Open AccessKey lessons from a mixed-method evaluation of a postnatal home visit programme in the humanitarian setting of Gaza
Author(s) -
Irene de Vries,
Bassam Abu Hamad,
Margo van Gurp,
Sandra Alba,
Umaiyeh Khammash,
Pam Baatsen
Publication year - 2021
Publication title -
eastern mediterranean health journal/eastern mediterranean health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 47
eISSN - 1687-1634
pISSN - 1020-3397
DOI - 10.26719/emhj.21.005
Subject(s) - breastfeeding , thematic analysis , focus group , context (archaeology) , medicine , psychological intervention , nursing , postnatal care , qualitative property , health care , population , qualitative research , breast feeding , family medicine , environmental health , pediatrics , pregnancy , business , geography , economic growth , social science , archaeology , marketing , machine learning , sociology , biology , computer science , economics , genetics
Background: The World Health Organization recommends postnatal home visits (PNHVs) to improve maternal and newborn health. Evidence of PNHV effectiveness in humanitarian settings is limited. Aims: To evaluate PNHVs implemented in the constrained humanitarian context of Gaza. Methods: Qualitative data were obtained through key informant interviews, in-depth interviews and/or focus group discussions with women targeted by the programme, nontargeted women, husbands, and home visitors. These data were complemented by a secondary analysis of quantitative data from existing household surveys and project monitoring data. Qualitative data were analysed using thematic analysis, and quantitative data were analysed to describe trends over time. Results: Women in the programme demonstrated improved breastfeeding practices and increased uptake of breastfeeding, and behavioural changes reduced harmful traditional norms and practices. The programme increased mutual understanding and respect between health providers and women, allowed for a more personalized approach and increased self-esteem among the women. To improve postnatal care throughout the population, interventions should focus not only on home visits but also address immediate postnatal care in maternity, postnatal follow-up in clinics, and improvements in the coordination and communication between the different levels of care. Conclusion: Implementation of PNHVs in a constrained humanitarian context such as Gaza is feasible and positively contributes to breastfeeding and newborn care practices, as well as to improved interactions between health providers and their clients. Positive effects could be leveraged if postnatal care were strengthened throughout the continuum of care.