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  • 1
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period. Methods This is a cluster randomised stepped-wedge trial with a nested realist process evaluation across 16 hospitals in Benin, Malawi, Tanzania and Uganda. The ALERT intervention will include four main components: i) end-user participation through narratives of women, families and midwifery providers to ensure co-design of the intervention; ii) competency-based training; iii) quality improvement supported by data from a clinical perinatal e-registry and iv) empowerment and leadership mentoring of maternity unit leaders complemented by district based bi-annual coordination and accountability meetings. The trial’s primary outcome is in-facility perinatal (stillbirths and early neonatal) mortality, in which we expect a 25% reduction. A perinatal e-registry will be implemented to monitor the trial. Our nested realist process evaluation will help to understand what works, for whom, and under which conditions. We will apply a gender lens to explore constraints to the provision of evidence-based care by health workers providing maternity services. An economic evaluation will assess the scalability and cost-effectiveness of ALERT intervention. Discussion There is evidence that each of the ALERT intervention components improves health providers’ practices and has modest to moderate effects. We aim to test if the innovative packaging, including addressing specific health systems constraints in these settings, will have a synergistic effect and produce more considerable perinatal mortality reductions. Trial registration Pan African Clinical Trial Registry ( www.pactr.org ): PACTR202006793783148. Registered on 17th June 2020.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 2
    Online Resource
    Online Resource
    Mark Allen Group ; 2015
    In:  African Journal of Midwifery and Women's Health Vol. 9, No. 1 ( 2015-01-02), p. 23-28
    In: African Journal of Midwifery and Women's Health, Mark Allen Group, Vol. 9, No. 1 ( 2015-01-02), p. 23-28
    Abstract: Male involvement in pregnancy and labour care has been shown to improve maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. Several interventions have been suggested for supporting male involvement in reproductive health and maternity care, but no assessment has been made in terms of their effectiveness. The objective of this review was to summarise and evaluate the current evidence related to male partner involvement in maternal health. Three databases were searched electronically. This review included two randomised controlled trials and two observational studies. Two interventions emerged from the review: facility-based couple health education and workplace-based health education. These interventions showed positive outcomes regarding the presence of partners during antenatal visits, postpartum visits, childbirth, and the initiation of breastfeeding within one hour of birth among others. More rigorous research is needed into strategies for, and the effect of, including men in maternal and newborn health.
    Type of Medium: Online Resource
    ISSN: 1759-7374 , 2052-4293
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2015
    detail.hit.zdb_id: 2946060-8
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  • 3
    Online Resource
    Online Resource
    Mark Allen Group ; 2017
    In:  African Journal of Midwifery and Women's Health Vol. 11, No. 2 ( 2017-04-02), p. 72-76
    In: African Journal of Midwifery and Women's Health, Mark Allen Group, Vol. 11, No. 2 ( 2017-04-02), p. 72-76
    Abstract: Although it is a cost effective tool in labour management, the partograph is not always used appropriately. The aim of this audit was to assess the initiation and completion of the partograph for women in labour at Mulago Hospital. Methods: A criteria-based audit was conducted, using patients’ files and delivery records from February to May 2016. A checklist was used to gather data and descriptive statistics computed. Findings: Of 7170 files, 256 (3.57%) had the partograph initiated. The recording of maternal wellbeing was low. For example, pulse was recorded in 20% of cases and blood pressure in 35%. Recording of vaginal examination results was 90% on admission but reduced to 57% in the first stage of labour. Similarly, recording of fetal heart rate in the first stage of labour was 62%. Conclusions: Partograph initiation was unacceptably low. Maternal well-being documentation was generally low compared to the set standard. There is need to strengthen the use of a partograph to improve care during labour
    Type of Medium: Online Resource
    ISSN: 1759-7374 , 2052-4293
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2017
    detail.hit.zdb_id: 2946060-8
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  • 4
    Online Resource
    Online Resource
    Mark Allen Group ; 2020
    In:  African Journal of Midwifery and Women's Health Vol. 14, No. 4 ( 2020-10-02), p. 1-11
    In: African Journal of Midwifery and Women's Health, Mark Allen Group, Vol. 14, No. 4 ( 2020-10-02), p. 1-11
    Abstract: Intimate partner violence during pregnancy is associated with adverse health outcomes for mothers and their unborn babies. Whereas the literature on intimate partner violence in the general population is extensive, little is known about this type of violence among pregnant teenagers, especially in resource-limited settings. This study aimed to determine the prevalence and factors associated with intimate partner violence among pregnant teenagers attending antenatal care clinics in Lira District, northern Uganda. Methods This was a cross-sectional study of 310 pregnant teenagers attending antenatal care clinics at the Lira Regional Referral Hospital and Ogur Health Center IV. Eligible teenagers were recruited consecutively until the required sample size was accrued. Data were collected using a structured questionnaire. Intimate partner violence was determined using the Revised Conflict Tactile Scale 2. Logistic regression analysis was performed to identify factors associated with violence during pregnancy, while considering potential confounding factors. Results The overall prevalence of intimate partner violence among pregnant teenagers was 40.6%. The prevalence of psychological violence was 37.1%, sexual assault was 29%, and physical violence was 24.8%. Partner alcohol intake (odds ratio=5.00, P=0.000); polygamy (odds ratio=2.80, P=0.001) and the inability of the teenage mother to make major decisions in the home (odds ratio=2.42, P=0.006) were independently associated with intimate partner violence during pregnancy. Conclusions Approximately 4 in 10 pregnant teenagers in Lira district, northern Uganda experienced intimate partner violence. This is higher than has been reported in the general population of pregnant women in Uganda. Intimate partner violence screening and counselling should be part of the routine antenatal care package.
    Type of Medium: Online Resource
    ISSN: 2052-4293
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2020
    detail.hit.zdb_id: 2946060-8
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  • 5
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2013
    In:  Journal of Religion and Health Vol. 52, No. 1 ( 2013-3), p. 307-317
    In: Journal of Religion and Health, Springer Science and Business Media LLC, Vol. 52, No. 1 ( 2013-3), p. 307-317
    Type of Medium: Online Resource
    ISSN: 0022-4197 , 1573-6571
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2013
    detail.hit.zdb_id: 2017250-3
    detail.hit.zdb_id: 410678-7
    SSG: 0
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  • 6
    Online Resource
    Online Resource
    Mark Allen Group ; 2022
    In:  African Journal of Midwifery and Women's Health Vol. 16, No. 4 ( 2022-10-02), p. 1-9
    In: African Journal of Midwifery and Women's Health, Mark Allen Group, Vol. 16, No. 4 ( 2022-10-02), p. 1-9
    Abstract: Danger signs are indicators of complications easily recognised by non-clinical personnel that may occur during pregnancy, childbirth or in the postpartum period. Some maternal deaths can be attributed to a lack of information about postnatal danger signs. Most studies on knowledge of danger signs have investigated groups of participants with mixed parities, meaning there is limited research on knowledge among first-time mothers. The aim of this study was to determine first-time mothers’ knowledge of postnatal danger signs and associated factors in Uganda. Methods This was a cross-sectional study that recruited 358 primigravidas. Data on knowledge of postnatal danger signs and the participants’ obstetric and sociodemographic factors were collected through interviewer-administered questionnaires. A multivariable logistic regression model was used to determine factors associated with knowledge of postnatal danger signs. Results Of the 358 participants, 63.4% could name at least one postnatal danger sign. Factors associated with knowledge of postnatal danger signs were having secondary or tertiary education (P=0.002), attending more than four antenatal care visits (P 〈 0.001) and having access to information platforms (P 〈 0.001). Conclusions There is insufficient knowledge of postnatal danger signs among first-time mothers at Tororo General Hospital. First-time mothers require health education as they lack experience and knowledge of danger signs. The use of media sources to convey health information should be strengthened in the healthcare system.
    Type of Medium: Online Resource
    ISSN: 2052-4293
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2022
    detail.hit.zdb_id: 2946060-8
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  • 7
    In: Journal of Global Health, International Society of Global Health, Vol. 11 ( 2021-07-24)
    Type of Medium: Online Resource
    ISSN: 2047-2978 , 2047-2986
    Language: English
    Publisher: International Society of Global Health
    Publication Date: 2021
    detail.hit.zdb_id: 2741629-X
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  • 8
    Online Resource
    Online Resource
    Elsevier BV ; 2022
    In:  Best Practice & Research Clinical Obstetrics & Gynaecology Vol. 80 ( 2022-04), p. 39-48
    In: Best Practice & Research Clinical Obstetrics & Gynaecology, Elsevier BV, Vol. 80 ( 2022-04), p. 39-48
    Type of Medium: Online Resource
    ISSN: 1521-6934
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2050090-7
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  • 9
    In: BMC Women's Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12-19)
    Abstract: Involuntary childlessness is a global phenomenon that negatively impacts the couple, or the family involved. The experiences of women living with involuntary childlessness have not been well documented in the literature, specifically in the Ugandan context. The purpose of the study was to explore the experiences of women living with involuntary childlessness in Uganda. Methods A qualitative phenomenological approach was used. Fifteen in-depth interviews were conducted among women experiencing involuntary childlessness attending a National Referral Hospital. Purposive sampling was, and data saturation determined the actual sample size. Thematic analysis was used for data analysis. The results are presented in the form of text and narrative quotes from participants. Results Six themes emerged (i) Inadequate social support (ii) psychological torture (iii) continued grief (iv) marital instability (v) failure attributed to childlessness and (vi) financial constraints. Inadequate social support was in the form of having an unsupportive partner, altered social relation, and altered social status, while women experienced name-calling, emotional abuse, stigma, and blame under the psychological torture theme. Women experienced feelings of distress and grief, including anger, irritability, sadness, stress, and feelings of despair. Women with involuntary childlessness recounted experiencing unstable marriages characterized by infidelity, divorce, abandonment, and polygamous marriages. Some women coped positively, while others employed negative coping strategies such as social withdrawal and isolation. Women who their partners and families well supported coped positively. In contrast, those who did not receive as much support were stressed, sad, angry, and had lost hope of pregnancy. Conclusions In this study, women with involuntary childlessness lacked social support amidst experiences of marital turmoil, psychological torture, feelings of distress and grief, unfulfilled motherhood expectations, and financial constraints while seeking treatment, therefore, there is a need to screen the women for psychological / mental illness symptoms and provide empathetic care and counseling. The prevalence of involuntary childlessness is not well documented in Uganda and a study can be done to determine its extent.
    Type of Medium: Online Resource
    ISSN: 1472-6874
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2050444-5
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  • 10
    In: Reproductive Health, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2021-12)
    Abstract: We aim to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care. Methods Using an explanatory sequential mixed method design we will employ three methods (i) a survey will be conducted using self-administered questionnaires assessing knowledge, (ii) skills drills assessing basic intrapartum skills and attitudes, using an observation checklist and (iii) Focus Group Discussions (FGDs) to explore midwifery care providers’ experiences and perceptions of in-service training. All midwifery care providers in the study facilities are eligible to participate in the study. For the skills drills a stratified sample of midwifery care providers will be selected in each hospital according to the number of providers and, professional titles and purposive sampling will be used for the FGDs. Descriptive summary statistics from the survey and skills drills will be presented by country. Conventional content analysis will be employed for data analysis of the FGDs. Discussion We envision comparative insight across hospitals and countries. The findings will be used to inform a targeted quality in-service training and quality improvement intervention related to provision of basic intrapartum care as part of the ALERT project. Trial registration: PACTR202006793783148—June 17th, 2020.
    Type of Medium: Online Resource
    ISSN: 1742-4755
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2149029-6
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