The Quality of Service Provision to Newborns in the Primary Healthcare, West Gojjam Zone, North-West of Ethiopia: A Cross-sectional Survey

2021 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke
Keyword(s):  
Rural Health ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Signal Functions ◽  
Rural Health Centres ◽  
Health Centres

Abstract Background: During 2019, neonatal conditions in Ethiopia accounted for 56% of under-5 deaths, with 33 neonatal deaths occurring for every 1,000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades. Methods: A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities from April to July 2017. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Results: Out of the ten quality of newborn care variables, 8.7 [95%CI: 6.03-11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168-7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152-6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867-5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007-7.325] and rural health centres had a lowest mean score, 2.3 [95%CI: 2.043-2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness score [95%CI: 0.134-0.768]. Conclusion: The quality of newborn care was high at the higher-level health facilities and lower in the lower level health facilities such as rural health centres and health posts; where these facilities are designed to provide the newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions were critically low in rural health centres where these are a referral receiving health facilities from health posts. Thus, the rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.

scholarly journals Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

BMJ Open ◽  
2017 ◽  
Vol 7 (3) ◽  
pp. e014680 ◽  
Author(s):  
Joseph de Graft-Johnson ◽  
Linda Vesel ◽  
Heather E Rosen ◽  
Barbara Rawlins ◽  
Stella Abwao ◽  
...  
Keyword(s):  
Newborn Care ◽  
Health Facilities ◽  
Observational Assessment ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Task-shifting in Mental Health Services: Extent, Impact and Challenges in Ghana

2017 ◽  
Vol 41 (S1) ◽  
pp. S618-S618
Author(s):  
V. Agyapong
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Health Workers ◽  
Continuing Professional Development ◽  
Task Shifting ◽  
Mental Health Workers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

AimTo examine the role and scope of practice of community mental health workers (CMHWs) as well as the impact and challenges associated with of work of CMHWs within Ghana's mental health delivery system.MethodsA cross sectional survey of 11 psychiatrists, 29 health policy directors and 164 CMHWs as well as key informant interviews with 3 CMHWs, 5 psychiatrists and 2 health policy directors and three focus group discussions with 21 CMHWs. Results of quantitative data were analysed with SPSS version 20 whilst the results from qualitative data were analysed manually through thematic analysis.ResultsIn addition to duties prescribed in their job descriptions, all the CMHWs identified several jobs that they routinely perform including jobs reserved for higher level cadres such as medication prescribing for which most of the CMHWs have no training. Some CMHWs reported they had considered leaving the mental health profession because of the stigma, risk, lack of opportunities for continuing professional development and career progression as well as poor remuneration. Almost all the stakeholders believed CMHWs in Ghana receive adequate training for the role they are expected to play although many identify some gaps in the training of these mental health workers for the expanded roles they actually play. All the stakeholders expressed concerns about the quality of the care provided by CMHWs.ConclusionThe study highlights several important issues, which facilitate or hinder effective task-shifting arrangements from psychiatrists to CMHWs and impact on the quality of care provided by the latter.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Health literacy and preparedness of health workers in the private health sector towards the COVID-19 pandemic: Need for integration into the nationwide response

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Ekaete Tobin ◽  
Vivian Ajekweneh ◽  
Andrew Obi ◽  
Eshan Henshaw
Keyword(s):  
Health Literacy ◽  
Health Workers ◽  
Health Sector ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Suspected Case ◽  
Willingness To Participate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Private Health Sector

The private health sector has the potential to participate in the COVID-19 pandemic response. The study aimed to assess the health literacy, perceptions, practices, willingness to participate and opportunities for engagement of the private health sector in the COVID-19 response. A cross-sectional survey was carried out among health workers in private health facilities in Edo Central and Edo North Senatorial districts of Edo state between May and June 2020. Data were collected using pre-tested questionnaires and analysis carried out using Statistical Package for Social Science (SPSS). Chi-square test of significance and logistic regression were applied at 5% cut off. A total of 153 health workers participated giving a response rate of 75.0%. Eighty-eight (57.5%) respondents had good knowledge of COVID-19 and 80 (52.3%) held negative perceptions towards COVID-19. Ninety-five (62.1%) respondents believed private health facilities had a role to play in the response particularly in the area of suspected case screening (85.4%). Thirty-one (20.3%) respondents indicated their willingness to participate in the COVID-19 response if their facilities were invited to. Sixty-one (39.9%) and 92 (60.1%) respondents respectively held poor and good practices towards COVID- 19 prevention, with practice significantly associated with educational level (χ2 = 14.10, P < 0.01), profession (χ2 = 15.28, P = 0.01). and previous training in infection prevention and control (IPC) (χ2 = 18.16, P < 0.01). The resources available from the private sector to support the response can be harnessed through engagements with medical directors and health workers in the sector to identify areas of collaboration, address identified gaps in knowledge, improve perception and participation.

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2019 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Low Income ◽  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential for both mothers and infants, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality, to assess the quality of routine maternal and newborn care and the proportion of women delivering in facilities with a good standard of care. Surveys were conducted in 2012 and 2015 to assess changes in the quality of care over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. 166 and 305 primary care facilities were sampled in 2012 and 2015 respectively. In each year we assessed whether each facility could provide four “signal” functions of routine maternal and newborn care. From facility registers we counted the number of deliveries in the previous six months and calculated the proportion of women giving birth in facilities which could offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities which provided all four signal functions rose from 40% (95% CI 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh in 2012 an estimated 4% (95% CI 1-24) of facility deliveries occurred in facilities which provided all four signal functions, rising to 39% (95% CI 25-55) in 2015. In Nigeria these estimates were 25% (95% CI 6-66) and zero for 2012 and 2015 respectively. Improvements in signal functions in Ethiopia and Uttar Pradesh were led by improved supplies of commodities while Nigeria experienced declines in supplies of commodities and the number of Skilled Birth Attendants employed. Conclusions This study quantifies how health facilities can provide sub-optimal maternal and newborn care, and may help explain inconsistent outcomes of health facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of the capacity of facilities to provide such care. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon maternal and newborn care.

scholarly journals Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257851
Author(s):  
Juliet Mwanga-Amumpaire ◽  
Grace Ndeezi ◽  
Karin Källander ◽  
Celestino Obua ◽  
Richard Migisha ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Treatment Guidelines ◽  
Health Workers ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
Low Level ◽  
Childhood Illnesses ◽  
Childhood Infections

Background Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. Methods We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections. Results Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed. Conclusion Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.

scholarly journals Assessment of Availability and Quality of Emergency Obstetric and Newborn Care Service in Southwestern Oromia, Ethiopia, 2017

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dejene Edosa
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Service ◽  
Newborn Care ◽  
Neonatal Morbidity ◽  
Categorical Variables ◽  
Care Providers ◽  
Cross Sectional ◽  
Signal Functions

Background. Emergency obstetrics and newborn care (EmONC) is an important lifesaving function which can avert the death of women facing obstetrics-related complications. It is a cost-effective, significant intervention to decrease maternal and neonatal morbidity and mortality in poor resource settings, including Ethiopia. Objective. The aim of this study was to assess the availability and quality of the EmONC services in southwestern Oromia, Ethiopia, in 2017. Methods. An institutional-based cross-sectional study was implemented from April to May 2017. Data were collected using checklists and questionnaires developed from different studies. Data were analyzed using EPI-info and exported to SPSS version 20 for further analysis. Each descriptive statistic was summarized using frequency, percentage, and tables for categorical variables. Results. Despite the fact that the overall coverage of fully functioning basic emergency obstetric and newborn care (BEmONC) facilities was greater than 5 per 500,000 people, nearly one-fourth (25.64%) provided less than expected signal functions, indicating that these facilities were nonfunctional. There were only 0.24 comprehensive emergency obstetric and newborn care (CEmONC) facilities per 500,000 people. The result of this study also revealed that the quality of EmONC facilities in all health-care settings was poor. Conclusion and Recommendation. There were gaps in performance signal functions as well as the availability and quality of EmONC in the study area. Availability and quality of EmONC necessitate improvements through enhancing health-care providers’ skills by training and mentoring as well as enabling facilities accessible for utilization of EmONC. Further research is needed to identify factors that could be barriers to the performance quality and coverage of EmONC services.

scholarly journals Quality of Pre-Service Midwifery Education in Public and Private Midwifery Schools in Afghanistan: A Cross Sectional Survey

2021 ◽  
Author(s):  
Partamin Manalai ◽  
Sheena Currie ◽  
Massoma Jafari ◽  
Nasratullah Ansari ◽  
Hannah Tappis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Assessment Tool ◽  
Rapid Assessment ◽  
Newborn Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Midwifery Education ◽  
Quality Aspects

Abstract Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. Aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders priorities for improving quality of midwifery education. Methods A cross-sectional assessment was conducted from September 12–December 17, 2017, using a modified Midwifery Education Rapid Assessment Tool to assess education quality aspects related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students in 29 midwifery schools. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

scholarly journals Patient Satisfaction with Healthcare at a Tertiary Hospital in Northern Malawi: Results from a Triangulated Cross-sectional Survey

2021 ◽  
Author(s):  
Frank Watson Sinyiza ◽  
Paul Uchizi Kaseka ◽  
Master Rodgers Chisale ◽  
Chikondi Sharon Chimbatata ◽  
Balwani Chingatichifwe Mbakaya ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health Workers ◽  
Health Sector ◽  
Likert Scale ◽  
Tertiary Hospital ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Satisfaction With Services

Abstract BackgroundIn 2016 the Malawi government embarked on several interrelated health sector reforms aimed at improving the quality of health services at all levels of care and attain Universal Health Coverage by 2030. Patient satisfaction with services is an important proxy measure of quality. We assessed patient satisfaction at a tertiary hospital in Northern Malawi to understand the current state in the country. MethodsWe conducted exit interviews with patients aged18 years and above using a 28 statement interviewer administered questionnaire. Patients were asked to express their level of agreement to the statements on a five-point Likert scale – strongly disagree to strongly agree, corresponding to scores of 1 to 5. Overall patient satisfaction was calculated by summing up the scores and diving the sum by the number of statements. Scores >3 constituted satisfaction while scores ≤3 constituted dissatisfaction. Patient self-rated satisfaction was determined from a single statement that asked patients to rate their satisfaction with services on a five-point Likert scale. We also solicited inputs from patients on aspects of hospital care that needed improvement. Responses were reviewed and grouped into themes. Recurring themes are presented according to frequencies.ResultsOverall patient satisfaction was 8.4% (95% CI: 5.2% - 12.9%). Patient self-rated satisfaction was 8.9% (95% CI: 5.5% - 13.4%). Patients raised six major issues that dampened their healthcare seeking experience including health workers reporting late to work, doctors not listening to patients concerns and neither examining them properly nor explaining the diagnosis, shortage of medicines, diagnostics and medical equipment, unprofessional conduct of health workers, poor sanitation and cleanliness, and health workers behaviour of favouring or priotising their relatives and friends over other patients.ConclusionWe found very low levels of patient satisfaction, suggesting that quality of services in the public health sector is still low. It is therefore critical to accelerate and innovate the Ministry of Health’s quality improvement initiatives to attain Malawi’s health goals.

scholarly journals Practices and problems of female health/medical technicians in North-West Frontier Province, Pakistan

2021 ◽  
Vol 1 (2) ◽  
pp. 253-260
Author(s):  
Arjumand Faisel ◽  
Parveen A. Khan ◽  
Alveena Noreen
Keyword(s):  
Rural Health ◽  
Health Workers ◽  
Improve Performance ◽  
North West ◽  
Basic Health ◽  
Rural Health Centres ◽  
North West Frontier Province ◽  
Expected Performance ◽  
Health Centres ◽  
Basic Health Units

The Ministry of Health in Pakistan introduced in 1977 mid-level health workers called medical technicians to provide emergency aid and rudimentary services at basic health units and rural health centres. With the policy of placement of doctors in these units in the early eighties, their name was changed to health technicians, whose duties emphasized preventive activities instead of working as doctors’ substitutes. The objectives of this study were to estimate the percentage of graduated female technicians in the service, understand their reasons for not joining or leaving the service, appraise their practices in comparison to the expected performance, identify and report the academic and operational problems and recommend measures to resolve these problems and improve performance

scholarly journals Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health (SRH) Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Rosine Uwase ◽  
Isabelle Kubwimana ◽  
Jean de la Croix Niyonzima ◽  
Roseline Dine Dzekem ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Care Providers ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool

Abstract Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

Sign in / Sign up

Export Citation Format

Share Document