scholarly journals Building a Maternal and Newborn Care Training Programme for Health-Care Professionals in Guinea-Bissau

2017 ◽  
Vol 30 (10) ◽  
pp. 734 ◽  
Author(s):  
Ana Reynolds ◽  
Ahmed Zaky ◽  
Joana Moreira-Barros ◽  
João Bernardes
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Newborn Care ◽  
Training Programme ◽  
Guinea Bissau ◽  
Care Training ◽  
Multiple Choice Questionnaire ◽  
Training Programmes ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Introduction: The Integrated Programme of Maternal and Child Health aims to reduce maternal and child mortality in Guinea-Bissau. The purpose of this article is to share our experience in building a training programme on maternal and newborn care for health-care professionals in Guinea-Bissau.Material and Methods: Regional directors of the four target areas chose a group of staff who provide prenatal and childbirth care to attend the course (12 to 15 trainees per region). In each region, 15 highly interactive and practical sessions were scheduled over eight weeks. The trainees’ summative and reactive assessment was obtained using a multiple choice questionnaire (final test) and an anonymous survey, respectively.Results: Attendees included 25 nurses, 17 midwives and 14 doctors. About two thirds had five years’ practice or less. Test median scores were higher among trainees with two to nine years of practice (54.4% to 60.9%), as compared to those with a year or less (47.8%) or 10 or more years (45.7%). Pedagogical variables were rated as ‘good’ or ‘very good’ by 91% to 95% of the attendees.Discussion: Use of an interactive and practical pedagogical methodology produced positive results and was crucial to tailoring the training to local needs. However, adapting the syllabus according to professional categories and experiences should be considered.Conclusion: Our results warrant further development and evaluation of training programmes on maternal and neonatal care in Guinea-Bissau.

scholarly journals Existing barriers to utilization of health services for maternal and newborn care in rural Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Ayodo ◽  
George O. Onyango ◽  
Salome Wawire ◽  
Nadia Diamond-Smith
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Western Kenya ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Understanding the existing barriers to utilization of maternal and newborn health care services can inform improvement of care services in the rural settings in sub-Saharan Africa. However, how unintended pregnancy relates to the uptake of antenatal care (ANC) services and also how gaps in the role of the community health workers and health facilities affect maternal and newborn care and referral services are poorly understood. Methods This was a formative ethnographic study design to determine barriers to the utilization of health care services for maternal and newborns in rural Western Kenya. We interviewed 45 respondents through in-depth interviews in rural Bondo Sub- County, Western Kenya: Mothers and Fathers with children under 5 years), 2 Focus Group Discussions (FGDs) with Traditional Birth Attendants (TBA), and 2 FGDs with Skilled Birth Attendants (SBAs). The data were analyzed using Atlas-ti. Results We found that unintended pregnancy results into poor uptake of antenatal care (ANC) services due to limited knowledge and poor support system. The respondents appreciated the role of community health workers but poor government infrastructure exists. Also, perceived harshness of the health care providers, poor management of high-risk pregnancies, and unavailability of supplies and equipment at the health facilities are of concern. Conclusions The findings of this study highlight barriers to the utilization of maternal and newborn services that if addressed can improve the quality of care within and outside health facilities.

scholarly journals Barriers to accessing maternal and newborn care: a qualitative study in district Thatta, Pakistan

2020 ◽  
Author(s):  
Muhammad Asim ◽  
Sarah Saleem ◽  
Zarak Hussain Ahmad ◽  
Imran Naeem ◽  
Farina Abrejo ◽  
...  
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Newborn Care ◽  
Structured Interview ◽  
Maternal And Newborn Health ◽  
Structural Level ◽  
Care Seeking ◽  
Structural Barriers ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background: Accessibility and utilization of health care play a significant role in preventing complications during pregnancy, labor, and the early postnatal period. However, multiple barriers can prevent women from accessing pregnancy and neonatal care. The aim of this study was to explore the multifaceted barriers that inhibit women to seek maternal and newborn health care in Thatta, Sindh, Pakistan.Methods: This study employed an interpretive research design using purposive sampling approach. Pre-tested semi-structured interview guides were used for data collection. The data were collected through eight focus group discussions with men and women, and six in-depth interviews with lady health workers and analyzed through thematic analysis. Findings: The study identified individual, socio-cultural, and structural level barriers that inhibit women from seeking maternal and newborn care. Individual barriers included: mistrust towards public health facilities, and inadequate symptom recognition. The two identified socio-cultural barriers were: aversion to biomedical interventions, and gendered imbalances in decision making. The structural barriers included: prohibitively expensive transportation services, and ineffective referral systems. Conclusion and Suggestions: Increasing the coverage of healthcare service without addressing the multifaceted barriers that influence service utilization will not reduce the burden of maternal and neonatal mortality. As this study reveals, care seeking is influenced by a diverse array of barriers that are individual, sociocultural, and structural in nature. A combination of capacity development, health awareness, and structural interventions can address many if not all of these barriers.

scholarly journals Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Rejina Gurung ◽  
◽  
Harriet Ruysen ◽  
Avinash K. Sunny ◽  
Louise T. Day ◽  
...  
Keyword(s):  
Newborn Care ◽  
Verbal Abuse ◽  
Standards Of Care ◽  
Skin Contact ◽  
Mode Of Birth ◽  
Survey Interviews ◽  
Maternal And Newborn Care ◽  
Poor Care ◽  
Respectful Care ◽  
Maternal And Newborn

Abstract Background Respectful maternal and newborn care (RMNC) is an important component of high-quality care but progress is impeded by critical measurement gaps for women and newborns. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study was an observational study with mixed methods assessing measurement validity for coverage and quality of maternal and newborn indicators. This paper reports results regarding the measurement of respectful care for women and newborns. Methods At one EN-BIRTH study site in Pokhara, Nepal, we included additional questions during exit-survey interviews with women about their experiences (July 2017–July 2018). The questionnaire was based on seven mistreatment typologies: Physical; Sexual; or Verbal abuse; Stigma/discrimination; Failure to meet professional standards of care; Poor rapport between women and providers; and Health care denied due to inability to pay. We calculated associations between these typologies and potential determinants of health – ethnicity, age, sex, mode of birth – as possible predictors for reporting poor care. Results Among 4296 women interviewed, none reported physical, sexual, or verbal abuse. 15.7% of women were dissatisfied with privacy, and 13.0% of women reported their birth experience did not meet their religious and cultural needs. In descriptive analysis, adjusted odds ratios and multivariate analysis showed primiparous women were less likely to report respectful care (β = 0.23, p-value < 0.0001). Women from Madeshi (a disadvantaged ethnic group) were more likely to report poor care (β = − 0.34; p-value 0.037) than women identifying as Chettri/Brahmin. Women who had caesarean section were less likely to report poor care during childbirth (β = − 0.42; p-value < 0.0001) than women with a vaginal birth. However, babies born by caesarean had a 98% decrease in the odds (aOR = 0.02, 95% CI, 0.01–0.05) of receiving skin-to-skin contact than those with vaginal births. Conclusions Measurement of respectful care at exit interview after hospital birth is challenging, and women generally reported 100% respectful care for themselves and their baby. Specific questions, with stratification by mode of birth, women’s age and ethnicity, are important to identify those mistreated during care and to prioritise action. More research is needed to develop evidence-based measures to track experience of care, including zero separation for the mother-newborn pair, and to improve monitoring.

scholarly journals Implementation of a referral and expert advice call Center for Maternal and Newborn Care in the resource constrained health system context of the Greater Accra region of Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ebenezer Oduro-Mensah ◽  
Irene Akua Agyepong ◽  
Edith Frimpong ◽  
Marjolein Zweekhorst ◽  
Linda Amarkai Vanotoo
Keyword(s):  
Decision Making ◽  
Call Center ◽  
Clinical Decision Making ◽  
Newborn Care ◽  
Clinical Decision ◽  
Series Data ◽  
Maternal And Newborn Care ◽  
Greater Accra Region ◽  
Maternal And Newborn ◽  
Decision Making Support

Abstract Background Referral and clinical decision-making support are important for reducing delays in reaching and receiving appropriate and quality care. This paper presents analysis of the use of a pilot referral and decision making support call center for mothers and newborns in the Greater Accra region of Ghana, and challenges encountered in implementing such an intervention. Methods We analyzed longitudinal time series data from routine records of the call center over the first 33 months of its operation in Excel. Results During the first seventeen months of operation, the Information Communication Technology (ICT) platform was provided by the private telecommunication network MTN. The focus of the referral system was on maternal and newborn care. In this first phase, a total of 372 calls were handled by the center. 93% of the calls were requests for referral assistance (87% obstetric and 6% neonatal). The most frequent clinical reasons for maternal referral were prolonged labor (25%), hypertensive diseases in pregnancy (17%) and post-partum hemorrhage (7%). Birth asphyxia (58%) was the most common reason for neonatal referral. Inadequate bed space in referral facilities resulted in only 81% of referrals securing beds. The national ambulance service was able to handle only 61% of the requests for assistance with transportation because of its resource challenges. Resources could only be mobilized for the recurrent cost of running the center for 12 h (8.00 pm – 8.00 am) daily. During the second phase of the intervention we switched the use of the ICT platform to a free government platform operated by the National Security. In the next sixteen-month period when the focus was expanded to include all clinical cases, 390 calls were received with 51% being for medical emergency referrals and 30% for obstetrics and gynaecology emergencies. Request for bed space was honoured in 69% of cases. Conclusions The call center is a potentially useful and viable M-Health intervention to support referral and clinical decision making in the LMIC context of this study. However, health systems challenges such inadequacy of human resources, unavailability of referral beds, poor health infrastructure, lack of recurrent financing and emergency transportation need to be addressed for optimal functioning.

scholarly journals The effect of multimodal comprehensive care methodology training on oral health care professionals’ empathy for patients with dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Dental Treatment ◽  
Oral Care ◽  
Training Programme ◽  
Comprehensive Care ◽  
Dental Hygienists ◽  
People With Dementia

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586

scholarly journals Ready to deliver maternal and newborn care? Health providers’ perceptions of their work context in rural Mozambique

2018 ◽  
Vol 11 (1) ◽  
pp. 1532631 ◽  
Author(s):  
Sibone Mocumbi ◽  
Kevin McKee ◽  
Khátia Munguambe ◽  
Rogério Chiau ◽  
Ulf Högberg ◽  
...  
Keyword(s):  
Newborn Care ◽  
Health Providers ◽  
Work Context ◽  
Care Health ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

scholarly journals Assessment of Critical Knowledge on Maternal and Newborn care Services among Primary Level Nurse Mid-wives in Kapilvastu District of Nepal

2017 ◽  
Vol 13 (4) ◽  
pp. 351-356 ◽  
Author(s):  
D. Acharya ◽  
R. Paudel
Keyword(s):  
Newborn Care ◽  
Neonatal Health ◽  
Poor Knowledge ◽  
Primary Level ◽  
Critical Knowledge ◽  
Care Services ◽  
Maternal And Neonatal Health ◽  
Nurse Midwives ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Background Despite greater emphasis on maternal and neonatal health through policy and programming in Nepal, maternal and neonatal health is still not impressive. Health care providers’ knowledge assessment on maternal and neonatal care has been well documented elsewhere, but it is very little understood in Nepal.Objective The primary objective of this study was to assess the critical knowledge of primary level nurse- midwives on maternal and newborn care in Kapilvastu District of Nepal.Method This was an Institution based cross-sectional study, conducted in Kapilvastu district, Nepal among sixty eight nurse-midwives. The participants were selected using simple random sampling technique. For collecting the data, health institutions were visited by enumerators for a month from 1st October to 1st November 2012. Data were entered into Microsoft Excel, cleaned and analyzed using SPSS version 17.0.Result More than 3/4th of the nurse-midwives had 10-20 years of experience. Majority of them (89.7%) had poor knowledge in taking action to prevent mother to child transmission for HIV positive women. More than half of them (54.4%) had some knowledge in performing the active management of third stage of labor whereas almost half (51.5%) had poor knowledge to actions needed on post-partum haemorrhage (PPH). Similarly, more than two third (69.1%) had poor knowledge in newborn care.Conclusion Majority of the nurse-midwives were found to have either poor or some level of knowledge in most of the components of maternal and newborn care services. So, greater emphasis should be given to upgrade the knowledge of nurse mid-wives.

scholarly journals KOKON: A Germany-Wide Collaborative Research Project to Identify Needs, Provide Information, Foster Communication and Support Decision-Making about Complementary and Alternative Medicine in Oncology

2019 ◽  
Vol 27 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Corina Güthlin ◽  
Hans-Helge Bartsch ◽  
Stefanie Joos ◽  
Alfred Längler ◽  
Claudia Lampert ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Collaborative Research ◽  
Knowledge Database ◽  
Self Help ◽  
Set Up ◽  
Training Programmes ◽  
Self Help Groups ◽  
Support Decision Making

Background: The German Cancer Aid set up a priority research programme with the intention to generate high-quality information based on evidence and to make this information easily accessible for health-care professionals and advisors, researchers, patients, and the general public. Summary: The Kompetenznetz Komplementärmedizin in der Onkologie (KOKON) received 2 funding periods within this programme. During the first funding period, KOKON assessed patients’ and health-care professionals’ informational needs, developed a consulting manual for physicians, developed an education programme for self-help groups, set up a knowledge database, and developed a pilot information website for patients. Funding period 2 continues with work that allows cancer patients and health-care professionals to make informed decisions about complementary and alternative medicine (CAM). For this aim, KOKON evaluates training programmes for physicians (oncology physicians, paediatric oncologists, and general practitioners) and for self-help groups. All training programmes integrate results from an analysis of the ethical, psychological, and medical challenges of CAM in the medical encounter, and the knowledge database is being extended with issues related to CAM for supportive and palliative care. Key Message: A Germany-wide collaborative research project to identify needs, provide information, foster communication, and support decision-making about CAM in oncology is being set up.

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