- Educational Research
- Obesity Research
- Clinical Research
- Mental Health
- Women’s Health
- Implementation Research
Qualitative Impact Evaluation for Health-Results Based Financing in Maternal and Child Health in Rural and Peri-Urban Zambia
The World Bank, 2011 – 2014
Brijnath, B, Friedman, J, Das, A, Sachingongu, N
The World Bank is assisting the Ministry of Health, Government of Zambia in implementing Health Results-Based Financing (HRBF) pilot programs to improve maternal and child health outcomes (Millennium Development Goals 4 and 5). Unfortunately the number of pregnant women and children seeking care at health facilities remains low in rural parts of Zambia and the majority of deliveries take place at home without skilled birth attendants. This results in high maternal and infant mortality. The goal of the HRBF pilot is to increase service utilization at sufficiently staffed and equipped facilities. Higher rates of health service utilization are associated with better maternal and child health outcomes. HRBF seeks to incentivize health workers to find, educate and promote good health practices amongst hard to reach populations and to incentivize women to seek appropriate health care. This pilot is part of the Government’s efforts to determine the most effective policy approach to improve maternal and child health outcomes with the ultimate aim of roll-out on a national scale.
To determine the impact of the Zambia HRBF an Impact Evaluation (IE) will be undertaken. The impact evaluation will generate valuable evidence to determine whether and how HRBF improves maternal and child health outcomes. The evaluation uses an experimental design and utilises qualitative and quantitative methods. This evaluation is concerned with the qualitative arm of the project.
The health effects of sexual violence for young Australian Women
Monash Faculty of Medicine Strategic Grant ($15,000)
A/Prof Jan Coles, Prof Danielle Mazza, Prof Jill Astbury, A/Prof Angela Taft (Latrobe University), Dr Deborah Loxton (University of Newcastle).
Violence accounts for the greatest burden of disease for women aged 18-44 in Victoria but the impact of sexual violence needs addressing because it is less well understood. Health care professionals have difficulties identifying and responding to violence. Sexual violence is particularly problematic because of the stigma and shame associated with it and the difficulties associated with making enquiries about such a sensitive topic. Better understanding the health impacts of sexual violence on Australian women and how Australian women present to services could assist health professionals to better identify and respond to the needs of women who have been sexually abused. This study will document the reproductive, mental and physical health impacts of sexual violence (including child sexual abuse) in Australian Women across time using data from Australian Longitudinal Study on Women’s Health (WHA) younger cohort (1996-2006). It will provide insights into the impact of sexual violence on young Australian women’s reproductive and mental health and healthcare service usage and inform professional education and service development.
Informing the development of a new model of care to improve the fertility-awareness of sub-fertile women in primary health care
Royal Australian College of General Practitioners, Family Medical Care, Education and Research Grant ($9,994.00) 2011
Mazza D, Hampton K
Observational studies have shown that accurately timed intercourse within the fertile window of the menstrual cycle reduces time-to-pregnancy and helps avoid unnecessary assisted fertility treatment. However, an intervention that aims to improve the fertility-awareness of these women in primary health care has not been developed. This qualitative study of general practitioners and practices nurses seeks to:
1. Explore and document the views of general practitioners and practice nurses about the optimum way to deliver fertility-awareness education to sub-fertile women in the general practice setting (e.g. effective ways to communicate with sub-fertile women; importance of the fertility window and planned timed sexual intercourse etc.)
2. Identify the key components of the new model of care (e.g. educational resources; who should deliver the education; time and resources)
3. Identify the barriers and enablers to implementing fertility-awareness education in the general practice setting
It builds on our previous studies including fertility-awareness surveys of infertile women and women attending general practice, and a review of current primary health care guideline recommendations for infertile couples and our current studies involving national surveys of general practitioners and practice nurses to determine their knowledge, attitudes and practices towards fertility-awareness education of sub-fertile couples.
Improving the Delivery and Uptake of HPV Vaccination in the General Practice Setting
Sponsored by GlaxoSmithKline Australia Pty Ltd ($124,000) 2010-2011
Mazza D, Petrovic K
This study is among the first research studies investigating GPs’ awareness, knowledge, attitudes and current practices regarding HPV vaccination in women aged above 26 years. The results of a clinical audit of GP practices revealed that once a HPV vaccination course is undertaken, there is an acceptable standard (over 90%) of immunisation of women in the 27 to 45 year age group, however, on the whole there is a relatively low level of HPV vaccine uptake in women of this age. A qualitative study of GP perceptions revealed a number of barriers to vaccine uptake, including insufficient research, low perceptions of HPV risk in this patient group, lack of patient interest and awareness, and time constraints within consultations. This study is an important step in the investigation of HPV-related knowledge, attitudes and practices of Australian GPs, particularly with respect to the older age group of eligible women who fell outside of the National HPV Immunisation Program.