COMMUNITY BASED SITUATIONAL ANALYSIS Maternal and ...

More documents

Recommendations

Info

LIST OF APPENDICES Appendix A: Quantitative Results Appendix 1: Socio-Economic Differences across the Sites Appendix 2: Distribution of Selected Measures of Income by Site Appendix 3: Mode of Travel and Time to Health Services Appendix 4: Factors associated with the Utilisation of Health Services with a Score >=5 Appendix 5: Barriers to ANC Appendix 6: What Sort of Things or People made it Easier to Attend ANC? Appendix 7: Why didn’t you go to ANC Earlier? Appendix 8: Pregnancy History Appendix 9 Family Planning Appendix 10: Immunisations Appendix 11: Where did you learn about Problems or Warning Signs in Pregnancy? Appendix 12: Sources of Information on Pregnancy Appendix 13: Source for Best Advice for Making Decisions about Health Appendix 14: What are some Dangerous or Warning Signs of a Problem during Pregnancy or Birth? Appendix 15: What are some Dangerous or Warning Signs of a Problem in the Woman in the First Month After Birth? Appendix 16: What Are some Danger or Warning Signs of a Problem in the Baby in the First Three Months After Birth? Appendix 17: Household Member: What are some Dangerous or Warning Signs of a Problem During Pregnancy, Birth or in the 1 st Month after Birth? Appendix 18: Utilisation Score by HIV Status Appendix 19: Immunisation by HIV Status Appendix 20: Quality of Care by HIV Status Appendix 21: Family Involvement in Pregnancy - Mother's Interview Appendix 22: Family Involvement in Labour/Birth - Mother's Interview Appendix 23: Family Involvement in Pregnancy - Household Member's Interview Appendix 24: Family Involvement in Labour - Household Member's Interview Appendix 25: Family Involvement after the Birth of the Baby - Household Member's Interview Appendix 26: Do you think That Poor Health of Women during Pregnancy is an Important Problem in South Africa - Household Member's Interview Appendix B: Appendix 1: Appendix 2: Appendix 3: Appendix 4: Appendix 5: Qualitative Results Maternal Verbal Autopsy case summaries Infant Verbal Autopsy Pilot Report Facility Sub-Study Report: Paarl Facility Investigation Facility Sub-Study Report: Rietvlei Facility Investigation Facility Sub-Study Report: Summary Community Based Situation Analysis: Maternal & Neonatal Follow-up Care iv
COMMUNITY BASED SITUATIONAL ANALYSIS Maternal and Neonatal Follow Up Care Abstract Introduction There were two overall aims to this project. Firstly, to conduct a community situational analysis to determine factors that impact on the utilisation of maternal health services. Secondly, it is hoped that the results of the research could be utilised to develop appropriate interventions to improve acceptability and utilisation of safe motherhood and PMTCT programmes. Objectives 1. To determine factors influencing utilisation of maternal health services and barriers to utilisation of maternal health services (including loss to follow-up of mothers and infants in the PMTCT programme). 2. To determine the level of awareness of risk factors associated with poor maternal and perinatal health outcomes among women and men. 3. To determine the health seeking behaviours of HIV-positive and HIV-negative pregnant women. Methods In order to capitalise on extensive background data and to build on ongoing research, three sites were chosen for the research related to objectives 1, 2 and 3, where the HST/UWC consortium has longstanding research links. These sites are in the Western Cape, KwaZulu- Natal and the Eastern Cape. The three sites in these provinces represent diverse geographical settings in South Africa, namely; a peri-urban township, a rural district and a peri-urban farming region as well as differences in HIV prevalence and socio-economic situations. Semi-structured household interviews with 3 groups of mothers, plus a member of each mother’s household were interviewed. All groups randomly sampled: HIV-positive mothers enrolled in national PMTCT cohort study; HIV-negative mothers enrolled in national PMTCT cohort study, and Women of unknown HIV status sampled from community lists of recently delivered mothers. Case studies with 3 groups of mothers were also conducted. Groups randomly sampled from community lists: No ANC; No ANC with home births; and Home births (with ANC). In addition, verbal autopsies using tools adapted from WHO, including Infant verbal autopsies (PMTCT cohort) and Maternal verbal autopsies (PMTCT cohort and non-cohort) were conducted. Finally, a facility based review of PMTCT follow-up services was conducted using qualitative and quantitative case study methodology. Data collection methods consisted of semistructured interviews with staff and management involved in the PMTCT programme and a review of PMTCT programme records. Data analysis used quantitative statistics for the semi-structured interviews and qualitative content-theme approach for the case studies and verbal autopsies. Each component was analysed separately and then triangulated. Community Based Situation Analysis: Maternal & Neonatal Follow-up Care v
Page 1 and 2: COMMUNITY BASED SITUATIONAL ANALYSI
Page 3: Table of Contents ABSTRACT ........
Page 7 and 8: Executive Summary COMMUNITY BASED S
Page 9 and 10: It was not possible to identify par
Page 11 and 12: With regard to knowledge of risk fa
Page 13 and 14: Themes that emerged from the qualit
Page 15 and 16: COMMUNITY BASED SITUATIONAL ANALYSI
Page 17 and 18: 3. METHODS Description of Research
Page 19 and 20: Data Collection The study utilised
Page 21 and 22: inclusion criteria required women t
Page 23 and 24: Table 2: Demographic Data Average a
Page 25 and 26: Graph 2: Comparing Average Travel T
Page 27 and 28: household members gave to women's h
Page 29 and 30: a source of information. CHWs were
Page 31 and 32: Provincial governments to improve h
Page 33 and 34: NO ANC ATTENDANCE The most commonly
Page 35 and 36: Attitude of nurses: Only one woman
Page 37 and 38: SECTION 2: MATERNAL DEATH REVIEW Me
Page 39 and 40: There was no delay from the time of
Page 41 and 42: women from Umlazi (33%) and neither
Page 43 and 44: SECTION 3: INFANT DEATH REVIEW Meth
Page 45 and 46: Maternal and infant HIV status for
Page 47 and 48: The role of traditional healers: In
Page 49 and 50: programme. This was all clearly doc
Page 51 and 52: 6. RECOMMENDATIONS: 24-hour emergen
Page 53 and 54: transport will likely not be succes
Page 55 and 56:
APPENDIX A: RESULTS* *Notes to Tabl
Page 57 and 58:
Appendix A2: Distribution of Select
Page 59 and 60:
Appendix A5: Barriers to accessing
Page 61 and 62:
OBJECTIVE 2: To determine the level
Page 63 and 64:
Appendix A15: What Are Some Dangero
Page 65 and 66:
Appendix A17: Household Member: Wha
Page 67 and 68:
Appendix A20: Quality of Care by HI
Page 69 and 70:
Appendix A22: Family Involvement in
Page 71 and 72:
Appendix A25: Family Involvement af
Page 73 and 74:
APPENDIX B1: MATERNAL VERBAL AUTOPS
Page 75 and 76:
APPENDIX B2: INFANT VERBAL AUTOPSY
Page 77 and 78:
areas covered during the interview
Page 79 and 80:
way home after having been admitted
Page 81 and 82:
APPENDIX B3: FACILITY SUB-STUDY REP
Page 83 and 84:
Staff at all facilities felt that t
Page 85 and 86:
8. HUMAN RESOURCES The District HIV
Page 87 and 88:
DATA FROM PMTCT REGISTER Page Numbe
Page 89 and 90:
counseling and not ongoing support
Page 91 and 92:
year. It has not been possible to l
Page 93 and 94:
8. HUMAN RESOURCES When the PMTCT p
Page 95 and 96:
Each clinic had a register in which
Page 97 and 98:
APPENDIX B5: FACILITY SUB-STUDY REP
Page 99 and 100:
THEMES PAARL RIETVLEI attached by t
show all

COMMUNITY BASED SITUATIONAL ANALYSIS Maternal and ...

Create successful ePaper yourself

Delete template?

Save as template?