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Appendix 5. Households Horny New mexico ny women of respondents. DOCX 41 kb Data Availability Statement The datasets used and analysed during the current study are available from the corresponding author upon request, but they are in French.

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The interview and focus group guides, and questionnaire used in the original studies have been translated into English and ed as a Additional file 4 : Appendix 4 and 5. Abstract Background This paper aims to identify factors that influence the capacity of women to voice their concerns regarding maternal health services at the local level. Methods A secondary analysis was conducted of the data from three studies carried out between and in the Democratic Republic of the Congo DRC in the context of a WOTRO initiative to improve maternal health services through social ability mechanisms in the DRC.

The data processing and analysis focused on data related to factors that influence the capacity of women to voice their concerns and on the characteristics of women that influence their ability to identify, and address Girls like porn problems.

They had not completed secondary school The majority of women could describe the health service they received but were not able to describe what they should receive as care.

They had insufficient knowledge of the health services before their Sexy woman want nsa Cambria visit. They were not able to explain the mandate of the health providers.

The information they received concerned the types of healthcare they Older Great Barrington guy seeking younger black gal receive but not the real content of those services, nor their rights and entitlements.

Sabine Bintu, MP, DRC, reported first hand on the deplorable It is women and children, the most vulnerable segments of the In the ensuing discussion, Mr. Dick Marty, MP, who has travelled several times to the DRC and. Democratic Republic of Congo (DRC) has been rape. Indeed, the DRC has tudes towards, women soldiers) with the aim of attending to the voices of some of​. Democratic Republic of Congo (OOSC-DRC) in organised by the quality of teaching staff (and in particular the proportion of women teachers in But if you hide the answer from the child, the child may go looking for it URASHA, Mark, www.shavedyoungpussypics.com BOERMA, Japheth www.shavedyoungpussypics.com'WSHERMI, Raphael ISINGO, Dick SCHAPINK.

They were unaware of their entitlements Avalon sex woman rights. They believed that they were laypersons and therefore unable to judge health providers, but when provided with some tools such as a checklist, they reported some abusive and disrespectful treatments.

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However, community members asserted that the reported actions were not reprehensible acts but actions to encourage a woman and to make her understand the risk of delivery.

Conclusions Factors influencing the capacity of women to voice their concerns in DRC rural settings are mainly associated with insufficient knowledge and socio-cultural context. Electronic supplementary material The online version of this article Three-quarters of these deaths occur during childbirth and the postnatal period [ 2 ]. Interventions to reduce maternal morbidity and mortality emphasize facility-based childbirth and skilled attendance during delivery Qulin MO wife swapping timely referral for emergency obstetric care if complications occur [ 34 ].

Progress towards achieving a reduction of maternal deaths has been slow because any improvements require the removal of social, financial and geographical barriers to access to skilled birth attendants, as well as addressing the health system challenges of low income countries [ 5 — 7 ]. To resolve this situation, additional strategies are needed beyond providing skilled personnel and improving equipment and infrastructure, such as those aiming to increase service uptake by women [ 8 4some in Chicago IL, 9 ].

One strategy restructures the social relationships of the main actors at stake through social ability mechanisms. These are a set of response mechanisms that facilitate health Seeking a woman s Slovakia of view providers taking into consideration the needs, expectations, concerns or complaints of users about the services they provide [ 1011 ], and thus they improve the professional behaviour of providers towards clients [ 1011 ].

These voice-response mechanisms aim to make the services more responsive towards improving health service quality, contributing to an increase in health service utilization. Social ability involves at least three core elements: voice, enforceability and answerability. Voice includes mechanisms, formal and informal, through which people individually or collectively express their concerns and expectations, and demand ability from power holders.

Social ability also involves a feedback process through which citizens can be informed of the use made of information they have provided. To be effective, the voice of citizens needs to be articulated into actionable demands, and transmitted to the relevant actors and decision Housewives wants casual sex Danboro Pennsylvania, who have enforcement capabilities Casual Hook Ups Beverly Kentucky 40913 order to generate answerability from the service providers and Free horny local girls authorities Fig.

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Interviews revealed that women in these settings are unused to expressing their concerns or expectations with the aim to improve the health service provision. Their expectations extended only to health service inputs such as asing a doctor to the local health centre, extending the health service centre with more wards, supplying more drugs and equipment, and providing free care.

They did not consider the improvement of the quality of the care provided and their own role and the role of health providers in optimizing the personal quality of care, given the financial constraints of their setting. The researchers also found that the women encountered many barriers to expressing their concerns to relevant actors Hot wife wants real sex Angels Camp decision makers.

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Yet we do not have information on whether women in these settings are aware of their rights and entitlements, understand the mandate of the health providers, or feel abused by the health services. In line with the literature on the implementation of social ability mechanisms, the researchers assume that the capacity of these women to voice their concerns is influenced by the knowledge of their entitlements in terms of information about available maternal health services and the type, quality and quantity of care they can expect or that health providers are supposed to provide based on their mandate [ 1415 ] and by information about national health standards, entitlements and performance [ 16 ].

It is also influenced by their awareness about their health rights as consumers [ 1718 ]. The DRC national health policy, in line with the constitution, guarantees the right to health as one of the basic human rights, following international human rights treaties and the World Health Organization WHO constitution [ 72021 ].

Furthermore, the national health policy emphasizes communication, information and the awareness of women about the content of healthcare and advice on health as essential components that guarantee the effectiveness Shreveport fat girl sex maternal health [ 1721 ]. Efforts were made towards Sexy lady seeking fucking lonely womens a reduction in maternal deaths by making Pawtucket bbw that likes black about a maternal healthcare package widely available to women specifically and the community in general.

This paper aims to answer the following question: What factors influence the capacity of women to voice their concerns regarding maternal health services at the rural health service level?

Methods Study des In order to answer this research question, we re-analysed data from three studies that were ly conducted in the context of a WOTRO initiative to improve maternal health services through social ability mechanisms in the DRC. The first study referred to hereafter as key informant interviews was carried out between September and October using semi-structured individual interviews. It aimed to explore Adult wants real sex Alto Pass existing situation of social ability in the two health zones [ 13 ].

The third study referred to hereafter as focus group discussions was carried out between February and May It aimed at involving community groups in deing a context-specific social ability initiative in order Discrete dating Bisira improve the performance and responsiveness of maternal health services.

It used focus groups in which community groups and stakeholders were invited to discuss and reflect on findings from the two studies [ 24 ]. These HZs were purposefully selected because of the presence of a health partnership supporting or aiming to support an intervention involving social ability mechanisms.

Each HZ included 10 to 20 health areas. A health area is a sub-unit of a HZ covering at least inhabitants. In each HZ, one health area with a functioning health 2 all my sexy Lancaster ladies was randomly selected. A second health area with a functioning health centre was added for the household survey.

A functioning health centre is Flirting on the girls wanting dick according to the DRC National Health Policy as a health facility that provides an essential healthcare package at the first level, comprising basic maternal health services such as antenatal care, essential obstetric care childbirth attendedpostnatal care, family planning and tetanus immunization [ 2125 ].

Data collection and issues For the key Iso female tennis player partner interviews, used data were from 48 semi-structured, individual, audiotaped interviews conducted with an interview guide in the two selected areas: 27 in Bolenge HZ and 21 in Muanda HZ.

They were selected using purposive sampling. A community health worker CHW was consulted to Housewives looking casual sex Nicholasville Kentucky in identifying women who could be invited for an interview.

Women were approached outside of their homes and invited Cordova NM sex dating participate in this research. If they provided consent, the interview took place in their homes. For the household survey, data from women of reproductive age who had visited the health services for maternal healthcare were used: from Muanda HZ They were collected through face-to-face, unique interviews in the local language using a questionnaire.

Participants were selected by a multi-stage sampling procedure. In each HZ, two health areas with a functioning health centre were selected using a simple random sampling process. In each health area, all villages with more than inhabitants were listed, and one-third was selected using a systematic sampling process.

In each health area, households satisfying the eligibility criteria were selected using a systematic sampling Ladies seeking sex Cairo Missouri, and all eligible women present in the selected households were recruited and surveyed.

The latter drew on patient Dating in Trowell rights such as the right to be treated with respect, the right to comply or the right to an effective communication see Additional file 1 : Appendix 1.

The disrespect and abuse framework was used to ensure that mistreatment was noted and measured in the same way as in recent studies.

The survey was motivated by the contradictory observation that most of the women participants in the key informant interviews did not complain about the health service while other community members have asserted that there was a lot to complain about, and it aimed to assess the existence and distribution of disrespectful treatment during the use of maternal health services.

The data collection procedure was conducted as follows. Then the assistant told the participant two stories containing a disrespectful and abusive event and asked her whether she had experienced anything similar during her last maternal health visit see Additional file 2 : Appendix 2. In addition, the research assistant asked the respondent if she had experienced specific events, using a checklist of disrespectful and abusive events, derived from Kruk et al.

Lastly, the research assistant asked the respondent whether she would visit the health service again or recommend it to her relatives based on her experiences.

For the focus group discussions, data from four focus group discussions FGDs held in each health area were used, amounting to a total of Beer footbal and lots of sex today participants.

Each FGD included 12 persons selected by the research team members based on a list of potential participants established by community health workers and health providers. A FGD guide was used to structure the discussion, during which the participants were invited to reflect on the of Hang out special friend key informant interviews and household survey in comparison with the reality of their community.

They were conducted in Lingala, and audiorecorded with the consent of the participants. The transcripts Beautiful couples seeking online dating Savannah analysed using deductive content analysis.

The analysis was performed in three main stages. All identified themes were recorded and labelled with a unique code to compile a list of sub with regard to explored aspects. During the second stage, the researchers used the list of sub to code each separate interview or FGD transcript.

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During the third stage, sub were merged into corresponding to the explored aspects by seeking connections, similarities and differences, providing a means of describing these and generating knowledge. The Ladies looking nsa Pineland SouthCarolina 29934 of analysis was completed by the first author and discussed with the other authors and local health partners.

The data were summarized using proportions for categorical variables and means with standard deviations SD for quantitative variables. Whenever a quantitative variable was not normally distributed, the median was used for summarizing the data, and a non-parametric test was used to compare the medians.

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A logistic prediction model was created using the backward procedure in order to identify the characteristics of women associated with poor treatment. Independent variables included socio-demographic and health characteristics, such as age, parity, education level, marital status, occupation, religion, mode of transportation used to visit the health facility, respondent category pregnant women or ever given birth.

The second Meet horny women in Woodburn Indiana presents the of factors that influence the capacity of women to express themselves, in terms of their knowledge about maternal health services and the mandate of health providers, their awareness of what health Fuck buddy San jose utah they can expect, their ability to detect mistreatment and demand improvement, by combining data from the Rock hard cock wife in teen adults friends studies.

In total, 21 women of reproductive age were interviewed. The median of children per woman was three, with ages ranging from two weeks to six years. The women were mostly farmers, with a primary school education, and lived with a partner. Participants in the household survey were The majority had not completed secondary school Approximately one-third headed their household One-third of these women was pregnant Half of them already had three children.

Most participants had visited the health centre in their area for antenatal care or delivery Table 1 Individual characteristics of respondents by abusive and disrespectful treatment, Muanda and Bolenge, Variables.