This document discusses a study on childbirth practices in rural communities in Akpabuyo, Nigeria. The study found that:
1) The majority (84.6%) of births occurred outside formal health facilities and were attended by traditional birth attendants. Only 15.4% of births occurred in hospitals or health centers.
2) Common objects used to cut the umbilical cord included knives (46.2%) and new razor blades (30.8%), with knives being most common. Methylated spirits (63.1%) and "western medicine" (23.8%) were most commonly used to treat the umbilical cord after birth.
3) While 39.5% of women sought
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The document discusses a study that examined the relationship between antenatal care and the prevention of maternal mortality among pregnant women in Bauchi State, Nigeria. The study found:
1) A significant relationship existed between the level of awareness of antenatal care and the prevention of maternal mortality.
2) A significant relationship also existed between the level of utilization of antenatal care services and the prevention of maternal mortality.
3) The study recommended increasing awareness of antenatal care benefits and encouraging regular attendance to allow early detection of risks and reduce maternal mortality.
This document provides background information on a study exploring the implementation challenges of Ghana's Free Maternal Health Care policy at the St. Dominic Hospital in Akwatia. The policy was introduced to improve maternal health and reduce mortality. However, the hospital has seen a decline in supervised deliveries and an increase in maternal deaths among women aged 25-29. The study aims to identify policy-related, external, and internal factors challenging the policy's implementation and make recommendations to address these challenges.
The document discusses two studies on family planning in Uganda. The first study finds that the societal costs of induced abortions in Uganda in 2009 was over $64 million, more than 4% of annual health care expenditures. The second study finds that increasing access to modern contraceptives to meet all unmet need could reduce costs, fertility rates, abortions and complications while improving health outcomes. The analysis suggests universal access to contraception would be highly cost-effective.
Pandora's eggs: Social Darwinism v. Economic Rationalism in access to IVFLouise Miller Frost
assisted reproduction remains a hot topic, polarising opinions. This paper examines some of the dominant discourses and the underlying assumptions and philosophies.
Breastfeeding Practices of Postnatal Mothers: Exclusivity, Frequency and Dura...IJEAB
This study examined breastfeeding practices of 299 postnatal mothers in southeast Nigeria in terms of exclusivity, frequency, and duration. The results showed that most mothers exclusively breastfed for a short period, with 22.3% exclusively breastfeeding for 1 month and 31.5% for 4-6 months. The majority (80.7%) breastfed infants on demand day and night, while 40.5% reported infants suckling for over 20 minutes. Breastfeeding patterns were found to differ across primary, secondary, and tertiary health institutions, though not significantly. The study concluded that efforts are needed to motivate mothers to exclusively breastfeed for the recommended 6 months.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
Bangladesh Maternal Mortality and Health Care Survey 2016MEASURE Evaluation
Presentation from the dissemination of the Bangladesh Maternal Mortality and health Care Survey 2016. Dhaka, Bangladesh, November 22, 2017. United States Agency for International Development; UKaid; MEASURE Evaluation, the International Centre for Diarrhoeal Disease Research, Bangladesh; Bangladesh Ministry of Health and Family Welfare, and the Bangladesh National Institute of Population Research and Training
Breastfeeding Rates In The United States By Characteristics Of The Child,Biblioteca Virtual
This study analyzed breastfeeding rates in the United States using data from the 2002 National Immunization Survey. It found that over two-thirds of infants were ever breastfed, but rates of exclusive and continued breastfeeding dropped significantly by 6 and 12 months. Certain groups had lower rates, including non-Hispanic black children, those in daycare, enrolled in WIC, from lower socioeconomic status families, or younger or less educated mothers. The results suggest more efforts are needed to improve and support breastfeeding, especially among disadvantaged populations.
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The document discusses a study that examined the relationship between antenatal care and the prevention of maternal mortality among pregnant women in Bauchi State, Nigeria. The study found:
1) A significant relationship existed between the level of awareness of antenatal care and the prevention of maternal mortality.
2) A significant relationship also existed between the level of utilization of antenatal care services and the prevention of maternal mortality.
3) The study recommended increasing awareness of antenatal care benefits and encouraging regular attendance to allow early detection of risks and reduce maternal mortality.
This document provides background information on a study exploring the implementation challenges of Ghana's Free Maternal Health Care policy at the St. Dominic Hospital in Akwatia. The policy was introduced to improve maternal health and reduce mortality. However, the hospital has seen a decline in supervised deliveries and an increase in maternal deaths among women aged 25-29. The study aims to identify policy-related, external, and internal factors challenging the policy's implementation and make recommendations to address these challenges.
The document discusses two studies on family planning in Uganda. The first study finds that the societal costs of induced abortions in Uganda in 2009 was over $64 million, more than 4% of annual health care expenditures. The second study finds that increasing access to modern contraceptives to meet all unmet need could reduce costs, fertility rates, abortions and complications while improving health outcomes. The analysis suggests universal access to contraception would be highly cost-effective.
Pandora's eggs: Social Darwinism v. Economic Rationalism in access to IVFLouise Miller Frost
assisted reproduction remains a hot topic, polarising opinions. This paper examines some of the dominant discourses and the underlying assumptions and philosophies.
Breastfeeding Practices of Postnatal Mothers: Exclusivity, Frequency and Dura...IJEAB
This study examined breastfeeding practices of 299 postnatal mothers in southeast Nigeria in terms of exclusivity, frequency, and duration. The results showed that most mothers exclusively breastfed for a short period, with 22.3% exclusively breastfeeding for 1 month and 31.5% for 4-6 months. The majority (80.7%) breastfed infants on demand day and night, while 40.5% reported infants suckling for over 20 minutes. Breastfeeding patterns were found to differ across primary, secondary, and tertiary health institutions, though not significantly. The study concluded that efforts are needed to motivate mothers to exclusively breastfeed for the recommended 6 months.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
Bangladesh Maternal Mortality and Health Care Survey 2016MEASURE Evaluation
Presentation from the dissemination of the Bangladesh Maternal Mortality and health Care Survey 2016. Dhaka, Bangladesh, November 22, 2017. United States Agency for International Development; UKaid; MEASURE Evaluation, the International Centre for Diarrhoeal Disease Research, Bangladesh; Bangladesh Ministry of Health and Family Welfare, and the Bangladesh National Institute of Population Research and Training
Breastfeeding Rates In The United States By Characteristics Of The Child,Biblioteca Virtual
This study analyzed breastfeeding rates in the United States using data from the 2002 National Immunization Survey. It found that over two-thirds of infants were ever breastfed, but rates of exclusive and continued breastfeeding dropped significantly by 6 and 12 months. Certain groups had lower rates, including non-Hispanic black children, those in daycare, enrolled in WIC, from lower socioeconomic status families, or younger or less educated mothers. The results suggest more efforts are needed to improve and support breastfeeding, especially among disadvantaged populations.
Health System Factors Affecting Uptake of Antenatal Care by Women of Reproduc...Premier Publishers
This study sought to determine how health system factors affect antenatal care services uptake. A descriptive cross-sectional study design was adopted. The population under study was selected household members of the community, facility in charges as well as community own resource persons in Kisumu county. The study used purposive sampling method in selecting the Key Informants. A total sample size of 300 respondents were interviewed. The study used an interview and questionnaires to collect data. Descriptive statistics and chi-square tests were used to analyse data with the help of Statistical Package for the Social Sciences. Chi-square analysis showed that distance to facility (p=0.043), waiting time (p=0.012), means of transport used (p=0.016), perceived quality of services (p=0.000) and perceived attitude of service provider (p=0.000) were significant as pertains to number of ANC visits. The study concluded that health system factors affect uptake of ANC. Specifically, lack long distance to hospital, long waiting time, poor quality of services, commodity stock outs and poor attitude of staff. The combination of these factors reduced uptake of ANC. The study recommended integration of traditional birth attendants, community health workers and health care workers services, regular ANC Outreaches and better equipping of rural health facilities.
Factors influencing the practice of exclusive breast feeding in rural communi...Alexander Decker
This study aimed to identify factors influencing the practice of exclusive breastfeeding in rural communities in Osun State, Nigeria. The study surveyed 480 nursing mothers across 5 communities. It found that only 20% of respondents practiced exclusive breastfeeding, while 80% did not. Factors found to significantly influence breastfeeding practices included: the mother's age, marital status, occupation, family income, education, and number of children. Mothers with higher incomes, education, and older/more experienced mothers were more likely to practice exclusive breastfeeding. The study concluded that health workers need to address cultural barriers through education to promote exclusive breastfeeding among rural women.
195 place personnel & recollection three modalities on antenatal and new...ijtsrd
The involvement of CHWs in the state of UP has a long history since the 70s and currently it is the key strategy to percolate primary health care to the masses through the Front Line Workers like the Accredited Social Health Activists ASHA and the Angan Wadi Workers AWW . Dr. Tridibesh Tripathy | Dr. Uma Kant Prusty "Place, Personnel & Recollection- Three Modalities on Antenatal and Newborn Care Messages for Recently Delivered Women in Uttar Pradesh, India" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30774.pdf Paper Url :https://www.ijtsrd.com/medicine/ayurvedic/30774/place-personnel-and-recollection-three-modalities-on-antenatal-and-newborn-care-messages-for-recently-delivered-women-in-uttar-pradesh-india/dr-tridibesh-tripathy
Current point of view in preterm labor management in albania (2)Alexander Decker
This study examined the use of maintenance tocolysis therapy to prevent preterm labor in Albania. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks (n=200) had greater benefits, with pregnancy prolonged by 6-8 weeks on average. The authors conclude maintenance tocolysis therapy can considerably prolong pregnancy for women diagnosed with preterm labor between 28-32 weeks gestation, though larger studies are still needed.
Bangladesh Demographic and Health Survey(BDHS) Summary OutputFarhad Sohail
Bangladesh Demographic and Health Surveys (DHS) are nationally-representative household surveys that provide data for a wide range of monitoring and impact evaluation indicators in the areas of population, health, and nutrition in Bangladesh
Presented by G-8, MDS’11,
Masters of Development Studies,
University of Dhaka
UTILIZATION OF IMMUNIZATION SERVICES AMONG CHILDREN UNDER FIVE YEARS OF AGE I...AM Publications
Immunization is the key strategy to curb communicable diseases which are the number one killer of children under five. Immunization prevents mortalities of approximating three million children under five annually. This study aimed to assess utilization of immunization services among children under five of age in Kirinyaga County, Kenya.
Web of a problem exclusive breastfeeding ratesDenise Breheny
This document discusses factors that contribute to low rates of exclusive breastfeeding in the United States. It begins by outlining the Healthy People 2010 goals for breastfeeding initiation and duration, which have not been met. Major health organizations recommend exclusive breastfeeding for the first six months. The document then examines reasons why mothers experience difficulties breastfeeding and cease breastfeeding, such as breast discomfort, perceptions of insufficient milk, lack of support, and the need to return to work. Identifying groups at higher risk, like low-income mothers and those returning to work, can help address barriers and improve breastfeeding outcomes.
Abstract: Home deliveries is common in developing countries Kenya included where mothers are assisted by Traditional Birth Attendant during delivery. Most birth which occur at home can result in complications which cannot be handled in the absence of qualified health personel and a health facility. To reduce maternal mortality its important that mothers deliver in a hospital with qualified health personnel.
Objective: The study aimed at establishing the factors that contribute to home deliveries in both rural and urban Districts in Kenya.
Methodology: A cross sectional study design was preferred. A sample of four hundred postnatal mothers in Rural and Urban hospital attending maternal child health clinics were selected for the study. Eligibility was mothers who had delivered at home within one year prior to the study. Focus group discussion guides were used to collect data. Data was analyzed by correspondence and thematic analysis and presented in figures and summary narratives.
Results: Most mothers in rural area delivered at home compared to urban 119 Mothers delivered at home in rural while only 47 did so in rural area. This is associated with lack of money and transport. Home deliveries are preferred because they are cheap, no cost of travelling, TBA have a positive attitude and use polite language, there is one to one care so chances of self-delivery do not arise and mothers are in familiar environment.
Conclusion: Home deliveries are still common in Kenya despite availability of health services.
Recommendation: Health worker should improve during delivery on the care they give to the mother irrespective of their socio-economic status.
Keywords: Care during delivery, Home deliveries, Tradition birth attendants.
Title: Home Deliveries in Rural and Urban Districts in Kenya
Author: Priscilla Kabue
ISSN 2350-1049
International Journal of Recent Research in Interdisciplinary Sciences (IJRRIS)
Paper Publications
The document presents an evaluation report of the Maama Project in Uganda which aims to increase maternal and newborn health through community health workers conducting home visits and providing birth kits. The project was implemented in 5 villages in Uganda and sought to improve antenatal care attendance, facility deliveries, and newborn health practices through education and incentives. The evaluation assessed the impact of the project and provided recommendations to address challenges and improve coverage of essential interventions.
1. The study assessed the impact of food supplementation provided by the World Food Programme to patients enrolled in a home-based care program for chronically ill patients in Malawi, most of whom had HIV/AIDS.
2. The study compared the survival and nutritional status of patients who did not receive food supplementation before July 2003 to those who received supplementation after. It found that food supplementation did not improve patient survival or nutritional status, though it had a small non-significant effect on nutritional status.
3. Providing additional oil to some families may have improved survival slightly but did not affect nutritional status. The study concludes that food supplementation was not very effective for these patients, possibly because it was introduced too late or
Achievements and Implications of Care and Support Programme among Orphans and...QUESTJOURNAL
Background: In Nigeria, children who need special protection on the account of being in vulnerable situations are observably increasing due to growing levels of poverty and the poor socio-economic situation of the country and it is necessary to ameliorate the problem by strengthening the capacity of families. This article therefore presents the achievements of care and support programme among orphans and vulnerable children (OVC) in Bayelsa State, Nigeria as well as the implications for future programming. Methods: The project was an intervention study carried out among OVC in Bayelsa State, Nigeria. Four civil society organizations were engaged by Bayelsa State Agency for the Control of AIDS (BYSACA) under HIV and AIDS Fund (HAF) II project to provide care and support services for OVC. The target population consisted of paternal orphan or maternal orphan, double orphan and vulnerable children whose parents are infected with HIV but alive in six local government areas. A total of 3000 was an estimated sample size for this intervention and data were collected using various data reporting tools and analyzed using Microsoft Excel. Results: The total number of OVC reached during the project period was 5410 given a target reached of 180.3%. Among these, 87.7% of the children were reached with at least one service, 74.9% were reached with psychosocial services, nutrition (37.4%), educational services (33.3%), healthcare services (9.5%) and protection services (4.4%). Thirty-five children withdrawn from the programme and two children reported died during this project. Conclusion: Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as food, education, water, shelter and clothing, but also on long-term developmental needs that reduce children's vulnerability such as life skills, child protection, vocational training, food security, and household economic strengthening.
This study assessed causes and factors associated with neonatal mortality in the neonatal intensive care unit (NICU) of Jimma University Medical Center in Ethiopia between 2014-2017. Of the 3,276 neonates admitted, 412 (13.3%) died, equating to a mortality rate of 30 deaths per 1,000 live births. The majority of deceased neonates had low birth weight, prematurity, or respiratory distress syndrome. Residency outside of Jimma city, length of stay under 7 days, low birth weight, prematurity, respiratory distress syndrome, perinatal asphyxia, and congenital malformations were significantly associated with neonatal mortality. Addressing factors like antenatal care and early identification/referral of
The International Journal of Engineering and Science (IJES)theijes
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
Care Seeking for Newborn Illness a Changing Paradigm_Steve Wall_4.25.13CORE Group
The document discusses evidence from community health worker programs in multiple countries that care seeking for newborn illness from qualified providers outside the home is higher than originally assumed, as cultural taboos can be overcome through community education. It also examines the roles of community health workers in improving newborn care practices through home visits and facilitating care seeking, finding that while practices and care seeking increased, timely care seeking could still be improved. Overall, the key lessons highlighted are that demand for care can be generated through community programs, but treatment also needs to be accessible, and strengthening monitoring and follow up of referrals is important.
State of Maternal and Children's Health and Nutrition During Pandemic and Cal...KABAYAN Partylist
We are looking forward to sharing with you the highlights of the recent stakeholder consultation of KABAYAN Partylist and Development Academy of the Philippines on the State of Maternal and Children’s Health and Nutrition During the Pandemic held last December 03, 2020.
The presentations made during the event are summarized in the attached report entitled “Second Stakeholder Consultation on the State of Maternal & Children’s Health and Nutrition During Pandemic and Calamities” which brings together the reports, excerpts, and key findings given by Cong. Ron P. Salo, Cong. Stella Quimbo, Department of Health Usec. Rosario Vergeire, Philippine Center for Population and Development Former Executive Director Dr. Jondi Flavier, DAP Family Medicine Consultant Dr. Jewehl Salo, and representatives from the Department of Social Welfare and Development during the event.
This document proposes health promotion strategies to increase family planning uptake in North Eastern Kenya. It begins with an analysis of the region's low contraceptive prevalence rate of 4% compared to the national average of 46%. It then recommends a multi-pronged approach including educational activities to provide family planning information, behavior change programs, medical outreach services, empowerment of women and youth, and policy advocacy. The proposed interventions aim to address social determinants of family planning at various levels of the community through strategies grounded in health behavior theories.
This document is a demographic research proposal investigating the determinants of modern contraceptive use among unmarried female adolescents aged 15-19 in Malawi. It begins with an introduction that provides background on the sexual and reproductive health problems faced by this population and discusses Malawi's efforts to address this issue through youth friendly health services. The problem statement notes that while modern contraceptive use has increased, unplanned pregnancy rates remain high. The literature review covers sexual health issues, benefits of modern contraceptives, and factors influencing use worldwide and in Malawi. The objectives and research questions aim to examine the association and influence of various determinants on modern contraceptive use. The methodology section outlines the study design, data sources, variables, and analysis
This document summarizes a study on the motivational drivers for non-skilled Kenyan community health volunteers. The study found that the largest proportion of volunteers provide services in maternal and child health and HIV/AIDS and malaria. The main motivations for volunteers include fulfilling religious values, serving humanity, and access to training and support. Most volunteers are female and over 30 years old, with the largest group providing maternal and child health services. Their motivations help address healthcare worker shortages in Kenya.
The Public Utilities Commission of Sri Lanka issued a consultation paper on setting electricity tariffs for the period of 2011-2015. The paper presented key issues for public comment, including sales forecasts and allowed losses for transmission and distribution licensees. Distribution licensees filed sales forecasts and loss allowances between 2011-2015 ranging from 11-14.8% losses. The transmission licensee filed purchases from generation and loss allowances of 11% for 2011. The paper proposed allowed revenues for licensees and the provision for energy sold for street lighting. It analyzed government subsidies to the electricity sector and presented a roadmap for tariff restructuring and rebalancing to achieve cost-reflective tariffs by 2015. Finally, the paper outlined proposed electricity tar
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
Health System Factors Affecting Uptake of Antenatal Care by Women of Reproduc...Premier Publishers
This study sought to determine how health system factors affect antenatal care services uptake. A descriptive cross-sectional study design was adopted. The population under study was selected household members of the community, facility in charges as well as community own resource persons in Kisumu county. The study used purposive sampling method in selecting the Key Informants. A total sample size of 300 respondents were interviewed. The study used an interview and questionnaires to collect data. Descriptive statistics and chi-square tests were used to analyse data with the help of Statistical Package for the Social Sciences. Chi-square analysis showed that distance to facility (p=0.043), waiting time (p=0.012), means of transport used (p=0.016), perceived quality of services (p=0.000) and perceived attitude of service provider (p=0.000) were significant as pertains to number of ANC visits. The study concluded that health system factors affect uptake of ANC. Specifically, lack long distance to hospital, long waiting time, poor quality of services, commodity stock outs and poor attitude of staff. The combination of these factors reduced uptake of ANC. The study recommended integration of traditional birth attendants, community health workers and health care workers services, regular ANC Outreaches and better equipping of rural health facilities.
Factors influencing the practice of exclusive breast feeding in rural communi...Alexander Decker
This study aimed to identify factors influencing the practice of exclusive breastfeeding in rural communities in Osun State, Nigeria. The study surveyed 480 nursing mothers across 5 communities. It found that only 20% of respondents practiced exclusive breastfeeding, while 80% did not. Factors found to significantly influence breastfeeding practices included: the mother's age, marital status, occupation, family income, education, and number of children. Mothers with higher incomes, education, and older/more experienced mothers were more likely to practice exclusive breastfeeding. The study concluded that health workers need to address cultural barriers through education to promote exclusive breastfeeding among rural women.
195 place personnel & recollection three modalities on antenatal and new...ijtsrd
The involvement of CHWs in the state of UP has a long history since the 70s and currently it is the key strategy to percolate primary health care to the masses through the Front Line Workers like the Accredited Social Health Activists ASHA and the Angan Wadi Workers AWW . Dr. Tridibesh Tripathy | Dr. Uma Kant Prusty "Place, Personnel & Recollection- Three Modalities on Antenatal and Newborn Care Messages for Recently Delivered Women in Uttar Pradesh, India" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30774.pdf Paper Url :https://www.ijtsrd.com/medicine/ayurvedic/30774/place-personnel-and-recollection-three-modalities-on-antenatal-and-newborn-care-messages-for-recently-delivered-women-in-uttar-pradesh-india/dr-tridibesh-tripathy
Current point of view in preterm labor management in albania (2)Alexander Decker
This study examined the use of maintenance tocolysis therapy to prevent preterm labor in Albania. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks (n=200) had greater benefits, with pregnancy prolonged by 6-8 weeks on average. The authors conclude maintenance tocolysis therapy can considerably prolong pregnancy for women diagnosed with preterm labor between 28-32 weeks gestation, though larger studies are still needed.
Bangladesh Demographic and Health Survey(BDHS) Summary OutputFarhad Sohail
Bangladesh Demographic and Health Surveys (DHS) are nationally-representative household surveys that provide data for a wide range of monitoring and impact evaluation indicators in the areas of population, health, and nutrition in Bangladesh
Presented by G-8, MDS’11,
Masters of Development Studies,
University of Dhaka
UTILIZATION OF IMMUNIZATION SERVICES AMONG CHILDREN UNDER FIVE YEARS OF AGE I...AM Publications
Immunization is the key strategy to curb communicable diseases which are the number one killer of children under five. Immunization prevents mortalities of approximating three million children under five annually. This study aimed to assess utilization of immunization services among children under five of age in Kirinyaga County, Kenya.
Web of a problem exclusive breastfeeding ratesDenise Breheny
This document discusses factors that contribute to low rates of exclusive breastfeeding in the United States. It begins by outlining the Healthy People 2010 goals for breastfeeding initiation and duration, which have not been met. Major health organizations recommend exclusive breastfeeding for the first six months. The document then examines reasons why mothers experience difficulties breastfeeding and cease breastfeeding, such as breast discomfort, perceptions of insufficient milk, lack of support, and the need to return to work. Identifying groups at higher risk, like low-income mothers and those returning to work, can help address barriers and improve breastfeeding outcomes.
Abstract: Home deliveries is common in developing countries Kenya included where mothers are assisted by Traditional Birth Attendant during delivery. Most birth which occur at home can result in complications which cannot be handled in the absence of qualified health personel and a health facility. To reduce maternal mortality its important that mothers deliver in a hospital with qualified health personnel.
Objective: The study aimed at establishing the factors that contribute to home deliveries in both rural and urban Districts in Kenya.
Methodology: A cross sectional study design was preferred. A sample of four hundred postnatal mothers in Rural and Urban hospital attending maternal child health clinics were selected for the study. Eligibility was mothers who had delivered at home within one year prior to the study. Focus group discussion guides were used to collect data. Data was analyzed by correspondence and thematic analysis and presented in figures and summary narratives.
Results: Most mothers in rural area delivered at home compared to urban 119 Mothers delivered at home in rural while only 47 did so in rural area. This is associated with lack of money and transport. Home deliveries are preferred because they are cheap, no cost of travelling, TBA have a positive attitude and use polite language, there is one to one care so chances of self-delivery do not arise and mothers are in familiar environment.
Conclusion: Home deliveries are still common in Kenya despite availability of health services.
Recommendation: Health worker should improve during delivery on the care they give to the mother irrespective of their socio-economic status.
Keywords: Care during delivery, Home deliveries, Tradition birth attendants.
Title: Home Deliveries in Rural and Urban Districts in Kenya
Author: Priscilla Kabue
ISSN 2350-1049
International Journal of Recent Research in Interdisciplinary Sciences (IJRRIS)
Paper Publications
The document presents an evaluation report of the Maama Project in Uganda which aims to increase maternal and newborn health through community health workers conducting home visits and providing birth kits. The project was implemented in 5 villages in Uganda and sought to improve antenatal care attendance, facility deliveries, and newborn health practices through education and incentives. The evaluation assessed the impact of the project and provided recommendations to address challenges and improve coverage of essential interventions.
1. The study assessed the impact of food supplementation provided by the World Food Programme to patients enrolled in a home-based care program for chronically ill patients in Malawi, most of whom had HIV/AIDS.
2. The study compared the survival and nutritional status of patients who did not receive food supplementation before July 2003 to those who received supplementation after. It found that food supplementation did not improve patient survival or nutritional status, though it had a small non-significant effect on nutritional status.
3. Providing additional oil to some families may have improved survival slightly but did not affect nutritional status. The study concludes that food supplementation was not very effective for these patients, possibly because it was introduced too late or
Achievements and Implications of Care and Support Programme among Orphans and...QUESTJOURNAL
Background: In Nigeria, children who need special protection on the account of being in vulnerable situations are observably increasing due to growing levels of poverty and the poor socio-economic situation of the country and it is necessary to ameliorate the problem by strengthening the capacity of families. This article therefore presents the achievements of care and support programme among orphans and vulnerable children (OVC) in Bayelsa State, Nigeria as well as the implications for future programming. Methods: The project was an intervention study carried out among OVC in Bayelsa State, Nigeria. Four civil society organizations were engaged by Bayelsa State Agency for the Control of AIDS (BYSACA) under HIV and AIDS Fund (HAF) II project to provide care and support services for OVC. The target population consisted of paternal orphan or maternal orphan, double orphan and vulnerable children whose parents are infected with HIV but alive in six local government areas. A total of 3000 was an estimated sample size for this intervention and data were collected using various data reporting tools and analyzed using Microsoft Excel. Results: The total number of OVC reached during the project period was 5410 given a target reached of 180.3%. Among these, 87.7% of the children were reached with at least one service, 74.9% were reached with psychosocial services, nutrition (37.4%), educational services (33.3%), healthcare services (9.5%) and protection services (4.4%). Thirty-five children withdrawn from the programme and two children reported died during this project. Conclusion: Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as food, education, water, shelter and clothing, but also on long-term developmental needs that reduce children's vulnerability such as life skills, child protection, vocational training, food security, and household economic strengthening.
This study assessed causes and factors associated with neonatal mortality in the neonatal intensive care unit (NICU) of Jimma University Medical Center in Ethiopia between 2014-2017. Of the 3,276 neonates admitted, 412 (13.3%) died, equating to a mortality rate of 30 deaths per 1,000 live births. The majority of deceased neonates had low birth weight, prematurity, or respiratory distress syndrome. Residency outside of Jimma city, length of stay under 7 days, low birth weight, prematurity, respiratory distress syndrome, perinatal asphyxia, and congenital malformations were significantly associated with neonatal mortality. Addressing factors like antenatal care and early identification/referral of
The International Journal of Engineering and Science (IJES)theijes
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
Care Seeking for Newborn Illness a Changing Paradigm_Steve Wall_4.25.13CORE Group
The document discusses evidence from community health worker programs in multiple countries that care seeking for newborn illness from qualified providers outside the home is higher than originally assumed, as cultural taboos can be overcome through community education. It also examines the roles of community health workers in improving newborn care practices through home visits and facilitating care seeking, finding that while practices and care seeking increased, timely care seeking could still be improved. Overall, the key lessons highlighted are that demand for care can be generated through community programs, but treatment also needs to be accessible, and strengthening monitoring and follow up of referrals is important.
State of Maternal and Children's Health and Nutrition During Pandemic and Cal...KABAYAN Partylist
We are looking forward to sharing with you the highlights of the recent stakeholder consultation of KABAYAN Partylist and Development Academy of the Philippines on the State of Maternal and Children’s Health and Nutrition During the Pandemic held last December 03, 2020.
The presentations made during the event are summarized in the attached report entitled “Second Stakeholder Consultation on the State of Maternal & Children’s Health and Nutrition During Pandemic and Calamities” which brings together the reports, excerpts, and key findings given by Cong. Ron P. Salo, Cong. Stella Quimbo, Department of Health Usec. Rosario Vergeire, Philippine Center for Population and Development Former Executive Director Dr. Jondi Flavier, DAP Family Medicine Consultant Dr. Jewehl Salo, and representatives from the Department of Social Welfare and Development during the event.
This document proposes health promotion strategies to increase family planning uptake in North Eastern Kenya. It begins with an analysis of the region's low contraceptive prevalence rate of 4% compared to the national average of 46%. It then recommends a multi-pronged approach including educational activities to provide family planning information, behavior change programs, medical outreach services, empowerment of women and youth, and policy advocacy. The proposed interventions aim to address social determinants of family planning at various levels of the community through strategies grounded in health behavior theories.
This document is a demographic research proposal investigating the determinants of modern contraceptive use among unmarried female adolescents aged 15-19 in Malawi. It begins with an introduction that provides background on the sexual and reproductive health problems faced by this population and discusses Malawi's efforts to address this issue through youth friendly health services. The problem statement notes that while modern contraceptive use has increased, unplanned pregnancy rates remain high. The literature review covers sexual health issues, benefits of modern contraceptives, and factors influencing use worldwide and in Malawi. The objectives and research questions aim to examine the association and influence of various determinants on modern contraceptive use. The methodology section outlines the study design, data sources, variables, and analysis
This document summarizes a study on the motivational drivers for non-skilled Kenyan community health volunteers. The study found that the largest proportion of volunteers provide services in maternal and child health and HIV/AIDS and malaria. The main motivations for volunteers include fulfilling religious values, serving humanity, and access to training and support. Most volunteers are female and over 30 years old, with the largest group providing maternal and child health services. Their motivations help address healthcare worker shortages in Kenya.
The Public Utilities Commission of Sri Lanka issued a consultation paper on setting electricity tariffs for the period of 2011-2015. The paper presented key issues for public comment, including sales forecasts and allowed losses for transmission and distribution licensees. Distribution licensees filed sales forecasts and loss allowances between 2011-2015 ranging from 11-14.8% losses. The transmission licensee filed purchases from generation and loss allowances of 11% for 2011. The paper proposed allowed revenues for licensees and the provision for energy sold for street lighting. It analyzed government subsidies to the electricity sector and presented a roadmap for tariff restructuring and rebalancing to achieve cost-reflective tariffs by 2015. Finally, the paper outlined proposed electricity tar
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
A trends of salmonella and antibiotic resistanceAlexander Decker
This document provides a review of trends in Salmonella and antibiotic resistance. It begins with an introduction to Salmonella as a facultative anaerobe that causes nontyphoidal salmonellosis. The emergence of antimicrobial-resistant Salmonella is then discussed. The document proceeds to cover the historical perspective and classification of Salmonella, definitions of antimicrobials and antibiotic resistance, and mechanisms of antibiotic resistance in Salmonella including modification or destruction of antimicrobial agents, efflux pumps, modification of antibiotic targets, and decreased membrane permeability. Specific resistance mechanisms are discussed for several classes of antimicrobials.
A unique common fixed point theorems in generalized dAlexander Decker
This document presents definitions and properties related to generalized D*-metric spaces and establishes some common fixed point theorems for contractive type mappings in these spaces. It begins by introducing D*-metric spaces and generalized D*-metric spaces, defines concepts like convergence and Cauchy sequences. It presents lemmas showing the uniqueness of limits in these spaces and the equivalence of different definitions of convergence. The goal of the paper is then stated as obtaining a unique common fixed point theorem for generalized D*-metric spaces.
A universal model for managing the marketing executives in nigerian banksAlexander Decker
This document discusses a study that aimed to synthesize motivation theories into a universal model for managing marketing executives in Nigerian banks. The study was guided by Maslow and McGregor's theories. A sample of 303 marketing executives was used. The results showed that managers will be most effective at motivating marketing executives if they consider individual needs and create challenging but attainable goals. The emerged model suggests managers should provide job satisfaction by tailoring assignments to abilities and monitoring performance with feedback. This addresses confusion faced by Nigerian bank managers in determining effective motivation strategies.
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
This document presents a framework for evaluating the usability of B2C e-commerce websites. It involves user testing methods like usability testing and interviews to identify usability problems in areas like navigation, design, purchasing processes, and customer service. The framework specifies goals for the evaluation, determines which website aspects to evaluate, and identifies target users. It then describes collecting data through user testing and analyzing the results to identify usability problems and suggest improvements.
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
Adolescents and utilization of family planning services in rural community of...Alexander Decker
This study examined family planning services utilization among adolescents in a rural Nigerian community. 400 adolescents ages 10-19 completed questionnaires. Over two-thirds reported family planning services being available, with main sources being health centers, chemists, and pharmacies. Reasons for service selection included low cost, privacy, and proximity. While most adolescents were sexually active and knowledgeable about contraception, condom use was low and many were unconcerned about pregnancy or STDs. The study concluded family planning services were available but underutilized, with worrisome attitudes towards unprotected sex among adolescents in the community.
Maternal health care trends in afghanistanIslam Saeed
The document summarizes findings from a 2010 Afghanistan mortality survey on trends in maternal health care. It finds that coverage of antenatal care, deliveries assisted by skilled birth attendants, and postnatal care have increased by about 10% on average. However, this level of progress is not as high as expected given major investments in Afghanistan's basic health package and hospital system aimed at improving maternal and child health. The results indicate efforts to expand access to maternal services have had an impact but more improvement is still needed.
On the Margins of Health Care Provision: Delivering at Home in Harare, Zimbabwepaperpublications3
Abstract: This paper analyses the phenomenon of home deliveries by pregnant women in an urban setting in Zimbabwe. It argues that, though home deliveries are commonly practiced in the rural areas, they have now found their way into and are even proliferating in the urban areas. Social cultural values, religious belief and economic status/resources determine women’s place of birth. Whilst government policies expounded through the Ministry of Health (MoH) programs and policies denounce home deliveries, the frail health care system characterized by mass exodus of qualified personnel, in availability of drugs and understaffing of healthcare centres do little to lure pregnant women to deliver in hospitals. Furthermore, the high levels of poverty among the populace entail that people cannot afford either public or private hospital services; and thus resort to home-based healthcare and subsequently home deliveries. The paper explores the factors fuelling home deliveries and the challenges associated with this practice in Harare, Zimbabwe.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Compliance to annual ivermectin treatment in abia state,Alexander Decker
The study assessed compliance with annual ivermectin treatment for onchocerciasis in Abia State, Nigeria over 14 years. A survey of 558 individuals found that 55.4% had previously taken ivermectin, but only 22.7% of those were "high compliers" who had taken it 8 or more times. The overall percentage of high compliers was 12.6%. Reasons for low compliance included lack of information, no reason for refusal, absence from village, and no distribution. The reasons given did not significantly affect general compliance levels.
The influence of prevention of mother to-child hiv transmission campaigns on ...Alexander Decker
The document discusses mother-to-child transmission of HIV in Nigeria and prevention efforts. It notes that mother-to-child transmission accounts for over 90% of pediatric AIDS cases globally. To address this, Nigeria and other countries have implemented Prevention of Mother-to-Child Transmission (PMTCT) campaigns. However, the document aims to study whether these campaigns have effectively improved knowledge, attitudes and practices around PMTCT among Nigerian women. It finds that while campaigns have increased to some degree, overall knowledge, attitudes and practices regarding PMTCT among Nigerian women remains quite low. It recommends campaign messages be more clear, specific and convincing to better educate women and encourage improved PMTCT practices.
Family planning in nigeria a myth or reality-implications for educationAlexander Decker
The document summarizes a study that investigated family planning practices in Nkanu Local Government Area of Enugu State, Nigeria. The study found that (1) the extent of family planning in the area was low, (2) the most common methods used were traditional ones like abstinence, withdrawal, and prolonged breastfeeding, and (3) education level had a positive influence on family planning practices, with more educated respondents using modern contraceptive methods to a greater extent.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Socio Demographic Determinants for Effective Use of Modern Contraceptive amon...ijtsrd
The document discusses a study that examined the socio-demographic determinants of modern contraceptive use among married women of childbearing age in Anambra State, Nigeria. The study found that older women and women with higher education levels used modern contraceptives more than younger women and less educated women. Religious women used modern contraceptives less frequently. The study concluded that health education on modern contraceptives should be provided in various community settings to increase awareness and use.
Usage of family planning practices and its effects on women healthmustafa farooqi
This document provides an introduction and literature review for a study on the usage of family planning practices and their effects on women's health in rural areas of Khanewal, Pakistan. The introduction discusses the importance of family planning for women's empowerment and health benefits. It also outlines the study's objectives to examine the role of financial factors and effects on family size, health, and future fertility intentions. The literature review covers past research on cultural perceptions of fertility, socioeconomic influences on contraceptive use, and programs to increase usage. The methodology describes the study design, including sampling techniques, to collect data on family planning practices in the target population.
Balancing demand, quality and efficiency in nigerian health care delivery systemAlexander Decker
The document discusses several challenges facing Nigeria's health care system that reduce progress and universal access to health care. Some key issues include inadequate health facilities and infrastructure, poor human resources and management, low government spending on health, and high out-of-pocket costs for citizens. Nigeria's health indicators, such as maternal mortality and child mortality, are among the worst in the world. Many factors contribute to these problems, including a lack of integrated disease prevention and treatment systems, shortages of essential drugs and supplies, and inadequate supervision of health care providers. Overall, the health system in Nigeria faces significant issues that must be addressed to improve quality, access, and efficiency of care.
Over the past decade, Kenya has made tremendous efforts to enhance maternal and child health. Secure maternity policies such as free maternity care are one of the initiatives that have enhanced maternal and child health in all public health facilities. Despite these attempts, public health facilities for maternal and child health are still underused. This study employed a cross-sectional descriptive study design to identify determinants of free maternal health services by evaluating factors determining perceptions and health-seeking behavior of 384 pregnant mothers in Malava Sub-County, Kakamega County. The study used a mixed-method (quantitative and qualitative approaches). Questionnaires were administered to pregnant mothers selected for the study. The study employed a purposive sampling of research participants. Quantitative data were collected using the questionnaire administered by the research assistants whereas qualitative data were collected by the researcher through interview schedules. Quantitative data analysis was carried out using SPSS 23. However, qualitative data were analyzed through content analysis. Quantitative data representation was done in terms of frequency and percentages. Analysis of chi-square testing was used to assess the association between the variables of socio-economic and health facilities and the provision of free maternity facilities (p<0.05). The study established that the uptake of free maternal service by pregnant mothers was influenced by their level of primitivism and religious beliefs. In addition, this study found out that 53.8% and 77.7% of the pregnant mothers could not attend antenatal and post-natal care because government facilities were located far away from their residences and they also had less access to some information about free maternal health care. The results of this research would be disseminated to the hospital management team, Sub-Country health management team, County health management team, and other stakeholders, thereby demonstrating reasons for low uptake of free maternity services and helping to strategize for better service delivery. Based on the finding, the study recommends that to improve access to free maternal health care, the county government ought to place health services as close as possible to the community where people live. Secondly, there is a need to embrace the usage of the existing media network to sensitize pregnant mothers to the danger signs and the need to have decision-making powers over their safety. Lastly, hospital management ought to increase the awareness of free maternal health care and to include it among the community priorities during dialog days, action days, and other group discussions.
Achievements and Implications of HIV Prevention of Mother-toChild Transmissio...QUESTJOURNAL
This intervention provided HIV prevention services to women of reproductive age in Plateau State, Nigeria. A total of 9,258 women were reached, exceeding the target of 7,460. Structural interventions included 85 community dialogues and 17 income generation activities. Behavioral interventions included distributing 87,028 condoms and providing HIV education to 5,079 peers. Biomedical interventions saw 5,606 women receive counseling, testing and results, with 44 (0.8%) testing positive for HIV. While the intervention helped reduce HIV burden, future programs need to improve coverage and extend services to more local government areas.
This document discusses unintended pregnancy and family planning. It provides background on family planning and defines unintended pregnancies. Unintended pregnancies are associated with negative health outcomes for both mothers and children. The document then discusses objectives of assessing attitudes toward unintended pregnancy and family planning in two regions of Ethiopia from 2004-2007. It aims to evaluate family planning programs and services, knowledge of methods, partner communication, and approval of family planning. The study seeks to increase skills and knowledge to reduce unintended pregnancies and problems related to lack of family planning. It is limited by time, lack of references, and internet access.
This study assessed the prevalence of neonatal sepsis and associated risk factors among neonates admitted to neonatal intensive care units (NICUs) at two hospitals in Ethiopia from February 2016 to February 2017. The overall prevalence of neonatal sepsis was found to be 77.9%. Age of neonates, birth asphyxia, and use of oxygen via mask were significantly associated with increased risk of neonatal sepsis. The study recommends focusing prevention efforts on modifiable risk factors to reduce neonatal sepsis.
This document summarizes a research study that assessed the knowledge, attitudes, and practices of reproductive age women regarding antenatal care services at Dr. Khalid MCH in Hargeisa, Somaliland. The study used a descriptive cross-sectional design and questionnaire to collect data from 112 women. The results found that most women (66.2%) had good knowledge of antenatal care services, while 20% had poor knowledge. Most respondents (72.3%) had a positive attitude, while 23.4% had a negative attitude. The study concludes that health workers should provide more information to women on the benefits of antenatal care and community programs are needed to improve attitudes.
[[INOSR ES 11(2)134-147 Evaluation of the Infant Mortality rate at Ishaka Adv...PUBLISHERJOURNAL
Evaluation of the Infant Mortality rate at Ishaka Adventist Hospital Bushenyi District
Mugaaga Paul
Department of Clinical Medicine Kampala International University, Uganda.
________________________________________ABSTRACT
Infant mortality is defined as the death of an infant before his or her first birthday, mainly caused by dehydration, diseases, congenital malformations and infections. The main objective of this study was to establish the determinants of infant mortality in Ishaka Adventist Hospital (IAH) in the months of April- July 2017, in Ishaka municipality in Bushenyi district. A descriptive cross sectional study design was used to determine the determinants of infant mortality in the study area. Majority of respondent (98%) were female and among them, 25.5% reported to have lost at least an infant and most of these respondents (70%) were married while 5% were widowed and among these, 40% reported to have lost an infant. Religiously, majority of the respondents (80%) were Christians, while 13% were Muslim and 7% constituted other religions including paganism, which showed the greatest infant mortality rate (71.4%). Most of the respondents (65%) attained primary level of education while 5% did not go to school at all, and the highest infant mortality rate (40%) was reported among these. The respondents who reported to have had preterm births appeared to have a higher infant mortality rate (65%) than those who did not report preterm births. A higher infant mortality rate (32.2%) was realized among respondents who reported their infants to have had such co-morbidities than those who didn’t report any co-morbidities like malaria and also a higher infant mortality rate (50%) was realized among infants who had not exclusively breastfed. Majority of respondents (80%) did not have children with birth defects while only 20% had children with birth defect, and a higher infant mortality rate of 70% was realized among these. Demographically, infant mortality rate is high among teenagers, the unemployed, the widowed, the pagans, and the uneducated. Direct determinants of infant mortality rate included preterm birth, birth defects, comorbidities and failure to breastfeed exclusively. Proximate determinants associated with infant mortality rate included teenage pregnancies, source of water, means of delivery and irregular immunization. Exclusive breast feeding for 6 months, mass immunization campaign up to grass root, intensive health education on health seeking behaviors and highlighting on dangers associated with risky behaviors and high quality monitoring and evaluation for quick action particularly for emergencies. There is also need for intersectional collaboration and initiation of income generating activities to boost their standards of living.
Keywords: Infant mortality, Breastfeeding, Morbidity, Determinants, Respondents.
Similar to Childbirth practices in the akpabuyo rural health and demographic surveillance system (20)
A therapy for physical and mental fitness of school childrenAlexander Decker
This document summarizes a study on the importance of exercise in maintaining physical and mental fitness for school children. It discusses how physical and mental fitness are developed through participation in regular physical exercises and cannot be achieved solely through classroom learning. The document outlines different types and components of fitness and argues that developing fitness should be a key objective of education systems. It recommends that schools ensure pupils engage in graded physical activities and exercises to support their overall development.
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
This document summarizes a study examining efficiency in managing marketing executives in Nigerian banks. The study was examined through the lenses of Kaizen theory (continuous improvement) and efficiency theory. A survey of 303 marketing executives from Nigerian banks found that management plays a key role in identifying and implementing efficiency improvements. The document recommends adopting a "3H grand strategy" to improve the heads, hearts, and hands of management and marketing executives by enhancing their knowledge, attitudes, and tools.
This document discusses evaluating the link budget for effective 900MHz GSM communication. It describes the basic parameters needed for a high-level link budget calculation, including transmitter power, antenna gains, path loss, and propagation models. Common propagation models for 900MHz that are described include Okumura model for urban areas and Hata model for urban, suburban, and open areas. Rain attenuation is also incorporated using the updated ITU model to improve communication during rainfall.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
1) The document discusses synthesizing Taylor's scientific management approach and Fayol's process management approach to identify an effective way to manage marketing executives in Nigerian banks.
2) It reviews Taylor's emphasis on efficiency and breaking tasks into small parts, and Fayol's focus on developing general management principles.
3) The study administered a survey to 303 marketing executives in Nigerian banks to test if combining elements of Taylor and Fayol's approaches would help manage their performance through clear roles, accountability, and motivation. Statistical analysis supported combining the two approaches.
A survey paper on sequence pattern mining with incrementalAlexander Decker
This document summarizes four algorithms for sequential pattern mining: GSP, ISM, FreeSpan, and PrefixSpan. GSP is an Apriori-based algorithm that incorporates time constraints. ISM extends SPADE to incrementally update patterns after database changes. FreeSpan uses frequent items to recursively project databases and grow subsequences. PrefixSpan also uses projection but claims to not require candidate generation. It recursively projects databases based on short prefix patterns. The document concludes by stating the goal was to find an efficient scheme for extracting sequential patterns from transactional datasets.
A survey on live virtual machine migrations and its techniquesAlexander Decker
This document summarizes several techniques for live virtual machine migration in cloud computing. It discusses works that have proposed affinity-aware migration models to improve resource utilization, energy efficient migration approaches using storage migration and live VM migration, and a dynamic consolidation technique using migration control to avoid unnecessary migrations. The document also summarizes works that have designed methods to minimize migration downtime and network traffic, proposed a resource reservation framework for efficient migration of multiple VMs, and addressed real-time issues in live migration. Finally, it provides a table summarizing the techniques, tools used, and potential future work or gaps identified for each discussed work.
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
This document discusses data mining of big data using Hadoop and MongoDB. It provides an overview of Hadoop and MongoDB and their uses in big data analysis. Specifically, it proposes using Hadoop for distributed processing and MongoDB for data storage and input. The document reviews several related works that discuss big data analysis using these tools, as well as their capabilities for scalable data storage and mining. It aims to improve computational time and fault tolerance for big data analysis by mining data stored in Hadoop using MongoDB and MapReduce.
1. The document discusses several challenges for integrating media with cloud computing including media content convergence, scalability and expandability, finding appropriate applications, and reliability.
2. Media content convergence challenges include dealing with the heterogeneity of media types, services, networks, devices, and quality of service requirements as well as integrating technologies used by media providers and consumers.
3. Scalability and expandability challenges involve adapting to the increasing volume of media content and being able to support new media formats and outlets over time.
This document surveys trust architectures that leverage provenance in wireless sensor networks. It begins with background on provenance, which refers to the documented history or derivation of data. Provenance can be used to assess trust by providing metadata about how data was processed. The document then discusses challenges for using provenance to establish trust in wireless sensor networks, which have constraints on energy and computation. Finally, it provides background on trust, which is the subjective probability that a node will behave dependably. Trust architectures need to be lightweight to account for the constraints of wireless sensor networks.
This document discusses private equity investments in Kenya. It provides background on private equity and discusses trends in various regions. The objectives of the study discussed are to establish the extent of private equity adoption in Kenya, identify common forms of private equity utilized, and determine typical exit strategies. Private equity can involve venture capital, leveraged buyouts, or mezzanine financing. Exits allow recycling of capital into new opportunities. The document provides context on private equity globally and in developing markets like Africa to frame the goals of the study.
This document discusses a study that analyzes the financial health of the Indian logistics industry from 2005-2012 using Altman's Z-score model. The study finds that the average Z-score for selected logistics firms was in the healthy to very healthy range during the study period. The average Z-score increased from 2006 to 2010 when the Indian economy was hit by the global recession, indicating the overall performance of the Indian logistics industry was good. The document reviews previous literature on measuring financial performance and distress using ratios and Z-scores, and outlines the objectives and methodology used in the current study.
A study to evaluate the attitude of faculty members of public universities of...Alexander Decker
This study evaluated faculty members' attitudes toward shared governance in public universities in Pakistan. It used a questionnaire to assess attitudes on 4 indicators of shared governance: the role of the dean, role of faculty, role of the board, and role of joint decision-making. The study analyzed responses from 90 faculty across various universities. Statistical analysis found significant differences in perceptions of shared governance based on faculty rank and gender. Faculty rank influenced perceptions of the dean's role and role of joint decision-making. Gender influenced overall perceptions of shared governance. The results indicate a need to improve shared governance practices in Pakistani universities.
A study to assess the knowledge regarding prevention of pneumonia among middl...Alexander Decker
1) The study assessed knowledge of pneumonia prevention among 60 middle-aged adults in rural Moodbidri, India. Most subjects (55%) had poor knowledge and 41.67% had average knowledge. The mean knowledge score was 40.66%.
2) Knowledge was lowest in areas of diagnosis, prevention and management (35.61%) and highest in introduction to pneumonia (45.42%).
3) There was a significant association between knowledge and gender but not other demographic factors like age, education level or occupation. The study concluded knowledge of prevention was low and health education is needed.
A study regarding analyzing recessionary impact on fundamental determinants o...Alexander Decker
This document analyzes the impact of fundamental factors on stock prices in India during normal and recessionary periods. It finds that during normal periods from 2000-2007, earnings per share had a positive and significant impact on stock prices, while coverage ratio had a negative impact. During the recession from 2007-2009, price-earnings ratio positively and significantly impacted stock prices, while growth had a negative effect. Overall, the study aims to compare the influence of fundamental factors like book value, dividends, earnings, etc. on stock prices during different economic conditions in India.
A study on would be urban-migrants’ needs and necessities in rural bangladesh...Alexander Decker
This document summarizes a study on the needs and necessities of potential rural migrants in Bangladesh and how providing certain facilities could encourage them to remain in rural areas. The study involved surveys of 350 local and non-local people across 7 upazilas to understand their satisfaction with existing services and priority of needs. The findings revealed variations in requirements between local and non-local respondents. Based on the analysis, the study recommends certain priority facilities, such as employment opportunities and community services, that should be provided in rural areas to improve quality of life and reduce migration to cities. Limitations include the small sample size not representing all of Bangladesh and difficulties collecting full information from all respondents.
A study on the evaluation of scientific creativity among scienceAlexander Decker
This study evaluated scientific creativity among 31 science teacher candidates in Turkey. The candidates were asked open-ended questions about scientific creativity and how they would advance science. Their responses showed adequate fluency and scientific knowledge, but low flexibility and originality. When asked to self-evaluate, most said their scientific creativity was partially adequate. The study aims to help improve the development of scientific creativity among future teachers.
A study on the antioxidant defense system in breast cancer patients.Alexander Decker
This document discusses a study on the antioxidant defense system in breast cancer patients. The study measured levels of reduced glutathione (GSH), superoxide dismutase (SOD) activity, total antioxidant potential (AOP), malondialdehyde (MDA), and nitrate in 40 breast cancer patients and 20 healthy controls. The results found increased MDA, SOD, and nitrite levels and decreased GSH and AOP levels in breast cancer patients compared to controls, indicating higher oxidative stress in patients from increased free radicals and lower antioxidant defenses.
This study examined 79 dry crania (55 male and 24 female) from southern Nigeria to determine the incidence and dimensions of single and double hypoglossal canals, and whether these dimensions differ between sexes. Measurements were taken of the internal and external diameters of the hypoglossal canals. The results showed significant differences in all dimensions between males and females. Bilateral single hypoglossal canals were most prevalent. In conclusion, the size of the hypoglossal canal is sex-specific, with significant differences found between males and females in this population.
A study on knowledge and practice of post menopausal womenAlexander Decker
The document discusses a study on the knowledge and practices of post-menopausal women in rural Karnataka regarding health maintenance. The study found that 75% of subjects had good overall knowledge, but their practices of breast self-examination and Kegel exercises were very poor, with average scores below 1%. While knowledge of preventing osteoporosis was high, knowledge of cancer prevention was average. There was a positive correlation between knowledge and practices. The study concludes that lifestyle changes, calcium/vitamin D intake, and health screenings are important for post-menopausal health but are lacking in the community.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
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Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
Childbirth practices in the akpabuyo rural health and demographic surveillance system
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Childbirth Practices in the Akpabuyo Rural Health and
Demographic Surveillance System
Ekaette Enang1,2
, Michael Ushie1,3
, Iwara Arikpo1,2
, Kalu Osonwa1,3
, Ekpereonne Esu1,4
, Friday Odey1,5
,
Angela Oyo-Ita1,6
, Martin Meremikwu1,5
*.
1. Cross River Health and Demographic Surveillance System, University of Calabar, PMB 1115, Calabar
2. Department of Mathematics, Statistics &Computer Science, University of Calabar
3. Department of Sociology and Anthropology, University of Calabar
4. Department of Public Health, University of Calabar
5. Department of Paediatrics, University of Calabar
6. Department of Community Medicine, University of Calabar
The research is financed by International Development Research Centre (IDRC) Canada No. 104613-027
Abstract
Maternal and neonatal mortality remain high in Nigeria. The State and Federal governments have adopted
several strategies to prevent maternal and infant deaths such as the Cross River State Free Health Services to
pregnant women and infants, and the National Midwives’ Service Scheme. This study assessed pregnancy and
childbirth practices of Nigerian women in rural communities located in Akpabuyo in the Niger Delta region of
Nigeria.
Women who were pregnant or had recently given birth in a population of 5,668 people under surveillance in
some rural communities of Akpabuyo were interviewed to obtain information on pregnancy and childbirth
practices. Validated semi-structured questionnaires were administered by well-trained field workers. Completed
questionnaires were entered into electronic data forms in OpenHDS software and exported to STATA for
analysis.
Results showed that, 39.5% of women reported that they had sought prenatal care from a traditional birth
attendant (TBA). 84.6% of all births occurred outside the formal health system with the majority attended by
TBAs. Only 15.4% of births occurred in hospitals or health centres. The implements used to cut the umbilical
cord were knives (46.2%), new razor blades, old razor blades, sharp stone and scissors. The materials used for
treating the umbilical cord were mostly methylated spirit (63.1%); other treatment materials were“western
medicine”, “black powder” and others including herbs and earth.
The study concluded that, childbirth practices that pose significant risk to maternal and newborn health remain
common in these rural communities. Majority of births were attended by TBAs despite free delivery services
available at the formal health facilities. TBAs should be assisted to enhance their role in health care delivery.
Effort should be made to increase public awareness and interest in facility-based services.
Keywords: Maternal health, neonatal infection, longitudinal data, pregnancy.
1. Introduction
Complications during pregnancy and childbirth have been found to be the leading cause of death and disability
among women of reproductive age in developing countries (WHO Health Statistics and HIS, 2011). The WHO
estimates that 800 women die daily from preventable causes related to pregnancy and childbirth; and in 2010
alone, 287,000 women died during and following pregnancy and childbirth (WHO Medical Centre, 2012).
Unfortunately most of these preventable deaths occurred in low resource settings.
High rates of neonatal death coexist with high maternal mortality in these low resource settings including
Nigeria. Prior to increased global effort at tetanus immunization and promotion of clean delivery practices, an
estimated one million cases of neonatal tetanus occurred yearly of which about 800,000 died (Whitman et al.,
1992).The commonest causes of newborn deaths in Nigeria are birth asphyxia and infections including cord
infections and tetanus (WHO World Health Statistics, 2011). The WHO has reported that cord infection and
neonatal tetanus contribute significantly to high neonatal mortality in developing countries (WHO, 1998).
Unhygienic childbirth practices such as those related to the care of the umbilical cord stump contribute to the
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high incidence of neonatal sepsis and tetanus in low income countries. In high income countries, majority of
births take place in hospitals and other formal health care settings where clean birth techniques (including use of
sterile blades or scissors to cut the umbilical cord) are the norm thereby minimizing the risk of neonatal
infections (Zupan, Garner and Omari, 2004).
On the contrary, many births in most of the low income countries occur in settings where unsterile tools and
materials are commonly used to sever and dress the umbilical cord stump. A recent qualitative study in northern
Ghana showed that a wide variety of tools were used in cord cutting, the most commonly used being razor blades
or scissors. That study reported that a wide variety of materials were applied as dressing on the cord, and
including traditional materials like shea butter, ground shea nuts, herbs, local oil and red earth (Moyer, et al.,
2012). Such unhygienic birth practices coupled with low rates of maternal immunization against tetanus account
for the high incidence of neonatal tetanus in Nigeria (Eregie and Ofovwe, 1993). The overall percentage of
women with a live birth within 24 months of a nationwide survey in 2007 that were protected against neonatal
tetanus was 51% with wide urban (72%) and rural (41%) disparity (National Bureau of Statistics, 2007).
Andrew and Dala (2011), in a study in Bangladesh observed that more than 80% of women delivered at home. In
6% of cases, blades from a clean-delivery kit (CDK) were used to cut the cord; in 90% of cases, the blades used
were from another source; in 4% of cases, other instruments such as bamboo strips and scissors were used to cut
the cord. In 51% of cases, a substance (e.g. antibiotic powder/ointment, alcohol/spirit, mustard oil with garlic,
boric powder, turmeric, and chewed rice) was applied to the stump after the cord was cut. Consequent upon
these, the paper seeks to bring to the fore, some common pregnancy and birth practices among women in these
rural communities in South-eastern Nigeria.
Governments of most of the 193 United Nations member States have made several efforts to achieve the
Millennium Development Goals (MDG) of reducing child mortality and improving maternal health. Nigeria is
not left out in these attempts, and has developed policies and programmes to address the problem of high burden
of maternal and child health such as the Reproductive Health Policy which aimed to reduce maternal mortality
by half by 2006 (Federal Ministry of Health, 2001), the Integrated Maternal, Newborn and Child Health Strategy
of 2007 targeted at addressing 90% of causes of maternal deaths (Federal Ministry of Health, 2007) and the
Midwives Service Scheme (MSS) which involved the recruitment, training and deployment of midwives at PHC
level to perform Basic Emergency Obstetric Care signal functions in all States of the Nigerian Federation
(National Primary Health Care Development Agency, 2010). Unfortunately, despite these efforts by government
to provide maternal and child care, Nigeria still ranks very high in maternal and child mortality making it needful
to appraise the level of access to and utilization of the services provided by the people.
Respective State Governments in Nigeria have taken turns to pass certain bills and launch different health
promotion packages in this direction. Recently in Cross River State, Government passed a bill committing to
offer free medical services for pregnant women and children under the age of 5years. This paper discusses the
results of a study of childbirth practices conducted in some rural communities within a newly established health
and demographic surveillance system in Cross River State.
2. Material and methods
2.1 Population
The study is carried out in 22 enumeration areas (EAs) within the Demographic Surveillance Area (DSA) of the
Cross River Health Demographic Surveillance System (CRHDSS) in Akpabuyo Local Government Area of
Cross River State – Nigeria.This Surveillance area, on which this study is based, had a population of 5,668
people and 1,370 households spread across a total of ten rural communities.
The study involved 130 women who had delivered within calendar 12 months of the study (with babies aged 0-
12 months). The population size is relatively small, but the data sets are statistically significant because it
includes all the women who have delivered within the period under study in all the communities studied; its
whole population was studied, not a sample.
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2.2 Data collection and Data Management Procedure
The International Network of Field Sites with continuous Demographic Evaluation of Populations and Their
Health (INDEPTH) has many tested forms (questionnaire) for the core HDSS processes which was adapted and
updated for use in the CRHDSS. The specific forms used to generate the data for this work are, Household
Registration Book (HRB) form;Housing and Institutional facility numbering form; Household characteristics,
Pregnancy registration and pregnancy outcome form. Field workers were employed to administer these forms in
the different 22 Enumeration Areas (EAs)and 1,370 households that constitute our study population.
These INDEPTH adapted questionnaires were administered by trained field workers to all the women with
children between 0-1years at the time of the study. The field workers through the field supervisors submit the
forms to the data clerk for entry into the computer. The completed forms are checked for consistency by the Data
Entry Supervisor and queries are generated wherever inconsistencies are spotted. Data Entry clerks enter the
completed questionnaires into their corresponding computerized form using the OpenHDS interface
(http://openhds.rcg.usm.maine.edu/ ). From the OpenHDS, data is extracted with the help of SQL queries and
exported to STATA statistical software for analysis. In this study, information on pregnancy and childbirth in the
community as it relates to places where the women gave birth was tracked and issues related to quality
healthcare including what was used to cut or dress the babies’ umbilical cord were explored.
3. Results
3.1 Prenatal Care
Longitudinal pregnancy observations and interviews conducted side by side with interviews of recently delivered
women in the same communities showed that 29 of the 48 (constituting 60.5%) of women who were at different
stages of pregnancy attended antenatal care in health centres (56.3%) and hospital (4.2%). The rest of the women
(39.5%) reported that they had sought prenatal care from a traditional birth attendant. Information on maternal
tetanus immunization was not obtained since there were no home records showing immunization status of these
pregnant women.
3.2 Place of childbirth
Analysis of information on birth practices obtained from interview of 130 women who had recently given birth
in the community showed that 84.6% of all births occurred outside the formal health system with the majority
attended by traditional birth attendants (TBAs). Only small proportion of the births (15.4%) occurred in hospitals
or health centres (see Figure 1).
Figure 1. Places of birth for 130 deliveries studied in Akpabuyo HDSS
3.3 Umbilical cord care practices
On issues related to the quality of the care of the umbilical cord, result of analysis on objects used in cutting the
umbilical cord revealed that the commonest cutting implements used to cut the cord were the knife (46.2%) and
new razor (30.8%). The other objects used were sharp stone, old razor blade and scissors. Table 1 shows the
frequency distribution of these cutting implements by place of childbirth. Of the 82 deliveries by TBAs,
umbilical cord was cut with the knife in 39 cases (47.6%) and with new razor in 23 (28%). The knife was used to
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cut the cord in majority of the births that occurred at home (9 of 17) and the church (7 of 11). No information
was obtained about the cleanliness or any effort made to disinfect these cutting implements.
Table 2 shows the types of materials used for treating the umbilical cord in 130 births studied in the Akpabuyo
HDSS. The commonest materials used were methylated spirit and “western medicine” referring to topically
applied medicine of unspecified description but assumed to be probably antiseptic. Herbal and other types of
traditional mixtures were reported to have been used in only a few cases.
Table 1. Tools used for cutting umbilical cord in Akpabuyo
Tools used to cut
the cord
Frequency of use/Places of childbirth Total
Hospital
Health
centre TBA Home Church/other Frequency %
Knife 2 3 39 9 7 60 46.2
New razor 5 5 23 4 3 40 30.8
Old razor 0 0 2 0 0 2 1.5
Sharp stone 0 0 2 0 1 3 2.3
Scissors 3 0 8 0 0 11 8.5
Don't know 1 1 8 4 0 14 10.8
Table 2. Materials used for treating the umbilical cord of babies in Akpabuyo
Materials used for treating
umbilicus
Number of babies whose umbilical
cord were treated
% treated
Spirit 82 63.1
Western medicine* 31 23.8
Other(herbal, earth, etc) 6 4.6
Nothing used 2 1.5
Black powder 1 0.8
Don't know 8 6.2
Notes: *Topically applied medicines (probably antiseptic)
4. Discussion
The results of this study of all childbirths within a number of communities making up 1,370 households which
have been under health and demographic surveillance from 2011 shows that majority of childbirths in this rural
Nigerian population occur outside the formal health system. The proportion of women who delivered in formal
health facilities was markedly less than those who sought prenatal care in these health facilities. This observation
is similar to the results of the 2008 Demographic and Health Survey which showed that 45.9% of the pregnant
women in rural communities across the country attended antenatal clinics (ANC) but only about half that number
(24.1%) delivered in health facilities (National Population Commission, 2009). Research and routine surveys
results have also shown that majority of women in rural areas who attend antenatal clinics prefer to give birth
with traditional birth attendants (TBA). A study carried out in Kenya has shown that, although over 88% of
Kenyan women attend an antenatal clinic at least once during each pregnancy, there are regional disparities in
where a woman delivers and who provides support at delivery. In the Western Kenyan Province, TBAs still
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attend over 34% of deliveries, whereas a skilled attendant delivers 28% of women. In contrast, a TBA delivers
only 6% women in Central Province and 70% women deliver with a skilled attendant (The Safe Motherhood
Demonstration Project, 2003).The continued preference for TBAs in Western Province according to the study
was attributed to several factors, including the TBAs’ proximity to the woman’s home, TBAs’ respectful attitude
for women, regardless of age or parity, and flexible modes of payment.
The majority of the deliveries reported in the present study were attended by traditional birth attendants
indicating that the women preferred the services delivered by this cadre of community-based maternal care
providers. It is common knowledge that traditional birth attendants are widely patronized in Nigeria and other
African countries like Ghana (Andreatta, et al., 2011), Sierra Leone (Oyerinde, et al., 2008) and Kenya (Ochako,
et al., 2011).TBAs have been associated with unsafe delivery services that contribute to maternal and neonatal
morbidity and mortality but many countries have embarked on various training programmes to improve the
quality of services delivered by TBAs (Naisho, et al., 1989; Sibley, et al., 2007). Conclusions of evaluation of
these TBA training initiatives have been varied and leave unresolved questions about the quality and usefulness
of the services rendered by TBAs (Piper, 1997; Harrison, 2011).
There have been major efforts in recent times to increase the proportion of births attended by trained personnel
such as National Midwives Services Scheme (National Primary Health Care Development Agency, 2010). In
Cross River State where this study was conducted; the Government has recently begun to offer free antenatal and
delivery services in State health facilities to all pregnant women in the State. The reasons for the observed low
utilization of delivery services of the government health facilities despite the offer of cost-free services need to
be carefully studied and interpreted.
A recent qualitative study of pregnant women in other parts of southern Nigeria identified some of the reasons
why women may choose to use the services of traditional birth attendants to include proximity, affordability and
cultural acceptability (Ebuehi and Akintujoye, 2012).Other authors (Chakraborty et al., 2002; Kulmala, et al.,
2000 ; Kabir, et al., 2005; Awusi, et al., 2009) have shown that the use of health-care services is related to the
availability, quality and cost of services, as well as to the social structure, health beliefs and personal
characteristics of the users. Some other factors as identified by Awusi et al (2009) to be responsible for poor
utilization of services included lack of motivation, non-accessibility, cultural and negative role played by
husbands, overconfidence, lack of education of women and partners, cost of services, inaccessibility of available
services are similar to findings elsewhere.
The report of a qualitative study on Traditional Birth Attendants and maternal health care in Ghana has asserted
that the decision of where to give birth by a woman is a very personal choice and one that has a number of
reasons behind it (Kennedy, 1999). A woman may choose the TBA over the hospital because of lack of finances,
proximity and fear of intimidation from the doctor while another chooses to go to hospital because she does not
trust the medicines administered by TBA or for the fear of having a difficult delivery which the TBA may not be
able to handle or because she is used to using the hospitals for her other ailments and it is just convenient to
deliver there. Whatever the case, it is ultimately the woman and her family’s decision as to where to go for
antenatal care or child birth.
The argument on why women may prefer TBAs addresses an aspect of explanation for the low utilization of
formal health facilities for childbirth in our study community despite the incentive provided by free health care
policy of government. There is no doubt that births attended by trained personnel with clean environment of
health facilities carries lower risk of maternal and newborn morbidity and mortality than births attended by
untrained persons. For instance, evidence from some analyses of hospital-based morbidity and mortality in
Nigeria shows that deliveries outside the health facilities are likely to be conducted by untrained persons and
associated with high rates of morbidity and mortality (Omoigberale, et al., 2010; Orimadegun, et al., 2008). The
obvious benefits of facility-based births by trained personnel has led to the implementation of several health
promotion interventions to make the women change their behaviour to the effect that they would choose facility-
based births instead of the more risky births by inadequately trained traditional attendants. One study show that
the expected behaviour change has not been achieved hence the persistence of home and TBA attended births.
The debate on reasons and choices that may explain the failure or delay in achieving increased utilization of free
facility-based maternal and child health services would be more logical if the discourse is done in the light of a
suitable health promotion theory. Debates on the choices that people make for preventive and curative health
care should derive from one or more of these known theories of health promotion; and this would make the
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attendant issues and questions more amenable to scientific investigation and possible proof. The choices women
make regarding when and where to receive care during pregnancy and childbirth are likely to be a product the
complex interaction of personal attributes and the influences of human and physical factors in the woman’s
immediate environment. The Ecological perspective theory offers a broad framework for the understanding of
the multi-level perspective to the processes and factors that determine change in health behavior (McLaren and
Hawe, 2005). Going by the postulate of this theory, it would follow that the failure or delay in the process of
convincing the women to change their current health behaviour of using TBAs could be explained by the
complex interplay of intrapersonal or individual factors; interpersonal factors; institutional or organizational
factors; community factors; and public policy factors.
Understanding the meaning and mechanism of interaction of these ecological theoretical concepts would offer
the researcher investigating the reason for the persistence of low utilization of facility-base delivery services the
pathways to the likely multi-level explanations for the failure or delay in achieving the desired change in health
behaviour. Understanding and applying theories in exploring the root cause of such public health problems as
the persistence of low utilization of antenatal and delivery services in Akpabuyo would offer a logical
framework to conceptualize suitable health promotion interventions (Rychetnik, et al., 2002).
This study has also shown that the practice of care of the umbilical cord remain suboptimal. The use of knife to
cut umbilical cords of babies was prevalent. There is no indication that these knives were sterilized in the
community setting where this was widely practiced. Many of the TBAs used new razor to cut the umbilical cord,
and these are unlikely to be contaminated and therefore constitute a safe practice. It is also a positive observation
that a good proportion of the TBAs used methylated spirit to clean the cord. A wide variety of methods and
materials have been reported for care of the umbilical stump in these non-formal settings (Whitmore, 2010;
McConnell, et al., 2004; Vural and Kisa, 2006; WHO 1998; Zupan, et al., 2004). Some of the substance that
have been used on umbilical cord stumps include; plant extracts, coins, olive oil, coconut oil, colostrum, triple
dye, povidone-iodine (Betadine), various antibiotics, sterile water, alcohol (70 % isopropyl alcohol), and no
treatment at all but evidence on the effectiveness of many of these materials remain inconclusive (Zupan, et al.,
2004).
A recent report on the evaluation of the effectiveness 4% chlorhexidine for the care of umbilical cord showed
significant reduction in umbilical cord infections (omphalitis) and neonatal mortality (Goldenberg, 2012). An
overview of studies on the effect of improved birth practices in Asia showed that the use of clean delivery kits
was associated with reduction in neonatal mortality. Specifically, these studies suggested that using a plastic
sheet during delivery, boiling the blade used to cut the cord and the thread used to tie the cord, as well as
cleaning the umbilicus with antiseptic lotion each contributed significantly to reductions in neonatal mortality
(Seward, 2012).
The number of pregnancies and deliveries observed in this study is small but remains significant because it
involves a whole population and not based on a sample. All the pregnancies and recent childbirths in the whole
of the study community were assessed.
5. Conclusion
Most child births still occur outside facilities and majority are attended by TBAs. Since the choice of place of
birth is arguably the main reason for the poor birth practices reported in this study, it would follow that efforts to
improve childbirths in health facilities is bound to improve cord care practice and reduce the incidence of
neonatal infections and mortality. Promotion of safe practices like use of clean delivery kits by community-based
birth attendants especially TBAs should be encouraged as this has been shown to reduce neonatal and maternal
mortality. It will be interesting to find out why women have so much confidence in TBAs despite the risks
involved. It is therefore important to investigate the factors and mechanism that influence the choice of women
for antenatal care and place of birth.
The Government’s free health program is at its early stage. This study will help in evaluating the success of this
policy. Government may also put effective policy monitoring systems on ground to ensure that the end users
benefit from the laudable policies. There is also the need to initiate a reward system for mothers who deliver in
the hospital and step up community based campaign where women are exposed to the dangers associated with
some of these common practices.
Since, the use of TBAs cannot be discouraged in the rural community; there is need for training, retraining and
supervision of TBAs to do their work more effectively.
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TBAs in various rural communities should be identified and assisted with up to date equipment to take up
deliveries. Partnership between the TBAs and the primary health care providers for the purpose of referrals
should be encouraged for effective practice.
6. Possible Future Research Directions
This paper has highlighted the need to study the key factors and mechanisms that determine choice of place of
childbirth among the women in these rural communities. The same multi-disciplinary research program should
also explore factors responsible for limited utilization of formal health service facilities for childbirth in rural
Nigeria. Intervention studies will be required to identify effective strategies for improving the quality of services
rendered by traditional birth attendants (TBAs). Priority area of research should include identifying mechanisms
for integrating this cadre of community health providers into the national health system with a view to increasing
the opportunity to offer supporting supervision and establish semi-formal regulation of the practice.
7. Acknowledgments/Disclosures
The author reports no conflicts of interest in this work. All authors participated in the design and conduct of the
study. MM coordinated the design and conduct of the study. EE prepared the first draft of paper and all authors
contributed to the completion. All authors read the final manuscript. The authors acknowledge the following
colleagues who contributed to the data collection, data management and analysis: Ideba Mboto, Anthony Okoro,
Unyimeabasi James, Michael Ubi and Ime Eti-Mfon. Authors also acknowledge the logistic and administrative
support of the Akpabuyo Local Government Council, Cross River State Ministry of Health and the University of
Calabar.
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