Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

A research project submitted to the School of Public Health in partial fulfilment of the requirement for the Degree of Master of Public Health, in the field of Social and Behaviour Change Communication. Date: June 2017 / Globally, access to maternal and child healthcare remains a fundamental human right for all, regardless of an individual’s migration status (1). People migrate for a variety of reasons, and this mobility brings forth implications for health provision, health care experiences and human rights, both for the migrants and their host population (2, 3). An increasing number of cross-border or international migrant women globally report difficulties in access to and use of healthcare services, including maternal and child health (4, 5). Little evidence in South Africa on these issues proposes that there is a need for deeper knowledge in this regard. South Africa is a signatory to a range of international commitments that place emphasis on the non-discriminatory provision of health services and a progressive health policy assuring health for all, including free access to antenatal care (ANC) (1). Despite this, South Africa’s maternal and child health outcomes continue to be poor - including that of migrants (6, 7). The increased number of migrants from neighbouring countries is perceived to have placed a burden on the South African healthcare system (4). The aim of this study was to explore the experiences and perceptions of Zimbabwean cross-border migrant mothers in accessing routine antenatal care, obstetric care and infant/child immunisation in public healthcare facilities in, Gauteng, South Africa (2015-2016). Through a qualitative study design, the researcher gathered data by means of 13 face-to-face interviews with a purposive and snowball sample of participants. Few participants gave positive reports on the quality of ANC and immunization services they had received. It is therefore important to ensure that this positive care is maintained across all public health facilities in order to instill confidence among health recipients. However, most of the study participants experienced barriers in accessing quality routine ANC and infant immunisation in the country’s public health facilities. These challenges include language barriers, discrimination and poor nurse-patient relationships. Based on these findings and conclusions, the researcher recommends that the South African National Department of Health addresses some of the challenges affecting cross-border migrant vi women in accessing maternal health care in public facilities nationally through the formulation, implementation and follow-up of policies. Furthermore, health care providers need to be continuously educated and motivated to respect the rights of all patients, regardless of an individual’s migration status, in order to instil positive attitudes and quality care. There is also a need to conduct further research in other provinces of the country, preferably with cross-border migrant women from other countries, and draw comparisons with South African women in order to take appropriate steps to address the challenges. / MT2017

published_or_final_version / Medicine / Master / Doctor of Medicine

Thesis (M.S.)--Wisconsin. / Includes bibliographical references (leaf 38).

OBJETIVO: Determinar el nivel de satisfacción sobre la atención prenatal en gestantes atendidas en los consultorios de obstetricia del Instituto Nacional Materno Perinatal durante enero - febrero del año 2016. METODOLOGÍA: Estudio de nivel aplicativo con diseño transversal prospectivo, para ello se trabajó con una muestra conformada por 368 gestantes atendidas en el consultorio de obstetricia del Instituto Nacional Materno Perinatal durante el enero - febrero del año 2016. Al tener una metodología descriptiva, solo se realizó un análisis univariado de los datos, es decir, para el análisis de variables cualitativas (nominal y ordinal) se estimaron frecuencias absolutas y frecuencias relativas (%). Para representar las gráficas de las tablas se utilizó el programa Microsoft Excel 2013. RESULTADOS: el nivel de satisfacción sobre la atención prenatal de las gestantes en el consultorio de obstetricia es “satisfecha” (86.4%), “medianamente satisfecha” (12%) e “insatisfecha” (1.6%). El nivel de satisfacción sobre la organización de la consulta prenatal, en las gestantes atendidas en el consultorio de obstetricia resultó que el 53.8% se encuentra “satisfecha”, el 40.2% “medianamente satisfecha” y el 6% se muestra “insatisfecha”. Respecto al nivel de satisfacción sobre la atención recibida por el profesional durante la atención prenatal: el 78.3% está “satisfecha”, el 17.9% “medianamente satisfecha” y el 3.8% se encuentra “insatisfecha”. En cuanto al nivel de satisfacción sobre los aspectos tangibles relacionados a la atención prenatal de las gestantes: el 76.6% se encuentra “satisfecha”, el 21.7% “medianamente satisfecha” y el 1.6% está “insatisfecha”. CONCLUSIÓN: Las gestantes atendidas en los consultorios de Obstetricia en el Instituto Nacional Materno Perinatal están satisfechas (86.4%), medianamente satisfechas (12%) e insatisfechas (1.6%) sobre la atención prenatal, durante enero - febrero del año 2016. PALABRAS CLAVES: Satisfacción, atención prenatal, gestantes. / --- OBJECTIVE: To determine the level of satisfaction with prenatal care in pregnant women at obstetrics clinics National Maternal Perinatal Institute during January-February 2016. METHODOLOGY: Level applicative study with prospective cross-sectional design, for that it worked with a sample composed of 368 pregnant women at the clinic of obstetrics National Institute of Maternal and Perinatal during January-February 2016. By having a descriptive methodology, only a univariate analysis of the data, that is, for the analysis of qualitative variables (nominal and ordinal) and absolute frequency relative frequency (%) were estimated was performed. Microsoft Excel 2013 the program was used to represent the graphs of tables. RESULTS: the level of satisfaction with prenatal care of pregnant women in obstetric practice is "satisfied" (86.4%), "moderately satisfied" (12%) and "unsatisfied" (1.6%). The level of satisfaction with the organization of the prenatal consultation, in pregnant women treated at the clinic of obstetrics it turned out 53.8% is "satisfied", 40.2% "fairly satisfied" and 6% are "dissatisfied". About the level of satisfaction with the care provided by the professional during prenatal care: 78.3% are "satisfied" 17.9% "fairly satisfied" and 3.8% are "dissatisfied". Regarding the level of satisfaction with the tangible aspects related to prenatal care of pregnant women: 76.6% are "satisfied" 21.7% "fairly satisfied" and 1.6% are "dissatisfied". CONCLUSIONS: The pregnant women at clinics Obstetrics at the National Maternal and Perinatal Institute are satisfied (86.4%), moderately satisfied (12%) and dissatisfied (1.6%) on prenatal care, during January-February 2016. KEYWORDS: Satisfaction, prenatal care, pregnant. / Tesis

OBJETIVO: Evaluar la calidad del control prenatal realizado en centros de salud pertenecientes a la Dirección de Salud V Lima Ciudad. MATERIAL Y METODOS: Estudio Retro-prospectivo, Polietápico. Se analizó la información secundaria de tres estudios cuantitativos (1° etapa) referentes a calidad del control prenatal y de un estudio cualitativo (2° etapa), aplicando entrevistas a profundidad a usuarias y prestadores de salud de centros de salud (primer nivel de atención), ambos con la finalidad de servir de insumo para la posterior triangulación. La metodología constó en la coincidencia entre las categorías encontradas en el estudio cualitativo y los resultados significativos de los estudios cuantitativos referentes a las dimensiones accesibilidad, seguridad, capacidad profesional, eficacia, eficiencia, continuidad, satisfacción y comodidades. El análisis, fue estadístico (descriptivas e inferencial) en los estudios cuantitativos y de entrevistas grabadas con equipos magnetofónicos (estudio cualitativo), para su posterior categorización y sistematización de los hallazgos. RESULTADOS: En controles prenatales de centros de salud del primer nivel de atención de Lima, las dimensiones adecuadas son accesibilidad, seguridad y capacidad profesional. Las dimensiones inadecuadas son eficacia, eficiencia, continuidad, satisfacción y comodidades, todas expresadas en ambos esquemas (cualitativo y cuantitativo), se presentó dos nuevas dimensiones: clima y cultura organizacional. CONCLUSIONES: En los estudios sobre el control prenatal en centros de salud del primer nivel de atención de Lima Ciudad se ha encontrado similitudes significativas en la influencia de la calidad del control prenatal en la capacidad profesional, accesibilidad, satisfacción del cliente, continuidad y comodidades.

OBJETIVO: Evaluar la calidad del control prenatal realizado en centros de salud pertenecientes a la Dirección de Salud V Lima Ciudad. MATERIAL Y METODOS: Estudio Retro-prospectivo, Polietápico. Se analizó la información secundaria de tres estudios cuantitativos (1° etapa) referentes a calidad del control prenatal y de un estudio cualitativo (2° etapa), aplicando entrevistas a profundidad a usuarias y prestadores de salud de centros de salud (primer nivel de atención), ambos con la finalidad de servir de insumo para la posterior triangulación. La metodología constó en la coincidencia entre las categorías encontradas en el estudio cualitativo y los resultados significativos de los estudios cuantitativos referentes a las dimensiones accesibilidad, seguridad, capacidad profesional, eficacia, eficiencia, continuidad, satisfacción y comodidades. El análisis, fue estadístico (descriptivas e inferencial) en los estudios cuantitativos y de entrevistas grabadas con equipos magnetofónicos (estudio cualitativo), para su posterior categorización y sistematización de los hallazgos. RESULTADOS: En controles prenatales de centros de salud del primer nivel de atención de Lima, las dimensiones adecuadas son accesibilidad, seguridad y capacidad profesional. Las dimensiones inadecuadas son eficacia, eficiencia, continuidad, satisfacción y comodidades, todas expresadas en ambos esquemas (cualitativo y cuantitativo), se presentó dos nuevas dimensiones: clima y cultura organizacional. CONCLUSIONES: En los estudios sobre el control prenatal en centros de salud del primer nivel de atención de Lima Ciudad se ha encontrado similitudes significativas en la influencia de la calidad del control prenatal en la capacidad profesional, accesibilidad, satisfacción del cliente, continuidad y comodidades.

This study examines the relationship between maternal emotional attachment to the fetus, beliefs about fetal health locus of control, and use of prenatal testing (i.e., amniocentesis and maternal serum screening). To date, no research has directly addressed the link between these psychosocial variables and prenatal testing uptake. Ninety-one pregnant women at risk for fetal abnormalities (i.e., 35 years of age or older) participated in the study, of whom 35 had no testing, 27 had serum screening, and 29 had amniocentesis in their current pregnancy. Results of a hierarchical multiple regression partially supported the hypothesis that internal and powerful others Fetal Health Locus of Control (Labs & Wurtele, 1986) and prenatal testing status would be predictive of attachment (Prenatal Attachment Inventory; Muller, 1993) over and above the effects of gestational age, maternal age and attitude toward abortion. Fetal Health Locus of Control beliefs regarding ones own role (FHLC-I) in determining the health of ones fetus were found to be predictive of prenatal attachment. Results failed to support the hypothesis that the role of health professionals (FHLC-P) would be predictive of prenatal attachment. As predicted, women who had not used prenatal testing or who underwent amniocentesis tended to have stronger prenatal attachment than those who underwent serum screening only. Results supported the hypotheses that stronger attachment to the fetus would be positively correlated with both FHLC-I and FHLC-P scores. Women who had no testing were found to hold less favourable attitudes toward abortion and rate their religious as stronger than those who had amniocentesis. Emotional attachment to the fetus was stronger among women who had previous miscarriages than those who had not, but did not differ between women who had a previous abortion and those who had not.

This study examines the relationship between maternal emotional attachment to the fetus, beliefs about fetal health locus of control, and use of prenatal testing (i.e., amniocentesis and maternal serum screening). To date, no research has directly addressed the link between these psychosocial variables and prenatal testing uptake. Ninety-one pregnant women at risk for fetal abnormalities (i.e., 35 years of age or older) participated in the study, of whom 35 had no testing, 27 had serum screening, and 29 had amniocentesis in their current pregnancy. Results of a hierarchical multiple regression partially supported the hypothesis that internal and powerful others Fetal Health Locus of Control (Labs & Wurtele, 1986) and prenatal testing status would be predictive of attachment (Prenatal Attachment Inventory; Muller, 1993) over and above the effects of gestational age, maternal age and attitude toward abortion. Fetal Health Locus of Control beliefs regarding ones own role (FHLC-I) in determining the health of ones fetus were found to be predictive of prenatal attachment. Results failed to support the hypothesis that the role of health professionals (FHLC-P) would be predictive of prenatal attachment. As predicted, women who had not used prenatal testing or who underwent amniocentesis tended to have stronger prenatal attachment than those who underwent serum screening only. Results supported the hypotheses that stronger attachment to the fetus would be positively correlated with both FHLC-I and FHLC-P scores. Women who had no testing were found to hold less favourable attitudes toward abortion and rate their religious as stronger than those who had amniocentesis. Emotional attachment to the fetus was stronger among women who had previous miscarriages than those who had not, but did not differ between women who had a previous abortion and those who had not.