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Are we too far from being client centered?

ABSTRACT: BACKGROUND:Quality of service provision in health facilities is fundamental to ensure effective care. However, women's actual experience of care is often neglected. OBJECTIVE:To assess perceived quality of institutional delivery services and associated factors among women who delivered in public health facilities of Southwest Ethiopia. METHOD:Community based cross-sectional study was conducted in three districts of Jimma zone, Southwestern Ethiopia, from February 29 to March 20, 2016. A total of 423 mothers who delivered in public health facilities during the last 12 months were selected to participate in the study. Study participants were identified using simple random sampling procedure. Principal component analysis was used to generate scores for three sub-dimensions of perceived quality. Multiple linear regression analysis was performed to identify predictors of these sub-dimensions. RESULTS:Perceived quality of institutional delivery services was measured with three dimensions: perceived interpersonal interaction, health care delivery and health facility/structure. We found that perceived quality of interpersonal interaction was negatively affected by educational level (read and write) (?: -0.331, 95% CI: -0.523, -0.140), urban residence (?: -0.485, 95% CI: -0.696, -0.275), antenatal care (less than three visits) (?: -0.238, 95% CI: -0.419,-0.056) and delivery service attended by male provider (?: -1.286, 95% CI: -1.463,-1.109). Perceived quality of health care delivery was negatively associated with still birth (?: -0.642, 95% CI: -1.092,-0.193) and delivery services attended by male provider (?: -0.689, 95% CI: -0.907,-0.472). Urban residence (?: -0.260, 95% CI: -0.515,-0.005), and antenatal care (less than three visits) (?: -0.394, 95% CI: -0.628,-0.161) were negatively associated with perceived quality of health facility/structure. CONCLUSION:Overall, the perceived quality of institutional delivery services was low. We recommend that health managers and health care providers jointly work to transform birth care at the health facilities to deliver person-centered care. Addressing the preferences of clients is as important as taking care of structural concerns pinpointed in this study.

SUBMITTER: Erchafo B

PROVIDER: S-EPMC6188795 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Are we too far from being client centered?

Erchafo Belay B Alaro Tesfamichael T Tsega Gebeyehu G Adamu Ayinengida A Yitbarek Kiddus K Siraneh Yibeltal Y Hailu Meaza M Woldie Mirkuzie M

PloS one 20181015 10

<h4>Background</h4>Quality of service provision in health facilities is fundamental to ensure effective care. However, women's actual experience of care is often neglected.<h4>Objective</h4>To assess perceived quality of institutional delivery services and associated factors among women who delivered in public health facilities of Southwest Ethiopia.<h4>Method</h4>Community based cross-sectional study was conducted in three districts of Jimma zone, Southwestern Ethiopia, from February 29 to Marc ...[more]

PMID: 30321212

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Project description:BACKGROUND:Many adolescents and young adults with chronic illness or disability often fail to develop the self-management skills necessary to independently handle medical and self-management routines. In light of these needs, we are developing iMHere 2.0 (Interactive Mobile Health and Rehabilitation), a mobile health (mHealth) system to support a self-management program. OBJECTIVE:Our objective was to gather data from persons with brain and spinal cord anomalies (BSA) and their caregivers to better understand how mHealth would be most helpful in supporting them to proactively manage daily self-care routines and to access medical care as needed. The specific purpose was not only to gather feedback and to gain increased insight into the design of the new version of iMHere, but also to gather perspectives of new groups, namely adolescents as young as 12 years and their parents and/or caregivers. METHODS:Our project employed focus group sessions and surveys to collect data from participants with BSA, as well as their caregivers. A total of six focus group sessions were conducted on four separate occasions until the data gathered reached saturation. The objectives of our focus group sessions were to better understand ways to develop mHealth systems to support self-management, to promote independence, to motivate long-term system use, and to prevent medical problems that lead to hospitalizations and emergency room visits for youth and young adults with BSA. RESULTS:A total of 16 youth and young adults with BSA and 11 caregivers participated in the sessions. Within and among our groups, the following five overarching themes emerged from the data: (1) make it easy, (2) engage, (3) educate and prepare, (4) motivate and support, and (5) personalize. Participants shared their perspectives and detailed information about mHealth apps that would be important for independence in self-care and self-management. CONCLUSIONS:Our findings suggest that most individuals keep their mobile phones with them at all times and typically use a mobile phone for social media, music, photos, and texting. Our qualitative analysis indicates that youth and young adults with BSA, as well as their caregivers, acknowledge the importance of being actively engaged in developing and using mHealth apps that monitor and manage their health care needs. Information gleaned from these focus group sessions and surveys have provided data to refine the iMHere 2.0 mHealth prototype platform that we have developed.

Project description:Teachers' healthy and effective functioning at work is impacted by the demands they face and the resources they can access. In this study, person-centered analysis was adopted to identify distinct teacher profiles of demands and resources. We investigated teachers' experiences of two job demands (barriers to professional development and disruptive student behavior), two job resources (teacher collaboration and input in decision-making), and one personal resource (self-efficacy for teaching). Using data from the Teaching and Learning International Survey (TALIS) 2013, the study involved 6,411 teachers from 369 schools in Australia and 2,400 teachers from 154 schools in England. In phase one, latent profile analysis revealed five teacher profiles that were similar across the two countries: the Low-Demand-Flourisher (12%), Mixed-Demand-Flourisher (17%), Job-Resourced-Average (34%), Balanced-Average (15%), and Struggler (21%). The profiles were differently associated with two background characteristics (teacher gender and teaching experience) and two work-related well-being outcomes (job satisfaction and occupational commitment). In phase two, we extended our analysis to the school-level to identify school profiles based on the relative prevalence of the five teacher profiles within a school. Indeed, a yield of large scale datasets such as TALIS is that there are sufficient units at the school-level to enable institutional insights, beyond insights garnered at the individual teacher-level. Two school profiles that were similar in both countries were revealed: the Unsupportive school profile (58%) and the Supportive school profile (42%). The Supportive school profile was associated with higher school-average teacher job satisfaction and occupational commitment than the Unsupportive school profile. Taken together, the findings yield knowledge about salient teacher and school profiles, and provide guidance for possible interventions at the teacher- and school level.

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Are we too far from being client centered?

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Are we too far from being client centered?

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