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How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported

Despite decades of training health workers in communication, complaints from clients and communities about poor health worker attitudes abound. This was found to be so in Zambia where the More Mobilizing Access to Maternal Health Services in Zambia (MORE MAMaZ) program was trying to ensure the inclu...

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Autores principales: Klouda, Tony, Green, Cathy, Soyoola, Miniratu, Quigley, Paula, Kureya, Tendayi, Barber, Caroline, Mubuyaeta, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164839/
https://www.ncbi.nlm.nih.gov/pubmed/30216997
http://dx.doi.org/10.3390/healthcare6030114
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author Klouda, Tony
Green, Cathy
Soyoola, Miniratu
Quigley, Paula
Kureya, Tendayi
Barber, Caroline
Mubuyaeta, Kenneth
author_facet Klouda, Tony
Green, Cathy
Soyoola, Miniratu
Quigley, Paula
Kureya, Tendayi
Barber, Caroline
Mubuyaeta, Kenneth
author_sort Klouda, Tony
collection PubMed
description Despite decades of training health workers in communication, complaints from clients and communities about poor health worker attitudes abound. This was found to be so in Zambia where the More Mobilizing Access to Maternal Health Services in Zambia (MORE MAMaZ) program was trying to ensure the inclusion of under-supported women in a community-based maternal and newborn health program in five intervention districts. Under-supported women suffer a disproportionate burden of child mortality and are poor users of health services. An exploratory small-scale qualitative survey involving nurses from training schools and health facilities found that nurses knew how to communicate well, but were selective with whom and in what circumstances they did this. In general, those who received the worst communication were under-supported and had low confidence—the very people who needed the best communication. An experiential training program was started to help health workers reflect on the reasons for their poor communication. The training was evaluated after 14 months using semi-structured interviews and focus group discussions with staff at participating health facilities. The results showed improved inclusion of under-supported women but also increased attendance generally for ante-natal clinics, deliveries and under-five clinics. Another outcome was improved communication between, and a sense of job satisfaction among, the health workers themselves. The program demonstrated an effective way to improve the inclusion and involvement of the least-supported women and girls. There are important lessons for other health programs that aim to operationalize the goals of the Global Strategy for Women’s, Children’s and Adolescent’s Health, which include an emphasis on reaching every woman.
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spelling pubmed-61648392018-10-10 How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported Klouda, Tony Green, Cathy Soyoola, Miniratu Quigley, Paula Kureya, Tendayi Barber, Caroline Mubuyaeta, Kenneth Healthcare (Basel) Article Despite decades of training health workers in communication, complaints from clients and communities about poor health worker attitudes abound. This was found to be so in Zambia where the More Mobilizing Access to Maternal Health Services in Zambia (MORE MAMaZ) program was trying to ensure the inclusion of under-supported women in a community-based maternal and newborn health program in five intervention districts. Under-supported women suffer a disproportionate burden of child mortality and are poor users of health services. An exploratory small-scale qualitative survey involving nurses from training schools and health facilities found that nurses knew how to communicate well, but were selective with whom and in what circumstances they did this. In general, those who received the worst communication were under-supported and had low confidence—the very people who needed the best communication. An experiential training program was started to help health workers reflect on the reasons for their poor communication. The training was evaluated after 14 months using semi-structured interviews and focus group discussions with staff at participating health facilities. The results showed improved inclusion of under-supported women but also increased attendance generally for ante-natal clinics, deliveries and under-five clinics. Another outcome was improved communication between, and a sense of job satisfaction among, the health workers themselves. The program demonstrated an effective way to improve the inclusion and involvement of the least-supported women and girls. There are important lessons for other health programs that aim to operationalize the goals of the Global Strategy for Women’s, Children’s and Adolescent’s Health, which include an emphasis on reaching every woman. MDPI 2018-09-13 /pmc/articles/PMC6164839/ /pubmed/30216997 http://dx.doi.org/10.3390/healthcare6030114 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Klouda, Tony
Green, Cathy
Soyoola, Miniratu
Quigley, Paula
Kureya, Tendayi
Barber, Caroline
Mubuyaeta, Kenneth
How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title_full How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title_fullStr How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title_full_unstemmed How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title_short How a Communication Intervention in Zambia Re-Oriented Health Services to the Needs of the Least-Supported
title_sort how a communication intervention in zambia re-oriented health services to the needs of the least-supported
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164839/
https://www.ncbi.nlm.nih.gov/pubmed/30216997
http://dx.doi.org/10.3390/healthcare6030114
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