Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

Cross-sectional study of the quality of neonatal care services in Armenia

2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Quality Assessment ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Neonatal Deaths ◽  
Live Births ◽  
Care Services

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

scholarly journals Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health (SRH) Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Rosine Uwase ◽  
Isabelle Kubwimana ◽  
Jean de la Croix Niyonzima ◽  
Roseline Dine Dzekem ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Care Providers ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool

Abstract Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

scholarly journals Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health (SRH) Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Rosine Uwase ◽  
Isabelle Kubwimana ◽  
Jean de la Croix Niyonzima ◽  
Roseline Dine Dzekem ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Care Providers ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool

Abstract Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

scholarly journals Quality of perinatal care services from the user’s perspective: a Dutch study applies the World Health Organization’s responsiveness concept

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Jacoba van der Kooy ◽  
Erwin Birnie ◽  
Nicole B. Valentine ◽  
Johanna P. de Graaf ◽  
Semiha Denktas ◽  
...  
Keyword(s):  
Perinatal Care ◽  
World Health ◽  
Care Services ◽  
Dutch Study ◽  
The World

scholarly journals Evaluation of malaria microscopy diagnostic performance at private health facilities in Tanzania

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Billy Ngasala ◽  
Samweli Bushukatale
Keyword(s):  
Health Facility ◽  
Malaria Parasite ◽  
Health Facilities ◽  
World Health ◽  
Substantial Agreement ◽  
Kappa Score ◽  
Cross Sectional ◽  
Parasite Detection ◽  
Malaria Microscopy

Abstract Background The World Health Organization (WHO) recommends use of parasitological diagnosis of malaria for all age groups in all malaria transmission settings. Many private health facilities rely on malaria microscopy for malaria diagnosis. However, quality of malaria microscopy is affected by number of factors including availability of skilled laboratory microscopists and lack of quality assurance systems in many malaria endemic countries. This study was carried out to assess quality of malaria microscopy in selected private health facilities in Tanzania. Methods A cross sectional study was conducted from August to September, 2017. A total of 40 private health laboratories in five regions were invited to participate in the study. Data were collected by distributing standardized pre-validated malaria slide-panels to each health facility. Sensitivity, specificity, and strength of agreement (with kappa score) were calculated to assess performance in detecting and quantification of Plasmodium species. Results Among the 40 health facilities, 31 (77.5%) returned their results to the reference centre (Muhimbili University of Health and Allied Sciences). Overall, the measures of malaria diagnostic accuracy were high, i.e. the sensitivity and specificity of malaria parasite detection by microscopy in the health facilities were 84.3% (95% CI 77–90) and 90.8% (95% CI 83.3–95.7), respectively. There was substantial agreement in parasite detection with (Kappa value: 0.74 (95% 0.65–0.83). However, only 17.8% (24 of 134) of blood slides were interpreted correctly at the health facilities in terms of parasite density counts. Conclusion Although there was substantial agreement between the private health microscopists and experienced microscopists in malaria parasite detection, there was poor performance in parasite counts. This calls for regular in-service training and external quality assessments at private health facilities to enhance the skills of private health facility microscopists in malaria microscopy.

scholarly journals Quality of antenatal care services in selected health facilities of Kaski district, Nepal

2018 ◽  
Vol 5 (6) ◽  
pp. 2182 ◽  
Author(s):  
Pabitra Bastola ◽  
Dipendra Kumar Yadav ◽  
Himlal Gautam
Keyword(s):  
Antenatal Care ◽  
Care Service ◽  
Blood Pressure Measurement ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Danger Signs ◽  
Care Services ◽  
Assess Quality

Background: Antenatal care service is an evidence based interventions given to the pregnant women. Objective of the study was to assess quality of antenatal care services in selected health facilities of Kaski district, Nepal.Methods: A cross sectional study was conducted in selected health institutions in Kaski district of Nepal during June to November 2017. Two hundred seven participants were selected from health facilities of Kaski district. Structured questionnaires were employed as tool for data collection.Results: This study showed that 50.7 percent respondents waited less than 35 minutes for receiving service. More than half of the total respondents (63.3%) reported that the consultation time provided for them was less than 20 minutes. All respondents reported that weight and blood pressure measurement was undertaken while none of them reported that height was measured. It was found that maximum number of participants (99.0%) were received iron/folate tablets and tetanus vaccination. Similarly, 97.6% of participants reported that they were counselled on nutrition and 96.6% of reported they get counselling on danger signs. In overall, 48.3% of the respondents were satisfied with the services they received and 43% of the respondents received good quality ANC service from different health institutions.Conclusions: In overall satisfaction of antenatal care services was found to be low and more than half of respondent does not received good quality ANC services.

scholarly journals Health Facility Capacity to Provide Maternal and Newborn Healthcare Services in Unguja

2019 ◽  
Vol 11 (10) ◽  
pp. 120
Author(s):  
Rukia Rajab Bakar ◽  
Rachel N Manongi ◽  
Blandina T. Mmbaga
Keyword(s):  
Child Health ◽  
Staff Training ◽  
Assessment Tool ◽  
Neonatal Care ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
And Child Health

Globally, every year 529,000 maternal deaths occur, 99% of which in developing countries with majority being in Sub-Saharan Africa. Maternal, Newborn and Child Health (MNCH) services depend on the accessibility, availability and quality of antenatal care (ANC), delivery and postnatal services. The aim of this study was to assess the health facilities’ capacity and readiness to provide MNCH services in Unguja Island, Zanzibar. A facility-based cross-sectional survey was conducted from May to June 2015 at public health facilities providing MNCH services. Data was collected by using the modified Service Availability and Readiness Assessment tool. Eighteen health facilities were assessed, two-thirds (66.7%, n = 12) of which were offering both maternity and reproductive and child health (RCH) services, 4 (22.2%) RCH services only, and 2 (11.1%) maternity services only. Readiness score for ANC services was 66% with high readiness scores in diagnostics services (89%) and equipment (69%). Overall, 14% offered all seven signal functions. Overall, delivery service readiness score was 48%. Overall readiness for comprehensive emergency obstetric and neonatal care services was 13%. Staff training and guidelines readiness score was 11%, while medicine and commodities score was 9%. The health facilities’ readiness in providing MNCH services remains inadequate in Unguja Island. Readiness in providing services was low for delivery and emergency obstetric and neonatal care services. Basic and advanced delivery services need to be improved in parallel with provision of necessary equipment, medicines and commodities and staff training for better MNCH service delivery.

Glittre ADL test in eutrophic, overweight and obese elderly

2020 ◽  
Vol 21 (1) ◽  
pp. 49
Author(s):  
Augusto Baumhardt Guidoti ◽  
Ângelo Pereira Cattani ◽  
Cintia Laura De Araujo ◽  
Fernanda Beatriz Costa Delacoste ◽  
Guilherme Scotta Hentschke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Elderly Women ◽  
Handgrip Strength ◽  
Exercise Intolerance ◽  
World Health ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
World Health Organization Quality

The Glittre ADL-test (TGlittre) has been designed and validated to measure functional capacity during daily living activities in patients with chronic obstructive pulmonary disease (COPD) but is now used in several other situations. The aim of this study was to evaluate the applicability of TGlittre in a sample of overweight and obese eutrophic elderly. This was an experimental and cross-sectional study, which included 21 elderly women, allocated by BMI, in eutrophic (n = 8), overweight (n = 6) and obese (n = 7) groups. They were assessed for functional capacity (TGlittre and 6MWT), quality of life (QOL) with the questionnaire World Health Organization Quality of Life for Older People (WHOQOL-OLD) and handgrip strength (HGS). TGlittre correlated with age (p = 0.0040) and with 6MWT (p = 0.0086), but no statistical difference was found in TGlittre's performance time and the distance covered in 6MWT between groups. TGlittre did not correlate with HGS (p = 0.1493) and WHOQOL-Old (p = 0.0905). The data obtained in the present study corroborate that TGlittre is used as a functional measurement variable in the elderly population.Keywords: aged, obesity, exercise intolerance.­­­

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

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