scholarly journals Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lina Sofia Morón-Duarte ◽  
Andrea Ramirez Varela ◽  
Andrea Dâmaso Bertoldi ◽  
Marlos R. Domingues ◽  
Fernando C. Wehrmeister ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Birth Cohort ◽  
Maternal Education ◽  
Linear Trend ◽  
First Trimester ◽  
Private Provider ◽  
Trend Test ◽  
Height Measurement ◽  
Adverse Pregnancy

Abstract Background Inadequate antenatal care (ANC) has been associated with adverse pregnancy outcomes. ANC quality is considered a key component of the right to health and a route to equity and dignity for women and their children. Although ANC coverage is relatively high in Brazil, there are revealed some health disparities when coverage is examined by socio-demographic determinants. In this study we evaluated ANC quality and its socio-demographic determinants using data from the 2015 Pelotas birth cohort, Rio Grande do Sul, Brazil. Methods This study is part of the 2015 Pelotas population-based birth cohort (n = 3923 pregnant women) conducted in southern Brazil. ANC quality was assessed through 19 content and service utilization indicators recommended by the Brazilian Ministry of Health. Descriptive analyses and associations of each of the ANC indicators and independent variables were performed using the chi-square and linear trend test. ANC indicators were analyzed individually and aggregated as a score. Associations between ANC score quality and socio-demographic variables were assessed with ordinal regressions. Mediation analysis with G-computation was performed to estimate direct and indirect effect of mother’s level of education on ANC quality mediated by the number of consultations and timing of ANC initiation. Base and post confounders were included. Results The results showed that except for breast examination, height measurement, tetanus toxoid vaccination and ANC starting at the first trimester, all ANC indicators showed more than 80% coverage during ANC visits. In the adjusted analysis, inadequate quality ANC was associated with lower maternal education level, not having a partner, being multiparous, being attended by a private provider and by the same professional in all consultations. In the mediation analyses, 6.8% of the association between ANC quality and mother’s education was mediated by the trimester in which ANC started, while 12.8% was mediated by the number of ANC visits. Conclusions ANC quality is associated with pregnant women’s socio-demographic characteristics. Significant efforts are needed to improve the quality of facility-based maternity care.

scholarly journals Quality of Antenatal Care at Urban and Rural Puskesmas (Public Health Center) in Jeneponto Regency

2020 ◽  
Vol 8 (T2) ◽  
pp. 177-182
Author(s):  
Nurul Fauziah ◽  
Ansariadi Ansariadi ◽  
Darmawansyah Darmawansyah ◽  
Wahidin M. Wahidin ◽  
Reski Amaliah ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Antenatal Care ◽  
Health Center ◽  
Health Centers ◽  
Blood Type ◽  
Height Measurement ◽  
Public Health Center ◽  
Rural And Urban

BACKGROUND: Increased coverage antenatal care (ANC) occurring in developing countries do not guarantee the success of the ANC, it is because a high rate of maternal and neonatal mortality associated with inadequate and poor quality of maternal care, including ANC. AIM: This study aimed to find out the differences in the quality of ANC in rural and urban primary health centers in Jeneponto Regency. METHODS: This research aims to determine the different quality of ANC at urban and rural puskesmas (public health center), Jeneponto regency. The type of the research was observational analysis with cross-sectional design. There were 139 fixed samples of rural and urban pregnant women visiting the puskesmas, from October 2015 to May 2016. The samples were selected using stratified random sampling method from two puskesmas of each area. RESULTS: The results indicate that 52.6% of ANC quality is categorized bad. There is different ANC quality based on body weight, the height of fundus uteri, and administration of Fe tablet (0.038, 0.029, and 0.006). There is no difference of antenatal quality based on body height, LILA, fetus’ heartbeat, fetus presentation, blood type and Hb, and immunization of TT (0.068, 0.501, 1.000, 1.000, 0.133, 0263, and 0530). Blood pressure is not analyzed. CONCLUSION: There are three components that show differences in rural and urban health centers, namely, weight measurement, fundal height measurement, and FE tablet administration. As for the components of height measurement, assessment of nutritional status (MUAC), fetal presentation, examination of fetal heart rate, administration of TT immunization, and examination of blood type and hemoglobin. The component of blood pressure measurement was not included in the statistical test because all respondents received the examination.

scholarly journals Antenatal care processes in rural Southern Nepal: gaps in and quality of service provision—a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056392
Author(s):  
Emily Bryce ◽  
Joanne Katz ◽  
Tsering Pema Lama ◽  
Subarna K Khatry ◽  
Steven C LeClerq ◽  
...  
Keyword(s):  
Cohort Study ◽  
Quality Of Care ◽  
Antenatal Care ◽  
Service Provision ◽  
Quality Care ◽  
First Trimester ◽  
Adjusted Risk ◽  
Provision Of Services ◽  
Standard Quality

ObjectivesThis study aimed to compare a standard quality of care definition to one that reflected focused antenatal care (FANC) guidelines and examine associations with receipt of good quality of care.DesignThis study was a longitudinal cohort study.SettingsFive government health posts in the Sarlahi district of Southern NepalParticipantsPregnant women between the ages of 15 and 49 who presented for their first antenatal care (ANC) visit at the study health posts.Main outcomesThere were two quality of care definitions: (1) provision of seven services at least once during pregnancy (QOC1) and (2) provision of services to reflect the FANC guidelines by incorporating a frequency of care dimension for certain services (QOC4+).ResultsThere was variation in service provision both in terms of frequency of provision and by gestational age at the visit. There were 213 women (49.1%) that received good quality care by the first definition, but when the frequency of service provision was included for the second definition the percentage dropped to 6.2%. There were significant differences in provision of quality care by health post for both definitions. The number of visits (QOC1 adjusted risk ratio (aRR) 1.18, 95% CI 1.13 to 1.23; QOC4+ aRR 1.46, 95% CI 1.11 to 2.80) and care during the first trimester (QOC1 aRR 1.22, 95% CI 1.01 to 1.49) and maternal age (QOC1 aRR 1.27, 95% CI 1.03 to 1.58) were associated with greater likelihood of good quality ANC.ConclusionThis analysis demonstrated that measuring quality of care by receipt of services at least once during pregnancy may overestimate the true coverage of quality of ANC. Future efforts should improve feasibility of including frequency of care in quality of care definitions.

scholarly journals Bipolar depression: the importance of being on remission

2006 ◽  
Vol 28 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Fernando Kratz Gazalle ◽  
Ana Cristina Andreazza ◽  
Pedro Curi Hallal ◽  
Márcia Kauer-Sant'Anna ◽  
Keila Maria Ceresér ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Mood State ◽  
Bipolar Depression ◽  
Linear Trend ◽  
World Health ◽  
Trend Test ◽  
Type I ◽  
Residual Symptoms

OBJECTIVE: The aim of the present study is to compare quality of life among currently depressed, subsyndromal and remitted patients with bipolar disorder (BD) and to assess whether the level of depression correlates with the scores of quality of life in BD patients. METHOD: Sixty bipolar outpatients diagnosed using the Structured Clinical Interview for DSM-IV who met criteria for diagnosis of BD type I, II or not otherwise specified (BD-NOS), and who were not currently on a manic or mixed episode were included. The main variables of interest were quality of life (QOL) assessed using the 26-item World Health Organization QOL instrument (WHOQOL-BREF) and depression assessed using the 17-item Hamilton Depression Rating Scale (HDRS). RESULTS: A linear trend test showed a dose response association between patients' current mood state and all domains of quality of life. Higher quality of life scores were found among remitted patients, followed by subsyndromal patients; depressed patients presented lower scores of quality of life, except for the social domain. The four domains of the WHOQOL scale correlated negatively with the HDRS. CONCLUSIONS: Our findings suggest that bipolar depression and residual symptoms of depression are negatively correlated with QOL in BD patients.

Trends in early prenatal screening for chromosomal abnormalities and congenital malformations in Russia in 2018

2020 ◽  
pp. 76-78
Author(s):  
Е.А. Калашникова ◽  
Е.Н. Андреева ◽  
П.А. Голошубов ◽  
Н.О. Одегова ◽  
Е.В. Юдина ◽  
...  
Keyword(s):  
Reference Values ◽  
Congenital Malformations ◽  
Prenatal Screening ◽  
Chromosomal Abnormalities ◽  
First Trimester ◽  
First Trimester Screening ◽  
Trimester Screening ◽  
Overall Effectiveness ◽  
Regions Of Russia

В ходе анализа результатов раннего пренатального скрининга (РПС) в России за 2018 г. (Аудит-2019) дана оценка качества мероприятий, общей эффективности и тенденций развития системы РПС в субъектах РФ посредством сравнения рассчитанных основных организационных, методологических и интегральных показателей с международными референтными значениями. In the course of analyzing the results of early prenatal combined first-trimester screening (FTS) in Russia for 2018 (Audit-2019) the assessment of the quality of measures, the overall effectiveness and trends in the development of the FTS system in the regions of Russia. They are presented by comparing the calculated main organizational, methodological and integral indicators with international reference values.

EFFECTIVENESS OF USING MCH BOOKS AND MONSCA APPLICATIONS IN THE IMPLEMENTATION OF 14 T ANTENATAL SERVICE STANDARDS

2020 ◽  
Vol 12 (1) ◽  
pp. 68-73
Author(s):  
Rahmawati Rahmawati ◽  
Syarif Syafruddin ◽  
Nontji Wena
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Continuity Of Care ◽  
Control Design ◽  
Sampling Technique ◽  
Limited Time ◽  
Control Groups ◽  
Post Test ◽  
Service Standards

The component of antenatal care received by pregnant women is classified as incomplete because the implementation of standard pregnancy services is still using conventional methods. There are obstacles faced by midwives, such as the limited time in a recording, which has an impact on the declining quality of antenatal care standards. This research aims to compare the effectiveness of the use of KIA books and MONSCA applications in midwives in the application of the standard Antenatal service 14 T. This research was conducted in Puskesmas Tanete and Puskesmas Bontobangun Bulukumba District. The method used in the study is experimental quasi (pre-test post-test nonequivalent control design). Using a sample of midwives in this study, as many as 36 people were divided into two groups (18 intervention groups and 18 control groups). The sampling technique in this study used purposive sampling. Data were analyzed using the Mann-Whitney Test. The results showed that there was a difference in the effectiveness of using KIA books with MONSCA applications, MOSCA's applications were easier to use, faster, safer, and more accurate than KIA books. It can be concluded that the MONSCA application is more effective than KIA books. Key words: Effectiveness, Android-based Smart Continuity of Care application, KIA book, Antenatal service 14 T

scholarly journals Implementation of a performance-based financing scheme in Malawi and resulting externalities on the quality of care of non-incentivized services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephan Brenner ◽  
Caterina Favaretti ◽  
Julia Lohmann ◽  
Jobiba Chinkhumba ◽  
Adamson S. Muula ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Services ◽  
Antenatal Care ◽  
Service Provision ◽  
Child Health Services ◽  
Negative Externalities ◽  
Positive Externalities ◽  
Performance Based Financing ◽  
A Performance

Abstract Background Countries in Africa progressively implement performance-based financing schemes to improve the quality of care provided by maternal, newborn and child health services. Beyond its direct effects on service provision, evidence suggests that performance-based financing can also generate positive externalities on service utilization, such as increased use of those services that reached higher quality standards after effective scheme implementation. Little, however, is known about externalities generated within non-incentivized health services, such as positive or negative effects on the quality of services within the continuum of maternal care. Methods We explored whether a performance-based financing scheme in Malawi designed to improve the quality of childbirth service provision resulted positive or negative externalities on the quality of non-targeted antenatal care provision. This non-randomized controlled pre-post-test study followed the phased enrolment of facilities into a performance-based financing scheme across four districts over a two-year period. Effects of the scheme were assessed by various composite scores measuring facilities’ readiness to provide quality antenatal care, as well as the quality of screening, prevention, and education processes offered during observed antenatal care consultations. Results Our study did not identify any statistically significant effects on the quality of ANC provision attributable to the implemented performance-based financing scheme. Our findings therefore suggest not only the absence of positive externalities, but also the absence of any negative externalities generated within antenatal care service provision as a result of the scheme implementation in Malawi. Conclusions Prior research has shown that the Malawian performance-based financing scheme was sufficiently effective to improve the quality of incentivized childbirth service provision. Our findings further indicate that scheme implementation did not affect the quality of non-incentivized but clinically related antenatal care services. While no positive externalities could be identified, we also did not observe any negative externalities attributable to the scheme’s implementation. While performance-based incentives might be successful in improving targeted health care processes, they have limited potential in producing externalities – neither positive nor negative – on the provision quality of related non-incentivized services.

Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

A model to predict the kinetics of mass loss in wood during thermo-vacuum modification

Holzforschung ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ottaviano Allegretti ◽  
Ignazia Cuccui ◽  
Nasko Terziev ◽  
Laerte Sorini
Keyword(s):  
Mass Loss ◽  
Treatment Process ◽  
Linear Trend ◽  
Thermal Modification ◽  
Thermal Treatments ◽  
Temperature Profiles ◽  
Relative Area ◽  
Heat Power ◽  
Kinetics Of

AbstractMass loss (ML) of wood caused by thermal degradation is one of the most important features of the thermal treatments and referred to as an indicator of intensity and quality of the process. The ML is proportional to the quantity of the effective heat power exchanged during the treatment process, represented by the area of the temperature profile versus time during the process. In this paper a model for the ML prediction based on the relative area was discussed. The model proposed an analytical solution to take into account the non-linear trend of ML when plotted versus temperature and time as observed in isothermal experiments. The model was validated comparing calculated and measured final ML of samples treated during thermal modification tests with different temperature profiles. The results showed that the relative area calculated in a transformed time-temperature space improves the correlation with the measured ML.

Sign in / Sign up

Export Citation Format

Share Document