Management of Maternal and Reproductive Health Program in Kwazulu
Table of contents
According to the World Health Organisation (2012, p.5), management of information management is vital to the foundation of substantially understanding the maternal and reproductive sector as per the goals of the millennium development. World Health Organisation (2012, p.5) states that the primary aim is enabling a decrease in child mortality, neonatal as well as a significant improvement in maternal health. Furthermore, they focus on the reduction of the menacing HIV/AIDS spread as well as great supporting the empowerment of women together with equality in gender World Health Organisation (2012, p.5).
It is undeniably important to have exemplary data as well as information that is statistical and disaggregated in management and even strategic planning. Pillitteri (2009, p.12) points out that enabling improvement of the processes involved in the management of information in the reproductive as well as maternal health sector enhances data interpretation as well as collection. Moreover non- governments together with governmental firms which are the main stakeholders can do data analyzing and then utilize the data in the processes of decision making (Pillitteri 2009, p.12).
The studies and research of women and their gender as a whole are focused on their high rate of reproductive health issues, as well as, the critical risks involved in maternity (Pillitteri 2009, p.15). Pillitteri (2009, p.15) mentions that maternal risks arise in preventing unwanted pregnancies, as well as complications that arise in childbirth and pregnancy processes. Lastly, infections of the reproductive tract also cause numerous complications (Pillitteri 2009, p.16).
Amongst the South African nine provinces, a significant survey and research were carried out in four of them in the year 2007. The survey results portrayed that amongst the female teenagers ranging between the ages of twelve and nineteen; 19.2% have experienced unwanted pregnancies, while male teenagers within the same age range have caused a girl’s impregnation. The research further shows that from the year 2012 there has been a drastic decrease in the utilization of condoms amongst the youth whose ages range from about fifteen to twenty-four years old, amongst the male youth the decrease is from 85.2% down to 67.5%. While on the other hand, amongst the female youth the decrease in condom usage is from 66.5% down to 49.8%.
Therefore, this study will attempt to attain substantial data on the younger aged women, particularly because they are the age group prone to the risks involved in issues of reproductive health. These risks include unregulated fertility, maternal mortality, as well as sexually transmitted diseases; especially HIV/AIDS which is a growing menace in South Africa. This information gathered will be effectively utilized in the measurement of the performance level of the material as well as the reproductive health program at Kwazulu district, in South Africa.
National Health Information (1998, p.6) defines dump data as raw as well as unprocessed data. National Health Information (1998, p.6) further describes dump data as collected information in the form of facts as well as figures which are determined from various surveys and experiments, that is utilized as the primary base when handling conclusion drawing and deriving calculations. Moreover, raw data is essential for storage after undergoing computer processing. National Health Information (1998, p.6) points out that in this particular case, data obtained from an informant, together with interviews that are semi-structured with the patients as well as staff; and discussions and utilization of focus groups.
Whereas, Alden et.al (2016,p.9) defines information as data that has been substantially organized as well as presented particularly in a fashion that is deemed organized to portray the deeper meaning that is underlying within the data. Alden et.al (2016,p.9) states that information is only obtained when raw data undergoes processing through software such as SPSS, thereafter the attained end product is essential in consideration to the district’s decision making processes.
Several methods are to be effectively used to monitor and ensure a level of information consistency, as well as to provide a thoroughly detailed and defined comprehension of the integration process particularly from the point of view of providers as well as clients (Holtz 2008, p.16). The main reason for obtaining information was to be knowledgeable of the services that are integrated, and specifically the mannerism it was carried out on, as well as the service delivery implications. Moreover, Holtz (2008,p.16) further states that the methodical inventory was to be effectively established through observation of the supplies as well as available equipment and supplies. Holtz (2008,p.16) also says that interviews were carried out interviewing a member of the senior staff in every health facility that was chosen.
World Health Organisation (2006, p.9) points out that reproductive health should not define by t just sex. Rather, World Health Organisation (2006, p.9) defines reproductive health as the state of an individual’s entire mental, physical as well as social well being; not restricted to the reproductive disease absence. World Health Organisation (2006, p.9) further explains that reproductive health consists of enlightenment of the processes involved in reproduction, as well as the system and functions of an individual’s life stages.
Therefore, establishing a well managed maternal and reproductive health program to help women from an earlier age to substantially teach values as well as help them in comprehending their bodies’ physiology as well as anatomy (Timmerman and Kruesmann 2009, p.11). Timmerman and Kruesmann ( 2009, p.11) state that, the program implemented effectively will help to continually educate and enable the younger women as well as men to experience acceptable safe fertility regulations methods, in consideration of their various choices. Furthermore, the Kwazulu district will enable women of age to efficiently access their right to quality standard appropriate healthcare services, which significantly enable them to have childbirth as well as safe pregnancy experiences.
The maternal and Reproductive Health program in Kwazulu will have a particular aim as well as objectives that will drive the program to effectively achieve its strategized goals.
• Contributing towards significant enhancements of maternal as well as reproductive health in Kwazulu district, by substantially educating and involvement of both men and women in the process of the healthcare decision-making process.
• Strengthening the district’s human resource as well as institutional resource capabilities of the major components such as the health centers, local governments, local communities, as well as the women and even men who are involved in the reproductive health sector. Thus, strive towards making significant steps towards quality growth in the reproductive as well as the maternal health sector.
- To efficiently enable a significant improvement in the accessibility of substantially quality services in the maternal as well as reproductive health facilities within the Kwazulu district.
- To significantly enable growth as well as development in strength in volumes in consideration of the change in attitude, upgrading of skills, growth in knowledge, gathering of data as well as information, dissemination and analyzing of major factors related to reproductive health i.e. women together with men, and lastly, maternal as well as needs in child health.
- To efficiently enhance and widen the disease prevention methods; particularly diseases that pose a threat to general maternal health, such as HIV/AIDS together with STDs by efficiently increasing the involvement of the entire community of Kwazulu in the activities and processes of support, care as well as prevention.
- To significantly back the government policing process, a process involved in decision making, UN SDG 3, as well as standard quality maintenance by providing thorough empirical research data together with the relevant information to enhancing reproductive and even maternal health.
- To efficiently back the agencies of; both; the local and central government, local communities, as well as the organizations that relate with the civil society to ensure assessments and the mobilization of the resources both external and local for the enhancement of the material as well as reproductive health.
At Kwazulu the reproductive and maternal health program has set particular targets. As per the WORLD HEALTH ORGANIZATION (2006, p.16), the appropriate target outputs include;
1. HIV as well as STD prevalence decrease
2. Practising contraceptive increase
4. Management of obstetrical complications increase by the healthcare staff
5. Complete maternal mortality elimination
It is important to note that a program run on measurable goals exhibits substantial potential risks (Gold and Richards 1996, p.36). According to Gold and Richards 1996, p.36), the amount of pressure that may be placed on employees with aim of achieving targets that are simple within a given period of time potentially leads to clients’ coercion as well as significant fundamental objectives distortion of fundamental objectives.
For instance, employees assigned to family planning assignments may be delegated particular targets that are method-specific targets, or even number targets in terms of recipients of all methods being offered, chances are they may be oblivious of the direct incentives that may be required to satisfy the various needs of the clients; as well as educate on the various options available. The drive to achieve assigned targets may lead them to be pervasive when it comes to incentives leading to fraud or even inappropriately aggressive methods of promotion for the contraceptives (Gold and Richards 1996, p.36).
Fonn et.al (1998, p.45) defines indicators as the markets and determinants of health status, availability of resources as well as the provision of services; which have a design to specifically enable the process of service performance monitoring and even the goals of the program (Fonn et.al 1998, p.45).
According to the World Health Organisation (2012, p.34), seventeen set indicators determine and covers the major areas in reproductive health; they are also the representation of agreement of the agencies globally.
The primary purpose of indicators is effectively having an essential overview of reproductive health issues globally as well as regionally (World Health Organisation 2012, p.34). World Health Organisation (2012, p.34) further states that the information gathered as well as reported on the indicators is highly essential in the management level of the program.
The seventeen indicators include;
- Total Fertility Rate (TFR)
Defining the total amount in numbers of children an individual woman can have from the beginning to the end of reproductive age; particularly if the woman has an experience of the present utilized fertility rates that are age-specific during her life of childbearing (World Health Organisation 2012, p.35).
2. Contraceptive Prevalence Rate (CPR)1
Defines the percentage of women population within the reproductive range age group of fifteen to forty-nine years old utilizing individual or with their significant other a particular method of contraception within a defined time length.
3. Maternal Mortality Ratio (MMR)
World Health Organisation (2012, p.35) refers to it as the deaths through maternal issues as per 100,000 live births yearly.
4. Antenatal Care Coverage
This is the percentage of women who have been attendance minimal of once pregnancy process, through the assistance of trained healthcare employees for pregnancy-related reasons; with the exclusion of birth assistance individuals who are untrained as well as trained.
5. Percent of Births Attended by Skilled Health Personnel
With the exclusion of birth assistance individuals who are untrained as well as trained, this is the percentage of the births that were under the attendance of well trained and therefore skilled healthcare employees.
6. Availability of Basic Essential Obstetric Care
World Health Organisation (2012, p.36) defines this as the total number of health facilities per half a million which function with the basic primary, standard essential obstetric care.
7. Availability of Comprehensive Essential Obstetric Care
This refers to the facilities number as per a population of half million which functions with an essential as well a relatively comprehensive obstetric care.
8. Perinatal Mortality Rate (PMR)
World Health Organisation (2012, p.36) describes this as the total number of perinatal deaths within every total of one thousand births.
9. Low Birth Weight Prevalence
This the percentage of births weighing a maximum of 2,500g that were live (World Health Organisation 2012, p.36).
10. Positive Syphilis Serology Prevalence in Pregnant Women
World Health Organisation (2012,p.36) refers to this as the percentage of the women who are pregnant, ranging between the ages of fifteen and twenty-four years old who are in antenatal clinic attendance; who have their syphilis screen and turn up positive.
11. Prevalence of Anemia in Women
This is the percentage within the population of women who are in their reproductive ages ranging from fifteen to forty-nine years old; who have had done their hemoglobin screening and turn up with 110g/l when pregnant, when not pregnant results to 120g/l (World Health Organisation 2012, p.36).
12. Percent of Obstetric and Gynecological Admissions Owing to Abortion
This describes the percentage admitted case scenarios to their service delivery time, thus effectively provides the obstetrics that is in-patient as well as gynecological services, resultant to the abortion procedures; these procedures are either induced or impromptu; however, this excludes any form of pregnancy termination that is planned(World Health Organisation 2012, p.36).
13. Reported Prevalence of Women with FGC
This refers to the percentage within the women populations that faced an interview during a planned survey in the community and have reported that they faced FGC.
14. Prevalence of Infertility in Women
According to World Health Organisation ( 2012, p.36), this is the percentage within the population of women within the defined reproductive ages of fifteen to forty-nine years old who all face the pregnancy risk and have reported their individual pregnancy trials that have lasted for a length of at least two years.
15. Reported Incidence of Urethritis in Men
World Health Organisation (2012, p.36) defines this as a percentage of the men’s population that range between the ages of fifteen to forty-nine who faced an interview in a survey that was carried out in their community who reported experiences within the previous year of urethritis.
16. HIV Prevalence among Pregnant Women
WORLD HEALTH ORGANIZATION (2012, p.36) describes this as the percentage in the population of women who are pregnant, ranging between the ages of fifteen to twenty-four years old who are in antenatal facilities attendance; who have HIV screening and turn up positive.
17. Knowledge of HIV-related Prevention Practices
This pertains to the percentage within the population of individuals who have clearly identified the three primary means of preventions from HIV through sexual transmission as well as those who rejected the three primary HIV transmission misunderstandings as well as the prevention methods(World Health Organisation 2012, p.36).
The sources of the data for the numerator and the denominator in reproduction, as well as maternal health program, includes;
- Vital Records
- Hospital Records
- Formal Surveillance Systems
- Community Identification of Deaths
The primary issues that may cause limitation in data quality as well as the data collection and information gathering process include;
Black et.al ( 2016, p.52) argue that it is critical for the quality of data quality to be strategically assessed before they are interpreted or even calculated. Black et.al (2016, p.52) emphasizes that having bias awareness that may result from the occurrence of common reporting errors in the particular surveys as well as consensus; thus more likely to affect the accuracy of their calculations.
According to Black et.al (2016, p.52), the births that have been underreporting are at a higher rate amongst the older women; as well as for the occurrence of births that have taken place a significantly long period of time back. Black et.al (2016, p.52) explains that may be seen as a minimal issue, unfortunately, this drastically affects the quality of data collected about the particular population under study.
Alden et.al (2014, p.46) points out that a major error discovered in the data survey is the issue of birth displacements. Alden et.al (2014,p.46) further state that the expected pattern is a distinctive peak within a four to nine-year period before the survey is carried out; as well as a period of five-year length trough displaying a definite decrease in the fertility rates. Moreover, census data remain exposed to the bias extreme.
Black et.al (2016, p.53) states that it is highly recommended to effectively examine all the potential misreporting possibilities of the ages of the women during the survey as well as by the census respondents.
According to Alden et.al (2014, p.46), an estimated derivation from community surveys remains exposed to the risk of significant errors in sampling. Alden et.al (2014, p.46) argue that is then critical in providing error samplings.
Glassman and Temin (2016, p.56) points out that the total fertility rate; remains the highly utilized demographic indicator. Glassman and Temin (2016, p.56) explains that it’s relatively in association with the prevalence of contraceptives; together with other reproductive health indicators; for example the ratio of maternal mortality. Thus, standing as an essential population momentum indicator; as well as an essential proxy measurement for the services of family planning failure as well as success levels. Glassman and Temin (2016, p.58) also mention that it may be utilized in the wanting physical reproductive health measurement because the parity is high and thus portrays the greater risks involved in mortality as well as morbidity.
According to Fonn et.al (1998, p.42), it is highly essential for global comparisons, as well as to effectively monitoring the trends within a longer period of time.
Furthermore, it is highly important in the reflection of the occurring fertility in the age patterns; particularly when dealing with the category classified at higher risks; for instance the older women as well as the adolescents.
For the program in Kwazulu to achieve maintenance of good and quality data it may require to implement the following steps;
- Assessment of quality
Holtz (2008, p.55) mentions that it is vital to be in substantial comprehension of the level of data quality available, to enable the determination of potential limitations.
- Integration of data
According to Holtz (2008, p.55), any firm should have a high level of insights quality, and therefore the integration of disparate data to portray a client’s perspective combines all data.
- Discovering an appropriate match
Exploration of data will have consequential interaction of systems, and thus showing how to collaborate a client’s records with more precision, accuracy, and completion.
- Management of current as well as ongoing changes
The program will require a continual assessment of data that ay path it to its potential level of success. Holtz (2008, p.55) says that with the incoming of different and new clients, address changes as well as the firm’s system change it is crucial to put in place the appropriate technology as well as process that will put this into account.
- Optimization of data
When there is the utilization of internal data only, chances are that the quality levels will be capped. Therefore, the utilization of a reference of a third-party set a company is enabled to enhance its data quality. A third party will assist through:
- Information verification
- Information enrichment
- New information accessing
- Downstream sharing of Information
To efficiently determine the quality level of your data; it is vital to pass the information attained back through the system’s source of the firm.
An action plan that will enable the monitoring work to be less time-consuming and at the same time easy to implement. The focal point would be ensuring the process produces information needed for decision making. The information gathered is a reflection of what happens not only to Kwa Zulu but the entire country will enable the government to come up with policies that would boost the health sector and narrow down to reproductive and maternal health.
In conclusion, with this information planning and tracking of reproductive health and maternal health program will be efficient and the stakeholders including the government will be able to make constructive decisions that would improve the current status of maternal and reproductive health in the Kwa Zulu district. This will be facilitated by the indicators used as it would be made it easier for making comparisons and continuous improvement in the reproductive health sector.
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