scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2020 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Good Quality Care ◽  
Facility Readiness ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality to assess their readiness to provide routine maternal and newborn care, and proportions of women using facilities that were ready to offer good quality care. Surveys were conducted in 2012 and 2015 to assess changes over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. At each facility the staffing, infrastructure and commodities were quantified. These formed components of four “signal functions” that describe aspects of routine maternal and newborn care. A facility was considered ready to perform a signal function if all the required components were present. Readiness to perform all four signal functions classed a facility as ready to provide good quality routine care. From facility registers we counted deliveries and calculated the proportions of women delivering in facilities ready to offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities classed as ready to offer good quality routine care rose from 40% (95% confidence interval (CI) 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh these estimates were 4% (95% CI 1-24) in 2012 and 39% (95% CI 25-55) in 2015, while in Nigeria they were 25% (95% CI 6-66) in 2012 and zero in 2015. Improved facility readiness in Ethiopia and Uttar Pradesh arose from increased supplies of commodities, while in Nigeria facility readiness fell due to depleted commodity supplies and fewer Skilled Birth Attendants. Conclusions This study quantifies the readiness of health facilities to offer good quality routine maternal and newborn care, and may help explain inconsistent outcomes of facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of such facility readiness. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon routine maternal and newborn care.

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2020 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Good Quality Care ◽  
Facility Readiness ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality to assess their readiness to provide routine maternal and newborn care, and proportions of women using facilities that were ready to offer good quality care. Surveys were conducted in 2012 and 2015 to assess changes over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. At each facility the staffing, infrastructure and commodities were quantified. These formed components of four “signal functions” that described aspects of routine maternal and newborn care. A facility was considered ready to perform a signal function if all the required components were present. Readiness to perform all four signal functions classed a facility as ready to provide good quality routine care. From facility registers we counted deliveries and calculated the proportions of women delivering in facilities ready to offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities classed as ready to offer good quality routine care rose from 40% (95% confidence interval (CI) 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh these estimates were 4% (95% CI 1-24) in 2012 and 39% (95% CI 25-55) in 2015, while in Nigeria they were 25% (95% CI 6-66) in 2012 and zero in 2015. Improved facility readiness in Ethiopia and Uttar Pradesh arose from increased supplies of commodities, while in Nigeria facility readiness fell due to depleted commodity supplies and fewer Skilled Birth Attendants. Conclusions This study quantified the readiness of health facilities to offer good quality routine maternal and newborn care, and may help explain inconsistent outcomes of facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of such facility readiness. Incorporating data on facility deliveries and repeating the analyses highlighted adjustments that could have greatest impact upon routine maternal and newborn care.

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2019 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Low Income ◽  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential for both mothers and infants, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality, to assess the quality of routine maternal and newborn care and the proportion of women delivering in facilities with a good standard of care. Surveys were conducted in 2012 and 2015 to assess changes in the quality of care over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. 166 and 305 primary care facilities were sampled in 2012 and 2015 respectively. In each year we assessed whether each facility could provide four “signal” functions of routine maternal and newborn care. From facility registers we counted the number of deliveries in the previous six months and calculated the proportion of women giving birth in facilities which could offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities which provided all four signal functions rose from 40% (95% CI 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh in 2012 an estimated 4% (95% CI 1-24) of facility deliveries occurred in facilities which provided all four signal functions, rising to 39% (95% CI 25-55) in 2015. In Nigeria these estimates were 25% (95% CI 6-66) and zero for 2012 and 2015 respectively. Improvements in signal functions in Ethiopia and Uttar Pradesh were led by improved supplies of commodities while Nigeria experienced declines in supplies of commodities and the number of Skilled Birth Attendants employed. Conclusions This study quantifies how health facilities can provide sub-optimal maternal and newborn care, and may help explain inconsistent outcomes of health facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of the capacity of facilities to provide such care. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon maternal and newborn care.

Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care

The Lancet ◽  
2014 ◽  
Vol 384 (9948) ◽  
pp. 1129-1145 ◽  
Author(s):  
Mary J Renfrew ◽  
Alison McFadden ◽  
Maria Helena Bastos ◽  
James Campbell ◽  
Andrew Amos Channon ◽  
...  
Keyword(s):  
Quality Care ◽  
Newborn Care ◽  
New Evidence ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

scholarly journals Existing barriers to utilization of health services for maternal and newborn care in rural Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Ayodo ◽  
George O. Onyango ◽  
Salome Wawire ◽  
Nadia Diamond-Smith
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Western Kenya ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Understanding the existing barriers to utilization of maternal and newborn health care services can inform improvement of care services in the rural settings in sub-Saharan Africa. However, how unintended pregnancy relates to the uptake of antenatal care (ANC) services and also how gaps in the role of the community health workers and health facilities affect maternal and newborn care and referral services are poorly understood. Methods This was a formative ethnographic study design to determine barriers to the utilization of health care services for maternal and newborns in rural Western Kenya. We interviewed 45 respondents through in-depth interviews in rural Bondo Sub- County, Western Kenya: Mothers and Fathers with children under 5 years), 2 Focus Group Discussions (FGDs) with Traditional Birth Attendants (TBA), and 2 FGDs with Skilled Birth Attendants (SBAs). The data were analyzed using Atlas-ti. Results We found that unintended pregnancy results into poor uptake of antenatal care (ANC) services due to limited knowledge and poor support system. The respondents appreciated the role of community health workers but poor government infrastructure exists. Also, perceived harshness of the health care providers, poor management of high-risk pregnancies, and unavailability of supplies and equipment at the health facilities are of concern. Conclusions The findings of this study highlight barriers to the utilization of maternal and newborn services that if addressed can improve the quality of care within and outside health facilities.

Evaluation of Community Health Workers’ Upskilling Training in Maternal and Newborn Care at Mount Hagen in Western Highlands Province, Papua New Guinea

2018 ◽  
Vol 1 (7) ◽  
Author(s):  
Jolly Kulimbua
Keyword(s):  
Community Health ◽  
Papua New Guinea ◽  
Community Health Workers ◽  
Health Workers ◽  
Newborn Care ◽  
New Guinea ◽  
Health Facilities ◽  
Care Providers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background:   Community Health Workers (CHWs) in Western highlands Province were given a 6-month CHW upskilling training to enable them to provide essential maternal-newborn care, do timely referral of high risk clients and refer emergencies to hospital. Five trainings were conducted over the five year period. Forty seven (47) CHWs were upskilled over that five year period.   Aim:   To evaluate the effectiveness of the CHW Upskilling Training during 2012 – 2016.   Methods:    A post-training assessment was conducted by direct observations of the CHWs and the Officer in Charges (OICs) at their workplaces. Assessors observed the application of knowledge and skills and determined if there were improvements in the health facilities. Purposeful discussions were carried out to elicit qualitative feedback from CHWs OICs of the health facilities.   Findings:   The findings were impressive. The organisation of health facilities improved with specific schedules made for priority reproductive and maternal health services. The recording of maternal and newborn care services indicated great improvement. The ANC, family planning and labour ward registers indicated the kinds of services provided including management of life-threatening conditions. Records show reduced maternal and newborn deaths. Records also show reduced unnecessary referrals.   Conclusions:   The CHW Up skilling Training Program is an effective intervention to improve reproductive health and maternal-newborn services in remote areas of Papua New Guinea, particularly where there are no midwives, or higher category health care providers. It has contributed to improved maternal-newborn survival.   Recommendations:   The evaluation recommends that the CHW Upskilling Training should reach more CHWs to fill in gaps in health facilities where there are no midwives or doctor. In Papua New Guinea, the CHWs Upskilling program in maternal and newborn care is recommended for all CHWs.

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