Authored by Soad Mahfoozpour*
Abstract
Background: A significant portion of maternal mortality has social causes. Inter-Sectoral Collaboration (ISC) is among important strategies for decrease the Maternal Mortality Rate (MMR). The present study aimed to explain participants’ viewpoint on the dimensions of the Inter-Sectoral Collaboration in Maternal Health Promotion Activities (MHPA) in Developing Countries.
Methods: In this qualitative phenomenological study, data were collected using semi-structured interviews with experts from 2019 to 2020. The participants were selected using the purposive sampling method; interviews were continued until reaching data saturation. Data were analyzed using the content analysis method with the MAXQDA software.
Results: From the participants’ view, ISC in the maternal health services has the 3 main themes and 9 sub-themes. The main themes were “Transparency”, “Participation” and “Coordination”.
Conclusion: The collaboration of activities within and outside of the health domain is a fundamental approach to promoting maternal health, so formulating effective community policies based on the dimensions of collaboration should be considered.
Keywords: Inter-sectoral collaboration; Mothers Health; Content Analysis
Background
Maternal mortality is an important indicator for health status in all countries. Despite the World Health Organization’s (WHO’s) goal of reducing maternal mortality, many countries have not attained it [1,2]. Many preventable deaths of pregnant mothers occur due to determinants out of health sector [3]. The factors affecting maternal health are complex; coordination and interactive plans between the health sector and other sectors of society are essential to improve the pregnant mothers’ health [2]. Some developed countries have been focused on ISC planning within and outside the health sector to reduce maternal mortality and improve their health, for example in the Republic of Korea, 25 laws have been adopted to coordinate implementation at different ministries to improve child nutrition and reduce obesity [4]. The structures of the ISC process vary from country to country and affected from the structure of the organizations and legislation of the country [5]. Commitment between sectors for collaboration can be achieved through the establishment of an understanding within the framework of policies, treaties, and legal support. Community policymakers can facilitate cross-sectoral communication through coordinated programs. For example, a coordinated program to reduce violence in society is a joint task of the police and the judiciary [2,4]. In other words, coordinated action by the education system, the police and the judiciary, as well as other relevant parts can identify the causes of violence and eliminate the roots of violence [6]. There is no coherence policy in Iran for ISC in maternal health services. Despite the planned efforts, maternal mortality rate is still far from the Millennium Development Goals [7,8]. A number of mothers lose their lives due to the lack of physical access to well-equipped health centers and in some cases, educational inequities between the rich and poor areas as well as the differences between regions in health literacy and self-care information [9]. In some parts of developing countries, differences in mothers’ access to social facilities Leads to maternal death; unfavorable roads and road accidents as well as lack of access to adequate food resources are other causes of maternal mortality [10]. Increasing knowledge and understanding of dimensions of inter-sectoral coordination and collaboration is necessary to create a higher sense of responsibility.
Objectives
The aim of this study was to extract the dimensions of the Inter-sectoral collaboration in maternal health promotion activities through interviews with experts in 2020.
Methods
This qualitative study was of content analysis type. After obtaining permission from the relevant institutions, explaining the study to the Interviewees and obtaining written consent, semi-structured, face-to-face interviews were conducted in the environment proposed by the participants. The interviews lasted 30-90 minutes. The study was performed among health departments at the universities of Tehran and Tehran Provincial Government.
Participants
Semi-structured interviews were conducted with 20 health staff of the medical sciences universities in Tehran, 10 faculty members from the relevant fields and 20 service providers both inside and outside the health sector which were selected by purpose-based method. The interviews based on having sufficient information about the study and research questions, proceeded until reaching data saturation. Experts in this study included graduate and postgraduate healthcare professionals and faculty members in midwifery, gynecology, epidemiology, sociology and social medicine with at least three years of experience.
Data collection
In this semi-structured study, the following questions were asked to achieve the participants’ viewpoint:
• Is cross-sectoral coordination in maternal health services necessary?
• In your opinion, in what areas can cross-sectoral coordination in maternal health services be?
• What do you think about the dimensions of cross-sectoral coordination in maternal health services?
After reaching data saturation, the interviews ended. Each interview lasted about 60 to 90 minutes.
Data analysis
• The interviews with experts were first recorded and then transcribed. In data analysis:
• First, the text of the interviews was carefully read.
• The text of the interviews’ interpretation was carefully written.
• The themes were identified by discussion between the members of the research team.
• To overcome any doubts and making the results conclusive, the text was revised.
• In the next step, the texts were compared, and the themes were identified.
• At this stage, the themes were discussed by the members of the research group.
• Finally, the themes were extracted. Code analysis was performed with MAXQDA-10.
Rigor
Goba and Lincoln methods were used to confirm the accuracy of the study [11]. Data transferability was determined through the review and approval of seven experts and the credibility of data from the interviews was confirmed by approval of the participants at the same time as the data collection and with the use of the viewpoints of six faculty members. Data confirmability was determined using the views of five faculty members who did not participate in the study; the study procedures were recorded and its coherence was identified. To confirm dependability, notes were taken while the data was collected and the collected data was merged.
Ethical considerations
The study was launched after permission from the Ethics Committee and obtaining a written certificate from the University. Considering the confidentiality of the information and the results of the research, the consent form was signed by the participants.
To read more about this article.....Open access Journal of Nursing & Care
Please follow the URL to access more information about this article
To know more about our Journals...Iris Publishers
No comments:
Post a Comment