The Role Of Interpersonal Communication On Maternal Health Of Expectant Mothers (A Case Study Of Selected Hospitals In Owerri)

ABSTRACT

This project is a survey on the interpersonal communication on maternal Health of Expectants mothers: a case study of selected Hospitals in Owerri. Study design Metareview of published and unpublished systematic reviews and meta-analyses conducted between January 2000 and March 2013 in any language. Assessment of Multiple Systematic Reviews (AMSTAR) is used to assess the methodological quality of systematic reviews. Settings Health systems of all states. Study outcome: QoC measured using surrogate indicators-effective, efficient, accessible, acceptable/patient centred, equitable and safe. Analysis Conducted in two phases (1) qualitative synthesis of extracted data to identify and group the facilitators and barriers to improving QoC, for each of the three population groups, into the six domains of WHO’s framework and explore new domains and (2) an analysis grid to map the common facilitators and barriers. Results We included 98 systematic reviews with 110 interventions to improve QoC from countries globally. The facilitators and barriers identified fitted the six domains of WHO’s framework–information, patient-population engagement, leadership, regulations and standards, organisational capacity and models of care. Two new domains, ‘communication’ and ‘satisfaction’, were generated. Facilitators included active and regular interpersonal communication between users and providers; respect, confidentiality, comfort and support during care provision; engaging users in decision-making; continuity of care and effective audit and feedback mechanisms. Key barriers identified were language barriers in information and communication; power difference between users and providers; health systems not accounting for user satisfaction; variable standards of implementation of standard guidelines; shortage of resources in health facilities and lack of studies assessing the role of leadership in improving QoC. These were common across the three population groups. Conclusions The barriers to good-quality healthcare are common for pregnant women, newborns and children; thus, interventions targeted to address them will have uniform beneficial effects. Adopting the identified facilitators would help countries strengthen their health systems and ensure high-quality care for all.

CHAPTER ONE

1.1 BACKGROUND OF THE STUDY
The persistent rise in maternal health of expectant, infant and child morbidity and mortality demand improved healthcare which does not pertain to coverage of health services alone. Recently, there is a growing interest in the quality of healthcare services provided. The health issues of pregnant women, mothers, infants and children cannot be addressed without due attention to quality of care (QoC) for the simple reason that the healthcare services will not be effective, efficient, acceptable and safe. However, it is not easy to conceptualise QoC and there are several definitions. Avedis Donabedian, a pioneer in introducing QoC into the health system, defined QoC as: that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts.
The WHO provides a framework of organisational management strategies to improve QoC in order to help the healthcare system achieve its desired goals. This is a general framework which suggests that overall the health systems should focus on improving six domains of organisational management strategies to improve QoC—information, leadership, engagement with patients and population, use of regulation and standards, developing organisational capacity and models of care. However, it is not known to what extent the current global issues in improving QoC for maternal, newborn and child health fit into the WHO framework. The objective of this study was to conduct a global situational analysis to identify the current facilitators and barriers to improving QoC for pregnant women, newborns and children with respect to the WHO’s quality improvement framework.

Simply by their presence, the interpersonal communication have the nature of societal communication norms. Large audiences have been created, that expect the media to provide continuous flow of news, entertainment, political commentary, and other types of messages. The people depend on the media for various forms of gratification based on content. If denied such communication, they will feel deprived (Berelson 1950:889). Even in relatively underdeveloped societies, population quickly develops media related habits, once mass communication becomes available in a form they understand.
Initially, the United Nations Organization (UNO) through its agency the World Health Organization (WHO) has championed the publicity and propaganda campaign for the introduction and acceptance of the modern agitations and clamoring against it.

1.2 STATEMENT OF THE PROBLEM
Although it is truism that the term “maternal health” is not unknown to many Nigerians, there is still need to clearly define the concept. So the problems this project sets out to study will focus on:

Leadership is considered to underpin the other five domains. While the framework suggests the requirement of effective leadership at all levels that is external and internal to the health system, this metareview focused only on ‘leadership’ within the healthcare system.
Information includes an information system in any shape and form (papers, checklists to computer-aided prompts) that enables service providers to deliver standard best practices and help patients and communities to manage their own health.
Patient and population engagement is described as central to quality improvement strategies because, ‘either directly or indirectly, they will be financing care, they will be working in partnership with health workers to manage their own care and they will sometimes be the final arbiter of what is acceptable and what is not across all the dimensions of quality’. etc.
Regulations and standards based on evidence of best practices are required to be adhered to in order to improve the performance of the health system. They are the means for checking the credibility of the healthcare system and thus are usually monitored by an agency external to the health system. These agencies could be governmental or non-governmental, but their role is to inspect and accredit the healthcare systems.
Organizational capacity is the fifth domain and ‘issues of quality within this domain apply throughout the health system’ from the organisation and structure of the healthcare system to the knowledge and capacity of the service providers. This is suggested to be the interface at which providers and users interact and directly experience QoC-related issues.

1.3 OBJECTIVE OF THE STUDY
The primary aims of this study are:

To examine the extent to which interpersonal communication helps in maternal health of expectant mothers in Owerri.
To know the ability to improve the health care of pregnant women in owerri.
To induce couples to change their behavior to expectant mothers.
To help them know more about change in their system and suggest ways of it practice.
To find out if they are really getting information (exposure) at their level of education.

1.4 RESEARCH QUESTIONS

To what extent does interpersonal communication helps in maternal health of expectant mothers in Owerri?
Can health care of pregnant women in owerri be improved through interpersonal communication?
Do couples have negative attitude towards expectant mothers?
Are they are really getting information (exposure) at their level of education?

1.5 SIGNIFICANCE OF THE STUDY
It is envisaged (imagined) that the outcome of this study will alert the parents’ population on dangers inherent in misinformation based on expectant mothers and equally contribute to existing write-ups (literature) in the area of interpersonal communication.
Also, the study will help the ministry of health in Nigeria to determine which media to employ in dissemination of pregnant mothers health care information. Above all, it is hoped that the study will further equip media practioners, communication experts and researchers to come up with a more concrete approach to covering all manners of campaigns without much ado (delay) in Nigeria.

1.6 SCOPE OF THE STUDY
The research is basically concerned with the role of interpersonal communication on maternal Health of expectant mothers in Owerri, Imo state, Nigeria. Many selected Hospitals in Owerri west, Municipals and Owerri North were used as case study.

1.7 LIMITATION OF THE STUDY
Collecting information about this particular study has not been an easy task. The most frustrating among others are;

Accessibility to hospitals; in the average situation of things, an average young woman is viewed by some parents with suspicious and skepticism.
This makes it near impossible for the researcher to get at peoples homes when he wanted to.
Finance has been seen to be a major set back the researchers encountered.
Enough time was not available for the researches.

1.8 DEFINITION OF TERMS
INTERPERSONAL COMMUNICATION: Is an exchange of information between two or more people. It is also an area of study. Communication skills are developed and may be enhanced or improved with increased knowledge and practice.
MASS MEDIA: In this context means various communication channel (especially radio, television, newspaper) through which information regarding expectant mother’s health care.
MEDIA COVERAGE: This is the reportage of expectants mothers health care through television, radio, newspaper (media).

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