Table 5.
Interview themes, categories and definitions
| Themes | Categories | Definitions |
|---|---|---|
|
Development of national maternal health guidelines |
· Development Process | · the steps taken to develop and produce guidelines |
| · Stakeholder participation | · level of involvement of stakeholders in guideline development | |
| · National guidelines' relation to WHO recommendations | · how contents of national CPGs compare with WHO PCPNC guidelines | |
| Health workers' access to guidelines | Perceived access barriers | |
| · Distribution | · physical distribution of printed guidelines | |
| · Staff mobility | · frequent changes of work-place displaces guidelines from health facilities | |
| · Health workers' participation in training courses | · course curricula frequently used as CPGs, health workers dependent on courses to obtain up-to-date guidelines | |
| Perceived solutions to improve access: | ||
| · Pocket sized guidelines | · personal portable guidelines for every health worker | |
| · Wall posters | · guidelines in a poster format increases availability for everybody working in the health facility | |
| Health workers' use of guidelines | · Low levels of guideline adherence | · perception among key informants of an overall low use of guidelines by front-line health workers |
| Perceived reasons for low guideline adherence: | ||
| · Attitudes towards continuing education | · health workers do not usually update their knowledge independently from organised training | |
| · Effects of training | · limited change in clinical practice following courses | |
| · Format of guidelines - lack of usability | · presence of flow-charts, algorithms etc. | |
| · Negative beliefs about using guidelines during patient consultations | · perception that patients' trust will be undermined if health workers use CPGs during consultations | |