Postpartum Women's Experiences of Postnatal Care in Sub-Saharan Africa: A Qualitative Evidence Synthesis.
experiences
postnatal care
postpartum women
qualitative evidence synthesis
sub‐Saharan Africa
Journal
Birth (Berkeley, Calif.)
ISSN: 1523-536X
Titre abrégé: Birth
Pays: United States
ID NLM: 8302042
Informations de publication
Date de publication:
17 Oct 2024
17 Oct 2024
Historique:
revised:
10
08
2024
received:
28
08
2023
accepted:
29
08
2024
medline:
17
10
2024
pubmed:
17
10
2024
entrez:
17
10
2024
Statut:
aheadofprint
Résumé
Postnatal care (PNC) is a critical service for the health and well-being of new mothers and newborns. However, in sub-Saharan Africa (SSA), most efforts to improve maternal and child health have been directed toward enhancing skilled birth attendance and urgent obstetric and neonatal care. This is despite the fact that more than half of maternal deaths globally occur in the postnatal period, with 65% of these occurring in the first week following birth. One of the health system factors influencing PNC utilization is the women's previous PNC experience at healthcare facilities. The aim of this review was to gain a better understanding of women's experiences of PNC in SSA. This study followed a qualitative evidence synthesis design. The phenomenon of interest was postpartum women's experiences of PNC in SSA. PubMed, CINAHL, EMBASE, Science Direct, Africa Journals Online (AJOL), SCOPUS, and Google Scholar were searched for peer-reviewed articles published in English between 2013 and 2023. To assess the quality of the included studies, we used an appraisal tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Two authors independently extracted relevant data from the included studies. Thomas and Harden's thematic synthesis framework was used to synthesize the data. Eight articles were used in this review. Seven articles reported on qualitative studies, and one reported on a mixed-method study. All the included studies fully or partially met the 12 quality assessment criteria. Synthesis of the data resulted in the development of five analytical themes. The five themes were the adequacy of physical examination and communication of the findings, adequacy of PNC information, the quality of interactions with healthcare workers (HCWs), the availability of resources and adequacy of HCWs, and denial of care. The overall confidence in the review's findings was either moderate or high. Based on our findings, we recommend that countries in the region address staff shortages, implement task shifting, electronic medicine stock management systems, optimal supply chain policies, and train HCWs on PNC and interpersonal communication skills.
Sections du résumé
BACKGROUND
BACKGROUND
Postnatal care (PNC) is a critical service for the health and well-being of new mothers and newborns. However, in sub-Saharan Africa (SSA), most efforts to improve maternal and child health have been directed toward enhancing skilled birth attendance and urgent obstetric and neonatal care. This is despite the fact that more than half of maternal deaths globally occur in the postnatal period, with 65% of these occurring in the first week following birth. One of the health system factors influencing PNC utilization is the women's previous PNC experience at healthcare facilities. The aim of this review was to gain a better understanding of women's experiences of PNC in SSA.
METHODS
METHODS
This study followed a qualitative evidence synthesis design. The phenomenon of interest was postpartum women's experiences of PNC in SSA. PubMed, CINAHL, EMBASE, Science Direct, Africa Journals Online (AJOL), SCOPUS, and Google Scholar were searched for peer-reviewed articles published in English between 2013 and 2023. To assess the quality of the included studies, we used an appraisal tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Two authors independently extracted relevant data from the included studies. Thomas and Harden's thematic synthesis framework was used to synthesize the data.
RESULTS
RESULTS
Eight articles were used in this review. Seven articles reported on qualitative studies, and one reported on a mixed-method study. All the included studies fully or partially met the 12 quality assessment criteria. Synthesis of the data resulted in the development of five analytical themes. The five themes were the adequacy of physical examination and communication of the findings, adequacy of PNC information, the quality of interactions with healthcare workers (HCWs), the availability of resources and adequacy of HCWs, and denial of care. The overall confidence in the review's findings was either moderate or high.
CONCLUSION
CONCLUSIONS
Based on our findings, we recommend that countries in the region address staff shortages, implement task shifting, electronic medicine stock management systems, optimal supply chain policies, and train HCWs on PNC and interpersonal communication skills.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Birth published by Wiley Periodicals LLC.
Références
M. Akibu, W. Tsegaye, T. Megersa, and S. Nurgi, “Prevalence and Determinants of Complete Postnatal Care Service Utilization in Northern Shoa, Ethiopia,” Journal of Pregnancy 2018 (2018): 8625437, https://doi.org/10.1155/2018/8625437.
United Nations Development Programme (UNDP), “Sustainable Development Goals,” accessed August 23, 2023, https://www.undp.org/content/undp/en/home/sustainable‐development‐goals.html.
WHO, UNICEF, UNFPA, World Bank Group, and UNDESA/Population Division, “Trends in Maternal Mortality 2000 to 2020: Estimates From WHO, UNICEF, UNFPA, World Bank Group, and UNDESA/Population Division,” 2023, https://www.who.int/publications/i/item/9789240068759.
United Nations International Children's Emergency Fund (UNICEF), “Neonatal Mortality,” 2021, https://data.unicef.org/topic/child‐survival/neonatal‐mortality/.
United Nations, “The Global Strategy for Women's, Children's, and Adolescents' Health (2016–2030),” 2016, https://data.unicef.org/resources/global‐strategy‐womens‐childrens‐adolescents‐health/.
G. G. Beraki, E. H. Tesfamariam, A. Gebremichael, et al., “Knowledge on Postnatal Care Among Postpartum Mothers During Discharge in Maternity Hospitals in Asmara: A Cross‐Sectional Study,” BMC Pregnancy and Childbirth 20, no. 17 (2020): 1–10, https://doi.org/10.1186/s12884‐019‐2694‐8.
World Health Organization, WHO Recommendations on Postnatal Care of the Mother and Newborn, 2nd ed. (Geneva, Switzerland: WHO, 2013).
V. Khanal, M. Adhikari, R. Karkee, and T. Gavidia, “Factors Associated With the Utilisation of Postnatal Care Services Among the Mothers of Nepal: Analysis of Nepal Demographic and Health Survey 2011,” BMC Women's Health 14, no. 1 (2014): 19, https://doi.org/10.1186/1472‐6874‐14‐19.
B. Masaba and R. Mmusi‐Phetoe, “Neonatal Survival in Sub‐Sahara: A Review of Kenya and South Africa,” Journal of Multidisciplinary Healthcare 13 (2020): 709–716, https://doi.org/10.2147/JMDH.S260058.
F. Appiah, T. Salihu, J. O. Fenteng, et al., “Factors Influencing Early Postnatal Care Utilisation Among Women: Evidence From the 2014 Ghana Demographic and Health Survey,” PLoS One 16, no. 4 (2021): e0249480, https://doi.org/10.1371/journal.pone.0249480.
M. Ibrahim, K. Mare, and M. Nur, “Postnatal Care Utilization and Associated Factors Among Mothers Who Gave Birth in the Aysaeta District, Northeast Ethiopia: A Community Based Cross‐Sectional Study,” Ethiopian Journal of Health Sciences 32, no. 6 (2022): 1123–1132, https://doi.org/10.4314/ejhs.v32i6.9.
K. G. Wudineh, A. A. Nigusie, S. S. Gesese, A. Tesu, and F. Y. Beyen, “Postnatal Care Service Utilization and Associated Factors Among Women Who Gave Birth in Debretabour Town, North West Ethiopia: A Community‐Based Cross‐Sectional Study,” BMC Pregnancy and Childbirth 18 (2018): 508, https://doi.org/10.1186/s12884‐018‐2138‐x.
A. Shibru, A. Belihu, and G. Abdissa, “Postnatal Care Services Utilization and Its Associated Factors Among Women Who Gave Birth in the Past One Year in Gulele Sub City, Addis Ababa, Ethiopia,” Journal of Health Medicine and Nursing 46 (2018): 238–246.
B. Adane, G. Fisseha, G. Walle, and M. Yalew, “Factors Associated With Postnatal Care Utilization Among Postpartum Women in Ethiopia: A Multi‐Level Analysis of the 2016 Ethiopia Demographic and Health Survey,” Archives of Public Health 78 (2020): 34, https://doi.org/10.1186/s13690‐020‐00415‐0.
A. L. Nyondo‐Mipando, M. Chirwa, A. Kumitawa, et al., “Uptake of, Barriers and Enablers to the Utilization of Postnatal Care Services in Thyolo,” Malawi. BMC Pregnancy Childbirth 23 (2023): 271, https://doi.org/10.1186/s12884‐023‐05587‐5.
G. Tesfaye, C. Chojenta, R. Smith, and D. Loxton, “Magnitude and Correlates of Postnatal Care Utilization Among Reproductive Aged Women in a Rural District in Eastern Ethiopia: A Cross‐Sectional Study,” Midwifery 70 (2019): 22–30, https://doi.org/10.1016/j.midw.2018.12.002.
Z. Tessema, L. Yazachew, G. Tesema, and A. Teshale, “Determinants of Postnatal Care Utilization in Sub‐Saharan Africa: A Meta and Multilevel Analysis of Data From 36 Sub‐Saharan Countries,” Italian Journal of Pediatrics 46, no. 175 (2020): 1–11, https://doi.org/10.1186/s13052‐020‐00944‐y.
The Endnote Team, “Endnote,” released in 2013, https://endnote.com/product‐details.
Covidence, “Better Systematic Review management,” released in May 2022, https://www.covidence.org/.
J. Thomas, K. Sutcliffe, A. Harden, et al., Children and Healthy Eating: A Systematic Review of Barriers and Facilitators, 1st ed. (London, UK: EPPI‐Centre, University of London, 2003).
J. Thomas and A. Harden, “Methods for the Thematic Synthesis of Qualitative Research in Systematic Reviews,” BMC Medical Research Methodology 8, no. 1 (2008): 45, https://doi.org/10.1186/1471‐2288‐8‐45.
S. Lewin, A. Booth, C. Glenton, et al., “Applying GRADE‐CERQual to Qualitative Evidence Synthesis Findings: Introduction to the Series,” Implementation Science 13, no. Suppl 1 (2018): 2, https://doi.org/10.1186/s13012‐017‐0688‐3.
S. Lewin, M. Bohren, A. Rashidian, et al., “Applying GRADE‐CERQual to Qualitative Evidence Synthesis Findings‐Paper 2: How to Make an Overall CERQual Assessment of Confidence and Create a Summary of Qualitative Findings Table,” Implementation Science 13, no. Suppl 1 (2018): 10, https://doi.org/10.1186/s13012‐017‐0689‐2.
M. Roed, I. Engebretsen, R. Mangeni, and I. Namata, “Women's Experiences of Maternal and Newborn Health Care Services and Support Systems in Buikwe District, Uganda: A Qualitative Study,” PLoS One 16, no. 12 (2021): e0261414, https://doi.org/10.1371/journal.pone.0261414.
B. Kanengoni, S. Andajani‐Sutjahjo, and E. Holroyd, “Women's Experiences of Disrespectful and Abusive Maternal Health Care in a Low Resource Rural Setting in Eastern Zimbabwe,” Midwifery 76 (2019): 125–131, https://doi.org/10.1016/j.midw.2019.06.003.
J. Oluoch‐Aridi, P. A. Afulani, D. B. Guzman, C. Makanga, and L. Miller‐Graff, “Exploring Women's Childbirth Experiences and Perceptions of Delivery Care in Peri‐Urban Settings in Nairobi, Kenya,” Reproductive Health 18, no. 1 (2021): 83, https://doi.org/10.1186/s12978‐021‐01129‐4.
S. Oosthuizen, A. Bergh, R. Pattinson, and J. Grimbeek, “It Does Matter Where You Come From: Mothers' Experiences of Childbirth in Midwife Obstetric Units, Tshwane, South Africa,” Reproductive Health 14, no. 1 (2017): 151, https://doi.org/10.1186/s12978‐017‐0411‐5.
T. M. Maung, N. O. Mon, H. Mehrtash, et al., “Women's Experiences of Mistreatment During Childbirth and Their Satisfaction With Care: Findings From a Multicountry Community‐Based Study in Four Countries,” BMJ Global Health 5 (2022): e003688, https://doi.org/10.1136/bmjgh‐2020‐003688.
J. Wesson, N. Hamunime, C. Viadro, M. Carlough, P. Katjiuanjo, and P. McQuide, “Provider and Client Perspectives on Maternity Care in Namibia: Results From Two Cross‐Sectional Studies,” BMC Pregnancy and Childbirth 18, no. 1 (2018): 363, https://doi.org/10.1186/s12884‐018‐1999‐3.
M. Muleya, L. Mwape, P. Katowa‐Mukwato, and M. Maimbolwa, “Postnatal Care Within Six Hours Following Delivery at Two Selected General Hospitals of Zambia—Mothers' Experiences,” Open Nursing Journal 8, no. 6 (2018): 355–371, https://doi.org/10.4236/ojn.2018.86029.
C. Sialubanje, J. L. Kaiser, T. Ngoma, L. Mwananyanda, R. M. Fong, and D. H. Hamer, “Postnatal Care Services in Rural Zambia: A Qualitative Exploration of User, Provider, and Community Perspectives on Quality of Care,” BMC Pregnancy and Childbirth 23, no. 1 (2023): 39, https://doi.org/10.1186/s12884‐023‐05350‐w.
E. Sacks, T. B. Masvaure, L. M. Atuyambe, et al., “Postnatal Care Experiences and Barriers to Care Utilization for Home‐ and Facility‐Delivered Newborns in Uganda and Zambia,” Matern Child Health 21, no. 1 (2017): 599–606, https://doi.org/10.1007/s10995‐016‐2144‐4.
C. Williams and P. Brysiewicz, “Women's Perceptions of Hospital‐Based Postnatal Care Following a Normal Vaginal Delivery in KwaZulu‐Natal, South Africa,” Africa Journal of Nursing and Midwifery 19, no. 2 (2017): 1–17, https://doi.org/10.25159/2520‐5293/2192.
G. R. Mahiti, D. A. Mkoka, A. D. Kiwara, C. K. Mbekenga, A. K. Hurtig, and I. Goicolea, “Women's Perceptions of Antenatal, Delivery, and Postpartum Services in Rural Tanzania,” Global Health Action 8, no. 1 (2015): 28567, https://doi.org/10.3402/gha.v8.28567.
J. Orpin, S. Puthussery, R. Davidson, and B. Burden, “Women's Experiences of Disrespect and Abuse in Maternity Care Facilities in Benue State, Nigeria,” BMC Pregnancy and Childbirth 18, no. 1 (2018): 213, https://doi.org/10.1186/s12884‐018‐1847‐5.
G. Tiruneh, M. Demissie, A. Worku, and Y. Berhane, “Community's Experience and Perceptions of Maternal Health Services Across the Continuum of Care in Ethiopia: A Qualitative Study,” PLoS One 16, no. 8 (2021): e0255404, https://doi.org/10.1371/journal.pone.0255404.
J. Haskins, S. Phakathi, M. Grant, and C. Horwood, “Attitudes of Nurses Towards Patient Care at a Rural District Hospital in the KwaZulu‐Natal Province of South Africa,” Africa Journal of Nursing and Midwifery 16, no. 1 (2014): 32–44.
J. O. Olasupo, Y. O. Tijani, A. A. Akinoso, et al., “(Bad) Attitudes and Behaviors of Some Health Workers: An Important Contributory Factor to High Maternal Mortality in Nigeria,” Journal of pat Care 7, no. 6 (2021): 1000176, https://doi.org/10.35248/2573‐4598.21.7.176.
J. Dol, B. Hughes, G. Tomblin Murphy, M. Aston, D. McMillan, and M. Campbell‐Yeo, “Canadian Women's Experience of Postnatal Care: A Mixed Method Study,” Canadian Journal of Nursing Research 54, no. 4 (2022): 497–507, https://doi.org/10.1177/08445621211052141.
E. T. Konje, I. E. Msuya, D. Matovelo, N. Basinda, and D. Dewey, “Provision of Inadequate Information on Postnatal Care and Services During Antenatal Visits in Busega, Northwest Tanzania: A Simulated Client Study,” BMC Health Services Research 22, no. 1 (2022): 700, https://doi.org/10.1186/s12913‐022‐08071‐6.
U. Ohrn, H. Parment, and I. Hildingsson, “Quality Improvement in Postnatal Care: Findings From Two Cohorts of Women in Sweden,” European Journal of Midwifery 4 (2020): 45–49.
L. T. Mselle, M. Aston, T. W. Kohi, et al., “The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse‐Midwives and Obstetricians,” Qualitative Health Research 27, no. 12 (2017): 1792–1803, https://doi.org/10.1177/1049732317717695.
Y. Sarikhani, S. M. Najibi, and Z. Razavi, “Key Barriers to the Provision and Utilization of Maternal Health Services in Low‐and Lower‐Middle‐Income Countries; a Scoping Review,” BMC Women's Health 24, no. 1 (2024): 325, https://doi.org/10.1186/s12905‐024‐03177‐x.
S. Zuma, “Assessment of Medicine Stock‐Outs Challenges in Public Health Services,” Africa's Public Service Delivery & Performance Review 10, no. 1 (2022): a578.
C. Lythgoe, K. Lowe, M. McCauley, and H. McCauley, “How Women's Experiences and Perceptions of Care Infuence Uptake of Postnatal Care Across Sub‐Saharan Africa: A Qualitative Systematic Review,” BMC Pregnancy and Childbirth 21, no. 1 (2021): 506, https://doi.org/10.1186/s12884‐021‐03910‐6.
Y. Amare, P. Scheelbeek, J. Schellenberg, D. Berhanu, and Z. Hill, “Early Postnatal Home Visits: A Qualitative Study of Barriers and Facilitators to Achieving High Coverage,” BMC Public Health 18, no. 1 (2018): 1074, https://doi.org/10.1186/s12889‐018‐5922‐7.
N. Nagesh, C. H. L. Ip, J. Li, et al., “Exploring South Asian Women's Perspectives and Experiences of Maternity Care Services: A Qualitative Evidence Synthesis,” Women and Birth 37, no. 2 (2024): 259–277, https://doi.org/10.1016/j.wombi.2023.12.002.
M. L. Prust, A. Kamanga, L. Ngosa, et al., “Assessment of Interventions to Attract and Retain Health Workers in Rural Zambia: A Discrete Choice Experiment,” Human Resources for Health 17, no. 1 (2019): 26, https://doi.org/10.1186/s12960‐019‐0359‐3.
B. Deller, V. Tripathi, S. Stender, E. Otolorin, P. Johnson, and C. Carr, “Task Shifting in Maternal and Newborn Health Care: Key Components From Policy to Implementation,” International Journal of Gynaecology and Obstetrics 130, no. S2 (2015): S25–S31, https://doi.org/10.1016/j.ijgo.2015.03.005.
M. Vledder, J. Friedman, M. Sjoblom, T. Brown, and P. Yadav, “Improving Supply Chain for Essential Drugs in Low‐Income Countries: Results From a Large Scale Randomized Experiment in Zambia,” Health Systems & Reform 5, no. 2 (2019): 158–177, https://doi.org/10.1080/23288604.2019.1596050.
A. O. Olajubu, A. O. Komolafe, T. O. Olajubu, A. E. Olowokere, and O. O. Irinoye, “Influence of Structured Training Programme on Healthcare Workers' Knowledge of Recommended Postnatal Care Services in Nigeria,” SAGE Open Nursing 8 (2022): 23779608221117387, https://doi.org/10.1177/23779608221117387.
Á. N. Mata, K. P. de Azevedo, L. P. Braga, et al., “Training in Communication Skills for Self‐Efficacy of Health Professionals: A Systematic Review,” Human Resources for Health 19, no. 1 (2021): 30, https://doi.org/10.1186/s12960‐021‐00574‐3.