Mothers’ perceptions on and learning from infant and young child feeding videos displayed in Mother and Child Health Centers in Kenya - a qualitative and quantitative approach

Objective The objective was to explore mothers’ perceptions of educational videos on infant and young child feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAPs). Design A set of 47 videos were displayed in health centers for 6 months. At three months, we conducted focus group discussions (FGDs) with mothers and at six months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design we compared groups according to video viewing frequencies. Setting The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Participants Forty-three mothers with children aged 0 to 48 months participated in six FGDs and 547 mothers of children aged 0 to 23 months in KAP interviews. Results The mothers from the FGDs found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breastfeeding (p=0.06) and complementary feeding knowledge (p=0.01), complementary feeding attitudes (p=0.08), as well as hygiene knowledge and practices (p=0.003) were better among mothers who had seen videos three to four times, or five or more times, compared to mothers who had seen the videos once or twice. Conclusions Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current IYCF education efforts in Kenya.

Healthcare Providers Experiences of Comprehensive Emergency Obstetric Care in Somaliland: An Explorative Study with Focus on Cesarean Deliveries

Background: Severe obstetric morbidity and mortality remain a serious challenge in developing countries such as Somaliland. Despite the wide implementation of comprehensive emergency obstetric care in Sub-Saharan Africa, including Somaliland, the reduction of severe maternal morbidity and mortality has been slow. Aim: This study aims to explore the experiences of healthcare providers (HCPs) regarding the provision of emergency obstetric care in a referral hospital and four maternal and child health centers in Somaliland. Method: An exploratory qualitative approach using focus group discussions was employed at the main referral and teaching hospital and four maternal and child health centers in Hargeisa, Somaliland. Twenty-eight healthcare providers were divided into groups of 6-8 for 1 to 2-hour discussions. HCPs included in the study had experiences in providing care to women with severe maternal complications. Data were analyzed using thematic analysis. Results: Collectivistic decision making through family ties was identified by HCPs to act as a barrier to provision of life saving obstetric interventions. This tradition of decision making at a group level rather than at the individual level was perceived as time-consuming and delayed HCPs from obtaining informed consent to provide lifesaving obstetric care. Low socioeconomic status, poor knowledge about maternal healthcare among users affected care seeking among women. Suboptimal care affecting provision of emergency obstetric care at the hospital was reported to be due to miscommunication, inadequate interprofessional collaboration and lack of infrastructure. Conclusion: HCPs experiences provided vital insights into the care provided to women with severe obstetric complications in Somaliland. To ensure smooth and timely decision-making processes, the antenatal period can be used to prepare families for potential obstetric emergencies and to obtain signed consents. Key Words: Maternal, Somaliland, Healthcare providers, Family ties, Emergency obstetric care, Cesarean section

Foreldres erfaringer med utfylling av ASQ kartleggingsskjema i forbindelse med to års konsultasjonen på helsestasjonen - en kvalitativ studie

Parents' experiences of completing the ASQ tool at the two-year consultation at the Child Health Center – a qualitative studyThis study has investigated the user perspective of parent-based screening tools at Child Health Centers. Age & Stage Questionnaires (ASQ) are used at the two years consultation at Child Health Centers. The aim was to explore parents experience of completing the ASQ tool at two years consultation at the Child Health Center. We used qualitative research methodology with in-depth interviews with parents. The findings show that parents felt positive to fill in the ASQ form. The study also shows a large variation in how parents experienced how the tool was used at the Child Health Centre. The parents' experiences are discussed against theory and other research in the field. The findings are also discussed in light of the purpose of implementing screening tools and results of previous studies in the field. The study concludes that there are many challenges related to the implementation of the tool in the service, and more research is needed in this area.

Myths and misconceptions regarding contraception in the urban poor community in Jamshedpur, India

Background: Family planning, a basic human right endorsed by the United Nations, allows everyone to decide the number, spacing and timing of their children. This leads to fewer complications related to pregnancy and childbirth, improves overall health. Despite the obvious benefits, because of deeply rooted myths and misconceptions, they do not access these services.Methods: Study was conducted in 10 Maternal and Child Health centers run by Tata Steel Family Initiatives Foundation in and around Jamshedpur in Jharkhand, India. The study is based on primary quantitative data. Data collection was by interviewing the respondents using a questionnaire.Results: A total of 500 respondents were interviewed. Out of 500 respondents 392 were women and 108 were men. The concept of family planning was well known. 99% women while 100% men had heard about family planning. Only 49 % women and 45% men had correct knowledge regarding spacing between two children. 78% women and men had correct knowledge about dual benefits of condom use. 63% women and 64% men feel that Cu T causes backache and pain abdomen, hence they avoid using it. 54% women and 51% men do not like OCP as a method of family planning as it is difficult to take it daily. Around 45% women and men were afraid regarding Tubectomy/ LTT. More women (41%) than men (38%) think that NSV causes weakness. Again, more women (36%) than men (34%) think that NSV decrease capacity to do heavy work.Conclusions: Results are showing that only knowledge about contraception is not enough to increase usage. Behaviour change communication activities are needed to provide accurate information to dispel common myths and misconceptions about modern contraceptives.