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Effect of Planned Nursing Intervention on Child Birth Education among Prinigravida Mothers Attending Antenatal Clinics at Selected Hospitals in Meerut (UP).
Nursing Journal of India. 2015 Sep; 106(5):210-212.With a view to assess the effectiveness of video-assisted teaching programme on child birth education, a pre-experimental design with one group pre-test and post-test with an evaluative approach was undertaken on 50 antenatal mothers. Prior to implementation of video- assisted teaching programme, the antenatal mothers had a poor knowledge whereas after implementation of video-assisted teaching programme, the antenatal mothers knowledge was significantly improved with the difference of mean percentage revealing effectiveness of video-assisted teaching programme. It was also found that the antenatal mothers were not aware of the importance of childbirth education.
Estimation of probability of coition on different days of a menstrual cycle near the day of ovulation: An application of Theory of Markov Chain.
Demography India. 2015 Jan-Dec; 44(1-2):31-39.Various research studies have evidences that the day of coition with respect to the day of ovulation in a menstrual cycle may affect the probability of conception as well as the sex ratio at birth. But the data on coition probabilities on different days of the menstrual cycle is rarely available and in this situation theoretical estimation may be helpful for estimating these probabilities. This research work presents a new theoretical approach for estimating the probabilities of coition near the day of ovulation for different couple coital patterns. These probabilities are then utilized for estimating the probability of conception in a menstrual cycle and the sex ratio at birth.
Correcting estimates of HIV prevalence due to survey non-participation in India using Heckman Selection Model.
Demography India. 2015 Jan-Dec; 44(1-2):17-30.Using the data from the third round of National Family Health Survey and Heckman Selection Model this paper aims to determine the estimates of HIV prevalence in India due to survey non-participation. Interviewer ID was taken as the selection variable, which affects the survey participation but did not affect HIV status independently. Study also compared the estimates of Heckman selection model to conventional imputation model. It has been found that prevalence of HIV is greater among men (0.77; 95% CI= (0.71-0.83)) and women (0.42; 95% CI= (0.39-0.45)), who did not participate in the survey as compare to those who participated in HIV test (0.35 for men & 0.22 for women). Thus, the national estimate for men and women derived from selection model was higher than the unadjusted imputation method. Results of this study demonstrate that the selection variable was significantly associated with the HIV status of the men and women. Further, this study shows the significant association between the survey participation and the HIV status of those who has been interviewed but did not consent to the HIV test, which clarifies that the sample selection led to substantial underestimation of the national HIV prevalence in men and women. Therefore, a valid and efficient way to provide the estimate of HIV prevalence is to incorporate the Heckman selection model instead of the conventional method to provide an estimate of the national prevalence.
Examining discrepancy in contraceptive use between two household health surveys in Ethiopia: EMDHS vs. EPMA.
[Baltimore, Maryland, Johns Hopkins University Bloomberg School of Public Health, Bill & Melinda Gates Institute for Population and Reproductive Health], 2015 Aug. 68 p.The Ethiopia Mini-DHS (EMDHS) and the Ethiopia Performance Monitoring and Accountability 2020 (EPMA) surveys collected data that allow the estimation of modern contraceptive prevalence rate (mCPR), method mix, fertility rate, among other indicators at the national, urban/rural and regional levels. Both surveys employed a multi-stage cluster sampling design. In addition, the surveys were fielded around the same time period: January-April 2014. However, the surveys differed in their use of technology for data collection. The EPMA employed a Smartphone-based technology for data collection while the EMDHS was based on the usual pen and paper-based approach. This analysis was setout to compare the mCPR, contraceptive method mix, source of current method and fertility rates between the EMDHS and EPMA surveys, and also to examine the sources of discrepancies. It also envisages to provide useful recommendation for future improvement of the EPMA survey. The tables and figures presented in this report are based on reanalysis of the EMDHS and EPMA surveys data. Ethiopia DHS 2000-2011 were also used for trend analysis and comparison, as deemed necessary. Potential sources of discrepancies in mCPR between the two surveys at national as well as regional levels were identified and discussed in this report although they were by no means comprehensive. Non-sampling errors, as potential sources of discrepant findings, were not sufficiently evaluated in this analysis due to paucity of information. This analysis also presupposes no part of the difference in mCPR between the two surveys was attributable to differences in the data collection approaches implemented by the surveys - paper-based vs. Smartphone-based. With the caveat of these limitations, it can be concluded that the mCPR estimates derived from the two surveys varied significantly at national level as well as in the Oromia and Addis Ababa regions. Differences in sample allocation across strata, variability in the socio-demographic compositions of respondents (in Addis Ababa), variability in questionnaires format, and age distortion around the eligible age boundaries emerged as potential sources of the discrepant findings. It should also be emphasized that most regional mCPR estimates of both surveys suffered from lower precision as compared to the DHS 2011 mainly due to smaller sample size. The conduct of a household survey is often a complex and lengthy process that involves critical technical inputs, mobilizing huge resources, and decision makings at various stages. Gauging the accuracy and reliability of either of the surveys simply because they produced discrepant results is not warranted. Rather, each survey should be evaluated in accordance with its goal, methodological scope and resource environment.
[Washington, D.C.], Population Council, 2015 Nov. 4 p.The Progesterone Vaginal Ring (PVR) is a vaginal ring which contains progesterone and can enhance the effect of breastfeeding on birth spacing.
Washington, D.C., The Child, Early, and Forced Marriage Resource Guide Task Order, Banyan Global, 2015. 185 p. (USAID Contract Number AID-OAA-I-14-00050/AID-OAA-TO-14-00036)This resource guide provides information on how the United States Agency for International Development (USAID) sectors, missions, and staff can integrate child, early, and forced marriage (CEFM) prevention and response into their programming. The guide provides both the rationale of why and approaches to how USAID’s efforts can address CEFM. In March 2012, USAID released its Gender Equality and Female Empowerment Policy with the goal to “improve the lives of citizens around the world by advancing equality between females and males, and empowering women and girls to fully participate in and benefit from the development of their societies.”30 The policy directs USAID investments toward the following outcomes, which can be adapted and translated at the country level: 1) reduce gender disparities in access to, control over, and benefits from resources, wealth, opportunities, economic services, social services, political services, and cultural services; 2) reduce gender-based violence (GBV) and mitigate its effects on individuals and communities; and 3) increase the capability of women and girls to recognize their rights; determine their life outcomes; and influence decision-making in households, communities, and societies.
A comparison of the menstruation and education experiences of girls in Tanzania, Ghana, Cambodia and Ethiopia.
Compare. 2015; 45(4):589-609.The barriers to menstrual hygiene management faced by adolescent schoolgirls in low-income countries are gaining interest at practice and policy levels. The challenges include inadequate water, sanitation and disposal facilities for the management of menses with privacy and dignity, and insufficient guidance to help girls feel confident in attending school during menses. The studies described here aimed to examine how menarche impacts the lives of schoolgirls in three low-income countries (Ghana, Cambodia and Ethiopia). The focus included girls’ school participation; their relationship with parents, teachers and peers; their evolving sanitation and hygiene needs; their understanding of cultural issues and taboos around menses; and what education, if any, they received prior to and during puberty. This comparative analysis was aimed at identifying similarities between the three countries that would enable the adaptation to each context of a training book on menstruation issues for girls, which was developed from a previous study conducted in Tanzania. In all three countries, participatory activities were utilised with girls and results were analysed using grounded theory. Findings included: similarities regarding the importance of culture in perpetuating negative attitudes towards menstruation, limited provision of health information and insufficient facilities within schools. Differences were revealed regarding menstrual myths, parent–child dynamics, sources of guidance and student–teacher relations. There is a critical knowledge gap around menstruation and girls’ education in these contexts that must be addressed to ensure that girls experience a positive menarche and can manage menstrual hygiene.
Nursing Journal of India. 2015 Nov; 106(6):271-273.This quasi-experimental study to assess the effectiveness of essential pre-tern care module on knowledge- and skill among 60 nurses (30 each in study and 30 in control group) was conducted at Christian Fellowship Hospital, Oddanchatram. The samples were selected based on need assessment. Lecture with video show on Assessment ofpre-term infants, Care of preterm infants, Nurse focussed intervention, Transportation of pre-term infants, Prevention and treatment of minor ailments in pre-term infants. Lecture-cum-demonstration on Swaddling, Oro-motor stimulation, Tube feeding, Kangaroo Mother Care and Hand washing were given. The post-test knowledge and skill was assessed with structured questionnaire and observational checklist. The findings showed that post-test mean score of knowledge and skill in study group.was statistically signifcant atp<0.001 level. This showed that the essential preterm care module was effective in promoting knowledge and skill regarding essential preterm care among nurses.
Durham, North Carolina, FHI 360, 2015 Feb. 10 p.Since the London Summit on Family Planning (FP) in 2012, 33 countries have thus far committed to making high-quality, voluntary FP services, information, and supplies more available, acceptable, and affordable for an additional 120 million women and girls in the world’s 69 poorest countries by 2020. These commitments evolved into a global partnership known as Family Planning 2020 (FP2020). The Ouagadougou Partnership emerged from a 2011 conference in West Africa, where countries agreed to reach at least 1 million additional women in the region with FP services by 2015. Meeting the commitments will ensure that every woman and every girl has the right, and the means, to shape her own life - to grow, to thrive, and to plan the family she wants. Costed implementation plans (CIPs) are multi-year action plans that contain detailed resource projections for achieving the goals of a FP program. CIP enables countries to operationalize and monitor progress toward their commitments. Thus far, 16 countries have developed CIPs: Bangladesh, Benin, Burkina Faso, Côte d’Ivoire, Democratic Republic of the Congo, Guinea, Kenya, Mali, Mauritania, Niger, Nigeria, Senegal, Togo, Tanzania, Uganda, and Zambia. Translating CIPs into action, and ultimately into results, requires a sustained deliberate approach to the execution process throughout the plan. This notion may sound simple and straightforward, but it can be complex. Strategic planners agree that planning seldom fails; it is the implementation that fails. Extensive literature describes the factors that can stall a plan, including lack of buy-in and ownership, unclear lines of responsibility and accountability, lack of dedicated efforts to mobilize resources, inability to recognize and facilitate change processes, poor communication and coordination among stakeholders, and inadequate leadership and management skills to effect execution. Two years before the London Summit, in March 2010, Tanzania became the first country to launch a CIP. June 2014 marked four years of implementation of its plan, which expires December 2015. This case study report gives an account of the process of translating and sustaining the plan into “action” and “measurable results” -what was done, challenges, and lessons learned. It is based on consultations with stakeholders, conducted in April 2014 to understand the implementation process, and is enriched by reports from performance-monitoring efforts. (excerpt)
A study in increasing vasectomy uptake: Understanding acceptability of vasectomy uptake amongst men in three regions of Papua New Guinea.
[Port Moresby, Papua New Guinea], Marie Stopes Papua New Guinea, 2015 Mar 4. 85 p.This report documents the findings of a qualitative investigation into the drivers behind men’s acceptance of vasectomy in three regions of Papua New Guinea (PNG). The purpose of the research is to inform and enhance Marie Stopes PNG’s behaviour change communication messaging and counselling content and serve as a resource for other agencies working in sexual and reproductive health in PNG. Fieldwork was carried out over a 4-week period in November – December 2014 in Eastern Highlands, Morobe and Central Provinces of PNG. In-depth interview data were gathered from 37 users (post-vasectomy clients) wives of users and accepters (men awaiting vasectomy) who talked about factors that lead to (and inhibit) male acceptance of vasectomy. This was complemented by data from eight focus group discussions with non-users of vasectomy and wives of non-users, which provided further insight into community perceptions and acceptability of vasectomy. This report documents the findings from the study and identifies the facilitators and barriers to vasectomy uptake in PNG. It provides an evidence base that will assist in the further development of the national vasectomy program and assist MSPNG tailor its messaging to better support male uptake of vasectomy services.
Bethesda, Maryland, Strengthening Health Outcomes through the Private Sector Project (SHOPS), Abt Associates, 2015 Dec. 65 p.Marie Stopes International Cambodia (MSIC) is developing a mobile health (mHealth) strategy for a project to improve access to high quality health care services among garment factory workers (GFWs). The project will collaborate with management from 60 garment factories (GF) to improve health outcomes and increase awareness among 100,000 GFWs. The project’s focus is on increased access to reproductive health services through improved infirmary services, linkages to a private provider network, and access to health financing services. The project will also create a quality assured health provider network with approximately 160 members around GFs. The Strengthening Health Outcomes through the Private Sector (SHOPS) project developed recommendations for investing in priority mobile applications including a costed menu of options to further MSIC’s objectives. Phone ownership among GFWs in Cambodia is estimated at 80 percent, ranging from basic phones used only for calling to a growing use of smartphones among the more literate. Text messaging is limited due to lack of Khmer language-enabled phones.
International Journal of Gynaecology and Obstetrics. 2015 Jul; 130(1):98-110.BACKGROUND: Maternal and neonatal mortality remains a serious challenge in Tanzania. Progress is tracked through maternal mortality ratios (MMR) and neonatal mortality rates (NMR), yet robust national data on these outcomes is difficult and expensive to ascertain, and mask wide variation. SEARCH STRATEGY: We searched EMBASE, MEDLINE, Popline, and EBSCO online databases, basing search terms on ("maternal" OR "neonatal") AND ("mortality" OR "cause of death") AND "Tanzania." SELECTION CRITERIA: Nationally representative or population representative from the subnational context were eligible, providing NMR, MMR, or numbers of maternal deaths or early neonatal deaths or neonatal deaths and live births. DATA COLLECTION AND ANALYSIS: Data were extracted on study context, time period, number of deaths and live births, definition of maternal and neonatal death, study design, and completeness and representativeness of data. NMR and MMR were extracted or calculated and study quality was assessed. Nationally representative data were compared with modelled national data from international agencies. MAIN RESULTS: 2107 records were screened yielding 21 maternal mortality and 15 neonatal mortality datasets. There were high mortality levels with wide subnational MMR and NMR variation. National survey data differed from the modelled estimates, with wide uncertainty ranges. CONCLUSION: Subnational data quality was generally poor with no observable trends and geographical clustering across several regions. Combined MMR and NMR reporting is uncommon. Modelled national estimates lack precision and are complex to interpret. Results suggest that aggregate national data are inadequate for policy generation and progress monitoring. We recommend strengthening of vital registration and Health Management Information Systems with complementary use of process indicators, for improved monitoring of, and accountability for maternal and newborn health. Copyright (c) 2015. Published by Elsevier Ireland Ltd.
Journal of Public Health In Africa. 2015 Aug 17; 6(2):484.Cervical cancer causes an estimated 266,000 deaths globally, 85% of which occurs in developing countries. It is a preventable disease, if detected and treated early via screen and treat, yet its burden is still huge in Nigeria. In 2012, 21.8% cases of cervical cancer and 20.3% deaths due to cervical cancer were recorded in Nigeria. This review, therefore, aims at indentifying the determinants of low cervical cancer screening in Nigeria in order to contribute in reducing the burden of the disease. Literature were obtained from Global Health, Popline and PubMed databases; WHO and other relevant websites using Eldis search engine; and from libraries in the University of Leeds and WHO in Geneva. Conceptual framework for analyzing the determinants of cervical cancer screening uptake among Nigerian women was formed by inserting service delivery component of the WHO health system framework into a modified Health Belief Model. Wrong perception of cervical cancer and cervical cancer screening due to low level of knowledge about the disease and inadequate cervical cancer prevention were identified as the major determinants of low cervical cancer screening uptake in Nigeria. Among women, belief in being at risk and/or severity of cervical cancer was low just as belief on benefits of cervical cancer screening, unlike high belief in barriers to screening. Support from the community and screening skills among health-workers were inadequate. Improving uptake of cervical cancer screening will reduce the burden of the disease. Therefore, researchers and other stakeholders interested in prevention of cervical cancer should carryout studies to identify interventions that could address the key determinants of low cervical cancer screening among Nigerian women.
Analysis of Family Planning Social Networks in Zinder and Maradi Regions (Sawki Project Sites). Provisional report. Analyse des Reseaux Sociaux de la Planificaiton Familiale dans les Regions de Zinder et Maradi (Sites du Projet Sawki). Rapport Provisoire.
[Washington, D.C., PSI], Transform PHARE, 2015 Nov 3. 54 p.The overall objective of this study is to understand the influence of social networks on unmet need for family planning to make interventions addressing the socio-cultural factors of family planning use more effective.
CHRISMED Journal of Health and Research. 2015 Apr-Jun; 2(2):109-114.Background: This study was a cross-sectional survey of children and their mothers in specialist Hospital Gombe, Nigeria. Objective: Anthropometric assessment of nutritional status of the children (0-12 months) and a survey of mothers’ opinion on malnutrition. Population: Children and mothers attending immunization sessions in specialist hospital Gombe, Nigeria. Materials and Methods: Hundred children (0-12 months) attending immunization sessions were purposefully sampled and measured using sensitive anthropometric tools and techniques, while on the other arm of the study structured interviews were administered on the children’s consenting mothers (100) who turned in for their wards’ immunization. Only 97 out of 100 data collected on the children were used. Anthropometric indices used were height-for-age, weight-for-height, weight-for-age, and mid-upper arm circumference. Results: The study revealed a higher prevalence of moderate stunting in male (46.9%) than in female (33.3%) children (P < 0.05). All (100%) children within the age group of >11 exhibited both severe and moderate forms of underweight. Among infants 3-5 months, moderate wasting was found to be less prevalent (4.2%). And despite the fact that 90% of their mothers showed a positive attitude toward exclusive breastfeeding, only 44% of them breastfed their infants exclusively from birth to the 6th month of life. Conclusion: In order to address the various forms of nutritional derangements detected among the children, mothers should be targeted for infant nutritional education and authorities should institute poverty alleviation measures so as to address underlying causes of malnutrition.
Human immunodeficiency virus infection and acquired immune deficiency syndrome vulnerability of men who have sex with men in a border area of West Bengal, India.
CHRISMED Journal of Health and Research. 2015 Oct-Dec; 2(4):349-355.Background: Studying level of living, awareness about sexually transmitted infections (STIs) including human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) and sex behavior of men who have sex with men (MSMs) is prerequisite for control of increasing AIDS among them in India. Objective: To assess sociodemographics, awareness about STIs including AIDS, and find out the pattern of high risk sex behavior of MSM. Methodology: Cross-sectional survey was undertaken in May, 2012 among MSMs catered by T I program via Nongovernmental Organization "Madhya Banglar Sangram" in Murshidabad District. 62 MSMs were included from five cruising spots sampled randomly out of fourteen such. Information was collected via interview and focused group discussions (FGD) using questionnaire and FGD guide. Blood samples were examined for VDRL reactivity. Results: Median age was 25 years and sexual debut at 13.67 +or- 4.29 years. 87% respondents were residing in parental house, 20% was married, 40% had low education, 80.33% had additional jobs but 54% reported poor income. About 56% respondents knew "what is AIDS" and its spread via anal sex, mother to child transmission, needle sharing, sex worker, and blood transfusion reported by 52.46, 50.82, 47.54, 45.90, and 34.43%, respectively. More than 2/3rd, about 40 and 34.43% MSMs played "anal and oral receptive," "anal insertive" and "oral insertive" role. About 33% used condom regularly. Majority knew main symptoms of STIs. About 2/3rd reported discrimination by neighbors. Blood examination showed 6.45% VDRL reactivity. Conclusion: Reducing vulnerability of MSMs to HIV/AIDS requires holistic programs.
Effect of free maternal health services on maternal mortality: An experience from Niger Delta, Nigeria.
CHRISMED Journal of Health and Research. 2015 Oct-Dec; 2(4):309-315.Background: Free maternal health care was launched by Delta State Government in 2007. This development was laudable as poverty has been identified as a big hindrance to accessing health care services among mothers in rural communities. There was need, however, to ascertain the effectiveness of this program. Aim: The study aimed at determining maternal mortality rate (MMR) from 2005 to 2009, its correlates, obstetric cause of death and to evaluate the effect of free maternal care on MMR. Methodology: MMRs were computed based on all maternal deaths and live births available in summary health report of Ika South local government area from 2005 to 2009. Correlational analysis was done to determine the correlates of MMRs. Statistical Package for Social Sciences (SPSS) version 16 (USA, 2007) was used in the analysis. Results: There was a reduction in MMR from 932/100,000 in 2005 to 604/100,000 in 2009. This reduction negatively correlated (r = -0.74, P = 0.15) with an increase in antenatal care registration within the period. The gradual increase in proportion of child delivery in health facilities from 59% in 2007 to 74.6% (2288/3065) in 2009 negatively correlated (r = -0.5, P = 0.4) with a reduction in MMR from 836/100,000 to 604/100,000. The number of skilled staff employed increased by 36.4% (51/140) since 2005 and negatively correlated (r = -0.34, P = 0.56) with MMR reduction of 328/100,000 since that period, with the employment of nurses being the stronger correlate (r = -0.48, P = 0.41). Hemorrhage (44%) was the leading obstetric cause of death. Conclusion: The study showed that MMR has been on a gradual downward trend since the introduction of free maternal health services in Delta State, Nigeria.
Global Journal of Medicine and Public Health. 2015; 4(1):7 p.Background: At least four out of ten women will develop unpredictable complications during pregnancy, childbirth and time after delivery which if not treated, contributes to the high observed maternal mortality worldwide. Access to Emergency Obstetric Care (EmOC) has been identified as one of the key strategies for maternal mortality reduction. This study assessed the availability of EmOC resources and service provision in Zaria Local Government Area (LGA) of Kaduna State, North Western Nigeria. Methods: Using a cross---sectional descriptive study, twenty public and private health facilities that offered antenatal care and delivery services in Zaria LGA of Kaduna State were studied in July 2012. Data was collected on availability of EmOC resources and services using checklist and interviewer---administered questionnaire. Results: None of the primary health care facilities had up to four midwives recommended for 24 hours delivery services, while five of the eight secondary health facilities (62.5%) had at least four midwives. There was dearth of equipment and drugs for EmOC service provision as only 10.0% primary health facilities and 40.0% of secondary health facilities had adequate equipment and drugs to provide EmOC service. Only two secondary health facilities (25%) performed signal functions recommended for comprehensive EmOC facility and additional three secondary health facilities (37.5%) performed signal functions recommended for basic EmOC facility, however, none of the primary health care facilities performed signal functions recommended for Basic EmOC facility. Availability of equipment was the only factor found to be significantly associated with EmOC service provision in the facilities (p = 0.032), but when stratified based on level of care (primary and secondary), no significantly associated was found (p = 0.429). Conclusion: Health facilities in Zaria LGA lacked adequate resources to provide EmOC services and EmOC service provision was abysmally low. Health planners and policy makers should step up interventions for providing the necessary resources to accelerate the attainment of Millennium Development Goal 5 (MDG 5).
Sexual health behavior of adolescents: A school based study conducted in Kathmandu district of Nepal.
Global Journal of Medicine and Public Health. 2015; 4(1):8 p.Adolescent (10-19 years) is a transitional phase of life marked by vulnerability to various risky sexual behaviors. The main aim of this study was to assess the sexual health behaviors of adolescent studying at grade nine and ten in a school of Kathmandu district, Nepal. A school based, descriptive cross-sectional study was carried out among all students (n=133 adolescents) aged 14 to 18 years studying at grade nine and ten. A structured self-administered questionnaire was adopted as a data collection technique. The data was entered into Statistical Package for Social Sciences (SPSS) version 16 and analysis was done by using simple descriptive and inferential statistics. The p-value less than 0.05 (5% level of significance) was considered to be statistically significant. Almost 66.9% of adolescents were aware about the concept of safer sex and 9% adolescents had done sexual intercourse. The median age at first sexual exposure was found to be 15.0 years. Majority (88.7%) of the respondents had no parent-child communication at home on matters related to risky sexual behavior. The late aged adolescents were more sexually exposed than the middle aged adolescents but condom use at first sexual exposure was found more among middle aged adolescents. Almost 91.66% of sexually exposed adolescents were male. The sex of the respondents, peer pressure to have risky sexual behavior, age categories were found as important factors for the sexual initiation of the adolescent groups. Therefore, peer groups approach should be designed and implemented for bringing desirable change in adolescents’ sexual practice.
Knowledge and attitude regarding STIs including HIV and RTIs among college adolescent girls in urban Udupi Taluk.
Global Journal of Medicine and Public Health. 2015; 4(2):6 p.Background: Adolescents compared to individuals in any other age group are most susceptible to sexually transmitted infections (STIs) including HIV (Human Immunodeficiency Virus) and reproductive tract infections (RTIs). Adolescents are vulnerable to STIs including HIV that account for 31 percent of the AIDS burden in India. Objective: To assess knowledge and attitude among adolescent girls regarding STIs including HIV/AIDS and RTIs. Methods A cross-sectional study was carried out among 17-19 year old college going adolescents studying in degree colleges in the urban area of Udupi taluk. A total of 410 adolescent girls were selected using cluster sampling with proportionate allocation method. A pre-tested, self-administered questionnaire was used to collect data, and anonymity was maintained. SPPS version 15 was used to analyze the data. Findings were depicted as percentages and proportions. Results: Around 14% of the adolescent girls had comprehensive knowledge regarding HIV/AIDS. Poor knowledge was reported among adolescent girls regarding STIs/RTIs other than HIV/AIDS. Around 27% had heard of STIs while 15% had knowledge regarding RTIs. Conclusion: The study identified lacunae in knowledge regarding STIs/RTIs and misconceptions on HIV transmission. Adolescents need to be educated regarding sexual and reproductive health and also to focus on capacity building of mothers and teachers to improve adolescents’ knowledge and attitude.
Global Journal of Medicine and Public Health. 2015; 4(2):9 p.The antenatal care and child immunization are important strategies for reducing maternal and infant mortality rate. The present study aims to measure the economic and educational inequity in the use of antenatal care and child immunization for the state of Goa. The data for the present study was collected using a cross sectional study design based on two stage stratified random sampling method in North Goa District. The sample size consisted of 250 mothers delivered during last two years for measuring antenatal care, and 250 mothers of children in the age group 12-24 months. The data was analyzed using chi-square test, logistic regression, Lorenz’s curve and Gini coefficient. The analysis of the data revealed that the use of antenatal care was 78.2% and the use of child immunization was 89.2 %. There was significant disparity in the use of antenatal care and use of child health care according to education of mother, religion and socio-economic status of mother. The Gini coefficient for the utilization antenatal care was 0.07 and 0.11 for educational and economic inequity respectively, whereas the Gini coefficient for child immunization was 0.04 and 0.03 for educational and economic inequity respectively. The inequity was more in use of antenatal care compared to child immunization, which highlights the needs for health administrators to reduce the gap in the antenatal care services provided to the pregnant women.
Assessing childhood malnutrition in Haiti: Meeting the United Nations Millennium Development Goal #4.
Global Journal of Medicine and Public Health. 2015; 4(2):7 p.Background: The United Nations (UN) Millennium Developmental Goal #4 addresses needed reductions in childhood mortality. A major cause of death in Haitian children is malnutrition and starvation. Objectives: Our primary objective was to identify population characteristics of children living in rural Haiti that may place them at higher risk of malnutrition than others. Armed with this knowledge, community health workers can recognize and attribute resources to those most in need. We will also examine the overall nutrition status in the population of interest and compare to the UN Millennium Goal statistics. Study design: The study cohort consisted of 103 children under the age of 5 years, who were consecutively seen in a rural medical clinic from 4 communities in the Thomazeau region of Haiti over a 7-day time period. Families were asked the following five questions: (1) How many children do you have? (2) What is the birth order of this child (1st, 2nd, etc.)? (3) What is the distance between your house and clean water? (4) Do you obtain water for your family? (5) What was the highest grade you finished in school? The medical team recorded each child’s gender, age, height, weight, household size, when the last meal was eaten, and last time protein was ingested. Nutritional status was assessed using World Health Organization growth standards. The data was then analyzed to determine each child’s level of malnutrition as measured by weight-for-height Z-score (number of standard deviations [SD] below reference value), percentage of malnutrition for all children surveyed, and whether correlations existed between malnutrition level and number of siblings, household size, or location. Trends were defined as associations significant at p<0.10. Results: The average age of the cohort was 2.1 years (range of 0-4 years). Average weight-for-height Z-score, number of siblings, and total number in the household were -0.29, 3.8, and 7.0, respectively. Eleven children (10.9%) were found be moderately malnourished (2-3 SD below normal Z-score) and an additional 5.9% were severely malnourished status (>3 SD below normal Z-score). Using a parsimonious multivariable regression model to compare family structure factors to anthropomorphic variables, multi-parity was positively associated with Z- score (p<0.05), suggesting that later birth-order may be protective. There was also a significant difference in nutritional status among the 4 communities surveyed with the two that were the furthest (2-hour walk) having 10.9% and 12.9% of children malnourished. Conclusion: In this cohort, malnutrition is prevalent in this region of rural Haiti. Children of new versus experienced mothers may have children at higher risk perhaps because new mothers are less knowledgeable and skilled at securing proper nutrition for their babies. Alternatively, more experienced mothers may simply have more resources. Additionally, distance from a medical clinic may prevent treatment for endemic parasites and other common illnesses compounding the effects of food shortage. Based on these findings, we can educate community health workers to focus attention and resources toward these at-risk families to prevent malnutrition and decrease child mortality thus progressing towards the UN Millennium Goal #4.
Hazardous traditional practices during postnatal care in low resource setting: A cross sectional study.
Global Journal of Medicine and Public Health. 2015; 4(3):6 p.Introduction: Postnatal care has a positive impact on maternal as well as child health. This period is culturally as well as traditionally sensitive; which is clearly reflected in WHO 1998 theme "Pregnancy is special, let’s keep it safe". Objective: To determine the existing postnatal care practices in rural community of Vantamuri primary health centre (PHC). Materials and Methods: A total of 390 women who delivered in the three sub centres of Vantamuri PHC, Belagavi district between 1st November 2009 to 31st October 2010 were interviewed at home. Predesigned and pretested questionnaire was used to collect the information. Results: It was found that 29% women discarded colostrums. Only 26% women initiated breastfeeding within 1 hour and 47% women applied some traditional mixture on the umbilical cord. Conclusion: Postnatal care is not free from hazardous traditional practices in the study area.
Global Journal of Medicine and Public Health. 2015; 4(3):8 p.Introduction: Improving knowledge on obstetric danger signs and promoting birth preparedness practices is a major strategy to increase the utilization of quality health services during pregnancy and childbirth. The aim of this study was to assess knowledge and practices of women on birth preparedness and complication readiness and factors associated with it. Methods: A community-based survey based on proportionate cluster random sampling was conducted among 310 women who gave birth in the last 12 months preceding the study in Lekhnath municipality, Nepal. Results: Only 34.8%, 59.0% and 39.7% women had knowledge on at least two danger sign during pregnancy, child birth and post-partum respectively. Only one-third (33.2%) women had knowledge on all five components of birth preparedness and complication readiness (BPACR). About same proportion (34.2%) women were prepared for all five components of BPACR. But very few proportion (8.4%) women utilized all five prepaid items of BPACR. The study found significant association of BPACR with women’s education (p<0.001, Crude OR 38.65, 95% CI 9.26-160.68), antenatal care service (p- 0.003, Crude OR 11.47, 95% CI 1.51-86.73) and awareness on obstetric danger signs during pregnancy (Crude OR 33.25, 95% CI 17.57-68.58), delivery (Crude OR 10.34, 95% CI 5.33.-20.04), and post-partum (Crude OR 15.38, 95% CI 8.61-27.38). Conclusion: The study concluded low level of knowledge, preparedness and utilization of all essential components of BPACR and positive influence of women’s education, antenatal care service and awareness on obstetric danger signs in BPACR.
Global Journal of Medicine and Public Health. 2015; 4(4):6 p.IMR and MMR in tribal areas of Telangana are still worrisome. Often two main reasons attributed to this problem were; low number of institutional deliveries and deliveries in the absence of skilled health provider. This study intended to know how skilled are the skilled health providers and it attempted to measure the knowledge and skills of Female Health Workers in maternal care, labour/child birth and neonatal care including communication skills. The participants’ perceived training needs were also considered as important and included in this study. Out of 700 notified scheduled villages, the participants were covered approximately in 1:2 ratio (n=350). Nearly 80% (mean=281.5) of the participants obtained scores below 50% and nearly 50% (mean=168.5) of the participants have scored below 30%. The scores of 40% of the participants reflected poor communication skills. Scores in all the areas found to be poor. Scores on skills in maternal care were better than skills in childbirth and scores on skills in child birth were better than neonatal care. On the scale of perceived training needs, skills in Labour/Child birth was given top priority by participants followed by Neonatal care, Communication skills and Maternal care respectively.