Gynecology and Obstetrics: A review of women healthcare system.

3. “Gynecology and Obstetrics: A review of healthcare system for
women in a tertiary care hospital in Rajshahi”
Presented by
Saima Akter
ID: 151211046
Session: Spring-2015
Department of Pharmacy
Varendra University

4. RESEARCH TOPIC:
“Gynecology and Obstetrics: A
review of healthcare system for
women in a tertiary care hospital
in Rajshahi”

5.  Introduction
Material and methods
Literature review
Results and discussion
Conclusion and summary
Reference
Project Overview

7. • Gynecology is the branch of physiology and medicine
which deals with the functions and diseases specific to
women and girls, especially those affecting the
reproductive system.
• On the other hand, obstetrics is a branch of medical
science that deals with pregnancy, childbirth, and the
postpartum period.
INTRODUCTION

8. Organ of Working:
INTRODUCTION

9. Disease Associated With Female
Reproductive System:
1. Cervical Cancer
2. Chlamydia
3. Gonorrhea
4. Endometriosis
5. Syphilis
6. Ovarian cancer
7. Menstrual cramping
8. Prolapsed uterus
INTRODUCTION

10. Type of Child Birth
INTRODUCTION
Vaginal
Delivery
Forceps
Delivery
Caesarian
Section
Vaginal Birth
After
Caesarian
Vacuum
Extraction

12. Objective setting and Study Design:
 Study was planned to determine the practical
scenario of the obstetrics and gynecology healthcare
system of women in a tertiary care hospital of
Rajshahi district.
 This was a cross sectional survey that was based on a
questionnaire and was conducted in inpatient and
outpatient of gynecology and obstetrics wards of
Rajshahi Medical College and Hospital, Rajshahi
,Bangladesh from 1st February 2018 till 15th June
2018.
MATERIAL & METHOD

13. Ethical Considerations:
 The human subjects only participated in this
interview, willingly, not forcefully, only use for
research purpose.
Data Collection and Research Instrument:
Involving a quantity research method of 500
interviewers in RMCH.
Data were collected by asking many question as
well as participated in the interview session.
The participants were both married and
unmarried reproductive women.
MATERIAL & METHOD

15. • Bangladesh has achieved important health gains over
the last decade. However, equivalent progress has not
been realized in the area of maternal health.
• Maternal health present a good understanding of the
key elements needed to reduce maternal mortality,
including skilled attendance at birth, effective referral
systems and access to quality emergency services to
manage complications.
• The study concludes that acceptance of antenatal
check up during last pregnancy have the greatest
potentiality to enhance the women reproductive health
behavior.
LITERATURE REVIEW

16. • Most of the C-section deliveries have been performed
without any valid demographic or medical reason. We
have observed from our research that there have been
some adverse effects on mothers and babies due to
caesarean deliveries.
• Attention is warranted towards reduction of the rising
trend of Caesarian operations. More care needs to be
given to pregnancy care, e.g., adequacy of rest,
reduction of psychological stress, ingestion of trace
elements and adequacy of food in all the trimesters.
LITERATURE REVIEW

17. • The concept of maternal morbidity is developing as a
new indicator for assessment of maternal healthcare
services.
• With the necessary inputs from the patients and the
attendants by pointing various drawbacks or
deficiencies should always be taken care of by the
hospital administration that will turn into a good
result of improvement in the hospital services to the
satisfaction of the patients.
LITERATURE REVIEW

19. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
Rural
Urban
Total
Rural Urban Total
Frequency 54 46 100
Percent 54 46 100
Resident Parameter

20. • I have Interviewed 100 respondent, among of them
54% women were from rural and 46% women were
from urban areas.
RESULT & DISCUSSION

21. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
15-25
26-35
36-55
56 and above
Total
15-25 26-35 36-55 56 and above Total
Frequency 52 29 10 9 100
Percent 52 29 10 9 100
Age Distribution

22. • After interviewing 100 respondent it is found that
52% of the respondent were among the age 15-
25years, 29% of the respondent were among the age
26-35years, 10 % of the respondent were among the
age 36-55years, 9% of the respondent were among the
age 56years to its above.
RESULT & DISCUSSION

23. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
Primary
SSC
HSC
Higher
Total
Primary SSC HSC Higher Total
Frequency 68 20 7 5 100
Percent 68 20 7 5 100
Educational Qualification

24. • Among total respondent it is found that 68%women
were primary passed, 20% women were SSC passed,
7% women were HSC passed,5% women were higher
degree passed. So it is found that the highest
percentage or respondents sere under graduate.
RESULT & DISCUSSION

25. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
House wife Service holder others Total
Percent 94 1 5 100
Frequency 94 1 5 100
Occupation

26. • In this survey after interviewing 100 patients and
among the total, it is found that 94% were house wife,
1% service holder and 5% were involved in others
occupation
RESULT & DISCUSSION

27. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
0 1 2 3
4
5
6
7
8
9
10
Total
0 1 2 3 4 5 6 7 8 9 10 Total
Frequency 9 43 22 15 3 2 1 1 2 1 1 100
Percent 9 43 22 15 3 2 1 1 2 1 1 100
No. of Children

28. • After interviewing 100 patients and among the total,
it is found that 9% of women have no children, 43%
women have only one child, 22% women have two
children, 15% women have three children, 3% women
have four children,2% women have five children, 1%
women have six children, 1% women have seven
children, 2% women have eight children, 1% women
have nine children and 1% women have 10 children.
RESULT & DISCUSSION

29. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No Total
Percent 50 50 100
Frequency 50 50 100
Idea About Precribed Medicine

30. • In this survey after interviewing 100 patients it is
found that 50% of the respondent has idea about
prescribed medicine and 50% of the respondent has
not any idea about prescribed medicine
RESULT & DISCUSSION

31. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
1-25-
26-35
36-55
56 and above
Total
1-25- 26-35 36-55 56 and above Total
Frequency 24 44 24 8 100
Percent 24 44 24 8 100
Age of Husband

32. • After interviewing 100 respondent it is found that
24% women’s husband was aging between1-25years,
44% women’s husband was aging between26-35years,
24% women’s husband was aging between36-55years,
8% women’s husband was aging between56 years to
above it.
RESULT & DISCUSSION

33. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
0
Primary
SSC
HSC
Higher
Total
0 Primary SSC HSC Higher Total
Frequency 5 56 27 7 5 100
Percent 5 56 27 7 5 100
Education of Husband

34. • Among total respondent it is found that 5%women’s
husband was illiterate,56%women’s husband was
primary passed, 27% women’s husband were SSC
passed, 7% women’s husband were HSC passed, 5%
women’s husband were higher degree passed. So it is
found that the highest percentage of respondents sere
under graduate.
RESULT & DISCUSSION

35. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
0 Business
Driver/Electritian/
Tailor
Farmar Labur
Teacher / service
holder
Total
Frequency 5 25 10 53 4 3 100
Percent 5 25 10 53 4 3 100
Husband's Occupation

36. • In this survey after interviewing 100 patients and
among the total, it is found that 5% respondent’s
husband were non-occupational, 25% respondent’s
husband were businessman, 10% respondent’s
husband were driver/electrician/ tailor,
53%respondent’s husband were farmer, 4%
respondent’s husband were labor and 3% respondent’s
husband were teacher or service holder.
RESULT & DISCUSSION

37. RESULT & DISCUSSION
0 1200-5000 -10000 +15,000- 30,000 Total
Percent 5 29 50 16 100
Frequency 5 29 50 16 100
0
50
100
150
200
250
Family Income

38. • In this survey after interviewing 100 patients and
among the total, it is found that 5% of the respondent
have zero family income, 29% of the respondent have
1200-5000tk family income, 50% of the respondent
have below 10000tk family income and 16% of the
respondent have 15000-30000tk family income.
RESULT & DISCUSSION

39. RESULT & DISCUSSION
0
10
20
30
40
50
60
70
80
90
100
11 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 30 31 32 Total
Frequency 1 2 9 7 9 4 15 6 15 6 7 5 1 6 2 1 1 1 2 100
Percent 1 2 9 7 9 4 15 6 15 6 7 5 1 6 2 1 1 1 2 100
Age During 1st Conception

40. • After interviewing 100 respondents it has found that
the respondents are conceived majority (15%) during
the age of 18 and 20.
RESULT & DISCUSSION

41. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Yes No Total
Percent 4 96 100
Frequency 4 96 100
Previous Prescription

42. • After interviewing 100 respondents it has found that
4% of the respondent has previous prescription and
96% of the respondent has no previous prescription.
RESULT & DISCUSSION

43. RESULT & DISCUSSION
Frequency
Percent0
10
20
30
40
50
60
70
80
90
100
42-52 kg
53-60kg
61 +
Total
42-52 kg 53-60kg 61 + Total
Frequency 14 44 42 100
Percent 14 44 42 100
Weight of Respondent

44. • After interviewing 100 respondents it has found that
14% of the respondent were weighted between 42-
52kg, 44% of the respondent were weighted between
53-60kg and 42% of the respondent were weighted
above 61kg.
RESULT & DISCUSSION

45. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Excecive bleeding Delivery Delivery with other
complecation
Infection tumor etc
in reproductiive
organ
Other problems Total
Percent 63 9 16 11 1 100
Frequency 63 9 16 11 1 100
Types of Sickness

46. • In this survey after interviewing 100 respondents,
it is found that 63% of the respondents were
suffering from excessive bleeding, 9% of the
respondents was delivery patient, 16% of the
respondents were suffering from delivery with
other complication, 11% of the respondent were
suffering from infection/tumor in reproductive
organ and 1% of the respondent was suffering
from other problems.
RESULT & DISCUSSION

47. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
addmited other than
delivery
Normal Cesarean Total
Percent 51 9 40 100
Frequency 51 9 40 100
Type of Delivery

48. • In this survey of 100 respondents, it has found that
51% of the respondent were admitted other than
delivery, 9% were admitted for normal delivery and
41% were admitted for cesarean delivery.
RESULT & DISCUSSION

49. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
WeaknessHeadacheNouse
a Abdominal pain
Weight and hair loss Abdominal pain Convulsion Total
Frequency 79 4 15 2 100
Percent 79 4 15 2 100
Symptom of the disease

50. • In this survey after interviewing 100 respondents, it is
found that 79% of the respondents were having
weakness, nausea, abdominal pain and headache. 4%
of the respondents were having Weight loss and hair
loss. 15% of the respondents were having abdominal
pain. 2% of the respondents were having convulsion.
RESULT & DISCUSSION

51. RESULT & DISCUSSION
10 11 12 13 14 Total
Frequency 2 25 48 21 4 100
Percent 2 25 48 21 4 100
0
20
40
60
80
100
120
AxisTitle
Age of 1st Period

52. • After interviewing 100 respondents, it is found that
2% of the respondent had their first period at the age
of 10, 25% the respondent had their first period at the
age of 11, 48%the respondent had their first period at
the age of 12, 21% the respondent had their first
period at the age of 13 and 4% the respondent had
their first period at the age of 14.
RESULT & DISCUSSION

53. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
Implant
Injection
Oral contraceptive
Others
Total
Implant Injection Oral contraceptive Others Total
Frequency 1 6 31 62 100
Percent 1 6 31 62 100
Birth Control Method

54. • In this survey after interviewing 100 respondents, it is
found that for birth control 1% respondent was using
implant, 6% respondent were using injection, 31%
respondent were using oral contraceptives (OCP) and
62% respondent were using other methods,
RESULT & DISCUSSION

55. RESULT & DISCUSSION
Frequency
Percent
0
10
20
30
40
50
60
70
80
90
100
Discharge of
menstrual cycle Caesarean
Ligation
Tumor / Stone
No Surgery
Total
Discharge of menstrual
cycle
Caesarean Ligation Tumor / Stone No Surgery Total
Frequency 3 8 8 2 79 100
Percent 3 8 8 2 79 100
Past Gynecological Surgery

56. • In this survey after interviewing 100 respondents, it is
found that 3% of the respondent were having surgery
for discharge of menstrual cycle, 8% of the
respondent were having surgery for Caesar, 8% of the
respondent were having surgery for ligation, 2% of
the respondent were having surgery for tumor or stone
and 79% of the respondent did not have record for
past gynecological surgery.
RESULT & DISCUSSION

57. RESULT & DISCUSSION
0
10
20
30
40
50
60
70
80
90
100
Arthritis Asthama Blood Pressure Blood pressure
with Diabetis
Epilepsi Others Total
Frequency 4 3 22 6 2 63 100
Percent 4 3 22 6 2 63 100
Past Medical History

58. • In this survey after interviewing 100
respondents, it is found that 4% of the
respondent were possessing arthritis, 3% of
the respondent were possessing asthma,
22% of the respondent were possessing
blood pressure, 6% of the respondent were
possessing blood pressure with diabetes,
2% of the respondent were possessing
epilepsy and 63% of the respondent were
possessing other problems.
RESULT & DISCUSSION

59. RESULT & DISCUSSION
Frequency
Percent0
10
20
30
40
50
60
70
80
90
100
0
Normal
Under Weight
Total
0 Normal Under Weight Total
Frequency 52 43 5 100
Percent 52 43 5 100
Weight of child during birth

60. • After interviewing 100 respondents, it is found that
52% of the respondent were not delivery patient so
that 52% data is not required for this data but 43%
child had normal had weight during birth and 5%
child had normal had weight during birth.
RESULT & DISCUSSION

61. RESULT & DISCUSSION
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dismenoreaha Irreguler bleeding Heavy flow Menopouse Normal Total
Percent 6 19 2 8 65 100
Frequency 6 19 2 8 65 100
Mestrual History

62. • In this survey after interviewing 100 respondents, it is
found that 6% of the respondents were having
dysmenorrheal, 19% the respondents were having
irregular bleeding, 2% the respondents were having
heavy flow, 8% the respondents had reached their
menopause stage and 65% the respondents were
having normal menstruation.
RESULT & DISCUSSION

64. • Obstetrics and gynecology is the branch of medicine
dealing with the administration of health care to
women, especially the diagnosis and treatment of
disorders affecting the female reproductive organ.
• As it has seen 50% of the respondent has not any idea
about prescribed medicine so, it should be in the
consideration of the hospital authority that the patient
should give an idea of the prescribed medicine
CONCLUSION & SUMMARY

65. • Most of the patients were from middle class family
and that is why they are coming in this hospital, so
they should be cared more lovingly.
• Reproductive health status in the rural area is not at all
satisfactory.
• This is expected to generate useful insights and may
assist health professionals and policy makers to define
the need for treatment and plan service delivery
models.
CONCLUSION & SUMMARY

66. • Besides this research the data of prescribed medicine
were also collected from respondents but for the
limited time it is not managed to analysis the data. In
near future I’m willing to analysis the data and from
this research we’ll be able to know what types of
medicine are using in women reproductive related
disease.
FUTURE SCOPE

67. • I’ve performed my research on gynecology
and obstetrics healthcare system of women
and similar types of research based on women
productive have been carried out in
worldwide.
Example:
• Maternal morbidity and associated factors at a
tertiary care hospital in Karachi.
• National low weight birth survey of India.
COMPARATIVE STUDY