Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study

BackgroundIn Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain women from attending these services have not yet been sufficiently explored. Using qualitative methods, we aimed to explore the factors that delay maternal health service utilization in eastern Ethiopia.MethodA total of 13 audio-recorded focus group discussions were conducted comprising 88 participants. We conducted separate group discussions with reproductive aged women, mothers-in-law, traditional birth attendants, husbands, and Health Extension Workers to capture their knowledge, practices, feelings, thoughts and attitudes towards maternal health service utilization. The recorded sessions were transcribed into the local language and then translated into English for analysis.ResultThe study identified a number of factors that may delay maternal health service utilization. Factors were grouped using the Three Delays model as a framework. Low level of awareness regarding need, poor involvement of husband, perceived absence of health problems, social power, community misperceptions and cultural restrictions, negative attitudes towards male midwives, acceptance of traditional birth attendants and poor social networking were Delay One factors. Lack of physical accessibility and high transportation costs were categorised as Delay Two factors for skilled birth care attendance. Perceived or experienced poor quality of care were categorised as Delay Three factors for both skilled birth and postnatal care utilization.ConclusionDespite the ongoing government measures to improve maternal health service utilization in Ethiopia, numerous factors continue to contribute to delays in service use, which in turn contribute to high maternal mortality.     

Analyzing free-text survey responses: An accessible strategy for developing patient-centered programs and program evaluation

Despite widespread availability of yoga in the Veterans Health Administration (VA), it remains unclear how to best evaluate yoga programs. This is particularly problematic for programs aimed at veterans with mental health concerns, as evaluation typically focuses narrowly upon mental health symptom severity, even though program participants may have other health-related priorities. We analyzed responses to free-text questions on 237 surveys completed by veterans with mental health concerns enrolled in a yoga program at six VA clinics in Louisiana to characterize veteran participants’ experiences with yoga. Qualitative analysis resulted in 15 domains reflecting veterans’ individual health-related values and priorities. We use results to illustrate the potential for analysis of free-text responses to reveal valuable insights into patient experiences, demonstrating how these data can inform patient-centered program evaluation. The approach we present is more accessible to those responsible for decision-making about local programs than conventional methods of analyzing qualitive evaluation data.     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

人类命运共同体的价值底蕴､文化范式与历史逻辑

推动构建人类命运共同体是新时代坚持和发展中国特色社会主义的基本方略之一,是对全球治理理念和模式的一种革新,是对人类社会发展理念的全新探索。党的十九大提出要“倡导构建人类命运共同体,促进全球治理体系变革”,这既是为全球治理贡献中国智慧与中国方案,也有利于构建具有中国特色的国际话语传播体系,有助于推动建立公正合理的国际新秩序。人类命运共同体的提出致力于全人类参与的共建、共享、共赢的价值导向,以包容互鉴的态度尊重不同文化之间的多样性与差异性,是对人类命运的历史思考,也是对当前全球化深入发展的现实回应。人类命运共同体思想承载着对人类命运的历史思辨,体现了人类对美好生活的向往与追求,成为推动人类文明进步与发展的价值引领。     

Professional quality of life of adult protective service workers

Adult Protective Services (APS) workers are exposed to substantial occupational hazards and job stress, but these stressors are underdocumented. Therefore, we sought to describe APS workers’ work environments and responses to occupational hazards and stressors, including compassion fatigue, burnout, and secondary traumatic stress. Survey data were gathered with closed-ended questionnaires administered to APS workers in an urban setting. Virtually all workers (97%) reported exposure to one or more environmental hazards in their work, and 80% reported hazard exposure in the past month. Workers also reported mixed responses to their work environment and to experiences with supervision. A sizable minority (22.7%) was at high risk for burnout, 24.6% were at risk for secondary traumatic stress, and 19.9% reported low compassion satisfaction. The results document multiple stressors in APS work. The APS partner is committed to ongoing efforts to better support its staff, and these findings can inform future efforts to enhance supervisor support and worker self-care, to minimize burnout and secondary traumatic stress.     

集体行动视角下的制度逻辑演化机制研究

通过对我国专车服务市场制度变革过程的纵向案例研究,探讨了组织场域中的集体行动如何推动制度逻辑演化的内在机制问题。研究发现：制度逻辑的演化过程主要经历了分离、冲突和共存三种状态,不同的制度逻辑的演化是由行动主体能动性策略和资源利用所构建的集体行动模式差异性驱动的。制度变革机会的涌现促使场域中的行动主体采用协调性的集体行动模式,促成了新制度逻辑的生成,并导致了新、旧两种制度逻辑的分离;在制度变革机会变得模糊的场域中,行动主体非协调的集体行动促使新、旧两种制度逻辑之间的激烈冲突;而在制度变革机会沉没的情境下,行动主体再协调性的集体行动最终促成了新、旧两种制度逻辑的共存。研究结论对我国当前复杂制度环境下新兴业态的发展以及传统业态的协同治理提供了重要的借鉴和启示。     

浅议西藏公共图书馆读者服务工作——以西藏自治区图书馆为例

文章介绍了服务在公共图书馆事业发展中的重要性,以及公共图书馆读者服务的主要内容和功能,并以西藏自治区图书馆为例,着重分析了公共图书馆读者服务工作的现状和存在的问题,最后对西藏公共图书馆如何提高读者服务工作提出了相应对策。     

第三方物流外包服务综合绩效评估模型的构建

本文根据全面性、特殊性、可比性、可操作性原则,参考评价第三方物流企业的一般评价指标的选取原则,选取了包括运力资源利用率、固定资产周转率、订单完成率、配送资源利用率等20个具有代表性的指标,详细地构建了第三方企业物流系统综合评价指标体系,并采用主成分因子分析法对企业物流系统进行了综合评价。