Top PDF A study on coverage utilization and quality of maternal care services

A study on coverage utilization and quality of maternal care services

A study on coverage utilization and quality of maternal care services

recommends that as a part of antenatal Care, women should get registered & receive at least three antenatal checkups which include weight and height measurement, blood pressure records, abdominal examination along with General Physical Examination (GPE) and investigations to detect any complication. It also includes provision of two doses of tetanus toxoid vaccine, 100 tablets of Iron and Folic Acid (IFA) prophylactically to prevent anemia, dietary advice, intranatal and postnatal care which includes, new born care, family planning etc. The reproductive age group (15-45 years) owing to their vulnerability deserves special attention. Because of the universality of
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Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

Specifically, it identifies a paradigm shift at policy level resulting in market segmentation, whereby public resources were to be used only for the deserving section of the society, while the affording population was expected to purchase medical care services from the private sector. The pro-poor subsidy spending from public is endorsed for its instrumental value in improving the health of the population and so the productivity of the labour force and consequently, economic growth (5). The issue of health should ideally not be looked at as an engine for economic growth or enhancement of social welfare in isolation. Health has a larger implication in enhancing capability and functioning of a person. In fact, it has an enormously wide reach and relevance in human life and freedom as it grips the issues of fairness and justice in social arrangements (6). However, if the rich people use and grab the subsidies in public health facilities for curative care, this deprives the poor people from using those services due to insufficient facilities with public health sector, resulting in partial crowding in. Thus it becomes extremely important for a government to target the subsidies well to cover the poor population with needed timely health interventions. On the other hand, with macroeconomic crises and fiscal austerity in the milieu, India, like most of the developing nations, found herself in the quagmire of limited public investment in healthcare, which resulted in inequality in access, utilization and finance of healthcare. Traditionally, Indian healthcare system is referred to as a mixed system where government and individuals share the burden of healthcare costs. However, the investment of the government for public provisioning of healthcare and finance social insurance in India has been extremely limited and hence Out-of-Pocket (OOP) expenditure by individuals comprise a major part of health finance (7). The public share in total health expenditure has never exceeded 30% in this overtly populous country. Public expenditure on health in India remained stagnant near one percent of GDP till 2010, with an urban-centric policy orientation. Given the insufficient
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Cad. Saúde Pública  vol.24 número8

Cad. Saúde Pública vol.24 número8

The maternal mortality ratio is one of the most sensitive indicators of poverty and social inequity. Calculation of the ratio requires complete, precise data on the number and causes of deaths in child- bearing-age women, and such information is not easy to obtain. Despite this difficulty, the maternal mortality ratio still provides an excellent indicator of coverage and quality of medical and health care for a given population.

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Socioeconomic Inequalities in the Use of Maternal Health Care Services
            in Nigeria

Socioeconomic Inequalities in the Use of Maternal Health Care Services in Nigeria

Like other DHSs, the Nigerian DHS does not provide direct information on income and expenditure, rather it pro- vides information on indirect measures such as housing qual- ity, household amenities, consumer durables, and size of land holding, which may be used as a proxy measure of household economic status (Filmer & Pritchett, 2001; Gwatkin et al., 2009; Montgomery, Gragnolati, Burke, & Paredes, 2000; O’Donnell & Wagstaff, 2008; Vyas & Kumaranayake, 2006). Using these proxy indicators, the Nigerian DHS-2008 calcu- lated a wealth index using principal component analysis (PCA), and the index is divided into five quintiles—poorest, poorer, middle, richer, and richest. However, the Nigerian DHS-1990 and 2003 computed standard of living index (SLI) based on arbitrary scoring of the economic proxies, and the index was divided into three categories—low, medium, and high. Therefore, in the present study, a separate wealth index (divided into five quintiles—20% each) for the DHS-1990 and DHS-2003 is computed using PCA and based on selected economic proxies of households. The aim was to make the wealth index comparable over the successive rounds of the survey.
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Rev. esc. enferm. USP  vol.47 número4

Rev. esc. enferm. USP vol.47 número4

The study estimated the effective cover- age of health services in primary care for the management of domestic violence against women in three municipalities in Mexico. We estimated the prevalence and severity of violence using a vali- dated scale, and the effective coverage proposed by Shengelia and partners with any modifications. Quality care was considered when there was a sugges- tion to report it to authorities. The use and quality of care was low in the three municipalities analyzed, used most fre- quently when there was sexual or physical violence. Effective coverage was 29.41%, 16.67% and zero in Guachochi, Jojutla and Tizimín, respectively. The effective cover- age indicator had difficulties in measuring events and responses that were not based on biomedical models. Findings suggest that the indicator can be improved by incorporating other dimensions of quality.
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Why are women dying when they reach hospital on time? A systematic review of the 'third delay'.

Why are women dying when they reach hospital on time? A systematic review of the 'third delay'.

Several of the studies included in this review aimed to assess the relative impact of the three phases of delay on maternal mortality. In some studies, Phase III delays contributed significantly more to maternal mortality than both Phase I and II delays. In a facility- based audit in Tigray, Ethiopia, 88% of the maternal deaths could be attributed to medical failures [30]. In a hospital-based case- control study of maternal mortality in Southern Nigeria, ‘‘the most striking difference between the [maternal mortality and control] groups was in the Phase III delays’’ [25]. In another facility-based maternal death review in Malawi, 20 out of 28 maternal deaths were associated with healthcare worker factors, and a further 6 with administrative failures [62]. Moreover, these findings are not unique to facility-based studies. In a district-based audit in Indonesia, 60% of maternal deaths involved a Phase III delay. [26] In a cohort study of pregnant Haitian women from 10 rural districts, inadequate care at a medical facility was a factor in 7 of the 12 maternal deaths that occurred [41]. Finally, an audit into maternal deaths in a Zimbabwean province found that 87% were avoidable; of these, 57% involved the heath services and 33% patient-related delays [67]. The findings of these studies are supported by the 2005 WHO World Health Report, which estimated that access to good obstetric care could prevent 50–70% of global maternal deaths and substantially reduce the number of women living with sequelae of obstetric complications [68].
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Assessment of Immunization coverage in East Zone (EZ) of Ahmedabad Municipal Corporation (AMC)

Assessment of Immunization coverage in East Zone (EZ) of Ahmedabad Municipal Corporation (AMC)

Routine Immunization against infectious disease is one of the most cost effective public health interventions. 1 In India, immunization services are provided through the network of Sub-Centre, Primary Health Centres (PHC) and Community Health Centres (CHC) in the rural area whereas through Urban Health Centres (UHC) in Urban area. Because of increased health care services in both urban and rural areas increase is expected in utilization of services but study reveals low utilization of health care services including Maternal and Child Health (MCH) care services. 2 Total urban area of Ahmedabad Municipal Corporation (AMC) is divided into 6 zones and each zone is subdivided into the different wards. The vaccination activity is carried out by multi-purpose health workers of the respective wards. Ahmedabad being a major city, there is wide variation in the field
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The impact of clinical social franchising on health services in low- and middle-income countries: a systematic review.

The impact of clinical social franchising on health services in low- and middle-income countries: a systematic review.

Health Care Service Utilization. Social franchising increas- es client volume and service utilization. A prospective cohort study in Myanmar showed increasing monthly client volume for family planning services for the first 4-years after joining a franchise network. Client volume also increased for child health services [32]. Another prospective study in Vietnam found franchise membership increased total client volume by 40%, and use of reproductive health services by 51% [33]. In India, Ethiopia, and Pakistan franchise clinics had higher client volume and family planning client volume than non-franchised private providers [25]. Seven studies evaluated the community-level effects of social franchising on utilization of health services with positive effects observed in child health and tuberculosis services. The strongest evidence comes from a cluster randomized trial in Myanmar where the introduction of a new franchise network increased the use of ORS + Zinc in the treatment of childhood diarrhea, and increased the number of caregivers seeking medical care for their children [34]. Analysis of DHS data in Kenya showed that children living near a franchise clinic were more likely to receive treatment for malaria, and received slightly more vaccinations, than children living a greater distance from franchised clinics [35]. The addition of tuberculosis services to a franchise in Myanmar improved TB reporting; the franchise contributed 15% of all TB case notification [36].
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Rev. Bras. Saude Mater. Infant.  vol.16 número2

Rev. Bras. Saude Mater. Infant. vol.16 número2

The results of the present study point out poten- tial problems regarding the quality of hospital and prenatal obstetric care, since an increase in coverage of these has occurred simultaneously with a rise in infant deaths preventable by adequate care during gestation and childbirth, in premature births, low weight, and Down syndrome, and an unchanged maternal mortality rate for direct obstetric causes.

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CoDAS  vol.26 número3

CoDAS vol.26 número3

Purpose: To evaluate the National Policy on Hearing Health Care (PNASA) based on the coverage of specialized services and diagnostic procedures in hearing health care in Brazil. Methods: This is an evaluation study focused on the coverage of specialized services that offer moderate- and high-complexity diagnostic procedures by region and in Brazil as a whole. We analyzed the data for the period of 2004–2011 collected from the Uniied Health System’s Informatics Department database (DATASUS), under the link “Information on health” and tabulated using the software Tabwin. While collecting data from this platform, we selected “procedures for diagnostic purposes”, and the selected way of organization was “diagnoses in otorhinolaryngology/audiology” of moderate and high complexity. We estimated coverage and evolution of the number of procedures according to the country’s ive geographic macroregions. Results: We identiied an increase of 113% in service coverage and of 61% in the quantity of moderate- and high-complexity hearing health diagnostic procedures throughout the country. The northern region had an increase of 78% in the number of procedures, higher than all other regions. However, a proportionally larger number of procedures were performed in the southeast. We identiied a signiicant increase in the number of examinations of otoacoustic emissions (OAE) for hearing triage, transient-evoked OAE and distortion product, as well as of diagnostic reassessments of hearing loss in patients older than 3 years. Conclusion: There has been an increase in services and actions in hearing health care in Brazil since PNASA was implemented, but regional inequalities in the distribution of these services still persist.
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Factors Influencing Mothers’ Utilization of Maternal and Child Care (MCC) Services

Factors Influencing Mothers’ Utilization of Maternal and Child Care (MCC) Services

Rural mothers availed more pre-natal MCC services than urban mothers. Mothers with higher educational attainment and higher monthly family income availed more MCC services than elementary graduate mothers and poor families respectively. Mothers have greater availment on Child care services than Maternal care services due to their deep concern of their baby’s health and safety. Mothers who gave birth in the hospital and RHU availed more MCC services than those who gave birth at home. Mothers from the rural areas availed more pre-natal services than natal and post natal services. Factors that influence the low utilization of the program were: lack of financial resources, low family income, educational attainment of the mother and common dialect for communication between mother and health worker and place of giving birth. The health workers used culturally appropriate communication during consultations however the mothers prefer Ilocano as spoken dialect during the availment of the services.
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Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

decisions about whether to take action to prevent, screen for, and control illness. They argued that people are ready to act if they: believe they are susceptible to the condition (perceived susceptibility), believe the condition has serious consequences (perceived severity), believe taking action would reduce their susceptibility to the condition or its severity (perceived benefits), believe costs of taking action (perceived barriers) are outweighed by the benefits, Are exposed to factors that prompt action ( a television ad or a text reminder on regular checkups and routines to follow during the pregnancy period) (cue to action), Are confident in their ability to successfully perform an action (self- efficacy). These six constructs of the HBM provide a useful framework for designing both short-term and long-term behavior change strategies. When applying the HBM to planning health programs, practitioners should ground their efforts in an understanding of how susceptible the target population feels to the health problem, whether they believe it is serious, and whether they believe action can reduce the threat at an acceptable cost. Attempting to effect changes in these factors is rarely as simple as it may appear (US Department of Health and Human Services, 2005). In the current study, mHealth is a noble platform for enhancing health care service delivery though the mobile telephone technology which according to Germann [8] has penetrated to nearly every household in the country as evidenced by 29.2 million mobile subscribers out of 41 million Kenyans. Majority of the current mobile phones are GPRS enabled and the current generation of smart phones have health applications for monitoring ones blood pressure, blood sugar, body mass index, among others. However the level of adoption of this technology remains scanty in the country. This could be explained by the lack of specialization in the application of the technology in the prevention or monitoring of a specific disease which would enable the service users to have thinking on the perceived susceptibility, perceived severity, and perceived benefits in relation to the disease or medical condition in question. The use of mobile technology also heavily by various challenges (perceived barriers) which hinder the adoption of mHealth. This study explores the barriers that hinder adoption of this technology along five lines, technological barriers, policy by the government and the health professionals, knowledge and awareness, ICT infrastructure and Cost of mHealth services.
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The quality of an integrated network: accessibility and coverage in prenatal care

The quality of an integrated network: accessibility and coverage in prenatal care

Although accessibility is a concept related to coverage, they are not equivalent. The coverage is related to the intensity of the supply of actions and services, or to the extent that existing resources are sufficient to meet the target population's needs. On the other hand, accessibility has been defined as a relationship between the power resources of the users and the obstacles placed by the health services. The power resources relate to issues of economic, social and cultural nature. Have the obstacles may be geographical (distance, transport), organizational (length of lines, unjustifiable waiting time, nature of the host) and economic. 15
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Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa.

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa.

tools to comprehensively measure QoPIIPC. Accordingly, this paper describes a study to iden- tify the key dimensions of QoPIIPC in facility-based deliveries and to develop and evaluate a measure of these dimensions for application in sub-Saharan Africa. The study focused on the intrapartum and immediate postpartum periods when most maternal deaths occur and when care quality may have the greatest impact on both maternal and neonatal mortality [54–57]. It emphasized indicators of care processes for several reasons: the unpredictability of adverse ma- ternal outcomes, the consequent difficulty of making inferences about QoC based on outcomes in small facilities or without adjusting for patient mix, and the importance of distinguishing the actual content of care from provider or facility capacity to provide care. Finally, the study targeted routine care—interventions or practices that should occur in all deliveries, rather than those that only apply to specific groups, for example multiparous women or neonates exhibit- ing danger signs.
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Modeling and Analysis of Queuing Systems in Banks A case study of Ghana Commercial Bank Ltd. Kumasi Main Branch

Modeling and Analysis of Queuing Systems in Banks A case study of Ghana Commercial Bank Ltd. Kumasi Main Branch

Data for this study was collected from the banking hall of Ghana Commercial Bank (GCB) Ltd. Kumasi Main Branch. The methods used during the data collection were direct observation and personal interview and questionnaire administering. The data gathered were the daily record of queuing system over a month. The variables measured included arrival and service rate per hour. They were analyzed for simultaneous efficiency in customer satisfaction and economic cost minimization through the use of a multi-channel single-line queuing model, which were compared for a number of queue performances such as; the average number of customers in the queue and in the system, average time each customer spends in the queue and in the system and the probability of the system being idle. The following assumptions were made for modeling the queuing system at Ghana Commercial Bank (GCB) Ltd. Kumasi Main Branch.
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Radiol Bras  vol.46 número1 en v46n1a04

Radiol Bras vol.46 número1 en v46n1a04

I see this not only as a problem affecting the quality of health care, but also our performance in the medium and long terms. As we enter the era of accountable care organizations, radiologists are going to have to assert their leadership. They should jointly act in nonclinical areas, such as that of informa- tion technology, to avoid marginalization and the predomi- nance of a commercial view of their knowledge; and that has to be done now in Brazil, before it is too late, since teleradiology is a one-way path on which one travels with ever increasing speed (2) .
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Effect Of Shape And Plan Configuration On Seismic Response Of Structure

Effect Of Shape And Plan Configuration On Seismic Response Of Structure

These 9 models are shaped by considering Plan irregularities i.e. the plan area for each structure is same only there is difference of geometry. For all types of structure total numbers of storeys are 12.The elevation is same for all the 9 models. Distribution of each storey height is shown below,

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Rev. LatinoAm. Enfermagem  vol.20 número4

Rev. LatinoAm. Enfermagem vol.20 número4

The research was carried out in a private hospital, a center of excellence for the care of high-risk pregnant women and newborns, situated in the city of São Paulo. As a center of excellence for high-risk pregnancies, it has a 60-bed NICU and a Neonatal Semi-intensive Care Unit with 22 beds. These are allocated in three distinct areas, with 22 beds located on the irst storey, 30 on the second and a further 30 on the third. It should be clariied that only neonates born in the hospital are admitted to these units.
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The Impact of E-Commerce Securi ty, and National Environment  on Consumer adoption of Intern et Banking in Malaysia and  Singapore

The Impact of E-Commerce Securi ty, and National Environment on Consumer adoption of Intern et Banking in Malaysia and Singapore

The research model is designed to examine the impact of customers’ perception of e- commerce security, and national environmental factors on their acceptance of Internet banking in Malaysia and Singapore. Several models have been used to explain factors determining consumer acceptance of Internet banking (Straub et. al., 1997; Liao et. al., 1999; Sathye, 1999; Tan & Teo, 2000; Pavlou, 2003; Suh & Han, 2003; Brown et. al., 2003; Venkatesh et. al., 2003). For example: technology acceptance model (TAM) devices by Davis (1986) was used by Suh and Han (2003). According to Suh and Han (2003), one of the most widely used models for explaining the factors that affects user acceptance of information systems or information technology is TAM. Another model is Fishbein and Ajzen’s (1989) theory of reasoned action (TRA), which is based on Davis’s (1986) technology acceptance model (TAM). TRA model asserts that attitude towards a behavior is determined by relevant beliefs (Davis et. al., 1989). Other theories are the theory of planned behavior (TPB), the decomposed theory of planned behavior (DTPB) by Taylor and Todd (1995) and the diffusion of innovation theory, Rogers (1983). The decomposed TPB model, according to Tan and Teo (2000), uses constructs from the innovation literature such as relative advantage, compatibility, subjective norms, and perceived behavioral control by decomposing them into more specific dimensions. While, Venkatesh et. al.’s (2003) unified theory of acceptance and use of technology (UTAUT) on the other hand posits four core determinants (performance expectancy, effort expectancy, social influence and facilitating condition) and four moderators (gender, age, experience and voluntariness of use) of the key relationships of intention and usage of information technology.
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Rev. Saúde Pública  vol.39 número1

Rev. Saúde Pública vol.39 número1

Data collection was carried out through three stand- ardized questionnaires. The first one was administered to immediate postpartum women, the second one was filled out with data collected from medical records and the third one consisted of questions on the moth- er’s and baby’s conditions at discharge. Both the inter- views of postpartum women and data collection from medical records were conducted by nursing and medi- cine grant students. The students received specific train- ing and were aided by three field supervisors. Inter- views were carried out daily, including weekends and holidays. The field team was in the facilities for the length of time needed to complete interviewing the required number of sampled postpartum women.
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