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Interventional study to improve patients’ continuum of care in Obstetrics and Gynecology, Kasr Al-Aini Hospitals

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Public Health

Advisors

El-Refaei, Mirvat R. , Tawfiq, Salwa A. , Abdel-Razeq, Madiha S. , Abdel-Hamid, Muna A.

Authors

Abdel-Gawwad, Walaa Ahmad Khayri

Accessioned

2017-07-12 06:40:49

Available

2017-07-12 06:40:49

type

M.D. Thesis

Abstract

Continuum of maternal care (CMC) denotes continuity of individual health carethroughout a birth cycle through utilization of four services: antenatal care (ANC),Natal Care (NC), Postnatal Care (PNC) and Family Planning (FP) services. Despite,CMC is considered one of the important quality components that should be deliveredin integrated package at critical times; health programs contemplate achievement ofCMC by coverage rates of the four vertical programs. Additionally, there are no testedinterventions and organizational modules that promotes CMC at individual and healthsystem levels. The objectives of the study are to describe the profile of CMC atindividual level, test the impact of the new health education communication tools onawareness of mothers on quality CMC and designate CMC-modules at health systemlevel. Methods: the study is an operations research-intervention study that wasconducted in Kasr-Al-Aini- Obstetrics and Gynecology Outpatient clinics, usingquantitative data collected during structured interview and recorded in a pre-testedquestionnaire forms to a convenient samples of 200 FP clients for needs assessmentfor quality CMC and 200 ANC clients for pre- post interventions. The studyintervention included: development and displaying video film, distribution of leafletsand conduction of seminars by trained social relation specialist on integrated packageon CMC in the ANC clinic. Results: FP clients reported coverage rates for ANC(90%), NC (95%), PNC (92%) and FP (86%). The CMC according to set standards atthe individual level was estimated to 400 mothers to be 27%. There were statisticallysignificant differences (p<0.001) between mothers committed to standard CMC andthose with Irregular Maternal Care (IMC) regarding CMC knowledge score (47% forCMC and 34% for IMC), and sources of maternal care services (private sector was thesource of 52% of services for CMC group and 34% for IMC group). CMC at thehealth sector level showed that Missed Opportunities (MO) for CMC was the highestfor Primary Health Care facilities (70%) and the lowest for private sector (22%). Atthe health system level integrated primary-secondary-tertiary module showed thelowest level of MO for CMC (14%). The intervention succeeded in achievingsignificant improvement in knowledge score on integrated package of CMC amongANC clients from 39% to 70% after exposure to health awareness materials(p<0.001) (OR= 3.6) (CI 3.3 ; 3.8 ). Educational video contributed by 36% of the totalknowledge score. The study concluded that empowerment of mothers withinformation about CMC, and supporting health systems to provide integrated packageof CMC services are pivotal for supporting of mothers' health through CMC.

Issued

1 Jan 2014

DOI

http://dx.doi.org/10.21473/iknito-space/35898

Details

Type

Thesis

Created At

28 Jan 2023