scholarly journals Barriers and Facilitators of Access to Maternal, Newborn and Child Health Services During the First Wave of COVID-19 Pandemic in Nigeria: Findings From a Qualitative Study

2021 ◽  
Author(s):  
Godwin Otuodichinma Akaba ◽  
Osasuyi Dirisu ◽  
Kehinde S Okunade ◽  
Eseoghene Adams ◽  
Jane Ohioghame ◽  
...  
Keyword(s):  
Public Health ◽  
Child Health ◽  
Qualitative Study ◽  
Health Workers ◽  
Health Facilities ◽  
Health Centers ◽  
Barriers And Facilitators ◽  
Immunization Service ◽  
Newborn And Child Health ◽  
And Child Health

Abstract BackgroundUnderstanding how COVID-19 has shaped access to maternal. newborn and child health (MNCH) services in Nigeria and the contextual factors attributable to these changes is crucial towards development of policies and interventions that will assist the country in maintaining focus towards sustaining the little gains it has made over the past few years towards improving MNCH despite the COVID -19 pandemic.The objective of the study was to explore the barriers and facilitators of access to MNCH services during the first wave of COVID-19 pandemic in Nigeria.MethodsA qualitative study was conducted among different stakeholder groups in 18 public health facilities in Nigeria between May and July,2020. In-depth interviews were conducted among 54 study participants (service users, service providers and policymakers,) selected from across the three tiers of public health service delivery system in Nigeria (primary health centers, secondary health centers and tertiary health centers). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.ResultsBarriers to accessing MNCH services during the first wave of Covid-19 pandemic in Nigeria include fear of contracting COVID-19 infection at health facilities, transportation difficulties, movement restriction, stigmatization of sick persons, lack of personal protective equipment (PPE) /medical commodities, long waiting times at hospitals, shortage of manpower, lack of preparedness by health workers, and prioritization of essential services. Enablers to access include the COVID-19 non-pharmacological measures instituted at the health facilities, community sensitization on healthcare access during the pandemic, and alternative strategies for administering immunization service at the clinics.Conclusion Access to MNCH services was negatively affected by the COVID-19 pandemic particularly due to challenges resulting from restrictions in movements and the health systems inability to provide enabling conditions for sustained utilization of MNCH services. There is need for national health managers and policy makers to institute measures that will allow unhindered access to MNCH services during future pandemics. This may include provision of socio-economic safety nets for women, provision of PPEs, use of e-health platforms for consultations, and incentives for health workers.

scholarly journals The effect of enhanced public–private partnerships on Maternal, Newborn and child Health Services and outcomes in Nairobi–Kenya: the PAMANECH quasi-experimental research protocol

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006608 ◽  
Author(s):  
Pauline Bakibinga ◽  
Remare Ettarh ◽  
Abdhalah K Ziraba ◽  
Catherine Kyobutungi ◽  
Eva Kamande ◽  
...  
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Health Facilities ◽  
Public Private Partnerships ◽  
Quality Healthcare ◽  
Newborn And Child Health ◽  
Quasi Experimental ◽  
The Impact ◽  
And Child Health

IntroductionRapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The ‘Partnership for Maternal, Newborn and Child Health’ (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public–private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya.Methods and analysisThis is a quasi-experimental study; our approach is to support private as well as public health providers and the community to enhance access to and demand for quality healthcare services. Key activities include: infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for healthcare providers as well as the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end-line survey will be conducted at least 1 year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference.Ethics and disseminationEthical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and academic publications to facilitate uptake by policymakers.Protocol registration numberKEMRI- NON-SSC-PROTOCOL No. 393.

scholarly journals Service Availability and Readiness Assessment of Maternal, Newborn and Child Health Services at Public Health Facilities in Madagascar

2016 ◽  
Vol 20 (3) ◽  
pp. 149-158 ◽  
Author(s):  
Sandrine Andriantsimietry ◽  
Raymond Rakotomanga ◽  
Jean Pierre Rakotovao ◽  
Eliane Ramiandrison ◽  
Marc Eric Razakariasy ◽  
...  
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Health Facilities ◽  
Child Health Services ◽  
Service Availability ◽  
Readiness Assessment ◽  
Newborn And Child Health ◽  
Public Health Facilities ◽  
And Child Health

scholarly journals The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana

2018 ◽  
Vol 3 (4) ◽  
pp. e000786 ◽  
Author(s):  
Akira Shibanuma ◽  
Francis Yeji ◽  
Sumiyo Okawa ◽  
Emmanuel Mahama ◽  
Kimiyo Kikuchi ◽  
...  
Keyword(s):  
Child Health ◽  
Continuum Of Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Newborn And Child Health ◽  
Care Services ◽  
Women And Children ◽  
And Child Health ◽  
The Continuum

IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.

Maternity and Child Health Care Services Delivered by Public Health Centers Compared to Health Cooperatives: Iran`s Experience

2006 ◽  
Vol 6 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Alireza Nikniyaz ◽  
Mostafa Farahbakhsh . ◽  
Kazem Ashjaei . ◽  
Djafarsadegh Tabrizi . ◽  
Homayoun Sadeghi-Baz . ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Child Health ◽  
Health Care Services ◽  
Health Centers ◽  
Child Health Care ◽  
Care Services ◽  
And Child Health

scholarly journals Determinants of Evidence Use by Frontline Maternal, Newborn and Child Health Staff in Selected Health Facilities in Ghana

2021 ◽  
Author(s):  
Gordon Abekah-Nkrumah ◽  
Doris Ottie-Boakye ◽  
Johnson Ermel ◽  
Sombié Issiaka
Keyword(s):  
Child Health ◽  
Organizational Structure ◽  
Health Facilities ◽  
Health Staff ◽  
Factors Affecting ◽  
Newborn And Child Health ◽  
Level Of Use ◽  
Attitudes And Knowledge ◽  
Reproductive And Child Health ◽  
And Child Health

Abstract Background The current paper examines the level of use of evidence and factors affecting the use of evidence by frontline maternal, newborn and child health (MNCH) and reproductive and child health (RCH) staff in practice decisions in selected health facilities in Ghana. Methods Data was collected from 509 respondents drawn from 44 health facilities in three regions in Ghana. Means were used to examine the level of use of evidence, whiles cross-tabulations and Partial least Squares-based regression were used to examine factors that influence the use of evidence in practice decisions by frontline MNCH/RCH staff. Conclusion We argue that any effort to improve the use of evidence by frontline MNCH/RC staff in practice decisions should focus on improving attitudes and knowledge of staff as well as challenges related to the structure of the organisation. Given however that the score for attitude was relatively high, emphases should be on knowledge and organizational structure in particular, which had the lowest score even though it has the single most important effect on the use of evidence.

scholarly journals Analisis Kebutuhan dan Pemanfaatan Buku Serta Pedoman Pelayanan KIA di Puskesmas: Studi Kualitatif

2020 ◽  
Vol 23 (2) ◽  
pp. 99-107
Author(s):  
Diyan Ermawan Effendi ◽  
Arief Priyo Nugroho ◽  
Suharmiati Suharmiati ◽  
Lestari Handayani
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Health Centers ◽  
High Rate ◽  
Needs Analysis ◽  
Primary Health ◽  
Expectant Mothers ◽  
Ease Of Access ◽  
And Child Health

The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.

scholarly journals Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria

2020 ◽  
Author(s):  
Ekechi Okereke ◽  
Godwin Unumeri ◽  
Akinwumi Akinola ◽  
George Eluwa ◽  
Sylvia Adebajo
Keyword(s):  
Child Health ◽  
Primary Healthcare ◽  
Health Workers ◽  
Healthcare Services ◽  
Child Health Services ◽  
Gender Preferences ◽  
Newborn And Child Health ◽  
Frontline Health Workers ◽  
Female Clients ◽  
And Child Health

Abstract Background In Nigeria, anecdotes abound that female clients, particularly within northern Nigeria, have gender-based preferences for frontline health workers (FLHWs) who provide healthcare services. This may adversely affect uptake of maternal newborn and child health services, especially at primary healthcare level in Nigeria, where a huge proportion of the Nigerian population and rural community members in particular, access healthcare services. This study explored female clients’ gender preferences for frontline health workers who provide maternal, newborn and child healthcare (MNCH) services at primary healthcare level in Nigeria. Methods The study adopted a cross-sectional quantitative design with 256 female clients’ exit interviews from 66 randomly selected primary health facilities within two States - Bauchi (northern Nigeria) and Cross-River (southern Nigeria). Data was collected using Personal Digital Assistants and data analysis was done using SPSS software. Descriptive analysis was carried out using percentage frequency distribution tables. Bivariate analysis was also carried out to examine possible relationships between key characteristic variables and the gender preferences of female clients involved in the study. Results Out of 256 women who accessed maternal, newborn and child health services within the sampled health facilities, 44.1% stated preference for female FLHWs, 2.3% preferred male FLHWs while 53.5% were indifferent about the gender of the health worker. However only 26.6% of female clients were attended to by male FLHWs. Bivariate analyses suggest a relationship between a female client’s health worker gender preference and her pregnancy status, the specific reason for which a female client visits a primary healthcare facility, a female client’s location in Nigeria as well as the gender of the health worker(s) working within the primary healthcare facility which she visits to access maternal, newborn and child health services. Conclusions The study findings suggest that female clients at primary healthcare level in Nigeria possibly have gender preferences for the frontline health workers who provide services to them. There should be sustained advocacy and increased efforts at community engagement to promote the acceptability of healthcare services from male frontline health workers in order to have a significant impact on the uptake of MNCH services, particularly within northern Nigeria.

scholarly journals The crowded space of local accountability for maternal, newborn and child health: a case study of the South African health system

2019 ◽  
Vol 35 (3) ◽  
pp. 279-290 ◽  
Author(s):  
Fidele Kanyimbu Mukinda ◽  
Sara Van Belle ◽  
Asha George ◽  
Helen Schneider
Keyword(s):  
Child Health ◽  
Health Workers ◽  
Perinatal Death ◽  
Local Level ◽  
Local Health ◽  
Mortality And Morbidity ◽  
Newborn And Child Health ◽  
Performance Targets ◽  
And Child Health

Abstract Global and national accountability for maternal, newborn and child health (MNCH) is increasingly invoked as central to addressing preventable mortality and morbidity. Strategies of accountability for MNCH include policy and budget tracking, maternal and perinatal death surveillance, performance targets and various forms of social accountability. However, little is known about how the growing number of accountability strategies for MNCH is received by frontline actors, and how they are integrated into the overall functioning of local health systems. We conducted a case study of mechanisms of local accountability for MNCH in South Africa, involving a document review of national policies, programme reports, and other literature directly or indirectly related to MNCH, and in-depth research in one district. The latter included observations of accountability practices (e.g. through routine meetings) and in-depth interviews with 37 purposely selected health managers and frontline health workers involved in MNCH. Data collection and analysis were guided by a framework that defined accountability as answerability and action (both individual and collective), addressing performance, financial and public accountability, and involving both formal and informal processes. Nineteen individual accountability mechanisms were identified, 10 directly and 9 indirectly related to MNCH, most of which addressed performance accountability. Frontline managers and providers at local level are targeted by a web of multiple, formal accountability mechanisms, which are sometimes synergistic but often duplicative, together giving rise to local contexts of ‘accountability overloads’. These result in a tendency towards bureaucratic compliance, demotivation, reduced efficiency and effectiveness, and limited space for innovation. The functioning of formal accountability mechanisms is shaped by local cultures and relationships, creating an accountability ecosystem involving multiple actors and roles. There is a need to streamline formal accountability mechanisms and consider the kinds of actions that build positive cultures of local accountability.

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