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 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 Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melvin Simuyaba ◽  
Bernadette Hensen ◽  
Mwelwa Phiri ◽  
Chisanga Mwansa ◽  
Lawrence Mwenge ◽  
...  
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Iterative Process ◽  
Service Use ◽  
Service Providers ◽  
Peer Pressure ◽  
Post Exposure Prophylaxis ◽  
Community Based ◽  
Research Activities ◽  
Lessons Learnt

Abstract Background Meeting the sexual and reproductive health (SRH) needs of adolescents and young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process of engaging AYP to finalise the design of a community-based, peer-led and incentivised SRH intervention for AYP aged 15–24 in Lusaka and the lessons learnt. Methods Between November 2018 and March 2019, 18 focus group discussions, eight in-depth interviews and six observations were conducted to assess AYP’s knowledge of HIV/SRH services, factors influencing AYP’s sexual behaviour and elicit views on core elements of a proposed intervention, including: community-based spaces (hubs) for service delivery, type of service providers and incentivising service use through prevention points cards (PPC; “loyalty” cards to gain points for accessing services and redeem these for rewards). A total of 230 AYP (15 participated twice in different research activities) and 21 adults (only participated in the community mapping discussions) participated in the research. Participants were purposively selected based on age, sex, where they lived and their roles in the study communities. Data were analysed thematically. Results Alcohol and drug abuse, peer pressure, poverty, unemployment and limited recreation facilities influenced AYP’s sexual behaviours. Adolescent boys and young men lacked knowledge of contraceptive services and all AYP of pre and post exposure prophylaxis for HIV prevention. AYP stated a preference for accessing services at “hubs” located in the community rather than the health facility. AYP considered the age, sex and training of the providers when choosing whom they were comfortable accessing services from. PPCs were acceptable among AYP despite the loyalty card concept being new to them. AYP suggested financial and school support, electronic devices, clothing and food supplies as rewards. Conclusions Engaging AYP in the design of an SRH intervention was feasible, informative and considered responsive to their needs. Although AYP’s suggestions were diverse, the iterative process of AYP engagement facilitated the design of an intervention that is informed by AYP and implementable. Trial registration This formative study informed the design of this trial: ClinicalTrials.gov, NCT04060420. Registered 19 August, 2019.

scholarly journals All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  
Keyword(s):  
Service Use ◽  
Service Providers ◽  
Theory And Practice ◽  
Community Based ◽  
Daily Diaries ◽  
Rural Caregivers ◽  
Service Expectations ◽  
Extensive Body ◽  
Barriers To Health ◽  
Community Based Services

Abstract An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.

scholarly journals Access to Healthcare for Immigrant Children in Canada

2020 ◽  
Vol 17 (9) ◽  
pp. 3320
Author(s):  
Bukola Salami ◽  
Alleson Mason ◽  
Jordana Salma ◽  
Sophie Yohani ◽  
Maryam Amin ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Service Providers ◽  
Social Determinant ◽  
Immigrant Children ◽  
Access To Healthcare ◽  
Cultural Barriers ◽  
Immigrant Parents ◽  
Financial Barriers ◽  
University Of Alberta ◽  
The University

Immigrants experience poorer health outcomes than nonimmigrants in Canada for several reasons. A central contributing factor to poor health outcomes for immigrants is access to healthcare. Previous research on access to healthcare for immigrants has largely focused on the experience of immigrant adults. The purpose of this study was to investigate how immigrants access health services for their children in Alberta, Canada. Our study involved a descriptive qualitative design. Upon receiving ethics approval from the University of Alberta Research Ethics Board, we invited immigrant parents to participate in this study. We interviewed 50 immigrant parents, including 17 fathers and 33 mothers. Interviews were audio recorded, transcribed, and analyzed according to the themes that emerged. Findings reveal that systemic barriers contributed to challenges in accessing healthcare for immigrant children. Participants identified several of these barriers—namely, system barriers, language and cultural barriers, relationship with health professionals, and financial barriers. These barriers can be addressed by policymakers and service providers by strengthening the diversity of the workforce, addressing income as a social determinant of health, and improving access to language interpretation services.

scholarly journals Modelling improved efficiency in healthcare referral systems for the urban poor using a geo-referenced health facility data: the case of Sylhet City Corporation, Bangladesh

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alayne M. Adams ◽  
Rushdia Ahmed ◽  
Shakil Ahmed ◽  
Sifat Shahana Yusuf ◽  
Rubana Islam ◽  
...  
Keyword(s):  
Critical Care ◽  
Urban Poor ◽  
Emergency Services ◽  
Census Data ◽  
Service Providers ◽  
Healthcare Services ◽  
Tertiary Hospital ◽  
Care Services ◽  
Referral Systems ◽  
Alternative Scenarios

Abstract Background An effective referral system is critical to ensuring access to appropriate and timely healthcare services. In pluralistic healthcare systems such as Bangladesh, referral inefficiencies due to distance, diversion to inappropriate facilities and unsuitable hours of service are common, particularly for the urban poor. This study explores the reported referral networks of urban facilities and models alternative scenarios that increase referral efficiency in terms of distance and service hours. Methods Road network and geo-referenced facility census data from Sylhet City Corporation were used to examine referral linkages between public, private and NGO facilities for maternal and emergency/critical care services, respectively. Geographic distances were calculated using ArcGIS Network Analyst extension through a “distance matrix” which was imported into a relational database. For each reported referral linkage, an alternative referral destination was identified that provided the same service at a closer distance as indicated by facility geo-location and distance analysis. Independent sample t-tests with unequal variances were performed to analyze differences in distance for each alternate scenario modelled. Results The large majority of reported referrals were received by public facilities. Taking into account distance, cost and hours of service, alternative scenarios for emergency services can augment referral efficiencies by 1.5–1.9 km (p < 0.05) compared to 2.5–2.7 km in the current scenario. For maternal health services, modeled alternate referrals enabled greater referral efficiency if directed to private and NGO-managed facilities, while still ensuring availability after working-hours. These referral alternatives also decreased the burden on Sylhet City’s major public tertiary hospital, where most referrals were directed. Nevertheless, associated costs may be disadvantageous for the urban poor. Conclusions For both maternal and emergency/critical care services, significant distance reductions can be achieved for public, NGO and private facilities that avert burden on Sylhet City’s largest public tertiary hospital. GIS-informed analyses can help strengthen coordination between service providers and contribute to more effective and equitable referral systems in Bangladesh and similar countries.

Service Delivery and Accountability of Urban Officials: Evidence from Urban-based Local Government in Bangladesh

2021 ◽  
pp. 097152312110163
Author(s):  
A. H. M. Kamrul Ahsan ◽  
Peter Walters ◽  
Md. Adil Khan
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Service Providers ◽  
City Government ◽  
Quality Monitoring ◽  
Government Service ◽  
The Poor ◽  
Similar Class ◽  
Rajshahi City

This study compares the state of city government service delivery for communities living in different areas with different level of affluence in Rajshahi City in Bangladesh. Based on the results of a qualitative study, we found a significant service disparity between the affluent and the poor communities. This disparity is due to the inability of the poor to hold service providers accountable, attributable to a lack of knowledge about services and a lack of social status. Lack of quality monitoring and a marked bias in the quality of interactions between the poor and the affluent contribute to the service disparity This disparity is largely invisible to the poor who, instead of comparing themselves with the affluent citizens, compare themselves with a similar class of people.

scholarly journals Diffusion of Handwashing Knowledge and Water Treatment Practices From Mothers in an Antenatal Hygiene Promotion Program to Nonpregnant Friends and Relatives, Machinga District, Malawi

2018 ◽  
Vol 39 (1) ◽  
pp. 63-69
Author(s):  
Anu Rajasingham ◽  
Janell A. Routh ◽  
Anagha Loharikar ◽  
Elly Chemey ◽  
Tracy Ayers ◽  
...  
Keyword(s):  
Water Treatment ◽  
Maternal Health ◽  
Service Use ◽  
Free Water ◽  
Antenatal Clinic ◽  
Maternal Health Service ◽  
Middle Income ◽  
Treatment Practices ◽  
Hygiene Practices

Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases in low- and middle-income countries. Integrating water treatment and hygiene products into antenatal clinic care can motivate water treatment and handwashing among pregnant women. Free water hygiene kits (water storage containers, sodium hypochlorite water treatment solution, and soap) and refills of water treatment solution and soap were integrated into antenatal care and delivery services in Machinga District, Malawi, resulting in improved water treatment and hygiene practices in the home and increased maternal health service use. To determine whether water treatment and hygiene practices diffused from maternal health program participants to friends and relatives households in the same communities, we assessed the practices of 106 nonpregnant friends and relatives of these new mothers at baseline and 1-year follow-up. At follow-up, friends and relatives were more likely than at baseline to have water treatment products observable in the home (33.3% vs. 1.2%, p < 0.00001) and detectable free chlorine residual in their water, confirming water treatment (35.7% vs. 1.4%; p < 0.00001). Qualitative data from in-depth interviews also suggested that program participants helped motivate adoption of water treatment and hygiene behaviors among their friends and relatives.

scholarly journals A study on evaluation of health and nutrition day in urban slums of Berhampur, Odisha

2017 ◽  
Vol 4 (9) ◽  
pp. 3479
Author(s):  
Radha Madhab Tripathy ◽  
Manasee Panda ◽  
Jyotshna Rani Sahoo
Keyword(s):  
Urban Poor ◽  
Service Providers ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Maternal Child Health ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Abdominal Examination ◽  
Depth Interviews

Background: Urban health and nutrition day (UHND) serves as a common platform to deliver maternal, child health care, nutrition and WASH services to the urban poor population. This study was formulated with an objective to study the availability of resources at the UHND, to assess the services provided and to determine the satisfaction by the beneficiaries.Methods: A cross sectional study was conducted in urban slum of Berhampur from November 2016 to January 2017 and 10% of UHND sessions were observed. Data was collected regarding the presence of service providers at the session sites, availability of required equipments and supplies with the help of a semi-structured checklist. In-depth interviews of the service providers and exit interview from the beneficiaries from each session was taken after obtaining their informed consent and analyzed.Results: Out of 21 sessions, ANMs were present at all sessions but AWWs were present only at 61.9% sessions. Examination table, bed screen were not present at any session. Registration of pregnant women & BP measurement was done at 90.5% but abdominal examination of the woman were not performed. Weighing of children and plotting of weight on the card was done in 71.4% and 52.4% sessions respectively. 78.5% clients were satisfied with the quality of services they received.Conclusions: There was inadequate logistics identified in many UHND sessions. Hence strengthening of resources and infrastructure as well as regular supportive supervision is recommended to ensure provision of quality services. 

scholarly journals iFRAMES DESIGN IN HEALTH SECTOR BLUD: ASSET AND INVENTORY SYSTEM

2019 ◽  
Vol 4 (01) ◽  
pp. 19
Author(s):  
Satrio Wicaksono Prakoso ◽  
Machmudin Eka Prasetya
Keyword(s):  
Information System ◽  
Information Systems ◽  
Financial Reporting ◽  
Internal Control ◽  
Asset Management ◽  
Health Sector ◽  
Primary Data ◽  
Service Agency ◽  
Information Need ◽  
Study Approach

<p class="Default"><em>This research aims to design an information system to record assets and inventories at DKI Jakarta Regional Public Service Agency (BLUD). This study is based on the findings from Examination Report (LHP) issued by the Indonesian Supreme Audit Institution (BPK RI) which states that there are quite a few problems about assets at BLUD (BPK RI, 2017). This research is expected to answer research questions about how to design the system of assets and inventories needed by BLUD to assist the process of internal control and asset management. This study uses the Framework for the Application of Systems Thinking (FAST) as a method for systems development popularized by Whitten and Bentley (2007). This study uses a case study approach with the triangulation method, where the qualitative data as primary data by conducting interviews and observations. Unit of analysis in this study is the BLUD responsible for asset management. Currently, the existing asset information systems only record fixed assets and not connected to the financial reporting system. Assets and inventories information need to move manually by re-inputting the value to prepare financial statements. The result of this research is a design of asset information system to enhance internal control.</em><em></em></p><p class="Default"><strong><em>Keywords:</em></strong><em> </em><em>Assets, Information Systems, Internal Control Systems</em><em></em></p>

scholarly journals Monitoring and Evaluation Practices and Performance of County Maternal Health Programmes

2021 ◽  
Vol 17 (37) ◽  
pp. 39
Author(s):  
John Gatimu ◽  
Christopher Gakuu ◽  
Anne Ndiritu
Keyword(s):  
Maternal Health ◽  
Capacity Building ◽  
Health Sector ◽  
Monitoring And Evaluation ◽  
Evaluation Practices ◽  
Health Sector Reforms ◽  
And Performance ◽  
Descriptive Survey ◽  
The Relationship ◽  
Health Programmes

The study sought to establish the relationship between monitoring and evaluation practices and performance of County Maternal Health programmes in Kenya. The combined monitoring and evaluation practices included planning for M&E, stakeholder engagement, capacity building for M&E, and M&E data use. The study adopted a descriptive survey research design. To obtain 282 respondents, stratified random sampling was used. A self-administered structured questionnaire was the study's research instrument. Using descriptive narratives, qualitative data was analyzed within specific themes. Quantitative data was analyzed descriptively using measures of central tendencies and measures of dispersion. Regression was conducted for testing the study hypotheses. Data was presented using frequency tables. The study found that stakeholders’ engagement in M&E and capacity building for M&E influenced the performance of County Maternal Health Programmes in Kenya. The study also found that the respondents agreed that planning for M&E and the data management for M&E. This implied that the combined monitoring and evaluation practices influence performance of County Maternal Health Programmes in Kenya.The study found a strong correlation between the performance of county maternal health programmes and combined monitoring and evaluation practices. The study concluded that combined planning for M&E monitoring and evaluation practices influenced the performance of county maternal health programmes. The study suggests that management develop an effective methodology as well as raise awareness of M&E activities for the success of the project. The study also suggests that human resources issues such as workers charged with monitoring and evaluation ought to have technical capabilities, and roles and duties of monitoring and evaluation personnel should be outlined at the start of projects. To ensure M&E sustainability health sector reforms, investments in strong and vibrant technical harmonization platforms that can sustain the change agenda at all times and every required level.

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