Factors associated with the uptake of immediate postpartum intrauterine contraceptive devices (PPIUCD) in Rwanda: a mixed methods study
Background: Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital. Methods: A concurrent mixed-method study was used. […]
A qualitative study of the dissemination and diffusion of innovations: Bottom up experiences of senior managers in three health districts in South Africa
Background: In 2012 the South African National Department of Health (SA NDoH) set out, using a top down process, to implement several innovations in eleven health districts in order to test reforms to strengthen the district health system. The process of disseminating innovations began in 2012 and senior health managers in districts were expected to […]
Using Network and Complexity Theories to Understand the Functionality of Referral Systems for Surgical Patients in Resource-Limited Settings, the Case of Malawi
Background: A functionally effective referral system that links district level hospitals (DLHs) with referral hospitals (RHs) facilitates surgical patients getting timely access to specialist surgical expertise not available locally. Most published studies from low-and middle-income countries (LMICs) have examined only selected aspects of such referral systems, which are often fragmented. Inadequate understanding of their functionality […]
Development of a tool to measure women’s perception of respectful maternity care in public health facilities
Background: Maternal mortality continues to be the biggest challenge facing Ethiopia and other developing countries. Although progress has been made in making maternity services available closer to the community, the rate of deliveries attended by skilled birth attendants has remained very low. Absence of respectful maternity care (RMC) is believed to have contributed to low […]
“It Depends on What They Experience in Each Health Facility. Some Are Satisfied, Others Are Not.” A Mixed-Methods Exploration of Health Workers’ Attitudes Towards Performance-Based Financing in Burkina Faso
Background: Evidence emerging from qualitative studies suggests the existence of substantial variation in how health workers experience performance-based financing (PBF) within the same setting. To date, however, no study has quantified or systematically explored this within-setting heterogeneity. Considering that differences in health workers’ affective reactions to PBF likely constitute an important element mediating the effectiveness […]
Applying the Consolidated Framework for Implementation Research to Identify Implementation Determinants for the Integrated District Evidence-to-Action Program, Mozambique
Introduction: The Integrated District Evidence-to-Action program is an audit and feedback intervention introduced in 2017 in Manica and Sofala provinces, Mozambique, to reduce mortality in children younger than 5 years. We describe barriers and facilitators to early-stage effectiveness of that intervention. Method: We embedded the Consolidated Framework for Implementation Research (CFIR) into an extended case […]
Building a competent health manager at district level: a grounded theory study from Eastern Uganda
Background: Health systems in low-income countries are often characterized by poor health outcomes. While many reasons have been advanced to explain the persistently poor outcomes, management of the system has been found to play a key role. According to a WHO framework, the management of health systems is central to its ability to deliver needed […]
Barriers to eHealth adoption in routine antenatal care practices: Perspectives of expectant mothers in Uganda – A qualitative study using the unified theory of acceptance and use of technology model
Current empirical evidence suggests that successful adoption of eHealth systems improves maternal health outcomes, yet there are still existing gaps in adopting such systems in Uganda. Service delivery in maternal health is operating in a spectrum of inadequacy, hence eHealth adoption cannot ensue. This study set out to explore the challenges that impede eHealth adoption […]
Developmental Disorder Probability Scores at 6–18 Years Old in Relation to In-Utero/Peripartum Antiretroviral Drug Exposure among Ugandan Children
(1) We examined the hypothesis that in utero/peripartum antiretroviral (IPA) exposure may affect the likelihood of developmental disorders—i.e., attention deficit and hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and functional impairment (FI). (2) Children and their primary caregivers were enrolled and followed for 12 months. The sample included 250 children perinatally HIV-infected (CPHIV), 250 children […]
Socioecological predictors of breastfeeding practices in rural eastern Ethiopia
Background: Estimates by the World Health Organization indicate that over 800,000 global neonatal deaths each year are attributed to deviations from recommended best practices in infant feeding. Identifying factors promoting ideal breastfeeding practices may facilitate efforts to decrease neonatal and infant death rates and progress towards achieving the Sustainable Development Goals set for 2030. Though […]
