Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study
Abstract Background The slow progress in reducing maternal and newborn death in low and middle-income countries is attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services in health facilities as well as demand for maternal and newborn healt...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Reproductive Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12978-017-0402-6 |
| _version_ | 1818695479474520064 |
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| author | Rornald Muhumuza Kananura Suzanne Namusoke Kiwanuka Elizabeth Ekirapa-Kiracho Peter Waiswa |
| author_facet | Rornald Muhumuza Kananura Suzanne Namusoke Kiwanuka Elizabeth Ekirapa-Kiracho Peter Waiswa |
| author_sort | Rornald Muhumuza Kananura |
| collection | DOAJ |
| description | Abstract Background The slow progress in reducing maternal and newborn death in low and middle-income countries is attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services in health facilities as well as demand for maternal and newborn health services in Eastern Uganda. Methods The health assessment data were collected in August 2013 and September 2015 in the districts of Kamuli, Pallisa, and Kibuku. We purposively collected data on the availability of services from 40 health facilities that provided maternal and newborn services. In addition, we conducted 24 focus group discussions (FGDs) with women and men; and 18 key informant interviews (KIs) with health workers. Results On the supply side, most health facilities persistently lacked lifesaving medicines such as misoprostol, IV Ampicillin, IV Gentamycin, IV Metronidazole, Magnesium Sulphate, Ergometrine, Corticosteroids, ferrous Sulphate, Folic Acid, Combined ferrous, Benzyl penicillin, and Diazepam (IM or IV). Basic newborn equipment such as stethoscope, fetal scope, working baby scale, newborn suction devices, newborn resuscitation device, and thermometer were persistently not available in most of the health facilities. Binders for Kangaroo Mother Care, blanket to wrap newborn, baby warmer or heat lamp were persistently not available in at least 80% of the health facilities. Other equipment for the management of labor and abortions such as Manual vacuum aspirator for abortion care, blank partographs and vacuum extractor were not available in most of the health facilities including referral facilities at baseline and follow-up. On the demand side, the qualitative interviews exposed long distances and inadequate transport to the health facilities, inadequate information, poverty, and poor services at the health facilities as major factors that impede women to utilize/access maternal and newborn services. Conclusion There are distinct influences on both demand and supply side, which restrain both health care uptake and its quality. The frequent disparity between the health facility readiness to provide services and the women readiness to utilize them needs to be addressed as the country intensifies its efforts to reduce maternal and newborn deaths through boosting facility deliveries. |
| first_indexed | 2024-12-17T13:46:08Z |
| format | Article |
| id | doaj.art-803c9dc9ebb34e189bfbdcafa7614626 |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-12-17T13:46:08Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-803c9dc9ebb34e189bfbdcafa76146262022-12-21T21:46:09ZengBMCReproductive Health1742-47552017-10-0114111510.1186/s12978-017-0402-6Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional studyRornald Muhumuza Kananura0Suzanne Namusoke Kiwanuka1Elizabeth Ekirapa-Kiracho2Peter Waiswa3Department of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthAbstract Background The slow progress in reducing maternal and newborn death in low and middle-income countries is attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services in health facilities as well as demand for maternal and newborn health services in Eastern Uganda. Methods The health assessment data were collected in August 2013 and September 2015 in the districts of Kamuli, Pallisa, and Kibuku. We purposively collected data on the availability of services from 40 health facilities that provided maternal and newborn services. In addition, we conducted 24 focus group discussions (FGDs) with women and men; and 18 key informant interviews (KIs) with health workers. Results On the supply side, most health facilities persistently lacked lifesaving medicines such as misoprostol, IV Ampicillin, IV Gentamycin, IV Metronidazole, Magnesium Sulphate, Ergometrine, Corticosteroids, ferrous Sulphate, Folic Acid, Combined ferrous, Benzyl penicillin, and Diazepam (IM or IV). Basic newborn equipment such as stethoscope, fetal scope, working baby scale, newborn suction devices, newborn resuscitation device, and thermometer were persistently not available in most of the health facilities. Binders for Kangaroo Mother Care, blanket to wrap newborn, baby warmer or heat lamp were persistently not available in at least 80% of the health facilities. Other equipment for the management of labor and abortions such as Manual vacuum aspirator for abortion care, blank partographs and vacuum extractor were not available in most of the health facilities including referral facilities at baseline and follow-up. On the demand side, the qualitative interviews exposed long distances and inadequate transport to the health facilities, inadequate information, poverty, and poor services at the health facilities as major factors that impede women to utilize/access maternal and newborn services. Conclusion There are distinct influences on both demand and supply side, which restrain both health care uptake and its quality. The frequent disparity between the health facility readiness to provide services and the women readiness to utilize them needs to be addressed as the country intensifies its efforts to reduce maternal and newborn deaths through boosting facility deliveries.http://link.springer.com/article/10.1186/s12978-017-0402-6Maternal and newbornSupply and demand side factorsHealth facility readinessUgandaAnd sub-Saharan Africa |
| spellingShingle | Rornald Muhumuza Kananura Suzanne Namusoke Kiwanuka Elizabeth Ekirapa-Kiracho Peter Waiswa Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study Reproductive Health Maternal and newborn Supply and demand side factors Health facility readiness Uganda And sub-Saharan Africa |
| title | Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study |
| title_full | Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study |
| title_fullStr | Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study |
| title_full_unstemmed | Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study |
| title_short | Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study |
| title_sort | persisting demand and supply gap for maternal and newborn care in eastern uganda a mixed method cross sectional study |
| topic | Maternal and newborn Supply and demand side factors Health facility readiness Uganda And sub-Saharan Africa |
| url | http://link.springer.com/article/10.1186/s12978-017-0402-6 |
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