scholarly journals Spurring the Uptake of Maternal Healthcare Services in Culturally Endowed Communities in Elgeyo Marakwet, Kenya

2020 ◽  
Vol 30 (2) ◽  
Author(s):  
Cheboi Solomon Kemoi ◽  
Kimeu Anastasiah Nyamilu Mailu ◽  
Rucha Kenneth Kibaara
Keyword(s):  
Maternal Health ◽  
Cultural Values ◽  
Cultural Practices ◽  
Well Being ◽  
Healthcare Services ◽  
Educational Outreach ◽  
Health Seeking ◽  
Maternal Healthcare ◽  
Patient Centered ◽  
Social Construct

BACKGROUND: Enhancing the well-being of the mother and newborn is an explicit goal in health. Of the most legendary neglected influencer is patient centered requirement. The hope for people-oriented maternal health interventions in societies is hinged on cultural differentials therefore, contextualizing beliefs, values and expectations is important. A study to identify maternal healthcare services needs amongst women in Marakwet communities was undertaken.MATERIALS AND METHODS: This was an explorative qualitative study. A stratified list of cultural subgroups was developed and used to purposively select study participants. Twelve focus group discussions (FGDs) and fourteen key informant interviews (KIIs) were undertaken. Data was collected using semi-structured FGD and KII guides. The data was analyzed using five steps of conventional content analysis.RESULTS: The finding of the study revealed that support and care during pregnancy, labour, childbirth and postpartum are systematic defined informational, instrumental and emotional processes pivoted by individual and society pathways. Social-cultural needs include continuous pregnancy and labor care, companionship, elective delivery methods, placenta interpretation, placenta disposal, newborn celebration, privacy and mother-child welfare services. Choice of delivery assistant is a dynamic social construct informed by cultural values such as initiation, age, gender and experience. Health behavior dynamics is therefore context-dependent, embodied by social network and social support as well as psychological and physiological expectation.CONCLUSION: Women maternity needs are multiple and diverse. Adapting care to meet the contextualized individual and community needs may spur positive maternal health seeking behaviour among women and assist healthcare workers to provide culturally competent care to improve health outcomes. Educational outreach and behaviour change communications to demystify and tackle retrogressive cultural practices should be increased. 

scholarly journals Intangible cultural heritage: a benefit to climate-displaced and host communities

2021 ◽  
Author(s):  
Gül Aktürk ◽  
Martha Lerski
Keyword(s):  
Cultural Heritage ◽  
Cultural Values ◽  
Climate Adaptation ◽  
Cultural Practices ◽  
Action Planning ◽  
Well Being ◽  
Living Environment ◽  
Intangible Cultural Heritage ◽  
Intangible Heritage ◽  
Resilient Communities

AbstractClimate change is borderless, and its impacts are not shared equally by all communities. It causes an imbalance between people by creating a more desirable living environment for some societies while erasing settlements and shelters of some others. Due to floods, sea level rise, destructive storms, drought, and slow-onset factors such as salinization of water and soil, people lose their lands, homes, and natural resources. Catastrophic events force people to move voluntarily or involuntarily. The relocation of communities is a debatable climate adaptation measure which requires utmost care with human rights, ethics, and psychological well-being of individuals upon the issues of discrimination, conflict, and security. As the number of climate-displaced populations grows, the generations-deep connection to their rituals, customs, and ancestral ties with the land, cultural practices, and intangible cultural heritage become endangered. However, intangible heritage is often overlooked in the context of climate displacement. This paper presents reflections based on observations regarding the intangible heritage of voluntarily displaced communities. It begins by examining intangible heritage under the threat of climate displacement, with place-based examples. It then reveals intangible heritage as a catalyst to building resilient communities by advocating for the cultural values of indigenous and all people in climate action planning. It concludes the discussion by presenting the implications of climate displacement in existing intangible heritage initiatives. This article seeks to contribute to the emerging policies of preserving intangible heritage in the context of climate displacement.

Maternal Healthcare Services Along Indo-Bangladesh Bordering Districts: Exploring Effects of Social Determinants on Access to Maternal Healthcare Services.

2021 ◽  
Author(s):  
Nayan Jyoti Nath ◽  
Bedanga Talukdar ◽  
Tanu Shukla ◽  
Sangeeta Sharma
Keyword(s):  
Geographical Location ◽  
Well Being ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Peripheral Region ◽  
Easy Access ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Younger Women ◽  
Utilization Of Healthcare

Abstract Background Regardless of government efforts toward ameliorating easy access and utilization of healthcare services, the disparity in Maternal Mortality Rate (MMR) is significantly higher across states of India. Post-Sustainable Development Goals (SDGs), equity in healthcare largely remain in the health policy discourse. The policy implementation's effectiveness remained confined to the central geographical location, remotely reaching the peripheral region. The study seeks to assess socio-demographic and household wealth's effect on the access and utilization of healthcare services among women. A cross-sectional study was conducted among 355 women aged 15–49 years in three Indian districts of Assam that share an international border with Bangladesh. Results The study's findings reported that utilization and accessibility are primarily influenced by households' wealth and women's age. Education qualification has no significant effect on healthcare utilization. Younger women from wealthier households are more likely to utilize government healthcare services in India's borderline regions. Conclusion Besides educating women, the availability of healthcare resources and empowering the livelihood resources in the peripheral region should be prioritized. In these fragile areas, efforts to empower women and their families to seek healthcare should be strengthened, which shall enhance well-being.

scholarly journals Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Umar Haruna ◽  
Gordon Dandeebo ◽  
Sylvester Z. Galaa
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Health Outcomes ◽  
Health Workers ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Transportation Systems ◽  
Successful Implementation ◽  
Maternal Healthcare ◽  
Focused Antenatal Care

Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.

scholarly journals Impact of Distance in the Provision of Maternal Health Care Services and Its Accountability in Murarai-II Block, Birbhum District

2016 ◽  
Vol 4 (1) ◽  
pp. 81
Author(s):  
Alokananda Ghosh ◽  
Biswaranjan Mistri
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Distribution System ◽  
Healthcare Services ◽  
P Value ◽  
Theoretic Model ◽  
Access To Health Services ◽  
Maternal Healthcare ◽  
Risk Pregnancy ◽  
Birbhum District

The maternal health issue was a part of the Millennium Development Goals (MDGs, Target-5). Now it has been incorporated into Target-3 of 17 points Sustainable Development Goal-2030, declared by the United Nations, 2015. In India, about 50% of newborn deaths can be reduced by taking good care of the mother during pregnancy, childbirth and postpartum period. This requires timely, well-equipped healthcare by trained providers, along with emergency transportation for referral obstetric emergency. Governments need to ensure physicians in the rural underserved areas. The utilisation of maternal healthcare services (MHCSs) depends on both the availability and accessibility of services along with accountability.This study is based on an empirical retrospective survey, also called a historic study, to evaluate the influences of distance on the provision of maternal health services and on its accountability in Murarai-II block, Birbhum District. The major objective of the study is to identify the influence of distance on the provision and accountability of the overall MHCSs. The investigation has found that there is a strong inverse relationship (-0.75) between accessibility index and accountability score with p-value = <0.05, where the direct connectivity index seem to have no direct influence on the accountability score (as the ‘r’ is 0.56 and p-value= >0.05). Tracking of pregnant women, identification of high risk pregnancy and timely Postnatal Care (PNC) have become the dominant factors of the maternal healthcare services in the first Principal Component Analysis (PCA), explaining 49.67% of the accountability system. Overall, institutional barriers to accessibility are identified as important constraints behind lesser accountability of the services, preventing the anticipated benefit. This study highlights the critical areas where maternal healthcare services are lacking. The analysis has highlighted the importance of physical access to health services in shaping the provision of maternal healthcare services.Drawing on empirical observations of operation of public distribution system in different states of India, the paper constructs a preliminary game theoretic model. It argues that an effective public distribution must be as universal as possible, delivery mechanism of fair price shops should be reformed, they should be make them commercially viable and that special attention should be paid to PDS at times of high food inflation.

Health-seeking cultural patterns in the use of available healthcare services among refugee groups in south-central Kentucky

2020 ◽  
Vol 16 (1) ◽  
pp. 12-21
Author(s):  
Chika Ejike ◽  
Grace Lartey ◽  
Randy Capps ◽  
David Ciochetty
Keyword(s):  
Health Care ◽  
Health Services ◽  
Care Facility ◽  
Well Being ◽  
Healthcare Services ◽  
Health Seeking ◽  
Content Type ◽  
Refugee Population ◽  
South Central ◽  
Use Of Health Services

Purpose Refugees resettle in the USA every year to escape genocide, famine, civil wars and crises in their countries. The diverse cultural identities of the refugee population in south-central Kentucky make it essential to research into their health-care usage patterns. The purpose of this study is to examine the health-seeking patterns of refugees in relation to their culture and the usage of available health services. Design/methodology/approach This is a descriptive correlational study that culled 110 refugees who completed self-administered or interviewer-administered semi-structured questionnaires. Questionnaires were translated into four different languages. T-tests and ANOVA assessed differences between variables. Findings Findings indicate that a demographic factor such as refugees’ nationality plays a role in both the access and use of health services [F (5, 98) = 4.29, p < 0.001]. Refugees’ beliefs and social factors such as acculturation (t = −2.03, p < 0.04) and having health insurance (t = −3.35, p <0.001) also affect the use of health services. The level of cultural competency of the health-care facility or provider as depicted by the presence of interpreters (t = 1.92, p < 0.05) was associated with increased use of the health services provided. Research limitations/implications The sample of refugees is only representative of the general refugee population in south-central Kentucky; hence, there is inadequate generalization. Originality/value Cultural diversity should be included in the health and policymaking debates that surround the refugee population of south-central Kentucky to ensure their well-being.

Maternal health outcomes of socially marginalized groups in India

2020 ◽  
Vol 33 (2) ◽  
pp. 172-188 ◽  
Author(s):  
Arvind Kumar Yadav ◽  
Pabitra Kumar Jena
Keyword(s):  
Maternal Health ◽  
Health Inequalities ◽  
Postnatal Care ◽  
Decomposition Method ◽  
Institutional Delivery ◽  
Healthcare Services ◽  
Rural India ◽  
Maternal Healthcare ◽  
Content Type ◽  
Marginalized Groups

PurposeThe present study delves into the health inequalities between the two most socially deprived groups namely Scheduled Tribes (STs) and Scheduled Castes (SCs) in rural India.Design/methodology/approachThis study used health-specific three rounds of National Sample Survey Office (NSSO) unit-level data for analyses. Probit model has been used to predict the differences in access to maternal healthcare services. Blinder–Oaxaca decomposition method is used to explore the inequality in health of rural population in India and assess the estimated relative contribution of socioeconomic and demographic factors to inequalities in maternal health.FindingsThe study establishes that STs women often perform poorly compared to SCs in terms of maternal health such as antenatal care, postnatal care and institutional delivery. Blinder–Oaxaca decomposition method shows that there exist health inequalities between STs and SCs women. Difference in household income contributes 21–34 percent and women's education 19–24 percent in the gap of utilization of maternal healthcare services between SCs and STs women. A substantial part of this difference is contributed by availability of water at home and geographical region. Finally, the study offers some policy suggestions in order to mitigate the health inequalities among socially marginalized groups of SCs and STs women in rural areas.Originality/valueThis study measures and explains inequalities in maternal health variables such as antenatal care, postnatal care and institutional delivery in rural India. Research on access to maternal healthcare facilities is needed to improve the health of deprived sections such as STs and SCs in India. The results of this study pinpoint the need for public health decision-makers in India to concentrate on the most deprived and vulnerable sections of the society. This study thus makes a detailed and tangible contribution to the current knowledge of health inequalities between the two most deprived social groups, i.e., SCs and STs.

scholarly journals Inequalities in access to birth by caesarean section in the context of user fee exemption for maternal health services in southwest and north central Nigeria

2020 ◽  
Author(s):  
Anthony Idowu Ajayi
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Positive Impact ◽  
Binary Logistic Regression ◽  
Healthcare Services ◽  
Maternal Health Services ◽  
Maternal Healthcare ◽  
Logistic Regression Models ◽  
Fee Exemption ◽  
User Fee

Abstract Background User fee exemption for maternal healthcare services was introduced with a focus on providing free maternal health services, including caesarean sections (CS), in Nigeria. This policy has had a positive impact on access to facility-based delivery; however, the extent to which inequality in access to CS exists in the context of user fee exemption is unclear. The objective of this study was to examine inequalities in access to birth by CS 5 y after the implementation of the user fee exemption policy. Methods Data were obtained from 1227 women who gave birth between 2011 and 2015 and were selected using cluster random sampling between May and August 2016 from two of the six main regions of the country. Adjusted and unadjusted binary logistic regression models were performed. Results An overall CS rate of 6.1% was found, but varied by income, education and place of residence. Women who earned a monthly income of ≤20 000 naira (US$150) were 50% less likely to have a birth by CS compared with those who earned more. Compared with women who were educated to the tertiary level, women who had a secondary education or less were 51% less likely to give birth by CS. Conclusions This study shows that inequality in access to CS persists despite the implementation of free maternal healthcare services.

scholarly journals Effects of Devolution on Maternal Health Care: The Case of Level Four Hospitals in Nairobi City County, Kenya

2019 ◽  
Vol 3 (II) ◽  
pp. 98-116
Author(s):  
Hudson Shilibwa Bulinda ◽  
Felix Kiruthu
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Professionals ◽  
Service Providers ◽  
Health Workers ◽  
Healthcare Services ◽  
National Government ◽  
Maternal Health Care ◽  
Maternal Healthcare ◽  
County Governments

Maternal healthcare is an integral part of the Millennium development goals. However, most developing countries have been experimenting with different types of interventions to increase access and utilization of maternal care services. Health care devolution was greeted with great anticipation in Kenya as a means of bringing services closer to the people. However, since the implementation of the recent devolution reforms, criticism has mounted, with evidence of corruption, poor management, late payment of county staff and considerable disaffection among service providers, especially health professionals. Thus, this study assessed the effects of devolution on maternal health care in Nairobi City County in Kenya.  Particularly, the study examined the situation of maternal healthcare before and after devolution and how devolution as affected provision of maternal healthcare in Nairobi City County. The study also assessed how devolution affected maternal health care programs implementation and the challenges facing the devolved maternal health care in Nairobi City County. The study adopted the systems approach and the decentralization theorem. This study employed a descriptive research design and the population of the study was made up of the 4 level four hospitals in Nairobi County and all the 189 selected medical health workers in the hospitals. A sample of 57 respondents was selected through simple random sampling. Additionally, the study used questionnaires and an interviews guide to collect data. The questionnaires were administered to the sampled medical workers and the interviews schedules were administered to the key informants who comprised of the medical superintendent from every hospital. Quantitative data was collected through the use of the questionnaires was analyzed using descriptive statistics with the aid of the Statistical Package for Social Sciences. Qualitative data was analyzed using content analysis. The study found that the status of maternal healthcare infrastructure under devolution of health services in Nairobi was good. The findings also established that most health workers preferred that the national government should manage maternal health care infrastructure as opposed to county governments. The study further revealed that county governments had not instituted and implemented effective maternal healthcare programs formulated by the national government. Finally, the study concludes the major challenges influencing the implementation of maternal healthcare services include attitude and perception of health professionals, resistance of devolution by health workers, strikes by health workers, shortage of healthcare workers corruption and tribalism, increased pressure on hospital equipment and infrastructure and stock outs of essential commodities in the facilities affect devolved maternal health care. The study recommended that both the county and national government should work together and combine their efforts to enhance the devolved systems of healthcare so that they can enhance maternal healthcare. This is an open-access article published and distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License of United States unless otherwise stated. Access, citation and distribution of this article is allowed with full recognition of the authors and the source.

scholarly journals Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya

2020 ◽  
Vol 16 ◽  
pp. 62-76
Author(s):  
George N. Mose ◽  
Joseph Abuga Orayo
Keyword(s):  
Health Insurance ◽  
Maternal Health ◽  
Insurance Coverage ◽  
Wealth Index ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Significant Rise ◽  
Probit Regression ◽  
Maternal Healthcare ◽  
Private Hospitals

Promotion of maternal healthcare services through the expansion of health insurance coverage has been a core strategy that has been adopted in the reduction of maternal and child mortalities in Kenya. In this study, we seek to establish how health insurance coverage and benefits influence the demand for maternal health utilization in private hospitals in Kenya. The study utilized the latest Kenya Demographic Household Survey 2014 data to estimate the relationship. The binary probit regression model was employed in estimation. From the findings, only 15 percent of mothers were enrolled in a health insurance plan, whereas 14 percent of the women reported to have attended antenatal clinics in private health facilities, and 13 percent benefited from skilled delivery in private healthcare facilities. Results further revealed that health insurance ownership led to a significant increase in the likelihood of utilizing maternal health care services in private hospitals in Kenya. Similarly, age of the mother, marital status, birth order, higher education level, all wealth index categories, and employment status were cofactors associated significantly with use of healthcare services. It was concluded that the advent and increase of health insurance coverage is associated with a significant rise in demand of maternal healthcare services in private hospitals. This study argues that the current health subsidies would be more effective if they were channeled through health insurance with wider coverage of private hospitals. The study recommends reforms in policies and guidelines governing insurance coverage, which we argue would significantly bring down the cost of insurance coverage, thus become more accessible to more Kenyans.

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