Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

Objective:To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia.Methods:Fifteen peer-reviewed,primary research articles published between 2011 and 2015 were selected for this scoping review.The articles included case-control,cross-sectional,and retro-spective follow-up studies conducted in Ethiopia.Results:Findings were categorized with use of content and factorial analysis.The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status,education,residence,autonomy in decision making,parity,and antenatal care attendance.Conclusion:Sociodemographic,accessibility,and obstetric factors are key determinants of skilled care utilization.Strategies and policy changes to address maternal health service use should aim to improve economic status,facilitate higher education,increase access to care,promote the empowerment of women,and enhance antenatal care initiatives.Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization,since few studies have examined these factors.

‘Feeling of despair’ as the leading cluster theme of conceptual descriptive analyses in participatory assessment: Russia Oxfam GB case study

This article provides a case study on participatory assessment based on experience gained from an EU-Oxfam GB project entitled“Empowering Municipalities to Effectively Address Poverty”conducted in five small towns in Russia.Participatory assessment through focus group discussions(FGDs)was the main approach used in the implementation of the project.A participatory assessment was performed through 25 FGDs in five remote areas in central Russia.More than 200 participants representing people living in poverty,such as single mothers,people with disabilities,families with many children,families with disabled children,and pensioners,voluntarily participated in the meetings.Most of the participants were women(75%)aged between 25 and 70 years.We consider that the participants’representation is relevant in accordance with the official poverty studies.Through identification of patterns of recurrent ideas and opinions,a qualitative method helps us understand social phenomena from the views of and on the basis of the opinions of the participants.The FGDs’narratives underwent pattern analysis,resulting in the framing of the cluster themes and narrative conceptualization.Cluster analysis of the FGDs’narratives led to the framing of 10 cluster themes of importance,followed by conceptual descriptions and related narratives.The conceptual description of the leading theme,feeling of despair(theme 1),was described by respondents’expressions/narratives,such as“Nobody needs us and there is no future for us and our children in this town,”the narrative idea that crosscuts the subsequent themes.The following nine themes are of equal importance,are interlinked,and for the major part constitute the leading theme,feeling of despair(theme 1):state social and family support(theme 2);health care(theme 3);who are those living in poverty?(theme 4);housing(theme 5);living costs(theme 6);employment(theme 7);children’s well-being and future(theme 8);environment and recreation(theme 9);and legal rights(theme 10).Equal importance of these themes is justified by the analysis of patterns and recurrence of the FGDs’narrative ideas.The assigned numbers from 2 to 10 are given to simplify the references to the corresponding cluster throughout the analysis and do not reflect the ranks of the clusters.The leading theme(theme 1)touches on the psychological status of the FGDs’participants,while the remaining nine themes(themes 2-10)relate to the state system of social services,including health care.For example,per the conceptual descriptions,the state social and family support(theme 2)is described by the following narrative:“Those who have a family network get their support,for those without family help,state support is crucial but is very little and not everybody can get it.Nobody wants to help or provide decent services-people in local government get fed up with you,you get sent from one place to another.”The frustration(“Nobody wants to help or provide decent services;the government gets fed up with you,you get sent from one place to another.”)caused by poor services(“State support is crucial but is very little and not everybody can get it.”) crosscuts the theme’s conceptual description. In this article, feeling of despair refers to a psychosocial condition caused by people living in poverty and their dissatisfaction with state services. Details of the remaining themes are given. The purpose of this article is to draw the attention of practitioners and policy makers to the participatory results rather than their focusing on the qualitative methodological details. We argue that a participatory understanding of community needs, through cluster theme analysis and conceptual descriptions, can help local municipalities develop more targeted community programs on poverty and vulnerability reduction.

Unregulated health care workers in the care of aging populations:Similarities and differences between Brazil and Canada

Introduction:The world’s population is rapidly aging.Unregulated health care workers(UH-CWs)are emerging as a potentially important workforce in the care of older adults.Objective:A review was conducted to identify the activities of UHCWs with respect to con-tributions and limitations.Methods:A systematic integrative literature review was conducted using online databases(LILACS,PubMed,EMBASE,CINAHL,and grey literature).The inclusion criteria were as fol-lows:(i)description of UHCW activities related to older adults;and(ii)description of UHCW activities performed in Brazil or Canada.Results:Eleven papers were included in this review.In both countries,UHCW activities included health promotion,mental health care,and rehabilitation.In Brazil,UHCWs performed integrated care,while in Canada UHCWs performed personal care and housekeeping.Conclusion:These results highlight the potential and limits of UHCWs who provide care for the aging population.Such information is important to health and social policy making and household decision making.

Long-term care for aged ethnic minority people in Yunnan,China:Understanding the situation

Chinese governmental sectors have been investing lots of money in setting up new institutions for long-term care(LTC)in rural China to respond to the predicted increasing and urgent needs of the growing number of aging people.However,very few have identified that many ethnic minority groups have been enjoying their traditional home-based LTC systems,which are cost-effective and have been working really well for generations.This article reports on a study on LTC needs and provisions for the Dai,one of the ethnic minority groups in rural areas of southwest China,in Yunnan(Province).A randomized sample was drawn from 12 villages in Ruili,a county 752 km from Kunming,the capital city of Yunnan.Totally,187 elderly persons were interviewed intensively.Activities of daily living were measured as the core indicator for understanding LTC.The research revealed that there is a significant disparity between the needs of the villagers and provisions from the different levels of government.There is an urgent need to reexamine the allocation of public resources for the aged.Traditional culture and practices of caring for the elderly,and practices in LTC of different ethnic groups,must be carefully considered.