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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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Autores principales: Sumankuuro, Joshua, Crockett, Judith, Wang, Shaoyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
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.
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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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