scholarly journals Maternal health care professionals’ experiences and views on the use of obstetric ultrasound in Rwanda: A cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ingrid Mogren ◽  
Joseph Ntaganira ◽  
Jean Paul Semasaka Sengoma ◽  
Sophia Holmlund ◽  
Rhonda Small ◽  
...  

Abstract Background This study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy. Methods A cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which was developed based on the results of earlier qualitative studies undertaken as part of the CROss Country Ultrasound Study (CROCUS). Results Nine hundred and seven health professionals participated: obstetricians/gynecologists (3.2%,) other physicians (24.5%), midwives (29.7%) and nurses (42.7%). Few physicians reported the existence of clinical guidelines at clinic, regional or national levels in Rwanda, and guidelines were moderately adhered to. Three obstetric ultrasound examinations were considered medically indicated in an uncomplicated pregnancy. Most participants (73.0%) were positive about obstetric ultrasound examinations on maternal request. Commercialisation was not considered a problem, and the majority (88.5%) agreed that ultrasound had contributed to medicalisation of pregnancy. Conclusions Findings indicate that clinical guidelines for the use of obstetric ultrasound are limited in Rwanda. Non-medically indicated obstetric ultrasound was not considered a current problem at any level of the healthcare system. The positive attitude to obstetric ultrasound examinations on maternal request may contribute to further burden on a maternal health care system with limited resources. It is essential that limited obstetric ultrasound resources are allocated where they are most beneficial, and clearly stated medical indications would likely facilitate this.

2021 ◽  
Vol 47 (2) ◽  
pp. 847-861
Author(s):  
Elia Magwaja ◽  
Jacqueline Minja ◽  
Majige Selemani Budeba ◽  
Rocky R.J. Akarro

This study examined some factors associated with the utilization of maternal health care servicesby adolescent mothers (15-19 years) in Tanzania in order to provide advice accordingly. The studyused cross-sectional study of adolescent mothers aged 15-19 years using Demographic HealthSurvey and Malaria indicator Survey 2015/16 data. The dependent variables were number ofantenatal care visits, the place where an adolescent mother delivered and post-natal checkup(adolescent mother’s health checking after being discharged or after a home delivery). Theindependent variables were birth order, education level of a mother, marital status of a mother,media exposure, wealth index, distance to health facility. Multiple binary logistic regression wasused to examine an association between each dependent variable and their respective independentvariables. Data was analyzed using IBM SPSS statistics and STATA. This study used 550adolescent mothers in the analysis. Majority of the adolescent mothers had less than four AntenatalCare (ANC) visits (53.5%), while 68.5% of adolescent mothers delivered at a health facility.Adolescent mothers with two or more children had less odds of having at least four ANCscompared to those with one child, whereas adolescent mothers with at least secondary educationhad greater odds of delivering at a health facility compared to those who had no education.Adolescent mothers who had at least four antenatal care visits and those who are married hadgreater odds of checking their health after being discharged compared to adolescent mothers whohad less than 4 ANCs and single adolescent mothers. It was advised that provision of maternaleducation to young girls on the importance of safe delivery and health checking after delivery isvery important to reduce adolescent maternal morbidity and mortality in the country. Keywords: Adolescent; Maternal Health; Logistic regression; Chi-square


2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.


2020 ◽  
pp. 1-3
Author(s):  
Syed Waseem Tahir ◽  
Sahila Nabi ◽  
Shazia Javaid

Background: Hand hygiene is one of the most effective ways to control health care related infection. Every year millions of patients around the world are affected by infections that are transmitted by the health-care professionals(HCPs).(2)(3). Rationale: Nurses and physicians are the main health care workers contacting with patients, representing the vector in the chain of infection. Thus, assessing their knowledge, attitude and practice regarding hand hygiene is very important to decrease the incidence of health care related infection and to improve quality of care. Objective: The objective of our study was to assess the knowledge, attitude and practices of handwashing among healthcare professionals of Kashmir Division. Methods: This study was an institutional based cross sectional study, conducted in various healthcare institutions of Kashmir Division which were selected randomly. A predesigned questionnaire was used to collect the data from the participants. The questionnaires contained questions about four different parts which included sociodemographic characteristics, knowledge of hand washing, attitude and practice of hand washing among healthcare professionals. The questionnaires were distributed to various healthcare professionals working in wards, emergency department, laboratories, outpatient departments, injection and dressing rooms, EPI unit and others. The distributed questionnaires were then collected back. Results: A total of 110 participants were included. Out of total 110 participants,53% were male ,36% were nurses 36% of health professionals were working in IPD (In Patient Department). 89% of the participants agreed that, direct or indirect contacts are the most important routes for transmission of hospital-acquired infections,97% agreed that
 proper and consistent hand washing prevents infections in health facilities,100% agreed that health professionals should always wash their hands immediately when they arrive at health institutions,98% said that they knew steps of handwashing(WHO)/rules of hand hygiene,91% agreed that hand washing is the single most effective mechanism to prevent spread of infection and 95% agreed that wearing jewellery, artificial fingernails, damaged skin and regular use of hand cream are associated with increased likelihood of colonisation of hands with harmful germs. 83% of the participants said that they are committed to the proper rules of hand hygiene all the time,78% said they comply with rules of hand hygiene even in emergencies,80% said that they think when they are wearing gloves it is not necessary to wash hands,92% feel irritated when others don’t follow hand hygiene rules,95% advice others to follow the rules of hand hygiene and 97% said it is easy for you to follow rules of hand hygiene. 40%(each) of the participants said that they always and usually wash hands before touching a patient,100% of the participants said that they always wash hands before performing aseptic and clean procedures, 100% of the participants said that they always wash hands after being at risk of exposure to body fluids and 95% of patients said that they wash hands after coming to and before leaving the hospital. DISCUSSION In this study we had a total of 110 participants. Health professionals had a satisfactory knowledge of hand hygiene but some lacunae are still there as is evident in the result part. Thus from this study we conclude adherence to handwashing is lacking among health professionals, so we need to have regular handwashing sessions for health professionals which will regularly sensitize them, also we need to address the reasons of this poor adherence both at the administrative and personal level. We also recommend to conduct more studies in this field so as to highlight the shortcomings in hand hygiene and then to improve upon them.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031761
Author(s):  
Sophia Holmlund ◽  
Pham Thi Lan ◽  
Kristina Edvardsson ◽  
Ho Dang Phuc ◽  
Joseph Ntaganira ◽  
...  

ObjectivesObstetric ultrasound is an important part of antenatal care in Vietnam, although there are great differences in access to antenatal care and ultrasound services across the country. The aim of this study was to explore Vietnamese health professionals’ experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.DesignA cross-sectional questionnaire study was performed as part of the CROss Country UltraSound study.SettingHealth facilities (n=29) in urban, semiurban and rural areas of Hanoi region in Vietnam.ParticipantsParticipants were 289 obstetricians/gynaecologists and 535 midwives.ResultsA majority (88%) of participants agreed that ‘every woman should undergo ultrasound examination’ during pregnancy to determine gestational age. Participants reported an average of six ultrasound examinations as medically indicated during an uncomplicated pregnancy. Access to ultrasound at participants’ workplaces was reported as always available regardless of health facility level. Most participants performing ultrasound reported high-level skills for fetal heart rate examination (70%), whereas few (23%) reported being skilled in examination of the anatomy of the fetal heart. Insufficient ultrasound training leading to suboptimal pregnancy management was reported by 37% of all participants. ‘Better quality of ultrasound machines’, ‘more physicians trained in ultrasound’ and ‘more training for health professionals currently performing ultrasound’ were reported as ways to improve the utilisation of ultrasound.ConclusionsObstetric ultrasound is used as an integral part of antenatal care at all selected health facility levels in the region of Hanoi, and access was reported as high. However, reports of insufficient ultrasound training resulting in suboptimal pregnancy management indicate a need for additional training of ultrasound operators to improve utilisation of ultrasound.


2018 ◽  
Author(s):  
Shangfeng Tang ◽  
Bishwajit Ghose ◽  
Md Rakibul Hoque ◽  
Gang Hao ◽  
Sanni Yaya

BACKGROUND The public health system in Bangladesh has been struggling to provide coverage and utilization of basic maternal health care services in pursuit of achieving maternal and child mortality-related goals. Interestingly, the rapid popularization of mobile technology in the country is transforming the landscape of health care access and delivery. However, little is known regarding the use of mobile phones from the perspective of maternal health care service utilization. OBJECTIVE In this study, we aimed to investigate the prevalence and sociodemographic pattern of mobile phone use for health services among women and relationship between the use of mobile phone use and the uptake of essential maternal health services (MHSs). METHODS Cross-sectional data from the Bangladesh Demographic and Health Survey on 4494 mothers aged between 15 and 39 years were used in the analysis. Using mobile phones to get health services or advice was hypothesized to have a positive association with the uptake of basic MHSs (antenatal care, ANC, facility delivery services, postnatal care) and postnatal care for the newborn. Data were analyzed using bivariate and multivariable techniques. RESULTS More than a quarter (1276/4494, 28.4%; 95% CI 26.8-30.3) of the women aged 15-39 years reported using mobile phones to get health services with significant sociodemographic variations in the use of mobile phones. Analysis of the specific purposes revealed that, in most cases, mobile phones were used to contact service providers and consult with the same about what to do, whereas a smaller proportion reported using mobile phone for the purposes of arranging money and transportation. Multivariable analysis showed that compared with respondents who reported not using mobile phones for health care services, those who used them had higher odds of making 3+ ANC visits and delivering at a health facility. The odds were slightly higher for rural residents than for those in the urban areas. CONCLUSIONS The findings of this study conclude that women who use mobile phones are more likely to use ANC and professional delivery services than those who do not. More in-depth studies are necessary to understand the mechanism through which mobile phone-based services enhance the uptake of maternal health care.


2014 ◽  
Vol 04 (04) ◽  
pp. 028-032
Author(s):  
K.S Sharath ◽  
Manavi Prabhu ◽  
Biju Thomas ◽  
Shamila Shetty

Abstract Objective: The purpose of the study is to estimate the knowledge, attitude and practise of the oral hygiene,and dental treatment, and its correlation with everyday oral hygiene practices among the health care professionals of south canara district ( Karnataka) Methods: A cross sectional survey was conducted on 200 health care professionals between Jan 20th to Feb 20th 2013.Two hundred health professionals were asked to answer a questionnaire containing 15 questions.Data once collected was analysed using SPSS software. Results: 56.3% health professionals visited the dentist once in six months. 26% health professionals felt that unavailability of time is the main factor influencing dental visits. Main cause of taking a dental appointment in 33% subjects was found to be dental caries. 54.6% obtained information on oral hygiene practices through mass media followed by 22.3 % who obtained it directly from the dentist.59.2% brushed their teeth twice daily.50% used medium bristle tooth brush.48.5 % had a brushing time of 3-5 min. 41.5% did not use any other oral hygiene aid.28.64% got scaling done in the last 3-6 months. 56% did not have an habit of using a tooth pick. 43.3% used combination of circular, vertical and horizontal method of brushing.45.5% felt that scaling caused loss of enamel. Conclusion: It appears that knowledge, attitude, and behaviour attitude, practice and knowledge of oral hygiene practices and dental treatment in health care professionals in South Canara district is gud.Though more information needs to be provided about other oral hygiene aids.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ivlabèhiré Bertrand Meda ◽  
Adama Baguiya ◽  
Valéry Ridde ◽  
Henri Gautier Ouédraogo ◽  
Alexandre Dumont ◽  
...  

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