Abstract:
BACKGROUND:Globally, an estimated 275,000 maternal deaths, 2.7 million neonatal deaths, and 2.6 million third trimester stillbirths occurred in 2015. Major improvements could be achieved by providing effective care in low- and middle-income countries, where the majority of these deaths occur. Mentoring programs have become a popular modality to improve knowledge and skills among providers in low-resource settings. Thus, a detailed understanding of interrelated factors affecting care provision and mentorship is necessary both to improve the quality of care and to maximize the impact of mentoring programs. METHODS:In partnership with the Government of Bihar, CARE India and PRONTO International implemented simulation-enhanced mentoring in 320 primary health clinics (PHC) across the state of Bihar, India from 2015 to 2017, within the context of the AMANAT mobile nurse mentoring program. Between June and August 2016, we conducted semi-structured interviews with 20 AMANAT nurse mentors to explore barriers and facilitators to optimal care provision and to implementation of simulation-enhanced mentorship in PHCs in Bihar. Data were analyzed using the thematic content approach. RESULTS:Mentors identified numerous factors affecting care provision and mentorship, many of which were interdependent. Such barriers included human resource shortages, nurse-nurse hierarchy, distance between labor and training rooms, cultural norms, and low skill level and resistance to change among mentees. In contrast, physical resource shortages, doctor-nurse hierarchy, corruption, and violence against providers posed barriers to care provision alone. Facilitators included improved skills and confidence among providers, inclusion of doctors in training, increased training frequency, establishment of strong mentor-mentee relationships, administrative support, and nursing supervision and feedback. CONCLUSIONS:This study has identified many interrelated factors affecting care provision and mentorship in Bihar. The mentoring program was not designed to address several barriers, including resource shortages, facility infrastructure, corruption, and cultural norms. These require government support, community awareness, and other systemic changes. Programs may be adapted to address some barriers beyond knowledge and skill deficiencies, notably hierarchy, violence against providers, and certain cultural taboos. An in-depth understanding of barriers and facilitators is essential to enable the design of targeted interventions to improve maternal and neonatal survival in Bihar and related contexts.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Morgan MC,Dyer J,Abril A,Christmas A,Mahapatra T,Das A,Walker DMdoi
10.1186/s12884-018-2059-8subject
Has Abstractpub_date
2018-10-25 00:00:00pages
420issue
1issn
1471-2393pii
10.1186/s12884-018-2059-8journal_volume
18pub_type
杂志文章abstract:BACKGROUND:Perinatal health-seeking behaviours are influenced by various factors, including personal beliefs. South Asian women, who often live within a wide kinship system, can be influenced by the advice and guidance of their mothers and/or mothers-in-law. METHODS:To explore the cultural health perceptions of South ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-2762-0
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s12884-018-2114-5
更新日期:2018-12-14 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-07-11 00:00:00
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/1471-2393-11-60
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2012-11-13 00:00:00
abstract:BACKGROUND:The aim of the qualitative study reported here was to: 1) explain the observed clustering of postnatal depressive symptoms in South Western Sydney; and 2) identify group-level mechanisms that would add to our understanding of the social determinants of maternal depression. METHODS:Critical realism provided ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-47
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1918-7
更新日期:2018-07-03 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2393-14-300
更新日期:2014-09-02 00:00:00
abstract:BACKGROUND:Clean birth practices can prevent sepsis, one of the leading causes of both maternal and newborn mortality. Evidence suggests that clean birth kits (CBKs), as part of package that includes education, are associated with a reduction in newborn mortality, omphalitis, and puerperal sepsis. However, questions re...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-12-158
更新日期:2012-12-19 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03254-7
更新日期:2020-09-21 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-6-8
更新日期:2006-03-19 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/s12884-017-1228-5
更新日期:2017-01-26 00:00:00
abstract:BACKGROUND:The Auckland Stillbirth study demonstrated a two-fold increased risk of late stillbirth for women who did not go to sleep on their left side. Two further studies have confirmed an increased risk of late stillbirth with supine sleep position. As sleep position is modifiable, we surveyed self-reported late pre...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1378-5
更新日期:2017-06-17 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12884-019-2594-y
更新日期:2019-11-21 00:00:00
abstract:BACKGROUND:Birth weight is one of the most important indicators of neonatal survival. A reliable estimate of foetal weight at different stages of pregnancy would facilitate intervention plans for medical practitioners to prevent the risk of low birth weight delivery. This study has developed reliable models to more acc...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2047-z
更新日期:2018-11-06 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0686-x
更新日期:2015-10-12 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-02864-5
更新日期:2020-03-26 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-11-36
更新日期:2011-05-20 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-6-18
更新日期:2006-05-30 00:00:00
abstract:BACKGROUND:This study investigate the influence of domestic violence against pregnant women on early complementary feeding and associated factors. METHODS:A longitudinal observational study was conducted with a convenience sample recruited from three public hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Data on...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03144-y
更新日期:2020-08-05 00:00:00
abstract:BACKGROUND:Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. Although the contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnanc...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2016-08-24 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1498-y
更新日期:2017-11-08 00:00:00
abstract:BACKGROUND:Preterm infants have an immature sucking behavior and the capacity to be exclusively breastfed may be reduced for a period of weeks or months, depending on gestational age. Nipple shields have been used, not only as a device to help mothers with sore nipples, but also to facilitate the infant's latch on to t...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-1183-6
更新日期:2017-01-03 00:00:00
abstract:BACKGROUND:In recent decades we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. However, the real reasons for this phenomenon are uncertain. Notably, the number of women requesting elective CS without accepted valid medical indic...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/s12884-014-0410-2
更新日期:2014-12-12 00:00:00