Readiness to Provide Antenatal Corticosteroids for Threatened Preterm Birth in Public Health Facilities in Northern India

Abstract Background In 2014, 16 women died following female sterilization operations in Bilaspur, a district in central India. In addition to those 16 deaths, 70 women were hospitalized for critical conditions (Sharma, Lancet 384,2014). Although the government of India’s guidelines for female sterilization mandate infection prevention practices, little is known about the extent of infection prevention preparedness and practice during sterilization procedures that are part of the country’s primary health care services. This study assesses facility readiness for infection prevention and adherence to infection prevention practices during female sterilization procedures in rural northern India. Method The data for this study were collected in 2016–2017 as part of a family planning quality of care survey in selected public health facilities in Bihar (n = 100), and public (n = 120) and private health facilities (n = 97) in Uttar Pradesh. Descriptive analysis examined the extent of facility readiness for infection prevention (availability of handwashing facilities, new or sterilized gloves, antiseptic lotion, and equipment for sterilization). Correlation and multivariate statistical methods were used to examine the role of facility readiness and provider behaviors on infection prevention practices during female sterilization. Result Across the three health sectors, 62% of facilities featured all four infection prevention components. Sterilized equipment was lacking in all three health sectors. In facilities with all four components, provider adherence to infection prevention practices occurred in only 68% of female sterilization procedures. In Bihar, 76% of public health facilities evinced all four components of infection prevention, and in those facilities provider’s adherence to infection prevention practices was almost universal. In Uttar Pradesh, where only 55% of public health facilities had all four components, provider adherence to infection prevention practices occurred in only 43% of female sterilization procedures. Conclusion The findings suggest that facility preparedness for infection prevention does play an important role in provider adherence to infection prevention practices. This phenomenon is not universal, however. Not all doctors from facilities prepared for infection prevention adhere to the practices, highlighting the need to change provider attitudes. Unprepared facilities need to procure required equipment and supplies to ensure the universal practice of infection prevention.

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Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_367_20 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3937

Author(s):

Sonia Trikha ◽

SureshK Dalpath ◽

Meenakshi Sharma ◽

Nusrat Shafiq

Keyword(s):

Public Health ◽

Antibiotic Resistance ◽

Cross Sectional Study ◽

Health Facilities ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Sectional Study ◽

Cross Sectional ◽

Public Health Facilities ◽

Northern India

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The Availability and Quality of Continuous Positive Airway Pressure (CPAP) for Neonatal Care in Public Health Facilities in India: A Cross- Sectional Cluster Survey

SSRN Electronic Journal ◽

10.2139/ssrn.3215571 ◽

2018 ◽

Author(s):

Juan Emmanuel Dewez ◽

Sushma Nangia ◽

Harish Chellani ◽

Sarah White ◽

Paul Francis ◽

...

Keyword(s):

Public Health ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Neonatal Care ◽

Health Facilities ◽

Cross Sectional ◽

Cluster Survey ◽

Public Health Facilities

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Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽

10.1136/bmjopen-2020-045997 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045997

Author(s):

Abhijit Pakhare ◽

Ankur Joshi ◽

Rasha Anwar ◽

Khushbu Dubey ◽

Sanjeev Kumar ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Multivariate Analysis ◽

Urban Slum ◽

Primary Care Providers ◽

Health Facilities ◽

Care Providers ◽

Community Based ◽

Public Health Facilities ◽

Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

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Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

Reproductive Health ◽

10.1186/s12978-021-01204-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Farzana Maruf ◽

Hannah Tappis ◽

Enriquito Lu ◽

Ghutai Sadeq Yaqubi ◽

Jelle Stekelenburg ◽

...

Keyword(s):

Public Health ◽

Family Planning ◽

High Volume ◽

Health Facilities ◽

Public Health Facilities ◽

Care Services ◽

Vacuum Aspiration ◽

Postabortion Care ◽

Products Of Conception ◽

Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

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Managing pneumonia through facility-based integrated management of childhood management (IMCI) services: an analysis of the service availability and readiness among public health facilities in Bangladesh

BMC Health Services Research ◽

10.1186/s12913-021-06659-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahmed Ehsanur Rahamn ◽

Shema Mhajabin ◽

David Dockrell ◽

Harish Nair ◽

Shams El Arifeen ◽

...

Keyword(s):

Public Health ◽

Distribution System ◽

Integrated Management ◽

Child Death ◽

Health Facilities ◽

Family Welfare ◽

Service Availability ◽

District Health ◽

Public Health Facilities ◽

District Hospitals

Abstract Background With an estimated 24,000 deaths per year, pneumonia is the single largest cause of death among young children in Bangladesh, accounting for 18% of all under-5 deaths. The Government of Bangladesh adopted the WHO recommended Integrated Management of Childhood Illness (IMCI)-strategy in 1998 for outpatient management of pneumonia, which was scaled-up nationally by 2014. This paper reports the service availability and readiness related to IMCI-based pneumonia management in Bangladesh. We conducted a secondary analysis of the Bangladesh Health Facility Survey-2017, which was conducted with a nationally representative sample including all administrative divisions and types of health facilities. We limited our analysis to District Hospitals (DHs), Maternal and Child Welfare Centres (MCWCs), Upazila (sub-district) Health Complexes (UHCs), and Union Health and Family Welfare Centres (UH&FWCs), which are mandated to provide IMCI services. Readiness was reported based on 10 items identified by national experts as ‘essential’ for pneumonia management. Results More than 90% of DHs and UHCs, and three-fourths of UH&FWCs and MCWCs provide IMCI-based pneumonia management services. Less than two-third of the staff had ever received IMCI-based pneumonia training. Only one-third of the facilities had a functional ARI timer or a watch able to record seconds on the day of the visit. Pulse oximetry was available in 27% of the district hospitals, 18% of the UHCs and none of the UH&FWCs. Although more than 80% of the facilities had amoxicillin syrup or dispersible tablets, only 16% had injectable gentamicin. IMCI service registers were not available in nearly one-third of the facilities and monthly reporting forms were not available in around 10% of the facilities. Only 18% of facilities had a high-readiness (score 8–10), whereas 20% had a low-readiness (score 0–4). The readiness was significantly poorer among rural and lower level facilities (p < 0.001). Seventy-two percent of the UHCs had availability of one of any of the four oxygen sources (oxygen concentrators, filled oxygen cylinder with flowmeter, filled oxygen cylinder without flowmeter, and oxygen distribution system) followed by DHs (66%) and MCWCs (59%). Conclusion There are substantial gaps in the readiness related to IMCI-based pneumonia management in public health facilities in Bangladesh. Since pneumonia remains a major cause of child death nationally, Bangladesh should make a substantial effort in programme planning, implementation and monitoring to address these critical gaps to ensure better provision of essential care for children suffering from pneumonia.

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Experiences of women receiving childbirth care from public health facilities in Kumasi, Ghana

Midwifery ◽

10.1016/j.midw.2017.09.010 ◽

2017 ◽

Vol 55 ◽

pp. 90-95 ◽

Cited By ~ 9

Author(s):

Veronica Millicent Dzomeku ◽

Brian van Wyk ◽

Jody R. Lori

Keyword(s):

Public Health ◽

Health Facilities ◽

Public Health Facilities ◽

Experiences Of Women ◽

Childbirth Care

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Prevalence of Antenatal Depression and Its Associated Risk Factors Among Pregnant Mothers Attending Antenatal Care Service at Jinka Public Health Facilities, Southern Ethiopia

International Journal of Childbirth ◽

10.1891/ijcbirth-d-20-00033 ◽

2021 ◽

pp. IJCBIRTH-D-20-00033

Author(s):

Aynalem Yetwale ◽

Teklemariam Gultie ◽

Dessalegn Ajema ◽

Bezawit Afework ◽

Semahegn Tilahun

Keyword(s):

Public Health ◽

Antenatal Care ◽

Unplanned Pregnancy ◽

Care Service ◽

Antenatal Depression ◽

Health Facilities ◽

Southern Ethiopia ◽

Medical Illness ◽

Public Health Facilities ◽

History Of

BACKGROUNDAntenatal depression is the most common psychiatric disorder during pregnancy with serious consequences for the mother and the fetus. However, there are few studies about this health issue in developing countries. This study aimed to determine the prevalence of antenatal depression and its associated risk factors among pregnant mothers attending antenatal care service at Jinka public health facilities, south Omo zone, Southern Ethiopia.METHODSInstitutional-based cross-sectional study design was conducted on 446 pregnant women at Jinka public health facilities, from June 1 to June 30, 2018. Beck Depression Inventory was used to assess women's level of depression. Statistical package for social science version 20.0 was used for analysis. Logistic regression was used to find out the association between explanatory and depression. The strength of association was evaluated using odds ratio at 95% confidence interval (CI).RESULTThe magnitude of antenatal depression in this study was 24.4% (20.2–28.5 at 95% CI) and it had statistically significant association with unmarried marital status a djusted o dds r atio (AOR) = 13.39 [(95% CI); (3.11–57.7)], chronic medical illness AOR = 3.97 [(95% CI); (1.07–14.7)], unplanned pregnancy AOR = 6.76 [(95% CI); (2.13–21.4)], history of abortion AOR = 2.8 [(95% CI); (1.14–7.02)], history of previous pregnancy complication AOR = 4.8 [(95% CI); (2.12–17.35)], and fear of pregnancy-related complications AOR = 5.4 [(95% CI); (2.32–12.4)].CONCLUSIONSNearly one pregnant woman develops antenatal depression in every four pregnant women. Variables like unmarried marital status, chronic medical illness and unplanned pregnancy, history of previous pregnancy complications, and fear of pregnancy-related complications were associated with antenatal depression. Therefore, it is recommended that these risks factors should be evaluated during antenatal care with a view to improving maternal health.

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