scholarly journals “…we were like tourists in the theatre, the interns assisted almost all procedures…” Challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania

2021 ◽  
Author(s):  
Nathanael Sirili ◽  
Amani Anaeli ◽  
Lilian Mselle ◽  
Obadia Venance Nyongole ◽  
Siriel Massawe
Keyword(s):  
Caesarean Section ◽  
Holistic Approach ◽  
Structured Interview ◽  
Group Discussions ◽  
District Hospitals ◽  
Caesarean Section Delivery ◽  
District Management ◽  
The Government ◽  
Almost All

Abstract Background: Training of mid-level providers is a task-sharing strategy that has gained popularity in the recent past for addressing the critical shortage of the health workforce. In Tanzania, training of mid-level providers has existed for over five decades; however, concerns exist regarding the quality of mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania. Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMO training colleges in Tanzania. A semi-structured interview guide was used to interview 29 key informants from the district hospitals, district management, regional management, AMO training college, and one retired AMO. Also, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include: use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), inadequate teaching infrastructure in the existence of many other trainees, including interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The findings of this study underscore that the challenges facing AMO training for the performance of Caesarean section delivery have the potential to negatively impact the quality of Caesarean sections performed by this cadre. A holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploying qualified tutors, and improving the competencies of the available tutors through continuing medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges in teaching infrastructure and providing financial support to this cadre that has continued to be the backbone of primary healthcare in Tanzania. Long-term solutions should consider deploying medical officers at the primary facilities and phasing out the performance of Caesarean section by AMOs.

scholarly journals “ … we were like tourists in the theatre, the interns assisted almost all procedures … ” Challenges facing the assistant medical officers training for the performance of caesarean section delivery in Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nathanael Sirili ◽  
Amani Anaeli ◽  
Lilian Mselle ◽  
Obadia Nyongole ◽  
Siriel Massawe
Keyword(s):  
Caesarean Section ◽  
Holistic Approach ◽  
Structured Interview ◽  
Group Discussions ◽  
District Hospitals ◽  
Caesarean Section Delivery ◽  
District Management ◽  
The Government ◽  
Almost All

Abstract Background Training of mid-level providers is a task-sharing strategy that has gained popularity in the recent past for addressing the critical shortage of the health workforce. In Tanzania, training of mid-level providers has existed for over five decades; however, concerns exist regarding the quality of mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania. Methods An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMO training colleges in Tanzania. A semi-structured interview guide was used to interview 29 key informants from the district hospitals, district management, regional management, AMO training college, and one retired AMO. Also, four focus group discussions were conducted with 35 AMO trainees. Results Training of AMOs in Tanzania faces many challenges. The challenges include: use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), inadequate teaching infrastructure in the existence of many other trainees, including interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions The findings of this study underscore that the challenges facing AMO training for the performance of Caesarean section delivery have the potential to negatively impact the quality of Caesarean sections performed by this cadre. A holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploying qualified tutors, and improving the competencies of the available tutors through continuing medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges in teaching infrastructure and providing financial support to this cadre that has continued to be the backbone of primary healthcare in Tanzania. Long-term solutions should consider deploying medical officers at the primary facilities and phasing out the performance of Caesarean section by AMOs.

scholarly journals “…we were like tourists in the theatre, the interns assisted almost all procedures…” Challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania

2020 ◽  
Author(s):  
Nathanael Sirili ◽  
Amani Anaeli ◽  
Lilian Mselle ◽  
Obadia Venance Nyongole ◽  
Siriel Massawe
Keyword(s):  
Caesarean Section ◽  
Holistic Approach ◽  
Structured Interview ◽  
District Hospitals ◽  
Caesarean Section Delivery ◽  
District Management ◽  
The Government ◽  
Almost All ◽  
Phase Out

Abstract Background: Training of mid-level providers is a task-sharing strategy that has gained popularity in the recent past for addressing the critical shortage of the health workforce. In Tanzania, training of mid-level providers has existed for over five decades, however, concerns are upon the quality of the mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMOs Training Colleges in Tanzania. A semi-structured interview guide was used to interview 29 Key informants from the district hospitals, district management, regional management, AMOs training college, and one retired AMO. Also, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include; use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), Inadequate teaching infrastructure in the existence of many other trainees to include interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The findings of this study underscore that the challenges facing AMO training for the performance of Caesarean section delivery have the potentials to negatively impact the quality of Caesarean section performed by this cadre. A holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploy qualified tutors, and improving the competencies of the available tutors through continuing medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges on teaching infrastructure and financial support to this cadre that has continued to be the backbone of the primary health care in Tanzania. Long term solution should consider to deploy the medical officers at the primary facilities and phase out the performance of Caesarean section by the AMOs.

scholarly journals “…we were like tourists in the theatre, the interns assisted almost all procedures…” Challenges facing the training of Assistant Medical Officers in Tanzania

2020 ◽  
Author(s):  
Nathanael Sirili ◽  
Amani Anaeli ◽  
Lilian Mselle ◽  
Obadia Venance Nyongole ◽  
Siriel Massawe
Keyword(s):  
Holistic Approach ◽  
Structured Interview ◽  
Group Discussions ◽  
District Hospitals ◽  
District Management ◽  
The Government ◽  
Almost All ◽  
Phase Out ◽  
Continued Medical Education

Abstract Background: Training of mid-level providers is a task sharing strategy that has gained popularity in the recent past for addressing critical shortage of health workforce. In Tanzania, training of mid-level providers has existed for over five decades, however, concerns are upon the quality of the mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the training of the Assistant Medical Offices in Tanzania.Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMOs Training Colleges in Tanzania. A semi-structured interview guide was used to interview 29 Key informants from the district hospitals, district management, regional management, AMOs training college and one retired AMO. In addition, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include; use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), Inadequate teaching infrastructure in existence of many other trainees to include interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The findings of this study underscore that the challenges facing AMO training have the potentials to negatively impact the quality of care rendered by this cadre. Holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploying qualified tutors and improving the competencies of the available tutors through continued medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges on teaching infrastructure and financial support to this cadre that has continued to be the backbone of the primary health care in Tanzania. Long term solution should consider to deploy the medical officers at the primary facilities and phase out the AMOs. Finally, challenges facing mid-level providers in Tanzania and similar settings are similar, thus these findings can be used as a starting pointing in addressing them.

scholarly journals “…we were like tourists in the theatre, the interns assisted almost all procedures…” Task sharing and the training of Assistant Medical Officers in Tanzania.

2020 ◽  
Author(s):  
Nathanael Sirili ◽  
Amani Anaeli ◽  
Lilian Mselle ◽  
Siriel Massawe
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Primary Health Care ◽  
Structured Interview ◽  
Task Sharing ◽  
Primary Health ◽  
District Hospitals ◽  
District Management ◽  
The Government

Abstract Background: Tanzania is among the countries that adopted task sharing as a strategy of addressing health workforce shortage. Although the strategy has existed for over five decades, concerns are upon the quality of the training of the mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the training of the Assistant Medical Offices, AMOs (a mid-level cadre) in Tanzania.Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMOs Training Colleges in Tanzania. A semi-structured interview guide was used to interview 29 Key informants from the district hospitals, district management, regional management, AMOs training college and one retired AMO. In addition, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include; use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), Inadequate teaching infrastructure in existence of many other trainees to include interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The challenges facing AMO training not only affect the quality of the graduates but also affect the realization of task sharing strategy that requires that task sharing should not compromise the quality of services produced by the task-shared cadre. It is high time for revising the AMOs curricula and train the tutor through continued medical education programmes to reflect the dynamics of medical education. The government in collaboration with other stakeholders should work together to address the challenges on teaching infrastructure and scholarships to this cadre that has continued to be the backbone of the primary health care in Tanzania. Keywords; Assistant medical Officers, Task sharing, Task shifting, Medical education, Tanzania, Primary health care

MALE PARTICIPATION IN FAMILY PLANNING: RESULTS FROM A QUALITATIVE STUDY IN MPIGI DISTRICT, UGANDA

2005 ◽  
Vol 37 (3) ◽  
pp. 269-286 ◽  
Author(s):  
ANGELA KAIDA ◽  
WALTER KIPP ◽  
PATRICK HESSEL ◽  
JOSEPH KONDE-LULE
Keyword(s):  
Family Planning ◽  
Public Attitudes ◽  
Structured Interview ◽  
Group Discussions ◽  
Family Planning Services ◽  
Spousal Communication ◽  
Interview Guide ◽  
Modern Family ◽  
The Government ◽  
Almost All

The aim of this study was to determine men’s perceptions about family planning and how they participate or wish to participate in family planning activities in Mpigi District, central Uganda. Four focus group discussions were conducted with married men and with family planning providers from both the government and private sector. In addition, seven key informants were interviewed using a semi-structured interview guide. The results indicate that men have limited knowledge about family planning, that family planning services do not adequately meet the needs of men, and that spousal communication about family planning issues is generally poor. However, almost all men approved of modern family planning and expressed great interest in participating. The positive change of the beliefs and attitudes of men towards family planning in the past years has not been recognized by family planning programme managers, since available services are not in line with current public attitudes. A more couple-oriented approach to family planning is needed. Measures could include, for example, recruiting males as family planning providers, offering more family planning counselling for couples, and promoting female-oriented methods with men and vice versa.

Factors affecting the development of e-government using a citizen-centric approach

2015 ◽  
Vol 6 (3) ◽  
pp. 206-222 ◽  
Author(s):  
Kanda Sorn-in ◽  
Kulthida Tuamsuk ◽  
Wasu Chaopanon
Keyword(s):  
Quantitative Research ◽  
Service Providers ◽  
Structured Interview ◽  
Government Agencies ◽  
Content Type ◽  
Factors Affecting ◽  
Government Services ◽  
Government Sector ◽  
The Government

Purpose – The purpose of this paper is to study the factors affecting the development of e-government by using a citizen-centric approach. Design/methodology/approach – This paper is a mixed-methods study consisting of qualitative and quantitative research. Data were collected from government agencies using a structured interview and questionnaire about e-government services. The research was collected from the people responsible for the management of an e-government project in 75 government agencies. In addition, the researcher collected data from 1,400 citizens by using an e-Survey questionnaire that grouped participants by age. Findings – By using a citizen-centric approach, the paper identified the factors affecting the development of e-government. There were five factors from the viewpoint of government agencies and citizen groups: quality of e-government services, policy and governance, information technology infrastructure, organization and economy and society. Research limitations/implications – The research covered the development patterns of e-government for services from government to citizens only. Practical implications – Seeing the importance of environmental factors for both service providers and service users would facilitate continuous improvement of e-government service provision by government agencies. Social implications – The results reflect citizens’ need for e-government services; quality is their priority. Hence, government agencies must consider the quality of the delivery of information and e-government services as they relate to the lifestyles and needs of citizens. Originality/value – The creation of knowledge from merging e-government concepts with citizen-centric principles is a modern government sector management theory. This research stresses the need for the government sector to see the need for e-government and to recognize the factors for its successful development. This means the design and development of e-government services should respond to the increasing needs of the citizens.

scholarly journals Penyempurnaan Hukum Formal Perpajakan Terkait Tata Cara Perpajakan

2020 ◽  
Vol 22 (2) ◽  
pp. 215-240
Author(s):  
Haula Rosdiana ◽  
Maria R.U.D. Tambunan ◽  
Inayati Hifni
Keyword(s):  
Law Enforcement ◽  
Focus Group ◽  
Group Discussion ◽  
Successful Implementation ◽  
Group Discussions ◽  
Strategic Role ◽  
The Government ◽  
Taxation System

Dalam mengoptimalkan penerimaan pajak, pemerintah selayaknya mendesain sistem perpajakan yang berpegang prinsip efisiensi dengan tetap memperhatikan aspek keadil-an dan kesederhana. Dalam sistem perpajakan, hukum formal mempunyai peranan penting dalam mengejawantahkan hukum material, karena itu Undang-undang Ketentu-an Umum dan Tata Cara Perpajakan (KUP) menjadi salah satu kunci keberhasilan implementasi kebijakan pajak. Mengingat strategisnya peran UU KUP, perlu untuk mereview kembali UU KUP yang saat ini berlaku serta perlu dilakukan suatu penyempurnaan. Penelitian ini menggunakan pendekatan kualitatif dengan teknik pengumpulan data kualitatif yang terdiri dari studi literatur dan focus group discussion. Penelitian bertujuan memberikan masukan atas KUP yang saat ini masih dalam proses pembahasan dengan menekankan pada aspek kemudahan (ease of administration), keadilan (equity) dan kepastian hukum (law enforcement). Hasil penelitian ini menekan-kan pada hal-hal terkait (i) perlunya meningkatkan basis data perpajakan, (ii) perlunya menjalankan kemudahan administrasi yang berdasarkan ketentuan yang tegas, jelas, dan sederhana, (iii) penegakan hukum yang tegas, (iv) adanya sanksi yang sebanding dengan pelanggaran yang dilakukan oleh wajib pajak, dan (v) peningkatan kualitas layanan dan profesionalisme petugas pajak. Kajian ini diharapkan mampu mendorong terwujudnya regulasi perpajakan pro terhadap optimalisasi penerimaan tanpa mencede-rai hak-hak wajib pajak. Proposal for Amendment of Formal Law on Taxation Procedure  In optimizing tax revenue, the government should design a taxation system that adheres to the principle of efficiency, justice and simplicity. In the taxation system, formal law has an important role in manifesting laws, therefore laws and taxation procedures (KUP) are one of the keys to the successful implementation of tax policies. Considering the strategic role of the KUP Law, it is necessary to review the KUP Law which is currently in force and needs to be improved. This study uses a qualitative approach with qualitative data collection techniques consisting of literature studies and focus group discussions. The research aims to provide input on KUP which is currently still in the process of discussion by emphasizing aspects of ease (ease of administration), justice (equity) and legal certainty (law enforcement). The results emphasize issues related to (i) the need to increase the taxation database, (ii) the need to carry out administrative facilities based on firm, clear and simple provisions, (iii) strict law enforcement, (iv) comparable sanctions with violations committed by taxpayers and (v) improving the quality of service and professionalism of tax officials. This study is expected to be able to encourage the realization of tax regulations that are pro to the optimization of revenue without harming the rights of taxpayers.

scholarly journals Analysis of Consumers’ Preference for Local Rice among Households in Ekiti State, Nigeria

2020 ◽  
pp. 18-23
Author(s):  
G. T. Ajayi ◽  
A. Ajiboye
Keyword(s):  
Logistic Regression ◽  
Control Policy ◽  
Structured Interview ◽  
Sampling Procedure ◽  
Primary Data ◽  
Multi Stage ◽  
Good Taste ◽  
The Mean ◽  
The Government

Consumers’ preference for local rice determines its demand. Therefore, the study was carried out to analyze consumers’ preference for local rice among households in Ekiti State. A multi-stage sampling procedure was used to select respondents for this study. A total of 240 women were randomly selected from three Local Government Areas (LGAs) in the State. Primary data were obtained with the use of a well-structured interview schedule. Data collected were analyzed using descriptive statistics as well as inferential statistic like logistic regression. The mean age of the respondents was 38 years and more than half (53.3%) of the respondents were females. Most (70.0%) of the respondents had a mean family size of 7 persons. Most (87.0%) preferred local rice and factors influencing consumers’ preference for local rice include good nutritional value, quality of rice and good taste. Local rice was very much preferred by the respondents. Logistic regression shows that significant influence exists between price, taste, availability of rice and presence of particles and preferred choice of rice. Therefore, efforts should be made by the government to formulate price control policy on local rice for its affordability by the consumers and there should be improvement on processing technology of local rice to eliminate presence of particles for improved quality and good taste to enhance the consumers’ preference for choice of rice. Also, the government should support farmers through provision of incentives and credit facilities so as to produce more local rice for its availability all year round.

PENGUJIAN PERFORMA DAN TINGKAT STRESS PADA WEBSITE RESMI PEMERINTAH (STUDI KASUS: KAB.SUBANG, KAB.BANDUNG BARAT, DAN KAB.CIANJUR)

2021 ◽  
Vol 5 (1) ◽  
pp. 132
Author(s):  
Carkiman Carkiman ◽  
Shandy Rikmansyah ◽  
Sandi Mahardi ◽  
Muhammad Adi Kuncoro
Keyword(s):  
Test Results ◽  
Display Time ◽  
The Public ◽  
Government Sector ◽  
District Government ◽  
Access Information ◽  
The Government ◽  
Almost All ◽  
Government Website

Melayani  masyarakat  ataupun  publik  dengan  menggunakan media teknologi informasi dan komunikasi berbasis  website  hampir  dilakukan  oleh  semua  sektor, termasuk sektor pemerintah seperti halnya pemerintahan ditingkat kabupaten. pemerintah kabupaten yang sudah memiliki website resmi diantaranya kab.subang  (subang.go.id), kab.bandung barat (bandungbaratkab.go.id), dan kab.cianjur (cianjurkab.go.id) yang  menjadi  fokus  penelitian ini. Keberadaan  website  resmi  milik  pemerintah, perlu dilakukan  pengukuran  kinerja  dan serta kualitas dari website tersebut dengan menggunakan alat uji  GTMetrix, WebPageTest, dan WAVE. Berdasarkan hasil pengujian dengan GTMetrix, maka website resmi pemerintah kabupaten  subang termasuk  kategori  lambat  dengan  waktu  tampil  18.9s,  sedangkan  untuk  website resmi pemerintah kabupaten cianjur  dan  kabupaten  bandung barat dengan waktu tampil  33.5s dan  31.0s  termasuk  kategori sangat  lambat. Berdasarkan  hasil  pengujian  dengan WebPagetest,  maka  website  resmi pemerintah kabupaten  Cianjur  memiliki  nilai performa baik dengan waktu tampil 20.015s dibandingkan dengan  kabupaten  subang dengan waktu tampil 65.871s dan  bandung  barat  dengan  waktu tampil  39.574s. Berdasarkan  hasil pengujian dengan WAVE, maka website resmi pemerintah  kabupaten  Bandung Barat memiliki nilai error sedikit  dengan jumlah  9 error dibandingkan dengan  kabupaten  subang dengan jumlah  61  error dan  kabupaten  cianjur  dengan  jumlah  168 error. Penelitian ini menyatakan bahwa dengan  fokus load time dari ketiga website resmi pemerintah kabupaten  tersebut, maka Semakin  kecil  angka  loadtime  yang dihasilkan, maka  kinerja  website  semakin  baik  dan  juga  Kualitas  sebuah  website  sangat  berpengaruh  terhadap minat    pengguna  ataupun  masyarakat  untuk  mengakses  website tersebut. saran  yang  dapat  diberikan berdasarkan hasil pengujian diatas adalah  meningkatkan  kinerja website  resmi pemerintah  terlebih  difokuskan  pada  load time website, dan  dari ketiga website resmi tersebut parameter security score nilainya F  itu  artinya  perlu ditingkatkan keamanan dari website milik pemerintah tersebut, sehingga dapat memberikan  kenyamanan dan  minat  pengguna untuk  mengakses  lnformasi  yang  terdapat  pada website  resmi  pemerintah  daerah  tersebut. Serving the public or the public by using information technology and website-based communication media is practiced by almost all sectors, including the government sector as well as the district level government. District governments that already have official websites include Kab.subang (subang.go.id), Kab.bandung Barat (bandungbaratkab.go.id), and Kab.cianjur (cianjurkab.go.id) which are the focus of this research. The existence of an official government website, it is necessary to measure the performance and quality of the website using the GTMetrix, WebPageTest, and WAVE test tools.  Based on the results of testing with GTMetrix, the official website of the Subang district government is in the slow category with a display time of 18.9s, while the official websites of the Cianjur regency and West Bandung regencies with a display time of 33.5s and 31.0s are in the very slow category. Based on the results of testing with WebPagetest, the official website of the Cianjur regency government has a good performance score with a display time of 20,015s compared to Subang district with a display time of 65,871s and Bandung Barat with a display time of 39,574s. Based on the results of testing with WAVE, the official website of the West Bandung district government has a slight error value with 9 errors compared to Subang district with 61 errors and Cianjur district with 168 errors. This research states that with the focus on the load time of the three official websites of the regency government, the smaller the load time is generated, the better the performance of the website and the quality of a website greatly affects the interest of users or the public to access the website. The suggestion that can be given based on the test results above is to improve the performance of the official government website, especially focused on the load time of the website, and from the three official websites the parameter of the security score is F, which means that the security of the government-owned website needs to be increased, so that it can provide user comfort and interest. to access information contained on the official website of the local governmen

scholarly journals Communication between mothers and health workers is important for quality of newborn care: a qualitative study in neonatal units in district hospitals in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christiane Horwood ◽  
Lyn Haskins ◽  
Silondile Luthuli ◽  
Neil McKerrow
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Health Workers ◽  
Newborn Care ◽  
Well Being ◽  
Structured Interview ◽  
Observation Data ◽  
Good Communication ◽  
District Hospitals

Abstract Background There is a high global burden of neonatal mortality, with many newborn babies dying of preventable and treatable conditions, particularly in low and middle-income countries. Improving quality of newborn care could save the lives of many thousands of babies. Quality of care (QoC) is a complex and multifaceted construct that is difficult to measure, but patients’ experiences of care are an important component in any measurement of QoC. We report the findings of a qualitative study exploring observations and experiences of health workers (HWs) and mothers of babies in neonatal units in South Africa. Methods A qualitative case study approach was adopted to explore care of newborn babies admitted to neonatal units in district hospitals. Observation data were collected by a registered nurse during working hours over a continuous five-day period. Doctors and nurses working in the neonatal unit and mothers of babies admitted during the observation period were interviewed using a semi-structured interview guide. All interviews were audio recorded. Observation data were transcribed from hand written notes. Audiotapes of interviews were transcribed verbatim and, where necessary, translated into English. A thematic content analysis was used to analyse the data. Results Observations and interviews were conducted in seven participating hospitals between November 2015 and May 2016. Our findings highlight the importance of information sharing between HWs and mothers of babies, contrasting the positive communication reported by many mothers which led to them feeling empowered and participating actively in the care of their babies, with incidents of poor communication. Poor communication, rudeness and disrespectful behaviour of HWs was frequently described by mothers, and led to mothers feeling anxious, unwilling to ask questions and excluded from their baby’s care. In some cases poor communication and misunderstandings led to serious mismanagement of babies with HWs delaying or withholding care, or to mothers putting their babies at risk by not following instructions. Conclusion Good communication between mothers and HWs is critical for building mothers’ confidence, promoting bonding and participation of mothers in the care of their baby and may have long term benefits for the health and well-being of the mother and her baby.

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