The educational and psychosocial needs of students with additional provisions during COVID-19 in Greece: Parents' perspectives against schools' crisis management.

BACKGROUND: The sudden breakdown of educational and care services following the COVID-19 outbreak caused severe implications to the educational and psychosocial well-being of students with additional needs. AIM: The present study investigates the perspectives of parents of students requiring additional provisions in relation to the schools' responsiveness against their children's educational and psychosocial needs during the COVID-19 pandemic, with a focus on (non-) applied inclusive and empowerment practices of parenthood. METHODS AND PROCEDURES: A sample of 125 parents in Greece filled out a self-reported questionnaire providing information on four main themes: school organisation in accordance with the COVID-19 measures; distance education; support on transition from quarantine and remote education back to school; and parental empowerment. OUTCOMES AND RESULTS: The data revealed that most of the participating parents felt poorly supported during the pandemic. The feeling of being left alone in supporting their children and in fully meeting their personal needs and emotions was also identified. The demographics of the participating parents with children with additional needs revealed an experiences mosaic in relation to the parents' level of education, the number of children who were present in their households, the children's gender as well as their level of school education (preschool- and primary school-aged or secondary school-aged pupils) and attendance of the school programme in regular or special schools. CONCLUSIONS AND IMPLICATIONS: Data suggest that regular and special schools in Greece, as orchestrated by the Ministry of Education, deployed practices that left students requiring additional provisions unsupported in relation to their educational and psychosocial needs while their parents felt disempowered during the whole period of the COVID-19 pandemic. A range of implications on a more effective support for families and their children with additional needs in alignment with the principles of inclusive education is detailed and discussed. WHAT THIS PAPER ADDS: The focus of research on the schools' responsiveness to the needs of students requiring additional provisions from the perspective of their parents is of critical importance as it may offer valuable insights pertaining to the school's inclusive policy practices and the promotion of empowering parent partnerships during crisis times. The knowledge gained by exploring parents' experiences will contribute significantly to inform modifications and changes in education delivery in crisis times so as school, as a social system, become more inclusive, supportive, and effective for pupils with additional needs. So far, little attention has been paid to the above-mentioned issues. In the current paper, the parents perspectives were explored through a self-reported questionnaire to reflect on the way schools responded to theirs and their children's educational and psychosocial needs during the COVID-19 pandemic. Most of the participating parents felt poorly supported. The feeling of being left alone in supporting their children and in fully meeting their personal needs and emotions was also identified. The demographics of the participating parents with children requiring additional provisions revealed an experiences mosaic in relation to the parents' level of education, the number of children who were present in their households, the children's gender as well as their level of school education (preschool and primary school or secondary school education) and attendance of the school programme in regular or special schools. A range of implications on a more effective support for families and their children with additional needs in alignment with the principles of inclusive education is detailed and discussed.

Barriers and facilitators to the provision of maternal health services at community health centers during the COVID-19 pandemic: Experiences of midwives in Indonesia.

OBJECTIVE: To explore the experiences of midwives in Indonesia on the provision of maternal health services during the COVID-19 pandemic. DESIGN AND METHODS: A qualitative descriptive study using focus group discussions was undertaken. A conventional content analysis was used to analyze the data. Coding categories were generated from the transcripts. SETTING AND PARTICIPANTS: Twenty-two midwives from five community health centers of three regions in the Province of Jambi, Indonesia were included. FINDINGS: The interviewees shared similar barriers and facilitators in delivering the services, including the unavailability of adequate protective equipment, the limitation of the number of services, and dealing with the new public health measures related to the COVID-19. Overall, midwives demonstrated a continued commitment to provide maternal health services during the pandemic. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Significant changes in service delivery have been made to comply with pandemic related restrictions. Despite the unprecedentedly difficult working environment, the midwives continue to provide adequate services to the community by implementing a strict health protocol. Findings from this study contribute to a better understanding of how the quality of the services changed, as well as how new challenges can be addressed and positive changes can be reinforced.

Exploring the Influence of Sociodemographic Characteristics on the Utilization of Maternal Health Services: A Study on Community Health Centers Setting in Province of Jambi, Indonesia.

The Maternal Mortality Ratio in Indonesia has remained high, making it a national priority. The low utilization of maternal health services at community health centers is considered to be one of the reasons for poor maternal health status. This study aims to assess the influence of sociodemographic factors on utilization of maternal health services. The analysis was completed using binary and logistic regression to examine the association between sociodemographic variables and maternal health services utilization. A total of 436 women participated in the survey. In the multivariable analysis, age, education, ethnicity, parity status, distance to health centers and insurance ownership were associated with the utilization of maternal health services. Ethnicity (OR, 2.1; 95% confidence interval, 1.4-3.3) and distance to the CHC (OR, 0.5; 95% confidence interval, 0.3-0.8) were significantly associated with ANC visits. The association between parity and place of delivery was statistically significant (OR, 0.8; 95% confidence interval, 0.5-1.4). A positive association between basic health insurance ownership and PNC services was reported (OR, 0.3; 95% confidence interval, 0.1-0.6). Several sociodemographic factors were positively associated with the utilization of maternal health services at the CHCs. The required measures to improve the utilization of maternal health services at the CHCs level have to take into consideration the sociodemographic factors of reproductive age women.

The utilization of maternal health services at primary healthcare setting in Southeast Asian Countries: A systematic review of the literature.

The reduction of Maternal Mortality Ratio (MMR) remains a global health issue. Although major progress has been achieved in the past 15 years, the ratio is still high, especially in Low Middle-Income Countries. In the Southeast Asian region, most of the countries have not reached the Sustainable Development Goals target yet. Although the countries have several similarities in many aspects, such as community characteristics, cultural context, health systems, and geographical proximity, the MMR in the region presents interesting variations. The scope of this systematic review is to explore published literature on the utilization of maternal health services at the community healthcare centre setting in Southeast Asian countries. The databases PubMed, Web of Science, and Google Scholar were searched systematically to identify quantitative, qualitative and mixed methods studies published in 2000-2020. A total of 1876 records were found, out of which 353 full text were screened. Finally, 27 studies on utilization of maternal health services met the inclusion criteria and were selected for analysis from seven Southeast Asian countries: Cambodia, Indonesia, Lao PDR, Myanmar, The Philippines, Timor Leste and Vietnam. Most of the articles focused on the utilization of maternal health services at primary health care setting. Several themes on maternal health services utilization in the countries emerged, including cultural and socioeconomic factors contributed to the utilization of maternal health services, factors associated with the low utilization of ANC, determinants affected place of delivery and delivery assistance choice. The utilization of maternal health services at primary healthcare setting in seven Southeast Asian countries was identified in a small number of studies. Sociocultural barriers and disparities of health services provision are the major factors associated with low utilization of the services. Further research on strengthening the role of primary healthcare in maternal health services provision is required.

Women, healthcare leadership and societal culture: a qualitative study.

PURPOSE: Women leaders encounter societal and cultural challenges that define and diminish their career potential. This occurs across several professions including healthcare. Scant attention has been drawn to the discursive dynamics among gender, healthcare leadership and societal culture. The aim of this study is to assess empirically gendered barriers to women's leadership in healthcare through the lens of sociocultural characteristics. The comparative study was conducted in Greece and Malta. The interest in these countries stems from their poor performance in the gender employment gap and the rapid sociocultural and economic changes occurring in the European-Mediterranean region. SUBJECTS AND METHODS: Thirty-six individual in-depth interviews were conducted with health-care leaders, including both women and men (18 women and 18 men). Directed content analysis was used to identify and analyze themes against the coding scheme of the Barriers Thematic Map to women's leadership. Summative content analysis was applied to quantify the usage of themes, while qualitative meta-summative method was used to interpret and contextualize the findings. RESULTS: Twenty and twenty-one barriers to women's leadership were identified within the Greek and Maltese healthcare settings, respectively. Prevailing barriers included work/life balance, lack of family (spousal) support, culture, stereotypes, gender bias and lack of social support. Inter-country similarities and differences in prevalence of the identified barriers were observed. CONCLUSION: The study appraised empirically the gendered barriers that women encounter in healthcare leadership through the lens of national sociocultural specificities. Findings unveiled underlying interactions among gender, leadership and countries' sociocultural contexts, which may elucidate the varying degrees of strength of norms and barriers embedded in a society's egalitarian practices. Cultural tightness has been found to be experienced by societal dividends as an alibi or barrier against sociocultural transformation. Findings informed a conceptual framework proposed to advance research in the area of women's leadership.

Exploring Women Healthcare Leaders' Perceptions on Barriers to Leadership in Greek Context.

Background: Gender inequalities have been identified as important derailment factors for health workforce and health system sustainability. Literature holds responsible a list of gendered barriers faced by female health workforce. However, there is a gap in the evidence based research on women leaders' own perceptions of barriers to leading positions advancement. This study aims to explore leadership barriers perceived by women healthcare leaders within country's context; research focused on Greece due to country's poor performance on gender equality index and current economic turbulence. Study supplements survey data and provides orientation for further gender sensitive research in health workforce development through country's specificity lens to better inform education and policy makers. Methods: The best-worst object case survey method was used, applying an online questionnaire designed in Qualtrics. The online questionnaire was sent to 30 purposively invited participants. Respondents were asked to tick the most and the least important barriers to women's leadership in provided choice scenarios. Descriptive data analysis was used to understand and interpret the results. Results: Women leaders perceived stereotypes, work/life balance, lack of equal career advancement, lack of confidence, gender gap and gender bias to be the barriers with the greatest relative importance in constraining opportunities for pursuing leading positions in Greek healthcare setting. Twenty more barriers were identified and ranked lower in relative importance. The results are considered exploratory and not to obtain population based outcomes. Conclusion: This exploratory study reports the perceived barriers of women leaders in pursuing leading positions within Greek healthcare context. The findings point mainly to organizational and socio-cultural related barriers potentially aggravated by country's unfortunate current economic turbulence. Further extensive research is required to establish grounded conclusions and better inform education and policy makers in developing gender sensitive strategies to sustainable health workforce development.

Exploring the Added Value of Women Health Care Managers in Poland.

INTRODUCTION: Female managers in the Polish health care system are seldom a subject of scientific investigation. MATERIAL AND METHODS: This study describes the share and profile of women in health care management positions and explores how and why Polish female health care managers add value to the leadership of health care organizations. Three data collection methods were used including: scoping review, analysis of data from governmental information bases and in-depth interviews with female health care managers. RESULTS: Men comprise nearly twice the number of hospital directors in Poland as compared to women, or 67% of the total representation. Traits often attributed to women including strength, perseverance, multi-tasking, empathy, emotional intelligence and intuition add value in leadership roles. Polish women managers value the complementarity of genders in professional roles and their contribution to constructive collaboration. CONCLUSION: The study contributes to the scarce literature on Polish female health care managers.