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      Pregnant women perceptions regarding their husbands and in-laws’ support during pregnancy: a qualitative study

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          Abstract

          Introduction

          pregnancy is a stressful condition during which women require family and in-laws´ support. This study was aimed to explore the women´s perceptions regarding their husband and in-law´s support during pregnancy.

          Methods

          by using qualitative exploratory design ten pregnant women in third trimester of pregnancy and living in joint family system were recruited through purposive sampling technique from a village of district Nowshehra, Khyber Pakhtunkhwa, Pakistan. Approval for conducting this study was obtained from Ethics Review Committee of Khyber Medical University. Data were collected from the recruited participants through face to face in-depth interviews. Data were analyzed through thematic analysis. One hundred open codes were generated from the data. Through axial coding, extra and unnecessary codes were omitted and then eleven categories were identified from open codes.

          Results

          the identified categories were kept under three salient themes of lack of comprehensive support mechanism, physical and mental strain, and barriers to antenatal services. Perceived support of husbands and in-laws, needs and barriers to maternal and child health were discussed by the participants.

          Conclusion

          the study findings suggest that family relationship quality might not be improved by taking interventions i.e. making policies only but the incorporation of health professionals´ support with family member´s behavior can improve maternal health.

          Most cited references24

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          Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries

          Background Relative to the attention given to improving the quality of and access to maternal health services, the influence of women's socio-economic situation on maternal health care use has received scant attention. The objective of this paper is to examine the relationship between women's economic, educational and empowerment status, introduced as the 3Es, and maternal health service utilization in developing countries. Methods/Principal Findings The analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in relation to the three covariates of interest: economic, education and empowerment status, additionally controlling for women's age and residence. We use meta-analysis techniques to combine and summarize results from multiple countries. The 3Es are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth. Conclusions/Significance Efforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1), universal primary education (MDG 2), and women's empowerment (MDG 3).
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            Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review

            Background High maternal mortality and morbidity persist, in large part due to inadequate access to timely and quality health care. Attitudes and behaviours of maternal health care providers (MHCPs) influence health care seeking and quality of care. Methods Five electronic databases were searched for studies from January 1990 to December 2014. Included studies report on types or impacts of MHCP attitudes and behaviours towards their clients, or the factors influencing these attitudes and behaviours. Attitudes and behaviours mentioned in relation to HIV infection, and studies of health providers outside the formal health system, such as traditional birth attendants, were excluded. Findings Of 967 titles and 412 abstracts screened, 125 full-text papers were reviewed and 81 included. Around two-thirds used qualitative methods and over half studied public-sector facilities. Most studies were in Africa (n = 55), followed by Asia and the Pacific (n = 17). Fifty-eight studies covered only negative attitudes or behaviours, with a minority describing positive provider behaviours, such as being caring, respectful, sympathetic and helpful. Negative attitudes and behaviours commonly entailed verbal abuse (n = 45), rudeness such as ignoring or ridiculing patients (n = 35), or neglect (n = 32). Studies also documented physical abuse towards women, absenteeism or unavailability of providers, corruption, lack of regard for privacy, poor communication, unwillingness to accommodate traditional practices, and authoritarian or frightening attitudes. These behaviours were influenced by provider workload, patients’ attitudes and behaviours, provider beliefs and prejudices, and feelings of superiority among MHCPs. Overall, negative attitudes and behaviours undermined health care seeking and affected patient well-being. Conclusions The review documented a broad range of negative MHCP attitudes and behaviours affecting patient well-being, satisfaction with care and care seeking. Reported negative patient interactions far outweigh positive ones. The nature of the factors which influence health worker attitudes and behaviours suggests that strengthening health systems, and workforce development, including in communication and counselling skills, are important. Greater attention is required to the attitudes and behaviours of MHCPs within efforts to improve maternal health, for the sake of both women and health care providers. Electronic supplementary material The online version of this article (doi:10.1186/s12992-015-0117-9) contains supplementary material, which is available to authorized users.
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              Barriers to and attitudes towards promoting husbands' involvement in maternal health in Katmandu, Nepal.

              Couple-friendly reproductive health services and male partner involvement in women's reproductive health have recently garnered considerable attention. Given the sensitive nature of gender roles and relations in many cultures, understanding the context of a particular setting, potential barriers, and attitudes towards a new intervention are necessary first steps in designing services that include men. In preparation for a male involvement in antenatal care intervention, this qualitative study specifically aims to: (a) understand the barriers to male involvement in maternal health and (b) explore men's, women's, and providers' attitudes towards the promotion of male involvement in antenatal care and maternal health. In-depth interviews were conducted with fourteen couples and eight maternal health care providers at a public maternity hospital in Katmandu, Nepal. Additionally, seventeen couples participated in focus group discussions. The most prominent barriers to male involvement in maternal health included low levels of knowledge, social stigma, shyness/embarrassment and job responsibilities. Though providers also foresaw some obstacles, primarily in the forms of hospital policy, manpower and space problems, providers unanimously felt the option of couples-friendly maternal health services would enhance the quality of care and understanding of health information given to pregnant women, echoing attitudes expressed by most pregnant women and their husbands. Accordingly, a major shift in hospital policy was seen as an important first step in introducing couple-friendly antenatal or delivery services. The predominantly favorable attitudes of pregnant women, husbands, and providers towards encouraging greater male involvement in maternal health in this study imply that the introduction of an option for such services would be both feasible and well accepted.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                09 August 2021
                2021
                : 39
                : 229
                Affiliations
                [1 ]Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan,
                [2 ]Himalaya College of Nursing, Mardan, Pakistan,
                [3 ]The School of Nursing and Midwifery, University of Sheffield, United Kingdom
                Author notes
                Corresponding author: Sehrish Naz, Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan. sehrish.ins@ 123456kmu.edu.pk
                Article
                PAMJ-39-229
                10.11604/pamj.2021.39.229.25659
                8486935
                34630841
                ae018abe-b50f-44d9-a052-a495adb3d4f4
                Copyright: Sehrish Naz et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 August 2020
                : 07 October 2020
                Categories
                Research

                Medicine
                support,husbands,pregnancy,pregnant women,perceptions,in-laws
                Medicine
                support, husbands, pregnancy, pregnant women, perceptions, in-laws

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