scholarly journals Birth attendance in rural Bangladesh: practices and correlates

2018 ◽  
Author(s):  
Fozlul Korim
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Maternal Mortality Ratio ◽  
The Other ◽  
Skilled Birth Attendants ◽  
Rural Regions ◽  
Rural Bangladesh ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Skilled Attendants

AbstractIntroductionThe maternal mortality ratio (MMR) and neonatal mortality rate (NMR) are higher in the rural regions of Bangladesh compared to the urban areas or the national average. These two rates could be reduced by increasing use of skilled birth attendance in rural regions of this country. Although the majority of Bangladeshi population lives in rural areas, there has been a little investigation of the practices and determinants of delivery attendance in this region of Bangladesh. This study investigated the practices and determinants of attendance during child-births in rural Bangladesh.MethodsData were collected by the 2014 Bangladesh Demographic and Health Survey (BDHS 2014). After reporting the distribution of deliveries by types of attendance and distribution of selected factors, logistic regression was applied to calculate the crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs), and p-values.ResultsMore than half of the deliveries (53.1%) were conducted by traditional attendants; community skilled attendants were present in only a small number of deliveries. The following factors were positively associated with deliveries by skilled attendants: 25-34 years age group of women (adjusted odds ratio (AOR): 1.4; 95% CI: 1.1-1.8), a higher education level of women (AOR: 2.9; 95% CI: 1.7-4.9), or their husbands (AOR: 2.4; 95% CI: 1.6-3.7), receiving antenatal care (AOR: 2.1; 95% CI: 1.6-2.7), and higher wealth quintiles (AOR of the richest wealth quintile vs the poorest: 3.5; 95% CI: 2.3-5.3). On the other hand, women having a higher parity (i.e., number of pregnancy, ≥2) led to a lower likelihood of delivery by skilled birth attendants. The proportion of deliveries attended by skilled attendants was significantly lower in the other six divisions compared to Khulna.ConclusionsSocioeconomic factors should be considered to design future interventions to increase the proportion of deliveries attended by skilled delivery attendants. Awareness programs are required in rural areas to highlight the importance of skilled attendants. Further re-evaluation of the community skilled birth attendants program is required.

The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kenneth M. Johnson ◽  
Dante J. Scala
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Metropolitan Areas ◽  
Political Attitudes ◽  
The United States ◽  
Rural America ◽  
Rural Regions ◽  
Urban America ◽  
Urban And Rural Areas ◽  
The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

scholarly journals Modelling of Social Policy and Initiatives under COVID-19: Rural NEET Youth Case Study

2021 ◽  
Vol 10 (10) ◽  
pp. 393
Author(s):  
Giedrė Kvieskienė ◽  
Ilze Ivanova ◽  
Karmen Trasberg ◽  
Viktorija Stasytytė ◽  
Eglė Celiešienė
Keyword(s):  
Social Policy ◽  
Young People ◽  
Social Exclusion ◽  
Rural Areas ◽  
Urban Areas ◽  
Positive Emotions ◽  
Mental Health Problems ◽  
Youth Unemployment ◽  
Rural Regions

NEET (Not in Education, Employment, or Training) youth rates in Europe are generally higher in rural regions than in urban areas and the share in rural regions is constantly increasing. During the COVID-19 pandemic, young people became even more vulnerable as they experienced social exclusion and mental health problems. The objective of this paper is to analyse NEET youth-related statistics in Europe and distinguish positive initiatives for young people in rural areas of the Baltic countries to encourage positive emotions and willingness to learn. Statistical analysis and case study methods were employed. Data on youth unemployment, NEET youth by age and gender, and poverty and social exclusion of young people, is analysed. Social policy initiatives in Lithuania, Latvia, and Estonia, mainly from rural municipalities, are presented and discussed. This research determines the key issues related to NEET youth and proposes initiatives to overcome existing problems among young people. Such social initiatives aim to promote positive social emotions of youth, promote their inclusion in society, and foster regional sustainability.

scholarly journals Prevalence and Determinants of Rural-Urban Utilization of Skilled Delivery Services in Northern Ghana

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Mahama Saaka ◽  
Jones Akuamoah-Boateng
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Northern Region ◽  
Northern Ghana ◽  
Skilled Delivery ◽  
Birth Attendance ◽  
Delivery Services ◽  
Study Population

Background. There are wide differences in the uptake of skilled delivery services between urban and rural women in the northern region of Ghana. This study assessed the rural-urban differences in the prevalence of and factors associated with uptake of skilled delivery in the northern region of Ghana. Methods. The study population comprised postpartum women who had delivered within the last three months prior to the study. The dataset was analyzed using the chi-square test and multivariable logistic regression. Results. The odds of skilled birth attendance (SBA) adjusted for confounding variables in urban areas were higher compared with their rural counterparts (AOR = 1.59; CI: 1. 07–2.37; p=0.02). The determinants of skilled delivery were similar but of different levels and strength in rural and urban areas. The main drivers that explained the relatively high skilled delivery coverage in the urban areas were higher frequency of antenatal care (ANC) attendance, proximity (physical access) to health facility, and greater proportion of women attaining higher educational level of at least secondary school. Distance from health facility less than 4 km was the greatest independent contributor to the variance in skilled delivery in the urban areas, whereas frequency of ANC attendance was the greatest independent contributor in the rural areas. Conclusions. This study identified underlying determinants accounting for rural-urban differences in skilled delivery, and covariate effect was more dominant than coefficient effect. Therefore, urban-rural differences in SBA outcomes were primarily due to differences in the levels of critical determinants rather than the nature of the determinants themselves. Therefore, improving skilled delivery outcomes in this study population and other similar settings will not require different policy frameworks and interventions in dealing with rural-urban disparities in SBA outcomes. However, context-specific tailored approaches and strategies including targeting mechanisms have to be designed differently to reduce the rural-urban differences.

scholarly journals The Prevalence of Skilled Birth Attendant Utilization and Its Correlates in North West Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Mulunesh Alemayehu ◽  
Wubegzier Mekonnen
Keyword(s):  
Skilled Birth Attendant ◽  
Skilled Birth Attendance ◽  
Northwest Ethiopia ◽  
Health Facilities ◽  
Health Centers ◽  
Skilled Birth Attendants ◽  
Urban Residence ◽  
North West ◽  
Birth Attendants ◽  
Birth Attendance

The low utilization of skilled birth attendants sustained high maternal mortality. The aim of this study was to assess its magnitude and correlates in Northwest Ethiopia. A study was conducted on 373 randomly selected women who gave birth in the 12 months preceding the survey. Correlates were identified using binary logistic regression. Skilled birth attendance was 18.8%. Inability to perform cultural practices in health facilities (65.5%), expecting smooth delivery (63.4%), and far distance (62%) were the main barriers. Women with urban residence (AOR = 5.46: 95% CI[2.21–13.49]), primary (AOR = 2.10: 95% CI[0.71–6.16]) and secondary-plus (AOR = 6.12:[1.39–26.92]) educational level, four-plus ANC visits (AOR = 17.33: 95% CI[4.22–71.29]), and proximity to health centers (AOR = 5.67: 95% CI[1.47–25.67]) had higher odds of using skilled birth attendants though women with no labor complications had lower odds (AOR = 0.02: 95% CI[0.01–0.05]). Skilled birth attendance use was low. Urban residence, primary-plus level of education, frequent ANC visits, living nearby the health centers, and a problem during labor were positively correlated with skilled birth attendance utilization. Stakeholders should enhance girls’ education beyond primary level and ANC services and shorten distances to health facilities.

scholarly journals Challenges experienced by midwives working in rural communities in the Upper East Region of Ghana: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peter Adatara ◽  
Philemon Adoliwine Amooba ◽  
Agani Afaya ◽  
Solomon Mohammed Salia ◽  
Mabel Apaanye Avane ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Qualitative Content Analysis ◽  
Maternal Mortality Ratio ◽  
Physical Space ◽  
Sub Saharan Africa ◽  
Northern Ghana ◽  
Maternal Deaths ◽  
East Region ◽  
Upper East Region

Abstract Background In 2017, a total of 295,000 women lost their lives due to pregnancy and childbirth across the globe, with sub-Saharan Africa and South Asia accounting for approximately 86 % of all maternal deaths. The maternal mortality ratio in Ghana is exceptionally high, with approximately 308 deaths/100,000 live births in 2017. Most of these maternal deaths occur in rural areas than in urban areas. Thus, we aimed to explore and gain insights into midwives’ experiences of working and providing women-centred care in rural northern Ghana. Methods A qualitative descriptive exploratory design was used to explore the challenges midwives face in delivering women-centred midwifery care in low-resource, rural areas. A total of 30 midwives practicing in the Upper East Region of Ghana were purposefully selected. Data were collected using individual semistructured interviews and analysed through qualitative content analysis. Results Five main themes emerged from the data analysis. These themes included were: inadequate infrastructure (lack of bed and physical space), shortage of midwifery staff, logistical challenges, lack of motivation, and limited in-service training opportunities. Conclusions Midwives experience myriad challenges in providing sufficient women-centred care in rural Ghana. To overcome these challenges, measures such as providing adequate beds and physical space, making more equipment available, and increasing midwifery staff strength to reduce individual workload, coupled with motivation from facility managers, are needed.

Franchise Bidding for Postal Services in Rural Regions

2004 ◽  
Vol 4 (1) ◽  
Author(s):  
Jörg Borrmann
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Small Town ◽  
Universal Service ◽  
Rural Regions ◽  
Franchise Bidding ◽  
Postal Services ◽  
Bidding Mechanism ◽  
Universal Service Obligation ◽  
The Government

Abstract In this paper, we develop a franchise bidding mechanism for postal services under the Universal Service Obligation (USO) in rural areas. For the collection and delivery of mail on rural routes and for small town counter operations, monopoly franchises are awarded. Deficits caused by the USO are balanced by transfers between the government and the incumbent postal operator, i.e. the franchiser. We analyze the efficiency properties of the mechanism and discuss the drawbacks when extending the mechanism to urban areas.

scholarly journals Determinants of skilled birth attendants for delivery in Nepal

2012 ◽  
Vol 8 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Y R Baral ◽  
K Lyons ◽  
J Skinner ◽  
E R Van Teijlingen
Keyword(s):  
Qualitative Research ◽  
Maternal Health ◽  
Health Services ◽  
Quantitative Research ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Women's Role

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women’s role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women’s involvement in decision making; and women’s autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women’s role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6223 Kathmandu Univ Med J 2010;8(3):325-32 

Suicide among Adolescents in Greece

1991 ◽  
Vol 159 (4) ◽  
pp. 515-519 ◽  
Author(s):  
Stavroula Beratis
Keyword(s):  
Suicide Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
The Other ◽  
The Mean

The mean suicide rate among 10–19–year-olds in Greece from 1980 to 1987 was 0.98/100 000 per year (male 1.07, female 0.89). Girls and boys demonstrated the greatest suicide rate at 16 and 19 years, respectively. The combined suicide rate was significantly higher in the rural areas (1.48) than in Athens (0.48) and the other urban areas (0.98). Boys committed suicide more frequently than girls in Athens and other urban areas, whereas girls did so in the rural areas. The suicide rate declined during the last three years of the study. Differences in the methods used and the reported reasons for suicide were observed among the adolescents in Athens, other urban areas, and the rural areas. Greek adolescents appear to be relatively protected from suicide, particularly those who live in the urban areas.

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