Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study

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dc.contributor.authorAllen, Elizabeth N
dc.contributor.authorGomes, Melba
dc.contributor.authorYevoo, Lucy
dc.contributor.authorEgesah, Omar
dc.contributor.authorClerk, Christine
dc.contributor.authorByamugisha, Josaphat
dc.contributor.authorMbonye, Anthony
dc.contributor.authorWere, Edwin
dc.contributor.authorMehta, Ushma
dc.contributor.authorAtuyambe, Lynn M
dc.date.accessioned2015-01-21T13:30:07Z
dc.date.available2015-01-21T13:30:07Z
dc.date.issued2014-10-31
dc.date.updated2015-01-15T17:54:50Z
dc.description.abstractBackground: 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. Methods: 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. Results: 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. Conclusions: 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.en_ZA
dc.identifier.apacitationAllen, E. N., Gomes, M., Yevoo, L., Egesah, O., Clerk, C., Byamugisha, J., ... Atuyambe, L. M. (2014). Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/12288en_ZA
dc.identifier.chicagocitationAllen, Elizabeth N, Melba Gomes, Lucy Yevoo, Omar Egesah, Christine Clerk, Josaphat Byamugisha, Anthony Mbonye, Edwin Were, Ushma Mehta, and Lynn M Atuyambe "Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study." <i>BMC Health Services Research</i> (2014) http://hdl.handle.net/11427/12288en_ZA
dc.identifier.citationAllen et al.: Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study. BMC Health Services Research. 2014 Oct 31;14(1):525en_ZA
dc.identifier.issn1472-6963en_ZA
dc.identifier.ris TY - Journal Article AU - Allen, Elizabeth N AU - Gomes, Melba AU - Yevoo, Lucy AU - Egesah, Omar AU - Clerk, Christine AU - Byamugisha, Josaphat AU - Mbonye, Anthony AU - Were, Edwin AU - Mehta, Ushma AU - Atuyambe, Lynn M AB - Background: 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. Methods: 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. Results: 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. Conclusions: 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. DA - 2014-10-31 DB - OpenUCT DO - 10.1186/s12913-014-0525-1 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1472-6963 T1 - Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study TI - Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study UR - http://hdl.handle.net/11427/12288 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-014-0525-1
dc.identifier.urihttp://hdl.handle.net/11427/12288
dc.identifier.urihttp://hdl.handle.net/11427/12288
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-014-0525-1
dc.identifier.vancouvercitationAllen EN, Gomes M, Yevoo L, Egesah O, Clerk C, Byamugisha J, et al. Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study. BMC Health Services Research. 2014; http://hdl.handle.net/11427/12288.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDivision of Clinical Pharmacologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderAllen et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/1472-6963
dc.titleInfluences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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