scholarly journals Practices and Women’s Perceptions of Childbirth in Western Nepal: A Qualitative Study

2020 ◽  
Vol 18 (1) ◽  
pp. 64-69
Author(s):  
Tulsi Ram Bhandari ◽  
Shreejana Wagle ◽  
Ganesh Dangal
Keyword(s):  
Institutional Delivery ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Home Delivery ◽  
Labor Pain ◽  
Delivery Care ◽  
Local Health ◽  
Care Services ◽  
Study Results ◽  
Women’S Perceptions

Background: Despite continuous efforts to increase the utilization of institutional delivery care services nearly two-fifths women deliver their babies at home without the assistance of skilled birth attendants (SBA) in Nepal. The skilled care at birth can reduce the high maternal and neonatal mortality. This study explored childbirth practices and women’s perceptions of childbirth and its associated factors.Methods: An exploratory study was conducted in three purposively selected remote villages of Kapilvastu district, from March to May 2017. Face-to-face in-depth interviews were conducted with women who had an under-one year child. We performed a thematic analysis to draw the findings of the study. Results: Women sought institutional delivery care either for long labor-pain or obstructed-delivery. Despite various incentives, people still preferred home for normal deliveries. There was also practiced skilled birth attendant (SBA) assisted home delivery care. Some of the local health workers also advised pregnant-women for assisted home delivery care. People considered childbirth as a normal process. Due to cultural beliefs and norms, people were also reluctant to pursue institutional delivery care services. Financial constraints, poor access to services and expensive transportation services were other underlining causes of home delivery practices. Conclusions: Despite various incentives for institutional delivery care; the study did not spectacle an encouraging reaction. It pointed to the very basic and strong relationship between women’s position in the household and the society and education with childbirth practices. There were limits to how far financial incentives can overcome these obstacles. So, the improvement of the socio-economic conditions of the women would be the viable way-out of the problem.Keywords: Childbirth practices; home delivery; institutional delivery; women’s perception

scholarly journals Socio-cultural Beliefs and Practices Influencing Institutional Delivery Service Utilization in Three Communities of Ethiopia: A Qualitative Study

1970 ◽  
Vol 29 (3) ◽  
Author(s):  
Sabit Ababor ◽  
Zewdie Birhanu ◽  
Atkure Defar ◽  
Kasahun Amenu ◽  
Amanuel Dibaba ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Facility ◽  
Institutional Delivery ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Cultural Factors ◽  
Beliefs And Practices ◽  
Delivery Service ◽  
Facility Birth ◽  
Health Facility Birth

BACKGROUND: The influence of socio-cultural factors on institutional birth is not sufficiently documented in Ethiopia. Thus, this study explores socio-cultural beliefs and practices during childbirth and its influences on the utilization of institutional delivery services.METHODS: A qualitative study was conducted in three regions of Ethiopia through eight focus group discussions (with women) and thirty in-depth interviews with key informants which included health workers, community volunteers, and leaders. The data were analyzed thematically.RESULTS: The study identified six overarching socio-cultural factors influencing institutional birth in the study communities. The high preference for traditional birth attendants (TBAs) and home as it is intergenerational culture and suitable for privacy are among the factors. Correspondingly, culturally unacceptable birth practices at health facilities (such as birth position, physical assessment, delivery coach) and inconvenience of health facility setting to practice traditional birth rituals such as newborn welcoming ceremony made women avoid health facility birth. On the other hand, misperceptions and worries on medical interventions such as episiotomy, combined with mistreatment from health workers, and lack of parent engagement in delivery process discouraged women from seeking institutional birth. The provision of delivery service by male health workers was cited as a social taboo and against communities' belief system which prohibited women from giving birth at a health facility.CONCLUSIONS: Multiple socio-cultural factors and perceptions were generally affected utilization of institutional birth in study communities. Hence, culturally competent interventions through education, re-orientation, and adaptation of beneficial norms combined with women friendly care are essential to promote health facility birth. 

scholarly journals How Do People Who Are Homeless Find Out about Local Health and Social Care Services: A Mixed Method Study

2021 ◽  
Vol 19 (1) ◽  
pp. 46
Author(s):  
Vanessa Heaslip ◽  
Sue Green ◽  
Bibha Simkhada ◽  
Huseyin Dogan ◽  
Stephen Richer
Keyword(s):  
Mixed Methods Research ◽  
Research Study ◽  
Social Care ◽  
Third Sector ◽  
Local Health ◽  
Care Services ◽  
Study Results ◽  
Health And Social Care ◽  
One To One ◽  
The Uk

Background: There are significant numbers of people experiencing homelessness both in the UK and internationally. People who are homeless are much more likely to die prematurely and, therefore, need strong access to ongoing health and social care support if we hope to address the health disparity they face. Objectives: The aim of the research was to explore how people who are homeless identify and locate appropriate health and social care services. Design: A mixed methods research study was applied on people who are currently homeless or had previously experienced homelessness. Settings: The research study was based in an urban area in the southwest of England. The area was chosen as it was identified to be in the top 24 local authorities for the number of homeless individuals. Participants: A hundred individuals participated in the survey, of those 32% were living on the streets whilst 68% were living in temporary accommodation such as a charity home, shelter or a hotel paid for by the local authority. In addition, 16 participated in either a focus group or one-to-one interview Methods: The quantitative component consisted of a paper-based questionnaire whilst the qualitative aspect was focus groups/one-to-one interviews. The COREQ criteria were used in the report of the qualitative aspects of the study. Results: Quantitative data identified poor health in 90% of the sample. Access to both healthcare and wider wellbeing services (housing and food) was problematic and support for this was largely through third sector charity organisations. Qualitative data identified numerous systemic, individual and cultural obstacles, leaving difficulty for people in terms of knowing who to contact and how to access services, largely relying on word of mouth of other people who are homeless. Conclusions: In order to address health inequities experienced by people who are homeless, there is a need to review how information regarding local health and wider wellbeing services is provided in local communities.

scholarly journals Progress in Lowering the Number of Malnutrition Cases in Toddlers in Bone Regency, South Sulawesi

2021 ◽  
Vol 2 (2) ◽  
pp. 25-37
Author(s):  
Zhery Mulyati ◽  
Sudirman Nasir ◽  
Ridwan Mochtar Thaha
Keyword(s):  
Health Worker ◽  
Health Care Services ◽  
Health Workers ◽  
Human Resources For Health ◽  
Community Leaders ◽  
Work Program ◽  
Study Approach ◽  
Care Services ◽  
Study Results ◽  
Stake Holder

This study aims to analyze the factors, thus advancement Kab. Bone in lowering malnutrition case in Toddler. This research uses qualitative research with a case study approach. Data were obtained by in-depth interviews and unstructured observations to 22 resource persons consisting of health workers, policy makers (stake holder), community leaders and cadres. Study results shows that all puskesmas carry out the PSG program, moreover the health worker perform the duties with positive attitude and good awareness. Availability of human resources for health care services for malnourished toddlers is 2-4 people, therefore at posyandu helped by 2-5 cadres. As well as support from stakeholder, and good participation from the community. However, there still a lack of knowledge from the community leaders, and cadres about PSG work program. Moreover, there is a shortfall for the availability of health worker in undernourished toddler, also the lack of awareness by some health workers towards teamwork. Inconclusion, the work program, attitude and health worker awareness, human resource availability, stake holder support, and community participation is proven to play a role in progress to reduce the number of cases of malnutrition at Kab. Bone. Stakeholders are expected to make new adaptations or innovations to adjust to the situation during the Covid-19 pandemic, improve the teamwork system, add health workers who serve in undernourished toddlers, and increase more massive and active socialization about the PSG program

scholarly journals Association of Antenatal Care Visit with Utilization of Institutional Delivery Care Services in Afghanistan: Intersections Between Education, Wealth, and Household Decision-Making Autonomy

2021 ◽  
Author(s):  
Mostafizur Rahman ◽  
Priom Saha ◽  
Jalal Uddin
Keyword(s):  
Decision Making ◽  
Social Status ◽  
Institutional Delivery ◽  
Skilled Birth Attendant ◽  
Safe Motherhood ◽  
Care Utilization ◽  
Delivery Care ◽  
Household Decision ◽  
Care Services ◽  
Statistical Interactions

Abstract Background: The importance of antenatal visits in safe motherhood and childbirth is well documented. However, less is known how social determinants of health interact with antenatal care (ANC) visits in shaping the uptake of professional delivery care services in low-income countries. This study examines the association of ANC visits with institutional delivery care utilization outcomes in Afghanistan. Further, we assess the extent to which ANC visits intersect with education, wealth, and household decision-making autonomy in predicting two outcomes of delivery care utilization- delivery at a health facility and delivery assisted by a skilled birth attendant.Methods: We used data from the Afghanistan Demographic and Health Survey (AfDHS) 2015. The analytic sample included 15,581 women of reproductive age (15-49). We assessed the associations using logistic regression models, estimated the predicted probability of delivery care outcomes using statistical interactions, and presented estimates in margins plot. Results: Regression analyses adjusted for socioeconomic and demographic covariates suggest that women who had 4 or more ANC visits were 5.7 times (95% CI= 4.78, 7.11, P<0.001) more likely to use delivery care at a health facility and 6.5 times (95% CI= 5.23, 8.03; P<0.001) more likely to have a delivery assisted by a skilled birth attendant compared to women who had no ANC visit. Estimates from models with statistical interactions between ANC, education, wealth, and decision-making autonomy suggest that women with higher social status were more advantageous in utilizing institutional delivery care services compared to women with lower levels of social status. Conclusion: Our findings suggest that the association of ANC visit with institutional delivery care services is stronger among women with higher social status. The results have implications for promoting safe motherhood and childbirth through improving women’s social status.

scholarly journals Access to institutional delivery care and reasons for home delivery in three districts of Tanzania

2014 ◽  
Vol 13 (1) ◽  
Author(s):  
Amon Exavery ◽  
Almamy Malick Kanté ◽  
Mustafa Njozi ◽  
Kassimu Tani ◽  
Henry V Doctor ◽  
...  
Keyword(s):  
Institutional Delivery ◽  
Home Delivery ◽  
Delivery Care

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

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.

scholarly journals PEP4LEP study protocol: integrated skin screening and SDR-PEP administration for leprosy prevention: comparing the effectiveness and feasibility of a community-based intervention to a health centre-based intervention in Ethiopia, Mozambique and Tanzania

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046125
Author(s):  
Anne Schoenmakers ◽  
Thomas Hambridge ◽  
Robin van Wijk ◽  
Christa Kasang ◽  
Jan Hendrik Richardus ◽  
...  
Keyword(s):  
Health Workers ◽  
Health Centre ◽  
Post Exposure Prophylaxis ◽  
Screening Methods ◽  
Local Health ◽  
Community Based ◽  
Treatment And Prevention ◽  
Study Results ◽  
Local Health Centre ◽  
Exposure Prophylaxis

IntroductionLeprosy, or Hansen’s disease, remains a cause of preventable disability. Early detection, treatment and prevention are key to reducing transmission. Post-exposure prophylaxis with single-dose rifampicin (SDR-PEP) reduces the risk of developing leprosy when administered to screened contacts of patients. This has been adopted in the WHO leprosy guidelines. The PEP4LEP study aims to determine the most effective and feasible method of screening people at risk of developing leprosy and administering chemoprophylaxis to contribute to interrupting transmission.Methods and analysisPEP4LEP is a cluster-randomised implementation trial comparing two interventions of integrated skin screening combined with SDR-PEP distribution to contacts of patients with leprosy in Ethiopia, Mozambique and Tanzania. One intervention is community-based, using skin camps to screen approximately 100 community contacts per leprosy patient, and to administer SDR-PEP when eligible. The other intervention is health centre-based, inviting household contacts of leprosy patients to be screened in a local health centre and subsequently receive SDR-PEP when eligible. The mobile health (mHealth) tool SkinApp will support health workers’ capacity in integrated skin screening. The effectiveness of both interventions will be compared by assessing the rate of patients with leprosy detected and case detection delay in months, as well as feasibility in terms of cost-effectiveness and acceptability.Ethics and disseminationEthical approval was obtained from the national ethical committees of Ethiopia (MoSHE), Mozambique (CNBS) and Tanzania (NIMR/MoHCDEC). Study results will be published open access in peer-reviewed journals, providing evidence for the implementation of innovative leprosy screening methods and chemoprophylaxis to policymakers.Trial registration numberNL7294 (NTR7503).

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