Project description:IntroductionTraditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia.ObjectivesThe aim of this study was to identify individual, sociocultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia.MethodsA community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men's involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software.ResultsOut of 800 men, only 36.5% (95% confidence interval: 33.3%-39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men's involvement in facility-based childbirth of this, being in the age group of 40-49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49-10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53-5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25-7.46) associated with men's involvement in facility-based childbirth.ConclusionRelevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men's involvement in the study area.

Project description:BACKGROUND:Plantar heel pain is a common source of pain and disability. Evidence-based treatment decisions for people with plantar heel pain should be guided by the best available evidence, expert clinical reasoning, and consider the needs of the patient. Education is a key component of care for any patient and needs to be tailored to the patient and their condition. However, no previous work has identified, far less evaluated, the approaches and content required for optimal education for people with plantar heel pain. The aim of this study was to gather the patients' perspective regarding their lived experience, attitudes and educational needs in order to inform the content and provision of meaningful education delivery approaches. METHODS:Using a qualitative descriptive design, semi-structured interviews were conducted with participants with a clinical diagnosis of plantar heel pain. A topic guide was utilised that focused on the experience of living with plantar heel pain and attitudes regarding treatment and educational needs. Interviews were audio recorded, transcribed verbatim and analysed using the Framework approach. Each transcription, and the initial findings, were reported back to participants to invite respondent validation. RESULTS:Eighteen people with plantar heel pain were interviewed. Descriptive analysis revealed eight themes including perceptions of plantar heel pain, impact on self, dealing with plantar heel pain, source of information, patient needs, patient unmet needs, advice to others and interest in online education. Participants revealed doubt about the cause, treatment and prognosis of plantar heel pain. They also expressed a desire to have their pain eliminated and education individually tailored to their condition and needs. Respondent validation revealed that the transcripts were accurate, and participants were able to recognise their own experiences in the synthesised themes. CONCLUSION:Plantar heel pain has a negative impact on health-related quality of life. Participants wanted their pain eliminated and reported that their expectations and needs were frequently unmet. Health professionals have an important role to be responsive to the needs of the patient to improve their knowledge and influence pain and behaviour. Our study informs the content needed to help educate people with plantar heel pain.

Project description:BackgroundGlobally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women's experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women's care experience and what women mean by satisfaction in two Ethiopian regions.MethodsHealth center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women's experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction.ResultsMaternal and newborn survival and safety were central to women's descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as 'satisfactory'. The texture behind this 'satisfaction', however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider's interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility's amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women's experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women's overall satisfaction, even in the context of poor-quality facilities and limited resources.ConclusionOur findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women's satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women's care experience.

Project description:Background: The amount of waste generated has been increasing over the years. Meanwhile, the capacity of solid waste management facilities (SWMFs) for waste disposal does not meet the needs, resulting in adverse consequences on the natural environment and health of residents living near these plants, which can significantly degrade their quality of life (QoL). This study aims to evaluate the QoL of residents living near an SWMF and the potential impacts it has on the residents. Methods: A cross-sectional descriptive study was conducted involving 801 subjects, aged 18 and above, who live near the SWMF of Hue City, Vietnam. The QoL of the subjects was quantitatively assessed using the WHO QoL assessment scale (WHOQOL-BREF). The general, health, and environmental factors influencing QoL were identified using bivariate and multivariate logistic regression analyses. Results: About 22.6% of the subjects had a good QoL. In particular, the proportions for good psychological health (6.9%) and environment (13.6%) were low, indicating an influence of the SWMF. Significant factors that degraded the QoL of residents were less education defined by not graduating from high school (odds ratio, OR = 2.78; 95% CI = 1.09-7.06), poor health status (OR = 2.50; 95% CI: 1.56-4.01), dissatisfaction with water quality (OR = 2.41; 95% CI: 1.10-5.25), and unacceptance of the SWMF presence (OR = 1.70; 95% CI: 1.11-2.60). Moreover, subjects living within 2 km of the plant had dermatological diseases and digestive disorders more frequently than those who lived away from the plant. They also reported more complaints regarding water, air, and soil quality, which were likely due to the operation of the SWMF. Conclusions: Burying and disposing of solid waste at the SWMF might lead to the degradation of the surrounding water and soil environments, and its collection and transportation are considered to cause odor and dust. The efforts of responsible authorities to strictly supervise and inspect these activities at the SWMF are essential, not only to protect the surrounding environment but also to improve the QoL of those who live nearby these plants.

Project description:Aims and objectivesTo examine perceived social and environmental barriers and facilitators for healthy eating and activity before and after knee replacement.BackgroundMany patients undergoing knee replacement surgery are overweight or obese. While obesity treatment guidelines encourage diet and activity modifications, gaps exist in understanding social and environmental determinants of these behaviours for knee replacement patients. Identifying these determinants is critical for treatment, as they are likely amplified due to patients' mobility limitations, the nature of surgery and reliance on others during recovery.DesignThis qualitative study used semi-structured interviews.MethodsTwenty patients (M = 64.7 ± 9.8 years, 45% female, 90% Caucasian, body mass index 30.8 ± 5.5 kg/m2 ) who were scheduled for or had recently undergone knee replacement were interviewed. Participants were asked to identify social and environmental factors that made it easier or harder to engage in healthy eating or physical activity. Deidentified transcripts were analysed via constant comparative analysis to identify barriers and facilitators to healthy eating and activity. This paper was written in accordance with COnsolidated criteria for REporting Qualitative research standards.ResultsIdentified social and environmental healthy eating barriers included availability of unhealthy food and attending social gatherings; facilitators included availability of healthy food, keeping unhealthy options "out of sight," and social support. Weather was the primary activity barrier, while facilitators included access to physical activity opportunities and social support.ConclusionsResults provide salient factors for consideration by clinicians and behavioural programmes targeting diet, activity, and weight management, and patient variables to consider when tailoring interventions.Relevance to clinical practicePractitioners treating knee replacement patients would be aided by an understanding of patients' perceived social and environmental factors that impede or facilitate surgical progress. Particularly for those directly interacting with patients, like nurses, physiotherapists, or other professionals, support from health professionals appears to be a strong facilitator of adherence to diet and increased activity.

Project description:BackgroundGlobal strategies to target high maternal mortality ratios are focused on providing skilled attendance at delivery along with access to emergency obstetric care. Research that examines strategies to increase facility-based skilled birth attendance among slum residents in Addis Ababa, Ethiopia, is limited.ObjectiveThe study aimed to explore women's perspectives on the measures that need to be taken to increase the use of the facility-delivery service among slums women, Addis Ababa, Ethiopia METHODS: Qualitative exploratory and descriptive research designs were used. Participants in the study were women in the reproductive age group (18-49 years of age) living in the slum areas of Addis Ababa, Ethiopia. A purposive sampling strategy was used to select study participants. Potential participants' names were gathered from health facilities and followed to their homes for the study. Four audio-recorded focus group discussions [FGDs] were conducted with 32 participants from the three public health centers and one district hospital. The number of participants in FGDs was between 6 and 10 women. Data were analyzed simultaneously with data collection. Thematic analysis was used in data analysis, which entails three interconnected stages: data reduction, data display, and data conclusion. In addition, thematic analysis entailed evaluating the structure and content of textual data, identifying data themes, coding the themes, and then interpreting the structure and content of the themes. A codebook was first devised, discussed, and adopted by the writers before they could use this technique. Using the codebook, the theme codes were then manually produced. To explain the study results, verbatim excerpts from participants were given. The researcher used Techs' eight steps of qualitative data analysis method for analyzing the data. A multi-level life-course framework of facility-based delivery in low- and middle-income countries (LMICs) developed by Bohren et al. was used to frame the current study and link the findings of the study to the body of knowledge.ResultsThe FGDs included a total of 32 participants. The mean age of the overall sample was 32.6 years (± SD = 5.2). Participants' educational characteristics indicate that the majority (24 out of 32) was found to have no formal education, and two-thirds of participants were found to have one to five children. Three-fourths of them attended the ANC twice and they all gave birth to their last child at home. Two themes emerged from the analysis of focus group data, namely provision of quality, respectful and dignified midwifery care, and lack of awareness about facility delivery. These themes were described as a rich and comprehensive account of the views and suggestions made by focused antenatal care [FANC] participants on measures required to improve the use of the facility-delivery services. The findings of the study raise concerns about the effectiveness of FANC in encouraging facility-deliveries since FANC participants had not used health facilities for their last childbirth. According to the findings of the focus groups, women who took part in this study identified measures required to increase the use of health facility-delivery services among FANC participants in Addis Ababa's slum residents. It is to be expected that diligent counseling during antenatal care about birth plans would facilitate prompt arrival at facilities consistent with the desires of women.

Dataset Information

'People have started to deliver in the facility these days': a qualitative exploration of factors affecting facility delivery in Ethiopia.

Publications

<i>'</i>People have started to deliver in the facility these days<i>'</i>: a qualitative exploration of factors affecting facility delivery in Ethiopia.

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