The perception of Italian pregnant women and new mothers about their psychological wellbeing, lifestyle, delivery, and neonatal management experience during the COVID-19 pandemic lockdown: a web-based survey

Abstract Background In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. Methods We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. Results We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. Conclusions The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage “home” physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.

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HUBUNGAN PENDIDIKAN, AKSES PELAYANAN KESEHATAN DAN DUKUNGAN KELUARGA DENGAN PEMANFAATAN PELAYANAN KESEHATAN PENDERITA TB PARU BTA+ DI PUSKESMAS JANTI KOTA MALANG

Preventia : The Indonesian Journal of Public Health ◽

10.17977/um044v4i1p1-14 ◽

2019 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Alfreda Dinayu Purbantari ◽

Roesdiyanto Roesdiyanto ◽

Nurnaningsih Herya Ulfah

Keyword(s):

Public Health ◽

Health Service ◽

Health Services ◽

Health Center ◽

Family Support ◽

Access To Health Services ◽

Cross Sectional ◽

Education Access ◽

Utilization Of Health Services ◽

Access To Health

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci: pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

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Restrictions on Undocumented Immigrants’ Access to Health Services: The Public Health Implications of Welfare Reform

American Journal of Public Health ◽

10.2105/ajph.93.10.1630 ◽

2003 ◽

Vol 93 (10) ◽

pp. 1630-1633 ◽

Cited By ~ 95

Author(s):

Jeffrey T. Kullgren

Keyword(s):

Public Health ◽

Health Services ◽

Welfare Reform ◽

Undocumented Immigrants ◽

Access To Health Services ◽

Health Implications ◽

The Public ◽

Access To Health

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Cultural singularities: indigenous elderly access to Public Health Service

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000400008 ◽

2015 ◽

Vol 49 (4) ◽

pp. 0589-0595 ◽

Cited By ~ 3

Author(s):

Ana Carla Borghi ◽

Angela Maria Alvarez ◽

Sonia Silva Marcon ◽

Lígia Carreira

Keyword(s):

Public Health ◽

Health Care ◽

Health Services ◽

Public Health Service ◽

Primary Caregivers ◽

The Elderly ◽

Access To Health Services ◽

Access To Health ◽

Assistance Service ◽

Routine Procedures

OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.

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Varzaghan Earthquake Affected Mothers’ and Their Newborns’ Health More Severely, in Socioeconomically Vulnerable Area

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.96 ◽

2018 ◽

Vol 13 (03) ◽

pp. 511-518

Author(s):

Mehdi Esfandyari ◽

Elnaz Vaghef-Mehrabany ◽

Mehrangiz Ebrahimi-Mameghani

Keyword(s):

Socioeconomic Status ◽

Health Services ◽

Pregnant Women ◽

Family Income ◽

First Trimester ◽

Local Health ◽

Access To Health Services ◽

Access To Health ◽

Before And After ◽

Moderate Malnutrition

ABSTRACTObjectiveWe aimed to compare the pregnancy status of the pregnant women and birth status of their newborns, socioeconomic status, and access to health services, between high- and low-damage areas in Heris, affected by the Varzaghan Earthquake, 2012.MethodsThe study was conducted on pregnant women at any trimester of pregnancy (with complete medical profiles in local health centers) in August 2012 (time of the earthquake) who lived in Heris and delivered up to March 2013. Data were obtained on pregnancy- and infant-related variables, housing, socioeconomic status, and access to health services, including food supplies, before and after the earthquake.ResultsFamily income and mothers’ education were lower in highly damaged areas. Among these women, underweight at first trimester of pregnancy was higher, and weight gain during the last trimester was lower, compared with low-damage regions. Preterm delivery was higher in low-damage areas. Birth indices of the infants were not significantly different between the 2 areas; however, in highly damaged areas, moderate malnutrition was more prevalent among children under 1 year (weight-for-age) and under 2 years (height-for-age).ConclusionsSocioeconomic status of mothers was lower in highly damaged areas and might have played a role in their own and newborns’ health status. (Disaster Med Public Health Preparedness. 2019;13: 511-518)

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A Survey Among Italian Pregnant Women and New-mothers During the COVID-19 Pandemic Lockdown.

10.21203/rs.3.rs-50602/v1 ◽

2020 ◽

Author(s):

Viviana STAMPINI ◽

Alice MONZANI ◽

Silvia CARISTIA ◽

Gianluigi FERRANTE ◽

Martina GERBINO ◽

...

Keyword(s):

Public Health ◽

Physical Exercise ◽

Pregnant Women ◽

Dietary Habits ◽

Care Delivery ◽

Well Being ◽

New Mothers ◽

Breastfeeding Rate ◽

Starting Point ◽

The Impact

Abstract In response to the COVID-19 pandemics, drastic measures for social distancing have been introduced also in Italy. The purpose of this study was to describe some aspects of lifestyle, access to health services, and mental wellness of Italian pregnant women and new-mothers during the lockdown. We carried out a web-based survey to assess how pregnant women and new-mothers were coping with the lockdown. Expected outcomes were categorized in different analysis domains: psychological well-being and support, physical exercise, dietary habits, access to care, delivery and obstetric care, neonatal care and breastfeeding.We included 742 respondents (response rate 86.2%), 603 were pregnant (81.3%) and 139 (18.7%) had delivered during lockdown. We found a high score for anxiety and depression in 62.7% of pregnant women and 61.9% of new-mothers. During the lockdown, 61.9% of pregnant women reduced their physical exercise, and 79.8% reported to eat in a healthier way. 94.2% of new-mothers reported to have breastfed their babies during hospital staying. Regarding the impact of restrictive measures on breastfeeding, no impact was reported by 56.1% of new-mothers, a negative impact by 36.7%.The higher prevalence of anxiety and depressive symptoms in pregnant women and new-mothers should be a public health issue. Clinicians might also consider to recommend and encourage “home” physical exercise. On the other hand, most women improved their approach towards healthy eating during the lockdown and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.

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Physical Exercise and Economic Burden Associated With Anxiety Symptoms in Pregnant Women During the COVID-19 Pandemic

10.21203/rs.3.rs-108769/v1 ◽

2020 ◽

Author(s):

Jie Deng ◽

Chun Hui Hu ◽

Yu Xin Ning ◽

Ping Xu ◽

Chen Lu ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Regression Analysis ◽

Mental Health Services ◽

Health Services ◽

Physical Exercise ◽

Pregnant Women ◽

Economic Burden ◽

Anxiety Symptoms ◽

Bank Loans

Abstract Background: COVID-19 with high infectivity and high concealment has been widely spread around the world. This major public health event has caused anxiety among the public, including pregnant women. The aim of this study was to assess the incidence of anxiety symptoms in pregnant women during the COVID-19 pandemic and its influencing factors.Methods: Using an ongoing prospective pregnancy registry, we performed a single center cross-sectional analysis to investigate the overall prevalence of anxiety symptoms among pregnant women during the COVID-19 pandemic. Online questionnaires were used to collect information including sociodemographic data, physical activity and economic situations. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety symptoms. The univariate regression analysis was performed to detect factors potentially influencing anxiety symptoms among pregnant women. The multivariate regression analysis was also conducted to analyze the association of physical exercise and economic burden with anxiety symptoms by adjusting for other variables.Results: A total of 1,517 pregnant women entered the analysis. The study reported that 31.64% of the respondents had anxiety symptoms. Those with bank loans were at higher odds of suffering from anxiety symptoms compared to those without bank loans [(adjusted odds ratio (aOR) 1.494, 95% confidence interval (CI) 1.181~1.889]. Those who took 2,000~5,000 steps/day (aOR 0.825, 95% CI 0.603~0.875) and >5,000 steps/day (aOR 0.924, 95% CI 0.439~0.945) were at lower odds of suffering from anxiety symptoms compared to those who took <500 steps/day. Similarly, the adjusted odds ratios for anxiety symptoms was 0.750 (95% CI 0.663~0.790) and 0.800 (95% CI 0.226~0.889) lower in participants with exercise frequencies of 4-6, and ≥7 times/week, compared to those with a frequency of <2 times/week.Conclusions: Three in ten pregnant women experienced anxiety symptoms during the COVID-19 pandemic, and anxiety symptoms showed association with bank loans and physical exercise. To prevent anxiety of pregnant women, the promotion of healthy lifestyles, improvement of mental health services, and expansion of social support should be implemented during epidemics. In parallel, the integration of psycho-educational interventions with mental health services among public health centers is required to minimize anxiety symptoms in pregnancy women.

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Physical exercise and economic burden associated with anxiety symptoms in pregnant women during the COVID-19 pandemic

10.21203/rs.3.rs-105483/v1 ◽

2020 ◽

Author(s):

Jie Deng ◽

Chunhui Hu ◽

Yuxin Ning ◽

Ping Xu ◽

Chen Lu ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Regression Analysis ◽

Mental Health Services ◽

Health Services ◽

Physical Exercise ◽

Pregnant Women ◽

Economic Burden ◽

Anxiety Symptoms ◽

Bank Loans

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Poor Women’s Access to Antenatal Care and Childbirth Services in Indonesia: Case Study in Five Districts

Jurnal Perempuan ◽

10.34309/jp.v24i3.345 ◽

2019 ◽

Vol 24 (3) ◽

pp. 233

Author(s):

Dyan Widyaningsih ◽

Elza Samantha Elmira ◽

Andi Misbahul Pratiwi

Keyword(s):

Health Services ◽

Antenatal Care ◽

Pregnant Women ◽

Health Facilities ◽

Local Context ◽

Health Issues ◽

Access To Health Services ◽

Birth Attendants ◽

Access To Health

<p>The health of pregnant women often becomes an indicator of human development. On the other hand, the fact of the high maternal mortality rate, raises questions related to the government’s attention to the health of pregnant women, especially women in poor areas. This article focuses on poor women’s access to health services for antenatal care and childbirth in five regencies in Indonesia. The aspects studied include the availability of health services for antenatal care and childbirth, poor women’s access to these services, and supporting factors/actors and barriers to poor women’s access to health services. This article showed that the availability of health facilities is not always in line with the increased awareness of pregnant women to access these services. Road infrastructure condition, distance, and cost to access health service still remain a challenge. Meanwhile, the policy of incentives and disincentives to traditional birth attendants has an influence on the increasing number of pregnant women who check their pregnancies and childbirth at health facilities. Thus, health issues of pregnant women and safe childbirth require a different effort. Aspects of the local context and supporting infrastructure also require serious attention.</p><p> </p>

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