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Surmounting difficulties to provide home based neonatal care – reflections of community health workers
BACKGROUND: In India, community health workers’ (CHW) effectiveness in providing home-based neonatal care (HBNC) has been well documented. The nature of challenges faced and strategies adopted while providing HBNC services need to be studied in-depth. METHODS: A qualitative study to understand the c...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769228/ https://www.ncbi.nlm.nih.gov/pubmed/29334946 http://dx.doi.org/10.1186/s12905-018-0511-6 |
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author | Prabhughate, Abhijit Shrinivas Tiwari, Pearl Sohoni, Shubhangi Morgaonkar, Vallaree Anant Phatak, Ajay Gajanan Nimbalkar, Somashekhar Marutirao Mahajani, Anagha Anand |
author_facet | Prabhughate, Abhijit Shrinivas Tiwari, Pearl Sohoni, Shubhangi Morgaonkar, Vallaree Anant Phatak, Ajay Gajanan Nimbalkar, Somashekhar Marutirao Mahajani, Anagha Anand |
author_sort | Prabhughate, Abhijit Shrinivas |
collection | PubMed |
description | BACKGROUND: In India, community health workers’ (CHW) effectiveness in providing home-based neonatal care (HBNC) has been well documented. The nature of challenges faced and strategies adopted while providing HBNC services need to be studied in-depth. METHODS: A qualitative study to understand the challenges faced and strategies used by Sakhis (women CHW) while providing services as part of a HBNC program implemented by a non-profit organization. Data consisted of 20 in-depth interviews and three focus group discussions (FGD) with Sakhis. RESULTS: Sakhis negotiated with the community to start working as a CHW. They faced challenges while changing behaviors at individual level and also while bringing about a change in harmful normative practices that increased chances of maternal and neonatal mortality. Managing crises at the time of deliveries and facilitating a safe delivery was the most critical challenge faced by many Sakhis. The key strategies used by Sakhis included: proactively and persistently providing services even when they faced resistance from the woman or her family; evolving contextually suitable counseling techniques and tactics to bring about behavioral change; balancing compliance to traditional practices and promoting HBNC; defying traditional practices and assisting the woman in times of an emergency to save lives. Having on-call support from supervisors and cultivating a good working relationship with health providers facilitated effective service provision by Sakhis. CONCLUSION: CHWs having a strong sense of commitment can develop strategies to address challenges and provide HBNC services effectively if they also have strong supervisory support. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi: 10.1186/s12905-018-0511-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5769228 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57692282018-01-25 Surmounting difficulties to provide home based neonatal care – reflections of community health workers Prabhughate, Abhijit Shrinivas Tiwari, Pearl Sohoni, Shubhangi Morgaonkar, Vallaree Anant Phatak, Ajay Gajanan Nimbalkar, Somashekhar Marutirao Mahajani, Anagha Anand BMC Womens Health Research Article BACKGROUND: In India, community health workers’ (CHW) effectiveness in providing home-based neonatal care (HBNC) has been well documented. The nature of challenges faced and strategies adopted while providing HBNC services need to be studied in-depth. METHODS: A qualitative study to understand the challenges faced and strategies used by Sakhis (women CHW) while providing services as part of a HBNC program implemented by a non-profit organization. Data consisted of 20 in-depth interviews and three focus group discussions (FGD) with Sakhis. RESULTS: Sakhis negotiated with the community to start working as a CHW. They faced challenges while changing behaviors at individual level and also while bringing about a change in harmful normative practices that increased chances of maternal and neonatal mortality. Managing crises at the time of deliveries and facilitating a safe delivery was the most critical challenge faced by many Sakhis. The key strategies used by Sakhis included: proactively and persistently providing services even when they faced resistance from the woman or her family; evolving contextually suitable counseling techniques and tactics to bring about behavioral change; balancing compliance to traditional practices and promoting HBNC; defying traditional practices and assisting the woman in times of an emergency to save lives. Having on-call support from supervisors and cultivating a good working relationship with health providers facilitated effective service provision by Sakhis. CONCLUSION: CHWs having a strong sense of commitment can develop strategies to address challenges and provide HBNC services effectively if they also have strong supervisory support. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi: 10.1186/s12905-018-0511-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-15 /pmc/articles/PMC5769228/ /pubmed/29334946 http://dx.doi.org/10.1186/s12905-018-0511-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Prabhughate, Abhijit Shrinivas Tiwari, Pearl Sohoni, Shubhangi Morgaonkar, Vallaree Anant Phatak, Ajay Gajanan Nimbalkar, Somashekhar Marutirao Mahajani, Anagha Anand Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title | Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title_full | Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title_fullStr | Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title_full_unstemmed | Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title_short | Surmounting difficulties to provide home based neonatal care – reflections of community health workers |
title_sort | surmounting difficulties to provide home based neonatal care – reflections of community health workers |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769228/ https://www.ncbi.nlm.nih.gov/pubmed/29334946 http://dx.doi.org/10.1186/s12905-018-0511-6 |
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