scholarly journals Factors influencing adoption of facility-assisted delivery - a qualitative study of women and other stakeholders in a Maasai community in Ngorongoro District, Tanzania

2019 ◽  
Author(s):  
Paul D Mosley ◽  
Kisiaya Saruni ◽  
Bernadetha Lenga
Keyword(s):  
Qualitative Study ◽  
Health Sector ◽  
Home Delivery ◽  
Care Group ◽  
Group Model ◽  
Theory Approach ◽  
Study Results ◽  
Assisted Delivery ◽  
Ngorongoro District ◽  
Project Data

Abstract BACKGROUND: Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50% to 80% from 2015-2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who resist going to a facility for birth even after completing 4+ ANC visits. Ebiotishu Oondomonok Ongera (EbOO) is a program in Nainokanoka ward to promote facility-births through a care-group model using trained traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for delivery. A qualitative study was conducted to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver. METHODS: In-depth interviews, focus group discussions and key-informant interviews were conducted with 24 pregnant and/or parous women, 24 TBAs, 3 nurse midwives at 3 health facilities, and 24 married men, living in Nainokanoka ward. Interviews and discussions were transcribed, translated, and analyzed thematically using a grounded theory approach. RESULTS: Most women interviewed expressed preference for a home delivery with a TBA and even those who expressed agency and preference for a facility delivery usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery. TBAs claim to support facility deliveries but in practice use them as a last resort and reported a significant trust gap based on a bad experience at a facility where women in labor were turned away. CONCLUSIONS: EbOO project data and study results show a slow but steady change in norms around delivery preference in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by promoting birth plans and perhaps constructing a maternity waiting house in the ward. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services, and increased sensitivity to women’s cultural preferences, could also close the gap between the number of women who are currently using facilities for ANC and those returning for delivery.

scholarly journals Factors influencing adoption of facility-assisted delivery - a qualitative study of women and other stakeholders in a Maasai community in Ngorongoro District, Tanzania

2019 ◽  
Author(s):  
Paul D Mosley ◽  
Kisiaya Saruni ◽  
Bernadetha Lenga
Keyword(s):  
Qualitative Study ◽  
Health Sector ◽  
Home Birth ◽  
Care Group ◽  
Group Model ◽  
Theory Approach ◽  
Study Results ◽  
Assisted Delivery ◽  
Project Data ◽  
Facility Births

Abstract BACKGROUND: Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50% to 80% from 2015-2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who robustly prefer home births to facility births even after completing 4+ ANC visits. Ebiotishu Oondomonok Ongera (EbOO) is a program in Nainokanoka ward to promote facility births through a care-group model using trained traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for delivery. A qualitative study was conducted to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver. METHODS: In-depth interviews, focus group discussions and key-informant interviews were conducted with 24 pregnant and/or parous women, 24 TBAs, 3 nurse midwives at 3 health facilities, and 24 married men, living in Nainokanoka ward. Interviews and discussions were transcribed, translated, and analyzed thematically using a grounded theory approach. RESULTS: Most women interviewed expressed preference for a home birth with a TBA and even those who expressed agency and preference for a facility birth usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery. TBAs report support for facility deliveries but in practice use them as a last resort, and a significant trust gap was documented based on a bad experience at a facility where women in labor were turned away. CONCLUSIONS: EbOO project data and study results show a slow but steady change in norms around delivery preference in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by promoting birth plans and perhaps constructing a maternity waiting house in the ward. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services, and increased sensitivity to women’s cultural preferences, could also close the gap between the number of women who are currently using facilities for ANC and those returning for delivery.

scholarly journals Understanding Barriers to Adoption of Facility Assisted Delivery in a Maasai Community in Ngorongoro District, Tanzania: A qualitative study to document psychosocial preferences, agency for decision-making, access barriers, and other factors that influence where a woman in Nainokanoka Ward will deliver

2019 ◽  
Author(s):  
Paul D Mosley ◽  
Kisiaya Saruni ◽  
Bernadetha Lenga
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health Sector ◽  
Facility Delivery ◽  
Care Group ◽  
Group Model ◽  
Theory Approach ◽  
Access Barriers ◽  
Study Results ◽  
Assisted Delivery

Abstract BACKGROUND Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50% to 80% from 2015-2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who resist going to a facility for birth even after completing 4+ ANC visits. EbOO is a program in Nainokanoka ward to promote facility-births through a care-group model using traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for birth. METHODS A qualitative study was conducted in Nainokanoka ward to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver. Interviews were conducted with twenty-three pregnant and/or parous women, along with 3 men’s and 2 TBA’s focus groups, and finally 3 key-informants from ward health facilities. Interviews were coded and analyzed thematically using a grounded theory approach. RESULTS Most women interviewed expressed preference for a home delivery with a TBA and even those who expressed agency and preference for a facility delivery usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery as husbands defer to their judgment. TBAs claim to support facility deliveries but in practice use them as a last resort and reported a significant trust gap based on a bad experience at a facility where women in labor were turned away. CONCLUSIONS EbOO project data and study results show a slow but steady change in norms in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by more intentionally promoting birth plans, and perhaps constructing a maternity waiting house near the ward health center. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services and assurance that women in labor will not be denied service, could also close the gap between the number of women who are currently using facilities for ANC and those returning for a facility delivery.

Reintegration of Ex-Offenders Convicted of Violent Crimes into the Community in the Iranian Context: A Qualitative Study

2021 ◽  
pp. 0306624X2110226
Author(s):  
Mohammad Sabzi Khoshnami ◽  
Fardin Alipour ◽  
Maliheh Arshi ◽  
Hassan Rafiey ◽  
Mohhamad Hossein Javadi
Keyword(s):  
Social Capital ◽  
Qualitative Study ◽  
Structured Interviews ◽  
Violent Crimes ◽  
Institutional Review ◽  
Main Challenge ◽  
Improved Outcomes ◽  
Study Results ◽  
Reducing Recidivism ◽  
Iranian Context

Community reintegration of ex-offenders is a main issue for reducing recidivism. This article aims to explain the process of reintegration into the community based on the experiences of people who have been convicted of violent crimes in Iran. A qualitative study based on grounded theory was conducted in 2020 in Tehran/Iran. Data was collected through in-depth semi-structured interviews with 26 participants. An institutional review board approved the study. Results indicate that the “worry trap” is the main challenge that those convicted of violent crimes face upon reentry into society. If these individuals are provided with governmental and non-governmental services and support, they can move toward “restoring their lost social capital.” The “redefinition of an independent identity” is a consequence of released individuals’ struggle to restore their lost social capital. Further research exploring the causality of social capital and improved outcomes after release from prison and reentry to community is needed.

scholarly journals The challenges of donor engagement with faith-based organizations in Cameroon’s health sector: a qualitative study

2021 ◽  
Author(s):  
Sibylle Herzig van Wees ◽  
Michael Jennings
Keyword(s):  
Qualitative Study ◽  
Health Outcomes ◽  
International Development ◽  
Health Sector ◽  
Top Down ◽  
Faith Based ◽  
The Past ◽  
Faith Based Organizations ◽  
The Government ◽  
Depth Interviews

Abstract Substantial global advocacy efforts have been made over the past decade to encourage partnerships and funding of faith-based organizations in international development programmes in efforts to improve social and health outcomes. Whilst there is a wealth of knowledge on religion and development, including its controversies, less attention has been payed to the role that donors might play. The aim of this study was to describe and analyse the engagement between donors and faith-based organizations in Cameroon’s health sector, following the implementation of the Cameroon Health Sector Partnership Strategy (2012). Forty-six in-depth interviews were conducted in selected regions in Cameroon. The findings show that global advocacy efforts to increase partnerships with faith-based organizations have created a space for increasing donor engagement of faith-based organizations following the implementation of the strategy. However, the policy was perceived as top down as it did not take into account some of the existing challenges. The policy arguably accentuated some of the existing tensions between the government and faith-based organizations, fed faith-controversies and complicated the health system landscape. Moreover, it provided donors with a framework for haphazard engagement with faith-based organizations. As such, putting the implications of donor engagement with FBOs on the research map acknowledges the limitations of efforts to collaborate with faith-based organizations and brings to the surface still-remaining blinkers and limited assumptions in donor definitions of faith-based organizations and in ways of collaborating with them.

scholarly journals Thoughts, beliefs and concepts concerning infectious childhood diseases of physicians practicing homeopathic, anthroposophic and conventional medicine – a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Mittring-Junghans ◽  
C. Holmberg ◽  
C. M. Witt ◽  
M. Teut
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Scarlet Fever ◽  
Conventional Medicine ◽  
Vaccination Schedule ◽  
Anthroposophic Medicine ◽  
Theory Approach ◽  
Parent Child Relationship ◽  
Childhood Diseases ◽  
Child Relationship

Abstract Background Physicians who include complementary medicine in their practice are thought to have an understanding of health and disease different from that of colleagues practicing conventional medicine. The aim of this study was to identify and compare the thoughts and concepts concerning infectious childhood diseases (measles, mumps, rubella, chickenpox, pertussis and scarlet fever) of physicians practicing homeopathic, anthroposophic and conventional medicine. Methods This qualitative study used semistructured interviews. Participating physicians were either general practitioners or pediatricians. Data collection and analysis were guided by a grounded theory approach. Results Eighteen physicians were interviewed (6 homeopathic, 6 anthroposophic and 6 conventional). All physicians agreed that while many classic infectious childhood diseases such as measles, mumps and rubella are rarely observed today, other diseases, such as chickenpox and scarlet fever, are still commonly diagnosed. All interviewed physicians vaccinated against childhood diseases. A core concern for physicians practicing conventional medicine was the risk of complications of the diseases. Therefore, it was considered essential for them to advise their patients to strictly follow the vaccination schedule. Homeopathic-oriented physicians viewed acute disease as a biological process necessary to strengthen health, fortify the immune system and increase resistance to chronic disease. They tended to treat infectious childhood diseases with homeopathic remedies and administered available vaccines as part of individual decision-making approaches with parents. For anthroposophic-oriented physicians, infectious childhood diseases were considered a crucial factor in the psychosocial growth of children. They tended to treat these diseases with anthroposophic medicine and underlined the importance of the family’s resources. Informing parents about the potential benefits and risks of vaccination was considered important. All physicians agreed that parent-delivered loving care of a sick child could benefit the parent-child relationship. Additionally, all recognized that existing working conditions hindered parents from providing such care for longer durations of time. Conclusions The interviewed physicians agreed that vaccines are an important aspect of modern pediatrics. They differed in their approach regarding when and what to vaccinate against. The different conceptual understandings of infectious childhood diseases influenced this decision-making. A survey with a larger sample would be needed to verify these observations.

scholarly journals Individuals' experiences of involuntary admissions and preserving control: qualitative study

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 501-509 ◽  
Author(s):  
David McGuinness ◽  
Kathy Murphy ◽  
Emma Bainbridge ◽  
Liz Brosnan ◽  
Mary Keys ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Theoretical Model ◽  
Qualitative Study ◽  
Involuntary Admission ◽  
Theory Approach ◽  
Therapeutic Approaches ◽  
Admission Process ◽  
Social Lives ◽  
Theoretical Sampling ◽  
Grounded Theory Approach

BackgroundA theoretical model of individuals' experiences before, during and after involuntary admission has not yet been established.AimsTo develop an understanding of individuals' experiences over the course of the involuntary admission process.MethodFifty individuals were recruited through purposive and theoretical sampling and interviewed 3 months after their involuntary admission. Analyses were conducted using a Straussian grounded theory approach.ResultsThe ‘theory of preserving control’ (ToPC) emerged from individuals' accounts of how they adapted to the experience of involuntary admission. The ToPC explains how individuals manage to reclaim control over their emotional, personal and social lives and consists of three categories: ‘losing control’, ‘regaining control’ and ‘maintaining control’, and a number of related subcategories.ConclusionsInvoluntary admission triggers a multifaceted process of control preservation. Clinicians need to develop therapeutic approaches that enable individuals to regain and maintain control over the course of their involuntary admission.Declaration of interestNone.

scholarly journals Coaching in design-based learning: a grounded theory approach to create a theoretical model and practical propositions

2019 ◽  
Author(s):  
M. R. van Diggelen ◽  
K. I. Doulougeri ◽  
S. M. Gomez-Puente ◽  
G. Bombaerts ◽  
K. J. H. Dirkx ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Theoretical Model ◽  
Qualitative Study ◽  
Formative Assessment ◽  
Theoretical Perspective ◽  
Problem Based Learning ◽  
Theory Approach ◽  
Coaching Model ◽  
Teachers And Students ◽  
Grounded Theory Approach

Abstract The purpose of this study is to determine what good coaching during design-based learning (DBL) entails by integrating theoretical and practical perspectives on good coaching. For this purpose, a grounded theory approach was used. For the practical perspective, themes on good coaching were derived from a qualitative study on coaching by observing and interviewing teachers and students involved in a DBL project. For the theoretical perspective, we consulted and analyzed literature on scaffolding, feedback, and formative assessment and coaching in problem-based learning from the learning sciences and the studio model from arts and design literature. Synthesizing themes from both perspectives led to the development of a theoretical coaching model consisting of three main categories (and four subcategories), seventeen themes and thirteen propositions. The model and propositions might be of use for those involved in coaching students in DBL and provide relevant directions for research on coaching in DBL.

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