12 The Contribution of Health Extension Workers in Improving the Utilization of Maternal Health Services in Rural Areas of Tigray, Ethiopia

2017 ◽  
pp. 237-248
Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.


2017 ◽  
Vol 12 (2) ◽  
pp. 55-61
Author(s):  
Thi Hoai Thu Nguyen ◽  
Fiona McDonald ◽  
Andrew Wilson

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.


2019 ◽  
Vol 6 ◽  
pp. 233339281983513 ◽  
Author(s):  
Achamyelesh Gebretsadik ◽  
Million Teshome ◽  
Mekdes Mekonnen ◽  
Akalewold Alemayehu ◽  
Yusuf Haji

Background: Health extension workers (HEWs) are primarily been assigned in rural areas of Ethiopia to provide maternal and child health services. Few studies have been done to investigate HEWs’ contributions towards maternal health services. This study describes HEWs involvement in the utilization of focused antenatal care (FANC). Methods: A population-based cross-sectional survey was conducted between January 21 and February 4, 2017. Mothers (2300) who gave birth in the last 6 months (0-6 months) in randomly selected 30 kebeles in the rural Sidama zone, participated in the study. A face-to-face interview was done using a structured questionnaire adapted from the Saving Newborn Lives Program. The main outcome variable was FANC utilization. Descriptive statistics and multivariate logistic regression analysis were used using SPSS statistical software. Results: The FANC was used by 525 (24.36%; 95% confidence interval [CI]: 22.5%-26.2%) women. Health extension workers accounted for 244 (46.47%; 95% CI: 43.5-47.7%) of mothers. The FANC utilization was less likely among those who were illiterate (adjusted odds ratio [AOR]: .32; 95% CI: .18-.57) and those who attended first cycle (AOR: .41; 95% CI: .23-.74), those who attended secondary cycle (AOR: .47; 95% CI: .27-.82), primipara (AOR: 0.53; 95% CI: .35-.83), and those who gave birth at home (AOR: .66; 95% CI: .51-.84). Mothers who had knowledge of pregnancy danger signs (AOR: 1.42; 95% CI: 1.2-1.7) and exposure to mass media (AOR: 1.35; 95% CI: 1.1-1.66) were more likely to utilize FANC. Conclusions: FANC utilization in this study was low compared to other studies. The HEWs had a major contribution to the services. However, it is low when compared to the plan set by the state ministry of health. The existing health extension program could be strengthened by increasing the number of HEWs. Empowering rural mothers through continuous education program to enhance the utilization of maternal health services.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuju Wu ◽  
Huan Zhou ◽  
Qingzhi Wang ◽  
Min Cao ◽  
Alexis Medina ◽  
...  

2013 ◽  
Vol 3 (2) ◽  
pp. 121 ◽  
Author(s):  
Anita Anima Daniels ◽  
Albert Ahenkan ◽  
Kwabena Adu Poku

Maternal mortality is a global issue and WHO recommends the use of maternal health services to help improve the health of women and babies during pregnancy and childbirth. Considering global and national interest in improving maternal health and the fact that Ghana is still battling with reducing maternal mortality, understanding the factors affecting the use of maternal services in rural areas is crucial as the women are seen as more vulnerable due to inequity issues. This study sets to examine the factors that influence the utilisation of antenatal and delivery services among rural women in Ghana, focusing on individual and area factors. A descriptive cross sectional study was carried out in three rural communities using Akuapim North District of Ghana as a case study.. The study adopted the quantitative approach. Structured interviews were used in data collection with the help of interview schedules. Two hundred and ninety-six (296) respondents were sampled using both probability and non probability techniques. Findings reveal that the use of the MHS is inadequate in relation to the WHO standards. Individual characteristics such as age, marital status and family size and the cost and time taken to a health facility were significantly associated with all the maternal health outcomes. Poor access to vehicles hindered women from delivery in a health institution and getting assistance from trained medical personnels. However, no significant association was established between education of respondents and the maternal health outcomes. It is recommended that the Ministry of Health engages in inter-sectoral collaboration to help ensure health equity.Effective integration of TBAs in providing care is needed to help improve utilisation of maternal services in rural areas


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