Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 8 Articles
Background: Obstetric Fistula (OF) remains a major public health problem in areas where unattended obstructed\r\nlabor is common and maternal mortality is high. Obstetric Fistula was able to be prevented, treated and eradicated in\r\nhigh-income countries; however, it still affects many women in low-income countries. To our knowledge, only few\r\nstudies have described the prevalence and factors associated with Obstetric Fistula in Ethiopia in population-based\r\nsurveys.\r\nObjective: The aim of this study is to describe the prevalence and factors associated with Obstetric Fistula in Ethiopia.\r\nMethods: The study used women�s dataset from the 2005 Ethiopian Demographic and Health Survey. The survey\r\nsample was designed to provide national, urban/rural, and regional representative estimates of key health and\r\ndemographic indicators. The sample was selected using a two-stage stratified sampling process. OF was measured\r\nusing questionnaire. The data is analyzed using descriptive and multivariate statistical methods to determine factors\r\nassociated with Obstetric Fistula.\r\nResults: A total of 14,070 women of reproductive age group were included in the survey. Of which 23.2% ever heard\r\nof obstetric fistula. Among women who ever given birth (9,713), some 103 (1.06%, 95% CI; 0.89%-1.31%) experienced\r\nobstetric fistula in their lifetime, which means 10.6 per 1000 women who ever gave birth. It is estimated that in Ethiopia\r\nnearly 142,387 (95% CI: 115,080-169,694) of obstetric fistula patients exist. Those women who are circumcised had\r\nhigher odds of reporting the condition (Chi square = 4.41, p-value = 0.036). In the logistic regression model women\r\nfrom rural areas were less likely to report obstetric fistula than their urban counterparts (OR = 0.21, 95% CI: 0.06-0.69).\r\nWomen who gave birth 10 or more had higher odds of developing obstetric fistula than women with 1-4 child\r\n(OR = 4.34; 95% CI; 1.29-14.55).\r\nConclusions: Obstetric fistula is a major public and reproductive health concern in Ethiopia. This calls for increased\r\naccess to emergency obstetric care, expansion of fistula repair service and active finding of women with OF with\r\ncampaigns of ending fistula is recommended....
late 50s, forecasting the need to control the population. Despite this early intervention, fertility rate has declined\r\nbut slower in Pakistan as compared to most other Asian countries. Pakistan has almost a stagnant contraceptive\r\nprevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning\r\nprograms. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and\r\nassociated with numerous issues. Married women who want to wait before having another child, or end\r\nchildbearing altogether, are not using any long term method of contraception.\r\nMethodology: A descriptive qualitative study was conducted from May to July 2012, to explore and understand\r\nthe perceptions of women regarding the use of IUCDs and to understand the challenges/issues at the service\r\nprovider�s end. Six FGDs with community women and 12 in-depth interviews were conducted with family planning\r\nproviders. The data was analyzed using the Qualitative Content Analysis approach.\r\nResults: The study revealed that the family planning clients are reluctant to use IUCDs because of a number of\r\nmyths and misconceptions associated with the method. They have reservations about the provider�s capability and\r\nquality of care at the facility. Private health providers are not motivated and are reluctant to provide the IUCDs\r\nbecause of inadequate counseling skills, lack of competence and improper supporting infrastructure. Government\r\nprograms either do not have enough supplies or trained staff to promote the IUCD utilization.\r\nConclusion: Besides a well-designed community awareness campaign, providers� communication and counseling\r\nskills have to be enhanced, as these are major contributing factors in IUCD acceptance. Ongoing training of all\r\nfamily planning service providers in IUCD insertion is very important, along with strengthening of their services....
Background: The choice of available contraceptive methods has increased in recent years; however, recent data on\r\nwomenââ?¬â?¢s awareness of methods and reasons for their method choice, or reasons for changing methods, is limited.\r\nThe aim of this study was to examine the use and awareness of contraceptive methods in the USA, UK, Germany,\r\nItaly and Spain.\r\nMethods: Quantitative survey of heterosexual women aged 25ââ?¬â??44 years (n=2544), with no known infertility.\r\nQuestions related to knowledge and use of contraceptive methods, reasons for choice and for changing methods,\r\nand sources of advice.\r\nResults: There was generally good awareness of most forms of contraception in all five countries. Awareness and\r\ncurrent usage was greatest for the contraceptive pill (awareness >98%, usage varied from 35% [Spain] to 63%\r\n[Germany]); and male condom (awareness >95%, usage varied from 20% [Germany] to 47% [Spain]); awareness of\r\nother methods varied between countries. Doctors have the greatest influence on womenââ?¬â?¢s choice of contraceptive\r\nmethod (>50% for all countries), and are most likely to suggest the contraceptive pill or male condom.\r\nWomenââ?¬â?¢s contraceptive needs change; 4ââ?¬â??36% of contraceptive pill users were likely to change their method within\r\n12 months. For previous contraceptive pill users (n=377), most common reason for change was concern about side\r\neffects (from 26% [Italy] to 10% [UK]); however, awareness of many non-hormonal contraceptive methods was low.\r\nConclusions: Women aged 25ââ?¬â??44 are aware of a wide variety of contraceptive methods, but knowledge and\r\nusage of the contraceptive pill and condoms predominates. Changing contraception method is frequent, occurring\r\nfor a variety of reasons, including change in life circumstances and, for pill users, concerns about side effects....
The present cytogenetic investigation was carried out on 16 Purebred Sahiwal cattle maintained at Department of Livestock Production and Management, College of Veterinary Science, Tirupati to know their chromosomal architecture. Short-term lymphocyte culture technique was employed for obtaining the metaphase chromosomes. Chromosomes of thirty well spread metaphases from each animal with a total of 480 metaphase spreads from Purebred Sahiwal cattle were screened for chromosomal count and ten metaphases from each animal were taken for karyotyping. The modal diploid chromosome number (2n) in Sahiwal was found to be 60. All the autosomes were acrocentric and X chromosome was submetacentric and the Y chromosome was acrocentric....
for maternal death in many developing countries. This paper examines how decisions for maternal care are made\r\nin two rural communities in Burkina Faso.\r\nMethods: Focus group discussions (FGDs) and individual interviews (IDIs)) were used to collect information with 30\r\nwomen in Ouargaye and Diapaga medical districts. All interviews were tape recorded and analyzed using QSR\r\nNvivo 2.0.\r\nResults: Decision-making for use of obstetric care in the family follows the logic of the family�s management.\r\nHusbands, brothers-in-law and parents-in-law make the decision about whether to use a health facility for antenatal\r\ncare or for delivery. In general, decision-makers are those who can pay, including the woman herself. Payment of\r\ncare is the responsibility of men, according to women interviewed, because of their social role and status.\r\nConclusions: To increase use of health facilities in Ouargaye and Diapaga, the empowerment of women could be\r\nhelpful as well as exemption of fees or cost sharing for care...
A karyological investigation was carried out on 16 Jersey X Sahiwal cattle maintained at Department of Livestock Production and Management, College of Veterinary Science, Tirupati to know their chromosomal architecture. Short-term lymphocyte culture technique was employed for obtaining the metaphase chromosomes. Chromosomes of thirty well spread metaphases from each animal with a total of 480 metaphase spreads from Jersey X Sahiwal Crossbred cattle were screened for chromosomal count and ten metaphases from each animal were taken for karyotyping. The modal diploid chromosome number (2n) in Jersey X Sahiwal cattle was found to be 60. All the autosomes were acrocentric and X chromosome was submetacentric in nature. The Y chromosome was submetacentric in Jersey X Sahiwal....
Background: Maternal mortality and morbidity are among the top public health priorities in Brazil, being quite\r\nhigh, especially among the most disadvantage women. A case control study was developed to identify risk factors\r\nfor severe maternal morbidity in Sao Luis, one of the poorest Brazilian State Capitals.\r\nMethods: The caseââ?¬â??control study was carried out between 01/03/2009 and 28/02/2010 in two public high-risk\r\nmaternities facilities and in two intensive care units (ICUs) for referral of obstetric cases. All cases hospitalized due to\r\ncomplications during gestation period, childbirth or up to 42 days of puerperium and who fulfilled any of Mantel''s\r\nand/or Waterstone''s criteria were identified. Two controls per case were randomly selected among patients of the\r\nsame clinics discharged for other reasons. Data were obtained through a structured interview as well as from\r\nmedical charts and prenatal cards and included sociodemographic variables, clinical and obstetric histories,\r\nbehavioral factors and exposure to stress factors during pregnancy, pre-natal assistance and obstetric complication\r\nand childbirth care.\r\nResults: In the final model of the unconditional logistic regression analysis, being older than 35 years (OR=3.11;\r\n95% CI:1.53-6.31), previous hypertension (OR=2.52; 95% CI:1.09-5.80), history of abortion (OR=1.61; 95% CI:0.97-2.68),\r\n4ââ?¬â??5 pre-natal consultations (OR=1.78; 95% CI:1.05-3.01) and 1ââ?¬â??3 pre-natal consultations (OR=1.89; 95% CI:1.03-3.49)\r\nwere independently associated with severe maternal morbidity.\r\nConclusions: The results corroborate the importance of reproductive healthcare, of identifying a high-risk\r\npregnancy and of a qualified and complete prenatal care to prevent severe morbid events....
Background: Despite Malawi government�s policy to support women to deliver in health facilities with the\r\nassistance of skilled attendants, some women do not access this care.\r\nObjective: The study explores the reasons why women delivered at home without skilled attendance despite\r\nreceiving antenatal care at a health centre and their perceptions of perinatal care.\r\nMethods: A descriptive study design with qualitative data collection and analysis methods. Data were collected\r\nthrough face-to-face in-depth interviews using a semi- structured interview guide that collected information on\r\nwomen�s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had\r\ndelivered at home in the period December 2010 to March 2011. The women were asked how they perceived the\r\ncare they received from health workers before, during, and after delivery. Data were manually analyzed using\r\nthematic analysis.\r\nResults: Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers� attitudes were\r\nrelated to the women delivering at home. The participants were assisted in the delivery by traditional birth\r\nattendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same\r\nday after delivery.\r\nConclusions: This study reveals beliefs about labor and delivery that need to be addressed through provision of\r\nappropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural\r\nbeliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers\r\nthat prevent women from accessing health care for better understanding and subsequently identification of\r\noptimal solutions with involvement of the communities themselves....
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