To achieve safe and respectful maternity care in tertiary level hospitals in Nepal, relatives are a valued addition to the provision of maternity care

Introduction: The White Ribbon Alliance for safe motherhood believes respectful maternity care is the universal right of every childbearing woman. Methods: NHRC in 2012 approved an inquiry of respectful care at facility-based childbirth. Individual-, focus group interviews and content analysis was used for gathering and analysis of data. Findings: The participating women and the SBAs shared similar views, and this was that together the SBAs and relatives ensured the women remained within the comfort and safety zone when giving birth in a tertiary level maternity unit. Conclusion: The SBAs strategy of having relatives provides basic care alongside the provision of medical care by the SBAs is a strategy that Nepal could use to improve the quality of its maternity care without any additional costs. Clinical implication: Prenatal classes might contribute to preparing relatives. Further Research: Further research could evaluate such a strategy in order to determine its effectiveness in reduction of morbidity and mortality.

Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

Continuous Delivery : Utmaningar ett förvaltningsuppdrag kan stå inför vid en övergång till Continuous Delivery

Continuous delivery (CD) is a software engineering approach where the focus lays on creating a short delivery cycle by automating parts of the deployment pipeline which includes build, deploy-, test and release process. CD is based on that during development should be possible to always automatically generate a release based on the source code in its current state. One of CD's many advantages is that through continuous releases it allows you to get a quick feedback loop leading to faster and more efficient implementation of new functions, at the same time fixing errors. Although CD has many advantages, there are also several challenges a maintenance management project must manage in the transition to CD. These challenges may differ depending on the maturity level for a maintenance management project and what strengths and weaknesses the project has. Our research question was: "What challenges can a maintenance management project face in transition to Continuous delivery?" The purpose of this study is to describe Continuous delivery and the challenges a maintenance management project may face during a transition to Continuous delivery. A descriptive case study has been carried out with the data collection methods of interviews and documents. A situation analysis was created based on the collected data in a shape of a process model that represent the maintenance management projects release process. The processmodel was used as the basis of SWOT analysis and analysis by Rehn et al's Maturity Model. From these analyzes we found challenges of a maintenance management project may face in the transition to CD. The challenges are about customers and the management's attitude towards a transition to CD. But the biggest challenge is about automation of the deployment pipeline steps.