Delivery Care For Women Research Articles

Sexual health in female under treatment for opiate dependence using diacetylmorphine

Sexual health is a key element to the well-being and quality of life of individuals. However, it is rarely incorporated into care delivery for women with an addictive condition. Female with severe dependence to opiate have their medical and social conditions improved by diacetylmorphine treatment. Which allows them to escape situations of high-risk of sexual violence. However, this pharmacotherapy can also induce adverse effects on the sexual sphere. This paper describes the relevance of integrating psycho-socio-sexological counselling into the care provision for the opiate dependence. The counselling should be oriented to respond to the specific relational and sexual issues faced by these female patients and empowering them on their lives and in recovering a better quality of life.

Factors Affecting Delivery Health Service Satisfaction of Women and Fear of COVID- 19: Implications for Maternal and Child Health in Pakistan.

ObjectiveHigh maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries.MethodsA total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied.ResultsThe results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R2 = 0.651); (ii) during delivery care (R2 = 0.716); (iii) after delivery care for women (R2 = 0.525); and (iv) after delivery care for newborn (R2 = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning.Conclusions for PracticeBased on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10995-021-03140-4.

Sex, Grief, and Psychic Trauma: Considering History and Politics in the Psychosexual Treatment of Women with FGC

This paper stems from a presentation given at the “Second International Expert Meeting on Female Genital Mutilation/Cutting (FGM/C): Sharing data and experiences, improving collaboration,” which took place at Centre Hospitalier Universitaire Ste. Justine, Montreal, Canada, in May 2018. It aims to shed light on the psychosexual health of women with female genital cutting (FGC), drawing from both scientific research and clinical work. This paper also addresses the inherent challenges to healthcare delivery for “cut” women and seeks to illuminate the social and historical realities that form the backdrop to the clinical encounter. While there is a vast body of literature on the psychological determinants of sexual health, studies on “cut” women’s sexual health have yet to delve into its psychological correlates. In addition, healthcare delivery for women with FGC poses a number of challenges, which impinge upon patient experience and health-seeking behavior. Ethical considerations in care delivery for women with FGC must delve into the hegemonic nature of the patient-practitioner interactions and politics of Otherness. Interdisciplinary research and praxis on FGC will prevent biological reductionism and the pathologization of these women. It will afford more integrated, comprehensive, and ethical care for women with FGC.

An Irish National Diabetes in Pregnancy Audit: aiming for best outcomes for women with diabetes.

The purpose of this study was to identify the number of pregnancies affected by pre-gestational diabetes in the Republic of Ireland; to report on pregnancy outcomes and to identify areas for improvement in care delivery and clinical outcomes. Healthcare professionals caring for women with pre-gestational diabetes during pregnancy were invited to participate in this retrospective study. Data pertaining to 185 pregnancies in women attending 15 antenatal centres nationally were collected and analysed. Included pregnancies had an estimated date of delivery between 1 January and 31 December 2015. The cohort consisted of 122 (65.9%) women with Type 1 diabetes and 56 (30.3%) women with Type 2 diabetes. The remaining 7 (3.8%) pregnancies were to women with maturity-onset diabetes of the young (MODY) (n=6) and post-transplant diabetes (n=1). Overall women were poorly prepared for pregnancy and lapses in specific areas of service delivery including pre-pregnancy care and retinal screening were identified. The majority of pregnancies 156 (84.3%) resulted in a live birth. A total of 103 (65.5%) women had a caesarean delivery and 58 (36.9%) infants were large for gestational age. This audit identifies clear areas for improvement in delivery of care for women with diabetes in the Republic of Ireland before and during pregnancy.

Delivering Care to Women who are Homeless: A Narrative Inquiry into the Experience of Health Care Providers in an Obstetrical Unit

The purpose of the study was to explore the experiences and perceptions of health care providers in an acute care setting delivering care to pregnant women who are experiencing homelessness. In recent years, the number of women experiencing homelessness has significantly increased. In North America, the emerging homeless profile is that of a younger person and more often women. Living in precarious housing situations increases one’s risk for serious health conditions. Women who are homeless often experience complex health issues but many intersecting barriers exist between homeless women and health care providers, which impacts the care provided. A better understanding of the health care providers who provide care is urgently needed. A narrative inquiry design was implement. We recruited 10 health care providers from antenatal, postpartum, and labour and delivery units in a large, urban tertiary care hospital. Using narrative inquiry methodology, and a conversation guide we explored care providers’ personal and professional experiences over time, place, and within social contexts. Conversations with participant were held 2 or 3 times. From participants’ narrative accounts, we identified four threads that were evident across their experiences: shaping and being shaped by institutional mandates, the importance of conversational spaces, the lack of interprofessional interactions and living with conflicted views about practice. Care practices are shaped by complex personal, interpersonal, and institutional factors. Contextualized learning experiences within health care settings may serve to encourage narrative reflective practices and support communities of practice with the ultimate goal to improve health care delivery for women in precarious housing situations.

Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa.

Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved.

Delivering quality care: What can emergency gynaecology learn from acute obstetrics?

Emergency obstetric care in the UK has been systematically developed over the years to high quality standards. More recently, advances have been made in the organisation and delivery of care for women presenting with acute gynaecological problems, but a lot remains to be done, and emergency gynaecology has a lot to learn from the evolution of its sister special interest area: acute obstetric care. This paper highlights areas such as consultant presence, risk management, patient flow pathways, out-of-hours care, clinical guidelines and protocols, education and training and facilities, where lessons from obstetrics are transferrable to emergency gynaecology.

Practitioner Perspectives of the Economic Coping Experiences of Women of Domestic Violence Abuse

Through this case study the author investigates women's coping experiences with economic challenges in the spectrum of domestic violence abuse. Women of abuse cope with financial difficulties compounded by other ecologically contributing factors. Eight non-abused, social service practitioners from four different agencies, two providers per agency, described the economic coping experiences of women of abuse they serve. Comprehensive and interdisciplinary care is necessary to meet women's multifaceted, complex economic needs. Study results corroborate with research. Service delivery of care for women of abuse coping with family, schooling, and economic hardships are enhanced through schools and service agencies working together, collaborating networking, and sharing of resources in order to better advocate for women and children.

Breast Cancer Patient Stories Project

It is estimated that there are almost half a million women living with or beyond a breast cancer diagnosis in the UK, often referred to as the breast cancer survivor population. We report on the setting up of a dedicated breast cancer and menopause symptoms service (BCMS), and present results from research undertaken with breast cancer survivors with the aim of obtaining their perspectives on the BCMS service. An action-oriented approach incorporating improvement science methodology has been used to help develop and drive changes to support a high standard of NHS patient care delivery for women with breast cancer within the BCMS setting. Evaluation was undertaken of this innovative service using qualitative methodology, and included discussion within a focus group setting, patient consent to record discussion, followed by thematic analysis of transcription. Women who have survived breast cancer identified a need for specialist support to help improve their quality of life, which is also affected by menopause type symptomology. This support can be provided within the BCMS service setting. Our recommendations are that the BCMS service model is incorporated into any regional or national breast cancer patient pathway and service redesign work in place. Breast cancer survivors would support the setting up of a BCMS service, and would actively help raise awareness and market this service.

Tracing pathways from antenatal to delivery care for women in Mumbai, India: cross-sectional study of maternity in low-income areas

SummaryIn many cities, healthcare is available through a complex mix of private and public providers. The line between the formal and informal sectors may be blurred and movement between them uncharted. We quantified the use of private and public providers of maternity care in low-income areas of Mumbai, India. We identified births among a population of about 300 000 in 48 vulnerable slum areas and interviewed women at 6 weeks after delivery. For 10,754 births in 2005–7, levels of antenatal care (93%) and institutional delivery (90%) were high. Antenatal care was split 50:50 between public and private providers, and institutional deliveries 60:40 in favour of the public sector. Women generally stayed within the sector and institution in which care began. Home births were common if women did not register in advance. The findings were at least superficially reassuring, and there was less movement than expected between sectors and health institutions. In the short term, we suggest an emphasis on birth preparedness for pregnant women and their families, and an effort to rationalize the process of referral between institutions. In the longer term, service improvement needs to acknowledge the private-public mix and work towards practicable regulation of quality in both sectors.

Distribution of treatment for human papillomavirus-associated gynecologic carcinomas before prophylactic vaccine

This report describes the distribution of treatment for cervix uteri, vagina, and vulva carcinomas by demographic characteristics before the widespread implementation of human papillomavirus (HPV) vaccination in the US. The authors used data collected by the Surveillance, Epidemiology, and End Results Program from 2000 through 2004 to calculate the distribution of surgical procedures and radiotherapy by carcinoma site, disease stage, and tumor histology (squamous vs nonsquamous). For women with localized cervical carcinomas, the proportions of hysterectomy procedures were analyzed by age, race, ethnicity, marital status, and histology, including a 13-year trend analysis of hysterectomy use. Although 75% of the women with cervical carcinomas underwent hysterectomy, there were significant differences in treatment by race and ethnicity. Black women were least likely to undergo hysterectomies: The large gap between them and other racial/ethnic groups persisted throughout the study period. For all 3 carcinoma sites, both tumor histology and disease stage influenced radiotherapy modality and the extent of surgery. Nonsquamous histology, ages 30 to 64 years, Asian/Pacific Islander race, and marriage were associated positively with hysterectomy. Overall, a gradual decrease in hysterectomy use was observed over time. Hysterectomies among Hispanic white women increased slightly. Cancer surveillance data suggest that treatment patterns of HPV-associated carcinomas are correlated with both clinical and demographic characteristics. The decreasing use of hysterectomy before introduction of the HPV vaccine and the vaccine's potential effect on the age-related stage distributions warrant consideration when evaluating its future impact on the delivery of care for women with HPV-associated tumors.

Knowledge as power

As we launch this first issue of African Journal of Midwifery and Women's Health (AJM), we must think critically about our mission and the tools that can enhance fulfillment of this mission. The complexity of midwifery and women's health in Africa will be reflected in the journal, which will provide a forum for topical debates on clinical and professional issues. Research and education will be integral to each issue, encouraging advanced skills, knowledge transfer and academic discussions. Dissemination of information and utilization of knowledge will provide powerful tools in midwifery and women's health, to promote our professional image as well as improving health care delivery for women, children and their families.

Women's health groups: alternatives to the health care system.

This article describes an empirical study of 28 alternative women's health organizations. These organizations were formed by women who rejected the existing institutions of health care, especially the nature and quality of reproductive health services. The study examined their philosophy of health care, the range of services provided and the characteristics of women who use them, their internal organization in terms of the distribution of power and authority, and the problems and challenges involved in their existence. Implications and impacts resulting from their continuing existence into the 1980s on the delivery of health care for women are addressed.