Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study
2. Materials and Methods
2.1. Study Setting
2.2. Interview Format
2.3. Data Collection
2.4. Study Population
2.5. Data Analysis
2.6. Ethical Considerations
3.1. Perceived Health of IDP Mothers and Children
3.3. Breastfeeding Practices
3.5. Access to Health Care Services in Home Towns
3.6. Registration at Health Care Centres in the Place of Displacement
3.7. Quality of Health Care
3.8. Attitudes of the Host Population in Health Care Organizations
3.9. Household Income Status
3.10. Financial Coping Strategies
Conflicts of Interest
Appendix A. Interview Guide
- Place of origin;
- Current location;
- When did you give birth?
- Previous and current occupation;
- Please, tell about your family composition. Who do you live with now? Do you have dependents (other children, older relatives)?
- What was the main reason for leaving your home?
- Can you describe your displacement experience? Which journey did you undertake to the current place of living? How did you choose the current place of living?
- Please, describe where do you live now? How would you describe you living conditions?
- On a scale from 0 to 100, can you estimate your current wellbeing, after displacement?
- On a scale from 0 to 100, can you estimate the current wellbeing of your younger child after displacement?
- If you or your child have or used to have any problems with health during or due to the displacement, which health problems were those?
- Have you used health services in your current location and for which purposes?
- What do you think about the quality of health care received in the new place of living?
- in the maternity hospital (when giving a birth);
- in the health care center where you are registered now, and from where you get pediatric and maternal health services (after childbirth till now).
- Could you describe how well have you been treated there? Can you recall any unpleasant situation related to your IDP status in receiving health care services (e.g., unfair/rude treatment, enquiry for bribes, and denial of health care services provision)?
- In your opinion, what is needed to improve availability and quality of services for IDP women and children?
- In your new place of living, how did you know about a health care center to visit? Is it easily accessible in terms of distance? How easy is that to get appointment with a health care specialist when needed? How affordable are the health services for you in terms of money?
- Before, during, and after pregnancy, have you received enough attention from medical personnel in your new place of living once at the facility? Have you made 4 obligatory visits to an MD before childbirth? Have you received follow-up visits of therapists (e.g., midwives) after childbirth?
- Where did you give birth (hospital, home or else)? How/why did you select this location? If it was in the hospital, how long have you been staying there after childbirth?
- Has your child been vaccinated? Which vaccines has your child received?
- In your new place of living, do you feel that you have been treated well in the hospital?
- How do you store and cook your food? Do you have enough utensils to cook?
- Did you breastfeed your child? If yes, for how long? Did you have an immediate contact with your child after childbirth?? If you breastfed, when did you start to change exclusive breastfeeding to the introduction of solid, semi-solid, or soft foods?
- Have you received advice on how to breastfeed from your medical specialist (midwife or other)?
- Could you describe your weekly ration during and after your pregnancy? If semi-solid and solid foods are already introduced, could you describe weekly ration of your child?
- Could you please describe your sources of income?
- Have you been registered for maternal leave payment (explanation: the lump-sum allowance paid once and keeping the workplace)? If yes, did you manage to obtain this sum, and how long the application process takes?
- Generally, do you receive any financial support from the government? If yes, which amount?
- Do you receive enough help for caring for a child from your partner/husband/family? If not enough care is received, which are the reasons (cultural norms/conflict/displacement)
- From a financial perspective, does your current economic status allow you to purchase:
- groceries for you and your child (sufficient amount and quality)?
- required medications for you and your child?
- required health care services and procedures?
- other goods for your child (hygiene-related, toys, etc.)
- Are there any other issues that you think of, related to this?
- If you do not meet basic needs for yourself and your children, how do you manage the situation?
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|Variable Name||Outcome||Number of Participants|
|Place of origin||Donetsk city and region||6|
|Luhansk city and region||3|
|Place of displacement *||Kyiv (the capital)||2|
|Eastern Ukraine (adjacent regions)||2|
|Mother age (year)||below 30||2|
|Mother occupation status||Currently employed||3|
|Presence of other dependents (older children, older relatives)||Yes||5|
|Number of children||1||4|
|The financial support is provided by a husband/father of a child||Yes||6|
|Variable Name||Outcome||Number of Participants|
|Perceived physical health *||good||7|
|Perceived mental health||remained stable||3|
|severely deteriorated (reported depression, anxiety)||2|
|Mother’s assessment of child health||good||9|
|Reported mistreatment in health care centers due to IDP status||yes||3|
|Dietary intake **||sufficient||2|
|Household income ***||poor||5|
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Nidzvetska, S.; Rodriguez-Llanes, J.M.; Aujoulat, I.; Gil Cuesta, J.; Tappis, H.; Van Loenhout, J.A.F.; Guha-Sapir, D. Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study. Int. J. Environ. Res. Public Health 2017, 14, 54. https://doi.org/10.3390/ijerph14010054
Nidzvetska S, Rodriguez-Llanes JM, Aujoulat I, Gil Cuesta J, Tappis H, Van Loenhout JAF, Guha-Sapir D. Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study. International Journal of Environmental Research and Public Health. 2017; 14(1):54. https://doi.org/10.3390/ijerph14010054Chicago/Turabian Style
Nidzvetska, Svitlana, Jose M. Rodriguez-Llanes, Isabelle Aujoulat, Julita Gil Cuesta, Hannah Tappis, Joris A. F. Van Loenhout, and Debarati Guha-Sapir. 2017. "Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study" International Journal of Environmental Research and Public Health 14, no. 1: 54. https://doi.org/10.3390/ijerph14010054