scholarly journals Acceptability and User Experiences of a Patient-Held Smart Card for Antenatal Services in Nigeria: A Qualitative Study

2022 ◽  
Author(s):  
Ijeoma Uchenna Itanyi ◽  
Juliet Iwelunmor ◽  
John Olawepo ◽  
Semiu Gbadamosi ◽  
Alexandra Ezeonu ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Smart Card ◽  
Mobile Health ◽  
Medical Information ◽  
Health Workers ◽  
Smart Cards ◽  
Major Barrier ◽  
Antenatal Services

Abstract Background Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria. Methods Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide. Results The participants were 18-44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women’s medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the “Baby showers” which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards. Conclusion These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting.

scholarly journals Mobile health messaging service and helpdesk for South African mothers (MomConnect): history, successes and challenges

2018 ◽  
Vol 3 (Suppl 2) ◽  
pp. e000559 ◽  
Author(s):  
Peter Barron ◽  
Joanne Peter ◽  
Amnesty E LeFevre ◽  
Jane Sebidi ◽  
Marcha Bekker ◽  
...  
Keyword(s):  
Pregnant Women ◽  
South African ◽  
Mobile Health ◽  
Health Workers ◽  
Digital Health ◽  
Universal Coverage ◽  
Text Messages ◽  
Time Data ◽  
Department Of Health ◽  
Early Decision

MomConnect is a flagship programme of the South African National Department of Health that has reached over 1.5 million pregnant women. Using mobile technology, MomConnect provides pregnant and postpartum women with twice-weekly health information text messages as well as access to a helpdesk for patient queries and feedback. In just 3 years, MomConnect has been taken to scale to reach over 95% of public health facilities and has reached 63% of all pregnant women attending their first antenatal appointment. The helpdesk has received over 300 000 queries at an average of 250 per day from 6% of MomConnect users. The service is entirely free to its users. The rapid deployment of MomConnect has been facilitated by strong government leadership, and an ecosystem of mobile health implementers who had experience of much of the content and technology required. An early decision to design MomConnect for universal coverage has required the use of text-based technologies (short messaging service and Unstructured Supplementary Service Data) that are accessible via even the most basic mobile phones, but cumbersome to use and costly at scale. Unlike previous mobile messaging services in South Africa, MomConnect collects the user’s identification number and facility code during registration, enabling future linkages with other health and population databases and geolocated feedback. MomConnect has catalysed additional efforts to strengthen South Africa’s digital health architecture. The rapid growth in smartphone penetration presents new opportunities to reduce costs, increase real-time data collection and expand the reach and scope of MomConnect to serve health workers and other patient groups.

scholarly journals Faktor- Faktor yang Berhubungan dengan Pemanfaatan Pelayanan Antenatal di Wilayah Kerja Puskesmas Air Tawar Kota Padang

2019 ◽  
Vol 19 (3) ◽  
pp. 661
Author(s):  
Desi Andriani ◽  
Husna Yetti ◽  
Roza Sriyanti
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Family Income ◽  
Health Workers ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Independent Practice ◽  
Cross Sectional ◽  
Antenatal Services

Antenatal care or antenatal care is a planned program that is observation, education and medical treatment for pregnant women, to obtain a safe and satisfying pregnancy and childbirth process. The indicator used to assess the access of pregnant women to antenatal care is K1 direction (first visit) is the contact of pregnant women to health workers and K4 (perspective visit) is 4 or more times contact with health workers. From the data of the Padang City Health Office, it was found that the Air Tawar Puskesmas with this low level was caused by various factors. The purpose of this study was to determine factors related to the use of antenatal services. This type of research is a quantitative study with cross sectional study design with 110 respondents of third trimester pregnant women with purposive sampling technique. Data analysis was performed univariate, bivariate with Chi squre test. From the research results obtained from the five factors studied, it was found that the factors related to the use of antenatal services in freshwater health centers were access or distance with pvalue 0.009 = OR 21.676), service availability factors with a p value of 0.001 = OR 9.293, the role factor midwives with a p value of 0.001 = OR 12.302, while the family income factor, disease complaints obtained results have nothing to do with the use of antenatal services. The author's suggestion is that there is a need for good coordination with the Independent Practice Midwife (BPM), revitalize puskesmas to more strategic places and improve better facilities, improve accessibility that can be minimized, strive to reach pregnant women, especially for accessibility that is less affordable.

scholarly journals Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Umar Haruna ◽  
Gordon Dandeebo ◽  
Sylvester Z. Galaa
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Health Outcomes ◽  
Health Workers ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Transportation Systems ◽  
Successful Implementation ◽  
Maternal Healthcare ◽  
Focused Antenatal Care

Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.

scholarly journals Perceptions of pregnant woman on monetary and time sacrifice for satisfaction based on health workers roles in antenatal services to reduce the risk of maternal death at Gowa district

2019 ◽  
Vol 10 (2) ◽  
pp. 111-118
Author(s):  
Serawati Dewi ◽  
Yuni Romalita ◽  
Yusriani Yusriani ◽  
Muhammad Khidri Alwi
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Study Design ◽  
Health Workers ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Latar belakang: Angka Kematian Ibu (AKI) merupakan salah satu indikator pembangunan kesehatan di Indonesia. Upaya percepatan penurunan AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu hamil yang berkualitas. Apabila antenatal care dimanfaatkan dengan baik maka kesehatan ibu dapat terpantau secara berkesinambungan dari masa kehamilan sampai dengan persalinan. Metode: Desain penelitian adalah kuantitatif dengan rancangan cross sectional study. Populasi pada penelitian ini adalah semua ibu yang memiliki bayi usia 0-11 bulan di Kabupaten Gowa sebanyak 122 orang. Sampel sebanyak 93 orang diambil dengan menggunakan teknik accidental sampling, besar sampel ditentukan dengan menggunakan rumus Slovin Hasil: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi. Ibu hamil yang memiliki persepsi pengorbanan moneter kecil dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90,0%. Ibu hamil yang memiliki persepsi pengorbanan moneter sangat kecil dan mengatakan peran petugas kesehatan kurang sebanyak 83.1%. Sedangkan persepsi pengorbanan waktu menunjukkan adanya korelasi dengan peran petugas kesehatan dalam pelayanan antenatal. Ibu hamil yang memiliki persepsi pengorbanan waktu besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 100%. Ibu hamil yang memiliki persepsi pengorbanan moneter besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90.2%. Kesimpulan: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi sedangkan berdasarkan pengorbanan waktu menunjukkan ada korelasi. Perlu meningkatkan kecepatan proses pelayanan pemeriksaan kehamilan pada ibu hamil oleh tenaga kesehatan. Kata kunci: Pelayanan antenatal, Ibu Hamil, Pengorbanan, Waktu, Moneter   Abstract Background: Maternal Mortality Rate (MMR) is one indicator of health development in Indonesia. Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services. If antenatal care is utilized properly, maternal health can be monitored continuously from pregnancy to delivery. Methods: The study design was quantitative with a cross sectional study design. The population in this study were all pregnant women who had a gestational age of 7 to 9 months in Gowa Regency as many as 122 people. A sample of 93 people was taken using accidental sampling technique, the sample size was determined using the Slovin formula. Results: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice did not show a correlation. Pregnant women who have a perception of small monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.0%. Pregnant women who have a perception of monetary sacrifice are very small and say the role of health workers is less as much as 83.1%. While the perception of sacrifice of time shows a correlation with the role of health workers in antenatal care. Pregnant women who have the perception of sacrifice of big time and say the role of health workers lacking in antenatal care as much as 100%. Pregnant women who have a perception of great monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.2%. Conclusion: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice does not show correlation while based on time sacrifice shows there is correlation. Need to increase the speed of the process of pregnancy examination services for pregnant women by health workers. Keywords: Antenatal care, Pregnant Women, Sacrifice, Time, Monetary

scholarly journals “He lets me go although he does not go with me.”: Rwandan women’s perceptions of men’s roles in maternal health

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Germaine Tuyisenge ◽  
Valorie A. Crooks ◽  
Nicole S. Berry
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Outcomes ◽  
Pregnant Women ◽  
Critical Time ◽  
Maternal Health Services ◽  
Birth Preparedness ◽  
Complication Readiness ◽  
Maternal Health Outcomes ◽  
Men’S Involvement

Abstract Background Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services. Methods We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care. Results Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions. Conclusion Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.

scholarly journals Understanding variation in maternal health service coverage and maternal health outcomes among districts in Rwanda

2019 ◽  
Author(s):  
Felix Sayinzoga ◽  
Tetui Moses ◽  
Koos van der Velden ◽  
Jeroen van Dillen ◽  
Leon Bijlmakers
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Outcomes ◽  
Health Workers ◽  
Text Messages ◽  
Maternal Health Service ◽  
Poor People ◽  
District Hospitals ◽  
Maternal Health Outcomes ◽  
Service Coverage

AbstractObjectiveTo identify factors that explain variations between districts in maternal health service coverage and maternal health outcomes.MethodsIndividual key informant interviews and focus group discussions using structured topic lists were conducted in May 2015 in four purposively selected districts.ResultsThe solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization. Geographical factors, in particular location close to borders with mobile populations and migrants, and large populations with sparsely distributed health infrastructure, exacerbated by hilly topography and muddy roads were identified as barriers. Shortages of skilled health providers at the level of district hospitals were cited as contributing to poor maternal health outcomes.ConclusionThere is a need to take into account disparities between districts when allocating staff and financial resources in order to achieve universal coverage for high-quality maternal health services and better outcomes. Local innovations such as the use of SMS and WhatsApp text messages by health workers and financial protection schemes for poor patients improve solidarity and are worth to be scaled up.

scholarly journals Barriers to Health Workers in Iron Deficiency Anemia Prevention among Indonesian Pregnant Women

Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Darmawati Darmawati ◽  
Tongku N. Siregar ◽  
Hajjul Kamil ◽  
Teuku Tahlil
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Health Workers ◽  
Deficiency Anemia ◽  
Sociocultural Factors ◽  
Content Analysis Method ◽  
Barriers To Health ◽  
Depth Interviews ◽  
Antenatal Services

Background. Anemia is a global maternal health problem that commonly occurs in developing countries. During pregnancy, a woman will receive antenatal services to check her condition and prevent complications. This study aimed to explore barriers towards achieving eradication of iron deficiency anemia among pregnant women in Aceh Besar District, Indonesia. Methods. This qualitative study was conducted on 18 health workers who were recruited through a purposive sampling method. Data were collected through in-depth interviews using open-ended questions to gain insight about participants’ experiences in managing iron deficiency anemia among pregnant women. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview’s result. Result. Three main themes emerged: (1) facilities, infrastructures, and supplement support; (2) sociocultural factors; and (3) health provider competency deficits and no developing guidelines. Conclusion. Our findings provide understanding that there are many obstacles and barriers encountered by health workers in iron deficiency anemia prevention management. Thus, the management of anemia must be supported by a skilled health worker and quality facilities. Health workers and pregnant women must work together to achieve optimal management of anemia prevention.

scholarly journals Effectiveness of A Community Level Maternal Health Intervention in Improving Uptake of Postnatal Care in Migori County, Kenya

2019 ◽  
Vol 3 (1) ◽  
pp. 11-20
Author(s):  
Moses M. Gitonga ◽  
Kenneth K. Ngure ◽  
Elizabeth E. Echoka
Keyword(s):  
Maternal Health ◽  
Community Health ◽  
Health Facility ◽  
Community Health Workers ◽  
Postnatal Care ◽  
Health Workers ◽  
Health Intervention ◽  
Community Level ◽  
Major Barrier ◽  
Ex Post

Background: Provision of a continuum of care during pregnancy, delivery, and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Complications and lack of skilled postnatal care has consequences for mothers and babies. We examined to what extent a community level integrated maternal health intervention contributed to improvements in uptake of skilled care after delivery by pregnant women.  Methods: An Ex post quasi-experimental design was applied. Among 590 reproductive-aged women, we assessed the effectiveness of a community level integrated maternal health intervention and predictors of uptake of postnatal care. Descriptive, bivariate and multivariate analyses were conducted.   Results: About three fifths (64%) of the women reported having sought postnatal care services at the health facility within six (6) weeks. Women in the intervention arm were 3.3 times more likely to take up postnatal care at a health facility (AOR= 3.31[95% CI 1.245 to 8.804] p=0.016). Women referred to the health facility for postnatal care by Community Health Workers (CHWs) were 2.72 times more likely to take up the services (AOR= 2.72[95% CI 1.05 to 7.07] p=0.039) than those not referred by CHWs. Distance to health facility (61%) was the major barrier, while some mothers did not feel the need for postnatal care (11%).  Conclusion and Implications for Translation: Routine health education by trained providers at community level health facilities, coupled with enhanced CHWs' involvement can improve uptake of postnatal care. Ignorance and accessibility challenges are some barriers to the uptake of postnatal care. Key words: • Community • Maternal • Health • Intervention • Postnatal-Care • Kenya • MAISHA • Community Health Volunteers (CHVs) • Community Health Workers (CHWs)   Copyright © 2019 Gitonga et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of an integrated neonatal care kit on neonatal health outcomes: a cluster randomised controlled trial in rural Pakistan

2019 ◽  
Vol 4 (3) ◽  
pp. e001393 ◽  
Author(s):  
Lisa G Pell ◽  
Ali Turab ◽  
Diego G Bassani ◽  
Joy Shi ◽  
Sajid Soofi ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Pregnant Women ◽  
Neonatal Mortality ◽  
Health Workers ◽  
Controlled Trial ◽  
Neonatal Care ◽  
Live Births ◽  
Rural Pakistan ◽  
Cluster Randomised ◽  
And Control

IntroductionIn 2016, 2.6 million children died during their first month of life. We assessed the effectiveness of an integrated neonatal care kit (iNCK) on neonatal survival and other health outcomes in rural Pakistan.MethodsWe conducted a community-based, cluster randomised, pragmatic, open-label, controlled intervention trial in Rahim Yar Khan, Punjab, Pakistan. Clusters, 150 villages and their lady health workers (LHWs), were randomly assigned to deliver the iNCK (intervention) or standard of care (control). In intervention clusters, LHWs delivered the iNCK and education on its use to pregnant women. The iNCK contained a clean birth kit, chlorhexidine, sunflower oil, a continuous temperature monitor (ThermoSpot), a heat reflective blanket and reusable heat pack. LHWs were also given a hand-held scale. The iNCK was implemented primarily by caregivers. The primary outcome was all-cause neonatal mortality. Outcomes are reported at the individual level, adjusted for cluster allocation. Enrolment took place between April 2014 and July 2015 and participant follow-up concluded in August 2015.Results5451 pregnant women (2663 and 2788 in intervention and control arms, respectively) and their 5286 liveborn newborns (2585 and 2701 in intervention and control arms, respectively) were enrolled. 147 newborn deaths were reported, 65 in the intervention arm (25.4 per 1000 live births) compared with 82 in the control arm (30.6 per 1000 live births). Neonatal mortality was not significantly different between treatment groups (risk ratio 0.83, 95% CI 0.58 – 1.18; p = 0.30).ConclusionProviding co-packaged interventions directly to women did not significantly reduce neonatal mortality. Further research is needed to improve compliance with intended iNCK use.

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