Understanding Afghan healthcare providers: A qualitative study of the culture of care in a Kabul maternity hospital
Authors: Arnold, R., Van Teijlingen, E., Ryan, K. and Holloway, I.
Journal: BJOG: An International Journal of Obstetrics and Gynaecology
Volume: 122
Issue: 2
Pages: 260-267
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.13179
Abstract:Objective To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies.
https://eprints.bournemouth.ac.uk/21587/
Source: Scopus
Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.
Authors: Arnold, R., van Teijlingen, E., Ryan, K. and Holloway, I.
Journal: BJOG
Volume: 122
Issue: 2
Pages: 260-267
eISSN: 1471-0528
DOI: 10.1111/1471-0528.13179
Abstract:OBJECTIVE: To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies. DESIGN: Qualitative ethnographic study. SETTING: A maternity hospital, Afghanistan. POPULATION: Doctors, midwives and care assistants. METHODS: Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts. MAIN OUTCOME MEASURES: The culture of care in an Afghan maternity hospital. RESULTS: A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment. CONCLUSIONS: Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability.
https://eprints.bournemouth.ac.uk/21587/
Source: PubMed
Preferred by: Edwin van Teijlingen
Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital
Authors: Arnold, R., van Teijlingen, E., Ryan, K. and Holloway, I.
Journal: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume: 122
Issue: 2
Pages: 260-267
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.13179
https://eprints.bournemouth.ac.uk/21587/
Source: Web of Science (Lite)
Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.
Authors: Arnold, R., van Teijlingen, E., Ryan, K. and Holloway, I.
Journal: BJOG : an international journal of obstetrics and gynaecology
Volume: 122
Issue: 2
Pages: 260-267
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.13179
Abstract:Objective
To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies.Design
Qualitative ethnographic study.Setting
A maternity hospital, Afghanistan.Population
Doctors, midwives and care assistants.Methods
Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts.Main outcome measures
The culture of care in an Afghan maternity hospital.Results
A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment.Conclusions
Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability.https://eprints.bournemouth.ac.uk/21587/
Source: Europe PubMed Central
Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.
Authors: Arnold, R., van Teijlingen, E., Ryan, K. and Holloway, I.
Journal: BJOG: An International Journal of Obstetrics & Gynaecology
Volume: 122
Issue: 2
Pages: 260-267
ISSN: 1471-0528
Abstract:To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies.
https://eprints.bournemouth.ac.uk/21587/
Source: BURO EPrints