scholarly journals The cutting edge in the blunt space: an anthropological construct of auxiliary nurse midwives’ social world in the community

2013 ◽  
Vol 1 (1) ◽  
pp. 10
Author(s):  
Avanish Kumar ◽  
Meerambika Mahapatro
Keyword(s):  
Health System ◽  
Uttar Pradesh ◽  
Health Providers ◽  
Public Health Services ◽  
Auxiliary Nurse ◽  
Nurse Midwives ◽  
Depth Interviews ◽  
Child Health Programme ◽  
Health Programme

Auxiliary nurse midwives (ANMs) are the most peripheral health providers and manage the rural health sub-centre in a community. They mediate directly between the community and the health system for the management of Maternal and Child Health Programme in India. The purpose of this study was to find out the role of cultural factors, such as ANMs’ caste, age, marital status, being non-resident in the working village and other social factors regarding their acceptance in the community. The study is exploratory and qualitative. The area of study was a multi-caste remote village, Mavaibhachan, in Kanpur Dehat district of Uttar Pradesh, India. Data were collected through in-depth interviews and fieldwork notes taken during and immediately after the interviews with ANMs, and thematically analyzed. Our results show that if ANMs belong to a different caste group, do not live in the working village and are relatively younger, they are socially insecure and stressed and the community hardly accepts them. Despite direct interface with the community, their social status and lowest position in the health system is reflected in acceptability and recognition. The position of ANMs needs to be strengthened, within society and the health system. In order to make public health services effective and efficient the health system has to reduce stratification based on role and status.

scholarly journals What Impact Have SARS-CoV-2/Covid-19 Pandemic on the Reproductive and Child Health Programme of Uttar Pradesh in India over the 3 months after nationwide Lockdown announcement in March 2020 -A brief analysis

2021 ◽  
Author(s):  
Piyush Kumar
Keyword(s):  
Child Health ◽  
Uttar Pradesh ◽  
Child Health Services ◽  
Limited Resources ◽  
Prime Concern ◽  
Reproductive And Child Health ◽  
Child Health Programme ◽  
Poor Infrastructure ◽  
And Child Health ◽  
Health Programme

Abstract Background: The delivery of reproductive and child health services is of utmost importance and prime concern in India particularly populous states like Uttar Pradesh with limited resources, poor infrastructure and huge demand on healthcare system. The SARS-CoV-2 pandemic had presented a challenge even for developed healthcare systems around the world.

scholarly journals Integrated reproductive health services: the perspectives of providers

Curationis ◽  
2004 ◽  
Vol 27 (1) ◽  
Author(s):  
P. Maharaj
Keyword(s):  
Family Planning ◽  
Pregnancy Prevention ◽  
Integrated Services ◽  
Health Providers ◽  
Reproductive Health Services ◽  
Group Discussions ◽  
Sexually Transmitted ◽  
Aids Epidemic ◽  
Depth Interviews

With the advent of the AIDS epidemic the focus of family planning programmes has shifted from an emphasis on pregnancy prevention to include disease prevention. The move towards integration has meant a major re-orientation in the role of health providers. This article seeks to expand knowledge about the implementation of integrated services from the perspective of providers. It focuses more specifically on the provider’s perceptions and experiences of integrated services. A range of methods is used to obtain information from providers, including an inventory of health facilities, in-depth interviews and focus group discussions. The results suggest that the majority of providers expressed favourable attitudes to integrated services. Integrated services are seen as a more client centred approach. However, there is a lack of clarity about the precise form that integration should take. As a result, providers seem more comfortable with the traditional focus on family planning and maternal and child health than sexually transmitted infections.

scholarly journals Nurses' and auxiliary nurse midwives' adherence to essential birth practices with peer coaching in Uttar Pradesh, India: a secondary analysis of the BetterBirth trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rose L. Molina ◽  
Brandon J. Neal ◽  
Lauren Bobanski ◽  
Vinay Pratap Singh ◽  
Bridget A. Neville ◽  
...  
Keyword(s):  
Peer Coaching ◽  
Secondary Analysis ◽  
Uttar Pradesh ◽  
Staff Nurses ◽  
Birth Attendants ◽  
Coaching Intervention ◽  
Safe Childbirth Checklist ◽  
Auxiliary Nurse ◽  
Nurse Midwives ◽  
Safe Childbirth

Abstract Background The BetterBirth trial tested the effect of a peer coaching program around the WHO Safe Childbirth Checklist for birth attendants in primary-level facilities in Uttar Pradesh, India on a composite measure of perinatal and maternal mortality and maternal morbidity. This study aimed to examine the adherence to essential birth practices between two different cadres of birth attendants—nurses and auxiliary nurse midwives (ANMs)—during and after a peer coaching intervention for the WHO Safe Childbirth Checklist. Methods This is a secondary analysis of birth attendant characteristics, coaching visits, and behavior uptake during the BetterBirth trial through birth attendant surveys, coach observations, and independent observations. Descriptive statistics were calculated overall, and by staffing cadre (staff nurses and ANMs) for demographic characteristics. Logistic regression using the Pearson overdispersion correction (to account for clustering by site) was used to assess differences between staff nurses and ANMs in the intervention group during regular coaching (2-month time point) and 4 months after the coaching program ended (12-month time point). Results Of the 570 birth attendants who responded to the survey in intervention and control arms, 474 were staff nurses (83.2%) and 96 were ANMs (16.8%). In the intervention arm, more staff nurses (240/260, 92.3%) received coaching at all pause points compared to ANMs (40/53, 75.5%). At baseline, adherence to practices was similar between ANMs and staff nurses (~ 30%). Overall percent adherence to essential birth practices among ANMs and nurses was highest at 2 months after intervention initiation, when frequent coaching visits occurred (68.1% and 64.1%, respectively, p = 0.76). Practice adherence tapered to 49.2% among ANMs and 56.1% among staff nurses at 12 months, which was 4 months after coaching had ended (p = 0.68). Conclusions Overall, ANMs and nurses responded similarly to the coaching intervention with the greatest increase in percent adherence to essential birth practices after 2 months of coaching and subsequent decrease in adherence 4 months after coaching ended. While coaching is an effective strategy to support some aspects of birth attendant competency, the structure, content, and frequency of coaching may need to be customized according to the birth attendant training and competency. Trial registration ClinicalTrials.gov: NCT2148952; Universal Trial Number: U1111–1131-5647.

Promoting child development

2019 ◽  
Author(s):  
James Law ◽  
Alan Emond
Keyword(s):  
Child Development ◽  
School Readiness ◽  
Well Being ◽  
Parental Awareness ◽  
The Family ◽  
Effective Service ◽  
Common Understanding ◽  
Child Health Programme ◽  
Health Programme

Recent evidence emphasizes the interconnectedness of different aspects of young children’s development, the variability of development, and the way that it unfolds in the context of the family. This chapter describes the role of primary prevention in promoting child development, particularly the cognitive aspects of child development. Parental awareness about child development is central to any child health programme. Professionals have a key role in providing appropriate information about child development to families and also in mediating what is available on the Internet. This highlights the need for regular monitoring with a common understanding of development across professionals and the use of appropriate outcomes which are meaningful to parents. A range of different interventions have been tested, many with positive results, but effective service delivery needs to be multifaceted and systemic. The outcome of promoting early child development should be seen in terms of improving school readiness, and enhancing children’s well-being.

scholarly journals Barriers and Facilitators for Exclusive Breastfeeding within the Health System and Public Policies from In-Depth Interviews to Primary Care Midwives in Tenerife (Canary Islands, Spain)

2021 ◽  
Vol 19 (1) ◽  
pp. 128
Author(s):  
Seila Llorente-Pulido ◽  
Estefanía Custodio ◽  
María Rosario López-Giménez ◽  
Laura Otero-García
Keyword(s):  
Primary Care ◽  
Health System ◽  
Canary Islands ◽  
Exclusive Breastfeeding ◽  
Qualitative Methodology ◽  
Healthcare Professionals ◽  
Maternity Leave ◽  
Public Policies ◽  
Depth Interviews

The aim of this study is to describe the perspectives of Primary Care midwives regarding factors that benefit or are detrimental to exclusive breastfeeding (EBF) within the health system and public policies. The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives who work in Primary Care centres in Tenerife, using a content analysis approach. The transcript data were then encoded following an inductive approach. The factors, according to midwives, that affect EBF, with regard to the healthcare system, are related to training of healthcare professionals in breastfeeding and their support to women during pregnancy, childbirth and postnatal care. Regarding public policies, midwives believe the maternity leave periods in Spain, together with a lack of laws and social policies to protect EBF are detrimental. The findings from our study show that there is a need to boost training and the role of professionals in EBF and, at the same time, promote protective policies that foster equality, favouring, among other issues, the work-life balance.

scholarly journals Interplaying role of healthcare activist and homemaker: a mixed-methods exploration of the workload of community health workers (Accredited Social Health Activists) in India

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Anand Kawade ◽  
◽  
Manisha Gore ◽  
Pallavi Lele ◽  
Uddhavi Chavan ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Social Health ◽  
Health Coverage ◽  
Nurse Midwife ◽  
Auxiliary Nurse

Abstract Background Globally, community health workers (CHWs) are integral contributors to many health systems. In India, Accredited Social Health Activists (ASHAs) have been deployed since 2005. Engaged in multiple health care activities, they are a key link between the health system and population. ASHAs are expected to participate in new health programmes prompting interest in their current workload from the perspective of the health system, community and their family. Methods This mixed-methods design study was conducted in rural and tribal Primary Health Centers (PHCs), in Pune district, Western Maharashtra, India. All ASHAs affiliated with these PHCs were invited to participate in the quantitative study, those agreeing to contribute in-depth interviews (IDI) were enrolled in an additional qualitative study. Key informants’ interviews were conducted with the Auxiliary Nurse Midwife (ANM), Block Facilitators (BFF) and Medical Officers (MO) of the same PHCs. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. Results We recruited 67 ASHAs from the two PHCs. ASHAs worked up to 20 h/week in their village of residence, serving populations of approximately 800–1200, embracing an increasing range of activities, despite a workload that contributed to feelings of being rushed and tiredness. They juggled household work, other paid jobs and their ASHA activities. Practical problems with travel added to time involved, especially in tribal areas where transport is lacking. Their sense of benefiting the community coupled with respect and recognition gained in village brought happiness and job satisfaction. They were willing to take on new tasks. ASHAs perceived themselves as ‘voluntary community health workers’ rather than as ‘health activists”. Conclusions ASHAs were struggling to balance their significant ASHA work and domestic tasks. They were proud of their role as CHWs and willing to take on new activities. Strategies to recruit, train, skills enhancement, incentivise, and retain ASHAs, need to be prioritised. Evolving attitudes to the advantages/disadvantages of current voluntary status and role of ASHAs need to be understood and addressed if ASHAs are to be remain a key component in achieving universal health coverage in India.

Credit constraints and Rural Migration: Evidence from Six Villages in Uttar Pradesh

2018 ◽  
Vol 15 (3) ◽  
pp. 389-398
Author(s):  
Ruchi Singh
Keyword(s):  
Credit Constraints ◽  
Uttar Pradesh ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Model ◽  
Male Migration ◽  
Rural Economies ◽  
And Migration ◽  
The Relationship ◽  
The Empirical Analysis

Rural economies in developing countries are often characterized by credit constraints. Although few attempts have been made to understand the trends and patterns of male out-migration from Uttar Pradesh (UP), there is dearth of literature on the linkage between credit accessibility and male migration in rural Uttar Pradesh. The present study tries to fill this gap. The objective of this study is to assess the role of credit accessibility in determining rural male migration. A primary survey of 370 households was conducted in six villages of Jaunpur district in Uttar Pradesh. Simple statistical tools and a binary logistic regression model were used for analyzing the data. The result of the empirical analysis shows that various sources of credit and accessibility to them play a very important role in male migration in rural Uttar Pradesh. The study also found that the relationship between credit constraints and migration varies across various social groups in UP.

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