scholarly journals Progress towards the Ending Preventable Maternal Mortality (EPMM) target for Bangladesh: The role of female education

2020 ◽  
Author(s):  
Karar Zunaid Ahsan ◽  
Peter Kim Streatfield ◽  
Kanta Jamil ◽  
Shams El Arifeen
Keyword(s):  
Maternal Mortality ◽  
Health Sector ◽  
Mortality Data ◽  
Female Education ◽  
Maternal Deaths ◽  
Education Levels ◽  
Education Status ◽  
Nationally Representative ◽  
Mortality Survey

AbstractEducational attainment among women is a well-recognized predictor for maternal mortality. Data from nationally representative surveys and the United Nations are used in the analysis for estimating maternal mortality due to improved education status up to 2030. Analysis of data from 2001 and 2010 Bangladesh Maternal Mortality Survey shows that MMR varies considerably by education level. The study shows that during 2011–2030, 15% maternal deaths will be averted due to fertility change (i.e. fewer births) and 24% of the maternal deaths can be averted only by improving the female education levels. However, in order to achieve the Ending Preventable Maternal Mortality (EPMM) target of 59 maternal deaths per 100,000 live births by 2030 for Bangladesh, a further 64% reduction will be required. Factors outside the health sector, like female education, will continue to have an impact maternal mortality in Bangladesh. However, reaching the EPMM target for Bangladesh by 2030 will also require significant investments in maternal health programs, in particular those to increase access to and quality of services.

Situational versus chronic loneliness as risk factors for all-cause mortality

2009 ◽  
Vol 22 (3) ◽  
pp. 455-462 ◽  
Author(s):  
Sharon Shiovitz-Ezra ◽  
Liat Ayalon
Keyword(s):  
Mortality Data ◽  
International Studies ◽  
Differential Impact ◽  
Mortality Risks ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Definition Of ◽  
Retirement Study

ABSTRACTBackground: Several international studies have substantiated the role of loneliness as a risk factor for mortality. Although both theoretical and empirical research has supported the classification of loneliness as either situational or chronic, research to date has not evaluated whether this classification has a differential impact upon mortality.Methods: To establish the definition of situational vs. chronic loneliness, we used three waves of the Health and Retirement Study (HRS), a nationally representative sample of Americans over the age of 50 years. Baseline data for the present study were collected in the years 1996, 1998, and 2000. The present study concerns the 7,638 individuals who completed all three waves; their loneliness was classified as either not lonely, situational loneliness or chronic loneliness. Mortality data were available through to the year 2004.Results: Those identified as “situationally lonely” (HR = 1.56; 95% CI: 1.52–1.62) as well as those identified as “chronically lonely” (HR = 1.83; 95% CI: 1.71–1.87) had a greater risk for all cause mortality net of the effect of possible demographic and health confounders. Nonetheless, relative to those classified as “situationally lonely,” individuals classified as “chronically lonely” had a slightly greater mortality risk.Conclusions: The current study emphasizes the important role loneliness plays in older adults’ health. The study further supports current division into situational vs. chronic loneliness, yet suggests that both types serve as substantial mortality risks.

MATERNAL DEATHS FROM OBSTETRIC HAEMORRHAGE: THE ROLE OF INDICATORS LATE MATERNAL MORTALITY

2015 ◽  
Vol 0 (2) ◽  
pp. 139
Author(s):  
Olga Vasilievna Tutynina ◽  
Antonina Timofeevna Yegorova ◽  
Natalia Vladimirovna Zhirova
Keyword(s):  
Maternal Mortality ◽  
Maternal Deaths ◽  
Obstetric Haemorrhage

scholarly journals The Educational Gradient in Health in China

2017 ◽  
Vol 230 ◽  
pp. 289-322 ◽  
Author(s):  
Qiulin Chen ◽  
Karen Eggleston ◽  
Wei Zhang ◽  
Jiaying Zhao ◽  
Sen Zhou
Keyword(s):  
Health Interventions ◽  
Mortality Data ◽  
Economic Factors ◽  
Health Technologies ◽  
Policy Interventions ◽  
Low Education ◽  
Education Levels ◽  
Average Education ◽  
Nationally Representative ◽  
Educational Gradient

AbstractIt has been well established that better educated individuals enjoy better health and longevity. In theory, the educational gradients in health could be flattening if diminishing returns to improved average education levels and the influence of earlier population health interventions outweigh the gradient-steepening effects of new medical and health technologies. This paper documents how the gradients are evolving in China, a rapidly developing country, about which little is known on this topic. Based on recent mortality data and nationally representative health surveys, we find large and, in some cases, steepening educational gradients. We also find that the gradients vary by cohort, gender and region. Further, we find that the gradients can only partially be accounted for by economic factors. These patterns highlight the double disadvantage of those with low education, and suggest the importance of policy interventions that foster both aspects of human capital for them.

scholarly journals ZERO-INFLATED POISSON REGRESSION TO DETERMINE THE FACTORS THAT INFLUENCE THE MATERNAL MORTALITY RATE IN BANDUNG 2016

2018 ◽  
Vol 10 (2) ◽  
pp. 93
Author(s):  
Sri Rahayu ◽  
Nurul Gusriani ◽  
Iin Irianingsih
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Expectation Maximization Algorithm ◽  
Postpartum Care ◽  
Mortality Data ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Excess Zeros ◽  
Raphson Iteration ◽  
Tetanus Toxoid Immunization

In Indonesia, especially Bandung, there are still many cases of maternal deaths during pregnancy, birth, and postpartum which can increase the Maternal Mortality Rate (MMR). Cases of maternal deaths are mostly due to exsanguination, infection, anemia, and the other causes that related to pregnancy. To reduce the MMR of Bandung, we can analyze to determine the factors that influence the MMR in order to maximize the maternal health care programs so as to prevent the possibility of death. The analysis is using Zero-Inflated Poisson (ZIP) regression because maternal mortality data is the result of counting that allows overdispersion due to excess zeros. Regression parameter estimation use expectation maximization algorithm followed by the Newton-Raphson iteration method. The analysis result showed that of the five suspected factors to affect the MMR -such as the first tetanus toxoid immunization (TT1), the provision of 90 Fe tablets (Fe3), postpartum care, pregnancy complications, and the first antenatal care (K1)- only TT1 and postpartum care are significantly affect the MMR.

scholarly journals Improving the Metrics and Data Reporting for Maternal Mortality:A Challenge to Public Health Surveillance and Effective Prevention

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
James Studnicki ◽  
David Reardon ◽  
Donna Harrison ◽  
John Fisher ◽  
Ingrid Skop
Keyword(s):  
Maternal Mortality ◽  
Pregnancy Outcome ◽  
Live Birth ◽  
Pregnancy Outcomes ◽  
Maternal Mortality Ratio ◽  
Mortality Data ◽  
Evidence Based ◽  
Maternal Deaths ◽  
Effective Prevention ◽  
Mortality Ratio

AbstractBackgroundThe current measuring metric and reporting methods for assessing maternal mortality are seriously flawed. Evidence-based prevention strategies require consistently reported surveillance data and validated measurement metrics.Main BodyThe denominator of live births used in the maternal mortality ratio reinforces the mistaken notion that all maternal deaths are consequent to a live birth and, at the same time, inappropriately inflates the value of the ratio for subpopulations of women with the highest percentage of pregnancies ending in outcomes other than a live birth. Inadequate methods for identifying induced or spontaneous abortion complications assure that most maternal deaths associated with those pregnancy outcomes are unlikely to be attributed. Absent the ability to identify all maternal deaths, and without the ability to differentiate those deaths by specific pregnancy outcomes, existing variations in pregnancy outcome-specific maternal deaths are masked by the use of an aggregated (all outcome) numerator. Under these circumstances, clear and accurate data is not available to inform evidence-based preventive strategies. As the result, algorithms applied for analyzing maternal mortality data may return distorted results.ConclusionImprovement in the effectiveness of maternal mortality surveillance will require: mandatory certification of all fetal losses; linkage of death, birth and all fetal loss (induced and natural) certificates; modification of the structure of the overall maternal mortality ratio to enable pregnancy outcome-specific ratio calculations; development of the appropriate ICD codes which are specific to induced and spontaneous abortions; education for providers on identifying and reporting early pregnancy losses; and, flexible information systems and methods which integrate these capabilities and inform users. 

scholarly journals Peningkatan Pengetahuan Kader Posyandu dalam Penggunaan Buku KIA

2020 ◽  
Vol 1 (2) ◽  
pp. 56-63
Author(s):  
Eli Rahmawati ◽  
Ernani Setyawati ◽  
Novia Nurhasanah
Keyword(s):  
Health Service ◽  
Social Service ◽  
Health Sector ◽  
Education Level ◽  
University Graduates ◽  
Huge Number ◽  
Service Workers ◽  
Education Levels ◽  
Post Test

In an attempt to accelerate the decline of AKI and AKB, the health sector made a breakthrough using the Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K), midwifemedicaster relations, the utilization of MCH, and the practical revitalization of Pemantauan Wilayah Setempat Kesehatan Ibu Anak (PWS KIA). The role of health service workers in the practice of Integrated Service Posts are crucial. Alas, a huge number of health service workers have the lack of comprehension and skills in regards of doing their tasks. The purpose of social service is to identify the characteristics of the Integrated Health Service workers that take parts in social service (i.e. Age, Education Level, and  their tenure as health services workers). Efforts regarding the development of the service workers’ comprehension of KIA books, and the effectiveness of MCH books towards society, particularly health service workers. The methods used are lectures and discussions. the results gained from the participants are as follows: Ages in the range of 27-63 years, Tenures in the range of 2-32 years, and Education Levels in the range of Junior high-university graduates. The numerical mean for pretest is 48.57 and for post test is 64.89. An increased number of mean had been achieved by 16.33. This result concludes that education may develop the comprehension of health service workers in the utilization of MCH book.  

scholarly journals On Zero-Inflated Hierarchical Poisson Models with Application to Maternal Mortality Data

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Kassim Tawiah ◽  
Samuel Iddi ◽  
Anani Lotsi
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Health Planning ◽  
Health Sector ◽  
Generalized Linear Mixed Model ◽  
Mortality Data ◽  
Model Framework ◽  
The Government

Count outcomes are commonly encountered in health sector data. The occurrence of count outcomes that exhibit many zeros has necessitated the extension of the ubiquitous Poisson regression model to accommodate the zero inflation and overdispersion as a result of the extra dispersion. We explored different extensions of the Poisson model including mixed models within the generalized linear mixed model framework to account for the repeated measurement of outcomes. These models are applied to maternal mortality data from fifty-six health facilities in four regions of Ghana. The objective is to identify factors associated with maternal mortality. The best-fitting model, the zero-inflated Poisson generalized linear mixed model, revealed that maternal mortality in hospital facilities is influenced by the number of referrals (into and out) of the hospital facility, number of antenatal visits exceeding four, number of midwives, and number of medical doctors at the facility. To be able to achieve targeted results in reducing maternal mortality and achieve the Sustainable Development Goal 3, the government, together with the ministry of health, should provide adequate maternal health services, especially at the district and community level. Additionally, there is a need for increased investment in Community Health Planning Services and related healthcare infrastructure and systems within the context of the Ouagadougou Declaration, that is, improve the training of skilled birth workers (midwives and doctors) and employ them at clinics to deal with labour complications without referring them to major hospitals. Furthermore, a well-structured awareness campaign is needed with importance given to avoiding adolescent pregnancy and improving antenatal care attendance to, at least, four, the gold standard, before delivery. Also, we recommend quality assessment form an essential part of all services that are directed towards improving maternal health and that more emphasis is needed to be given on research with multiple allied partners.

Toothbrushing as Part of the Adolescent Lifestyle Predicts Education Level

2003 ◽  
Vol 82 (5) ◽  
pp. 361-366 ◽  
Author(s):  
L. Koivusilta ◽  
S. Honkala ◽  
E. Honkala ◽  
A. Rimpelä
Keyword(s):  
School Achievement ◽  
Education Level ◽  
Level Of Education ◽  
Four Dimensions ◽  
Health Differences ◽  
Education Levels ◽  
Health Related ◽  
Nationally Representative ◽  
Representative Samples

Socio-economic differences in health and health behavior are well-known. Our hypothesis was that toothbrushing frequency in adolescents predicts their education level in adulthood. The aim was also to study the role of toothbrushing in adolescents’ health-related lifestyle. Data from nationally representative samples of 12- to 16-year-olds (N = 11,149) were linked with register data on the highest level of education attained at age 27–33 years. Adolescents with a low toothbrushing frequency reached only the lowest education levels. School achievement or sociodemographic background only partly accounted for the association. Exploratory factor analysis found four dimensions of health behaviors. At age 12, a low toothbrushing frequency was loaded highly with “street-oriented” behaviors, concentrated around smoking and alcohol use. At ages 14 and 16, it was associated with a “traditional” lifestyle of the less-well-educated. Altogether, a low toothbrushing frequency indicated selection into the less-well-educated stratum of society. This is likely to be reflected in socio-economic health differences in adulthood.

Pelaksanaan Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4K) Melalui Peran Keluarga

2019 ◽  
Vol 18 (2) ◽  
pp. 49-58
Author(s):  
Yusriani Yusriani ◽  
Muh. Said Mukharrim ◽  
Reza Aril Ahri
Keyword(s):  
Public Health ◽  
Maternal Mortality ◽  
Health Center ◽  
Sampling Technique ◽  
Maternal Deaths ◽  
Live Births ◽  
South Sulawesi ◽  
Work Area ◽  
The Family

The maternal mortality rate (MMR) is one of the important indicators of public health. AKI describes the number of women who die from a cause of death related to pregnancy disorders or treatment (excluding accident or incidental cases) during pregnancy, childbirth and during the puerperium (42 days after delivery) regardless of the length of pregnancy per 100,000 live births. South Sulawesi Province is one of the regions experiencing high maternal mortality problems, especially in Gowa Regency, namely in 2018 as many as 17 cases of maternal deaths, the highest cases of which were in the work area of Somba Opu Health Center, namely 5 cases. The general objective of this study is to analyze the role of the family in implementing the P4K program. The design of this study was qualitative with descriptive explanative design using purposive sampling technique with 33 informants consisting of 6 pregnant women, 4 husbands, 5 posyandu cadres, 3 village midwives, 1 coordinator midwife puskesmas, 8 heads environment and 6 village heads. The role of the family in implementing the P4K program in the work area of Somba Opu Health Center in Gowa Regency has been carried out but not optimally, there are still some indicators that have not been fulfilled.

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