scholarly journals Perception and Experience of Health Extension Workers on Facilitators and Barriers to Maternal and Newborn Health Service Utilization in Ethiopia: A Qualitative Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10467
Author(s):  
Alemayehu Hunduma Higi ◽  
Gurmesa Tura Debelew ◽  
Lelisa Sena Dadi
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Health Extension Workers ◽  
Facilitators And Barriers ◽  
Maternal And Newborn

Background: Health extension workers (HEWs) have substantial inputs to reduce maternal and newborn morbidity and mortality in Ethiopia. However, their perceptions and experiences were not well understood. Therefore, this study aimed to explore their perceptions and experiences on facilitators and barriers to maternal and newborn health services in Ethiopia. Methods: A descriptive qualitative study was conducted from 8–28 April 2021 in Oromia, Amhara and Southern Nation, Nationality, and People’s Regional State of Ethiopia. Focused group discussions were made with purposively selected 60 HEWs. The data were transcribed verbatim and translated into English. An inductive thematic analysis was carried out using Atlas ti.7.1. The findings were presented in major themes, categories, and sub-categories with supporting quote(s). Results: The findings were categorized into two major themes (i.e., facilitators and barriers) and seven sub-themes. Community-related facilitators encompass awareness and behavior at the individual, family, and community. Significant others such as traditional birth attendants, religious leaders, women developmental armies, and kebele chairman substantially contributed to service utilization. Availability/access to infrastructures such as telephone, transportation services, and solar energy systems facilitated the service utilization. Furthermore, health facility-related facilitators include the availability of HEWs; free services; supervision and monitoring; maternity waiting rooms; and access to ambulance services. Maternal and newborn health services were affected by community-related barriers (i.e., distance, topography, religious and socio-cultural beliefs/practices, unpleasant rumors, etc.,), health facility-related barriers (i.e., health worker’s behaviors; lack of logistics; lack of adequate ambulance service, and placement and quality of health post), and infrastructure (i.e., lack or poor quality of road and lack of water). Conclusions: The HEWs perceived and experienced a wide range of facilitators and barriers that affected maternal and newborn health services. The study findings warrant that there was a disparity in behavioral factors (awareness, beliefs, and behaviors) among community members, including pregnant women. This underscores the need to design health education programs and conduct social and behavioral change communication interventions to address individuals, families, and the broader community to enhance maternal and newborn health service utilization. On the other hand, the health sector should put into practice the available strategies, and health workers provide services with empathy, compassion, and respect.

scholarly journals The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study

2020 ◽  
Author(s):  
Duncan Ndombi Shikuku ◽  
Geofrey Tanui ◽  
Mercy Wabomba ◽  
Dennis Wanjala ◽  
Josephine Friday ◽  
...  
Keyword(s):  
Health Service ◽  
Health Service Utilization ◽  
Newborn Health ◽  
Significant Decline ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Monthly Average ◽  
Quasi Experimental ◽  
Time Periods ◽  
Maternal And Newborn

Abstract Background: Poor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers' strikes in rural Kenya. Methods: The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods: December 2016-February 2017 when doctors were on strike (P1), March-May 2017 when no healthcare providers were on strike (P2), and June-October 2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies/means of maternal and newborn health service utilization data across the three periods. Results: The monthly average number of clients obtaining services from CMs across the three time periods was: first antenatal care (ANC) (P1-1.8, P2-2.3, P3-9.9), fourth ANC (P1-1.4, P2-1.0, P3-7.1), skilled birth (P1-1.5, P2-1.7, P3-13.1) and the differences in means were statistically significant (p<0.05). Over the period, the monthly average number of clients obtaining services from health facilities was: first ANC (P1-55.7, P2-70.8, P3-4.0), fourth ANC (P1-29.6, P2-38.1, P3-1.2) and skilled birth (P1-63.1, P2-87.4, P3-5.6), p<0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p>0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3 accompanied by a statistically significant decline in the average number of clients obtaining services from health facilities (p<0.05). First ANC increased by 68%, fourth ANC by 75%, skilled births by 68%, and postnatal care by 33% in P3 (p<0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3. Conclusions: The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.

PENGARUH KEPUASAN PASIEN TENTANG PELAYANAN KEBIDANAN TERHADAP PEMANFAATAN PELAYANAN KESEHATAN DI PUSKESMAS PONTAP TAHUN 2016

2018 ◽  
Vol 6 (08) ◽  
pp. 1-7
Author(s):  
Devi Darwin ◽  
Ny. Irmayanti ◽  
Tirta Nirwana
Keyword(s):  
Quality Of Service ◽  
Patient Satisfaction ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Statistical Test ◽  
Test Analysis ◽  
Utilization Of Health Services

Satisfaction is formed from a result and a comparative reference, comparing the results received with a particular standard. The comparison forms three possibilities: first is if the service is perceived to be above the expectation (quality surprise), the second when the quality of service fulfills the expectation, and the last if the service received is worse than the expected service.The influence of physical needs in patient satisfaction on the utilization of health service shows that from 89 respondents, respondents who have good physical needs about patient satisfaction on utilization of health services as much as 43 respondents and respondents who need less physical as much as 46 respondents. Based on the result of statistical test analysis, it is said that there is influence of physical requirement in patient satisfaction to health service utilization. Keywords: Satisfaction, Midwifery Services

scholarly journals The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study

2020 ◽  
Author(s):  
Duncan Ndombi Shikuku ◽  
Geofrey Tanui ◽  
Mercy Wabomba ◽  
Dennis Wanjala ◽  
Josephine Friday ◽  
...  
Keyword(s):  
Health Service ◽  
Health Service Utilization ◽  
Newborn Health ◽  
Significant Decline ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Monthly Average ◽  
Quasi Experimental ◽  
Time Periods ◽  
Maternal And Newborn

Abstract Background: Poor women in hard-to-reach areas are least likely to receive healthcare and carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers' strikes in rural Kenya. Methods: The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods (P), including December’2016-February’2017 when medical doctors were on strike (P1), March -May’2017 when no healthcare providers were on strike (P2), and June-October’2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies and means of maternal and newborn health service utilization data across the three time periods. Results: The monthly average number of clients obtaining services from CMs across the three time periods (P1-P2-P3) was as follows: first antenatal care (ANC) (1.8-2.3-9.9), fourth ANC (1.4-1.0-7.1), skilled birth (1.5-1.7-13.1) and the differences in means were statistically significant (p<0.05). Over the period, the monthly average number of clients obtaining services from health facilities was as follows: first ANC (55.7 -70.8-4.0), fourth ANC (29.6-38.1-1.2) and skilled birth (63.1-87.4-5.6), p<0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p>0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3, which was accompanied by a statistically significant decline in the average number of clients of obtaining services from health facilities (p<0.05). First ANC increased by 68, fourth ANC by 75, skilled births by 68, and postnatal care by 33 percentage points in P3 (p<0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3.Conclusions: The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.

scholarly journals The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: a quasi-experimental study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Duncan N. Shikuku ◽  
Geofrey Tanui ◽  
Mercy Wabomba ◽  
Dennis Wanjala ◽  
Josephine Friday ◽  
...  
Keyword(s):  
Health Service ◽  
Health Service Utilization ◽  
Newborn Health ◽  
Significant Decline ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Monthly Average ◽  
Quasi Experimental ◽  
Time Periods ◽  
Maternal And Newborn

Abstract Background Poor women in hard-to-reach areas are least likely to receive healthcare and thus carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers’ strikes in rural Kenya. Methods The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods: December 2016-February 2017 when doctors were on strike (P1), March-May 2017 when no healthcare providers were on strike (P2), and June-October 2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies/means of maternal and newborn health service utilization data across the three periods. Results The monthly average number of clients obtaining services from CMs across the three time periods was: first antenatal care (ANC) (P1-1.8, P2-2.3, P3-9.9), fourth ANC (P1-1.4, P2-1.0, P3-7.1), skilled birth (P1-1.5, P2-1.7, P3-13.1) and the differences in means were statistically significant (p < 0.05). Over the period, the monthly average number of clients obtaining services from health facilities was: first ANC (P1-55.7, P2-70.8, P3-4.0), fourth ANC (P1-29.6, P2-38.1, P3-1.2) and skilled birth (P1-63.1, P2-87.4, P3-5.6), p < 0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p > 0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3 accompanied by a statistically significant decline in the average number of clients obtaining services from health facilities (p < 0.05). First ANC increased by 68%, fourth ANC by 75%, skilled births by 68%, and postnatal care by 33% in P3 (p < 0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3. Conclusions The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.

Double depression: its morbidity and management in a community setting

2006 ◽  
Vol 18 (5) ◽  
pp. 210-215 ◽  
Author(s):  
Robert D. Goldney ◽  
Marcus A. Bain
Keyword(s):  
Quality Of Life ◽  
Major Depression ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Double Depression ◽  
Antidepressant Use ◽  
Use Of Health Services

Background:Double depression, the combination of major depression and dysthymia, is associated with poor health-related quality of life (HRQoL) and increased health service utilization.Objective:To determine the prevalence of double depression, its associated morbidity and use of health services and antidepressants.Methods:A random and representative sample of the South Australian general population was interviewed. The mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD), the Short-Form Health Status Questionnaire (SF-36) and Assessment of Quality of Life (AQoL) instruments were administered, and data relating to health service utilization, antidepressant use and role functioning were collected.Results:Double depression was present in 3.3% of the population. The use of health services was significantly higher in this group than those with no depression, or dysthymia or major depression alone. Only 15.2% had attended a community health service, 18.2% had seen a psychiatrist, 10.1% a psychologist, 16.2% a social worker and 9.1% any other counsellor in the last month. While 41.4% were currently taking an antidepressant, the average doses of the two most commonly prescribed antidepressants were below the maximum recommended doses, and the use of antidepressant augmentation strategies was also minimal.Conclusions:While double depression is associated with increased morbidity and use of health services, the optimum use of both pharmacological and nonpharmacological treatments is clearly lacking in this community sample.

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