Barriers and Facilitators to Modern Contraception Among Married Women in Conflict Affected Town of Mogadishu, Somalia

Abstract Background - With a maternal mortality ratio of 692 per 100,000 live births and modern contraception prevalence of 1%, understanding factors hindering Somali women from using modern contraception is key to developing and implementing locally adopted public health responses. The purpose of this qualitative study is to explore barriers and facilitators to the use of modern contraception among married women in Mogadishu. Methods - We conducted a qualitative study using semi-structured, in-depth interviews with 21 married women aged >18 years, living in different neighborhoods in Mogadishu between July—December 2018. We recruited the participants using a convenience sampling method. We used thematic analysis and adapted ecological model as a framework for the synthesis.Results – The findings show that systemic, individual and socio-cultural barriers hinder women’s ability to access modern contraception. Barriers identified by this study include: Health communication messages and contraceptive information provided by health providers, prevalent religious fallacies among women and fear of permanent infertility upon modern contraception. Conclusion - Training health providers in the principles of modern contraception, in addition to the medical ethics that govern their responsibility to provide correct and relevant information to their patients, is vital for increasing modern contraception use among Somali women. The findings of this study may be used for designing public health interventions that promote acceptance and the use of modern contraception among both women and men in Somalia.

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Intimate partner violence and condom versus other modern contraception use among married women in rural India

Annals of Global Health ◽

10.1016/j.aogh.2015.02.1001 ◽

2015 ◽

Vol 81 (1) ◽

pp. 218 ◽

Cited By ~ 1

Author(s):

A. Dasgupta ◽

N. Saggurti ◽

B. Donta ◽

M. Battala ◽

M. Ghule ◽

...

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Married Women ◽

Rural India ◽

Modern Contraception ◽

Contraception Use

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Health System Barriers and Facilitators to Delivering Additional Vaccines through the National Immunisation Programme in China: A Qualitative Study of Provider and Service-User Perspectives

Vaccines ◽

10.3390/vaccines9050476 ◽

2021 ◽

Vol 9 (5) ◽

pp. 476

Author(s):

Dan Gong ◽

Qiyun Jiang ◽

Tracey Chantler ◽

Fiona Yueqian Sun ◽

Jiatong Zou ◽

...

Keyword(s):

Public Health ◽

Information Systems ◽

Qualitative Study ◽

Health System ◽

Barriers And Facilitators ◽

System Capacity ◽

Cold Chain ◽

Western China ◽

Process Data ◽

National Immunisation Programme

In China, there are two categories of vaccines available from the Chinese Center for Disease Control and associated public health agencies. Extended Program of Immunization (EPI) vaccines are government-funded and non-EPI vaccines are voluntary and paid for out-of-pocket. The government plans to transition some non-EPI vaccines to EPI in the coming years, which may burden public health system capacity, particularly in terms of budget, workforce, supply chains, and information systems. Our study explored vaccinator and caregiver perspectives on introducing non-EPI vaccines into routine immunization and perceived facilitators and barriers affecting this transition. We conducted a qualitative study from a realist perspective, analysing semi-structured interviews with 26 vaccination providers and 160 caregivers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. Data were analysed thematically, using deductive and inductive coding. Most participants were positive about adding vaccines to the national schedule. Candidate EPI vaccines most frequently recommended by participants were varicella, mumps vaccine, and hand–foot–mouth disease. Providers generally considered existing workspaces, cold-chain equipment, and funding sufficient, but described frontline staffing and vaccine information systems as requiring improvement. This is the first qualitative study to explore interest, barriers, and facilitators related to adding vaccines to China’s national schedule from provider and caregiver perspectives. Findings can inform government efforts to introduce additional vaccines, by including efforts to retain and recruit vaccine programme staff and implement whole-process data management and health information systems that allow unified nationwide data collection and sharing.

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Determinants of Modern Contraceptive Utilization Among Married Women in sub-Saharan Africa; Multilevel Analysis of Recent Demographic and Health Survey

10.21203/rs.3.rs-628571/v1 ◽

2021 ◽

Author(s):

Zemenu Tadesse Tesema ◽

Getayeneh Antehunegn Tesema ◽

Moges Muluneh Boke ◽

Temesgen Yihunie Akalu

Keyword(s):

Married Women ◽

Sub Saharan Africa ◽

Modern Contraceptive ◽

African Countries ◽

Wealth Status ◽

Modern Contraception ◽

Pooled Prevalence ◽

Contraception Use ◽

Contraceptive Utilization ◽

Sub Saharan

Abstract Background Family planning is a low-cost, high-impact public health and development strategy. Planned pregnancies are essential for both the child and mother’s health. However, there is a lack of evidence on modern contraceptive use and determinants in sub-Saharan Africa, hence this study aimed to determine the pooled prevalence and determinants of modern contraceptive utilization across Sub-Saharan Africa. Methods Thirty-six sub-Saharan African countries' demographic and health survey (DHS) data were used for pooled analysis. A total weighted sample of 322,525 married women was included in the study. Cross tabulations and summary statistics were done using STATA version 14 software. The pooled prevalence of modern contraceptive utilization with a 95% Confidence Interval (CI) was reported for sub- Saharan Africa countries. Four models were fitted to select the best-fitted model for the data using Likelihood Ratio (LLR) and Deviance. Model III was selected because of its highest LLR and Smallest deviance. Results The pooled estimate of modern contraception use in sub–Saharan African countries were 18.36% [95% CI: 18.24, 18.48], with highest in Lesotho (59.79%) and the lowest in Chad (5.04%). The odds of modern contraception utilization were increased; women living in East Africa (AOR = 1.47 (1.40, 1.54)), urban (AOR = 1.18 (1.14, 1.24)), women primary and secondary and above educational level (AOR = 1.49 (1.44, 1.55)), and (AOR = 1.66 (1.58, 1.74)) respectively, husband primary and secondary and above educational level (AOR = 1.38 (1.33, 1.42)) and (AOR = 1.38 (1.36, 1.47)), wealth status middle and rich (AOR = 1.17, (1.14, 1.21)) and (AOR = 1.29 (1.25, 1.34)) respectively, media exposure (AOR = 1.25 (1.22, 1.29)), Postnatal care(PNC) utilization (AOR = 1.25 (1.22, 1.29)), deliver at health facility (AOR = 1.74 (1.69, 1.79)), and birth order 2–4 and 5+ (AOR = 1.36 (1.31, 1.41)) and (AOR = 1.35 (1.28, 1.43)) whereas the odds of contraception use were decreased among women living in Central, and Western regions (AOR = 0.23 (0.22, 0.24)), and (AOR = 0.46 (0.40, 0.54)) respectively, women decided with husband and husband alone (AOR = 0.90 (0.87, 0.93)) and (AOR = 0.73 (0.71, 0.75)). Conclusion The uptake of modern contraception in sub-Saharan Africa is low compared to other developing region. Therefore, family planning program activities need to give attention to the rural resident, illiterate women and low wealth status community.

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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

10.21203/rs.3.rs-398162/v1 ◽

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.

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Re: Letter to the Editor of Public Health in response to ‘Vaccination against pertussis and influenza in pregnancy: a qualitative study of barriers and facilitators.’

Public Health ◽

10.1016/j.puhe.2019.04.022 ◽

2019 ◽

Vol 177 ◽

pp. 144

Author(s):

A. Maisa ◽

S. Milligan ◽

A. Quinn ◽

D. Boulter ◽

J. Johnston ◽

...

Keyword(s):

Public Health ◽

Qualitative Study ◽

Barriers And Facilitators ◽

Letter To The Editor ◽

In Pregnancy

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Promoting HIV, HBV and HCV screening among migrants with a language barrier: Protocol for the development and evaluation of an electronic application (Apidé) (Preprint)

10.2196/preprints.22239 ◽

2020 ◽

Author(s):

Frédérique Thonon ◽

Saleh Fahmi ◽

Olivia Rousset-Torrente ◽

Pascal Bessonneau ◽

James W Griffith ◽

...

Keyword(s):

Public Health ◽

Qualitative Study ◽

Controlled Trial ◽

Healthcare Providers ◽

Evaluation Study ◽

Language Barrier ◽

Screening Tests ◽

Health Providers ◽

Missed Opportunities ◽

System Usability Scale

BACKGROUND Late diagnoses of HIV, Hepatitis B and Hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis’ screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing. OBJECTIVE The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and to evaluate its acceptability and impact in terms of public health. METHODS The study will go through three stages: 1) concept development, 2) app development, and 3) app evaluation. A qualitative study has been undertaken to explore language barriers during healthcare encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted in order to have a comprehensive overlook of electronic tools designed to help healthcare providers communicate with migrants with a language barrier. In order to generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the application will include translation and voice recording of items. The electronic development will also include three steps of testing with users. The acceptability of the application will be evaluated in a survey with the System Usability Scale. The evaluation of the application’s efficacy will consist of a stepped-wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome measured is the percentage of screening tests realized. The secondary outcomes are rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app. RESULTS The app evaluation study has received a 3-year grant from Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review have been completed. CONCLUSIONS This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and measure its acceptability and effectiveness in terms of public health. When completed, this application could be distributed to numerous workers carrying out screening with migrant populations in various healthcare settings. CLINICALTRIAL

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