scholarly journals Free contraception and behavioural nudges in the postpartum period: evidence from a randomised control trial in Nairobi, Kenya

2018 ◽  
Vol 3 (5) ◽  
pp. e000888 ◽  
Author(s):  
Margaret McConnell ◽  
Claire Watt Rothschild ◽  
Allison Ettenger ◽  
Faith Muigai ◽  
Jessica Cohen
Keyword(s):  
Postpartum Period ◽  
Randomised Control Trial ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Birth Intervals ◽  
Financial Barriers ◽  
Maternity Hospitals ◽  
Sms Reminder ◽  
The Impact

BackgroundShort birth intervals are a major risk factor for poor maternal and newborn outcomes. Utilisation of modern contraceptive methods during the postpartum period can reduce risky birth intervals but contraceptive coverage during this critical period remains low.MethodsWe conducted a randomised controlled experiment to test whether vouchers for free contraception, provided with and without behavioural ‘nudges’, could increase modern contraceptive use in the postpartum period. 686 pregnant women attending antenatal care in two private maternity hospitals in Nairobi, Kenya, were enrolled in the study. The primary outcomes were the use of modern contraceptive methods at nearly 3 months and 6 months after expected delivery date (EDD). We tested the impact of a standard voucher that could be redeemed for free modern contraception, a deadline voucher that expired 2 months after delivery and both types of vouchers with and without a short message service (SMS) reminder, relative to a control group that received no voucher and no SMS reminder.ResultsBy nearly 6 months after EDD, we find that the combination of the standard voucher with an SMS reminder increased the probability of reporting utilisation of a modern contraceptive method by 25 percentage points (pp) (95% CI 6 pp to 44 pp) compared with the control group. Estimated impacts in other treatment arms were not statistically significantly different from the control group.ConclusionsReducing financial barriers to postpartum contraception alone may not be enough to encourage take-up. Programmes targeting the postpartum period should consider addressing behavioural barriers to take-up.

Resistant Starch Supplementation Improves Bifidobacteria Colonization and Lipid Profile in Adult Obese Subjects Residing in Urban Vadodara

2018 ◽  
Vol 55 (4) ◽  
pp. 432
Author(s):  
Mini Sheth ◽  
Aanchal Johari ◽  
Isha Shah
Keyword(s):  
Lipid Profile ◽  
Resistant Starch ◽  
Age Groups ◽  
Randomised Control Trial ◽  
Control Group ◽  
Obese Adults ◽  
Obese Subjects ◽  
The Mean ◽  
The Impact ◽  
Experimental Group

Obesity continues to be a growing problem globally among all age groups, further associated with life threatening co-morbidities. Resistant Starch (RS) as a dietary component has been recently recognized as a prebiotic with potential role in improving the bacterial ecology of human gut. The present study was undertaken to evaluate the impact of resistant starch supplementation by the obese adults in urban Vadodara on microbial changes in gut flora with respect to Bifidobacteria and Enterobacteria. Using a non randomised control trial study design, 60 obese adults were enrolled from the free living population of urban Vadodara. Baseline information was collected and subjects were classified into control (n=30) and experimental group (n=30). Experimental group was supplemented with 10 g of RS daily for the period of two months (60 days). The control group were not given anything during this period. Blood and stool samples were analysed for lipid profile and the presence of Bifidobacteria and pathogenic Enterobacteria, respectively both at baseline and after the intervention period. Results revealed a significant increase in the mean log counts of Bifidobacteria by 11.7% with no significant reduction in the mean log counts of enteric pathogens and lipid profile of subjects. Hence study concludes that a daily supplementation of 10 grams of RS for 60 days to the obese subjects improved colonization of beneficial gut microbiota in terms of Bifidobacteria, but had little effect on obesity.

scholarly journals The effect of Women’s decision-making autonomy on family Planning acces in Senegal in 2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N M Sougou ◽  
O Bassoum ◽  
M M M M Leye ◽  
A Tal-Dia
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Contraceptive Method ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Contraceptive Method ◽  
Significant Difference ◽  
Modern Contraceptive Use ◽  
The Impact

Abstract Background The impact of access to decision-making on women’s health in the choice of fertility control has been highlighted by research. The aim of this study was to analyze the impact of access to decision-making for women’s health on access to family planning in Senegal in 2017. Methods The analyses of this study had been done on the Individual Records file of Senegal’s Demographic Health Survey 2017. This data covered 8865 women aged 15 to 49 years. The propensity scores matching method had been done. The variable access to the decision was considered as the variable of interest. Matching was done using variables that were not modified by the effect of the treatment. These were religion and socio-economic level. The outcome variables were modern contraceptive use, the existence of unmet needs and the type of modern contraceptive method used. Significance was at 5%. The condition of common support had been respected. The analysis was done with the STATA.15 software. Results Six percent (6.26%) of women could decide about their health on their own. Access to decision-making increased significantly with the woman’s age (p < 0.05). Fifteen percent (15.24%) women used a modern contraceptive method. Women using a contraceptive method were more numerous in the group with access to decision-making (29.43%) with a significant difference with the other group of 8% (p < 0.05). After matching, there was no significant difference between women in terms of modern contraceptive use and the existence of unmet needs. There was a significant difference in the type of contraceptive method used between the two groups of women. These differences were 23.17% for Intra Uterine Device, 52.98% for injections, 08.9% for implants and 10.79% for condoms. Conclusions Access to decision-making for health would facilitate women’s access to long-acting contraceptive methods. These findings show the importance of implementing gender transformative interventions in improving access to family planning. Key messages Access to decision-making for health would allow better access to modern contraceptive methods, especially those with a long duration of action. Better consideration of gender disparity reduction could improve access to family planning in Senegal.

Early rehabilitation after hospital admission for road trauma using an in-reach multidisciplinary team: a randomised controlled trial

2017 ◽  
Vol 31 (9) ◽  
pp. 1189-1200 ◽  
Author(s):  
Jane Wu ◽  
Steven G Faux ◽  
John Estell ◽  
Stephen Wilson ◽  
Ian Harris ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Usual Care ◽  
Intervention Group ◽  
Psychological Status ◽  
Randomised Control Trial ◽  
Control Group ◽  
Rehabilitation Team ◽  
Secondary Outcomes ◽  
The Impact

Objective: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. Design: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. Setting: Four participating trauma services in New South Wales, Australia. Subjects: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. Intervention: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). Main measures: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). Results: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. Conclusion: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.

scholarly journals Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Discontinuation and Switching of Postpartum Contraceptive Methods Over Twelve Months in Burkina Faso and the DRC: A Secondary Analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction: Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Impact of umbilical cord cleansing with 4% chlorhexidine on rate of omphalitis and separation time among newborns in Khartoum state, Sudan

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Abdelmoneim E.M. Kheir ◽  
Amna M.A. Mustafa ◽  
Awatif A. Osman
Keyword(s):  
Developing Countries ◽  
Umbilical Cord ◽  
Intervention Group ◽  
Control Group ◽  
Subsequent Increase ◽  
Separation Time ◽  
Maternity Hospitals ◽  
Umbilical Cord Care ◽  
Quasi Experimental ◽  
The Impact

Infection of the umbilical cord remains high in developing countries with subsequent increase in neonatal mortality rates. This may be due to the practice of applying potentially harmful substances to the freshly cut cord. The aim of this study was to assess the impact of umbilical cord care with 4% chlorhexidine on the rate of omphalitis and separation time among newborns in Khartoum State. This was a quasi-experimental research design that was carried out in the main maternity hospitals of Khartoum state between February and August 2012. One hundred mothers and their respective babies were selected by convenience sampling and were divided equally into intervention and control groups. The tools used for data collection were a questionnaire and an observational checklist. The data were analyzed using Statistical Package for Social Sciences version 17 for descriptive and inferential statistics. Umbilical cord training was effective in enhancing mothers’ knowledge and skills in the intervention group. The result showed that the omphalitis rate was reduced significantly in the intervention group; also the intervention group had a shorter separation time (mean=5.02) compared to the control group (mean=7.24). In conclusion, the application of 4% chlorhexidine on the freshly cut umbilical cord stump, significantly reduces omphalitis rate. This inexpensive and simple intervention can save a significant number of newborn lives in developing countries.

scholarly journals Personalised nutrition advice delivered online or face-to-face is more effective at motivating healthier dietary choices than generalised advice in Kuwait

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Balqees Alawadhi ◽  
Rosalind Fallaize ◽  
Rodrigo Zenun ◽  
Faustina Hwang ◽  
Julie Lovegrove
Keyword(s):  
Healthy Eating ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Randomised Control Trial ◽  
Control Group ◽  
Web Based ◽  
Personalised Nutrition ◽  
Face To Face ◽  
The Impact

AbstractIntroductionThe adoption of poor dietary and lifestyle habits have been associated with the development of non-communicable disease. The majority of strategies implemented to enhance dietary quality of individuals follow a “one size fits all” standardised approach. Results of recent trials have suggested that Personalised Nutrition (PN), tailored to individual requirements, is able to improve dietary intakes, yet limited focus has been given to the effectiveness of face-to-face compared with online methods. The aim of the EatWellQ8 randomised control trial (RCT) was to assess the impact of web-based PN advice, face-to-face PN advice and standardised advice, on adherence to healthy eating in Kuwait.Materials and MethodsFree living adults aged 21–65 years, were recruited for the 12-week study and randomised to; face-to-face PN, web-based PN or generalised (control) advise groups. Dietary intake and self-reported anthropometric measurements were assessed at baseline, 6 and 12 weeks. A validated food frequency questionnaire (FFQ) modified from the EPIC FFQ was used to assess food and nutrient intake. Diet quality was assessed by a 10-component modified Alternative Healthy Eating Index (m-AHEI) which was used to generate the PN advice. At 0 and 12-weeks post FFQ completion, participants randomised to the PN intervention groups were presented with 3 tailored dietary messages based on the m-AHEI components that received the lowest scores.Results320 participants completed the trial. Due to over/underreporting, 100 were included in the analysis (71% female, 29% male) with a mean age of 38.6 years (SD 14.3), and body mass index (BMI) of 25.1 kg/m2 (SD 4.2). After 12-weeks intervention, m-AHEI scores increased significantly in both PN intervention groups (face-to-face PN 19%, web-based 12%) compared to controls (4%) (P < 0.01) and significantly higher intakes of vegetables and fruits, and lower intakes of sugars compared with controls (P < 0.05). The PN intervention groups also significantly increased their intakes of omega 3 fatty acids and total folate compared with the control group (P < 0.05). The Face-to-face PN group significantly reduced weight (-1.9 kg) and BMI (-0.5 kg/m2) compared to web-based PN and control groups(P < 0.01).DiscussionIn adults living in Kuwait, PN advice, delivered face-to-face or online, was more effective at improving dietary quality than population-based advice. Face-to-face PN was found to be more effective at inducing weight-loss in adults compared to web-based PN and population-based advice.

scholarly journals OVERVIEW OF IMMEDIATE NEW-BORN CHECK-UP

2021 ◽  
Vol 12 (02) ◽  
Author(s):  
Muthanna Kanaan Zaki ◽  
Muthanna Kanaan Zaki
Keyword(s):  
Obstetric Care ◽  
Infant Care ◽  
Maternity Hospital ◽  
Control Group ◽  
Newborn Resuscitation ◽  
New Born ◽  
Basic Care ◽  
Maternity Hospitals ◽  
Available Information ◽  
The Impact

There's proof from maternity hospital-based settings in developing countries that newborn resuscitation education of the staff diminishes new-born deaths from inborn associated events, such as neonatal asphyxia (by 30%), with potential saving 93,700 neonates globally per year by investigating missed attendance of birth clinics or maternity hospitals, together with (up to 192,000) new-born at 90% scope, as it was considering the impact on intrapartum-related neonatal passings. In an arrangement to realize a higher reduction in intrapartum-related newborn passing's, preterm delivery and intrapartum death, a compelling obstetric plan is considered as the most vital intercession and this ought to be complemented with prompt infant care and resuscitation. There is expanding venture in obstetric care, yet to be coordinated by viable execution and supportability of quick infant care and essential newborn resuscitation. Within the private settings, prompt basic care at birth is essential and accessible, even though evaluated by specialists to be of low effects (10% on before delivery and on stillbirths associated with newborn passings). private hospital settingsbased newborn revival may minimise all the reasons of newborn and before delivery deaths, but available information is critical and controversial to directly gauge an effect size from the prove. Future researches ought to endeavour to address impediments distinguished here especially in terms of intercession definitions, plan, comparative control group, outcome identification and subdivision of reasons of stillbirths and neonatal passings. Whereas the available types of evidence for incitement at delivery and neonatal revival are low, mostly since they are regarded as a plan of care, there is adequate and consistent prove of effect. However, such fundamental care stays irregular particularly for the global 60 million home births. Disentangled preparing plan, and effective protocol, low price hardware are presently ac

scholarly journals A randomised control trial to evaluate messages that promote limit setting and the impact of limits on online gambling behaviour

2020 ◽  
Author(s):  
Robert Heirene ◽  
Sally M Gainsbury
Keyword(s):  
Online Gambling ◽  
Randomised Control Trial ◽  
Control Group ◽  
Gambling Behaviour ◽  
Message Content ◽  
Limit Setting ◽  
Gambling Operators ◽  
Social Messages ◽  
The Impact ◽  
Comparison Measurements

Background &amp; Aim: Deposit limits may be an effective strategy for minimising the harm associated with online gambling. However, voluntary uptake of these tools is low. This study aimed to compare the effectiveness of different messages to increase use of deposit limits by customers of online gambling sites and to examine the effects of limit setting on gambling behaviour. Design: A pre-registered, naturalistic randomised control trial was conducted wherein customers were sent varied messages by online gambling operators. Setting: Four online Australian sports and racing wagering websites. Participants: 31,989 wagering customers (reduced to 26,516 after screening for eligibility) who had placed bets on at least five days during the last 30. Interventions: Messages were sent via email or in-account notification and were designed to either: [1] be informative, describing the availability and purpose of the tool, [2] highlight the benefits other people receive from using the tool (social messages), or [3] promote the benefit individuals could receive from using the tool (personal messages). Comparators: A control group of customers who did not receive messages was monitored for comparison. Measurements: We collected customer account data for 90-days pre- and post-messages. Findings: 161 (0.71%) customers set a deposit limit within five days of messages being sent. Those sent messages via in-account notification were more likely to set limits than those sent messages via email. Differences in message content had little effect on deposit limit uptake. Customers who set limits showed significantly greater decreases in average daily wager amount, the SD of average daily wager, net loss, and betting intensity compared to a randomly selected subsample of non-limit-setters. Conclusions: Customer messages are inexpensive and can lead to small but impactful increases in the uptake of deposit limits on gambling sites. Setting deposit limits was associated with decreased gambling intensity, expenditure, and losses and may therefore be an effective harm-reduction strategy.

Optimal birth interval and empowerment: a closer look at women's agency in Kenya

2020 ◽  
Vol 14 (4) ◽  
pp. 1-10
Author(s):  
Rumyana Kudeva ◽  
Beth Halaas ◽  
Njeri Kagotho ◽  
Guijin Lee ◽  
Bipasha Biswas
Keyword(s):  
Intimate Partner Violence ◽  
Women’S Health ◽  
Women's Health ◽  
Partner Violence ◽  
Birth Interval ◽  
Intimate Partner ◽  
Individual Characteristics ◽  
Modern Contraceptive ◽  
Birth Intervals ◽  
The Impact

Background/Aims Birth interval is measured by the number of months between two consecutive births, and is an important factor related to maternal and child health, family planning, and empowerment. A woman's ability to regulate time between pregnancies remains a human rights issue, especially in low- and middle-income countries. This study aimed to explore the impact of autonomous decision making and attitudes about intimate partner violence on birth interval among married/partnered women in Kenya. Methods This study analysed data from fecund women (15 − 49 years old) included in the Kenya Demographic and Health Survey. Autonomy and intimate partner violence perceptions were explored and analysed. The survey included married and partnered women. Structural equation modelling was used to determine the association between individual characteristics and optimal birth intervals. Results Women with higher permissive attitudes regarding intimate partner violence were more likely to report shorter birth intervals. Specifically, the results demonstrated that each unit increase in permissive attitudes towards domestic violence was associated with a 0.033 increase in the relative log odds of having birth intervals that were shorter than optimal. More than half of surveyed women (56%) reported using modern contraceptive methods, but 55% of them had non-optimal birth intervals. Conclusions Despite the majority of women using contraception, over half of surveyed women had non-optimal birth intervals. This calls for the expansion of education regarding contraceptive use for spacing of births. Equally, a shorter birth interval was associated with more permissive attitudes towards intimate partner violence. As perceptions of intimate partner violence may be socially constructed, targeting structural inequalities to address women's health may help this issue. Investigating data specific to Kenya will benefit the development of women's health and empowerment education strategies and interventions.

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