scholarly journals Barriers and facilitators to exclusive breastfeeding practices in a disadvantaged community in southern Zimbabwe: A maternal perspective

2021 ◽  
Vol 12 (1) ◽  
pp. 73-91
Author(s):  
Paddington Tinashe Mundagowa ◽  
Elizabeth Marian Chadambuka ◽  
Pugie Tawanda Chimberengwa ◽  
Fadzai Naomi Mukora-Mutseyekwa
Keyword(s):  
Infant Feeding ◽  
Healthcare Workers ◽  
Maternal Diet ◽  
Barriers And Facilitators ◽  
Group Discussions ◽  
Disadvantaged Community ◽  
Hot Climate ◽  
Suboptimal Breastfeeding ◽  
Maternal Autonomy ◽  
Thematic Network Analysis

Background: Despite the well-documented significance of EBF in developing countries, many poor communities still present with the highest percentage of disease burden resulting from suboptimal breastfeeding. Objectives: To identify the maternal perception on barriers and facilitators to EBF in Gwanda District, Zimbabwe. Methods: Five focused group discussions were conducted using 40 purposively-selected mothers while eight in-depth key informant interviews were also conducted. The qualitative data collected were analyzed using thematic network analysis. The themes were used in interpreting the perceived barriers and facilitators of EBF. Results: The study identified individual, socio-cultural, health service-related and environmental factors as the basic themes influencing maternal infant feeding choice. These were grouped into two organizing themes, namely, barriers and facilitators of EBF which were summarized into one global theme: EBF intention. Facilitating factors were maternal autonomy, self-efficacy, knowledge of EBF definition, maternal diet, support and sourcing information from healthcare workers. Poor infant feeding practices, affordability of alternative infant feeding options, ritualistic/symbolic infant preparations, family conflicts, increased workload and hot climate were barriers to EBF. Conclusion: To increase in uptake of EBF in the study area required comprehensive multiple stakeholder interventions incorporating the mothers, influential family members, religion and traditional advisors, and healthcare workers.

scholarly journals The Mentor Mothers Program in the Department of Defense in Nigeria: An Evaluation of Healthcare Workers, Mentor Mothers, and Patients’ Experiences

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 328
Author(s):  
Josephine Moshe Ibu ◽  
Euphemia Mbali Mhlongo
Keyword(s):  
Department Of Defense ◽  
Healthcare Workers ◽  
Psychosocial Support ◽  
Hiv Infections ◽  
Health Facilities ◽  
World Health ◽  
Group Discussions ◽  
Analysis Technique ◽  
Hiv Awareness ◽  
Health Organization

Nigeria contributes the highest to the global burden of HIV/AIDS and also accounts for the largest proportion of new vertically transmitted HIV infections among children. The Mentor Mothers program in the Nigerian Department of Defense was introduced in accordance with the World Health Organization and its implementing partner guidelines to curb the high incidence of vertically acquired HIV infections. Understanding the experiences of participants could serve as a gateway to evaluating the effectiveness of the program to better provide quality services within targeted health facilities. This qualitative study employed key informant interviews with six healthcare workers as well as two focus group discussions with six mentor mothers and six prevention of mother-to-child transmission (PMTCT) patients in four selected hospitals in the Nigerian Department of Defense to explore their experiences of the Mentor Mothers program. A thematic analysis technique was used to analyze the collated data. As a result, four main themes emerged, with the program perceived by most participants as providing psychosocial support to the patients, a valuable educational resource for raising HIV awareness, a valuable resource for promoting exclusive breastfeeding and mitigating vertical transmission of the virus, and functioning as a link between patients and the healthcare system. The participants reported that the program had effectively decreased HIV infections in children, reduced child and maternal mortality, and supported the livelihood and development of women, families, and communities in and around the Nigerian Department of Defense health facilities.

scholarly journals Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 552
Author(s):  
Phiona Nalubega ◽  
Emilie Karafillakis ◽  
Lydia Atuhaire ◽  
Pamela Akite ◽  
Flavia Zalwango ◽  
...  
Keyword(s):  
Side Effects ◽  
Pregnant Women ◽  
Healthcare Workers ◽  
Community Leaders ◽  
Community Members ◽  
Group Discussions ◽  
Maternal Vaccination ◽  
Key Informant ◽  
Maternal Immunisation ◽  
The Government

Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme managers (10) between November 2019 and October 2020. Data were analysed thematically. Results: Pregnant women, community leaders and some HCWs had limited maternal immunisation knowledge. There was confusion over what constitutes a vaccine. Pregnant women may not receive vaccines because of mistrust of government; use of expired vaccines; reliance on traditional medicine; religious beliefs; fear of side effects; HCWs attitudes; and logistical issues. The key facilitators of maternal vaccination were a desire to prevent diseases, positive influences from HCWs and information about vaccine side effects. Community leaders and some pregnant women highlighted that pregnant women do not make decisions about maternal vaccination independently and are influenced by different individuals, including other pregnant women, older people, partners, relatives (parents), community leaders, HCWs and the government. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines.

Implementation of ultrasound after central venous catheter insertion: A qualitative study in early adopters

2021 ◽  
pp. 112972982110534
Author(s):  
Enyo A Ablordeppey ◽  
Shannon M Keating ◽  
Katherine M Brown ◽  
Daniel L Theodoro ◽  
Richard T Griffey ◽  
...  
Keyword(s):  
Focus Group ◽  
Central Venous Catheter ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Venous Catheter ◽  
Barriers And Facilitators ◽  
Central Venous ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Post Procedure

Background: The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR. Methods: We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation. Results: The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators. Conclusion: Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.

scholarly journals ‘Sometimes you are forced to play God…’: a qualitative study of healthcare worker experiences of using continuous positive airway pressure in newborn care in Kenya

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034668
Author(s):  
Helen M Nabwera ◽  
Jemma L Wright ◽  
Manasi Patil ◽  
Fiona Dickinson ◽  
Pamela Godia ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Focus Group ◽  
Airway Pressure ◽  
Healthcare Workers ◽  
Positive Airway Pressure ◽  
Scale Up ◽  
Newborn Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

​ObjectiveTo explore the experiences of using continuous positive airway pressure (CPAP) in newborn care among healthcare workers in Kenya, and to identify factors that would promote successful scale-up.​Design and settingA qualitative study using key informant interviews and focus group discussions, based at secondary and tertiary level hospitals in Kenya.​ParticipantsHealthcare workers in the newborn units providing CPAP.​Primary and secondary outcome measureFacilitators and barriers of CPAP use in newborn care in Kenya.​Results16 key informant interviews and 15 focus group discussions were conducted across 19 hospitals from September 2017 to February 2018. Main barriers reported were: (1) inadequate infrastructure to support the effective delivery of CPAP, (2) shortage of skilled staff rendering it difficult for the available staff to initiate or monitor infants on CPAP and (3) inadequate knowledge and training of staff that inhibited the safe care of infants on CPAP. Key facilitators reported were positive patient outcomes after CPAP use that increased staff confidence and partnership with caregivers in the management of newborns on CPAP. Healthcare workers in private/mission hospitals had more positive experiences of using CPAP in newborn care as the relevant support and infrastructure were available.​ConclusionCPAP use in newborn care is valued by healthcare workers in Kenya. However, we identified key challenges that threaten its safe use and sustainability. Further scale-up of CPAP in newborn care should ensure that staff members have ready access to optimal training on CPAP and that there are enough resources and infrastructure to support its use.EthicsThis study was approved through the appropriate ethics committees in Kenya and the UK (see in text) with written informed consent for each participant.

scholarly journals Maternal perspectives on infant feeding practices in Soweto, South Africa

2020 ◽  
pp. 1-13
Author(s):  
Stephanie V Wrottesley ◽  
Alessandra Prioreschi ◽  
Wiedaad Slemming ◽  
Emmanuel Cohen ◽  
Cindy-Lee Dennis ◽  
...  
Keyword(s):  
South Africa ◽  
Infant Feeding ◽  
Breast Feeding ◽  
Feeding Practices ◽  
African Women ◽  
Infant Feeding Practices ◽  
Eating Behaviours ◽  
Group Discussions ◽  
Exclusive Breast Feeding ◽  
South African Women

Abstract Objective: To (i) describe the infant feeding practices of South African women living in Soweto and (ii) understand from the mothers’ perspective what influences feeding practices. Design: Semi-structured focus group discussions (FGD) and in-depth interviews (IDI) were conducted, and data were analysed using thematic analysis. Setting: Soweto, South Africa. Participants: Nineteen mothers were stratified into three FGD according to their baby’s age as follows: 0–6-month-olds, 7–14-month-olds and 15–24-month-olds. Four mothers from each FGD then attended an IDI. Results: Although mothers understood that breast-feeding was beneficial, they reported short durations of exclusive breast-feeding. The diversity and quality of weaning foods were low, and ‘junk’ food items were commonly given. Infants were fed using bottles or spoons and feeding commonly occurred separately to family meal times. Feeding practices were influenced by mothers’ beliefs that what babies eat is important for their health and that an unwillingness to eat is a sign of ill health. As such, mothers often force-fed their babies. In addition, mothers believed that feeding solid food to babies before 6 months of age was necessary. Family matriarchs were highly influential to mothers’ feeding practices; however, their advice often contradicted that of health professionals. Conclusions: In South Africa, interventions aimed at establishing healthier appetites and eating behaviours in early life should focus on: (i) fostering maternal self-efficacy around exclusive breast-feeding; (ii) challenging mixed feeding practices and encouraging more responsive feeding approaches and (iii) engaging family members to promote supportive household and community structures around infant feeding.

scholarly journals Perceptions of barriers and facilitators in physical activity participation among women in Thiruvananthapuram City, India

2016 ◽  
Vol 23 (4) ◽  
pp. 27-36 ◽  
Author(s):  
Elezebeth Mathews ◽  
J. K. Lakshmi ◽  
T. K. Sundari Ravindran ◽  
Michael Pratt ◽  
K. R. Thankappan
Keyword(s):  
Physical Activity ◽  
Physical Activity Intervention ◽  
Physical Activity Promotion ◽  
Activity Level ◽  
Barriers And Facilitators ◽  
Cultural Barriers ◽  
Cultural Norms ◽  
Group Discussions ◽  
Activity Promotion ◽  
Social Norming

Background: Despite the known benefits of physical activity, very few people, especially women, are found to engage in regular physical activity. This study explored the perceptions, barriers and facilitators related to physical activity among women in Thiruvananthapuram City, India. Methods: Four focus group discussions were conducted among individuals between 25 and 60 years of age, in a few areas of Thiruvananthapuram City Corporation limits in Kerala, preparatory to the design of a physical activity intervention trial. An open-ended approach was used and emergent findings were analyzed and interpreted. Results: Women associated physical activity mostly with household activities. The majority of the women considered their activity level adequate, although they engaged in what the researchers concluded were quite low levels of activity. Commonly reported barriers were lack of time, motivation, and interest; stray dogs; narrow roads; and not being used to the culture of walking. Facilitators of activity were seeing others walking, walking in pairs, and pleasant walking routes. Walking was reported as the most feasible physical activity by women. Conclusion: Physical activity promotion strategies among women should address the prevailing cultural norms in the community, and involve social norming and overcoming cultural barriers. They should also target the modifiable determinants of physical activity, such as improving self-efficacy, improving knowledge on the adequacy of physical activity and its recommendations, facilitating goal-setting, and enhancing social support through peer support and group-based activities.

scholarly journals The influence of early feeding practices on healthy diet variety score among pre-school children in four European birth cohorts

2014 ◽  
Vol 18 (10) ◽  
pp. 1774-1784 ◽  
Author(s):  
Louise Jones ◽  
George Moschonis ◽  
Andreia Oliveira ◽  
Blandine de Lauzon-Guillain ◽  
Yannis Manios ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Short Duration ◽  
School Children ◽  
Linear Models ◽  
Complementary Feeding ◽  
Maternal Diet ◽  
Food Groups ◽  
Healthy Foods ◽  
Birth Cohorts ◽  
Breast Fed

AbstractObjectiveThe present study examined whether maternal diet and early infant feeding experiences relating to being breast-fed and complementary feeding influence the range of healthy foods consumed in later childhood.DesignData from four European birth cohorts were studied. Healthy Plate Variety Score (HPVS) was calculated using FFQ. HPVS assesses the variety of healthy foods consumed within and across the five main food groups. The weighted numbers of servings consumed of each food group were summed; the maximum score was 5. Associations between infant feeding experiences, maternal diet and the HPVS were tested using generalized linear models and adjusted for appropriate confounders.SettingThe British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de L’Enfant study (EDEN), the Portuguese Generation XXI Birth Cohort and the Greek EuroPrevall cohort.SubjectsPre-school children and their mothers.ResultsThe mean HPVS for each of the cohorts ranged from 2·3 to 3·8, indicating that the majority of children were not eating a full variety of healthy foods. Never being breast-fed or being breast-fed for a short duration was associated with lower HPVS at 2, 3 and 4 years of age in all cohorts. There was no consistent association between the timing of complementary feeding and HPVS. Mother’s HPVS was strongly positively associated with child’s HPVS but did not greatly attenuate the relationship with breast-feeding duration.ConclusionsResults suggest that being breast-fed for a short duration is associated with pre-school children eating a lower variety of healthy foods.

scholarly journals From chaos to control – experiences of healthcare workers during the early phase of the COVID-19 pandemic: a focus group study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fredrik Rücker ◽  
Maria Hårdstedt ◽  
Sekai Chenai Mathabire Rücker ◽  
Emma Aspelin ◽  
Alexander Smirnoff ◽  
...  
Keyword(s):  
Content Analysis ◽  
Focus Group ◽  
Healthcare Workers ◽  
Qualitative Content Analysis ◽  
Working Environment ◽  
Infection Prevention And Control ◽  
Hospital Inpatient ◽  
Work Situation ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Background The Coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges to healthcare systems worldwide. Healthcare workers (HCWs) have faced particular challenges: being exposed to the coronavirus SARS-CoV-2 and caring for patients having a new and potentially life-threatening disease. The aim of this study was to explore how HCWs in the Swedish healthcare system perceived their work situation during the first phase of the COVID-19 pandemic in 2020. Methods Focus group discussions and interviews with HCWs were performed from June to October 2020 in one Swedish healthcare region. A purposeful sampling approach was used to select a variety of professions (physicians, nurses, nurse aides and cleaners) and workplaces (hospital inpatient wards, emergency department, nursing home and home care service). Qualitative content analysis was used for data analysis. Results In total, 51 HCWs participated in eight focus group discussions and one HCW participated in an individual interview. The content analysis identified two main categories: ‘Concerns about the risk of infection and transmission of infection to others’, and ‘Transition from chaos to managing in a new and challenging work situation’. The findings revealed how HCWs perceived working conditions, including experiences of fear for personal health, confusion and uncertainty regarding personal protective equipment and infection prevention and control (PPE/IPC), and fear of infecting others. Both fearful and appreciating attitudes were achieved from the surrounding community. Helpful strategies for transition from chaos to control were lifted i.e. present and supportive leadership, and finding comfort and strength in the working team. Both helplessness and meaningfulness were described when caring for COVID-19 patients. Conclusions This study provides unique insights into HCWs experiences of an extremely challenging work situation during the first phase of the COVID-19 pandemic, including feelings of stress and insecurity in a chaotic and hazardous working environment. But there is also mitigation of these challenges and even positive experiences including feelings of safety and meaningfulness. To enhance safety among HCWs in healthcare crises such as the COVID-19 pandemic, the findings highlight the importance of avoiding confusion about PPE/IPC, having a supportive healthcare leadership and ensuring accurate information provision about virus transmission to the public.

scholarly journals A qualitative study of barriers and facilitators to adequate environmental health conditions and infection control for healthcare workers in Malawi

2022 ◽  
Author(s):  
Raymond Tu ◽  
Hayley Elling ◽  
Nikki Behnke ◽  
Jennifer Mmodzi Tseka ◽  
Holystone Kafanikhale ◽  
...  
Keyword(s):  
Environmental Health ◽  
Healthcare Workers ◽  
Barriers And Facilitators ◽  
Infection Prevention And Control ◽  
Structured Interviews ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Management Procedures ◽  
Water Provision ◽  
Healthcare Associated

Abstract The burden of healthcare-associated infections (HAIs) is greater in low- and middle-income countries than in high-income countries. Inadequate environmental health (EH) conditions and work systems contribute to HAIs in countries like Malawi. We collected qualitative data from 48 semi-structured interviews with healthcare workers (HCWs) from 45 healthcare facilities (HCFs) across Malawi and conducted a thematic analysis. The facilitators of infection prevention and control (IPC) practices in HCFs included disinfection practices, patient education, and waste management procedures. HCWs reported barriers such as lack of IPC training, bottlenecks in maintenance and repair, hand hygiene infrastructure, water provision, and personal protective equipment. This is one of the most comprehensive assessments to date of IPC practices and environmental conditions in Malawian HCFs in relation to HCWs. A comprehensive understanding of barriers and facilitators to IPC practices will help decision-makers craft better interventions and policies to support HCWs to protect themselves and their patients.

scholarly journals COVID-Well: Evaluation of the Implementation of Supported Wellbeing Centres for Hospital Employees During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Holly Blake ◽  
Mehmet Yildirim ◽  
Ben Wood ◽  
Steph Knowles ◽  
Helen Mancini ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Work Engagement ◽  
Healthcare Workers ◽  
Online Survey ◽  
Service Use ◽  
Turnover Intentions ◽  
Psychological Impact ◽  
Barriers And Facilitators ◽  
Staff Retention ◽  
Hospital Employees

Supported Wellbeing Centres have been set up in UK hospital trusts in effort to mitigate the psychological impact of COVID-19 on healthcare workers, although the extent to which these are utilised and the barriers and facilitators to access are not known. The aim of the study was to determine facility usage and gather insight into employee wellbeing and the views of employees towards this provision. The study included i) 17-week service use monitoring, ii) employee online survey with measures of wellbeing, job stressfulness, presenteeism, turnover intentions, job satisfaction, and work engagement as well as barriers and facilitators to accessing the Wellbeing Centres. Over 17 weeks, 14,934 facility visits were recorded across two sites (peak attendance in single week n= 2,605). Facilities were highly valued, but the service model was resource intensive with 134 wellbeing buddies supporting the centres in pairs. 819 hospital employees completed an online survey (88% female; 37.7% working in COVID-19 high risk areas; 52.4% frontline workers; 55.2% had accessed a wellbeing centre). There was moderate-to-high job stress (62.9%), low wellbeing (26.1%), presenteeism (68%) and intentions to leave (31.6%). Wellbeing was higher in those that accessed a wellbeing centre. Work engagement and job satisfaction were high. Healthcare organisations are urged to mobilise access to high-quality rest spaces and Psychological First Aid, but this should be localised and diversified. Strategies to address presenteeism and staff retention should be prioritised, and high dedication of healthcare workers should be recognised.

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