Bypassing birth centres for childbirth: an analysis of data from a community-based prospective cohort study in Nepal.

Abstract:

BACKGROUND:In Nepal, women residing in rural areas tend to bypass local birth centres and deliver at urban hospitals, despite the availability of obstetric care in these centres. This study investigated the incidence of bypassing, characteristics of bypassers and their reasons for bypassing the birth centres. METHODS:A prospective cohort study was undertaken in the Kaski district of central Nepal. The 353 pregnant women of 5 months or more gestation recruited from the community had access to local birth centres. They were interviewed at baseline using a structured questionnaire, and were followed up within 45 days post-partum. Comparisons were made between women who delivered at birth centres and those who gave birth at hospital. Logistic regression analysis was performed to determine the factors affecting the risk of bypassing. RESULTS:Of the final sample of 258 participants who delivered in a health facility, 181 women (70.2%) bypassed their nearest birth centres to deliver at hospitals. Bypassers tended to be wealthy and have intrapartum complications, but the likelihood of bypassing apparently decreased by higher parity and frequent (four or more) antenatal care visits. Availability of operating facility, adequacy of medical supplies and equipment and competent health staff at the facility were the main reasons for their bypassing decision. CONCLUSIONS:The risk of bypassing for childbirth was high in central Nepal. Provision of quality and reliable emergency obstetric services together with well trained and competent staff at birth centres are recommended to reduce bypassing and pressure on the public hospital system.

journal_name

Health Policy Plan

authors

Karkee R,Lee AH,Binns CW

doi

10.1093/heapol/czt090

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

1-7

issue

1

eissn

0268-1080

issn

1460-2237

pii

czt090

journal_volume

30

pub_type

杂志文章
  • Sub-national health care financing reforms in Indonesia.

    abstract::Indonesia has seen an emergence of local health care financing schemes over the last decade, implemented and operated by district governments. Often motivated by the local political context and characterized by a large degree of heterogeneity in scope and design, the common objective of the district schemes is to addr...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw101

    authors: Sparrow R,Budiyati S,Yumna A,Warda N,Suryahadi A,Bedi AS

    更新日期:2017-02-01 00:00:00

  • Cost-effectiveness of strategies to reduce mother-to-child HIV transmission in Mexico, a low-prevalence setting.

    abstract:OBJECTIVE:To estimate and compare the cost-effectiveness of selected interventions to reduce mother-to-child transmission (MTCT) of HIV in Mexico. METHODS:A spreadsheet-based model was used to examine five scenarios, each estimated using both zidovudine (ZDV) and nevirapine (NVP). Scenarios differ according to coverag...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czg035

    authors: Rely K,Bertozzi SM,Avila-Figueroa C,Guijarro MT

    更新日期:2003-09-01 00:00:00

  • Community-Based Interventions for Newborns in Ethiopia (COMBINE): Cost-effectiveness analysis.

    abstract::About 87 000 neonates die annually in Ethiopia, with slower progress than for child deaths and 85% of births are at home. As part of a multi-country, standardized economic evaluation, we examine the incremental benefit and costs of providing management of possible serious bacterial infection (PSBI) for newborns at hea...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czx054

    authors: Mathewos B,Owen H,Sitrin D,Cousens S,Degefie T,Wall S,Bekele A,Lawn JE,Daviaud E

    更新日期:2017-10-01 00:00:00

  • The patient costs of care for those with TB and HIV: a cross-sectional study from South Africa.

    abstract:Background:This study describes the post-diagnosis care-seeking costs incurred by people living with TB and/or HIV and their households, in order to identify the potential benefits of integrated care. Methods:We conducted a cross-sectional study with 454 participants with TB or HIV or both in public primary health car...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw183

    authors: Mudzengi D,Sweeney S,Hippner P,Kufa T,Fielding K,Grant AD,Churchyard G,Vassall A

    更新日期:2017-11-01 00:00:00

  • Intergovernmental health policy decisions in Brazil: cooperation strategies for political mediation.

    abstract::The advantages of established intergovernmental decision-making arenas for the implementation of health policies in decentralized settings are not well known. This paper presents the case of the joint health management committee, known as the Tripartite Committee, created to formalize intergovernmental decisions about...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czm004

    authors: Miranda AS

    更新日期:2007-05-01 00:00:00

  • Acceptability of conditions in a community-led cash transfer programme for orphaned and vulnerable children in Zimbabwe.

    abstract::Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash tran...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt060

    authors: Skovdal M,Robertson L,Mushati P,Dumba L,Sherr L,Nyamukapa C,Gregson S

    更新日期:2014-10-01 00:00:00

  • Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.

    abstract::The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress t...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/14.3.229

    authors: Lanjouw S,Macrae J,Zwi AB

    更新日期:1999-09-01 00:00:00

  • User fees and drug pricing policies: a study at Harare Central Hospital, Zimbabwe.

    abstract::In 1991, Zimbabwe introduced cost recovery measures as part of its programme of economic reforms, following a course taken by many developing countries. The system of user fees in public health care, aimed to 'protect and support the vulnerable groups' by exemption or incremental fees based on 4 income brackets. Drugs...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/10.3.319

    authors: Chisadza E,Maponga CC,Nazerali H

    更新日期:1995-09-01 00:00:00

  • Exploring referral systems for injured patients in low-income countries: a case study from Cambodia.

    abstract::Injury is a growing public health concern worldwide. Since severe injuries require urgent treatment, involving smooth, timely patient referral between facilities, strengthening of the referral system would reduce injury mortality. Smooth referral consists of identification of severe cases, organization of transportati...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp063

    authors: Nakahara S,Saint S,Sann S,Ichikawa M,Kimura A,Eng L,Yoshida K

    更新日期:2010-07-01 00:00:00

  • The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health.

    abstract::Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa079

    authors: Ohrnberger J,Fichera E,Sutton M,Anselmi L

    更新日期:2020-11-20 00:00:00

  • Providing information on pregnancy complications during antenatal visits: unmet educational needs in sub-Saharan Africa.

    abstract:INTRODUCTION:Lack of information on the warning signs of complications during pregnancy, parturition and postpartum hampers women's ability to partake fully in safe motherhood initiatives. We assessed the extent to which women in 19 countries of sub-Saharan Africa recall receiving information about pregnancy complicati...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp017

    authors: Nikiéma B,Beninguisse G,Haggerty JL

    更新日期:2009-09-01 00:00:00

  • Predictors of nursing leadership in Uganda: a cross-sectional study.

    abstract::Evidence regarding the role of nurses-in-leadership and how to engage nurses in policy decisions is minimal in sub-Saharan Africa. The purpose of this study was: (1) to assess the leadership practices of nurses-in-leadership in Uganda (by self-report) and from the perspective of 'followers' (direct-report, peers, co-w...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa100

    authors: Nanyonga RC,Bosire EN,Heller DJ,Bradley E,Reynolds NR

    更新日期:2020-11-01 00:00:00

  • Treatment as insurance: HIV antiretroviral therapy offers financial risk protection in Malawi.

    abstract::Many countries have expanded insurance programmes in an effort to achieve universal health coverage (UHC). We assess a complementary path toward financial risk protection: increased access to technologies that improve health and reduce the risk of large health expenditures. Malawi has provided free HIV treatment since...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa023

    authors: Dickerson S,Baranov V,Bor J,Barofsky J

    更新日期:2020-07-01 00:00:00

  • Insured yet vulnerable: out-of-pocket payments and India's poor.

    abstract::Protecting households from high out-of-pocket (OOP) payments for health care is an important health system goal. High OOP payments can push households into poverty and make them vulnerable to catastrophic health expenditures. This study, based in India, aims to: (a) estimate OOP payments for health and related impover...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr029

    authors: Shahrawat R,Rao KD

    更新日期:2012-05-01 00:00:00

  • Delivery systems for insecticide treated and untreated mosquito nets in Africa: categorization and outcomes achieved.

    abstract:INTRODUCTION:Coverage of insecticide-treated nets (ITNs) in sub-Saharan Africa is still low despite their proven efficacy, effectiveness and cost-effectiveness. Delivery systems for ITNs have been hotly debated, but there has been no structured approach to assessing their relative effectiveness. This paper aims to: pro...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czm021

    authors: Webster J,Hill J,Lines J,Hanson K

    更新日期:2007-09-01 00:00:00

  • From the field side of the binoculars: a different view on global public health surveillance.

    abstract::It is generally assumed by the donor community that the targeted funding of global, regional or cross-border surveillance programmes is an efficient way to support resource-poor countries in developing their own national public health surveillance infrastructure, to encourage national authorities to share outbreak int...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czl035

    authors: Calain P

    更新日期:2007-01-01 00:00:00

  • Geographic aspects of poverty and health in Tanzania: does living in a poor area matter?

    abstract::Previous studies have consistently found an inverse relationship between household-level poverty and health status. However, what is not well understood is whether and how the average economic status at the community level plays a role in the poverty-health relationship. The purpose of this study is to investigate the...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czj008

    authors: Mahmud Khan M,Hotchkiss DR,Berruti AA,Hutchinson PL

    更新日期:2006-03-01 00:00:00

  • Design and implementation of a health management information system in Malawi: issues, innovations and results.

    abstract::As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. Malawi began strengthening its health management information system with an ana...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi044

    authors: Chaulagai CN,Moyo CM,Koot J,Moyo HB,Sambakunsi TC,Khunga FM,Naphini PD

    更新日期:2005-11-01 00:00:00

  • A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings.

    abstract::BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aim...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr012

    authors: Petersen I,Lund C,Bhana A,Flisher AJ,Mental Health and Poverty Research Programme Consortium.

    更新日期:2012-01-01 00:00:00

  • Renewing membership in three community-based health insurance schemes in rural India.

    abstract::Low renewal rate is a key challenge facing the sustainability of community-based health insurance (CBHI) schemes. While there is a large literature on initial enrolment into such schemes, there is limited evidence on the factors that impede renewal. This article uses longitudinal data to analyse what determines renewa...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw090

    authors: Panda P,Chakraborty A,Raza W,Bedi AS

    更新日期:2016-12-01 00:00:00

  • Influencing policy change: the experience of health think tanks in low- and middle-income countries.

    abstract::In recent years there has been a growth in the number of independent health policy analysis institutes in low- and middle-income countries which has occurred in response to the limitation of government analytical capacity and pressures associated with democratization. This study aimed to: (i) investigate the contribut...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr035

    authors: Bennett S,Corluka A,Doherty J,Tangcharoensathien V,Patcharanarumol W,Jesani A,Kyabaggu J,Namaganda G,Hussain AM,de-Graft Aikins A

    更新日期:2012-05-01 00:00:00

  • Supporting mental health in South African HIV-affected communities: primary health care professionals' understandings and responses.

    abstract::How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients' distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoni...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu092

    authors: Burgess RA

    更新日期:2015-09-01 00:00:00

  • Dual practice of public hospital physicians in Vietnam.

    abstract::Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physician...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy075

    authors: Do N,Do YK

    更新日期:2018-10-01 00:00:00

  • Review of corruption in the health sector: theory, methods and interventions.

    abstract::There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and ...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czm048

    authors: Vian T

    更新日期:2008-03-01 00:00:00

  • The influence of gender and household headship on voluntary health insurance: the case of North-West Cameroon.

    abstract::Within the existing health financing literature, males are typically categorized as the household's decision-makers. While this view accurately reflects many local sociocultural realities, approximately a quarter of sub-Saharan African households are now headed by females. In light of various efforts to expand health ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx152

    authors: Oraro T,Ngube N,Atohmbom GY,Srivastava S,Wyss K

    更新日期:2018-03-01 00:00:00

  • Developing a logic model for youth mental health: participatory research with a refugee community in Beirut.

    abstract::Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory resear...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr001

    authors: Afifi RA,Makhoul J,El Hajj T,Nakkash RT

    更新日期:2011-11-01 00:00:00

  • Allocating scarce financial resources for HIV treatment: benchmarking prices of antiretroviral medicines in Latin America.

    abstract::Public sector price analyses of antiretroviral (ARV) medicines can provide relevant information to detect ARV procurement procedures that do not obtain competitive market prices. Price benchmarks provide a useful tool for programme managers and policy makers to support such planning and policy measures. The aim of the...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs011

    authors: Wirtz VJ,Santa-Ana-Tellez Y,Trout CH,Kaplan WA

    更新日期:2012-12-01 00:00:00

  • Review of quality assessment tools for family planning programmes in low- and middle-income countries.

    abstract::Measuring and tracking the quality of healthcare is a critical part of improving service delivery, clinic efficiency and health outcomes. However, no standardized or widely accepted tool exists to assess the quality of clinic-based family planning services in low- and middle-income countries. The objective of this lit...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czw123

    authors: Sprockett A

    更新日期:2017-03-01 00:00:00

  • How to do (or not to do) ... Tracking data on development assistance for health.

    abstract::Development assistance for health (DAH) has increased substantially in recent years and is seen as important to the improvement of health and health systems in developing countries. As a result, there has been increasing interest in tracking and understanding these resource flows from the global health community. A nu...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr076

    authors: Grépin KA,Leach-Kemon K,Schneider M,Sridhar D

    更新日期:2012-09-01 00:00:00

  • Dropping out of Ethiopia's community-based health insurance scheme.

    abstract::Low contract renewal rates have been identified as one of the challenges facing the development of community-based health insurance (CBHI) schemes. This article uses longitudinal household survey data gathered in 2012 and 2013 to examine dropout in the case of Ethiopia's pilot CBHI scheme. We treat dropout as a functi...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu142

    authors: Mebratie AD,Sparrow R,Yilma Z,Alemu G,Bedi AS

    更新日期:2015-12-01 00:00:00