scholarly journals Determinants of Antenatal Care Visit Utilization of Child-Bearing Mothers in Kaffa, Sheka, and Bench Maji Zones of SNNPR, Southwestern Ethiopia

2019 ◽  
Vol 6 ◽  
pp. 233339281986662 ◽  
Author(s):  
Abiyot Negash Terefe ◽  
Assaye Belay Gelaw
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Rural Areas ◽  
Goodness Of Fit ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Care Program ◽  
Normal Pregnancy ◽  
World Health ◽  
Child Bearing

Background: Antenatal care (ANC) is a preventive obstetric health-care program aimed at optimizing maternal fetal outcome through regular monitoring of pregnancy. Even if World Health Organization recommends a minimum of 4 ANC visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it due to different reasons. The purpose of this article is to identify determinants significantly influencing the ANC visit utilization of child-bearing mothers in the Kaffa, Sheka, and Bench-Maji zones of Southern Nation Nationalities and Peoples Region, Ethiopia. Methods: A total of 1715 child-bearing mothers were selected. Several count models such as Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial, hurdle Poisson, and hurdle negative binomial regression models were fitted to select the model which best fits the data. The parameters were estimated by maximum likelihood. Measures of goodness of fit were based on the Rootogram. Results: The data were found zeros (8.1%); the variance (3.794), which is less than its mean (3.91). Hurdle Poisson regression model was found to be better fitted with the data given. Variables are selected by backward selection method, through the analysis, zones, residence, age at first pregnancy, source of information, knowledge during danger sin, willingness, time of visit, and satisfaction, which were major predictors of ANC service utilization. The estimated odds that the number of ANC visits those child-bearing mothers made (mothers who lived in urban) are 3.52 times more likely than mothers who lived in rural keeping others variables constant and the like. Conclusion: Based on our findings, a lot of effort needs to be made by health offices to create awareness, maternal health-care programs should be expanded and intensified in rural areas, improve women’s knowledge and awareness about the risk factor of late visit, the necessary investigations and follow-up throughout the antenatal period to promote regular attendance for ANC, and fulfill the client’s satisfaction.

scholarly journals Analyzing Overdispersed Antenatal Care Count Data in Bangladesh: Mixed Poisson Regression with Individual-Level Random Effects

2021 ◽  
Vol 50 (4) ◽  
pp. 78-90
Author(s):  
Zakir Hossain ◽  
Maria
Keyword(s):  
Antenatal Care ◽  
Random Effects ◽  
Count Data ◽  
Poisson Regression ◽  
Negative Binomial ◽  
Wealth Index ◽  
Negative Binomial Regression ◽  
Information Criterion ◽  
World Health ◽  
Individual Level

Poisson regression (PR) is commonly used as the base model for analyzing count data with the restrictive equidispersion property. However, overdispersed nature of count data is very common in health sciences. In such cases, PR produces misleading inferences and hence give incorrect interpretations of the results. Mixed Poisson regression with individual--level random effects (MPR_ILRE) is a further improvement for analyzing such data. We compare MPR_ILRE with PR, quasi-Poisson regression (Q_PR) and negative binomial regression (NBR) for modelling overdispersed antenatal care (ANC) count data extracted from the latest Bangladesh Demographic and Health Survey (BDHS) 2014. MPR_ILRE is found to be the best choice because of its minimum Akaike information criterion (AIC) value and the overdispersion exists in data has also been modelled very well. Study findings reveal that on average, women attended less than three ANC visits and only 6.5\% women received the World Health Organization (WHO) recommended eight or more ANC visits for the safe pregnancy and child birth. Administrative division, place of residence, birth order, exposure of media, education, wealth index and body mass index (BMI) have significant impact on adequate ANC attendance of women to reducing pregnancy complications, maternal and child deaths in Bangladesh.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

scholarly journals Sickness absence and disability pension after carpal tunnel syndrome diagnosis: A register-based study of patients and matched references in Sweden

2021 ◽  
pp. 140349482110027
Author(s):  
Tea Lallukka ◽  
Rahman Shiri ◽  
Kristina Alexanderson ◽  
Jenni Ervasti ◽  
Ellenor Mittendorfer-Rutz ◽  
...  
Keyword(s):  
Health Care ◽  
Carpal Tunnel Syndrome ◽  
Sickness Absence ◽  
Carpal Tunnel ◽  
Disability Pension ◽  
Negative Binomial ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Sociodemographic Factors ◽  
Tunnel Syndrome

Aims: The aim of this study was to examine sickness absence and disability pension (SA/DP) during working lifespan among individuals diagnosed with carpal tunnel syndrome (CTS) and their matched references, accounting for sociodemographic factors. Methods: We used a register cohort of 78,040 individuals aged 19–60 years when diagnosed with CTS in secondary health care (hospitals and outpatient specialist health care) and their 390,199 matched references from the general population in 2001–2010. Sociodemographic factors and SA/DP net days during a three-year follow-up were included. Negative binomial regression was used. Results: For those not on DP at inclusion, the average number of SA/DP days per person-year was 58 days (95% confidence interval (CI) 56–60 days) among individuals with CTS and 20 days (95% CI 19–21 days) among the matched references. Among both groups, these numbers increased with age and were higher among women than among men. The rate ratio (RR) of SA/DP days was threefold higher among people with CTS than among the matched references (adjusted RR=3.00, 95% CI 2.91–3.10) Moreover, compared to the matched references, the RR for SA/DP was higher among men with CTS (RR=3.86, 95% CI 3.61–4.13) than among women with CTS (RR=2.69, 95% CI 2.59–2.78). The association between CTS and the number of SA/DP days was smaller among older age groups. Sociodemographic factors were similarly associated with SA/DP among people with and without CTS. Conclusions: Numbers of SA/DP days were higher among people with CTS than their matched references in all age groups, particularly among individuals in their early work careers, highlighting public-health relevance of the findings.

Patient hospital experience and satisfaction on social media

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Subhajit Chakraborty ◽  
E. Mitchell Church
Keyword(s):  
Health Care ◽  
Social Media ◽  
Patient Satisfaction ◽  
Mixed Methods ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Health Service Delivery ◽  
Health Care Team ◽  
Care Team ◽  
Content Type

Purpose The purpose of this paper is to show the value of open-ended narrative patient reviews on social media for elucidating aspects of hospital patient satisfaction. Design/methodology/approach Mixed methods analyses using qualitative (manual content analyses using grounded theory and algorithmic analyses using the Natural Language Toolkit) followed by quantitative analyses (negative binomial regression). Findings Health-care team communication, health-care team action orientation and patient hospital room environment are positively related to patient hospital satisfaction. Patients form their hospital satisfaction perceptions based on the three facets of their hospital stay experience. Research limitations/implications In the spirit of continuous quality improvement, periodically analyzing patient social media comments could help health-care teams understand the patient satisfaction inhibitors that they need to avoid to offer patient-centric care. Practical implications By periodically analyzing patient social media comments hospital leaders can quickly identify the gaps in their health service delivery and plug them, which could ultimately give the hospital a competitive advantage. Originality/value To the best of the authors’ knowledge, this is one of the first studies to apply mixed methods to patient hospital review comments given freely on social media to critically understand what drives patient hospital satisfaction ratings.

Safety Evaluation of Destination Lighting Treatment at Stop Controlled Cross-Intersections

2018 ◽  
Vol 2672 (16) ◽  
pp. 113-121 ◽  
Author(s):  
Amrita Goswamy ◽  
Shauna Hallmark ◽  
Theresa Litteral ◽  
Michael Pawlovich
Keyword(s):  
Rural Areas ◽  
Negative Binomial ◽  
Safety Evaluation ◽  
Negative Binomial Regression ◽  
State Agencies ◽  
Crash Frequency ◽  
Binomial Regression ◽  
Manual Selection ◽  
Roadway Lighting ◽  
Selection Of

Intersection crashes during nighttime hours may occur because of poor driver visual cognition of conflicting traffic or intersection presence. In rural areas, the only source of lighting is typically provided by vehicle headlights. Roadway lighting enhances driver recognition of intersection presence and visibility of signs and markings. Destination lighting provides some illumination for the intersection but is not intended to fully illuminate all approaches. Destination lighting has been widely used in Iowa but the effectiveness has not been well documented. This study, therefore, sought to evaluate the effect on safety of destination lighting at rural intersections. As part of an extensive data collection effort, locations with destination/street lighting were gathered with the assistance of several state agencies. After manual selection of a similar number of control intersections, propensity score matching using the caliper width technique was used to match 245 treatments with 245 control sites. Negative binomial regression was used to evaluate crash frequency data. The presence of destination lighting at stop-controlled cross-intersections generally reduced the night-to-day crash ratio by 19%. The presence of treatment or destination lighting was associated with a 33%–39% increase in daytime crashes across all models but was associated with an 18%–33% reduction in nighttime crashes. Injuries in nighttime crashes decreased by 24% and total nighttime crashes reduced by 33%. Property damage crashes were reduced by 18%.

Drug control: a prerequisite for health

1980 ◽  
Vol 209 (1174) ◽  
pp. 159-163
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Third World ◽  
Health Care Expenditure ◽  
World Health ◽  
Health Care Needs ◽  
Care Needs ◽  
Pharmaceutical Manufacturers ◽  
Health Organization ◽  
Limited List

The purchase of drugs employs an increasingly large part of the health budget of many Third World countries. Like health care expenditure as a whole, drug spending is heavily biased in favour of urban hospitals, often for expensive proprietary drugs that offer little benefit over cheaper preparations. As a result, because limited funds are available, vaccines and drugs for prevention and primary care are sometimes unavailable, especially in rural areas. The World Health Organization and many individual countries have responded to the problem of drug costs by creating a limited list of drugs considered essential for health care needs. Other methods of curtailing spending on drugs have included tendering for supplies and the establishment of plants to manufacture and formulate drugs. Controls of this type meet enormous resistance from doctors and pharmaceutical manufacturers, but are vital for the implementation of policies for appropriate health care.

Group regularization for zero-inflated negative binomial regression models with an application to health care demand in Germany

2018 ◽  
Vol 37 (20) ◽  
pp. 3012-3026 ◽  
Author(s):  
Saptarshi Chatterjee ◽  
Shrabanti Chowdhury ◽  
Himel Mallick ◽  
Prithish Banerjee ◽  
Broti Garai
Keyword(s):  
Health Care ◽  
Regression Models ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Health Care Demand ◽  
Binomial Regression

scholarly journals Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Saidi Mgata ◽  
Stephen Oswald Maluka
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Cultural Beliefs ◽  
Dar Es Salaam ◽  
World Health ◽  
Health Providers ◽  
Care Workers

Abstract Background Antenatal care (ANC) provided by a trained health care provider is important for monitoring pregnancy thereby reducing potential risks for the mother and child during pregnancy and delivery. The World Health Organization (WHO) recommends at least four ANC visits to all pregnant women. While the proportion of women who attend at least one ANC in low-income countries is high, most pregnant women start their first ANC attendance very late. In Tanzania only 24% of pregnant women start their first ANC attendance before the fourth month of pregnancy. While factors for the utilization of antenatal care in general have been widely studied, there is paucity of studies on the factors affecting timing of the first ANC attendance. This study aimed to understand individual, community, and health system factors that lead to the delay in seeking ANC services among pregnant women in Ilala Municipal in Dar es Salaam region, Tanzania. Methods A qualitative exploratory study, using in-depth interviews with 20 pregnant women and five health care workers was conducted in three different health facilities in Dar es Salaam Tanzania. Thematic analysis approach was used to analyse the data. Results Individual perceptions of antenatal care, past experience with pregnancy, fear of pregnancy disclosure, and socio-cultural beliefs were the key individual and social factors for late ANC attendance. Shortage of trained health care workers, lack of spouse’s escort and health providers’ disrespect to pregnant women were the main health system barriers to early ANC attendance. Conclusions This study concludes that community members should be sensitized about the importance of early ANC attendance. Additionally, while spouse’s escort policy is important for promoting PMTCT, the interpretation of the policy should not solely be left to the health providers. District and regional health officials should provide correct interpretation of this policy.

scholarly journals Fire Incidents in a Mental Health Setting: Effects of Implementing Smokefree Polices and Permitting the Use of Different Types of E-Cigarettes

2020 ◽  
Vol 17 (23) ◽  
pp. 8951
Author(s):  
Debbie Robson ◽  
Gilda Spaducci ◽  
Ann McNeill ◽  
Mary Yates ◽  
Melissa Wood ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
False Alarm ◽  
Negative Binomial ◽  
Positive Impact ◽  
Negative Binomial Regression ◽  
Smoke Detector ◽  
False Alarms ◽  
Health Care Settings ◽  
Smokefree Policy

Comprehensive smokefree policies in health care settings can have a positive impact on patients’ smoking behaviour, but implementation is impeded by concern that surreptitious smoking may increase fire incidents. We investigated the incidence of routinely reported fire and false alarm incidents in a large mental health organisation in England over an 81-month period when different elements of a smokefree policy were implemented. We used negative binomial regression models to test associations between rates of fire and false alarm incidents and three hospital smokefree policy periods with mutual adjustment for occupied bed days: (1) an indoor policy which allowed disposable e-cigarettes; (2) a comprehensive policy which allowed disposable e-cigarettes; and (3) a comprehensive policy with all e-cigarette types allowed. We identified 90 fires and 200 false alarms. Fires decreased (incidence rate ratio (IRR): 0.35, 95% CI: 0.17–0.72, p = 0.004) and false alarms increased (IRR: 1.67, 95% CI: 1.02–2.76, p = 0.043), each by approximately two-thirds, when all e-cigarette types were allowed, after adjusting for bed occupancy and the comprehensive smokefree policy. Implementation of smokefree policies in mental health care settings that support use of all types of e-cigarettes may reduce fire risks, though measures to minimise effects of e-cigarette vapour on smoke detector systems may be needed to reduce false alarm incidents.

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