Thesis (D.N. Sc.)--Catholic University of America. / Typescript. Bibliography: leaves 279-290.

Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

Philosophiae Doctor - PhD / The unacceptable high rate of maternal and neonatal deaths in Nigeria has been persistently unabated. Therefore, the present quality of maternal care evident by the magnitude of severe maternal/neonatal morbidity and mortality in this region makes designing of a model that will serve as a framework for provision of quality maternity care to women and their new-born a worthwhile study. The global report of deaths related to pregnancy and childbirth documented 600,000 maternal deaths annually. Developing countries, including Nigeria, have the highest burden of maternal and neonatal deaths resulting from complications related to pregnancy and childbirth. There has been no improvement in Nigeria as far as maternal and neonatal deaths are concerned. In Nigeria, the maternal mortality ratio in 2008 was recorded as 545/100,000 live births, and 576/100,000 live births in 2013. Women and children from low socioeconomic background are the vulnerable groups. The peculiarity of their vulnerability predisposes them to finding quicker and cheaper avenues to seek health care. The Primary Health Care (PHC) maternity facilities are to serve this large population of women and their babies at grassroots level. Few studies have been done to measure quality of antenatal and delivery care separately at higher level of care with resultant subjective findings and conclusions. Each of these aspects of maternity is a part of the whole and not the whole. Currently, there is gross dearth of literature regarding quality of maternity services at the disposal of the vulnerable women, who are likely to utilize the PHC facilities. The measurement of the quality of the existing maternity services at primary level is imperative for designing a more effective model capable of improving quality of services at this level. This study sought to develop a quality service improvement model for primary level-based maternity following rigorous analysis of the quality of its structure, the process and the outcome as proposed by Donabedian. The specific objectives of the study were to describe the status of infrastructures, equipment, instruments, medications; investigate the degree to which the services rendered are timely, appropriate, satisfactory and consistent with current professional knowledge; investigate the degree to which services rendered in the facilities are satisfactory to the women and uphold their basic reproductive rights; measure clients’ return rates for maternity-related services in the facilities; and to develop a validated model to guide provision of quality maternity care in PHC facilities. Using a theory-generating approach, the study was conducted in two distinct phases. The first phase focused on analysis of the existing maternity services at PHC level, while the second phase concentrate on model development. The first phase, which is an embedded mixed-methods approach, utilized validated clients’ questionnaire, health workers’ questionnaire, observation checklist, focused group discussions, and in-depth interviews for data collection. A multistage sampling method was used for sample size selection. Five local government areas (LGAs) in Ibadan were selected purposively. Similarly, all the facilities that offer maternity care in each LGA were purposively selected. Postnatal women, health workers in each facility, medical officers of health (MOHs) and heads of facilities were the participants in the study. A total of 755 postnatal women who participated in the surveys were recruited from the sample frames (attendance registers) using systematic random sampling. A validated structured questionnaire was utilized to elicit information on their experiences with their chosen places of antenatal and childbirth care from pregnancy to puerperium. Similarly, the 130 health workers who participated in the surveys were recruited from the sample frames (duty rosters) using systematic random sampling. A validated structured questionnaire was utilized to elicit information on their competences, attitudes and the midwifery practice in their respective facilities. In addition to the quantitative surveys, focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted for some postnatal women and four MOHs/heads of group of facilities. The participants for the FGDs and the IDIs were conveniently and purposively selected, respectively. FGD guide and IDI guide were used to guide the interviewers. The study was approved by the Faculty Board Research and Ethics Committees, the Senate Research Committee of University of the Western Cape and Oyo State Research Ethical Review Committee in Nigeria. Informed consent was obtained from each study participant. Autonomy, anonymity, and confidentiality of information provided by the participants were ensured. Nobody was coerced to participate in the study. The data collected with the aid of observation checklist and questionnaire from the selected PHC, health workers and client (postnatal women) were analyzed using descriptive statistics (frequency/percentage distributions); while association between variables of interest and difference in mean values were done using chi-square and t-test statistics, respectively. The second phase of the study focused on model development, and was done in line with a theory- generating research process in the literature supported by McKenna & Slevin, (2008) and Chinn& Kramer (2014). The developed model was tested for its appropriateness, adequacy, accuracy and whether it represents reality, for it to be assumed effective in achieving the goal if applied in midwifery practice at primary level.Client-participants were between 15 and 44 years; their mean age ± standard deviation was 28 ±5.3. The health workers were between 20 and 58 years; mean age ± standard deviation being 41 ±10. Out of the 730 client-participants, 92.1 % were married. None of the women had access to preconception counselling in any health facility. A total of 92.6 % of the women received prenatal care under the existing traditional model of antenatal care (ANC), out of which 22.6 %registered for ANC in two different facilities for various reasons. Although there was gross shortage of manpower in all the facilities, the percentage of nurses/midwives was fewer than that of the community health extension workers (CHEWs) and health assistants (HAs), while only one medical doctor was employed to cover all the different types of facilities in each local government area . There was a questionable staff level of competence reported in the study. Evidence of training in life-saving skill (LSS), post-abortion care (PAC) and safe motherhood was rare among the health worker participants. Among health workers who had witnessed vaginal laceration and those who claimed to have performed episiotomy on women, 30.2% and 32.6 % would depend on other health workers for repair of the vaginal traumas, respectively. Partograph was not in use for management of progress of labour by any health worker in any of the facilities. Both quantitative and qualitative data analysis showed evidences of abuse of women’s rights to timely, quality and respectful maternity care and risky practices by the health workers. The conditions of the buildings used for PHC centres and the beds were not satisfactory. There was gross inadequacy of essential and basic items needed to provide standard and quality care across all the facilities, while significant proportion of the available equipment/instruments were obsolete, dirty, rusty and faulty. The infection prevention and control practices were sub- standard. Inadequate funding by respective local government authorities was implicated for the poor conditions of infrastructures, equipment/instruments, staff recruitments and consequent shortage of manpower. Low level of patients’ satisfaction, evidenced by verbal expression, percentage difference between antenatal registration and childbirth record, immunization clinic visits and childbirth record in each facility, was reported. Therefore, fixing the deplorable and/or non-commodious building infrastructures to meet the required standard, provision of facilities and items needed for quality care and infection prevention, recruitment of skilled qualified health professionals, establishing a new Primary Health Board in the state to provide efficient funding and effective monitoring systems were recommended, based on the findings of the study. Lastly, the implementation of the newly developed model is strongly recommended in order to improve women’s and new-born’s health. / Centre for Teaching and Learning Scholarship, School of Nursing, University of the Western Cape

Transitions developed after experiencing one of the largest transitions of my life from an autonomous being and business owner to a pregnant woman to a mother, all during my three year Masters of Fine Art program at Southern Illinois University Carbondale. The first section of the show follows my emotional progression throughout pregnancy, as well as physical form, highlighting inner conflict. An emotional conflict and progression is illustrated through the use of emotional landscapes on the exterior walls of the space. Each emotional landscape is created from 25 canvas prints that I photographed on my mobile devices. The interior walls showcase my growing pregnant torso and separated oversized heads. The second section of Transitions deals with the issues of motherhood, specifically the working mother. As a working mother and graduate student, I have had to spend a large amount of time away from my daughter, and because of this I have felt a large amount of guilt and sadness. To illustrate these feelings I created installations from empty rocking chairs and all of the milk storage bags that have been used to feed my daughter in my absence. These two sculptures bookend a 10 minute long projection of my drive home taken on my iPhone. Around the exterior walls of this space, images of my daughter sleeping, and personal affects of her room are shown on large 36"x24" digital inkjet prints.

Coyote Midwives is a documentary film about the birth workers who are leading alternative maternity care and reproductive justice in the state of Illinois. This film examines the medicalization of labor and delivery, the patriarchal norms that constitute a threat to a birthing parent’s health, and the structure in place to ensure that birth remains exclusively physician-controlled. Coyote Midwives captures the energy, spirit, and empowering potential of birth, the negotiation and compromise of “professionalizing” midwives, and the networks of criminalized, black market, safe maternity care that persevere despite the illegalities.

Made available in DSpace on 2014-06-11T19:29:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2003-12-12Bitstream added on 2014-06-13T18:58:27Z : No. of bitstreams: 1 moura_smsr_me_assis.pdf: 747183 bytes, checksum: 1545f3f26717d129f05d202d1d54a49a (MD5) / Este trabalho problematiza as práticas discursivas e não discursivas referentes ao papel materno que circulam no âmbito da saúde pública e no contexto da família. Para isso utilizamos um programa de saúde materno-infantil - o Programa Canguru, contextualizando historicamente os elementos envolvidos tanto em sua concepção quanto em sua efetivação: o conceito de maternidade, as práticas de maternagem e as políticas de humanização ao atendimento desenvolvido nas instituições hospitalares. Nosso objetivo foi analisar como estes elementos se articulam na construção de novos sentidos para o papel materno. Para isso entrevistamos dez mulheres usuárias do Programa Canguru num hospital da rede pública e também as observamos durante esta prática. Na análise dos dados utilizamos como método a análise do discurso. A partir de núcleos de sentidos apreendidos nos discursos das entrevistadas, definimos quatro dimensões de análise: família e religião; o impacto do nascimento prematuro; desconfiança e resistência nas relações com instituições e profissionais de saúde; e a experiência com o Programa Canguru. No trabalho analítico buscamos apreender o processo de singularização e as estratégias utilizadas pelas entrevistadas na produção de sentidos sobre a maternidade e as práticas de maternagem. A família, estruturada de forma hierárquica e com rígida divisão de papéis segundo o sexo, aparece como o principal organizador das experiências das entrevistadas e dos sentidos atribuídos à maternidade. O exercício da maternidade é descrito como essencial para a constituição do papel feminino. A religião surge... / This paper question the speech practices and non speech referring at the maternal function that are around the ambit of the public health and in the family context. For that was used a health program of maternal-childish - The Kangaroo Care, putting on the historical context the elements that are involved as much the conception as the effectuation: the concept of maternity, the practices of maternal care and the policy of humanization of the service developed at the hospital institutions. Our goal was analyze how these elements are articulate at the construction of new feelings to maternal play. So we interviewed ten women that was usurers of the Kangaroo Care in a public hospital and we observed them during the practice too. At the analyze of the dates it was used as a method the analyze of the speech. From the nucleus of the senses took at the speech of the subject, were define four dimensions to analyze: family and religion; the impact of the premature birth; suspicion and resistance in relations with institutions and health workers; and the experience with the Kangaroo Care. At the analytic work we tried to took the process of the signalize and the strategies used by the subjects at the production of the feelings about the maternity and the practices of maternal care. The family that has a hierarchy structure and rigid division of places according to the sex, appears as a mainly organizer of the experiences of the subjects and of the feelings attributed to maternity. The exercise of the maternity is descript as essential to the constitution of the feminine place. Religion shows up as an important element to guarantee the emotional support to the family in situation of crises, such as a premature birth of a child... (Complete abstract, click electronic access below)

Magister Curationis / Research has shown that there is a problem in the delivery of quality care in maternal and child health services in Zambia. The 1996 Zambia demographic and health survey estimated maternal mortality rate as high as 649 per 100,000 live birth, with this reason among others, human resource constraints and low number of supervised antenatal clinics, deliveries and postnatal clinics by skilled personnel as some of the reasons for the high maternal mortality. Selected studies identify the role of a clinical nurse specialist in advanced midwifery and neonatology who has acquired the knowledge and practical skills to bring about the desired impact of quality care in safe mother hood in order to bring down the high maternal mortality rates. In order to achieve this, the government needs to integrate the advanced midwifery and neonatology clinical nurse specialist in the health system. It was the purpose of the study to inquire into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the Ndola District Health system . / South Africa

Master of Public Health - MPH / Maternal health care services are one of the health interventions to reduce maternal and infant morbidity and mortality. The health of mothers of childbearing age and of the unborn babies is influenced by many factors some of which include the availability and accessibility of health services for pregnant women. Low quality of health services being provided, and limited access to health facilities is correlated with increases maternal morbidity and mortality. This situation is caused by long distances between facilities as well as the people's own beliefs in traditional practices. This study was about the assessment of the women's knowledge on benefits of delivery in a hospital, the barriers to delivery services, and the perception of the delivery services rendered in the maternity ward of Okakarara hospital. / South Africa

No description available.

This thesis examines the post childbirth employment behaviour of women in England and Wales who are self-employed during pregnancy. It presents a secondary analysis of nationally representative data for England and Wales via the 2001 Individual Sample of Anonymised Records and the Millennium Cohort Study (2001-2005).A multinomial regression analysis of Census data is used to assess self-employed labour supply for women of childbearing age. In addition to this a combination of descriptive statistics and logistic regressions are used to examine the post-childbirth employment trajectories and outcomes of women who worked as self-employed during pregnancy.The majority (eighty percent) of women who are self-employed during pregnancy go on leave from their job rather than finish work, and only seventeen percent of these women are absent from self-employment at nine months postpartum. A comparable percentage of employees make the same transitions back to work but the self-employed women return quicker, with twenty-five percent returning in less than one month. The factors associated with a continuation in employment can vary between the two types of work. Whilst educational qualifications are positively associated with continuing to work as an employee, this does not apply to those who are self-employed. Evidence suggests that maternity pay influences whether women continue in self-employment and the number of women who do not receive Statutory Maternity Pay or Maternity Allowance is a cause for concern. The thesis also considers such women’s preferred working hours, time with children, working schedules and autonomy as indicators of the mothers’ work-family balance. The data suggests that in England and Wales (2001-02) the women who returned to self-employment within nine months of birth did not have an increased work-family balance when compared to their employee counterparts. On the basis of the findings, I discuss the possibility that self-employed women may benefit from financial assistance beyond what is currently offered.