Browsing by Author "Ackers, Louise"

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    Anti-Microbial Resistance in Global Perspective
    (Springer Nature, 2020) Ackers, Louise; Gavin, Ackers-Johnson; Welsh, Joanne; Kibombo, Daniel; Opio, Samuel
    The Maternal Sepsis Intervention has had a profound impact on maternal mortality and antibiotic use whilst also reducing hospital costs. The Ministry of Health is keen to explore opportunities to extending the lessons learnt and integrate them in national policy-making.' -Dr. Richard Mugahi, Ministry of Health, Uganda. This open access book provides an accessible introduction to the mechanics of international development and global health text for policy-makers and students across a wide range of disciplines. Antimicrobial resistance is a major threat to the well-being of patients and health systems the world over. In fragile health systems so challenged, on a day-today basis, by the overwhelming burden of both infectious and non-communicable disease, it is easy to overlook the impacts of AMR. The Maternal Sepsis Intervention, focusing on a primary cause of maternal death in Uganda, demonstrates the systemic nature of AMR and the gains that can be made through improved Infection Prevention Control and direct engagement of laboratory testing in antibiotic prescribing.
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    What price a welcome? Understanding structure agency in the delivery of respectful midwifery care in Uganda
    (Emerald, 2018-03-05) Ackers, Louise; Webster, Hannah; Mugahi, Richard; Namiiro, Rachel
    Purpose The purpose of this paper is to present the findings of research on mothers and midwives’ understanding of the concept of respectful care in the Ugandan public health settings. It focusses on one aspect of respect; namely communication that is perhaps least resource-dependent. The research found endemic levels of disrespect and tries to understand the reasons behind these organisational cultures and the role that governance could play in improving respect. Design/methodology/approach The study involved a combination of in-depth qualitative interviews with mothers and midwives together with focus groups with a cohort of midwives registered for a degree. Findings The findings highlight an alarming level of verbal abuse and poor communication that both deter women from attending public health facilities and, when they have to attend, reduces their willingness to disclose information about their health status. Respect is a major factor reducing the engagement of those women unable to afford private care, with health facilities in Uganda. Research limitations/implications Access to quality care provided by skilled birth attendants (midwives) is known to be the major factor preventing improvements in maternal mortality and morbidity in low income settings. Although communication lies at the agency end of the structure-agency continuum, important aspects of governance contribute to high levels of disrespect. Originality/value Whilst there is a lot of research on the concept of respectful care in high income settings applying this to the care environment in low resource settings is highly problematic. The findings presented here generate a more contextualised analysis generating important new insights which we hope will improve the quality of care in Uganda health facilities.