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International Journal of Community Medicine and Public Health. 2016 Oct; 3(10):2749-2756.Background: Low birth weight is one of the main contributors to very high infant and under-five mortality rates in developing countries. The study aimed to identify the predicting risk factors for LBW in Yemen. Methods: An institutional-based, cross-sectional study was conducted from September 2014 to March 2015 and September 2015 to January 2016. Study procedures have included completing a questionnaire, maternal measurement of mid upper arm circumference, testing for haemoglobin level in mothers and weighing all targeted neonates. Descriptive, cross tabling and binary logistic regression analyses were used. Results: A total of 585 mother-neonate pairs were interviewed and examined for LBW and the associated risk factors. Logistic regression analysis identified three significant independent predicting factors; maternal under-nutrition (odds ratio (OR) 11.4, 95% CI 3.8 - 35.2), maternal anemia (OR 5.3, 95% CI 1.5 - 18.6) and rural residents (OR 0.2, 95% CI 0.1 - 0.7). Conclusions: Incidence of LBW in these communities was high. Maternal under-nutrition, maternal anaemia and rural settlements were significantly associated with babies with low weight at birth. There is a need for continued focus on maternal nutrition at the time of conception and during pregnancy both for the optimum feto-maternal health and national development.
Contraceptive use as limiters and spacers among women of reproductive age in southwestern, Saudi Arabia.
Saudi Medical Journal. 2018 Nov; 39(11):1109-1115.OBJECTIVES: To examine the prevalence, socioeconomic, and demographic determinants of contraceptive use among women of reproductive age residing in Abha, Kingdom of Saudi Arabia. METHODS: The data of this study was collected through a cross sectional survey conducted on unmet need for family planning in Abha, Kingdom of Saudi Arabia, between March and May 2016. Three hundred and seventy-four married women were recruited from 6 primary health care centers by a consecutive sampling technique. Data was collected via an interviewer-administered questionnaire. Chi-square test was carried out to identify the factors associated with contraceptive use. RESULTS: The prevalence of contraceptive use rate was 58.8%. Among users, 60% were spacers and 40% were limiters. Among more than two-thirds of the women, the decision to use a family planning method was a joint decision of the couple; and 25% reported it as their own decision. Oral pills and intrauterine contraceptive device (IUCD)were the most popular methods. The most significant associated factors were age, education of women, gravida, number of living children, gender, and age of the last child. Younger age was related with the spacers and older age with birth limiting. Woman's education level showed a significant positive association with birth spacing. CONCLUSION: This study demonstrated that a sizable percentage of women in Abha, Kingdom of Saudi Arabia, are using contraceptions. This finding indicates the need of comprehensive family planning program in the region.
Auditing the appropriateness of cesarean delivery using the Robson classification among women experiencing a maternal near miss.
International Journal of Gynaecology and Obstetrics. 2018 Oct 24;OBJECTIVE: To evaluate appropriateness of cesarean delivery and cesarean delivery-related morbidity among maternal near misses (MNMs) using the Robson ten-group classification system. METHODS: In the present audit study, medical records were assessed for women who experienced MNM and underwent cesarean delivery at three university hospitals in Tehran, Iran, between March 1, 2012, and May 1, 2014. Local auditors assessed cesarean delivery indications and morbidity experienced. All records were re-assessed using Swedish obstetric guidelines. Findings were reported using the Robson ten-group classification system. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS: Of the 61 women included, cesarean deliveries were more likely to be considered appropriate by local auditors compared with Swedish ones (OR 2.7, 95% CI 1.3-5.7). Cesarean delivery-related morbidity was attributed to near-miss events for 10 (16%) MNMs and was found to have aggravated 25 (41%). Of 16 women classified as Robson group 1-4, cesarean delivery-related MNM was identified in 15 (94%), compared with 13 (43%) of 30 women in group 10. Cesarean delivery with appropriate indication was associated with very low likelihood of cesarean delivery-related MNM (OR 0.2, 95% CI 0.1-0.6). CONCLUSION: Cesarean delivery in the absence of appropriate indication could be an unsafe delivery choice. Audits using the Robson classification system facilitate understanding inappropriate cesarean delivery and its impact on maternal health. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Changes in support for the continuation of female genital mutilation/cutting and religious views on the practice in 19 countries.
Global Public Health. 2018 Nov 13; 13 p.Campaigns to end female genital mutilation/cutting (FGM/C) have been ongoing for decades. Many countries have adopted legislation that criminalises the practice and programmatic interventions aim to reduce support for it by presenting it as a violation of human rights and by highlighting associated health risks. We used Demographic and Health Survey data from 19 countries to measure national-level trends in the prevalence of FGM/C, reported support for the continuation of the practice, and the belief that it is a religious requirement among men and women. Levels and patterns in each of these outcomes vary markedly between countries. More than half of men and women born in recent years in Guinea and Mali support the continuation of the practice and believe that it is a religious requirement. Support for the continuation of FGM/C has fallen in Benin, Burkina Faso, Chad, Egypt, Ethiopia, Kenya, Senegal, and Tanzania, but has risen in Guinea, Niger, Nigeria, and Sierra Leone. The belief that FGM/C is a religious requirement is common, particularly in countries with high prevalence of cutting. Changes in support for cutting mirror those in the belief that it is a religious requirement.
Lancet. 2018 May 12; 391(10133):1886.Add to my documents.
Sexually Transmitted Infections. 2018 May; 94(3):173.Add to my documents.
The effects of oral contraceptive usage on thrombin generation and activated protein C resistance in Saudi women, with a possible impact of the body mass index.
PloS One. 2018; 13(10):e0206376.BACKGROUND AND OBJECTIVES: The effect of oral contraceptive (OC) usage on coagulation has been studied worldwide. However, no such studies have been conducted in Saudi Arabia on Saudi women using OCs. The aim of this study was to investigate the effects of OC-induced changes of thrombin generation (TG) in the absence and presence of activated protein C (APC) or thrombomodulin (TM) in Saudi women. METHODS: A total of 115 adult women, 47 on oral contraception (OC users) and 68 controls (not using OCs) were recruited from the obstetrics-gynecology outpatient clinic in Saudi Arabia. OCs that were used in this study include the following: Marvelon, Gynera, Cerrazetem, Yasmine, Microlut, Gracial and Diane. The plasma calibrated automated thrombinography (CAT) was used to determine TG which was expressed as endogenous thrombin potential (ETP; nM/min), lag time (min), peak (nM) and time-to-peak (ttpeak; min). In the presence of TM or APC, TG parameters were expressed relative to the parameters in the absence of TM or APC. RESULTS AND CONCLUSION: As in other populations, our study demonstrated that OC usage induced prothrombotic changes in plasma of Saudi women, including resistance to the inhibitory actions of TM and APC. More specifically, OC usage in our population predominantly influenced TG and APC/TM sensitivity in overweight and obese individuals, a finding that needs confirmation in large cohort studies. The effects of APC and TM on TG parameters showed a positive association, and the correlation coefficients were higher in OC users for both ETP and peak values.
Amman, Jordan, Department of Statistics, 2018 Jun. 53 p.The 2017-18 Jordan Population and Family Health Survey (JPFHS) is the seventh Demographic and Health Survey to be conducted in Jordan. Like the first six JPFHS surveys, conducted respectively in 1990, 1997, 2002, 2007, 2009, and 2012, the 2017-18 JPFHS was carried out by the Department of Statistics (DOS). The main objective of the survey is to provide comprehensive data on fertility and mortality, family planning, and maternal and child health and nutrition. The information will be used as a tool to evaluate existing population and health policies and programs. The survey sample is nationally representative and has been designed to produce estimates of major survey variables for the country as a whole, urban and rural areas, three regions (Central, North and South), twelve governorates, and Jordanian, Syrian, and other nationalities. More than 19,000 households, 14,870 ever-married women age 15-49, and 6,640 men age 15-59 were interviewed between October 2017 and January 2018. The 2017-18 JPFHS was funded by the Government of Jordan, with additional funding provided by the U.S. Agency for International Development (USAID), the United Nations Population Fund (UNFPA), and the United Nations Children’s Fund (UNICEF). ICF provided technical assistance through the DHS Program. The objective of the 2017-18 JPFHS is to facilitate important government policies and programs that promote maternal and child health. The survey will be useful to those interested in the fields of population studies and family planning. This report provides preliminary findings of the 2017-18 JPFHS. Detailed findings will be presented in the main survey report to be released in the first quarter of 2019.
Awareness about breastfeeding benefits among mothers in maternity and children hospital of Buraidah Qassim region, Saudi Arabia.
International Journal of Community Medicine and Public Health. 2018 Nov; 5(11):4696-4701.Background: Breastfeeding is a healthy, safe and economical way of providing proper and wholistic nutrition to the newborn. It reduces incidences of infection in the respiratory, gastrointestinal systems and systemic infections. As will as it deepens the bond between the mother and her child, and also it offers a number of health benefits to the mother. Despite these profound advantages, it remains under-fulfilled and sometimes missed altogether. The aim of the study is to assess the knowledge about breastfeeding benefits among mothers. Methods: The study involved 397 mothers visiting general pediatrics clinics at Maternity and Children Hospital of Buraidah, Qassim Region, Saudi Arabia from 18 March 2018 to 18 April 2018. Results: Most of the surveyed women were Saudi (93.5%), (46.1%) university or higher education level. (12.3%) rely on breastfeeding as the only source. (23.9%) were breastfeeding for more than 6 months. Some questions had as high correct answers as (49.2%), while others had as low correct answers as (20.4%), university or higher education level have the highest correct answers (73%). (61%) discussed the benefits of breastfeeding with a doctor and the correct answers were (72%) while (39%) didn't discuss and the correct answers were (65%). Conclusions: Analysis of the collected material on the surveyed women showed that Saudi women have insufficient knowledge about breastfeeding. Knowledge is improving after discussing with a doctor about breastfeeding benefits. Based on these results we highly recommend increasing the efforts to promote and endorse the benefits of breastfeeding by pediatricians and other health professionals.
Maternal-fetal emotional relationship during pregnancy, its related factors and outcomes in Iranian pregnant women: a panel study protocol.
Reproductive Health. 2018 Oct 17; 15(1):176.BACKGROUND: Considering the importance of attachment in child's development and mother's health, various related factors and also lack of necessary information in this regard in our country, the research team decides to conduct this study to evaluate maternal-fetal attachment during pregnancy, its changes and post-partum consequences on mother-infant relationship. This process should be studied during pregnancy and also after delivery so that the effect of related factors and the changes in attachment over time could be determined and comprehensible information about the effective underlying conditions on this issue would be gathered. METHODS: The present research is a longitudinal study (panel study). Data gathering would start at the first trimester, continue during second and third trimesters of pregnancy, first visit after delivery, second, fourth and end sixth months later. Pregnant women in the first trimester would be selected and contacted. If they have inclusion criteria, they would be selected as a participant. At first, their demographic-reproductive characteristics, Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (SSTAI), The Social Support Appraisal (SSA), Adult Attachment Scale (AAS) and Parental Bonding Instrument (PBI) would be completed; during the second trimester, BDI, SSTAI and Cranley's Maternal-Fetal Attachment Scale (CMFAS) would be completed. In the third trimester, the same questionnaires would be completed. During the first month after birth, Avant's questionnaire of Mother-Infant Attachment Behaviors would be completed. At the second, fourth and sixth months after delivery Muller's Mother -Infant Attachment Scale would also be completed. DISCUSSION: The results of the study will be provided to maternal child health policy-makers in the health system. This information could not be obtained through cross-sectional studies and through one episode of data collection and more studies are needed to provide us a perspective of the mother-infant relation over time. Studying attachment during pregnancy would provide us a chance to learn more about this process.
Lancet. Infectious Diseases. 2017 Jul; 17(7):700-701.Add to my documents.
Lancet. HIV. 2017 Jul; 4(7):e282-e283.Add to my documents.
The knowledge and perceptions of the first year medical students of an International University on family planning and emergency contraception in Nicosia (TRNC).
BMC Women's Health. 2018 Sep 15; 18(1):149.BACKGROUND: Informing the individuals on family planning including emergency contraception is a significant step for preventing unintended pregnancies. Although there is a number of studies on family planning and emergency contraception globally and in Turkey, no such data are available in the Turkish Republic of Northern Cyprus. The objective of this study was to evaluate the knowledge and perceptions on family planning and emergency contraception of the first year students of an international medical school in Nicosia, Northern Cyprus and to increase awareness for developing new policies on the issue. METHODS: The data of this cross-sectional study were collected in February 2016 by a questionnaire of 36 questions. Of the 229 students, 189 (82.5%) completed the questionnaire. The data were evaluated by SPSS 18.0 statistical program. The differences of variables were evaluated by Chi square test, p < 0.05 being accepted as significant. RESULTS: The distribution of participants from 23 countries according to nationality revealed three leading countries: Nigeria, Turkey and Syria. Of the students, 53.6% knew the definition of family planning. The sources of information were mainly school, the internet and media, with a total of 60.9% of the participants who stated having prior information on the subject. Awareness of contraceptive methods was indicated by more than 90% and emergency contraception by 66.1% of the participants. However, the students were unable to differentiate between modern and traditional family planning methods; 85.6% did not have knowledge of the most effective period for emergency contraception and 63.1%, of the definition of emergency contraceptive pills. CONCLUSIONS: In conclusion, the knowledge and awareness level of the first year medical students on family planning and emergency contraception was insufficient. Family planning and emergency contraception education should be provided for the students at the first year of all faculties as well as medical schools and relevant programs should be included in the curricula of medical education.
Can a midwife-led continuity model improve maternal services in a low-resource setting? A non-randomised cluster intervention study in Palestine.
BMJ Open. 2018 Mar 22; 8(3):e019568.OBJECTIVES: To improve maternal health services in rural areas, the Palestinian Ministry of Health launched a midwife-led continuity model in the West Bank in 2013. Midwives were deployed weekly from governmental hospitals to provide antenatal and postnatal care in rural clinics. We studied the intervention's impact on use and quality indicators of maternal services after 2 years' experience. DESIGN: A non-randomised intervention design was chosen. The study was based on registry data only available at cluster level, 2 years before (2011and2012) and 2 years after (2014and2015) the intervention. SETTING: All 53 primary healthcare clinics in Nablus and Jericho regions were stratified for inclusion. PRIMARY AND SECONDARY OUTCOMES: Primary outcome was number of antenatal visits. Important secondary outcomes were number of referrals to specialist care and number of postnatal home visits. Differences in changes within the two groups before and after the intervention were compared by using mixed effect models. RESULTS: 14 intervention clinics and 25 control clinics were included. Number of antenatal visits increased by 1.16 per woman in the intervention clinics, while declined by 0.39 in the control clinics, giving a statistically significant difference in change of 1.55 visits (95% CI 0.90 to 2.21). A statistically significant difference in number of referrals was observed between the groups, giving a ratio of rate ratios of 3.65 (2.78-4.78) as number of referrals increased by a rate ratio of 3.87 in the intervention group, while in the control the rate ratio was only 1.06.Home visits increased substantially in the intervention group but decreased in the control group, giving a ratio of RR 97.65 (45.20 - 210.96) CONCLUSION: The Palestinian midwife-led continuity model improved use and some quality indicators of maternal services. More research should be done to investigate if the model influenced individual health outcomes and satisfaction with care. TRIAL REGISTRATION NUMBER: NCT03145571; Results. (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Prevalence of malnutrition among Iran’s under five-year-old children and the related factors: a systematic review and meta-analysis.
Iranian Journal of Pediatrics. 2018 Feb; 28(1): p.Context: Children’s health is one of the priorities in most societies. Nevertheless, the highest prevalence rate of malnutrition occurs among under five-year-old children worldwide. Objectives: The aim of this study was to estimate the rate of malnutrition in Iranian children through a systematic review and meta-analysis. Also we tried to identify the most prevalent factors causing malnutrition. Data Sources: The required data were collected by searching the keywords of nutrition, malnutrition, under-nutrition, prevalence, epidemiology, etiology, occurrence and Iran in PubMed, Google Scholar, Scopus, Index Copernicus, DOAJ, EBSCO-CINAHL, SID, Magiran and Iranmedex. Results: Twenty studies were selected for the final analysis stage, dating from 1999 to 2014. Number of children investigated for wasting, stunting and underweight was 53612, 54312 and 55012 respectively. The results showed that the prevalence of each type of malnutrition, in terms of wasting, stunting and underweight were 7.8% (95% CI: 4.8% - 12.6%), 12.4% (95% CI: 8.3% - 18.5%) and 10.5% (95% CI: 7.1% - 15.4%), respectively. Parents’ educational level, in particular mothers’, gender, birth weight, the place of residence, and mother’s occupation were mentioned as important factors causing malnutrition. Conclusion: The rate of malnutrition in Iran’s under five-year-old children is lower than the average of that in world and the Eastern Mediterranean region. Breastfeeding, the proper use of complementary feeding, and the principled spacing between births and improving the quality of maternal care have important role in prevention of malnutrition.
Medical Journal of the Islamic Republic of Iran. 2018; 32:54.Background: Reviewing the reproductive health indicators (RHIs) provides the possibility of periodic health system performance evaluation to achieve balanced development. This study aimed to determine the trend of ten reproductive health indicators changes during 2002-2011, and examining their relationship with the Human Development Index (HDI). Methods: In this ecological study the trend of ten reproductive health indicators from five selected provinces of Iran were mapped. Then the relationship of these ten indicators with HDI was investigated using non parametric Spearman's rank correlation coefficient in SPSS v. 20. Results: There was a statistically significant direct and strong correlation between the percentage of childbirth by a trained person and HDI (r= 0.9, p=0.037). Conclusion: In our study, it can be expected that the provinces with similar reproductive health indicators, likely have similar HDI.
Comparative study of teaching natural delivery benefits and optimism training on mothers' attitude and intention to select a type of delivery: an educational experiment.
Electronic Physician. 2018 Jul; 10(7):7038-7045.Background: Despite advantages of normal vaginal delivery (NVD) and disadvantages of caesarean section (C-section) and the increasing C-section rate Iran, appropriate training is essential in reducing this trend. Optimism is one of the important psychological determinants which is a combination of positive desire and attitude in people. Objective: The purpose of this study was to determine the effects of optimism training as well as training the benefits of natural childbirth on attitude and intentions to choose the type of delivery. Methods: In this experimental study, 96 primiparous women referring to health centers in Mashhad (Iran) in 2014 with pregnancy duration of 30 to 34 weeks and without indication of C-section, were selected and randomly divided into two training groups and one control group. Optimism training was provided during six 60-minute sessions, whereas training the benefits of NVD was conducted in four 60-minute sessions. Pre-test and post-test were performed using valid and reliable questionnaires, researcher-made questionnaire, attitude-measuring questions on NVD and C-section, and optimism-measuring standard questionnaires (LOT-R). Data were analyzed by IBM-SPSS version 22, using Kruskal-Wallis, Chi square, paired-samples t-test, Independent-samples t-test, Man-Whitney U, and Wilcoxon signed-rank test. Result: There was a significant difference between the mean scores of attitudes towards natural delivery in the group that received both optimism and natural delivery advantages trainings compared with the group receiving only the latter (p>0.001). Frequency of intentions to choose the type of delivery after optimism and natural delivery advantages trainings compared with training the benefits of natural childbirth only, did not show a significant difference (p=0.135). Conclusion: Optimism training combined with training the benefits of natural childbirth is more effective in creating positive attitude towards natural delivery in comparison with only the NVD advantages education, but it has no effect on selecting the type of delivery. Probably one of the most important reasons of failure of achieving a proper result is the low sample size. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015063022995N1. Funding: This trial is funded by Mashhad University of Medical Sciences in collaboration with the Evidence-Based Research Center (Ref: research/930321/1/172).
Electronic Physician. 2018 Jul; 10(7):7063-7070.Background: Sex preference is one of the cultural problems of countries in the field of demographic issues. It can increase the number of pregnancies, reduce the interval between births and delay in seeking prenatal care, which can threaten the health of mother, baby, child and family, especially in traditional societies. Objectives: To determine the role of ethnicity on sex preference of different ethnicities living in North Khorasan Province (Iran). Methods: This cross-sectional study was conducted using a multistage cluster sampling method and a researcher-made questionnaire of reproductive behavior on 1,000 women from 5 ethnicities (Fars, Turk, Kurd, Turkman and Tat) in North Khorasan Province in the summer of 2016. Data were analyzed by IBM-SPSS version 21, using descriptive statistics, ANOVA, t-test, and logistic regression. A significance level of =0.05 was set for examining the study hypotheses. Results: The results showed sex preferences among different ethnicities of North Khorasan Province. The highest level of preference for sons was seen in Turkman (66% vs. 23%). Unlike other ethnic groups, Turkman (21%) and Kurdish people (29.7%) were under pressure from the spouse's family to give birth to sons. Conclusion: Sex preference, especially among the Turkman ethnic group, which are different in terms of geographical, economic and social conditions, affects the fertility and reproductive behavior of the respondents; and it is necessary to reduce son preference for the health and well-being of children and women.
Healthcare providers' attitude and knowledge regarding medication use in breastfeeding women: a Jordanian national questionnaire study.
Journal of Obstetrics and Gynaecology. 2018 Feb; 38(2):217-221.Medication use among women who have recently given birth is unavoidable in some situations. The aim of this study was to assess the attitude and knowledge of healthcare providers (HCPs) in Jordan about the safe use of medications during breastfeeding. The data were collected from HCPs in maternal and children care centres and hospitals from April 2015 to January 2016, using a self-administered questionnaire. A total of 904 HCPs (79.3%) were enrolled in the study. Half of the participants followed the World Health Organisation's and American Academy of Pediatrics' recommendations. The awareness of HCPs regarding these recommendations was lower among nurses (OR 0.212, 95%CI 0.132-0.338, p < .001) and pharmacists (OR 0.476, 95%CI 0.297-0.763, p = .002) than physicians. The majority of participants (80%) had low level of knowledge and nurses were more likely to have low knowledge than physicians (OR 0.099, 95%CI 0.050-0.197, p < .001). Professional continuous education programmes were highly encouraged. Impact statement What is already known on this subject: Use of medications among women who have recently given birth is unavoidable in some situations and most of them are safe to be given during breastfeeding. What the results of this study add: Healthcare providers in Jordan have variable attitudes regarding the safety of medication use during breastfeeding. The majority of healthcare providers have a low level of knowledge regarding the safe use of medication during breastfeeding. Nurses are more likely to have low knowledge as compared to physicians. IMPLICATIONS FOR CLINICAL PRACTICE: Healthcare providers should be encouraged to seek information regarding compatibility of medication use during breastfeeding from reliable sources. Professional continuing education programmes concerning the safety of medication use during breastfeeding period are needed to target all involved HCPs. More attention should be directed toward medical schools' curricula to widen the knowledge of medication use and focus on practice-based clinical experience.
Determinants of marriage to first birth interval in Birjand, Iran: A retrospective-prospective cohort and survival analysis.
International Journal of Women's Health and Reproduction Sciences. 2018; 6(3):328-334.Objectives: The time-interval between marriage and first childbirth (IMF) can affect fertility and pave the way for decreased fertility in future. This study aimed to determine the effective factors on the time of first childbirth in married women of Birjand, Iran. Materials and Methods: This was a retrospective and prospective cohort study incorporating a total of 180 couples from Birjand who were married in 2011. The data were collected by a checklist and subsequently assessed using survival analysis in STATA13 software. Results: From among the participants, 55.2% had a child and the rest were censored. The man’s age at the time of marriage, the interval between marriage contract to marriage ceremony, type of marriage, wife’s place of birth, application of modern methods of contraception, family income per month, and tendency to have a son were the determining factors affecting IMF. Conclusions: More than half of the freshmen admitted to universities across the country are women who will seek employment after they are graduated. Considerations must be made so that they can have their desired number of children, suitable education, and employment. © 2018 The Author (s).
International Journal of Women's Health and Reproduction Sciences. 2018; 6(3):356-362.Objectives: Improving the maternal health requires an understanding of the men’s level of knowledge as well as the attitude about participation in their wives’ perinatal care in different societies. The present study aims to investigate men’s knowledge and attitude about participation in their nulliparous wives’ perinatal care. Materials and Methods: In this descriptive cross-sectional study, 300 husbands of nulliparous women completed the questionnaire of “men’s knowledge and attitude about participation in prenatal care”, in a referral perinatal care clinic in Hamadan, Iran, in 2015. Results: The level of knowledge about the wives’ perinatal care in more than half of the men (58 %) was poor and in nearly half of them (41.7%) was moderate. Based on different aspects of the perinatal care, the knowledge level of 59.7%, 69.7%, 52.3 %, 63.3%, 64.7%, 66.7%, 51.7%, 62%, 84%, and 78.7% of the men was poor in the physical changes, general health, nutrition, exercise, sexual health, risk signs, mental and psychological changes in pregnancy, delivery, puerperium, and neonatal care, respectively. None of the men had good knowledge about the aspects related to postpartum care (including puerperium and neonatal care). Further, the majority of men (65.3%) had a positive attitude towards participation in perinatal care. Conclusions: In the present study, the emphasis was put on the need for training the men interested in participating in various perinatal cares, especially physical changes during pregnancy, prenatal nutrition, risk signs during pregnancy, and maternal as well as neonatal postpartum cares. © 2018 The Author (s).
Iranian Journal of Nursing and Midwifery Research. 2018 Jul-Aug; 23(4):311-315.Background: Correct health behaviors such as dietary habits before pregnancy ensure desired pregnancy outcomes. The aim of this study was to determine the relationship between psychosocial factors and dietary habits using social cognitive theory (SCT) in women undergoing preconception care (PCC). Materials and Methods: This cross-sectional study was conducted among 120 women from October to December 2015 in health centres in Isfahan, Iran. Using a researcher-made questionnaire, the researcher conducted stratified random sampling and convenience sampling for selecting health centres and participants, respectively. For data analysis, the researcher applied the Pearson, Spearman's, and linear regression test in SPSS software. Results: The results showed that perceived support from healthcare personnel and outcome expectations are not associated with any of the components of dietary habits. Access to healthy food was inversely correlated with incorrect dietary habits (beta = -0.19, p = 0.039) and had a direct correlation with daily consumption of fruits (beta = 0.27, p = 0.006). Perceived support from the spouse had a direct correlation with desired dietary habits (beta = 0.27, p = 0.006). Self-efficacy was inversely correlated with incorrect dietary habits (beta = -0.22, p = 0.011) and had a direct relationship with desired dietary habits (beta = 0.25, p = 0.004). Conclusions: To improve the nutritional status of women prior to pregnancy, interventions must be focused on increasing women's access to healthy food and their self-efficacy in maintaining a healthy diet.
Effectiveness of Postpartum Homecare Program as a New Method on Mothers' Knowledge about the Health of the Mother and the Infant.
Iranian Journal of Nursing and Midwifery Research. 2018 Jul-Aug; 23(4):316-321.Background: Reduced maternal mortality due to pregnancy and delivery is one of the priorities of reproductive health programs of World Health Organization. Benefiting from appropriate social support, such as receiving homecare, has an important role in mothers' adaptation and health. Lack of access to comprehensive and desirable health services is the most important barrier to improvement of maternal health. In this study, the effect of postpartum homecare on mother's knowledge about maternal and child health is evaluated. Materials and Methods: This study was two-group field trial which was conducted in 2015 on 62 postpartum mothers who were selected randomly in Shahid Beheshti Hospital of Isfahan. Mothers and infants of the intervention (experimental) groups were first visited at the hospital and then received two visits at home. The control group received routine postpartum care. A researcher-designed questionnaire was used for data collection. Data analysis was conducted using SPSS18 and independent, paired t-test, and Chi-square tests. Results: Comparing the demographic characteristics between both groups revealed no significant difference. After the intervention mothers' knowledge about maternal (t = 4.26; p < 0.001) and child (t = 3.19; p = 0.003) health showed a significant difference between the intervention (experimental) and control groups. Conclusions: Performance of postpartum homecare as a new and useful method in the health system of Iran can increase mothers' knowledge about their own health and their children, enhance their ability to adapt with the postpartum period, and improve the health level of vulnerable populations.
Socioeconomic inequalities in neonatal and postneonatal mortality: Evidence from rural Iran, 1998-2013.
International Journal For Equity In Health. 2017 May 18; 16(1):83.BACKGROUND: Over the past three decades, interventions have been implemented to reduce childhood mortality in Iran. Despite declines in overall mortality rates, inequalities in mortality across socioeconomic groups have remained unchanged. In this study, we assessed inequalities in infant mortality in rural regions of Iran. METHODS: We obtained data from the Iranian vital registration system, which includes data on 5,626,158 live births, 79,457 neonatal deaths, and 36,397 postneonatal deaths in rural areas of Iran over the course of a 16-year period, which was then divided into 4 four-year intervals. In addition to building multivariate regression models to identify factors associated with mortality, we calculated a concentration index for each province to measure inequalities in neonatal and postneonatal mortality, using wealth index as the socioeconomic variable of interest. We further assessed these inequalities as a component of their contributors by using the decomposition method. RESULTS: Although both neonatal (17.62 to 10.92) and postneonatal (8.11 to 5.14) mortality rates exhibited decreasing trends from 1998-2001 to 2010-2013, the inequalities observed in these indices remained nearly unchanged (concentration indices of -0.062 to -0.047 and -0.098 to -0.083, respectively). Furthermore, fraction of births occurred in hospitals and literate women contributed positively to the inequalities observed in both neonatal and postneonatal mortality rates, whereas the proportion of infants classified as low birth weight contributed negatively over all study periods. We also identified decreasing trends in inequalities of the proportion of infants classified as having low birth weight, being born in hospitals, being covered by health insurance, mothers' age, and literacy of women within the time intervals under study. CONCLUSIONS: Although infant mortality rates in Iran decreased over the studied time period, we observed notable inequalities in these measures. Several steps are needed to overcome these inequalities, including improving access to professional health services for lower income households, fairly distributing facilities and human resources, and improving insurance coverage to protect families from financial hardships. Moreover, social factors, such as literacy of women, were found to be important in decreasing inequalities in infant mortality. These steps require improving societal awareness of infant mortality and implementing improved and problem-oriented health policies.
Survival and negotiation: narratives of severe (near-miss) neonatal complications of Syrian women in Lebanon.
Reproductive Health Matters. 2017 Oct; 25(sup1):27-34.The World Health Organization has elaborated a maternal and neonatal near-miss reporting, audit and feedback system designed to improve the quality of care during and after childbirth. As part of a four-hospital comparative study in the Middle East, this article discusses the experiences of mothers whose newborns suffered from severe complications at birth in the Rafik Hariri University Hospital, the only public hospital in Beirut. Based on in-depth home interviews several weeks after childbirth, it aims to explore the experience of neonatal near-miss events through the mothers' birth narratives. The central concerns of these vulnerable and marginalised women regarded access to neonatal care, and how to negotiate hospital bureaucracy and debt. It argues that financial and bureaucratic aspects of the near-miss event should be part of the audit system and policy-making, alongside medical issues, in the quest for equitable access to and management of quality perinatal care.