scholarly journals Lack of autonomy in facility-based births makes women become absentees of maternity services in Somaliland fragile contexts - a qualitative study

2021 ◽  
Author(s):  
Jama Ali Egal ◽  
Amina Essa ◽  
Rahma Yusuf ◽  
Fadumo Osman ◽  
Marie Klingberg- Allvin ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Healthcare Providers ◽  
Medical Knowledge ◽  
Care Seeking ◽  
Place Of Birth ◽  
Maternity Services ◽  
Risk Pregnancy ◽  
Respectful Care

Abstract ObjectiveSomaliland has high levels of both maternal and infant mortality. This has been attributed, in part, to the fact that nearly 80% of births in the country take place at home, with women assisted by Traditional Birth Attendants (TBA) who have limited medical knowledge when it comes to obstetric complications. In this study we aim to capture multipara women’s decision-making when choosing the place of birth, illuminated by their experiences of maternity services in SomalilandDesignAn explorative qualitative approach using individual interviews conducted in Somaliland with 25 multiparous women who had experience of both a home and facility-based birth within the last three years.FindingsThe main finding of this study was the description of how valuable autonomy and respectful care were for Somaliland women. Respectful care and the cost of maternity services were vital parts of women’s autonomous decision-making when choosing a place of birth. Disrespectful care in maternity services made low-risk pregnancy women chose homebirth instead of a health facility birth. Women who had previous high-risk pregnancies that suggested they should be returnees to facility-based antenatal care, were still planning for a homebirth as their first choice.Key conclusionThis qualitative study was conducted in the fragile context of Somaliland and suggest a need to transform maternal and child health clinics into midwifery-led birthing centers that promote natural birth. It is further important to create new roles and responsibilities for TBAs that link them to the formal health system assuring timely health care seeking during pregnancy and in relation to delivery. There is a need to conduct a country-wide study on the availability and distribution of healthcare providers and to construct a long-term sustainable plan to assure quality and equal access to maternal health care in the country.

scholarly journals Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

2021 ◽  
pp. 1-25
Author(s):  
Simon Turner ◽  
Danielle D´Lima ◽  
Jessica Sheringham ◽  
Nick Swart ◽  
Emma Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Evidence Use

scholarly journals Health care seeking behaviour of women during pregnancy in rural south India: a qualitative study

2017 ◽  
Vol 4 (10) ◽  
pp. 3636 ◽  
Author(s):  
Antony Vincent ◽  
K. Keerthana ◽  
Damotharan K. ◽  
Ariarathinam Newtonraj ◽  
Joy Bazroy ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Rural Area ◽  
South India ◽  
Care Seeking ◽  
Important Indicator ◽  
Good Opportunity ◽  
Study Population

Background: Antenatal care is an important indicator in any health system. Through our study we intended to assess the perception of pregnant women regarding health seeking behaviour and awareness about complications during pregnancy. Methods: A qualitative study was carried out in August 2016, among the 41 pregnant women over 27 weeks of gestation in a rural area of south India. Women were selected randomly from the routine surveillance system maintained by Pondicherry Institute of Medical Sciences – Rural Health Training Centre, Chunampet, Kancheepuram District. Interviews audio recorded. After verbatim, manual coding and analysis was done based on pre decided eight themes. Results: In general all the antenatal women aware of the importance of regular antenatal check up. Knowledge regarding complications and danger sign was not adequate. Most of the women in rural area seek care in government facility due to its availability, accessibility and affordability. Decision making in health care is mostly taken by their husbands. Transportation has been identified as a barrier in seeking health care. Conclusions: Although few of the antenatal mothers in the study population were aware about some complications of pregnancy, but in general knowledge among most of the women was inadequate. There is a need for creating awareness among the antenatal mothers about common complications in pregnancy. On the other hand, the notion of routine care seeking during the antenatal period seems to be well rooted among the study population which is a very good sign. It is a good opportunity and is foundational to all other interventions relating to betterment of antenatal care in the community. 

scholarly journals Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Semistructured Interview ◽  
Design Data ◽  
Care System

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.

scholarly journals Maternal health care-seeking behaviour of married adolescent girls: A prospective qualitative study in Banke District, Nepal

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217968
Author(s):  
ASM Shahabuddin ◽  
Therèse Delvaux ◽  
Christiana Nöstlinger ◽  
Malabika Sarker ◽  
Azucena Bardají ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Adolescent Girls ◽  
Maternal Health Care ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Care Seeking Behaviour ◽  
Care Seeking Behaviour

scholarly journals A Triangulated Qualitative Study of Veteran Decision-Making to Seek Care During Heart Failure Exacerbation: Implications of Dual Health System Use

2018 ◽  
Vol 55 ◽  
pp. 004695801775150
Author(s):  
Charlene A. Pope ◽  
Boyd H. Davis ◽  
Leticia Wine ◽  
Lynne S. Nemeth ◽  
Robert N. Axon
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Health Administration ◽  
Dual Use ◽  
Primary Specialty ◽  
System Use

Among Veterans, heart failure (HF) contributes to frequent emergency department visits and hospitalization. Dual health care system use (dual use) occurs when Veterans Health Administration (VA) enrollees also receive care from non-VA sources. Mounting evidence suggests that dual use decreases efficiency and patient safety. This qualitative study used constructivist grounded theory and content analysis to examine decision making among 25 Veterans with HF, for similarities and differences between all-VA users and dual users. In general, all-VA users praised specific VA providers, called services helpful, and expressed positive capacity for managing HF. In addition, several Veterans who described inadvertent one-time non-VA health care utilization in emergent situations more closely mirrored all-VA users. By contrast, committed dual users more often reported unmet needs, nonresponse to VA requests, and faster services in non-VA facilities. However, a primary trigger for dual use was VA telephone referral for escalating symptoms, instead of care coordination or primary/specialty care problem-solving.

scholarly journals “I can guess the month … but beyond that, I can’t tell” an exploratory qualitative study of health care provider perspectives on gestational age estimation in Rajasthan, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
K. Scott ◽  
S. Gupta ◽  
E. Williams ◽  
M. Arthur ◽  
U. V. Somayajulu ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Gestational Age ◽  
Age Estimation ◽  
Clinical Decision Making ◽  
Healthcare Providers ◽  
Clinical Decision ◽  
Provider Perspectives ◽  
Gestational Age Estimation ◽  
Age Estimates

Abstract Background Accurately estimating gestational age is essential to the provision of time-sensitive maternal and neonatal interventions, including lifesaving measures for imminent preterm birth and trimester-specific health messaging. Methods We explored healthcare provider perspectives on gestational age estimation in the state of Rajasthan, India, including the methods they use (last menstrual period [LMP] dating, ultrasound, or fundal height measurement); barriers to making accurate estimates; how gestational age estimates are documented and used for clinical decision-making; and what could help improve the accuracy and use of these estimates. We interviewed 20 frontline healthcare providers and 10 key informants. Thematic network analysis guided our coding and synthesis of findings. Results Health care providers reported that they determined gestational age using some combination of LMP, fundal height, and ultrasound. Their description of their practices showed a lack of standard protocol, varying levels of confidence in their capacity to make accurate estimates, and differing strategies for managing inconsistencies between estimates derived from different methods. Many frontline healthcare providers valued gestational age estimation more to help women prepare for childbirth than as a tool for clinical decision making. Feedback on accuracy was rare. The providers sampled could not offer ultrasound directly, and instead could only refer women to ultrasound at higher level facilities, and usually only in the second or third trimesters because of late antenatal care-seeking. Low recall among pregnant women limited the accuracy of LMP. Fundal height was heavily relied upon, despite its lack of precision. Conclusion The accuracy of gestational age estimates is influenced by factors at four levels: 1. health system (protocols to guide frontline workers, interventions that make use of gestational age, work environment, and equipment); 2. healthcare provider (technical understanding of and capacity to apply the gestational age estimation methods, communication and rapport with clients, and value assessment of gestational age); 3. client (time of first antenatal care, migration status, language, education, cognitive approach to recalling dates, and experience with biomedical services); and, 4. the inherent limitations and ease of application of the methods themselves.

scholarly journals Perceptions about caesarean section among women and health care providers: a qualitative study in a rural maternity hospital in Karnataka, India

2020 ◽  
Vol 9 (2) ◽  
pp. 646
Author(s):  
Teny Attokaran ◽  
Merlyn Joseph ◽  
Ramya B. ◽  
Caroline Pretista D’souza ◽  
Soumya . ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Caesarean Section ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Family Members ◽  
Maternity Hospital ◽  
Care Providers ◽  
Framework Analysis ◽  
Postnatal Women

Background: Caesarean section is life-saving, but rising rates are a cause for concern. Perceptions surrounding caesarean delivery may play a significant role in the shared-decision making process. Objective of this study was to explore the perceptions of caesarean section among antenatal, postnatal women and healthcare providers in a rural maternity hospital in Ramanagara district, Karnataka.Methods: Qualitative research methodology was adopted to explore perceptions regarding preferred birthing mode, caesarean and its perceived complications. Focus group discussions and in-depth interviews were conducted with antenatal and postnatal women, their caregivers and health care providers. Inductive coding approach and thematic framework analysis was done.Results: Five major themes emerged regarding perceptions of caesarean section among women in a rural area of Karnataka: understanding, fears, decision making, after-care and prevention. Women had a strong preference for normal vaginal birth, but willing to accept doctor’s decision for caesarean as they believed that it would protect the life of unborn child. Women perceived that caesarean was profitable to the hospital. Common mentioned side effects following caesarean were backache and pain at the surgical site.Conclusions: The understanding regarding caesarean section was adequate. Women had fears linked to caesarean such as pain, inability to work, weight gain, prolonged recovery and caesarean deliveries in subsequent pregnancies. Husbands and other family members as well as the doctors were the important decision makers, while the women themselves had little say in the matter. Obstetricians need to focus on alleviating concerns among pregnant women and their family members regarding caesarean section.

Sign in / Sign up

Export Citation Format

Share Document