The devastating consequences of HIV/AIDS have caused untold harm and human suffering globally. Over 33 million people worldwide are estimated to be living with HIV and AIDS and a majority of these are in sub-Saharan Africa. Women and children are more infected particularly in sub-Saharan countries. Globally, an estimated number of 370 000 children were newly infected in 2007, mainly through mother to child transmission (MTCT). Implementation of prevention of mother to child transmission (PMTCT) programmes has been introduced in many sub-Saharan countries during the last years. Operational research was conducted to study the demand and adherence of key components within a PMTCT Programme among women in rural Malawi. This study was carried out at Malamulo SDA Hospital in rural Malawi and employed a mixture of both quantitative and qualitative approaches. Data sources included antenatal care (ANC), PMTCT and delivery registers, structured questionnaires, in-depth interviews with HIV positive women in the programme and focus group discussions with community members, health care workers and traditional birth attendants. Over the three year period of the study (January 2005 to December 2007), three interventions were introduced in the antenatal care (ANC) at the hospital at different times. These were HIV testing integrated in the ANC clinic in March 2005, opt-out testing in January 2006 and free maternal services in October 2006. A steady increase of the service uptake as interventions were being introduced was observed over time. HIV testing was generally accepted by the community and women within the programme. However, positive HIV tests among pregnant women were also experienced to cause conflicts and fear within the family. Although hospital deliveries were recognised to be safe and clean, home deliveries were common. Lack of transport, spouse support and negative attitudes among staff were some of the underlying factors. Further study on the quality of care offered in the presence of increased service uptake is required. Community sensitisation on free maternal care and male involvement should be strengthened to enable full utilisation of services. Additionally, service providers at facility and community levels, policy makers at all levels and the communities should see themselves as co-workers in development to reduce preventable maternal and infant mortality including MTCT of HIV.

Includes bibliographical references / Maternal mortality is an enormous global challenge that is most prevalent in sub-Saharan Africa (SSA). Its prevalence in the SSA region has been attributed to inadequate access to maternal services (MHS) amongst the poor and rural women. In an attempt to improve access to maternal services, women with disabilities (WWDs) have generally been neglected. Little is known about the health systems factors that facilitate or hinder access to MHS for WWDs. However, available studies for women in general in SSA, examining health systems determinants of access to MHS, utilise the silo approach thereby providing fragmented and ineffective solutions to maternal mortality. Globally, taking a comprehensive health systems approach to understand the full range and interconnectedness of health factors is now recognised as crucial in understanding and planning complex health problems such as access to MHS. This paper presents findings from a qualitative systematic review of empirical studies providing evidence on the health systems factors that impact on access to MHS for WWDs in SSA. This dissertation comprises three sections, namely Part A, Part B and Part C. Part A reviews the Protocol; it presents the background and the qualitative systematic review methodology that is utilised in this study. A systematic search of five data bases is outlined and inclusion and exclusion criteria set out to select the suitable tool. A data extraction tool is designed to summarise the studies in a common format and to facilitate synthesis and coherent presentation of data. Part B is the review of existing empirical literature on access to MHS for both women in general SSA and for WWDs globally. Theoretical frameworks of access to health care services and health systems frameworks are also presented in this section. Furthermore, Part B provides the background on why access to MHS for WWDs is important. This section explores how health systems approach can be adopted to reveal the factors that impact on access to MHS; it links the complex systems framework to the availability, accessibility, acceptability and quality framework. Part C is a complete systematic review journal manuscript. The background of the study and methodology are described. This section also includes the findings from the systematic review of original journal articles published in English from 2000 to 2014 that report empirical findings on health systems factors that impact on access to MHS WWDs in SSA.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Felaktigt serienummer 1251. Härtill 4 uppsatser.

Thesis(M. A. (Nursing)) -- University of Limpopo, 2021 / BACKGROUND The quality Kangaroo Mother Care (KMC) continues to be sub-standard as it is not managed properly, despite the maternal and neonatal services provided by the midwives during postpartum and neonatal period, as this can lead to increased neonatal mortality rate and maternal depression at selected hospitals of Limpopo Province, therefore the researcher is interested in developing strategies to enhance quality KMC at selected hospitals of Limpopo Province. KMC has been found to have physiological, behavioural, psychosocial and cognitive developmental benefits, and it enhances motherinfant bonding. The aim of the study was to develop strategies to enhance quality Kangaroo Mother Care in selected hospitals of Limpopo Province. RESEARCH METHOD A quantitative descriptive cross-sectional research method was used to collect numerical data with regard to the factors that hinders the quality Kangaroo Mother Care in selected hospitals of Limpopo Province. Population size was 77, Simple Random Probability Sampling was used in this study with the sample size of 65 midwives. Data were collected using self-administered questionnaires and analysed using Statistical Package for Social Sciences (SPSS) version 24. Quantitative analysis is the numerical representation and manipulation of observations for the purpose of describing and explaining the phenomenon reflected on observations (Babbie & Roberts, 2018). RESULTS The study revealed that the factors that hinders quality of Kangaroo Mother Care are lack of education and training to midwives regarding Kangaroo Mother Care, and other sources suggested that all categories of nurses should also be trained. The midwives are knowledgeable with regard to KMC, however, the problem remains the work overload when they have to monitor both the mother and neonate during feeding. It was further indicated that family members can also assist with regard to KMC. Strategies were developed, as optimal KMC environment, optimal KMC interventions, enhance optimal mother attitude to KMC crate gender sensitive environment. CONCLUSION The study concluded that the quality of KMC should be enhanced through both the promotion of education and training to all midwives, and involvement of families to assist in KMC at selected hospitals of Limpopo Province