Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

被引:16
作者
Beltman, Jogchum Jan [1 ,2 ]
van den Akker, Thomas [1 ,2 ,3 ]
Bwirire, Dieudonne [3 ]
Korevaar, Anneke [4 ]
Chidakwani, Richard [1 ]
van Lonkhuijzen, Luc [5 ]
van Roosmalen, Jos [2 ,6 ]
机构
[1] Minist Hlth, Thyolo Dist Hlth Off, Thyolo, Malawi
[2] Leiden Univ, Dept Obstet, Med Ctr, Leiden, Netherlands
[3] Med Sans Frontieres, Thyolo, Malawi
[4] Univ Groningen, Univ Med Ctr Groningen, Dept Obstet, NL-9713 AV Groningen, Netherlands
[5] Univ Toronto, Dept Gynecol Oncol, Toronto, ON, Canada
[6] Vrije Univ Amsterdam, Med Ctr, Dept Med Humanities, EMGO Inst Hlth & Care Res, Amsterdam, Netherlands
关键词
TRANSMISSION PROGRAM; MATERNAL MORTALITY; FOLLOW-UP; PREVENTION; MOTHERS;
D O I
10.1186/1471-2393-13-39
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers. Methods: Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical assistants' and 'clinical officers'). Results: Factors contributing to facility-based obstetric hemorrhage mentioned by participants were categorized into four major areas: (1) limited availability of basic supplies, (2) lack of human resources, (3) inadequate clinical skills of available health workers and (4) substandard referrals by traditional birth attendants and lack of timely self-referrals of patients. Conclusion: Health workers in this district mentioned important community, system and provider related factors that need to be addressed in order to reduce the impact of obstetric hemorrhage.
引用
收藏
页数:5
相关论文
共 19 条
[1]  
[Anonymous], 1997, Guidelines for Monitoring the Availability and Use of Obstetric Services
[2]   Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi [J].
Beltman, J. J. ;
Fitzgerald, M. ;
Buhendwa, L. ;
Moens, M. ;
Massaquoi, M. ;
Kazima, J. ;
Alide, N. ;
van Roosmalen, J. .
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV, 2010, 22 (11) :1367-1372
[3]   Beyond maternal mortality: obstetric hemorrhage in a Malawian district [J].
Beltman, Jogchum ;
Van Den Akker, Thomas ;
Van Lonkhuijzen, Luc ;
Schmidt, Aniek ;
Chidakwani, Richard ;
Van Roosmalen, Jos .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2011, 90 (12) :1423-1427
[4]  
Bisika Thomas, 2008, East Afr J Public Health, V5, P103
[5]   Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi [J].
Bwirire, L. D. ;
Fitzgerald, M. ;
Zachariah, R. ;
Chikafa, V. ;
Massaquoi, M. ;
Moens, M. ;
Kamoto, K. ;
Schouten, E. J. .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 2008, 102 (12) :1195-1200
[6]  
Dawson S., 1993, MANUAL USE FOCUS GRO
[7]  
Geller SE, 2006, WOMEN HEALTH ISS, V16, P76
[8]   Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5 [J].
Hogan, Margaret C. ;
Foreman, Kyle J. ;
Naghavi, Mohsen ;
Ahn, Stephanie Y. ;
Wang, Mengru ;
Makela, Susanna M. ;
Lopez, Alan D. ;
Lozano, Rafael ;
Murray, Christopher J. L. .
LANCET, 2010, 375 (9726) :1609-1623
[9]  
Integrated Management of Pregnancy and Childbirth, 2006, MAN COMPL PREGN CHIL
[10]  
Integrated Management of Pregnancy and Childbirth, 2006, PREGN CHILDB POSTP N