"If you are on duty, you may be afraid to come out to attend to a person": fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.
"If you are on duty, you may be afraid to come out to attend to a person": fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.
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DOI：
10.1186/s12913-020-05747-9
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发表时间：
2020-09-29
影响因子：
2.8
通讯作者：
Mirzoev T
中科院分区：
文献类型：
--
作者：
Etiaba E;Manzano A;Agbawodikeizu U;Ogu U;Ebenso B;Uzochukwu B;Onwujekwe O;Ezumah N;Mirzoev T
妇幼保健是全球优先事项。在低收入和中等收入国家，获得和利用基于设施的保健服务仍然是一个挑战。关于提供和获取服务的障碍的证据忽略了关于设施内安保作用的信息。本文探讨了安全的作用，在提供和使用孕产妇保健服务的初级保健设施在尼日利亚。研究在尼日利亚的阿南布拉州进行。定性数据最初收集了35个深度访谈和24个焦点小组有目的地确定的关键线人。收集的信息被用来建立一个方案理论，并通过另一轮访谈（17）和焦点小组讨论（4）进行了测试。数据分析和报告基于现实主义评估方法的情境-机制-结果启发。该设施内有一名男性警卫是便利提供和接受服务的最重要的安全因素。其他设施包括周边围栏、照明和工作人员宿舍。缺乏这些组成部分会影响工作人员和病人的行为，从而限制了服务的提供和使用。设施工作人员的安全关切，他们认为让人进入无人看守的设施不安全，这反映了孕妇的安全关切，她们因为害怕不让人进入和得不到设施工作人员的照顾而不利用保健设施。保健设施的安全应是方案规划的关键考虑因素，以避免工作人员和妇女对犯罪的恐惧，这种恐惧目前限制了保健设施提供和使用产妇保健。
Maternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of security in the provision and use of maternal health services in primary healthcare facilities in Nigeria. Study was carried out in Anambra state, Nigeria. Qualitative data were initially collected from 35 in-depth interviews and 24 focus groups with purposively identified key informants. Information gathered was used to build a programme theory that was tested with another round of interviews (17) and focus group (4) discussions. Data analysis and reporting were based on the Context-Mechanism-Outcome heuristic of Realist Evaluation methodology. The presence of a male security guard in the facility was the most important security factor that facilitated provision and uptake of services. Others include perimeter fencing, lighting and staff accommodation. Lack of these components constrained provision and use of services, by impacting on behaviour of staff and patients. Security concerns of facility staff who did not feel safe to let in people into unguarded facilities, mirrored those of pregnant women who did not utilize health facilities because of fear of not being let in and attended to by facility staff. Health facility security should be key consideration in programme planning, to avert staff and women’s fear of crime which currently constrains provision and use of maternal healthcare at health facilities.
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影响因子：
3.1
作者：
Mpembeni RN;Killewo JZ;Leshabari MT;Massawe SN;Jahn A;Mushi D;Mwakipa H
通讯作者：
Mwakipa H
影响因子：
3.2
作者：
Bovaird, Tony
通讯作者：
Bovaird, Tony
影响因子：
1.6
作者：
Ebenso, Bassey;Manzano, Ana;Mirzoev, Tolib
通讯作者：
Mirzoev, Tolib
影响因子：
7.2
作者：
Dalkin, Sonia Michelle;Greenhalgh, Joanne;Lhussier, Monique
通讯作者：
Lhussier, Monique
影响因子：
6.1
作者：
FERN, EF
通讯作者：
FERN, EF