Maternal and child health nursing practices in rural health centres, Ethiopia: prospects for health outcomes

Abstract

The Purpose of the study to provide evidence-based suggestions for maternal and child health nursing practice guideline improvements based on in-depth investigation of existing situations, challenges, missed-opportunities, innovative ideas and best practices that could improve the maternal and child health care practices. The method of the study applied was qualitative study design which was conducted by using phenomenological and ethnographic approaches. Totally, 42 in-depth interviews and 12 focus group discussions were conducted. Among Key informant interviews, 24 (57.1%) were female participants and 18 (42.9%) participants were male. Each focus group discussion involved 6 individual participants in which 8 Fucus Group Discussions purely involved 48 (66.7%) female participants and 4 Fucus Group Discussions purely involved 24 (33.3%) male participants in the context of twelve rural health centres in six selected districts, namely: Babile, Chalanko, Dadar, Fadis, Kersa, Meta and Gursum which are found in East Hararghe Zone, Oromia, Ethiopia. The study involved healthcare managers, community leaders, religious leaders, health officers, midwives, nurses, health extension workers (HEWs), traditional birth attendants (TBAs), volunteer health promoters and mothers, as well as family members. Data collection instruments used were In-depth interview questions, focus group guides and observation checklists with audio recorder and camera. In qualitative research, the triangulation of these methods was advantageous for enabling participation of a broad spectrum of participants and a range of views concerning the investigated phenomenon of MCH care practices. Data analysis was performed based on the need for triangulation in this study and its vast sample size, both inductive and deductive analytical approaches were applied to analyse and interpret the collected data from these varied categories of research subjects by using the Atlas ti Version 8.2 statistical software. The study found out the environmental, physical, institutional, material, financial, ethical, attitudinal, perceptual, behavioural, procedural conditions and human interaction that positively or negatively affect the quality of maternal and child health care services. The study further explored major barriers, enabling factors and innovative ideas for improving maternal child health care practices based on the lessons learnt from experiences in the context of local communities. v The study inferred useful insights on the nature of existing maternal and child health care related issues including: the rationale, purpose, components, methods of care and practice, nature of interaction, levels of satisfaction and level of dissatisfaction. Based on the findings, the recommendations were given largely focus on multiple approaches and guidelines for improvement of maternal and child health practices by all stakeholders, from the personal, institutional/ organisational and governmental levels.