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Browsing Research Output by Author "0051ef06-cec7-4d63-a928-a492fd795a67"

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    Open Access
    Anticipated benefits and challenges of implementing group care in Suriname’s maternity and child care sector: a contextual analysis
    (BioMed Central, 2023-08-18) Martens, Nele; Hindori-Mohangoo, Ashna D.; Hindori, Manodj P.; Damme, Astrid V.; Beeckman, Katrien; Reis, Ria; Crone, Mathilde R.; van der Kleij, Rianne R.
    Background Suriname is a uppermiddle-income country with a relatively high prevalence of preventable pregnancy complications. Access to and usage of high-quality maternity care services are lacking. The implementation of group care (GC) may yield maternal and child health improvements. However, before introducing a complex intervention it is pivotal to develop an understanding of the local context to inform the implementation process. Methods A context analysis was conducted to identify local needs toward maternity and postnatal care services, and to assess contextual factor relevant to implementability of GC. During a Rapid Qualitative Inquiry, 63 online and face-to-face semi-structured interviews were held with parents, community members, on-and off-site healthcare professionals, policy makers, and one focus group with parents was conducted. Audio recordings were transcribed in verbatim and analysed using thematic analysis and Framework Method. The Consolidated Framework for Implementation Research served as a base for the coding tree, which was complemented with inductively derived codes. Results Ten themes related to implementability, one theme related to sustainability, and seven themes related to reaching and participation of the target population in GC were identified. Factors related to health care professionals (e.g., workload, compatibility, ownership, role clarity), to GC, to recipients and to planning impact the implementability of GC, while sustainability is in particular hampered by sparse financial and human resources. Reach affects both implementability and sustainability. Yet, outer setting and attitudinal barriers of health professionals will likely affect reach. Conclusions Multi-layered contextual factors impact not only implementability and sustainability of GC, but also reach of parents. We advise future researchers and implementors of GC to investigate not only determinants for implementability and sustainability, but also those factors that may hamper, or facilitate up-take. Practical, attitudinal and cultural barriers to GC participation need to be examined. Themes identified in this study will inspire the development of adaptations and implementation strategies at a later stage.
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    Open Access
    Child mental health in Sierra Leone: a survey and exploratory qualitative study
    (2016) Yoder, Hélène N C; Tol, Wietse A; Reis, Ria; de Jong, Joop T V M
    Abstract Background This study complements the growing amount of research on the psychosocial impact of war on children in Sierra Leone by examining local perceptions of child mental health, formal and informal care systems, help-seeking behaviour and stigma. Methods The study combined: (1) a nationwide survey of mental health care providers, with (2) exploratory qualitative research among service users and providers and other stakeholders concerned with child and adolescent mental health, with a particular emphasis on local explanations and stigma. Results Formal mental health care services are extremely limited resulting in an estimated treatment gap of over 99.8 %. Local explanations of child mental health problems in Sierra Leone are commonly spiritual or supernatural in nature, and associated with help-seeking from traditional healers or religious institutions. There is a considerable amount of stigma related to mental disorders, which affects children, their caregivers and service providers, and may lead to discrimination and abuse. Conclusions Child and Adolescent Mental Health (CAMH) care development in Sierra Leone should cater to the long-term structural effects of war-violence and an Ebola epidemic. Priorities for development include: (1) the strengthening of legal structures and the development of relevant policies that strengthen the health system and specifically include children and adolescents, (2) a clearer local distinction between children with psychiatric, neurological, developmental or psychosocial problems and subsequent channelling into appropriate services (3) supplementary CAMH training for a range of professionals working with children across various sectors, (4) specialist training in CAMH, (5) integration of CAMH care into primary health care, education and the social welfare system, (6) further research on local explanations of child mental disorders and the effect they have on the well-being of the child, and (7) a careful consideration of the role of religious healers as care providers.
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    Open Access
    Understanding deprescribing of preventive cardiovascular medication: a Q-methodology study in patients
    (2017) Luymes, Clare H; Boelhouwer, Nelleke J; Poortvliet, Rosalinde K E; de Ruijter, Wouter; Reis, Ria; Numans, Mattijs E
    Patients with low cardiovascular disease (CVD) risk potentially use preventive cardiovascular medication unnecessarily. Our aim was to identify various viewpoints and beliefs concerning the preventive CVD management of patients with low CVD risk using preventive cardiovascular medication. Furthermore, we investigated whether certain viewpoints were related to a preference for deprescription or the continuation of preventive cardiovascular medication.
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    Unravelling the factors decisive to the implementation of EPODE-derived community approaches targeting childhood obesity: a longitudinal, multiple case study
    (2016) van der Kleij, Maria Rianne; Crone, Mathilde; Reis, Ria; Paulussen, Theo
    Abstract Background Implementation of intersectoral community approaches often fails due to a translational gap between the approach as intended and the approach as implemented in practice. Knowledge about the implementation determinants of such approaches is needed to facilitate future implementation processes. Methods The implementation of five EPODE-derived intersectoral community approaches was studied longitudinally. Semi-structured interviews were held with 189 community stakeholders from four sectors to elucidate which determinants influenced implementation, and if an to which extent determinants differed across communities, sectors and over time. A framework approach was used to analyze our data. Results Twenty-two key determinants of implementation were identified. Facilitators named were mostly proximal (stakeholder level), and barriers were mostly distal (context level). Key determinants varied greatly across sectors and over time, especially between the educational & health care sector and the private, welfare & sports sector. Only ‘perceived importance of IACO goals’ was identified as an universal implementation facilitator. Conclusions Striking differences in determinants were found across sectors and over time. Also, stakeholders expressed that possibilities to adapt the approach to the local context were needed to improve implementation. We therefore propose to develop sector- and time specific leads for implementation, which should be approved and amended (over time) by stakeholders. This so-called ‘mutual adaptation’ allows for the use of both scientific insights and practice-based knowledge, enabling program management and community stakeholders to collaboratively improve their implementation efforts.