Attitude Of Health Workers Research Articles

Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment

BackgroundBarriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction.ObjectiveThe objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities.MethodsA discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios.ResultsA total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics.ConclusionThe pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities.

Factors Affecting Quality of Health Care Services in Government Facilities in Kakindo Health Centre IV in Kakumiro District

This study aimed to examine the factors that affect quality of health services in Kakindo Health Center IV in Kakumiro District. The study used a cross-sectional design using a quantitative approach on the population which was under study. Data was collected using questionnaires, processed in excel, and word using SSP software for correlation purposes. The study found a high significant relationship between health-related factors, health worker related factors and quality of health service delivery. Patient related factors had a low significance. The study concluded that the quality of health services depends on the level to which the management of the facility provides the employees with a conducive work environment. appropriate knowledge and skills, and positive attitude of health workers towards patients was emphasized. health workers were argued to carry out daily patient education in order to change their traditional beliefs. Grading the facility to a level of Hospital this would help to build more infrastructure for both patients and staffs, for security of both patients and staff, the facility needs tapped water so that staff can access clean water inwards, especially the paediatric ward, theatre, general ward, outpatient department, A R T Clinic Cold chain unit and a few staff quarters. A proper fence must be put constructed at the facility. Keywords: Health service, Health workers, Patients, Delivery, Staff.

Attitude of healthcare workers towards information technology

<p><strong>Introduction.</strong> Digital literacy includes things like being able to use information systems and supporting infrastructure. With the increasing use of technology in healthcare, it is important for healthcare staff to be digitally literate. The aim of the paper is to determine the attitudes of primary and secondary health care workers towards the use of computers in health care and to examine the influence of sociodemographic factors on the information literacy of health care workers. <br /><strong>Methods.</strong> The research was conducted according to the principle of a cross-sectional study. The research included 80 respondents, healthcare workers. Data analysis included methods of descriptive and inferential statistics. The data will be presented in the form of a table.<br /><strong>Results.</strong> The results showed that certain socio-demographic factors influenced the attitude of health workers towards the use of computers. The most significant factors were the level of education and previous IT education, but the time the respondents sopent working on the computer and whether they used the computer exclusively at work or at home also had an impact.<br /><strong>Conclusion. </strong>Healthcare workers showed a positive attitude towards the use of computers in healthcare. The most significant socio-demographic factors influencing knowledge of computer work are the level of education of the respondents and whether and where they received their education in information technology.</p>

Perception and Attitude of Health Care Workers in Tertiary Health Care Facilities in Plateau State, Nigeria towards Sexual and Reproductive Health Services for Unmarried Adolescents

Adolescents are faced with the challenges of having access to and the utilization of quality sexual and reproductive health services, and one of the barriers responsible for this situation is the negative personal attributes of service providers. This study aimed to assess the perception and attitude of health workers in the tertiary health facilities in Plateau State towards sexual and reproductive health services for unmarried adolescents. A cross-sectional study was conducted in December 2020 among 208 doctors and nurses/midwives who were selected using a stratified sampling technique. Data were collected using a semi-structured self-administered questionnaire and analyzed using the Statistical Product and Service Solutions version 23. The mean age of the respondents was 37.1 ± 9.1 years, 131 (63.0%) were doctors and females constituted 120 (57.7%). One hundred and twenty-nine (62.0%) had a good perception, while 105 (50.5%) had a positive attitude towards sexual and reproductive health services for unmarried adolescents. Younger age below 55 years and a good perception were found to be predictors of a positive attitude towards sexual and reproductive health services for unmarried adolescents. A considerable number of the health workers in the tertiary health facilities in Plateau state had a negative attitude towards sexual and reproductive health services for unmarried adolescents, an attribute that was significantly seen more in those who were older and had a poor perception. There is a need to improve healthcare workers’ attitudes towards the provision of sexual and reproductive health services for unmarried adolescents.

FACTORS CONTRIBUTING TO POOR HEALTH-SEEKING BEHAVIORS AMONG HIV ADOLESCENTS ATTENDING ART CLINIC AT KALAGALA HEALTH CENTRE IV, LUWERO DISTRICT. A CROSS-SECTIONAL STUDY.

Background: The purpose of the study: was to find out individual, community, and health facility-related factors contributing to poor health-seeking behaviors among HIV adolescents attending the ART clinic at Kalagala Health Centre IV, Luwero district. Methodology: A cross-sectional study design using a simple random sampling technique sampled 50 respondents. A questionnaire with open and ended questions written in English language was used as the data collection tool and data was analyzed manually by use of tally sheets and presented in tables and figures by support of narratives. Findings: The majority of the respondents were 18-19 years old (46%), female (60%), and in secondary school (52%). Many (92%) perceived ART as very important, (58%) had ever been exposed to drug adverse effects, and (38%) missed prescribed ART medications ART due to forgetfulness. Respondents (48%) affirmed that their parents don’t usually support them in taking medication, (48%) noted that community members were unfriendly towards HIV-positive adolescents, and (82%) were day scholars. When it came to the health facilities (60%) of the respondents noted the waiting time was quite long, (64%) reported that the attitudes of health workers were fair, (70%) agreed that they received adequate counseling services in regards to timely ART, (56%) reported a very far distance from their homes to the health facility. Conclusion: Exposure to drug adverse effects missed prescribed medications due to forgetfulness, unsupportive parents/caretakers, unpleasant perceptions of community members towards HIV-positive adolescents, tight school programs, long waiting times, spiteful attitudes of health workers, and distances from homes to health facilities were the foremost factors contributing to poor health-seeking behaviors among adolescents on ART. Recommendation: Kalagala Health Center IV administration should build a good client-based relationship with adolescents so that they can freely express themselves and develop their preferred mode for accessing timely ART.

Client’s Experiences on Skilled Delivery Services among Women of Reproductive Age in Rural Communities in Kenya

Background: Globally Skilled delivery services are critical aspects to combat Maternal and neonatal mortality. In Kenya, skilled deliveries account for 62% of all deliveries; unskilled deliveries pose a higher risk of maternal and neonatal mortality and morbidity. The maternal mortality ratio in Kenya is currently 462 per thousand live births, with 40% of these deaths occurring at home. The main objective of the study was to explore the experiences of women of reproductive age on skilled delivery services.
 Materials And Methods: The baseline study was conducted between November 2022 and January 2023. It employed a cross-sectional research design involving 347 women of reproductive age. The study aimed to examine their current practices, challenges, and experiences with skilled delivery services. Focus Group Discussions (FGDs) were conducted with 48 recently delivered women (within one year), as well as with 48 Community Health Volunteers (CHVs) and 10 Community Extension Workers (CHEWs). In-depth interviews were also held with local health facility administrators. Quantitative data analysis was performed using SPSS version 25.0. Measures of central tendency were employed for continuous data tabulation. The analyzed data was then presented through charts, tables, and frequencies. The qualitative data underwent thematic arrangement and analysis using NVIVO version 13 and then triangulated with descriptive data.
 Results: The results revealed that (90.6%) of women's previous childbirth experiences influenced their utilization of skilled birth attendance services in subsequent pregnancies. Women who had never given birth in health facilities or had chosen home births were less likely to utilize skilled birth attendance services.
 Conclusion and Recommendations: This study identified factors influencing skilled birth attendance use in Kandara SubCounty, highlighting the role of previous childbirth experiences, health facility-related factors, and danger signs during pregnancy. To improve utilization, interventions should focus on health facility conditions, health worker attitudes, and community awareness programs.

Attitudes of Health Workers Towards Management of Hepatitis B Infection in General Hospitals in Kwara State, Nigeria

Hepatitis B is one of the most dangerous diseases in the world and it has become a serious threat to public health. Health workers are mostly at risk of contracting the disease as they remain the first point of call to the victims. This study examined the attitudes of health workers towards management of HBV infection and the difference in attitudes of health workers based on area of specialization. An ex-post facto research design sampling 412 health workers across different areas of specialization which include doctors, nurses, laboratory scientists and laboratory technicians. Majority of the health workers had negative attitudes towards HBV patients. However, doctors (mean score=3.72) and nurses (mean score=3.54) had mild negative attitudes towards HBV patients, while laboratory scientists (mean score=3.02) and laboratory technicians (mean score=3.04) had the poorest attitudes towards HBV patients. There is need to improve the attitudes of the different cadres of health workers in the state, in order to improve the quality of life of HBV patients and reduce stigma which may impact negatively on patients’ mental health.

Enhancing Utilization of PMTCT Services: Investigating Knowledge Factors Among Pregnant and Breastfeeding Mothers at Kiryandongo General Hospital, Western Uganda

This study aimed to determine the factors affecting the utilization of PMTCT services among mothers attending the ART clinic at Kiryandongo General Hospital. This was a facility-based cross-sectional which recruited a total of 185 pregnant and lactating mothers attending Kiryandongo Hospital. STATA software version 14.0 was used for data analysis. To identify factors affecting utilization of PMTCT services, univariate analysis and modified Poisson regression run and crude prevalence ratios with 95% confidence interval were used to determine the level of significance at bivariate meanwhile adjusted prevalence ratios were calculated at multivariate analysis to establish independent significant factors. The mean age of the study participants was 25.6 with a standard deviation of 6. Results showed that the mean score on knowledge was 5.21 with a standard deviation of 1.36. The median score was 5 with an interquartile range of 4 to 6. The majority of 59.46% (110/185) of the study participants had inadequate knowledge of PMTCT meanwhile less than of the study participants 40.54% (75/185) had adequate knowledge. The factors independently affecting utilization of PMTCT services were; Unemployment (aPR 4.05, 95%CI 2.19-7.50, P<0.001), Rude and harsh attitude of health workers (aPR 2.17, 95%CI 1.38-3.44, P=0.001). Unsatisfactory services (Apr 2.40, 95%CI 1.22-4.74, P=0.011). The study has shown that there are more than half of the pregnant women and lactating mothers attending Kiryandongo Hospital have inadequate knowledge of PMTCT services. The proportion of mothers found with adequate knowledge of PMTCT in the present study is low compared to most studies done in Africa. At Kiryandongo Hospital, the utilization of PMTCT services among pregnant and lactating mothers was found to be slightly high. Employment status was the only socio-demographic factor affecting the utilization of PMTCT services meanwhile Rude and harsh attitudes of health workers and unsatisfactory services were the health facility-related factors affecting the utilization of PMTCT services. Keywords: HIV, PMTCT services, Children, Pregnant mothers, Lactating mothers.

Health Insurance, Attitude of Health Workers and Delivery at Health Facility: Outcome from Demographic and Health Survey in Nigeria.

The authors are concerned about poor utilization of health facility during pregnancy and delivery in Nigeria which are contributing to high incidence of maternal mortality. The causes of the poor utilization of health facility during delivery were examined so as to proffer policy solution on how to overcome the high incidence of maternal mortality in the country. The authors sourced data from Nigerian Demographic and Health Survey (DHS, 2013) because cost of attending health facility was not covered in the 2018 Demographic Health Survey. Moreover, the Ordinary Least Squares (OLS) method of regression analysis was used in the study because the dependent variable was not binary.Finding shows that cost of accessing health care in the hospitals, health insurance, and attitude of health workers have a positive and significant effect on delivery at health facility. This makes it important for wider coverage of national health insurance program and organization of regular training on work attitudes for health workers in Nigeria to increase use of health facility during child delivery. It will help to reduce maternal health problems in Nigeria.

Assessment of Awareness, Attitude, and Consequences of Healthcare Waste Among Health Workers at Health Facilities In Southeast Nigeria

Healthcare waste which consists of waste materials generated at healthcare facilities is hazardous to both the environment and human life. However, many people are unaware of the dangers of medical wastes. Previous studies have neglected the assessment of the level of awareness and attitude of health workers toward healthcare waste. Therefore, this study assesses the level of awareness of healthcare workers about the dangers and their attitude toward the waste and its implications. The study, which employed cross-sectional design with 334 participants, was conducted in Southeast Nigeria. Data collection was through questionnaire and in-depth interview guide. Data analyzed through descriptive statistics revealed that the level of awareness of health workers about the dangers of healthcare waste is high; their attitude toward healthcare waste is poor; and that the consequences of mismanaged healthcare waste are devastating. Therefore, healthcare facilities should have a functional waste management policy, train their staff on ways of handling waste and educate the public about dangers of healthcare waste.

Factors Affecting the Utilization of Maternal and Child Health Services in Urban Primary Health Care Centers in Enugu State (Abakpa and Uwani)'

10.18103/mra.v12i1.5064 Background/Aim: Poor Maternal and Child Health service indicators have been a recurring Public Health challenge in Nigeria since the documentation of National Maternal, Newborn, and Child Health (NMNCH) statistics began in the early 1990s. This study was aimed at identifying the factors that affect the utilization of Maternal and Child Health services among women of childbearing age attending urban Primary Health Care centers in Enugu State (Abakpa and Uwani). Methodology: This was a retrospective and descriptive cross-sectional study and data was collected through a self-administered questionnaire. 296 respondents participated and analysis of data was done using Statistical Package for Social Sciences (SPSS) version 20.0. The findings revealed that the number of deliveries in the health centers was highest in 2018 with a total of 378 deliveries compared to 2016 & 2017 with 280 and 254 deliveries respectively. The total number of under 5 children receiving yellow fever/ measles vaccine in the health center increased throughout the years with a total of 1493 vaccinations in 2016, 1510 in 2017, and 2083 in 2018. Results: It was also observed that the main factors that enhanced Maternal and Child Health (MCH) services in the health centers were decreased maternal age, maternal educational status, affordability of services rendered, good attitude of health workers, and the proximity of both health centers to the homes of the respondents. On the other hand, increased maternal age, poor maternal education, high parity, and long waiting hours experienced by the patients were the major factors hindering the utilization of services rendered in the health centers. Conclusion: To improve utilization of MCH services as identified by the women include; advocacy and sensitization campaigns, community dialogue, and upgrading of the existing health care centers.

Constraints on the functioning of Community-based Health Planning and Services facilities: A qualitative study in the Jirapa Municipality, Ghana.

The declaration of the Alma-Alta on primary health care (PHC) in 1978 enjoined nations to make health care accessible, affordable, and situated within their cultural contexts. The Ghana Community-based Health Planning and Services (CHPS), as a strategy to achieve the goal of PHC, has shown significant successes in communities where it has been implemented. However, a number of challenges continue to affect the effective functioning of CHPS. This study explored the community level and health system constraints on the effective functioning of CHPS in the delivering of PHC services in the Jirapa Municipality. A qualitative approach was implemented. A criterion-based purposive sampling technique was employed to recruit 51 managers and health service providers of CHPS for key informant interviews. The respondents included 25 community health management committee members, 25 health officers in charge of CHPS facilities, and one municipal CHPS coordinator. The interviews were held from September 18 to November 23, 2020. All interviews were face-to-face, audio-recorded and transcribed verbatim. Thematic analysis based on the constant comparative method was employed to analyse the data. The results showed that low community involvement in CHPS activities, disputes over the location and naming of CHPS zones, inadequate understanding of the CHPS concept and religious beliefs were the key community level factors which negatively affected the functioning of CHPS. Also, lack of logistics, financial constraints, poor attitude of health workers and inadequate staff motivation were the health sector constraints on the effective functioning of CHPS. In conclusion, concerted efforts are needed to tackle the community level and health system constraints to improve the overall functioning and effectiveness of the CHPS strategy. We recommend the strengthening of community sensitization, timely disbursement of funding, and provision of infrastructure and supplies to improve upon the effective functioning of CHPS as a strategy for delivery PHC in Ghana.

CORRELATION OF MEDICATION ADHERENCE WITH THE CHARACTERISTICS AND QUALITY OF LIFE OF TUBERCULOSIS PATIENTS IN DR. DRADJAT PRAWIRANEGARA HOSPITAL

Tuberculosis remains a health threat in Indonesia because its prevalence is relatively high; therefore, special tuberculosis control is needed. One way to control tuberculosis is to increase compliance with treatment, which can affect quality of life. The main objective of this study was to determine the relationship between the level of treatment compliance and the characteristics and quality of life of patients at dr. Dradjat Prawiranegara Serang Hospital. This study used a cross-sectional, observational research method. Data were collected by distributing questionnaires filled out through direct interviews with the patients. The questionnaires used were the MARS and EQ-5D-5L questionnaires were used. The subjects in this study were outpatients with tuberculosis who were undergoing treatment at our hospital. The Drajat Prawiranegara Serang Hospital met the inclusion and exclusion criteria. Sequential sampling was used as a sampling technique in this study. Statistical data analysis was performed using the chi-square test and correlation. The number of respondents in this study who met the inclusion criteria was 30. As many as 80.0% of tuberculosis patients adhere to taking medication, and 83.3% of tuberculosis patients have a good quality of life. The results of statistical tests show that there is a relationship between the level of compliance of tuberculosis patients and the level of knowledge, income, attitude of health workers, and family support. In contrast, the variables of the level of education, employment, motivation, distance to health facilities, and quality of life did not have a significant relationship with the level of tuberculosis patient compliance...

Kepatuhan Tenaga Kesehatan dalam Penggunaan Sarung Tangan Non Steril

This study aims to identify factors that influence compliance with the use of non-sterile gloves among health workers. The method used is a literature review. There are ten articles obtained from online databases on Pubmed, Science Direct, and other sources. Articles were selected using PRISMA and article appraisal. The results of this study show that health workers use gloves not in accordance with guidelines such as not carrying out hand hygiene before and after using gloves, using gloves more often than necessary, and failing to remove or change gloves at the right time. Factors that encourage health workers to wear non-sterile gloves are personal protection, patient protection, motivation to create a professional image and follow in the footsteps of seniors. Meanwhile, misuse and non-compliance with the use of gloves is influenced by a lack of knowledge and situational understanding of indications for use, age, gender, discomfort due to the use of PPE, lack of availability and access to PPE, attitude of health workers, and lack of supervision. In conclusion, health workers' compliance in using gloves can be improved with health education about controlling and preventing the spread of disease, training and refreshers in the proper use of PPE, supervision and management support to increase the availability and accessibility of PPE.
 
 Keywords: Compliance, Non-Sterile Gloves, Health Workers

Perceptions of pregnant women on antenatal care visit during their first trimester at area 25 health center in Lilongwe, Malawi – a qualitative study

BackgroundInitiation of antenatal care during the first trimester is crucial for reducing maternal and neonatal morbidity and mortality. Unfortunately, only 24% of pregnant women in Malawi initiate antenatal care during this time with even lower rates of 15% at Area 25 Health Centre in Lilongwe. Despite such cases, there is little literature on obstacles that prevent women from accessing first-trimester antenatal care in Malawi.AimTo explore perceptions of pregnant women and how they influence antenatal care visits during the first trimester at Area 25 Health Centre in Lilongwe, Malawi.MethodsWe employed a qualitative exploratory study on 55 purposely identified participants. The participants were aged between 18 and 37 years with a gestational period of 36 weeks and below and attended antenatal care at Area 25 Health Centre in Lilongwe Urban, Malawi. Data were collected by MN and 2 data collectors from 19th March 2021 to 16th April 2021 through a total of 15 In-depth Interviews (IDIs) and four Focus Group Discussions (FGDs). Data were manually analysed using thematic analysis, which included categorization and deductive theme identification with reference to the study objectives and the Health Belief Model (HBM).ResultsPregnant women perceived that the first-trimester antenatal care visits were only for those experiencing ill health conditions like backache, headache, and HIV/AIDS during pregnancy. First-trimester pregnancy was perceived as too small and not worthy of seeking antenatal care; the women placed a low value on it. The majority of those who initiated antenatal care in the first trimester had previously experienced disorders and complications such as previous cesarean sections and abortions. In addition to limited knowledge about the required total number of ANC visits, challenges such as long-distance, preoccupation with business, multiple antenatal visits, scheduling of antenatal care visits, negative attitude of health workers, adherence to COVID-19 containment measures, and inadequate partner support, were identified as barriers to seeking antenatal care during the first trimester.ConclusionThe negative perceptions among pregnant women, coupled with various health systems, socio-economic and individual barriers, contributed to low attendance rates for first trimester antenatal care in Malawi. Addressing knowledge gaps and overcoming barriers related to economic, individual and health care delivery can improve women’s early antenatal care visits. Future research should consider the pregnant women from diverse socioeconomic backgrounds to gain a better understanding of these perceptions and barriers.

Reasons for switching the primary health providers among national health insurance participants in Klungkung District, Bali Province, Indonesia

Background and purpose: National Health Insurance Provider (BPJS Kesehatan) facilitates the distribution of National Health Insurance (NHI) participants. High number of 1,947 NHI participants were switched primary health providers in Klungkung, Bali between July to December 2021.This study aims to explore the reasons for the switching of providers among NHI participants and the health providers’ efforts to minimize it. Methods: A qualitative descriptive study guided by an access theory was conducted in Klungkung District between December 2022 to March 2023. A total of 18 informants were purposively recruited, consisting of NHI participants (12 people), health service providers (4 people), BPJS Kesehatan (1 person) and staff of the district health office (1 person). Data was collected through in-depth interviews guided by interview guidelines. Data were analyzed using a thematic approach and presented in a descriptive narrative. Results: NHI participants in Klungkung District switched provider due to spatial and non-spatial reasons. Spatial reason was the distance and time to the health provider. Non-spatial reasons included (1) conflict in social relations due to service and negative attitudes of health workers, (2) economic considerations in the health system which are difficult to reach, and (3) external encouragement. Strategies that have been or can be implemented to minimize the switching of PHCs were adjusting operational hours, improving the infrastructures, administration through fulfilling accreditation, service quality and training for human resources. Conclusion: The dominant reason for switching of PHCs is associated with negative social interaction experiences related to human resources and service facilities at PHCs. PHCs are expected to be able to improve the quality of services through improving human resources and service delivery facilities.

Gaps in vaccine management practices during vaccination outreach sessions in rural settings in southwestern Uganda

BackgroundOutreach efforts were developed to bolster people’s access to and use of immunization services in underserved populations. However, there have been multiple outbreaks of diseases like measles in Uganda, prompting policy makers and stakeholders to ask many unanswered questions. This research study was created to uncover the discrepancies between vaccine management practices at immunization outreach sessions in rural South Western Uganda compared with existing standards.MethodsThe observational qualitative study, was done in 16 public health facilities across four districts of Uganda. Data were collected using in-depth interviews, facility record reviews, and observation. We assessed the vaccine management procedures before immunization session, transportation used, set up at the outreach site, management practices during the outreach session and packing of vaccines - according to World Health Organization immunization practice recommendations. The data were transcribed, coded and categories were formed and triangulated. Themes were generated based on a socio-ecologic framework to gain a better understanding of healthcare provider practices during immunization sessions.ResultsFifty-one individuals were interviewed; four Assistant District Health Officers, four cold chain technicians, 15 focal persons for the Expanded Program on Immunization, and 28 health care providers. The respondents’ mean age was 35, 43 (84.3%) were females and 24 (47.1%) had a diploma. 11 (69%) outreaches were conducted at a distance of 5-12 km from the health facility and 7 (44%) were conducted in a building. For 8 outreaches (50%) health facility staff did not check the vaccine vial monitor status before the outreach while 12(75%) did not keep the vaccine hard lid cover closed during the sessions. The main areas of concern were insufficient vaccine integrity monitoring, improper handling and storage practices, deficient documentation, and inadequate vaccine transportation. These were similar across immunization outreach sites regardless of vaccine preventable disease outbreaks occurrences. The majority of these gaps were located at the individual level but were enabled by policy/environmental factors.ConclusionsThere are poor vaccine management procedures during outreach sessions contrary to established guidelines. Specific tactics to tackle knowledge deficiencies, health worker attitude, and fewer equipment shortages could improve compliance to guidelines.

Assessment of antenatal care satisfaction amongst postpartum women at the University College Hospital, Ibadan, Nigeria

BackgroundMaternal mortality is unacceptably high especially in developing countries. About 287,000 women died during and following pregnancy and childbirth in 2020. The vast majority of these deaths (95 %) occurred in low and lower middle countries in 2020 and most could have been prevented. Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth. Utilization of antenatal visit has been shown to improve birth outcome as well as the maternal outcome during pregnancy-related events, giving a positive impact when the visit frequency and care are adequate while satisfaction has equally been an important outcome measures of quality of care. In order to improve feto-maternal outcome and turn the tide against maternal deaths, it is expedient to assess the satisfaction of women who had experienced antenatal care with the aim of identifying areas requiring additional attention. ObjectiveThis study aimed to assess the level of antenatal care satisfaction of postpartum women and factors associated with satisfaction at the University College Hospital (UCH), Ibadan and their future intention for subsequent utilization of antenatal care. MethodsA descriptive cross-sectional study of 261 women in the postnatal ward using simple random sampling technique was conducted with an interviewer-administered structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data was entered, cleaned and analyzed by computer using the Statistical Package for Social Sciences Version 23.0 (SPSS, IBM). The variables were summarized using frequencies, proportions, means and standard deviation. Chi Square was used for test of significance with the p-value set at P < 0.05. ResultsOf the 261 participants 176 (67.5 % percent) were aged 25–34 years; majority (244,93.5 %) had tertiary education while (189, 72.4 %) were skilled workers or professionals. Most of the women (243, 93.2 %) were Para 1–3 and the pregnancy was planned (80.8 %) while financing was mostly out of pocket (60.9 %). Only one-third of the participants has at least eight (8) antenatal contacts. In overall rating, most women (90.0 %) were satisfied with the antenatal care services received. The highest rating of satisfaction was with the competence of the service providers (90.4 %) especially with the care given to them and their unborn babies (90.4 %). The parity, distance of their home from antenatal clinic, number of antenatal contacts, number of health education sessions attended, total time spent, attitude of health workers, cost of services and desire to register again at the facility were statistically associated with patient’s satisfaction. Also, the number of antenatal visits was statistically associated with the fetal outcome. ConclusionThere is a high overall level of satisfaction with antenatal services among postpartum women in UCH. It is important to encourage women to register early to ensure they have adequate number of antenatal contacts and also participate in the health education sessions.

Patient’s experiences of diabetes care at a tertiary health facility in Lilongwe, Malawi

BackgroundLittle is known about experiences of rural people with diabetes care at a tertiary health facility in low-income settings. Understanding their experiences is essential for developing effective diabetes care interventions.MethodsThe study employed a qualitative narrative inquiry. Participants were identified at a diabetes clinic at a tertiary-level healthcare facility. Ten participants from the rural areas attending the diabetes clinic were purposively selected. Data were collected through in-depth interviews in the privacy of the homes of the study participants and analysis was done using the Riessman approach to thematic narrative analysis.ResultsIn this study, the following four themes emerged: (1) the long pathway to a diagnosis of diabetes; (2) Poverty-related hardships and diabetic clinic attendance; (3) The impact of health worker attitudes and behavior on diabetes care; and (4) Low resources and their impact on self-management.ConclusionsRural-based patients living with diabetes encounter enormous challenges as they access diabetes care. One of the challenges is delayed diagnosis of diabetes. There is a need to introduce point-of-care (POC) testing to improve diabetes diagnosis. In addition, there is a need to strengthen awareness campaigns among the population so that people are well informed about the signs and symptoms of diabetes to promote early diagnosis. Diabetes care must be decentralized from tertiary hospitals to primary health centers. This will improve access to diabetes care and reduce the burden associated with traveling a long distance to access diabetes care in Malawi.

DETERMINANTS OF REPRODUCTIVE HEALTH SEEKING BEHAVIOUR AMONG WOWEN OF REPRODUCTIVE AGE IN AJAOKUTA VILLAGE, KOGI STATE

Women of reproductive age play a pivotal role in ensuring the continuity of the society, yet, they are faced with high risks of complications and even death in the course of performing this role. The study examined the determinants of reproductive health-seeking behaviour among women of reproductive age (15-49 years) in Ajaokuta village. The Behavioural Model of Health Service Use was adopted as a theoretical framework of the study. A self-administered open-and closed-ended structured questionnaire was used as instrument of data collection. A descriptive survey was carried out among 156 respondents using the multi-stage sampling technique. Frequency distribution tables and percentage were used to analyze the data. The respondents had the knowledge of reproductive health service, seeks reproductive health care services but the traditional and the faith-based care services. Family influence, educational qualification, inadequate healthcare services, access to health care service, lack of quality services, inadequate health workers, attitudes of health workers, cost of services, lack of confidentiality, waiting period to access care and volume of patients awaiting treatments were the determining factors found by the study. More awareness centered on the benefits of orthodox services utilization, minimal family interference, education of women, availability of quality and accessible reproductive health services, adequate health workers with good attitudes, affordability of healthcare services, strict confidentiality, urgent attention to avoid large number of patients awaiting care services were the recommendations provided by the study&#x0D; Keywords: Ajaokuta Village, Maternal Morbidity, Maternal Mortality, Reproductive Health, Reproductive Health Seeking Behaviour.