scholarly journals Why Do Some Ethiopian Women Give Birth at Home after Receiving Antenatal Care? Phenomenological Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yohannes Mehretie Adinew ◽  
Netsanet Abera Assefa ◽  
Yimenu Mehretie Adinew
Keyword(s):  
Antenatal Care ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Study ◽  
Care Service ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Skilled Attendance ◽  
At Home

Background. In Ethiopia, majority (62%) of pregnant women receive at least one antenatal follow-up, yet only 26% give birth in health facility. Understanding factors underlying this high uptake of antenatal care and low institutional delivery service is critical. Women had antenatal care follow-up means; by default they have access to health facilities. Thus, why do some give birth at home even after receiving antenatal care? Methods. Fourteen key informant interviews and six focused group discussions were held among purposively selected women who gave birth in the last 12 months without skilled attendance after receiving antenatal care. The study explored women’s perspectives on maternity care, care providers, and factors that influence place of delivery. Interpretative phenomenological analysis was used to examine various behaviors and beliefs of respondents. Results. Study participants described range of experiences and beliefs that made them give birth at home after receiving antenatal care at health facilities. Four themes emerged from women’s description: poor counseling during antenatal care service, traditions, early pregnancy symptoms, and lack of planning in advance for childbirth. Conclusion. Poor counseling during antenatal care is deterring women from seeking skilled attendance at birth. Thus, healthcare providers need to stress necessity of facility based delivery care during antenatal follow-up counseling.

scholarly journals Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Daniel Adane ◽  
Biresaw Wassihun
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Postnatal Care ◽  
Associated Factors ◽  
Client Satisfaction ◽  
Post Partum ◽  
Care Providers ◽  
Amhara Region ◽  
Awi Zone

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

scholarly journals What does effective end-of-life care at home for children look like? A qualitative interview study exploring the perspectives of bereaved parents

2021 ◽  
pp. 026921632110233
Author(s):  
Cari Malcolm ◽  
Katherine Knighting
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Life Care ◽  
Care Providers ◽  
Specialist Care ◽  
Bereaved Parents ◽  
Home Based ◽  
Qualitative Interview Study ◽  
At Home

Background: End-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home. Aim: To explore the value and assess the effectiveness of an innovative model of care providing home-based, end-of-life care as perceived by families who accessed the service. Design: A qualitative descriptive study design was employed with in-depth semi-structured interviews conducted with bereaved parents. Setting/participants: Thirteen bereaved parents of 10 children supported by the home-based end-of-life care service. Results: Parents reported effective aspects of end-of-life care provided at home to include: (1) ability to facilitate changes in preferred place of death; (2) trusted relationships with care providers who really know the child and family; (3) provision of child and family-centred care; (4) specialist care and support provided by the service as and when needed; and (5) quality and compassionate death and bereavement care. Parents proposed recommendations for future home-based end-of-life care including shared learning, improving access to home-based care for other families and dispelling hospice myths. Conclusion: Parents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

2021 ◽  
pp. 2150041
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah
Keyword(s):  
Health Care ◽  
Signal Processing ◽  
Health Care Providers ◽  
Mobile Phones ◽  
Model Parameters ◽  
Care Providers ◽  
Server Side ◽  
Respiration Signal ◽  
At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

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

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.

scholarly journals Prevalence of antenatal depression and its associated factors among pregnant mothers who attend antenatal care service at Jinka public health facilities, Jinka town, SNNPR, Ethiopia,

2021 ◽  
Author(s):  
Aynalem Yetwale ◽  
Teklemariam Gultie ◽  
Dessalegn Ajema ◽  
Semahegn Tilahun ◽  
Bezawit Afework
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Antenatal Care ◽  
Care Service ◽  
Antenatal Depression ◽  
Health Facilities ◽  
P Value ◽  
Public Health Facilities ◽  
Care Assessment ◽  
History Of

Abstract Background Antenatal depression is the most common psychiatric disorder during pregnancy and it’s associated with psychosocial and obstetric factors. Antenatal depression has serious consequences for the mother and fetus, such as recurrent spontaneous abortions, pregnancy induced hypertension, pre-eclampsia, postpartum bleeding, pre-term delivery, postnatal depressive disorders and low birth weight. However it doesn’t get appropriate attention.Methods Institutional based cross-sectional study design was conducted on 446 pregnant women coming for antenatal care service at Jinka public health facilities, from June 01 to June 30, 2018. Data was collected through semi-structured and pretested questionnaire by face to face interview technique and Beck Depression Inventory was used to assess women’s depression condition. Collected data was entered in to Epi data version 3.3.1 after checking their completeness and exported to statistical package for social science version 20.0 for analysis. Logistic regression was used to find out association between explanatory and response variables. Explanatory variables which fulfill the assumption of logistic regression and had P-value less than 0.25 from bi-variable logistic regression were considered for the multivariable logistic regression model. Strength of association was evaluated using odds ratio at 95% confidence interval and P-value < 0.05 was considered to declare significant associations.Result The 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 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)].Conclusion and recommendation The magnitude of antenatal depression was high. So integrating mental health service in antenatal care assessment, provide comprehensive family planning service and improve obstetric service are recommended.

scholarly journals Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

2021 ◽  
Vol 4 ◽  
pp. 19
Author(s):  
Subhash Chander ◽  
Ines Gonzalez-Casanova ◽  
Sandra S. Chaves ◽  
Nancy A. Otieno ◽  
Marc-Alain Widdowson ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Critical Role ◽  
Healthcare Providers ◽  
Attitudes And Beliefs ◽  
Care Providers ◽  
Middle Income ◽  
Maternal Immunization ◽  
Maternal Vaccination ◽  
Vaccine Recommendations ◽  
And Behavior

Background: Maternal immunization is known to be one of the best strategies to protect both mothers and their infants from infectious diseases. Studies have shown that healthcare providers play a critical role in implementation of maternal immunization. However, little is known about providers’ attitudes and beliefs towards vaccination that can influence their vaccine recommendations, specifically in low to middle income countries (LMIC). Methods: A self-administrated knowledge, attitude and behavior (KAB) survey was provided to 150 antenatal care providers across four different regions (Nairobi, Mombasa, Marsabit, and Siaya counties) of Kenya. The research staff visited the 150 clinics and hospitals and distributed a quantitative KAB survey. Results: Nearly all of the antenatal care providers (99%) recommended tetanus maternal vaccination. Similarly, 99% of the providers agreed that they would agree to provide additional vaccinations for pregnant women and reported that they always advise their patients to get vaccinated. Between 80 and 90% of the providers reported that religious beliefs, ethnicity, cultural background and political leaders do not affect their attitude or beliefs towards recommending vaccines. Conclusions: Considering the positive responses of healthcare providers towards vaccine acceptance and recommendation, these results highlight an opportunity to work in partnership with these providers to improve coverage of maternal vaccination and to introduce additional vaccines (such as influenza). In order to achieve this, logistical barriers that have affected the coverage of the currently recommended vaccines, should be addressed as part of this partnership.

scholarly journals Why do women attend antenatal care but give birth at home? a qualitative study in a rural Ghanaian District

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261316
Author(s):  
Kennedy A. Alatinga ◽  
Jennifer Affah ◽  
Gilbert Abotisem Abiiro
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Belief Systems ◽  
Home Delivery ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
At Home

Background The Sustainable Development Goal Three has prioritised reducing maternal, under-5 and neonatal mortalities as core global health policy objectives. The place, where expectant mothers choose to deliver their babies has a direct effect on maternal health outcomes. In sub-Saharan Africa, existing literature has shown that some women attend antenatal care during pregnancy but choose to deliver their babies at home. Using the Andersen and Newman Behavioural Model, this study explored the institutional and socio-cultural factors motivating women to deliver at home after attending antenatal care. Methods A qualitative, exploratory, cross-sectional design was deployed. Data were collected from a purposive sample of 23 women, who attended antenatal care during pregnancy but delivered their babies at home, 10 health workers and 17 other community-level stakeholders. The data were collected through semi-structured interviews, which were audio-recorded, transcribed and thematically analysed. Results In line with the Andersen and Newman Model, the study discovered that traditional and religious belief systems about marital fidelity and the role of the gods in childbirth, myths about consequences of facility-based delivery, illiteracy, and weak women’s autonomy in healthcare decision-making, predisposed women to home delivery. Home delivery was also enabled by inadequate midwives at health facilities, the unfriendly attitude of health workers, hidden charges for facility-based delivery, and long distances to healthcare facilities. The fear of caesarean section, also created the need for women who attended antenatal care to deliver at home. Conclusion The study has established that socio-cultural and institutional level factors influenced women’s decisions to deliver at home. We recommend a general improvement in the service delivery capacity of health facilities, and the implementation of collaborative educational and women empowerment programmes by stakeholders, to strengthen women’s autonomy and reshape existing traditional and religious beliefs facilitating home delivery.

Palliative care quality measures: an exploratory study

2019 ◽  
pp. bmjspcare-2018-001679
Author(s):  
Alessandra Buja ◽  
Michele Rivera ◽  
Vincenzo Baldo ◽  
Marta Soattin ◽  
Ylenia Rizzolo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Indicators ◽  
Care Service ◽  
Healthcare Providers ◽  
Palliative Care Service ◽  
Care Quality ◽  
Local Health ◽  
Monotonic Trend ◽  
Intensity Of Care ◽  
At Home

ObjectivesThe aim of this study was to investigate how palliative care service structures and processes correlate with their outputs and outcomes, measuring the latter respectively in terms of intensity of care and death at home.MethodsThe Veneto Regional Health Authorities collected a set of 37 quality indicators for the year 2016, covering the following five dimensions: service integration, service structure, accessibility, professional processes and organisational processes. Their validity was assessed by a panel of 29 palliative care experts. A score was assigned to each indicator on the basis of its relevance. Non-parametric correlations between the care quality indicators and the measures of the palliative care outputs and outcomes were investigated, along with the presence of a monotonic trend in the performance of the local health units (LHU) grouped by ‘low’, ‘medium’ or ‘high’ scores and differences between these groups of LHUs.ResultsThe data showed that palliative care service structure and professional processes were the dimensions correlating significantly with the intensity of care coefficient. An increasingly significant statistical trend was found in both the intensity of care coefficient and the proportion of deaths at home for the three groups of LHUs in terms of the professional processes dimension.ConclusionsDespite its limitations, this study brought to light some statistically significant findings that are worth investigating in larger samples. To achieve improvements in the quality of palliative care, it is important for healthcare providers to know which variables most affect the output and especially the outcomes of the services offered.

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