Maternal and child health nurses’ experiences of implementing two community-based breastfeeding interventions in Victoria, Australia: A mixed methods process evaluation

2019 ◽  
Vol 16 (1) ◽  
pp. 4-14 ◽  
Author(s):  
Rhian L Cramer ◽  
Helen L McLachlan ◽  
Touran Shafiei ◽  
Lisa H Amir ◽  
Meabh Cullinane ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Breastfeeding Initiation ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Community Based ◽  
Significant Drop ◽  
And Child Health

Despite high rates of breastfeeding initiation in Australia, there is a significant drop in breastfeeding rates in the early postpartum period, and Australian government breastfeeding targets are not being met. The Supporting breastfeeding In Local Communities (SILC) trial was a three-arm cluster randomised trial implemented in 10 Victorian local government areas (LGAs). It aimed to determine whether early home-based breastfeeding support by a maternal and child health nurse (MCH nurse) with or without access to a community-based breastfeeding drop-in centre increased the proportion of infants receiving ‘any’ breast milk at four months. Focus groups, a written questionnaire and semi-structured interviews were undertaken to explore the interventions from the perspective of the SILC-MCH nurses (n=13) and coordinators (n=6), who established and implemented the interventions. Inductive thematic analysis was used to identify themes, then findings further examined using Diffusion of Innovations Theory as a framework. SILC-MCH nurses and coordinators reported high levels of satisfaction, valuing the opportunity to improve breastfeeding in our community; and having focused breastfeeding time with women in their own homes. They felt the SILC interventions offered benefits to women, nurses and the MCH service. Implementing new interventions into existing, complex community health services presented unforeseen challenges, which were different in each LGA and were in part due to the complexity of the individual LGAs and not the interventions themselves. These findings will help inform the planning and development of future programs aimed at improving breastfeeding and other interventions in MCH.

scholarly journals Effect of a maternal and child health handbook on maternal knowledge and behaviour: a community-based controlled trial in rural Cambodia

2015 ◽  
Vol 30 (9) ◽  
pp. 1184-1192 ◽  
Author(s):  
Satoko Yanagisawa ◽  
Ayako Soyano ◽  
Hisato Igarashi ◽  
Midori Ura ◽  
Yasuhide Nakamura
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Controlled Trial ◽  
Maternal Knowledge ◽  
Community Based ◽  
And Child Health

scholarly journals Introduction of Community-Based Preconception Care for Men and Women of Childbearing Age in Seoul

2020 ◽  
Vol 24 (3) ◽  
pp. 123-132
Author(s):  
Baeg Ju Na ◽  
Mi Jeom Lee ◽  
Hwa Sun Lee ◽  
Seung Ki Min ◽  
Hye Ok Kim ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Preconception Care ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Community Based ◽  
Men And Women ◽  
Korean Society ◽  
And Child Health ◽  
In Pregnancy

Community-based preconception care for men and women of childbearing age has been introduced in Seoul. The program aims to focus on problem areas such as low birth rate, fertility issues potentially due to late marriages, preterm or premature births, and low-birthweight in newborn babies. The district administration officials of Seoul, as well as, academics from the Korean Society of Maternal and Child Health, developed a protocol by using a questionnaire and laboratory test for screening risk factors in pregnancy. The protocol was tested on a trial basis in four local districts in Seoul from July 2017 to 2018, extended to 12 local districts in 2019, and all 25 districts in Seoul in 2020. The protocol includes Anti-Mullerian Hormone tests to assess women’s ovarian reserve and male health checkups that include semen analysis and physical examinations of genitalia. These tests are conducted for early detection and treatment of infertility, especially in cases of late marriages. In order to prevent women being abandoned during pregnancy (leading them to single-parenting), the protocol also emphasizes building a gender-sensitive environment by encouraging more male participation. A monitoring group comprised of Seoul city district officials and academics from the Korean Society of Maternal and Child Health, regularly visited the local districts to observe improvements and keep the program officials up to date. In addition, the group also conducted a mobile phone survey for feedback on the program. The interest and support of the residents in Seoul city, and positive results and development in pregnancy care and childbirth, are needed to stabilize and extend this protocol.

scholarly journals Maternal and Child Health Services in Rural Settings of The Gambia: Contextual Determinants of Postnatal Care from Mothers’ Perspectives—A Community-Based Analytical Cross-Sectional Study

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Bakary Kinteh ◽  
Amadou Barrow ◽  
Musa Nget ◽  
Ebrima Touray ◽  
Jainaba Touray ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Rural Women ◽  
Postnatal Care ◽  
The Gambia ◽  
Community Based ◽  
Cross Sectional ◽  
Number Of Children ◽  
Rural Settings ◽  
And Child Health

Background. Maternal and child health in The Gambia is a trending public health burden. The postnatal period is critical and vital to the lives and health of the maternal mothers and their newborns, and pieces of evidence deduced that a majority of maternal and newborn deaths occur during this period. Hence, this research aimed to assess the prevalence and determinants of postnatal care utilization across women in rural Gambia. Methods. A community-based cross-sectional design was conducted in January 2020, with 265 women of childbearing age were recruited from the selected households in rural communities across the Upper River Region (URR), Gambia, using multistage sampling technique. A structured-interview questionnaire was developed to elicit contextual sociodemographic characteristics regarding the use of postnatal care. Percentages, chi-square/Fisher’s exact test for variables with p value ≤0.15 were considered for inclusion into the logistic regression model. The significance level was set at p < 0.05 . The adjusted odds ratios (aOR) with 95% confidence interval (CI) were computed to declare significance. Results. The study revealed that 90% of women utilize postnatal care (PNC) services in the rural settings of URR, Gambia. Factors such as women’s occupation, location, number of pregnancies, attending in last pregnancy, current uptake of family planning, and complication(s) in last labor were found to be associated with PNC utilization. Women who attended antenatal care (ANC) services in their last pregnancy were 10.8 times (aOR = 10.795, 95% CI: 1.025–113.694), current users of FP were 10.7 times (aOR = 10.708, 95% CI: 1.379–83.152), women’s number of pregnancies increases by a factor of 4.6 times (aOR = 4.649, 95% CI: 1.518–14.243) more likely to utilize PNC while women’s number of children alive were less likely by 76.1% (aOR = 0.239, 95% CI: 0.071–0.810) as compared to those who were not utilizing PNC services. Conclusion. The findings showed that attending ANC services, current uptake of FP, women’s number of pregnancies, and number of children alive were associated with PNC. Strengthening women empowerment and designing responsive ANC programs especially for rural women to improve PNC services are required.

scholarly journals Trust of community health workers influences the acceptance of community-based maternal and child health services

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Merridy Grant ◽  
Aurene Wilford ◽  
Lyn Haskins ◽  
Sifiso Phakathi ◽  
Ntokozo Mntambo ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health System ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Community Members ◽  
Community Based ◽  
Complex Relationships ◽  
And Child Health

Background: Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings.Aim: To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves.Setting: Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa.Methods: A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing.Results: Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW’s role; if they appeared to question the CHW’s competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community.Conclusion: Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

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