Tesi sul tema "Antenatal care"
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1
Majoko, Franz. "Assessing Antenatal Care in Rural Zimbabwe". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6018.
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2
Draper, J. "An experiment in community antenatal care". Thesis, University of Cambridge, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598641.
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3
Thorley, Kevan. "Seeing mothers as partners in antenatal care". Thesis, Keele University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414753.
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4
Mametja, Selaelo Mabu. "Factors associated with late antenatal care attendance". Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/9401.
Testo completoAbstract (sommario):
Includes bibliographical references.The prevalence of late attendance for antenatal care in South Africa remains high despite the reported benefits of early initiation of antenatal care. The study aimedat identifying factors associated with late initiation of antenatal care. Methods: Cross sectional survey data collected for a FAS prevention programme in rural and urban South Africa were used. The primary study made use of face-to-face interviews with female participants the age range of 18 to 44 years. The dependent variable, gestational age, was categorized into a binary variable across 4 months gestational age. Independent variables consisted of scales and categorical variables (mostly binary) within the following domains: (a) socio-demographic factors; (b) characteristics of index pregnancy including substance use information; (c) psychosocial factors; (d) community factors; and (e) partner characteristics.
5
McCaw-Binns, Affette Michelle. "Does antenatal care make a difference? An examination of antenatal care in Jamaica and its relationship to pregnancy outcome". Thesis, University of Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335732.
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6
Kufa, Erica. "The timing of first antenatal care visit and factors associated with access to care among antenatal care attendees at Chitungwiza municipal clinics, Zimbabwe". Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4553.
Testo completoAbstract (sommario):
Magister Public Health - MPHBackground and Rationale: Antenatal care (ANC) is vital for accessing prevention of mother to child transmission (PMTCT) services. The timing of the first ANC visit is critical for HIV infected pregnant women to access antiretroviral (ARV) prophylaxis as recommended. In addition pregnant women access other interventions like syphilis screening and treatment, provision of ferrous iron supplements, malaria prevention and treatment, health education, identification and management of risk factors. There is however paucity of information on factors associated with the timing and adequate use of ANC services in Chitungwiza Township, Zimbabwe. Aim: This study aimed to determine the factors associated with early access to and adequate use of ANC services among women attending ANC in the four polyclinics in Chitungwiza Township.Method:The study included a retrospective record review of women who registered for ANC in 2010 and a cross sectional study of pregnant women attending ANC clinic for the first time during the current pregnancy during the survey period. Data on gestation age at first ANC visit, number of ANC visits, age, gravidity, parity, tetanus, iron sulphate, rhesus results, HIV test result, WHO clinical stage, CD4 count, cotrimoxazole, PMTCT option accepted, date of initiation of AZT or ART; partner HIV test results; and infant feeding adherence done was abstracted into an MS Excel spreadsheet from the 2010 ANC registers in the four primary health care clinics. Every fourth record was captured. Exit interviews were also conducted on all women attending ANC for the first time during the current pregnancy using a structured questionnaire. Questions on socio-economic status, pregnancy history, reasons for seeking ANC, knowledge and belief about ANC services and their perception of the service received were asked. The outcome variables were gestation age at first ANC visit and the number of ANC visits. The spreadsheet was imported into Epi Info 7.0.9.7 and STATA 11 for analysis. The questionnaires were captured into an Epi Info 7 database exported to STATA 11 for analysis. A sample of 1,236 of first ANC visit records were abstracted from the 2010 ANC registers in the four primary care clinics and 80 women coming for ANC were interviewed in three clinics. The prevalence of pregnant women attending ANC for the first time at gestation age less or equal to 14 weeks and the prevalence of women with less than 4 ANC visits were computed. Pearson Chi-square tests were used to determine the strength of the relationships between the dependent variable (gestation age at the time of the first visit) and independent variables of age, marital status, level of education, parity, gravidity. All statistical tests were performed at 5% significance level and estimates were calculated at 95% confidence interval. Multiple logistic regression analysis was used to investigate the association between the outcome and the independent variables. Model interpretation was done using odds ratios (OR). Levels of knowledge and perception about ANC services as well as service content during the visit were also summarized. Results: Less than 1% of the women who attended ANC in 2010 came for 1st visit at week 14 or less, while of the women interviewed, 2.5% came at similar gestation age. Thirty-nine percent of women attending ANC in 2010 had at least four visits. Lower parity and tetanus immunization were significantly associated with early ANC initiation, while tetanus immunization and syphilis screening were associated with the number of visits.Among the interviewed women (n=80), 72.1% believed that a pregnant women should start ANC at 14 weeks or earlier. Most women (61.7%) cited having no money for booking as the reason for not coming earlier. Need for husband or partners permission, procrastination and not having any health problems with previous pregnancies were also a barrier to access. Uptake of HIV testing was very high at 94.7% of the women. However partner testing was very low at 2.1%. Knowledge of the appropriate time of the first ANC visit was somewhat high but not universal. Conclusions and Recommendations: Timely and adequate uptake of ANC services is very low in Chitungwiza Township. The user-fees appeared to be a major barrier to accessing ANC timely. While correct knowledge about when to go for ANC and the health problems women face during pregnancy and childbirth is prevalent,other factors like the need for permission from spouse or partner and procrastination were barriers to seeking service. Abolishing maternity fees should be seriously considered in order to increase access to timely ANC services. Sustainable means of financing services without reducing quality should be sought. There was variable uptake of various interventions in the ANC package due in part to supplies stock outs. There is need for strengthening the procurement and distribution systems so as to ensure continuous supplies at service delivery level.
7
Simelane, Lungile. "Pregnant women’s perceptions and understanding of the barriers to early antenatal care booking in the Shiselweni region in Swaziland". University of the Western Cape, 2020. http://hdl.handle.net/11394/8099.
Testo completoAbstract (sommario):
Master of Public Health - MPHGlobally, the maternal mortality rate (MMR) dropped by 44%, from 342 deaths per 100 000 to 211 maternal deaths per 100,000 live births in 2017. Developing countries have reached two-thirds coverage (69 %) of the recommended focused visits and first ANC. In sub-Saharan Africa alone, approximately 66% (201,000) of deaths occur during birth. MMR can be reduced if pregnant women initiate ANC early enough and receive quality care. In Swaziland, only 14% of pregnant women make their first ANC visit during the first trimester, 64% during the 2nd trimester and 22% during the 3rd trimester. The study aimed to explore pregnant women's perceptions of the factors contributing to late ANC booking in the Shiselweni Region.
8
Simkhada, Bibha. "Antenatal care uptake in Nepal : barriers and opportunities". Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=166164.
Testo completoAbstract (sommario):
Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. Only 29% of pregnant women receive the recommended four antenatal visits in Nepal and reasons for such low utilisation of ANC are poorly understood. The main aim of this thesis is to explore opportunities and barriers in ANC uptake and the family’s role in decision-making in Nepal. In-depth interviews were conducted with 30 purposively selected prenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two communities (one semi-urban, one rural). There is no single factor that determines the use of ANC in the study area. Use of ANC is influenced by cultural norms and values. Culturally women have low status in the household and this contributes to the low uptake of ANC. Heavy workloads (inside and outside the home) are expected of all young women and challenge ANC uptake in rural areas. The findings suggest that husbands and mothers-in-law have a strong influence in the use of ANC. Mostly the mothers-in-law are pivotal family members who make decisions about ANC for their daughters-in-law. Educated husbands are reported to be positive towards ANC. Husbands’ lack of support in ANC is mostly related to alcoholic habit. Education had a positive effect on ANC uptake due to improved knowledge of its function. Perceptions regarding the need for ANC are shaped by previous experiences and severity of the condition of pregnancy. Some women did not go for ANC as pregnancy was seen as a normal condition. Similarly, perceived quality of care such as satisfaction towards the services, privacy and confidentiality, communication skills of the health worker are highlighted as important issues in ANC uptake. Factors related to affordability of care such as poverty and cost of the services are discouraging to some, especially poor families. Similarly, availability and accessibility of the services were highlighted as important issues in ANC uptake. Comprehensive health promotion and educational interventions could be positive actions but should target both women and their family members, particularly mothers-in-law and husbands.
9
Doubell, Chantéll. "Antenatal care for HIV positive women / Chantéll Doubell". Thesis, North-West University, 2007. http://hdl.handle.net/10394/741.
Testo completoAbstract (sommario):
Approximately 29.1% of South African women of childbearing age tested HIV positive during their first antenatal visit in 2006 (DoH, 2007). This rate of HIV amongst the women of childbearing age reinforces the importance of understanding the management of HIV during pregnancy. During antenatal visits the general health of the woman and her unborn baby is assessed and managed. Management includes antiretroviral therapy to the HIV infected women with a CD4 count below 200 cells/mm3, while women with a CD4 count above 200 cells/mm3 receive a single dose of nevirapine with the onset of labour provided to them by their local clinics. Currently, in Potchefstroom, women receive antenatal care at local primary health-care clinics and antiretroviral drugs at the antiretroviral clinic. There is little or no collaboration between the various clinics and the question arises if the needs of the women are being met.
The aim of the research was to promote the health of HIV positive pregnant women by providing insight into the needs of these women and to formulate recommendations for antenatal care. The specific objective is to explore and describe the needs of HIV positive pregnant women regarding antenatal care.
An explorative, descriptive, contextual design, following a qualitative approach was used during the research. Semi-structured interviews were used to collect data. Interview questions were compiled from the research problems. Before the commencement of data collection, permission was obtained from the district health manager and Potchefstroom Hospital. A total of sixteen (16) HIV positive women were interviewed after informed consent had been obtained. Data analysis was done after each session and themes were categorised according to the women's needs.
From the interviews it was found that each woman has her own specific needs regarding antenatal care. The needs of the participants followed a similar pattern and for this reason it could be divided into various categories. These categories
include a need for support, a need for education, a need for improved services and a need for a non-judgemental environment. Conclusions were drawn and recommendations were made for nursing practice, nursing education and nursing research.Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.
10
Snyman, J. S. "Effectiveness of the basic antenatal care package in primary health care clinics". Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/728.
Testo completoAbstract (sommario):
Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.
11
Kaye, Debra Anne. "Women's perceptions of telephone nursing care within an antenatal home care program". Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/26308.
Testo completoAbstract (sommario):
Purpose/problem. Telephone nursing care (TNC) has replaced some home visits to increase efficiency of The Ottawa Hospital Antenatal Home Care Program (AHCP). There is limited published research addressing TNC in similar settings to guide program development. Therefore, chose an evaluation strategy to explore the clients' the researchers and organization perceptions of TNC.
Objectives. (1) Perform a systematic literature review of TNC in the high risk antenatal population. (2) Profile high risk antenatal population receiving telephone nursing care. (3) Describe clients' perceptions of telephone nursing care. (4) Explore the feasibility of this methodology for continuous program evaluation and informing development and improvement.
Method. A mixed methods approach was used. Two surveys and a semi-structured interview were completed by 13 participants. Data were analyzed using descriptive statistics and constant comparative analysis.
Results. Sample was similar to the population in diagnosis, maternal and fetal outcomes. Anxiety scores were high and women identified the highest needs related to high risk pregnancy, psychological and information domains. Four main themes emerged: the experience of being at home, perceptions of the telephone care, perceived benefits, and perceived health systems issues.
12
Mxoli, Winnifred Nonkonzo. "Women's perceptions and experiences of antenatal care rendered by midwives". Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/575.
Testo completoAbstract (sommario):
The general health status of pregnant women depends largely on the quality of the antenatal services available to them. The provision of good antenatal services ensures early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. In order to ensure high quality care, antenatal services need to be evaluated at regular intervals, both from provider and client perspective, to ensure their effectiveness in improving the health status of pregnant women. The midwife, as the first contact person for most pregnant women attending antenatal clinics in South Africa, has the potential to play a major role in improving the health status of these women. However, for the midwife to be effective in achieving this, antenatal services need to be effectively utilized by women. One of the factors that affect utilization of any service is client satisfaction with the service being rendered. This study, therefore, explores the perceptions that pregnant women have of the care that they receive from midwives at the selected antenatal clinics. The objectives of the study are to: {u100083} Explore and describe the perceptions and experiences of pregnant women attending antenatal clinic regarding the care they receive from midwives. {u100083} Make recommendations to assist registered midwives in optimizing the accompaniment of women during the antenatal period. A qualitative, descriptive, exploratory and contextual design was used for the study. The sample was chosen from the target population by means of purposive sampling and data was collected through unstructured interviews with the participants. Before data collection, permission was obtained from the Eastern Cape Department of Health and the Nursing Service Manager of the Gateway clinic, in the district hospital where the research was conducted. The Nursing Service Manager was acting as a Medical Superintendent at the time of the study. Written, informed consent was obtained from all participants before conducting interviews. Trustworthiness was ensured by means of Guba’s model throughout the study, and the aspects of truth value, applicability, consistency and neutrality were considered. Tesch’s eight steps of data analysis were used to analyze the data collected, and four main themes were identified namely: • Women perceive midwives as considerate and knowledgeable • Women perceive midwives as lazy and rude • Women experience mixed emotions about the care they receive from midwives • Though their experiences, women identified certain needs in the services and care they received at the clinic. Conclusions were drawn and recommendations for midwifery practice made based on the results of the study, with the aim of improving antenatal services rendered to pregnant women.
13
Stenson, Kristina. "Men's Violence against Women – a Challenge in Antenatal Care". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4140.
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14
Candelier, Claire Kathleen. "Studies on antenatal care in the South Wales valleys". Thesis, University of Sheffield, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296766.
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Haddrill, Rosalind. "Understanding delayed access to antenatal care : a qualitative study". Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/10533/.
Testo completoAbstract (sommario):
Background Delayed access to antenatal care (‘late booking’) is linked to poor maternal, fetal and neonatal outcomes. There have been few studies of women’s attitudes towards the initiation of antenatal care in the UK. The aim of the study was to understand why some women delay accessing antenatal care, and ultimately to improve such access and outcomes. Methods The synthesis of a large and methodologically diverse body of evidence, around perceptions and beliefs towards late booking for antenatal care, identified that antenatal care participation behaviour is complex, with a broad range of interacting barriers. A qualitative study was undertaken in Sheffield, interviewing 27 women presenting for their first hospital booking appointment after 19 weeks gestation, in community and maternity hospital settings. The interviews were transcribed verbatim and an iterative thematic analysis completed. Results The women were diverse in terms of age, parity, socioeconomic status and educational attainment. Three key themes relating to late booking were identified: • ‘not knowing’: realisation (absence of classic symptoms, misinterpretation), belief (age, subfertility, contraceptive use, lay hindrance); • ‘knowing’: avoidance (ambivalence, fear, self-care), postponement (fear, location, not valuing care, self-care); • ‘delayed’ (professional and system failures, knowledge and empowerment issues). Conclusions The analysis suggests a new taxonomy of themes around late booking, reflecting the interaction of cognitive, emotional, social and environmental factors which must be navigated prior to a woman’s first antenatal appointment. Common themes were evident across the social spectrum, including poor reproductive health knowledge and delayed recognition of pregnancy, but also the influence of a pregnancy ‘mindset’ and previous pregnancy experience, and the perceived priority of antenatal care. Three recommendations are made, namely to 1. address unintended pregnancies through improved reproductive health literacy, 2. enhance access to early antenatal care, and 3. improve the quality and focus of care, thus influencing women’s perceptions of its value and relevance. In combination these will facilitate the provision of timely antenatal care for all women.
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Hepburn, Mary. "The role of antenatal inpatient care in obstetric practice". Thesis, University of Edinburgh, 1986. http://hdl.handle.net/1842/19839.
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Chege, Eunice Nyambura. "Geographic Variations in Antenatal Care Services in Sierra Leone". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5062.
Testo completoAbstract (sommario):
Despite antenatal care presenting opportunities to identify and monitor women at risk, use of recommended antenatal care services remains. Barriers preventing use of antenatal services vary between countries, and limited knowledge exists about the link between geographical settings and antenatal service use. The objective of this cross-sectional quantitative study was to explore geographical variations and investigate how social demographic characteristics affect use of antenatal care for women in Sierra Leone using the Andersen behavioral model. The data used were from the 2016 maternal death surveillance report of the whole counrty (N =706). Logistic regression analysis was used to determine the individual predictor effects on antenatal care, including geographical location, the age of women, marital status, parity, and institution of birth impact. Southern, Northern, and Eastern women had significantly lower odds of attending the recommended antenatal services compared to women in the Western region (OR = .517, p = .019; OR = .497, p = .021; OR = 0.014, p = .041, respectively). The odds of married women attending the recommended antenatal services was 7.3 times more than that of the single women (OR = 7.397). Also, significantly associated with less uptake of recommended antenatal visits was lower education level among women (OR = .517). This study will contribute to positive social change by highlighting inequities in antenatal care use among women, thus allowing for accurate targeting of health promotion programs and ultimately saving lives of mothers and children of Sierra Leone through more inclusive policies.
18
Watson-Jones, Deborah Lindsay. "Impact of syphilis on outcome of pregnancy and evaluation of syphilis screening strategies for the reduction of adverse pregnancy outcomes in Mwanza, Tanzania". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246851.
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Saltvedt, Sissel. "Prenatal diagnosis in routine antenatal care : a randomised controlled trial /". Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-549-6/.
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Ho, Kit-ching Jane, e 何潔貞. "Screening for antenatal depression in a primary health care setting". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251183.
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Ho, Kit-ching Jane. "Screening for antenatal depression in a primary health care setting". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251183.
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De, Vaal Sybrand Johannes. "Late booking at the Michael Mapongwana antenatal clinic, Khayelitsha : understanding the reasons". Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/95545.
Testo completoAbstract (sommario):
Thesis (MFamMed) Stellenbosch University, 2011.ABSTRACT: Background: The initiation of antenatal care (“booking”) is universally recommended in the first trimester. While working in the Michael Mapongwana antenatal clinic (ANC) in Khayelitsha, the researcher noticed that late booking was prevalent, with consequent impaired antenatal care and increased potential for adverse outcomes. The objective of this qualitative study was to understand why women book late at this specific ANC. Methods: Twenty-three in-depth, open-ended interviews were conducted with 23 late bookers (i.e. who booked after 18 weeks) who attended the ANC between June and October in 2009. The interviews were recorded, transcribed, and analysed according to the “Framework” model. Results: The mean gestational age at booking was 26,4 weeks (range: 20 to 34 weeks). The majority were multigravid, unmarried and unemployed. A high incidence of previous or current obstetric problems was noted. Important personal barriers included ignorance of purpose of antenatal care, ignorance of ideal booking time, and denial or late recognition of an unplanned pregnancy. Provider barriers appeared to be significant, especially the cumbersome booking system, absence of an ultrasound service, and perceived poor quality of care. Conclusion: A combination of personal and provider barriers contributed to late booking at this clinic - it seems that the perceived effort of attending this antenatal service outweighed the perceived value thereof. Provider barriers should be addressed by accommodating patients’ needs, optimising nurse-patient interaction, provision of an ultrasound service and improvement of the booking system. Public awareness of early booking and the holistic value of antenatal care should also be enhanced.
23
Iyekekpolor, Maria E. "The antenatal care experiences of overweight pregnant women in the UK". Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/34176/.
Testo completoAbstract (sommario):
The current position of the World Health Organisation (WHO, 2014) is that there is a threat of a global “obesity epidemic” (Boero, 2007, p.1); and existing studies in the UK report that a 5th of pregnant women are overweight. This has created increased scrutiny of fatness and weight, especially in pregnant women. The concern about obesity and pregnancy outcomes also contributes to the National Institute for Health Care Excellence (NICE, 2010), recommending that the antenatal care delivered to overweight pregnant women should be within the guidelines of a high-risk pathway of antenatal care. This has increased the medicalisation of the care for overweight pregnant women. The aim of this study is to explore the experiences of overweight pregnant women in relation to their heightened medicalised antenatal care. Using a social constructionist approach and a Foucauldian interpretive lens, semi-structured face-to-face interviews were used to collect data from 12 women who were between 16 and 30 weeks pregnant, 6 midwives who provide antenatal care for them, and 3 obstetricians to whom women are referred. The data were analysed using thematic analysis. The findings show that pregnant women do not identify with being ‘obese’ and perceive themselves as being overweight but healthy. Key themes that emerged from the data describing women’s perception of heightened antenatal care are: their understanding of risk and risk perception, the power of science and how it constructs their maternal health and the power of obstetricians justifying medical interventions in pregnancy and childbirth. This study creates and contributes to the awareness of how overweight pregnant women who are healthy experience antenatal care. It explores the need of overweight pregnant women, and identifies changes that need to be made to positively enhance how these women experience pregnancy and childbirth. These findings need to be considered by policy makers, individuals in practice and those with a role in educating health care practitioners so that overweight pregnant women are provided the appropriate antenatal care.
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Doi, Lawrence K. "Screening and alcohol brief interventions in antenatal care : a realistic evaluation". Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/9513.
Testo completoAbstract (sommario):
Background: Prenatal alcohol consumption is one of the leading preventable causes of birth defects, including fetal alcohol syndrome and learning disabilities. Although there is strong evidence of the benefits of screening and alcohol brief interventions (ABIs) in reducing hazardous and harmful drinking among the primary care population, evidence of its effectiveness with the antenatal care population is limited. Nevertheless, the Scottish Government is incorporating an alcohol screening and ABI programme as part of the routine antenatal care provided to women in a bid to protect the health and safety of the unborn child and improve subsequent health and developmental outcomes. This research therefore seeks to increase understanding of the factors that are likely to influence the effectiveness of this recently implemented programme. It also aims to explore the extent to which contemporary issues such as change in guidelines regarding alcohol consumption during pregnancy influences perceptions and attitudes, and the possible implications of these on the screening and ABI delivery. Methods: The study described in this thesis employed a realistic evaluation methodology. Realistic evaluation is a theory-driven approach to investigating social programmes. It is concerned with hypothesising, testing and refining programme theories by exploring the interaction of contexts, mechanisms and outcomes. To identify the relevant screening and ABI programme theories, two separate systematic reviews, a critical review and four face-to-face interviews were undertaken with health policy implementers. The findings were used to construct context, mechanism and outcomes propositions. The propositions were then tested by conducting individual interviews with seventeen pregnant women and fifteen midwives, a further six midwifery team leaders were involved in a focus group discussion. A thematic approach using a hybrid of inductive and deductive coding and theme development informed the qualitative analysis. Results: In the context of uncertainties regarding the threshold of drinking that causes fetal harm, pregnant women reported that screening assessment helped them to reflect on their drinking behaviour and facilitate behaviour change. For women who drank at hazardous and harmful levels before attending the booking appointment, screening and ABI may be helpful in terms of eliciting behaviour change. However, they may not be very beneficial in terms of reducing harm to the fetus as it has been found that drinking during the first trimester poses the most risk to the fetus. Training and resources provided to midwives as part of the screening and ABI programme were found to be facilitating mechanisms that midwives indicated improved their skills and confidence. However, most of the midwives had not subsequently employed the motivational interviewing skills required for the ABI delivery, as many of the pregnant women reported that they reduced or abstained from alcohol consumption once pregnancy was confirmed. The outcome noted was that midwives confidence decreased leading to missed opportunities to appropriately deliver the ABI to eligible women. The small numbers of women being identified for ABI meant midwives rarely delivered the ABI. This negatively influenced midwives attitudes as they then accorded ABI low priority in their workload. Other disenabling mechanisms noted to be hampering the implementation of the screening and ABI initiative included midwives contending with competing priorities at the booking appointments, and the lack of adequate rapport between midwives and pregnant women at the booking appointment to discuss alcohol issues appropriately, leading to women providing socially desirable responses to screening questions. Conclusions: The findings of this study has generated greater explanations of the working of the screening and ABI programme in antenatal care setting and has provided transferable lessons that can be used by others intending to implement similar programmes in other settings.
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Percat, Ariella. "“I think we’ve lost it”. Sexuality counselling at the antenatal care". Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-27049.
Testo completoAbstract (sommario):
Bakgrund: Flera studier visar att sjuksköterskor inte tillgodoser patientgruppers behov av att tala om sexualitet och sexuell hälsa. Barnmorskors samtal om sexualitet är ett nästan helt outforskat område. Syfte: Syftet är att undersöka barnmorskors syn på och erfarenhet av samtal om sexualitet på barnmorskemottagningen. Metod: Semistrukturerade intervjuer utfördes med nio barnmorskor på sju olika mottagningar i Skåne. Intervjuerna analyserades med en kvalitativ innehållsanalys genom identifiering av kodord, kategorier och teman. Resultat och analys: Skriptteorin har använts för att analysera och förstå hur barnmorskorna agerar och samtalar i relation till sexualitet. Analysen utmynnade i ett övergripande tema: Sexualitet är betydelsefullt men lätt att tappa bort. Barnmorskorna ser sexualitet som ett angeläget ämne men svårt att adressera i möten. Svårigheter att kommunicera sexualitet beror på tids- och kunskapsbrist samt brist på uppmuntran från ledningen och/eller avsaknad av samtalsverktyg samt ytterligare osäkerhet då patienten avviker från heteronormen eller har en annan kulturell bakgrund. Konklusion: Utbildning i sexologi efterfrågas av barnmorskorna för att kommunicera sexualitet och kunna ge den holistiska vård patienter har rätt till oavsett sexuell orientering eller kulturell bakgrund. Men resultatet antyder att tydliga förväntningar och riktlinjer kring att och hur samtal tas upp är viktigare än fördjupad kunskap. Så länge det finns ett kulturellt och interpersonellt skript på arbetsplatsen i vilket sexualitet inte förväntas adresseras kommer inte utbildning förändra förhållningssättet. Stöd från ledningen och/eller organisationen och möjligheter till handledning/reflektion som rör sexuella frågor kan stötta och uppmuntra barnmorskor att initiera frågor om sexualitet och förändra skripten. Vidare studier behöver göras för att till fullo förstå vilka mekanismer som ligger bakom svårigheten att adressera sexualitet på barnmorskemottagningen.Background: Several studies show that nurses don’t meet the need from groups of patients to talk about sexuality and sexual health. There are almost no studies on midwives’ view on sexuality counselling. Aim: The aim of this study is to explore midwives’ views and experiences on sexuality counselling at the antenatal care. Method: Semi-structured interviews were conducted with nine midwives’ at seven different antenatal care centers in Skåne. The interviews were then analyzed with a qualitative content analysis through identification of codes, categories and themes. Results and analysis: The study utilizes scripting theory to analyze and understand how midwives act and counsel patients in relation to sexuality. One main theme emerged: Sexuality is important but easy to lose. The midwives’ consider sexuality as important but sometimes hard to address. The reasons for this is said to be lack of time, lack of knowledge, lack of encouragement from the managerial level and/or lack of counseling tools, and, added to that, even more uncertainty when the patient deviates from the heterosexual norm or has another cultural background. Conclusion: Midwives’ ask for education to communicate around sexuality and to be able to provide the holistic care that the patients are entitled to. The result, however, suggest that clear expectations and guidelines about when and how to address sexuality is more important than deepened knowledge. As long as there is cultural and interpersonal scripts in the workplace in which sexuality is not expected to be addressed, additional education won’t help to change addressing patients’ sexuality. Organizational and managerial support along with opportunities for reflection concerning dialogue regarding sexual issues might evoke the interest and intent of midwives’ to approach sexuality and change the cultural and interpersonal scripts. Further studies are needed to understand fully what mechanisms underline the barriers that prevent midwives’ from addressing patients’ sexuality.
26
Adanri, Olubunmi A. "Maternal Health Literacy, Antenatal Care, and Pregnancy Outcomes in Lagos, Nigeria". Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10282020.
Testo completoAbstract (sommario):
Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by the social cognitive theory and health belief model, the purpose of this cross-sectional quantitative study was to determine if there is a relationship between maternal health literacy, antenatal care visits, development of medical conditions during pregnancy, and pregnancy outcomes (measured by healthy or unhealthy baby) in Lagos, Nigeria. The research question for this study tested if there was a relationship between these variables. Lisa Chew’s health literacy assessment tool was used in a sample of 130 women in Shomolu local government in Nigeria who met the inclusion criteria. Using binary logistic correlations, only problems developed during pregnancy is statistically significant with pregnancy outcomes (p < .05). The results suggested an increase in problems developed during pregnancy most likely will increase the chance of having negative pregnancy outcomes. Results from this study could promote positive social change by helping health professionals identify the characteristics of at-risk women during antenatal education sessions. The results could also help health professionals in the development of targeted antenatal care interventions.
27
Ngongo, Ngashi. "Health System Predictors of Antenatal Care Compliance Among Rural Congolese Women". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2038.
Testo completoAbstract (sommario):
Fewer rural Congolese women complete 4 antenatal care (ANC) visits than do urban women, despite high maternal and child mortality rates. This quantitative cross-sectional survey applied Andersen's behavioral model of service utilization to examine whether the ANC facility type, provider type, provider gender, time to ANC facility, cost, and number of services can predict ANC compliance among rural women. The study was a secondary analysis of the 2015 Maternal and Child Health (MCH) survey, which comprised 1,280 eligible women selected through stratified random sampling. The analysis included bivariate and multivariate logistic regressions. The findings showed that women seen in private facilities, AOR = 2.220, 95% CI [1.384, 3.561], p < .01; women seen by female providers, AOR = 1.407, 95% CI [1.055, 1.877], p < .05; and women receiving 7 to 9 ANC services, AOR = 1.680, 95% CI [1.142, 2.472], p < .05, were more likely to complete 4 ANC visits. The cost of services and time to the ANC facility had no association with ANC compliance. Further analysis showed that private facilities provided more services (median of 6 vs. 5, p = .000) and had more women attended to by doctors (11% vs. 2%, p = .000) and female providers (72.9% vs. 58.4%, p < .001). These findings suggest that service quality and provider gender play a role in ANC compliance in rural areas. Therefore, Congolese health authorities should establish quality improvement programs and incentives to attract female providers to rural areas. This study contributes to positive social change by identifying ANC access barriers of rural populations and informing future efforts to close the urban-rural gap in MCH outcomes.
28
Adanri, Olubunmi. "Maternal Health Literacy, Antenatal Care, and Pregnancy Outcomes in Lagos, Nigeria". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3651.
Testo completoAbstract (sommario):
Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by the social cognitive theory and health belief model, the purpose of this cross-sectional quantitative study was to determine if there is a relationship between maternal health literacy, antenatal care visits, development of medical conditions during pregnancy, and pregnancy outcomes (measured by healthy or unhealthy baby) in Lagos, Nigeria. The research question for this study tested if there was a relationship between these variables. Lisa Chew's health literacy assessment tool was used in a sample of 130 women in Shomolu local government in Nigeria who met the inclusion criteria. Using binary logistic correlations, only problems developed during pregnancy is statistically significant with pregnancy outcomes (p < .05). The results suggested an increase in problems developed during pregnancy most likely will increase the chance of having negative pregnancy outcomes. Results from this study could promote positive social change by helping health professionals identify the characteristics of at-risk women during antenatal education sessions. The results could also help health professionals in the development of targeted antenatal care interventions.
29
Noncungu, Thabani Mishack. "Investigating health education needs of pregnant women in their first antenatal visit at primary health care facilities in Khahyelitsha". University of the Western Cape, 2017. http://hdl.handle.net/11394/5777.
Testo completoAbstract (sommario):
Magister Curationis - MCurThe use of health education during antenatal care of pregnant women has been a commonly used strategy in improving maternal health worldwide. However the health education strategy sometimes does not prove to be effective in promoting maternal health, especially in Sub-Sahara Africa.
30
Bayouh, Fikirte Girma. "Developing antenatal maternal mental health services: Identifying depression in pregnant women attending antenatal care in Sodo district health centres, Ethiopia". Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32589.
Testo completoAbstract (sommario):
Background Major Depressive Disorder is a leading cause of disease burden for women of childbearing age. The prevalence of perinatal depression is significantly higher in women from low and middle income countries than from high income countries. Antenatal depression is associated with low birth weight and preterm delivery. There is also evidence that depression during pregnancy can alter the development of a woman's fetus and her child, with an increased risk for child emotional and behavioral problems. Detection of perinatal depression in primary health care (PHC) is very low. This research gathered evidence on the current practice of detection of pregnant women with moderate-severe depression in the Sodo district and explored potential solutions to the identified challenges. Methods A qualitative study was conducted in four health centres and a primary hospital, located in the Sodo district, Ethiopia. In-depth interviews were carried out with pregnant women diagnosed to have depression. Focus group discussions (FGDs) were conducted with antenatal care (ANC) PHC workers. A framework approach to qualitative data analysis was used. OpenCode computer software was used for data handling during the analysis. Results Nine pregnant women were interviewed in-depth and twelve ANC PHC workers participated in two FGDs. Identified themes were categorized under client, provider and system level barriers, and illness related influences. Women's reluctance to disclose symptoms and seek help and not thinking what they had was an illness and/or not thinking they would get help from ANC clinic were client-side barriers to identifying depression. ANC PHC workers not asking about depressive symptoms, their reluctance to disclose a diagnosis of depression to the affected women and not thinking women with mental health problems are in their clinics were the main provider level barriers. The setting not being conducive for depression assessment, inadequate mental health training and ANC assessment format not having a place for recording mental health assessment were system level barriers raised. Difficulty in differentiating clinical depression from normal emotional reaction emerged as the main illness related influence. ANC PHC workers proposed community awareness-raising, improving communication between women and PHC workers and making mental health assessment part of the routine ANC service, among others, as possible solutions to improve detection of antenatal depression in ANC clinics. Conclusion Multiple client, provider and system level barriers to detection of depression in pregnant women in ANC clinics were identified in the current study. The identified barriers call for interventions at different levels; awareness raising at a community level, training on communicating about emotional concerns and mental health care at a provider level and enabling the health care system to support integration of mental health care into maternal health services at a higher level. Follow-up studies are required to better understand the experiences of women and providers, to quantify the magnitude of the problem and to develop and evaluate contextually appropriate interventions to improve detection of depression in pregnant women.
31
De, Vaal Sybrand Johannes. "Late booking at the Michael Mapongwana antenatal clinic, Khayelitsha – understanding the reasons". Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97233.
Testo completoAbstract (sommario):
Background: The initiation of antenatal care (“booking”) is universally recommended in the first trimester. While working in the Michael Mapongwana antenatal clinic (ANC) in Khayelitsha, the researcher noticed that late booking was prevalent, with consequent impaired antenatal care and increased potential for adverse outcomes. The objective of this qualitative study was to understand why women book late at this specific ANC.
Methods: Twenty-three in-depth, open-ended interviews were conducted with 23 late bookers (i.e. who booked after 18 weeks) who attended the ANC between June and October in 2009. The interviews were recorded, transcribed, and analysed according to the “Framework” model.
Results: The mean gestational age at booking was 26,4 weeks (range: 20 to 34 weeks). The majority were multigravid, unmarried and unemployed. A high incidence of previous or current obstetric problems was noted. Important personal barriers included ignorance of purpose of antenatal care, ignorance of ideal booking time, and denial or late recognition of an unplanned pregnancy. Provider barriers appeared to be significant, especially the cumbersome booking system, absence of an ultrasound service, and perceived poor quality of care.
Conclusion: A combination of personal and provider barriers contributed to late booking at this clinic - it seems that the perceived effort of attending this antenatal service outweighed the perceived value thereof. Provider barriers should be addressed by accommodating patients’ needs, optimising nurse-patient interaction, provision of an ultrasound service and improvement of the booking system. Public awareness of early booking and the holistic value of antenatal care should also be enhanced.
32
Roelofse, Maryke. "Investigating factors contributing to late initiation of antenatal care in a health facility in Cape Town". University of the Western Cape, 2018. http://hdl.handle.net/11394/6849.
Testo completoAbstract (sommario):
Magister Curationis - MCurDespite the awareness of the importance of initiating antenatal care in the first trimester of a pregnancy (before 12 weeks gestation), late initiation of antenatal care (on or after 24 weeks of gestation) remains a common trend amongst pregnant women. The late initiation of antenatal care poses such a risk, to both the pregnant women and their unborn babies that it can contribute to maternal and foetal mortality and morbidity. The late initiation of antenatal care, an entirely avoidable occurrence, has an impact on targets set by the United Nations Millennium Development Goals (MDGs), now focusing on the Sustainable Development Goals (SDG‟s) set out by the United Nations. This study aim to investigate the factors which contribute to and cause the late initiation of antenatal care in pregnant women in a region in the Western Cape. Aim: The aim of this study was to investigate the factors that influence pregnant woman and contribute to late initiation of antenatal care (after 24 weeks gestational age) in one health facility/district in Cape Town. The findings of the study identified possible factors that may cause pregnant women to initiate antenatal care late in pregnancy and these findings could facilitate planning and possible interventions targeting the importance of early initiation in the community.
33
Ferreira, Nicole. "Enduring "lateness": biomedicalisation and the unfolding of reproductive life, sociality, and antenatal care". Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/27691.
Testo completoAbstract (sommario):
The dissertation examines how pregnant women seeking antenatal care at a state facility in the Southern Peninsula of Cape Town conceptualise and experience their pregnancies in relation to the biomedical model that informs state practices of care. I specifically explore the experiences that contribute to the state's definition of 'late' presentation at antenatal clinics (i.e. after the first trimester). The antenatal care model advises that pregnant women report "early", at 12 weeks, and have regular follow up visits up until 40 week period, yet recent public health research showed that women present "late" to the antenatal clinics, with only 40.2% of first antenatal visits occurring in the first trimester in South Africa. The women who were a part of the research were chosen in the clinic space, in waiting rooms, booking rooms and while waiting for ultrasounds. The women were selected based on age (17 upwards), and gestational age at first antenatal booking. I examine the ways biomedicine frames temporality, and the way that health policy enacts this through antenatal care. I contest the brackets of 'lateness' and biomedicalisation of pregnancy, and the state's version of the female reproductive body as I describe the unfolding experiences of a reproductive life, showing how pregnancy and health care seeking are enmeshed in social worlds. The discursive framings of antenatal attendance exhorts women to seek antennal care at 12 weeks gestation, to "be responsible" "good women" managing their sexual and reproductive lives with a mode surveillance that presumes a certain way of knowing and counting the body. I explore the other ways of experiencing, knowing, and counting, showing how pregnancy experiences and healthcare seeking behaviours are influenced by social, economic, political, and historical factors, and by the moral and religious values that shape daily life for women. My thesis is grounded in the growing literature on anthropology of reproduction and the biosocial. In doing so, I examine what it means to have and experience a reproductive body within the unfolding events of everyday life, where moments and 'quasievents' (such as structural inequalities, and the daily bouts of gang violence and domestic violence) become enmeshed, such that they influence temporality, differing perceptions of trust, distrust, risk and testing, and differing social values of testing. I further show how maternal kinship networks of support are valued, yet precarious as are intimate partnerships, which both influence experiences of care, neglect, abuse, punishment and shape antenatal attendance. In contesting temporal boundaries of biomedicine I show how women's bodily and relational experiences, their everyday lives and quasi-events within them are inseparable in shaping antenatal health seeking practices and how pregnancies are imagined.
34
Peabody, John W. "Will measuring the quality of antenatal care tell us how it works?" Santa Monica, CA : Rand, 1995. http://catalog.hathitrust.org/api/volumes/oclc/33073688.html.
Testo completo
35
Okafor, Amaka Tonia. "Antenatal Care and Maternal Sociocultural Determinants of Childhood Immunization in Northern Nigeria". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7052.
Testo completoAbstract (sommario):
Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.
36
Nwafor, A. O. "Reasons pregnant women who attend antenatal care in Mecklenburg Hospital eat soil". Thesis, University of Limpopo (Medunsa Campus), 2008. http://hdl.handle.net/10386/198.
Testo completoAbstract (sommario):
Thesis (M Med.(Family Medicine))--University of Limpopo, 2008.Objective: To determine what proportion of pregnant women attending antenatal care in Mecklenburg Hospital eat soil. Study Design: A cross-sectional descriptive study was conducted at Mecklenburg Hospital. Results: A total 273 pregnant women participated in the study, of which 85% eat soil. The majority (74%) were single, mean age of 26 years. About seventy-eight percent had secondary education. Most of the women were unemployed. The majority of women believed that soil eating gives energy, taste nice, makes women feel strong, and makes stomach feel full. The other reason given by these women is that soil eating protects unborn baby from poison, gives nutrients to unborn baby, prevent prolonged labor, stops morning sickness. Conclusion: We conclude that the majority of pregnant women seen at Mecklenburg Hospital eat soil. There was not direct relationship between education level and nutritional reasons for eating soil. Furthermore, fetal and maternal reasons for eating soil were not associated with education level.
37
Presern, Carole Bridget. "Reproductive health care in poor urban areas of Nepal". Thesis, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243545.
Testo completo
38
Kausar, Farah. "Maternal health care utilisation among the urban poor of Maharashtra, India". Thesis, University of Southampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340665.
Testo completo
39
Umunna, Zeluwa Ifeoma. "Exploring the factors that contribute to poor utilization of primary health care services: a study of two primary health care clinics in Nasarawa State, Nigeria". Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4536.
Testo completoAbstract (sommario):
Magister Public Health - MPHIntroduction: Nigeria operates a three tiered health care delivery system with a large percentage of health care delivery vested at the primary care level. There has been over the years a continued effort by the government to decentralize health care service thereby increasing the range of services provided at the primary care level. Despite all these efforts there is still low utilization of primary health care services. This study therefore seeks to explore the factors that may be responsible for poor utilization of primary health service in Nasarawa State, Nigeria using two primary health clinics in Lafia local government area as case studies. Methodology: The study was carried out using the qualitative research methodology primarily using two data collection methods, the focus group discussions and individual interviews. A total of sixty participants were sampled, these consisted of ten members of staff, twenty non facility users and thirty facility users. Thirty individual interviews were conducted and four focus group discussions held with staff and facility users at the two clinics. Facility users were randomly selected as they attended the clinic on the data collection days and were invited to participate in the study. Every second patient attending the clinic was selected for the focus group discussion and every third person for the interviews. The staff participants were randomly selected based on their availability while non-facility users were selected using snowballing. Data was analyzed using thematic analysis method. Findings: Two major themes emerged following data analysis; these were perception and experiences of facility users and barriers to utilization of health services. Users had a good perception of the services they received and are reasonably satisfied but certain deficiencies in the health care systems compromised the quality of service. Several factors were however hindering the utilization of these services and these include mainly institutional factors such as lack of infrastructure, equipment and staffing constraints; household factors such as cost of service and responsibility of decision making and other factors such as stigmatization and beliefs. Conclusion: Facility users of these clinics seem to have an overall good impression of services at the clinics; however there are certain fundamental deficiencies that need to be urgently addressed to improve the care provided at these clinics as these constitute barriers to utilization. These deficiencies such as the absence of electricity and water, lack of basic work equipment and inappropriate staff composition need to be addressed by the local government health department to ensure utilization and improved quality of service.
40
Olsson, Pia. "Antenatal midwifery consultations : a qualitative study". Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96903.
Testo completo
41
Mokhondo, Kgabiso Rachel. "The effect of involving the private practioners on the quality of antenatal care of the indigent population of Tembisa". Diss., University of Pretoria, 2011. http://hdl.handle.net/2263/25747.
Testo completoAbstract (sommario):
INTRODUCTION. The perinatal mortality rate is of concern worldwide. In South Africa at the time of the study, 2000, it was estimated to be of the order of 40/1000 live births. However in the setting in which this study took place, namely Tembisa, (Ekhuruleni, Gauteng, South Africa) it was said to be 50/1000 live births. One of the patient- related avoidable factors that has been found to be associated with perinatal and to a lesser extent maternal mortality, is either no, or late initiation of antenatal care. It has been found in an area which, is in many respects similar to Tembisa that 50% of women go the private general practitioner (PGP) for confirmation of pregnancy but, due of lack of funds, do not continue care with the private practitioner but, initiate care in the public sector and in a proportion of these women, this is at an advanced gestational age, making it difficult to prevent or intervene if there are problems in the pregnancy. As (PGP’s) are well placed in the district to render antenatal care, it was decided to perform a study looking at the effect of involving them in the antenatal care of women who presented to them for confirmation of pregnancy. METHODS Sixteen general practitioners agreed to be part of the study. The women who confirmed their pregnancy and who were going to deliver in Tembisa hospital were included in the study after giving written informed consent. They comprised the intervention group, the first antenatal visit was performed, the findings were recorded on the antenatal card which is used in the public sector and which was introduced to the private practitioner at 2 workshops held by the Department of Obstetrics and Gynaecology, University of Pretoria prior to the study. The woman was then to attend antenatal care with the private practitioner until delivery. The private general practitioners waived the costs normally associated with this care for the period of the study. The control group consisted of the women who confirmed their pregnancies in the public health care sector known as the public service health care workers group (PSHCWG). Data collection took place in the postnatal ward of Tembisa hospital over the period of 3 months. By means of systematic sampling, 100 cards from the PGPG and 100 cards from the PSHCWG were obtained. The 2 groups were compared with respect to gestational age at initiation of care and a modified version of the Quality Check for Antenatal Records Score (MQCARS), an audit score which, when applied to the antenatal card, gives a measure of the effectiveness of record keeping, and whether problems in the antenatal period are detected and appropriately managed. RESULTS. There was a statistically significant difference between the two groups in terms of gestational age at initiation of care [PGPG mean gestational age -19.96 (5.86), PSHCW 25.96(5.98,) p<0.0001]. The majority of women in the PGPG initiated care in the 2nd trimester (79%) while the majority of the women in the PSHCWG (53%) confirmed their pregnancies in the third trimester. Six per cent of PGPG confirmed their pregnancies in the first trimester compared to the PSHCWG (3%). The two groups differ significantly with respect to the total MQCARS with the PGPG group performing better [(8.16 (1.55) vs. 16.34(2.58), p<0.0001]. The associated sub- scores are statistically different [History score 5.99 (0.10) vs.7 (0.96), Examination score 9.59(1.29) vs.8.03 (1.85) Interpretation Score 2.55(0.50) vs.2.80 (0.49)]. CONCLUSION Despite the limitations of the study it is felt that if private general practitioners in Tembisa are involved in the antenatal care of those women who confirm their pregnancies with them, there is a reduction in the gestational age at initiation of care. There is a small difference between the two groups in record keeping, detection and management of problems.Dissertation (MCur)--University of Pretoria, 2011.
Nursing Science
unrestricted
42
van, Zyl Tharine. "An exploration of the reasons for late presentation of pregnant women for antenatal care in Worcester, Cape Winelands District". University of the Western Cape, 2018. http://hdl.handle.net/11394/6858.
Testo completoAbstract (sommario):
Magister Public Health - MPHBackground: Antenatal Care (ANC) is a key strategy in achieving positive maternal health outcomes. ANC is an important entry point into formal health care services. ANC is very low in cost and among the most effective packages to promote and establish good health before childbirth and the early postnatal period; therefore, it is very feasible for the good results it is proven to have on maternal and child health. South Africa has had free ANC services since 1994. Despite these free services a lot of women still attend the ANC clinics late or do not attend follow-up visits, hindering the quality of care during pregnancy. The first ANC visit should be in the first trimester of pregnancy or as early as possible, because with the first visit underlying conditions must be identified and managed to promote maternal and foetal health. ANC initiation after 20 weeks may increase maternal, foetal and perinatal morbidity and mortality. In the Cape Winelands there are still 27.3% of women that attend ANC after 20 weeks gestation. This may hinder the quality of care during pregnancy and may lead to negative health outcomes for mother and or baby. The purpose of the study is to understand why some women still do not attend ANC before 20 weeks gestation even when it is available.
43
Shennan, Andrew Hoseason. "Ambulatory blood pressure measurement in pregnancy and pre-eclampsia". Thesis, Imperial College London, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286663.
Testo completo
44
Laryea, Maureen Gato Gasele. "A cross-cultural study of women's preparation for childbirth : Canada and England". Thesis, University of Ulster, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390065.
Testo completo
45
Rankin, Jean. "Effects of antenatal exercise on psychological well-being, pregnancy and birth outcome". London : Whurr, 2002. http://dx.doi.org/10.1002/9780470699263.
Testo completo
46
Dyeli, Nolwando. "An investigation into the implementation of the basic antenatal care programme by midwives in Mdantsane clinics". Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/425.
Testo completoAbstract (sommario):
Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.
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Cragg, Carol Diane. "Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16490.
Testo completoAbstract (sommario):
Includes bibliographical referencesBACKGROUND: A viral load monitoring algorithm in the 2013 Western Cape Department of Health PMTCT guidelines include VL measurement in women who are antiretroviral (ART)-experienced at presentation for antenatal care, the timing of subsequent VL measurements and criteria for regimen change. The study evaluates the implementation of the algorithm in women who are virologically nonsuppressed and determines the outcomes of virological resuppression and infant PCR status. METHODS: This retrospective cohort study focused on all ART-experienced women who presented for antenatal care at one of two primary level Maternity Obstetric Units (MOUs) in Khayelitsha, Cape Town between July 2013 and June 2014. The study used routine data from facility registers, clinical records and electronic monitoring systems at the MOU, and referral ART sites and hospitals. Data collected included age, ART clinic, start date and regimen, and maternal VL and infant PCR results. RESULTS: Forty percent of the 1412 HIV-positive pregnant women, were ART-experienced, of whom 14.1 % were VNS. Predictors of being VNS included a duration on ART of more than 4 years (p= 0.04), attending an ART clinic other than that in the facility (p= 0.02), being on a second-line ART regimen (p=0.07) and being younger than 25 years (p= 0.05). The algorithm was correctly followed in up to 87.5% of women identified as VNS. The rate of virological resuppression by three months postpartum was 70.0% to 82.3%. Excluding three neonates who died, all of the 82.2% of infants tested were PCR negative. CONCLUSIONS: Nearly 15% of ART-experienced women were virologically nonsuppressed on presentation for antenatal care. Levels of adherence to the guideline, and virological resuppression rates of up to 82.3% are encouraging. The implementation of the VLM algorithm could be improved by the integration of obstetric and ART care, the adoption of a single electronic monitoring system and the use of standardised integrated clinical stationery.
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Steyn, Petrus Schonken. "Development and validation of a scale to measure patient satisfaction with antenatal care". Thesis, Stellenbosch : University of Stellenbosch, 1999. http://hdl.handle.net/10019.1/95694.
Testo completoAbstract (sommario):
Thesis (MA)--Stellenbosch University, 1999.ENGLISH ABSTRACT: There is no standardised instrument available in South Africa to measure patient satisfaction with antenatal care. The measurement of patient satisfaction is especially important after the implementation of a free antenatal care service in the South African health system. The purpose of this study was to develop and validate an appropriate scale to measure patient satisfaction. Several methods to measure patient satisfaction are described in the literature. A questionnaire was developed for the Tygerberg Hospital patients. This questionnaire was tested in 200 antenatal patients through a structured interview. The importance of cross-cultural research is emphasised in the validation of the measuring instrument. Factor analysis was used to validate the instrument. This showed that a single factor accounted for most of the total variance. All the items had to do with the process of antenatal care. The findings of this survey showed the following: • One cannot use overseas measuring instruments without adjusting for cross-cultural differences. • The patient satisfaction score is negatively skewed with a high mean. • Social desirability response sets may play an important role in these questionnaires. • There is a statistically significant difference in patient satisfaction with antenatal care between the different antenatal clinics, even after controlling for socio-demographic differences. • That the satisfaction score is a reflection of the service rendered to the patient and not of the socio-demographic differences. This research identified the difficulties of developing a standardised instrument to measure patient satisfaction with antenatal care and opens the way for future research into patient satisfaction with medical services.
AFRIKAANSE OPSOMMING: Daar is geen gestandaardiseerde meetinstrument om pasiente se tevredenheid met voorgeboortesorg in Suid Afrika te bepaal nie. Die noodsaaklikheid van die bepaling van tevredenheid met voorgeboortesorg het nou belangriker geword nadat 'n stelsel van gratis voorgeboortesorg in Suid-Afrika gei"mplementeer is. Die doel van hierdie navorsing was om 'n skaal te ontwikkel om pasiente se tevredenheid met voorgeboortesorg te bepaal en om die geldigheid van hierdie meetinstrument plaaslik te toets. In die literatuur is daar verskeie metodes om pasiente se tevredenheid te bepaal. 'n Vraelys is ontwikkel vir Tygerberg Hospitaal se voorgeboorte pasiente. Hierdie vraelys is getoets by 200 pasiente in die voorgeboorte klinieke in Tygerberg Hospitaal deur middel van 'n gestruktureerde onderhoud. In die geldigheidsbepaling van die meetinstrument 1s die belangrikheid van kruiskulturele navorsing beklemtoon. Faktoranalise is gebruik vir die bepaling van geldigheid. Met faktoranalise is aangetoon dat een onderliggende faktor, naamlik die voorgeboortesorgsisteem, pasiente se tevredenheid verklaar. Die bevindings in hierdie ondersoek het die volgende getoon: • Dat aile meetinstrumente nie summier transkultureel toegepas kan word nie . • Dat die tevredenheidsmeting van voorgeboortesorg 'n negatiewe skewe verspreiding het, met 'n hoe gemiddelde telling. • Sosiaal-aanvaarbare antwoorde speel waarskynlik 'n groat rol in hierdie vraelyste. • Dat daar 'n statistiese betekenisvolle verskil is in die tevredenheidsgraad van pasiente met voorgeboortesorg tussen sommige klinieke; selfs nadat gekontroleer is vir sosiodemografiese verskille tussen pasiente. • Dat die tevredenheidsmeting 'n weerspieeling is van die diens gelewer aan die pasient, en nie net 'n weerspieeling is van die pasient se sosio-demografiese verskille nie. Hierdie navorsmg identifiseer die probleme met die opstel van 'n gestandaardiseerde meetinstrument vir die bepaling van pasente se tevredenheid met voorgeboortesorg en baan die weg vir verdere navorsing oor pasiente se tevredenheid met mediese dienste.
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Paul, Pooja Lilly. "Gatekeepers or Equal Partners?: An Examination of Male Partner Attendance in Antenatal Care". Thesis, Boston College, 2021. http://hdl.handle.net/2345/bc-ir:109137.
Testo completoAbstract (sommario):
Thesis advisor: Shanta PandeyA growing body of literature, particularly from low and middle-income countries, has focused on the role of male involvement in maternal care as a crucial strategy to improve maternal and neonatal health outcomes. The purpose of this three-paper dissertation is to add to this evidence base within the context of India, and to gain an in-depth understanding of one aspect of male involvement – that is, male partner attendance in antenatal care. This dissertation utilized data from the National Family Health Survey (NFHS-3, 2005-06 and NFHS-4, 2015-16) and was framed using the Social Ecological Model, Connell’s Theory of Gender and Power and a Gender-Transformative lens. Paper 1 summarized the levels of male partner attendance in antenatal care and assessed changes over time. Further, multivariable logistic regression models were used to examine the factors influencing male partner attendance in antenatal care. The results show an overall increase in male partner attendance in India during the period of 2005-06 to 2015-16, with the Southern region reporting the highest level of male partner attendance in both years. Higher level of education and household wealth, increased knowledge of pregnancy-related complications, older age at marriage, and women’s autonomy were positively associated with male partner attendance in antenatal care. Paper 2 examined the association between male partner attendance in antenatal care and maternal health service utilization. Controlling for all socio-demographic variables and adjusting for report of pregnancy complications, the results showed that women who were accompanied by a male partner for antenatal care reported increased odds of maternal health service utilization (early initiation of antenatal care, frequency of antenatal care contacts and institutional delivery). While the place of residence (rural/urban) did not influence the association between male partner attendance and maternal health service utilization, region had a significant moderating effect. Paper 3 examined the association between antenatal care and infant birth weight, adjusting for gestational age. Further, the analysis also assessed whether the relationship between antenatal care and infant birth weight varied by male partner attendance. Findings indicate that early initiation of antenatal care and maternal immunization was associated with reduced odds of low birth weight among infants. The results showed that male partner attendance in antenatal care did not have a moderating influence. Taken together, the findings of the three papers have implications for policy and practice; further, they provide support for interventions that aim for a more inclusive and gender-transformative approach to maternal and neonatal health
Thesis (PhD) — Boston College, 2021
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social work
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Al, Maqbali Fatma. "Navigating antenatal care in Oman : a grounded theory of women's and healthcare professionals' experiences". Thesis, University of Manchester, 2018. https://www.research.manchester.ac.uk/portal/en/theses/navigating-antenatal-care-in-oman-a-grounded-theory-of-womens-and-healthcare-professionals-experiences(498154bf-961f-427d-8b08-89a640bfb270).html.
Testo completoAbstract (sommario):
Background: In Oman, 33.3% of women attended late for publicly funded antenatal care in 2015 and 24% did not attend for the recommended 4-6 visits during their pregnancy. This low attendance suggests a need to explore attendance for antenatal care for low-risk pregnant women in Oman. Methodology: An exploratory qualitative design informed by constructivist grounded theory methodology was used in this research. Methods: In-depth semi-structured interviews were conducted with an initial purposive sample of nine pregnant women. The initial analysis enabled theoretical sampling of thirteen non-participant observations during women's appointments, interviews with ten care providers, and six women who booked late after 12 weeks of gestation. A constructivist grounded theory analytical framework of initial, focused and theoretical coding was followed to analyse all the data collected. Findings: The core category consists of five interrelated sub-categories: perceived benefits and value of antenatal care; timing of the first antenatal visit; woman-carer interactions during antenatal care; experiences with antenatal care delivery; and supplementary use of private healthcare. The integral categories explain the social processes and issues surrounding antenatal care. The emergent core category, Navigating antenatal care, reflects the views of the women and their care providers. The women were unhappy with the organisation and physical environment of care but attended their appointments to ensure optimal pregnancy outcome and to alleviate their fears of developing complications. Thus, they used both private and public healthcare and sourced online information in response to their feelings of obligation to protect their fetus. Conclusion: The women appeared disempowered and to lack control over the care they received. Thus, they accepted conditions such as long waiting times in an uncomfortable environment and the disrespect they encountered during their visits. There was a discrepancy between what the women expected and needed from their antenatal care and the actual care and information they received, which did not satisfy their needs. This could be due to a lack of woman-centred care and limited involvement in the plan of care. Thus, women sought further reassurance by accessing private clinics, using online information, and networking with others, which also resulted in a late booking for public antenatal care.