Perspectives on Awareness of Unintended Pregnancy Among Young South African Women, Healthcare Providers and Policy Makers

Abstract BackgroundSouth Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women’s experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers’ and policy makers’ ideas for public sector strategies to facilitate prompt confirmation of unintended pregnancy.Methods We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and focus group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis.ResultsUncertainties around being pregnant greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of unintended pregnancy and for pregnancy tests to be made more readily accessible.ConclusionEarly recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women with unintended pregnancy confirm their pregnancy status promptly.

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Reproductive awareness and recognition of unintended pregnancy: young women, key informants and health care providers perspectives in South Africa

Reproductive Health ◽

10.1186/s12978-021-01262-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Oluwaseyi Dolapo Somefun ◽

Jane Harries ◽

Deborah Constant

Keyword(s):

South Africa ◽

Health Care ◽

Unintended Pregnancy ◽

Health Care Providers ◽

Signs And Symptoms ◽

Second Trimester ◽

Care Providers ◽

Policy Makers ◽

Abortion Care ◽

Pregnancy Status

Abstract Background South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women’s experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers’ and policy makers’ ideas for public sector strategies to facilitate prompt confirmation of pregnancy. Methods We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis. Results Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible. Conclusion Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.

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Comparing the Quality of Health Care Providers

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1019 ◽

2000 ◽

Vol 3 (1) ◽

Cited By ~ 3

Author(s):

Mark McClellan ◽

Douglas Staiger

Keyword(s):

Quality Indicators ◽

Health Care Providers ◽

Healthcare Providers ◽

Quality Of Healthcare ◽

Care Providers ◽

Policy Makers ◽

New Approach ◽

Provider Quality ◽

Alternative Measures

This article introduces a new approach for evaluating the quality of healthcare providers, including an integrated solution to several problems that limit the usefulness of available methods. Our approach combines information from all the quality indicators available for a provider (e.g., from other years, other patients, or other indicators for the same patients) to estimate more accurately the providers previous or expected quality. The approach also provides an empirical basis for comparing and combining alternative quality indicators, thereby enabling policy makers to choose among potential indicators, explore the potential bias in alternative measures, and increase the value of quality measures for assessing and improving care. Using hospital care for elderly heart attack patients as an example, we demonstrate that these methods can be used to create reliable, precise predictions about provider quality. Comparing quality of care across providers may be far more feasible than many now believe.

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Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

Myanmar Health Sciences Research Journal ◽

10.34299/mhsrj.00936 ◽

2019 ◽

Vol 31 (2) ◽

pp. 131

Keyword(s):

Health Care ◽

General Hospital ◽

Health Care Providers ◽

Quality Care ◽

Healthcare Providers ◽

Medical Services ◽

Tertiary Level ◽

Care Providers ◽

Level Hospital ◽

Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

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COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

10.2196/preprints.22978 ◽

2020 ◽

Author(s):

Emad Aborajooh ◽

Mohammed Qussay Al-Sabbagh ◽

Baraa Mafrachi ◽

Muhammad Yassin ◽

Rami Dwairi ◽

...

Keyword(s):

Social Media ◽

Psychological Stress ◽

Health Care Providers ◽

Best Practice ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Care Providers ◽

Cross Sectional ◽

Ordinal Logistic Regression Analysis ◽

Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

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407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

International Psychogeriatrics ◽

10.1017/s1041610220002604 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 123-123

Author(s):

Ken Schwartz ◽

Robert Madan ◽

Anna Berall ◽

Marsha Natadira ◽

Anna Santiago

Keyword(s):

Family Caregivers ◽

Health Care Providers ◽

Healthcare Providers ◽

Well Being ◽

Moderate Degree ◽

Quick Response ◽

Care Providers ◽

High Level ◽

Person With Dementia ◽

The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

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A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158061 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8061

Author(s):

Ariana Kong ◽

Michelle Dickson ◽

Lucie Ramjan ◽

Mariana S. Sousa ◽

Joanne Goulding ◽

...

Keyword(s):

Oral Health ◽

Health Care Providers ◽

Torres Strait Islander ◽

Health Workers ◽

Healthcare Providers ◽

Aboriginal Health ◽

Health Staff ◽

Care Providers ◽

Aboriginal Women ◽

Torres Strait

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.

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Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis

International Urogynecology Journal ◽

10.1007/s00192-020-04636-3 ◽

2021 ◽

Author(s):

Heidi F. A. Moossdorff-Steinhauser ◽

Bary C. M. Berghmans ◽

Marc E. A. Spaanderman ◽

Esther M. J. Bols

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Pregnant Women ◽

Health Care Providers ◽

Meta Analysis ◽

Care Providers ◽

Case Definitions ◽

Monthly Basis ◽

Policy Makers ◽

In Pregnancy

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

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Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v3i2.405 ◽

2013 ◽

Vol 3 (2) ◽

pp. 154-159

Author(s):

Janet Perkins ◽

Aminata Bargo ◽

Cecilia Capello ◽

Carlo Santarelli

Keyword(s):

Health Care ◽

Burkina Faso ◽

Health Care Providers ◽

Health Workers ◽

Healthcare Providers ◽

Newborn Health ◽

World Health ◽

Maternal And Newborn Health ◽

Care Providers ◽

Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities. While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

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Managing Sexual Dysfunction For Women With Breast Cancer: The Perspective Of Health Care Providers In North East Malaysia.

10.21203/rs.3.rs-161097/v1 ◽

2021 ◽

Author(s):

Siti Balqis Chanmekun ◽

Maryam Mohd Zulkifli ◽

Rosediani Muhamad ◽

Norhasmah Mohd Zain ◽

Wah Yun Low ◽

...

Keyword(s):

Breast Cancer ◽

Sexual Dysfunction ◽

Sexual Health ◽

Health Care Providers ◽

Thematic Analysis ◽

Healthcare Providers ◽

Phenomenological Approach ◽

Care Providers ◽

North East ◽

East Malaysia

Abstract Purpose: Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers’ (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using phenomenological approach. Methods: This qualitative study was conducted using a face-to-face interview method to HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis. Results: Three key barriers were identified through the thematic analysis: a scarcity of related knowledge; the influence of socio-cultural ideas about sex; and the speciality-centric nature of the healthcare system. Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that is, both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients. Conclusion: Therefore, interventions to empower the knowledge, break the sociocultural barriers and improve the clinic settings are crucial for HCPs in managing FSD confidently.

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Development of a tool to assess health applications for healthcare providers: A Delphi Expert Panel Study (Preprint)

10.2196/preprints.17660 ◽

2020 ◽

Author(s):

Immaculada Grau-Corral ◽

Percy Efran Pantoja ◽

Francisco J. Grajales III ◽

Belchin Kostov ◽

Valentí Aragunde ◽

...

Keyword(s):

Literature Review ◽

Health Care Providers ◽

Expert Panel ◽

Panel Study ◽

Healthcare Providers ◽

Care Providers ◽

Web Based ◽

Health Apps ◽

Agreement Assessment ◽

Health Applications

BACKGROUND The presence of the mobile phone and devices is generating knowledge about the use of applications to support patient care, but there are few recommendations for apps dedicated to healthcare professionals OBJECTIVE To establish a validated scale to assess healthcare mobile applications is the most efficient step for health care providers and systems. The main goal is to create and validate a tool to evaluate health apps destined to be used by health professionals. METHODS A five steps simplified methodology to assess of the scale was followed. The first step consists of building a scale for professionals based on a literature review. Next step would be an expert panel validation by a Delphi method, rating web-based questionnaires to evaluate inclusion and weight of the indicators. It was agreed to carry out, as many iterations as necessary, to reach a consensus of 75%. Finally, a pilot of the score was developed to evaluate the reliability of the scale. For the inter-rater agreement assessment during the pilot, the Cohen Kappa was used. RESULTS After the literature review, a first scale draft was developed. Two rounds of interactions of the local investigation group and the external panel of experts were needed to select final indicators. Seventeen indicators were included in the score. For the pilot test, 280 apps were evaluated and 66 meet the criteria. The interrater agreement was strong (higher than 82% with significant kappa >0.72 per app and item). CONCLUSIONS We have developed, with a reproducible methodology, a tool that allows us to evaluate health applications for clinical, surgical and general medical providers. The ISYScore-PRO scale to be reliable and reproducible. The assessment permitted to consolidate every step of the methodology. We were able to reach consensus on the dimensions and items on the scale with only two rounds. The process of validation included two robust methodologies. The ISYScore-PRO scale is reliable and reproducible.

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