Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study
Identifieur interne : 000470 ( Main/Exploration ); précédent : 000469; suivant : 000471Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study
Auteurs : Elizabeth N. Allen [Afrique du Sud] ; Melba Gomes [Suisse] ; Lucy Yevoo [Ghana] ; Omar Egesah [Kenya] ; Christine Clerk [Ghana] ; Josaphat Byamugisha [Ouganda] ; Anthony Mbonye [Ouganda] ; Edwin Were [Kenya] ; Ushma Mehta [Afrique du Sud] ; Lynn M. Atuyambe [Ouganda]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2014.
Abstract
The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome.
Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically.
Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby.
Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry shows potential to enhance their reporting of these substances at the antenatal clinic. However, more work is needed to find optimal techniques for eliciting accurate reports, especially where the detail of constituents may never be known. It will also be important to find ways of sustaining such drug exposure surveillance systems in busy antenatal clinics.
Url:
DOI: 10.1186/s12913-014-0525-1
PubMed: 25367130
PubMed Central: 4229602
Affiliations:
- Afrique du Sud, Ghana, Kenya, Ouganda, Suisse
- Région du Grand Accra
- Accra, Legon (Ghana)
- Université du Ghana
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Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome.</p>
</sec>
<sec><title>Methods</title>
<p>Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically.</p>
</sec>
<sec><title>Results</title>
<p>Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby.</p>
</sec>
<sec><title>Conclusions</title>
<p>Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry shows potential to enhance their reporting of these substances at the antenatal clinic. However, more work is needed to find optimal techniques for eliciting accurate reports, especially where the detail of constituents may never be known. It will also be important to find ways of sustaining such drug exposure surveillance systems in busy antenatal clinics.</p>
</sec>
</div>
</front>
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<author><name sortKey="Aubrun, E" uniqKey="Aubrun E">E Aubrun</name>
</author>
<author><name sortKey="Benichou, J" uniqKey="Benichou J">J Benichou</name>
</author>
<author><name sortKey="Abenhaim, L" uniqKey="Abenhaim L">L Abenhaim</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gallo, M" uniqKey="Gallo M">M Gallo</name>
</author>
<author><name sortKey="Einarson, A" uniqKey="Einarson A">A Einarson</name>
</author>
<author><name sortKey="Koren, G" uniqKey="Koren G">G Koren</name>
</author>
</analytic>
</biblStruct>
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</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Ghana</li>
<li>Kenya</li>
<li>Ouganda</li>
<li>Suisse</li>
</country>
<region><li>Région du Grand Accra</li>
</region>
<settlement><li>Accra</li>
<li>Legon (Ghana)</li>
</settlement>
<orgName><li>Université du Ghana</li>
</orgName>
</list>
<tree><country name="Afrique du Sud"><noRegion><name sortKey="Allen, Elizabeth N" sort="Allen, Elizabeth N" uniqKey="Allen E" first="Elizabeth N" last="Allen">Elizabeth N. Allen</name>
</noRegion>
<name sortKey="Mehta, Ushma" sort="Mehta, Ushma" uniqKey="Mehta U" first="Ushma" last="Mehta">Ushma Mehta</name>
</country>
<country name="Suisse"><noRegion><name sortKey="Gomes, Melba" sort="Gomes, Melba" uniqKey="Gomes M" first="Melba" last="Gomes">Melba Gomes</name>
</noRegion>
</country>
<country name="Ghana"><noRegion><name sortKey="Yevoo, Lucy" sort="Yevoo, Lucy" uniqKey="Yevoo L" first="Lucy" last="Yevoo">Lucy Yevoo</name>
</noRegion>
<name sortKey="Clerk, Christine" sort="Clerk, Christine" uniqKey="Clerk C" first="Christine" last="Clerk">Christine Clerk</name>
</country>
<country name="Kenya"><noRegion><name sortKey="Egesah, Omar" sort="Egesah, Omar" uniqKey="Egesah O" first="Omar" last="Egesah">Omar Egesah</name>
</noRegion>
<name sortKey="Were, Edwin" sort="Were, Edwin" uniqKey="Were E" first="Edwin" last="Were">Edwin Were</name>
</country>
<country name="Ouganda"><noRegion><name sortKey="Byamugisha, Josaphat" sort="Byamugisha, Josaphat" uniqKey="Byamugisha J" first="Josaphat" last="Byamugisha">Josaphat Byamugisha</name>
</noRegion>
<name sortKey="Atuyambe, Lynn M" sort="Atuyambe, Lynn M" uniqKey="Atuyambe L" first="Lynn M" last="Atuyambe">Lynn M. Atuyambe</name>
<name sortKey="Mbonye, Anthony" sort="Mbonye, Anthony" uniqKey="Mbonye A" first="Anthony" last="Mbonye">Anthony Mbonye</name>
</country>
</tree>
</affiliations>
</record>
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