scholarly journals Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

2019 ◽  
Author(s):  
Oludoyinmola Omobolade Ojifinni ◽  
Latifat Ibisomi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Pregnancy Outcomes ◽  
Preconception Care ◽  
Reproductive Age ◽  
Care Providers ◽  
Medical Problems ◽  
Care Services ◽  
Potential Benefits

Abstract Background Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has however shown that preconception care services are not routinely provided as part of maternal health services in Nigeria. This study explored the perceptions about preconception care services among health care workers in Ibadan, Nigeria.Methods This was a qualitative descriptive study involving 25 in-depth interviews among 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. Interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis.Results Six main themes were identified from the data – what PCC is, people who require PCC, where PCC services can be provided, acceptability of PCC services, the relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and the possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all the participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Acceptance and use of PCC services could however be hindered by the attitude of potential clients especially for those without any known pre-existing condition who may not use the service even if they were aware of its existence. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes.Conclusion Preconception care is important for positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Its uptake will however depend on its acceptability to the people who will benefit from the service.

scholarly journals Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

2019 ◽  
Author(s):  
Oludoyinmola Omobolade Ojifinni ◽  
Latifat Ibisomi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Pregnancy Outcomes ◽  
Preconception Care ◽  
Reproductive Age ◽  
Care Seeking ◽  
Care Providers ◽  
Medical Problems ◽  
Potential Benefits

Abstract Background: Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has shown that PCC services are minimally available and yet to be fully integrated into maternal health services in Nigeria. This study explored the perceptions about PCC services among health care providers in Ibadan, Nigeria. Methods: This was a case study research among 26 health care providers – 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. Results: Six main themes were identified from the data – scope of PCC, people who require PCC, where PCC services can be provided, acceptability of PCC services, relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes. Conclusion: Preconception care is perceived as being more important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will however require establishment of guidelines and its uptake will depend on acceptability to people with known medical problems who will benefit from the service.

scholarly journals Preconception Care to Improve Pregnancy Outcomes: The Science

2020 ◽  
Vol 30 (3) ◽  
pp. 355-362
Author(s):  
Hani Atrash ◽  
Brian Jack
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Pregnancy Outcomes ◽  
Preconception Care ◽  
Scientific Evidence ◽  
Clinical Care ◽  
Scientific Basis ◽  
Reproductive Age ◽  
World Health ◽  
Care Providers

Introduction: In the last decades, improvements in the care of pregnancy and child development have been observed worldwide. However, pregnancy problems remain high in most countries. There was a concentration of care in the prenatal period as the primary approach for improving pregnancy results. Currently, attention to the care of pregnant women, women who have recently given birth, and newborns are focused on the care of preconception to improve the results of pregnancy and improve the outcomes of child growth and development. Objective: Describe the evidence for preconception care (PCC) and information to the health care provider, as well as describe instruments to present health care providers with PCC, its definition, its components, recommended interventions, and the scientific basis for recommendations. Methods: There was a search for published and unpublished literature related to scientific evidence for the effectiveness of PCC in improving pregnancy results. The search was carried out based on Pubmed and using data scraping techniques, in the material available on the internet and disseminated by international organizations, such as the World Health Organization and reports by government agencies. Results: It is reported that the literature on the scientific basis for PCC is fragmented, and most publications discuss evidence of one or a few interventions, with the majority of reports considering PCC for specific populations, such as women with chronic health problems and couples with infertility. However, these publications do not offer a realistic view of the proposed PCC interventions, with the scientific evidence that supports them. The general aspects of the existing literature and the recommended preconceived care interventions are described, together with the quality of the scientific evidence and the strength of the recommendations behind each of these interventions. Conclusion: Many clinical interventions have been identified that could be offered to women before conception to help avoid adverse outcomes. Most of these interventions have scientific evidence to support their role in improving pregnancy outcomes. Therefore, it is recommended that clinical care providers incorporate evidence-based prejudice services in their daily care of women of reproductive age, in an effort to improve women’s health before and during pregnancy, as well as improve pregnancy outcomes for women and their children.

scholarly journals Knowledge of preconception care and associated factors among maternal health care providers working in urban public health institutions of Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110461
Author(s):  
Seboka Abebe Sori ◽  
Kedir Teji Roba ◽  
Tesfaye Assebe Yadeta ◽  
Hirut Dinku Jiru ◽  
Keyredin Nuriye Metebo ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Confidence Interval ◽  
Health Care Providers ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Preconception Care ◽  
Maternal Health Care ◽  
Good Knowledge ◽  
Care Providers

Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.

scholarly journals Mothers satisfaction on delivery service and associated factors among mothers who gave birth at Gondar University specialized and teaching hospital, Northwest Ethiopia 2018.

2019 ◽  
Author(s):  
Yohannes Tibebu Agimas ◽  
Moges Muluneh Boke ◽  
Solomone Mokennen Abebe
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Mode Of Delivery ◽  
Northwest Ethiopia ◽  
Satisfaction Level ◽  
Care Providers ◽  
Child Birth ◽  
Care Services ◽  
Birth Space

Abstract Abstract Background: Assessing maternal satisfaction level on maternal health care services is agreeable proxy to improve the quality of health care service, maternal health service utilization and providing client centered care. Therefore, the aim of this study was to assess the mothers’ satisfaction level and associated factors on delivery care of Gondar specialized teaching hospital, Northwest Ethiopia. Methods: A Hospital based cross-sectional study with an exit interview was conducted in Gondar university referral hospital, from November 1 to 31 2018. Total of Four hundred seventy-one postpartum mothers were participated in the study. Systematic random sampling method was employed to recruit study participants. The collected data was checked visually for incompleteness and entered to Epi-info version 7 statistical software and exported to SPSS version 20 software to descriptive, bi-variable and multivariable logistic analysis. Finally, the result was presented in tables and graphs. Results: The magnitude of mothers’ satisfaction on delivery service was 21.2%, with 95% Cl (17.6, 25.1). In multivariable logistic analysis, Residence being Urban with odd ratio 0.34 (AOR=0.34; 95% CI 0.17, 0.68), Spontaneous vaginal delivery with odd ratio 0.28 [AOR=0.28; 95%; Cl (0.14, 0.57] and Child birth space interval of 12-24 months with odd ratio 0.22 [AOR=0.22; 95%; Cl (0.08,0.55)] were inversely associated with mothers’ satisfaction. while, short waiting time to see health care providers with odd ratio 9.69 [AOR=9.69; 95% Cl: (3.16,29.76)] was positively associated with mothers’ satisfaction on childbirth care services. Conclusion and Recommendation: The overall satisfaction of mothers on facility based child birth care is low when compared with other studies. Urban dwellers, mode of delivery and short child birth space interval and short waiting time to see health care providers were significantly associated with mother’s satisfaction level of facility delivery care services. Therefore, to elating the faced maternal health care services quality difficulty, the policymakers and quality improvement program designers need to give attention on activities that change wrong perceptions of mothers on mode of delivery and intervention that ensure normal healthy child birth space time interval.

scholarly journals Pregnancy and childbirth in Mozambique: men as decision makers and women as caretakers?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Galle ◽  
H Cossa ◽  
N Osman ◽  
K Roelens ◽  
S Griffin ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Male Involvement ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Pregnancy And Childbirth ◽  
Policy Level ◽  
Sub Saharan

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

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.

Payment Accuracy in Value-Based Care Contracts

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Model Risk ◽  
Care Services ◽  
Value Based Care ◽  
Stochastic Risk

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.

Umowy o udzielanie świadczeń opieki zdrowotnej zawierane przez Narodowy Fundusz Zdrowia (leczenie w ramach ubezpieczenia zdrowotnego) a leczenie na zasadach komercyjnych. Implikacje prawne i praktyczne

2021 ◽  
pp. 141-151
Author(s):  
Paweł Lipowski
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Services ◽  
Care Providers ◽  
Care Services ◽  
Public Payer ◽  
Universal Health

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.

scholarly journals M-health for maternal health- bridging the gaps!!

2017 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Sheeba Marwah ◽  
Pratima Mittal
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Maternal Health ◽  
Medical Care ◽  
Health Care Providers ◽  
Mobile Technology ◽  
Clinical Applications ◽  
Obstetrics And Gynecology ◽  
Care Providers ◽  
Effectiveness Data

This article reviews significance, potential and principles to consider when setting up a telemedicine (TM) program to provide care to women in the field of obstetrics and gynecology, essentially deploying mobile technology. There are various benefits of such TM clinical applications. The consensus among patients and health care providers is that this technology is convenient to provide needed subspecialty medical care, even when it is not available locally. Such innovations are clinically successful, but economic and cost-effectiveness data are lacking.

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