wow-inequalities/02-data/intermediate/wos_sample/dfafa22382d298c2960288a41739761e-flanagan-sara-v.-an/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background Postpartum hemorrhage (PPH) is the leading cause of maternal
mortality in low-income countries, and is the most common direct cause
of maternal deaths in Madagascar. Studies in Madagascar and other
low-income countries observe low provider adherence to recommended
practices for PPH prevention and treatment. Our study addresses gaps in
the literature by applying a behavioral science lens to identify
barriers inhibiting facility-based providers'' consistent following of
PPH best practices in Madagascar. Methods In June 2019, we undertook a
cross-sectional qualitative research study in peri-urban and rural areas
of the Vatovavy-Fitovinany region of Madagascar. We conducted 47
in-depth interviews in 19 facilities and five communities, with
facility-based healthcare providers, postpartum women, medical
supervisors, community health volunteers, and traditional birth
attendants, and conducted thematic analysis of the transcripts. Results
We identified seven key behavioral insights representing a range of
factors that may contribute to delays in appropriate PPH management in
these settings. Findings suggest providers'' perceived low risk of PPH
may influence their compliance with best practices, subconsciously or
explicitly, and lead them to undervalue the importance of PPH prevention
and monitoring measures. Providers lack clear feedback on specific
components of their performance, which ultimately inhibits continuous
improvement of compliance with best practices. Providers demonstrate
great resourcefulness while operating in a challenging context with
limited equipment, supplies, and support; however, overcoming these
challenges remains their foremost concern. This response to chronic
scarcity is cognitively taxing and may ultimately affect clinical
decision-making. Conclusions Our study reveals how perception of low
risk of PPH, limited feedback on compliance with best practices and
consequences of current practices, and a context of scarcity may
negatively affect provider decision-making and clinical practices.
Behaviorally informed interventions, designed for specific contexts that
care providers operate in, can help improve quality of care and health
outcomes for women in labor and childbirth.'
affiliation: 'Flanagan, SV (Corresponding Author), Ideas42, 80 Broad St Fl 30, New
York, NY 10004 USA.
Flanagan, Sara V.; Razafinamanana, Tina; Smith, Jana, Ideas42, 80 Broad St Fl 30,
New York, NY 10004 USA.
Warren, Charlotte, Populat Council, 4301 Connecticut Ave NW, Washington, DC 20008
USA.'
article-number: '320'
author: Flanagan, Sara V. and Razafinamanana, Tina and Warren, Charlotte and Smith,
Jana
author-email: sara@ideas42.org
author_list:
- family: Flanagan
given: Sara V.
- family: Razafinamanana
given: Tina
- family: Warren
given: Charlotte
- family: Smith
given: Jana
da: '2023-09-28'
doi: 10.1186/s12884-021-03801-w
eissn: 1471-2393
files: []
journal: BMC PREGNANCY AND CHILDBIRTH
keywords: 'Maternal mortality; Postpartum hemorrhage; Healthcare provider;
Madagascar; Facility-based birth; Behavioral barriers'
keywords-plus: '3RD STAGE; ACTIVE MANAGEMENT; RISK PERCEPTION; CONDOM USE; LABOR;
IMPLEMENTATION; FEEDBACK'
language: English
month: APR 22
number: '1'
number-of-cited-references: '33'
papis_id: 60680c68062ab8abae46c0d29a56e8f4
ref: Flanagan2021barriersinhibiting
times-cited: '4'
title: 'Barriers inhibiting effective detection and management of postpartum hemorrhage
during facility-based births in Madagascar: findings from a qualitative study using
a behavioral science lens'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000644071000002
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '21'
web-of-science-categories: Obstetrics \& Gynecology
year: '2021'