- and 2.6-times higher likelihood of attending ANC4+ times and facility delivery, while women who believed ANC was only for sickness or pregnancy complications had 17% lower likelihood of attending ANC4+ times. Self-efficacy and supportive spousal influence were also significantly associated with both outcomes.ConclusionsTo improve pregnancy and childbirth practices in northwestern Nigeria, programs should address a range of psychosocial factors – across cognitive, emotional and social domains – that were significantly associated with pregnancy and childbirth behaviors: raising knowledge and dispelling myths, building women’s confidence to access services, engaging spousal support in decision-making, and improving perceived (and actual) maternal health services quality.

scholarly journals Empirical analysis of socio-economic determinants of maternal health services utilisation in Burundi

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Desire Habonimana ◽  
Neha Batura
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Professional ◽  
Multivariate Regression Analysis ◽  
Maternal Health Services ◽  
Wealth Status ◽  
Economic Determinants ◽  
Pregnancy And Childbirth ◽  
The Government ◽  
Trained Health Professional

Abstract Background Timely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distances to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi. Methods We use data from the 2016–2017 Burundi Demographic and Health Survey (DHS) collected from 8941 women who reported a live birth in the five years that preceded the survey. We use multivariate regression analysis to explore which individual-, household-, and community-level factors determine the likelihood that women will seek ANC services from a trained health professional, the number of ANC visits they make, and the choice of assisted childbirth. Results Occupation, marital status, and wealth increase the likelihood that women will seek ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than non-educated women and women not in union. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are to have assisted childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth. Conclusions In Burundi, utilisation of maternal health services is low and is mainly driven by legal union and wealth status. To improve equitable access to maternal health services for vulnerable population groups such as those with lower wealth status and unmarried women, the government should consider certain demand stimulating policy packages targeted at these groups.

scholarly journals Empirical analysis of socio-economic determinants of maternal health services utilisation in Burundi

2020 ◽  
Author(s):  
Desire Habonimana ◽  
Neha Batura
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Professional ◽  
Maternal Health Services ◽  
Long Distance ◽  
Economic Determinants ◽  
Pregnancy And Childbirth ◽  
Point Of Use ◽  
Education Levels ◽  
Trained Health Professional

Abstract Background Timely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distance to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite prenatal, childbirth and postanal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four antenatal care (ANC) visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi.Methods We use data from the 2017 Burundian Demographic and Health Survey (DHS) collected from 8,941 women who reported a live birth in the five years preceding the survey. We use multiple regression analysis to explore the factors that determine the likelihood of seeking ANC services from a trained health professional, the number of ANC visits made and the choice of assisted childbirth.Results Occupation, marital status and wealth increase the likelihood of seeking ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than others. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are assisted during childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth.Conclusions In Burundi, utilisation of maternal health services is low. There is inequality in services utilisation among women based on wealth, parity, religion, and occupation. ANC is an important determinant of subsequent delivery care. There is a gap between married and unmarried women. This has a strong health policy implication to improve access to maternal health services for unmarried women.

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