Ali, S; Kabajaasi, O; Kawooya, MG; Byamugisha, J; Zakus, D; Papageorghiou, AT; Klipstein-Grobusch, K; Rijken, MJ
(2021)
Antenatal Doppler ultrasound implementation in a rural sub-Saharan African setting: exploring the perspectives of women and healthcare providers.
Reprod Health, 18 (1).
p. 199.
ISSN 1742-4755
https://doi.org/10.1186/s12978-021-01233-5
SGUL Authors: Papageorghiou, Aris
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Abstract
BACKGROUND: The World Health Organization recommends research to evaluate the effects of a single third trimester Doppler ultrasound examination on preventable deaths in unselected-risk pregnancies, particularly in low- and middle-income countries (LMICs) where the evidence base is scarce. While evaluating such technologies, researchers often ignore women and health care provider perspectives. This study explored the views and experiences of women and healthcare providers regarding the use of advanced ultrasound technology to optimize the health of mothers and their babies in a rural community in mid-western Uganda. METHODS: We enrolled 53 mothers and 10 healthcare providers, and captured data on their perceptions, barriers, and facilitators to the use of Doppler ultrasound technology using focus group discussions, semi-structured interviews and observations. Using qualitative content analysis, we inductively coded the transcripts in ATLAS.ti 8.0, detecting emerging themes. RESULTS: Women were afraid that ultrasound would harm them or their fetuses and many of them had never seen an ultrasound scan. The majority of the women found their partners supportive to attend antenatal care and use ultrasound services. Healthcare providers in Kagadi Hospital were unfamiliar with Doppler technology and using it to guide clinical decisions. Other barriers to the implementation of Doppler ultrasound included shortage of trained local staff, insufficient equipment, long distance to and from the hospital, and frequent power cuts. CONCLUSIONS: We found limited exposure to Doppler ultrasound technology among women and healthcare providers in mid-western Uganda. Engaging male partners may potentially influence the likelihood of accepting and using it to improve the health of women and their fetuses while wide spread myths and misconceptions about it may be changed by community engagement. Healthcare workers experienced difficulties in offering follow-up care to mothers detected with complications and Doppler ultrasound required a high level of training. While introducing advanced ultrasound machines to weak health systems, it is important to adequately train healthcare providers to avoid inappropriate interventions based on misinterpretation of the findings, consider where it is likely to be most beneficial, and embed it with realistic clinical practice guidelines.
Item Type: | Article | |||||||||
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Additional Information: | © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | |||||||||
Keywords: | Antenatal care, Doppler ultrasound, Healthcare workers, Low- and middle-income countries, Pregnancy, Qualitative, Africa South of the Sahara, Female, Health Personnel, Humans, Infant, Male, Pregnancy, Qualitative Research, Rural Population, Ultrasonography, Doppler, Humans, Ultrasonography, Doppler, Pregnancy, Qualitative Research, Infant, Health Personnel, Rural Population, Africa South of the Sahara, Female, Male, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical & Biomedical Education (IMBE) Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE ) |
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Journal or Publication Title: | Reprod Health | |||||||||
ISSN: | 1742-4755 | |||||||||
Language: | eng | |||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||
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PubMed ID: | 34620186 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/113778 | |||||||||
Publisher's version: | https://doi.org/10.1186/s12978-021-01233-5 |
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