Implementation of the Perinatal Death Surveillance and Response guidelines: Lessons from annual health system strengthening interventions in the Rwenzori Sub‐Region, Western Uganda

Masereka, Enos Mirembe; Naturinda, Amelia; Tumusiime, Alex

doi:10.1002/nop2.524

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Investing in sense making efforts and creating more awareness about the characteristics that distinguish the MPDSR policy from other interventions, its benefits, aims and objectives, processes involved, activities, inputs and outputs, as well as implementation barriers and facilitators, may contribute to success. While previous efforts have been geared towards understanding the barriers and facilitators to implementations (50,(75)(76)(77)(78) further studies aimed at differentiating implementation of the MPDSR policy from other interventions could enable implementers to devise context-appropriate mechanisms and strategies to enhance integration and embedding within specific contexts (e.g., district vs. health facility).…”

Section: Discussionmentioning

confidence: 99%

“…Since the inception of the MPDSR policy in Uganda, there have not been empirical studies conducted across the health system to assess its implementation. Previous efforts have explored implementation of the policy in one facility or across facilities funded by a particular implementing partner (75)(76)(77)(78). However, the design of this study has helped generate findings across various levels of care without being limited to a particular funding agency or implementing partner.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the implementation of the MPDSR policy still varies across settings within Uganda's health care system (72-74), and there is little research on Uganda's implementation of the MPDSR policy (50,(75)(76)(77)(78), with very few of these studies explicitly articulating their theoretical approach (49,50,75). Thorsen et al (2014) observe that studies have focused on the entirety of the MPDSR process with heavy emphasis on establishing a committee and implementing the recommendations as a way to institutionalize them.…”

Section: Mpdsr Implementation In Ugandamentioning

confidence: 99%

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Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda

Walugembe,

Plamondon,

Kaharuza

et al. 2024

Preprint

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Background Despite growing literature, few studies have explored the implementation of policy interventions to reduce maternal and perinatal mortality in low- and middle-income countries (LMICs). Even fewer studies explicitly articulate the theoretical approaches used to understand contextual influences on policy implementation. This under-use of theory may account for the limited understanding of the variations in implementation processes and outcomes. We share findings from a study exploring how a health system-level policy intervention was implemented to improve maternal and child health outcomes in a resource limited LMIC. Methods Our qualitative multiple case study was informed by the Normalization Process Theory (NPT). It was conducted across eight districts and among ten health facilities in Uganda, with 48 purposively selected participants. These included health care workers located at each of the case sites, policy makers from the Ministry of Health, and from agencies and professional associations. Data were collected using semi-structured, in-depth interviews to understand uptake and use of Uganda’s maternal and perinatal death surveillance and response (MPDSR) policy and were inductively and deductively analyzed using NPT constructs and subconstructs. Results We identified six broad themes that may explain the observed variations in the implementation of the MPDSR policy. These include: 1) perception of the implementation of the policy, 2) leadership of the implementation process, 3) structural arrangements and coordination, 4) extent of management support and adequacy of resources, 5) variations in appraisal and reconfiguration efforts and 6) variations in barriers to implementation of the policy. Conclusion and recommendations The variations in sense making and relational efforts, especially perceptions of the implementation process and leadership capacity, had ripple effects across operational and appraisal efforts. Adopting theoretically informed approaches to assessing the implementation of policy interventions is crucial, especially within resource limited settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Mpdsr Implementation In Ugandamentioning

confidence: 99%

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Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda

Walugembe,

Plamondon,

Kaharuza

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…The team activated immediately after detecting a severe non-reassuring fetus would resolve the problem of severe hypoxic-ischaemic encephalopathy or perinatal death [ 23 – 25 ]. Timely and appropriate intervention by the in-utero resuscitation technique during non-reassuring fetal status includes changing maternal position, oxygen administration, uterine relaxation and an intravenous fluid bolus to reduce severe hypoxia [ 23 , 26 – 28 ].…”

Section: Introductionmentioning

confidence: 99%

Contributing factors of birth asphyxia in Thailand: a case–control study

Rattanaprom,

Ratinthorn,

Sindhu

et al. 2023

BMC Pregnancy Childbirth

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Background Birth asphyxia is of significant concern because it impacts newborn health from low to severe levels. In Thailand, birth asphyxia remains a leading cause of delayed developmental health in children under 5 years old. The study aimed to determine the maternal, fetal and health service factors contributing to birth asphyxia. Methods A case–control design was conducted on a sample of 4256 intrapartum chart records. The samples were selected based on their Apgar scores in the first minute of life. A low Apgar score (≤ 7) was chosen for the case group (852) and a high Apgar score (> 7) for the control group (3408). In addition, a systematic random technique was performed to select 23 hospitals, including university, advanced and secondary, in eight health administration areas in Thailand for evaluating the intrapartum care service. Data analysis was conducted using SPSS statistical software. Results The odds of birth asphyxia increases in the university and advanced hospitals but the university hospitals had the highest quality of care. The advanced and secondary hospitals had average nurse work-hours per week of more than 40 h. Multivariable logistic regression analysis found that intrapartum care services and maternal–fetal factors contributed to birth asphyxia. The odd of birth asphyxia increases significantly in late–preterm, late–term pregnancies, low-birth weight, and macrosomia. Furthermore, maternal comorbidity, non-reassuring, and obstetric emergency conditions significantly increase the odd of birth asphyxia. In addition, an excellent quality of intrapartum care, a combined nursing model, low nurse work-hours, and obstetrician-conducted delivery significantly reduced birth asphyxia. Conclusion Birth asphyxia problems may be resolved in the health service management offered by reducing the nurse work-hours. Excellent quality of care required the primary nursing care model combined with a team nursing care model. However, careful evaluation and monitoring are needed in cases of comorbidity, late–preterm, late–term pregnancies, low-birth weight, and macrosomia. Furthermore, increasing the obstetrician availability in obstetric emergencies and non-reassuring fetal status is important.

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“…33, No.2, 2022; doi 10.47985/dcidj.506 challenges when trying to access such services, including negative perceptions of health personnel, disability-unfriendly infrastructures at health facilities and the absence of trained personnel to provide targeted care to people with disabilities (Rugoho & Maphosa, 2017). Other difficulties include the communication gap, especially when communicating with women who are aphasic, blind or deaf ( Masereka, Naturinda, Tumusiime & Munguiko, 2020). This is compounded by the inability of many women with disabilities to protect themselves, the isolation in which they may live, and dependency on others as compared to their counterparts without any form of disability (Spratt, 2013).…”

Section: Introductionmentioning

confidence: 99%

Lived Experiences of Women with Disabilities in Accessing Sexual and Reproductive Health Services in Lira District, Northern Uganda

Emoru¹,

Masereka

Kabanda

2022

DCID

Self Cite

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Purpose:The study aimed at exploring the lived experiences of women with disabilities in accessing sexual and reproductive health services in Lira district, Northern Uganda. Method:This study utilised a phenomenological study design. Ten women, aged 15 -49 years, were purposively selected from Lira District Union of Persons with Disabilities. They were accessing sexual and reproductive health services across the district. Data was collected using an in-depth interview guide, and thereafter thematic analysis was done.Results: More than half (60%) of the participants were 40-50 years old and had more than 2 children. Half of them (50%) were married; the majority (70%) resided in the rural area and had a physical disability. They related their positive and negative experiences. On the positive side, they indicated the existence of supportive stakeholders, availability of services, and being served with no discrimination in some health facilities. Negatively, they experienced difficulty in navigating the physical environment in health facilities, lack of transport, negative healthcare provider attitudes, long waiting time, side effects of family planning methods, lack of privacy and unhygienic sanitary environments in health facilities. Conclusion and Recommendations:Women with disabilities in Lira district had both positive and negative experiences in accessing sexual and reproductive

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Implementation of the Perinatal Death Surveillance and Response guidelines: Lessons from annual health system strengthening interventions in the Rwenzori Sub‐Region, Western Uganda

Cited by 5 publications

References 26 publications

Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda

Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda

Contributing factors of birth asphyxia in Thailand: a case–control study

Lived Experiences of Women with Disabilities in Accessing Sexual and Reproductive Health Services in Lira District, Northern Uganda

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