scholarly journals Development of a Study tool to Assess Gaps in Respectful Maternity Care in Health Facilities of India

2021 ◽  
Author(s):  
Shalini Singh ◽  
Aparajita Gogoi ◽  
Leila Caleb-Varkey ◽  
Mercy Manoranjini ◽  
Tina Ravi ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Maternity Care ◽  
Development Process ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Advisory Group ◽  
Care Providers ◽  
Technical Advisory Group

Abstract Background: Maternal mortality perdures to be a major challenge for India like in other developing countries. Though the efforts to increase the institutional deliveries have resulted in appreciable results, it has not translated to the corresponding decline in maternal mortality rates. Dearth in quality of care especially concerning respectful maternity care in health facilities is considered as a major reason for this phenomenon. This work describes the development process of the study tool to assess respectful maternity care in the health facilities of India. Methods: A collaborative approach was employed for the development of a comprehensive tool to be used to assess respectful maternity care in the Indian setting. The tool development process comprised of four steps: 1) literature review and meeting with Technical Advisory Group; 2) the National Stakeholders workshop and development of the initial tool; 3) feedback on the tool from twenty tertiary care public health facilities from various regions of India; 4) the final tool and its validity approval by Technical Advisory Group. Results: A comprehensive tool was made comprising of indicators for assessing deficits in respectful maternity care, and for assessing contextual data of the health care facility. The initial tool was tested at twenty facilities. The changes suggested and observed were adapted, and the final tool was prepared. The Technical Advisory Group approved the content validity of the tool.Conclusions: A comprehensive tool was made to assess various aspects of respectful maternity care provided in tertiary Indian institutional settings aiding in in a deeper understanding of the phenomenon. This tool is recommended, especially to health care providers of India, for assessing the status of maternity care in health facilities and bringing the required interventions in the health care facilities.

scholarly journals An Innovative Intervention to Improve Respectful Maternity Care in Three Districts in Ethiopia

2019 ◽  
Author(s):  
Birkety Mengistu Jembere ◽  
Haregeweyni Alemu ◽  
Munir Kassa ◽  
Meseret Zelalem ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Maternity Care ◽  
Interrupted Time Series ◽  
Health Facilities ◽  
Respectful Maternity Care ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Experience Of Care

Abstract BackgroundDisrespect and abuse (D&A) during childbirth are major violations of human rights and often deter women from accessing skilled delivery in health facilities. In Ethiopia, D&A has been documented to occur in up to 49.4% of mothers delivering in health facilities. This study describes the development, implementation and results of a novel intervention to improve respectful maternity care (RMC) and decrease D&A in three districts in Ethiopia.MethodsAs part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed a novel RMC training module with three core components: testimonial videos, didactic sessions on communication, and onsite coaching. As of February 2017, we implemented the RMC training in three districts within the regions of Oromia; Southern Nations, Nationalities, and People’s; and Tigray. Measures of births with privacy and a birth companion from a 27-month data from 17 health centers and three hospitals were analyzed using STATA version 13 for interrupted time series and a regression analysis was conducted to assess the significance of improvement. Facilitated discussions were conducted among health care providers to gauge the effectiveness of the videos. Facility level solutions applied to enhance RMC were documented. ResultsAn analysis of the effectiveness of integrating RMC using available programmatic data showed significant improvement following the RMC training, which was sustained beyond the project intervention (regression coefficients ranging from 0.18 to 0.77). Several local solutions were devised and implemented in the health facilities to improve the experience of care for mothers. Facilitated discussions with health care providers participating in the RMC training showed improved understanding of patients’ perspectives and the psychosocial needs of their clients. ConclusionThis study suggests that integrating the RMC training into the district-wide quality improvement (QI) collaborative is effective in improving RMC. Use of testimonial videos are especially helpful as they remind providers of the need to treat mothers with dignity and helps them reflect on potential root causes for this type of treatment and develop effective solutions.

scholarly journals MATERNITY CARE SERVICES

2016 ◽  
Vol 23 (06) ◽  
pp. 721-726
Author(s):  
Sadaf Faiz ◽  
Zahira Batool ◽  
Sana Ejaz ◽  
Abid Rashid
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Rural Women ◽  
Rural Areas ◽  
Maternity Care ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Family Type ◽  
Bivariate Analysis ◽  
Care Services

Introduction: Maternal health care refers to high quality health care providedto a pregnant woman during pregnancy, delivery and postnatal period. The maternal mortalityratio is quite high in the rural areas of Pakistan. Rural society is highly associated with itstraditions and cultural values. There are some cultural and social barriers for women. Theyare being considered negligible part of the population and are facing a number of hardshipsin availing health facilities. Objective: The aim of the study was to find out the socioeconomic,cultural and demographic factors affecting the access of rural women to maternity care services.Study Design: A cross-sectional study was conducted in the rural areas of District Faisalabad.Quantitative research method was used to get meaningful, detailed information. Material andMethods: A sample of 205 pregnant women aged 18-38 was taken, purposively to explore theresearch objectives through pre-designed interviewing schedule with open and closed endedquestions. Results: Univariate and bivariate analysis reveal the factors associated with theutilization of maternity care services such as education of the respondents and their husbands,family type, household income, age at marriage, attitudes towards health care facilities werefound to be associated with the utilization of maternity care service. Conclusion: The studyreveals that a number of reproductive problems occurred among pregnant women in the ruralareas of Pakistan due to the limited health facilities, socio-demographic and cultural barricadeswhich restricted them to utilize maternity care services

scholarly journals Assessment of Facility based newborn care at various health care facilities in Rajkot district

2017 ◽  
Vol 4 (4) ◽  
pp. 1125
Author(s):  
Jasmin R. Oza ◽  
Ashutosh D. Jogia ◽  
Bhavesh R. Kanabar ◽  
Dhara V. Thakrar
Keyword(s):  
Health Care ◽  
Health Personnel ◽  
Newborn Care ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Centers ◽  
Care Providers ◽  
Digital Thermometer ◽  
Neonatal Deaths ◽  
District Hospitals

Background: India carries the single largest share (around 25-30%) of neonatal deaths in the world. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively with high coverage.Methods: A cross-sectional observational study was conducted at various health facilities of Rajkot district where facility based newborn care are created as per the guidelines under NRHM. It was conducted during August 2013 to October, 2013. The data entry was done in Microsoft Office Excel 2007 and analyzed in Epi info software from CDC Atlanta. Results: This study included total 32 health facilities including 10 Primary Health Centers (PHC) (24X7), 15 Community Health Centers (CHC), 5 Sub District Hospitals (SDH), one District Hospital (DH) and one Medical College (MC). There are a total of 36 facilities of different level available in government set up for newborn care starting from NBCC to SNCU. All (100%) of the health centers visited were equipped with NBCC for newborn care, while NBSU and SNCU for newborn care were created at only 2 (6.2%) centers respectively. Only 2 out of 10 PHC had all required equipments for NBCC. All the required equipments were available at 3 CHCs out of total 15 CHCs. All the SDH were having adequate equipment for NBCC except resuscitator & separate Digital Thermometer were not available at 2 SDH. At DH, except for Digital thermometer, all equipments were adequate. Only 1 SDH has been established for NBSU and it did not have adequate no. of radiant warmer and resuscitator. DH is lacking in all the required equipment for SNCU except for resuscitator (250 ml) and refrigerator. Out of total 101 health personnel, 68 (67.3%) have been trained for NSSK.  From total 68 trained health personnel, 12 (17.7%) got the score above the cut off for resuscitation skill. Out of the trained respondents, 29 (42.7%) acquired score above cut off for routine care.Conclusion: All the PHCs, CHCs, SDHs and DH were deficient in equipments. NBSU was created in only one SDH. SNBU was created at DH and MC, but equipments were not sufficient at both centers. Health care providers involved in facility based newborn care units had poor knowledge regarding routine newborn care and also not properly trained in resuscitation.

scholarly journals Respectful maternity care delivered within health facilities in Bangladesh, Ghana and Tanzania: a cross-sectional assessment preceding a quality improvement intervention

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039616
Author(s):  
Alexander Manu ◽  
Nabila Zaka ◽  
Christina Bianchessi ◽  
Edward Maswanya ◽  
John Williams ◽  
...  
Keyword(s):  
Emotional Support ◽  
Maternity Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Social Scientists ◽  
Cross Sectional ◽  
Respectful Care

ObjectiveTo assess respectful maternity care (RMC) in health facilities.DesignCross-sectional study.SettingForty-three (43) facilities across 15 districts in Bangladesh, 16 in Ghana and 12 in Tanzania.ParticipantsFacility managers; 325 providers (nurses/midwives/doctors)—Bangladesh (158), Ghana (86) and Tanzania (81); and 849 recently delivered women—Bangladesh (295), Ghana (381) and Tanzania (173)—were interviewed. Observation of 641 client–provider interactions was conducted—Bangladesh (387), Ghana (134) and Tanzania (120).AssessmentTrained social scientists and clinicians assessed infrastructure, policies, provision and women’s experiences of RMC (emotional support, respectful care and communication).Primary outcomeRMC provided and/or experienced by women.ResultsThree (20%) facilities in Bangladesh, four (25%) in Ghana and three (25%) in Tanzania had no maternity clients’ toilets and one-half had no handwashing facilities. Policies for RMC such as identification of client abuses were available: 81% (Ghana), 73% (Bangladesh) and 50% (Tanzania), but response was poor. Ninety-four (60%) Bangladeshi, 26 (30%) Ghanaian and 20 (25%) Tanzanian providers were not RMC trained. They provided emotional support during labour care to 107 (80%) women in Ghana, 95 (79%) in Tanzania and 188 (48.5%) in Bangladesh, and were often courteous with them—236 (61%) in Bangladesh, 119 (89%) in Ghana and 108 (90%) in Tanzania. Due to structural challenges, 169 (44%) women in Bangladesh, 49 (36%) in Ghana and 77 (64%) in Tanzania had no privacy during labour. Care was refused to 13 (11%) Tanzanian and 2 Bangladeshi women who could not pay illegal charges. Twenty-five (7%) women in Ghana, nine (6%) in Bangladesh and eight (5%) in Tanzania were verbally abused during care. Providers in all countries highly rated their care provision (95%–100%), and 287 (97%) of Bangladeshi women, 368 (97%) Ghanaians and 152 (88%) Tanzanians reported ‘satisfaction’ with the care they received. However, based on their facility experiences, significant (p<0.001) percentages—20% (Ghana) to 57% (Bangladesh)—will not return to the same facilities for future childbirth.ConclusionsFacilities in Bangladesh, Ghana and Tanzania have foundational systems that facilitate RMC. Structural inadequacies and policy gaps pose challenges. Many women were, however, unwilling to return to the same facilities for future deliveries although they (and providers) highly rated these facilities.

scholarly journals Respectful maternity care in public health care facilities in Gujarat: A direct observation study

2021 ◽  
Vol 10 (4) ◽  
pp. 1699
Author(s):  
Hiral Raval ◽  
Tapasvi Puwar ◽  
Prakash Vaghela ◽  
Manshi Mankiwala ◽  
ApurvaKumar Pandya ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Direct Observation ◽  
Maternity Care ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Respectful Maternity Care ◽  
Observation Study ◽  
Care Facilities

scholarly journals Hospital Workers Disaster Management and Hospital Nonstructural: A Study in Bandar Abbas, Iran

2015 ◽  
Vol 8 (4) ◽  
pp. 221 ◽  
Author(s):  
Parvin Lakbala
Keyword(s):  
Health Care ◽  
Disaster Management ◽  
National Level ◽  
Hospital Staff ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Referral Hospital ◽  
Care Providers ◽  
Patient Admissions ◽  
Bandar Abbas

<p><strong>INTRODUCTION:</strong> A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions.</p> <p><strong>METHODS:</strong> The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital.</p> <p><strong>RESULTS:</strong> This study found that knowledge, awareness,<em> </em>and<em> </em>disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities.</p> <p><strong>CONCLUSION:</strong> It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities.</p>

scholarly journals Women’s experiences with labor companionship in public facilities in Arab countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Kabakian-Khasholian ◽  
H Bashour ◽  
A El-Nemer ◽  
N Nameh
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Maternity Care ◽  
Arab Countries ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Public Facilities ◽  
Women's Experiences ◽  
Care System

Abstract Background Childbirth in the Arab region is characterized by over-medicalization and inequities in access to-and provision of care. Hospital practices do not provide choices for women and respond to the convenience of providers rather than women’s needs. Provision of maternity care is reflective of existing social inequities which is manifested through mistreatment and disrespect of women within the health care system. One such example lies in the restriction of birth companions in public facilities in Arab countries despite being practiced in private settings and the strong evidence supporting its implementation globally. Methods A phased mixed-methods implementation research study was undertaken in three public hospitals in Lebanon, Egypt and Syria with the aim of developing a tailored labor companionship model and evaluating its implementation. Data presented emanate from the qualitative component of the study. Semi-structured interviews were conducted with women giving birth (n = 59) and their labor companions (n = 57) in three facilities. Thematic analysis was used. Results Beyond the introduction of the model into the system, women reported improvements in dimensions of respectful maternity care. Changes made in shared labor rooms improved women’s privacy. The presence of labor companions improved communication between health care providers, women and their families. Women reported feeling “dignified” and “strong” in the presence of companions. There was a “feedback loop” from the facility to the community with word spreading about labor companionship “just like in private hospitals”. Conclusions The labor companionship model improved equitable access to dignified and respectful maternity care through better rapport between women and health care providers, preservation of women’s privacy and having access to birth companion of choice. The provision of evidence-based care has potential implications on women’s experiences with the health care system. Key messages This labor companionship model ensured positive experiences for women giving birth in public facilities in Arab countries. Women perceived the model as type of care that reduces differential treatment based on social status and enhances respectful maternity care.

scholarly journals Promoting Respectful Maternity Care for Adolescents In Ghana: a Quasi-Experimental Research Study Protocol

2020 ◽  
Author(s):  
Helen H Habib ◽  
Kwasi Torpey ◽  
Ernest Tei Maya ◽  
Augustine Ankomah
Keyword(s):  
Maternal Mortality ◽  
Maternity Care ◽  
Health Facilities ◽  
The Body ◽  
Human Reproduction ◽  
World Health ◽  
Respectful Maternity Care ◽  
Birth Attendance ◽  
Post Test ◽  
Quasi Experimental

Abstract BackgroundIntra-partum mistreatment by healthcare providers remains a global public health and human rights challenge. Adolescents, who are typically younger, poorer and less educated have been found to be disproportionately exposed to intra-partum mistreatment. In Ghana, maternal mortality remains a leading cause of death among adolescent females, despite increasing patronage of skilled birth attendance in health facilities. In response to the the World Health Organisation Human Reproduction Programme (WHO-HRP) recommendations to address mistreatment with Respectful Maternity Care (RMC), this study aims to generate evidence on promoting respectful treatment of adolescents using an intervention that trains health providers on the concept of mistreatment, their professional roles in RMC and the rights of adolescents to RMC.MethodsThis study will employ a pre-test post-test quasi-experimental design. At pre-test and post-test, quantitative surveys will be conducted among adolescents who deliver at health facilities about their labour experience with mistreatment and RMC. A total target of 392 participants will be recruited across intervention and control facilities. Qualitative interviews will also be conducted with selected adolescents and health professionals for an in-depth understanding of the phenomenon. Following the pre-test, a facility-based training module will be implemented at intervention facilities for the facility midwives. The modules will be co-facilitated by the principal investigator and key resource persons from the district health directorate Quality of Care teams. Training will cover the rights of adolescents to quality healthcare, classifications of mistreatment, RMC as a concept and the role of professionals in providing RMC. No intervention will occur in the control facilities. Descriptive statistics, logistic regressions and difference in differences analyses will be computed. Qualitative data will be transcribed and thematically analysed.DiscussionThis study is designed to test the success of an intervention in promoting RMC and reducing intra-partum mistreatment towards adolescents. It is expected that the findings of this study will be beneficial in adding to the body of knowledge in improving maternal healthcare and reducing maternal mortality, especially for adolescents.Trial Registry DetailsName of the registry: Pan African Clinical Trials RegistryDate of registration: 9th March, 2020URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9837

scholarly journals Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: an application of K-means clustering algorithm

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Milka Bochere Gesicho ◽  
Martin Chieng Were ◽  
Ankica Babic
Keyword(s):  
Clustering Algorithm ◽  
Distinct Pattern ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Hiv Care ◽  
Care Providers ◽  
Homogeneous Groups ◽  
Reporting Requirements ◽  
Low Middle Income Countries ◽  
Over Time

Abstract Background The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV-indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. The aim of this study is to conduct a comprehensive assessment of the reporting status for HIV-indicators, from the time of DHIS2 implementation, using Kenya as a case study. Methods A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 and 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness facility reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters. Results Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups. Conclusions The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.

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