학술논문
Perspectives of stakeholders regarding the value of maternal and newborn health interventions and practices supported by UNICEF and other partners in the West Nile region of Uganda: a qualitative study.
Document Type
Academic Journal
Author
Muhumuza S; School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda.; Nsabagasani X; School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda.; Muhangi CN; School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda.; Latigi G; UNICEF, PO Box 2381, Kampala, Uganda.; Pirio P; UNICEF, PO Box 2381, Kampala, Uganda.; Msukwa C; UNICEF, PO Box 2381, Kampala, Uganda.; Mwanyumba F; UNICEF, PO Box 2381, Kampala, Uganda.; Gohar F; UNICEF Eastern and Southern African Regional Office, P.O. Box 44145-00100, Nairobi, Kenya.; Hailegebriel TD; UNICEF Headquarters, New York, NY, 10017, USA.; Asfaw AG; UNICEF, PO Box 2381, Kampala, Uganda.; Bergh AM; Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, 0031, South Africa. anne-marie.bergh@up.ac.za.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Uganda has high maternal, neonatal, and under-five mortality rates. This study documents stakeholder perspectives on best practices in a maternal and newborn health (MNH) quality-improvement programme implemented in the West Nile region of Uganda to improve delivery and utilisation of MNH services.
Methods: This exploratory cross-sectional qualitative study, conducted at the end of 2021, captured the perspectives of stakeholders representing the different levels of the healthcare system. Data were collected in four districts through: interviews with key informants working at all levels of the health system; focus group discussions with parents and caretakers and with community health workers; and interviews with individual community members whose lives had been impacted by the MNH programme. The initial content analysis was followed by a deductive synthesis pitched according to the different levels of the health system and the health-systems building blocks.
Results: The findings are summarised according to the health-systems building blocks and an account is given of three of the interventions most valued by participants: (1) data use for evidence-based decision making (with regard to human resources, essential reproductive health commodities, and financing); (2) establishment of special newborn care units and high-dependency maternity units at district hospitals and training of the health workforce (also with reference to other infrastructural improvements such as the provision of water, sanitation and hygiene facilities at health facilities); and (3) community referral of pregnant women through a commercial motorcycle voucher referral system.
Conclusion: The MNH programme in the West Nile region adopted a holistic and system-wide approach to addressing the key bottlenecks in the planning, delivery, and monitoring of quality MNH services. There was general stakeholder appreciation across the board that the interventions had the potential to improve quality of care and newborn and maternal health outcomes. However, as the funding was largely donor-driven, questions about government ownership and sustainability in the context of limited resources remain.
(© 2023. The Author(s).)
Methods: This exploratory cross-sectional qualitative study, conducted at the end of 2021, captured the perspectives of stakeholders representing the different levels of the healthcare system. Data were collected in four districts through: interviews with key informants working at all levels of the health system; focus group discussions with parents and caretakers and with community health workers; and interviews with individual community members whose lives had been impacted by the MNH programme. The initial content analysis was followed by a deductive synthesis pitched according to the different levels of the health system and the health-systems building blocks.
Results: The findings are summarised according to the health-systems building blocks and an account is given of three of the interventions most valued by participants: (1) data use for evidence-based decision making (with regard to human resources, essential reproductive health commodities, and financing); (2) establishment of special newborn care units and high-dependency maternity units at district hospitals and training of the health workforce (also with reference to other infrastructural improvements such as the provision of water, sanitation and hygiene facilities at health facilities); and (3) community referral of pregnant women through a commercial motorcycle voucher referral system.
Conclusion: The MNH programme in the West Nile region adopted a holistic and system-wide approach to addressing the key bottlenecks in the planning, delivery, and monitoring of quality MNH services. There was general stakeholder appreciation across the board that the interventions had the potential to improve quality of care and newborn and maternal health outcomes. However, as the funding was largely donor-driven, questions about government ownership and sustainability in the context of limited resources remain.
(© 2023. The Author(s).)