1 / 31

Our Reference: COHEA 2012. AIHA No: 195/2012. D ate: 12-13 December 2012, Indonesia.

Our Reference: COHEA 2012. AIHA No: 195/2012. D ate: 12-13 December 2012, Indonesia. Vilathong Souksenesamlane (Mr) MD, MSc.ICP (PHM). Luang Prabang Province. Northern Laos. vilas609@gmail.com. Title: “Factors Influencing the Utilization of Delivery

odeda
Télécharger la présentation

Our Reference: COHEA 2012. AIHA No: 195/2012. D ate: 12-13 December 2012, Indonesia.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Our Reference: COHEA 2012.AIHA No: 195/2012.Date: 12-13 December 2012, Indonesia. Vilathong Souksenesamlane (Mr) MD, MSc.ICP (PHM). Luang Prabang Province. Northern Laos. vilas609@gmail.com Title: “Factors Influencing the Utilization of Delivery Service at Health Facilities in Xieng Ngeurn District, Luang Prabang Province, Laos”. Date of study: August 2008. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  2. Outline of Presentation: 1. The results of study _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  3. Area of study _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  4. 1. The Result of study: ________________________________ 1.1 Rational Study: • Women are at risk for unsafe delivery at home and/or attended by unskilled personnel under unhygienic conditions. • The problems can affect the accessibility, availability, affordability and effectiveness of infant delivery services. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  5. 1. The Result of study (Cont.): ________________________________ • To investigate and clarify the factors associating with women and /or pregnant women who failed to use the delivery services at health facilities for their giving-birth in Xieng Ngeurn District, Luang Prabang Province. 1.2 Objectives of the Study: The initial beliefs on the causes of low utilization of delivery services are demographic, socio-cultural, economic status, geographical, and health services elements. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  6. 1. The Result of study (Cont.): ------------------------------- • Literature Review. • Cross-Sectional Description & Multiple Regression Model with both Qualitative & Quantitative Method (STATA.10 for Analysis). 1.3 Methodology of the Study: • Target Group: 152 women (15-45 years old), 11 health providers, 7 TBAs and 25 leaders of villagers for interview. • Target Area: One Semi-Urban (3 villages) and One Rural Area (2 villages), 2 health centers/2 areas and 1 district hospital. • Following as the key research questions and hypothesis. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  7. 1. The Result of study (Cont.): ------------------------------- • What factors contribute to underutilization of healthcare facilities?. 1.4 Research Questions & Hypothesis: • Which place is most used for delivery as “HOME,” “HEALTH FACILITIES.” or “Others”? Hypothesis: women have had an experience in giving-birth did not utilize to deliver the qualified staff at health facilities because of socio- economic factors. This comportment contributes to higher health risks caused by home delivery. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  8. 1. The Result of study (Cont.): ------------------------------- Women did not use their infant delivery at health facilities. Low Utilization of Infant Delivery Services. High risk for unsafe delivery and high mortality rate. 1.5 Conceptual Framework of the Study: Factors 1.Economic, 2.Socio-Cultural, 3.Geographic and 4.Health Services _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  9. 1. The Result of study (Cont.): ------------------------------- 1.6.1 Socio-Cultural Factor: • 53.25% [illiteracy] for those who is unable to read and write the Lao Language. Therefore, this issue can be affected to access to health facilities too. 1.6 Key Findings: • 100% (n=152) of the responds reported that no prohibition before delivery to interfere [Taboos practice before delivery for women]. • 69.77% of the responds said that men made the decision for delivery at health facilities and 20.93% by elderly people. Only 9.30% by women. Therefore, elderly people and men had significant influence on the choice of delivery than women. [Decision- Making during delivery for women]. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  10. 1. The Result of study (Cont.): ------------------------------- 1.6.1 Socio-Cultural Factor (cont.): • 90.70% [Decision-Making for all expenditures during delivery] reported that men decided to pay. 1.6.2 Economic Factor: 1.6 Key Findings: • 81.58% [As farmers] reported that are farmers. • 75.00% [Monthly Family Income] of most respondents had a monthly family income less than 300,000 kip (35USD). Average income: 48$/month/person. • Average of All expenditure for delivery services: 84$/person/time [Expenditure for Delivery cost]. Therefore, the financial constraint has an influence on the access to the delivery services at health facilities too. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  11. 1. The Result of study (Cont.): ------------------------------- 1.6.3 Geographical Factor: • 65% [Location] reported that are living in semi-urban area and 35% are rural areas. The distance from home to health facilities is about 2-5Km. But no public transportation. 1.6 Key Findings: • The distance and time are not associated with access to the utilization of delivery services because their living areas are near health facilities. 1.6.4 Health Services Factor: • 93.02% [Waiting Time <15mns] reported that accepted the waiting time to see the doctors. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  12. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): 1.6 Key Findings: Affordability of payment (Out-of-pocket): very high, compared with the family income. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  13. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • 97.73% (n=42) of respondents accepted that health staff had good attitude [Attitude of health staff during delivery services]. • 97.67% (n=42) of respondents satisfied delivery services at the health facilities in terms of quality of delivery, communication, responsiveness, technical staff, attitude, payments, prompt, counseling/information, cleaning place, referral system & document procedures [Patient satisfied for delivery services]. 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  14. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Place for ANC (Care-Seeking Behavior). 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  15. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Place for Delivery (Care-Seeking Behavior). 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  16. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Place for PNC (Care-Seeking Behavior). 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  17. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Delivered Assistants (Care-Seeking Behavior). 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  18. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • 84.87% (n=152)[Received General Health Information] reported that received health information from health district office every year. 38.16% (n=58) reported that they received HI at least two time per year. 1.6 Key Findings: • 44.08% (n=67)[the PLACE for Women Received Health Information on delivery] reported that received health information on delivery at home rather than health facilities because moving mobile clinic in each village for every three months. 30.26% at HC, 6.58% at DH, 2.63% at PH and 16.45% no received HI. • 78.95% (n=120)[Women Received Health Information on delivery by WHOM] reported that received health information on delivery from health providers. 1.97% from TBAs and/or all of them, 0.66% from Elderly people, and 16.45% no received HI. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  19. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • 95.39% (n=145)[Relationship between women and TBAs during delivery service] reported that have very good relationship with TBAs’ Services in the village. A few respondents said that not good relationship (4.61%) e.g unfriendly manners, bad communication, lack of medical equipment and drugs. 94.08%(n=143) said that TBAS can come to see them immediately during delivery at home and had skills’ delivery. However, the emergency case, TBAs cannot come in time to help. 1.6 Key Findings: • Average of knowledge: 55.71% (n=7) and skills: 79.09% (n=7)[Knowledge and Skills of TBAs on delivery] as following: basic knowledge & Skills on dangerous signs’ delivery, techniques’ delivery, using medical equipment, stopping bleeding, normal delivery, position of birth, timing of delivery/stage, liquid of delivery, manual removal placenta technique, estimated delivery date. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  20. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): 1.6 Key Findings: • Average of knowledge: 88.18% (n=11) and skills: 79.09% (n=11)[Knowledge and Skills of Health Providers on delivery] as following: basic knowledge & Skills on dangerous signs’ delivery, techniques’ delivery, using medical equipment & medicines, stopping bleeding, normal delivery, position of birth, timing of delivery/stage, liquid of delivery, manual removal placenta technique, estimated delivery date, and episiotomy for vagina. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  21. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): [Delivery performance by Health Providers & TBAs]. 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  22. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): [Place of Delivery chosen by women]. 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  23. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Reasons to choose home delivery. 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  24. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Reasons to choose health facilities for delivery. 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  25. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Group Discussions: 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  26. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Group Discussions: 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  27. 1. The Result of study (Cont.): ------------------------------- 1.6.4 Health Services Factor (cont.): • Group Discussions (cont.): 1.6 Key Findings: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  28. 1. The Result of study (Cont.): ------------------------------- • Most of respondents demonstrated that their monthly family income and level of education (especially language) were still one of the most serious problems among those who did not utilize their delivery at health facilities. In addition, the data shows that the care-seeking behaviors of women (attitude) were very low at health facilities and very high at home delivery level. Furthermore, the choice of place delivery of women depends on the head of family to choose rather than others. • In conclusion, socio-cultural, economic, and quality of health services factors influenced are significant variables. To improve the delivery services, these people should get more information, education and communication (IEC) as the strategy. 1.7 Conclusions: _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, LuangPrabang Province, Laos.

  29. References ------------------------------- Abramson, J. A. (1997). Survey Methods in Community Medicine. In Epidemiological Research Programme Evaluation Clinical Trials.Churchill Livingstone: New York. A.Y. Ellencweig and O. Grafstein. (1989). Inequity in Health a Case Study. European Journal of Epidemiology,244-250. Beaglehole, R. (2002). Global Public Health: A new era. University of Auckland, New Zealand. , P.30-34. Bell J, H. B. (2003). Improving skilled attendance at delivery: A preliminary report on the SAFE Strategy Development Tool. Birth , 30 (4): 227-234. Booyens, SW. (1998). Dimension of nursing management. 2nd Edition CapeTown: Juta. Bowlin, A. (1997). Research Methods in Health. Philadelphia, USA: Open University Press. P.172. Buttiens H, M. B. (2004). Editorial: Skilled attendance at childbirth: let us go beyongthe rhetorics. Tropical Medicine and International Health, Vol.9(6):653-654. Carlough M and McCall M. (2005). Averting Maternal and Death and Disability. Skilled birth attendance: What does it mean and how can it be measured? A clinial skills assessement of maternal and child health workers in Nepal. International Journal of Gynaecology and Obstetrics. , Vol.89:200-2008. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  30. References (cont.)------------------------------- Carol Perks, M. J. (2006). District Health Programmes and Health-Sector Reform: Case Study in the Lao People's Democratic Republic. Policy and Practice, P.143. CPI, Laos (2006). National Socio-Economic Development Plan (2006-2010).Vientiane, Lao PDR. Page 36. Daniel WW. (1998). Biostatitics: A Foundation for Analysis in the Health Science. Boston: PWS-Kent. Duong, D. V. (2005. ). Factors that influence the utilization of maternity services and breastfeeding practices in rural Vietnam. _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

  31. ¢º®Ã¥ (Thanks for your attention & sharing) _______________________________________________________________________________________________________ Factors Influencing the Utilization of Delivery Services at Health Facilities in XiengNgeurn District, Luang Prabang Province, Laos.

More Related