Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study
Abstract Background India contributes the highest share of under-five and neonatal deaths and stillbirths globally. Diagnostic autopsy, although useful for cause of death identification, have limited acceptance. Minimally invasive tissue sampling (MITS) is an alternative to autopsy for identificatio...
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doaj-710236f43bc346f9a122b35bbda67e982020-11-25T02:53:11ZengBMCBMC Health Services Research1472-69632020-09-012011910.1186/s12913-020-05693-6Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative studyManoja Kumar Das0Narendra Kumar Arora1Reeta Rasaily2Gurkirat Kaur3Prikanksha Malik4Mahisha Kumari5Shipra Joshi6Harish Chellani7Harsha Gaekwad8Pradeep Debata9K. R. Meena10The INCLEN Trust InternationalThe INCLEN Trust InternationalDivision of Reproductive Biology Maternal and Child Health, Indian Council of Medical ResearchThe INCLEN Trust InternationalThe INCLEN Trust InternationalThe INCLEN Trust InternationalThe INCLEN Trust InternationalDepartment of Pediatrics, Safdarjung Hospital and Vardhman Mahavir Medical CollegeDepartment of Obstetrics and Gynaecology, Safdarjung Hospital and Vardhman Mahavir Medical CollegeDepartment of Pediatrics, Safdarjung Hospital and Vardhman Mahavir Medical CollegeDepartment of Pediatrics, Safdarjung Hospital and Vardhman Mahavir Medical CollegeAbstract Background India contributes the highest share of under-five and neonatal deaths and stillbirths globally. Diagnostic autopsy, although useful for cause of death identification, have limited acceptance. Minimally invasive tissue sampling (MITS) is an alternative to autopsy for identification of the cause of death (CoD). A formative research linked to pilot MITS implementation was conducted to document the perceptions and attitudes of the healthcare professionals and the barriers for implementation. Methods This exploratory qualitative study conducted at a tertiary care hospital in New Delhi, India included the hospital staffs. In-depth interviews were conducted with the doctors, nurses and support staffs from pediatrics, neonatology, obstetrics and forensic medicine departments. Inductive data analysis was done to identify the emerging themes and codes. Results A total of 26 interviews (doctors, n = 10; nurses, n = 9 and support staffs, n = 7) were conducted. Almost all professional and support staffs were positive about the MITS and its advantage for CoD identification including co-existing and underlying illnesses. Some opined conduct of MITS for the cases without clear diagnosis. All participants perceived that MITS would be acceptable for parents due to the non-disfigurement and preferred by those who had unexplained child deaths or stillbirths in past. The key factors for MITS acceptance were appropriate communication, trust building, involvement of senior doctors, and engagement of the counselor prior to deaths and training of the personnel. For implementation and sustenance of MITS, involvement of the institute authority and government stakeholders would be essential. Conclusions MITS was acceptable for the doctors, nurses and support staffs and critical for better identification of the causes of death and stillbirths. The key facilitating factors and challenges for implementing MITS at the hospital in Indian context were identified. It emphasized on appropriate skill building, counseling, system organization and buy-in from institution and health authorities for sustenance of MITS.http://link.springer.com/article/10.1186/s12913-020-05693-6Minimal invasive tissue samplingCause of deathChildNeonatesStillbirthHealthcare providers |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Manoja Kumar Das Narendra Kumar Arora Reeta Rasaily Gurkirat Kaur Prikanksha Malik Mahisha Kumari Shipra Joshi Harish Chellani Harsha Gaekwad Pradeep Debata K. R. Meena |
spellingShingle |
Manoja Kumar Das Narendra Kumar Arora Reeta Rasaily Gurkirat Kaur Prikanksha Malik Mahisha Kumari Shipra Joshi Harish Chellani Harsha Gaekwad Pradeep Debata K. R. Meena Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study BMC Health Services Research Minimal invasive tissue sampling Cause of death Child Neonates Stillbirth Healthcare providers |
author_facet |
Manoja Kumar Das Narendra Kumar Arora Reeta Rasaily Gurkirat Kaur Prikanksha Malik Mahisha Kumari Shipra Joshi Harish Chellani Harsha Gaekwad Pradeep Debata K. R. Meena |
author_sort |
Manoja Kumar Das |
title |
Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study |
title_short |
Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study |
title_full |
Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study |
title_fullStr |
Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study |
title_full_unstemmed |
Perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (MITS) to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study |
title_sort |
perceptions of the healthcare providers regarding acceptability and conduct of minimal invasive tissue sampling (mits) to identify the cause of death in under-five deaths and stillbirths in north india: a qualitative study |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2020-09-01 |
description |
Abstract Background India contributes the highest share of under-five and neonatal deaths and stillbirths globally. Diagnostic autopsy, although useful for cause of death identification, have limited acceptance. Minimally invasive tissue sampling (MITS) is an alternative to autopsy for identification of the cause of death (CoD). A formative research linked to pilot MITS implementation was conducted to document the perceptions and attitudes of the healthcare professionals and the barriers for implementation. Methods This exploratory qualitative study conducted at a tertiary care hospital in New Delhi, India included the hospital staffs. In-depth interviews were conducted with the doctors, nurses and support staffs from pediatrics, neonatology, obstetrics and forensic medicine departments. Inductive data analysis was done to identify the emerging themes and codes. Results A total of 26 interviews (doctors, n = 10; nurses, n = 9 and support staffs, n = 7) were conducted. Almost all professional and support staffs were positive about the MITS and its advantage for CoD identification including co-existing and underlying illnesses. Some opined conduct of MITS for the cases without clear diagnosis. All participants perceived that MITS would be acceptable for parents due to the non-disfigurement and preferred by those who had unexplained child deaths or stillbirths in past. The key factors for MITS acceptance were appropriate communication, trust building, involvement of senior doctors, and engagement of the counselor prior to deaths and training of the personnel. For implementation and sustenance of MITS, involvement of the institute authority and government stakeholders would be essential. Conclusions MITS was acceptable for the doctors, nurses and support staffs and critical for better identification of the causes of death and stillbirths. The key facilitating factors and challenges for implementing MITS at the hospital in Indian context were identified. It emphasized on appropriate skill building, counseling, system organization and buy-in from institution and health authorities for sustenance of MITS. |
topic |
Minimal invasive tissue sampling Cause of death Child Neonates Stillbirth Healthcare providers |
url |
http://link.springer.com/article/10.1186/s12913-020-05693-6 |
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