scholarly journals Factors Influencing the Choice of Place of Delivery among Women in Rural Northern Ghana: A Cross-sectional Descriptive Study

2021 ◽  
Vol 17 (7) ◽  
Author(s):  
Agulu Gilbert Gangtaba ◽  
Mitsuaki Matsui ◽  
Yasuhiko Kamiya
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Services ◽  
Health Facility ◽  
Educational Level ◽  
Facility Delivery ◽  
Health Facilities ◽  
Northern Ghana ◽  
Care Providers ◽  
Statistical Software

Background of the Study: Studies have shown that three-quarters of all maternal deaths happen during childbirth and the immediate postpartum periods. Most of these deaths occur due to a lack of support from a health care provider. Globally, in 2016, one out of five childbirths took place without the assistance of a skilled birth attendant (SBA). The coverage among women in deprived areas is even lower. Women’s choice of a birthing place is often influenced by a complex mixture of factors ranging from individual, household, accessibility, health facility and provider-related factors, socioeconomic status, etc. Despite many interventions put in place in Ghana to encourage the use of health facilities for deliveries, utilization remains inadequate and the reasons have not been explored in detail. This study examines the factors affecting utilization of health facilities for delivery by pregnant women in the West Mamprusi Municipality (WMM) of Northern Ghana by adopting the three delays model. Materials and Methods: A crosssectional household survey of 381 women within the age group, 15-49 years, was conducted from January to March 2019 in the WMM. Data was collected using a structured questionnaire consisting of open and closed-ended questions. Data entry was done using IBM-SPSS version 25 statistical software, and it was exported to Stata version 15 statistical software for the analysis. Descriptive statistics and Chi-square tests were done. Bivariate and multivariate logistic regression analysis was conducted to identify the variables associated with facility delivery. All statistical tests were set at a 5% level of significance and a 95% confidence interval. Results: This study revealed that 75.3% of the respondents delivered their last child in a health facility while 24.7% delivered at home. The ANC coverage was high (98.2%). However, this does not translate into the proportion of facility deliveries. Factors leading to the choice of the delivery place include; poor health care provider’s attitudes, low knowledge about the signs of labor, poor quality of health services, sociocultural beliefs, low socioeconomic status of women, low educational level of mothers, and inaccessibility to health services. It was observed that respondents with a higher educational level were almost four times [AOR=3.66; 95% CI:1.19-68.9] more likely to deliver their children in a health facility. Women who made more ANC contacts with health care providers have a higher chance [AOR=1.17; 95% CI:1.04-36.7] of delivering in a health facility than those who made less or no contact. Conclusion: Though the findings show a high proportion of facility delivery in the study area, much can be achieved by intensifying health education on early initiation of ANC, signs of labor and delivery, as well as the importance of health facility delivery.

Subnational Variation in Facility-based Childbirth in Nigeria: Evidence from 2013 and 2018 Nigeria Demographic Health Surveys

2021 ◽  
Vol 19 (1) ◽  
pp. 23-40
Author(s):  
Anthony Idowu Ajayi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Facility ◽  
Health Surveys ◽  
State Level ◽  
Facility Delivery ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Health Facility Delivery ◽  
Access To Health

Background Previous studies have not examined the state-level variations in health facility delivery in Nigeria. Because of the decentralised system, state governments have a huge role in decision-making and policy direction for each state. As such, it is important to disaggregate the data at state level to understand patterns and best performing states that can be exemplars for others. We address this gap by examining the sub-national variations in health facility delivery in Nigeria. Methods Data of 37,928 and 40,567 live births in the 2013 and 2018 Nigeria Demographic and Health surveys (NDHS) respectively were analysed in this study. NDHS employs a multistage sampling and is representative of both the country and each of the 36 states and Federal Capital Territory (FCT). We used descriptive statistics to examine the trend in health facility delivery in Nigerian states and presented the results using maps. Also, we used logistic regression analysis to examine progress in expanding access to health facility delivery across Nigerian states. Results The proportion of births delivered in health facilities increased from 35.8% in 2013 to 39.4% in 2018, representing a 3.6% increment. After adjusting for relevant covariates, women were 17% more likely to deliver in health facilities in 2018 than in 2013 surveys. However, progress in expanding access to health facility delivery was uneven across the country. While the odds of delivering in a health facility significantly increased in 13 of the 36 states and FCT, the odds reduced significantly in seven states and no progress was recorded in 17 states. Conclusion There was a slight improvement in access to health facility delivery in Nigeria between 2013 and 2018. However, progress remains uneven across the states with only 13 states recording some progress. Four states stood out, recording over a three-fold relative increase in odds of health facility deliveries. These states implemented maternal health care policies that not only made services free but also improved infrastructure and human resources for health. Thus, providing examples of what works in improving access to maternal health care services for other states to follow.

scholarly journals Effectiveness of Essential Health Care Services Delivery in Nepal

1970 ◽  
Vol 6 (2) ◽  
pp. 74-83 ◽  
Author(s):  
B Devkota
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Services ◽  
Health Facility ◽  
Health Care Services ◽  
Health Facilities ◽  
Care Services ◽  
Services Delivery ◽  
Equity And Efficiency

Background: Ensuring delivery of quality health services in a sustainable and equitable manner is a challenge in Nepal. A host of factors may have impeded the access, quality and utilization of the health services particularly by the marginalized and disadvantaged sections of the population. Review essential health care services (EHCS) provided by the public health facilities, level of progress, effectiveness, sustainability, equity and efficiency, quality of care and inclusion of marginalized and disadvantaged populations in health care servicesMethods: A total of 40 VDCs from 10 districts representing five regions and three eco-zones were covered. Altogether 800 mothers with under two year children, 40 health service providers, 145 key informants and 40 exit clients were interviewed. Forty focused group discussions were also conducted. From each district, health records of one hospital, PHCC, HP, SHP and Ayurvedic health facility each were collected.Results: More than two-third (68.2%) of the mothers received antenatal checks, highest in hills (85%) followed by terai (64.5%) and mountain districts (52.8%).Tetanus vaccine coverage (80.7%) seems higher compared to Nepal Demographic Health Survey 2001 (45%). FP use rate in mountain, hill and terai are 57.6%, 54.1% and 49.7%, higher than in DoHS 2003/2004 statistics, which were 26.8%, 36.4% and 45.3% respectively. Nine out of ten patients visiting the health facilities were outpatients. The coverage of DPT 3, Polio 3, BCG and measles are 92.8%, 93.4%, 95.2% and 90.7% respectively. From the service utilization perspective, disparities in terms of gender, ecological regions, season of the year and health facility were revealed.Conclusion: Health sector services are yet to be made responsive to the ecological and district specific health problems, and be made more inclusive linking with doable safety nets.  Key words: Essential health care services; Effectiveness; Sustainability; Equity and efficiency; Quality of care and inclusion  doi: 10.3126/jnhrc.v6i2.2188Journal of Nepal Health Research Council Vol. 6 No. 2 Issue 13 Oct 2008 Page: 74-83 

scholarly journals Quality of Health Services in the First Level Health Facilities and the Role of Quality and Cost Control Team in Lampung Province

2020 ◽  
Vol 3 (1) ◽  
pp. 8
Author(s):  
Asep Sukohar ◽  
Arli Suryawinata ◽  
Aulian Mediansyah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Cost Control ◽  
Health Facilities ◽  
Care Providers ◽  
Primary Health ◽  
Control Team ◽  
Quality Of Health Services

Background: The National Health Insurance/Jaminan Kesehatan Nasional (JKN) program is a public health protection guarantee held by the Social Securite Management Agency/Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) to ensure that all Indonesians receive comprehensive, fair, and equitable health care benefits. The health services are provided using a tiered service system with the first stage in the First Level Health Facilities/Fasilitas Kesehatan Tingkat Pertama (FKTP) acting as a gatekeeper. In conducting these duties, they must always be maintained with good cost-efficiency to be able to provide optimal health service quality. The audit function is imposed by the Quality and Cost Control Team/Tim Kendali Mutu Kendali Biaya (TKMKB) which partners with BPJS. Until now, various efforts to improve the quality of services continue to be developed, one of which is the capitation-based service commitment/Kapitasi Berbasis Komitmen Pelayanan (KBK) payment method. Quality of health services in FKTP can be seen through the high number of FKTP that are affected by the capitation-based service commitment (FKTP KBK-K) payment. Additionally, the high number of FKTP KBK-K can also be a measure of the success of the quality and cost control program implemented by the regional TKMKB. Objective: To assess the quality of health services in FKTP and the TKMKB performance of Lampung Province. Methods: This research was a descriptive-analytic study using data from the BPJS report of Lampung Province and TKMKB in the first and second quarters of 2019. Results: There was an increase in the number of FKTP KBK-K in Lampung Province in the second quarter of 2019, not achieving the minimum contact number, with a low ratio of Prolanis Routine Participants Visiting/Rasio Peserta Prolanis Rutin Berkunjung (RPPRB) especially at the FKTP non-Primary Health Care Centers (non-Puskesmas) in Lampung Province. Conclusion: An increase in the number of FKTP KBK-K that is not accompanied by an increase in the clinical ability of primary health care providers (such as family doctors/primary care doctors) can reflect suboptimal health services in FKTP. Also, this can further serve as a benchmark that the performance of the provincial TKMKB is not yet optimal.

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

scholarly journals Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

2021 ◽  
pp. 238008442110119
Author(s):  
M. McNally ◽  
L. Rock ◽  
M. Gillis ◽  
S. Bryan ◽  
C. Boyd ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Services ◽  
Return To Work ◽  
Health Care Providers ◽  
Online Survey ◽  
Knowledge Exchange ◽  
Oral Health Care ◽  
Care Providers ◽  
Oral Health Services

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

2021 ◽  
pp. 1-5
Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Information Access ◽  
Care Providers ◽  
Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

scholarly journals Public Reproductive Health Facilities: A Client-Satisfaction Survey

2016 ◽  
Vol 9 (2) ◽  
pp. 208
Author(s):  
Fariba Moradi ◽  
Zohreh Balaghi ◽  
Mohsen Moghadami ◽  
Hassan Joulaei ◽  
Najaf Zare
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Quality Of Health Care ◽  
Client Satisfaction ◽  
Service Providers ◽  
Health Facilities ◽  
Health Centers ◽  
Significant Difference ◽  
Improvement Programs

<p><strong>INTRODUCTION:</strong> Understanding clients’ perspectives on quality improvement programs is essential to achieve the goals of health services. Determining client satisfaction could help decision makers to implement programs fit to their needs as perceived by service providers and clients. This study aimed to assess the level of satisfaction among women attending health centers regarding the services received in governmental health facilities in Shiraz, southern Iran.</p><p><strong>METHOD:</strong> This cross-sectional study was performed in 24 urban health centers. Using systematic random sampling method, 8 clinics were assigned to each group. Then questionnaires were distributed among 240 married women in 15-49 year-old age group who had referred to selected clinics for receiving some services. For data analysis, SPSS version 15 software and Chi-square statistical procedure were used to evaluate clients’ satisfaction.</p><p><strong>RESULTS:</strong> Data showed that 101 out of 240 respondents were completely satisfied with the personnel as well as the health center. Furthermore, satisfaction was found to be the highest among clients of those centers ranked as middle class socioeconomic status, while no significant difference was found between centers based on their socioeconomic status.</p><p><strong>CONCLUSION: </strong>The results of the present study would enable policy-makers to effectively improve the quality of health care, keeping a balance between providers’ and patients’ perspectives on the quality of health care.</p>

scholarly journals Management of services in total quality management implemented and non-implemented health facilities

2021 ◽  
Vol 6 (4) ◽  
pp. 689-696
Author(s):  
Muhsina Begum ◽  
Ashees Kumar Saha ◽  
Sheuly Begum ◽  
Nasima Akhter ◽  
Pritikona Borua ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Total Quality Management ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Facilities ◽  
Working Environment ◽  
Care Providers ◽  
Total Quality ◽  
Medical College

5S-CQI-TQM is a management technique that is aimed at bringing satisfaction of staff as well as the patients through improvement of working environment. A cross-sectional comparative study was carried out among 226 respondents who were selected purposively from the selected study place from 1st January to 31st December 2017. Among 226 respondents, 113 were taken from Dhaka Medical College and another 113 were taken from Mugdha Medical College. Among 113 respondents, 56 respondents were health care providers and 57 respondents were health care receivers. The purpose of this study to compare the management of services in Total Quality Management implemented (Dhaka Medical College and Hospital) and non-implemented (Mugdha Medical College and Hospital) health facilities. A Semi-structured interviewer administered questionnaire and an observational check list were developed to collect the data. Separate questionnaire was used for health care providers and health care receivers. The statistical analysis was conducted using SPSS (statistical package for social science) version 20 statistical software. Significant statistical differences were found between TQM implemented and TQM non-implemented hospital regarding workload (p=0.043), hospital authority always seriously consider staff’s suggestions for the improvement of quality of service (p<0.001), employees always respect to each other in the hospital (p<0.001) and 35 (62.5%) service providers expressed satisfactory opinion regarding management of the hospital. Asian J. Med. Biol. Res. December 2020, 6(4): 689-696

scholarly journals Assessment of the Implementation of Tuberculosis and Diabetes Care in health systems: A Situational Analysis in Western Nigeria for consideration

2019 ◽  
Author(s):  
ASAGA MAC PETER ◽  
JUDE OSAGIE Aighobahi.
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Facilities ◽  
Situational Analysis ◽  
Care Providers ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Low Middle Income Countries ◽  
Diabetes Patients

Abstract Background: Tuberculosis (TB) coexists with other non-communicable diseases (NCDs), including Diabetes Mellitus (DM). Smoking increases the risk of TB as well as DM. Health systems are poorly prepared in many low middle income countries (LMICs) and are currently facing the "triple burden of smoking, TB, and DM" that drives these countries into the vicious cycle of poverty. Methods: A cross-sectional study method was carried out to assess the proportion of TB care centers that included integration measures for diabetic care as well as those providing DM care that included integration measures for TB. A list of 49 health care centers in Lagos offering TB care and managing Diabetes patients were recruited. A focus Group Discussion(FGD) and Individual interviews were conducted to investigate health care providers ' knowledge, attitudes and practices and the barriers encountered in the process of integrating TB and DM care. Results: Out of the 49 health care centres recruited in this study, 6% of health care units are aware of a surveillance to screen for diabetes in tuberculosis patients, while 2% of health facilities confirmed awareness of a surveillance to screen for tuberculosis in diabetes patients. 91% of health centres either verified the lack of or no understanding of monitoring of both diseases. The percentage of health facilities that have existing guideline on TB and DM screening was evaluated, it was perceived that 8% of health facilities had implemented a guideline to screen for DM in TB patients, while 4% of these Care Centres have implemented a guideline for diabetes patients to be screened for TB. Conclusion TB/DM integrative screening, treatment and management could be better attained if both co-morbidities integration program is initiated in the healthcare centres and policies of western states and Nigeria as a whole.

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