ABSTRACT
Background: In South Africa, maternal healthcare guidelines are distributed to primary health care (PHC) facility for midwives to refer and implement during maternal healthcare services. Different training was offered for the use of maternal care guidelines. However, poor adherence and poor implementation of guidelines were discovered. Aim: This study aimed to develop and prioritise strategies to improve the implementation of maternal healthcare guidelines at PHC facilities of Limpopo province, South Africa. Method: Strengths, weaknesses, opportunities and threats analysis and its matrix together with the nominal group technique were used to develop the current strategy. Midwives, maternal, assistant and operational managers from PHC facilities of the two selected district of the Limpopo province were selected. Criterion-based purposive sampling was used to select participants. Data collection and analysis involved the four steps used in the nominal group technique. Results: Strategies related to strengths and weaknesses such as human resources, maternal health services and knowledge deficit were identified. Opportunities and threats such as availability of guidelines, community involvement and quality assurance as factors that influenced the provision of maternal healthcare services were identified. Conclusion: Researchers formulated actions that could build on identified strengths, overcome weaknesses such as human resources, explore opportunities and mitigate the threats such as quality assurance
Subject(s)
Schools, Nursery , Health Strategies , Supply , Allied Health Personnel , Quality ImprovementABSTRACT
Objectives: Despite numerous interventions to facilitate adolescents' access to family planning (FP) services in West Africa, studies reveal that unmarried adolescents have difficulties accessing these services. This study analyses the supply of the FP services package to unmarried adolescents as well as the profiles of the facilities that provide this package in Burkina Faso, Ghana, and Niger. Also, it examines the determinants of the supply of this package. Design: The study adopted a spatiotemporal descriptive analysis and a binary logistic Generalized Estimating Equation (GEE) model. The data come from surveys conducted in the three countries between 2013 and 2019 as part of the Performance Monitoring and Accountability 2020 program. Participants: The target population consists of health facilities that provide health services. Results: The study indicates that more than 80% of FP services are provided by basic health facilities in Burkina Faso and Niger, while in Ghana, the profile is more diversified, including hospitals, polyclinics, and public and private primary health centres. The econometric analysis indicates that regional ownership, examination of client opinion data, ownership of a functioning computer, and knowledge of the served population are the main determinants of the supply of the FP services package to unmarried adolescents. Conclusion: By identifying facility profiles and determinants of FP services supply, this study provides a pathway for action to ensure that adolescents have access to these services regardless of their marital status in West Africa.