Utilization of rural maternity delivery services in Nawalparasi and Kapilvastu District: A Qualitative Study

Increasing the proportion of births attended by skilled health providers is likely the key factor in reducing maternal and perinatal morbidity and mortality. Study objectives were to identify key factors influencing the utilization delivery services and stakeholders’ perceptions about these services. The study utilized focus group discussions and in-depth interviews with a diversity of community members users and nonusers , dalit women and health facility staffs to gain insights about the factors influencing use of trained attendants. Field researchers were trained to use FGD guides and interview schedules, and then gathered information on the perspectives of the women and their families and health staff. In Nawalparasi and Kapilvwastu we conducted a comparative study to compare on factors affecting the volume of delivery services.In Nawalparasi the deliveries in the pervious six months was relatively large number from hospital and PHCC whereas in Kapilvastu the delivery was in smaller number. The vast majority of women planned to have a home delivery attended by relatives and/or a Trained Birth Attendants and to reserve attendance at a health facility as a back-up plan in case of prolonged labor and complications. Ritual pollution considerations interfere with a decision to seek delivery in a facility, especially in the Western Hills. The cost recovery scheme ("incentives") deals with a major factor which inhibits use of health facilities. TBAs can encourage clients to deliver in health facilities. Staff feel that the large number of vacant positions inhibits availability of services and requires strenuous efforts on their part to cover for vacancies. Key Words: Maternity; delivery; health staff DOI: 10.3126/jcmsn.v6i3.4072Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.29-36

Download Full-text

Determinants of Evidence Use by Frontline Maternal, Newborn and Child Health Staff in Selected Health Facilities in Ghana

10.21203/rs.3.rs-961642/v1 ◽

2021 ◽

Author(s):

Gordon Abekah-Nkrumah ◽

Doris Ottie-Boakye ◽

Johnson Ermel ◽

Sombié Issiaka

Keyword(s):

Child Health ◽

Organizational Structure ◽

Health Facilities ◽

Health Staff ◽

Factors Affecting ◽

Newborn And Child Health ◽

Level Of Use ◽

Attitudes And Knowledge ◽

Reproductive And Child Health ◽

And Child Health

Abstract Background The current paper examines the level of use of evidence and factors affecting the use of evidence by frontline maternal, newborn and child health (MNCH) and reproductive and child health (RCH) staff in practice decisions in selected health facilities in Ghana. Methods Data was collected from 509 respondents drawn from 44 health facilities in three regions in Ghana. Means were used to examine the level of use of evidence, whiles cross-tabulations and Partial least Squares-based regression were used to examine factors that influence the use of evidence in practice decisions by frontline MNCH/RCH staff. Conclusion We argue that any effort to improve the use of evidence by frontline MNCH/RC staff in practice decisions should focus on improving attitudes and knowledge of staff as well as challenges related to the structure of the organisation. Given however that the score for attitude was relatively high, emphases should be on knowledge and organizational structure in particular, which had the lowest score even though it has the single most important effect on the use of evidence.

Download Full-text

Factors Influencing Obstetric Home Delivery and Outcome Among Women of Reproductive Age in Dusmareb District, Somalia

10.21203/rs.2.19610/v1 ◽

2019 ◽

Author(s):

Abdinasir Abdullahi Jama ◽

Ayodele O Arowojolu ◽

IkeOluwapo O Ajay

Keyword(s):

Focus Group ◽

Focus Group Discussion ◽

Tertiary Education ◽

Group Discussion ◽

Home Delivery ◽

Reproductive Age ◽

Health Staff ◽

Women Of Reproductive Age ◽

Cross Sectional ◽

Factors Influencing

Abstract Background: Homebirth (home delivery) is a birth that takes place in a residence rather than in a hospital or a birth center. Aims: The aim of the study is to determine factors influencing obstetric home delivery and the outcomes among women of reproductive age in Dusmareb district, Somalia. Methods: The study was used a descriptive cross-sectional study in Dusamreb district of Somalia with both qualitative and quantitative techniques of data collections and random technique was used to select 228 women of reproductive age. Well-structured questionnaires were administered by the interviewer to participants who gave their consent and also two focus group discussion sessions were conducted with discussion guides. Data were analysed using the Statistical Package for Social Sciences version 20.0. Descriptive , and Inferential statistics were used to test association, with the level of significance set at 5%. Results: The findings of this study show that 41% have had at least one child delivery at home. The mean age of the respondents was 32.9 ± 8.1 years; 15(6.6%) had tertiary education and Women with 4 – 6 children were four times more likely to have a home delivery (OR = 3.65, p = 0.002), Women with employment were 59% less likely to have a home delivery (OR = 0.41, p = 0.009); the study also found as outcome of home delivery that 22% of the women reported their baby was not okay and have taken to hospital, while 41(73.2%) reported the child died within 28 days following delivery while 24 (42.8%), women experienced prolonged labour during their last delivery at home.in the focus group discussion the women reported that there is poor communication relationship between the mothers and health staff. Conclusion: the study is highly recommended the government to create employment for the women,also the hospital directors were recommended to monitor the relationship between the care giver and the pregnant mother.

Download Full-text

Health facility or home delivery? Factors influencing the choice of delivery place among mothers living in rural communities of Eritrea

Journal of Health Population and Nutrition ◽

10.1186/s41043-018-0153-1 ◽

2018 ◽

Vol 37 (1) ◽

Cited By ~ 20

Author(s):

Meron Mehari Kifle ◽

Hana Fesehaye Kesete ◽

Hermon Tekeste Gaim ◽

Goitu Seltene Angosom ◽

Michael Berhane Araya

Keyword(s):

Rural Communities ◽

Health Facility ◽

Home Delivery ◽

Factors Influencing ◽

Delivery Place

Download Full-text

Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan

European Journal of Public Health ◽

10.1093/eurpub/ckz186.151 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Shah ◽

Q Jamali ◽

F Aisha ◽

F Shahid

Keyword(s):

Health Facility ◽

Community Mobilization ◽

Kangaroo Mother Care ◽

Health Facilities ◽

Neonatal Health ◽

Health Providers ◽

Care Providers ◽

Household Level ◽

Barriers And Enablers ◽

Facility Readiness

Abstract Background More than 2.5 million newborns die each year, contributing to 47% of under 5 mortality worldwide. Globally, Every Newborn Action Plan has emphasized on Kangaroo Mother Care (KMC) as an essential component of neonatal health initiatives. An international joint policy statement and endorsement from health professional associations also recommended practicing KMC for newborn care. Methods We conducted a qualitative study with 12 in-depth interviews (IDIs) and 14 focus group discussion (FGD) sessions, in two health facilities of Sindh, Pakistan during October-December 2016, to understand the key barriers and enablers to a mother’s ability to practice KMC and the feasibility of implementing and improving these practices. Results Our study findings revealed that community stakeholders were generally aware of health issues especially related to maternal and neonatal health. Both the health care providers and managers were supportive of implementing KMC in their respective health facilities as well as for continuous use of KMC at household level. In order to initiate KMC at facility level, study respondents emphasized on strengthening of availability and quality of services as well as training of health providers as critical prerequisites. Also in order to continue practicing KMC at household level, engaging the community and establishing functional referral linkage between community and facilities were focused issues in facility and community level FGDs and IDIs. The study participants considered it feasible to initiate KMC practice at health facility and to continue practicing at home after returning from facility. Conclusions Ensuring facility readiness to initiate KMC, improving capacity of health providers, coupled with strengthened community mobilization, and targeting specific audiences may help policy makers and program planners to initiate KMC practice at health facility and keep KMC practice continued at household level. Key messages Introducing KMC at health facility followed by continuing practice at household level is feasible, even in a religiously conservative setting like Pakistan. Facility readiness, improved health workers’ capacity coupled with strengthened community mobilization targeting specific audiences could help scaling up this public health intervention in Pakistan.

Download Full-text

Factors affecting the implementation of evidence-based Progressive Tinnitus Management in Department of Veterans Affairs Medical Centers

PLoS ONE ◽

10.1371/journal.pone.0242007 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242007

Author(s):

Tara L. Zaugg ◽

Emily J. Thielman ◽

Kathleen F. Carlson ◽

Anaïs Tuepker ◽

Christine Elnitsky ◽

...

Keyword(s):

Mental Health ◽

Program Implementation ◽

Veterans Affairs ◽

Stepped Care ◽

Evidence Based ◽

Mental Health Providers ◽

Department Of Veterans Affairs ◽

Health Providers ◽

Factors Affecting ◽

Factors Influencing

Purpose Progressive Tinnitus Management (PTM) is an evidence-based interdisciplinary stepped-care approach to improving quality of life for patients with tinnitus. PTM was endorsed by Department of Veterans Affairs (VA) Audiology leadership in 2009. Factors affecting implementation of PTM are unknown. We conducted a study to: 1) estimate levels of PTM program implementation in VA Audiology and Mental Health clinics across the country; and 2) identify barriers and facilitators to PTM implementation based on the experiences of VA audiologists and mental health providers. Method We conducted an anonymous, web-based survey targeting Audiology and Mental Health leaders at 144 major VA facilities. Quantitative analyses summarized respondents’ facility characteristics and levels of program implementation (full PTM, partial PTM, or no PTM). Qualitative analyses identified themes in factors influencing the implementation of PTM across VA sites. Results Surveys from 87 audiologists and 66 mental health clinicians revealed that few facilities offered full PTM; the majority offered partial or no PTM. Inductive analysis of the open-ended survey responses identified seven factors influencing implementation of PTM: 1) available resources, 2) service collaboration, 3) prioritization, 4) Veterans’ preferences and needs, 5) clinician training, 6) awareness of (evidence-based) options, and 7) perceptions of scope of practice. Conclusion Results suggest wide variation in services provided, a need for greater engagement of mental health providers in tinnitus care, and an interest among both audiologists and mental health providers in receiving tinnitus-related training. Future research should address barriers to PTM implementation, including methods to: 1) improve understanding among mental health providers of their potential role in tinnitus management; 2) enhance coordination of tinnitus-related care between health care disciplines; and 3) collect empirical data on Veterans’ need for and interest in PTM, including delivery by telehealth modalities.

Download Full-text

Strategies to Improve Facility-based Attendance of Skilled Birth Among Slum Residents, Addis Ababa, Ethiopia: a Qualitative Study.

10.21203/rs.3.rs-276995/v1 ◽

2021 ◽

Author(s):

Endalew Gemechu Sendo ◽

Motshedisi E. Chauke ◽

M Ganga-Limando

Keyword(s):

Focus Group ◽

Health Facility ◽

Qualitative Data ◽

Addis Ababa ◽

Health Facilities ◽

The Body ◽

Focus Group Discussions ◽

Group Discussions ◽

Study Results ◽

Delivery Services

Abstract Background: Global strategies to target high maternal mortality ratios are focused on providing skilled attendance at delivery along with access to emergency obstetric care. Research that examines strategies to increase facility-based skilled birth attendance among slum residents in Addis Ababa, Ethiopia, is limited.Objective: The objective of the study was to explore women’s views on measures needed to enhance the utilization of health facility-based delivery services. Methods: A qualitative exploratory and descriptive research design was used. The design was contextual. Participants in the study were women in the reproductive age group (18-49 years of age) living in the slum areas of Addis Ababa, Ethiopia. A purposive sampling strategy was used to select study participants. Four audio-recorded Focus Group Discussions [FGDs] were conducted with 32 participants from the three public health centers chosen and one district hospital. The number of participants in FGDs was between 6 to 10 women. Data were analyzed simultaneously with data collection. Thematic analysis was done for the study. The qualitative data were analyzed in three phases: exploring and creating initial codes; searching for themes by collecting coded data addressing particular themes, and identifying and naming themes found. To explain the study results, verbatim excerpts from participants were given. The researcher used Techs' eight steps of qualitative data analysis method for analysing the data. The analysis involved the use of both a priori codes (from the question guide) and emergent inductive codes. A multi-level life-course framework of facility-based delivery in low- and middle-income countries (LMICs) developed by Bohren, et al was used to frame the current study and link the findings of the study to the body of knowledge. Results: The Focus Group Discussions included a total of 32 participants. The mean age of the overall sample was 32.6 years (±SD = 5.2). Participants' educational characteristics indicate that the majority (24 out of 32) was found to have no formal education, and two-thirds of participants were found to have one to five children. Three-fourths of them attended the ANC twice and they all gave birth to their last child at home. Two themes emerged from the analysis of focus group interviews data, namely provision of quality, respectful and dignified midwifery care, and increased awareness of FANC. These themes were described as a rich and comprehensive account of the views and suggestions made by FANC participants on measures required to improve the use of delivery services based on health facilities. The findings of the study raise concerns about the effectiveness of FANC in encouraging facility-based deliveries since FANC participants had not used health facilities for their last childbirth. According to the findings of the focus groups, women who took part in this study identified measures required to increase the use of health facility-based delivery services among FANC participants in Addis Ababa's slum residents. It is to be expected that diligent counseling during antenatal care about birth plans would facilitate prompt arrival at facilities consistent with the desires of women.

Download Full-text

Satisfaction with Delivery Services Offered under the Free Maternal Healthcare Policy in Kenyan Public Health Facilities

Journal of Environmental and Public Health ◽

10.1155/2018/4902864 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 8

Author(s):

C. M. Gitobu ◽

P. B. Gichangi ◽

W. O. Mwanda

Keyword(s):

Public Health ◽

Health Facility ◽

Healthcare Services ◽

Healthcare Policy ◽

Health Facilities ◽

Maternal Healthcare ◽

Healthcare Facilities ◽

Public Health Facilities ◽

Delivery Services ◽

Consultation Time

Background. Patients’ satisfaction is an individual's positive assessment regarding a distinct dimension of healthcare and the perception about the quality of services offered in that health facility. Patients who are not satisfied with healthcare services in a certain health facility will bypass the facility and are unlikely to seek treatment in that facility. Objective. To determine satisfaction level of mothers with the free maternal services in selected Kenyan public health facilities after the implementation of the free maternal healthcare policy. Methods. Data was collected through a quantitative exit survey questionnaire. The respondents were mothers who had delivered in the health facilities and were waiting to leave the health facilities after discharge. The sample included 2,216 mothers in 77 public health facilities across 14 counties in Kenya under tier 3 and tier 4 categories. The number of respondents to be interviewed was proportionately arrived at based on each health facility’s bed capacity. Results. The study established a satisfaction rate of 54.5% among the beneficiaries of the free maternal healthcare services in the country. Mothers benefiting from the free delivery services were satisfied with communication by the healthcare workers, staff availability in the delivery rooms, availability of staff in the wards, and drug and supplies availability (>56%) but unsatisfied with consultation time, cleanliness, and privacy in the wards (<56%). High education levels and lengthy stay in healthcare facilities were negatively associated with the satisfaction with the free delivery services (P<0.05). Conclusion. There is a high satisfaction with the free maternal healthcare services in Kenya. However, the implementation of the free maternal healthcare policy was associated with low privacy, poor hygiene, and low consultation time in the health facilities. Therefore there is need to address these service gaps so as to attract more mothers to deliver in public health facilities.

Download Full-text

Why institutional delivery is still the last option to rural women in North West Ethiopia: Qualitative study

10.21203/rs.2.17654/v1 ◽

2019 ◽

Author(s):

Netsanet Fentahun Babbel ◽

Wubegzier Mekonnen ◽

Yosef Wasihun ◽

Mulunesh Alemayehu

Keyword(s):

Risk Perception ◽

Qualitative Study ◽

Health Facility ◽

Rural Women ◽

Institutional Delivery ◽

Cultural Beliefs ◽

Home Delivery ◽

Health Facilities ◽

Care Providers ◽

Related Factors

Abstract Background: whatever the actions has been implemented, home delivery preference in Ethiopia is still over 72%. To date, no studies explored why institutional delivery is still the last option to rural women in Ethiopia. This study was conducted to explore the reason why institutional delivery is still the last option to rural women in Awi Zone Northwest Ethiopia.Methods: An explanatory qualitative study was conducted from February to March 2014. Participants were selected purposively and written informed consent was sought. Twelve reproductive aged females, ten religious and twelve community leaders and sixteen key informants were participated. Data were collected by using semi-structured questionnaire using focused group discussion and in-depth interview guides. Thick description and peer debriefing were applied to assure data quality. Thematic analysis framework was used to analyse the data. Results: The study revealed that institutional delivery is still the last option to the study area. Individual related factors like information gap, low risk Perception to pregnancy and delivery have been mentioned as drive factors for not using institutional delivery. Community related factors of women’s poor position to decision, beliefs and cultural practices for home delivery preference affects institutional delivery. In addition, health facility related barriers like inaccessibility of health facility, infrastructure, lack of privacy during delivery, misconducts of health care providers and high risk perception to health facility delivery were repeated raised as reasons of last option of institutional delivery. Conclusion: This study elucidated that home delivery preference was existed, given high social and cultural price for home delivery and misconceptions towards institutional delivery. Thus, the Ethiopian government together with its partners should focus on accessing health facilities, infrastructure, equipping health facilities with essential materials and skilled health professionals and increasing knowledge of the community, avert communities’ misconceptions and deep-rooted socio-cultural beliefs towards institutional delivery.

Download Full-text

Study on Selective Depression of Pyrite during Copper Bioleaching

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.20-21.172 ◽

2007 ◽

Vol 20-21 ◽

pp. 172-173 ◽

Cited By ~ 1

Author(s):

Ren Man Ruan ◽

Gui Ying Zhou ◽

Jian Kang Wen

Keyword(s):

Redox Potential ◽

Culture Medium ◽

Influencing Factor ◽

Size Fraction ◽

Key Factors ◽

Factors Affecting ◽

Factors Influencing ◽

Key Factor ◽

Initial Ph ◽

Leaching Efficiency

During Zijinshan copper heap bioleaching, pyrite was leached in plenty resulting in high ferric concentration in solution. This affected bioleaching and extraction processing greatly. The paper studied the factors influencing in the course of leaching of pyrite and a mixture of chalcocite and pyrite respectively. It focuses on the effect of the redox potential for copper bioleaching so as to find key factors affecting the dissolution difference between chalcocite and pyrite. The experiment results showed that redox potential is an important influencing factor in bioleaching. Copper and pyrite extents of the leaching process were 95% and 11% respectively and there is great dissolution difference between them at redox potential 700 mV (SHE). It is indicated that copper can be selectively bioleached by controlling redox potential of bioleaching. The conclusion will provide theoretic foundation on balance of acid and iron during bioleaching for copper of higher S/Cu ratio. A simple sulfide, pyrite and chalcocite, were selected as test minerals. The samples were obtained from rich mineral in Zijin Mine. The concentrated samples were milled to obtain the size fraction of 320 mesh percent of 90. Bacterium culture: 9K culture medium contained the following composition in kg/m3 distilled water: (NH4)2SO4, 3.0; K2HPO4·3H2O, 0.5; KCl, 0.1; MgSO4·7H2O, 0.5; Ca(NO3)2·2H2O, 0.01. The initial ferrous concentration was 9.0g/L, the initial pH was adjusted to 1.6, and the temperature set at 30°C. The rotation speed of shaking bed was 150r/min. A three-day-old inoculum previously grown in medium was used in bioleaching process. A 5% inoculum was added to give an initial bacteria concentration in the medium was (3-6)×107 cells/m3. The experiments investigated factors influencing bioleaching including ferrous concentration and redox potential during bioleaching. The extent Cu leached was over 90%. Cu leached velocity increased as redox potential turned higher. Cu leached velocity rapid increased at redox potential 700mV. During chalcocite and pyrite bioleaching, redox potential is important factor to influence of bioleaching rate and the results showed that pyrite and chalcocite bioleaching rate was correlated with redox potential. It is indicated that copper can be selectively bioleached during copper bioleaching by controlling redox potential of bioleaching. It can be concluded that: (1) Pyrite and chalcocite bioleaching rate was correlated with redox potential. Redox potential was shown to be the key factor affecting the dissolution difference between chalcocite and pyrite. (2) Chalcocite and pyrite leaching efficiency were 95% and 11% respectively and there is great dissolution difference between them at redox potential 700 mV (SHE). (3) It is indicated that copper can be selectively bioleached during copper bioleaching by controlling redox potential of bioleaching.

Download Full-text

Why institutional delivery is still the last option to rural women in North West Ethiopia: Qualitative study

10.21203/rs.2.17654/v2 ◽

2020 ◽

Author(s):

Netsanet Fentahun Babbel ◽

Yosef Wasihun ◽

Wubegzier Mekonnen ◽

Mulunesh Alemayehu Mulunesh Alemayehu

Keyword(s):

Risk Perception ◽

Qualitative Study ◽

Health Facility ◽

Rural Women ◽

Institutional Delivery ◽

Cultural Beliefs ◽

Home Delivery ◽

Health Facilities ◽

Care Providers ◽

Related Factors

Abstract Background: Whatever the actions has been implemented, home delivery preference in Ethiopia is still over 72%. To date, no studies explored why institutional delivery is still the last option to rural women in Ethiopia. This study was conducted to explore the reason why institutional delivery is still the last option to rural women in Awi Zone Northwest Ethiopia. Methods : An explanatory qualitative study was conducted from February to March 2014. Participants were selected purposively and written informed consent was sought. Twelve reproductive aged females, ten religious and twelve community leaders and sixteen key informants were participated. Data were collected by using semi-structured questionnaire using focused group discussion and in-depth interview guides. Thick description and peer debriefing were applied to assure data quality. Thematic analysis framework was used to analyse the data. Results : The study revealed that institutional delivery is still the last option to the study area. Individual related factors like information gap, low risk Perception to pregnancy and delivery have been mentioned as drive factors for not using institutional delivery. Community related factors of women’s poor position to decision, beliefs and cultural practices for home delivery preference affects institutional delivery. In addition, health facility related barriers like inaccessibility of health facility, infrastructure, lack of privacy during delivery, misconducts of health care providers and high risk perception to health facility delivery were repeated raised as reasons of last option of institutional delivery. Conclusion: This study elucidated that home delivery preference was existed, given high social and cultural price for home delivery and misconceptions towards institutional delivery. Thus, the Ethiopian government together with its partners should focus on accessing health facilities, infrastructure, equipping health facilities with essential materials and skilled health professionals and increasing knowledge of the community, avert communities’ misconceptions and deep-rooted socio-cultural beliefs towards institutional delivery.

Download Full-text