Influence of Supply-side Factors on Access to Healthcare: An Empirical Analysis of Service Delivery in Sierra Leone | Chapter 8 | An Overview of Disease and Health Research Vol. 8

The capacity of the health system to respond timely and adequately to the health needs of the people is critical to averting deaths, especially in vulnerable populations such as pregnant women and children. The robustness and responsiveness of a country’s health system predict access to a range of health services, including maternal and child health (MCH) services.  The purpose of this cross-sectional study was to examine the influence of five (5) health system characteristics (i. type of health provider, ii. level of facility, iii. availability of essential medicines, iv. availability of basic equipment, and v. type of facility) on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black’s framework for evaluating the scale-up to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment (SARA) dataset, which comprised 100% (1,284) of the country’s health facilities. Data analysis included bivariate and multivariate logistic regressions. In the bivariate analysis, all the independent variables showed statistically significant association with access to MCH services and achieved a p-value < .001. In the multivariate analysis, however, only 3 predictors explained 38% of the variance (R² = .380, F (5, 1263) = 154.667, p<.001). The type of health provider significantly predicted access to MCH services (β =.549, p <.001) as did the availability of essential medicines (β= .255, p<.001) and the availability of basic equipment (β= .258, p <.001). According to the study findings, the availability of the right mix of health providers, essential medicines, and basic equipment significantly influenced access to MCH services, regardless of the level and type of health facility. The study has highlighted the relative influence of health system access to MCH services. The findings would inform efforts towards broadening strategies to address weak health system blocks to optimise access to quality MCH services, which ultimately can contribute towards the reduction of maternal and child mortality rates in Sierra Leone and similar contexts.

 

 

Author(s) Details

Alhassan Fouard Kanu
Institute for Health Professionals Development (IHPD), Sierra Leone and Paris Graduate School, France.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v8/6993

 

Determinants and Patterns of Antenatal Care Utilizations among Women in Thiruvarur District, Tamil Nadu: An Analytical Study |Chapter 8 | An Overview of Disease and Health Research Vol. 7

 

Timely utilisation of antenatal care (ANC) remains critical for reducing maternal mortality, yet considerable disparities in ANC access persist due to multifaceted socio-economic and health system determinants. The present study aims to (1) identify and quantify the socio-economic, demographic, psychological, and infrastructural determinants influencing ANC utilisation among women in Thiruvarur district, Tamil Nadu; (2) examine the principal barriers to accessing ANC; and (3) analyse district-level trends in childbirth and infant mortality. Data were obtained from 2,101 pregnant women aged 17–36 years who received care at 42 Primary Health Centres and 9 Government General Hospitals. Utilizing structured questionnaires and robust statistical analysis—including stratified random sampling and multiple regression techniques—the study assessed key factors associated with ANC uptake. The results demonstrate that maternal age, age at marriage, family size, educational attainment, health status, and proximity to health care facilities are statistically significant predictors of ANC use. In contrast, household income was not a statistically significant predictor of ANC utilization (p=0.060), indicating that the widespread availability of free public health services likely mitigates direct financial barriers. The findings also establish that Primary Health Centres serve as the predominant sources of ANC, with institutional deliveries prevailing across the district. Despite these positive trends, the research reveals ongoing geographic disparities in infant mortality rates. Collectively, the results underscore that demographic and infrastructural variables substantially shape patterns of ANC utilisation. The study thus highlights the necessity of targeted interventions, especially those aimed at educational advancement, improved accessibility, and service delivery improvements, to address enduring inequities faced by socioeconomically or geographically marginalised women.

 

 

Author(s) Details

Vadivel Sivalingam
Postgraduate and Research Department of Geography, Thanthai Periyar Government Arts and Science College (Autonomous), Tiruchirappalli – 620023, Tamil Nadu, India.

 

Anandan Rethinam
The Government of Tamil Nadu, India.

 

Mayakannan Ayyanar
Department of Geography, Government Arts College for Women, Nilakottai, 624208, Tamil Nadu, India.

 

Sankar Karuppaiyan
Postgraduate and Research Department of Geography, Government Arts College (Autonomous), Kumbakonam – 612001, Tamil Nadu, India. India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v7/6585

Improving Maternity Care Quality in Nampula, Mozambique: An Implementation Research | Chapter 9 | Disease and Health Research: New Insights Vol. 7

 

Background: Maternity care is an important indicator of national health systems, and the quality of maternity services is an essential factor in reducing maternal and newborn morbidity and mortality, which remains extremely high in Africa. Maternal and child mortality have their highest incidence around delivery time. In Mozambique, the maternal mortality rate was 451.6 deaths per 100,000 live births (2017). The reasons for this are complex, but one important factor in reducing this burden is to provide effective and efficient care, to improve institutional deliveries.  To reduce maternal and new-born mortality rates in Nampula, researchers from Lúrio University and the University of Saskatchewan, carried out an implementation research program, including different interventions such as training activities for health professionals in maternal and child health care, information campaigns through radio, theatre and meetings, and transport for deliveries in maternity. A mid-project evaluation was planned to assess the training’s impact on the quality of services at Marrere Hospital Maternity.

Methods: Quantitative pre-post study, carrying out two cross-sectional surveys about maternity service quality, one being conducted after five health professionals’ training and the other after six more training. The two surveys included samples of post-partum women in maternity, calculated with a 10% margin error and 90% confidence interval for the first survey, and with a 7% margin error and 95% confidence interval for the second. The surveys were entered into REDCap and analysed to assess frequencies, percentages, means, and standard deviations. This research was approved by the Institutional Committees of Bioethics at Lúrio University and at the University of Saskatchewan.

Results: 116 post-partum women were surveyed at the maternity, assessing standards of patient-centred care during delivery labour. Most areas showed no improvement. Some positive improvements were delivering women were given the option to have a person of their choice accompany them during labour (75%), notably a traditional birth attendant (34%), and they had continuous support from a health professional (68%). But many shortcomings persisted in areas of privacy (33%) and confidentiality (57%).

Discussion: Health professionals informed delivering women that they had the option to have a person of their choice to accompany them during labour, and this is a low-cost and effective intervention to improve the quality of maternity care, in a context where Traditional Birth Attendants are pregnant women’s trusted partners.

Most post-partum women in maternity were satisfied with the service, perhaps due to their low education level leading to lower expectations, since health professionals did not generally proceed according to the rules of good care.

This finding might be related to the high turnover of mother and child health professionals, by a mandated reduction of those professionals with an overload of work to those remaining, associated with a hospital’s economic resources reduction, in parallel with low salaries and missing payments for extra-hours.

Conclusion: The quality of patient-centred care at Marrere Hospital Maternity did not improve much with health professionals’ training. Decreasing the large turnover rate of such staff, reviewing their learning styles, and promoting continuous professional capacity building would be the next steps to improve the quality of care. These policy developments could significantly better mother and child health at Mozambican health centres and hospitals.

 

Author (s) Details

Paulo Pires
Faculty of Health Sciences, Lúrio University, Bairro de Marrere, Rua Nr. 4250, Km 2.3, CP 364, Nampula, Mozambique.

 

Martins Abudo Mupueleque
University Mussa Bin Bique, Nampula, Mozambique.

 

Jaibo Rassul Mucufo
Faculty of Health Sciences, Lúrio University, Nampula, Mozambique.

 

David Zakus
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

 

Ronald SiemensFaculty of Medicine, University of Saskatchewan, Saskatoon, Canada.

 

Celso Belo
Faculty of Health Sciences, Lúrio University, Nampula, Mozambique.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v7/2172

Assessment of Maternal Health Knowledge and Access to Maternal Health Information among Mothers in Windhoek | Chapter 6 | Recent Updates in Disease and Health Research Vol. 2

Introduction: Maternal and neonatal morbidity and mortality occurs due to unexpected obstetric emergencies, and by delays in recognizing complications, seeking and receiving care for these complications. Knowledge regarding pregnancy risk factors and warning signs in pregnancy is a major contributor to delayed response and maternal health seeking behaviour. This study aimed to assess maternal health knowledge and access to maternal health information among mothers in Windhoek.

Methods: A cross-sectional, pilot study was done with 56 women and 30 health workers. Data was collected with questionnaires, and analysed using SPSS version 28, in descriptive and inferential statistics, presented in tables and charts. Ethical approval and informed consent were obtained; confidentiality, anonymity and privacy were maintained; participation was voluntary.

Results: The study revealed that almost half of the women (46.4%) have average knowledge regarding maternal health issues. All women mentioned at least 1 danger sign (100%) and most women mentioned 2 or more danger signs (96.0%), unprompted. Most women had access to maternal health information, mainly through access to health facilities/health workers (72.2%), antenatal clinics (26.6%) and informal channels such as family members (11.4%) and social media (15.2%). Challenges reported in accessing maternal health information was that information sources often had insufficient reach, was difficult to understand, and often not in local languages. Information from informal sources was often unreliable, misleading and contradictory. These indicate maternal health information gaps that need to be addressed to improve access to useful information to pregnant women.

Conclusion: Findings indicated opportunity to scale up dissemination of relevant maternal health information through suitable media, made universally acceptable and accessible to all women in an equitable and individualised manner. It highlights the need to strengthen, diversify and simplify health messages and language used therein, thereby increasing the reach of maternal health information through diverse media, to positively influence birth preparedness and maternal health seeking behaviour.

Author(s) Details:

Larai Aku-Akai,
Environmental Health Sciences, Department of Preventative Health Sciences, Namibia University of Science and Technology, Windhoek, Namibia.

Please see the link here: https://stm.bookpi.org/RUDHR-V2/article/view/13506

Epidemiological and Clinical Profile of Emergencies Received at the Maternity Unit of Saint-Louis Regional Hospital, Senegal: A Retrospective Cross-sectional and Descriptive Study| Chapter 15 | Current Innovations in Medicine and Medical Science Vol. 8

 The aim of this study search out provide the epidemiological and clinical traits of women taken in emergency at the maternity part of the regional clinic of Saint-Louis. In Senegal, reducing motherly mortality is one of the main preference of the National Health Development Plan.On the basis of the office for a year, a retrospective, cross-divided, and descriptive study was transported (July 1, 2017 - June 30, 2018). Out of 5822 collected files, skilled were 1364 evacuations (23.43%). The majority of women were under 25 age of age (42.53%), ignorant (60.92%), married (97.73%), low-gains (96.68%), first-time meaningful (37.91%), prim pregnant (38.57%), with a full-term gestation (85.28%) and less than 4 fetal consultations (56.02%).The most common pathologies were dystocic (20.16%), hypertensive (18.40%), and hemorrhagic (8.65%). Medical treatment (72.87%) was governed by vascular filling, medicine and antihypertensive medication, ancestry transfusion, and magnesium sulphate injection. Gynaeco-obstetrical care contained 42 abortions, 834 births, and 303 caesarean divisions, for a total of 1179 cases (86.44%).It is concluded that improving the position requires a more learned population and a better systematized network of “obstetric and neonatal emergency care (ONEC)” services (healing transport, sufficient and improved staff, better maternity and neonatology, correct suffused databases).

Author(s) Details:

Niang Khadim,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Sylla Béïtyr,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Thiam Ousmane,
Genecology and Obstetric Service, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Ndiaye Papa,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Please see the link here: https://stm.bookpi.org/CIMMS-V8/article/view/8732

Prognostic Factors for Obstetrical Emergencies Received at the Regional Hospital of Saint-Louis in Senegal: A Retrospective, Cross-sectional and Descriptive Study| Chapter 14 | Current Innovations in Medicine and Medical Science Vol. 8

 The objective concerning this work was to label prognostic factors for obstetrical emergencies taken at the Regional Hospital of Saint-Louis. The one-period retrospective, cross-sectional, and explanatory investigation was established the archives (July 1, 2017 - June 30, 2018). The categorical and relative frequencies of each qualitative changeable were calculated utilizing a confidence interval. Thus, were filled out: the socio-demographic description of the woman, the environments of evacuation, and the care. Out of 5822 collected files, skilled were 1364 evacuations (23.43%). The majority of daughters were under 25 years of age (42.53%), ignorant (60.92%), married (97.73%), reduced-income (96.68%), first-occasion pregnant (37.91%), prim pregnant (38.57%), with a entire-term pregnancy (85.28%) and less than 4 fetal consultations (56.02%).The most common pathologies were dystocic (20.16%), hypertensive (18.40%), and hemorrhagic (8.65%). Medical situation (72.87%) was dominated by vascular contents, antibiotic and antihypertensive medication, ancestry transfusion, and magnesium sulphate dose. Gynaeco-obstetrical treatment worried 42 abortions, 834 deliveries and 303 caesareans; for a total of 1179 cases (86.44%). The surgery involved 22 laparotomies (containing 7 hysterectomies), 5 perineal recoveries, and 3 others; for a total of 30 cases (2.20%). Hospitalization, approximately 2.34 days, resulted in maternal death for 14 cases (1.26%) and perinatal mortality for 157 cases (13.81%). Improving the issue makes necessary a more informed people as well as a more coordinated network of "obstetric and neonatal danger care / soins obstétricaux et néonatals d’urgence (SONU)" services: healing transport, sufficient and upgraded stick, better maternity and neonatology, correct suffused databases.

Author(s) Details:

Niang Khadim,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Sylla Béïtyr,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Thiam Ousmane,
Genecology and Obstetric Service, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Ndiaye Papa,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Please see the link here: https://stm.bookpi.org/CIMMS-V8/article/view/8731

Progressing Quality Care Process Metrics for Public Health Nursing: An Approach towards Modified Delphi | Chapter 8 | Issues and Development in Health Research Vol. 1

 Background: Nursing plays a critical role in enabling care in the community, but there is no consensus on how to quantify public health nurses' contributions to care and how to measure what they do to offer high-quality, safe care. With the goal of creating quality care process measurements for public health nursing care, as well as respective indicators that could quantify their distinctive and multidimensional contribution to care, a modified Delphi approach with an expert panel was devised. A four-round survey of 218 nurses, face-to-face discussions with a patient representative and key stakeholder holders within public health nursing services, and a final consensus conference with a panel of 29 expert nurses in the community were all part of this modified Delphi study. Results: Delphi rounds 1-4 resulted in a consensus on fourteen quality care process nursing metrics and sixty-nine associated indicators for the community care context, incorporating expert panellists' ideas. Despite the Delphi rounds' critical evaluation, at the final consensus meeting, in-depth discussions were held on all proposed measures and indicators. Conclusion: Using a modified Delphi technique, this research explains the development of a set of 14 quality care measures linked with a set of 69 comparable indicators via the lens of public health nursing. The next step is to put these quality care process indicators in place so that public health nurses' distinctive and multifaceted contribution to patient-centered care can be measured in the community.

Author (s) Details

Professor L. O’Connor
UCD School of Nursing Midwifery and Health Systems, University College Dublin, Ireland.

Professor E. McAuliffe
UCD School of Nursing Midwifery and Health Systems, University College Dublin, Ireland

M. Casey
UCD School of Nursing Midwifery and Health Systems, University College Dublin, Ireland.

Dr. L. Rogers
UCD School of Nursing Midwifery and Health Systems, University College Dublin, Ireland.

Dr. A. Gallen
Nursing and Midwifery Planning Development Unit, National Lead for Nursing and Midwifery Quality Care Metrics Project, Health Service Executive, Ireland.

Professor M. E. Glasgow
School of Nursing, Duquesne University, Pittsburgh, USA.

Dr. C. White
Dublin City University, Ireland.

Ms. C. Buckley

Nursing and Midwifery Planning Development Unit, HSE South, Cork, Ireland.

Dr. M. Giltenan
National University of Ireland, Galway, Ireland.

Dr. A. Lane
NMPDU Officer Health Service Executive, Ireland.

Ms. M. Barnard
UCD School of Nursing Midwifery and Health Systems, University College Dublin, Ireland.

View Book :- https://stm.bookpi.org/IDHR-V1/article/view/2159