Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Cote d'Ivoire.
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Aboriginal maternal and infant care workers: partners in caring for Aboriginal mothers and babies.
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INTRODUCTION: Aboriginal Maternal and Infant Care (AMIC) workers and midwives work in intellectual and inter-cultural partnerships in a new perinatal care model the Anangu Bibi Family Birthing Program that aims to provide culturally focussed perinatal care for Aboriginal mothers and families at two sites in regional South Australia. This study investigated the views of the AMIC workers and midwives about their roles, their partnership and the program, following the first 45 births. METHODS: Semi-structured interviews with all five AMIC workers and four of the five midwives working in the program were conducted. Tapes were transcribed and main themes extracted. RESULTS: The AMIC workers' role included clinical, cultural, social and aspects from the confirmation of pregnancy through to 6-8 weeks after the birth. Themes relating to their work role included: clinical work; social and emotional support; language and advocacy for the partnership: mutually equivalent roles and for the program: clinical benefits and cultural safety. The midwives' role included clinical practice, skill-sharing and mentoring. Midwives were guided by AMIC workers' social, cultural and community knowledge. Themes that emerged for the midwives on the partnership were: time and commitment to working inter-culturally; issues with the new AMIC worker role; clinical skill sharing and mentoring; resistance of some hospital midwives; respect for AMIC workers' cultural knowledge and community links; and two-way learning. Themes of perceived benefit were: increased use of services and cultural benefits. CONCLUSIONS: The study provides a snapshot of a living, developing, inter-cultural partnership established to tackle the vitally important issue of Aboriginal mothers' and babies' health. Development of the partnership took commitment and time. There were issues initially with resistance from hospital staff. Skill sharing and two-way learning engendered mutual respect. Clear benefits of the care model were highlighted by both the AMIC workers and midwives while cultural safety was maintained for the Aboriginal mothers and families. The AMIC worker role will continue to require acknowledgement, support and development. This equivalent inter-cultural partnership model has the potential for much wider application and evaluation. Future programs should factor in the time required to build and sustain partnership relationships. (+info)
Residential therapeutic communities for female substance abusers.
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Therapeutic communities provide a unique model for the needs of chemically dependent mothers who are pregnant or of child bearing age. These programs have been treating female addicts, many of whom reflect the profile and needs of the current generation of addicted mothers in clinical problems, social disadvantages, and poor socialization. Specific issues of their recovery can be most efficiently addressed in a residential community that provides housing and a comprehensive approach including medical, social, psychological care, parental training, and child care. Most evident is that these women need a lifestyle change, an opportunity for maturation. In this regard, the therapeutic community offers the essential element of community as a setting for learning right living. (+info)
Evaluation of community-based health projects: the healthy tomorrows experience.
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