Rapid formative research to inform health promotion for safe motherhood in Papua New Guinea (original) (raw)
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Formative Research Findings: Shahjadpur Integrated Maternal & Neonatal Health Project
icddrb.org
Chapter 4 Home-delivery observation Chapter 5 Recommendations Study site: The study is being implemented in Shahzadpur upazila of Sirajganj district under Rajshahi division about 180 km northwest of Dhaka. It consists of nine upazila. The population of Shahjadpur as of 2001 census is ~600,000. v Evaluation methods: This study will be evaluated using a pre-post-design with the use of quantitative research method. Qualitative research methods will be used to inform the development of the intervention package as well as to document the process of implementation. An ongoing monitoring system is in place to observe progress in process indicators. Formative research: A total of 56 semi-structured in-depth interviews (IDIs) and 6 Focus Groups Discussions (FGDs) were conducted between February and April 2009. IDIs were conducted with women who gave birth within the last six months prior to the baseline survey, their husbands, and female family members for both normal and complicated deliveries. IDIs were also conducted with facility-based skilled providers. FGDs were carried out with CSBAs, traditional birth attendants (TBAs), and village doctors (VDs). Finally, key informant interviews were conducted with community leaders, program managers, and religious leaders. Semi structured guidelines were used for in-depth and key informant interviews. The IDIs and key informant interviews were focused on birth preparedness activities, care seeking during delivery from skilled attendants and care during maternal and neonatal complications. FGDs were to explore the quality of routine maternal and newborn care according to standards and protocols. We also discussed arrangements for referral (transport, funds etc.) and linkages with emergency obstetric care (EmOC) facilities. A matrix of key theme areas to facilitate the analysis and provide information on the intervention package was developed. The individual matrixes were then compiled in one matrix by categories of respondents to analyze the patterns, associations, and their explanations of each theme.
maternal-health-and education_060916.pdf
Aim: This study aims to assess the educational needs of family practitioners and evaluate the efficacy of the ongoing “Maternal Health and Family Planning Distance Education” program conducted by the General Directorate of Health Research (SAGEM) of the Turkish Ministry of Health. Methods: This study consisted of three phases. In the first phase, an online survey on maternal health and family planning educational needs was sent to 20,611 physicians via e-mail. Of the 20,611 physicians, 4,729 completed the survey. In the second phase, of the 1,061 physicians registered to the education program, 632 physicians with active participation were included. In the third phase, the preeducation expectations of 287 physicians and posteducation satisfaction of 54 physicians were analyzed with a questionnaire. Results: The majority of the physicians were employed in a family health center (97.4%) and practicing for 16–20 years (23.2%) without any prior in-service training (60.9%). High-to-very high educational need was expressed by 56.4% of physicians for pregnancy, delivery, and puerperality. Topics that the physicians, including both those with $16 years in practice and without prior in-service training, expressed need for more detailed content were pregnancy, delivery, and puerperality (37.5%); emergency obstetric approach in the primary care setting (33.1%); and gynecological infectious diseases and treatment approach (32.4%). Following the education program, the participants’ expectations were fulfilled in terms of refreshing their knowledge, particularly in the field of Maternal Health and Family Planning (87.1% and 75.9%) and the percentage of participants who expressed that they had sufficient high level knowledge increased from 55% to 68.5%. Conclusion: The education on Maternal Health and Family Planning refreshed the knowledge of participants and highly met the preeducation expectations. Determining the educational needs and expectations of the target population prior to the education program seems to have an important role on determining its overall success.
MEDICAL BOOK AUTHORED BY DR. JEMIMA SILAS, GRACE DE-GRAFT AITEE AND EMELIA FRIMPONG BROBBEY, 2023
Childbirth is one of the most painful and stressful events in a woman’s life. Most women perceive labour and childbirth as the most severe and distressing experience they may encounter in life. Majority of the maternal deaths have been associated directly or indirectly with pregnancy and childbirth such as unsafe abortion, severe bleeding, infection, hypertensive disorders, and obstructed labour among those pregnant women who received poor health care service or inadequate care. In addition, access to care is slowed down by delays in deciding to seek care, delays in reaching care, and delays in receiving care. These delays arise from logistic and financial concerns, unsupportive policies, and gaps in services. This study therefore aimed at finding out the knowledge, perception and practice of pregnant women on their birth preparedness and complication readiness at Kasoa Polyclinic. A quantitative study and descriptive cross-sectional survey were used to sample sixty (60) respondents from a larger population using the census sampling and findings were analyzed using the SPSS version 24. The findings from the study revealed over half 39(65.0%) of the mothers indicated doctor/midwife as their source of information on preparedness with the mean value of overall knowledge being (3.33) and the SD of (±1.217). Also, about 20(33.3%) of the mothers were able to indicate some danger signs during pregnancy like severe vaginal bleeding, hyperemesis gravidarium (severe vomiting) and high blood pressure. A chi-square test of association between the educational background of respondents and their knowledge on when should they start antenatal care show a statistically significant at α = 0.05 with P-value = 0.112. Finally, it was recommended that pregnant women should be motivated to utilize Antenatal Clinic for effective complication readiness and GHS should promote culturally appropriate motivations on BPCR activities at the facilities levels. Keywords: Childbirth, Labour, Complications, Preparedness, Pregnant, Women, Skilled
Journal of Medical Science And clinical Research, 2019
Birth preparedness and complication readiness (BP/CR) comprise a strategy to make women plan for birth, recognize common complications and encourage them to seek professional care in order to reduce poor pregnancy outcome by reducing the delays in seeking, reaching or receiving care. However, there are lacunae somewhere as the BP/CR messages do not translate to complete comprehension and full utilization of facility delivery. This qualitative study using focus group discussions (FGDs) explores the perceptions of the community on BP/CR. Methods: Six FGDs were conducted during May-June 2016. The FGDs had 10-12 participants in each group. Each group comprised older men and women and young men and women in a community in rural Maharashtra. A pretested questionnaire was used to conduct the FGDs. The topics for discussion centred around community experiences with antenatal and postnatal care services, cultural and social issues surrounding birth preparedness, recognition of maternal danger signs, and the use of traditional practices during pregnancy and childbirth. Qualitative content analysis was used to analyse the data. Results: The study revealed that hospital delivery was perceived to be safer than home delivery. Reasons cited for not attending the minimum requirement of four antenatal care services or two postnatal care services within the first month after delivery included distance to the health facility, poor road conditions and lack of money for transport. Findings included lack of community awareness about the danger signs during pregnancy and childbirth, that traditional birth attendants were important but that deliveries needed skilled care. Conclusion: This study shows that the perceptions of the community regarding BP/CR are in favour of skilled care. The community is aware of the importance of attending ANC, saving money for buying supplies and organizing transport, but there was little awareness about recognising complications and importance of obstetric emergency care. It is important to provide information on BP/CR and schemes like JSK, JSSK through community health workers particularly during antenatal visits.
Family Healthcare: Safe and Convenient, Mandailing Community Option for Childbirth
International Journal on Advanced Science, Engineering and Information Technology
Healthy individuals are greatly influenced by their beliefs, values, and practices in the family. Related to the above, the social factors of culture also affect the health of individuals in the family through its role in defining cultural norms and regulations on health, especially in pregnant women who live in affluent are still steeped in culture in their daily lives and trusting care pregnant women in addition to using the health service so that it appears the infant mortality rate and maternal mortality rate increased. This study is a qualitative research phenomenology that aims to explore how families Mandailing in Mandailing Natal in the care of the mother during pregnancy and in the postpartum period. The informant was chosen to represent the community Mandailing Natal as 8 people and has done interviews. The data collection was done by using in-depth interviews (in-depth interview) researchers concluded that the causes of high maternal mortality rate in Mandailing Natal are not checkups health worker or midwife, but the shaman.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: To assess stakeholder's perception of giving importance to various aspects of antenatal care. Methods: This community based observational study was conducted by Dept. of OBGYN; SKNMC Medical college, Narhe Pune which started from Feb 2016 and culminated on occasion of 'Safe Motherhood Day' on 11/04/2016. A poster showing components of safe motherhood was prepared and pregnant patients, their relatives, paramedical staff visiting antenatal OPD were targeted. They were asked to mark the most essential component (in their view) with 'Bindi'; only one chance was given per participant. Total 2450 women were recruited. Results: Though many women are aware about essential obstetric care, still much emphasis is given on traditional component like diet. There is still unawareness about importance of other components like immunization and intake of iron, calcium tablets or role of investigations or conduction of delivery by trained health care personnel. Conclusions: Knowledge gap found in this study points that easy access to medical care during pregnancy should be improved to have its impact on practices of safe motherhood.
Midwifery
OBJECTIVES: to explore women's perceptions and experiences of pregnancy and childbirth in a rural community in PNG. DESIGN: a qualitative, descriptive study comprising focus group discussions (FGDs) and in depth interviews. SETTING: this study took place in a rural community in Eastern Highlands Province, PNG. PARTICIPANTS: 51 women participated in seven focus group discussions. In depth interviews were undertaken with 21 women, including women recruited at the antenatal clinic, women purposively selected in the community and three key informants in the community. FINDINGS: the majority of women mentioned the benefits of receiving antenatal care at the health facility and the importance of a supervised, facility birth. Women faced numerous challenges with regards to accessing these services, including geographical, financial and language barriers. Cultural and customary beliefs surrounding childbirth and lack of decision making powers also impacted on whether women had a supervi...
ABSTRACT Introduction Labour procedures conducted by trained TBAs have always raised safety concerns and this consequently led to transforming them into SMAGs where they are only required to provide maternal health sensitisations. This study set out to answer the following questions; • Has the policy directive of restricting the roles of trained TBAs to only sensitizations reached the communities and being followed? • What are the maternal health effects of restricting the roles of trained TBAs to only sensitizations? • Which group between the former trained TBAs and current SMAGs is more relevant to the community needs. • What future roles should trained TBAs/SMAGs play in providing maternal health services. Methods This was a qualitative evaluation conducted in Chiparamba community of Chipata district. Purposive, Snowball and Convenient sampling techniques were used to select fifteen (15) participants and data was collected using in-depth interviews and Focus Group Discussions. Findings The new policy directive is being followed and respondents indicated that SMAGs are more relevant and should continue with their roles. Positive effects of the transition include; increased sensitisation coverage, increased health centre deliveries, reduced maternal deaths and improved participation of husbands in preparing for the birth of their babies. However, workload in the labour ward has also increased and some women have resorted to using untrained TBAs since trained TBAs are banned and the health centre is far away from their villages. Finally, demand for sanitary materials from pregnant mothers is making some to shun the labour ward. Conclusion Inasmuch as this policy directive is reducing maternal deaths, there is need for more obstetric staff at the clinic. The monthly grant to the clinic must also be increased so that mothers are not asked to contribute sanitary materials