Challenges and opportunities for implementing evidence-based antenatal care in Mozambique: A qualitative study

Autor: Fernando Althabe, Eduardo Bergel, María Belizán, Armando Melo, Beatrice Crahay, Jennifer Requejo Harris, Mario Merialdi, Diederike Geelhoed, Adriano Biza, Marleen Temmerman, Leonardo Chavane, Alicia Aleman, Celsa Regina Malapende, Nafissa Bique Osman, Ana Pilar Betrán, Ingeborg Jille-Traas, Metin Gülmezoglu, Mercedes Colomar, Thérèse Delvaux, Mariana Widmer, Alicia Carbonell, My Huong Nguyen
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Program evaluation
Psychological intervention
Obstetricia y Ginecología
Medicina Clínica
Pregnancy
hemic and lymphatic diseases
Obstetrics and Gynaecology
Health care
Outcome Assessment
Health Care
purl.org/becyt/ford/3.2 [https]
Medicine and Health Sciences
Medicine
Mozambique
Qualitative Research
education.field_of_study
Evidence-Based Medicine
WOMEN
Obstetrics and Gynecology
Prenatal Care
Focus Groups
female genital diseases and pregnancy complications
Checklist
Needs assessment
TRIAL
INDIA
Female
purl.org/becyt/ford/3 [https]
Needs Assessment
Research Article
Adult
CIENCIAS MÉDICAS Y DE LA SALUD
Evidence-based practice
Adolescent
BIRTH
Population
Risk Assessment
Interviews as Topic
Young Adult
Nursing
antenatal care
Humans
Maternal Health Services
education
Developing Countries
Poverty
business.industry
Patient Acceptance of Health Care
Focus group
PRENATAL-CARE
Cross-Sectional Studies
PERSPECTIVES
business
Qualitative research
Zdroj: CONICET Digital (CONICET)
Consejo Nacional de Investigaciones Científicas y Técnicas
instacron:CONICET
BMC Pregnancy and Childbirth
BMC PREGNANCY AND CHILDBIRTH
ISSN: 1471-2393
DOI: 10.1186/s12884-015-0625-x
Popis: Background: Maternal mortality remains a daunting problem in Mozambique and many other low-resource countries. High quality antenatal care (ANC) services can improve maternal and newborn health outcomes and increase the likelihood that women will seek skilled delivery care. This study explores the factors influencing provider uptake of the recommended package of ANC interventions in Mozambique. Methods: This study used qualitative research methods including key informant interviews with stakeholders from the health sector and a total of five focus group discussions with women with experience with ANC or women from the community. Study participants were selected from three health centers located in Maputo city, Tete, and Cabo Delgado provinces in Mozambique. Staff responsible for the medicines/supply chain at national, provincial and district level were interviewed. A check list was implemented to confirm the availability of the supplies required for ANC. Deductive content analysis was conducted. Results: Three main groups of factors were identified that hinder the implementation of the ANC package in the study setting: a) system or organizational: include chronic supply chain deficiencies, failures in the continuing education system, lack of regular audits and supervision, absence of an efficient patient record system and poor environmental conditions at the health center; b) health care provider factors: such as limited awareness of current clinical guidelines and a resistant attitude to adopting new recommendations; and c) Users: challenges with accessing ANC, poor recognition amongst women about the purpose and importance of the specific interventions provided through ANC, and widespread perception of an unfriendly environment at the health center. Conclusions: The ANC package in Mozambique is not being fully implemented in the three study facilities, and a major barrier is poor functioning of the supply chain system. Recommendations for improving the implementation of antenatal interventions include ensuring clinical protocols based on the ANC model. Increasing the community understanding of the importance of ANC would improve demand for high quality ANC services. The supply chain functioning could be strengthened through the introduction of a kit system with all the necessary supplies for ANC and a simple monitoring system to track the stock levels is recommended. Fil: Biza, Adriano. No especifíca; Fil: Jille Traas, Ingeborg. No especifíca; Fil: Colomar, Mercedes. No especifíca; Fil: Belizan, Maria. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Requejo Harris, Jennifer. Johns Hopkins Bloomberg School of Public Health; Estados Unidos Fil: Crahay, Beatrice. No especifíca; Fil: Merialdi, Mario. No especifíca; Fil: Nguyen, My Huong. No especifíca; Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Alemán, Alicia. No especifíca; Fil: Bergel, Eduardo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Carbonell, Alicia. No especifíca; Fil: Chavane, Leonardo. No especifíca; Fil: Delvaux, Therese. Institute of Tropical Medicine Antwerp; Bélgica Fil: Geelhoed, Diederike. No especifíca; Fil: Gülmezoglu, Metin. No especifíca; Fil: Malapende, Celsa Regina. No especifíca; Fil: Melo, Armando. No especifíca; Fil: Osman, Nafissa Bique. No especifíca; Fil: Widmer, Mariana. No especifíca; Fil: Temmerman, Marleen. No especifíca; Fil: Betrán, Ana Pilar. No especifíca
Databáze: OpenAIRE
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