scholarly journals Access to Maternal Health Services During the COVID-19 Pandemic: Experiences of Indigent Mothers and Health Care Providers in Kilifi County, Kenya

2021 ◽  
Vol 6 ◽  
Author(s):  
Stephen Okumu Ombere
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Care Providers ◽  
Maternal Health Services ◽  
Traditional Birth Attendants ◽  
Mobile Phone Data ◽  
Extensive Literature ◽  
Care Providers ◽  
Birth Attendants ◽  
Expectant Mothers

COVID-19 has spread rapidly in Kenya and has not spared pregnant women. Evidence from Kenya shows that during the COVID-19 pandemic, health systems have been either stressed to their maximum capacity or are becoming overwhelmed. However, the population is advised not to attend hospital unless strictly necessary, and this advice seems to apply to all, including expectant mothers. There is a dearth of information on how poor expectant mothers with low bargaining power cope during COVID-19 in Kenya, which this study addresses for those in Kilifi County. This rapid qualitative study draws data from an extensive literature review and from interviews with 12 purposively selected mothers who were either expectant or had newborn babies during the pandemic in Kilifi County. Five matrons-in-charge of maternal health services and four traditional birth attendants were also interviewed via mobile phone. Data were analyzed thematically and are presented in a textual description. It emerged that expectant mothers feared attending hospitals for perinatal care due to the possibility of contracting COVID-19. Therefore, there was an increase in home deliveries with the assistance of traditional birth attendants (TBAs)/traditional midwives, who were also overwhelmed with women who sought their services. Since most causes of maternal morbidity and mortality can be prevented by prompt, suitable treatment by qualified health practitioners, the health officials interviewed recommended training and integration of TBAs in emergency healthcare responses to help during crises in MHS because they are trusted by their local communities. Notably, such integration of traditional midwives should be supported and should also include additional training and monetary incentives.

scholarly journals HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

2021 ◽  
Vol 3 (2) ◽  
pp. 479-495
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Skilled Birth Attendant ◽  
Maternal Health Care ◽  
Traditional Birth Attendants ◽  
Care Providers ◽  
Birth Attendants

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

scholarly journals The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda

2018 ◽  
Vol 6 ◽  
pp. 205031211775363 ◽  
Author(s):  
Primus Che Chi ◽  
Henrik Urdal
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Providers ◽  
Traditional Birth Attendants ◽  
Northern Uganda ◽  
Local Health ◽  
Care Providers ◽  
Birth Attendants ◽  
Post Conflict

Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. Conclusion: The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system.

scholarly journals Determinants of skilled birth attendants for delivery in Nepal

2012 ◽  
Vol 8 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Y R Baral ◽  
K Lyons ◽  
J Skinner ◽  
E R Van Teijlingen
Keyword(s):  
Qualitative Research ◽  
Maternal Health ◽  
Health Services ◽  
Quantitative Research ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Women's Role

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women’s role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women’s involvement in decision making; and women’s autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women’s role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6223 Kathmandu Univ Med J 2010;8(3):325-32 

scholarly journals Health care professional knowledge and attitude towards the use of digital technologies in provision of maternal health services at Tumbi regional referral hospital in Tanzania

2020 ◽  
Vol 5 (1) ◽  
pp. e000233
Author(s):  
Willcliff K Thadeus ◽  
Lawrencia D Mushi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Digital Technologies ◽  
Maternal Health Services ◽  
Referral Hospital ◽  
Care Providers ◽  
Regional Referral Hospital ◽  
Services Delivery ◽  
Knowledge And Attitude

Objectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH). Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies. Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT. Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities.

scholarly journals TRADITIONAL BIRTH ATTENDANTS AND REPRODUCTIVE HEALTH SERVICES IN THE CONTEXT OF COVID-19: A SCOPING REVIEW

2021 ◽  
Vol 15 (1) ◽  
pp. 1-12
Author(s):  
Gadanya MA ◽  
◽  
Adamu KA ◽  
Ibrahim UM
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Traditional Birth Attendants ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Community Based ◽  
Birth Attendants

Background: In developing countries, the lack of accessible, affordable and acceptable orthodox care makes a significant proportion of the populace patronize the nearby available and cheap traditional birth attendants (TBAs) that share similar local custom and tradition. Although there are widely diverging shreds of evidence regarding their effectiveness as health care providers, they may have a limited role as a workforce during the ongoing COVID-19 pandemic where the more community-based distribution of commodities is increasingly considered due to movement restrictions. However, it is still doubtful if their integration into the formal health system may substantially contribute to basic health care delivery especially in the rural often hard to reach areas. Objectives: To explore the various roles of TBAs in reproductive health service delivery with implication for redefining their roles especially with the advent of the COVID-19 pandemic. Methodology: We searched and reviewed relevant literature on TBAs in PubMed, Africa Journals Online (AJOL) and Google scholar and relevant institutional websites for the role of TBAs pre and during the pandemic. The databases searched yielded 92 articles of potential significance to this review. After title/abstract review, 65 articles were moved to full document review. Nineteen articles explicitly and strictly focusing on TBAs concerning reproductive health were included in this review. Results: TBAs are providers of a wide range of reproductive health services and training to expand their roles and makes them safer is necessary for any consideration of their engagement; this implies the fight against COVID-19. TBAs should only be engaged if the gap in the resources for health must be filled by leveraging on their existing traditional roles and acceptance in the community. Conclusion: TBAs are widely utilised providers of care to their communities especially in the area of maternal care. With increasing emphasis on community-based services in healthcare delivery and the emergence of COVID-19, their roles must be reviewed and updated regularly to redefine their role in the health care delivery system especially because of the myriad personal and technical limitations associated with them. Any engagement with them should be with caution and as a stop-gap measur.

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