Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Providers ◽  
Health Workers ◽  
Healthcare Providers ◽  
Newborn Health ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

Shared Decision-making in Maternal and Newborn Health in Burkina Faso

2015 ◽  
Vol 5 (2) ◽  
pp. 68-73
Author(s):  
Janet Perkins ◽  
Cecilia Capello ◽  
Aminata Bargo ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Burkina Faso ◽  
Health Sector ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Maternal And Newborn

Community participation in decision-making within the health sector is an essential component in advancing efforts toward primary health care (PHC). Since 2006, Enfants du Monde, a Swiss non-governmental organization (NGO), in collaboration with the local NGO Fondation pour le Développement Communautaire/Burkina Faso (FDC/BF), has been supporting the Ministry of Health (MoH) to include communities in decision-making related to maternal and newborn health (MNH) services. Notably, participatory community assessments (PCA) are conducted to provide a platform for community members to discuss MNH needs and be involved in the decision-making within the health sector. During the PCAs, participants identify and prioritize needs and propose solutions to improve MNH, solutions which are then integrated in the annual district health action plan. Integrated interventions include: promotion of birth preparedness and complication readiness; training health care providers in counselling skills; building awareness of men on MNH issues and their capacity to support women; and strengthening community bodies to manage obstetrical and neonatal complications. The inclusion of these interventions has contributed to the advancement of PHC in three regions in Burkina Faso.     

Combined clinical audits and low-dose, high-frequency, in-service training of health care providers and community health workers to improve maternal and newborn health in Mali: protocol for a pragmatic cluster randomized trial (Preprint)

2021 ◽  
Author(s):  
David Zombre ◽  
Diego Bassani ◽  
Farhana Zareef ◽  
Moussa Doumbia ◽  
Sekou Doumbia ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Workers ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Classroom Setting ◽  
Care Providers ◽  
Mortality And Morbidity ◽  
Hands On ◽  
Service Training ◽  
Maternal And Newborn

BACKGROUND Despite most births in Mali occurring in health facilities, a substantial number of newborns still die during delivery and within the first 7 days of life, mainly due to existing training deficiencies and the challenges of maintaining intrapartum and postpartum care skills. OBJECTIVE This trial aims to assess the effectiveness, and cost-effectiveness, of an intervention combining clinical audits and low-dose high-frequency (LDHF) in-service training of health care providers and community health workers in reducing perinatal mortality. METHODS The study is a three-arm cluster RCT in the Koulikoro region, in Mali. The unit of randomization are each of 84 primary care facilities. Each trial arm will include 28 facilities. The facilities in the first intervention arm will receive support in implementing mortality and morbidity audits followed by one-day LDHF training biweekly, for 6 months. The health workers in second intervention arm (28 facilities), will receive a refresher course in Maternal, Newborn and Child Health (MNCH) for 10 days in a classroom setting, in addition to mortality and morbidity audits and LDHF hands-on training for 6 months. The control arm, also with 28 facilities, will consist solely of the standard MNCH refresher training delivered in a classroom setting. The main outcome are perinatal deaths in the intervention arms compared to the control arm. A final sample of approximately 600 deliveries per cluster is expected, for a total of 30,000 newborns over 14 months. Data sources include both routine health records and follow-up household surveys of all women who recently gave birth in study facility 7 days post-delivery. Data collection tools will capture perinatal deaths, complications and adverse events, as well as the status of the newborn during the perinatal period. A full economic evaluation will be conducted to determine the incremental cost-effectiveness of each of the case-based focused LDHF hands-on training strategies in comparison to MNCH refresher training in a classroom setting. RESULTS NA CONCLUSIONS The results will provide policy makers and practitioners crucial information on both the impact of different healthcare provider training modalities on maternal and newborn health outcomes, and how to successfully implement these strategies in resource-limited settings. CLINICALTRIAL Trial registration: ClinicalTrials.gov NCT03656237, registered on September 4, 2018.

Advancing People-Centered Maternal and Newborn Health Care through Birth Preparedness and Complication Readiness in Rural Bangladesh

2018 ◽  
Vol 7 (2) ◽  
pp. 107-117
Author(s):  
Tapas Mazumder ◽  
Ahmed Ehsanur Rahman ◽  
Emdadul Hoque ◽  
Md. Al Mahmud ◽  
Md. Abu Bakkar Siddique ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Local Level ◽  
Newborn Health ◽  
Local Context ◽  
Maternal And Newborn Health ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Maternal And Newborn

Background: In Bangladesh, women and newborns continue to face elevated risks around the time of pregnancy, birth and postpartum. Applying a people-centered approach to maternal and newborn (MNH) services is a priority in such contexts to increase appropriate use of services and improve the health of women and newborns. In 2009, Enfants du Monde and PARI Development Trust began supporting the Ministry of Health at local level to implement birth preparedness and complication readiness (BPCR) for improving MNH in Netrokona district, Bangladesh. Objective: To assess the contribution of the BPCR intervention in advancing people-centered MNH care in Netrokona district, Bangladesh. Methods:We conducted 15 in-depth interviews (IDIs), one focus group discussion (FGD) and four group discussions with different stakeholders. In addition, a household survey was conducted with 725 women (intervention n=444, control n=281) and 317 of their husbands (intervention n=178, control n=139) at baseline and with 737 women (intervention n=442, control n=295) and 732 husbands at endline.Results: The BPCR intervention was co-designed through a consultative process with national and local stakeholders, ensuring the reflection of local context. Training health care providers to improve their counseling skills allowed them to apply effective BPCR counseling during ANC visits and be responsive to women’s situations and individual needs. In addition, discussion on BPCR in households and courtyard meetings provoked families’ and communities’ engagement in MNH. Consequently. there was significant increase across most indicators related to BPCR practice among women and husbands’ involvement between baseline and endline.Discussion: The BPCR intervention was successful in advancing people-centered MNH care by empowering women and increasing the engagement of men, families and communities in MNH care. Our study findings are coherent with the findings of studies conducted in similar settings. Conclusions: Carefully co-designed BPCR interventions should be further expanded within Bangladesh and beyond in order to advance people-centered care and progress toward the Sustainable Development Goals (SDGs).  

scholarly journals Assessment of quality of care in maternal and newborn health services available in public health care facilities in Bangladesh

2009 ◽  
Vol 35 (2) ◽  
pp. 53-56 ◽  
Author(s):  
Sameena Chowdhury ◽  
Syed Akram Hossain ◽  
Abdul Halim
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Information Exchange ◽  
Newborn Health ◽  
Health Care Facilities ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

The study was conducted using the exit interview with patients (n=120), in depth interview with health care providers (n=87) and focus group discussion (n=16) with stakeholders to assess the perceived level of quality of care in maternal and newborn health at public facilities in Bangladesh.  Both clients and providers expressed dissatisfaction for inadequate quality of care represented by poor cleanliness, long waiting time with less consultation time, poor compassion by providers, inadequate supply of drugs and unnoticed cost for services varied by level of facilities. Inadequacy in human resource and absenteeism and poor laboratory service were reported to worsen the condition especially at lower level of service delivery. Thus this study explored some important factors like poor quality of care, inadequate technical competencies, information exchange and follow-up services. A deficit in supplies and logistics are strong barrier in regards to quality of care at various levels which needs to be addressed immediately.Keywords: Bangladesh; Maternal health; Newborn health; Quality of careOnline: 13 August 2009DOI: 10.3329/bmrcb.v35i2.3044Bangladesh Med Res Counc Bull 2009; 35: 53-56 

scholarly journals Exploring the lived experiences of pregnant women and community health care providers during the pandemic of COVID-19 in Bangladesh through a phenomenological analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sadika Akhter ◽  
Feroza Akhter Kumkum ◽  
Farzana Bashar ◽  
Aminur Rahman
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Community Health ◽  
Lived Experience ◽  
Health Care Providers ◽  
Health Workers ◽  
Maternal And Newborn Health ◽  
Community Health Care ◽  
Care Providers ◽  
The Government

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.

scholarly journals A double-edged sword - Telemedicine for maternal care during COVID-19: Findings from a global mixed methods study of healthcare providers

2020 ◽  
Author(s):  
Anna Galle ◽  
Aline Semaan ◽  
Elise Huysmans ◽  
Constance Audet ◽  
Anteneh Asefa ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare Providers ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
List Type ◽  
Care Provision ◽  
New Findings ◽  
Provision Of Care ◽  
Maternal And Newborn ◽  
The Continuum

AbstractIntroductionThe COVID-19 pandemic has led to a rapid and wide implementation of telemedicine for provision of maternal and newborn health care worldwide. Studies conducted before the pandemic, mainly deriving from high-income countries, showed telemedicine was a safe and cost-effective tool for delivering healthcare under certain conditions. The objective of this study was to document the experiences of healthcare professionals globally with the provision of telemedicine for maternal and newborn healthcare during the COVID-19 pandemic.MethodsWe analysed responses received to the second round of a global, online survey of maternal and newborn health professionals, disseminated through professional networks and social media in 11 languages. Data were collected between July 5, 2020 and September 10, 2020. The questionnaire included questions regarding background, preparedness for and response to COVID-19 and experiences with providing telemedicine during the pandemic. Descriptive statistics and qualitative thematic analysis were used concurrently to analyse responses, disaggregated by country income level.ResultsResponses from 1,060 maternal and newborn health professional were analysed. Among the sample, 58% reported using telemedicine, with the lowest proportion reported by professionals working in low-income countries (24%). Two fifths of telemedicine users reported not receiving guidelines on the provision of care through technology. Key practices along the continuum of maternal and newborn healthcare provided through telemedicine included online group birth preparedness classes, antenatal and postnatal care by video/phone, setting up a COVID-19 helpline at maternity wards, and online psychosocial counselling. Challenges reported technological barriers, lack of technological literacy, financial and language barriers, lack of nonverbal feedback, and distrust from patients. Maternal and newborn health providers considered telemedicine to be an important alternative to in-person consultations to maintain care provision during the COVID-19 pandemic. However, they also emphasized the lower quality of care and risk of increasing the already existing inequalities in access to healthcare.ConclusionsTelemedicine has been applied globally to address the disruptions of care provision during the COVID-19 pandemic. However, some crucial aspects of maternal and newborn healthcare seem difficult to deliver by telemedicine. Pitfalls of health care provision by telemedicine include exacerbated inequalities in access to care, patient-provider communication problems, and a financial burden for certain healthcare workers and women. More research regarding the effectiveness, efficacy, and quality of telemedicine for maternal health care in different contexts is highly needed before considering long-term adaptations in provision of care away from face to face interactions. Clear guidelines for care provision and approaches to minimising socio-economic and technological inequalities in access to care are urgently needed.Summary boxWhat is already known?Telemedicine is the delivery of healthcare services by healthcare professionals from distance through using information and communication technologies for the exchange of valid and correct information.Telemedicine for maternal and newborn health can safely be used to deliver certain components of care in highly controlled settings where the technology is available and accessible to patientsTelemedicine has been applied rapidly and on a wide scale during the COVID-19 pandemic to replace face to face visits along the continuum of maternal and newborn health care.What are the new findings?Maternal and newborn healthcare providers globally considered telemedicine of benefit during the pandemic and applied it on a wide scale for different aspects of maternal and newborn healthcare.The rapid adaptation to provision of care via telemedicine was not optimally supported by guidelines, training for health providers, adequate equipment, reimbursement for cost of connectivity and insurance payments for care provided remotely.Healthcare providers reported not being able to reach a substantial group of families by telemedicine and encountered different barriers in providing high quality maternity care by telemedicine due to challenges present worldwide, but more prominent in low- and middle-income countries.What do the new findings imply?Pre-existing inequalities in terms of access to high quality care might have increased by the large scale and rapid implementation of telemedicine during the COVID-19 pandemic in different settings.Access to telemedicine for women was hampered by various factors such as internet connection problems, lack of the necessary equipment, digital illiteracy and distrust.In-depth research is needed to formalise evidence-based guidelines for the implementation of telemedicine along the continuum of maternal and newborn care as lessons learned for building back beyond the COVID-19 pandemic and also for future emergency preparedness.

scholarly journals Knowledge, Attitude and Practice of nurse-midwives on the use of partograph in health care centres of Bhutan

2021 ◽  
Vol 7 (1) ◽  
pp. 10-15
Author(s):  
Karma Choden ◽  
Nidup Dorji
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Continuous Medical Education ◽  
World Health ◽  
Care Providers ◽  
Neonatal Deaths ◽  
Attitude And Practice ◽  
Nurse Midwives ◽  
Knowledge Attitude And Practice

Introduction: World Health Organization recommends using partograph to reduce maternal and neonatal deaths due to obstetric complications. Proper utilization of partograph by health care providers was noted to be good when it is associated with better knowledge and a positive attitude towards partograph. There is a paucity of scientific study about knowledge, attitude and practice on the use of partograph among healthcare providers in Bhutan. Therefore, this study aimed to assess the knowledge, attitude and practice of nurse-midwives on the use and completeness of partograph in seven hospitals and one Basic Health Unit grade I. Methods: A descriptive study was carried out from September 2017 to February 2018. Non-probability sampling method was used to survey all nurse-midwives who attended deliveries in the selected health facilities using a standard semi-structured questionnaire. All partographs filled three months before the data collection was selected purposefully and reviewed using a checklist. Results: A total of 96 participants consisting of 66 (68.8%) females and 30(31.3%) males consented for the survey. Good knowledge of partograph was reported among 48(50%) of the participants with a mean score of 12.1 (SD: ± 1.52). Attitude on the usage of partograph was found to be favorable with a median of 42 (range 32-48). Partograph usage was reported by 86 (89.6%) while only 10.4% reported having received in-service training on partograph. Out of 426 partographs reviewed, only 68 (16.0%) were found to be complete. Conclusions: Despite the encouraging findings on the use of partograph, completeness of the partograph was very low. This study therefore, recommends the reinforcement of knowledge and practice through periodic continuous medical education and auditing of the partographs.

scholarly journals Knowledge of hand hygiene among healthcare providers in a tertiary care hospital, Bengaluru

2018 ◽  
Vol 5 (10) ◽  
pp. 4433
Author(s):  
Karavadi Sri Sai Vidusha ◽  
Margaret Menzil
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Providers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
World Health ◽  
Care Hospital ◽  
Care Providers ◽  
Cross Sectional

Background: Healthcare providers (HCPs) have been identified as the most common vehicle for transmission of hospital acquired infections (HAIs) from patient to patient and within the healthcare environment. Hand hygiene has been identified as the single most important, simplest and least expensive means of preventing HAIs. This study was conducted to assess the knowledge of hand hygiene among healthcare providers in a tertiary care hospital in Bengaluru.Methods: A cross sectional descriptive study was conducted among all the health care providers who have been working in the hospital for more than one year. Total 122 health care providers were included in the study. A semi-structured, self-administered questionnaire was developed and used to obtain information on respondent’s socio-demographic characteristics, and knowledge of hand hygiene. For collecting data in this study, the World Health Organization (WHO) "Hand Hygiene Knowledge Questionnaire "revised 2009 edition was used. Descriptive statistics was used as necessary.Results: A total of 122 health care providers participated in the study. Among them 78 (63.9%) have received formal training in hand washing. The mean age of the study participants was 29.11±8.6 years. Majority opined that hand rubbing is required before palpation of the abdomen (86.9%) knowledge about hand hygiene was found to be moderate in majority of the study subjects (144 out of 200, 74%).Conclusions: In the present study the knowledge on hand hygiene among health care providers is moderate it highlights the importance of improving the current training programs targeting hand hygiene practices among health care providers.

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