scholarly journals Assessment of Tribal Healthcare Infrastructure for Delivery of Maternal Health Program in Balasore District, Odisha, India

2021 ◽  
Vol 16 (3) ◽  
pp. 165-173
Author(s):  
Ranjit Kumar Dehury

Introduction: There are still large number of maternal deaths in India nearing up to 50,000 deaths in a year which is one sixth of the world in recent years. Odisha (India) is also not performing well in maternal health care management despite its commitment in MDG and SDG. Odisha constitute 23% of tribal population, where the maternal mortality is very high and difficult to provide health services, particularly maternal health services. The study aims to assess provision of necessary health services for pregnant women in an inaccessible tribal pockets. Methods: The study was conducted in Balasore district, Odisha (India) where a sizable population is consisting of various indigenous tribes, particularly in some blocks. The Parijata tool was used to assess various health care facilities which was developed by UNICEF and ARTH, Rajasthan. By this, availability of basic things like manpower, drugs and consumables are assessed along with laid down clinical practices and procedures. Results: The study found that there is lack of provisioning of health services in healthcare facilities. Both District hospital at Balasore and Sub-district hospitals lack basic services recommended by WHO for taking care of women. Further, the effort of government to implement a uniform program across the state hinder the tailoring of services for tribal pockets. Conclusion: The study provides remedial measures for improving the role and functioning of grass roots workers, integrating indigenous medicine with biomedicine, and revamping health information system to incorporate cultural features, thereby improving its utilization in the study area. The study raised critical issues about potential of maternal health program to deliver effective care of pregnant women in tribal dominated areas.

2020 ◽  
Vol 2 (2) ◽  
pp. 48-52 ◽  
Author(s):  
Smriti Pant ◽  
Saugat Koirala ◽  
Madhusudan Subedi

Most causes of maternal morbidity and mortality can be prevented by giving prompt, suitable treatment to the women by qualified health practitioners. Maternal health services (MHS), which include antenatal care, delivery care, and postnatal care, can play a crucial role in preventing maternal health problems. The recent coronavirus disease (COVID-19) pandemic has had a disastrous effect on the health care delivery system of people of all ages, on a global scale but pregnant women face particular challenges. The aim of this review is to assess the effect of COVID-19 on access to MHS. For writing this narrative review, national and international reports on maternal health services during COVID-19, along with journal articles on the related topic were reviewed. Due to this pandemic, women worldwide are facing more barriers to accessing maternal health care, including restrictions, transport challenges, and anxiety over possibly being exposed to coronavirus. Many women preferred not to seek healthcare due to the fear of themselves being infected with the virus or transmitting it to their unborn babies. Additionally, movement restriction has made it difficult for many pregnant women to reach health care facilities. Even those who managed to reach health facilities have reported not receiving timely care. As a result, a considerable rise in maternal mortality globally has been estimated over the next six months. Despite the circumstances, efforts have been made to boost maternal health in both developed and developing countries. This pandemic has highlighted the importance of health preparedness with special attention given to vulnerable people like pregnant women and newborns while planning for such events. Keywords: Childbirth, COVID19, Maternal Health, Pandemic, Pregnancy, Women’s health


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257032
Author(s):  
Ni Ketut Aryastami ◽  
Rofingatul Mubasyiroh

Background Maternal Mortality Ratio (MMR) in Indonesia is still high, 305, compared to 240 deaths per 100,000 in South East Asian Region. The use of Traditional Birth Attendance (TBA) as a cascade for maternal health and delivery, suspected to be the pocket of the MMR problem. The study aimed to assess the influence of traditional practices on maternal health services in Indonesia. Methods We used two data sets of national surveys for this secondary data analysis. The samples included 14,798 mothers whose final delivery was between January 2005 and August 2010. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC≥4), attended by skilled birth attendance (SBA), and having a facility-based delivery (FBD). The independent variables were the use of traditional practices, type of family structure, and TBA density. We run a Multivariate logistic regression for the analysis by controlling all the covariates. Results Traditional practices and high TBA density have significantly inhibited the mother’s access to maternal health services. Mothers who completed antenatal care were 15.6% lost the cascade of facility-based delivery. The higher the TBA population, the lower cascade of the use of Maternal Health Services irrespective of the economic quintile. Mothers in villages with a high TBA density had significantly lower odds (AOR = 0.30; CI = 0.24–0.38; p<0.01) than mothers in towns with low TBA density. Moreover, mothers who lived in an extended family had positively significantly higher odds (AOR = 1.33, CI = 1.17–1.52; p<0.01) of using maternal health services. Discussion Not all mothers who have received proper antenatal delivered the baby in health care facilities or preferred a traditional birth attendance instead. Traditional practices influenced the ideal utilization of maternal health care. Maternal health care utilization can be improved by community empowerment through the maternal health policy to easier mothers get delivery in a health care facility.


2021 ◽  
Author(s):  
Rahul Shrivastava ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi

BACKGROUND Pregnant women are considered to be a “high risk” group with limited access to health facilities in urban slums. Barriers to utilization of health services may lead to maternal and child mortality, morbidity, low birth weight, and children with stunted growth. Application of artificial intelligence (AI) can provide substantial improvements in all areas of healthcare from diagnostics to treatment. There have been several technological advances within the field of AI, however, AI not merely driven by what is technically feasible, but by what is humanly desirable is the need of the hour. OBJECTIVE The objective of our study is to develop and evaluate the AI guided citizen centric platform to enhance the uptake of maternal health services (antenatal care) amongst the pregnant women living in urban slum settings. METHODS A cross-sectional mixed method approach employed to collect data among pregnant women, aged 18-44 years, living in urban slums of South Delhi. A convenience sampling used to recruit 225 participants at the Anganwadi centres (AWC) after obtaining consent from the eligible participants. Inclusion criteria includes pregnant individuals residing in urban slums for more than 3 months, having smartphones, visiting AWC for seeking antenatal care. Quantitative and qualitative data will be collected electronically using Open Data Kit (ODK) based opensource tool from eligible participants. Data will be collected on clinical as well as socio-demographic parameters (based on existing literature). We aim to develop an innovative AI guided citizen centric decision support platform to effectively manage pregnancy and its outcomes among urban poor populations. The proposed research will help policymakers to prioritize resource planning, resource allocation and development of programs and policies to enhance maternal health outcomes. RESULTS The AI guided citizen centric decision support platform will be designed, developed, implemented and evaluated using principles of human centred design and findings of the study will be reported to diverse stakeholders. The tested and revised platform will be deployed for use across various stakeholders such as pregnant women, healthcare professionals, frontline workers, and policymakers. CONCLUSIONS With the understanding, use and adoption of emerging and innovative technologies such as AI, maternal health informatics can be at the forefront to help pregnant women in crisis. The proposed platform will potentially be scaled up to different geographic locations for adoption for similar and other health conditions.


2014 ◽  
Vol 55 (3) ◽  
pp. 235 ◽  
Author(s):  
ChinomnsoC Nnebue ◽  
UzoE Ebenebe ◽  
ProsperOU Adogu ◽  
EchenduD Adinma ◽  
ChigozieO Ifeadike ◽  
...  

Inovasi ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 141-150
Author(s):  
Jonni Sitorus

The number of maternal deaths in North Sumatra in 2017 was recorded in Labuhanbatu Regency and Deli Serdang Regency as many as 15 deaths, Langkat Regency with 13 deaths, and Batubara Regency with 11 deaths. Efforts to accelerate the reduction of Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are carried out to ensure that every mother is able to access quality maternal health services, such as maternal health services, delivery assistance by trained health personnel in health care facilities, postpartum care for mothers and babies, special care and referrals if complications occur, the ease of obtaining maternity and childbirth leave and family planning services. Efforts to reduce MMR and IMR are not only the responsibility of one sector, but need the involvement and roles of other stakeholders to accelerate the reduction of MMR/IMR. This study aims to provide recommendations for the reduction of MMR/IMR through the role of stakeholders in North Sumatra. The study used a qualitative method with a phenomenological approach which was conducted from May to September 2019. The research locations were: Mandailing Natal Regency, Deli Serdang Regency, Simalungun Regency, and Sibolga City. The research subjects consisted of 3 (three) elements, namely: Government, Private and Community. Data collection was carried out through observation and through Focus Group Discussion (FGD). This study concludes that the model of efforts to reduce maternal and infant mortality rates must be carried out in a holistic and integrative manner with medical, social, and cultural approaches, starting from health services for adolescent girls, women of productive age, pregnant women, maternity, newborns and toddlers. Efforts to reduce MMR and IMR are the responsibility of all DPOs and elements of academia, business and community, whose programs and activities are integrated. Efforts to reduce MMR and IMR must be viewed from various perspectives, including from a medical, social and cultural perspective.


2021 ◽  
Vol 2 ◽  
Author(s):  
Siri Aas Rustad ◽  
Helga Malmin Binningsbø ◽  
Haakon Gjerløw ◽  
Francis Mwesigye ◽  
Tony Odokonyero ◽  
...  

Introduction: Uganda is one of the largest refugee-hosting nations in the world, with the majority of the refugees having fled South Sudan. In the early 2000's the local government and refugee health systems were merged to create a more equal and integrated system for refugees and the host population. Our aim is to investigate whether mothers from the two groups experience the same access to and quality of maternal health services, and whether refugee- and host-community mothers perceive the maternal health services differently.Methods: In November–December 2019, we conducted a household survey of 1,004 Ugandan nationals and South Sudanese refugee mothers aged 15–49 in the West Nile region covering the districts of Arua, Yumbe, and Adjumani, and elicited information on access to maternal health care services, perceptions of the quality of services, and feelings of discrimination. The data was then analyzed using Ordinary Least Squares and logistic regression.Results: Our analyses do not reveal large differences between refugees and the host community in terms of access to and the quality of maternal health services. Results from bivariate models indicate that refugee mothers are 6% points less likely to receive antenatal care (p-value &lt; 0.05) but are 8% points more likely to give birth at a health facility (p-value &lt; 0.05). Refugee mothers are generally less satisfied with how they were treated during antenatal care (0.132 lower average value on a Likert scale, p-value &lt; 0.01). Refugee mothers are also 4% points more likely to feel discriminated against during ANC compared to their counterparts in the host community (p-value &lt; 0.05).Discussion: The way women feel treated at the health facility during maternal health care is an important aspect of quality care. While there seems to be equal access to resources between refugees and host community mothers in Northern Uganda in terms of access to and quality of care, there is still a discrepancy between the two groups in terms of how the women feel treated. Policymakers and practitioners in the health sector should pay attention to these perceived inequalities between refugees and women from the host communities to ensure equally inclusive treatment across groups.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 700
Author(s):  
Sajaan Praveena Gunarathne ◽  
Nuwan Darshana Wickramasinghe ◽  
Thilini Chanchala Agampodi ◽  
Indika Ruwan Prasanna ◽  
Suneth Buddhika Agampodi

Background: Investigating the out-of-pocket expenditure (OOPE) associated with maternal health is important since OOPE directly affects the affordability of health services. Global evidence suggests the importance of capturing the productivity cost during pregnancy in terms of absenteeism and presenteeism. Furthermore, the impact of the ongoing COVID-19 pandemic on the household economy needs to be further evaluated as pregnant women are one of the most vulnerable groups. This study aims at determining the economic burden of OOPE, productivity cost, and COVID-19 impact on pregnant women's household economy in a cohort of pregnant women in Anuradhapura District, Sri Lanka. Methods: The study setting is all 22 Medical Officer of Health (MOH) areas in Anuradhapura district, Sri Lanka. The study has three components; a follow-up study of a cohort of pregnant women to assess the magnitude and associated factors of OOPE and to assess the productivity cost (Component 1), a qualitative case study to explore the impact and causes of the OOPE under free health services (Component 2) and a cross-sectional study to describe the effects of COVID-19 outbreak on household economy (Component 3). The study samples consist of 1,393 and 1,460 participants for components one and three, respectively, and 25 pregnant women will be recruited for component two. The data will be analyzed using descriptive, parametric, and non-parametric statistics for the first and third components and thematic analysis for the second component. Discussion: With the lack of evidence on OOPE, productivity loss/cost in terms of maternal health, and COVID-19 impact on household economy in Sri Lanka, the evidence generated from this study would be valuable for policymakers, health care administrators, and health care practitioners globally, regionally, and locally to plan for future measures for reducing the OOPE, productivity loss/cost, and minimizing the economic hardship of the COVID-19 outbreak during pregnancy.


1992 ◽  
Vol 31 (03) ◽  
pp. 182-192 ◽  
Author(s):  
A. K. Singh ◽  
K. Boström ◽  
S. Chowdhury ◽  
E. Trell ◽  
O. Wigertz ◽  
...  

Abstract:There is a need for consensus on the quantity of data that must be available in a computer-based information system of a health care organization. In this paper we take up the issue of defining the data content of an information system and introduce the concept of Essential Data Sets with an explicit methodology which was applied to define a data set for the Maternal Health Services program. A key step in the method was a recognized technique used in systems development process called data modelling, in this case infological modelling, by an interdisciplinary group. A preliminary set of 86 data elements was identified and it provided the foundation for development of an application software for discussion and a real-world testing framework. The acceptability of the data set was tested in a laboratory perspective by retrospective data entry from records of 94 pregnant women registered at a maternal health care center in Sweden. Data from a total of 1,318 prenatal visits, an outcome visit, and a postnatal visit for each woman was entered into a computer using the software, with no loss of information. Thus, in a short-term perspective the acceptability of the data set was demonstrated. The software has since been implemented for pilot prospective studies at sites in India and Sweden. The use of a common data protocol is an essential foundation for patient outcome research, especially as the trend of health care management has changed from a “process of care” orientation to an “outcome of care” orientation.


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