To see the other types of publications on this topic, follow the link: Maternal health care.
Dissertations / Theses on the topic 'Maternal health care'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Maternal health care.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Wood, David L., and R. Nathawad. "Health Care Transition." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5155.
Full text
2
Urassa, David Paradiso. "Quality Aspects of Maternal Health Care in Tanzania." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distrubutör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4221.
Full text
3
Hagan, Teresa. "Under-utilisation of maternal and child health care." Thesis, Sheffield Hallam University, 1988. http://shura.shu.ac.uk/3084/.
Full textAbstract:
The central aim of this study is to identify and describe the experiences of first time mothers who are underusers of child care clinics. An attempt is made to counterbalance the tendency of researchers in this area to be judgmental of underusers who "neglect" their children, and their own health care needs, -by reporting the mothers' views of the child health services in their own terms. Underusers within a certain Health Authority area were identified using a purposely developed Index of Uptake. The achieved sample of predominantly working class mothers constituted a group of people who are particularly difficult to research. It is believed that success in locating and eliciting evidence from this group was in itself an important contribution to the research literature. In depth interviews were undertaken, and the data analysed in two ways; (1) A Subsample, made up of those having made least use of the services available to them, was analysed interpretively to provide detailed material of an idiographic kind on the lifeworld of the person and the place of medical care within it; (2) All interviews were subjected to content analysis to provide a more general picture of mothers' experiences of health care provision. The main findings include the following; (1) The particular population studied had a generally low level of visage as assessed by the index, but use of specifically medical provision was greater. A process of rational decision making is implicated. (2) Accounts of underusers' experiences highlight as a central theme the mothers' vulnerability to personal undermining by many aspects of health care provision. The thesis concludes with a discussion of the approach which health care providers adopt towards'underusers, and argues that there must be an explicit recognition of the point of view of the clients if the services are to reach this deprived segment of the community. Such recognition is rarely found in research or comment on the problem of underusage. In fact apparently irrational and blameworthy behaviour by underusers can be. rendered explicable when considered in the light of the individuals' perceptions and experiences, and this leads to a serious questioning of the utility and appropriateness of the negative judgements made of them.
4
Manthalu, Gerald Herbert. "The impact of user fee exemption on maternal health care utilisation and health outcomes at mission health care facilities in Malawi." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=214843.
Full textAbstract:
The Government of Malawi has entered into agreements with Christian health association of Malawi (CHAM) health care facilities in order to exempt their catchment populations from paying user fees. These agreements are called service level agreements (SLAs). Government in turn reimburses the CHAM health care facilities for the health services that they provide. The agreements started in 2006 with 28 out of 166 CHAM health care facilities and increased to 68 in 2010. The aim of the exemption policy is to guarantee universal access to a basic package of health care services. Although the agreements were designed to cover every health service in the basic health care package, only maternal and neonatal health services are included due to limited resources. The main objective of this thesis was to evaluate the impact of the health care financing change on health care utilisation and health. The specific objectives were as follows: first, to examine whether health care facility visits for maternal health care changed due to user fee exemption; second, to evaluate whether user fee exemption affected the choice of the health care provider where women living in the catchment areas of CHAM health care facilities with user fee exemption sought maternal health care; third, to analyse the effect of user fee exemption on birth weight and; fourth, to explore and apply novel methods in the evaluation of user fee exemption. The gradual uptake of service level agreements by CHAM health care facilities provided a natural experiment with treated and control health care facilities. An additional control group comprised of other demographic groups apart from pregnant women and neonates at CHAM health care facilities with service level agreements. In household survey data, individuals were assigned to treatment and control groups based on their proximity to either a CHAM health care facility with SLA or a CHAM health care facility without SLA. This proffered the unique opportunity to estimate the effect of a single treatment on multiple outcomes. The difference-in-differences (DiD) approach was used to obtain causal effects of user fee exemption. It was implemented in the context of fixed effects, switching regression and multinomial logit models across different chapters. Health care facility level panel data for utmost 146 health care facilities for a maximum of 8 years, 2003-2010, were used. The data were obtained from the Malawi health management xiii information system (HMIS). Linked survey data were also used. Malawi demographic and survey data for 2004 and 2010 were linked to health care facility data and then merged. Analyses that utilised health care facility data showed that user fee exemption had led to increases in first antenatal care visits in the first trimester, first antenatal care visits in any trimester, average antenatal care visits and deliveries at CHAM health care facilities with SLAs. Results from survey data showed that the probability of using a CHAM health care facility with user fee exemption for antenatal care increased, the probability of using home antenatal care declined and the probability of not using antenatal care also declined due to user fee exemption. The probability of delivering at a CHAM health care facility with SLA also increased while the probability of delivering at home declined. User fee exemption did not affect the choice of where to go for postpartum care. Results of the effect of user fee exemption on birth weight were not reported because of potential endogeneity bias arising from lack of instrumental variables for antenatal care. The key policy messages from this thesis are that the user fee exemption policy is an important intervention for increasing the utilisation of maternal health care and needs to be extended to as many CHAM health care facilities as necessary. User fee exemption is not enough, however. Other factors such as education of the woman and her husband/partner, wealth status and cultural factors are also important. This thesis has contributed to the body of knowledge in the following ways. First, it has generated evidence on the impact of user fee exemption on maternal health care utilisation and birth weight in Malawi. Second, with respect to maternal health care utilisation, the thesis has looked at variables that capture the whole maternal health care process from early pregnancy to postpartum care and in a policy relevant way. Third, the thesis has evaluated the effect of user fee exemption on a variable that have not been looked at before, first antenatal care visits in the first trimester. Fourth, the thesis has examined the effect of a single treatment on multiple outcomes in a methodologically unique way. Treatment effects, which were the changes in the probabilities of using different alternatives summed up to zero, thus showing where any increase in the probability of using the outcome of interest came from. Fifth, this thesis is first to use disequilibrium theory of demand and supply in health economics. Application of this theory entailed using switching regression models with unknown sample separation, a seldom used estimation method in health economics. This was an important contribution to the methods xiv of analysing aggregate health care utilisation. Sixth, the STATA program that was written for the estimation of the disequilibrium models was itself a very important contribution to the methods for estimating aggregate supply and demand.
5
Shellhorn, Wendy Lauran Struchen. "Maternal interaction style, reported experiences of care, and pediatric health care utilization." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001478.
Full text
6
Jaffer, Khadija. "Child safety in day care centres within the Western Cape." Master's thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/27004.
Full textAbstract:
The aim of the study is to explore aspects of child safety in registered day care centres situated in a lower socio-economic area of the Cape Town Metropole. This can be achieved by: a) describing the physical environment in day care centres b) assessing the infrastructure of day care centres to deal with potential injurjes c) reviewing injury reporting systems already in place d) highlighting the issue of child safety in the course of conducting the study.
7
Nyberg, White Maria. "Preventing maternal mortality : - Nurses’ and midwives’ experiences from Tanzanian maternal health care services." Thesis, Linköpings universitet, Avdelningen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-116479.
Full textAbstract:
Background: Half a million women died during pregnancy or childbirth in 2005. Bleeding, infections, high blood pressure, obstructed labor, unsafe abortions, malaria and HIV/Aids were the main causes. Tanzania is a highly affected country with 460 maternal deaths per 100 000 live births. Nurses and midwives play an important role in preventing maternal mortality. Purpose: The aim of this study was to explore and analyze nurses’ and midwives’ experiences of maternal mortality prevention on the Tanzanian island of Unguja. Method: Interviews with nine nurses and midwifes from four different hospitals and health care facilities were conducted with the assistance of an interpreter. A structural analysis designed by Ricoeur was undertaken. Results: The findings suggest that family planning, a more accessible health care, referral of severe cases, medical interventions, health education, community resource persons and involving fathers in maternal health care are preventive strategies that can reduce maternal mortality. Conclusion: To further improve the quality of maternal mortality prevention further knowledge aboutindividual differences in learning from health education is needed. Involvement of all fathers in maternal health care should also be considered. Training of unskilled personnel is believed to improve early identification of life-threatening complications and thereby reduce maternal mortality.Bakgrund: En halv miljon kvinnor i världen dog under graviditet eller förlossning under 2005. Huvudorsaker var blödningar, infektioner, högt blodtryck, långdragna förlossningar, osäkra aborter, malaria samt HIV/Aids. Tanzania är ett drabbat land med 460 fall av mödradödlighet per 100 000 levande födda barn. Sjuksköterskor och barnmorskor spelar en viktig roll i det preventiva arbetet mot mödradödlighet. Syfte: Syftet med studien var att utforska och analysera sjuksköterskors och barnmorskors upplevelser och erfarenhet av arbetet mot mödradödlighet på ön Unguja, Tanzania. Metod: Intervjuer med nio sjuksköterskor och barnmorskor från fyra olika sjukhus/hälsocentraler genomfördes med hjälp av en tolk. En strukturanalys utformad av Ricoeur genomfördes. Resultat: Resultatet visar att familjeplanering, en mer tillgänglig hälso- och sjukvård, remitterande av patienter med allvarliga komplikationer, medicinska interventioner, hälsoutbildning, resurspersoner i samhället och att involvera pappor i mödrahälsovården var preventiva strategier som kan minska mödradödlighet. Slutsats: För att ytterligare förbättra arbetet mot mödradödlighet tycks mer kunskap om individers förmåga att ta till sig hälsoutbildning behövas. Att i ännu större utsträckning även välkomna alla blivande pappor till mödrahälsovården föreslås också kunna fungera preventivt. Utbildning för outbildade kvinnor som hjälper till vid förlossningar (Traditional Birth Attendants) tros kunna förbättra tidig identifikation av livshotande komplikationer och därmed kunna minska mödradödligheten.
8
Chama-Chiliba, Chitalu Miriam. "An economic analysis of maternal health care in Zambia." Thesis, University of Pretoria, 2013. http://hdl.handle.net/2263/40259.
Full textAbstract:
This thesis investigates the utilisation of maternal health care in Zambia, where despite being a signatory to the Safe Motherhood Initiative and Millennium Development Goals, which are aimed at improving maternal health, indicators of maternal health continue to perform poorly. The need to understand crucial factors in improving maternal health motivated the current research, especially since there is a dearth of literature in this area in Zambia. The thesis focuses on two aspects of maternal health care: antenatal care (ANC) and facility-based deliveries, to answer two broad questions. Firstly, what factors determine the use of ANC in Zambia? Secondly, to what extent has the abolition of user fees affected facility-based deliveries?
An assessment of the factors, which explain the utilisation of ANC in Zambia, using three sets of comparable datasets reveals that, while there are differences in the factors explaining the decision to use ANC and the frequency of visits over time, the decision to seek ANC and the frequency of use is low among the poor and less educated, and there are marked regional differences in utilisation. The most appropriate econometric specification for antenatal visits, according to different performance indicators, was the two-part model, which differs from recent research favouring more complex methodologies.
The analysis is further extended through the inclusion of supply-side factors and the examination of individual and community level factors associated with inadequate and non-use of ANC, following the adoption of the focused ANC approach in Zambia. To incorporate the supply side factors, the 2007 Zambia Demographic and Health Survey was linked to administrative and health facility census data using geo-referenced data. To assess the factors associated with (1) the inadequate use of ANC (defined as three or less visits), and (2) the non-use of ANC in the first trimester of pregnancy, we specify two multilevel logistic models. At the individual level, the woman’s employment status, quality of ANC received and the husband’s educational attainment are negatively associated, while parity, the household childcare burden and wealth are positively associated with inadequate utilisation of ANC. Both individual and community level characteristics influence inadequate use and non-use of ANC in the first trimester; however, community level factors are relatively stronger in rural areas.
Although ANC is an important facet of maternal care, it occurs before delivery, but does not necessarily provide much information with respect to delivery decisions. Therefore, the thesis investigates delivery decisions, as well, in particular, the effect of user fee removal in rural areas of Zambia on facility-based deliveries. To account for regional differences, we employ a Seemingly Unrelated Regression model incorporating an Interrupted Time Series design. The analysis uses quarterly longitudinal data covering 2003q1-2008q4. When unobserved heterogeneity, spatial dependence and quantitative supply-side factors are controlled for, user fee removal is found to immediately increase aggregate facility-based deliveries, although the national trend was unaffected. Drug availability and the presence of traditional birth attendants also influence facility-based deliveries at the national level, such that, in the short-term, strengthening and improving community-based interventions could increase facility-based deliveries. However, there is significant variation and spatial dependence masked in the aggregate analysis. The results highlight the importance of service quality in promoting facility-based deliveries, and also suggest that social and cultural factors, especially in rural areas, influence the use of health facilities for delivery. These factors are not easily addressed, through an adjustment to the cost of delivery in health facilities.
Additionally, we analyse the effect of user fee abolition on the location of childbirth, focussing on deliveries that occur in public health facilities using household survey data. To elicit the causal relationship, we exploit the relative change in fees across health districts within a difference-in-differences framework. Surprisingly, although reductions in home deliveries were observed, as expected, reductions in public health facility-based deliveries were also uncovered, along with increases in deliveries at private health facilities. However, these findings were statistically insignificant; suggesting that the abolition of user fees had little, if any, impact on the choice of location for childbirth. The statistically insignificant, but unexpected, causal effects further suggest that the removal of user fees have unintended consequences, possibly the transference of facility costs to the client, which would deter the utilisation of delivery services. Therefore, abolishing user fees, alone, may not be sufficient to affect changes in outcomes; instead, other efforts, such as improving service quality, could have a greater impact.Thesis (PhD)--University of Pretoria, 2013.
gm2014
Economics
unrestricted
9
Wood, David L. "Health Care Transition: Bridge or Abyss?" Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5175.
Full text
10
Källmark, Amanda. "Maternal health care in natural disasters : A study on the International Federation of the Red Cross’s maternal health care in flooding disaster relief." Thesis, Uppsala universitet, Statsvetenskapliga institutionen, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-439538.
Full textAbstract:
This thesis aims to describe how the International Federation of Red Cross and Red Crescent Societies (IFRC) tends to maternal health care in floodings and whether it should be deemed sufficient. Floodings in Pakistan (2010), Bangladesh (2017) and Sudan (2013) are used as units of analysis when conducting a content analysis. The theoretical framework consists of critical success factors for disaster response based in the emergency management literature. A big part of the theoretical framework revolves around the importance of expertise and rationality in disaster response planning and implementation. The three floodings received relief efforts from IFRC which are presented in emergency appeal reports. Lists on essential maternal health care interventions in combination with the theoretical framework create analysis questions that are posed to the appeals. Results are presented in a table naming the prevalence of each intervention in each report. The findings show that maternal health care was seen to and deemed sufficient in only one of the three cases: Pakistan. The conclusion is that the discourse on maternal health care in natural disasters should be developed and that further research on the subject needs to be conducted.
11
Wood, David L. "Screening Tools in Adolescent Health Care." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5187.
Full textAbstract:
Learning Objectives: (1) Identify three primary care friendly screening tools useful for identifying behavioral health concerns in adolescents. (2) Describe how a "champion" (quality improvement) team can help facilitate implementation of a screener in a primary care.
12
Moran, Tracy E. "Infant health care use : the influences of maternal psychosocial factors." Diss., University of Iowa, 2008. http://ir.uiowa.edu/etd/39.
Full text
13
Tsawe, Mluleki. "Utilization of health care services and maternal education in South Africa." University of the Western Cape, 2014. http://hdl.handle.net/11394/4358.
Full textAbstract:
Magister Philosophiae - MPhilThe importance of maternal health care services cannot be stressed enough. Maternal health services are important in reducing pregnancy-related complications as well as maternal and infant deaths. This study was concerned with investigating the relationship between maternal education and maternal health care utilization. Furthermore, the study aimed to investigate the rates of maternal health care use, the reasons for non-use of maternal health services, as well as the determinants of maternal health care use. Primary data was used from selected areas (Tsolo, Qumbu and Mqanduli), which fall within the O.R. Tambo district in the Eastern Cape Province. Simple random sampling was used (with a structured questionnaire) to study maternal health care use among the sampled women. To analyse this data, univariate, bivariate, and multivariate techniques were employed. The results indicated that maternal education was not statistically significant with antenatal and postnatal services, but the percentages were important in explaining the use of maternal health care services in relation to maternal education. Women with higher levels of education reported higher rates of antenatal and delivery care utilization, while those with lower levels of education reported higher rates of postnatal care use. Access factors, such as transport, payment and distance to health facilities, also played an important role in the use of maternal health care services. It was recommended that the Department of Health implement mobile clinics and centralize health care facilities as this will bring essential health services closer to the communities. Women in the study area also need to be educated about the importance of these services, more particularly pertaining to postnatal care.
14
Magadi, Monica Akinyi. "The determinants of poor maternal health care and adverse pregnancy outcomes in Kenya." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310540.
Full text
15
Adanri, Olubunmi A. "Maternal Health Literacy, Antenatal Care, and Pregnancy Outcomes in Lagos, Nigeria." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10282020.
Full textAbstract:
Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by the social cognitive theory and health belief model, the purpose of this cross-sectional quantitative study was to determine if there is a relationship between maternal health literacy, antenatal care visits, development of medical conditions during pregnancy, and pregnancy outcomes (measured by healthy or unhealthy baby) in Lagos, Nigeria. The research question for this study tested if there was a relationship between these variables. Lisa Chew’s health literacy assessment tool was used in a sample of 130 women in Shomolu local government in Nigeria who met the inclusion criteria. Using binary logistic correlations, only problems developed during pregnancy is statistically significant with pregnancy outcomes (p < .05). The results suggested an increase in problems developed during pregnancy most likely will increase the chance of having negative pregnancy outcomes. Results from this study could promote positive social change by helping health professionals identify the characteristics of at-risk women during antenatal education sessions. The results could also help health professionals in the development of targeted antenatal care interventions.
16
Sosa-Rubi, Sandra Gabriela. "Maternal health care utilisation and the production function of the health of the newborn." Thesis, University of York, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.434158.
Full text
17
Nordin, Cecilia, and Elin Eklund. "Women's trust in maternal health care : A qualitative interview study about nurses' experiences within primary health care in Ghana." Thesis, Röda Korsets Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2255.
Full textAbstract:
Background: In Ghana, many women die every year due to preventable causes related to pregnancy and child birth. Several national strategies have been made to improve women’s access to essential maternal health care. Still there is a significant inequality in the number of women attending to maternal health care in between different parts of the country. An important determinant that affects women’s utilization of the subsidized maternal health care is the quality of health care, including the health providers’ attitudes to their patients. Aim: The aim of this study was to describe nurses’ experiences of interacting with women in a maternal health care context within primary care in Ghana. Method: Five qualitative semi-structured interviews were conducted at three different primary health care clinics. Content analysis was used to analyse the data. Results: Three main-themes, patient compliance, building trust and nursing strategies and ten sub-themes were identified. Conclusion: Although the nurses expressed a desire to have more women attend maternal health care, they seemed unaware of how their own behaviour might contribute to the current underutilization. A hierarchical power imbalance within the nurse-patient interactions, where the patients were perceived and treated as subordinate passive receivers of the nurses’ expertise, was identified. The nurses’ lack of critical approach towards their own actions might be at the source of this underutilization. Suggestion for further research: The authors recommend further studies to explore nurses’ ability to allow self-reflective critical thinking and also how implementation of a more patient-centred approach in Ghana would affect the quality of health care.Bakgrund: Varje år dör många kvinnor i Ghana på grund av förebyggbara komplikationer relaterade till graviditet och förlossning. Flera nationella strategier har genomförts i syfte att ge fler kvinnor tillgång till nödvändig mödrahälsovård. Trots det råder en signifikant skillnad i andel kvinnor som söker mödrahälsovård mellan olika delar av landet. En viktig faktor som påverkar utnyttjandet av den subventionerade mödrahälsovården är vårdkvaliteten, inklusive vårdpersonalens bemötande. Syfte: Syftet med denna studie var att beskriva sjuksköterskors erfarenheter av bemötande av kvinnor i en mödrahälsovårdskontext inom primärvården i Ghana. Metod: Fem kvalitativa semistrukturerade intervjuer genomfördes vid tre olika primärvårdskliniker. Innehållsanalys användes for att analysera insamlad data. Resultat: Tre huvudteman, patientföljsamhet, bygga förtroende och omvårdnadsstrategier och tio underteman hittades i resultatet. Slutsats: Trots att sjuksköterskorna uttryckte en vilja att få fler kvinnor att nyttja tillgänglig mödrahälsovård så verkade de omedvetna om hur deras eget agerande skulle kunna bidra till att kvinnorna väljer att inte söka vård. En hierarkisk maktobalans inom sjuksköterskornas vårdrelation med patienterna framträdde genom intervjuerna, där patienterna sågs och bemöttes som underordnade, passiva mottagare av sjuksköterskornas expertis. Sjuksköterskornas brist på kritiskt förhållningssätt till egna insatser kan göra att de oavsiktligt arbetar emot sina egna mål. Förslag på fortsatta studier: Ytterligare studier för att utforska sjuksköterskors förmåga att tillämpa kritiskt tänkande rekommenderas samt vilken nytta det skulle vara för kvaliteten på omvårdnaden om ett mer patientcentrerat förhållningssätt implementerades inom vården i Ghana.
18
Kausar, Farah. "Maternal health care utilisation among the urban poor of Maharashtra, India." Thesis, University of Southampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340665.
Full text
19
Nguyen, Thu Ha Chanya Sethaput. "Factors influencing utilization of maternal health care services in northern Vietnam /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd381/4738660.pdf.
Full text
20
Adanri, Olubunmi. "Maternal Health Literacy, Antenatal Care, and Pregnancy Outcomes in Lagos, Nigeria." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3651.
Full textAbstract:
Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by the social cognitive theory and health belief model, the purpose of this cross-sectional quantitative study was to determine if there is a relationship between maternal health literacy, antenatal care visits, development of medical conditions during pregnancy, and pregnancy outcomes (measured by healthy or unhealthy baby) in Lagos, Nigeria. The research question for this study tested if there was a relationship between these variables. Lisa Chew's health literacy assessment tool was used in a sample of 130 women in Shomolu local government in Nigeria who met the inclusion criteria. Using binary logistic correlations, only problems developed during pregnancy is statistically significant with pregnancy outcomes (p < .05). The results suggested an increase in problems developed during pregnancy most likely will increase the chance of having negative pregnancy outcomes. Results from this study could promote positive social change by helping health professionals identify the characteristics of at-risk women during antenatal education sessions. The results could also help health professionals in the development of targeted antenatal care interventions.
21
Biswas, Animesh. "Maternal and Neonatal Death Review System to Improve Maternal and Neonatal Health Care Services in Bangladesh." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-46379.
Full textAbstract:
Bangladesh has made encouraging progress in reducing maternal and neonatal mortality over the past two decades. However, deaths are much higher than in many other countries. The death reporting system to address maternal, neonatal deaths and stillbirths is still poor. Moreover, cause identification for each of the community and facility deaths is not functional. The overall objective of this thesis is to develop, implement and evaluate the Maternal and Neonatal Death Review (MNDR) system in Bangladesh. The study has been conducted in two districts of Bangladesh. A mixed method is used in studies I and II, whereas a qualitative method is used in studies III-V, and cost of MNDR is calculated in study VI. In-depth interviews, focus group discussions, group discussions, participant observations and document reviews are used as data collection techniques. Quantitative data are collected from the MNDR database. In study I, community death notification in the MNDR system was found to be achievable and acceptable at district level in the existing government health system. A simple death notification process is used to capture community-level maternal and neonatal deaths and stillbirths. It was useful for local-level planning by health managers. In study II, death-notification findings explored dense pocket areas in the district. The health system took local initiatives based on the findings. This resulted in visible and tangible changes in care-seeking and client satisfaction. Death numbers in 2012 were reduced in comparison with 2010 in the specific area. In study III, verbal autopsies at community level enabled the identification of medical and social causes of death, including community delays. Deceased family members cordially provided information on deaths to field-level government health workers. The health managers used the findings for a remedial action plan, which was implemented as per causal findings. In study IV, social autopsy highlights social errors in the community, and promotes discussion based on a maternal or neonatal death, or stillbirth. This was aneffective means to deliver some important messages and to sensitize the community. Importantly, the community itself plans and decides on what should be done in future to avert such deaths. In study V, facility death review of maternal and neonatal deaths was found to be possible and useful in upazila and district facilities. It not only identified medical causes of death, but also explored gaps and challenges in facilities that can be resolved. The findings of facility death reviews were helpful to local health mangers and planners in order to develop appropriate action plans and improve quality of care at facility level. Finally, in study VI, the initial piloting costs required for MNDR implementation were estimated, including large capacity development and other developmental costs. However, in the following year, costs were reduced. Unit cost per activity was 3070 BDT in 2010, but, in the following years, 1887 BDT and 2207 BDT, in 2011 and 2012 respectively.
22
Robinson, Rachel Elizabeth. "Living knowledge : embodied health care research practice /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/11187.
Full text
23
Hagen, Catherine A. "Maternal mortality, fertility, and the utilization of prenatal care in Karachi, Pakistan." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22736.
Full textAbstract:
A community health survey was conducted in Karachi, Pakistan, with three objectives: first, to estimate maternal mortality using the sisterhood method; second, to describe current fertility and family planning trends; and third, to determine which factors are associated with the utilization of prenatal care.The study population of 2,897 households was chosen randomly from the catchment area of the three maternity hospitals of the Aga Khan Health Services of Pakistan. Data were collected using household interviews of all married women less than 55 years of age.
Results show a maternal mortality estimate of 153 deaths per 100,000 live births and perinatal mortality of 30/1000. Strong declining trends in fertility and increased utilization of prenatal care were documented in this urban population, in contrast to recent national survey data. After adjustment for socioeconomic factors and confounding variables, maternal education and perceived importance of prenatal care were found to be important predictors of the utilization of maternal health care. The majority of families in this population utilize the private sector for family planning and pregnancy care.
The study demonstrates the importance of maternal education and attitudes in promoting utilization of adequate maternal health care, and documents the emerging role of the private sector in the provision of maternal health services in Karachi.
24
Wood, David L. "Engaging Primary Care Providers in Health Care Transition For Persons with Hydrocephalus." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5171.
Full text
25
Yakong, Vida Nyagre. "Rural Ghanaian women's experience of seeking reproductive health care." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/3805.
Full textAbstract:
Ghana, a low-income developing country in sub-Saharan Africa is experiencing low
maternal health service utilization and high rates of maternal mortality, especially in the rural
areas. The Talensi-Nabdam District is one of the poorest and most remote districts in Ghana. The
reproductive health status of women in the most remote communities in this District is poor.
Dialogue about women’s reproductive health care needs in Ghana have been influenced by
health care authorities, professionals, researchers and experts’ perceptions.
The purpose of this ethnographic research was to explore rural Ghanaian women’s
experiences of seeking reproductive health care from their own perspectives. The study was
based on data collected from participant observations, unstructured face-to-face interviews and
focus group discussions. A total of 27 women of varying socio-demographic backgrounds
participated in the study.
Interviews were conducted at locations of the women’s choice and in women’s local
dialect. Data were translated and transcribed verbatim, and analyzed thematically. Four major
themes emerged from the findings: submitting to the voices of family, women’s experiences of
receiving nursing care, the community of gossip, and gaining voice.
The findings of this study have implications for nursing practice, education and nursing
inquiry. Awareness of barriers that rural women encounter in meeting their reproductive health
care needs among health care providers is important in facilitating positive health care seeking
behaviours. Nurse educators should orient themselves to the challenges to meeting women’s
health care needs, and include in culturally sensitive approaches in nursing education programs.
Further research is needed to investigate strategies that will enhance women’s
reproductive health care seeking behaviours in rural settings and to focus on women’s
perspectives in particular. In addition, research is needed to examine nurses’ perspectives on
factors that influence quality care delivery to address women’s reproductive health issues.
26
Gottvall, Karin. "Birth centre care : reproduction and infant health /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-825-4/.
Full text
27
Saroj, Prasad Orapin Singhadej. "A comparative study of knowledge, attitude and practice of women in reproductive age, concerning maternal and (antenatal care) child health care activities with blue card and without blue card program in Ratchaburi province /." Abstract, 1988. http://mulinet3.li.mahidol.ac.th/thesis/2531/31E-Saroj-P.pdf.
Full text
28
Singogo, Irene Miti. "Perinatal deaths in Lusaka, Zambia : mothers’ experiences and perceptions of care." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6015.
Full text
29
Devkota, H. R. "Maternal health care service access to disabled and Dalit women in Nepal." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/1559753/.
Full textAbstract:
BACKGROUND: The access and utilization of maternal health care services by disabled and Dalit women in Nepal has not been well studied, and yet disparities in these may result in poor health outcomes. Co-existence of caste and disability may lead Dalit women with disability to further exclusion and marginalization, preventing them to access basic human rights and opportunities such as maternal health care services. It is therefore important to understand disabled and Dalit women’s access and utilization of health care service and the effect of intersectionality between their caste status and disability in the use of services. Previous efforts have focused on disability, gender and caste separately, but few studies have attempted to understand the inter-relationship between them or where they co-exist. This study explored this complex relationship and the multiple perspectives of Dalit women with and without disability about their access and utilization of maternal health care services with the assumption that all of these factors interacting together lead to exclusion and marginalization preventing their access and utilization of services. The study objectives were: (i) to compare and determine maternal health care service access and utilization patterns among disabled and non-disabled, Dalit and non-Dalit women in the Rupandehi district; (ii) to understand the attitude and behaviours of society and maternal health care providers towards disability; and (iii) to identify inhibiting and enabling factors for disabled and Dalit women with regards to access and utilization of maternal health care service. METHODS: The study employed a mixed methods design combining quantitative and qualitative components of data collection and analysis. Quantitative data was obtained from survey questionnaires administered to women between aged 15 - 49 years and also of their health care providers. A total 354 women, of which 79 were disabled (18 disabled Dalit and 61 disabled non-Dalit) and 275 non-disabled (133 non-disabled Dalit and 142 non-disabled non-Dalit) participated in the survey. While qualitative data was gathered from 37 in-depth interviews, six focus group discussions with women (disabled and non-disabled; Dalit and non-Dalit), and six key informant interviews with activists, community leaders and policy makers. Quantitative data was analysed using descriptive statistics, bivariate and multivariate analysis with a logistic regression model and theme content analysis was applied to the qualitative data. RESULTS: The study found inequitable utilization of maternal health care services, with disabled women having lower utilization of ANC one (83.5% vs 96.7%, P < 0.001), HF delivery (52.6% vs 69%, P < 0.05) and PNC (18.4% vs 32.5%, P < 0.05) services compared to non-disabled women. Household indicators relating to education, wealth and family circumstances were the main determinants for disabled women having less service utilization (P < 0.05). Low utilization of postnatal care (PNC) services among all groups found due to the poor information received by women from local health providers and strong negative traditional beliefs among communities. The study did not find differences in the utilization of maternal health care services between Dalits and non-Dalits (P > 0.05). Rather it found that maternal health care services are not easily or equitably accessible to all social groups, preventing full utilization for disabled. Societal and health care providers’ attitudes towards disability were often found to be negative, although there were positive and negative user experiences and perceptions of provider’s attitude and behaviours. A further finding of the study was that the health care needs of disabled women are invisible at the policy level, which appeared to translate into unsuitable health care settings and ill-prepared health care providers to cater for them. Women from all social groups encountered a number of barriers to access, relating to personal, socio-cultural, and policy or system factors; however, disabled women faced additional barriers. Women with disabilities from all social groups faced physical, attitudinal, socio-cultural and policy related issues, including a lack of knowledge and skills among providers were critical barriers for women with disabilities; whereas having positive providers, a favourable family environment, as well as education and information, were enabling factors for disabled women’s access and utilization of care. Women with disabilities from all social groups also have higher levels of fear and perceived risks associated with pregnancy and delivery. This is primarily linked to worries about delivery complications associated with their disability and also that the baby would inherit their disability. The study did not find any compounding effect of caste and disability in access and utilization of maternal health care services. CONCLUSION: Improving equity and maternal health care access and utilization for disabled and other marginalised women requires that policy and existing traditional strategies be re-examined, re-developed and implemented through a human rights-based lens, with programme interventions focused on addressing persistent negative attitudes and socio-cultural barriers. Women’s education, social status, decision-making power and access to resources are critical factors associated with health care access and utilization among all groups of women. Significantly, women with disabilities, no matter what their social group, faced greater barriers than non-disabled women. Therefore, in order to increase access and utilization of maternal health care services across the population, holistic approaches including multi-sectoral interventions should be adopted.
30
Chilvers, R. "Planning framework for human resources for health for maternal and newborn care." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2014. http://researchonline.lshtm.ac.uk/2124342/.
Full textAbstract:
With approximately 1.3 billion births estimated to be taking place globally over a decade up to 2020, the demand for maternal and newborn health (MNH) workforce continues to be a key aspect of public health service delivery. Human resources for health (HRH) projection models can contribute the quantitative evidence required for policy design for education commissioning and distribution of skilled personnel. To date, HRH supply and requirement projection models have not been developed specifically for system-based subnational planning within maternal and newborn care. In addition, current methodologies are often limited to national level and have a professional silo approach to considering the workforce, with informing policy and planning as a secondary consideration. The aim of this thesis was to fill the gap through improved understanding of the role of HRH projections for policy and development of a new model for projecting the future MNH clinical teams with spatial equity and system perspective at the centre of the planning framework. The specific objectives were to • review the literature for strengths and limitations for current HRH planning and outline the main components of an evidence-informed MNH-HRH planning framework with relevance to subnational contexts and MNH systems • translate the main components into a working prototype as a spreadsheet-based model to estimate and MNH-HRH requirements and supply for each occupation • apply the MNH-HRH planning model in three countries from low to high income contexts and critique the implications for future research and development in this field. Following the construction of a new planning framework, a working prototype called the ‘MNH.HRH Planning App’ was developed. The spreadsheet-based model was applied using secondary data sources to England, Bangladesh, and Ethiopia which have varied health systems, levels of spatial disaggregation and HRH structures for MNH care. The thesis concludes by highlighting the implications of the new planning framework for the future development of a web-based MNH.HRH Planning App, potential for engaging policy-makers for evidence-informed planning and contributes to the wider discourse on the use of quantitative projection models for planning the future human resources for healthcare.
31
Oliveira, Camila Almeida Neves de. "Quality of maternal and neonatal care in Cearà health region: puerpera vision." Universidade Federal do CearÃ, 2017. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=18655.
Full textAbstract:
CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel SuperiorThe reduction of maternal and neonatal morbimortality is based on the approach to quality of health care during the pregnancy-puerperal period, with a view to prevention. Maternal and neonatal care quality (QMNC), referential quality of obstetric and neonatal care international gold standard, consists of essential elements for an evaluation of practices and effective care needed for women and newborns. In this perspective, the evaluation of practices currently performed in Rede Cegonha strategy, having as basis the QMNC, it is necessary, given the completeness of the model, for its rigorous process of building and broad theoretical framework. The objective was to evaluate the quality of care of the woman and the newborn from the perspective of the puerperal woman. Evaluative study, carried out in reference maternity for the 10 municipalities belonging to the 18th Health Region of the State of CearÃ, located in Iguatu-CE. The sample consisted of 92 puerperae, who were interviewed during the period of October to December of 2016, y adjusting the pre-established inclusion criteria. Statistical analysis and cross-checking of variables were performed in SPSS software, version 22.0. The study was approved by the Assis Chateaubriand School Maternity Research Ethics Committee. In this perspective, it was observed that the puerperae were at the age of 29 years old (76.1%), were primiparous (56.5%), coming from the municipality of the Region (56.5%), with a stable partner ( 79.8%), practiced extra-household activity (50%), had between 5 and 12 years of education (88.8%) and had a monthly family income between a minimum or lower wage (61.9%). In the category education, information and health promotion, a higher prevalence was found between six and nine (64.4%) pre-natal consultations being performed jointly by nurses and physicians (94.5%), with reference to the nurse for most of the guidelines provided in the consultations (60.4%). In the category of evaluation, screening and care planning, low-risk gestation was evidenced (92.3%), with the recommended tests performed at rates above 80%, however, the professional responsible for the delivery of the child was the physician (85,7%), to the detriment of the obstetrician nurse. As for the category promotion of normal processes and prevention of complications, there was a slight overlap of normal delivery (52.2%) to cesarean section (47.8%); however, there was no adequate filling of the partograph (26.1%), stimulation for adhesion of vertical positions during labor(12.0%) and late clamping of the umbilical cord (3.3%), practices considered beneficial for the quality of obstetric and neonatal care. In the category first-line management and treatment of severe complications, the prevalence of urinary tract infection during pregnancy was identified (54.3%), followed by treatment (67.6%), while in the newborn complications were predominant in the puerperium, with a prevalence of respiratory discomfort (42.9%). Furthermore, only the number of abortions was linked to the occurrence of complications. Thus, it is inferred that changes in maternal and child care are happening in this scope, but there is still a need to adapt some unused charitable practices, which can be reversed over time, investment, training of professionals and complete structuring of the health equipment that make up the Rede Cegonha.
A reduÃÃo da morbimortalidade materna e neonatal està fundamentada na abordagem da qualidade dos cuidados ofertados durante o perÃodo gravÃdico-puerperal, em atuaÃÃo na perspectiva da prevenÃÃo. O Quality Maternal and Newborn Care (QMNC), referencial de qualidade da atenÃÃo obstÃtrica e neonatal padrÃo-ouro internacional, à constituÃdo de elementos essenciais para a avaliaÃÃo das prÃticas e dos cuidados efetivos necessÃrios Ãs mulheres e recÃm-nascidos. Nesta Ãtica, a avaliaÃÃo das prÃticas desempenhadas atualmente na estratÃgia Rede Cegonha, tendo como embasamento o QMNC, faz-se necessÃria, haja vista a completude do modelo, por seu rigoroso processo de construÃÃo e vasto referencial teÃrico utilizado. Objetivou-se avaliar a qualidade do cuidado ofertado à mulher e ao recÃm-nascido sob a Ãtica da puÃrpera. Estudo avaliativo, realizado em maternidade de referÃncia para os 10 municÃpios pertencentes à 18 RegiÃo de SaÃde do Estado do CearÃ, localizada em Iguatu-CE. A amostra foi composta por 92 puÃrperas, as quais foram entrevistadas durante o perÃodo de outubro a dezembro de 2016, mediante a adequaÃÃo aos critÃrios de inclusÃo prÃ-estabelecidos. A anÃlise estatÃstica e cruzamento das variÃveis foram realizados no software SPSS, versÃo 22.0. O estudo obteve aprovaÃÃo do Comità de Ãtica em Pesquisa da Maternidade Escola Assis Chateaubriand. Nesta perspectiva, apreende-se que as puÃrperas encontravam-se na idade atà 29 anos (76,1%), eram primÃparas (56,5%), procedentes do municÃpio pÃlo da RegiÃo (56,5%), com companheiro estÃvel (79,8%), exerciam atividade extra-lar (50%), apresentaram entre 5 a 12 anos de estudo (88,8%) e detinham um rendimento mensal familiar entre um salÃrio mÃnimo ou inferior (61,9%). Na categoria educaÃÃo, informaÃÃo e promoÃÃo da saÃde constatou-se uma maior prevalÃncia entre seis e nove (64,4%) consultas prÃ-natais sendo realizadas conjuntamente por enfermeiros e mÃdicos (94,5%), com referÃncia ao enfermeiro pela maior parte das orientaÃÃes prestadas ao longo das consultas (60,4%). Na categoria avaliaÃÃo, triagem e planejamento do cuidado evidenciou-se a gestaÃÃo de baixo risco (92,3%), com realizaÃÃo dos exames preconizados em taxas superiores a 80%, todavia, o profissional responsÃvel pelo acompanhamento do parto foi o mÃdico (85,7%), em detrimento do enfermeiro obstetra. Quanto à categoria promoÃÃo de processos normais e prevenÃÃo de complicaÃÃes verificou-se discreta sobreposiÃÃo do parto normal (52,2%) à cesÃrea (47,8%), contudo, nÃo hà o preenchimento adequado do partograma (26,1%), estÃmulo à adesÃo de posiÃÃes verticais durante o parto (12,0%) e clampeamento tardio do cordÃo umbilical (3,3%), prÃticas consideradas benÃficas para a qualidade da assistÃncia obstÃtrica e neonatal. Jà na categoria gestÃo de primeira linha e tratamento de complicaÃÃes graves identificou-se a prevalÃncia para infecÃÃo do trato urinÃrio na gestaÃÃo (54,3%), seguido pelo tratamento (67,6%), enquanto no recÃm-nascido as intercorrÃncias foram predominantes no puerpÃrio, com prevalÃncia de desconforto respiratÃrio (42,9%). Ademais, apenas o nÃmero de abortos esteve associado à ocorrÃncia de complicaÃÃes. Destarte, infere-se que mudanÃas no cuidado materno-infantil estÃo acontecendo neste Ãmbito, porÃm ainda hà necessidade de adequaÃÃo de algumas prÃticas benÃficas nÃo utilizadas, o que poderà ser revertido com o tempo, investimento, capacitaÃÃo dos profissionais e a estruturaÃÃo completa dos equipamentos de saÃde que compÃem a Rede.
32
Mukong, Alfred Kechia. "Social networks, bargaining power within couples, and maternal health care in Tanzania." Doctoral thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16691.
Full textAbstract:
Includes bibliographical referencesThis thesis focuses on the use of maternal health services and child health in Tanzania. The main focus is on how these issues relate to social networks and bargaining power within couples. These issues are interrelated and are discussed in three essays. The first essay investigates the impact of information externalities in social networks on the use of antenatal services. Particular emphasis is placed on the extent to which the probability of early antenatal check-up and antenatal completion are affected by social networks. Adopting an econometric technique that minimises the problem of omitted variable bias, the analysis suggests that these network effects increase the probability of antenatal care completion by an additional 6 to 35 percent, and may be as high as 59 percent. The study further finds that without adequate control of omitted variables, the network impact would be understated. It is also evident that failure to control for individual and household observable characteristics overstates the impact of networks. Results from the two approaches used in this study confirm that irrespective of the definition of social network, having a high quality contacts increase the probability of utilising maternal health services. The second essay examines the effect of bargaining power within couples on the probability of delivering in a health facility (public and private), as opposed to a home birth. It further investigates the effect of bargaining on the probability of health care provider choice at childbirth using a multinomial nested logit. Evidence suggests that cooperation within couples in decision-making, female discretion over household resources, and freedom from domestic violence increases the probability of childbirth in a facility, as opposed to home. The study finds that a woman's influence on service use varies if she is better educated than her partner. In addition, while cooperation in household decision and the incidence of domestic violence significantly affect private facility use, female discretion over household resources has a strong effect on public facility choice. Finally, antenatal completion, health knowledge, and maternal specific factors increase the probability of delivering in a public and private facility. ii The third essay empirically explores the contribution of intra-household bargaining, to the rural-urban gap in child nutrition. The study analyses the effect of parental bargaining indicators (cooperation in household decisions, the incidence domestic violence and discretion over household resources) on the probability of child stunting in both rural and urban areas. The essay contributes to the literature by demonstrating empirically that differences in intra-household bargaining increase the rural-urban gap in child health. It further contributes to the literature by correcting for possible sample selection bias. The results suggest that the significant effects of household bargaining indicators on child stunting in Tanzania are mainly from the rural and not the urban population. It provides evidence that weak bargaining power within couples in rural areas account for 5 percent of the rural-urban gap in child nutrition. The contribution reduces to 4 percent after correcting for sample selection bias. The results also suggest that failure to adequately correct for selection bias leads to a substantial underestimation of the overall rural-urban gap in child nutrition by 11 percent.
33
Wood, David L. "Health Care Transition for Youth with Epilepsy." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/5158.
Full text
34
Wood, David L. "Health Care Transition for Youth with Epilepsy." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5162.
Full text
35
Wood, David L. "Health Care Transition for Youth with Hydrocephalus." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5163.
Full text
36
Wood, David L. "Health Care Transition for Youth with Hydrocephalus." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/5157.
Full text
37
Duhn, Lenora Jane. "The impact of a maternity cooperative care program on maternal and infant complications, maternal competence, social support, and stress." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23999.
Full textAbstract:
The purpose of this study was to assess the impact of a Maternity Cooperative Care Program (MCCP) on the prevalence of maternal and infant complications, maternal competence, social support, stress, and first-time-mothers' descriptions of their postpartum experience. Forty-one healthy, primiparous mothers who participated in a MCCP and forty-three healthy, primiparous mothers who received traditional maternity care were asked to complete the Perceived Competence Questionnaire, the Personal Resource Questionnaire, "The Help I Get" Questionnaire (spousal support), and three numerical rating scales relating to stress in general, as well as self- and infant-care stress 24-48 hours postpartum while in hospital and over the telephone at two weeks postpartum. Ten randomly selected mothers from each group also answered twelve open-ended questions during a home visit at 2-3 weeks postpartum. There were no statistically significant differences between the two groups for any of the outcome variables assessed. For both groups, competence with self- and infant-care increased over the two weeks postpartum, while support and stress remained stable. Interviews with the mothers revealed that the number of stressors increased once at home, while support continued to be of value in relieving stress and helping maternal adjustment and confidence. Results of a qualitative comparison between the groups suggests that the MCCP mothers felt more prepared to be discharged home, and identified their partner more often as an active participant during hospitalization.
38
Wibbelink, Margreet. "Perceptions of private sector midwives and obstetricians regarding collaborative maternity." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1020979.
Full textAbstract:
The World Health Organization (WHO) states that no region in the world is justified in having a caesarean section rate greater than 10-15 percent, calculated as the number of caesarean deliveries over the total number of live births. There is however, an international increase in the rate of caesarean section deliveries and this is a concern to midwives. The increase is evident in South Africa as well. Currently the rate of caesarean section deliveries in the private sector can be as high as 70 percent per total number of live births per year. As a result, the public often perceives giving birth surgically in South Africa as ‘normal’ and ‘safer’ than vaginal delivery, even for low-risk pregnancies. The lack of involvement of midwives in the care of pregnant women in the private sector is indicated as one of the reasons related to the high caesarean section delivery rates. This motivated the researcher to undertake a study to explore and describe the perceptions of private sector midwives and obstetricians regarding the feasibility of collaboration in maternity care. A literature review to support the study identified research done previously regarding collaborative maternity care. The study followed a qualitative, exploratory, descriptive, contextual design. The research population included midwives and obstetricians in the private sector in the Eastern Cape. Non-probability, purposive sampling was used. The researcher conducted semi-structured one-to-one interviews to collect information rich data. The researcher ensured that the study was conducted in an ethical manner by adhering to ethical principles such as autonomy, non-maleficence, beneficence and justice. The interviews were transcribed and Creswell’s’ data analysis spiral was used as a guide for the data analysis. Themes and sub-themes were identified and grouped together to form new categories. An independent coder assisted with the coding process. Data analysis results revealed the following results Participants perceived a collaborative working relationship as being beneficial to maternity care. Participants identified that there might be critical impediments that need to be faced in order to realize collaborative maternity care. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four criteria namely credibility, transferability, dependability and conformability. The information obtained from this study assisted in developing guidelines to facilitate the implementation of collaborative maternity care between midwives and obstetricians in private practice in South Africa. The objective of the study was thus met.
39
Wood, David L. "Promoting Health Care Transition Readiness Among Youth with Hydrocephalus." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5170.
Full text
40
Kazaure, Nura Ibrahim. "Impact of Free Maternal and Child Health Services on Health Care Utilization in Jigawa State, Nigeria." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10831383.
Full textAbstract:
In spite of a decrease globally, the maternal mortality rate (MMR) in Nigeria and its Jigawa State has remained persistently high. Few efforts to address the MMR in Nigeria have been undertaken. The purpose of this study was to investigate the impact of Jigawa State’s Free Maternal and Child Health Program (JSFMCHP), education, employment, and parity of pregnant women on health care utilization (the outcome variable), as measured by antenatal care (ANC) visits. Anderson’s behavioral model served as the study’s theoretical framework. The sample size included 400 antenatal records of pregnant women who were randomly selected from the state’s Health Management and Information data collected between 2011 and 2015. Chi-square tests showed a significant association between those who did not participate in the JSFMCHP, education, employment, with ANC. There was no association between parity and the number of ANC visits. The odds ratio suggested that pregnant women who did not participate in the program were 5.53 times as likely to have 4 or more visits compared to those who participated. Furthermore, the recommended number (4 or more) of ANC visits was predicted by tertiary education and employment. This study’s findings indicate the need for a reevaluation of JSFMCHP policy, with a focus on ensuring a minimum recommended number of ANC visits for all program participants. These results can influence positive social change if used by policy makers to strengthen policies that have a beneficial impact on maternal morbidity and mortality in Jigawa State, in particular, and Nigeria, in general.
41
Johnson, Kiana R., David L. Wood, and A. L. McBee. "Ready or Not? Health Care Transition Readiness Among Rural Appalachian Youth with and Without Special Health Care Needs." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5192.
Full textAbstract:
Background:
Transition readiness is a critical set of skills that youth must acquire as they prepare for managing their healthcare in adulthood, for both youth with and without special health care needs (SHCN). Currently much of the literature pertaining to transition readiness focuses youth with special health care needs (YSHCN). However, all youth, including those without special healthcare needs, should develop skills for managing their health as they transition into adult healthcare. Additionally, youth from rural areas may face additional barriers to acquiring the skills for transition, yet a paucity of information on transition readiness among this population.
Objective:
We examined transition readiness among youth in two rural high schools in South Central Appalachia. Specifically, we examined differences in readiness among youth with and without SHCN.
Design/Methods:
We used data from a 2016 school-based survey of adolescents ages 16-18 at two high schools in rural South Central Appalachia Tennessee (n = 437). Using a validated screener, we identified 23% of youth as YSHCN. Compared to healthy youth, a greater proportion of YSHCN were female (68% vs. 49%) or non-Hispanic white (96% vs. 83%). We assessed differences in transition readiness as measured by four subscales (managing medications, appointment keeping, tracking health, and talking with providers) of the the Transition Readiness Assessment Questionnaire (TRAQ). Responses were collasped into two categories, yes/no, for each item and summed to create scale scores. We conducted MANOVA models predicting transition readiness by YSHCN status and demographics as potential covariates.
Results:
YSHCN scored significantly higher than youth without SHCN on all four measures of transition readiness (p<.01). In multivariate analyses YSHCN (versus other youth) had significantly greater transition readiness for the four subscales: F(4, 401= 5.36, p<.001), controlling for age. Table 1 displays overall and group means, and p-value for the TRAQ subscales.
Conclusion(s):
Rural YSHCN scored higher on the scale, perhaps due to their increased exposure to the health care system. Readiness skills for the transition to adult health are necessary for all youth however, findings from this study suggest that many rural youth—particularly those often thought of as “healthy”—may not be fully prepared for this transition. Findings point to the need for the development of interventions to help all youth effectively make transition to adult healthcare
42
Wood, David L., L. Edwards, and B. Hennen. "Health Care Transition for Youth and Adults with IDD." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/5143.
Full textAbstract:
Book Summary: This book provides a broad overview of quality health care for people with intellectual and developmental disabilities (IDD). It focuses on providing the reader a practical approach to dealing with the health and well-being of people with IDD in general terms as well as in dealing with specific conditions. In addition, it offers the reader a perspective from many different points of view in the health care delivery system as well as in different parts of the world. This is the 3rd , and much expanded edition, of a text that was first published in 1989 (Lea and Fibiger). The second edition was published in 2006 (Paul Brookes) and has been used as a formal required text in training programs for physicians, nurses and nurse practitioners as well as by administrators who are responsible for programs serving people with IDD. This book is considered the “Bible” in the field of health care for people with IDD since 1989 when the first edition came out.
43
Snyman, J. S. "Effectiveness of the basic antenatal care package in primary health care clinics." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/728.
Full textAbstract:
Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.
44
Wood, David L. "Health Care Transition for Youth with Neurosurgical Conditions." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5156.
Full text
45
Graner, Sophie. "Reproductive outcomes in rural Vietnam. Perspectives and experiences by pregnant women and health care professionals on pregnancy promotion and maternal health care." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-37266.
Full textAbstract:
Background Reproductive health and health events associated with pregnancy including induced abortions are among the most important factors for the health of fertile women. Adverse outcomes have an impact on women’s reproductive health and their overall health as well as the health of their offspring. Pregnancy and child bearing take place within a cultural context. Risk factors for adverse pregnancy outcomes depend on factors both associated with the individual woman as well as contextual factors. Aims This thesis investigates reproductive health indicators and their determinants for women in a rural district in Vietnam with special focus on adverse pregnancy outcomes and their determinants. In addition, this thesis explores the perspectives and experiences among pregnant women and health care professionals on maternal health care in Vietnam and risks during pregnancy and delivery. Methods The studies used quantitative and qualitative methods. In the quantitative studies a total of 4,396 women reporting 5,838 pregnancies, and 5,521 infants were included. Parametric and non parametric tests and univariate and multivariate logistic regression analysis was performed. For the estimation of small for gestational age a population-specific reference curve was constructed based on the mean birth weight at term in the study population. In the qualitative studies data were collected from eight focus group discussions, four with pregnant women and four with health care professionals. Manifest and latent content analysis was applied. Main findings Women belonging to an ethnic minority or women giving birth at home were at increased risk of stillbirth. The risk of induced abortion increased with maternal age. Neonatal mortality was estimated to 11.6 per 1000 live births and perinatal mortality to 25.0 per 1000 births. The prevalence of small for gestational age was estimated to 6.4%. Risk factors for small for gestational age included women in farming occupations and post-term birth. There was a marked decrease in perinatal mortality after 33 weeks of gestation. Contextual conditions influenced both pregnant women’s use of maternal health care and the performance of the health care professionals. The use of maternal health care was influenced by economical conditions as well as cultural norms that impeded women’s autonomy. Structural constraints included inadequate financing of the health system, including lack of staff, insufficient professional re-training, and inadequate equipment. Pregnant women in rural Vietnam created a strategy to promote a healthy pregnancy through lifestyle adjustments, gathering of information, and seeking timely medical care. Insights in pregnancy-related conditions were sought from various sources and were influenced both by Vietnamese traditions and modern medical knowledge. Conclusions Knowledge about pregnancy complications and their related signs and symptoms, and a high confidence in the maternal health care probably contribute to the relatively good maternal health status and pregnancy outcomes in Vietnam. To improve perinatal and neonatal outcomes there is a need to ensure access for all pregnant women to delivery units with surgical capacity in case of an obstetrical emergency. Also, a higher proportion of premature infants need to be born at units with access to neonatal care. This may be achieved by an improved system for referral including capacity of medical care during transportation. Other desirable improvements include antenatal identification of small for gestational age foetuses. In our study the induced abortion rate increased with maternal age and was highest among married women, indicating that induced abortions may be used as a method for family planning. The cultural norms in Vietnam limit women’s autonomy and reduce their possibility to make independent decisions about their reproductive health. Our studies emphasize the importance of adequate access for all women to maternal health care adjusted for their individual needs. A better understanding is needed of context-specific factors that influence couples’ choice of family planning methods, place of birth, and maternal health care. The communication between pregnant women and health care professionals needs further investigation. This knowledge is essential in order to develop reproductive health services that are accessible, acceptable and affordable to all.
46
Whelan, Amanda Rebecca. "Measuring quality of health care delivery : maternal satisfaction in the South Wales valleys." Thesis, Cardiff University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337715.
Full text
47
Hubbard, Mai Noguchi Gilleskie Donna B. "Effects of maternal employment and child care on the health of young children." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2737.
Full textAbstract:
Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.Title from electronic title page (viewed Mar. 10, 2010). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Economics." Discipline: Economics; Department/School: Economics.
48
Wood, David L. "White Paper on Health Care Transition for Youth with Hydrocephalus." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5184.
Full text
49
Kuang, Xiaoxin, Kiana R. Johnson, Karen Schetzina, Claudia Kozinetz, and David L. Wood. "An Ecological Model of Health Care Access Disparities for Children." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5139.
Full text
50
Samusodza, Chengetai Rosemary. "The potential of mHealth technologies for maternal health-care services : a case of selected public hospitals' maternal units in Zimbabwe." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2425.
Full textAbstract:
Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.Zimbabwe has a fairly developed health-care delivery system that is served by public and private hospitals at district, provincial and national level. The public health-care system is the largest provider of health-care services and caters for the majority of the population but this is done in a resource-restricted context, typical of a developing context. In this context, this research sought to establish the potential of mHealth Technologies in Zimbabwe’s maternal health sector using Parirenyatwa and Harare hospitals as case studies. The reviewed body of knowledge, which was largely a comparative assessment of mHealth technology adoption in developing countries, indicated that the full adoption of the prevailing eHealth strategy in Zimbabwe remains hamstrung by the slow pace of policy implementation. This is a qualitative study and data was collected with unstructured interviews. Purposive and snowball sampling were used to recruit the participants. The gathered data was analyzed through content and thematic analysis. Four broad themes emerged from the primary data collected during the interviews and these include: trends in information dissemination in Zimbabwe’s Public Health System; information needs for expectant women and midwives; the prevalence of ICT use in Zimbabwe’s Public Health System, and mobile technology use in the maternal health sector in Zimbabwe. The research was able to establish that while there is a high proliferation of smartphone use among most expectant women, this has not translated into their use for health information-related purposes.