Task sharing for family planning services, Burkina Faso

Problem: In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services.Approach:Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels.Local setting In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010.Relevant changes Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported.Lessons learnt The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success

Comparing static and outreach immunization strategies and associated factors in Uganda, Nov-Dec 2016

Introduction: the government of Uganda aims at reducing childhood morbidity through provision of immunization services. We compared the proportion of children 12-33 months reached using either static or outreach immunization strategies and factors affecting utilization of routine vaccination services in order to inform policy updates.Methods: we adopted the 2015 vaccination coverage cluster survey technique. The sample selection was based on a stratified three-stage sample design. Using the Fleiss formula, a sample of 50 enumeration areas was sufficient to generate immunization coverages at each region. A total of 200 enumeration areas were selected for the survey. Thirty households were selected per enumeration area. Epi-Info software was used to calculate weighted coverage estimates.Results: among the 2231 vaccinated children aged 12-23 months who participated in the survey, 68.1% received immunization services from a health unit and 10.6% from outreaches. The factors that affected utilization of routine vaccination services were; accessibility, where 78.2% resided within 5km from a health facility. 29.7% missed vaccination due to lack of vaccines at the health facility. Other reasons were lack of supplies at 39.2% and because the caretaker had other things to do, 26.4%. The survey showed 1.8% (40/2271) respondents had not vaccinated their children. Among these, 70% said they had not vaccinated their child because they were busy doing other things and 27.5% had not done so because of lack of motivation.Conclusion: almost 7 in 10 children aged 12-23 months access vaccination at health facilities. There is evidence of parental apathy as well as misconceptions about vaccination

Health information sources awareness, use and service delivery of resident doctors in babcock university teaching hospital, Ogun state

The study investigated the relationship between health information source awareness, use and service delivery of resident doctors in Babcock University Teaching Hospital. The study adopted descriptive research design. Out of the 60 copies of questionnaire administered to all the resident doctors, 52 (87%) were returned and used for the study. The data were analyzed using percentages, mean and Pearson Product Method correlation. The findings revealed there is no significant relationship between health information use and service delivery (r = 452, p < .05). The findings also revealed that the major health information sources consulted in Babcock University Teaching Hospital by resident doctors were medical textbooks, internet and personal collections. The major challenges facing resident doctors in Babcock University Teaching Hospital were non-availability of relevant information, inadequate information retrieval skills, lack of accessibility of sources. The study concluded that there is a need to provide more relevant materials and enhance the internet service in order to improve the quality of service delivery of resident doctors. Key words: health information sources use, awareness, service delivery, resident doctors.

Factors Responsible for Under-Utilization of Postnatal Care Services in Maiduguri; North-Eastern Nigeria

Background: In Maiduguri; the utilization of available postnatal care services is still very low. This may be influenced by demographic; socioeconomic; cultural; and obstetric factors among others. Objective: The aim of this study is to understand the current status of utilization of maternal postnatal health care services and identify factors responsible for under.utilization of available postnatal care services in Maiduguri. Materials and Methods: A. cross.sectional; questionnaire.based study was conducted involving 350 women in their reproductive age group. (15.49. years); who had delivered previously; residing in Maiduguri and who came to access any of the available maternal health care services at the State Specialist Hospital; Maiduguri over a 3.month period. The Chi.squared statistics and multivariate logistic regression analysis were used. Results: Out of the grand total of 350 questionnaires that were distributed during the study period; 18 questionnaires were excluded from analysis due to incomplete responses; 332 with complete responses were therefore analyzed; giving a response rate of 94.9. The results showed that only 16.9 of the respondents attended postnatal care services within 42. days after delivery. Most of the mothers. (60.9) were not knowledgeable about postnatal care services. A. very high proportion of participants. (69.4) did not attend antenatal clinics; and over. 70of the study population had delivered at home. The study has identified some factors that have an important influence on utilization of postnatal care services in Maiduguri. These included awareness of postnatal care services. (odds ratio. [OR] 12.04; 95 confidence interval. [CI]: 10.26; P =. 0.000); higher educational status of the woman. (OR 7.15; 95 CI: 5.19; P =0.000); lower parity. (OR 5.22; 95 CI: 3.21; P = 0.001) and marital status. (married woman.OR 3.44; 95 CI: 2.17; P =0.002). Educational attainment of the husband also significantly affected the respondents' seeking behavior of postnatal care. (OR 2.01; 95 CI: 1.13; P =0.042). Conclusion: Utilization of postnatal care services is quite low in Maiduguri. Socioeconomic and sociodemographic factors influenced the use of postnatal care services. Government should provide culturally acceptable health educational programs and expands maternal health care services into the communities for the better; effective and efficient health care delivery

Barriers to utilization of pre-hospital emergency medical services among residents in Libreville, Gabon: a qualitative study

Introduction :In 2002; the West-African nation of Gabon established an emergency medical system (EMS); Service d'Aide Medicale Urgente (SAMU); in Libreville; yet few people access it. Our objective was to describe Libreville residents' knowledge and attitudes toward the SAMU in an effort to understand why this service is underutilized. Methods :Qualitative interviews consisting of nine open-ended questions were conducted on a convenience sample of twenty patients; three visitors and two patient/visitor dyads at the Jeanne Ebori Hospital Emergency Centre in October 2009. Eligible subjects arrived in vehicles other than the SAMU and were ill enough to require hospital admission. Exclusion criteria were: under 21years old; unable to speak French; or medically unstable. A bilingual team member audio-recorded the interviews in French and transcribed them into eng. Investigators organized text into codes; then into themes and theoretical constructs. Intercoder agreement was excellent. Data were collected until theoretical saturation was achieved. Results: Analysis of data revealed no difference in response between patients and visitors. People underused SAMU because of financial costs; lack of awareness of the program; use of traditional modes of transportation; infrastructure flaws; perceived response times and other misconceptions. Conclusion: We identified remediable barriers to EMS (SAMU) access in Libreville; Gabon: lack of awareness; misperceptions; established alternatives; and cost. Interventions and future investigations designed to increase EMS utilization in Gabon should target these four areas

Determinants de la frequentation tardive des services de soins prenatals dans les zones de sante de l'Equateur et du Katanga en Republique Democratique du Congo

Objectifs. Estimer la frequence de la frequentation tardive des soins prenatals; et en identifier les principaux determinants dans certaines zones de sante de la Republique Democratique du Congo. Methodologie. Etude transversale analytique; dans 6 zones de sante de 2 provinces de la RD Congo; portant sur 465 gestantes ou femmes allaitantes; selectionnees selon un echantillonnage a plusieurs degres. Les caracteristiques sociodemographiques; l'histoire genesique; et les facteurs d'utilisation des soins de sante ontete collectes. La frequentation prenatale tardive etait definie comme une premiere visite accomplie par une femme enceinte apres le 4eme mois de gestation; ou apres la 16eme semaine d'amenorrhee. Le test de chi-carre; le test t de Student; et la regression logistique ont ete utilises pour etudier les associations; comparer les moyennes; et identifier les determinants. Resultats. La frequentation des soins prenatals interessait 85.7des repondantes; et etait tardive pour 59.8des grossesses (IC95: 54.0-65.6). Sa frequence etait plus elevee dans le milieu rural et parmi les multipares. Elle est motivee par les contraintes financieres ou l'absence de problemes lors de la grossesse. Elle est determinee par le milieu de vie; le niveau d'etude; la religion; la parite; la gestite; l'age; la taille du menage; l'occupation; et la perception du tarif applique. Elle est reduite par l'instruction et l'emploi remunere. Conclusion. Le delai dans l'initiation de la CPN demeure encore un probleme dans les zones de sante de notre pays. Cette situation handicape l'atteinte des objectifs de sante de la mere et de l'enfant. L'identification de principaux determinants de ce retard incite a promouvoir des strategies ciblees; en vue d'influencer les comportements et les attitudes des personnes les plus vulnerables. L'education sanitaire; l'implication de la communaute; et la mise en oeuvre desstrategies qui reduisent le payement direct au point de prestation; peuvent contribuer a minimiser ce phenomene dans notre contexte