Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework
BackgroundHome visitation has emerged as an effective model to provide high-quality care during pregnancy, childbirth, and post-natal period and improve the health outcomes of mother- new born dyad. This 3600 assessment documented the constraints faced by the community health workers (known as the A...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.956422/full |
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| author | Vaishali Deshmukh Shibu John Abhijit Pakhare Rajib Dasgupta Ankur Joshi Sanjay Chaturvedi Kiran Goswami Manoja Kumar Das Rupak Mukhopadhyay Rakesh Singh Pradeep Shrivastava Bhavna Dhingra Steven Bingler Bobbie Provosty Hill Narendra K. Arora |
| author_facet | Vaishali Deshmukh Shibu John Abhijit Pakhare Rajib Dasgupta Ankur Joshi Sanjay Chaturvedi Kiran Goswami Manoja Kumar Das Rupak Mukhopadhyay Rakesh Singh Pradeep Shrivastava Bhavna Dhingra Steven Bingler Bobbie Provosty Hill Narendra K. Arora |
| author_sort | Vaishali Deshmukh |
| collection | DOAJ |
| description | BackgroundHome visitation has emerged as an effective model to provide high-quality care during pregnancy, childbirth, and post-natal period and improve the health outcomes of mother- new born dyad. This 3600 assessment documented the constraints faced by the community health workers (known as the Accredited Social Health Activists, ASHAs) to accomplish home visitation and deliver quality services in a poor-performing district and co-created the strategies to overcome these using a nexus planning approach.MethodsThe study was conducted in the Raisen district of Madhya Pradesh, India. The grounded theory approach was applied for data collection and analysis using in-depth interviews, and focus group discussions with stakeholders representing from health system (including the ASHAs) and the community (rural population). A key group of diverse stakeholders were convened to utilize the nexus planning five domain framework (social-cultural, educational, organizational, economic, and physical) to prioritize the challenges and co-create solutions for improving the home visitation program performance and quality. The nexus framework provides a systemic lens for evaluating the success of the ASHAs home visitation program.ResultsThe societal (caste and economic discrimination), and personal (domestic responsibilities and cultural constraints of working in the village milieu) issues emerged as the key constraints for completing home visits. The programmatic gaps in imparting technical knowledge and skills, mentoring system, communication abilities, and unsatisfactory remuneration system were the other barriers to the credibility of the services. The nexus planning framework emphasized that each of the above factors/domains is intertwined and affects or depends on each other for home-based maternal and newborn care services delivered with quality through the ASHAs.ConclusionThe home visitation program services, quality and impact can be enhanced by addressing the social-cultural, organizational, educational, economic, and physical nexus domains with concurrent efforts for skill and confidence enhancement of the ASHAs and their credibility. |
| first_indexed | 2024-12-10T05:16:12Z |
| format | Article |
| id | doaj.art-6b69fdfac3c54270aad5bc0b1717ea25 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-10T05:16:12Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-6b69fdfac3c54270aad5bc0b1717ea252022-12-22T02:00:57ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-09-011010.3389/fpubh.2022.956422956422Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning frameworkVaishali Deshmukh0Shibu John1Abhijit Pakhare2Rajib Dasgupta3Ankur Joshi4Sanjay Chaturvedi5Kiran Goswami6Manoja Kumar Das7Rupak Mukhopadhyay8Rakesh Singh9Pradeep Shrivastava10Bhavna Dhingra11Steven Bingler12Bobbie Provosty Hill13Narendra K. Arora14The INCLEN Trust International, New Delhi, IndiaSchool of Management and Business Studies, Jamia Hamdard, New Delhi, IndiaDepartment of Community Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, IndiaCentre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, IndiaDepartment of Community Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, IndiaDepartment of Community Medicine, University College of Medical Sciences, New Delhi, IndiaDepartment of Community Medicine, All India Institute of Medical Sciences, New Delhi, IndiaThe INCLEN Trust International, New Delhi, IndiaThe INCLEN Trust International, New Delhi, IndiaThe INCLEN Trust International, New Delhi, IndiaThe INCLEN Trust International, New Delhi, IndiaDepartment of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, IndiaConcordia–Architecture, Planning, Community Engagement, New Orleans, LA, United StatesConcordia–Architecture, Planning, Community Engagement, New Orleans, LA, United StatesThe INCLEN Trust International, New Delhi, IndiaBackgroundHome visitation has emerged as an effective model to provide high-quality care during pregnancy, childbirth, and post-natal period and improve the health outcomes of mother- new born dyad. This 3600 assessment documented the constraints faced by the community health workers (known as the Accredited Social Health Activists, ASHAs) to accomplish home visitation and deliver quality services in a poor-performing district and co-created the strategies to overcome these using a nexus planning approach.MethodsThe study was conducted in the Raisen district of Madhya Pradesh, India. The grounded theory approach was applied for data collection and analysis using in-depth interviews, and focus group discussions with stakeholders representing from health system (including the ASHAs) and the community (rural population). A key group of diverse stakeholders were convened to utilize the nexus planning five domain framework (social-cultural, educational, organizational, economic, and physical) to prioritize the challenges and co-create solutions for improving the home visitation program performance and quality. The nexus framework provides a systemic lens for evaluating the success of the ASHAs home visitation program.ResultsThe societal (caste and economic discrimination), and personal (domestic responsibilities and cultural constraints of working in the village milieu) issues emerged as the key constraints for completing home visits. The programmatic gaps in imparting technical knowledge and skills, mentoring system, communication abilities, and unsatisfactory remuneration system were the other barriers to the credibility of the services. The nexus planning framework emphasized that each of the above factors/domains is intertwined and affects or depends on each other for home-based maternal and newborn care services delivered with quality through the ASHAs.ConclusionThe home visitation program services, quality and impact can be enhanced by addressing the social-cultural, organizational, educational, economic, and physical nexus domains with concurrent efforts for skill and confidence enhancement of the ASHAs and their credibility.https://www.frontiersin.org/articles/10.3389/fpubh.2022.956422/fullhome visitationnew-born carecommunity health worker (CHW)ASHAs (accredited social health activists)Indianexus planning |
| spellingShingle | Vaishali Deshmukh Shibu John Abhijit Pakhare Rajib Dasgupta Ankur Joshi Sanjay Chaturvedi Kiran Goswami Manoja Kumar Das Rupak Mukhopadhyay Rakesh Singh Pradeep Shrivastava Bhavna Dhingra Steven Bingler Bobbie Provosty Hill Narendra K. Arora Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework Frontiers in Public Health home visitation new-born care community health worker (CHW) ASHAs (accredited social health activists) India nexus planning |
| title | Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework |
| title_full | Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework |
| title_fullStr | Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework |
| title_full_unstemmed | Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework |
| title_short | Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework |
| title_sort | barriers in reaching new borns and infants through home visits a qualitative study using nexus planning framework |
| topic | home visitation new-born care community health worker (CHW) ASHAs (accredited social health activists) India nexus planning |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.956422/full |
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