Journal Of Midwifery & Women's Health[JOURNAL]
Sun
103 papers
Continuum of maternal healthcare services utilization and its associated factors in Ethiopia: A systematic review and meta-analysis.
Addisu D, Mekie M, Melkie A … +6 more , Abie H, Dagnew E, Bezie M, Degu A, Biru S, Chanie ES
Womens Health (Lond) · 2022 · PMID 35412408 · Full text
The continuum of care throughout pregnancy, childbirth, and postnatal period is one of the vital strategies for improving maternal and neonatal health and preventing maternal and neonatal mortalities and morbidities. The...
The continuum of care throughout pregnancy, childbirth, and postnatal period is one of the vital strategies for improving maternal and neonatal health and preventing maternal and neonatal mortalities and morbidities. The level and determinants of the complete continuum of care for maternal health services reported by different studies were extremely varied in Ethiopia. Therefore, this meta-analysis aimed to estimate the overall prevalence of a complete continuum of maternal health care services utilization and its associated factors in Ethiopia. Databases such as PubMed/MEDLINE, Science Direct, DOJA, African journals online, Cochrane library, Google scholar, web of science, and Ethiopian universities' institutional repository were used to search for relevant studies. A total of seven studies with 4854 study participants were involved in this study. Data were extracted by two reviewers and exported to STATA Version 11 for analysis. The statistics and Egger's test were used to assess heterogeneity and publication bias, respectively. The random-effects random effects model was used to estimate the level of complete continuum of care for maternal health services. The pooled prevalence of complete continuum of maternal healthcare services utilization was 25.51%. Employed mothers (OR = 3.16, 95%CI = 1.82, 5.47), first antenatal ante natal care visit before 16 weeks (OR = 7.53, 95% CI = 2.94, 19.29), birth preparedness and complication readiness plan (OR = 1.95, 95% CI = 1.12, 3.41), secondary and above educational status (OR = 2.97, 95% CI = 2.00, 4.41), planned pregnancy (OR = 6.86, 95% CI = 3.47, 13.58) and autonomy (OR = 3.73, 95% CI = 2.24-6.23) were significantly associated with continuum of maternal healthcare services utilization. In conclusion, the national level of complete continuum of maternal healthcare service utilization was low in Ethiopia. Being employed mothers, first ante natal care visit before 16 weeks, birth preparedness and complication readiness plan, secondary and above educational status, autonomy, and planned pregnancy were the major determinants of continuum of maternal healthcare services utilization.
Re-thinking lactation-related nipple pain and damage.
Douglas P
Womens Health (Lond) · 2022 · PMID 35343816 · Full text
Nipple pain is a common reason for premature cessation of breastfeeding. Despite the benefits of breastfeeding for both infant and mother, clinical support for problems such as maternal nipple pain remains a research fro...
Nipple pain is a common reason for premature cessation of breastfeeding. Despite the benefits of breastfeeding for both infant and mother, clinical support for problems such as maternal nipple pain remains a research frontier. Maternal pharmaceutical treatments, and infant surgery and bodywork interventions are commonly recommended for lactation-related nipple pain without evidence of benefit. The pain is frequently attributed to mammary dysbiosis, candidiasis, or infant anatomic anomaly (including to diagnoses of posterior or upper lip-tie, high palate, retrognathia, or subtle cranial nerve abnormalities). Although clinical protocols universally state that improved fit and hold is the mainstay of treatment of nipple pain and wounds, the biomechanical parameters of pain-free fit and hold remain an omitted variable bias in almost all clinical breastfeeding research. This article reviews the research literature concerning aetiology, classification, prevention, and management of lactation-related nipple-areolar complex (NAC) pain and damage. Evolutionary and complex systems perspectives are applied to develop a narrative synthesis of the heterogeneous and interdisciplinary evidence elucidating nipple pain in breastfeeding women. Lactation-related nipple pain is most commonly a symptom of inflammation due to repetitive application of excessive mechanical stretching and deformational forces to nipple epidermis, dermis and stroma during milk removal. Keratinocytes lock together when mechanical forces exceed desmosome yield points, but if mechanical loads continue to increase, desmosomes may rupture, resulting in inflammation and epithelial fracture. Mechanical stretching and deformation forces may cause stromal micro-haemorrhage and inflammation. Although the environment of the skin of the nipple-areolar complex is uniquely conducive to wound healing, it is also uniquely exposed to environmental risks. The two key factors that both prevent and treat nipple pain and inflammation are, first, elimination of conflicting vectors of force during suckling or mechanical milk removal, and second, elimination of overhydration of the epithelium which risks moisture-associated skin damage. There is urgent need for evaluation of evidence-based interventions for the elimination of conflicting intra-oral vectors of force during suckling.
Re-thinking benign inflammation of the lactating breast: A mechanobiological model.
Douglas P
Womens Health (Lond) · 2022 · PMID 35156466 · Full text
Despite the known benefits of breastfeeding for both infant and mother, clinical support for problems such as inflammation of the lactating breast remains a research frontier. Breast pain associated with inflammation is...
Despite the known benefits of breastfeeding for both infant and mother, clinical support for problems such as inflammation of the lactating breast remains a research frontier. Breast pain associated with inflammation is a common reason for premature weaning. Multiple diagnoses are used for inflammatory conditions of the lactating breast, such as engorgement, blocked ducts, phlegmon, mammary candidiasis, subacute mastitis, mastitis and white spots, which lack agreed or evidence-based aetiology, definitions and treatment. This is the first in a series of three articles which review the research literature concerning benign lactation-related breast inflammation. This article investigates aetiological models. A complex systems perspective is applied to analyse heterogeneous and interdisciplinary evidence elucidating the functional anatomy and physiology of the lactating breast; the mammary immune system, including the human milk microbiome and cellular composition; the effects of mechanical forces during lactation; and the interactions between these. This analysis gives rise to a mechanobiological model of breast inflammation, in which very high intra-alveolar and intra-ductal pressures are hypothesized to strain or rupture the tight junctions between lactocytes and ductal epithelial cells, triggering inflammatory cascades and capillary dilation. Resultant elevation of stromal tension exerts pressure on lactiferous ducts, worsening intraluminal backpressure. Rising leucocyte and epithelial cell counts in the milk and alterations in the milk microbiome are signs that the mammary immune system is recruiting mechanisms to downregulate inflammatory feedback loops. From a complex systems perspective, the key mechanism for the prevention or treatment of breast inflammation is avoidance of excessively high intra-alveolar and intra-ductal pressures, which prevents a critical mass of mechanical strain and rupture of the tight junctions between lactocytes and ductal epithelial cells.
High parity is associated with increased risk of cervical cancer: Systematic review and meta-analysis of case-control studies.
Tekalegn Y, Sahiledengle B, Woldeyohannes D … +7 more , Atlaw D, Degno S, Desta F, Bekele K, Aseffa T, Gezahegn H, Kene C
Womens Health (Lond) · 2022 · PMID 35114865 · Full text
BACKGROUND: Cervical cancer is the fourth most common cancer among women. High parity has long been suspected with an increased risk of cervical cancer. Evidence from the existing epidemiological studies regarding the as...
BACKGROUND: Cervical cancer is the fourth most common cancer among women. High parity has long been suspected with an increased risk of cervical cancer. Evidence from the existing epidemiological studies regarding the association between parity and cervical cancer is variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to synthesize the best available evidence on the epidemiological association between parity and cervical cancer. METHODS: Case-control studies reporting the association between parity and cervical cancer were systematically searched in databases like MEDLINE/PubMed, HINARI, Google scholar, Science direct, and Cochrane Libraries. All studies fulfilling the inclusion criteria and published between 2000 and 7 March 2020 were included in this meta-analysis. This study reported according to PRISMA guideline. Cochran's -statistics and tests were performed to assess heterogeneity among included studies. Egger's regression analysis was performed to assess publication bias. A random-effect meta-analysis model was used to compute pooled odds ratio of the association between parity and cervical cancer. RESULTS: A total of 6685 participants (3227 patients and 3458 controls) were incorporated in the 12 studies included in this meta-analysis. The meta-analysis revealed that women with high parity had 2.65 times higher odds of developing cervical cancer compared to their counterparts (odds ratio = 2.65, 95% confidence interval = 2.08-3.38). CONCLUSION: High parity is positively associated with cervical cancer. Strong epidemiological studies are recommended to further explore the mechanisms and role of parity in the causation of cervical cancer.
Quality of antenatal care and associated factors among pregnant women in East Africa using Demographic and Health Surveys: A multilevel analysis.
Raru TB, Mamo Ayana G, Bahiru N … +7 more , Deressa A, Alemu A, Birhanu A, Yuya M, Taye Merga B, Negash B, Letta S
Womens Health (Lond) · 2022 · PMID 35114855 · Full text
INTRODUCTION: Antenatal care offers a forum for critical healthcare functions, including health education, screening, and disease prevention. Several pocket studies carried out in specific localities of East African coun...
INTRODUCTION: Antenatal care offers a forum for critical healthcare functions, including health education, screening, and disease prevention. Several pocket studies carried out in specific localities of East African countries were investigated. However, these were neither representative of the country nor specific to the recommended minimum of four antenatal care visits. Therefore, this study aimed to identify factors associated with quality of antenatal care among pregnant women in East Africa. METHODS: A secondary data analysis was done using Demographic and Health Survey data of six East African Countries from 2008 to 2018. A total of 46,656 women who gave birth in the 5 years preceding the survey were included in this study. A multilevel mixed-effect logistic regression model was fitted. Variables with a p-value < 0.05 were declared as significant factors associated with the quality of antenatal care. RESULTS: The magnitude of quality of antenatal care in East Africa was 11.16% (95% confidence interval: 10.87-11.45). Women of age 35-49 (adjusted odds ratio = 1.51; 95% confidence interval: 1.25-1.80), primary education (adjusted odds ratio = 1.35; 95% confidence interval: 1.18-1.55), richest wealth index (adjusted odds ratio = 2.35; 95% confidence interval: 2.02-2.74), and rural resident (adjusted odds ratio = 0.62; 95% confidence interval: 0.55-0.69) were among factors significantly associated with quality of antenatal care. CONCLUSION: The magnitude of antenatal care quality was low in East Africa. Age, level of education, wealth index, birth order, husband/partners' level of education, residence, and living countries were among the factors associated with the quality of antenatal care. It would be useful to increase financial support strategies that enable mothers from poor households to use health services and enhance women's understanding of the significance of antenatal care utilization through health education targeting both women and partners with no education is very crucial.
Intimate partner violence and COVID-19 among reproductive age women: A community-based cross-sectional survey, Ethiopia.
Shewangzaw Engda A, Dargie Wubetu A, Kasahun Amogne F … +1 more , Moltot Kitaw T
Womens Health (Lond) · 2022 · PMID 35098815 · Full text
INTRODUCTION: Intimate partner violence is one of the most common psychological, physical, and sexual assaults toward women which suit the entire life of women, and nowadays, the magnitude accelerates due to coronavirus...
INTRODUCTION: Intimate partner violence is one of the most common psychological, physical, and sexual assaults toward women which suit the entire life of women, and nowadays, the magnitude accelerates due to coronavirus pandemic. Hence, this study was aimed to examine the prevalence of intimate partner violence and predictors during coronavirus among childbearing-age residents in Debre Berhan. METHODS: A community-based cross-sectional survey was employed from 1 May to 1 July 2020. Eight items of women abuse screening tool were used to estimate intimate partner violence. Trained data collectors directly interview randomly selected participants. The data were entered using Epi-info V. 7 and analyzed using SPSS V. 23. Descriptive statistics were used to determine the prevalence of intimate partner violence and the frequency distribution of other variables. During bivariate analysis, predictor variables with a -value less than 0.25 were nominated to further analysis. An adjusted odds ratio with a 95% confidence interval was used and a -value less than 0.05 was considered statistically significant. RESULT: A total of 700 participants were included with a response rate of 95.1%. The prevalence of intimate partner violence in the past single year was 19% with 95% confidence interval = 16.1-21.9. Besides, the prevalence of emotional (19.9%, 95% confidence interval = 16.9-22.8), sexual (10.9%, 95% confidence interval = 8.6-13.2) and physical (9.4%, 95% confidence interval = 7.3-11.6) violence was reported. Women with depressive symptoms, overweight, suicidal ideation, and body image disturbance were significantly associated with intimate partner violence, but not educational status, employment, income, stressful life events, lifetime alcohol use, suicidal attempt, and abortion. CONCLUSION AND RECOMMENDATION: Nearly one out of five interviewed participants had intimate partner violence. Being overweight, having poor body image, and having depression increase intimate partner violence. Special preventive measures and treatment, and other legal services should be taken to alleviate the predictor variables and intimate partner violence.
Knowledge about vertical transmission of HIV and associated factors among women living with HIV or AIDS attending antiretroviral therapy clinic, Western Ethiopia.
Balis B, Assefa N, Egata G … +5 more , Bekele H, Getachew T, Ayana GM, Raru TB, Taye Merga B
Womens Health (Lond) · 2022 · PMID 35001747 · Full text
BACKGROUND: The United Nations Program on HIV or AIDS has committed to eliminating the vertical transmission of human immunodeficiency virus. However, significant number of newborn and children are acquiring HIV every ye...
BACKGROUND: The United Nations Program on HIV or AIDS has committed to eliminating the vertical transmission of human immunodeficiency virus. However, significant number of newborn and children are acquiring HIV every year. Therefore, the aim of this study was to assess knowledge of mother on vertical transmission of HIV and associated factors among non-pregnant women receiving antiretroviral therapy in the West Wollega, Western Ethiopia. METHODS: A facility-based cross-sectional study design was used on a sample of 422 non-pregnant women attending antiretroviral therapy clinic in West Wollega from 26 February to 26 March 2019. Systematic sampling was used to select the study participants. Pretested and structured interviewer-administered questionnaires and telephone interview were used to collect the data. Multivariable logistic regression model was used to identify factors associated with the knowledge of mother on vertical transmission of HIV. Odds ratio along with 95% confidence interval were estimated to measure the strength of the association. Level of statistical significance was declared at p-value less than 0.05. RESULT: Out of total participants, 94.1% (95% confidence interval: (91.7%, 96.2%)) of them were knowledgeable about vertical transmission of HIV. Urban resident (adjusted odds ratio: 2.36, 95% confidence interval: (1.27, 4.39)), primary school (adjusted odds ratio: 2.94, 95% confidence interval: (1.11, 7.83)), secondary school (adjusted odds ratio: 3.39, 95% confidence interval: (1.53, 7.55)), being on antiretroviral therapy for greater than 2 years (adjusted odds ratio: 2.67, 95% confidence interval: 1.02, 6.99)), and having child living with HIV (adjusted odds ratio: 1.54, 95% confidence interval: (1.07, 3 .83)) were significantly associated with the knowledge of mother on vertical transmission of HIV. CONCLUSION: The study indicated that 5.9% of the women lack knowledge about vertical transmission of HIV. This knowledge associated with sociodemographic factors, such as residence, educational status, experiences of having child living with HIV, and being on antiretroviral therapy for greater than 2 years. Thus, interventions toward the elimination of new newborn HIV infections should consider these factors.
Multilevel analysis of factors associated with HIV among women of reproductive age (15-49 years old) in Ethiopia: Bayesian approach.
Negesse Y, Mankelkl G, Setegn M … +1 more , Fetene G
Womens Health (Lond) · 2021 · PMID 34937460 · Full text
BACKGROUND: Human immunodeficiency virus remains the leading cause of morbidity and mortality throughout the world. Sub-Saharan Africa regions are the most affected regions and accounted for 67% of HIV infections worldwi...
BACKGROUND: Human immunodeficiency virus remains the leading cause of morbidity and mortality throughout the world. Sub-Saharan Africa regions are the most affected regions and accounted for 67% of HIV infections worldwide, and 72% of the world's AIDS-related deaths. OBJECTIVE: To estimate the prevalence of HIV and identify factors associated with it among women of reproductive age in Ethiopia. METHODS: This study was conducted based on the 2016 Ethiopian Demographic and Health Surveys data. The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then, a total of 14,161 weighted sample women were used to investigate the study. Finally, a multilevel analysis was done based on the Bayesian approach to identify factors associated with HIV among women of reproductive age in Ethiopia. RESULTS: This study showed the prevalence of HIV among reproductive age group women was 0.85%. Being rural resident (adjusted odds ratio = 0.20; 95% CrI = 0.1-0.4), secondary education level (adjusted odds ratio = 0.20; 95% CrI = 0.1-0.4), rich wealth status (adjusted odds ratio = 4; 95% CrI = 3-6), married women but living separately (adjusted odds ratio = 2.3; 95% CrI = 1.2-4.5), long distance from the health facility (adjusted odds ratio = 0.4; 95% CrI = 0.3-0.5), and exposure to media (adjusted odds ratio = 2.9; 95% CrI = 1.8-4.7) were significantly associated with HIV. CONCLUSION: Being rural residents, women whose marital status is separated, wealthy, travel a long distance to get health facility, and are exposed to media are risky to be infected by HIV. Whereas being a rural resident and educated are preventive factors for HIV. Therefore, the government of Ethiopia and the ministry of health should consider those factors when they design HIV prevention and control strategies.
Impact of cervical cancer on the sexual and physical health of women diagnosed with cervical cancer in Ghana: A qualitative phenomenological study.
Osei Appiah E, Amertil NP, Oti-Boadi Ezekiel E … +2 more , Lavoe H, Siedu DJ
Womens Health (Lond) · 2021 · PMID 34937442 · Full text
INTRODUCTION: Although cervical cancer is preventable, it is a major gynecological disorder among women currently. More than 500,000 new cases of cervical cancer are being diagnosed across the globe, with one woman dying...
INTRODUCTION: Although cervical cancer is preventable, it is a major gynecological disorder among women currently. More than 500,000 new cases of cervical cancer are being diagnosed across the globe, with one woman dying of cervical cancer every 2 min. In addition, about half of cervical cancer survivors have challenges with their sexual function. Despite these findings, literature regarding the sexual function of women with cervical cancer is scanty. The study aims to assess cervical cancer's impact on the sexual and physical health of women diagnosed with cervical cancer in Ghana. METHODS: The researchers of this study employed a qualitative approach with phenomenological design. A purposive sampling technique was used to select 30 participants engaged in face-to-face in-depth interviews that were audio-recorded. The content of the transcripts was analyzed using content analysis. RESULTS: This study revealed that cervical cancer patients experienced low libido due to the cervical cancer symptoms and the side effects of chemotherapy. This low libido made them divert their sexual gratification from the vagina to other centers of the body. Findings further revealed that some participants showed apathy toward their partners' sexual feelings. Some physical problems experienced by the participants were also unraveled. CONCLUSION: Cervical cancer affects all aspects of a woman's health, including sexual function and physical well-being. Therefore, there is the need for more to help address challenges faced by cervical cancer women about their sexual and physical health.
Indonesian antenatal nutrition education: A qualitative study of healthcare professional views.
Rahmawati W, van der Pligt P, Worsley A … +1 more , Willcox JC
Womens Health (Lond) · 2021 · PMID 34892998 · Full text
BACKGROUND: Early lifestyle intervention, including antenatal nutrition education, is required to reduce the triple burden of malnutrition. Understanding healthcare professionals' views and experiences is essential for i...
BACKGROUND: Early lifestyle intervention, including antenatal nutrition education, is required to reduce the triple burden of malnutrition. Understanding healthcare professionals' views and experiences is essential for improving future nutrition education programmes for Indonesian pregnant women. This study aimed to investigate the views of Indonesian antenatal healthcare professionals regarding nutrition education for pregnant women and the improvements required to provide more effective antenatal nutrition education. METHODS: A descriptive qualitative study involved semi-structured interviews was conducted with 24 healthcare professionals, including nutritionists ( = 10), midwives ( = 9) and obstetricians ( = 5) in Malang, Indonesia, between December 2018 and January 2019. Data were analysed using thematic analysis. RESULTS: The study identified four main themes. First, healthcare professionals were aware of the importance of providing antenatal nutrition education, which included supporting its targeted delivery. Second, there were differing views on who should provide nutrition education. Most midwives and obstetricians viewed nutritionists as the prime nutrition education provider. Nutritionists were confident in their capability to provide nutrition education. However, some nutritionists reported that only a few women visited primary health centres and received nutrition counselling via this pathway. Third, healthcare professionals revealed some barriers in providing education for women. These barriers included a limited number of nutritionists, lack of consistent guidelines, lack of healthcare professionals' nutrition knowledge and lack of time during antenatal care services. Fourth, participants expressed the need to strengthen some system elements, including reinforcing collaboration, developing guidelines, and enhancing capacity building to improve future antenatal nutrition education. CONCLUSIONS: Healthcare professionals play a central role in the provision of antenatal nutrition education. This study highlighted the importance of educational models that incorporate various antenatal nutrition education delivery strategies. These methods include maximizing referral systems and optimizing education through multiple delivery methods, from digital modes to traditional face-to-face nutrition education in pregnancy classes and community-based health services.
Predictors of success of trial of labor after cesarean section: A nested case-control study at public hospitals in Eastern Ethiopia.
Tefera M, Assefa N, Teji Roba K … +1 more , Gedefa L
Womens Health (Lond) · 2021 · PMID 34856839 · Full text
BACKGROUND: One of the primary reasons for an increase in cesarean sections is obstetricians' uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean s...
BACKGROUND: One of the primary reasons for an increase in cesarean sections is obstetricians' uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. METHODS: A nested case-control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. RESULTS: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. CONCLUSION: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.
Determinants of maternal near-miss in private hospitals in eastern Ethiopia: A nested case-control study.
Geze Tenaw S, Girma Fage S, Assefa N … +1 more , Kenay Tura A
Womens Health (Lond) · 2021 · PMID 34844476 · Full text
OBJECTIVE: Maternal near-miss refers to a woman who nearly died but survived complications in pregnancy, childbirth, or within 42 days of termination of pregnancy. The study of maternal near-miss has become essential for...
OBJECTIVE: Maternal near-miss refers to a woman who nearly died but survived complications in pregnancy, childbirth, or within 42 days of termination of pregnancy. The study of maternal near-miss has become essential for improving the quality of obstetric care. The objective of this study was to identify the determinants of maternal near-miss among women admitted to major private hospitals in eastern Ethiopia. METHOD: An unmatched nested case-control study was conducted in major private hospitals in eastern Ethiopia from 5 March to 31 March 2020. Cases were women who fulfilled the sub-Saharan African maternal near-miss criteria and those admitted to the same hospitals but discharged without any complications under the sub-Saharan African maternal near-miss tool were controls. For each case, three corresponding women were randomly selected as controls. Factors associated with maternal near-misses were analyzed using binary and multiple logistic regressions with an adjusted odds ratio along with a 95% confidence interval. Finally, p-value < 0.05 was considered as a cut-off point for the significant association. RESULTS: A total of 432 women (108 cases and 324 controls) participated in the study. History of prior cesarean section (AOR = 4.33; 95% CI = 2.36-7.94), anemia in index pregnancy (AOR = 4.38; 95% CI = 2.43-7.91), being ⩾ 35 years of age (AOR = 2.94; 95% CI = 1.37-6.24), not attending antenatal care (AOR = 3.11; 95% CI = 1.43-6.78), and history of chronic medical disorders (AOR = 2.18; 95% CI = 1.03-4.59) were independently associated with maternal near-miss. CONCLUSION: Maternal age ⩾ 35 years, had no antenatal care, had prior cesarean section, being anemic in index pregnancy, and have history of chronic medical disorders were the determinants of maternal near-miss. Improving maternal near-misses requires strengthening antenatal care (including supplementation of iron and folic acid to reduce anemia) and prioritizing women with a history of chronic medical illnesses. Interventions for preventing primary cesarean sections are crucial in this era of the cesarean epidemic to minimize its effect on maternal near-miss.
Factors associated with maternal near-miss at public hospitals of South-East Ethiopia: An institutional-based cross-sectional study.
Mekonnen A, Fikadu G, Seyoum K … +3 more , Ganfure G, Degno S, Lencha B
Womens Health (Lond) · 2021 · PMID 34798796 · Full text
INTRODUCTION: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of mat...
INTRODUCTION: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia. METHODS: Facility-based cross-sectional study design was carried out from 1 October 2018 to 28 February 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 were used to examine the association between the independent and dependent variables. RESULT: The prevalence of maternal near-miss in our study area was 28.7%. Age < 20 years, age at first marriage < 20 years, husbands with primary education, and being from rural areas are factors significantly associated with the prevalence of maternal near-miss. The zonal health department in collaboration with the education department and justice office has to mitigate early marriage by educating the community about the impacts of early marriage on health.
Immigrant Southeast and East Asian mothers' transnational postpartum cultural practices: A meta-ethnography.
Vo T, Desai M
Womens Health (Lond) · 2021 · PMID 34798791 · Full text
OBJECTIVE: Southeast and East Asian mothers experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of postpartum cultural prac...
OBJECTIVE: Southeast and East Asian mothers experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of postpartum cultural practices in nursing and midwifery research. The purpose of this meta-ethnography is to synthesize qualitative findings from studies that examined postpartum cultural practices of Southeast and East Asian mothers globally to ensure better maternal health outcomes. METHODS: Noblit and Hare's seven-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using Krippendorff's content analysis. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS: The collaborative search process in the following databases, PsycINFO, CINAHL, and Scopus, resulted in eight high quality research studies published between January 2017 and February 2020. Five studies discussed postpartum traditions of immigrant mothers ( = 67) living in North America ( = 67), while three studies explored that of mothers living in Southeast and East Asian. Mothers ( = 132) from China, Hong Kong, Taiwan, Korea, Vietnam, and Hmong participated. FINDINGS: Three themes emerged: (1) importance of maintaining postpartum cultural practices; (2) barriers of "doing-the-month"; and (3) modification: practicality over tradition. Although participants recognized value in postpartum traditions, the lack of social support deterred more immigrant than non-immigrant Southeast and East Asian mothers from "doing-the-month." Due to the influence of western medicine, clinicians' postpartum care suggestions, and use of modern technology (e.g., Internet), Southeast and East Asian mothers had informed choices to adapt, modify, or "break with tradition." CONCLUSION: Similarities and differences existed in how each Southeast and East Asian mother accepted and engaged with postpartum cultural practices, a process which aligned with one's definition of health. Maternity care providers should further elicit Southeast and East Asian mothers' needs based on individualized assessments beginning in prenatal care with emphasis on social support for mothers who have recently immigrated and given birth in their adopted countries.
Knowledge of preconception care and associated factors among maternal health care providers working in urban public health institutions of Eastern Ethiopia.
Sori SA, Teji Roba K, Yadeta TA … +4 more , Jiru HD, Metebo KN, Weldekidan HA, Regassa LD
Womens Health (Lond) · 2021 · PMID 34553661 · Full text
BACKGROUND: Provision of preconception care is significantly affected by the health care provider's knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health...
BACKGROUND: Provision of preconception care is significantly affected by the health care provider's knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. METHODS: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. RESULTS: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4-65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85-12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52-4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25-4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40-6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37-6.15) were significantly associated with good knowledge of preconception care. CONCLUSIONS AND RECOMMENDATIONS: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.
Overdiagnosis and overtreatment of nipple and breast candidiasis: A review of the relationship between diagnoses of mammary candidiasis and in breastfeeding women.
Douglas P
Womens Health (Lond) · 2021 · PMID 34269140 · Full text
BACKGROUND: Breastfeeding mothers commonly experience nipple pain accompanied by radiating, stabbing or constant breast pain between feeds, sometimes associated with pink shiny nipple epithelium and white flakes of skin....
BACKGROUND: Breastfeeding mothers commonly experience nipple pain accompanied by radiating, stabbing or constant breast pain between feeds, sometimes associated with pink shiny nipple epithelium and white flakes of skin. Current guidelines diagnose these signs and symptoms as mammary candidiasis and stipulate antifungal medications. AIM: This study reviews existing research into the relationship between and nipple and breast pain in breastfeeding women who have been diagnosed with mammary candidiasis; whether fluconazole is an effective treatment; and the presence of in the human milk microbiome. METHOD: The author conducted three searches to investigate (a) breastfeeding-related pain and ; (b) the efficacy of fluconazole in breastfeeding-related pain; and (c) composition of the human milk mycobiome. These findings are critiqued and integrated in a narrative review. RESULTS: There is little evidence to support the hypothesis that spp, including , in maternal milk or on the nipple-areolar complex causes the signs and symptoms popularly diagnosed as mammary candidiasis. There is no evidence that antifungal treatments are any more effective than the passage of time in women with these symptoms. spp including are commonly identified in healthy human milk and nipple-areolar complex mycobiomes. DISCUSSION: Clinical breastfeeding support remains a research frontier. The human milk microbiome, which includes a mycobiome, interacts with the microbiomes of the infant mouth and nipple-areolar complex, including their mycobiomes, to form protective ecosystems. Topical or oral antifungals may disrupt immunoprotective microbial homeostasis. Unnecessary use contributes to the serious global problem of antifungal resistance. CONCLUSION: Antifungal treatment is rarely indicated and prolonged courses cannot be justified in breastfeeding women experiencing breast and nipple pain. Multiple strategies for stabilizing microbiome feedback loops when nipple and breast pain emerge are required, in order to avoid overtreatment of breastfeeding mothers and their infants with antifungal medications.
Reasons for the utilization of the services of traditional birth attendants during childbirth: A qualitative study in Northern Ghana.
Tabong PT, Kyilleh JM, Amoah WW
Womens Health (Lond) · 2021 · PMID 33730960 · Full text
BACKGROUND: Skilled delivery reduces maternal and neonatal mortality. Ghana has put in place measures to reduce geographical and financial access to skilled delivery. Despite this, about 30% of deliveries still occur eit...
BACKGROUND: Skilled delivery reduces maternal and neonatal mortality. Ghana has put in place measures to reduce geographical and financial access to skilled delivery. Despite this, about 30% of deliveries still occur either at home or are conducted by traditional birth attendants. We, therefore, conducted this study to explore the reasons for the utilization of the services of traditional birth attendants despite the availability of health facilities. METHOD: Using a phenomenology study design, we selected 31 women who delivered at facilities of four traditional birth attendants in the Northern region of Ghana. Purposive sampling was used to recruit only women who were resident at a place with a health facility for an in-depth interview. The interviews were recorded and transcribed into Microsoft word document. The transcripts were imported into NVivo 12 for thematic analyses. RESULTS: The study found that quality of care was the main driver for traditional birth attendant delivery services. Poor attitude of midwives, maltreatment, and fear of caesarean section were barriers to skilled delivery. Community norms dictate that womanhood is linked to vaginal delivery and women who deliver through caesarean section do not receive the same level of respect. Traditional birth attendants were believed to be more experienced and understand the psychosocial needs of women during childbirth, unlike younger midwives. Furthermore, the inability of women to procure all items required for delivery at biomedical facilities emerged as push factors for traditional birth attendant delivery services. Preference for squatting position during childbirth and social support provided to mothers by traditional birth attendants are also an essential consideration for the use of their services. CONCLUSION: The study concludes that health managers should go beyond reducing financial and geographical access to improving quality of care and the birth experience of women. These are necessary to complement the efforts at increasing the availability of health facilities and free delivery services.
Prevalence of hypertensive disorders of pregnancy and pregnancy outcomes in Sub-Saharan Africa: A systematic review and meta-analysis.
Gemechu KS, Assefa N, Mengistie B
Womens Health (Lond) · 2020 · PMID 33334273 · Full text
Hypertensive disorders of pregnancy are one of the leading causes of poor pregnancy outcomes and are associated with increased rates of maternal mortality, preterm birth, small for gestational age newborns, stillbirth, a...
Hypertensive disorders of pregnancy are one of the leading causes of poor pregnancy outcomes and are associated with increased rates of maternal mortality, preterm birth, small for gestational age newborns, stillbirth, and neonatal death. The overall and type-specific prevalence of hypertensive disorders of pregnancy and associated pregnancy outcomes are unknown in Sub-Saharan Africa. Therefore, this review aimed to identify the prevalence of hypertensive disorders of pregnancy and associated pregnancy outcomes in Sub-Saharan Africa. A systematic review and meta-analysis were conducted on observational facility-based studies irrespective of publication status, sample size, language, and follow-up duration from 19 countries between the years 2000 and 2018 in Sub-Saharan Africa. A review of studies using PubMed, EMBASE, African Index Medicus, and African Journals Online was completed with independent extraction of studies by review authors using the predefined inclusion criteria. Quality and risk of bias of individual studies were assessed using the Joanna Briggs Institute Checklist. Random effects model was used to estimate the pooled prevalence of hypertensive disorders of pregnancy and type-specific hypertensive disorders of pregnancy. A pooled adjusted odds ratio with 95% confidence interval for each study was calculated using comprehensive meta-analysis version 2 software to estimate the association of hypertensive disorders of pregnancy and its outcomes. The existence of heterogeneity was assessed using I and its corresponding P value. We assessed the presence of publication bias using the Egger's test. Subgroup analysis was performed to assess the potential effect of variables, and a sensitivity analysis was conducted to assess any undue influence from studies. The analysis included 70 studies. The pooled prevalence of hypertensive disorders of pregnancy (all types combined), chronic hypertension, gestational hypertension, preeclampsia, and eclampsia were 8% (95% confidence interval = [5, 10]), 0.9% (95% confidence interval = [0.4, 1.8]), 4.1% (95% confidence interval = [2.4, 7]), 4.1% (95% confidence interval = [3.2, 5.1]), and 1.5% (95% confidence interval = [1, 2]), respectively. Compared with normotensive pregnant or postpartum women, women with hypertensive disorders of pregnancy were associated with increased risk of maternal mortality, odds ratio = 17 (95% confidence interval = [9.6, 28.8]); cesarean section, odds ratio = 3.1 (95% confidence interval = [1.7, 5.6]); perinatal mortality, odds ratio = 8.2 (95% confidence interval = [2.8, 24]); low birth weight, odds ratio = 3.2 (95% confidence interval = [2, 5]); and preterm delivery, odds ratio = 7.8 (95% confidence interval = [2.5, 25.3]) according to this analysis. The pooled prevalence of hypertensive disorders of pregnancy was high in Sub-Saharan Africa compared to those reported from other regions. Pregnant or postpartum women with hypertensive disorders of pregnancy have increased risk of maternal mortality, cesarean section, preterm delivery, perinatal mortality, and low birth weight newborn. Therefore, creating awareness of the risks of hypertensive disorders of pregnancy is essential. Pregnant women with hypertensive disorders need due attention to manage appropriately and more importantly to have favorable outcomes in this population.
Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia.
Adane D, Wassihun B
Womens Health (Lond) · 2020 · PMID 33315539 · Full text
BACKGROUND: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. OBJECTIVE: The aim of this study among...
BACKGROUND: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. OBJECTIVE: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. METHODS: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. RESULT: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11-3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23-1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77-3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47-1.69)) were some of the factors associated with client satisfaction. CONCLUSION: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.
Determinants of uterine rupture among mothers who gave birth in Jinka and Arba Minch General Hospitals, institution-based case-control study, Southern Ethiopia, Ethiopia, 2019.
Girmay G, Gultie T, Gebremichael G … +2 more , Afework B, Temesgen G
Womens Health (Lond) · 2020 · PMID 32985385 · Full text
BACKGROUND: Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even...
BACKGROUND: Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even though the Ethiopian government and nongovernmental organizations tried to strengthen the health care system, significant adverse maternal and fetal outcome is still associated with uterine rupture. The aim of this study was to identify determinants of uterine rupture in Jinka and Arba Minch General Hospitals. METHODS: The study was conducted in Jinka and Arba Minch General Hospitals, and the data collection period was 15 to 30 November 2018. A case-control study design was used with simple random sampling of 1:4. Data were collected using data extraction sheets. Variables with p < 0.25 in bivariate logistic regression were entered into multivariable logistic regression. Variables with p < 0.05 in multivariable logistic regression were used to determine significant association between dependent and independent variables. RESULT: Uterine rupture occurred in 112 cases with 448 controls. Women referred from health facilities (adjusted odds ratio = 8.0, 95% confidence interval: 3.5-17.8), multiparous women (adjusted odds ratio = 12.7, 95% confidence interval: 4.2-39.0), duration of labor more than 18 h (adjusted odds ratio = 11.5, 95% confidence interval: 5.5-24.1), malpresentation (adjusted odds ratio = 3.5, 95% confidence interval: 1.0-8.0) and gestational age of ⩾37 weeks (adjusted odds ratio = 5.2, 95% confidence interval: 1.4-19.3) were independent factors associated with uterine rupture. CONCLUSION: Mothers referred from health facilities, multiparous women, duration of labor more than 18 h, gestational age of ⩾37 weeks and malpresentation were significantly associated with uterine rupture. Early referral, encouraging family planning, proper use of partograph, early identification and appropriate intervention for malpresentation are recommended.
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