scholarly journals Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

2019 ◽  
Author(s):  
Evelyne Baelvina Nyachwo ◽  
Rose Naigino ◽  
Rebecca Rachael Apolot ◽  
Rhoda K. Wanyenze ◽  
Juliet Kiguli ◽  
...  
Keyword(s):  
Child Health ◽  
Health Facility ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Health Belief ◽  
Significant Others ◽  
Facility Delivery ◽  
Northern Uganda ◽  
Health Facility Delivery ◽  
And Child Health

Abstract Background: Health facility delivery improves maternal and child health outcomes but has not been fully achieved in countries with the poorest maternal health indicators. We identified and examined the roles of key influencers (significant others) of mother’s perceptions towards health facility delivery in Northern Uganda. Methods: This was an exploratory study conducted using in-depth interviews with eleven significant others in a mother’s life; who were purposively selected from four sub-counties of; Ogur, Agweng, Amach and Agali, as part of a larger study in Lira district, Northern Uganda. We also conducted seven key informant interviews with health workers involved in maternal and child health care. Data analysis using Atlas ti version.7.0 was conducted deductively following a thematic framework approach to analyse themes adapted from the health belief model. Results: The study identified husbands, biological mothers, mothers-in-law, fathers-in-law, brothers and co-wives as influencers of mother’s perceptions on uptake of health facility delivery. Other significant others included traditional birth attendants who were believed to have the ability to determine when the condition of a mother required the intervention of a medical expert. Community members such as local village leaders, village health extension workers and neighbours were also cited . Whereas husbands were regarded as ke y significant others of women, health workers emphasized that, husbands were not always available to support the mothers during pregnancy and child birth. The roles of significant others of women included: planning for birth, providing financial support, making decisions on where a mother will deliver from, continued counselling and psychosocial support. Conclusion: Programs aimed at increasing male involvement to improve maternal and child health outcomes should also target other influencers of women’s perceptions on health facility delivery including family and community members, to provide back-up support to mothers in the absence of their husbands.

scholarly journals Assessing coverage of essential maternal and child health interventions using health-facility data in Uganda

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Elizabeth M. Simmons ◽  
Kavita Singh ◽  
Jamiru Mpiima ◽  
Manish Kumar ◽  
William Weiss
Keyword(s):  
Child Health ◽  
Health Facility ◽  
Maternal And Child Health ◽  
Gold Standard ◽  
Health Interventions ◽  
Household Surveys ◽  
Skilled Delivery ◽  
Improve Accuracy ◽  
Nationally Representative ◽  
And Child Health

Abstract Background Nationally representative household surveys are the gold standard for tracking progress in coverage of life-saving maternal and child interventions, but often do not provide timely information on coverage at the local and health facility level. Electronic routine health information system (RHIS) data could help provide this information, but there are currently concerns about data quality. This analysis seeks to improve the usability of and confidence in electronic RHIS data by using adjustments to calculate more accurate numerators and denominators for essential interventions. Methods Data from three sources (Ugandan Demographic and Health (UDHS) survey, electronic RHIS, and census) were used to provide estimates of essential maternal (> 4 antenatal care visits (ANC), skilled delivery, and postnatal care visit (PNC)) and child health interventions (diphtheria, pertussis, tetanus, and hepatitis B and Haemophilus influenzae type b and polio vaccination series, measles vaccination, and vitamin A). Electronic RHIS data was checked for quality and both numerators and denominators were adjusted to improve accuracy. Estimates were compared between the three sources. Results Estimates of maternal health interventions from adjusted electronic RHIS data were lower than those of the UDHS, while child intervention estimates were typically higher. Adjustment of electronic RHIS data generally improved accuracy compared with no adjustment. There was considerable agreement between estimates from adjusted, electronic RHIS data, and UDHS for skilled delivery and first dose of childhood vaccination series, but lesser agreement for ANC visits and second and third doses of childhood vaccinations. Conclusions Nationally representative household surveys will likely continue being the gold standard of coverage estimates of maternal and child health interventions, but this analysis shows that current approaches to adjusting health facility estimate works better for some indications than others. Further efforts to improve accuracy of estimates from RHIS sources are needed.

Task shifting in maternal and child health care: An evidence brief for Uganda

2011 ◽  
Vol 27 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Harriet Nabudere ◽  
Delius Asiimwe ◽  
Rhona Mijumbi
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Professionals ◽  
Health Workers ◽  
Perinatal Outcomes ◽  
Implementation Strategies ◽  
Cost Effective ◽  
Task Shifting ◽  
Care Seeking ◽  
And Child Health

The Problem: There is a shortage and maldistribution of medically trained health professionals to deliver cost-effective maternal and child health (MCH) services. Hence, cost-effective MCH services are not available to over half the population of Uganda and progress toward the Millennium Development Goals for MCH is slow. Optimizing the roles of less specialized health workers (“task shifting”) is one strategy to address the shortage and maldistribution of more specialized health professionals.Policy Options: (i) Lay health workers (community health workers) may reduce morbidity and mortality in children under five and neonates; and training for traditional birth attendants may improve perinatal outcomes and appropriate referrals. (ii) Nursing assistants in facilities might increase the time available from nurses, midwives, and doctors to provide care that requires more training. (iii) Nurses and midwives to deliver cost-effective MCH interventions in areas where there is a shortage of doctors. (iv) Drug dispensers to promote and deliver cost-effective MCH interventions and improve the quality of the services they provide. The costs and cost-effectiveness of all four options are uncertain. Given the limitations of the currently available evidence, rigorous evaluation and monitoring of resource use and activities is warranted for all four options.Implementation Strategies: A clear policy on optimizing health worker roles. Community mobilization and reduction of out-of-pocket costs to improve mothers’ knowledge and care-seeking behaviors, continuing education, and incentives to ensure health workers are competent and motivated, and community referral and transport schemes for MCH care are needed.

scholarly journals Analisis Kebutuhan dan Pemanfaatan Buku Serta Pedoman Pelayanan KIA di Puskesmas: Studi Kualitatif

2020 ◽  
Vol 23 (2) ◽  
pp. 99-107
Author(s):  
Diyan Ermawan Effendi ◽  
Arief Priyo Nugroho ◽  
Suharmiati Suharmiati ◽  
Lestari Handayani
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Health Centers ◽  
High Rate ◽  
Needs Analysis ◽  
Primary Health ◽  
Expectant Mothers ◽  
Ease Of Access ◽  
And Child Health

The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.

scholarly journals Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

2019 ◽  
Author(s):  
Eveline Muika Kabongo ◽  
Ferdinand Mukumbang ◽  
Peter N/A Delobelle ◽  
Edward N/A Nicol
Keyword(s):  
Health Care ◽  
Child Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Care Providers ◽  
And Child Health

Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

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