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Kyomuhendo, Grace Bantebya. "Treatment seeking behaviour among poor urban women in Kampala Uganda." Thesis, University of Hull, 1997. http://hydra.hull.ac.uk/resources/hull:4928.
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This thesis examines women's treatment seeking behaviour for their own illnesses and that of children underfive in Kamwokya . The focus is on the extent to which women's access to money and time use patterns affect treatment seeking. It has been argued that women's treatment seeking behaviour is influenced more by their time use than their access to and availability of money.The findings obtained through the use of case histories and in-depth interviews indicate that though women in Kamwokya have access to their own money, mainly through participation in income generating activities (business), illness management for children under-five and even more for the women themselves, remains problematic. Women are overworked and manage fragile businesses that require their personal attention and presence. Hence, treatment seeking is done in a manner that will ensure minimal disruption of businesses. Consequently children's health, and even more so, that of women , is compromised for the sake of other family needs.This thesis demonstrates that illness management is not context free, and that no one factor can explain the whole process ; it both affects and is affected by other things happening in the family. Due to the multiple roles women have to fulfil, "time use "is found to be the organising and central factor in illness management for both women and children in Kamwokya, whether from rich or poor households.The thesis concludes by suggesting that policy makers, health care providers and professionals ought to take into account the daily routines of family life in their plans and programmes. Strengthening of private sector health providers, health education programmes and increased awareness raising of male responsibilities towards their families are recommended as a way of improving the health of women and children in Uganda.
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Pang, Po-yu, and 彭寶如. "An analytical paper: the impact of non-entitled pregnant women on Hong Kong healthcare system and the wayforward." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48425199.
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Background: Medical tourism is arising in Asian countries and in Hong Kong, the maternal tourism is evolving due to the influx of non-entitled pregnant women from mainland China for deliveries. The visitors were attracted not only by the technical advancement of Hong Kong healthcare system, but its special administrative background which grants the babies with a permanent resident identity as well as the citizenship benefits regardless to their parental status. Besides, the parents could avoid penalties from the "One Child Policy" in China.
With the limited healthcare resources, non-local mothers started to compete with the local mothers for obstetric services. The community raised their concerns in developing of maternity tourism and verbalised their demands in protecting local rights and equity to resources.
Aims and Objectives: There are limited published researches available on maternal tourism or the specific situation faced by Hong Kong. By analysing grey literature, this paper would like to suggest the impact exerted on the healthcare system by the influx of non-eligible mothers with a medical tourism framework.
Results: The impact of non-local-mother deliveries on healthcare system were discussed in the areas of governance, delivery, financing, human resources and regulation. Future research could be done on assessing the priorities in the framework components and the direction, effectiveness of the management strategies for non-entitled deliveries.published_or_final_version
Public Health
Master
Master of Public Health
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Shiu, Wan-yee Ruby. "An evaluation on 2007 obstetric service policy in Hong Kong a solution to the service-seeking behaviour of Mainland pregnant women? /." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38598358.
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Fordyce, Meredith Ann. "An evaluation of the consistency of selected county-level rural typologies in determining rate and risk : the case of inadequate prenatal care /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/5647.
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Persson, Margareta. "Gestational diabetes mellitus experiences of pregnant women, midwives, and obstetricians and the performance of screening /." Doctoral thesis, Umeå : Umeå university, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-27761.
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Helsper, Linda Pearl. "Identifying community specific barriers to prenatal care services." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1451.
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The intent of this research project was to discover the barriers that exist in this community when a woman attempts to access prenatal care. A concern for the well being of the children in the community and a belief in the importance of early intervention to enhance outcomes inspired the idea for this project.
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Shiu, Wan-yee Ruby, and 邵韻儀. "An evaluation on 2007 obstetric service policy in Hong Kong: a solution to the service-seeking behaviourof Mainland pregnant women?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38598358.
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Jama, Nontembiso Mary. "Strategies used by professional nurses to manage newly diagnosed HIV positive pregnant women who fail to return within a month for further management and care." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/444.
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This study explored and described the strategies used by nurses to manage newly diagnosed HIV positive pregnant women who do not return to the clinic within a month following diagnosis, for continuity of care. The main aim was to prevent mother-to-child transmission of HIV (PMTCT). Method: The study sites were two accredited antiretroviral- ante-natal care (ARV-ANC) clinics at the Dimbaza community health centre (CHC) and the East London Hospital Complex (ELHC) which comprises of Cecilia Makiwane and Frere hospitals, in the Buffalo City Metropolitan Municipality (BCM). The majority of health personnel at these clinics are professional nurses. An in-depth semi structured interview guide was used to collect data through focus group interviews from professional nurses who work in these units. They were required to share their experiences about intervention strategies used for newly diagnosed HIV- positive, pregnant women who fail to return for continuity of care within a month after diagnosis. Results: Follow up of these women is done by tracking them (by calling them; calling the clinic nearest to their homes and doing home visits). Decentralisation of further management and care to the nearest clinic was also cited, especially for the patients who stay far from these accredited sites. Family support was also mentioned as a strategy to intervene for the non-compliant patients. Challenges: The challenges that were encountered with these interventions include wrong contact details, wrong addresses and being evasive when visited at home. Another challenge cited was related to the stigma attached to the diagnosis and the tracking devices used, for example, the car as it is familiar to the community it serves. Despite known benefits for early initiation of HIV treatment newly diagnosed HIV- positive, pregnant women continue to refrain from accessing care after diagnosis, thus posing a risk to the transmission of HIV to the baby and further comprising their own health. They miss out on general HIV management and ante-natal care. Conclusion: The identified intervention strategies used by nurses to follow up newly diagnosed HIV- positive, pregnant women need to be reinforced and strategies put in place to control the related challenges for a better response by the patients.
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Claas, Bianca Muriel. "Self-reported oral health and access to dental care among pregnant women in Wellington : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1205.
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Pregnancy can have important effects on oral health and pregnant women are a population group requiring special attention with regard to their oral health and their babies? health. International research shows that oral health care for pregnant women has been inadequate, especially in relation to education and health promotion and there is some evidence of disparities by SES and ethnicity. Improving oral health is one of the health priorities in the New Zealand Health Strategy (Ministry of Health, 2000) and the Ministry of Health (Ministry of Health, 2006a) has recently identified a need for more information on the oral health and behaviour of pre-natal women. The aims of this study were to gain an understanding of pregnant women?s oral health care practices, access to oral health care information and use of dental care services and to identify any difference by ethnicity and socio-economic position. A self-reported questionnaire was completed by 405 pregnant women (55% response rate) who attended antenatal classes in the Wellington region. The questionnaire was broadly divided into four parts: (1) care of the teeth when the woman was not pregnant; (2) care of the teeth and diet during the pregnancy; (3) sources of oral health information during pregnancy and; (4) demographic information . Data were analysed by age, ethnicity, education and income and odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression. The majority of women in this survey were pakeha (80.2%), compared to 19.7% „Others? (8.8% Maori, 1.9% Pacific, 8.6% other). Most of the subjects were aged 31-35 years (34.5%), of high SES (household income and education level). Half of the women reported having regular visits to the dentist previous pregnancy while a significant percentage of women saw a dentist basically when they had problems. The usual dental hygiene habits were maintained during pregnancy. However, during pregnancy more than 60% of women reported bleeding gums. Just 32% of women went to see the dentist during pregnancy and less than half had access to oral health information related to pregnancy. „Others? (OR 0.38, 95% CI 0.15-0.91) and low income (OR 0.27, 95% CI 0.10-0.76) groups were significantly less likely to report access to oral health information compared to pakeha and high income groups (respectively). Women who went to see the dentist during pregnancy were more likely to receive information on dental health. However, low income women were more likely to report the need to see a dentist (OR 2.55, CI 1.08-5.99). Information on dental health and access to oral care should be prioritised to low income women, Maori, Pacific and other ethnic groups. Little attention has previously been given to oral health for pregnant women in New Zealand and there is a need to increase awareness of the importance of this area amongst health practitioners particularly Lead Maternity Carers and Plunket and tamariki ora nurses.
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Fredriksson, Sara, and Ida Jonsson. "Gravida kvinnors förväntningar på förlossningsvården." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-79943.
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Background:Today 99% of Sweden's pregnant women give birth at labour wards assisted by a midwife, only 0.1 % give birth at home. In Sweden, delivery care is currently burdened due to lack of delivery rooms and shortage of staff. If pregnant women do not receive the right support and care of a present midwife the risk of a more negative childbirth experience increases.Aim: The aim of this study was to describe pregnant women's expectations of delivery care.Method:A qualitative interview study was conducted with seven informants. A qualitative content analysis was used with an inductive approach. The analyze resulted in sixteen subcategories and four categories. Result:The results of the study showed that the informants expected that there was a lack of delivery rooms and that reffering in delivery care occurs. However, it appeared that they did not expect it to happen to themselves. The informants expected the staff to be competent, be able to guide the woman and provide security during childbirth. The informants' expectations were mostly based on experiences which could be both positive and negative. They had also received expectations about delivery care from media, local newspapers, Facebook and blogs. There was also an expectation that the organization is under pressure. The effect of this is staff shortages and stressful working conditions for the midwives. Despite this, the informants expected that they would receive good delivery care. Conclusion:Stressful and unexpected events can be experienced more manageable if pregnant women feel secure. It is therefore of value that midwives in maternity care and in maternity wards create realistic expectations of delivery care to minimize concerns.Bakgrund: Av Sveriges gravida kvinnor föder 99 % idag barn på förlossningsavdelningar assisterade av en barnmorska, endast 0.1% föder i hemmet. Förlossningsvården i Sverige idag är belastad på grund av plats- och personalbrist. Om gravida kvinnor inte får rätt stöd och vård av en närvarande barnmorska ökar riskerna för dåliga förlossningsupplevelser.Syfte: Syftet var att beskriva gravida kvinnors förväntningar på förlossningsvården.Metod: En kvalitativ intervjustudie genomfördes med sju informanter. Den dataanalys som användes var en kvalitativ innehållsanalys med induktiv ansats. Sexton subkategorier och fyra kategorier analyserades fram.Resultat: Studiens resultat visade att informanterna förväntade sig att det förekommer platsbrist och hänvisningar inom förlossningsvården. Det framkom dock att de inte förväntade sig att det skulle hända dem själva. Informanterna förväntade sig av personalen att de skulle vara kompetenta, kunna guida kvinnan samt inge trygghet under förlossningen. Informanternas förväntningar grundades mestadels på tidigare erfarenheter vilka kunde både vara positiva och negativa. De hade också fått förväntningar kring förlossningsvården av media, lokaltidningar, Facebook och bloggar. Det framkom även en förväntan att organisationen brister inom förlossningsvården, vilket gjort att personalbrist och stressiga arbetsförhållanden föreligger för barnmorskorna. Trots detta var förväntningarna att de skulle få en bra förlossningsvård.Slutsats:Stressfulla och oväntade händelser kan upplevas mer hanterbara om gravida kvinnor känner trygghet. Det vore därför av värde om barnmorskor i mödrahälsovården och på förlossningkliniker skapar realistiska förväntningar på förlossningsvården hos gravida kvinnor för att minimera oro.
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Viganô, Sabrina Momesso 1979. "Avaliação da vacina antitetânica na gravidez em Campinas, SP : o informado e o registrado." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308262.
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Orientador: Antonieta Keiko Kakuda ShimoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-23T03:53:00Z (GMT). No. of bitstreams: 1 Vigano_SabrinaMomesso_M.pdf: 5635836 bytes, checksum: 99824b10e6b0d821fbed6859a3516a9f (MD5) Previous issue date: 2013
Resumo: Objetivo: Avaliar os registros acerca da vacinação antitetânica na gestação e verificar a conformidade deles com o relato das pacientes. Metodologia: Trata-se de um estudo transversal com abordagem quantitativa e caráter avaliativo. Foi realizado estudo piloto e Validação de Conteúdo do Instrumento de Coleta de Dados. Os dados foram coletados por entrevista semi-estruturada com puérperas, fotografia de Cartões de Gestante e de Fichas Obstétricas. Para análise dos dados foi utilizado o programa estatístico SAS 9.2 e calculado o coeficiente Kappa. O estudo está em conformidade com a Resolução 196/96. Resultados: 38 (12,30%) puérperas relataram não ter recebido vacina na gestação. 39,11% (106 de 309) das mulheres referiram ter recebido a vacina antitetânica na gestação, 50,16% (155) dos Cartões de Gestante e 20,06% (62) de Fichas Obstétricas continham registro desta vacina. Quanto a vacina antitetânica na gestação, o relato da mulher comparado ao registro do Cartão de Gestante é pouco coincidente (Kappa 0,55, moderado), o registro do Cartão de Gestante com o registro da Ficha Obstétrica é menos coincidente (Kappa 0,27, suave) e o relato com o registro da Ficha Obstétrica é menos coincidente ainda (0,11, desprezível). Status vacinal adequado foi identificado em 62,14% (192). Conclusão: O relato da mulher e o registro do Cartão de Gestante são mais coincidentes do que os registros entre si. Os profissionais registram vacinas mais no Cartão de Gestante do que na Ficha Obstétrica. A média de 8,91 consultas por mulher e a idade gestacional de início do pré-natal com 12 semanas ou menos de 72,49% (224) evidenciam vínculo satisfatório da paciente com os serviços. As consultas à gestante de baixo risco podem ser intercaladas entre os profissionais médicos e enfermeiros
Abstract: Objective: Evaluate records about tetanus vaccination in pregnancy and to check their compliance with the reporting of patients. Methodology: This is a cross-sectional study with a quantitative approach and evaluate character. Pilot study was performed and Content Validation Instrument for Data Collection. Data were collected through semi structured interview with puerperal, photography maternity card and obstetric records. For data analysis we used the statistical program SAS 9.2 and calculated the Kappa coefficient. For data analysis we used the statistical program SAS 9.2, calculated the degree of agreement between the data sources and calculated the Kappa coefficient. The research is in accordance with Resolution 196/96. Results: 38 (12,30%) reported not having received vaccine during pregnancy. 39,11% (106) of women reported having received tetanus toxic vaccination during pregnancy, 50,16% (155) of maternity card and 20,06% (62) document obstetrical record contained this vaccine. About tetanus vaccination during pregnancy, the reported of the woman compared to the record of maternity card is almost coincidental (Kappa 0,55, moderate), the record of maternity card with the record of the obstetric records is less coincident (Kappa 0,27, suave) and the reported with the record of the obstetric records is still less coincident (0,11, insignificant). Status suitable vaccine was identified in 62,14% (192). Adequate vaccination status are 62,14% (192). Conclusion: The reported of the woman and record of the maternity card are more coincident than the records together. Professionals register about vaccine more in maternity card than the obstetric records. The average of 8,91 consultations per woman and gestational age at first prenatal care at 12 weeks or less (72,49% = 224) show satisfactory bond of women with the services. The antenatal care at low risk women can be interspersed among medical and nurses professionals
Mestrado
Enfermagem e Trabalho
Mestra em Enfermagem
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Kkonde, Anthony. "Factors that influence pregnant women's choice of delivery site in Mukono district, Uganda." Diss., 2010. http://hdl.handle.net/10500/3601.
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The purpose of this study was to analyse and describe the factors that influence the choice of site of delivery by pregnant women in Mukono district. By employing quantitative, non experimental research methods, 431 women were interviewed by using structured questionnaires. These women had either delivered at; home, TBA, private or public clinic and 72% had been delivered by skilled attendants. Choice of delivery site was influenced by the attitudes of health workers which were rather poor in public sites, proximity of site, attendance of antenatal clinic at a site, availability of supplies and drugs, plus level of care including emergency obstetric care.Health Studies
M. A. (Public Health)
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Ruder, Bonnie J. "Shattered lives : understanding obstetric fistula in Uganda." Thesis, 2012. http://hdl.handle.net/1957/36140.
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In Uganda, there are an estimated 200,000 women suffering from obstetric fistula, with
1,900 new cases expected annually. These figures, combined with a persistently high
maternal mortality rate, have led to an international discourse that claims the solution to
improving maternal health outcomes is facility-based delivery with a skilled birth
attendant. In accord with this discourse, the Ugandan government criminalized traditional
birth attendants in 2010. In this study, I examine the lived experience of traditional birth
attendants and women who have suffered from an obstetric fistula in eastern Uganda.
Using data collected from open-ended, semi-structured interviews, focus groups, and
participant-observation, I describe the biocultural determinants of obstetric fistula. Based
on findings, I argue that although emergency obstetric care is critical to prevent obstetric
fistula in cases of obstructed labor, the criminalization of the locally constructed system
of care, TBAs, serves as yet another layer of structural violence in the lives of rural, poor
women. Results demonstrate how political-economic and cultural determinants of
obstetric fistula are minimized in favor of a Western prescribed, bio-medical solution,
which is heavily resource dependent. This solution is promoted through a political
economy of hope fueled by the obstetric imaginary, or the enthusiastic belief in Western-style
biomedical obstetric care’s ability to deliver positive health outcomes for women
and infants regardless of local context and constraints. Recommendations include
increased obstetric fistula treatment facilities with improved communication from
medical staff, decriminalization of traditional birth attendants and renewed training
programs, and engaging local populations in maternal health discourse to ensure
culturally competent programs.Graduation date: 2013
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Selala, Dikeledi Beauty. "Factors contributing to late booking amongst pregnant women at Ekurhuleni health district." Diss., 2017. http://hdl.handle.net/10500/24575.
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The aim of the study was to determine factors contributing to late booking amongst pregnant women at Ekurhuleni health district in order to offer recommendations for enhancing early booking. Interpretative phenomenological analysis design was used. Data were collected using semi-structured individual face-to-face interviews from 20 purposively selected pregnant women. Each interview was audio recorded and lasted between 45-60 minutes. Fields notes were taken to triangulate data collection method. Audio recorded interviews were transcribed verbatim. Data were thematically analysed using Interpretative Phenomenological Analysis framework for data analysis. Results indicate that healthcare service related factors such as human resources, infrastructure and the type of service rendered at the clinic contribute to late bookings. Client related factors such as socioeconomic status, cultural beliefs and knowledge deficit also contribute to late bookings. Recommendations are made addressing both healthcare service and client related factors in order to enhance early booking among pregnant woman at Ekurhuleni district.Health Studies
M.A. (Nursing science)
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Bbosa, Richard Serunkuma. "Factors that influence pregnant women’s utilisation of anti-malaria services in the Buikwe district of Uganda." Thesis, 2015. http://hdl.handle.net/10500/20713.
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Text in EnglishMalaria is endemic throughout Uganda and the leading cause of morbidity and mortality. Malaria causes complications in 80.0% of all pregnancies in Uganda. This study attempted to identify factors that influence pregnant women’s utilisation of anti-malaria services in the Buikwe district of Uganda. These factors were contextualised within the Social Learning Theory’s major concepts. The target populations comprised pregnant women attending antenatal clinics (phase 1) and midwives providing antenatal services (phase 2) at 16 clinics in the Buikwe district of Uganda during the data collection phase of the study. Structured interviews were conducted with a sample of 400 randomly selected pregnant women and with the accessible population of 40 midwives. Pregnant women, who had progressed beyond primary school level education, were more likely to take intermittent preventive treatment (IPT) drugs and to use long lasting insecticide treated nets (LLINs) to prevent malaria. Pregnant women were more likely to implement malaria-preventive actions if they lived within five kilometres of clinics, were satisfied with available health services, were knowledgeable about the malaria preventive measures and had used IPT during previous pregnancies. Pregnant women who implemented one malaria-preventive action were likely to implement other actions as well (Pearson’s correlation coefficient was 0.65; p<0.05). Midwives’ provision of malaria-preventive services to pregnant women were influenced by the availability of IPT drugs, accessibility of safe drinking water, frequency of giving health education to pregnant women, cooperation with village health teams, malaria-related in-service training, midwives’ education level and experience. Although 97.9% of the pregnant women had taken IPT and 84.2% of those who had received LLINs, utilised these nets, malaria prevention during pregnancy could be improved. All pregnant women should attend antenatal clinics at least four times during each pregnancy, commencing during the first trimester of pregnancy to receive adequate health education and prenatal services, including IPT and LLINs. All midwives should receive malaria-related in-service training. Regular audits of midwives’ records should identify and address strengths and weaknesses related to the prevention and management of malaria during pregnancy. Such actions could enhance the prevention and management of malaria, estimated to affect 80% of pregnant women in Uganda.
Health Studies
D. Litt. et Phil. (Health Studies)
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Matyukira, Sesedzai Peggie. "Knowledge and utilisation of antenatal care services by pregnant women at a clinic in Ekurhuleni." Diss., 2014. http://hdl.handle.net/10500/13617.
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The aim of the study was to investigate the knowledge and utilisation of antenatal care (ANC) services by pregnant women at a clinic in Ekurhuleni. A quantitative, descriptive correlational study was carried out on 90 eligible pregnant women. Data were collected with a self-administered questionnaire and analysed with the help of a statistician using the Epi Info version 7 computer program.
The results of the study indicate that most women initiated ANC later than the recommendations by the World Health Organization (WHO). Over half of the respondents had overall good knowledge of ANC, but lacked knowledge of medication and screening tests done during pregnancy, some danger signs during pregnancy and of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC were current employment status, number of children, transport costs to clinic and number of antenatal visits.Department of Health Studies
M.A. (Public Health)
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Haith-Cooper, Melanie, and Gwendolen Bradshaw. "Meeting the health and social needs of pregnant asylum seekers; midwifery students’ perspectives. Part 2; Dominant discourses and approaches to care." 2013. http://hdl.handle.net/10454/6687.
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yesPregnant women seeking asylum in the United Kingdom appear particularly vulnerable, having complex health and social care needs and could benefit from a woman centred approach to midwifery care. This article is the second of three parts and reports on the findings from one objective of a wider doctorate study. It focuses on exploring midwifery students' perceptions of how to approach the care of pregnant women seeking asylum. Although the design of the study is explored in article one, in this context, the data was subject to critical discourse analysis to meet this objective. Key words and phrases were highlighted which appeared to reveal power and ideology implicit in the language used when discussing midwifery care of the pregnant woman seeking asylum. Dominant discourses were identified which appeared to influence the way in which care was approached and the possible sources of these discourses critically analysed. The findings suggest an underpinning ideology around following policies and guidelines to meet the physical needs of the woman at the expense of her other holistic needs. Despite learning to adopt a woman centred approach in theory, once in practice some students appear to be socialised into (re)producing these dominant medical and managerial discourses with “midwifery discourse” being marginalised. In addition, some students appeared to have difficulty understanding how to adopt a woman centred approach and the importance of considering the woman's context and its impact on care. These findings have implications for midwifery educators and this article identifies that the recent Nursing and Midwifery Council requirement for students to undertake a caseloading activity could provide the opportunity for them to adopt a consistent woman centred approach in practice, rejecting dominant medical and managerial discourses. However, these discourses appear to influence midwives caring for women more widely and will be difficult to challenge.
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Mukhalela, Tatenda. "Utilisation of antenatal care services in rural primary health care facilities in Mutasa District, Zimbabwe." Diss., 2019. http://hdl.handle.net/11602/1446.
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MPHDepartment of Public Health
The high maternal mortality ratio is caused by various factors, including avoidable complications which can be reduced by attendance to antenatal care visits. The utilisation of antenatal care has been low in rural areas, especially in Africa. The purpose of this study was to explore the utilisation of antenatal care in Mutasa District of Zimbabwe. This study used a qualitative study approach, adopting the descriptive, explorative design that presented an active image of the research participants’ reality and capture live experiences. Participants of the study were pregnant women and women with children under the age of one. The participant were sampled using purposive and snow-ball sampling techniques. In-depth interviews were conducted. The participants were interviewed in their native language, Shona. The main question was: Can you explain in your own words how you use antenatal care services from the primary health care facility? The researcher clarified questions which the participant failed to understand. The researcher wrote down all responses and used a tape recorder to capture the responses. The researcher analysed data using thematic content analysis where themes and sub-themes were discussed. The main theme was low uptake of antenatal care in rural primary health care facilities. From the main theme there were factors influencing and perceptions of women on uptake of antenatal care services in primary health care facilities. Trustworthiness was ensured through credibility, dependability, transferability and conformability. Permission from the relevant authorities, such as the University of Venda Higher Degrees Committee, the Provincial Medical Director and the District Administrator was sought before conducting this study. Informed consent was also sought before interviewing the participants. The study concluded that socio-demography of participants affected antenatal care attendance. These are age, level of education, low income, high parity and distance to facility. Other hindering factors to utilization of antenatal care were lack of knowledge, religion and acceptability of antenatal care by the women in rural primary health care facilities. Findings will be disseminated through a research report and published in relevant accredited journals with the help of the supervisors. The study recommended that the Ministry of Health and Child Care of Zimbabwe review Antenatal Care policies to ensure friendliness and to increase awareness through health education and continuous dissemination of antenatal care information.
NRF
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Magoro, Salphy Mamoropo. "Factors contributing to self-referrals of antenatal women for delivery at Dilokong Hospital, Grater Tubatse Local Municipality." Thesis, 2015. http://hdl.handle.net/10386/1368.
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Thesis (M. Cur.) --University of Limpopo, 2015The purpose of this study was to determine the factors that were contributing to selfreferrals of antenatal women at the Dilokong Hospital in the Tubatse Local Municipality. By employing a quantitative, non-experimental research method, 360 women completed and submitted a structured questionnaire. Validity and reliability were insured by pre-testing the data collection instrument on respondents who were not part of the main study. Data was analysed by using the SPSS and Excel computer programs with the assistance of a statistician. The age group between 21 and 30 years 197 (54.7%) was larger than the other age groups. Primigravida women represented less than half 147 (40.3%) of the respondents. These women were also supposed to be referred to the hospital for delivery; however, only 23.3% of the women were referred to the hospital for delivery. The choice of the delivery site was influenced by a lack of women’s knowledge about the referral system and of services offered at the clinics, as well as the unavailability of doctors, midwives, food, equipment, enough space for delivery at the clinics, and the perceptions that nurses and midwives were rude. The government should ensure that the clinics are provided with adequate human resources and other resources that are needed for providing these health services. Pregnant women should be given referral letters and information with regard to where they are supposed to deliver. Key concepts: Antenatal women, self-referral, referral system, and Primary Health Care (PHC).
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Watson, Annaliese. ""A fragile job" : Haitian traditional midwives (matwons) and the navigation of clinical, spiritual and social risk." Thesis, 2013. http://hdl.handle.net/1957/36502.
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Haiti's political and economy history has led to a maternity care system that lies out of reach, geographically and financially, of most Haitians, resulting in excessively high maternal and infant mortality. The most common birth practitioners are homebirth midwives (matwòns), who attend roughly three-fourths of all births in Haiti (UNICEF), often without the benefit of emergency obstetric services. In this ethnographic study, I examine how matwòns experience caring for mothers and babies in extraordinarily low-resource and high-risk settings. This qualitative research employed a critical approach and feminist research methodologies. In in-depth interviews I asked participants to describe the challenges they find in their work. Then, in an innovative style of group meeting called Open Space, matwòns reflected on those challenges collectively, with an aim to ameliorate their current situations. Data analysis utilized a modified grounded theory approach, which allowed the matwòns' own narratives to determine the categories of analysis. Emergent themes resulting from this analysis revealed four main challenges in the work of matwòns, as well as matwòns' own strategies to mitigate those challenges. The four broad challenges, which include physical risks, social/spiritual threats, a lack of livelihood, and an obligation to practice, are experienced either as episodic hazards or chronic stressors. Matwòns' personal mitigation strategies centered on two broad approaches, providing protection, and offering service. However, the Open Space meeting created an opportunity for matwòns to strategize collective mitigation efforts through professional organization. Based on these findings, I argue that a more nuanced understanding of matwòns' experiences reveals their adaptive skills, which, in part, resemble Davis Floyd's (2007) notion of a postmodern midwife, and offers opportunities for mutual accommodation (Jordan 1997[1978]). Recommendations include support and advocacy for the self-organization of Haitian matwòns, as well as their greater inclusion in efforts to improve maternal and infant health outcomes in post-earthquake Haiti.Graduation date: 2013
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Dememew, Zewdu Gashu. "Human immunodeficiency virus and diabetes mellitus : a missed link to improve pregnancy outcome in Ethiopia." Thesis, 2018. http://hdl.handle.net/10500/25602.
Full textAbstract:
Introduction: Evidences indicate that human immuno-deficiency virus (HIV) and diabetes (DM) impact pregnancy outcomes but no experience on the integrated service delivery of HIV, DM and pregnancy care. This study explored the domains and levels of integration among DM, HIV and pregnancy care to prepare a service delivery model in Ethiopia.
Methods: A sequential exploratory mixed method and the integration theoretical framework guided the study. An exploratory qualitative phase used focused group discussion, in-depth interview and observation to explore the level of integration and to refine a questionnaire for the quantitative phase. The data were transcribed and coded for theme-based analysis. The descriptive quantitative phase described HIV, DM and pregnancy care services, and determined the burden of DM among HIV patients and the prevalence of pregnancy and pregnancy outcomes. Data was analysed using Epi-info. The findings were triangulated, discussed and interpreted.
Results: Seven themes were generated: joint plan, shared budget, monitoring system, structural location, the need of policy guide, the practice of integrated service delivery and suggested integration approaches. A coordinated HIV and pregnancy care services were noted. There was a linkage between diabetes and HIV, and diabetes and pregnancy care. The 1.5% of diabetes among HIV, the low number of pregnancies per a mother in diabetes (1.8) and HIV (1.3); the high adverse pregnancy outcomes among HIV (13.4% abortion, 12.4% low birth weight (LBW), 3.5% pre-term birth, 2.1% congenital malformation) and diabetes (3.2% big baby, 3.2% LBW, 3.1% Cesarean-section); the respective absent and low (16.2%) diabetes screening service at anti-natal and HIV clinics, the absent pregnancy care service for diabetic females justified the development of the tripartite integrated service delivery model of diabetes, HIV and pregnancy care.
Conclusions: The model suggests active diabetes screening, evaluation and treatment at HIV and antenatal clinics. It considers the coordination between non-communicable diseases (NCD), HIV and maternal health units. Pregnancy care could be coordinated at HIV and NCD units. Full integration can be practiced between HIV and pregnancy care units. Preparing policy guide, building the capacity of health providers, advocating and piloting the model may be prioritized before the implementation of the model.Health Studies
D. Litt. et Phil. (Health Studies)
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Bhengu, Thandeka Jacqueline. "Access and utilisation of antenatal care services in a rural community of eThekwini District in KwaZulu-Natal." Thesis, 2016. http://hdl.handle.net/10321/2300.
Full textAbstract:
Dissertation submitted in compliance with the requirements for the Masters Degree in Technology: Nursing, Durban University of Technology, 2016.Introduction Although the South African Government adopted a primary health care approach to health care service provision in order to ensure equitable access to and utilization of health care services to all communities, the country continues to face challenges regarding access and utilisation of health care services especially in the rural communities. Antenatal care which is mostly provided at primary health care level is regarded as the cornerstone for the success of the maternal and child health care programme. Therefore, poor access to and under-utilisation of health care services could potentially influence the success of this programme and pregnancy outcomes. Aim of the study The aim of the study was to determine whether pregnant women from KwaMkhizwana rural community had access to and were utilising antenatal care services. Methodology A qualitative, exploratory, descriptive and contextual study was conducted guided by Thaddeus and Maine’s three delays model. Purposive sampling of the pregnant women and all categories of nurses who were employed in the three health care facilities in the area was done. Data was collected in two phases through in-depth semi-structured interviews with both the pregnant women and the nurses respectively between February and March 2016. The sample size was guided by data saturation. All data were analysed using the Tesch’s method of data analysis. Study findings Six major themes and several sub-themes emerged from the interviews with both Phase 1 and Phase 2 participants. The major themes included: 1) access to health care and emergency services, 2) availability of human and material resources, 3) social and cultural beliefs, 4) past pregnancy experiences, 5) communication and transparency regarding health care service delivery and 6) quality of antenatal care services. Summary of the findings The pregnant women encountered several challenges which led to delays in seeking, reaching and receiving antenatal care. Most of the pregnant women participants related limited access to health care, with under-utilisation of antenatal services. They were unhappy about the antenatal care services they received in the three available health care facilities in the area, which made these facilities to be inaccessible and underutilised. The nurse participants recognised the challenges facing the pregnant women regarding the access and utilisation of antenatal care services, together with the challenges faced by the nurses while working in the three available health care facilities in the area. Recommendations The recommendations that were made included: to consider building a centrally located fixed primary health care clinic that would ensure equal access to health care services, strengthening the implementation of policies regarding the referral system and ambulance services, ensuring sustainable availability of human and material resources, developing strategies to ensure that the antenatal care services are delivered in line with the South African Department of Health policies and guidelines and strengthening community education. A further study on provision of antenatal care services in the area is also recommended.
M
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Emenike, Obiageli Ugwumsinachi. "Knowledge and use of intermittent prevention for malaria among pregnant women attending antenatal clinics in health centers in the Federal Capital Territory, Nigeria." Diss., 2016. http://hdl.handle.net/10500/21592.
Full textAbstract:
Background
Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy.
Purpose
The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria.
Methods
A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22.
Results
The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme.
Conclusion
Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs.Health Studies
M.P.H.
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Chitambo, Beritha Ruth. "The expectations of mothers regarding community participation in antenatal care at the Chinamhora Clinic in Goromonzi District, Zimbabwe." Diss., 2001. http://hdl.handle.net/10500/16538.
Full textAbstract:
Community participation has been hailed as the panacea for most community programmes.
Community participation at high levels empowers communities, increases self-reliance, selfawareness
and confidence in self-examination of problems and seeking solutions for them
Behavioural changes are promoted and utilisation and support of services is facilitated, which is
of great importance in antenatal care and generally in this present day of HIV/AIDS. The
purpose of this study was to determine the extent to which women were participating in the
provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and
expectations regarding their participation in the provision of antenatal care and to find out at
what level if any, the women wanted to be involved in the provision of antenatal care.
The theoretical model guiding this study was Rifkin' s model for evaluating community
participation. A guided interview was conducted with 30 conveniently selected pregnant
mothers residing in the area of the Chinamhora clinic. The results indicated limited participation
in the five process indicators of community participation.
However, all the women regarded community participation as being important. The majority of
the women wished to be involved at high levels of participation.
The results of this study should be valuable to health care professionais in formulating strategies
and modifying existing programmes to enhance community participation, with the
decentralisation of health services in Zimbabwe.Health Studies
M.A. (Advanced Nursing Sciences)
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Ragolane, Victoria Joyce. "Factors contributing to late antenatal care booking in Mopani District of Limpopo Province." Diss., 2017. http://hdl.handle.net/10500/25028.
Full textAbstract:
Late booking is associated with high perinatal and maternal morbidity and mortality. The World Health Organization (WHO, 2016) recommends that pregnant women should book for ANC full first before 12 weeks of gestation. The aim of the study was to explore and describe factors contributing to late antenatal care booking at public health facilities of Mopani District. A qualitative approach was used. In-depth interviews were conducted with twenty one pregnant women who booked after twelve weeks of gestation and agreed to participate in the study.
The study was conducted at four selected public health care facilities rendering maternal health services in Mopani district. Data was collected through in-depth interview with the aid of an interview guide. The analysis of data was done manually using a coding system to develop themes.
The results revealed that there are personal and provider factors contributing to late antenatal care booking in Mopani district. Personal factors contributing to late antenatal care booking were unplanned and unaccepted pregnancy, lack of support, late recognition of pregnancy, cultural and religious beliefs, ignorance of the importance of antenatal care and fear.
System or provider factors contributing to late booking were long waiting time, midwives’ attitude and lack of resources.Health Studies
M.A. (Public Health)