scholarly journals Utilization of hospital services during delivery among post-natal mothers in Thika urban and Kangundo rural Counties, Kenya

2018 ◽  
Vol 3 (1) ◽  
pp. 39-45
Author(s):  
Priscilla Kabue ◽  
M Keraka ◽  
J Simbauni
Keyword(s):  
Health Facility ◽  
Health Workers ◽  
Hospital Setting ◽  
Home Delivery ◽  
Rural Hospital ◽  
Urban Setting ◽  
Rural Setting ◽  
Maternal Child Health ◽  
Hospital Services ◽  
Long Distance

Background: Maternal mortality rate due to pregnancy-related complications in Kenya remains high at 362 per 100,000 live births. Hospital deliveries are low despite government strategies on improving health system and human resources. Home delivery practice is common in many parts of Kenya, especially in the rural areas. Generally, midwifery in home delivery lacks the necessary expertise to identify, resolve or prevent maternal complication, a situation which could raise maternal delivery related morbidity and mortality rates. Objectives: The study aimed to determine the rates of hospital deliveries both in urban and the rural hospital settings and establish the factors that determined the choice for hospital services. Methods: The study population was composed of post-natal mothers attending Maternal Child Health Clinics in an urban hospital setting and a rural hospital setting. The mothers were those who had delivered less than one year earlier. Thika Level 5 Hospital in Kiambu County represented the urban setting while Kangundo Level 4 Hospital represented the rural setting. A total of 400 post-natal mothers in each of the two hospitals were interviewed using a structured questionnaire to collect the relevant data in each hospital. Focus Group Discussions and Key informants interviews were also conducted in each hospital. Results: Client specific factors that were associated with hospital delivery included a steady source of income and occupation (p = 0.028, p = 0.007), ability to pay for hospital expenses and remedies (p = 0.000, p = 0.00), accessibility and short distance from the health facility (p= 0.001, p = 0.029), and client having a positive experience from a previous delivery and hope for a better services in the hospital (p = 0.000, p = 0.000) respectively. Health facility factors were lack of privacy (p = 0.000) manner in which the mother was handled by the health care worker (p = 0.0901) and the expected care (p =0.017). Conclusion: The study concludes that mothers fail to utilize the health facility for delivery due to service related factors such as long distance from the hospital, negative attitude of health workers, lack of privacy and poor quality of care, an improvement of which will make them deliver in hospitals and not at home.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Kwikiriza Magambo ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Factors Affecting Home Delivery among Women Living in Remote Areas of Rural Zambia: A Cross-Sectional, Mixed-Methods Analysis

2021 ◽  
pp. 1-13
Author(s):  
Ireen Chola Mwape Musonda
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Rural Areas ◽  
Home Delivery ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Home Deliveries ◽  
At Home

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: A health facility level assessment

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background: Globally immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of health facility may influence performance of their immunization programs. Therefore, the purpose of this study was to examine whether geographical location of health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda.Methods: We conducted a cross sectional study using a mixed methods approach. The study unit was a health center and we interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results: We collected data at 49 health facilities. Most of the health units (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p<0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations.Conclusions: Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda, a Health Facility level assessment

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background: Globally immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda.Methods: We conducted a cross sectional study using a mixed methods approach. The study unit was a health center and we interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results: We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p<0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations.Conclusions: Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Associated Factors for Dropout of First Vs Third Doses of Diphtheria Tetanus Pertussis (DPT) Vaccination in Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kanchan Thapa ◽  
Pratik Adhikary ◽  
Mahmud Hossain Faruquee ◽  
Bhim Raj Suwal
Keyword(s):  
Health Facility ◽  
Secondary Data ◽  
Home Delivery ◽  
Long Distance ◽  
Final Model ◽  
Mortality And Morbidity ◽  
Internet Users ◽  
The Family ◽  
Education Status ◽  
Formal Employment

Background. Immunization acts as a key intervention to reduce under-five mortality and morbidity. Despite global progress on vaccination, difficulties in the utilization of this service in developing countries have been observed. According to Nepal Demographic and Health Survey (NDHS) 2016, only 78% of children received a complete dose of vaccine among which the first-dose receiver of DPT is 98%, whereas only 83% received a third dose. This study aims to explore the influencing factors of DPT vaccination dropout in Nepal. Methods. The explorative study was done through secondary data analysis of NDHS 2016. The KR file was used for the analysis of information for 2883 children. Factors influencing dropout of DPT vaccination were explored against the independent variables such as external environment, predisposing factors, and enabling resources. All the analyses were weighted before the analysis. The descriptive, bivariate, and multivariate analyses were performed. The variables showing collinearity have been removed in the final model. Results. A higher dropout was reported in Terai (18.9%) and province 2 (22.0%), among uneducated mothers (18.1%) and uneducated fathers (19.4%), less than once a week internet users (22.2%), the nonradio listener (17.4%), who had <4 ANC visits (22.7%), home delivery (19.2%), no advised SBA (19.1%), long distance to health facility (17.9%), no iron supplementation in pregnancy (24.3%), and PNC by TBA/others (21.1%). All these tested relationships were found statistically significant ( P value <0.05). The aOR for dropout was found to be 7.94 (4.07–15.51) for mothers with less than 4 or no ANC visit, long distance to health facility 4.68 (1.98–10.67), province 2 3.53 (1.13–11.03), and mother without formal employment 2.33 (1.52–3.55). Conclusion. Factors related to health services, distance, provinces, and socioeconomic status of the family were influencers for vaccine dropout. Targeted intervention towards disadvantaged regions, counseling the mother during ANC, improving the education status of parents, access to the health facility, and use of mass media for advocacy are hereby recommended.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda, a facility level assessment

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background Globally immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of health facility may influence performance of their immunization programs. Therefore, the purpose of this study was to examine whether geographical location of health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The study unit was a health center and we interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of the health units (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p<0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Assessment of Factors Affecting Attendance of Antenatal Care in Kagote Health Center III, Kabarole District, Uganda

2021 ◽  
Author(s):  
◽  
MARGARET APISO
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Sampling Method ◽  
Service Providers ◽  
Health Workers ◽  
Reproductive Age ◽  
Evaluation Methodology ◽  
Long Distance ◽  
Cross Sectional ◽  
Factors Affecting

Background: Antenatal care is generally thought to be an effective method of improving outcomes in pregnant women and their babies, although many specific Antenatal Care practices have not been subject to rigorous evaluation Methodology: A descriptive cross-sectional study was carried out in Kagote HCIII aimed at assessing the factors affecting ANC attendance in the Kabarole district. Using a convenience sampling method, Kagote HCIII was chosen by the random sampling method. A sample of 100 respondents was interviewed. Questionnaires were used to obtain data from the individuals and these were in form of closed and open-ended questions. Results: The majority of the respondents 92(92%) used ANC information in subsequent pregnancies. 48(48%) said that multiparous women did not need to attend ANC if they were healthy while 12% were not sure. Challenges include long distance from the ANC clinic 32(13%), harsh health service providers 8(3%), lack enough support from husbands 22(9%), segregation and discrimination 12(5%), negative attitude towards ANC 16(7%), high transport costs 37(15.4%), lack of enough money 43(18%), lack of enough time 10(4%), too much workload at home 16(7%), long waiting time 20(8.3%), unavailability of some drugs at times 24(10%). Conclusion and recommendation: The factors affecting ANC attendance in Kagote HCIII are; age, occupation, education level, marital status, address, the number of health workers, their cadre, skill, authority, knowledge, nature, the services they and how they offer them, availability of incentives like drugs, multiparity, the order of pregnancy and the challenges mentioned above.  There is a need for the MOH to continue sensitizing people about the importance of ANC attendance, outreaches by the health facility to the community to offer the service and encourage attendance, a collaboration between the health facility and the village health team continued health education of women of reproductive age about ANC and its attendance. 

scholarly journals Factors Associated With Maternal Death among Women of Child Bearing Age on the Community Perspectives; a Case Study of Kisemvule Village in Mkuranga District, Tanzania 2019

2020 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Risk Factors ◽  
Health Facility ◽  
Maternal Death ◽  
Health Workers ◽  
Care Facility ◽  
Women Of Childbearing Age ◽  
Pregnant Mother ◽  
Childbearing Age ◽  
Long Distance ◽  
Pregnancy And Childbirth

Objective: In the world, 303,000 women lose their life due to the complications related to pregnancy and childbirth. Tanzania is ranked 6th and 4th among the countries with high maternal mortality globally and Africa respectively. About 23 women in Tanzania are dying daily due to preventable causes, related to pregnancy and childbirth that is approximately one woman every hour. The objective of this study was assessment of risk factors on community setting associated with maternal death among women of childbearing age. Results: We enrolled 124 women of childbearing age. The mean age was 17.7. (37%) mentioned preeclampsia as the most risk factor leading to maternal death, 21% reported abortion, 13.7% mentioned anemia, and 12.1% reported postpartum hemorrhage, and 10.5% pregnancy induced hypertension (PIH), 3.2% ante partum hemorrhage and 2.4% early pregnancy. Other risk factors that seemed to cause maternal death included; delay to seek health facility to pregnant mother (8.9%), long distance from health facility to people’s residents (57.%), poor transport system in the village to reach the present health care facility (4.8%), negligence from health workers was also reported by the women as contributing factor (13.7%), economic condition-poverty (7.3%) absence of emergency blood bank in the health facility(4.8%), and poor nutrients to pregnant mother (3.2%). More studies are needed in the community to explore more on the risk factors among women of different life group.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: A health facility level assessment

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background: Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda.Methods: We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results: We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p<0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations.Conclusions: Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Ugandan

2020 ◽  
Author(s):  
Nicholas Magambo Kwikiriza ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Health Management Information System ◽  
Program Performance ◽  
Immunization Program

Abstract Background Globally immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of health facility may influence performance of their immunization programs. Therefore, the purpose of this study was to examine whether geographical location of health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda.Methods We conducted a cross sectional study using a mixed methods approach. The study unit was a health center and we interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test.Results We collected data at 49 health facilities. Most of the health units (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Inadequate commitment and competing interests of health workers in the more urban areas were suggested as possible explanations.Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

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