# Welcoming pregnant women: introducing navigation and support services in a secondary health facility in Bangladesh

## TL;DR

This study explores the introduction of 'Welcome Persons' in a Bangladeshi hospital to support pregnant women and improve maternal health care.

## Contribution

The study introduces and evaluates a novel hospital navigation and support service for pregnant women in a secondary health facility in Bangladesh.

## Key findings

- Welcome Persons positively influenced maternal health care by ensuring timely services and emergency management.
- Challenges included lack of night shift staff, logistical constraints, and potential gender insensitivity.
- The intervention was generally accepted but requires addressing barriers for sustainability.

## Abstract

Maternal mortality remains high in low- and middle-income countries like Bangladesh, driven by preventable causes such as inadequate health care access and delays in receiving care in health facilities, highlighting the need for improved support in health facilities. This study aimed to explore the opportunities and difficulties of introducing ‘Welcome Persons’, a hospital navigation and support cadre for pregnant women, from the perspectives of recipients, patients’ attendance, health care providers, and facility managers.

This qualitative study was conducted from 15 March to 30 April 2023, in the District Hospital of Gaibandha, Bangladesh. Data were collected through purposive sampling from health care providers, facility managers, ‘Welcome Persons’, pregnant and delivered women, and their attendants, utilising observations, in-depth interviews, focus group discussions, and key informant interviews, and analytical approaches to ensure scientific rigour. Thematic analysis was performed.

The study revealed the positive influence of ‘Welcome Person’ in maternal health care provision by ensuring timely services, preventing outsiders’ interference, as well as contributing to prompt emergency management, specifically for educationally disadvantaged patients. The triangulated perspectives of the participants highlighted the overall acceptance and usefulness of the ‘Welcome Persons’ but also discovered challenges such as a lack of human resources on the night shift, logistical constraints, and potential gender insensitivity by the recipients.

The study findings provided an explicit understanding of the ‘Welcome Persons’ intervention for facilitating maternal health care services and navigation among pregnant women. While they were well-received, addressing identified barriers is crucial for a sustainable positive impact on maternal health care in secondary health facility settings in Bangladesh.