scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals Do adult health outcomes in urban population reflect local health risk? A matched cohort analysis of migration effects in Ouagadougou, Burkina Faso

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029059
Author(s):  
Philippe Bocquier ◽  
Abdramane Bassiahi Soura ◽  
Souleymane Sanogo ◽  
Sara Randall
Keyword(s):  
Health Status ◽  
Health Services ◽  
Health Outcomes ◽  
Health Risks ◽  
Rural Areas ◽  
Urban Areas ◽  
Cohort Analysis ◽  
Local Health ◽  
Access To Health Services ◽  
Access To Health

BackgroundSelective migration may affect health indicators in both urban and rural areas. Sub-Saharan African urban areas show evidence of both negative and positive selection on health status at outmigration. Health outcomes as measured in urban populations may not reflect local health risks and access to health services.MethodsUsing the Ouagadougou Health and Demographic Surveillance System and a migrant follow-up survey, we measured differences in health between matched non-migrants and outmigrants. We applied Cox and competing risks models on migration and death.ResultsControlling for premigration health status, migrants who moved out of Ouagadougou have higher mortality (HR 3.24, 95% CI 1.23 to 8.58) than non-migrants and migrants moving to other Ouagadougou areas. However, these effects vanish in the matched sample controlling for all interactions between death determinants. These and other results show little evidence that migration led to higher mortality or worse health.ConclusionsHealth outcomes as measured in Ouagadougou population do reflect local health risks and access to health services despite high migration intensity. However, neither the hypothesis of effect of health on migration nor the hypothesis of negative effect of migration on health or survival was confirmed.

scholarly journals Review of obstetric fistulas in a rural hospital in South-South Nigeria

2011 ◽  
Vol 25 (1) ◽  
pp. 7
Author(s):  
Aniefiok J. Umoiyoho ◽  
Aniekan M. Abasiattai ◽  
Okon E. Akaiso
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Formal Education ◽  
Health Workers ◽  
Medical Condition ◽  
Obstetric Fistula ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Medical Personnel ◽  
Health Facilities

<em>Background</em>. Obstetric fistula is a devastating medical condition associated with adverse social, psychological and reproductive health consequences. This study was carried out to review the pattern of presentation and outcome of patients with obstetric fistulas in a rural health facility in South-South Nigeria. <em>Design and Method</em>. A retrospective review of case notes of 51 patients with obstetric fistula that were managed at the Family Life Center, Mbribit Itam, in Itu, Local Government Area of Akwa Ibom State. <em>Results</em>. During the study period, 51 obstetric fistulas were repaired in the hospital. The ages of the patients ranged from 15 to 50 years with median age of 25.8 years and modal age group of 21-30 years (45.1%). The majority of the patients were of low parity (72.5%), 56.9% had no formal education and 27.5% were traders. Thirty four patients (66.7%) had their fistulas for between 1 and 6 years, 19.6% of the patients had juxta-cervical fistulas, while eight (15.7%) had circumferential loss of the urethra. Thirty-seven (72.5%) of them where unbooked and thus had no antenatal care, while 4 (7.8%) booked and had antenatal care in conventional health facilities. Thirty-four patients (66.7%) remained dry twenty-one days after surgery, thirteen (23.5%) were still wet, while 4 patients (7.8%) had stress incontinence despite repair. <em>Conclusion</em>. Obstetric fistulas are found most commonly among young, poorly educated women of low parity who do not avail themselves of orthodox ANC in our environment. Government, community and religious leaders must make concerted efforts to ensure women obtain formal education and when pregnant, have access to emergency obstetric care even if resident in the rural areas. Government, relevant non-Governmental organisations, community leaders and health workers should through relevant health messages enlighten women in the community about obstetric fistulas and the dangers of delivering in unorthodox health facilities. More medical personnel should be trained as the first attempt at repair is the one that is most likely to succeed.

scholarly journals Equality Analysis of Main Health Indicators among Children under 5 Years in Uganda

1970 ◽  
Vol 29 (2) ◽  
Author(s):  
Adel Hussein Elduma
Keyword(s):  
Child Health ◽  
Health Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Indicators ◽  
Great Effort ◽  
Access To Health Services ◽  
Data Set ◽  
Access To Health ◽  
Children Under 5

BACKGROUND: Inequality in the access to health services is a major cause of health problemsamong children under five old. The aim of this analysis is to measure the inequality among children under-5 years in relation to main health indicators inUganda.METHOD: Main child health indicators data in Uganda were obtained from WHO inequity data set for the years 1995, 2000, 2001 and 2011. Indicators such as under-5 years mortality rate, underweight prevalence and full vaccination converge and child with infection access to health facilities were included in th analysis. For simple indicators, inequality difference wascalculated, and relative concentration index for complex order indicators was used. Four different inequality dimensions were used to work as stratifies for these indicators.RESULTS: Inequality regarding child health indicators was observed in different dimensions. It was clear that inequality among people living in rural areas were more than urban areas. Femaleshad high inequality than males. Poor and uneducated people are more likely to have inequality than rich and educated people.CONCLUSION: Great effort should be made to decrease inequality among children less than five years through access to health services for all groups in different areas. 

scholarly journals KAJIAN KEBERLANGSUNGAN RUMAH TUNGGU KELAHIRAN (RTK) DALAM UPAYA MENURUNKAN ANGKA KEMATIAN MATERNAL DI INDONESIA

2018 ◽  
Vol 21 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Noor Edi Widya Sukoco
Keyword(s):  
Local Government ◽  
Pregnant Women ◽  
Health Workers ◽  
Secondary Data ◽  
Access To Health Services ◽  
Policy Makers ◽  
Care Services ◽  
Access To Health ◽  
Asean Countries ◽  
Emergency Detection

Maternal Mortality Rate in Indonesia is still the highest compared to other ASEAN countries and faces a gap in access to health services. It needs a waiting house that is close to health service facility and can be temporarily occupied by pregnant mother before delivery which is Maternal Waiting Homes (MWH). This analysis to know aspects that can maintain the continuity of RTK services. This study uses secondary data by listing the policy and regulatory documents related to RTK policy and by organizing several workshops to gain a view of policy makers. The results show that the MWH fi nancing system is still local and not well coordinated. The number of health workers who provide services in MWH is still limited. Likewise, MWH facilities and facilities are still inadequate, in particular, water and electricity problems, as well as a place for families accompanying maternity mothers. Most MWH s only provide facilities for living without maternal and neonatal care services. Several efforts have been made by the local government in encouraging the utilization of MWH in pregnant women among others by involving customary institutions and the use of communication technology for early emergency detection of pregnant women. MWH sustainability can be built with the full support of local government, socialization and synergies with related sectors. Abstrak Angka Kematian Ibu di Indonesia tertinggi dibandingkan negara-negara ASEAN lain dan menghadapikesenjangan akses pelayanan kesehatan. Rumah tempat menunggu yang dekat dengan fasilitas pelayanankesehatan dan dapat dihuni sementara oleh ibu hamil sebelum persalinan yaitu Rumah Tunggu Kelahiran(RTK) merupakan salah satu alternatif solusi. Analisis dilakukan untuk mengetahui aspek yang dapat menjagakeberlangsungan layanan RTK. Kajian ini menggunakan data sekunder dengan cara menginventarisir dokumenkebijakan dan peraturan perundangan yang terkait dengan kebijakan RTK serta dengan mengadakan beberapaworkhop untuk memperoleh sudut pandang para penentu kebijakan. Hasil menunjukkan sistem pembiayaanRTK masih bersifat lokal dan belum terkoordinasi dengan baik. Jumlah tenaga kesehatan yang memberikanpelayanan di RTK masih terbatas. Demikian juga fasilitas dan sarana RTK masih belum memadai, terutama,masalah air dan listrik, serta tempat untuk keluarga yang mendampingi ibu bersalin. Sebagian besar RTKhanya menyediakan fasilitas untuk tinggal tanpa pelayanan perawatan kesehatan ibu dan bayi. Beberapaupaya telah dilakukan pemerintah lokal dalam mendorong pemanfaatan RTK pada ibu hamil di antaranyadengan melibatkan lembaga adat dan penggunaan teknologi komunikasi untuk deteksi darurat dini bumil risti.Keberlangsungan RTK dapat dibangun dengan dukungan penuh pemerintah daerah, sosialisasi dan bersinergidengan lintas sektor terkait.

scholarly journals Gambaran Akses Pelayanan Kesehatan pada Balita di Indonesia

2019 ◽  
Vol 22 (1) ◽  
pp. 54-61
Author(s):  
Zainul Khaqiqi Nantabah ◽  
Zulfa Auliyati A ◽  
Agung Dwi Laksono
Keyword(s):  
Health Services ◽  
Health Center ◽  
Rural Areas ◽  
Golden Age ◽  
Urban Areas ◽  
Inpatient Care ◽  
Health Care Facilities ◽  
Access To Health Services ◽  
Access To Health ◽  
The Rich

ABSTRAK Anak balita merupakan periode masa yang disebut golden age. Akses pelayanan kesehatan untuk kelompok ini menjadi perhatian karena kesinambungan hidup pada kelompok tersebut menjadi salah satu tolok ukur pembangunan kesehatan. Penelitian ini merupakan analisis lanjut data Riskesdas 2013, yang disajikan secara deskriptif kuantitatif. Analisis dilakukan pada variabel-variabel cakupan kunjungan balita ke pelayanan kesehatan. Pelayanan kesehatan dimaksud adalah Rumah Sakit, Puskesmas/Pustu, Praktik Dokter/Klinik, dan Polindes/Praktik Bidan. Hasil penelitian menunjukkan bahwa balita yang tinggal di perkotaan dan pada kelompok kaya dan sangat kaya memiliki akses yang lebih baik di Rumah Sakit dan praktik dokter/klinik pada akses rawat jalan dan rawat inap. Sementara mereka yang tinggal di perdesaan dan pada kelompok miskin memiliki akses yang lebih baik ke Puskesmas/Pustu dan Polindes/praktik bidan baik di rawat jalan maupun rawat inap. Berdasarkan hasil penelitian dapat disimpulkan bahwa balita yang tinggal di perkotaan dan pada kelompok kaya memiliki akses yang lebih baik pada pelayanan kesehatan rujukan, sementara mereka yang tinggal di perdesaan dan pada kelompok miskin memiliki akses yang lebih baik di fasilitas pelayanan kesehatan dasar. Kata kunci: akses, pelayanan kesehatan, balita   ABSTRACT Toddler is a period of time called golden age. Access to health services for this group is a concern because the continuity of life in the group is one of the benchmarks for health development. This research is an advance analysis of the Riskesdas 2013, which is presented in quantitative descriptive manner. Analysis was carried out on the variables of coverage of toddler visits to health services. The intended health services are hospitals, health center/Pustu, doctor/clinic, and Polindes/midwife, both on outpatient visits and inpatients. The results showed that toddlers who lived in urban areas and in the rich and very rich groups had better access in hospitals and doctor/clinic practices on access to outpatient and inpatient care. While those who live in rural areas and the poor have better access to health center/Pustu and Polindes/ midwives both in outpatient and inpatient care. Based on the results of the study it can be concluded that toddlers who live in urban areas and in rich groups have better access to referral health services, while those who live in rural areas and in poor groups have better access to basic health care facilities. Keyword: access, health services, toddler

scholarly journals Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041746
Author(s):  
Ryan Proos ◽  
Hanna Mathéron ◽  
Jonathan Vas Nunes ◽  
Abdul Falama ◽  
Patricia Sery Kamal ◽  
...  
Keyword(s):  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Rural Areas ◽  
Healthcare Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Structured Interviews

ObjectivesSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes factors affecting timely and adequate referral of women with obstetric complications in rural areas of Sierra Leone as viewed by health workers in rural health facilities.DesignQualitative research with semi-structured interviews using open-ended questions. Data were analysed by systematic text condensation.SettingInterviews were held in nine peripheral health units in rural Sierra Leone.Participants19 health workers including nurses, midwives and clinical health officers participated in nine interviews.ResultsFrom the interviews, four major themes describing possible factors of delay in referral of women in need of emergency obstetric care emerged: (1) communication between healthcare workers; (2) underlying influences on decision-making; (3) women’s compliance to referral and (4) logistic constraints.Several factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among healthcare workers for having maternal deaths or severe obstetric complications occurring at their own facilities. Furthermore, decision-making of healthcare workers whether to refer a woman or not is negatively influenced by a hierarchical culture with high power distance between healthcare workers.ConclusionFactors identified that complicate timely and adequate referral of women in need of emergency obstetric care must be considered in efforts to reduce maternal mortality. Possible interventions that may reduce delay in referral include increased communication by mobile phones between health workers for advice and feedback regarding referrals, involvement of influential stakeholders to increase women’s compliance to referral, and consistent use of standardised management protocols.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

scholarly journals Integrated home-based screening for people living with disabilities: A case study from rural Malawi

2019 ◽  
Vol 8 ◽  
Author(s):  
Elizabeth M. Petersen ◽  
Emily B. Wroe ◽  
Kondwani Nyangulu ◽  
Chisomo Kanyenda ◽  
Sam Njolomole ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Screening Programme ◽  
Health Workers ◽  
Hiv Care ◽  
Access To Health Services ◽  
Home Based ◽  
Poor Access ◽  
Access To Health ◽  
Integrated Screening

People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. This case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.

scholarly journals Community Health Workers: Challenges and Vulnerabilities of Accredited Social Health Activists Working in Conflict-affected Settings in the State of Assam, India

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

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