scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Shuchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to study association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75 th and q90 th ) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90 th ). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon in future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population and to improve neonatal care services.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Quantile Regression ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Multivariate Quantile

Abstract Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge.Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice.Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.

scholarly journals Quality of Basic Care During Neonatal Resuscitation Among Health Care Providers at Three District Hospitals in Kigali

2020 ◽  
Vol 3 (2) ◽  
pp. 225-237
Author(s):  
Kellen Muganwa ◽  
Alice Muhayimana ◽  
Joella Mukashyaka ◽  
Pamela Meharry
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Work Experience ◽  
Neonatal Resuscitation ◽  
Care Providers ◽  
Cross Sectional ◽  
Basic Care ◽  
District Hospitals ◽  
One Year

Background Globally, about 10% of neonates require extra respiratory support to initiate breathing at birth. Over a million neonatal deaths could be prevented with quality basic care during neonatal resuscitation. Objective To determine the quality of care (QoC) of basic NR at birth among health care providers (HCPs) at three district hospitals in Kigali. Methods A descriptive cross-sectional study was conducted. Thirty-six HCPs were observed 2-3 times using a structured checklist. Descriptive and inferential statistics were used to analyze the data.  Results The majority had ‘good’ QoC scores for drying and stimulation (74.7%), and fair scores for airway clearance (85.1%). Some had poor scores for advanced bag and mask ventilation (BMV) (13%). Maternity work experience (1-5 years) was significantly associated with good quality drying and stimulation (p = 0.03), initial BMV (p = 0.02), and advanced BMV (p = 0.03), than HCPs with less than one-year experience.  Conclusion Maternity work experience of more than one year significantly improved the QoC during neonatal resuscitation. More NR support during the first year of work and regular NR refresher training would improve neonatal outcomes.  Rwanda J Med Health Sci 2020;3(2):225-237

scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

10.2196/23951 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23951
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

scholarly journals Postnatal Care in Rural Egypt: Perspectives of Women and Health Care Providers

2021 ◽  
Vol 9 (E) ◽  
pp. 328-335
Author(s):  
Ghada Wahby Elhady ◽  
Tarek Amin Tawfik ◽  
Eman Aly Hussein ◽  
Sherry Magdy ◽  
Marwa Rashad Salem
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Postnatal Care ◽  
Family Income ◽  
Service Providers ◽  
Care Program ◽  
Cross Sectional Study ◽  
Care Providers ◽  
High Coverage ◽  
Cross Sectional

Objectives: Postnatal care (PNC) is an essential component of maternal care program. However, gap exists between high coverage with antenatal and natal care and low coverage with PNC in Egypt. Consequently, the current study was conducted to explore pattern of early PNC (after first day following delivery) among rural mothers. Methods: An exploratory cross-sectional study was done in four Primary Health Care (PHC) centers related to one district in rural Egypt. Mothers who had delivered in the previous year were invited to a structured exit interview. Focus group discussions and in-depth interviews were done with mothers and health care providers (HCPs). Results: Out of the total mothers (n=600), 34.2% received PNC. Multivariate analysis showed that low family income was a significant negative predictor for receiving PNC (P=0.000), while utilization of ANC (P=0.00), delivery at public (P=0.004) or private health facility (P=0.00) were significant positive predictors for receiving PNC. Qualitative data identified barriers for seeking PNC as shortage in HCPs, especially nurses, poor communication by HCPs, mothers perceived HCPs as incompetent in PNC service delivery. Lack of knowledge among women about the importance of PNC and unavailability of female physicians formed social barriers. Conclusion: Inadequate knowledge about the importance and components of PNC among service providers and served community reduces the demand for PNC.

scholarly journals Brazilian women’s use of evidence-based practices in childbirth after participating in the Senses of Birth intervention: A mixed-methods study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248740
Author(s):  
Luísa da Matta Machado Fernandes ◽  
Sônia Lansky ◽  
Hozana Reis Passos ◽  
Christine T. Bozlak ◽  
Benjamin A. Shaw
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Care Providers ◽  
Bivariate Analysis ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Practices ◽  
Birth Plan ◽  
Individualized Care ◽  
The Senses

Brazil has a cesarean rate of 56% and low use of Intrapartum Evidence-based Practices (IEBP) of 3.4%, reflecting a medically centered and highly interventionist maternal health care model. The Senses of Birth (SoB) is a health education intervention created to promote normal birth, use of EBP, and reduce unnecessary c-sections. This study aimed to understand the use of intrapartum EBP by Brazilian women who participated in the SoB intervention. 555 women answered the questionnaire between 2015 and 2016. Bivariate analysis and ANOVA test were used to identify if social-demographic factors, childbirth information, and perceived knowledge were associated with the use of EBP. A qualitative analysis was performed to explore women’s experiences. Research participants used the following EBP: birth plan (55.2%), companionship during childbirth (81.6%), midwife care (54.2%), freedom of mobility during labor (57.7%), choice of position during delivery (57.2%), and non-pharmacological pain relief methods (74.2%). Doula support was low (26.9%). Being a black woman was associated with not using a birth plan or having doula support. Women who gave birth in private hospitals were more likely not to use the EBP. Barriers to the use of EBP identified by women were an absence of individualized care, non-respect for their choices or provision of EBP by health care providers, inadequate structure and ambiance in hospitals to use EBP, and rigid protocols not centered on women’s needs. The SoB intervention was identified as a potential facilitator. Women who used EBP described a sense of control over their bodies and perceived self-efficacy to advocate for their chosen practices. Women saw the strategies to overcome barriers as a path to become their childbirth protagonist. Health education is essential to increase the use of EBP; however, it should be implemented combined with changes in the maternal care system, promoting woman-centered and evidence-based models.

scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

BACKGROUND Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. OBJECTIVE This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. METHODS The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. RESULTS Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). CONCLUSIONS In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

scholarly journals 120. Antimicrobial Prescribing Guidance and Communication Among Health Care Professionals in Five Guatemalan Hospitals

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S173-S174
Author(s):  
Brooke M Ramay ◽  
Clara I Secaira ◽  
Nuria Chavez ◽  
Mario Augusto Melgar Toledo ◽  
Randall M Lou-Meda ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Antimicrobial Use ◽  
Care Providers ◽  
Research Support ◽  
Cross Sectional ◽  
Antimicrobial Prescribing

Abstract Background Communication among health care professionals during antimicrobial prescribing is critical to ensure appropriate use. This is of concern in Guatemala where physicians seldom consider guidance from other professionals during antimicrobial prescribing activities. Methods We carried out a cross sectional questionnaire and open ended interviews with physicians from five hospitals in Guatemala to describe perceptions of communication between health care providers, and acceptance of antimicrobial guidance during prescribing. Results From January to April 2021 an electronic questionnaire was sent to enrolled physicians of which 74% completed participation (n=107/145). Fifty-five percent participated in open ended interviews (n=79/145). Respondents perceived high levels of communication between physicians and ID specialists (94% of respondents); 52%, and 54% perceived high levels of physician-pharmacist, and physician-nurse communication respectively. Significant differences in the perception of physician-pharmacist communication were detected when comparing responses between hospitals, and between respondent sex (chi2, p< 0.05). Barriers to communication between professionals included lack of local guidelines or protocols, patient overload, COVID-19 pandemic, lack of mentorship, and little room to discuss antimicrobial therapy with higher-ranking physicians. Eighty percent and 45% of physicians were open to receiving antibiotic optimization recommendations from other physicians, and pharmacists respectively. Notable barriers to accepting recommendations from pharmacists included lack of regular communication, lack of clinical experience, and concern about evidence based recommendations. Conclusion Effective communication is perceived between physicians during antimicrobial prescribing activities. Marginal levels of communication and acceptance of prescribing recommendations have been detected between physicians and pharmacists.In this milieu, there is an opportunity to strengthen multidisciplinary teams to optimize antimicrobial use. Disclosures Mario Augusto Melgar Toledo, MD, Merck (Grant/Research Support)Pfizer (Grant/Research Support)

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