Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study

Shah, Rajani; Rehfuess, Eva; Paudel, Deepak; Maskey, Mahesh; Delius, Maria

doi:10.1186/s12978-018-0553-0

Cited by 48 publications

(67 citation statements)

References 39 publications

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“…This study found that mothers-in-law often close off this gap by providing psychosocial support by escorting the mothers to the health facility. Studies have shown the importance of psychosocial support to pregnant women in averting maternal and child health negative outcomes [24,25]. Our study also found that community members such as neighbours, local council village leaders and village extension health workers are instrumental in averting structural barriers to access to a health facility by sending for a boda-boda (motor cycle rider) in real time or other transport means to get the labouring mother to a health facility.…”

Section: Perceived Barriers To Uptake Of Health Facility Deliverymentioning

confidence: 54%

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Nyachwo

Naigino

Apolot

et al. 2019

Preprint

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Background: Health facility delivery improves maternal and child health outcomes but has not been fully achieved in countries with the poorest maternal health indicators. We identified and examined the roles of key influencers (significant others) of mother’s perceptions towards health facility delivery in Northern Uganda. Methods: This was an exploratory study conducted using in-depth interviews with eleven significant others in a mother’s life; who were purposively selected from four sub-counties of; Ogur, Agweng, Amach and Agali, as part of a larger study in Lira district, Northern Uganda. We also conducted seven key informant interviews with health workers involved in maternal and child health care. Data analysis using Atlas ti version.7.0 was conducted deductively following a thematic framework approach to analyse themes adapted from the health belief model. Results: The study identified husbands, biological mothers, mothers-in-law, fathers-in-law, brothers and co-wives as influencers of mother’s perceptions on uptake of health facility delivery. Other significant others included traditional birth attendants who were believed to have the ability to determine when the condition of a mother required the intervention of a medical expert. Community members such as local village leaders, village health extension workers and neighbours were also cited . Whereas husbands were regarded as ke y significant others of women, health workers emphasized that, husbands were not always available to support the mothers during pregnancy and child birth. The roles of significant others of women included: planning for birth, providing financial support, making decisions on where a mother will deliver from, continued counselling and psychosocial support. Conclusion: Programs aimed at increasing male involvement to improve maternal and child health outcomes should also target other influencers of women’s perceptions on health facility delivery including family and community members, to provide back-up support to mothers in the absence of their husbands.

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Section: Perceived Barriers To Uptake Of Health Facility Deliverymentioning

confidence: 54%

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Nyachwo

Naigino

Apolot

et al. 2019

Preprint

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“…Among studies included in the review, a majority was from India (n=30, 48 %) . There were 11 studies from Nepal (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) , 10 from Bangladesh (53)(54)(55)(56)(57)(58)(59)(60)(61)(62) , six from Indonesia (63)(64)(65)(66)(67)(68) and two from Timor-Leste 69,70 . From Bhutan 71 , Thailand 72 , and Myanmar 73 one from each was identi ed.…”

Section: Resultsmentioning

confidence: 99%

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Perera

Gilks

Alemu

2020

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Background: Sustainable Development Goal 3 (SDG-3) aims to ensure healthy lives and promote wellbeing for all. Universal Health Coverage (UHC) assures delivering health services to all who need without suffering from financial hardships. This paper aims to identify the successes, challenges and opportunities towards achieving UHC for maternal and childcare in countries in the World Health Organization, South East Asian Region (SEAR). Methods: We conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, CINAHL, PsycINFO, WHO research portal and Google scholar for studies published in English from 2010 to 2020. We included studies conducted in maternal and childcare focusing on challenges, opportunities or successes towards UHC in countries in SEAR. Data was synthesized and presented as a narrative description, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: We identified 62 studies with different study designs from eight SEAR countries , majority were from India. We observed successes or opportunities in access and quality in MCH with government cash transfer schemes and private sector contribution in India, Bangladesh and Indonesia. Politically prioritized MCH care was identified as an opportunity in a state of India. Inadequate healthcare infrastructure including trained human resources, medical products and other supplies were identified as the main challenges in the region. Facilities are overcrowded in Bangladesh and Indonesia. From provider perspective, health care workers’ knowledge and skills as well as attitudes and behaviors were also identified as issues in the region. Lack of health literacy, misconceptions and cultural barriers are identified as challenges from clients’ side. Difficulties in geographical distribution and transport were contributing to poor healthcare access in four countries. Deficiencies in government policies and administration were identified in some fields. Poverty was detected as an overarching barrier.Conclusions: SEAR countries have demonstrated improvements in access, quality and equity on MCH towards UHC. There are, however, challenges related to human and other resources, health care facilities and socio-economic determinants of health. Regional bodies as well as authorities in individual countries should work on these issues to address challenges to achieve UHC.Registration: PROSPERO: CRD42020166404

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“…Involving FCHVs in these wide ranges of interventions would aid in the integration of maternal, child and newborn services thus leading better outcomes in human capital and development. It is however equally important to consider the work burden of FCHVs while task shifting and also capacitate FCHVs to deal with cultural and religious issues that surround during pregnancy and childbirth in Nepal [25,26].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with child health service delivery by female community health volunteers in Nepal: Findings from a national survey

Bhattarai

Khanal

et al. 2020

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Background: Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been a lot of documented studies and reports, rarely has been explored the status and factors associated with the child health service provided by these volunteers. The aim of this study was to identify the factors associated with the child health service delivery by FCHVs.Methods : A national survey was conducted in 2014 in Nepal that included 4,302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. The data was extracted and the association of child health services with characteristics was examined using Chi-square test (χ2) followed by logistic regression. Results: Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers’ group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technology-wise, FCHVs who were using mobile were more likely to provide child health services.Conclusions : FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs, availability of key commodities, involvement of FCHVs in regular health mothers’ group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.

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Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study

Cited by 48 publications

References 39 publications

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Factors associated with child health service delivery by female community health volunteers in Nepal: Findings from a national survey

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