scholarly journals Using Community Informants to Estimate Maternal Mortality in a Rural District in Pakistan: A Feasibility Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ali Mohammad Mir ◽  
Mohammad Saleem Shaikh ◽  
Siti Nurul Qomariyah ◽  
Gul Rashida ◽  
Mumraiz Khan ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Large Scale ◽  
Health Workers ◽  
Rural District ◽  
Reproductive Age ◽  
Religious Leaders ◽  
Women Of Reproductive Age ◽  
Community Based ◽  
Capture Recapture ◽  
Elected Representatives

Background.We aimed to assess the feasibility of using community-based informants’ networks to identify maternal deaths that were followed up through verbal autopsies (MADE-IN MADE-FOR technique) to estimate maternal mortality in a rural district in Pakistan.Methods. We used 4 community networks to identify deaths in women of reproductive age in the past 2 years in Chakwal district, Pakistan. The deaths recorded by the informants were followed up through verbal autopsies.Results. In total 1,143 Lady Health Workers (government employees who provide primary health care), 1577 religious leaders, 20 female lady councilors (elected representatives), and 130 nikah registrars (persons who register marriages) identified 2001 deaths in women of reproductive age. 1424 deaths were followed up with verbal autopsies conducted with the relatives of the deceased. 169 pregnancy-related deaths were identified from all reported deaths. Through the capture-recapture technique probability of capturing pregnancy-related deaths by LHWs was 0.73 and for religious leaders 0.49. Maternal mortality in Chakwal district was estimated at 309 per 100,000 live births.Conclusion. It is feasible and economical to use community informants to identify recent deaths in women of reproductive age and, if followed up through verbal autopsies, obviate the need for conducting large scale surveys.

Gestational Diabetes Mellitus Knowledge Among Women of Reproductive Age in Southern Nigeria: Implications for Diabetes Education

2019 ◽  
Vol 40 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Rosemary N. Ogu ◽  
Omosivie Maduka ◽  
Vetty Agala ◽  
Folusho Alamina ◽  
Obelebra Adebiyi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Local Government ◽  
Large Scale ◽  
Health Workers ◽  
Sampling Technique ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Southern Nigeria ◽  
In Pregnancy

Background Diabetes mellitus (DM) has attained the status of an epidemic in slow motion. Gestational DM (GDM) is a subtype of DM, which occurs in pregnancy. As part of a baseline assessment, the knowledge of GDM was determined among women of reproductive age. Methods The study was a descriptive cross-sectional household survey involving 2,595 women of reproductive age residing in five local government areas in Southern Nigeria. It employed a multistage sampling technique to collect data using an interviewer administered questionnaire built using Open Data Kit software uploaded on android mobile phones. Results The response rate was 100%. Mean age was 29.25 ± 7.11 years. The majority (2,351; 90.6%) had heard about DM but only 991 (38.2%) knew that diabetes can occur for the first time in pregnancy. Only 747 (28.8%), 929 (35.8%), and 790 (30.4%) respondents had good knowledge scores for GDM definition and risk factors, GDM screening diagnosis and treatment, and GDM complications, respectively. Only 681 (26.2%) had good overall knowledge of GDM. The major sources of knowledge of GDM were from friends (49.8%), health workers (34.6%), and mass media (10.4%). Residence in two urban local government areas (adjusted odds ratio [adj OR] = 1.79; 95% confidence interval [CI] = 1.36–2.34 and adj OR = 1.89; 95% CI = 1.37–2.61), being married (adj OR = 1.50; 95% CI = 1.16–1.95), and having been pregnant (adj OR = 2.69; 95% CI = 1.99–3.64) positively predicted good overall knowledge of GDM. Conclusion These results underscore the need for diabetes information and education activities on a large scale targeted at women of reproductive age and their partners for the prevention and control of GDM.

scholarly journals Examining the Multilevel Barriers and Facilitators to Iron Folic Acid Supplement Use and Anemia Reduction in Rural India (OR25-07-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erica Sedlander ◽  
Rajiv Rimal ◽  
Michael Long ◽  
Ashita Munjral ◽  
Hagere Yilma ◽  
...  
Keyword(s):  
Folic Acid ◽  
Health Workers ◽  
Reproductive Age ◽  
World Health ◽  
Women Of Reproductive Age ◽  
Individual Level ◽  
Supplement Use ◽  
The Government ◽  
Iron Folic Acid ◽  
Health Organization

Abstract Objectives Over half of women of reproductive age in India are anemic so the World Health Organization recommends daily iron folic acid (IFA) for all women of reproductive age. The government has distributed free IFA for over four decades but initial uptake and adherence remain inadequate. Objectives 1) to understand the multilevel factors that hinder IFA use and adherence; and 2) to inform a behavioral intervention to increase IFA use to reduce anemia. Methods We conducted this study in four rural villages in the state of Odisha, India. We held 25 key informant interviews with front-line health workers, 16 focus groups with women of reproductive age, husbands, and mothers-in-law (n = 148) and 18 direct observations in health centers, pharmacies and women's groups. We purposively sampled key informants and randomly sampled focus group participants from an enumeration of all eligible residents of each village, and stratified them by sex, age and relation to a woman of reproductive age. We analyzed the data using applied thematic analysis and Nvivo software. Results At the individual level, we found that most people knew that IFA prevents anemia, but they did not recognize its widespread prevalence, believing instead that it was rare in their community. They also believed that taking too many IFA supplements during pregnancy would “make your baby big” causing a painful birth and possibly the need for a cesarean section. At the interpersonal level, mothers-in-law were not supportive of their daughters-in-law taking IFA too often because they themselves did not take them when they were younger. Husbands were more supportive. At the policy level, frontline health workers distribute IFA but are not incentivized to follow up on adherence. Finally, state and national policies are not consistent around which sub-populations should take IFA (e.g., whether all non-pregnant women of reproductive age should take them). Conclusions To address these multilevel barriers to IFA use and adherence, interventions should take a normative approach that includes a woman's social network and targets both descriptive norms (ideas about how many women in the community have anemia and are taking IFA) and injunctive norms around who should be taking IFA (e.g., all women of reproductive age). Funding Sources The Bill and Melinda Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: empirical evaluation using data of the EAT Addis study, Ethiopia

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049602
Author(s):  
Tigest Shifraw ◽  
Katarina Selling ◽  
Alemayehu Worku ◽  
Hanna Yemane Berhane ◽  
Eva-Charlotte Ekström ◽  
...  
Keyword(s):  
Large Scale ◽  
Addis Ababa ◽  
Population Based ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Overweight Women ◽  
Arm Circumference ◽  
Scale Population ◽  
Mid Upper Arm Circumference

ObjectivesThe present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting.DesignThis study draws data from a community-based cross-sectional study conducted between July–August 2017 and January–February 2018 to account for seasonality in Addis Ababa, Ethiopia.SettingOne hundred and sixteen districts were included in Addis Ababa, Ethiopia.ParticipantsA total of 4914 women of reproductive age with children less than 5 years of age were participated in this study.Primary and secondary outcome measuresPrimary outcome measures included anthropometric indices. There were no secondary outcomes.ResultsThe optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC.ConclusionsOur result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.

scholarly journals Pakistan’s Community-based Lady Health Workers (LHWs): Change Agents for Child Health?

2020 ◽  
Vol 12 (11) ◽  
pp. 177
Author(s):  
Shehla Zaidi ◽  
Maryam Huda ◽  
Ammarah Ali ◽  
Xaher Gul ◽  
Rawshan Jabeen ◽  
...  
Keyword(s):  
Child Health ◽  
Large Scale ◽  
Health Workers ◽  
Information Source ◽  
Child Health Services ◽  
Growth Monitoring ◽  
Continuous Variables ◽  
Maternal Knowledge ◽  
Community Based ◽  
Child Illness

BACKGROUND: In Pakistan’s high child mortality context, a large-scale Lady Health Worker (LHW) Program raises the need to look at whether LHWs are delivering their key mandate as agents of change for child health. This study examines the quantity and quality of LHW interactions with mothers for child health and their impact on mothers' knowledge and child health practices. METHODS: 1,968 mothers of children <2 years (n=1,968) were interviewed through a cross-sectional survey in two rural districts of Pakistan focusing on immunization, nutrition, and early child illness. Data on frequency of LHW’s visits; services provided, specific services related to routine immunization (RI), nutrition and child illness, and maternal knowledge and practices were analyzed using median values for continuous variables and counts and percentages for categorical data. RESULTS: Monthly visits by LHW were reported by only 63% of LHW covered households. During LHW monthly encounters, Oral Polio drops administration was most frequently reported (77%), followed by RI (59%), breastfeeding counseling (20%), child illness management advice (18%), growth monitoring (9.5%), while none reported receiving hygiene counseling. Although LHWs were reported to be the main information source for child health; limited impact of LHW-mother interaction was seen on maternal knowledge and practices: 76% mothers reported receiving ORS packets from LHWs but only 27% knew of correct usage, only 34% washed hands before feeding children, less than a third could correctly recall early signs of pneumonia and awareness of Vaccine Preventable Diseases other than Polio ranged from 42%-9% only. CONCLUSION: Although LHWs are main information source for child health services but infrequent, poor quality household encounters indicate ineffective delivery on the key mandate of community-based child health. Policy debate instead of focusing on scaling up or downsizing the program, should prioritize quality and supervision to improve value for money of a critical community resource.

scholarly journals Deaths Due to Cancer Among Women of Reproductive Age in Bangladesh on the Rise: Findings From Two National Level Mortality and Health Care Survey

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 220s-220s
Author(s):  
S. Khan ◽  
S. Arifeen ◽  
N. Chakrobarty ◽  
A.E. Rahman
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Cause Of Death ◽  
Action Plan ◽  
National Level ◽  
Reproductive Age ◽  
Epidemiologic Transition ◽  
Women Of Reproductive Age ◽  
Health Care Survey ◽  
Care Survey

Background: Bangladesh, a developing country from southeast Asia has the population of 160 million and currently ranks as being the 7th most populated country in the world. Like many other developing countries, Bangladesh is going through an epidemiologic transition, with significant reductions in mortality due to acute, infectious, and parasitic diseases and increases in noncommunicable, degenerative, and chronic diseases over the last 20 years. In this course, of transition, the deaths due to cancer is also on the rise. Among all adult deaths, cancer the third leading cause of death and accounts for one fifth of all mortality in Bangladesh. However, for women the proportions are even higher. Aim: This abstract looks into the datasets of 2 national surveys - Bangladesh maternal mortality and health care survey 2010 and 2016 - and assess the cause of death among women from reproductive age in Bangladesh. The 2010 survey covered over 150,000 households around Bangladesh, while the 2016 survey covered over 310,000 households from the whole of Bangladesh. Methods: Both the survey followed the same clustering process and sampling procedure, to ensure the compatibility among the surveys. Though the main objective of the survey was to look into the status of maternal mortality and corresponding health service seeking behavior, the surveys also shed lights on overall cause of death for women of reproductive age in Bangladesh. The death cases were assessed by verbal autopsy - using WHO process - and the cause of deaths were classified following ICD 10. The particular deaths due to cancer or neoplasm were separated from the main datasets and then it was looked by demographic information of the respondents. Results: The comparison between the national datasets reveals that, in 2010, 21% Bangladeshi women of reproductive age (15-49 years) were dying due to cancer, meaning 1 in 5 Bangladeshi women from reproductive age is dying due to cancer. However, in 2016 the proportion of death due to cancer raised up to 24% women of reproductive age (15-49 years), meaning 1 in 4 Bangladeshi women from reproductive age is dying due to cancer. Age segregated data shows that, only within this 6 years of timespan, more women from younger age (40-45 vs 50-55 years) are dying out of cancer. Conclusion: The findings of this comparison between the 2 national survey shows that, deaths due to cancer among women of reproductive age in Bangladesh is on the rise. Though Bangladesh has developed a National Cancer Control Strategy and Action Plan with the aim of delivering a universal, quality-based and timely service, the initiative are still boutique. A comprehensive preventive approach through tobacco control, health promotion and vaccination program, in addition to, early detection needs to be established with effective referral chain.

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