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Arnedillo-Sánchez S, Suffo-Abouza JA, Carmona-Rodríguez MÁ, Morilla-Romero-de-la-Osa R, Arnedillo-Sánchez I. Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study. Nutrients 2024; 16:2116. [PMID: 38999864 PMCID: PMC11242974 DOI: 10.3390/nu16132116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 07/14/2024] Open
Abstract
Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.
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Affiliation(s)
- Socorro Arnedillo-Sánchez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
- Midwifery Training Unit, Department of Materno-Fetal Medicine, Genetics and Reproduction, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
- Institute of Biomedicine of Seville, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Seville, Spain
| | - Jose Antonio Suffo-Abouza
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
| | - Miguel Ángel Carmona-Rodríguez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
| | - Rubén Morilla-Romero-de-la-Osa
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (S.A.-S.); (J.A.S.-A.); (M.Á.C.-R.)
- Institute of Biomedicine of Seville, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Inmaculada Arnedillo-Sánchez
- School of Computer Science & Statistics, O’Reilly Institute, Trinity College Dublin, College Green 2, D02 PN40 Dublin, Ireland;
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Yassegoungbe MG, Assan BR, Houegban ASCR, Metchihoungbe CS, Lecompte JF, Aguemon CT, Gbetey SB, Breaud J, Gbenou AS. Are multidisciplinary consultation meetings for prenatal diagnosis achievable in a low-income country? A descriptive cross-sectional survey in Benin. WORLD JOURNAL OF PEDIATRIC SURGERY 2023; 6:e000576. [PMID: 37899843 PMCID: PMC10603329 DOI: 10.1136/wjps-2023-000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/01/2023] [Indexed: 10/31/2023] Open
Abstract
Objective The multidisciplinary antenatal diagnosis staff bring together practitioners who are involved in the management of the antenatal period at birth. This project was designed following the French experience to institute multidisciplinary consultation meetings for prenatal diagnosis (MCMPD) in Benin. Methods This is a descriptive cross-sectional study examining the knowledge, attitudes, and practices of Beninese practitioners in the field of MCMPD to develop the pilot phase of the project. Results We collected 108 participants from different specialties. Pediatricians and pediatric surgeons were in the majority at 23.9% and 16.5%, respectively. Sixty-seven percent of participants were from the public sector (n=75). One practitioner felt that it was not a good idea to implement these meetings. Almost all staff (96.2%) agreed that this meeting would have a positive impact on reducing neonatal mortality. Omphalocele (58.5%), spina bifida aperta (43.6%), and gastroschisis (34%) were the most commonly diagnosed antenatal conditions in Benin. No neonatal pathology required medical termination of the pregnancy according to 35.6% of the participants. Conclusions The objective of reducing infant mortality due to medical and surgical pathologies is a noble one and deserves to be supported. This innovative project, developed through this study, the first of its kind in the subregion, will contribute inexorably to the achievement of the third Goal Sustainable Development.
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Affiliation(s)
- Monsoia Gildas Yassegoungbe
- Pediatric Surgery Department, Mother and Child Teaching Hospital Lagune, University of Abomey-Calavi, Cotonou, Benin
| | - Beaudelaire Romulus Assan
- Pediatric Surgery Department, Mother and Child Teaching Hospital Lagune, University of Abomey-Calavi, Cotonou, Benin
| | | | - Codjo Serge Metchihoungbe
- Pediatric Surgery Department, National Teaching Hospital Hubert Koutoukou Maga, University of Abomey-Calavi, Cotonou, Benin
| | | | - Christine Tschabu Aguemon
- University Clinic of Gynecological Obstetrics, National Teaching Hospital Hubert Koutoukou Maga, University of Abomey-Calavi, Cotonou, Benin
| | - Sidoine Bitho Gbetey
- Intellectual Production Department, Center of Expertise in Applied Social Sciences, Cotonou, Benin
| | - Jean Breaud
- Pediatric Surgery Department, CHU-LENVAL Paediatric Hospitals of Nice, Nice, France
| | - Antoine Seraphin Gbenou
- Pediatric Surgery Department, Mother and Child Teaching Hospital Lagune, University of Abomey-Calavi, Cotonou, Benin
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Factors associated with food consumption score among pregnant women in Eastern Ethiopia: a community-based study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:6. [PMID: 35232495 PMCID: PMC8889778 DOI: 10.1186/s41043-022-00286-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/10/2022] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although assessing the nutritional status of pregnant women is becoming a common research agenda, evidence on food consumption scores, particularly among rural residents, is limited. This study aimed to assess the level of food consumption score and associated factors among pregnant women in Haramaya district, eastern Ethiopia, 2021. METHODS A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews by trained research assistants, using a validated food frequency questionnaire. Food consumption score, a proxy measure for food security, was assessed through a seven-day dietary recall of consumption of food items. Each food item was given a score of 0-7 depending on the number of days it was consumed then grouped into food groups and summed up each food group. The pregnant women were labeled as "acceptable food consumption score" when they had a food composite score of > 42 during the reference period. Otherwise, they were defined as "unacceptable." A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the food consumption score. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p value < 0.05. RESULTS The acceptable food consumption score among the study participants was 54.46% (95% CI 49-59%). The level of acceptable food consumption score was higher among respondents who were in the richest class (APR = 1.31; 95% CI 1.04-1.66), those who had ANC follow-up (APR = 1.78; 95% CI 1.40-2.27), those who had a favorable attitude toward dietary practice (APR = 1.30; 95% CI 1.12-1.52), and those who consumed high animal source foods (APR = 1.28; 95% CI 1.01-1.51). However, acceptable food consumption score was lower among women who were not owned agricultural land (APR = 0.84; 95% CI 0.72-0.99). CONCLUSION We found a low acceptable food consumption score among pregnant women in this predominantly rural setting. Nutritional counseling in pregnancy should address the importance of food diversity and consumption of animal source foods to improve nutrition in pregnancy. Our findings highlight the imperative requirement for policies and programs to support farmers who had no farmland to improve their overall food security and maximize their food consumption score. Assessing perinatal outcomes associated with food consumption score is essential for unraveling the spectrum of nutrition in pregnancy and beyond.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Lee JY, Knauer HA, Lee SJ, MacEachern MP, Garfield CF. Father-Inclusive Perinatal Parent Education Programs: A Systematic Review. Pediatrics 2018; 142:peds.2018-0437. [PMID: 29903835 DOI: 10.1542/peds.2018-0437] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Fathers contribute to their children's health starting at the beginning of life. Few parent education programs include fathers. Among those that do, there is little effort to report program effects on father outcomes. OBJECTIVE In this systematic review, we examined father-inclusive perinatal parent education programs in the United States as they relate to a range of father outcomes. DATA SOURCES The databases searched were PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Ovid Medline, Cochrane Central Register of Controlled Trials, and PsycINFO. STUDY SELECTION Studies were included if they included an evaluation of a parent education program and a report of father outcomes measured within 1 year of the child's birth and were conducted within the United States. DATA EXTRACTION Of 1353 total articles, 21 met study criteria. RESULTS The overall state of the father-inclusive perinatal parent education program literature was poor, with few interventions available to fathers. Available programs were associated with increased father involvement, coparenting relationship, partner relationship quality, father's mental health, and father's supportive behaviors. Program effects on father-infant interaction, parenting knowledge, and attitudes and parenting self-efficacy were inconclusive. Three programs emerged as best evidence-based interventions. LIMITATIONS Risk of bias was high for many studies. Outcome variability, small sample size, and publication bias contributed to the weak evidence base. CONCLUSIONS There is a need for more evidence-based interventions to support fathers. Clinicians play a key role in engaging fathers in early parent education programs and health care settings. PROSPERO registration number: CRD42017050099.
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Affiliation(s)
- Joyce Y Lee
- School of Social Work, University of Michigan, Ann Arbor, Michigan;
| | - Heather A Knauer
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Shawna J Lee
- School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - Mark P MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan
| | - Craig F Garfield
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; and.,Division of Hospital Based Medicine, Lurie Children's Hospital of Chicago, Chicago, Illinois
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Solnes Miltenburg A, van der Eem L, Nyanza EC, van Pelt S, Ndaki P, Basinda N, Sundby J. Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study. PLoS One 2017; 12:e0188279. [PMID: 29236699 PMCID: PMC5728494 DOI: 10.1371/journal.pone.0188279] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 11/04/2017] [Indexed: 12/01/2022] Open
Abstract
Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client's wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria.
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Affiliation(s)
- Andrea Solnes Miltenburg
- Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Oslo, Norway
- Women Centered Care Project, a project of the African Woman Foundation, Magu District, Mwanza Region, Tanzania
| | - Lisette van der Eem
- Women Centered Care Project, a project of the African Woman Foundation, Magu District, Mwanza Region, Tanzania
- Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
| | - Elias C. Nyanza
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Sandra van Pelt
- Women Centered Care Project, a project of the African Woman Foundation, Magu District, Mwanza Region, Tanzania
| | - Pendo Ndaki
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Namanya Basinda
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Johanne Sundby
- Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Oslo, Norway
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Oloko O, Ogunbode OO, Roberts O, Arowojolu AO. Antenatal care visits' absenteeism at a secondary care medical facility in Southwest Nigeria. J OBSTET GYNAECOL 2016; 36:1026-1030. [PMID: 27616013 DOI: 10.1080/01443615.2016.1188270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Antenatal care (ANC) is a specialised pattern of care organised for pregnant women with the goal of maintaining good health and promoting safe delivery of healthy infants. It is an indispensable part of effective maternity care services. This study identified the factors responsible for absenteeism from ANC follow-up visits. It was a hospital-based prospective cross-sectional descriptive study conducted at a faith based secondary healthcare facility in Ibadan, Nigeria. Relevant data were retrieved using interviewer-administered structured questionnaires and antenatal health record cards. The major reasons identified for absenteeism were delay in receiving hospital services due to long queues at service points and understaffing. The pregnant women aged 35 years and above were the most likely to miss the visits. Therefore, there is the need for hospital administrators and health care givers to make the services patient-friendly.
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Affiliation(s)
- Olakunle Oloko
- a Department of Obstetrics and Gynaecology , Our Lady of Apostle Catholic Hospital, Oluyoro Oke-Offa , Ibadan , Nigeria
| | | | - Olumuyiwa Roberts
- c Department of Obstetrics and Gynaecology, College of Medicine , University of Ibadan , Ibadan , Nigeria
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Abstract
The aim of health education during antenatal is to provide advice, education, reassurance and support, to address and treat the minor problems of pregnancy, and to provide effective screening during the pregnancy. Exploring current practices in this regard revealed the need for more organized educational activities to ensure high quality and clients satisfaction.
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Affiliation(s)
- Mohammed A Al-Ateeq
- College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Amal A Al-Rusaiess
- Department of Family Medicine and Primary Health Care, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Mackert M, Guadagno M, Donovan E, Whitten P. Including men in prenatal health: the potential of e-health to improve birth outcomes. Telemed J E Health 2014; 21:207-12. [PMID: 25489723 DOI: 10.1089/tmj.2014.0048] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The U.S. infant mortality rate is the highest in the developed world, and disparity impacts underserved populations. Traditional maternal health focuses on women, excluding men from information affecting family health. Scholars advocate including men in prenatal health to reduce infant mortality, a proven strategy in developing nations. This study explored the role of U.S. men in prenatal health, barriers to involvement, and the use of e-health. Special attention was given to health literacy; research indicates e-health is effective in educating low health-literate audiences. MATERIALS AND METHODS This study interviewed men with an average age of 33 years (n=32). The sample was 38% Hispanic, 28% African American, 28% white, and 6% multiracial. Participants were asked about pregnancy health and used a pregnancy-related e-health application on a tablet computer. Participants provided opinions on content, ease of use of the tablet, and willingness to use similar applications. RESULTS Men believe it is important to be involved in pregnancy to help ensure healthy births. Most use mobile devices and computers for health information and found the application to be useful and interesting. Most concluded they would use a similar application to learn about pregnancy. Health literacy had minimal impact on participants' use of the tablet and information. CONCLUSIONS This study explored the role men play in prenatal health, a promising avenue toward better birth outcomes. Using e-health is an opportune approach-it can reach men unavailable to attend prenatal programs because of work or feeling unwelcome at programs deemed "only for women."
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Affiliation(s)
- Michael Mackert
- 1 Department of Advertising and Public Relations, The University of Texas at Austin , Austin, Texas
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Banchani E, Tenkorang EY. Occupational Types and Antenatal Care Attendance Among Women in Ghana. Health Care Women Int 2014; 35:1040-64. [DOI: 10.1080/07399332.2014.919581] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Saizonou J, Agueh DV, Aguemon B, Mongbo Adé V, Assavedo S, Makoutodé M. Évaluation de la qualité des services de consultation prénatale recentrée à l'hôpital de district de Suru-Léré au Bénin. SANTÉ PUBLIQUE 2014. [DOI: 10.3917/spub.138.0249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
The U.S. infant mortality rate is among the highest in the developed world, with recent vital statistics reports estimating 6.14 infant deaths per 1,000 live births. Traditional health education and promotion to improve maternal, infant, and child health in the United States has focused only on women, leaving men out of important health messages that may affect pregnancy outcomes as well as family well-being. Recently, public health scholars have suggested that men be included in prenatal health education in an effort to improve birth outcomes and reduce infant mortality. Incorporating men in prenatal health promotion and education has been found to improve overall birth preparedness, reduce the risk of maternal–infant HIV transmission, and reduce perinatal mortality in less-developed nations. Although these results are positive, research on paternal impact in pregnancy outcomes in the United States to date is lacking. This article proposes a U.S.-specific research agenda to understand the current role of men in pregnancy health, as well as actual involvement, barriers, and the influence men can have in prenatal health. A discussion of culture, individual motivations, health care providers, and social marketing is also considered.
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Solnes Miltenburg A, Roggeveen Y, van Elteren M, Shields L, Bunders J, van Roosmalen J, Stekelenburg J. A protocol for a systematic review of birth preparedness and complication readiness programs. Syst Rev 2013; 2:11. [PMID: 23394138 PMCID: PMC3599634 DOI: 10.1186/2046-4053-2-11] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 01/28/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND One of the effective strategies for reducing the number of maternal deaths is delivery by a skilled birth attendant. Low utilization of skilled birth attendants has been attributed to delay in seeking care, delay in reaching a health facility and delay in receiving adequate care. Health workers could play a role in helping women prepare for birth and anticipate complications, in order to reduce delays. There is little evidence to support these birth preparedness and complication readiness (BP/CR) programs; however, BP/CR programs are frequently implemented. The objective of this review is to assess the effect of BP/CR programs on increasing skilled birth attendance in low-resource settings. METHODS Due to the complexity of BP/CR programs and the need to understand why certain programs are more effective than others, we will combine both quantitative and qualitative studies in this systematic review. Search terms were selected with the assistance of a health information specialist. Three reviewers will independently select and assess studies for quality. Data will be extracted by one reviewer and checked for accuracy and completeness by a second reviewer. Discussion between the reviewers will resolve disagreements. If disagreements remain, a third party will be consulted. Data analysis will be carried out in accordance with the BP/CR matrix, developed by the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO). Study data will be grouped and analyzed by quality and study design and regrouped according to type of intervention strategy. DISCUSSION This review will provide: 1) an insight into existing BP/CR programs, 2) recommendations on effective elements of the different approaches, 3) proposals for concrete action plans for health professionals in the field of reproductive health in resource-poor settings and 4) an overview of existing knowledge gaps requiring further research. TRIAL REGISTRATION PROSPERO registration no.: CRD42012003124.
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Affiliation(s)
- Andrea Solnes Miltenburg
- Athena Institute for Research on Innovation and Communication in Health and Life sciences, Faculty of Earth and Life Sciences, VU University, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands.
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Conrad P, De Allegri M, Moses A, Larsson EC, Neuhann F, Müller O, Sarker M. Antenatal care services in rural Uganda: missed opportunities for good-quality care. QUALITATIVE HEALTH RESEARCH 2012; 22:619-629. [PMID: 22232296 DOI: 10.1177/1049732311431897] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Experience from countries that have achieved low maternal mortality suggests that access to good-quality maternity services is critical to improve maternal health. In this article we appraise the quality of antenatal care (ANC) services in a rural district of Uganda. We used a mixed methods approach, relying on a combination of semistructured interviews with both clients and providers, structured observations of provider-patient interactions, and infrastructure assessment of selected health facilities. We found several bottlenecks in health service delivery, including ineffective organization of educational sessions; selective omission of certain services; lack of explanation of important clinical and laboratory procedures; failure to link the performed procedures with preventive information; and occasional lack of respect for clients. The policy implications of these findings are discussed in relation to the need to (a) ensure an adequate supply of medical equipment and drugs, (b) enhance health workers' compliance with ANC guidelines, and (c) combine medical procedures with educational messages.
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Affiliation(s)
- Paul Conrad
- University of Heidelberg, Heidelberg, Germany
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Abstract
Men's supportive stance is an essential component for making women's world better. There are growing debates among policymakers and researchers on the role of males in maternal health programmes, which is a big challenge in India where society is male driven. This study aims to look into the variations and determinants of maternal health care utilization in India and in three demographically and socioeconomically disparate states, namely Uttar Pradesh, West Bengal and Maharashtra, by husband's knowledge, attitude, behaviour towards maternal health care and gender violence, using data from the National Family Health Survey III 2005-06 (equivalent to the Demographic and Health Survey in India). Women's antenatal care visits, institutional delivery and freedom in health care decisions are looked into, by applying descriptive statistics and multivariate models. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. From a policy perspective, proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units secure better male involvement in maternal health care.
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Magoma M, Requejo J, Merialdi M, Campbell OMR, Cousens S, Filippi V. How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania. BMC Pregnancy Childbirth 2011; 11:64. [PMID: 21943347 PMCID: PMC3195209 DOI: 10.1186/1471-2393-11-64] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 09/24/2011] [Indexed: 11/16/2022] Open
Abstract
Background Many women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC) including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC. Methods The study was conducted in 16 health units (eight units in each arm of the trial). We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction. Results The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47) in the intervention arm versus 19.9 (range 12-32) in the control arm p < 0.0001. Except for drug administration, which was the same in both arms of the trial, the time spent on each component of care was also greater in the intervention health units. Similar trends were observed for subsequent ANC consultations. Birth plans were always discussed in the intervention health units. Counselling on HIV/AIDS was also prioritized, especially in the control health units. Most other recommended topics (e.g. danger signs during pregnancy) were rarely discussed. Conclusion Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.
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Affiliation(s)
- Moke Magoma
- Department of Obstetrics & Gynaecology, Bugando Medical Centre and Teaching Hospital, Mwanza, Tanzania.
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16
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Ren Z. Utilisation of antenatal care in four counties in Ningxia, China. Midwifery 2010; 27:e260-6. [PMID: 21145633 DOI: 10.1016/j.midw.2010.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 08/25/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To analyse and evaluate the antenatal care services and its quality so as to improve the antenatal care, and make it more available and cost-effective. DESIGN Retrospective survey. A multistage sampling technique was used to select townships and villages. SETTING The four rural counties of a project in Ningxia Hui Autonomous Region in northwest China, where more than one half of the population was Hui ethnicity, the average hospital delivery rate was 47% in 2005, and the maternal mortality ratio was estimated to be higher than 65 deaths per 100,000 live births in 2005. PARTICIPANTS Five hundred and fifty-four mothers of children under the age of five were interviewed at home using a structured questionnaire between August and September in 2006. No mothers refused to take part in the survey. MEASUREMENTS AND FINDINGS The percentage using antenatal care, the number of antenatal visits and the timing of the first antenatal visit during the pregnancy of the youngest child were analysed. 78.2% of the mothers had received antenatal care services, but only 12.9% had at least five antenatal visits and 35.2% had their initial visit in the first trimester. Only 9.0% whose first antenatal visit took place during the first trimester had at least five antenatal visits. Ethnicity was an important factor determining antenatal care use. Hui mothers had significantly lower odds ratios of obtaining antenatal care in the first trimester (OR = 0.32, P < 0.001) or having at least five antenatal visits (OR = 0.11, P < 0.001) than Han mothers. KEY CONCLUSIONS The quality of the antenatal care which the women received was low. It is necessary to rethink the current model of antenatal care, and to develop and standardise a new model of antenatal care.
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Affiliation(s)
- Zhenghong Ren
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Centre, Beijing 100191, PR China.
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Aniebue UU, Aniebue PN. Women's perception as a barrier to focused antenatal care in Nigeria: the issue of fewer antenatal visits. Health Policy Plan 2010; 26:423-8. [PMID: 21088079 DOI: 10.1093/heapol/czq073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The attitude of pregnant women to a new antenatal care model with four antenatal visits (focused antenatal care) is examined using a cross-sectional survey in Enugu, Nigeria. Only 20.3% of the parturients desired a change to the new model. Parturients who defaulted from antenatal care three or more times, those dissatisfied with their current antenatal care, senior civil servants and parturients who received secondary school education or less most commonly desired a change to the new model (P < 0.05). Default from antenatal care and dissatisfaction with current antenatal care were most predictive of the desire for change in multiple logistic regression analysis. The most common reasons for desiring the change were convenience (65.1%) and cost considerations (24.1%). Reasons given for the rejection of the new model were: fear of inadequate learning during antenatal care (45.7%), the suspicion that four visits were inadequate for familiarization with care providers (12.9%), the need for early detection of disease (6.7%) and social satisfaction from antenatal visits (6.7%). These concerns are amenable to change by health education and social mobilization.
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Affiliation(s)
- U U Aniebue
- Department of Obstetrics/Gynaecology, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
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Ay P, Hayran O, Topuzoglu A, Hidiroglu S, Coskun A, Save D, Nalbant H, Ozdemir E, Eker L. The influence of gender roles on health seeking behaviour during pregnancy in Turkey. EUR J CONTRACEP REPR 2009; 14:290-300. [DOI: 10.1080/13625180902925211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- Amal Omer-Salim
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pia Olsson
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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von Both C, Fleβa S, Makuwani A, Mpembeni R, Jahn A. How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania. BMC Pregnancy Childbirth 2006; 6:22. [PMID: 16796749 PMCID: PMC1557863 DOI: 10.1186/1471-2393-6-22] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Accepted: 06/23/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO). In this study we assess the time health workers currently spent on providing ANC services and compare it to the requirements anticipated for the new ANC model in order to identify the implications of Focused ANC on health care providers' workload. METHODS Health workers in four dispensaries in Mtwara Urban District, Southern Tanzania, were observed while providing routine ANC. The time used for the overall activity as well as for the different, specific components of 71 ANC service provisions was measured in detail; 28 of these were first visits and 43 revisits. Standard time requirements for the provision of focused ANC were assessed through simulated consultations based on the new guidelines. RESULTS The average time health workers currently spend for providing ANC service to a first visit client was found to be 15 minutes; the provision of ANC according to the focused ANC model was assessed to be 46 minutes. For a revisiting client the difference between current practise and the anticipated standard of the new model was 27 minutes (9 vs. 36 min.). The major discrepancy between the two procedures was related to counselling. On average a first visit client was counselled for 1:30 minutes, while counselling in revisiting clients did hardly take place at all. The simulation of focused ANC revealed that proper counselling would take about 15 minutes per visit. CONCLUSION While the introduction of focused ANC has the potential to improve the health of pregnant women and to raise the number of births attended by skilled staff in Tanzania, it may need additional investment in human resources. The generally anticipated saving effect of the new model through the reduction of routine consultations may not materialise because the number of consultations is already low in Tanzania with a median of only 4 visits per pregnancy. Special attention needs to be given to counselling attitudes and skills during the training for Focused ANC as this component is identified as the major difference between old practise and the new model. Our estimated requirement of 46 minutes per first visit consultation matches well with the WHO estimate of 40 minutes.
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Affiliation(s)
- Claudia von Both
- Department of Tropical Hygiene and Public Health, Ruprecht-Karls-University, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Steffen Fleβa
- Department of Health Care Management, Faculty of Law and Economics, University of Greifswald, Friedrich-Loeffler-Str. 70, D-17487 Greifswald, Germany
| | - Ahmad Makuwani
- School of Public Health & Social Sciences, Muhimbili University College of Health Sciences, Daressalaam, Tanzania
| | - Rose Mpembeni
- School of Public Health & Social Sciences, Muhimbili University College of Health Sciences, Daressalaam, Tanzania
| | - Albrecht Jahn
- Department of Tropical Hygiene and Public Health, Ruprecht-Karls-University, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
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Dudgeon MR, Inhorn MC. Men's influences on women's reproductive health: medical anthropological perspectives. Soc Sci Med 2004; 59:1379-95. [PMID: 15246168 DOI: 10.1016/j.socscimed.2003.11.035] [Citation(s) in RCA: 223] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Reproductive health has emerged as an organizational framework that incorporates men into maternal and child health (MCH) programs. For several decades, medical anthropologists have conducted reproductive health research that explores male partners' effects on women's health and the health of children. This article summarizes exemplary research in this area, showing how ethnographic studies by medical anthropologists contribute new insights to the growing public health and demographic literature on men and reproductive health. The first half of the article begins by exploring reproductive rights, examining the concept from an anthropological perspective. As part of this discussion, the question of equality versus equity is addressed, introducing anthropological perspectives on ways to incorporate men fairly into reproductive health programs and policies. The second half of the article then turns to a number of salient examples of men's relevance in the areas of contraception, abortion, pregnancy and childbirth, infertility, and fetal harm. Medical anthropological research--as well as prominent gaps in that research--is highlighted. The article concludes with thoughts on future areas of anthropological research that may improve understandings of men's influences on women's reproductive health.
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Affiliation(s)
- Matthew R Dudgeon
- Department of Anthropology, 1557 Pierce Drive, Emory University, Atlanta, GA 30322, USA.
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