An evaluation of Health Workers for Change in seven settings: a useful management and health system development tool

Onyango-Ouma, Washington; Laisser, Rose; Mbilima, Musiba; Araoye, Margaret O.; Pittman, Patricia; Agyepong, Irène Akua; Zakari, Mairo; Fonn, Sharon; Tanner, Marcel; Vlassoff, Carol

doi:10.1093/heapol/16.suppl_1.24

Cited by 41 publications

(33 citation statements)

References 2 publications

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“…Studies have reported improvements in service provision and provider-client relations following training of healthcare providers on interpersonal and communication skills[50, 51]. This form of targeted training could improve providers’ self-awareness and sensitize them on how to better engage women during childbirth.…”

Section: Discussionmentioning

confidence: 99%

Disrespect and abuse of women during childbirth in Nigeria: A systematic review

2017

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BackgroundPromoting respectful care at childbirth is important to improve quality of care and encourage women to utilize skilled delivery services. However, there has been a relative lack of public health research on this topic in Nigeria. A systematic review was conducted to synthesize current evidence on disrespect and abuse of women during childbirth in Nigeria in order to understand its nature and extent, contributing factors and consequences, and propose solutions.MethodsFive electronic databases were searched for relevant published studies, and five data sources for additional grey literature. A qualitative synthesis was conducted using the Bowser and Hill landscape analytical framework on disrespect and abuse of women during childbirth.ResultsFourteen studies were included in this review. Of these studies, eleven were cross sectional studies, one was a qualitative study and two used a mixed method approach. The type of abuse most frequently reported was non-dignified care in form of negative, poor and unfriendly provider attitude and the least frequent were physical abuse and detention in facilities. These behaviors were influenced by low socioeconomic status, lack of education and empowerment of women, poor provider training and supervision, weak health systems, lack of accountability and legal redress mechanisms. Overall, disrespectful and abusive behavior undermined the utilization of health facilities for delivery and created psychological distance between women and health providers.ConclusionThis systematic review documented a broad range of disrespectful and abusive behavior experienced by women during childbirth in Nigeria, their contributing factors and consequences. The nature of the factors influencing disrespectful and abusive behavior suggests that educating women on their rights, strengthening health systems to respond to specific needs of women at childbirth, improving providers training to encompass interpersonal aspects of care, and implementing and enforcing policies on respectful maternity care are important. This review has also shown that more robust research is needed to explore disrespect and abuse of women during childbirth in Nigeria and propose compelling interventions.

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Section: Discussionmentioning

confidence: 99%

Disrespect and abuse of women during childbirth in Nigeria: A systematic review

2017

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“…Adopting qualitative methods to ensure gender equity in healthcare and improving provider-client interaction and humanity of health services are still needed as recommended by many researchers. [27][28][29][30] The current study showed that physically abused women were significantly less likely to be covered by medical insurance. Only a small proportion of women: those working, of higher education, higher wealth index or older age cohorts were medically insured.…”

Section: Discussionmentioning

confidence: 99%

Physical violence, obstacles to accessing healthcare, and insurance coverage of Egyptian currently-married women

Afifi¹

2010

Ann Trop Med Public Health

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Objectives:To study the association between women's exposure to marital physical violence with self-reported obstacles to use health facilities, and coverage by medical insurance. Material and Methods: This study was conducted on the 2005 Egypt Demographic Health Survey (EDHS) data. A subsample of 5249 currently-married women were investigated for both ever and the 12 months prior to survey exposure to physical violence by their current husbands, and its association with self-reported obstacles to use health facilities and coverage by medical insurance, adjusting for respondents' age, education, work, residence, wealth index, number of children ever borne, and empowerment in household decisions. Results: A total of 57% and 56% of women reported lack of healthcare provider and lack of drugs as obstacles to use medical care, respectively. Only 14% were covered by medical insurance. Around 29.4% of the studied women had been ever exposed to physical violence by their current husbands; of them 60% had been subjected to it in the 12 months prior to the survey. Logistic regression models showed that exposure to physical violence predicted reporting of the aforementioned two obstacles. Physically abused women were significantly less likely to be covered by medical insurance. Only a small proportion of women: those working, of higher education, higher wealth index or older age cohorts were medically insured. Conclusion: Extending the umbrella of medical insurance along with finding remedies to the existing obstacles of medical care in Egypt would play a significant role in both health sector reform and management of violence against women.

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“…While the engagement of midwives improved, the majority of the doctors did not participate in the mentorship sessions. Iterative team engagement with data to identify problems and track progress on implementing local solutions is a hallmark of quality improvement cycles [22], but they also need to address organizational culture and norms that may inhibit frontline health workers' critical engagement and ability to implement the required changes [22,23].…”

Section: Pathways Of Changementioning

confidence: 99%