Health Care Services For Pregnant Women Research Articles

Applying the WHO INSPIRE Framework to Ending Violence Against Pregnant Women and Unborn Children: A Case Study in Vietnam.

This article adapted the INSPIRE framework, developed by the World Health Organization to prevent violence against children, to the systematic analysis of city-level healthcare services for pregnant women who experienced intimate partner violence. A mixed-methods study conducted in-depth interviews with 22 health and social care professionals and 140 pregnant women in Vietnam. The women were more likely to report limited system-level support for partners regarding violence and mental health, while the professionals perceived more weaknesses in policies and management of services. Traditional values tend to isolate abused women from receiving social services. The INSPIRE framework is innovative and could be applied in other contexts.

Prevalence of food insecurity amid COVID-19 lockdowns and sociodemographic indicators of household vulnerability in Harar and Kersa, Ethiopia

BackgroundThe COVID-19 pandemic was associated with widespread social disruptions, as governments implemented lockdowns to quell disease spread. To advance knowledge of consequences for households in resource-limited countries, we examine food insecurity during the pandemic period.MethodsWe conducted a cross-sectional study and used logistic regression to examine factors associated with food insecurity. Data were collected between August and September of 2021 through a Health and Demographic Surveillance System (HDSS) using a survey instrument focused on knowledge regarding the spread of COVID-19; food availability; COVID-19 related shocks/coping; under-five child healthcare services; and healthcare services for pregnant women. The study is set in two communities in Eastern Ethiopia, one rural (Kersa) and one urban (Harar), and included a random sample of 880 households.ResultsRoughly 16% of households reported not having enough food to eat during the pandemic, an increase of 6% since before the pandemic. After adjusting for other variables, households were more likely to report food insecurity if they were living in an urban area, were a larger household, had a family member lose employment, reported an increase in food prices, or were food insecure before the pandemic. Households were less likely to report food insecurity if they were wealthier or had higher household income.ConclusionsAfter taking individual and household level sociodemographic characteristics into consideration, households in urban areas were at higher risk for food insecurity. These findings suggest a need for expanding food assistance programs to more urban areas to help mitigate the impact of lockdowns on more vulnerable households.

Maternal, newborn, and children under-five health surveillance system: a scoping review protocol

BackgroundPublic health surveillance is crucial in monitoring the progress of maternal, newborn, and children under-five health outcomes (MNCH). Consequently, mapping the existing surveillance system from countries with different income and development levels is needed to learn and compare the effectiveness of surveillance. However, the current COVID-19 pandemic has disrupted the health system, including the healthcare services for pregnant women, neonates, infants, and children under five, as well as the recording, reporting, and surveillance system. The need to adapt to the new normal during the pandemic has stimulated innovation while incorporating new COVID-19-related indicators into the existing public health system. Therefore, this review aims to describe the existing implementation and the COVID-19 pandemic’s influence on the MNCH surveillance system.MethodsWe will search published literature (from MEDLINE, Embase, and Portal Garuda), manually search from all reference lists of included studies, and conduct a targeted search of relevant gray literature. This review will include studies of surveillance systems or describe COVID-19 surveillance or routine reports involving MNCH (morbidity and mortality). The studies included will be in English or Indonesian language, observational study designs, and published or documented from 2010 to 2023. Two investigators will independently screen the title and abstract, including each full article to determine the eligibility of studies. The data will be assessed using a narrative approach. Data will be reported in simple descriptive tables.DiscussionOur findings are expected to map the existing implementation of MNCH surveillance systems before and during the pandemic, including the influence of the COVID-19 pandemic on MNCH surveillance across countries with different income levels. This may contribute to existing knowledge on the MNCH health surveillance system that could be integrated into the surveillance of emerging diseases, such as COVID-19.Systematic review registrationThe protocol has been registered on the Open Science Framework (https://osf.io/bc6t4).

The roles of Tuha Peut Gampong in healthcare services for pregnant women

This research was aimed to identify the roles of Tuha Peut in healthcare service for pregnant women. This study was also examined the obstacles of Tuha Peut in implementing the roles and identified the efforts taken to strengthen the roles. This research employed quantitative and qualitative approaches. The quantitative approach using a questionnaire to collect data was used to provide indicators for maternal healthcare and the knowledge of Tuha Peut towards maternal health care. Meanwhile, the qualitative approach using open-ended interview guide and focus group discussion (FGD) was employed to explore the constraints and efforts in improving maternal healthcare. The research location was in Nagan Raya, Aceh Province. A total of 48 respondents was recruited in this study. The result shows there is a relevance between the health care achievement and TuhaPeut knowledge as the legislative assembly in decision making regarding the village fund (p 0.001). Concerning the decision-making, most Tuha Peut were not involved in decision-making related to the health sector. Some of them were only passively involved, and some could not provide considerations for maternal healthcare. Unfortunately, efforts to maximize their roles in improving maternal healthcare had not been carried out. It is recommended that TuhaPeut can be more involved in every planning process of maternal healthcare service, such as arranging Qanun as the jurisdictional basis. Tuha Peut’s roles can be maximized to increase the health care for pregnant mothers.

The utilization of maternal healthcare services during the COVID-19 pandemic in South Sulawesi, Indonesia

Aim: The aim of this study was to evaluate the utilization of healthcare services for pregnant women during the COVID-19 pandemic in South Sulawesi, Indonesia. Design: An analytical cross-sectional study. Methods: A group of 226 pregnant women completed the study questionnaire. The questionnaire was developed based on the basic health research questionnaire from the Ministry of Health, Indonesia, and the Navigating Pregnancy during the COVID-19 Pandemic article from UNICEF. Results: Of the 226 pregnant women, 122 (54%) had poor knowledge related to COVID-19 and negative attitudes regarding health protocols for COVID-19 (79.6%). Most (n = 189; 83.6%) experienced anxiety; however, this did not affect their intention to use healthcare services. Utilization of antenatal care services during the pandemic was associated with antenatal care visiting behavior (p = 0.000) and access to healthcare services (p = 0.000). The most significant predictor of utilization of antenatal care services during the pandemic was antenatal care visiting behavior (p = 0.002; OR = 5.904). Conclusion: These findings provide important information on maternal healthcare provision during the pandemic in Indonesia.

Correction: Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study

[This corrects the article DOI: 10.1371/journal.pone.0188280.].

Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study.

BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone.Methods and findingsData were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made.ConclusionsPregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone.

Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study.

Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women.

Health workers' perceptions of access to care for children and pregnant women with precarious immigration status: Health as a right or a privilege?

The Canadian government's recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April–June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada's socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as “deserving” of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as “underserving” of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a “privilege”, that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.

Giving to receive? The right to donate in umbilical cord blood banking for stem cell therapies

ObjectivesTo explore the views of lay and professional stakeholders about the donation of cord blood to public banks in England and the policies surrounding it. MethodsQualitative in-depth interviews were undertaken between April 2009 and August 2010 with 62 participants based in England who play a key role in cord blood banking and therapy. All interviews were recorded, transcribed in full, and coded and analysed thematically. ResultsParticipants claimed pregnant women had a right to know of the value of cord blood. This highlighted the flaws of the existing donation infrastructure, which was portrayed as playing a significant role in determining public health. Participants called for a right to donate cord blood to readdress the inequity in healthcare services for pregnant women and transplant recipients. Donors maintained a sense of right over their donation when they discussed cord blood donation as potentially benefiting their family as well as society. ConclusionIn order to keep receiving donated body parts, tissue and blood, there is a need to take into account the way in which donation operates within a prevalent ‘rights’ discourse.