This paper has two aims, first to examine the feasibility of using an omnibus survey to estimate the prevalence and characteristics of families who home educate and secondly to provide an empirical contribution to recent research on home education in the UK. Because there is no statutory requirement for families who home educate to register with the Local Authority, there are no nationally representative data on the prevalence and characteristics of the home educating population in this country. Therefore gathering data from a fully randomised sample of home educating families would be prohibitively expensive. In this study we used a national omnibus survey to collect data on the homeschooling experiences of over 6000 households from across the UK, of whom 52 were found to have engaged in homeschooling. Our findings estimate that around 1% of families with dependent children have home educated either on a full or part-time basis. Provision of home education was often episodic and reflects the diversity of the home educating population. While the findings presented here largely confirm previous work on home education in the UK, other work tends to be based largely in the home educating community and often lacks a comparison with the general population. Using an omnibus survey like the Opinions and Lifestyle Survey enables researchers to gather data from a nationally representative sample of a small and diverse social group.
BackgroundAlthough maternal mortality has decreased substantially since the 1990s, it remains one of the top priorities in global health, as most deaths can be prevented if women have access to and utilise skilled health personnel for childbirth delivery. While efforts have been made to increase the supply and accessibility of services, the lack of maternal utilisation of skilled health delivery services is a contributing cause of death, particularly among mothers from rural areas. MethodsWe conducted interviews in December 2019 in the Eastern Region of Ghana, with 24 rural mothers who had given birth within the past two years, 12 women who had and 12 women who had not given birth utilising skilled health personnel. ResultsThe main differences between women who did and did not use skilled health personnel for delivery were for Health Belief Model constructs of perceived risk, self-efficacy, and cues to action. Most women who delivered with skilled health personnel believed they were susceptible to complications during childbirth, reported high perceived self-efficacy to overcome barriers to deliver with skilled health personnel, and planned and prepared in advance to deliver with skilled health personnel. In contrast, women who did not deliver with skilled health personnel were less likely to believe in susceptibility to complications, reported low perceived self-efficacy to overcome barriers, and had not planned or prepared in advance for skilled health delivery.Nelson JR, Gren LH, Dickerson TT, et al. Using the Health Belief Model to explore rural maternal utilisation of skilled health personnel for childbirth delivery: a qualitative study in three districts of the Eastern Region of Ghana.
Background Skilled attendance at birth is considered key to accomplishing Sustainable Development Goal (SDG) 3.1 aimed at reducing maternal mortality. Many maternal deaths can be prevented if a woman receives care by skilled health personnel. Maternal utilization of skilled health delivery services in rural areas in low- and middle-income countries is 70% compared to 90% in urban areas. Previous studies have found community-based interventions may increase rural maternal uptake of skilled health delivery services, but evidence is lacking on which strategies are most effective. Objective To review the effectiveness of community-based strategies to increase rural maternal utilization of skilled health personnel for childbirth delivery in low-and middle-income countries. Methods We conducted a narrative review. PubMed, CINAHL, Cochrane Library, and PsycINFO databases were searched for articles from database inception through 13 November 2019. Key search terms were pre-determined. Information was extracted on studies meeting our inclusion criteria: cluster and randomized trials, rural setting, reproductive aged women, community engagement, low- and middle-income countries. Studies were considered effective if statistically significant (p < 0.05). A narrative synthesis was conducted. Results Ten cluster randomized trials out of 5,895 candidate citations met the inclusion criteria. Strategies included home-based visits, women’s groups, and combined approaches. Out of the ten articles, only three studies were found to significantly increase maternal uptake of skilled health personnel for delivery, and each used a different strategy. The results are inconclusive as to which strategies are most effective. Limitations of this review include heterogeneity and generalizability of studies. Conclusions This research suggests that different strategies may be effective at improving maternal utilization of skilled health personnel for delivery in certain rural settings while ineffective in others. More research is warranted to better understand the context in which strategies may be effective and under what conditions.
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