Exploring Drivers of Infant Deaths in Rural Rwanda Through Verbal Social Autopsy
| Autor: | Neil Gupta, Lisa R. Hirschhorn, Cheryl Amoroso, Felix Sayinzoga, Shalini Navale, Lameck Habumugisha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Parents Rural Population Time Factors mixed methods 030231 tropical medicine Context (language use) Infectious and parasitic diseases RC109-216 Infections Health Services Accessibility Infant Death World health Experiential quality Interviews as Topic 03 medical and health sciences barriers to care verbal social autopsy 0302 clinical medicine Nursing Professional-Family Relations Cause of Death Health care Health insurance Humans Medicine Active listening 030212 general & internal medicine Qualitative Research Medically Uninsured Insurance Health business.industry Communication Rwanda Infant General Medicine Health Services Patient Acceptance of Health Care Infant mortality infant mortality Female Autopsy Thematic analysis Public aspects of medicine RA1-1270 business |
| Zdroj: | Annals of Global Health, Vol 83, Iss 5-6, Pp 756-766 (2017) |
| ISSN: | 2214-9996 |
| Popis: | BackgroundRwanda has been a leader in the global effort to reduce infant mortality, particularly in regions of sub-Saharan Africa. Although rates have dropped, deaths still occur.ObjectiveTo explore the care pathways and barriers taken by infant caregivers before the death of their infant through a verbal social autopsy study in 2 districts in eastern Rwanda.MethodsWe adapted the World Health Organization verbal socialautopsy tools to reflect local context and priorities. Caregivers of infants in the 2 districts were interviewed using the adapted quantitative survey and semistructured interview guide. Interviews were recorded and thematic analysis employed on a subsample (n = 133) to extract the content relevant to understanding the drivers of infant death and inform results of the quantitative data until saturation was reached (66). Results were interpreted through a driver diagram framework to explore caregiver-reported challenges in knowledge and experiences with care access and delivery.FindingsMost study participants (82%) reported accessing the formal health system at some point before the infant's death. The primary caregiver-reported drivers for infant death included challenges in accessing care in a timely manner, concerns about the technical quality of care received, and poor responsiveness of the system and providers. The 2 most commonly discussed drivers were gaps in communication between providers and patients and challenges obtaining and using the community-based health insurance. The framework of the driver diagram was modified to identify the factors where change was needed to further reduce mortality.ConclusionThis study provides important information on the experiential quality of care received by infants and their caregivers within the current health care space in rural Rwanda. By listening to the individual stories of so many caregivers regarding the gaps and challenges they faced, appropriate action may be taken to bolster the existing health care system. |
| Databáze: | OpenAIRE |
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