Barriers to quality of work life among Bangladeshi nurses: a qualitative study.

AIM: To explore and provide understanding of the barriers to quality of work life among registered nurses in Bangladesh. BACKGROUND: Globally, there is growing interest in the working environments of nurses, especially at a time of nursing shortages and with the focus on safety and care quality in health systems. In a low socio-economic country like Bangladesh, nurses struggle in a grossly underfunded healthcare system to deliver care to the people but no studies have been conducted on their quality of work life. METHODS: This qualitative descriptive study was conducted at three Bangladeshi tertiary hospitals in May 2015-January 2016. Three focus group discussions were held with 30 registered nurses exploring their perceived barriers to quality of work life. Data were analysed with content analysis. FINDINGS: Seven barriers to their work-life arose: heavy workloads; lack of government accommodation and transportation; poor health status; lack of support from nursing supervisors; lack of promotion opportunities; incomplete hospital policies and procedures; and lack of night shift and risk allowances. DISCUSSION: Participants described many issues and barriers impacting on their work-life. They perceived little reward for their hard work, felt that their health suffered from their working conditions and described a low QWL. CONCLUSION AND POLICY IMPLICATIONS: Findings provide information for nursing and health policymakers and leaders to reduce barriers to improve work-life quality among nurses that can contribute better to quality of nursing care, and nursing retention and satisfaction. Work policies and practices, and funding and other resources need to be scrutinized to ensure better working conditions for Bangladeshi nurses. LIMITATIONS: Interviews were conducted with nurses only in tertiary hospitals in the Bangladeshi capital, and understanding of barriers to work-life quality of nurses in other health settings and regions needs to be explored.

The challenges of prenatal care for Bangladeshi women: a qualitative study.

BACKGROUND: Maternal and infant morbidity and mortality are major issues in developing countries, but the literature reveals there are limited studies on the sociocultural issues affecting adequate prenatal care in Bangladesh. AIM: To explore the sociocultural influences underlying perceived barriers to prenatal care among pregnant women in an urban area of Bangladesh. METHODS: A descriptive qualitative research was conducted with 20 women and 20 of their significant others in three purposively sampled hospitals using individual in-depth interview between November 2016 and March 2017. Content analysis was used for analysis. FINDINGS: Six themes emerged as follows: women's lack of opportunity to make decision; pregnancy as a normal life event; insufficient money for prenatal care; heavy family workload without family support; no permission to go to hospital without a guardian; and inconvenient transportation. DISCUSSION: Good prenatal care is vital for maternal and infant health, but our participants were challenged by a number of key issues as follows: they lacked empowerment to make their own pregnancy decisions, they were impoverished financially, struggled to get to their prenatal appointments by local transport and they lacked family understanding and support for necessary prenatal care. CONCLUSION AND POLICY IMPLICATIONS: Based on the findings, it is recommended that promoting prenatal care adequacy among pregnant women in Bangladesh needs socioculturally sensitive health education programmes which target are not only pregnant women, but also their significant others who are authorized persons in the family. It should be established remote PNC services. Empowerment of women is vital in the country and free antenatal education programmes are needed through a variety of media. Findings provide information for nursing and health policymakers to develop policies to improve adequacy of prenatal care among pregnant women.