scholarly journals What makes the pregnant women revisit public hospitals for research? Participant engagement and retention trial in a public hospital (PERTH): an RCT protocol

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Giridhara R Babu ◽  
Maithili Karthik ◽  
Deepa Ravi ◽  
Yamuna Ana ◽  
Prafulla Shriyan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Public Hospital ◽  
Research Participant ◽  
Public Hospitals ◽  
Participant Engagement ◽  
Retention Trial

scholarly journals Female perspectives of male partners’ inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Mondli Miya ◽  
Tennyson Mgutshini
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
Child Health Services ◽  
Mother To Child Transmission ◽  
Male Partners ◽  
Child Transmission ◽  
Financial Investment ◽  
Mother To Child

Background: The South African government intervened by implementing the prevention of mother–to-child transmission programme (PMTCT) to curb the HIV transmission from mother to child during and after pregnancy. The PMTCT programme has been at the forefront of global prevention efforts since 1998. Without treatment, the risk of transmission ranges from one in five to one in two newborns; however, the risk of mother-to-child transmission can be reduced to as low as 2%–5% with evidenced interventions. Sub-Saharan Africa, and most particularly South Africa, is the most affected by the pandemic despite having the largest financial investment in PMTCT services across the continent.Objectives: The objectives of the study were to describe and explore the female perspectives of male inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal.Methodology: A qualitative, descriptive, explorative study was conducted through in-depth individual interview of pregnant women until data saturation.Results: The findings of the study revealed that the existing design of public hospitals was not wholly conducive to facilitating male inclusion in maternal and child health services. Resources were largely insufficient to support the participation of pregnant mothers and any attempts to support the inclusion of males needed to be based on a clear increase in service provision.Conclusion: The study recommended male partners’ inclusion in the prevention of mother- to-child HIV transmission to support effective management of HIV in pregnancy and PMTCT programmes. The inclusion of men will provide the holistic support needed by pregnant women on PMTCT programmes.

scholarly journals Longitudinal Evaluation on the Operation Index Applied to Public Hospitals in Pudong New District of Shanghai, China

2018 ◽  
Vol 55 ◽  
pp. 004695801879059
Author(s):  
Shanshan Liu ◽  
Jiaoling Huang ◽  
Yanting Li ◽  
Jincheng Fan ◽  
Hong Liang ◽  
...  
Keyword(s):  
Financial Risk ◽  
Public Hospital ◽  
Risk Index ◽  
Condition Index ◽  
Public Hospitals ◽  
Operating Index ◽  
The Public ◽  
Management Condition ◽  
Service Operation ◽  
Public Hospital Reform

The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012. Overall operating index, development foundation index, and management condition index were found to be statistically different ( P = .010, P = .016, P = .031) in different years, whereas the service operation index and financial risk index were not so ( P = .543, P = .228). Moreover, the results demonstrated that no obvious difference was observed in the overall operating index between the general and specialized hospitals ( P = .327), which was the same in the 4 first-class indexes. However, there were statistical differences in the overall operating index and development foundation index among these 5 years ( P = .018, P = .036), but none in the service operation index, management condition index, and financial risk index ( P = .503, P = .062, P = .177). No interaction effects were discovered between year and hospital categories in the current study ( P = .673, P = .375, P = .885, P = .152, P = .288).

scholarly journals Client Satisfaction on Antenatal Care Service by Pregnant Women in Public and Private Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Comparative Descriptive Study

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Waiting Time ◽  
Client Satisfaction ◽  
Addis Ababa ◽  
Care Service ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals

Background: Antenatal care (ANC) is an important health care service which is intended to potentially reduce maternal morbidity and mortality particularly in areas where the general health status of women is presumed poor, choice of facilities is limited and the service delivery compromised by geography (terrain, transport), socio-demographic factors, financial capability and awareness. Though improving the quality of health care is one of the targeted strategies in the Health Sector Development Program IV (HSDP IV) of Ethiopia, little is known about the quality of antenatal care service and client satisfaction at the different hospitals in Addis Ababa, the capital city of Ethiopia. Objective: To determine satisfaction of ANC services among pregnant women at the public teaching and private hospitals in Addis Ababa, Ethiopia. Methods: Health institution-based comparative cross-sectional study was conducted from February to June, 2019 in public and private hospitals, in Addis Ababa, using sample size determination for comparisons of proportion between the two populations. All participants who fulfilled the inclusion criteria were enrolled based on the flow of pregnant women to the ANC clinics at the selected hospitals. Data were entered and cleaned using EPI-info version 3.5.1 and analysis was performed by SPSS version 21. Association of independent variables with the client satisfaction was done using binary and multivariate logistic regression. Significant association of variables with outcome was determined using adjusted odds ratio (AOR) together with 95 % confidence interval. Level of significance was set at P-value of ≤ 0.05. Results: Five hundred seventy one pregnant women attending Antenatal Care at private (281) and public (290) hospitals were included with response rates of 94.1 and 91.2% for public and private hospitals, respectively. The age distribution of the participants was between 17 and 43 years with a mean age of 27.3±5.1 years. Most of the clients, 249 (88.7%) at private and 276 (95.2%) at public hospitals were between the ages of 20 and 34 years. One hundred fourteen (39.3%) of the clients at public and 113 (40.2%) at private hospitals were nulliparous. The clients overall satisfaction with antenatal care was mostly positive both at the private and public hospitals and two hundred twenty eight (81.1%) of the private and 174 (60%) of the public hospitals were satisfied with the services provided. Having ANC follow up at the private hospitals had statistically significant difference in client satisfaction compared to those in public hospitals with P value of 0.019, (AOR 2.97, 95% CI:1.19 -7.74). Clients’ satisfaction with the cleanliness of the environment was 11.1 times more likely to be satisfied with the general ANC service, P<0.05, (AOR 12.18 95% CI: 7.45-19.91). Having more than 4 ANC visits was positively associated with client overall satisfaction, P= 0.021, (AOR 2.41, 95% CI: 1.12-5.24,) while long waiting time is negatively associated with client satisfaction. Conclusions: The study showed significant difference in client satisfaction rate between the selected private and public facilities. Private facilities outperformed public facilities with regards to structural features (privacy, waiting time, space, and neatness). We recommend concerted effort to improve ANC visits and pay due attention to the privacy, waiting time, and the neatness of the facilities in public hospitals.

scholarly journals Assessment of biochemical profile among patients of gestational diabetes mellitus

2020 ◽  
pp. 17-19
Author(s):  
Umna Rehman ◽  
Misbah Arshad ◽  
Amir Iqbal
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Public Hospitals ◽  
Clinical Test ◽  
Biochemical Profile ◽  
Test Results ◽  
Major Health Problem ◽  
Hba1c Test

Gestational diabetes mellitus is common but a major health problem in pregnant women. The rate of gestational diabetes mellitus has increased globally from 3% to 14% within last 10 years. Objective: To assess the biochemical profile of women with gestational diabetes mellitus visiting public hospitals, Lahore city. Methods: A cross-sectional study was carried out at gynae department of Sir Ganga Ram Hospital, Lahore and Services Institute of Medical Sciences, Lahore within 4 months using the convenient sampling technique. The data of 100 patients were collected through pre-tested questionnaire. Data were analyzed statistically using SPSS version 21.0. Frequencies were calculated, Pearson’s chi-square test was applied. Results: According to the results, 81% patients were not having insulin therapy during pregnancy and only 19% were having insulin.  73% patients had OGTT values above 200 mg/dl during pregnancy while 27% had values above 140 mg/dl. An insignificant association was found between HbA1c test results and cereal food (paratha) consumption (p< .72). Conclusions: Study concluded that more than half of female had high OGTT rate. Improper medication, irregular treatment and lack of proper medication to control diabetes during pregnancy were a major cause of high clinical test values of diabetes in pregnant women. There was no significant association between HbA1c test results and cereal food consumption

Effectiveness and safety of integrase inhibitors in HIV-infected pregnant women followed up in the Madrid Cohort

2019 ◽  
Author(s):  
Marta Illán Ramos ◽  
Diana Mazariegos ◽  
José Beceiro ◽  
Luis Escosa ◽  
Eloy Muñoz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Public Hospitals ◽  
Integrase Inhibitors ◽  
Hemodynamic Compromise ◽  
Cd4 Lymphocyte Count ◽  
Observational Cohort ◽  
Cd4 Lymphocyte ◽  
Mother To Child ◽  
Hiv 1

Abstract Background The risk of HIV-1 mother-to-child transmission (MTCT) is associated mainly with the gestational age at which antiretroviral therapy (AT) begins and HIV-1-RNA viral load (VL) at delivery. The importance of achieving virological supression during pregnancy, has led to an increased use of integrase inhibitors (INIs) in risky conditions. Our objective was to assess the safety and effectiveness in Madrid-Cohort of mothers-children exposed to INIs during pregnancy. Methods Retrospective, multicentric, observational, cohort study, of HIV-1-infected pregnant women exposed to INIs during pregnancy and their infants, from 2000 to 2017, from the nine public hospitals belonging to the Madrid Cohort. Maternal demographic characteristics, clinical data, HIV-1 infection features, AT regimens and changes of treatment during pregnancy were recorded. Blood count, biochemistry panel, HIV-1 VL and CD4+ lymphocyte counts/percentage at first trimester and at the last one near delivery were also collected. Results Sixty seven pregnant women exposed to INIs from the Madrid cohort (n: 1423) and their 68 children were identified (17.6% premature). Neonatal prophylaxis consited mostly on zidovudine (AZT) monotherapy, followed by combined prophylaxis with ‘triple therapy’. There were no cases of MTCT. Twenty women were diagnosed with HIV-1 in the current pregnancy. Of 43 women with AT before pregnancy, 65% received INI before conception. Raltegravir was the most commonly used (80.5%). The median lenght with INI at delivery was 148 days [interquartile rang (IR): 29-251]. Median CD4+ lymphocyte count increased from 428 cells/mL (IR: 310-642) in first trimester to 636 cells/mL (IR: 408-818) in the third. There was a statistically significant increase (p=0.02) of mothers with undetectable VL at delivery compared with first trimester. INIs were well tolerated, without any relevant adverse effect notification. There was no case of discontinued medication due to intolerance or toxicity. 11,7% of children had minor birth defects and one patient had ventricular septal defect without hemodynamic compromise. All of them evolved favourably. Conclusions INI seems safe and effective in prevention of MTCT. Antiretroviral regimens during pregnancy that include INI are increasingly being used. Our findings support the use of INI as intensification in pregnant women at high risk of MTCT.

scholarly journals Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ahmed Alatawi ◽  
Sayem Ahmed ◽  
Louis Niessen ◽  
Jahangir Khan
Keyword(s):  
Public Hospital ◽  
Meta Analysis ◽  
Hospital Efficiency ◽  
Public Hospitals ◽  
Quality Data ◽  
Risk Level ◽  
Gulf Region ◽  
Substantial Impact ◽  
Gcc Countries ◽  
Strategic Plans

Abstract Background The assessment of hospital efficiency is attracting interest worldwide, particularly in Gulf Cooperation Council (GCC) countries. The objective of this study was to review the literature on public hospital efficiency and synthesise the findings in GCC countries and comparable settings. Methods We systematically searched six scientific databases, references and grey literature for studies that measured the efficiency of public hospitals in appropriate countries, and followed PRISMA guidelines to present the results. We summarised the included studies in terms of samples, methods/technologies and findings, then assessed their quality. We meta-analysed the efficiency estimates using Spearman’s rank correlations and logistic regression, to examine the internal validity of the findings. Results We identified and meta-analysed 22 of 1128 studies. Four studies were conducted in GCC nations, 18 came from Iran and Turkey. The pooled technical-efficiency (TE) was 0.792 (SE ± 0.03). There were considerable variations in model specification, analysis orientation and variables used in the studies, which influenced efficiency estimates. The studies lacked some elements required in quality appraisal, achieving an average of 73%. Meta-analysis showed negative correlations between sample size and efficiency scores; the odd ratio was 0.081 (CI 0.005: 1.300; P value = 0.07) at 10% risk level. The choice of model orientation was significantly influenced (82%) by the studied countries’ income categories, which was compatible with the strategic plans of these countries. Conclusions The studies showed methodological and qualitative deficiencies that limited their credibility. Our review suggested that methodology and assumption choices have a substantial impact on efficiency measurements. Given the GCC countries’ strategic plans and resource allocations, these nations need further efficiency research using high-quality data, different orientations and developed models. This will establish an evidence-based knowledge base appropriate for use in public hospital assessments, policy- and decision-making and the assurance of value for money.

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