scholarly journals Implementation of respectful maternal care in health facilities in Conakry, Guinea

2021 ◽  
Author(s):  
Soumah Aboubacar Fode Momo1 ◽  
Diallo Mamadou Cellou1 ◽  
Conte Ibrahima1 ◽  
Sylla Ibrahima1 ◽  
Bah Oumou Hawa2 ◽  
...  
Keyword(s):  
Maternal Care ◽  
Good Practice ◽  
Performance Standards ◽  
Daily Practice ◽  
Maternity Hospital ◽  
Lessons Learned ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional

Abstract Objective: Describe the implementation of Respectful Maternal Care in health facilities in the capital and discuss lessons learned. Methods: This was a cross-sectional descriptive study by direct observation of providers from November 29 to December 01, 2020. It consisted of a baseline assessment of pilot sites prior to training in respectful maternal care, followed by the traditional five-day training and an extension to urban health centers, due to their on-site training in SONUB (obstetric and neo-natal care) Basic emergency natals) including the Respectful Maternal Care Training Module (PMF). Random random sampling by random draw, three guards per site, a midwife with a parturiente and their families, providers of health centers in post-training follow-up, were observed through the seven (7) performance standards (Table2) on the skills received. The investigators were clinical synthesis students who were trained in the use of the tool. Results: 199 providers (138 midwives, 49 nurses and 12 doctors) were trained in PMSC in the 24 health facilities in the capital. Post-training follow-up through providers made the following findings in the different areas of PMSCs: The seven (7) standards were observed prior to training in the 6 pilot sites (Center Médical Communal (CMC) of Matam, Minière, Ratoma, Coléah, Bernard Kouchner and the maternity hospital of the National Ignace Deen Hospital) (Fig.1), two were achieved or 0.3 the practice improved compared to the situation of the basic evaluation: in the seven areas of respectful maternal care evaluated and monitored, performance varied by area from 26% to 100% (Fig.2). In health centers, good practice was observed with the observation of skills during post-training follow-up: In the seven areas monitored, performance varied from 50% to 100% (Fig.3) Conclusion: SMR. integration was effective in 25 health facilities in the city of Conakry; training, internal and external regular supervision and provider awareness are essential to sustain PMSCs in daily practice.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma Woks ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and determine improvement in maternal health. Objective: Evaluate a change in attitudes and practice and determine improvement in outcomes 6 months after initiation of the safe childbirth checklist use. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. P -values below 5% were considered statistically significant. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). The proportion of neonatal deaths recorded amongst cases with a used checklist was smaller compared to cases without checklists (0·2% Vs 0·7%, p = 0·380). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications.

scholarly journals Level and timing of Implanon discontinuation and associated factors among women who used Implanon in Andabet District, public health facilities, North-West Ethiopia, 2017

2019 ◽  
Author(s):  
Gizachew Worku Dagnew ◽  
Yared Mulu Gelaw ◽  
Melash Belachew Asresie ◽  
Zelalem Alamrew Anteneh
Keyword(s):  
Public Health ◽  
Side Effects ◽  
Health Facilities ◽  
Outcome Variable ◽  
P Value ◽  
Cross Sectional ◽  
North West ◽  
Public Health Facilities ◽  
North West Ethiopia

Abstract Abstract Background: Implanon discontinuation is unacceptably high in developing countries, including Ethiopia; furthermore there is an observed problem of high unintended pregnancy rate after method discontinuation this might stride to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Adabet district, public health facilities, North-West Ethiopia, 2017. Methods: Facility-based cross-sectional study was conducted among 537 women, from Feb.03 to April 28, 2017, by face to face interview. Systematic random sampling technique was used to select the study subjects. The collected data were entered into Epi Info- version 7 then exported to SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multi-variable binary logistics regression, p-value and odds ratio (AOR) with 95%Ci was used to showing statistical association with the outcome variable. Results: In this study, 36.9% of Implanon users were discontinued the method before the intended time period. Among those women who discontinue the method 85.9% of them were discontinued before two years of Implanon insertion. Women who had no live child at the time of Implanon insertion[AOR=2.17,95%CI:1.25-3.77], didn’t received pre-insertion counseling on potential side effects [AOR=1.85,95%CI: 1.15-2.97], developed side effect secondary to Implanon insertion [AOR=5.17,95%CI:3.18-8.40], received appointment follow-up [AOR=0.23,95%CI:0.13-0.41], and not satisfied by the service provided [AOR=5.40,95%CI:3.04-9.57] were statistically associated with Implanon discontinuation. Conclusions: level of Implanon discontinuation before its intended period was high. Hence, to increase Implanon continuation rate; provide pre-insertion counseling including its possible side effects, improve client’s service satisfaction and strength appointment follow-up for Implanon users should be made.

scholarly journals Evaluation of Clinical Follow-Up of The Patients Monitored at Home Due To COVID-19 Pandemic

2021 ◽  
Vol 10 (4) ◽  
pp. 163-170
Author(s):  
Ayse Didem Esen ◽  
Secil Arica ◽  
Mikail Ozdemir
Keyword(s):  
Family Health ◽  
Definitive Diagnosis ◽  
Hospitalized Patients ◽  
Health Centers ◽  
The Novel ◽  
Cross Sectional ◽  
The Family ◽  
The Mean ◽  
At Home

Aim: The most valuable approach to prevent the spread of the novel COVID-19, which is a pandemic today, is to detect, isolate, and treat patients. The majority of patients are mild or asymptomatic cases. These cases are followed up and isolated at home in many countries. With a governmental decision issued in Turkey, it has been deemed appropriate to follow up the suspected, contact or definitive diagnosis patients who do not indicate inpatient treatment, have a mild clinical course, or do not have a risk factor that may lead to a severe course of COVID-19, at home by the family practice units. In this study, we aimed to investigate the characteristics of the patients with COVID-19 who were being monitored at home. Methods: The study was designed as a retrospective cross-sectional observational study. In this study, 321 people who were registered at the Education and Family Health Centers of our hospital and followed up as COVID-19 suspects, contacts, or definitive cases were identified. Home follow-up data of these patients between April 1-30 were obtained retrospectively from the records of family health centers. Data, such as the presence and course of symptoms of people followed at home, their isolation status, medicine usage status, and test results were recorded electronically for further analysis. Results: In this study, 321 patients, 163 (50.28%) males, and 158 (49.22%) females were included. Among 321 patients, 287 (89.41%) were contact patients, 54 (16.82%) were suspected patients, and 28 (8.72%) had a definitive diagnosis. The mean age of the patients was 40.00±20.68. Among the patients included in this study, 27 (8.41%) were hospitalized, symptoms worsened in 8 (2.49%), 5 (1.56%) were re-applied to the hospital, 5 (1.56%) were re-hospitalized, and 28 people (8.72%) were administered medication. Conclusion: The mean age of patients who complied with the measures of isolation was higher than patients who did not. The mean age of hospitalized patients was higher than in non-hospitalized patients. The frequency of observed symptoms was consistent with the previous studies in the literature. Keywords: cough, fever, pandemics, quarantine, SARS-CoV-2

scholarly journals Storage Management and Wastage of Reproductive Health Medicines in Public Health Facilities of West Wollega Zone, Ethiopia: Mixed Study

2021 ◽  
Author(s):  
Oliyad Kebede ◽  
Gizachew Tilahun ◽  
Desalegn Feyissa
Keyword(s):  
Reproductive Health ◽  
Storage Conditions ◽  
Storage Management ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Life Saving ◽  
Resource Stock ◽  
Poor Infrastructure ◽  
Expired Medicines

Abstract Background: Keeping proper storage conditions at health facilities is important to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities led to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expirationMethod: A facility-based descriptive cross-sectional quantitative and qualitative study was conducted using a checklist, structured and semi-structured questionnaires.Results: Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75mg tablet contributed highest percentage to expired medicines.Conclusion: Pharmaceutical stores in hospitals had equipment and furniture, fulfilled desirable storage conditions, whereas, significant number of the health centers’ medical store did not comply with the recommended storage conditions. Challenges of store management identified were poor infrastructure, administrative challenges, and shortage of human resource. Stock wasted due to expiration was high and the contributing challenge was non-need-based supply. So Ethiopian pharmaceutical Supply Agency should supply reproductive health medicines based on need and concerned government bodies should avail pharmaceutical store infrastructures, hire professionals, and follow health facilities administrations.

scholarly journals Evaluation of the Initial 12 Months of a Routine Cryptococcal Antigen Screening Program in Reduction of HIV-Associated Cryptococcal Meningitis in Uganda

2021 ◽  
Author(s):  
Kagimu Enock ◽  
Kiwanuka Julius ◽  
Bridget C Griffith ◽  
Derrick Bary Abila ◽  
Morris K Rutakingirwa ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Cryptococcal Meningitis ◽  
Screening Program ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Fluconazole Therapy ◽  
Screening Cascade

Abstract Background: Asymptomatic Cryptococcal Antigenemia (CrAg) patients develop meningitis within a month of testing positive. Pre-emptive antifungal therapy can prevent progression to Cryptococcal meningitis(CM). In April 2016, a national CrAg screening program was initiated in 206 high-volume health facilities that provide antiretroviral therapy in Uganda. We report the evaluation of the CrAg screening cascade focusing on linkage to care, fluconazole therapy for 10 weeks, and ART initiation in a subset of facilities.Methods: We conducted a retrospective, cross-sectional survey of patients with CD4<100 at seven urban and seven rural facilities after one year of program implementation. We quantified the number of patients who transitioned through the steps of the CrAg screening cascade over six-months follow-up. We defined cascade completion as a prophylactic fluconazole prescription. We conducted semi-structured interviews with lab personnel and clinic staff to assess functionality of the CrAg screening program. Data was collected using REDCap.Results:We evaluated 359 patient records; the majority (358/359, 99.7%) were from government owned health facilities and just over half (193/359, 53.8%) had a median baseline CD4 cell count of <50 cell/µL. Overall, CrAg screening had been performed in 255/359 (71.0%, 95% CI, 66.0-75.7) of patients’ records reviewed, with a higher proportion among urban facilities (170/209 (81.3%, 95% CI, 75.4-86.4)) than rural facilities (85/150 (56.7%, 95% CI, 48.3-64.7)). Among those who were CrAg screened, 56/255 (22.0%, 95% CI, 17.0-27.5%) had cryptococcal antigenemia, of whom 47/56 (83.9%, 95% CI, 71.7-92.4%) were initiated on pre-emptive therapy with fluconazole and 8/47 (17.0%, 95% CI, 7.6-30.8%) of these were still receiving antifungal therapy at 6 months follow up. Atleast one CNS symptom was present in 70% (39/56) of those with antigenemia. In patients who had started ART, almost 40% initiated ART prior to CrAg screening. Inadequacy of equipment/supplies was reported by 15/26 (58%) of personnel as a program barrier, while 13/26 (50%) reported a need for training about CM and CrAg screening.Conclusion:There was a critical gap in the follow-up of patients after initiation on fluconazole therapy. ART had been initiated in almost 40% of patients prior to CrAg screening, which predisposes them to unmasking Cryptococcal IRIS. Higher antigenemia patients presenting with CNS symptoms could be related to late presentation. There is need to address these gaps after a more thorough evaluation.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma WOKS ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health. Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data on the checklist from personnel of the maternity and another data collection form used to extract information from patient records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. Fewer cases of pre-eclampsia and eclampsia were associated with the use of the checklist, compared to patients in whom the checklist was not used (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime.

scholarly journals Breastfeeding technique and associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia: observational method

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Boko Loka Safayi ◽  
Nega Tezera Assimamaw ◽  
Destaye Guadie Kassie
Keyword(s):  
Breast Feeding ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Health Facilities ◽  
Age Group ◽  
Cross Sectional ◽  
Lactating Mothers ◽  
Feeding Technique ◽  
Gondar Town

Abstract Background The breastfeeding technique is explained positioning, attachment, and suckling during breastfeeding. Ineffective breast feeding technique is one of the factors leading to premature discontinuation of breastfeeding and malnutrition. There is a limited study on the assessments of BFT and associated factors among lactating mothers in the study area. Therefore, the study aimed to assess breastfeeding technique and the associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February 20 to March 20, 2020. An observational checklist and structured interviewer-administered questionnaire were applied to collect the data. The data were entered into Epi-Data 4.6 version and transferred to analyzed using SPSS version 20. Bi-variable and multivariable logistic regressions were performed to identify the association. The strength of association was identified using odds ratio with a 95% confidence interval (), and a p-value of 0.05 was declare as statistically significant. Results The proportion of effective BFT was 48% (95%, CI: 43.0–53.0%). The likelihood of applying proper BFT among age group of 18–20 years was 70% lower than (AOR = 0.3; 95% CI: 0.11–0.83) age group > 30 years. The odds of effective BFT in primipara mothers were 49% (AOR = 0.51; 95% CI: 0.32–0.82) lower compared to multiparous mothers. Likewise, the provability of effective BFT was 55% (AOR = 0.45; 95% CI: 0.29–0.70) times lower in women who had no counseling immediately after delivery compared to their counterparts. Moreover, effective breast feeding technique mothers who have breast problem was 78% lower than (AOR = 0.22; 95% CI: 0.07–0.68) mothers who have no breast problem. And mothers who had counselling of BFT during ANC follow up was 55% (AOR = 0.45; 95% CI: 0.29, 0.70) lower than mothers who had no counseling. Conclusion Just under half of the women in the study area applied proper breast feeding technique Younger and primipara mothers poorly performed to effective BFT. But women having counseling during antenatal care follow-up and immediately after delivery and not having breast problems applied BFT effectively. Hence, special emphasis have to give for younger and primipara mothers. Besides, educate the mother for preventing breast problems and working on enhancing counseling at postnatal clinic.

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