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Table 3 Results of thematic analysis of qualitative open-ended questions on Solar Suitcase

From: Impact of reliable light and electricity on job satisfaction among maternity health workers in Uganda: A cluster randomized trial

Themes

Codes

Representative examples from field notes

In response to the question:

Please comment more about any of the items you identified, such as one or more memorable situations when the Solar Suitcase LED lights, headlamps, phone charging ports and/or fetal Doppler were able to help you or other staff at the health facility in caring for a patient

Assist in procedures

Doppler, headlamp, overhead light

One day [the health worker] was using a fetoscope on a mother in labor and could not hear the heart beat as she has a hearing problem, but with the Doppler she was able to get the heart rate and it was normal

Midwife received a mother late about 1 month ago who was a multigravida and in second stage of delivery. Mother got a third-degree tear. [The midwife] was able to see very well while suturing with the aid of the headlamp and light from the Solar Suitcase. She praised the headlamp having a bright focused light which made the procedure to be done easily without difficulty

[The health worker] gave an episiotomy with help of the overhead light and sutured it after still using the same head light.it really helped as compared to those days when she had to hold a torch in her mouth or call the attendant to help her hold

Avoid unnecessary referral

Doppler, headlamp, suitcase

There was a time when [the health worker] failed to get the fetal heart rate of a mother who she almost referred out to hospital due to IUFD [intrauterine fetal demise]. Then she remembered the fetal Doppler which she used and it helped her get a clear fetal heart rate of the baby successfully, kept the mother with her until the mother delivered a live baby

One night the nursing assistant had a delivery after which she came and called [the health worker]that the mother had got a third-degree tear and wanted to refer the mother, so [the health worker] got the headlamp and examined closely only to realize that the tear had just extended near the anus. [The health worker was then able to repair it with the headlamp on

Midwife reported to have received a mother with retained placenta at around 01:00 h when they had just received the Solar Suitcase, and because the Solar Suitcase was providing very bright light for manual removal of the placenta to be done, she didn’t refer the patient as it was the trend when they hadn’t received the Solar Suitcase

Reduce delay in diagnose, treatment, or referral

Doppler, overhead lamp

Last month Antenatal mother came in third trimester and [the health worker] examined her with fetoscope; fetal heart was not clear, so [the health worker] used fetal Doppler to find out that fetal heart rate was 173 b/m. [The health worker] suspected fetal distress then immediately referred the mother to a bigger facility for further evaluation

One day [the health worker] had a mother he delivered well. Both the mother and the baby were transferred to postnatal ward in a good condition, but after that the cord started oozing some blood. It was only because of the solar led lights that he was able to detect it early enough and retied the cord again

Enhanced personal security

Headlamp

One night a mother came at night and [the health worker] was called from the staff quarters to come and examine the mother. [The health worker] was holding the headlamp to light the way since the staff houses are about 100 m away from the labor ward. [The health worker] saw a medium sized black snake in the grass near the path. [The health worker] called the night watchman and they killed it

Reduce stress/ create better work environment

Overhead lamp

[The facility] had a solar which was unreliable and could go off any time. Now the lights are reliable; [health workers] deliver a mother when they are relaxed. No unnecessary augmenting because [health workers]are fearing the lights to go off before mother gives birth

Increase patient satisfaction

Doppler

The fetal Doppler quickens work most especially when carrying out antenatal exams. There was a day when mothers were many but they were all worked on in a very short time and that day they were very happy

Enable mothers to stay postpartum

Overhead lamp

Solar Suitcase has been able to provide light in postnatal and labor suite now when it’s 20:00 pm. After delivery, mothers stay till morning because there is adequate lighting

Emergency communication

Phone charger

[Health workers] charged the phone to call a doctor for C-section as the facility had taken almost the whole week without power

Reduced cost

Phone charger

[The health worker] always keeps her phone fully charged because Solar Suitcase is always available. She is able to consult with a midwife if the midwife is away about patient care in maternity. Before the Solar Suitcase came, they used to take phones to a local trading center for charging and would pay money