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Santos BNSD, Araújo FG, Paula TFD, Matozinhos FP, Felisbino-Mendes MS. Prevalence of preconception health indicators among Brazilian women of reproductive age. CIENCIA & SAUDE COLETIVA 2023; 28:3367-3381. [PMID: 37971017 DOI: 10.1590/1413-812320232811.16282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/13/2023] [Indexed: 11/19/2023] Open
Abstract
This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.
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Affiliation(s)
- Bruna Nicole Soares Dos Santos
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Fernanda Gontijo Araújo
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Thayane Fraga de Paula
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Fernanda Penido Matozinhos
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Mariana Santos Felisbino-Mendes
- Programa de Pós-Graduação em Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Reis-Muleva B, Vilela Borges AL, Simões Duarte L, da Silva Dos Santos CC, de Castro Nascimento N. Assessment of the quality of antenatal care in Mozambique. Midwifery 2023; 118:103598. [PMID: 36706649 DOI: 10.1016/j.midw.2023.103598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/21/2022] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess the quality of antenatal care and its covariates among postpartum women in Mozambique. DESIGN Cross-sectional study. SETTING The study was undertaken either at the maternity hospital or at home, in Mozambique, in 2019. PARTICIPANTS A total of 393 women aged 18 to 49 years were interviewed immediately after giving birth. MEASUREMENTS The quality of antenatal care was analysed based on the guidelines of the Ministry of Health of Mozambique: antenatal appointment in the first 16 weeks of gestation, 4 or more antenatal appointments, at least one laboratory test, at least 4 or more clinical-obstetric procedures, 3 doses of the prophylactic intermittent treatment for malaria, 2 doses of the tetanus vaccine, and counselling related to general health care. Women who reported all of these situations were classified as having had quality antenatal care. FINDINGS All women reported at least one antenatal care visit, but only 13.0% were classified as having had quality antenatal care. Women who underwent antenatal care in previous pregnancies (aOR=4,28; 95% CI=1,45-12,62) and whose current pregnancy was planned (aOR=2,51; 95% CI=1,11-5,68) were more likely to have quality antenatal care than those who had never had access to antenatal care in previous pregnancies and those who currently had an unplanned pregnancy. It was observed that the criteria recommended by the Ministry of Health were not followed during antenatal care, especially regarding the gestational age at the beginning of antenatal care, the minimum number of consultations, performing blood tests (complete blood count, blood glucose, blood typing and Rh factor) and guidance on signs of risk in pregnancy and childbirth. KEY CONCLUSIONS In general, the criteria recommended for quality antenatal care are not incorporated into clinical practice in Mozambique. IMPLICATIONS FOR PRACTICE While quality antenatal care is essential to reduce maternal morbidity and mortality, many sub-Saharan countries still have low-quality antenatal care services, which is one of the reasons why these countries have the highest maternal mortality rates worldwide.
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Affiliation(s)
- Belarmina Reis-Muleva
- Lúrio University of Nampula, Mozambique, Bairro de Marrere, R Nr. 4250, Km 2,3 - Nampula, Mozambique.
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil. School of Nursing. University of São Paulo. Avenida Doutor Enéas de Carvalho Aguiar, 419, 05403-000, São Paulo, SP, Brazil.
| | - Luciane Simões Duarte
- Chronic Noncommunicable Diseases Division of Disease Control Coordination of São Paulo State Department of Health. Avenue Doutor Arnaldo, 351, 01246-000, São Paulo, SP, Brazil.
| | - Carolina Cavalcante da Silva Dos Santos
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil. School of Nursing. University of São Paulo. Avenida Doutor Enéas de Carvalho Aguiar, 419, 05403-000, São Paulo, SP, Brazil.
| | - Natália de Castro Nascimento
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil. School of Nursing. University of São Paulo. Avenida Doutor Enéas de Carvalho Aguiar, 419, 05403-000, São Paulo, SP, Brazil.
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Preconception health behaviours of women planning a Pregnancy: A scale development study. Eur J Obstet Gynecol Reprod Biol 2022; 279:19-26. [DOI: 10.1016/j.ejogrb.2022.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/15/2022] [Accepted: 09/25/2022] [Indexed: 11/17/2022]
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Firoz T, Pineles B, Navrange N, Grimshaw A, Oladapo O, Chou D. Non-communicable diseases and maternal health: a scoping review. BMC Pregnancy Childbirth 2022; 22:787. [PMID: 36273124 PMCID: PMC9587654 DOI: 10.1186/s12884-022-05047-6] [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: 03/05/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Non-communicable diseases [NCDs] are leading causes of ill health among women of reproductive age and an increasingly important cause of maternal morbidity and mortality worldwide. Reliable data on NCDs is necessary for accurate measurement and response. However, inconsistent definitions of NCDs make reliable data collection challenging. We aimed to map the current global literature to understand how NCDs are defined, operationalized and discussed during pregnancy, childbirth and the postnatal period. Methods For this scoping review, we conducted a comprehensive global literature search for NCDs and maternal health covering the years 2000 to 2020 in eleven electronic databases, five regional WHO databases and an exhaustive grey literature search without language restrictions. We used a charting approach to synthesize and interpret the data. Results Only seven of the 172 included sources defined NCDs. NCDs are often defined as chronic but with varying temporality. There is a broad spectrum of conditions that is included under NCDs including pregnancy-specific conditions and infectious diseases. The most commonly included conditions are hypertension, diabetes, epilepsy, asthma, mental health conditions and malignancy. Most publications are from academic institutions in high-income countries [HICs] and focus on the pre-conception period and pregnancy. Publications from HICs discuss NCDs in the context of pre-conception care, medications, contraception, health disparities and quality of care. In contrast, publications focused on low- and middle-income countries discuss NCDs in the context of NCD prevention. They take a life cycle approach and advocate for integration of NCD and maternal health services. Conclusion Standardising the definition and improving the articulation of care for NCDs in the maternal health setting would help to improve data collection and facilitate monitoring. It would inform the development of improved care for NCDs at the intersection with maternal health as well as through a woman's life course. Such an approach could lead to significant policy and programmatic changes with the potential corresponding impact on resource allocation. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05047-6.
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Affiliation(s)
- Tabassum Firoz
- Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USA
| | - Beth Pineles
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | | | - Alyssa Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA
| | | | - Doris Chou
- World Health Organization, Geneva, Switzerland.
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Paiva CCN, Caetano R. Theoretical model of sexual and reproductive health care: subsidies for evaluative research. Rev Gaucha Enferm 2022; 43:e20200425. [DOI: 10.1590/1983-1447.2022.20200425.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 08/30/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To elaborate a Theoretical Model of Sexual and Reproductive Health care offered in Primary Health Care. Method: Documentary research, with a qualitative approach. Government documents and evaluative studies constituted the data sources, collected between August 2018 and June 2019, and analyzed based on the health evaluation literature. Results: Promotion of Sexual and Reproductive Health and Clinical Care were two structural components of the theoretical model of sexual and reproductive health care in Primary Care. The model includes disease prevention activities, health promotion, treatments, and diagnoses related to sexual and reproductive health. Conclusion: The theoretical model developed in this study presents the theory that supports the operationalization of sexual and reproductive health care in primary care according to government regulations in Brazilian scenario and may be useful in future evaluative research on the subject.
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Paiva CCN, Caetano R. Modelo teórico da atenção à saúde sexual e reprodutiva: subsídios para pesquisas avaliativas. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20200425.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Construir um Modelo Teórico da atenção à saúde sexual e reprodutiva ofertada na Atenção Primária à Saúde. Métodos: Pesquisa documental, com abordagem qualitativa. Documentos governamentais e estudos avaliativos constituíram as fontes de dados, coletadas entre agosto de 2018 e junho de 2019 e analisadas com base na literatura de avaliação em saúde. Resultados: A Promoção da Saúde Sexual e Reprodutiva e a Assistência Clínica foram os dois componentes estruturantes do modelo teórico da atenção à saúde sexual e reprodutiva na Atenção Primária. O modelo contempla atividades de prevenção de doenças, promoção da saúde, tratamentos e diagnósticos relacionados à saúde sexual e reprodutiva. Conclusão: O modelo teórico elaborado apresenta a teoria que subsidia a operacionalização da atenção à saúde sexual e reprodutiva na atenção primária, segundo as normativas governamentais no cenário brasileiro, e poderá ser útil em pesquisas avaliativas futuras sobre o tema.
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Amorim F, Maia B, Melo V, Almeida C, Magalhães J, Carvalho C, Viana M, Veras J, Mendes C, Damasceno C. Experiences of Motherhood in University Students in Brazil: A Qualitative Study. Open Nurs J 2021. [DOI: 10.2174/1874434602115010313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
The women’s rise to higher education contrasts with the phenomenon of motherhood, since it instigates changes in various contexts, whether physiological or emotional, and directly affects the way of life and routine of those women, resulting in a constant conflict between motherhood and academic career. In this sense, the student has to restructure responsibilities and behaviors, as well as requires family support and laws that support her in this period.
Objectives:
To describe the experiences of motherhood in university students, and to identify the strategies developed by university students to adapt motherhood with academic routine.
Methods:
This is a descriptive, exploratory and qualitative research carried out in a private University Center in Brazil. The participants were ten Nursing undergraduate students, regularly enrolled and who experienced motherhood during the academic term. Data were collected during August and September 2019, through a recorded interview using a semi-structured form. For the treatment and analysis of the data, the Collective Subject Discourse was used. The study followed the ethical precepts and was approved by the ethics committee (opinion n. 3.419.572).
Results:
The participants’ discourses gave rise to four central ideas: Feelings experienced from the discovery of pregnancy; The discovery of pregnancy and the decision to continue the course; Support relationships as a decisive factor for the non-abandonment of the course and Strategies to reconcile motherhood with academic routine. The main key expressions identified in the discourses were: joy, fear, insecurity, anguish, concern, distress, anger, sadness, interrupting, giving up, taking time off from the course, not taking time off from the course, family support, support from friends, support from the institution, adjusting schedules, studying while my child sleeps, family help, taking the baby to college, storing milk while breastfeeding.
Conclusion:
The analysis of the discourses revealed that the experience of motherhood in the university sphere is marked by a combination of different feelings, and by an important process of adaptations to the new moment, since there is a reflection and indecision about the continuity of the academic trajectory. The reports also highlight the importance of family, institutional and friend support, such as a support network of incentive to the care with the child, as well as the use of strategies to reconcile academic routine with motherhood.
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Solís-Cordero K, Couto LA, Duarte LS, Borges ALV, Fujimori E. Pregnancy planning does not interfere with child development in children aged from 11 to 23 months old. Rev Lat Am Enfermagem 2021; 29:e3506. [PMID: 34816875 PMCID: PMC8616240 DOI: 10.1590/1518-8345.5356.3506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE to analyze the correlation between child development and pregnancy planning and other associated aspects. METHOD a cross-sectional study conducted with 125 mother-child dyads, the children aged from 11 to 23 months old and attending daycare centers located in socially disadvantaged areas. Child development according to domains was assessed using the Ages & Stages Questionnaire-BR and pregnancy planning was evaluated through the London Measure of Unplanned Pregnancy. The mothers were interviewed at their homes and non-parametric tests were used for data analysis. RESULTS 17.6% of the pregnancies were unplanned, 24.8% were planned and 57.6% were ambivalent. Inadequate development in the different domains ranged from 21% to 40% and was not associated with pregnancy planning. However, the "communication" domain was associated with Bolsa Família and the "personal/social" and "communication" domains, with gender; while "personal/social", "broad motor coordination" and "fine motor coordination" were domains related to the child's age. CONCLUSION no correlation between pregnancy planning and child development was observed; however, the low frequency of planned pregnancies and the high percentages of inadequate child development show the need to invest in the training of health professionals, both for contraceptive care and preconception health and for the promotion of child development, especially in socioeconomically disadvantaged contexts.
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Affiliation(s)
| | - Luciana Assis Couto
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP,
Brazil
- Scholarship holder at the Programa Institucional de Bolsas de
Iniciação Científica/Conselho Nacional de Desenvolvimento Científico e Tecnológico
(PIBIC/CNPq), Brazil
| | - Luciane Simões Duarte
- Secretaria de Estado da Saúde do Estado de São Paulo, Divisão de
Doenças Crónicas não Transmissíveis, São Paulo, SP, Brazil
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Reis-Muleva B, Duarte LS, Silva CM, Gouveia LMR, Borges ALV. Antenatal care in Mozambique: Number of visits and gestational age at the beginning of antenatal care. Rev Lat Am Enfermagem 2021; 29:e3481. [PMID: 34730761 PMCID: PMC8570256 DOI: 10.1590/1518-8345.4964.3481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/17/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE 1)to assess the gestational age at the beginning of antenatal care and its covariates; 2)to assess the number of antenatal visits and its covariates; and 3)to identify the reasons for the late initiation of antenatal care and for attending less than four visits among postpartum women living in Nampula, Mozambique. METHOD cross-sectional study conducted with 393 mothers who answered a structured instrument in face-to-face interviews. Logistic regression was used to analyze the covariates of having initiated antenatal care up to the 16thgestational week, having attended four or more antenatal visits, and reporting both situations simultaneously. RESULTS all postpartum women underwent antenatal care, but only 39.9% started it until the 16thgestational week, 49.1% attended four or more visits, and 34.1% reported both events. Having concluded high school (ORadj=1.99; 95%CI=1.19-3.31) or college (ORadj=3.87; 95%CI=1.47-10.18) were aspects associated with reporting both situations. The reasons for the late initiation of antenatal care and attending less than four visits were as follows: not finding it important to attend several visits, not having easy access to the health facility, not being aware about pregnancy, and not having a companion for the visits. CONCLUSION the gestational age at the beginning of antenatal care and the number of antenatal visits are lower than the current recommendations in the country.
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Affiliation(s)
- Belarmina Reis-Muleva
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil
- Bolsista da Universidade Lúrio, Nampula, Moçambique
| | - Luciane Simões Duarte
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doenças, Divisão de Doenças Crônicas Não Transmissíveis, São Paulo, SP, Brazil
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