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Article
Publication date: 23 August 2013

Roger A. Atinga and Anita A. Baku

To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services…

Abstract

Purpose

To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services. In spite of this, facility‐based deliveries continue to be low due partly to poor quality of antenatal care that prevents pregnant women from giving birth in hospitals. The aim of this study is to examine factors shaping quality of antenatal care in selected public hospitals in the country.

Design/methodology/approach

363 expectant mothers were randomly selected for interview. Women who have previously received antenatal care in the health facilities for at least two occasions were interviewed. Multivariate logistic regression model were computed to examine correlates of antenatal care quality.

Findings

The odds of reporting quality of antenatal care as good was higher among women aged between 30 and 34 years. Similarly women with junior/senior high education were more likely to report antenatal care quality as good. Distance to the health facilities generally influence women perception of antenatal care quality but the relative odds of reporting quality of care as good attenuated with proximity to the health facility. Five factors (pleasant interaction with providers, privacy during consultation, attentiveness of providers, adequate facilities and availability of drugs) emerged as statistically significant in explaining antenatal care quality after controlling for selected demographic variables.

Originality/value

Results of the study generally demonstrate the need to improve maternal services in public facilities to stimulate utilisation and facility‐based deliveries.

Details

International Journal of Social Economics, vol. 40 no. 10
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 7 June 2011

Patience Aseweh Abor, Gordon Abekah‐Nkrumah, Kojo Sakyi, Charles K.D. Adjasi and Joshua Abor

The study aims to examine the socio‐economic determinants of maternal health services utilization in Ghana.

Abstract

Purpose

The study aims to examine the socio‐economic determinants of maternal health services utilization in Ghana.

Design/methodology/approach

Probit and ordered probit models are employed in this study.

Findings

The results generally indicate that most women in Ghana undertake the required visits for antenatal services and also take both doses of the tetanus toxoid vaccine as required by World Health Organization. However, the results show low levels of usage in terms of the other maternal health care services (i.e. prenatal care, delivery at a health facility, and postnatal care). There is clearly an urgent need to develop innovative strategies that will help upscale intervention especially for improvement in the use of these services by women in Ghana. The regression results reveal that utilization of maternal health services and intensity of use of antenatal services are influenced by age of mother, type of birth, education of mother, ethnicity, economic status, geographic location, residence, and religious affiliation. Obviously, this suggests that more than medical factors are responsible for the differences in the use of maternal health services by women in Ghana as well as the decision on the number of visits to undertake with respect to antenatal visits.

Originality/value

The findings of this study have important implications for health policy formulation targeted at improving maternal health care service utilization.

Details

International Journal of Social Economics, vol. 38 no. 7
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 4 March 2019

Titaree Phanwichatkul, Elaine Burns, Pranee Liamputtong and Virginia Schmied

The purpose of this paper is to describe Burmese migrant women’s perceptions of health and well-being during pregnancy, their health promoting practices and their…

Abstract

Purpose

The purpose of this paper is to describe Burmese migrant women’s perceptions of health and well-being during pregnancy, their health promoting practices and their experiences with the Thai antenatal services.

Design/methodology/approach

The study used an ethnographic design. Observations were conducted in two antenatal clinics in southern Thailand. Ten Burmese migrant women and three Burmese interpreters participated in interviews. Data were analysed using thematic analysis.

Findings

The Burmese women wanted to take care of themselves and their baby to the best of their ability. This included following traditional practices and attending the antenatal clinic if able. Negotiating the demands of earning an income, and protecting their unborn baby, sometimes led to unhealthy practices such as consuming energy drinks and herbal tonics to improve performance. Accessing antenatal care was a positive health seeking behaviour noted in this community, however, it was not available to all.

Research limitations/implications

This is a small ethnographic study conducted in one Province in Thailand and all Burmese participants were legal migrants. Further research is required to understand the needs of pregnant women not able to access maternity services because of their status as an illegal migrant.

Practical implications

Community-based health promotion initiatives need to focus on the nutrition of pregnant women who are migrants living in southern Thailand. New models of care may increase migrant women’s use of antenatal services.

Originality/value

Most studies of the health of migrant women are conducted in high-income countries. This study demonstrates the difficulties experienced by women migrating from a low to middle-income country.

Details

International Journal of Migration, Health and Social Care, vol. 15 no. 1
Type: Research Article
ISSN: 1747-9894

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Article
Publication date: 7 March 2020

Sandra Hakiem Afrizal, Achmad Nizar Hidayanto, Putu Wuri Handayani, Besral Besral, Evi Martha, Hosizah Markam, Meiwita Budiharsana and Tris Eryando

This study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the…

Abstract

Purpose

This study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.

Design/methodology/approach

An exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.

Findings

The results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.

Research limitations/implications

The contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.

Practical implications

Practical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.

Originality/value

Since only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

Details

Journal of Integrated Care, vol. 28 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

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Article
Publication date: 30 May 2020

Lubna Naz and Kamalesh Kumar Patel

The aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.

Abstract

Purpose

The aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.

Design/methodology/approach

It uses an analytical framework and Cox proportional hazards regression to break down the effects of factors determining infant mortality. Factors utilized in the empirical investigation include sex of the child, birth size, birth spacing, mother's working status, age of mother, antenatal care, postnatal care, mother's anemia level, religion, mother's education and wealth status.

Findings

Results suggest that birth spacing of three years and above associated with a reduced risk of infant mortality contrasted with short birth intervals. Children born to nonanemic mothers have a lower hazard (22%) of infant mortality compared to those born to anemic mothers (HR = 0.78; 95% CI: 0.64–0.96). At least one antenatal care visit by mothers lowers infant mortality rate by 41% compared to no antenatal visits at all ( HR = 0.59; 95% CI: 0.36–0.96). Similarly, infants whose mothers have received postnatal care are at lower risk (31%) of dying than those whose mothers have not received (HR = 0.69; 95% CI: 0.52, 0.93). Infant mortality is likely to decrease with the increase in the birth order.

Practical implications

The family health and planning programs should aim at educating men and women about the usefulness of birth spacing methods.

Originality/value

This paper might be the first attempt to analyze the determinants of infant mortality by utilizing a methodological framework and Cox regression.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2019-0478.

Details

International Journal of Social Economics, vol. 47 no. 6
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 1 April 2006

Dawn Kernaghan, Gillian C. Penney and Donald W.M. Pearson

To assess pregnancy‐related care and outcomes for women with pre‐gestational, Type 1 diabetes.

Abstract

Purpose

To assess pregnancy‐related care and outcomes for women with pre‐gestational, Type 1 diabetes.

Design/methodology/approach

The study was a prospective, population‐based, clinical audit in Scotland. A total of 273 and 179 pregnancies in two 12‐month audit periods (during 1998/99 and 2003/04 respectively) were examined.

Findings

In both years, antenatal care for women with diabetes was well organised by dedicated multi‐professional teams. Provision of formal pre‐pregnancy clinics increased (1998, four of 22 maternity units; 2003, six of 20 units). Pregnancies documented as “planned” (1998/99, 116/273, or 42.5 per cent; 2003/04, 105/179, or 58.7 per cent; p=0.001) and periconceptual folic acid supplementation, 5 mg daily (1998/99, 40/273, or 14.7 per cent; 2003/04, 71/179, or 39.7 per cent; p<0.0001) increased over time. In both years, women whose pregnancies progressed to delivery attended early for antenatal care (median eight weeks' gestation) and had meticulous monitoring of diabetic control and foetal wellbeing. In the recent year, fewer women had hypoglycaemia during pregnancy (1998/99, 86/212, or 43.9 per cent; 2003/04, 47/160, or 29.4 per cent; p<0.0001). In both years, macrosomia was common (mean z scores: 1.57 in 1998/99 and 1.64 in 2003/04; standard deviations above a reference population mean) and perinatal mortality appeared higher than for the Scottish population (27.9/1,000 in 1998/99 and 24.8/1,000 in 2003/04). There was a (non‐significant) fall in congenital anomaly rate (1998/99: 13/215 births, or 60/1,000; 2003/04, 6/161 births, or 24.8/1,000).

Originality/value

Re‐audit after a five‐year interval showed that periconceptual care and pregnancy planning for Scottish women with Type 1 diabetes has improved. Although pregnancy outcomes remain poorer than for the general Scottish population, the apparent reduction in congenital anomalies is encouraging.

Details

Clinical Governance: An International Journal, vol. 11 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

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Article
Publication date: 1 December 2001

Janet Hirst and Jenny Hewison

A criticism of using women’s views as an assessment of the maternity services in the UK is that the views of some have been under‐represented and inappropriately…

Abstract

A criticism of using women’s views as an assessment of the maternity services in the UK is that the views of some have been under‐represented and inappropriately researched, in particular those from minority ethnic groups. In addition, there is criticism that “what” has been assessed within the maternity services, and other health‐care arenas, has been driven by the perspective of those who provide the service rather than those who use it. The purpose here is to explore integrating Pakistani and indigenous “white” women’s views with the Donabedian‐Maxwell grid, as a means of offering a consumer‐focused template for underpinning quality assessment and quality assurance strategies for the maternity services in the UK.

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 11 August 2014

Ingrid A Peters, Vera LN Schölmerich, Daniëlle W van Veen, Eric AP Steegers and Semiha Denktaş

The purpose of this paper is to study the characteristics of the participants and the success of the recruitment methods and increase in knowledge of participants in…

Abstract

Purpose

The purpose of this paper is to study the characteristics of the participants and the success of the recruitment methods and increase in knowledge of participants in reproductive health peer education. Dutch perinatal mortality rates are relatively high compared to other European countries. Non-Western ethnic minorities show particularly adverse outcomes. They seem to have low health literacy and less access to health care.

Design/methodology/approach

These groups were specifically targeted, and reproductive health education covering the full spectrum of obstetric care was developed, led by specifically trained female peer educators coming from the targeted communities.

Findings

“Active” recruitment methods were the most successful methods; 1,896 women and 275 men were recruited and participated in the intervention. Sixty-five per cent of the total female participants had a first-generation immigrant background. Significant knowledge improvements were found on all five measurements of reproductive behaviour and antenatal and postnatal health care system knowledge (24 per cent average knowledge increase in already knowledgeable participant group and 46 per cent in the not knowledgeable group). Active interpersonal recruitment methods were most successful in reaching the target groups. Peer education resulted in knowledge increase in these groups.

Practical implications

Invest in training of educators for peer education reproductive health. Organize recruitment by verbal advertising by community organizations and social networks of peer educators.

Originality/value

To the authors’ knowledge, no studies have been conducted combining investigation of the results of specific recruitment methods, the characteristics of reached participants in a multi-ethnic population and their increase in knowledge about reproductive health and care.

Details

Journal for Multicultural Education, vol. 8 no. 3
Type: Research Article
ISSN: 2053-535X

Keywords

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Article
Publication date: 10 September 2018

Nantaga Sawasdipanich, Supa Puektes, Supaporn Wannasuntad, Ankana Sriyaporn, Chulepon Chawmathagit, Jirapa Sintunava and Gamjad Paungsawad

The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement.

Abstract

Purpose

The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement.

Design/methodology/approach

This research and quality improvement project was comprised of three phases. Surveying healthcare facilities and in-depth interviews with female inmates as well as prison nurses were employed in Phase I. Expert reviews and public hearing meetings were used for developing the SHF-TFI in Phase II. Satisfaction questionnaires, focus group interviews of the female inmates, and in-depth interviews with nurses and prison wardens were utilized to evaluate feasibility and effectiveness of SHF-TFI implementation in Phase III.

Findings

The SHF-TFI was elaborated in order to be more specific to the context of the correctional institutes and correspond with healthcare as to the needs of female inmates. It was divided into three main aspects: administrative standards, health service standards and outcome standards. After implementation, nurses reflected on the feasibility and benefits of the SHF-TFI on the organizations, inmates and nurses. The female inmates perceived remarkable improvement in the healthcare services including physical activity promotion and screening programs for non-communicable diseases, the physical environment and sufficiency of medical equipment. Moreover, the pregnant inmates and incarcerated mothers with children shared their views on better antenatal and child developmental care, as well as availability of baby supplies.

Originality/value

The findings support the feasibility and effectiveness of the SHF-TFI for quality care improvement and applicability of the Bangkok Rules in women’s correctional institutes.

Details

International Journal of Prisoner Health, vol. 14 no. 3
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 14 March 2016

Patricia M. Jarrett

Up to 25 per cent of women will experience depression during their pregnancy. Perinatal mental health problems are a leading cause of maternal morbidity and mortality…

Abstract

Purpose

Up to 25 per cent of women will experience depression during their pregnancy. Perinatal mental health problems are a leading cause of maternal morbidity and mortality, however care provided to women is often a low priority. The purpose of this paper is to explore women’s perspective of care from GPs and midwives, when they experience symptoms of depression during pregnancy.

Design/methodology/approach

Women, with self-reported symptoms of depression, were invited to post comments in response to a series of on-line questions posted on two discussion forums over a nine month period. The questions were related to the care women received from GPs and midwives. Data were analysed using thematic analysis.

Findings

In total, 22 women responded to the on-line questions. A number of themes were identified from the data including women’s disclosure of symptoms to GPs and midwives; lack of knowledge of perinatal mental health among health providers; attitudes of staff and systemic issues as barriers to good care; anti-depressant therapy and care that women found helpful.

Research limitations/implications

Women often face significant emotional and psychological health issues in the transition to motherhood. This small study indicates women often experience difficulties in interacting with their GP and midwife in seeking help. This research has identified some contributing factors, however more rigorous research is needed to explore these complex issues.

Originality/value

This paper highlights service provision in the care of women with depression in pregnancy.

Details

The Journal of Mental Health Training, Education and Practice, vol. 11 no. 1
Type: Research Article
ISSN: 1755-6228

Keywords

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