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Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings
OBJECTIVES: In considering explanations for poor maternal and newborn health outcomes, many investigations have focused on the decision-making patterns and actions of expectant mothers and families, as opposed to exploring the ‘supply side’ (health service provider) barriers. Thus, we examined the h...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231574/ https://www.ncbi.nlm.nih.gov/pubmed/30413495 http://dx.doi.org/10.1136/bmjopen-2017-021223 |
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author | Sumankuuro, Joshua Crockett, Judith Wang, Shaoyu |
author_facet | Sumankuuro, Joshua Crockett, Judith Wang, Shaoyu |
author_sort | Sumankuuro, Joshua |
collection | PubMed |
description | OBJECTIVES: In considering explanations for poor maternal and newborn health outcomes, many investigations have focused on the decision-making patterns and actions of expectant mothers and families, as opposed to exploring the ‘supply side’ (health service provider) barriers. Thus, we examined the health system factors impacting on access to and delivery of quality maternal and newborn healthcare in rural settings. DESIGN: A semistructured qualitative study using face-to-face in-depth interviews with health professionals, and focus group sessions with community members, in eight project sites in two districts of Upper West Region, Ghana, was employed. Participants were purposively selected to generate relevant data to help address the study objective. The survey was guided by WHO standard procedures and Ghana Health Ministry’s operational work plan for maternal and newborn care. SETTING: Nadowli–Kaleo and Daffiama–Bussie–Issa districts in Upper West Region, Ghana. PARTICIPANTS: Two hundred and fifty-three participants were engaged in the study through convenient and purposive sampling: healthcare professionals (pharmacist, medical doctor, two district directors of health services, midwives, community health and enrolled nurses) (n=13) and community members comprising opinion leaders, youth leaders and adult non-pregnant women (n=240 in 24 units of focus groups). RESULTS: Results show significant barriers affecting the quality and appropriateness of maternal and neonatal health services in the rural communities and the Nadowli District Hospital. The obstacles were inadequate medical equipment and essential medicines, infrastructural challenges, shortage of skilled staff, high informal costs of essential medicines and general limited capacities to provide care. CONCLUSION: Implementation of the birth preparedness and complication readiness strategy is in its infancy at the health facility level in the study areas. Increasing the resources at the health provider level is essential to achieving international targets for maternal and neonatal health outcomes and for bridging inequities in access to essential maternal and newborn healthcare. |
format | Online Article Text |
id | pubmed-6231574 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-62315742018-12-11 Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings Sumankuuro, Joshua Crockett, Judith Wang, Shaoyu BMJ Open Health Services Research OBJECTIVES: In considering explanations for poor maternal and newborn health outcomes, many investigations have focused on the decision-making patterns and actions of expectant mothers and families, as opposed to exploring the ‘supply side’ (health service provider) barriers. Thus, we examined the health system factors impacting on access to and delivery of quality maternal and newborn healthcare in rural settings. DESIGN: A semistructured qualitative study using face-to-face in-depth interviews with health professionals, and focus group sessions with community members, in eight project sites in two districts of Upper West Region, Ghana, was employed. Participants were purposively selected to generate relevant data to help address the study objective. The survey was guided by WHO standard procedures and Ghana Health Ministry’s operational work plan for maternal and newborn care. SETTING: Nadowli–Kaleo and Daffiama–Bussie–Issa districts in Upper West Region, Ghana. PARTICIPANTS: Two hundred and fifty-three participants were engaged in the study through convenient and purposive sampling: healthcare professionals (pharmacist, medical doctor, two district directors of health services, midwives, community health and enrolled nurses) (n=13) and community members comprising opinion leaders, youth leaders and adult non-pregnant women (n=240 in 24 units of focus groups). RESULTS: Results show significant barriers affecting the quality and appropriateness of maternal and neonatal health services in the rural communities and the Nadowli District Hospital. The obstacles were inadequate medical equipment and essential medicines, infrastructural challenges, shortage of skilled staff, high informal costs of essential medicines and general limited capacities to provide care. CONCLUSION: Implementation of the birth preparedness and complication readiness strategy is in its infancy at the health facility level in the study areas. Increasing the resources at the health provider level is essential to achieving international targets for maternal and neonatal health outcomes and for bridging inequities in access to essential maternal and newborn healthcare. BMJ Publishing Group 2018-11-08 /pmc/articles/PMC6231574/ /pubmed/30413495 http://dx.doi.org/10.1136/bmjopen-2017-021223 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Health Services Research Sumankuuro, Joshua Crockett, Judith Wang, Shaoyu Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title | Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title_full | Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title_fullStr | Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title_full_unstemmed | Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title_short | Perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
title_sort | perceived barriers to maternal and newborn health services delivery: a qualitative study of health workers and community members in low and middle-income settings |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231574/ https://www.ncbi.nlm.nih.gov/pubmed/30413495 http://dx.doi.org/10.1136/bmjopen-2017-021223 |
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