Search results

The purpose of this study was to examine adverse outcomes associated with cesarean deliveries and to assess potential confounding factors.

A hospital-based cross-sectional study was conducted from September 1−30, 2019 using mixed methods of data collection. Multistage sampling was used to draw the eligible study participants. The sample size was calculated using the single population proportion formula. A systematic random sampling technique was used to draw the sample size. 180 original medical records were excluded because of having missed information, leaving 1,618 women as the study population. We used the questionnaire adapted from the Ethiopian Demographic and Health Survey to collect quantitative data and analyzed using SPSS version 22, while thematic analysis for qualitative measures was used to generate themes regarding associated perspectives of participants from a community.

More than 383 women delivered by cesarean section. 20% of the mothers with the mean age at birth of 26.1 ± 4.8 experienced adverse outcomes. Adjusted odds ratio (AOR) was used to measure the association of determinants and was 2.95 (95% CI 1.19–7.29) for nonuse of antenatal care, 3.18 (95% CI 1.43–6.94) for nonuse of prophylaxis, 4.28 (95% CI 1.58−11.61) for history of medical illness and 7.09 (95% CI 1.19−45.59) for use of substandard operation set up compared with their counterparts.

Strengths of the study include the finding of the study are reliably reported in mixed study methods examining hospital-based institutional and personal risk factors and exploring the whole community's perspectives. However, the important limitations of the study indicate that the study poses a number of challenges related to studying design, therefore there was not sufficient evidence of causality to draw conclusions from the findings. In addition, the study was conducted at a single hospital so that it is not convenient to generalize the findings of the study for setting different in social and economic status.

Based on the findings, attention has been drawn to healthcare personnel to provide training and consultation services for pregnant women and for health care administration to ensure standard set up for operation.

The aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.

The data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.

The results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, received no advice about the delivery place, no pregnancy complications, decision about health care, and prior plan for home delivery were identified as significant predictors of home delivery. Cost of services, cultural practices and attitude towards health facility, lack of a female delivery assistant, perceived fear of caesarian section, poor quality of services, and lack of knowledge about maternity services appeared as important barriers for institutional delivery.

Based on primary data from a rural area, this study would help understand reasons and factors affecting home delivery and developing an appropriate strategy for the improvement of institutional delivery and maternity care services in Bangladesh.

This study aims to explore whether there is an association between women's empowerment and the utilization of maternal healthcare facilities.

This study considered four indices for measuring women's empowerment – labor force participation index (LFPI), decision-making power index (DMPI), attitude toward partner’s violence index (ATPVI) and knowledge level index (KLI) – and three healthcare facilities – number of antenatal visits, delivery with healthcare facilities and postnatal checkup after delivery. Data extracted for this study were from the Bangladesh Demographic and Health Survey 2011 and 2014. A chi-square test was used for bivariate analysis, and a three-level logistic regression model was applied for multivariate analysis.

An increment was observed in the practice of all considered healthcare facilities, and the percentage of highly empowered women in DMPI decreased from 2011 to 2014. This study found that higher empowerment of women in DMPI, KLI and ATPVI significantly (p-value < 0.05) increases the utilization of healthcare facilities. High empowerment of mothers in LFPI was found negatively associated with facility delivery and positively associated with the postnatal checkup.

Women's empowerment was found significantly associated with the utilization of maternal healthcare facilities. This study is seeking the attention of corresponding authority to come up with a more effective intervention program to empower women to utilize maternal healthcare facilities.

The purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth.

This is a scoping literature review based on the synthesis of secondary literature.

Not all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care.

There are a few published literature on the topic in sub-Saharan Africa.

This review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies.

The findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being.

The paper is original.

Gombe state in northeast Nigeria records a high prevalence of home deliveries with very low facility deliveries despite the efforts of government and international non-governmental organizations in supporting maternal health services. The purpose of this paper is to assess the factors influencing the decision to choose a birth center by pregnant women in Gombe, Nigeria.

The design was a cross-sectional study of women from a baseline survey conducted in August 2016 in Gombe state, Nigeria. Data on women groups’ utilization of maternal services with a focus on antenatal care, delivery and postnatal care were collected using a structured questionnaire used for household survey conducted in the state. Data for 157 pregnant women from the sample of 750 women (15–49 years) were selected for the purpose of this analysis. Descriptive statistics, bivariate and multivariate analyses were used to determine the factors associated with choice of birth center.

Religion (AOR=12.117, 95% CI 1.774–82.741), paid work (AOR=3.633, 95% CI 1.243–10.615) and identification and knowledge of pregnancy complications (AOR=4.281, 95% CI 1.054–17.387) were the factors found to be significantly associated with choice of birth center by pregnant women. Age, education, closeness to a facility and decision by husband or woman were not found to be statistically significant.

The significance of disseminating knowledge about pregnancy complications, role of religious leaders and encouraging savings from women earnings need attention of the government to improve facility-based delivery.

Corporate social responsibility (CSR) in India includes education, environment, healthcare and rural development. In post-liberalized India, the healthcare sector (services and facilities) has grown in leaps and bounds over last two decades. The purpose of this paper is to reveal and explain the CSR profile of select healthcare companies of India and reveal gaps and scope of healthcare activities with a special consideration towards maternal health.

Primary data are collected from seven listed companies of Goa state which were willing to participate in the study. In total, 67 companies constituting the Healthcare Sector Index of Standard & Poor of the Bombay Stock Exchange are considered as secondary source. Data of 59 companies that come within the threshold of Companies Act, 2013, are studied. CSR guidelines (with a turnover of Rs 10bn or a market capitalization of Rs 5bn or a net profit of Rs 50m) are taken as an initial frame of reference.

In total, 89.83 per cent of these companies have initiatives related to health care. Structured companies (contribute to the company’s overall mission and goals) with CSR policy have committee size varying from three to five directors with an independent director. During 2016–2017, they were mandated to spend Rs 4.2613bn out of which only 74.59 per cent was spent. Geographical spread of CSR initiatives is skewed, with majority of companies focussing on the states of Maharashtra and Gujarat, whereas the states of Odisha and North-Eastern being neglected. The focus areas of CSR are education, healthcare and rural development. The variation of MMR in different states of India is an indicator for corporate as to which state needs more attention. The corporate sector in India needs to focus on SDG3 target of MMR and move towards a newer dimension and direction.

The originality of this paper lies in the recognition of the initiative of Government of India of weaning out CSR activities outside the purview of business sense and towards instilling a social sense in company behaviour. This is a dimensional and directional change in the evolution of CSR practices in companies and countries. To this end, 59 healthcare sector companies under the threshold of Companies Act 2013 were studied and results were outlined.

The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study.

A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions (n = 32) were conducted through purposeful sampling method. Data was analysed thematically.

Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users’ related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation.

The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.

The practice of consanguinity has been culturally preferred in most Arab countries, including Morocco. This behavior leads to an increase in genetic abnormalities, such as hypertension and diabetes. This paper examines the prevalence and determinants of first-cousin marriages and their impact on diabetes among offspring.

Data on 882 couples were collected through face-to-face interview via a pre-established questionnaire based on the variables selected within the objectives of this study. The authors used the multiple logistic regression modeling procedure in this study.

The results of the study indicate that the prevalence of first-cousin marriages were 15% among students’ parents. From the multiple logistic regression modeling, the authors found a significant effect of paternal and maternal grandparents’ first-cousins marriage on that of parents (aOR = 3.27 and aOR = 3.36, respectively). However, an 11-fold higher risk of first relative marriages among parents once the paternal and maternal grandparents were first-cousins and the father was illiterate (aOR = 11.01). Moreover, the authors reported a diabetes risk of more than 14 times when the effects of first-cousin maternal grandparents and parents and the hypertension among mother or her sibling were combined (aOR = 14.48) or when the effects of first-cousins maternal grandparents, first-cousin parents and mother’s age at marriage between 21 and 29 years were combined (aOR = 14.56).

First-cousin marriage depends on the father’s illiteracy and the consanguinity of grandparents’ factors. The cumulative effect of first-cousin marriage among grandparents, parents and a family history of hypertension among mother or her sibling increase the risk of diabetes among these mothers.

This study aimed to determine mothers' knowledge of children with congenital heart disease (CHD) and to examine the relationship between types of CHD, the duration of treatments, the perception of the severity of illness and the mothers' knowledge.

A correlation study was conducted among 84 mothers of children (from infancy to six years old) with CHD who had attended pediatric cardiology clinics and pediatric units in three tertiary hospitals in Bangkok, Thailand. The two questionnaires aimed to evaluate the mothers' knowledge and perceptions of the severity of illness. Descriptive statistics, Spearman's rank-order correlation and Fisher's exact test were used to analyze the data.

Knowledge levels of mothers of children with CHD were at a high level with a mean score of 34.79 (SD = 8.23), but the knowledge domain of preventing complications was at a low level with a mean score of 14.95 (SD = 5.28). The types of CHD and the perceptions of illness were not correlated with the mothers' knowledge, but the duration of treatments was significantly correlated (r = 0.271, p < 0.05).

Healthcare professionals, especially nurses, should emphasize proper health education on complication prevention and the duration of treatments for children. Moreover, mothers should be supported to nurture children with CHD to reduce possible complications and prepare for cardiac surgery where needed.