scholarly journals “Our culture prohibits some things”: Qualitative inquiry into how sociocultural context influences the scale up of community-based injectable contraceptives in Nigeria

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Scale Up ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Injectable Contraceptives ◽  
Depth Interviews

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.

scholarly journals ‘Our culture prohibits some things’: qualitative inquiry into how sociocultural context influences the scale-up of community-based injectable contraceptives in Nigeria

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035311 ◽  
Author(s):  
Oluwaseun Oladapo Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Health Workers ◽  
Scale Up ◽  
Qualitative Inquiry ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
North East ◽  
Injectable Contraceptives ◽  
Depth Interviews

ObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on inductive thematic analysis was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North-East Nigeria. Other participants were from Ibadan (South-West) and Abuja (Federal Capital Territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study conducted in 2016 was part of a larger study on scale-up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale-up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale-up process as active, although they also identified the scope for further involvement and recognition.ConclusionScale-up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. Policy implementers should also see scale-up as a learning process and be willing to move at the speed of the community.

scholarly journals Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
South African ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Video Adaptation ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Human Centered Design ◽  
Depth Interviews

BACKGROUND Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. OBJECTIVE The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. METHODS Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. RESULTS We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. CONCLUSIONS Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.

scholarly journals Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study

10.2196/13604 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13604
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
South African ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Video Adaptation ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Human Centered Design ◽  
Depth Interviews

Background Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. Objective The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. Methods Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. Results We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. Conclusions Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.

scholarly journals Assessing the operational feasibility and acceptability of an inhalable formulation of oxytocin for improving community-based prevention of postpartum haemorrhage in Myanmar: a qualitative inquiry

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022140
Author(s):  
Kyu Kyu Than ◽  
Victoria Oliver ◽  
Yasmin Mohamed ◽  
Thazin La ◽  
Pete Lambert ◽  
...  
Keyword(s):  
Focus Group ◽  
Cold Storage ◽  
Postpartum Haemorrhage ◽  
Healthcare Providers ◽  
Qualitative Inquiry ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Depth Interviews

ObjectiveThis study assessed the potential operational feasibility and acceptability of a heat-stable, inhaled oxytocin (IOT) product for community-based prevention of postpartum haemorrhage in Myanmar.MethodsA qualitative inquiry was conducted between June 2015 and February 2016 through focus group discussions and in-depth interviews. Research was conducted in South Dagon township (urban setting) and in Ngape and Thanlyin townships (rural settings) in Myanmar. Eleven focus group discussions and 16 in-depth interviews were conducted with mothers, healthcare providers and other key informants. All audio recordings were transcribed verbatim in Myanmar language and were translated into English. Thematic content analysis was done using NVivo software.ResultsFuture introduction of an IOT product for community-based services was found to be acceptable among mothers and healthcare providers and would be feasible for use by lower cadres of healthcare providers, even in remote settings. Responses from healthcare providers and community members highlighted that midwives and volunteer auxiliary midwives would be key advocates for promoting community acceptance of the product. Healthcare providers perceived the ease of use and lack of dependence on cold storage as the main enablers for IOT compared with the current gold standard oxytocin injection. A single-use disposable device with clear pictorial instructions and a price that would be affordable by the poorest communities was suggested. Appropriate training was also said to be essential for the future induction of the product into community settings.ConclusionIn Myanmar, where home births are common, access to cold storage and skilled personnel who are able to deliver injectable oxytocin is limited. Among community members and healthcare providers, IOT was perceived to be an acceptable and feasible intervention for use by lower cadres of healthcare workers, and thus may be an alternative solution for the prevention of postpartum haemorrhage in community-based settings in the future.

scholarly journals Persepsi Ibu Terhadap Iklan Vaksin Measles Rubella (MR)

2019 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Muslimah Muslimah ◽  
Dian Ayubi
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Focus Group ◽  
Data Collection ◽  
Qualitative Study ◽  
Electronic Media ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Data Collection Process ◽  
Depth Interviews

Measles and Rubella (MR) is a disease that is highly contagious and usually occurs in children aged 9 months until the age of 15 years. One effort that can be done to reduce the incidence of the disease is through health promotion about the importance of immunization. Purpose the promotion was packaged in the form of advertisements on electronic media with the aim of building perceptions that the importance of immunization for public health. Methods this research was a qualitative study with a method of collecting in-depth interviews and focus group discussions. The number of informants in this study was 19 mothers who had children aged 0.9 to 15 years in one of the Puskesmas work areas in Merangin District, Jambi Province. Before the data collection process, all informants were asked to see two MR immunization advertisements. Results that immunization advertisements are interesting and contain humor. Meanwhile, informants who did not give MR immunization to their children tended to be negative towards MR immunization advertisements and tended to ignore the effects that arose if they did not give immunizations to their children. The recommendation that MR immunization advertisements should avoid using the fear arousal method and use the pay off idea method in those ads

scholarly journals The Meaning of Having an Autistic Child in Malay Family Indonesia

2019 ◽  
Vol 8 (2) ◽  
pp. 73-80
Author(s):  
Cau Kim Jiu ◽  
Somporn Rungreangkulkij
Keyword(s):  
Autistic Child ◽  
Health Workers ◽  
Ethnographic Study ◽  
Autistic Children ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Study Results ◽  
Second Category ◽  
Depth Interviews

The condition of families with autistic children raises many views and judgments both from family and society. This ethnographic study aimed to describe the meaning of families and communities towards families with autistic children. Data were collected through focus group discussions and in-depth interviews. Key informants come from families who have autistic children and community members recruited by purposive sampling, while the data were analyzed using thematic analysis. This study results generate  two categories of perception of the meaning of having autistic children.  The first category was made by the families which comprises four themes such as 1) A test from God, 2) Destiny of God, 3) Autistic children different with other children, and 4) Children who need intensive helping. The second category was the perception made by the community members which consists of two themes, such as 1) Test for family, and 2) An autistic child as a holy child. This study further shows that  culture is believed to determine how families and the members of the community perceive and interpret the existence of autistic children in the families so that it is very important for health workers to understand the culture that exists in the community.

scholarly journals Socio-cultural Factors Associated with Complementary Feeding in Two Rural Districts in Ghana: A qualitative study involving Health Workers

2020 ◽  
pp. 10-24
Author(s):  
Christiana Naa Atsreh Nsiah-Asamoah
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Complementary Feeding ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Feeding Practices ◽  
Cultural Factors ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Rural Districts

Aim: This study sought to explore the cultural factors that are associated with complementary feeding from the reports of Community Health Workers (CHWs) and Volunteers (CHVs) in two rural districts in Ghana. Study Design: This was a cross-sectional qualitative study that assessed cultural beliefs, norms, superstitions and practices that influence complementary feeding practices of young children under two years in two rural farming districts in Ghana Study Area: The study was conducted at Kwahu Afram Plains North and South Districts in the Eastern Region of Ghana. Methodology: The study employed qualitative methods which entailed conducting 9 focus group discussions among CHWs and CHVs working at two rural districts in Ghana. The focus group discussions were conducted with the aid of a validated, interview guide, after obtaining informed consent (written) from the health workers. Ethical clearance for the study was obtained from the Institutional Review Boards of the Dodowa Health Research Centre and the University of Cape Coast. Thematic content analytical procedures were applied to analyze the transcripts, interpret and present findings as a narrative account. Results: The reports of the health workers indicate a common practice of early introduction of solid foods to infants before they attain six(6) months of age. Cultural beliefs, superstitions, beliefs, food taboos and prohibitions influence mothers’ complementary-feeding practices and result in limiting the food scope and dietary diversity of their young children. Conclusions: Interventions designed to promote appropriate complementary feeding practices should incorporate an understanding of social context, family, and cultural factors in developing nutrition promotion messages that are tailored to meet the needs of rural populations. More community interventions that draw on the support of key influential persons in the community and fathers are needed to address cultural barriers to appropriate complementary feeding practices.

scholarly journals Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

2020 ◽  
Author(s):  
Sarah Saleem ◽  
Narjis Rizvi ◽  
Anam Feroz ◽  
Sayyeda Reza ◽  
Saleem Jessani ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Contraceptive Use ◽  
Health Workers ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Qualitative Assessment ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Men And Women

Abstract Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was been conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs(Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

scholarly journals Experiences of patients who developed oral mucositis during solid neoplasms treatment: a Ugandan qualitative study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Adriane Kamulegeya ◽  
Damalie Nakanjako ◽  
Jackson Orem ◽  
Harriet Mayanja-Kizza
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Patient Management ◽  
Tropical Diseases ◽  
Preventive Strategies ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Management Of Complications ◽  
Depth Interviews

Abstract Background Research on the management of complications of chemotherapy is important in facilitating the growing approaches to individualized patient management. Hence the need to document patient’s perspectives about chemotherapy-induced mucositis and the support they need from cancer care teams. Methods We carried out a qualitative study using in-depth interviews (IDI) and focus group discussions (FGD). We collected patient’s experiences on chemotherapy-induced mucositis by conducting 5 FGD and 13 IDIs. Results One glaring improvement that we need to make is the provision of information and counseling before, during, and after chemotherapy. Additionally, we need to explore inexpensive mucositis preventive strategies to aid our patients as they undergo treatment. Conclusion As a country, we must move away from taking cancer patients’ needs as those of common tropical diseases. This will allow us to provide that extra help needed outside the usual diagnosis and administration of medication.

scholarly journals Perception and Experiences of Sexual Harassment among Women Working in Hospitality Workplaces of Bahir Dar city, Northwest Ethiopia: A qualitative study

2020 ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Zewdie Birhanu Koricha ◽  
Gurmesa Tura Debelew
Keyword(s):  
Focus Group ◽  
Sexual Harassment ◽  
Qualitative Study ◽  
Bahir Dar ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informants ◽  
Women Employees ◽  
Key Informant ◽  
Depth Interviews

Abstract Background: Workplace sexual harassment is a public health problem that depends on gender, context, and perceivers ideology. Though studies documented the prevalence and consequences worldwide, the perception, experience, risk, and effects on victims are still at an earlier stage and not well understood in low and middle-income countries, particularly Ethiopia. The issue is worsened among women employees in the hospitality workplace that comprises hotels, bars, restaurants, fast-food establishments, and cafeterias. Hence, this study aimed to explore workplace sexual harassment perception and experience among women in these workplaces.Methods: An exploratory qualitative study was conducted from January 1 to August 30, 2019. Data were collected from women employees, managers, cashiers, and customers from several hospitality workplaces in the Bahir Dar City. The data were collected through focus group discussions, in-depth interviews, and key-informant interviews. Women who experienced sexual harassment were selected using the snowball method, and the key informants were recruited purposefully until the data theoretically saturated. Key informants who were supposed to give adequate information to study objectives were selected. The selection process was based on their responsibility concerning women working in hospitality workplaces. Data were analyzed via the thematic analysis approach using the ATLAS ti version 8.4.24 software package. Results: In this study, six focus group discussions, ten in-depth interviews, and thirteen key informant interviews were conducted. The majority of the participants perceived that sexual harassment is pressuring, threatening, touching, abducting for sexual advances; and experienced verbal, physical, and non-verbal forms. Similarly, the perceived risk factors were organization related, customer-related, victim-related; and the consequences were work-related, health-related, finance-related, and family undermining.Conclusions: Workplace sexual harassment in hospitality workplaces was poorly understood but widely experienced by women. It was also caused by multiple factors and affected both organizational and individual-level factors. Awareness creation campaigns, pre-service education, and in-service training, prevention, and rehabilitation are needed. Likewise, organizational policies and strategies should have to be developed and implemented.

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