Search

OBJECTIVE: To compare the clinical and paraclinical features and outcomes of pregnant and nonpregnant women with COVID-19. METHODS: A multicenter retrospective cohort study of pregnant and nonpregnant women of reproductive age hospitalized between March and October 2020 in Tehran, Iran. Medical records were reviewed and women who tested positive for SARS-CoV-2 on RT-PCR were included. Extracted data were compared and logistic regression performed. RESULTS: A total of 110 pregnant and 234 nonpregnant COVID-19-positive women were included. Frequency of severe disease was higher in nonpregnant women than pregnant women (29% vs 11.8%; P

This paper examines the experiences of people displaced internally by climate-related factors in mainland Bangladesh, one of the world's most climate-vulnerable countries. The data derives from a r...

Introduction There is limited data on newborns born to mothers with COVID-19 infection. This multicenter cohort study aimed to investigate the clinical characteristics and outcomes of neonates born to mothers with and without COVID-19 infection to fill a gap in the literature review. Methods The medical records of all neonates in Isfahan, Iran, between October 2020 and March 2021, were retrospectively reviewed. Results Among the 600 neonates in this study, 255 (42.5%) were in the infected group and 345 (57.5%) were assigned to the control group as they were born to non-infected mothers. In the infected group, sepsis, fever and pneumothorax were detected in 3 (1.2%), 3 (1.2%) and 4 (1.6%) neonates, respectively, compared with no case in the control group. In the infected group, neonatal respiratory distress (NRDS) (32, 12.5%) was significantly higher than the control group (27, 10.6%). Asphyxia in the infected group was 22(6.4%), compared with 19 (5.5%), in the control group. Preterm labor (PTL) (55, 21.65%), premature rupture of membranes (PROMs) (24, 9.4%) and intra-uterine growth retardation (IUGR) (15, 5.9%) were significantly higher in women with COVID-19 (45, 13.0%, 4, 1.2% and 7, 2.0%, respectively). Low birth weight (LBW) accounted for 42 (16.5%) neonates in the infected group and 25 (7.2%) in the control group (p < 0.05). Of the 255 neonates born to infected mothers, 38 (14.9%) were admitted to the Neonatal Intensive Care Unit (NICU), compared with 31 out of 345 (9.0%) in the control group (p < 0.05). RT-PCR test results were positive in two newborns (0.8%), one of whom died of necrotizing enterocolitis. Conclusion As a result of maternal COVID-19 infections, neonates experienced higher rates of sepsis, fever, pneumothorax, asphyxia and NRDS in addition to PTL, PROMs, IUGR, and LBW.

Unwanted pregnancy is a world problem. In 2008, there were 208 million pregnancies in the world, and 41% of them were unwanted pregnancy. Cross-national reproductive health studies have indicated that the unwanted pregnancy rates remain substantially high in many developing regions, including in Indonesia (Bearak et al. 2018). Unwanted pregnancies in Indonesia increased from 13.6% in 2012 to 16% in 2015. The high rates of unwanted pregnancies are often linked to the gaps in family planning services such as the effective use of contraceptive methods which is also influenced by family socioeconomic backgrounds such as their occupational status. Using the case study at health clinics of PKBI in East Java, this paper attempts to explore the association or relationship between the risk of unwanted pregnancy among couples of childbearing age (CCA) with their use of contraceptive methods and occupational status. A quantitative method of a case-control research design was applied by using a random sampling technique. The study was 50 women couples of childbearing age (15–45 years), who had unwanted and wanted pregnancies. Simple correlation analysis shows that the association are relatively significant between the occurrence of an unwanted pregnancy with the long-term contraceptive use (p-value = 0.008), and with the employed in occupational status (p-value = 0.027). However, there is no correlation between the unwanted pregnancy occurrence with the short-term contraceptives use (p-value = 0.118). The study concludes that the use of short-term contraceptive methods and the employed status can still affect the risk of unwanted pregnancies, while the effective use of long-term contraceptive method has a vital role in preventing unwanted pregnancies.

Extreme weather events cause large-scale population displacement in Bangladesh. It is important to know how household displacement due to such events might affect women's antenatal care (ANC) service utilization.In 2017, a cross-sectional household survey was conducted in 25 rural villages in either displacement prone or non-displacement prone areas of Bangladesh. Data were collected from 611 respondents (a woman or her husband) who reported having had a live birth in the past three years; of those, 289 had experienced household displacement due to an extreme weather event. Logistic regression analyses were conducted to examine the relationship between experience of household displacement and women's ANC service utilization during their last pregnancy resulting in a live birth.Eighty-three percent of women had received at least one ANC visit during their last pregnancy resulting in a live birth; of those, 31% received at least four visits with a trained provider. Women from households that had been displaced three or more times were less likely than those from nondisplaced households to have received an ANC visit and at least four visits with a trained provider (odds ratios, 0.3 and 0.4, respectively). Receiving at least four visits with a trained provider was also associated with having previous children (0.3-0.4), age at pregnancy (2.5-3.9), husband's occupation (2.2 for "other") and joint parental decision-making about ANC visits (1.8).Strengthening family planning services and extending eligibility for Bangladesh's Maternity Allowance benefits in the areas prone to floods and riverbank erosion are recommended to improve ANC service utilization.RESUMEN Contexto: Los eventos climáticos extremos causan desplazamientos de población a gran escala en Bangladesh. Es importante conocer cómo el desplazamiento de hogares debido a tales eventos podría afectar la utilización que las mujeres hacen de los servicios de atención prenatal (APN). Métodos: En 2017, se condujo una encuesta transversal de hogares en 25 pueblos rurales de Bangladesh tanto en áreas propensas al desplazamiento como en áreas no propensas al mismo. Se recolectaron datos de 611 personas entrevistadas (mujeres o sus cónyuges) que reportaron haber tenido un nacido vivo en los tres años previos; de ellas, 289 habían experimentado desplazamiento del hogar debido a un evento climático extremo. Se llevaron a cabo análisis de regresión logística para examinar la relación entre la experiencia del desplazamiento del hogar y la utilización de servicios de APN por las mujeres durante su último embarazo que resultó en un nacido vivo. Resultados: Ochenta y tres por ciento de las mujeres habían tenido al menos una visita de APN durante su último embarazo que resultó en un nacido vivo; de ellas, 31% tuvo al menos cuatro visitas con un proveedor de servicios capacitado. Las mujeres de hogares que habían sido desplazados tres o más veces tuvieron menos probabilidad que las mujeres de hogares no desplazados de haber tenido una visita de APN y al menos cuatro visitas con un proveedor de servicios capacitado (razón de probabilidades, 0.3 y 0.4, respectivamente). Tener hijos previamente (0.3–0.4), edad al embarazo (2.5–3.9), ocupación del cónyuge (2.2 para “otro”) y toma de decisiones parentales conjunta sobre visitas de APN (1.8) también estuvieron asociados con el hecho de tener al menos cuatro visitas con un proveedor de servicios capacitado. Conclusiones: Se recomienda fortalecer los servicios de planificación familiar y extender la elegibilidad para los beneficios de la Prestación por Maternidad del Gobierno de Bangladesh en las áreas propensas a inundaciones y erosión de las riberas de los ríos para mejorar la utilización de servicios de APN.RÉSUMÉ Contexte: Les phénomènes météorologiques extrêmes sont la cause de déplacements de population à grande échelle au Bangladesh. Il importe de documenter l'effet éventuel de ce déplacement des ménages sur le recours des femmes aux prestations de soins prénatals (SPN). Méthodes: En 2017, une enquête transversale auprès des ménages a été menée dans 25 villages bangladais situés dans des zones sujettes ou non au déplacement. Les données ont été collectées auprès de 611 répondants (les femmes ou leur mari) ayant déclaré avoir eu une naissance vivante au cours des trois dernières années. Parmi ces répondants, 289 avaient connu un déplacement du ménage dû à un phénomène météorologique extrême. La relation entre le vécu de ce déplacement et le recours des femmes aux prestations SPN durant leur dernière grossesse ayant abouti sur une naissance vivante a été examinée par analyses de régression logistique. Résultats: Quatre-vingt-trois pour cent des femmes avaient obtenu au moins une consultation SPN durant leur dernière grossesse ayant abouti sur une naissance vivante; parmi elles, 31% en avaient obtenu au moins quatre avec un prestataire qualifé. Les femmes des ménages déplacés trois fois ou davantage étaient moins susceptibles que celles des ménages non déplacés d'avoir obtenu une consultation SPN et au moins quatre consultations avec un prestataire qualifié (RC, 0,3 et 0,4, respectivement). L'expérience antérieure de la maternité (0,3–0,4), l'âge au moment de la grossesse (2,5–3,9), l'activité professionnelle du mari (2,2 pour « autre ») et la prise de décision parentale conjointe concernant les consultations SPN (1,8) se sont aussi avérés associés à l'obtention d'au moins quatre consultations avec un prestataire qualifié. Conclusions: Le renforcement des services de planification familiale et l'admissibilité accrue aux prestations de maternité du gouvernement bangladais dans les zones vulnérables aux inondations et à l'érosion des rives sont recommandés pour améliorer le recours aux prestations SPN.

Programs for saving lives at birth have been implemented in many countries, especially in the less developed countries, such as Indonesia, where maternal and child deaths are still too high. Internationally, ensuring healthy lives and promoting well-being for all is one of the 17 United Nations Sustainable Development Goals (UN SDGs) launched in 2015. The UN SDGs is a global plan of action for prosperity, people, and the planet that presents an opportunity to mobilise both government and society to ensure no one is left behind and equality for all. This chapter represents an attempt to understand the varying results achieved at a sub-regional level by a saving lives at birth program in the eastern part of Indonesia. Through this case study, we focus on identifying the barriers to program participation and the enablers that successfully prompt women to give birth at a health facility. We also explore two theoretical frameworks used in business and economics—social marketing for health promotion and shared leadership—to ascertain whether they might improve the region’s saving lives program.

Studies have shown that child survival can be greater when fathers are more highly involved in infant care than when they are less involved. This paper investigates fathers’ and paternal grandmothers’ knowledge and experiences relating to infants’ survival in a rural district of Eastern Indonesia, a context for which such information is lacking. Twenty fathers or replacement relatives participated in in-depth interviews. Most had very limited knowledge of the danger signs of childhood illness. None of participants had received child health-related information from local health personnel. Male-dominated forms of decision-making in relation to infant health care are the norm. Inadequacies in the child health services, such as difficulties in accessing health facilities, health personnel unavailability and discomfort during delivery, remain as challenges. Fathers appear to rely largely on their wives for their infant health and survival knowledge and have little involvement with their infants. They see their roles in terms of providing economic support and basic care for their infants. Grandmothers are seen as a major source of health information by fathers, but have limited knowledge of infant survival. The findings demonstrate a need for child health promotion programs and campaigns, including the safe motherhood program, to include fathers as well as mothers, in order to increase their awareness of infant survival and involvement in infant raising, and to persuade them to allow mothers greater scope to make child health-seeking decisions, especially when children require emergency treatment.

In Indonesia, high rates of maternal and child mortality can be attributed, in part at least, to a lack of access to medical facilities, especially in rural communities. In response, the Indonesian government developed a program to address the high rate of home births. A key element of the program involved drawing upon the contribution of community members to assist with facility-based births of pregnant women in their community. The success of the program was attributed to active participation from many groups, including community members, government officials and health-care workers who collaborated successfully to achieve a reduction in the maternal and infant mortality rates.

Exposure to extreme climate events causes population displacement and adversely affects the health of mothers and children in multiple ways. This paper investigates the effects of displacement on whether a child is delivered at a health center, as opposed to at home, and on postnatal care service utilization in Bangladesh. Using cross-sectional survey data from 599 mothers who gave birth in the three years prior to the date of interview, including 278 from households which had previously been displaced and 231 from households which had not been displaced, we use multivariate logistic regression to identify the factors associated with maternal healthcare service utilization. The results show that displaced households' mothers are only about a quarter as likely to deliver at a health center as mothers from non-displaced households. The use of health center-based delivery decreases as the numbers of past displacements increases. Higher number of previous children, lower use of antenatal care during pregnancy, lower household income, and lack of access to radio/television also significantly reduce a mother's likelihood of delivery at a health center. Displaced mothers are also substantially less likely to use postnatal care services for their neonates, especially those supplied by trained providers. Use of health facilities for delivery, use of antenatal care services, and previous number of children are other important predictors of postnatal care service utilization for neonates. In light of these findings, relocation of local health facilities with basic and emergency care provisions to areas in which the displaced have resettled, reinforcement of Family Planning services, and extension of coverage of the Maternity Allowance benefits in the displacement-prone mainland riverine areas are recommended policy responses.

In Bangladesh climate change has contributed to a massive displacement of people. This study examines the effects of climate-related displacement, socioeconomic status, availability of healthcare providers and disease-related attributes on the healthcare-seeking behaviors of parents for their children. Using cross-sectional survey data from the parents of 1003 children aged under 15 who were ill in the four weeks prior to the interview, collected from 600 randomly-selected households in climate displacement-susceptible areas and 600 households in non-climate-displacement-susceptible areas in Bangladesh, we use multivariate logistic regression to identify the factors associated with parental healthcare-seeking behaviors. The results show that 15.5% of the children who had been ill receive either no care or curative care at home. Of those receiving care outside the home, only 22.1% are treated by trained providers. Climate-related displaced parents are significantly less likely to seek care or to use provider-prescribed care to manage children's illnesses. Areas lacking local healthcare providers, poorer households, females, child age and mild illness are also associated with a child being significantly less likely to be treated outside the home. The children of climate-related displaced parents are around half as likely as those of non-displaced parents to be treated by a trained provider. The local availability of medical doctors, cost of reaching a healthcare center, household income, type and severity of illness, child's age, and joint parental decision-making about care providers are also important predictors of the selection of trained healthcare providers for children. Thus, climate-related displacement affects the healthcare-seeking behaviors of parents for their children. Policy aimed at improving child health should address the socioeconomic disadvantage and access to healthcare of the displaced, the training of local untrained providers about Primary Health Care service provision, and the numbers of medical doctors in the displacement-prone areas.

This article contributes to the emerging scholarship on institutional and regulatory innovations to extend core employment protections to workers on non-standard contracts by examining different policy models that could potentially improve access to statutory long service leave entitlements in Australia. With the growth of casual, contract and short-term employment reducing access to this entitlement for many workers, there have been calls for the creation of a national long service leave scheme that would be portable between employers, so that the benefit is more generally available to workers over the course of their working life. The article proposes three possible models for implementing a portable long service leave scheme. These are evaluated with regard to the relative costs and benefits for employers and workers and implementation issues for governments. We find that the three models distribute risks, costs and benefits differently between the stakeholders, and any model adopted will involve trade-offs.

Cet article envisage divers modeles, tant spatiaux que temporels, afin de permettre une comparaison internationale des niveaux de migration interne entre tous les pays du monde. En premier lieu, parmi les divers modeles spatiaux utilises, le modele reliant les migrations aux decoupages du territoire permet de resumer simplement cette relation. Mais ses parametres n’ont pas de signification claire pour une comparaison internationale. En second lieu, le modele « migrant-migration » permet de ramener des effectifs de migrants, mesures sur des periodes variables, a un taux instantane independant des migrations multiples et des retours survenant sur une periode plus large. Des lors, une comparaison internationale n’est possible que pour les taux instantanes de changement de logement, indicateur classique dont la signification est claire. Les auteurs montrent a l’aide de nombreux exemples que l’utilisation simultanee des deux types de modeles permet, sous certaines conditions, d’estimer de facon approchee un tel taux, que l’on peut relier aux parametres de ces modeles. Dans certains pays, ou l’on dispose d’une mesure directe des changements de logement, la validite des modeles peut etre testee et confirmee.

South East Queensland is projected to grow by an estimated 1.3 million people over the next 20 years. To date, much of the debate on how best to respond to this unprecedented rate of growth has focused attention on the need to provide better infrastructure, more housing and to sustain and protect ecosystems and habitats. Less attention has been paid to the human dimensions of growth, and how the needs of an increasingly diverse population are to be met – including planning for a more multicultural urban future. Utilising a social inclusion framework this article explores the challenges for planning where nearly half of South East Queensland's growth results from overseas migration. In providing a case study of Moorooka, Brisbane, we argue that the sustainability and liveability of a more urban South East Queensland depends greatly on the creation of a socially inclusive and progressive environment. This will inevitably involve renewing the very practices of planning itself.

In this article, we undertake an event-history analysis of fertility in Ghana. We exploit detailed life history calendar data to conduct a more refined and definitive analysis of the relationship among personal traits, urban residence, and fertility. Although urbanization is generally associated with lower fertility in developing countries, inferences in most studies have been hampered by a lack of information about the timing of residence in relationship to childbearing. We find that the effect of urbanization itself is strong, evident, and complex, and persists after we control for the effects of age, cohort, union status, and education. Our discrete-time event-history analysis shows that urban women exhibit fertility rates that are, on average, 11% lower than those of rural women, but the effects vary by parity. Differences in urban population traits would augment the effects of urban adaptation itself. Extensions of the analysis point to the operation of a selection effect in rural-to-urban mobility but provide limited evidence for disruption effects. The possibility of further selection of urbanward migrants on unmeasured traits remains. The analysis also demonstrates the utility of an annual life history calendar for collecting such data in the field.

The need for methods of indirectly estimating migration flows is particularly important in developing countries, where migration data are often incomplete and inaccurate. This paper focuses on the use of an indirect internal migration estimation method applied to Mexican and Indonesian census data. It shows that the mobility propensities of infants can be used to infer the corresponding propensities of all other age groups. However, the promise of this method is reduced in instances of inadequate data, and great care must be taken to identify outlying values in the data and to correct obviously erroneous patterns. Future work increasingly will be directed to this issue.

Families in the Timor society of Indonesia have customarily used traditional houses, called Ume Kbubu, for confinement practices of a newborn baby and the mother during the first 40 days after birth. The practice, known as Sei (smoke) tradition, involves retaining heat, which is believed to foster healing, inside the house by continuously burning a wood burning stove. Exacerbated by inadequate ventilation in the traditional house, this practice results in poor indoor air quality and negatively affects the health of the mother and baby. Preliminary findings from a baseline study conducted in 2009 identified high levels of indoor air pollution in Ume Kbubu where mothers practiced the Sei tradition. Many respondents expressed that they suffered from respiratory health problems during the practice. On the basis of those results, a follow-up study was conducted in 2011 to develop and test a communication-focused behavior change intervention that would foster conversion of traditional houses into healthy Ume Kbubu and promote changes to traditional practices for better health outcomes. The study suggests that redesigning an Ume Kbubu house could promote better air quality inside the house and involving the community in the health intervention program led to positive changes in the Sei practice (i.e., decreasing the Sei period's length from 40 days to 4 days on average and attempting to reduce household air pollution). The study resulted in several recommendations in relation to sustained transformation to improve health behaviors.

In the last few years, there is an increasing interest in connecting Indonesian diaspora around the world in order to assist in the national development. A recent event called “Congress of Indonesian Diaspora” held by Indonesian Diaspora Network (IDN) in Jakarta has been conducted to focus on this issue. Nevertheless, there is still little known about the actual size and composition of the global Indonesian diaspora. This paper attempts to contribute to fill in this gap by analysing migration patterns and several specific demographic factors among Indonesian diaspora as part of the largest global community. The paper will also explore the potential impacts of Indonesian diaspora could play in Indonesian development.

SummaryIndonesia's infant mortality rates are among the highest in South-East Asia, and there are substantial variations between its sub-national regions. This qualitative study aims to explore early mortality-related health service provision and gender inequity issues based on mothers' pregnancy, delivery and early-age survival experience in Ende district, Nusa Tenggara Timur province. Thirty-two mothers aged 18–45 years with at least one birth in the previous five years were interviewed in depth in May 2013. The results show most mothers have little knowledge about the danger signs for a child's illness. Mothers with early-age deaths generally did not know the cause of death. Very few mothers had received adequate information on maternal and child health during their antenatal and postnatal visits to the health facility. Some mothers expressed a preference for using a traditional birth attendant, because of their ready availability and the more extensive range of support services they provide, compared with local midwives. Unprofessional attitudes displayed by midwives were reported by several mothers. As elsewhere in Indonesia, the power of health decision-making lies with the husband. Policies aimed at elevating mothers' roles in health care decision-making are discussed as measures that would help to improve early-age survival outcomes. Widening the public health insurance distribution, especially among poorer mothers, and equalizing the geographical distribution of midwives and health facilities are recommended to tackle geographical inequities and to increase early-age survival in Ende district.

Building on recent work for the 2009 UN Human Development Report, this chapter aims to explore one of the measures identified in a recent review by Bell et al. (Journal of the Royal Statistical Society A 165(3):435–464, 2002), as originally proposed by Courgeau (Population 28:511–537, 1973a). The particular appeal of Courgeau’s ‘k’ statistic is that it purports to provide a single summary index of migration intensity which transcends the differences in zonal systems that commonly confound cross-national comparisons. Courgeau’s k is applied to examine differences in mobility between 27 countries, using census data drawn primarily from the Integrated Public Use Microdata Series (IPUMS) database maintained by the University of Minnesota. Our goals of the chapter are threefold: first, to establish the strengths and limitations of Courgeau’s k as a summary measure of internal migration; second, to identify the extent of international differences in mobility; and third, to determine the general trajectory of internal migration over time.

Internal migration is the most significant process driving changes in the pattern of human settlement across much of the world, yet remarkably few attempts have been made to compare internal migration between countries. Differences in data collection, in geography and in measurement intervals seriously hinder rigorous cross-national comparisons. We supplement data from the University of Minnesota IPUMS collection to make comparisons between 28 countries using both five year and lifetime measures of migration, and focusing particularly on migration intensity and spatial impacts. We demonstrate that Courgeau's k (Courgeau 1973) provides a powerful mechanism to transcend differences in statistical geography. Our results reveal widespread differences in the intensity of migration, and in the ages at which it occurs, with Asia generally displaying low mobility and sharp, early peaks, whereas Latin America and the Developed Countries show higher mobility and flatter age profiles usually peaking at older ages. High mobility is commonly offset by corresponding counter-flows but redistribution through internal migration is substantial in some countries, especially when computed as a lifetime measure. Time series comparisons show five year migration intensities falling in most countries (China being a notable exception), although lifetime data show more widespread rises due to age structure effects. Globally, we estimate that 740 million people, one in eight, were living within their home country but outside their region of birth, substantially above the commonly cited figure of 200 million international migrants.