scholarly journals Barriers to access in maternal healthcare services in the Northern Bangladesh

2017 ◽  
Vol 6 (2) ◽  
pp. 23-36 ◽  
Author(s):  
Bijoy Krishna Banik
Keyword(s):  
Maternal Health ◽  
Urban Areas ◽  
Health Workers ◽  
Health Sector ◽  
Emergency Obstetric Care ◽  
Healthcare Services ◽  
Northern Region ◽  
Early Marriage ◽  
Primary Data ◽  
Health Staff

Poor women, in both rural and urban areas in the northern region of Bangladesh, experience high maternal mortality rate (MMR), and compared to other regions, this group also has a low proportion of receiving antenatal care (ANC) and of births assisted by the skilled health personnel. One of the prime factors for this situation is the lack of the poor mothers’ access to maternal health care (MHC) services. Finding out physical, social and organisational access barriers to MHC services and exploring how these barriers caused three delays in healthcare seeking behaviour were therefore the main objectives of the paper. The study used both primary and secondary data to meet its objectives. The primary data was collected from October to December in 2010 interviewing 160 mothers who were pregnant or delivered at least one baby during the last ten years and the heads of seven relevant health centres, administering eight focus group discussions and observing the field. An assortment of articles, reports, theses and books were consulted in complementing and substantiating the argument. The study found social (early marriage, perception of pregnancy and childbirth, high financial cost) and organizational (lack of female health staff, lack of a guiding principle in the health sector, in/exclusion errors in benefit distribution, low quality services) barriers more acute than physical (distance and waiting time) barriers. As concluded, all these barriers seem to have caused delays in seeking healthcare, reaching facility centres at the right time and receiving adequate services. The findings of the current study suggest that rescheduling official time of the service centre, recruiting and posting female health workers, following a guiding path and providing emergency obstetric care at free of costs are the feasible ways of getting better maternal health situation in the study areas.South East Asia Journal of Public Health Vol.6(2) 2016: 23-36

scholarly journals Barriers to access maternal health services among urban poor women in Bangladesh: A Case of Rajshahi City

2019 ◽  
Vol 8 (1) ◽  
pp. 22-31
Author(s):  
Bijoy Krishna Banik ◽  
Md Saidur Rashid Sumon
Keyword(s):  
Maternal Health ◽  
Urban Poor ◽  
Service Use ◽  
Service Providers ◽  
Health Sector ◽  
Early Marriage ◽  
Primary Data ◽  
Financial Barriers ◽  
Barriers To Access ◽  
Rajshahi City

Bangladesh has made tremendous achievements in the health sector over the last few decades, albeit worse in maternal health (MH) compared to other South Asian countries. The fact that women, particularly poor, have less access to maternal health care (MHC) services is one of the prime reasons. The main objective of this study was to explore what types of barriers poor mothers faced during the service use. A triangulation of method (interviews of service recipients through interview schedule and service providers through checklist, focus group discussion and observation) was used for the collection of primary data (sample 200) from two slum areas in Rajshahi City between March and April, 2013. The study found socio-cultural and organizational barriers to access to MHC services more acute than physical and financial barriers. As suggested, building awareness of bad consequences of early marriage on MH, ensuring a strong coordination among service providing organizations in dispensing free drugs and posting female doctors in study areas are urgently needed for further improvement of MH. South East Asia Journal of Public Health Vol.8(1) 2018: 22-31

scholarly journals (A234) Disasters as an Opportunity to Train and Prepare for Future Disasters

2011 ◽  
Vol 26 (S1) ◽  
pp. s64-s64
Author(s):  
T. Ranasinghe ◽  
E.K. Vithana ◽  
H. Herath ◽  
L. Pattuwage
Keyword(s):  
Sri Lanka ◽  
Disaster Preparedness ◽  
Health Workers ◽  
Healthcare Delivery ◽  
Health Sector ◽  
Ground Level ◽  
Health Staff ◽  
Ministry Of Health ◽  
Non Governmental Organizations

Asian tsunami in 2004 had a tremendous impact on the health system of Sri Lanka leaving many healthcare institutions damaged in the costal provinces and destabilizing the healthcare delivery network. Immediately after the tsunami, health authorities in Sri Lanka realized, health workers should be prepared well if they are to face any future disasters successfully. In this background, the Ministry of Health set its agenda to train all levels of health cadres on disaster preparedness and mitigation whenever there are opportunities. Ministry of Health established the Tsunami Rehabilitation Unit (TRU), later renamed as Disaster Preparedness and Response Unit (DPRU) and mandated it to prepare the health sector for future disasters. During a disaster, well trained health cadre is an asset to any health manager facing the burden of the emergency at the ground level. Trained health personnel on disaster management become a human resource multiplier to fill the gaps of scarce skilled health staff in the field operations. We reviewed the Ministry of Health reports, plans, meeting minutes, reports of training institutions, routine reporting from Ministry of Health departments and reports from health sector partners to compile and then analyze to construct this case study. We provide an overview of how DPRU coordinated and used the opportunities following Tsunami 2004 and then during the humanitarian crisis at the end of 30 years of armed conflict in 2009 to train the health staff. This case study also describes how DPRU networked with government and non governmental organizations to train the different categories of government health staff.

scholarly journals Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Umar Haruna ◽  
Gordon Dandeebo ◽  
Sylvester Z. Galaa
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Health Outcomes ◽  
Health Workers ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Transportation Systems ◽  
Successful Implementation ◽  
Maternal Healthcare ◽  
Focused Antenatal Care

Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.

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 Social Media, Vaccine Hesitancy and Trust Deficit in Immunization Programs: A Qualitative Enquiry in Malappuram District of Kerala, India

2021 ◽  
Author(s):  
Anoop T Nair ◽  
Kesavan Rajasekharan Nayar ◽  
Shaffi Fazaludeen Koya ◽  
Minu Abraham ◽  
Jinbert L. Azariah ◽  
...  
Keyword(s):  
Social Media ◽  
Vaccination Coverage ◽  
Health Workers ◽  
Healthcare Providers ◽  
Health Sector ◽  
Vaccine Hesitancy ◽  
Health Staff ◽  
Immunization Programs ◽  
Soft Skill ◽  
Medical Practitioners

Abstract BackgroundWith increased penetration of the internet and social media, there are concerns regarding its negative role in influencing parents’ decisions regarding vaccination for their children. It is perceived that a mix of religious reasons and propaganda by anti-vaccination groups on social media are lowering the vaccination coverage in Malappuram district of Kerala. We undertook a qualitative study to understand the factors responsible for generating and perpetuating vaccine hesitancy; to understand the pathways of trust deficit in immunization programs; and to understand the interaction between various social media actors. MethodsIn-depth interviews and focus group discussions conducted among parents/caregivers, physicians, public sector health staff, alternate system medical practitioners, field healthcare workers, and teachers in areas with highest and lowest vaccination coverage in the district as well as with communication experts. ResultsThe trust-deficit between parents/caregivers and healthcare providers is created by multiple factors such as providers’ lack of technical knowledge, existing patriarchal societal norms, and vaccine critical views of naturopaths and homeopaths. Anti-vaccine groups use social media to influence caregivers' perceptions and beliefs. Religion does not appear to play a major role in creating vaccine resistance in this setting. ConclusionsA long-term, multi-pronged strategy should be adopted to address the trust deficit. In the short to medium term, health sector can focus on appropriate and targeted vaccine related communication strategies including the use of infographics, soft skill development of health workers, technical competency improvement through a mobile application-based repository of information, and creation of a cell to monitor vaccine related conversations in social media and intervene if needed.

scholarly journals Effects of Devolution on Maternal Health Care: The Case of Level Four Hospitals in Nairobi City County, Kenya

2019 ◽  
Vol 3 (II) ◽  
pp. 98-116
Author(s):  
Hudson Shilibwa Bulinda ◽  
Felix Kiruthu
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Professionals ◽  
Service Providers ◽  
Health Workers ◽  
Healthcare Services ◽  
National Government ◽  
Maternal Health Care ◽  
Maternal Healthcare ◽  
County Governments

Maternal healthcare is an integral part of the Millennium development goals. However, most developing countries have been experimenting with different types of interventions to increase access and utilization of maternal care services. Health care devolution was greeted with great anticipation in Kenya as a means of bringing services closer to the people. However, since the implementation of the recent devolution reforms, criticism has mounted, with evidence of corruption, poor management, late payment of county staff and considerable disaffection among service providers, especially health professionals. Thus, this study assessed the effects of devolution on maternal health care in Nairobi City County in Kenya.  Particularly, the study examined the situation of maternal healthcare before and after devolution and how devolution as affected provision of maternal healthcare in Nairobi City County. The study also assessed how devolution affected maternal health care programs implementation and the challenges facing the devolved maternal health care in Nairobi City County. The study adopted the systems approach and the decentralization theorem. This study employed a descriptive research design and the population of the study was made up of the 4 level four hospitals in Nairobi County and all the 189 selected medical health workers in the hospitals. A sample of 57 respondents was selected through simple random sampling. Additionally, the study used questionnaires and an interviews guide to collect data. The questionnaires were administered to the sampled medical workers and the interviews schedules were administered to the key informants who comprised of the medical superintendent from every hospital. Quantitative data was collected through the use of the questionnaires was analyzed using descriptive statistics with the aid of the Statistical Package for Social Sciences. Qualitative data was analyzed using content analysis. The study found that the status of maternal healthcare infrastructure under devolution of health services in Nairobi was good. The findings also established that most health workers preferred that the national government should manage maternal health care infrastructure as opposed to county governments. The study further revealed that county governments had not instituted and implemented effective maternal healthcare programs formulated by the national government. Finally, the study concludes the major challenges influencing the implementation of maternal healthcare services include attitude and perception of health professionals, resistance of devolution by health workers, strikes by health workers, shortage of healthcare workers corruption and tribalism, increased pressure on hospital equipment and infrastructure and stock outs of essential commodities in the facilities affect devolved maternal health care. The study recommended that both the county and national government should work together and combine their efforts to enhance the devolved systems of healthcare so that they can enhance maternal healthcare. This is an open-access article published and distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License of United States unless otherwise stated. Access, citation and distribution of this article is allowed with full recognition of the authors and the source.

scholarly journals Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

2021 ◽  
Vol 9 (T4) ◽  
pp. 18-26
Author(s):  
Arlina Dewi ◽  
Sri Sundari ◽  
Nursetiawan Nursetiawan ◽  
Supriyatiningsih Supriyatiningsih ◽  
Dianita Sugiyo ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Urban Area ◽  
Urban Areas ◽  
Health Workers ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Integrated System

BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality. AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas. METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising. RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity. CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

scholarly journals Exploring the constraints regarding maternal health in reproductive age among the rural women in Bangladesh

Mediscope ◽  
2016 ◽  
Vol 3 (2) ◽  
pp. 1-10
Author(s):  
Akkur Chandra Das
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Care Services ◽  
Reproductive Age ◽  
Early Marriage ◽  
Care Services ◽  
Health Related

The study evaluated the constraints of maternal health in reproductive age in the rural Bangladesh. The study used qualitative approach to gather information where individual in-depth interviews adopted for data collection among women aged 15-49 years old. The overall study revealed that rural women faced many maternal health related complications and problems in their reproductive age such as hemorrhage, sepsis, hypertensive diseases of pregnancy, obstructed labour and complications of abortion, etc. Maternal health situation still in rural areas was not developed in comparison to the situation of urban areas of Bangladesh and there was not available women’s health care accesses for their emergency; low education level, low per capita income, many family members, early marriage and pregnancy, number of pregnancies, poor nutrition and lack of family support status resulted in low status of maternal and child health in the rural areas of Bangladesh. Adequate measures should be taken for providing proper health care services in rural areas of Bangladesh for better maternal health status.Mediscope Vol. 3, No. 2: July 2016, Pages 1-10

scholarly journals Digital opportunities in the healthcare enterprises during COVID-19: An empirical analysis of the developing country

2021 ◽  
Vol 5 (2) ◽  
pp. 44-55
Author(s):  
Muhammad Mahboob Ali
Keyword(s):  
Industrial Revolution ◽  
Health Workers ◽  
Health Sector ◽  
Healthcare Services ◽  
Healthcare Management ◽  
Medical Robots ◽  
The Public ◽  
Universal Healthcare ◽  
Blockchain Technology ◽  
Large Investment

The health sector in Bangladesh is yet to develop and provide universal healthcare services. The aim of this study is to investigate whether the applicability of digitization especially medical robots and blockchain technology can help to improve healthcare enterprises in Bangladesh during the ongoing COVID-19 pandemic. The findings indicate that Bangladesh healthcare enterprises are in a vulnerable situation because of unethical work practices of health workers, the need for medical robots, artificial intelligence, and blockchain technology to improve healthcare management. The study suggests that large investment, pro-patient care, corruption-free and ethical services in the healthcare management and service delivery is required, through joint collaboration with the public and the private sectors and also collaborative effort from the foreign sectors to implement the fourth industrial revolution in healthcare enterprises of the country

scholarly journals The State of Health in Pakistan: An Overview

2013 ◽  
Vol 18 (Special Edition) ◽  
pp. 233-247 ◽  
Author(s):  
Uzma Afzal ◽  
Anam Yusuf
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Service Delivery ◽  
Urban Areas ◽  
Health Sector ◽  
Health Indicators ◽  
Health Service Delivery ◽  
World Health ◽  
Double Burden ◽  
Out Of Pocket Payments

Although the Millennium Development Goals provide countries with wellrounded objectives for achieving human development over a period of 25 years, Pakistan is not on track to achieving the health-related goals. With the eighth highest newborn death rate in the world, in 2001–07 one in every ten children born in Pakistan died before reaching the age of five. Similarly, women have a 1 in 80 chance of dying of maternal health causes during reproductive life. Compared to other South Asian countries, Pakistan currently lags behind in immunization coverage, contraceptive use, and infant and child mortality rates. Expenditure as a percentage of private expenditure on health is about 98 percent, positioning Pakistan among those countries with the highest share of out-of-pocket payments relative to total health expenditure (World Health Organization, 2009). Pakistan is also going through an epidemiological transition where it faces the double burden of communicable diseases combined with maternal and perinatal conditions, as well as chronic, noninfectious diseases. The landscape of public health service delivery presents an uneven distribution of resources between rural and urban areas: The rural poor are at a clear disadvantage in terms of primary and tertiary health services, and also fail to benefit fully from public programs such as the immunization of children. The poor state of public facilities overall has contributed to the diminished role of public health facilities, while the private sector’s role in the provision of service delivery has increased enormously. Following the 18th Amendment to the Constitution, the health sector has been devolved to the provinces, but the distribution of responsibilities and sources of revenue generation between the tiers remains unclear. A multipronged national health policy is needed that tackles the abysmal child and maternal health indicators, and reduces the burden of disease. Moreover, it is imperative to improve the provision of primary and tertiary healthcare with a strong monitoring system in place.

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