scholarly journals Stakeholders’ Perspectives on the Implementation of Maternity Waiting Homes in Rural Ethiopia: A Qualitative Study

2021 ◽  
Author(s):  
Mekdes Kondale Gurara ◽  
Jean-Pierre Geertruyden ◽  
Yves Jacquemyn ◽  
Veerle Draulans
Keyword(s):  
Geographic Area ◽  
Skilled Birth Attendance ◽  
Cultural Barriers ◽  
Group Discussions ◽  
Healthcare Facilities ◽  
Rural Ethiopia ◽  
Guide Field ◽  
Birth Attendance ◽  
Maternity Waiting Homes ◽  
Field Notes

Abstract Background The rural community in Ethiopia is scattered over a wide geographic area, some regions with difficult mountains, making access to healthcare facilities a great challenge. To overcome geographical barriers and improve access to skilled childbirth care, maternity waiting homes (MWHs), shelters built nearby health facilities, where pregnant women are lodged until labour begins, were introduced decades ago. This study identifies the demand and supply-side determinants of access to MWH services in rural Ethiopia. Methods This descriptive, exploratory study included five focus group discussions and eight in-depth interviews using a semistructured interviewer guide. Field notes were collected, and interviews were audio-recorded. Using Quirkois®, data were coded, transcribed verbatim, translated into English, and analyzed following Penchansky and Thomas’s modified framework of access. Results The study identified several challenges of the implementation of the MWH program in the study area. Subthemes that emerged from the discussions were lack of awareness about the MWH services, geographic inaccessibility, inadequacy of facilities and unaffordability-related issues, substandard and culturally insensitive care at MWHs, and logistic barriers. Most participants rated the MWH quality as poor and requested better MWH services to promote access to skilled birth attendance. Conclusions Several contextual, structural and socio-cultural barriers have been hindering the implementation of MWHs in the study area. To improve women’s access to skilled childbirth, it is crucial to tailor context-based MWH messages, upgrade existing MWHs and ensure that the services are culturally sensitive.

scholarly journals Making Pastoralists Count: Geospatial Methods for the Health Surveillance of Nomadic Populations

2019 ◽  
Author(s):  
Hannah Wild ◽  
Luke Glowacki ◽  
Stace Maples ◽  
Iván Mejía-Guevara ◽  
Amy Krystosik ◽  
...  
Keyword(s):  
Sampling Strategy ◽  
Population Data ◽  
Population Level ◽  
Skilled Birth Attendance ◽  
Cultural Barriers ◽  
Demographic And Health Surveys ◽  
Sampling Frame ◽  
Nomadic Pastoralists ◽  
Birth Attendance ◽  
Feasible Alternative

AbstractNomadic pastoralists are among the world’s hardest-to-reach and least-served populations. Pastoralist communities are difficult to capture in household surveys due to factors including their high degree of mobility over remote terrain, fluid domestic arrangements, and cultural barriers. Most surveys utilize census-based sampling frames which do not accurately capture the demographic and health parameters of nomadic populations. As a result, pastoralists are “invisible” in population data such as the Demographic and Health Surveys (DHS). By combining remote sensing and geospatial analysis, we developed a sampling strategy designed to capture the current distribution of nomadic populations.We then implemented this sampling frame to survey a population of mobile pastoralists in southwest Ethiopia, focusing on maternal and child health (MCH) indicators. Using standardized instruments from DHS questionnaires, we draw comparisons with regional and national data finding disparities with DHS data in core MCH indicators including vaccination coverage, skilled birth attendance, and nutritional status. Our field validation demonstrates that this method is a logistically feasible alternative to conventional sampling frames and may be used at the population level. Geospatial sampling methods provide cost-affordable and logistically feasible strategies for sampling mobile populations, a crucial first step towards reaching these groups with health services.

scholarly journals Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hee sang Yoon ◽  
Chong-Sup Kim
Keyword(s):  
El Salvador ◽  
Maternal Mortality Ratio ◽  
Health Indicators ◽  
Skilled Birth Attendance ◽  
Fertility Rate ◽  
Birth Attendance ◽  
Maternity Waiting Homes ◽  
Health Factors ◽  
Mortality Ratio

Abstract Background El Salvador is recognized as a country that has effectively reduced its Maternal Mortality Ratio (MMR). While health indicators, such as total fertility rate, adolescent fertility rate, skilled birth attendance, and health expenditures, have improved in El Salvador, this improvement was unremarkable compared to advancements in other developing countries. How El Salvador could achieve an outstanding decrease in MMR despite unexceptional improvements in health and non-health indicators is a question that deserves deep research. We used quantitative methods and an observational case study to show that El Salvador could reduce its MMR more than expected by instituting health policies that not only aimed to reduce the (adolescent) fertility rate, but also provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. Methods We ran pooled ordinary least squares regression and panel regression with fixed effects using MMR as the dependent variable and health and non-health factors as the independent variables. We conducted residual analysis, calculated the predicted value of MMR, and compared it with the observed value in El Salvador. To explain the change in MMR in El Salvador, we carried out an observational case study of maternity waiting homes in that country. Results El Salvador could reduce MMR by improving health factors such as fertility rate skilled birth attendance and non-health factors, such as gross domestic product (GDP) per capita and female empowerment. However, even while considering these factors, the MMR of El Salvador decreased by more than expected. We confirmed this by analyzing the residuals of the regression model. This improvement in MMR, which is larger than expected from the regression results, can be attributed partly to government measures such as maternity waiting homes. Conclusions The reason for the unexplained reduction in El Salvador’s MMR seems to be attributed in part to health policies that not only aim to reduce the fertility rate but also to provide safe birthing conditions and medical services to pregnant women through maternity waiting homes.

Problems and Practice of Management on Menstruation by Adolescents Girls of Basic Schools of Chitwan, Nepal

2020 ◽  
Vol 8 ◽  
pp. 85-94
Author(s):  
Sudha Ghimire
Keyword(s):  
Current Practice ◽  
Quantitative Information ◽  
Community Schools ◽  
Mixed Method Research ◽  
Participatory Action ◽  
Group Discussions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Field Notes ◽  
Sanitary Pads

Managing menstruation in a hygienic way is a challenge in most of the low and middle-income countries (LMIC) including Nepal, where normal and natural physiological process of menstruation is considered as girls’ problem which is viewed as sinful, unholy and matter of shame. This paper explores the current practice and existing difficulties that adolescents girls encounter hygienic management of menstruation (MHM) especially during school days. The study was conducted on five purposively selected community schools of Chitwan district. The study adopted Participatory Action Research (PAR) as an approach, that is encapsulated with mixed method research design. For qualitative information observation, focus group discussions (FGD) and field notes were used, whereas for quantitative data self-administrative questionnaires were used. Quantitative information was collected from 205 girls students who were present at schools on the day of data collection. The finding shows that majority of the girls (93.7%) who encounter hygienic management of menstruation were of 10-14 years old age, whereas nearly one third of them were (29%) from grade eight. Similarly, among the total 205 girls, only 79 girls have already started their menstruation; among those who have started menstruation majority (78%) had heard about menstruation form their mothers. Likewise, 35% girls used homemade cotton pads and 40.5% of them changed pad three times a day. During FGD, adolescents girls shared that lack of water and soap in toilets, stress and lack of concentration during menstruation are the major difficulties which they encounter during days of menstruation. They suggested the concerned authorities to manage pad bank, make soap and water available, and develop skills for proper disposing of used sanitary pads for MHM at schools. 

scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

scholarly journals Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edward Kwabena Ameyaw ◽  
Kwamena Sekyi Dickson ◽  
Kenneth Setorwu Adde
Keyword(s):  
Binary Logistic Regression ◽  
Skilled Birth Attendant ◽  
World Health Organisation ◽  
Skilled Birth Attendance ◽  
World Health ◽  
Maternal Healthcare ◽  
Wealth Status ◽  
Maternal Characteristics ◽  
Birth Attendance ◽  
Three Components

Abstract Background To achieve the Sustainable Development Goal target 3.1, the World Health Organisation recommends that all pregnant women receive antenatal care (ANC) from skilled providers, utilise the services of a skilled birth attendant at birth and receive their first postnatal care (PNC) within the first 24 h after birth. In this paper, we examined the maternal characteristics that determine utilisation of skilled ANC, skilled birth attendance (SBA), and PNC within the first 24 h after delivery in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey. Women aged 15-49 with birth history not exceeding five before the survey were included in the study. A total of 2839 women were included. Binary logistic regression was employed at a 95% level of significance to determine the association between maternal factors and maternal healthcare (MCH) utilisation. Bivariate and multivariate regression was subsequently used to assess the drivers. Results High proportion of women had ANC (93.2%) with skilled providers compared to the proportion that had SBA (76.9%) and PNC within the first 24 h after delivery (25.8%). Only 21.2% utilised all three components of MCH. Women who were covered by national health insurance scheme (NHIS) had a higher likelihood (AOR = 1.31, CI = 1.04 – 1.64) of utilising all three components of MCH as compared to those who were not covered by NHIS. Women with poorer wealth status (AOR = 0.72, CI = 0.53 – 0.97) and those living with partners (AOR = 0.65, CI = 0.49 – 0.86) were less likely to utilise all three MCH components compared to women with poorest wealth status and the married respectively. Conclusion The realisation that poorer women, those unsubscribed to NHIS and women living with partners have a lower likelihood of utilising the WHO recommended MCH strongly suggest that it is crucial for the Ministry of Health and the Ghana Health Service to take pragmatic steps to increase education about the importance of having ANC with a skilled provider, SBA, and benefits of having the first 24 h recommended PNC.

scholarly journals Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals

Curationis ◽  
2015 ◽  
Vol 38 (1) ◽  
Author(s):  
Sindiwe James ◽  
Thenjiwe M. Miza
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Group Discussions ◽  
State Hospitals ◽  
African Health ◽  
Outpatient Departments ◽  
Field Notes ◽  
Professional Nurses

Background: The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace.Objectives: To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles.Method: A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in thePort Elizabeth Hospital Complex. Guba’s model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch’s data analysis spiral and with the involvement of an independent-coder.Results: Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception.Conclusion: Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.

scholarly journals Using graphic illustrations to uncover how a community of practice can influence the delivery of compassionate healthcare

2018 ◽  
Vol 45 (4) ◽  
pp. 381-387 ◽  
Author(s):  
Trisha Parsons ◽  
Deborah Tregunno ◽  
Mala Joneja ◽  
Nancy Dalgarno ◽  
Leslie Flynn
Keyword(s):  
Community Of Practice ◽  
Personal Growth ◽  
Daily Practice ◽  
Professional Relationships ◽  
Group Discussions ◽  
Cultural Shift ◽  
Professional Educators ◽  
Secondary Sources ◽  
Narrative Design ◽  
Field Notes

Our modern-day frenetic healthcare culture has progressed to a state where healthcare professionals tend to detach themselves from the emotions of their patients/clients, rather than embed compassion into their daily practice. The AMS Phoenix Project: A Call to Caring was implemented with the goal to instil and sustain empathy and compassion in environments where clinicians learn and work. The purpose of this study is to report on how an interprofessional community of practice (CoP) of healthcare educators can contribute to a cultural shift in promoting and delivering compassion in healthcare through health professionals education. Using an imaginative creative autoethnography that adopts a narrative design through graphic illustrations, data were collected from 25 members of the Phoenix@Queen’s CoP during a 1-day retreat. Data collection included a graphic recorder who visually depicted all retreat dialogue, field notes that highlighted emergent themes and artefacts produced during the day. Audio recordings of the discussions were used as secondary sources of data. Using thematic analysis, three themes emerged: the call to caring is a long and winding road with many barriers and rewards; CoP members experienced personal growth in and through the community; and the Phoenix@Queen’s CoP matters in terms of professional relationships, leadership and moving forward a shared agenda about practising compassionate healthcare. This study describes the development of a CoP that moves away from traditional committees and discussions to an experiential creation of connections and shared meaning by its members. By using autoethnography, and by demonstrating how graphic illustration can be an innovative and creative method for recording and interpreting group discussions, we have demonstrated the accelerated development of an authentic CoP. With a richer and more authentic community, the shared goals of healthcare professional educators are more likely to be achieved.

scholarly journals The Same but Different: Making Meaning from Modified Texts with Cross-cultural Themes

2017 ◽  
Vol 19 (2) ◽  
pp. 82
Author(s):  
Cynthia B. Leung ◽  
Susan V. Bennett ◽  
AnnMarie Alberton Gunn
Keyword(s):  
Cross Cultural ◽  
Group Discussions ◽  
Reader Response Theory ◽  
Basal Reader ◽  
Fifth Grade Students ◽  
Cultural Themes ◽  
Information Group ◽  
Field Notes ◽  
Cultural Responses ◽  
Constant Comparative Analysis

Reader response theory provides the framework for the present study that explored literary elements and cultural responses of fifth-grade students to two modified versions of a cross-cultural text, Homesick: My Own Story by Jean Fritz. One group of students read the first chapter of the book and another group read a modified basal reader version that had deleted cultural information. Group discussions of the texts were videotaped and transcribed. Through constant comparative analysis of field notes and transcripts, two themes emerged: (a) personal interest and connections to stories and (b) cultural implications and misinterpretations.

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