scholarly journals Maternal Health Care Providers and the Challenges of Quality Services in Rural Communities of Kaduna State, Nigeria

Author(s):  
Godswill James ◽  
Ada Helen Ochi

It is widely assumed by maternal health care programmers and policy makers that expanding coverage of maternal health care services will improve reproductive health indices such as maternal mortality; this is without taking into account the quality of care especially in rural areas. Despite various attempts by Governments to increase the utilization of maternity service and improve maternal health, the progress made so far remains little in rural areas. This study examines the challenges faced by maternal health care providers in providing quality services in rural communities of Kaduna State. A community-based cross-sectional research design was adopted and data were obtained using both quantitative and qualitative methods. A survey of 300 women aged 15-49 years was carried out, using multi-stage sampling techniques involving Local Government Areas, wards, main streets, houses, households and individuals. Focus group discussions were conducted among women who delivered three months before the survey, and those who experienced acute morbidity and complications. In-depth interviews were conducted with maternal health care providers in the study communities. The study reveals inadequacy in equipment, number and quality of staff in the rural health facilities; younger women were more likely to have positive experience of care than older women. Care was discontinued if health care providers were perceived as unqualified, neglectful or too young. Many pregnant women were discouraged from taking their drugs due to the perception that the drugs increased the baby’s weight which makes delivery difficult. Engagement with political, religious leaders and community groups needs to be fostered through sensitization and sustained advocacy to remove constraints to accessibility of quality health care in rural areas.

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Daniel Asfaw Erku

Background.Today, complementary and alternative medicine (CAM) use is being routinely practiced by cancer patients worldwide. This study aimed at examining the prevalence of CAM use in patients with cancer and comparing the quality of life (QoL) in CAM users and nonusers.Methods.A cross-sectional study was employed on 195 cancer patients receiving chemotherapy at Gondar University Referral Hospital (GURH) chemotherapy center. Interviewer-administered questionnaires were used and the collected data were analyzed by the Statistical Package for the Social Sciences (SPSS) software version 21.0 for Windows.Results.154 (79%) patients were found to be users of CAM. Educational status, average monthly income, disease stage, and comorbidity were strong predictors of use of CAM. The most commonly utilized types of CAM were traditional herbal based medicine (72.1%) and only 20.8% of patients discuss with their doctors CAM use. No significant difference was found in QoL between CAM users and nonusers except in financial difficulties (p=0.020).Conclusions.This study revealed a high rate of CAM use with very low disclosure rate to their health care providers. Health care providers should be open to discuss the use of CAM with their patients as it will lead to better health outcome.


2021 ◽  
Vol 17 ◽  
pp. 174550652110461
Author(s):  
Seboka Abebe Sori ◽  
Kedir Teji Roba ◽  
Tesfaye Assebe Yadeta ◽  
Hirut Dinku Jiru ◽  
Keyredin Nuriye Metebo ◽  
...  

Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dejene Edosa

Background. Emergency obstetrics and newborn care (EmONC) is an important lifesaving function which can avert the death of women facing obstetrics-related complications. It is a cost-effective, significant intervention to decrease maternal and neonatal morbidity and mortality in poor resource settings, including Ethiopia. Objective. The aim of this study was to assess the availability and quality of the EmONC services in southwestern Oromia, Ethiopia, in 2017. Methods. An institutional-based cross-sectional study was implemented from April to May 2017. Data were collected using checklists and questionnaires developed from different studies. Data were analyzed using EPI-info and exported to SPSS version 20 for further analysis. Each descriptive statistic was summarized using frequency, percentage, and tables for categorical variables. Results. Despite the fact that the overall coverage of fully functioning basic emergency obstetric and newborn care (BEmONC) facilities was greater than 5 per 500,000 people, nearly one-fourth (25.64%) provided less than expected signal functions, indicating that these facilities were nonfunctional. There were only 0.24 comprehensive emergency obstetric and newborn care (CEmONC) facilities per 500,000 people. The result of this study also revealed that the quality of EmONC facilities in all health-care settings was poor. Conclusion and Recommendation. There were gaps in performance signal functions as well as the availability and quality of EmONC in the study area. Availability and quality of EmONC necessitate improvements through enhancing health-care providers’ skills by training and mentoring as well as enabling facilities accessible for utilization of EmONC. Further research is needed to identify factors that could be barriers to the performance quality and coverage of EmONC services.


2020 ◽  
Vol 3 (2) ◽  
pp. 225-237
Author(s):  
Kellen Muganwa ◽  
Alice Muhayimana ◽  
Joella Mukashyaka ◽  
Pamela Meharry

Background Globally, about 10% of neonates require extra respiratory support to initiate breathing at birth. Over a million neonatal deaths could be prevented with quality basic care during neonatal resuscitation. Objective To determine the quality of care (QoC) of basic NR at birth among health care providers (HCPs) at three district hospitals in Kigali. Methods A descriptive cross-sectional study was conducted. Thirty-six HCPs were observed 2-3 times using a structured checklist. Descriptive and inferential statistics were used to analyze the data.  Results The majority had ‘good’ QoC scores for drying and stimulation (74.7%), and fair scores for airway clearance (85.1%). Some had poor scores for advanced bag and mask ventilation (BMV) (13%). Maternity work experience (1-5 years) was significantly associated with good quality drying and stimulation (p = 0.03), initial BMV (p = 0.02), and advanced BMV (p = 0.03), than HCPs with less than one-year experience.  Conclusion Maternity work experience of more than one year significantly improved the QoC during neonatal resuscitation. More NR support during the first year of work and regular NR refresher training would improve neonatal outcomes.  Rwanda J Med Health Sci 2020;3(2):225-237


Author(s):  
Nishant Sharma ◽  
Anant Gupta ◽  
Makhdoom Killedar ◽  
Ashish Bindra ◽  
Asmita Patil ◽  
...  

ABSTRACT Objective: This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask. Methods: This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute’s register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets. Results: A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer “cup-shaped N95 mask with respirator”. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each. Conclusions: It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.


2019 ◽  
Vol 52 (3) ◽  
pp. 452-471 ◽  
Author(s):  
Suresh Jungari ◽  
Balram Paswan

AbstractIn many cultural settings worldwide, within families, men tend to be responsible for important choices relating to the allocation of household resources and care-seeking behaviour that directly impact on the health of women and newborns. This study examines the extent of male participation in antenatal care (ANC), delivery, postnatal care (PNC), household chores and providing food to wives among tribal communities in India. In addition, health care providers’ views on male participation in maternal health were examined. Primary data were collected from 385 men aged 15–49 from rural Gadchiroli District in Maharashtra, India. Interviews of 385 men whose wives had delivered a child within the previous 2 years were conducted between November 2014 and March 2015. Bivariate and multivariate analyses were done. The results showed that the tribal men’s participation in maternal health care was minimal. Around 22% of the men reported accompanying their wives to ANC, 25% were present at the time of delivery of their children and 25% accompanied their wives to PNC. Participation in household work, and support for wives in other ways, were slightly better. The main reason given by men for not participating in maternal health care was that they didn’t think it was necessary, believing that all maternal health issues were women’s concern. Health care providers among these tribal communities in India should encourage men to participate in issues related to maternal health care.


Author(s):  
Samita Bhardwaj ◽  
Sonal Raut ◽  
Vidyadhar B. Bangal

Background: Postpartum haemorrhage (PPH) is a life-threatening complication, that occurs suddenly and unexpectedly. Institutional delivery by skilled birth attendant who are trained in active management of third stage of labour and those who can use of Uterine Balloon Tamponade and Non-pneumatic anti shock garment can reduce incidence and morbidity related to PPH. The objective of the paper was to share the experiences of the training programmes held for maternal health care workers in the newer modalities of PPH management.Methods: During one and a half year period, 32 Continuation of Medical Education (CME) programmes, with the theme of “Managing Obstetric Emergencies and Obstetric Trauma”, covering important topics related to high risk pregnancies like Hypertension, Eclampsia ,Anaemia and Haemorrhage at 32 health institutions, spread over 11 states and 2 union territories in India, were conducted .In addition,42 hands on workshops  at various health facilities were conducted with training of more than 2575 maternal health care providers.Results: The pre and post test scores revealed that 95 percent of the maternal health care providers were unaware about the use of Uterine Balloon Tamponade (Bakri balloon) in PPH and Non-pneumatic anti shock garment (NASG). Seventy percent were unaware about the proper sequence of steps of active management of third stage of labour. Training programmes helped to improve the knowledge, whereas hands on workshop, helped in skill development of the health care providers. The participants expressed great satisfaction regarding the knowledge and skills they acquired through training programme on management of post-partum haemorrhage. They gave positive feedback about the quality, contents and conduct of training programme.Conclusions: There is need for refresher training of maternal health care providers in newer modalities like AMTSL, NASG and Bakri balloon, which have potential to save lives.


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