Search

Introduction: Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban--rural discrepancies. Objectives: The objectives of this study were to compare the practice of BP/CR amongst women in rural and urban areas of Rivers State, Nigeria, and determine the individual-level predictors. Methods: A facility-based cross-sectional comparative study using a multistage sampling method was employed in the selection of 924 (462 urban and 462 rural) women who gave birth within the last 12 months in urban and rural local government areas. Outcome measures were birth preparedness (defined as undergoing antenatal care (ANC) with a skilled birth provider, voluntary counselling and testing for HIV and saving money for childbirth at an agreed place of delivery with a skilled birth attendant) and complication readiness (defined as being knowledgeable about danger signs, identifying decision-maker, a nearest functional institution in case of emergency, emergency means of transport and funds and a suitable blood donor). Bivariate and multivariate analyses were performed at P < 0.05. Results: The proportion of women who were birth prepared was significantly higher amongst women in urban areas (85.9%; 95% confidence interval [CI]: 82.7%-89.1%) versus rural counterparts (56.7%; 95% CI: 52.2%-61.2%), whereas the proportion of complication readiness was significantly higher in rural (31.8%; 95% CI: 27.6%-36.1%) than urban (18.2%; 95% CI: 15.2%-47.8%) groups. Predictors were possession of secondary educational level or higher (adjusted odds ratio [AOR]: 4.9; 95% CI: 1.5-15.5), being employed (AOR: 2.7; 95% CI: 1.5-15.0) and ANC attendance (AOR: 29.2; 95% CI: 8.8-96.9) in urban, whereas amongst the rural, it was ANC attendance (AOR: 20.0; 95% CI: 9.1-43.7). Conclusion: In urban areas, more women were birth prepared while fewer women were complication ready compared to the women in rural areas, with predictors such as education, employment and ANC attendance in urban areas and only ANC attendance in rural areas. Measures to promote ANC uptake, maternal education and empowerment could promote BP/CR. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is an increasing public health problem worldwide. Measuring the level of knowledge in a population at high risk for GDM will highlight the gaps and help in designing appropriate interventions. The objective of this study was to measure the knowledge about GDM and to identify the factors associated with it among pregnant women in Riyadh city, Saudi Arabia. Methodology: A cross-sectional study was conducted with pregnant women seeking antenatal care services in two of the public sector tertiary care hospitals in Riyadh city. The study was performed using a self-administrated predesigned questionnaire. Collected data were analyzed using SPSS program. Results: More than 40% of the participants had poor knowledge about GDM complications, diagnosis and management. Women with lack of exercise [adjusted odds ratio 3.3 (95% CI 1.8, 6.1)]; having past histroy of GDM [3.2 (1.8, 5.7); primigravida [2.9 (1.6, 5.1)]; information on GDM received from doctors [2.0 (1.2, 3.4)] and those with low education level [1.8 (1.1, 2.9)] were more likely to have poor knowledge about GDM. Whereas, women with positive family history were 60 times more likely to have good knowledge about GDM. Conclusion: Primigravida mothers and those with low education level should receive specific information and awareness regarding GDM. Healthy lifestyle is important for the prevention and improvement in the diagnosis and management of GDM among pregnant women in Riyadh. [ABSTRACT FROM AUTHOR]

Background: Globally, more than 40% of pregnant women experience acute obstetric problems and a large burden of it is shared by India. Birth Preparedness and Complication Readiness (BPCR) strategy is used to addresses these problems by encouraging women and communities to effectively plan for births, deal with birth emergencies. Objective: This study was conducted to assess the status of birth preparedness and complication readiness and to find out the factors associated with inadequate BPCR among pregnant woman in a rural area of West Bengal. Methodology: Institution based, observational study with cross‑sectional design was conducted from January 2019 to September 2020 among pregnant women, attending antenatal care clinics in Singur block, Hooghly district West Bengal. Sample size was 272. Participants were chosen by systematic random sampling. Response rate was 94.5% (257). Data were collected using a predesigned pretested schedule and analyzed using Microsoft Excel version 2016 and SPSS version 16.0. Results: Overall, 60.3% mothers had inadequate BPCR. 66.1% mothers had poor BPCR knowledge and 72.8% mothers had poor BPCR practice. In multivariable logistic regression model, the odds of maternal morbidity [AOR = 2.03 (1.14 –3.62), P value = 0.16], ≤4 No. of ANC visits [AOR = 10.96 (4.82–22.9), P value = 0.001], first trimester USG [OR = 12.53 (5.8–24.5), P value = 0.001] showed significance with inadequate BPCR. Conclusion: Glimpse of BPCR is seen in government programmes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK). Yet a big void exists among Indian pregnant women’s knowledge and practice of BPCR. Thus, there is a need to include BPCR in health care system to improve outcomes for pregnant women. [ABSTRACT FROM AUTHOR]

Background: Anemia is one of the contributing factors for morbidity and mortality during pregnancy in developing country including India, which eventually leads to fetal and maternal consequences. Growing fetus depends completely on mothers for all its growth and maturity. Anemia is one of the nutritional deficiency disorders and around 56% of women are suffering from anemia in India. It is one of the reasons for maternal deaths and fetal complication during pregnancy. Aim: The aim of the study was to assess the prevalence of anemia and to determine the risk factors of anemia among pregnant women in PBMH hospital, Bhubaneswar, Odisha. Materials and Methods: A descriptive cross-sectional study was conducted over a period of 1 month from October 11, 2022, to November 11, 2022, from the Department of Obstetrics and Gynecology of Pradyumna Bal Memorial Hospital KIMS, Bhubaneswar. A total sample comprised of 52 pregnant women who were interviewed by using self-structured questionnaire for data collection and classification of anemia was performed according to the Indian Council of Medical Research (ICMR) criteria. Results: A total of 52 antenatal mothers were admitted during this study period (October 11, 2022, to November 11, 2022), and all were selected as study sample. The incidence of anemia among antenatal mother in PBM hospital was found as follows: 17 (33%) mild, 04 (07%) moderate, and 02 (04%) were severe in this present study. The most common indication of anemia among antenatal mother as per the present study was found to be H/O infection (21%), chronic malaria (15%), hook worm (27%), and birth interval (42%). Conclusion: The study implies that the prevalence rate of Anemia is high, that is, 44.2%. Spacing between pregnancy and H/O infection plays a significant role in considering anemia in pregnant women, which eventually affects both maternal and fetal condition. [ABSTRACT FROM AUTHOR]

Background: The practice of newborns being put to the breasts soon after birth results in a reduction in neonatal mortality. Factors such as antenatal care attendance, delivery at the Baby Friendly Hospital Initiative (BFHI) facility, mode of delivery, number of children, and various socio-cultural practices are found to have a positive impact on the early initiation of breastfeeding. The present study was performed to determine the socio-demographic, maternal, and neonatal factors affecting the early initiation of breastfeeding. Methodology: A hospital-based cross-sectional study was performed at the Immunization Clinic and Nursery situated in a government tertiary care hospital for assessing the pattern of breastfeeding initiation. Children born at the hospital and also those reporting to the clinic from outside were included in the study. Results: Breastfeeding initiation within 1 hour after delivery was only 30%, and 9% did not initiate breastfeeding at all. About half of the reasons for not initiating breastfeeding were related to mothers, followed by 30% related to babies. Conclusion: Upon regression analysis, it was found that urban residence, higher educational status of the mothers, and those mothers who were not counselled on breastfeeding during antenatal visits had higher odds of not initiating breastfeeding and that was statistically significant. [ABSTRACT FROM AUTHOR]

Introduction: It is likely that a pregnant woman is more motivated and receptive to accepting healthy habits and practices if talked about the benefits to the fetus. When explained about the harmful effects of tobacco on the health of the baby, the mother can be encouraged to modify her tobacco consumption habits and work toward quitting tobacco. Aim: Our aim was to study the effectiveness of brief counseling (5As)—Antenatal Tobacco Cessation Support Program among pregnant women availing antenatal care (ANC). Methodology: A quasi‑randomized study design was used to conduct the study. The participants were identified by screening during ANC visits, and women consuming tobacco were subjected to detailed history taking and very brief counseling with the help of 5A’s framework. Results: We found that Mishri was the commonest form of tobacco consumed by these women. Around 93.33% of the women consume Mishri, followed by 6.66% of women consuming chewing tobacco. The method of brief counseling made an impact in the cessation of tobacco consumption in 13.37% of the study subjects. Conclusion: We conclude that the use of brief counseling and motivational interviewing is feasible in most settings without inhibiting the other important aspects of ANC or disrupting the patient flow. [ABSTRACT FROM AUTHOR]

Introduction: Obstetrics teleconsultation is a new concept to enable health-care services in the COVID pandemic by limiting in-person visits. This study describes the methodology of mobile-based teleconsultation, preliminary findings, and the experience of the obstetricians. Material and Methods: The data of pregnant women who got registered for teleconsultation in early phase of COVID pandemic lockdown were reviewed and analyzed. A qualitative analysis was performed to assess the experience of obstetricians (consultants, senior residents, and junior residents) via an online electronic survey. Results: The majority of obstetrics teleconsultations were for routine antenatal care (75%) and fetal medicine consultation (12.3%). Out of 187 women, 29.9% were advised to continue antenatal care at local hospitals, whereas 33.6% were asked to follow up via teleconsultation. Most of the obstetricians (73.68%) felt that they were able to satisfy the pregnant women and rated the teleconsultation satisfactory. Conclusion: Obstetrics telemedicine found to be beneficial for providing routine antenatal care services via reducing physical visits and overcrowding in outpatient departments, promoting antenatal care at local hospitals, and making specialized (maternal–fetal medicine) care accessible even during COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Despite concerted global efforts to reduce the burden of maternal anemia, it remains a major public health issue. Over 40% of pregnant women worldwide are anemic; low- and middle-income countries (especially those in sub-Saharan Africa) make a disproportionately higher contribution to the global burden. The condition can lead to undesirable outcomes for the mother and child. This study was conducted to determine the prevalence of anemia in pregnancy among women attending antenatal clinics in Chikun LGA, Kaduna. Methods: This study was conducted among 145 women attending antenatal clinics in Chikun LGA. Data were collected using a pretested, semi-structured interviewer-administered questionnaire. Hemoglobin (Hb) level was determined and anemia was defined using the World Health Organization-recommended cutoff of <11 g/dl. The results were presented in frequency tables. Data were analyzed using IBM SPSS Statistics version 26. Statistical significance was set at P < 0.05. Results: Fifty-five (37.9%) of the respondents were between the ages of 25 and 29 years. The mean age of the respondents was 28.61 ± 5.5 years. The majority, 107 (73.8%), had a household size of 2–4. Only 16 (11.0%) respondents were aware of anemia. Pregnant women were identified by half (50.0%) of the respondents as being more at risk of anemia. Only a quarter (25.0%) of respondents had good knowledge of anemia. Over two-fifth (42.8%) of the respondents were anemic. There was a statistically significant relationship between household size and anemia in respondents. Conclusion: A large proportion of the respondents were anemic; this underscores the need to strengthen the nutritional counseling and routine hematinics given during the antenatal period. Social drivers should also be addressed in terms of favorable public policies. [ABSTRACT FROM AUTHOR]

The present review was intended to explore the effectiveness of perinatal services such as antenatal care (ANC) and post-natal care (PNC) on the health indicators such as maternal, child and neonatal mortality. Globally, indicators are considered very important in determining the health status and the overall performance of a country's healthcare system. A literature search was conducted using maternal mortality, child mortality, neonatal mortality, ANC and PNC in the PubMed, Google, Academia, The Lancet and Journal of the American Medical Association databases. Globally, implementing integrated perinatal care services has brought positive changes in the maternal, child and neonatal mortality indices. The United Nations (UN) is committed to improving the overall living conditions in all countries, significantly improving the population's health status. The UN came up with eight Millennium Development Goals in 2000, aiming to eliminate poverty and increase development in member states. The World Health Organization was a partner in implementing these goals. Later, the UN introduced 17-fold Sustainable Development Goals in 2015 as a blueprint for peace and prosperity for all citizens towards a better future by 2030. As a result, many countries have experienced positive changes in most indicator areas, including service utilisation, maternal mortality and child mortality. Some Sub-Saharan African and South Asian countries are progressing, however, slowly. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is limited literature available on the alloimmunization rates among pregnant women in India. Our primary aim was to estimate the occurrence of irregular erythrocyte alloantibody (IEA) immunization amongst women attending our antenatal care (ANC) clinic and to guide our obstetricians for improved ANC as well as their fetal outcomes. Methods: A cross-sectional study was performed at the blood center in North India over 12 months. We recruited a total of 212 study participants. Antibody screening and identification were performed by using semi-automated column agglutination technology and commercially available 3-red cell antibody screen panel with reagent cards having anti-human globulin (AHG) (Ortho Clinical Diagnostics Inc., USA) and 11-red cell antibody identification panel with reagent cards having AHG (Resolve Panel A; Ortho Clinical Diagnostics Inc., USA) respectively. Once identified, the semi-quantitative doubling dilutions, i.e., serial titrations of the respective IEA were performed by the conventional tube technique to assess their potency. The association of various antibodies identified was analyzed using the Pearson's Chi-square test. Results: Of the 7248 pregnant women attending our ANC clinics, the antibody screening was requested for 212 cases. Out of these, 10.8% (n = 23/212) of women were positive and were sensitized both by active and passive immunization. Their average age (in years) was 27.6 ± 3.52 (20 to 34). The majority belonged to the Dehradun district of Uttarakhand. ABO systemwise, the most common type amongst the included subjects was A as recorded in 34.4%, followed by B (30.18%), O (24.12%) and AB (11.3%), respectively. Rh system-wise, nearly 47% (n=100/212) of subjects had Rh (D) negative blood group. Interestingly, amongst these 23 ANC cases with positive IAT, nearly 13% had a history of having received a blood transfusion. Conclusion: To sum up, the screening of majority of ANC in our hospital is restricted to Rh (D) negative pregnancies. Perhaps, more awareness among obstetricians regarding the universal screening of all ANC cases irrespective of their Rh (D) status is the need of the hour. [ABSTRACT FROM AUTHOR]

Background: Involvement in antenatal care (ANC) is one of the husband's responsibilities for his wife's health. Objective: This study analyzed the contribution of the husband's education level to his involvement in ANC visits among poor households. Methods: The study employed secondary data from the 2017 Indonesian Demographic and Health Survey. The study analyzed 6429 respondents. The analysis units were poor women aged 15-49 years, had a husband, and had ever been pregnant for the past 5 years. Besides husband's education, other independent variables analyzed were residence, husband's age and occupation, and wife's parity. The analysis used a binary logistic regression test in the final step. Results: Husbands with a primary education record were 1.381 times more likely to participate in ANC visits than those without education. Husbands who had secondary education were 2.339 times more likely to get involved in ANC visits than those without education records. Moreover, husbands who had higher education were 3.376 times more likely to be engaged in ANC visits than those without education records. Conclusions: The study concludes that better education levels will be more likely to motivate husbands to get involved in ANC visits. [ABSTRACT FROM AUTHOR]

Background: Telemedicine facilitates patient care in various fields including antenatal care. Its application and usefulness need objectification and can be a guide to using this service in the care of pregnant women. Material and Methods: This was a prospective observational study conducted from May 2020 to December 2020. Following the telemedicine practice guideline of the country, 3,360 teleconsultations were sought by 862 antenatal patients. The duration of each call, an indication of referral and pregnancy risk stratification were noted. Further management was classified into three categories depending upon the need for an immediate hospital visit, no hospital visit or scheduled visit after at least 48 h after the first contact. Results: The antenatal cases were referred for either maternal, foetal or both indications in 24.7, 54.8 and 20.5% of the cases, respectively. Women were classified as low risk (61.6%), high risk (35.7%) and severe risk (2.7%). In 1.4% of the patients, history and review of the records could not be done through telemedicine. The average time spent was 16.6 min for the first contact and 3.1 min for subsequent contacts. Further management was done with immediate visits in 385 (45.3%), scheduled hospital visits in 292 (34.3%) women and no tertiary care hospital visit in 173 (20.4%). Discussion: Women (20.4%) not called to the maternal-foetal medicine department of the institute were managed along with the treating obstetrician and no difference in pregnancy outcome was noted. Conclusion: Antenatal care can be provided following triage over teleconsultation and 1.4% of the women may not be able to use telehealth. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the effect of a mHealth (text message) intervention compared with a structured health educational session on the oral care and hygiene practices of pregnant women. Materials and Methods: We conducted a pilot randomized control trial, parallel design superiority trial, with a 1:1 allocation ratio. A total of 76 pregnant women up to 20 weeks of gestational age and capable of reading mobile phone text messages were recruited during August–October 2020 from the antenatal clinic of a primary health center in a low-income urban agglomeration in Delhi, India. The mHealth intervention arm participants were sent a daily text message for 30 days, while all participants were provided a one-time, face-face, brief didactic structured educational session toward oral health promotion. Results: The baseline characteristics of both groups were comparable in terms of age structure, education, parity, and oral hygiene but differed in terms of oral health problems. Postintervention, although the twice-brushing frequency increased in both arms, only the mHealth arm revealed a statistically significant reduction in the incidence of missed twice-daily brushing episodes (P = 0.016). Conclusions: A mHealth-based daily text-message intervention for 1 month was not superior to a one-time brief didactic structured educational intervention for oral health promotion in antenatal women. [ABSTRACT FROM AUTHOR]

Aims This study was set to determine the prevalence of pregnancy complications and associated sociodemographic factors in Nnewi, South-East Nigeria, from 2014 to 2018. Patients and methods This was a retrospective, descriptive study of pregnant women, who received antenatal care and/or delivered at the Nnamdi Azikiwe University Teaching Hospital, Nnewi. Results Of the 821 deliveries documented at Nnamdi Azikiwe University Teaching Hospital, Nnewi, 435 (52.98%) had complications. Sixteen clinical conditions were identified in the complicated pregnancies; the most common being malaria (20.23%), hemorrhage (13.79%), and HIV infection (10.11%). The least were ectopic pregnancy (2.07%), uterine rupture (2.07%), and placenta abruption (2.30%). The number of pregnancies with complications were significantly higher than those without (P=0.039). There was a statistical association between pregnancy complication and the woman's occupation (P=0.028). Conclusion The prevalence of pregnancy complications in Nnewi was found to be 52.98%, with malaria being the most common complication (22.23%), and ectopic pregnancy and uterine rupture the least (2.07%). Recommendation Women are advised to access antenatal care during pregnancy to stem complications, while efforts should be intensified by relevant bodies to control malaria in pregnancy. [ABSTRACT FROM AUTHOR]

Background: Suboptimal utilization of maternal health-care services is a perennial problem in Empowered Action Group (EAG) states. This study examines role of women's and partners' education on usage of antenatal, postnatal care (PNC), and skilled birth attendance in these states. Methodology: National Family Health Survey-4 (2015–2016) data for 13,443 women in reproductive age group of 15–49 years in Bihar, Madhya Pradesh (MP), Odisha, Rajasthan, and Uttar Pradesh (UP) were analyzed using logistic regression. Results: Increasing level of education had a significant impact on utilization of antenatal services in all states, highest and lowest odds being observed with higher and primary level of partner's education, respectively. Skilled birth attendance universally showed rising trend with increasing women education, while it remained substantially low even at higher level of partner's education. For PNC, utilization increased with increasing level of maternal education. While significantly lower odds of PNC were seen with primary level of partner education in Rajasthan and UP, partner's secondary education showed positive and significant association in Bihar, Rajasthan, and UP. At higher level of partner education, positive and significant effects on PNC were observed only in Bihar, MP, and UP. Conclusions: Universal education is vital to attain sustainable development goals at the grassroot level, which is happening relatively slowly in the EAG states. [ABSTRACT FROM AUTHOR]

Background: According to WHO, 536,000 women die every year in the world from causes relating to pregnancy, childbirth, or postpartum. Ninety nine percent of these deaths occur in the developing countries. Primary health centres (in densely populated areas and in urban slums are also referred to as family welfare centres, since they provide the whole continuum of care, from birth through adolescent and delivery and thereafter. Aim: To evaluate the antenatal services under Reproductive, Maternal, Newborn, Child plus Adolescent (RMNCHA) programme at a family welfare centre located in Central Delhi, India. We have proposed an action plan that will help in evaluating and improving these services. Methodology: The study included health providers of antenatal services and the beneficiaries. With a response rate of 90% from a sample of 218, 203 consenting antenatal women (beneficiaries) visiting the centre for ANC check-up under RMNCH + A programme and PMSMA were included. For quantitative component, a pre-designed, pre-tested semi-structured screening questionnaire were administered to the beneficiaries and healthcare providers to evaluate the antenatal services under RMNCH + A programme at the family welfare centre. Results: Qualitative and quantitative analysis was done separately. Only 43% of ANC women said health workers visited them at home during pregnancy and very few could tell about importance of lab investigations. Almost all (97%) knew about key messages given by health workers. Nearly all participants considered that the screening process was smooth. The waiting time and time to undergo varied from 4 to 6 min. [ABSTRACT FROM AUTHOR]

Background: High-risk pregnancy (HRP) puts current pregnancy at an increased risk of complications. In the absence of pre-existing HRP implementation model of the country, in collaboration with the Government of Himachal Pradesh, a new digital HRP model called the 'SEWA—A System E-approach for Women at risk' was developed. The current article demonstrates a model for the early identification and line listing of high-risk pregnant women (PW) with appropriate referrals and increased engagement with the healthcare workers using a digital tool in the form of the Android App. Methods: SEWA was implemented as a pilot intervention in two community development blocks of the Chamba district. The key implementation steps included finalizing protocols for the identification of HRPs, defining processes and roles, mapping health facilities, setting up the communication loop, and developing of digital solutions. The digital app, used by the auxiliary nurse midwife (ANM) and program officers, tracked PW for a year from October 19 to October 20 and recorded the ANC visits, referrals, and birth outcomes. A qualitative assessment was conducted among the health workers to find out their level of acceptance. Results: A total of 1,340 high-risk PW were identified. The intervention year saw a rise in the identification of HRP to 27.9% from 3.5% in the previous year. A total of 2,559 conditions were tagged to the identified 1,340 women categorized into current pregnancy (81%), previous pregnancy (16%), and any existing chronic illness (3%). A majority of the women who required urgent referrals were provided referrals. The application recorded 53% of the delivered HRP with a digital birth preparedness plan, prepared and shared with the PW and Accredited Social Health Activists (ASHA), by text message for compliance. Conclusion: The SEWA application is a feasible and sustainable solution to complement the competency of the care providers for early identification of the high-risk conditions and reduce the burden of preventable unprecedented deaths around the time of birth. [ABSTRACT FROM AUTHOR]

Background: A traditional African phrase, 'A pregnant woman has one foot in the grave' expresses the immense health risks associated with pregnancy and childbirth. Antenatal care (ANC) is considered an important determinant to alleviate mortalities and morbidities associated with maternal health. Objectives: The study aimed to identify the utilization pattern of ANC services by pregnant women in a remote, tribal, and hilly district of Himachal Pradesh and to understand their healthcare needs during antenatal period. Methods: A community based descriptive, cross-sectional study was carried out in 41 far-flung villages of Lahaul and Spiti district in Himachal Pradesh, India, using a mixed-method approach of data collection. Purposive sampling was done to select 103 females who had experienced delivery in the past 2 years and were residents of Lahaul for minimum of 3 years. The participants were interviewed using a semi-structured questionnaire and the data were analysed by SPSS-20. Results: The study revealed high utilization of ANC services by indigenous women, but it was accompanied by physical, psychological, and financial hardships. The triple challenge of inadequacy of quality antenatal services, transport facilities, and unfavourable weather conditions compelled women to leave their communities in Lahaul and relocate to adjoining districts during the maternity period. Conclusion: Pregnancy is still a stressful event that disrupts the link between families and communities in such underserved areas. The study recommends the establishment of programs that promote availability of quality ANC services within the rural and remote communities. [ABSTRACT FROM AUTHOR]

Background and Aim: Inadequate nutrition during fetal development resulting from poor dietary habits leads to reprogramming within fetal tissues and poses as a risk factor for non-communicable diseases in later life. This study was conducted to determine the dietary habits, diversity, and predictors among pregnant women in Lagos, Nigeria. Methods: A descriptive cross-sectional study was conducted using a structured interviewer-administered questionnaire to obtain data from pregnant women attending primary health care centers in Lagos, Nigeria. A multistage sampling method was used to select 350 pregnant women. A food frequency questionnaire was used to assess the dietary habits while dietary diversity was measured using non-quantifiable 24-hour recall. Data were analyzed using Epi-Info version 7.2 computer software. Chi-square and t-test were used to test for associations and P value < 0.05 was considered to be statistically significant. Results: Only 16.7% of respondents consumed five servings of fruits and vegetables daily while the rice was the most frequent meal taken (45.4%). Meat was the commonest animal protein (20.3%) and only 30.8% had a high dietary diversity score (DDS). High DDS was significantly associated with parity of 1–3, living in a duplex or detached house, completion of at least secondary school education, and highly skilled professionals. Conclusion: Healthy dietary habits and high DDS were low and associated with low parity and higher socio-economic status. Nutrition intervention that encourages higher dietary diversity is needed especially among women of higher parity and lower socioeconomic status in Lagos. [ABSTRACT FROM AUTHOR]

Background: In India mother related mortalities and morbidities are still significantly higher even after having various maternal program and schemes at regional and national level which reflects that such services are being under-utilized. Aim: The current study focused in assessing utilization pattern of maternal health services and associated factors in Nuh (Mewat). Methods: This present cross-sectional study was done for one year (2015-16) among mothers (15-49 years) under field practice area, PHC Taoru with minimum calculated sample as 645. The selection of participants was made using simple random sampling technique from available randomized list of villages. Data was collected by home-to-home visits using pretested, predesigned, standardized questionnaire and during analysis an association between variables was considered as significant if P < 0.05. Results: Out of 645 participants, 632 provided consent for inclusion into study. Any ANC and full ANC services was made by only 58.3% and 11.7% of participants respectively. More than half of the participants (52.7%) had suffered from pregnancy related complications. Variables such as lower age group, low decision-making capacity were significantly associated with not obtaining full ANC services (P < 0.05). Conclusion: In the present study major determinants of a women which influence utilization of maternal health care service includes their age, literacy status, parity, socioeconomic status and occupation. Such determinants shall be considered for upcoming intervention aiming to bring attitudinal changes and concurrently leading to improved and enhanced usage of maternal health care services. [ABSTRACT FROM AUTHOR]

Background: Lack of male spouse involvement can affect the delays in the decision to take health care facilities, these are the main contributing factor for increasing maternal mortality and child death ratio. Men involvement in reproductive and sexual health including child health is important in reducing teenage pregnancy, maternal mortality, infant mortality, risky abortions, and total fertility rate. This study aimed to assess the awareness and practices of male spouse in maternal care services in rural areas. Methods: This is a community-based and cross-sectional study which was undertaken in randomly selected four villages of Kashi Vidyapeeth block, Varanasi. Total enumeration of women from the selected villages delivered within last 3 years was done and their husbands were interviewed by using a pre-designed, pretested interview schedule. Data on socioeconomic and demographic characteristics, awareness of various aspects and antenatal and postnatal care were collected and analyzed with SPSS 20 trial version. Results: Out of the total 130 interviewed male spouse (respondents), only 9.8% knows about minimum four antenatal visits. 26.9% were aware about the health related problems during pregnancy and only 7.7% were aware about the danger signs. Janani Suraksha Yojna was known to 11.5% only. 22.4% respondents accompanied their wife for antenatal registration and36.2% for T. T vaccination but 70.2% were present in the hospital during delivery. Logistic regression analysis shows that education of respondents is a key determinant of their involvement during pregnancy. Conclusions: This study identified overall low awareness of male spouse about antenatal visits and involvement during antenatal care. Therefore, there is a strong need to re-strategize the involvement of male spouse in reproductive health including antenatal period. [ABSTRACT FROM AUTHOR]

Background: The HIV sentinel surveillance (HSS) serves to estimate the levels and trend of HIV prevalence among high-risk, bridge, and general population and monitors HIV management at national, state, and district levels. Data from HSS are valuable in understanding the risk factors associated with HIV transmission with particular demographic characteristics. Objectives: The objective was to analyze the sociodemographic profile of the pregnant mothers attending the antenatal care (ANC) clinics in Karnataka, in order to understand the dynamics of HIV within the general population in Karnataka. Materials and Methods: Study design: this was a cross-sectional study conducted using consecutive sampling method. Study setting: the surveillance was conducted at select antenatal clinics, in Karnataka, India, between January and March, in the years 2013, 2015, and 2017. Methodology: in total, 74,278 eligible pregnant women aged between 15 and 49 years, attending the sentinel sites for the first time during the surveillance period, were included in the study. Information on their sociodemographic characteristics and blood samples was collected. Results: HIV prevalence among the ANC clinic attendees has significantly declined, reaching a recent stabilization. The risk factors significantly associated with HIV among pregnant women were age, education, occupation, and marital status. HIV is highly concentrated in the northern and southern districts of Karnataka. Conclusion: Despite the declining trends of HIV prevalence in Karnataka, the epidemic is heterogeneous and concentrated within the state, calling for decentralized region-specific interventions. [ABSTRACT FROM AUTHOR]

Background: The postchildbirth period presents considerable challenges in the form of health risks for the mother and the newborn, yet postnatal care (PNC) remains seldom utilized maternal and newborn health intervention. Objectives: The present study aims to study the coverage of PNC among rural women in Punjab and understand the factors that determine the utilization of PNC services. Materials and Methods: From rural areas of seven districts of Punjab, a total of 420 respondents were questioned using semi-structured interview schedule. Binary logistic regression is employed to understand the factors that influence the utilization of complete PNC. Results: The utilization of complete PNC has remained mere 25.9% in the present study. The results of multivariate logistic regression reveal that variables district, caste, birth order, and type of delivery significantly influence the utilization of complete PNC. Conclusion: The utilization of PNC component is found to be abysmal as compared to antenatal component and institutional delivery among the study group. There is a need to create awareness regarding the necessity of PNC among the women. [ABSTRACT FROM AUTHOR]

Objectives: LBW is the strong determinant of neonatal morbidity and mortality with a global prevalence of nearly 15%. India's prevalence, though not yet established, ranges from 16-30% and influenced by maternal nutritional status, antenatal care and associated maternal morbidity. Hence, the study was aimed to determine the influencing parameters for occurrence of LBW. Study Design: A retrospective observational study conducted for all live newborns delivered in a tertiary care centre during the study period of twenty four months. Methods: Data from institutional medical record section was recorded on predesigned questionnaire from a total of 1216 newborns. Results: The percentage of LBW was found to be 27.55% (335/1216) with a proportion of LBW to NBW babies was approximately 1:3. The occurrence of LBW was significantly higher in babies of anemic mothers (59.39%, P < 0.0001), young mothers (30.39%, P < 0.01), mothers with parity ≥ 3 (35.71%, P < 0.05), those with <3 ANC check-up (56.88%, P < 0.0001) and those with premature delivery (71.57%, P < 0.0001). Maternal anemia (OR 4.7, 95%CI 3.4-6.7, P < 0.001); ANC with <3 visits (OR 2.2, 95%CI 1.4-3.4, P < 0.01) and prematurity (OR 7.6, 95%CI 5.1-11.2, P < 0.0001) were considered as independent risk factor for LBW. Significant association of neonatal complications was found with LBW babies (OR 1.6, 95%CI 1.1-2.5, P < 0.05). Conclusions: Inadequate antenatal care, maternal anemia and other maternal illness causing premature delivery are considered critical determinants for LBW and thus associated with high neonatal mortality and morbidity. Continued focus for improving the overall maternal health status would lead to lowering burden of LBW. [ABSTRACT FROM AUTHOR]

Purpose: To determine the attitude of antenatal attendees towards birth preparedness and complication readiness (BPACR) in Southern Nigeria and factors associated with a positive attitude. Materials and Methods: This cross-sectional study was carried out among 405 pregnant women in their third trimester attending antenatal care (ANC) in Benin City. The attitude of the respondents was measured using the composite variable of the 8 items in a Likert scale. Analysis was with SPSS v21. The binary logistic regression model was fitted, and statistically significant association of variables was determined based on the adjusted odds ratio (OR) at 95% confidence interval (CI) and level of statistical significance at P < 0.05. Results: Overall, 368 (90.9%) of the attendees displayed a positive attitude to BPACR. They displayed a more positive attitude towards planning for place to give birth 402 (99.3%) and poorest towards partner's participation in accompanying them to ANC visits 189 (46.7%). The age groups 25-29 (OR = 4.535; 95% CI = 1.581-13.006) and 30-34 (OR = 3.506; 95% CI = 1.257-9.778) and multiparity (OR = 2.564; 95% CI = 1.022-6.433) were predictive of positive attitude towards BPACR. Conclusion: This study found a positive attitude towards BPACR among the majority of the attendees which was poorest in domains relating to partner's participation. Their age and parity were found to be predictive of their positive attitude. ANC services should be made available to provide the appropriate health information. Women should be counselled on the major roles of men in reproductive health to improve their attitude towards male involvement in maternity care. [ABSTRACT FROM AUTHOR]

Background: Iron-deficiency anemia in pregnancy is a major public health problem despite the efforts taken by the Ministry of Health and Family Welfare for the past five decades. Adherence to iron and folic acid supplementation (IFAS) is the key factor for the prevention and management of nutrition anemia. Aim: The aim of this study was to assess the adherence to its associated factors and to explore the reasons for the non-adherenc among pregnant women attending a tertiary care center. Materials and Methods: It is an explanatory mixed-methods design (quantitative cross-sectional analytical design and qualitative descriptive design). Statistical Analysis Used: Results presented as proportion with 95% confidence interval (CI). Chi-square test was done to assess the association of the factors to adherence. Qualitative data were transcribed verbatim, translated to English, and analyzed by manual content analysis. Results: A total of 340 pregnant women were included, and the adherence to IFAS among the antenatal mothers was 63.8 (95% CI [58.61–68.6]). The factors associated with adherence to IFAS (prevalence ratio with 95% CI) were primigravida status [1.22 [1.02–1.45]), nonanemic in the first trimester (1.27 [1.09–1.49]), and absence of side effects (3.16 [1.95–5.12]). Conceptual framework was constructed using the emerging themes: (i) knowledge-related factors, (ii) behavior-related factors, and (iii) facilitating factors. Conclusion: About three-fourth of the participants were adherent to IFAS. Compliance is directly influenced by the gravida status, anemic status, and absence of side effects. Based on qualitative results, measures to improve palatability and the quality of IFAS are recommended. [ABSTRACT FROM AUTHOR]

Obstetric population because of its unique and varying needs specific for different gestations justifies for distinctive considerations in times of pandemic like COVID-19. Healthcare facilities providing obstetric care need to develop contingency plans for minimizing antenatal visits to limit exposure of both healthy pregnant women and care providers from ill people. However, to mitigate any potential adverse effects of reduced antenatal visits, intelligent and smart use of evolving telemedicine capabilities can provide the continuum of care despite overwhelming burden due to pandemic. A collaborative work-model involving health workers in the community and the regional levels of health centres also has the potential to prevent the catastrophic collapse of obstetric care services during any pandemic like COVID-19. [ABSTRACT FROM AUTHOR]

BACKGROUND: This case-control study aimed to assess the prevalence of symptoms and risk of obstructive sleep apnea (OSA) among Saudi pregnant women. METHODS: The study included consecutive Saudi pregnant women attending the antenatal service between July 2015 and December 2016. Pregnant women were compared with an age-matched group of nonpregnant women. OSA symptoms and risk were assessed using a validated Arabic version of the Berlin questionnaire (BQ). RESULTS: The study included 742 pregnant women and 742 age-matched nonpregnant women. At the time of the survey, 8.2% were in the first trimester; 33.4% in the second trimester; and 58.4%in third trimester. Snoring was reported by 14% of pregnant women, and 5% reported breathing pauses during sleep. Based on the BQ stratification for risk of OSA, 19.3% of pregnant women and 16.6% of the control group were at high risk for OSA. A comparison between the high OSA-risk and low OSA-risk pregnant women revealed that the pregnant women in high risk group were older (30.9 ± 5.9 years vs. 29 ± 5.4 years, P = 0.001), had a higher body mass index (BMI) (34.3 ± 5.2 kg/m2 vs. 28.7 ± 5.8 kg/m2,P < 0.001), and higher parity (1.9 ± 2 vs. 1.5 ± 1.7, P = 0.020). A multivariate logistic regression analysis revealed the following independent variables, BMI (odds ratio [OR] 1.173 [95% confidence interval [CI] 1.129–1.219],P < 0.001), pregnancy-induced hypertension (OR 7.85 [95% CI 1.691–36.447], P = 0.013), and the presence of restless legs syndrome (OR 2.209 [95% CI 1.332–3.279],P < 0.001). CONCLUSIONS: OSA symptoms and risk were relatively common among Saudi pregnant women. Increasing the awareness among physicians about this association is essential to improve early detection of the disorder. [ABSTRACT FROM AUTHOR]

Context: There is a paucity of research investigating the association between antenatal care (ANC) attendance and child undernutrition in Madhya Pradesh, India. Aim: To determine whether body weight status in children under the age of 5 years is associated with ANC attendance in Madhya Pradesh. Methods: A cross-sectional study was carried out using data from India's National Family Health Survey (2005–2006). Bodyweight status (an indicator of undernutrition) was determined using weight-for-age. Descriptive statistics and logistic regression were used to estimate prevalence and obtain adjusted odds ratios (AOR) to investigate associations between ANC indicators and weight-for-age. Results: Majority of children were underweight (55.1%). ANC attendance was inadequate, with only 36.8% of women having four or more visits. None of the ANC indicators were associated with body weight status. Increased child age especially an age of 2 years (AOR 2.29; 1.66–3.15), belonging to a scheduled tribe [ST] (AOR 2.36; CI 1.64–3.39), scheduled caste [SC] (AOR 1.75; CI 1.25–2.45) or other backward caste [OBC] (AOR 1.43; CI 1.08–1.89) were associated with being underweight; a birth weight of ≥2.5 kg was associated with lower relative odds of being underweight (AOR 0.43; CI 0.29–0.64). Mothers who had a normal BMI (AOR 0.66; CI 0.53–0.82) or were overweight (AOR 0.42; CI 0.25–0.69) were less likely to have underweight children. Conclusions: ANC attendance was not associated with body weight status. Increased child age, low birth weight, poor maternal nutrition status and belonging to SCs, STs or OBCs increased the odds of child undernutrition. [ABSTRACT FROM AUTHOR]

Context: Birth preparedness and complication readiness (BPCR) have been shown to increase knowledge of danger signs and enhance access to skilled obstetric care. Previous studies have focused on intermediate outcomes of BPCR such as utilization of skilled care for pregnancy and delivery. Aims: This study aims to determine the maternal and perinatal outcomes associated with birth preparedness and complication readiness. Settings and Design: A cross-sectional study involving 827 recently delivered women, attending selected health facilities in Ikenne, southwestern Nigeria. Materials and Methods: BPCR was determined from a set of eight indicators that were developed by the John Hopkin's Bloomberg School of Public Health. Statistical Analysis: The data were analyzed using SPSS version 21. Bivariate analysis was done using Chi-square test, and binary logistic regression model was used to assess factors related to BPCR practice among respondents. The level of statistical significance was set to P < 0.05. Results: BPCR was observed in 470/827 (56.8%) of the participants. Only a minority had knowledge of financial – 125/827 (15.1%) and transportation assistance – 56/827 (6.8%). Knowledge of ≥ 5 danger signs of pregnancy was also low, 286/827 (34.6%). Institutional delivery was in only 331/827 (40%), and it depended on being birth prepared and complication ready (adjusted odds ratio [AOR] =0.534, 95% confidence interval [CI] =0.319–0.893). Significantly more perinatal deaths occurred to women who were not birth prepared (AOR = 2.951, 95% CI = 1.436–6.062), although no difference existed for perinatal (AOR = 1.202, 95% CI = 0.653–2.214) and maternal (AOR = 0.744, 95% CI = 0.452–1.226) morbidities. Conclusion: The knowledge and practice of key indicators of BPCR that reflect utilization of community resources in Ikenne Local Government Area is very poor. BPCR was an important determinant of perinatal survival. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality is an indicator of state of maternal health services, status of women, women's health, and above all developments of nation. Objectives: The objectives of the study were to identify the patterns and causes, medical as well as sociocultural, of maternal death as well as consider and list out the rights realization perspective of the mothers, their immediate families and the community at large. Materials and Methods: A cross-sectional study was conducted in three districts of Madhya Pradesh, India, for 1 year. One hundred and two maternal deaths were covered, and verbal autopsy was conducted. Human right perspective was assessed using questionnaire. Results: Majority (64.7%) of maternal deaths occurred between 18 and 25 years of age. About 50.9% were primigravida, and postpartum hemorrhage was the most common cause. Nearly 53.9% had visited more than one facility before death. Conclusion: Poor antenatal care and lack of human resources posed major reasons for death in all facilities. Rights realization among the beneficiaries was found to be very poor. [ABSTRACT FROM AUTHOR]

Background: India had highest number of under-five deaths, 1.2 million deaths out of 5.9 million (2015). As per the results from the first phase of National Family Health Survey (NFHS-4), 2015-2016, under-five mortality rate was highest in rural area of Madhya Pradesh (MP), 69/1000 live birth as compared to urban areas, 52/1000 live birth. The objective of the study was to identify potentially high-risk districts (HRD). Methods: This study was carried out from the secondary data of 50 districts of MP State which was available from NFHS-4 with information from 49,164 households. Scoring method was used to identify HRD by comparing variables related to maternal and child health care of rural MP with rural Tamil Nadu. Results: Eleven HRDs were identified with poor maternal and child health care along with high women's illiteracy and high percentage of child marriages in women. Indore division had 3 topmost HRD, Alirajpur, Jhabua, and Barwani followed by Rewa division with 2, Singrauli and Sidhi along with Sagar division. Conclusions: HRDs should be considered for targeted interventions using the strategies for reducing under-five mortality rate in rural MP. [ABSTRACT FROM AUTHOR]

Background: Developing countries continue to have a high maternal mortality ratio. Antenatal care (ANC) has been termed as one of the "four pillars" of safe motherhood by the World Health Organization. Male involvement has been recognized as having a great impact on women's utilization of maternal health-care service. Objectives: The objective was to assess husband's knowledge and attitude toward their involvement in ANC and to determine factors that influence husband's attitude toward involvement in ANC. Methodology: A community-based observational cross-sectional study on husbands of pregnant women enrolled in an urban health center located in the Malvani slum community of Mumbai with a sample size of 86 was undertaken. Results: The study findings revealed that majority of the husbands 67.4% had a positive attitude, whereas 32.6% had a negative attitude toward involvement in ANC. Knowledge of the husbands regarding early registration of pregnancy, tetanus toxoid, routine blood investigations, and increased dietary requirements were 35%, 45%, 51%, and 65%, respectively. Husband's level of education, their occupation type, distance of health facility from home, length of time spent at health-care facility, and attitude of health-care providers affect the attitude toward involvement in their wife's ANC. Conclusion: Changes in husband's knowledge and attitude about ANC are necessary conditions required to detect pregnancy-related complications at the earliest and for prompt referral. [ABSTRACT FROM AUTHOR]

Background: Antenatal care (ANC) is one of the basic components where it can provide pregnant women with an expansive scope of well-being, health promotion, and preventive health services. However, still 830 women die every day from preventable pregnancy-related causes, and 99% of these deaths occur in developing countries, out of which 20% of these deaths were from India. Objectives: The objective of this study is to explore the factors influencing the utilization of reproductive health services among mothers and to find the association between various factors and utilization of reproductive health services. Methods: A community-based cross-sectional study was conducted during January–June 2017 among 160 mothers who had an infant aged <6 months in Mawkyrwat Block, South West Khasi Hills District in Meghalaya. Respondents were selected through simple random sampling, and semi-structured questionnaire was used for data collection. Data were analyzed using SPSS 16. Results: Mothers attending four or more antenatal checkups were 10.6%, where 53.5% of the mothers registered their first ANC checkups only by the second trimester and 57.5% preferred home delivery. Nearly 52.9% of the mothers were staying more than 5 km away from the health-care facilities. The usage of family planning methods was very low, i. e., 96.9% of the mothers are not using any of the family planning methods. Conclusion: Study finding reveals that the utilization of health-care services was low. Area-specific approaches such as health camps and mobile clinics might result in improved utilization of reproductive health services. [ABSTRACT FROM AUTHOR]

Background: Considering the global and national level commitments in improving the maternal health as well as reducing the maternal mortality, assessment of factors influencing the delivery of antenatal healthcare services becomes essential. Objectives: The aim is to assess the utilization of antenatal health services and to identify the factors influencing their utilization among women of fishermen population in Kanchipuram district, Tamil Nadu. Materials and Methods: The cross-sectional study was carried out among the mothers in Kovalam area of Kanchipuram district. Details were collected using a pretested questionnaire and analyzed using statistical software. Results: The study included 284 mothers, of which 35% were illiterates. Nearly 60.21% have got registered with the Government sector, 59.51% of the mothers had three or more antenatal visits, 64.08% have received two doses of tetanus toxoid, and 73.24% have taken iron and folic acid tablets. Factors which were identified to have statistically significant association with better utilization of antenatal health services were age >30 years, higher educational status, skilled workers, those having their first child, and higher socioeconomic class. Conclusion: This study has reported the fact that antenatal healthcare services were not utilized fully by the community and the fishermen population being a special group has to be given the needed attention from the healthcare delivery system. [ABSTRACT FROM AUTHOR]

Background: Delivery of maternal health care services is a major challenge to the health system in developing countries. Provision of antenatal care (ANC) services is the major function of public health delivery system in India to improve maternal health outcomes and its impact on maternal morbidity and mortality. Studies are lack in documenting variation in utilization of ANC services between geographical regions of Andhra Pradesh (AP). Objective: The objective of this study is to assess variation in utilization of ANC services stratified by geographical region, type of delivery and determinants of utilization of ANC services in AP. Methodology: It is a cross-sectional study of District Level Household and Facility Survey-4 of the state of AP. Multistage, stratified and probability proportional to size sample with replacement was used. Around 3982 women who delivered after the year 2007 were considered for analysis. Binomial logistic regression was carried out to determine association of demographic, system level variables with adequate ANC. Results: Study reveals wide variation across four regions of AP in utilization of ANC services. Reception of adequate ANC was low in Rayalaseema region (27.9%) and high in North-coastal region (42.4%). The utilization of private health facilities for ANC services were highest in South-coastal region (73.2%) and lowest in North-coastal region (43.2%). Conclusion: Policy measures are to be adopted and implemented by government to address the demand-supply imbalance such as public health infrastructure and quality of services in underperforming districts of AP and to increase outreach of current programs by engaging communities. [ABSTRACT FROM AUTHOR]

Background: India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO). Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care. [ABSTRACT FROM AUTHOR]

Introduction: Migrant is a vulnerable population. They face several barriers in accessing health services. The immigration status presents various challenges for maternity services utilization. So this study was conducted (1) to estimate proportion of women utilizing full ANC package and to find out reasons for its nonutilization (2) to estimate the proportion of institutional deliveries and reasons for home deliveries. Methods: A cross-sectional community based study was conducted among migrant women in reproductive age group in an urban slum. The sample size was 120. Multistage simple random sampling was done. Results: Maximum numbers of migrants (71.7%) were from Uttar Pradesh. Sixty two percent married before the age of 18 years. Full ANC package was received by only 18% migrants. Proportion of home deliveries was 12%, and all were conducted by Untrained Dai. Lack of transport facility and availability of Dai (local birth attendant) were the reasons mentioned for home delivery. For nonutilization of full ANC package, far location of health center (30%); it is not necessary (25.8%); and family did not allow them to visit health center (21.8%) were the reasons mentioned. Religion and type of family were significantly associated with nonutilization of full ANC package. Conclusion: The present study revealed low utilization of ANC services and high proportion of home deliveries among the migrant women even after availability of health facilities for providing ANC care and to conduct deliveries in urban area. [ABSTRACT FROM AUTHOR]

Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC) is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women. [ABSTRACT FROM AUTHOR]

Background: The satisfaction of antenatal women to antenatal services has rarely been studied in India. In a nation with a maternal mortality ratio of 178/100,000 live births, it is crucial to explore all avenues to reduce it. Aims: Our study aims to assess the pregnant women's satisfaction with regard to antenatal care services provided by nurse-midwives in an urban health center in South India. Methods: We administered a satisfaction of care questionnaire to 200 consecutive antenatal women attending the nurse run antenatal clinics from April 2014 to November 2014. The date entry was done using Epi-Data system and the analysis by SPSS version 16. Statistical Analysis Used: The absolute distribution of each of the question in the satisfaction of care questionnaire was calculated as proportions. The relationship between satisfaction of care and parity, number of visits, years of experience of the care provider and mother's education was tested using Mann-Whitney test for two independent groups. Results: The mean age of the mothers was 23.5 years. More than 95% of the mothers expressed satisfaction with the number of antenatal visits components of antenatal care. Only 31.8% of the mothers were satisfied with the health education on family planning. There was no significant relationship between satisfaction of care and parity of mothers or years of experience of care provider. Conclusions: Pregnant women attending a nurse run antenatal care service have positively expressed satisfaction of care provided therein. [ABSTRACT FROM AUTHOR]

Background: Neonatal tetanus (NNT) is one of the childhood's preventable diseases and a leading cause of neonatal death especially in developing countries. It is entirely preventable through effective immunisation of women of child-bearing age, and through simple and basic precautionary measures in child delivery. Objective: This study highlighted the burden of neonatal tetanus in Kano over a period of ten years. Materials and Methods: We retrospectively studied the case notes of neonatal tetanus admitted over a ten-year period (2000--2009). The records of neonates admitted as cases of neonatal tetanus into the special care baby unit of Aminu Kano Teaching Hospital, a tertiary health facility in Kano, northern Nigeria, over a ten-year period were reviewed. Data on age at presentation, local government area from which the neonates presented, antenatal history, maternal immunisation status, clinical feature, complications and the outcome were noted. Results: Majority of the cases (74%) were concentrated in the cosmopolitan areas of Kano. Only 33% of the mothers had antenatal care (ANC) while only 18 (24%) of the mothers received immunisation against tetanus. In all, 76% of the mothers delivered outside the medical facility. The umbilical cord was the route of infection in 52.7% of cases. The case-specific fatality rate was 51.4%. Conclusion: The incidence of NNT is still very high in Kano and this scourge can be tackled through improved quality and accessibility of ANC services and tetanus toxoid (TT) vaccination, provision of skilled attendants at delivery under hygienic conditions and avoidance of harmful traditional practices. [ABSTRACT FROM AUTHOR]

Background: Improving the utilization rate of antenatal care is a critical strategy for achieving the reproductive health goals in Iran. The aim of this study was to assess the utilization rate of antenatal care (ANC) by women after health sector reform (HSR) interventions in rural areas of Islamic Republic of Iran (IR Iran). Materials and Methods: This is a retrospective cross-sectional study. The data were gathered by cluster sampling from 400 motherhood records of mothers whose last pregnancies had been terminated in the first 3 months of 2013. Data were collected from 21 rural health centers of Isfahan district during the year 2013. The utilization rate of ANC by mothers was assessed by the number of visits they had, the time of the first ANC visit, the occurrence of pregnancy- or delivery-related complications, and the number of postpartum visits. Results: The mean time of the first ANC was 9 ± 5.23th week of gestational age. For 69.3% of pregnant women, the first ANC was before the 12th week. Overall, the frequency of ANC visits ranged from 2 to 21, with the average of 10.6 ± 3.23 visits. 93.8% of the utilized ANC visits were adequate. 99.8% of the deliveries took place in the hospital. 99% of mothers had at least one visit in the postpartum period. 4% of the mothers had suffered from pregnancy-related complications. Conclusion: It seems that IR Iran has achieved to one of the important objectives by its reform in health care access, that is, more ANC for pregnant women. [ABSTRACT FROM AUTHOR]

Background: Infant death depends upon the care during the infancy and also upon the service utilization during antenatal and intra.natal periods and with its decline, it is necessary to find the under.reporting if any and identify the most appropriate agency for its reporting. Objectives: (1) To document disparities between different reporting systems about infant deaths and find out the under.reporting if any and identify the most appropriate agency and (2) To identify utilization of health services during ante, intra and post.natal period for all infant deaths. Materials and Methods: Study was conducted in 51 villages of 3 Primary Health Centers (PHCs) from a tribal dominated Taluka (block) of South Gujarat during September - November 2005. Information was gathered for 1 year (1 September 2004 to 31 August 2005) from 4 sources namely health care system, Integrated Child development services (ICDS) scheme, Civil Registration System (CRS) and Investigator himself (Gold standard). Data was collected in a designed verbal autopsy questionnaire by house to house survey and analyzed in Epi Info. Results: A total of 48 infant deaths were recorded by investigator against reported 2, 10 and 8 infant deaths by CRS, Health System and ICDS respectively. While profiling these 48 infant deaths it was found that only 29.2% mothers received full antenatal care (ANC) and 60.4% delivered at home (by untrained personnel). Not a single delivery was done at PHCs or its sub centers (SC). In 25% cases there was poor cord care. 39.6% mothers did not breastfeed and 35.4% gave pre.lacteal feeding. Conclusions: There was gross under-reporting of infant mortality in all 3 agencies. The utilization of ANC and post natal care (PNC) services was poor in these death cases. Health system and ICDS need to be sensitized to work in coordination to provide quality ANC, INC and PNC to prevent such avoidable infant deaths. [ABSTRACT FROM AUTHOR]