scholarly journals Women’s Perspectives on Influencers to the Utilisation of Skilled Delivery Care: An Explorative Qualitative Study in North West Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Biruhtesfa Bekele Shiferaw ◽  
Lebitsi Maud Modiba
Keyword(s):  
Health Facility ◽  
Health Workers ◽  
Delivery Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Skilled Delivery ◽  
Obstetric Danger Signs ◽  
North West ◽  
Danger Signs ◽  
North West Ethiopia

Skilled attendance at birth is widely regarded as an effective intervention to reduce maternal and early neonatal morbidity and mortality. However, many women in Ethiopia still deliver without skilled assistance. This study was carried out to identify factors that influenced or motivated women to give birth in a health facility in their previous, current, and future pregnancies. This descriptive explorative qualitative study was conducted in two districts of West Gojjam zone in North West Ethiopia. Fourteen focus group discussions were conducted with pregnant women and women who gave birth within one year. An inductive thematic analysis approach was employed to analyze the qualitative data. In this study, two major themes and a number of subthemes emerged from the focus group discussions with the study participants. The factors that influenced or motivated women to give birth in health facility in their previous, current, and future pregnancies include access to ambulance transport service, prevention of mother to child HIV transmission service, referral service, women friendly service, and emergency obstetric services, good interpersonal care from health workers, and fear and experience of obstetric danger signs and complications. In addition, reception of information and advice on importance of skilled delivery care and obstetric danger signs and complications from health workers, use of antenatal care, previous use of skilled delivery care, ensuring wellbeing of parturient women and newborns, and use of emergency obstetric care were also identified as influencers and motivators for health facility childbirth in previous, current, and future deliveries. Increased understanding of the factors that influenced or motivated women to deliver in facilities could contribute to developing strategies to improve the uptake of facility-based maternity services and corresponding declines in maternal morbidity and mortality.

scholarly journals Impacts of Border in Borderland Conflict along the Ethio-Sudan Border: Evidence from Metema Woreda, North-Western Ethiopia

2020 ◽  
Vol 32 (1) ◽  
pp. 10
Author(s):  
TEMESGEN EYILET KEBEDE
Keyword(s):  
Qualitative Research ◽  
Participant Observation ◽  
Structured Interviews ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Precise Location ◽  
North West ◽  
North West Ethiopia ◽  
North Western ◽  
Western Ethiopia

The aim of the study is to understand the dynamics of borderland conflicts in one location –Gonder, north-west Ethiopia, specifically, Metema Woreda – which lies along the Ethiopia-Sudan border. The study employed qualitative research methods such as semi-structured interviews, focus group discussions, case studies, and non-participant observation. The colonial origin of the Ethio-Sudan border is the overall background to the confrontation between farmers and investors over the contested lands in the region. The continued uncertainty over the precise location of the border has aggravated conflict that has yet to be resolved.

scholarly journals Why do women not use skilled birth attendance service? An explorative qualitative study in north West Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Biruhtesfa Bekele Shiferaw ◽  
Lebitsi Maud Modiba
Keyword(s):  
Data Analysis ◽  
Health System ◽  
Pregnant Women ◽  
Health Facility ◽  
Supply Side ◽  
Major Theme ◽  
Related Factors ◽  
Skilled Delivery ◽  
North West ◽  
North West Ethiopia

Abstract Background Having a birth attendant with midwifery skills during childbirth is an effective intervention to reduce maternal and early neonatal morbidity and mortality. Nevertheless, many women in Ethiopia still deliver a baby at home. The current study aimed at exploring and describing reasons why women do not use skilled delivery care in North West Ethiopia. Methods This descriptive explorative qualitative research was done in two districts of West Gojjam Zone in North West Ethiopia. Fourteen focus group discussions (FGDs) were conducted with pregnant women and mothers who delivered within one year. An inductive thematic analysis approach was employed to analyse the qualitative data. The data analysis adhered to reading, coding, displaying, reducing, and interpreting data analysis steps. Results Two major themes client-related factors and health system-related factors emerged. Factors that emerged within the major theme of client-related were socio-cultural factors, fear of health facility childbirth, the nature of labour, lack of antenatal care (ANC) during pregnancy, lack of health facility childbirth experience, low knowledge and poor early care-seeking behaviour. Under the major theme of health system-related factors, the sub-themes that emerged were low quality of service, lack of respectful care, and inaccessibility of health facility. Conclusions This study identified a myriad of supply-side and client-related factors as reasons given by pregnant women, for not giving birth in health institution. These factors should be redressed by considering the specific supply-side and community perspectives. The results of this study provide evidence that could help policymakers to develop strategies to address barriers identified, and improve utilisation of skilled delivery service.

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 ‘People have started to deliver in the facility these days’: a qualitative exploration of factors affecting facility delivery in Ethiopia

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025516 ◽  
Author(s):  
Zelee Hill ◽  
Yared Amare ◽  
Pauline Scheelbeek ◽  
Joanna Schellenberg
Keyword(s):  
Rural Communities ◽  
Focus Group ◽  
Health Workers ◽  
Facility Delivery ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Factors Affecting ◽  
Positive Experiences ◽  
Qualitative Exploration ◽  
Push And Pull

ObjectivesTo understand the recent rise in facility deliveries in Ethiopia.DesignA qualitative study.SettingFour rural communities in two regions of Ethiopia.Participants12 narrative, 12 in-depth interviews and four focus group discussions with recently delivered women; and four focus group discussions with each of grandmothers, fathers and community health workers.ResultsWe found that several interwoven factors led to the increase in facility deliveries, and that respondents reported that the importance of these factors varied over time. The initial catalysts were a saturation of messages around facility delivery, improved accessibility of facilities, the prohibition of traditional birth attendants, and elders having less influence on deciding the place of delivery. Once women started to deliver in facilities, the drivers of the behaviour changed as women had positive experiences. As more women began delivering in facilities, families shared positive experiences of the facilities, leading to others deciding to deliver in a facility.ConclusionOur findings highlight the need to employ strategies that act at multiple levels, and that both push and pull families to health facilities.

scholarly journals Skills2Care: An innovative, cooperative learning programme for community health workers in South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Therese M. Boulle ◽  
Paul Cromhout ◽  
Khuzwayo August ◽  
Dave Woods
Keyword(s):  
South Africa ◽  
Focus Group ◽  
Cooperative Learning ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Large Numbers ◽  
Cognitive Knowledge

Background: Community health workers (CHWs) hold potential to support universal health coverage and better health for vulnerable communities. They are integral to the re-engineered Primary Health Care (PHC) strategy, introduced in South Africa in 2011. This study focussed on how to train CHWs in large numbers, especially in resource-limited, rural settings. Skills2Care, a method of cooperative learning for CHWS, has been pioneered in the Eastern Cape of South Africa.Aim: To determine whether Skills2Care could improve the cognitive knowledge of CHWs; to understand their response and attitude to the programme; to explore factors that enabled and inhibited learning and to consider its viability as a training method.Setting: Research was conducted in 2019 in the Ngqeleni subdistrict of the O.R. Tambo district, in rural Eastern Cape.Methods: A group-learning model using specifically tailored study modules in booklet format, addressing mother and baby care, was used. A facilitator promoted learning. Knowledge assessment was conducted by pre- and post-study testing using multiple choice questions. Focus group discussions and interviews explored the appropriateness and acceptability of this method, and factors enabling and inhibiting the learning.Results: This method of peer group cooperative learning can significantly increase the cognitive knowledge of CHWs. Test scores indicated a significant (13%) improvement. Focus group discussions indicated that participants valued this method as it increased knowledge and boosted their confidence.Conclusion: This innovative approach to district-based, continuing education suggests that CHWs could be trained in large numbers without the need for additional resources.

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 Exploring Indonesian mothers' perspective on anemia during pregnancy: A qualitative approach

2020 ◽  
Author(s):  
Darmawati Darmawati ◽  
Tongku Nizwan Siregar ◽  
Hajjul Kamil ◽  
Teuku Tahlil
Keyword(s):  
Pregnant Women ◽  
Cultural Competency ◽  
Health Workers ◽  
Qualitative Approach ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Clinical Indicators ◽  
Beliefs And Values ◽  
Anemia During Pregnancy ◽  
Prevalence Of Anemia

Abstract Background: Anemia is a major problem experienced during pregnancy in Indonesia due to its effect on mothers and babies. Hence, various interventions have been implemented, but a significant reduction in the prevalence of anemia has not been attained. The present study, therefore, aims to investigate the perceptions of anemia among pregnant women in Aceh to design culturally relevant interventions.Methods: This qualitative study collected data from 24 pregnant women in Aceh Besar District, Indonesia, through focus group discussions (FGDs). Data were analyzed using the inductive content analysis (ICA) method.Results: Five themes emerged from the experiences of pregnant women with anemia: (1) anemia during pregnancy is perceived as a woman’s destiny, (2) there is a lack of knowledge related to clinical indicators of anemia, (3) there is a traditional taboo related to anemia, (4) the husband and family provide support related to preventing anemia, and (5) there is a need for cultural and religious-based health counseling.Conclusions: Interventions should be designed to provide health information on anemia in Aceh that considers the local knowledge, beliefs and values, combined with medical elements. This intervention will likely change the perceptions of pregnant women about anemia to ensure that they are able to better maintain their pregnancy. Furthermore, the implementation of programs to support pregnant women with anemia should ensure that health workers are adequately trained in cultural competency and are able to understand the needs of pregnant women.

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 Utilization of health facility delivery services in the Jomoro District of the Western Region of Ghana

2021 ◽  
Vol 2 (1) ◽  
pp. 173-180
Author(s):  
Samuel Nyarko ◽  
Anthony Kusi ◽  
Kwabena Opoku - Mensah
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Health Facility ◽  
Facility Delivery ◽  
Delivery Care ◽  
Western Region ◽  
Health Facility Delivery ◽  
Skilled Delivery ◽  
Care Services ◽  
Delivery Services

Background: In the year 2000, member states of the United Nations pledged to work towards a three-quarters reduction in the 1990 maternal mortality ratio by 2015 in line with Millenium. Development Goal 5, but this could not be achieved. This pledge became imperative given the high maternal mortality being recorded, especially among developing countries. The high maternal deaths in developing countries have been attributed partly to the lack of access to skilled birth attendants during delivery. Objective: This study aimed to investigate factors that influence the utilization of health facility delivery services among pregnant women in the Jomoro District of the Western Region of Ghana. Methods: The study used data from a cross-sectional survey among women aged 18 - 49 yr. living in the Jomoro District of Ghana and had given birth between 2012 and 2016 (n = 374). The study participants were randomly selected from women who attended child welfare clinics on clinic days with their babies in eighteen communities. The study used a structured questionnaire to solicit for information about the women’s demographic and socio-economic characteristics, community characteristics and health systems factors likely to influence their decision to seek skilled delivery care as well as their experiences relating to their last delivery. Bivariate analyses were performed between the primary dependent variable and background characteristics of the respondents. Factors influencing the choice of place of delivery were estimated by multiple logistic regression analysis. Data analysis was performed using STATA Statistical Software, Release 14. Results: About 61.0% (n= 228/374) of the women had their last delivery at a health facility while the remaining 38.8% (n= 145/374) delivered at home without skilled assistance. In multivariate analysis, women aged 25 – 29 yr. were less likely to have a skilled delivery (aOR, 0.40; 95% CI: 0.17 - 0.93). Also, professional women had 4.77 odds of having skilled delivery (aOR, 4.77; 95% CI: 1.53 - 14.93). Distance to the nearest health facility also had a statistically significant association with skilled delivery. Women living at 10 – 19 km to a health facility were less likely to have a skilled delivery (aOR, 0.56; 95% CI: 0.32 - 0.97). In addition, the presence of a midwife at a health facility increased the odds of skilled delivery among women (aOR, 4.59; 95% CI: 2.47 - 8.55). Conclusion: Interventions aimed at increasing the uptake of delivery care services to achieve the SDG’s target on maternal mortality must consider improving the socio-economic wellbeing of women in addition to removing the physical and health system barriers impeding access and utilisation of delivery care services.

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