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Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4281
Nakachwa MariaCorresponding author
School of Post Graduate Studies and Research, Nkumba University, Entebbe 237, Uganda
Uganda still grapples with a high maternal mortality rates of 336 deaths per 100,000. Expectant mothers across the country lack awareness about the availability of antenatal care services; yet attendance of antenatal care services during pregnancy is crucial in protecting the health of women and unborn children. This article describes a protocol for investigating the effectiveness of mobile telephone communication interventions on the utilization of antenatal care services among expectant mothers in the districts of Kyotera and Rakai Districts in Uganda. Under the protocol, 28 health facilities in the districts of Kyotera and Rakai will be selected using simple random sampling and allocated into the intervention and control arms at a ratio of 1:1. A total of 2224 expectant mothers receiving antenatal care from the sampled health facilities will be recruited using systematic sampling. Expectant mothers receiving antenatal care from facilities allocated into the intervention arm will receive mobile telephone voice and text messages reminders for scheduled ANC visits. The mobile telephone messages will further provide maternal health information and availability of ANC services on a fortnightly basis. On the other hand, expectant mothers receiving antenatal care from facilities allocated into the control group will not get any reminders for scheduled ANC visit and maternal health information through the mobile telephone communication platform. Expectant mothers in the control arm will receive standard maternal health care without reminders. Expectant mothers in both groups will provide baseline data, midterm data will be obtained from the ANC registers at 6 moths while end of term data will be collected after an intervention period of 12months. The data collected will include the number of antenatal care visits attended, antenatal care services obtained from the health facilities, sociodemographic factors and mobile telephone usage, ownership and knowledge. The anticipated outcomes are; increased awareness and utilization of ANC services.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3444
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.
Nov 2025 DOI 10.14302/issn.2379-7835.ijn-24-5360
Alam RashedCorresponding author
Background Malnutrition is a significant public health issue in Bangladesh, particularly impacting women and children. Rajshahi, marked by socio-economic disparities, offers a distinctive context to explore the nutritional status and health outcomes of these vulnerable groups. Objectives This study aims to assess the nutritional status of women and children in Rajshahi and investigate associated health outcomes. Additionally, it seeks to identify socio-economic and cultural factors that influence nutrition. Methods A mixed-methods approach was utilized, incorporating a cross-sectional survey of 460 households and in-depth interviews with mothers and caregivers. Anthropometric measurements were taken to evaluate the nutritional status of women and children, while dietary assessments measured nutrient intake and diversity. Logistic regression analysis was performed to determine the likelihood of malnutrition based on socio-economic characteristics, thereby identifying key risk factors. Results The findings indicate a troubling prevalence of malnutrition, with 36% of children under five classified as stunted and 25% as underweight. The analysis highlights critical factors contributing to chronic undernutrition, including maternal education, employment, and dietary diversity. Notably, mothers aged 27-37 exhibit a lower risk of undernutrition, and urban households with secure food access demonstrate better nutritional outcomes. Discussion Maternal education and employment were positively associated with better nutritional outcomes, as educated and employed mothers had higher chances of maintaining a normal BMI. Regular ANC visits (≥4 visits) were crucial for improved maternal nutrition. Household food security emerged as a significant determinant, with food-secure households showing better maternal nutritional status. Safe water access and adequate dietary diversity were also linked to improved maternal BMI. Additionally, factors such as child birth weight, exclusive breastfeeding, and childhood diarrhea significantly influenced maternal nutrition. Moreover, frequent antenatal care visits and a diverse diet are vital in mitigating undernutrition risks among children. Conclusion This study emphasizes the urgent need for targeted interventions to combat malnutrition in Rajshahi. Recommendations include implementing community-based nutrition education programs and improving access to healthcare services. By addressing the socio-economic and cultural determinants of nutrition, stakeholders can enhance health outcomes for women and children in the region, ultimately contributing to broader public health objectives in Bangladesh.
Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865
Abdullahi Dahie HassanCorresponding author
Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Róbert PókaCorresponding author
University of Debrecen, Faculty of Medicine, Department of Obstetrics and Gynecology.
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Nov 2017 DOI 10.14302/issn.2641-5526.jmid-17-1762
F. Phillips JamesCorresponding author
Columbia University Medical Center, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, 60 Haven Avenue, B-2 ,New York, NY 10032 USA
Despite widespread use of Geographic Information System (GIS) technology to strengthening health systems, the application of GIS to health systems strengthening in resource-poor Sub-Saharan Africa remains rare. Over the June 2012 to December 2013 period, the Ghana Health Service (GHS) conducted a pilot application of GIS to health systems development in one rural impoverished district of the Upper East Region (UER). Workers were deployed to gather coordinates of health care facilities throughout the UER. Coordinates were linked to routine health information data, and utilized to generate maps for guiding task prioritization. For example, geocoded Community-based Management of Severe Acute Malnutrition (CMAM) program data were used to target services in communities where the prevalence of childhood acute malnutrition was relatively high. GIS was pivotal in tracking and responding to infectious disease morbidity from causes such as diarrheal diseases and tuberculosis. UER Regional Health Administration (RHA) authorities are currently utilizing GIS to map antenatal care coverage, skilled birth deliveries, neonatal mortality, still births, family planning service caseloads as well as for targeting programmatic action. Experience emerging from this trial attests to the value of GIS in contributing to efforts to strengthen health systems in rural impoverished regions of Africa.
Jan 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1292
Salim Bin Ghouth AbdullaCorresponding author
Professor, Department of Community medicine, Hadramout University, Yemen.
Objective: A cross-sectional study was designed to collect socio-demographic and obstetric data about female teenagers who have pregnancy and visiting primary health care centers for antenatal care. Subjects and methods: Data were collected by a trained 60 medical students of the 6th level in Hadramout University during their post in primary health care centers from 20 May – 10 June 2008. A convenience sample of 237 teenagers who were attending the 12 PHC centers for antenatal care checking constituted the study subjects. Results: Fifty-one out of 237 (21.5%) pregnant women were of age 17 years or less. Most of them were from rural areas with statistically significant difference in both age groups (p-value <0.002),they were housewives (232/237 97.8%) and their husband’s mostly had non-professional jobs with a significant difference between both age groups (p-value <0.005). A high prevalence of anemia in teenage pregnant women was reported (76.7% of them had Hb level less than 11 g/dl) but there were no significant difference between mean Hb level in those at age of 17 years or less (9.9 SD=1) and those at age >17-<20 years (10.1 SD=1.18) p-value >0.05 About one-third of pregnant teenagers were second or multigravida (81/237 pregnant women 34.2%) but only 66 of them were delivered before. The majority of second/multigravida were delivered normally (57/66 pregnant women 86.4%) while only 31 of them (47%) gets their births in a health facility where LSCS was done for 9 pregnant women. The outcome of the pregnancy in teenage multigravida are 67 children; three of them were stillbirth and other 6 babies died within the first week of their life indicating the total children died during the perinatal period as 9 children ; so the perinatal mortality rate was very high in teenagers (9/67*1000 = 134/1000 births). Conclusions: Teenage pregnancy is common and accepted in Hadramout in Yemen; the main consequences are a high prevalence of anemia and high perinatal mortality rate.