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Mourtada R, Bashour H, Houben F. A qualitative study exploring barriers to adequate uptake of antenatal care in pre-conflict Syria: low cost interventions are needed to address disparities in antenatal care. Contracept Reprod Med 2021; 6:17. [PMID: 34059151 PMCID: PMC8167987 DOI: 10.1186/s40834-021-00156-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/04/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Syria has made progress in reducing maternal mortality and morbidity before the conflict in 2011. Despite the improvement in antenatal care (ANC) coverage and patterns of use, analyses of national surveys demonstrated wide regional variations in uptake, timing and number of visits even after controlling for women's socio-demographic characteristics. This study compares two governorates: Latakia, where uptake of ANC was high and Aleppo, where uptake of ANC was low to highlight the barriers to women's adequate uptake of ANC that existed in Syria pre-conflict. METHODS This qualitative study carried out 30 semi-structured interviews with (18-45-year-old) pregnant women from Aleppo and Latakia (recruited purposively from different types of health facilities in rural and urban areas), and 15 observation sessions at health facilities. Transcripts and fieldnotes were analyzed using the Framework Method with attention to the dimensions of availability, accessibility and acceptability of services. RESULTS Inadequate uptake of ANC in Aleppo included not attending ANC, seeking care with providers who are not trained to provide ANC or discontinuing care. Three themes explained the regional disparities in the uptake of ANC in Aleppo and Latakia: women's assessment of their health status and reasoning of causes of ill health in pregnancy; women's evaluation of the risks of seeking ANC; and women's appraisal of the value of different types of service providers. Poor experiences at public health facilities were reported by women in Aleppo but not by women in Latakia. Evaluations of ANC services were connected with the availability, accessibility (geographical and financial) and acceptability of ANC services, however, women's views were shaped by the knowledge and prevailing opinions in their families and community. CONCLUSIONS Findings are utilized to discuss low-cost interventions addressing the disparities in ANC uptake. Interventions should aim to enable vulnerable women to make informed decisions focusing on regions of low uptake. Women's groups that foster education and empowerment, which have been effective in other low resource settings, could be of value in Syria. Increased use of mobile phones and social media platforms suggests mobile health technologies (mHealth) may present efficient platforms to deliver these interventions.
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Affiliation(s)
- Rima Mourtada
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK.
- Faculty of Health Sciences, American University of Beirut, Bliss Street, Beirut, Lebanon.
| | - Hyam Bashour
- Faculty of Medicine, University of Damascus, Damascus, Syria
| | - Fiona Houben
- Faculty of Health and Wellbeing, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1QU, UK
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Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE. Nutrients 2019; 11:nu11081939. [PMID: 31426498 PMCID: PMC6723319 DOI: 10.3390/nu11081939] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022] Open
Abstract
Premenstrual syndrome (PMS) is a cyclical late luteal phase disorder of the menstrual cycle whereby the daily functioning of women is affected by emotional and physical symptoms substantially interfering with their quality of life. Little is known about PMS in the United Arab Emirates (UAE). This study aimed to determine the prevalence and severity of PMS among university students in Sharjah, UAE, and clarify its associations with dietary habits, lifestyle behaviors, and anthropometric factors. A cross-sectional study was conducted on female college students at the University of Sharjah, UAE. Data were collected using self-administered questionnaires and anthropometric assessments. Descriptive statistics and multiple logistic regression analyses were performed. Participants were 300 adult university students aged 18-24 years (mean age 20.07 ± 1.53 years). In total, 95% of participants reported at least one PMS symptom during their menstrual period. The prevalence of PMS was 35.3%, with mild symptoms being the most commonly reported. Multiple regression analysis showed that smoking was associated with increased risk of reporting psychological (OR 2.5, 95% CI 1.1-5.8; p < 0.05) and behavioral symptoms (OR 2.2, 95% CI 1.0-4.9; p < 0.05), while high calorie/fat/sugar/salt foods intake was associated with increased risk of reporting physical symptoms (OR 3.2, 95% CI 1.4-7.3; p < 0.05). However, fruit consumption (OR 0.34, 95% CI 0.125-0.92; p < 0.05) was associated with a decreased risk of reporting behavioral symptoms. A high prevalence of PMS was reported among university students, with smoking and high calorie/fat/sugar/salt food consumption identified as strong risk factors for PMS.
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Assessment of Dapagliflozin Effectiveness as Add-on Therapy for the Treatment of Type 2 Diabetes Mellitus in a Qatari Population. Sci Rep 2019; 9:6864. [PMID: 31053747 PMCID: PMC6499803 DOI: 10.1038/s41598-019-43052-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/15/2019] [Indexed: 01/10/2023] Open
Abstract
The effectiveness of dapagliflozin in the management of type-2 diabetes mellitus (T2-DM) is an essential issue for establishing a basis for prescribing dapagliflozin. This study aimed to assess the effectiveness of dapagliflozin in combination with other hypoglycemic agents (OHAs) in reducing glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) at 3, 6, 9 and 12 months. This retrospective observational study included all patients who visited the endocrine clinics at Hamad Medical Corporation (HMC) and were treated with dapagliflozin. Demographics and laboratory data were obtained retrospectively from computerized patient medical profiles (eMR-viewer). The main outcome measures were the differences in HbA1c and FBG from baseline at different months. Eighty-one Qatari patients were found to have received dapagliflozin during the study period; 72% of them (n = 58) were males, with a mean age of 57.0 ± 9.0 years and a mean baseline HbA1c of 9.0 ± 1.4%. Administration of dapagliflozin as an add-on therapy was found to decrease HbA1c significantly by 0.8 percentage point after 6 months (P = 0.006) and by 1.5 percentage point after 12 months (P = 0.062). FBG was significantly reduced at 6 months and 9 months (P = 0.001 and P = 0.03, respectively). Dapagliflozin effectively reduced the HbA1c level and FBG when used in combination with other OHAs or insulin within 6 to 12 months.
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Robinson AM, Benzies KM, Cairns SL, Fung T, Tough SC. Who is distressed? A comparison of psychosocial stress in pregnancy across seven ethnicities. BMC Pregnancy Childbirth 2016; 16:215. [PMID: 27514674 PMCID: PMC4982239 DOI: 10.1186/s12884-016-1015-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 08/01/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Calgary, Alberta has the fourth highest immigrant population in Canada and ethnic minorities comprise 28 % of its total population. Previous studies have found correlations between minority status and poor pregnancy outcomes. One explanation for this phenomenon is that minority status increases the levels of stress experienced during pregnancy. The aim of the present study was to identify specific types of maternal psychosocial stress experienced by women of an ethnic minority (Asian, Arab, Other Asian, African, First Nations and Latin American). METHODS A secondary analysis of variables that may contribute to maternal psychosocial stress was conducted using data from the All Our Babies prospective pregnancy cohort (N = 3,552) where questionnaires were completed at < 24 weeks of gestation and between 34 and 36 weeks of gestation. Questionnaires included standardized measures of perceived stress, anxiety, depression, physical and emotional health, and social support. Socio-demographic data included immigration status, language proficiency in English, ethnicity, age, and socio-economic status. RESULTS Findings from this study indicate that women who identify with an ethnic minority were more likely to report symptoms of depression, anxiety, inadequate social support, and problems with emotional and physical health during pregnancy than women who identified with the White reference group. CONCLUSIONS This study has identified that women of an ethic minority experience greater psychosocial stress in pregnancy compared to the White reference group.
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Affiliation(s)
- Alexandra M. Robinson
- Faculty of Education, Counselling Psychology, University of Calgary, Calgary, AB Canada
| | - Karen M. Benzies
- Faculty of Nursing, and Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Sharon L. Cairns
- Faculty of Education, Counselling Psychology, University of Calgary, Calgary, AB Canada
| | - Tak Fung
- Information Technologies, University of Calgary, Calgary, AB Canada
| | - Suzanne C. Tough
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, Calgary, AB Canada
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Enhancing the care of women with rheumatic diseases during pregnancy: challenges and unmet needs in the Middle East. Clin Rheumatol 2015; 35:25-31. [PMID: 26304021 PMCID: PMC4710648 DOI: 10.1007/s10067-015-3052-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/21/2015] [Accepted: 07/26/2015] [Indexed: 12/16/2022]
Abstract
Pregnancy in women with rheumatic disorders is known to be associated with risks for both the mother and fetus; however, these risks can be minimized with proper planning and careful management of the disease. In the Middle East, there are specific cultural challenges that may have a negative impact on the care that women with rheumatic disorders receive. There is a need for cross-collaboration between specialist physicians, improved awareness of rheumatic disorders among the general public and more open discussion with patients about the potential complications of pregnancy. Women in the region are often unwilling to discuss their disease with their partner and are even less likely to seek advice regarding family planning from their physician. The objective of this review is to highlight the specific challenges of pregnancy management and to discuss why establishing specialist pregnancy clinics for women with rheumatic disorders could be an effective solution. Such clinics can provide high quality care before, during and after pregnancy as shown in several European and US centers. Additionally, such clinics could be useful for the collection of pregnancy outcomes data from the Middle East, which may currently be lacking in the region, in order to highlight where further improvements can be made. With specialist care and analysis of pregnancy outcomes, the standard of care for women with rheumatic disorders in this area could be significantly improved.
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Marrone SR. Informed Consent Examined Within the Context of Culturally Congruent Care. J Transcult Nurs 2015; 27:342-8. [DOI: 10.1177/1043659615569537] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The process of obtaining informed consent for diverse patients poses many challenges for health care professionals as they try to balance ethical, legal, and accreditation requirements of the country within which they practice with the culture care needs of diverse consumers. Culturally competent health care organizations create a governance infrastructure that promotes equity and supports the delivery of culturally appropriate health care services that are responsive to diverse patients. The purpose of this article is to examine the concept of informed consent within the context of culturally congruent care to Saudi patients and families in an American hospital setting. The need for the provision of culturally congruent care that respects the contextual rights and dignity of patients and families while, at the same time, recognizing the legal, ethical, and moral codes of the health professions and requirements of federal, state, and regulatory agencies within the United States will be explored.
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Affiliation(s)
- Stephen R. Marrone
- Long Island University, Brooklyn, NY, USA
- Columbia University, New York, NY, USA
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Othman A, Ahram M, Al-Tarawneh MR, Shahrouri M. Knowledge, Attitudes and Practices of Breast Cancer Screening Among Women in Jordan. Health Care Women Int 2014; 36:578-92. [DOI: 10.1080/07399332.2014.926900] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Aim, Background, and Introduction. Bearing and rearing children are an important part of life in nearly all cultures and are a central role for Jordanian Muslim women. Infertility can create anxiety, stress, and depression for couples who are infertile. Women frequently bear the emotional stigma of a couple’s infertility. There is a paucity of literature focusing on Jordanian Muslim women experiencing infertility and failed assistive reproductive technology. Therefore, this study explored these women’s lived experience. Methods. Qualitative data were collected through interviews with 30 Jordanian Muslim women who experienced failed assistive reproductive technology for infertility. Perceptions of experiences with failed treatment of infertility were documented and analyzed. Results. Major themes were identified: missing out on motherhood and living with infertility, experiencing marital stressors, feeling social pressure, experiencing depression and disappointment, having treatment associated difficulties, appreciating support from family and friends, using coping strategies, and fear of an unknown future. Discussion, Conclusion, and Implications for Clinical Practice. Being infertile significantly influences the physical, emotional, social, and spiritual health of Jordanian Muslim women as well as their quality of life. Perceived social support and personal coping strategies were used by study participants to mediate failed attempts to conceive. Designing and implementing culturally appropriate interventions for Muslim women globally who are experiencing infertility are essential.
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Legault A, Marquis M. Nutrition Information-seeking Behaviour of Low-income Pregnant Maghrebian Women. CAN J DIET PRACT RES 2014; 75:22-8. [DOI: 10.3148/75.1.2014.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Methods Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women’s nutrition decision-making. Results Environmental factors likely to influence informationseeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Conclusions Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women’s specific information needs.
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Affiliation(s)
- Anik Legault
- RD, PhD candidate
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC
| | - Marie Marquis
- PhD
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC
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Farage MA, Miller KW, Davis A. Cultural aspects of menstruation and menstrual hygiene in adolescents. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.11.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Martyn KK, Munro ML, Darling-Fisher CS, Ronis DL, Villarruel AM, Pardee M, Faleer H, Fava NM. Patient-centered communication and health assessment with youth. Nurs Res 2013; 62:383-93. [PMID: 24165214 PMCID: PMC4235338 DOI: 10.1097/nnr.0000000000000005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patient-centered communication is fundamental to individualizing healthcare, but there has been limited evaluation of provider communication with youth. OBJECTIVES The aim was to compare communication outcomes after use of an event history calendar (EHC) and Guidelines for Adolescent Preventive Services (GAPS) to structure interactions during a clinic visit. Patient and provider descriptions of EHC and GAPS communication experiences were also obtained. METHODS This is a secondary analysis of data obtained during a randomized controlled trial. A sequential explanatory mixed-methods approach was used. A split-plot design with one between factor (EHC, GAPS) and one within factor (pretest, posttest) was used for the quantitative portion. Qualitative data were collected from open-ended questions, audiotaped visits, and exit interviews. Providers (n = 9) at three clinics were assigned at random and trained to implement either the EHC or GAPS protocol. Male and female youth (n = 186) were randomly assigned to the EHC or GAPS intervention. Before their clinic visit, youth completed assessments of past communication experiences with healthcare providers (pretest); communication during the current visit was assessed immediately after the visit (posttest). RESULTS Communication outcomes from pretest to posttest improved for youth in both the EHC and GAPS groups. Post hoc subgroup analysis suggested that men and Arab Americans derived more benefit from the EHC intervention in some aspects of communication. Qualitatively, the EHC group identified improved outcomes in validating patient perspective, being viewed in context, reaching a shared understanding of needs and preferences, and being helped to share power in the healthcare interaction. DISCUSSION EHC and GAPS provided effective frameworks for structuring communication during a clinic visit. Compared with GAPS, the integrated time-linked assessment captured by the EHC enhanced patient-centered communication in select groups.
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Affiliation(s)
- Kristy K. Martyn
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd., Rm. 346, Atlanta, GA 30322
| | - Michelle L. Munro
- University of Michigan School of Nursing, 400 North Ingalls Building, Room 3188, Ann Arbor, MI 48109-5482
| | - Cynthia S. Darling-Fisher
- University of Michigan School of Nursing, 400 North Ingalls Building, Room 3176, Ann Arbor, MI 48109-5482
| | - David L. Ronis
- University of Michigan School of Nursing, 400 North Ingalls Building, Room 4330, Ann Arbor, MI 48109-5482
| | - Antonia M. Villarruel
- University of Michigan School of Nursing, 400 North Ingalls Building, Room 4320, Ann Arbor, MI 48109-5482
| | - Michelle Pardee
- University of Michigan School of Nursing, 400 North Ingalls Building, Room 3185, Ann Arbor, MI 48109-5482
| | - Hannah Faleer
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - Nicole M. Fava
- Wayne State University, 71 East Ferry, Detroit, MI 48202
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Higginbottom GMA, Safipour J, Mumtaz Z, Chiu Y, Paton P, Pillay J. "I have to do what I believe": Sudanese women's beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada. BMC Pregnancy Childbirth 2013; 13:51. [PMID: 23442448 PMCID: PMC3599128 DOI: 10.1186/1471-2393-13-51] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/11/2013] [Indexed: 11/10/2022] Open
Abstract
Background Evidence suggests that immigrant women having different ethnocultural backgrounds than those dominant in the host country have difficulty during their access to and reception of maternity care services, but little knowledge exists on how factors such as ethnic group and cultural beliefs intersect and influence health care access and outcomes. Amongst immigrant populations in Canada, refugee women are one of the most vulnerable groups and pregnant women with immediate needs for health care services may be at higher risk of health problems. This paper describes findings from the qualitative dimension of a mixed-methodological study. Methods A focused ethnographic approach was conducted in 2010 with Sudanese women living in an urban Canadian city. Focus group interviews were conducted to map out the experiences of these women in maternity care, particularly with respect to the challenges faced when attempting to use health care services. Results Twelve women (mean age 36.6 yrs) having experience using maternity services in Canada within the past two years participated. The findings revealed that there are many beliefs that impact upon behaviours and perceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe could harm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without need for special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family by males and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment for women, and the women tend to exert control in ways that may or may not be respected by their husbands. Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength. Conclusion In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.
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Al-Akour NA, Gharaibeh M, Al-Sallal RAK. Perception of Jordanian mothers to nursing support during their children hospitalisation. J Clin Nurs 2012; 22:233-9. [DOI: 10.1111/j.1365-2702.2012.04278.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Nemeh A Al-Akour
- Maternal and Child Health Department; School of Nursing; Jordan University of Science and Technology (JUST); Irbid; Jordan
| | - Muntaha Gharaibeh
- Maternal and Child Health Department; Jordan University of Science and Technology; Irbid; Jordan
| | - Ranyah AK Al-Sallal
- School of Nursing; Jordan University of Science and Technology (JUST); Irbid; Jordan
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Hassan SJ, Sundby J, Husseini A, Bjertness E. The paradox of vaginal examination practice during normal childbirth: Palestinian women's feelings, opinions, knowledge and experiences. Reprod Health 2012; 9:16. [PMID: 22929060 PMCID: PMC3560273 DOI: 10.1186/1742-4755-9-16] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 06/09/2012] [Indexed: 12/15/2022] Open
Abstract
Background Vaginal examination (VE), is a frequent procedure during childbirth. It is the most accepted ways to assess progress during childbirth, but its repetition at short intervals has no value. Over years, VE continued to be plagued by a nature that implies negative feelings and experiences of women. The aim of this exploratory qualitative study was to explore women’s feelings, opinions, knowledge and experiences of vaginal examinations (VE) during normal childbirth. Methods We interviewed 176 postpartum women using semi-structured questionnaire in a Palestinian public hospital in the oPt. Descriptive statistics were conducted; frequency counts and percentages for the quantitative questions. The association between the frequency of VE and age, parity, years of education, locale and the time of delivery was tested by Chi-squared and Fisher’s Exact test. The open-ended qualitative questions were read line-by-line for the content and coded. The assigned codes for all responses were entered to the SPSS statistical software version 18. Results As compared with WHO recommendations, VE was conducted too frequently, and by too many providers during childbirth. The proportion of women who received a ‘too high’ frequency of VEs during childbirth was significantly larger in primipara as compared to multipara women (P = .037). 82% of women reported pain or severe pain and 68% reported discomfort during VE. Some women reported insensitive approaches of providers, insufficient means of privacy and no respect of dignity or humanity during the exam. Conclusions Palestinian women are undergoing unnecessary and frequent VEs during childbirth, conducted by several different providers and suffer pain and discomfort un-necessarily. Practice implications Adhering to best evidence, VE during childbirth should be conducted only when necessary, and if possible, by the same provider. This will decrease the laboring women’s unnecessary suffering from pain and discomfort. Providers should advocate for women’s right to information, respect, dignity and privacy.
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Affiliation(s)
- Sahar J Hassan
- Section of Preventive Medicine and Epidemiology, Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Box 1130, 0318 Oslo, Norway.
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Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, Fatima J, Mohsin F. South Asian consensus statement on women's health and Ramadan. Indian J Endocrinol Metab 2012; 16:508-11. [PMID: 22837905 PMCID: PMC3401745 DOI: 10.4103/2230-8210.97995] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Fasting during Ramadan, the holy month of Islam, is mandatory for all healthy adult Muslims. It is estimated that there are 1.1-1.5 billion Muslims worldwide, comprising 18-25% of the world population. About 62% of the world's Muslim population resides in Asia. Women comprise approximately 50% of this population. There is great religious fervor and enthusiasm in the majority of Muslims the world over for observing the religious fasting. Many of the Muslim women perhaps due to the family and societal pressures or lack of proper information hesitate and fail to avail themselves of the generous provisions of temporary or permanent exemptions from fasting available in Islam. It is therefore important that medical professionals as well as the general population be aware of potential risks that may be associated with fasting during Ramadan. This familiarity and knowledge is as important in South Asia and the Middle East as it is in Europe, North America, New Zealand, and Australia. There has not yet been any statement of consensus regarding women's health issues during Ramadan, namely menstruation, sexual obligations of married life, pregnancy, and lactation. This document aims to put forward some of the general guidelines for these issues especially for the South Asian Muslim women.
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Affiliation(s)
- Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, India
| | - Afreen Khan
- Department of Medicine, MLN Medical College, Allahabad, India
| | - Farah Naaz Fathima
- Department of Community Health, St. John's Medical College, Bangalore, India
| | - Mohammed Abdul Jaleel
- Department of Medicine, Bangalore Diabetes Hospital, Vasanthanagar, and AJ Diabetes Care and Polyclinic, BTM Layout, Bangalore, India
| | - Aisha Sheikh
- Section of Endocrinology, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Kishwar Azad
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Jalees Fatima
- Department of Medicine, Era's Lucknow Medical College, Lucknow, India
| | - Fauzia Mohsin
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
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Abstract
Islam is the world's second largest religion, representing nearly a quarter of the global population. Here, we assess how Islam as a religious system shapes medical practice, and how Muslims view and experience medical care. Islam has generally encouraged the use of science and biomedicine for the alleviation of suffering, with Islamic authorities having a crucial supportive role. Muslim patients are encouraged to seek medical solutions to their health problems. For example, Muslim couples who are infertile throughout the world are permitted to use assisted reproductive technologies. We focus on the USA, assessing how Islamic attitudes toward medicine influence Muslims' engagement with the US health-care system. Nowadays, the Arab-Muslim population is one of the fastest growing ethnic-minority populations in the USA. However, since Sept 11, 2001, Arab-Muslim patients--and particularly the growing Iraqi refugee population--face huge challenges in seeking and receiving medical care, including care that is judged to be religiously appropriate. We assess some of the barriers to care--ie, poverty, language, and discrimination. Arab-Muslim patients' religious concerns also suggest the need for cultural competence and sensitivity on the part of health-care practitioners. Here, we emphasise how Islamic conventions might affect clinical care, and make recommendations to improve health-care access and services for Arab-Muslim refugees and immigrants, and Muslim patients in general.
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Affiliation(s)
- Marcia C Inhorn
- Department of Anthropology and Council on Middle East Studies, Yale University, New Haven, CT 06520, USA.
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Brar S, Tang S, Drummond N, Palacios-Derflingher L, Clark V, John M, Ross S. Perinatal Care for South Asian Immigrant Women and Women Born in Canada: Telephone Survey of Users. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2009; 31:708-716. [DOI: 10.1016/s1701-2163(16)34274-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Carolan M, Cassar L. Antenatal care perceptions of pregnant African women attending maternity services in Melbourne, Australia. Midwifery 2008; 26:189-201. [PMID: 18653262 DOI: 10.1016/j.midw.2008.03.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 02/05/2008] [Accepted: 03/22/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE to explore the experiences and concerns of an African-born sample of pregnant women receiving antenatal care in Melbourne, Australia. DESIGN qualitative in-depth interviews. SETTING the African Women's Clinic located in Melbourne's western suburbs, an area known for social deprivation and high numbers of recently arrived African migrants. PARTICIPANTS 18 pregnant African-born women were interviewed. FINDINGS African women receiving pregnancy care in Australia undergo a process of adjustment as they travel from a view of pregnancy as not 'special' to valuing continuous antenatal care. Five themes were identified along the trajectory: pregnancy is not special; resettlement is a priority; childbearing is a normal process; coming to value continuous pregnancy care; and cultural sensitivity is important. Throughout each stage, valuing and acceptance of Australian pregnancy care were mediated by the women's cultural beliefs. CONCLUSION the African population in Melbourne is not homogenous, and women's experiences differ with cultural background, residential status, educational level and prior experience. All, however, seem to progress through phases of adjustment to value continuous antenatal care. In this climate of change, the provision of a supportive sensitive service appears to promote acceptance of services and attendance at appointments.
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Affiliation(s)
- Mary Carolan
- School of Nursing and Midwifery, St. Alban's Campus, Victoria University, PO Box 14428, Melbourne 8001, Australia.
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Khalaf IA, Abu-Moghli F, Callister LC, Rasheed R. Jordanian women's experiences with the use of traditional family planning. Health Care Women Int 2008; 29:527-38. [PMID: 18437598 DOI: 10.1080/07399330801949632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The United Nations Population Fund (UNFPA) and the Hashemite Kingdom of Jordan Ministry of Health (MOH) have identified the importance of strengthening national capacity through the integration of reproductive health (RH) services into the primary health care system. It is reported that a high percentage of Jordanian women use traditional family planning (TFP) methods, frequently using them incorrectly. Our purpose in this qualitative descriptive study was to explore the issues and challenges related to the use of TFP among Jordanian women. Six focus groups with women of childbearing age (18-44 years of age; n = 51) were held in the northern, central, and southern regions of Jordan. Study participants used traditional methods such as withdrawal, periodic abstinence, and breastfeeding. Often TFP methods were used incorrectly, resulting in a high failure rate with unplanned pregnancies occurring within short inter pregnancy intervals. Women preferred using TFP because of side effects experienced while using modern family planning (MFP) methods, misconceptions, and lack of correct information about MFP methods. Husbands often declined to use condoms but supported the use of TFP methods. Women indicated that they have unmet needs for family planning and that they would consider using MFP methods if accurate information was available at health centers. They emphasized the importance of competent and knowledgeable health care providers (HCPs) who contribute to decision making regarding use of family planning.
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Srikanthan A, Reid RL. Religious and cultural influences on contraception. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008; 30:129-137. [PMID: 18254994 DOI: 10.1016/s1701-2163(16)32736-0] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To elucidate the religious and cultural influences that may affect the acceptance and use of various methods of contraception, including emergency contraception. METHODS Literature searches were conducted to identify religious teachings related to family, sexual relations, and family planning for Christianity, Judaism, Islam, Hinduism, Buddhism, and Chinese religious traditions. Religious scholars from each of the major religions were consulted for additional information regarding how various subgroups within that religion may interpret and apply religious teachings in specific circumstances. RESULTS Religious and cultural factors have the potential to influence the acceptance and use of contraception by couples from different religious backgrounds in very distinct ways. Within religions, different sects may interpret religious teachings on this subject in varying ways, and individual women and their partners may choose to ignore religious teachings. Cultural factors are equally important in couples' decisions about family size and contraception. CONCLUSION When new immigrants are faced with the challenges of acclimating to a new society and a new way of life, they may anchor strongly to traditional religious and cultural expectations regarding family, sexuality, and fertility. While health care providers must be cautious not to attribute stereotypical religious, social, and cultural characteristics to women seeking advice about contraception, they do need to recognize that different value systems may influence contraception decision-making in couples of different faiths. This increased cultural awareness needs to be tempered by the understanding that each patient encounter is unique. The values that an individual woman holds may not be in keeping with the official teachings of her religion or the cultural norms reported by other members of the same culture.
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Affiliation(s)
- Amirrtha Srikanthan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Kingston ON
| | - Robert L Reid
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Kingston ON
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Berger G, Peerson A. Giving young Emirati women a voice: participatory action research on physical activity. Health Place 2008; 15:117-24. [PMID: 18515171 DOI: 10.1016/j.healthplace.2008.03.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Revised: 03/06/2008] [Accepted: 03/10/2008] [Indexed: 11/16/2022]
Abstract
International evidence on health promotion indicates the importance of regular physical activity for preventing and reducing the incidence of obesity and chronic diseases. This study investigated the relationship between physical activity and the social milieu of young Muslim women in the United Arab Emirates. This participatory action research project included semi-structured in-depth interviews and focus groups and yielded qualitative data. Set within a context of rapid social change, perceived barriers to daily exercise influenced participants' physical activity levels and overall well-being. Results indicated a lack of physical exercise and strategies were proposed for implementation by college staff and students.
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Abstract
This project was an exploratory effort to screen and treat immigrant Yemeni children who were at high risk for lead poisoning. The Detroit metropolitan area is home to the largest number of Arabic immigrants in the United States. In addition, Detroit has the largest rate of childhood lead poisoning in the state of Michigan. No published studies were found that explored the prevalence of lead poisoning among Yemeni children in Michigan. Immigrant children from countries where knowledge of lead poisoning is limited may be particularly vulnerable because of difficulties in language and accessing health care. Children's Hospital of Michigan CATCH School Mobile Health Center conducted this health-screening project. This article reports on the gender and health issues encountered during the community outreach lead testing effort within a Yemeni neighborhood in Detroit.
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Bramante M. Genital Hygiene. THE VULVA 2006:183-216. [DOI: 10.1201/9781420005318-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Ferrero S, Abbamonte LH, Giordano M, Alessandri F, Anserini P, Remorgida V, Ragni N. What is the desired menstrual frequency of women without menstruation-related symptoms? Contraception 2006; 73:537-41. [PMID: 16627042 DOI: 10.1016/j.contraception.2006.01.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Revised: 12/12/2005] [Accepted: 01/06/2006] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study aimed to investigate the desired menstrual frequency of subjects without menstruation-related symptoms. MATERIALS AND METHODS The study included 270 women of reproductive age. Women with menstrual headache, dysmenorrhea, hypermenorrhea and/or premenstrual syndrome were excluded. The study subjects completed a standardized questionnaire. RESULTS Of the women, 75.6% declared that menstrual periods interfere with their sexual life, 28.8% preferred not having their menstrual period when at work and 48.4% reported that menstrual periods interfere with practicing sports. Given the choice, 28.5% of the women would desire amenorrhea and 27.8% would prefer a reduction in the frequency of menstrual periods. Of the 152 women desiring to reduce menstrual frequency, 73.0% declared that they would accept to use a drug to reduce menstrual frequency. CONCLUSIONS Over 50% of women without menstruation-related symptoms would like to lessen the frequency of menstrual periods and about 50% of them would desire amenorrhea.
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Affiliation(s)
- Simone Ferrero
- Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, 16132 Genoa, Italy.
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Goldstein-Ferber S, Granot M. The association between somatization and perceived ability: roles in dysmenorrhea among Israeli Arab adolescents. Psychosom Med 2006; 68:136-42. [PMID: 16449424 DOI: 10.1097/01.psy.0000197644.95292.00] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether somatization and attitudes toward menstruation predict the incidence of pain intensity and dysmenorrhea among Israeli Arab adolescent females. METHODS Participants were 160 Israeli Arab adolescents, including 50 Muslims, 50 Christians, and 60 Druze. A 20-item questionnaire was used to assess attitudes regarding menstruation. The short version of the Brief Symptom Inventory was used to measure the level of somatization. RESULTS Factor analysis of the Attitudes Toward Menstruation Instrument revealed two significant composites: perceived ability and impurity during menstruation. High levels of somatization predicted pain intensity and low levels of perceived ability predicted the prevalence of dysmenorrhea. Although the Israeli Muslim adolescents revealed higher levels of somatization as compared with their Christian and Druze counterparts and the Druze revealed the lowest levels of perceived ability compared with the other subgroups, no significant role for ethnicity and impurity was found. No differences were found between groups in scores of menstrual pain and prevalence of dysmenorrhea. Higher levels of somatization and lower levels of perceived ability, as well as a greater portion of Muslim and Druze and higher levels of religiosity, were found among rural residents. CONCLUSIONS The role of cultural variables and personality traits in the complexity of dysmenorrhea as a socio-bio-psychological phenomenon is proposed in light of contemporary interactive models. It is suggested that within the Israeli Arab minorities the impact of cultural background on health affects more the perceptual and cognitive levels and are not generalized to overt behavior and morbidity such as dysmenorrhea.
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Affiliation(s)
- Sari Goldstein-Ferber
- Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
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Grewal S, Bottorff JL, Hilton BA. The influence of family on immigrant South Asian women's health. JOURNAL OF FAMILY NURSING 2005; 11:242-63. [PMID: 16287827 DOI: 10.1177/1074840705278622] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The purpose of this study was to examine the influence of family members on immigrant South Asian women's health and health-seeking behavior. This qualitative study was part of a larger study that examined the health-seeking practices of immigrant South Asian women living in the Lower Mainland of British Columbia, Canada. Using ethnographic methods, data were collected through face-to-face interviews with women who had lived in Canada for 10 months to 31 years. Analysis of translated and transcribed data revealed that women made decisions about their health in consultation with family members. Overall, family members were perceived to be supportive and provided direct and indirect assistance to women in ways that influenced their health. Expected roles and responsibilities often had detrimental influences on women's health. Health care for immigrant South Asian women needs to take into account women's relationships with family members and the influence of family on women's health.
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Walsh S. Formulation of a Plan of Care for Culturally Diverse Patients. Elaboration d'un plan de soin pour des patients de cultures differentes. . Elaboracao de um plano de cuidados para pacientes culturalmente diversos. Formulacion de un plan de cuidados para pacientes de diversas culturas. ACTA ACUST UNITED AC 2004; 15:17-26. [PMID: 15156839 DOI: 10.1111/j.1744-618x.2004.00017.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To formulate a plan of care for a culturally diverse population and develop a resource for the healthcare team in providing culturally competent care. DATA SOURCES Books, journal articles. DATA SYNTHESIS Healthcare workers are challenged to provide appropriate care for an increasingly diverse population. A cluster of nursing diagnoses were used to develop a plan of care addressing the unique challenges of caring for a diverse population served by a community hospital. CONCLUSION A care plan was devised and inserted into the nursing diagnosis-based nursing documentation computer system for easy access when needed. PRACTICE IMPLICATIONS A care plan for a diverse population can promote respectful and excellent care for every patient.
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Affiliation(s)
- Susan Walsh
- Neonatal Intensive Care Unit at Saint Elizabeth Regional Medical Center in Lincoln, NE, USA.
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