The impact of family physicians in rural maternity care

Birth ◽  
2021 ◽  
Author(s):  
Mark Deutchman ◽  
Francesca Macaluso ◽  
Emily Bray ◽  
David Evans ◽  
James Boulger ◽  
...  
Keyword(s):  
Maternity Care ◽  
Family Physicians ◽  
The Impact ◽  
Rural Maternity Care

scholarly journals Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2093
Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Perceived Stress ◽  
Depression Scale ◽  
Family Physicians ◽  
Knowledge Score ◽  
Well Being ◽  
Anxiety And Depression ◽  
Event Scale ◽  
The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

scholarly journals Investigating the Effective Factors on Family Physicians’ prescriptions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Ghanbarzadegan ◽  
Z Kavosi ◽  
S Karimi ◽  
M Peyravi ◽  
A Ghorbanian ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Structural Equation ◽  
Behavioral Control ◽  
Family Physicians ◽  
Quality Criterion ◽  
Behavioural Control ◽  
Perceived Behavioral Control ◽  
Cross Sectional ◽  
Perceived Behavioural Control ◽  
The Impact

Abstract Introduction The physicians are responsible for prescribing medicine rationally. Physician's awareness of prescribing guidelines can lead to the selection of the most effective, appropriate and effective measures to the improved prescription. This study aim is to determine the factors influencing drug prescribing behaviour in family physicians. Methods This cross-sectional study was conducted in 2016 on a case study including 150 family physicians from Shiraz City who were selected by systematic random sampling method. A questionnaire related to the behaviour of prescribing physicians was used based on the theory of planned behaviour to collect data. The validity of the questionnaire was confirmed by the experts' opinion and its reliability was confirmed by calculating the Cronbach's alpha. The data were analyzed using structural equation modelling (SEM) by SPSS and Smart PLS software. Results It was specified that 39.3% of Shiraz family physicians have prescribed medicines for their most patients (61-70%) during the last month. Furthermore, 60% of physicians have prescribed for about 20% of their patients without any examination. In addition, 63% of doctors have repeated prescription for about 20% of patients with chronic disease. Based on the obtained results of the Research Structural Equation Model, none of the four considered variables explains changes in physicians' behaviour regarding prescribing. Although, “mental and perceived behavioural control” explain 30.2% of the changes in the intention of prescribing medication of family physicians in Shiraz. Conclusions The family physicians' behaviour in prescribing medicine shows the impact of factors such as the patient's request, as well as the role of the patients and colleagues pressure for prescribing medicine as a quality criterion for their practice. norms of mental and perceived behavioural control are effective in explaining the purpose of prescribing. Key messages Policymakers should implement policies to develop physicians’ behavior and logical prescription by education, financial incentives; consequently. Mental and perceived behavioral control are effective in explaining the purpose of prescribing.

scholarly journals Midwives’ experiences of implementing respectful maternity care knowledge in daily maternity care practices after participating in a four-day RMC training

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Adwoa Bemah Boamah Mensah ◽  
Emmanuel Kweku Nakua ◽  
Pascal Agbadi ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Maternity Care ◽  
Positive Impact ◽  
Good Practice ◽  
Healthcare Facility ◽  
Positive Influence ◽  
Respectful Maternity Care ◽  
Training Workshop ◽  
Care Practices ◽  
The Impact ◽  
Childbearing Women

Abstract Background In Ghana, studies documenting the effectiveness of evidence-based specialized training programs to promote respectful maternity care (RMC) practices in healthcare facilities are few. Thus, we designed a four-day RMC training workshop and piloted it with selected midwives of a tertiary healthcare facility in Kumasi, Ghana. The present paper evaluated the impact of the training by exploring midwives’ experiences of implementing RMC knowledge in their daily maternity care practices 4 months after the training workshop. Methods Through a descriptive qualitative research design, we followed-up and conducted 14 in-depth interviews with participants of the RMC training, exploring their experiences of applying the acquired RMC knowledge in their daily maternity care practices. Data were managed and analysed using NVivo 12. Codes were collapsed into subthemes and assigned to three major predetermined themes. Results The findings have been broadly categorized into three themes: experiences of practising RMC in daily maternity care, health facility barriers to practising RMC, and recommendations for improving RMC practices. The midwives mentioned that applying the newly acquired RMC knowledge has positively improved their relationship with childbearing women, assisted them to effectively communicate with the women, and position them to recognize the autonomy of childbearing women. Despite the positive influence of the training on clinical practice, the midwives said the policy and the built environment in the hospital does not support the exploration of alternative birthing positions. Also, the hospital lacked the required logistics to ensure privacy for multiple childbearing women in the open labour ward. The midwives recommended that logistics for alternative birthing positions and privacy in the ward should be provided. Also, all midwives and staff of the hospital should be taken through the RMC training program to encourage good practice. Conclusion Despite the report of some RMC implementation challenges, the midwives noted that the 4-day RMC training has had a positive impact on their maternity caregiving practice in the hospital. Policies and programs aimed at addressing the issue of disrespect and abusive practices during maternity care should advocate and include the building of facilities that support alternative birthing positions and privacy of childbearing women during childbirth.

Competencies and skills for remote and rural maternity care: a review of the literature

2007 ◽  
Vol 58 (2) ◽  
pp. 105-115 ◽  
Author(s):  
Jillian Ireland ◽  
Helen Bryers ◽  
Edwin van Teijlingen ◽  
Vanora Hundley ◽  
Jane Farmer ◽  
...  
Keyword(s):  
Maternity Care ◽  
Review Of The Literature ◽  
Rural Maternity Care

scholarly journals The Impact of the Physical Environment on Intrapartum Maternity Care: Identification of Eight Crucial Building Spaces

2019 ◽  
Vol 12 (4) ◽  
pp. 67-98
Author(s):  
Nicoletta Setola ◽  
Eletta Naldi ◽  
Grazia Giulia Cocina ◽  
Liv Bodil Eide ◽  
Laura Iannuzzi ◽  
...  
Keyword(s):  
Maternity Care ◽  
Physical Environment ◽  
Architectural Design ◽  
Well Being ◽  
Physical Characteristics ◽  
Interdisciplinary Studies ◽  
Room Size ◽  
Direct And Indirect Impacts ◽  
Indirect Impacts ◽  
The Impact

Objectives, Purpose, or Aim: This article investigates whether the physical environment in which childbirth occurs impacts the intrapartum intervention rates and how this might happen. The study explores the spatial physical characteristics that can support the design of spaces to promote the health and well-being of women, their supporters, and maternity care professionals. Background: Medical interventions during childbirth have consequences for the health of women and babies in the immediate and long term. The increase in interventions is multifactorial and may be influenced by the model of care adopted, the relationships between caregivers and the organizational culture, which is made up of many factors, including the built environment. In the field of birth architecture research, there is a gap in the description of the physical characteristics of birth environments that impact users’ health. Method: A scoping review on the topic was performed to understand the direct and indirect impacts of the physical environment on birth intervention rates. Results and Discussion: The findings are organized into three tables reporting the influence that the physical characteristics of a space might have on people’s behaviors, experiences, practices and birth health outcomes. Eight building spaces that require further investigation and research were highlighted: unit layout configuration, midwives’ hub/desk, social room, birth philosophy vectors, configuration of the birth room, size and shape of the birth room, filter, and sensory elements. Conclusions: The findings show the importance of considering the physical environment in maternity care and that further interdisciplinary studies focused on architectural design are needed to enrich the knowledge and evidence on this topic and to develop accurate recommendations for designers.

scholarly journals Midwives’ experiences of implementing respectful maternity care knowledge in daily maternity care practices after participating in a four-day RMC training

2020 ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Boamah Mensah Adwoa Bemah ◽  
Nakua Kweku Emmanuel ◽  
Agbadi Pascal ◽  
Lori R. Jody ◽  
...  
Keyword(s):  
Maternity Care ◽  
Positive Impact ◽  
Good Practice ◽  
Healthcare Facility ◽  
Positive Influence ◽  
Respectful Maternity Care ◽  
Training Workshop ◽  
Care Practices ◽  
The Impact ◽  
Childbearing Women

Abstract Background: In Ghana, studies documenting the effectiveness of evidence-based specialized training programs to promote respectful maternity care (RMC) practices in healthcare facilities are few. Thus, we designed a four-day RMC training workshop and piloted it with selected midwives of a tertiary healthcare facility in Kumasi, Ghana. The present paper evaluated the impact of the training by exploring midwives’ experiences of implementing RMC knowledge in their daily maternity care practices four months after the training workshop.Methods: Through a descriptive qualitative research design, we followed-up and conducted 14 in-depth interviews with participants of the RMC training, exploring their experiences of applying the acquired RMC knowledge in their daily maternity care practices. Data were managed and analysed using NVivo 12. Codes were collapsed into subthemes and assigned to three major predetermined themes.Results: The findings have been broadly categorized into three themes: experiences of practising RMC in daily maternity care, health facility barriers to practising RMC, and recommendations for improving RMC practices. The midwives mentioned that applying the newly acquired RMC knowledge has positively improved their relationship with childbearing women, assisted them to effectively communicate with the women, and position them to recognize the autonomy of childbearing women. Despite the positive influence of the training on clinical practice, the midwives said the policy and the built environment in the hospital does not support the exploration of alternative birthing positions. Also, the hospital lacked the required logistics to ensure privacy for multiple childbearing women in the open labour ward. The midwives recommended that logistics for alternative birthing positions and for privacy in the ward should be provided. Also, all midwives and staff of the hospital should be taken through the RMC training program to encourage good practice.Conclusion: Despite the report of some RMC implementation challenges, the midwives noted that the 4-day RMC training has had a positive impact on their maternity caregiving practice in the hospital. Policies and programs aimed at addressing the issue of disrespect and abusive practices during maternity care should advocate and include the building of facilities that support alternative birthing positions and privacy of childbearing women during childbirth.

scholarly journals Workshop: The Danish MAMAACT trial as an example for discussing evaluation methods in complex interventions

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Antenatal Care ◽  
Vulnerable Populations ◽  
Infant Death ◽  
Maternity Care ◽  
Sociological Theory ◽  
Immigrant Women ◽  
Complex Interventions ◽  
Ethnic Disparities ◽  
Care Systems ◽  
The Impact

Abstract Over recent years, immigration to Europe has risen significantly. This development has led to increasing birth rates by non-Western immigrant women. Maternity care systems are not yet adapted to this increased diversity of women. In Denmark, 13 % of all children are currently born by women originating from non-Western countries. Despite a publically funded antenatal care, non-Western immigrant women have lower utilization of Danish antenatal care compared to other women giving birth. Many non-Western immigrant women have an increased prevalence of severe maternal morbidity and higher risks of maternal death, stillbirth and infant death compared to the majority populations. Poor health status at birth can impair the cognitive, sensory and motor development and lead to learning disabilities during school age, and thus reduce equality in life chances. Suboptimal care is a contributing factor to these ethnic disparities. Provision of appropriate antenatal care is pivotal to reduce these serious disparities and challenges to public health, however little is known about models of care, which can overcome these barriers. The MAMAACT intervention was developed to increase response to symptoms of pregnancy complications among maternity care providers as well as non-Western immigrant women. The intervention consisted of postgraduate training of midwives in intercultural communication and health education materials (leaflet and an app) for non-Western immigrant women describing how to respond to warning signs during pregnancy in six different languages, The intervention was implemented at 10 out of 20 Danish maternity wards as part of a national trial from the year 2018 to 2019, potentially reaching 25.000 pregnant women, including 2500 of non-Western origin. This workshop shares insight into innovative ways of providing antenatal care for non-Western immigrant women and will focus on methodological aspects of scientific evaluation of complex interventions for vulnerable populations. The workshop includes an introduction, three presentations, and a discussion with the audience. Using quantitative data, the first presentation will give an overview of ethnic disparities in stillbirth and infant death in Denmark. The second presentation will present qualitative data from the implementation evaluation of the MAMAACT intervention with a focus on the interventions program theory, methodological considerations and evaluation results. Finally, the third presentation will illuminate how the concepts of Health Literacy and cultural health capital contribute to an understanding of mechanisms leading to ethnic disparities and how they can be used for evaluating the impact of the MAMAACT intervention. The final discussion will stimulate knowledge sharing between the participants on how to combine quantitative and qualitative insights in trials, how to build partnerships and recruit vulnerable populations in evaluations, and how to use sociological theory in evaluations. Key messages Reducing ethnic disparity in reproductive health requires maternity care systems to rethink their antenatal care services so they are better equipped to support non-Western immigrant women’s needs. Sharing knowledge on the use of mixed methods, recruitment of vulnerable populations, and the use of sociological theory can contribute to future approaches to evaluate complex interventions.

Routine Healthcare Utilization Among Reproductive-Age Women Residing in a Rural Maternity Care Desert

2020 ◽  
Vol 46 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Natalie A. DiPietro Mager ◽  
Terrell W. Zollinger ◽  
Jack E. Turman ◽  
Jianjun Zhang ◽  
Brian E. Dixon
Keyword(s):  
Healthcare Utilization ◽  
Maternity Care ◽  
Reproductive Age ◽  
Reproductive Age Women ◽  
Rural Maternity Care
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