Search

Abstract Background Anaemia among pregnant women and post-partum mothers is a public health challenge in Ghana, especially in the Volta Region. While literature abounds on anaemia among pregnant women, the same cannot be said for anaemia among post-partum mothers in the region. This study, therefore, examined the prevalence and associated risk factors of anaemia among women attending antenatal care and post-natal care. Methods This descriptive cross-sectional survey recruited 409 pregnant women and 194 post-natal mothers attending antenatal and post-natal care, at the Hohoe Municipal Hospital. Background characteristics were collected using a semi-structured questionnaire, blood samples were analysed for the presence of anaemia and malaria parasitaemia and folders were reviewed for estimated blood loss. Results We found the prevalence of anaemia among pregnant women and post-partum mothers to be 33 and 16% respectively. Higher malaria parasitaemia (2%) was found in pregnant women compared with postpartum mothers (1%). We found that 4% of post-partum mothers had abnormal blood loss (301mls-500mls) whereas 5% of them had postpartum haemorrhage (>500mls) during child birth. A univariate logistics regression of anaemia status on some risk factors in pregnant women showed no significant association between anaemia and any of the risk factors. Among post-partum mothers, only mothers’ age was statistically significant in the univariate analysis [COR = 0.27 (95% CI:0.103, 0.72);0.008]. Mothers aged 20–29 were 73% less likely to be anaemic. Conclusion The prevalence of anaemia among pregnant women found in this study points to a situation of moderate public health problem according to WHO cut-off values for the public health significance of anaemia. Strategies should therefore be put in place to encourage thorough health education and promotion programmes among both pregnant and post-partum women.

Abstract Background The use of post-partum family planning (PPFP) methods such as post-partum intrauterine device (PPIUD) in general remains low despite its benefits for the women. The reasons or factors affecting the uptake and continuation of such PPFP methods in developing countries such as Nepal remains unclear. This qualitative research aims to explore the factors affecting PPIUD uptake and continuation related behaviors among post-partum mothers within 6 weeks of childbirth in Nepal. Methods This qualitative study was conducted through 43 in-depth interviews among post-partum mothers who delivered in 3 selected hospitals in Nepal. Data were analyzed through content analysis using the theory of planned behavior (TPB) as the theoretical framework. Results The themes and categories were structured around the three major components of the TPB on attitude, subjective norms, and behavioral control. Majority of the women in this study, irrespective of their behavioral outcome expressed a positive attitude towards PPIUD use. However, the women who expressed an unfavorable attitude towards PPIUD influenced their behavior to not choose or discontinue PPIUD. Subjective norms such as the family, peer, and societal influences against PPIUD negatively affected the women’s intention and behavior related to PPIUD. Whereas, the positive influence of the health providers positively affected their behavior. Regarding the behavior control, women who had their own control over decisions tended to use PPIUD. However, external factors such as their husband’s preference or medical conditions also played a prominent role in preventing many to use PPIUD despite their positive intentions. Conclusion As suggested in TPB, this study shows that multiple factors that are interlinked affected the behaviors related to uptake and continuation of PPIUD. The attitude helped in s`haping intention but did not always lead to the behavioral outcome of PPIUD uptake and continuation. Subjective norms had a strong influence on both intention and behavior. Behavior control belief also had an important role in the outcome with respect to PPIUD uptake and continuation. Thus, a more layered, multidimensional and interlinked intervention is necessary to bring positive behavior changes related to PPIUD.

Introduction: Globally, iron deficiency anaemia is considered as a risk factor for maternal morbidity and mortality. It is estimated to cause 591,000 perinatal deaths and 115,000 maternal deaths annually. The World Health Organisation recommends iron supplementation to first trimester to 45 days after delivery. The Government of Nepal is supplementing Iron and Folic Acid (IFA) to pregnant and postpartum women to reduce the burden of disease and deaths, however Nepal reports low compliance and coverage. We sought to determine compliance of IFA and associated factors among postnatal mothers in Kathmandu valley. Methods: A cross-sectional study was conducted with 132 mothers attending the immunisation clinic. Face to face interview was done using structured questionnaire consisting of sociodemographic information, IFA, maternal knowledge and compliance practices. Statistical analysis was done using SPSS version 23. Results: We found 68.9% compliance of IFA among the respondents. The mean age of the respondents was 27.53 ± 4.6 years (Mean ± SD). Significant association was observed between the compliance of IFA with education,age,employment status of women and family type (p < 0.00). No significant association was observed in the compliance of IFA and religion (p = 0.93) and delivery related complications (p = 0.143). Similarly, delivery type showed significant association with the compliance of IFA (p < 0.00). Conclusions: This study concludes that mothers from Kathmandu had better compliance and coverage of IFA was found. Private pharmacy is an important service provider for urban women. [ABSTRACT FROM AUTHOR]

Abstract: The most effective modern family planning method is long-acting reversible contraceptives (LARCs), including intra-uterine contraceptive devices (IUCD). It has multiple advantages over other reversible methods. Despite all known advantages of IUCD, its uptake is still low in Uganda. The purpose was to determine the factors influencing the utilization of intra-uterine contraceptive device among postpartum mothers. A facility-based cross-sectional analytical design was used. 202 Postpartum mothers were sampled and interviewed. Key informants interviews and FGDs were held. Out of 202 post-partum mothers, the prevalence of IUCD utilization was low at 16.3%. Knowledge level at was 55.9%. Education of mothers significantly influenced utilization (X2(3) = 28.22, p =

Abstract: The most effective modern family planning method is long-acting reversible contraceptives (LARCs), including intra-uterine contraceptive devices (IUCD). It has multiple advantages over other reversible methods. Despite all known advantages of IUCD, its uptake is still low in Uganda. The purpose was to determine the factors influencing the utilization of intra-uterine contraceptive device among postpartum mothers. A facility-based cross-sectional analytical design was used. 202 Postpartum mothers were sampled and interviewed. Key informants interviews and FGDs were held. Out of 202 post-partum mothers, the prevalence of IUCD utilization was low at 16.3%. Knowledge level at was 55.9%. Education of mothers significantly influenced utilization (X2(3) = 28.22, p = <0.001) with primary education and secondary education being 10 times more likely (COR = 9.67, 95%CI (2.639–35.411)) and 6 times more likely (COR = 6.17, 95%CI (2.234–17.023) to influence IUCD utilization, respectively. Occupation of mothers also influenced utilization (p < 0.000). Most of the mothers were skilled laborers and yet they were less likely to utilize IUCD compared to non-skilled counterparts (COR = 0.19 95%CI: 0.082–0.431). Culture influenced utilization of IUCD (X2(1) = 18.22, p = 0.007). Healthcare providers should build the capacity of community health workers to promote effective community awareness about IUCD and its advantages. This will increase uptake. [ABSTRACT FROM AUTHOR]

Dr. Holtz and colleagues present a synthesis of evidence from published studies over the previous decade on the collective impact of HIV-targeted interventions on maternal mortality. Amongst an assortment of interventions [that include antiretroviral therapy (ART), micronutrients (multivitamins, vitamin A and selenium), and antibiotics], only ART reduced maternal mortality among HIV-infected pregnant and post-partum mothers. These findings have fundamental and global strategic implications. They are also timely since they provide the evidence that ART reduces HIV-related maternal mortality, and by further enhancing access to ART in HIV-challenged and poor regions of the world, significant improvement in maternal morbidity and mortality indices could be attained. The paper bears good tidings and sound scientific proof that the financial investment made globally by government and non-governmental organizations and agencies to reduce the global burden of HIV/AIDS primarily by making ART more accessible to regions of the world most affected by the epidemic is beginning to show beneficial effects not only in terms of numerical reductions in the rates of new cases of HIV/AIDS among women, but also in maternal mortality levels.

Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C‐reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = −0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut‐off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut‐off values during this period. [ABSTRACT FROM AUTHOR]

Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C-reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = -0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut-off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut-off values during this period., (© 2015 John Wiley & Sons Ltd.)