Implementation of a Community Transport Strategy to Reduce Delays in Seeking Obstetric Care in Rural Mozambique

Amosse, Felizarda; Boene, Helena; Kinshella, Mai-Lei Woo; Drebit, Sharla; Sharma, Sumedha; Makanga, Prestige Tatenda; Valá, Anifa; Magee, Laura A.; Dadelszen, Peter von; Vidler, Marianne; Sevene, Esperança; Munguambe, Khátia

doi:10.9745/ghsp-d-20-00511

Cited by 16 publications

(15 citation statements)

References 24 publications

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“…1 The barriers to safe deliveries are encountered at three-level decision to seek care (delay 1), reaching care (delay 2) and receiving care (delay 3). 8 Some of the interventions that may be utilised to deal with these barriers include community transport strategy, 9 use of maternity waiting homes 10 and community participation. 11 Support from the community should be highly prioritised to promote safe childbirth considering that a substantial proportion of deliveries still occur at home because of limitations in economic conditions, transportation and social infrastructure 12 across the country.…”

Section: Introductionmentioning

confidence: 99%

“…However, community support on safe motherhood remains unknown. strategy, 9 use of maternity waiting homes 10 and community participation. 11 Support from the community should be highly prioritised to promote safe childbirth considering that a substantial proportion of deliveries still occur at home because of limitations in economic conditions, transportation and social infrastructure 12 across the country.…”

Section: Introductionmentioning

confidence: 99%

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Exploring community support on safe motherhood: A case of Lilongwe District, Malawi

Pindani

Chilinda

Botha

et al. 2021

African Journal of Primary Health Care & Family Medicine

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Background: Malawi is grappling with a high maternal mortality of 439 per 100 000 live births. It is estimated that 80% of maternal deaths can be prevented by actively engaging the community in the country. However, community support on safe motherhood remains unknown.Aim: This study, therefore, explored community support rendered to mothers and babies during antenatal, intrapartum and postpartum periods.Setting: This study was conducted in the Lilongwe District, Malawi.Methods: This was a qualitative study that collected data from 30 village health committee members through Focus Group Discussions (FGDs). Data were analysed using thematic analysis.Results: This study found that community support on safe motherhood rendered to women varied. The following five themes emerged from FGDs data on community support on safe motherhood: antenatal support, intrapartum support, postpartum support, bylaws reinforced by chiefs in the community and safe motherhood support groups. Community members encourage pregnant women to attend antenatal care, escorted pregnant women to the hospital for delivery and assisted women to care for a child and go for postpartum checkups. Community bylaws were considered as a necessary tool for encouraging women to attend antenatal care, deliver at the health facility and attend postpartum checkups.Conclusion: This study suggests that community members play a crucial role in providing support to women and newborns during antenatal, intrapartum and postpartum periods.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring community support on safe motherhood: A case of Lilongwe District, Malawi

Pindani

Chilinda

Botha

et al. 2021

African Journal of Primary Health Care & Family Medicine

View full text Add to dashboard Cite

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“…It is associated with the sociocultural context, socioeconomic status of the parturient, knowledge of the signs of danger in pregnancy and/or perception of the severity of the disease during pregnancy, previous cost of care, and previous experience with the health system [ 21 ] Delay II (R2) This delay pertains to the arrival of the parturient at the health facility for obstetric care. It refers to the problems of accessibility—the distance between the woman’s home and the health facility, poor road infrastructure, cost of transportation, and distribution of health facilities in the health zone where she resides—that prevent her from timely arriving at the hospital [ 22 ] Delay III (R3), This delay pertains to obstetric care of the woman by the healthcare personnel in a health facility. This factor is linked to the service offered by the health facility to the parturient and refers to the incompetence of the healthcare personnel and the insufficiency or absence of materials, medical equipment, supplies (medicines), and qualified personnel who could provide a suitable environment and other essential factors [ 23 ] …”

Section: Methodsmentioning

confidence: 99%

Maternal mortality study in the Eastern Democratic Republic of the Congo

Ramazani

Ntela

Ahouah

et al. 2022

BMC Pregnancy Childbirth

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Background The reduction of maternal mortality in developing countries such as the Democratic Republic of Congo (DRC) still raises many questions. Indeed, this large country in the heart of Africa ranks 4th among the eight countries that alone account for more than 50% of maternal deaths in the world, behind India, Nigeria and Pakistan. However, there is no up-to-date data on maternal mortality in eastern DRC. This study measures the mortality rate rate in health facilities in eastern DRC and identifies the associated risk factors. Methods This analytical epidemiological study was based on retrospective data materna deaths recorded in 59 health facilities, in three health zones in the southern part of Maniema province in east DRC. The study was conducted from July 1, 2015 to June 30, 2020. Descriptive, bi and multivariate analyses were used. Results The maternal mortality rate was estimated at 620 deaths per 100,000 live births, of which 46% of maternal deaths were related to a parturients’ delayed decision in seeking healthcare in time (first delay). Maternal deaths were significantly associated with extreme ages (≤ 19 years and ≥ 40 years: p = < 0.001), patient parity (in primigravidas and in large multiparas: p = 0.001), complications such as hemorrhagic, (p = < 0.001), uterine ruptures:(p = < 0.001), infections, (p = < 0.001), and dystocia (p = < 0.001). Conclusion Despite the efforts made by the DRC and its partners in the fight against maternal mortality, women continue to lose their lives when they decide to give birth. The results imply that it is imperative to strengthen both women and health professionals’ knowledge about pregnancy and maternal health and their power to reduce instances of first delay by supporting women in formulating their birth plans.

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“…In this exploratory qualitative study, we undertook a secondary analysis of a cross-sectional evaluation of health care workers in the CLIP Mozambique trial in Maputo and Gaza provinces. Located in southern Mozambique, the study area is largely rural and transport between communities and local health facilities is a recognized challenge (12)(13)(14). We followed a constructivist grounded theory approach to inductively explore the meanings CHWs construct within social interactions with pregnant women, their families, community members and other health workers during the CLIP trial while using POM (15,16).…”

Section: Study Design and Settingmentioning

confidence: 99%

How Gender Influenced the Experience of Using a mHealth Intervention in Rural Mozambique: Secondary Qualitative Analysis of Community Health Worker Survey Data

Kinshella

Boene

Sevene

et al. 2022

Front. Glob. Womens Health

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BackgroundThe mixed-gender community health worker (CHW) program in Mozambique is a window into the different experiences that male and female CHWs may face in their work. The objective of this study is to investigate how gender influenced the experiences of community health workers using the PIERS on the Move (POM) mHealth app in Mozambique.MethodsThis is a secondary analysis by gender of health care workers involved in the Mozambique Community Level Intervention for Pre-eclampsia (CLIP) cluster randomized trial (NCT01911494). A structured survey with 10 open-ended questions was used to elicit CHW experiences using the POM app. Data collection took place in 2017 after completion of the CLIP trial. This analysis examined emergent themes to consider how experiences may have been shaped by health worker gender.ResultsOf the 43 CHWs who used the POM app, there were 31 (72%) women and 12 (28%) men. Gender differences emerged in descriptions of how using POM increased their value and respect by pregnant women and community members. Fifty-eight percent of female CHWs (18/31) said that POM positively influenced their status in the community in comparison to 33% of their male counterparts (4/12). While the small sample sizes, particularly of male CHWs who used POM, preclude conclusions, these findings were supported by qualitative results. Female CHWs tended to elaborate more about community perceptions of their increased value and status as health care providers than male CHWs.ConclusionCHWs work within existing gender norms. While gender norms are perceived to support the comfort of women to speak to another woman about their maternal and child health issues, gender norms also work against female CHWs as their professionalism may be questioned more than for their male counterparts. CHW's narratives suggested that the mHealth intervention was valued beyond the technology itself because it also added symbolic clinical value and demonstrated a tangible investment in their professional capacities, which may have been especially appreciated by the female CHWs.

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Implementation of a Community Transport Strategy to Reduce Delays in Seeking Obstetric Care in Rural Mozambique

Cited by 16 publications

References 24 publications

Exploring community support on safe motherhood: A case of Lilongwe District, Malawi

Exploring community support on safe motherhood: A case of Lilongwe District, Malawi

Maternal mortality study in the Eastern Democratic Republic of the Congo

How Gender Influenced the Experience of Using a mHealth Intervention in Rural Mozambique: Secondary Qualitative Analysis of Community Health Worker Survey Data

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