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The Journal of Health, Population and Nutrition
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ISSN: 1606-0997 EISSN: 1606-0997
Vol. 35, No. 1, 2016, pp. 1-10
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Bioline Code: hn16024
Full paper language: English
Document type: Research Article
Document available free of charge
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The Journal of Health, Population and Nutrition, Vol. 35, No. 1, 2016, pp. 1-10
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What does quality of care mean for maternal health providers from two vulnerable states of India? Case study of Bihar and Jharkhand
Karvande, Shilpa; Sonawane, Devendra; Chavan, Sandeep & Mistry, Nerges
Abstract
Background: Quality instillation has its own challenges, facilitators and barriers in various settings. This paper focuses on
exploration of quality components related to practices, health system challenges and quality enablers from providers’
perspectives with a focus on maternal health studied through a pilot research conducted in 2012–2013 in two states of
India—Bihar and Jharkhand—with relatively poor indicators for maternal health.
Methods: Qualitative data through in-depth interviews of 49 health providers purposively selected from various cadres
of public health system in two districts each from Bihar and Jharkhand states was thematically analysed using MAXQDA
Version 10.
Results: Maternity management guidelines developed by the National Health Mission, India, were considered as a tool
to learn instillation of quality in provision of health services in various selected health facilities. Infrastructure, human
resources, equipments and materials, drugs, training capacity and health information systems were described as health
system challenges by medical and paramedical health providers. On a positive note, the study findings simultaneously
identified quality enablers such as appreciation of public-private partnerships, availability of clinical guidelines in the form
of wall posters in health facilities, efforts to translate knowledge and evidence through practice and enthusiasm towards
value of guidelines.
Conclusions: Against the backdrop of quality initiatives in the country to foster United Health Care (UHC), frontline
health providers’ perspectives about quality and safety need to be considered and utilized. The provision of adequate
health infrastructure, strong health management information system, introduction of evidence-based education and
training with supportive supervision must constitute parallel efforts.
Keywords
Healthcare quality; Maternal-child health services; Quality perspectives
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