scholarly journals Social Determinants of Anemia and Overweight/Obesity among Pregnant Women in Nepal

2021 ◽  
Vol 76 (0) ◽  
pp. n/a
Author(s):  
Rina KAWATA ◽  
Yoko ODA ◽  
Akiko IWAKUNI ◽  
Arjun ACHARYA ◽  
Rajesh ADHIKARI ◽  
...  
2019 ◽  
Vol 122 (03) ◽  
pp. 284-292 ◽  
Author(s):  
Marcos Pereira-Santos ◽  
Gisele Queiroz Carvalho ◽  
Djanilson Barbosa dos Santos ◽  
Ana Marlucia Oliveira

AbstractThe relationship among social determinants, vitamin D serum concentration and the health and nutrition conditions is an important issue in the healthcare of pregnant women and newborns. Thus, the present study analyses how vitamin D, prenatal monitoring and social determinants are associated with birth weight. The cohort comprised 329 pregnant women, up to 34 weeks gestational age at the time of admission, who were receiving care through the prenatal services of Family Health Units. Structural equation modelling was used in the statistical analysis. The mean birth weight was 3340 (sd 0·545) g. Each nmol increase in maternal vitamin D serum concentration was associated with an increase in birth weight of 3·06 g. Prenatal healthcare with fewer appointments (β −41·49 g, 95 % CI −79·27, −3·71) and late onset of care in the second trimester or third trimester (β −39·24 g, 95 % CI −73·31, −5·16) favoured decreased birth weight. In addition, low socio-economic class and the practice of Afro-Brazilian religions showed a direct association with high vitamin D serum concentrations and an indirect association with high birth weight, respectively. High gestational BMI (β 23·84, 95 % CI 4·37, 43·31), maternal education level (β 24·52 g, 95 % CI 1·82, 47·23) and length of gestation (β 79·71, 95 % CI 52·81; 106·6) resulted in high birth weight. In conclusion, maternal vitamin D serum concentration, social determinants and prenatal care, evaluated in the context of primary healthcare, directly determined birth weight.


2021 ◽  
Vol 224 (2) ◽  
pp. S712
Author(s):  
D'Angela S. Pitts ◽  
Nicolina Smith ◽  
Mariam Ayyash ◽  
Louise O'Brien

2020 ◽  
Author(s):  
Laura Isaza-Arias ◽  
Andrés A Agudelo-Suárez ◽  
Cielo J Chicangana ◽  
Julián Alfredo Fernández-Niño

Abstract Background gender-based violence is considered a phenomenon of importance in the field of public health and social sciences. From a social determinants’ perspective, it seems important to study this topic in social groups considered as vulnerable, in order to establish prevention strategies. This study aims to explore the experiences of gender-based violence and its social determinants in a group of undocumented pregnant women in the city of Barranquilla, Colombia.Methods qualitative study based on 15 semi-structured interviews with undocumented pregnant Venezuelans residing in the district of Barranquilla. The interview guide included various dimensions in order to discover the opinions and experiences of each participant related to their migration process, their health during pregnancy, experiences of gender-based violence, individual and institutional responses to violence and, lastly, the health care they have received in Colombia. Narrative contents analysis was carried out by means of emergent categories from the perspective of the interviewed women. Ethical considerations for gender-based violence studies were taking into consideration.Results interviewed women migrated from Venezuela to Barranquilla in Colombia motivated to improve their quality of life and for their families. In the adaptation process, some women reported having been victims of physical, psychological, sexual and economic violence, which can be associated with their vulnerability conditions related to their pregnancy and motherhood, economic dependency, lack of networks of support and insecurity of the sectors in which they resided. This situation affected their physical, mental and psychosocial health.Conclusion immigrant pregnant women in Barranquilla are in an especial situation of social vulnerability considering their experiences about gender-based violence, and its social determinants related to the migratory process and their adaptations to the Colombian territory.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ana Reyes ◽  
Rabih Dahdouh ◽  
Precious Akanyirige ◽  
Araceli Estrada ◽  
Maria R Young ◽  
...  

Introduction: Consistent evidence has shown that the social determinants of health (SDoH) play an important role in shaping overall health. As health systems become more focused on improving the health of populations, there is an urgent need for interventions that address upstream factors such as the social determinants of health. Such interventions have not been widely studied and even less work exists in the realm of maternal health. But as maternal and infant mortality remain critical issues, there is great opportunity for the study and development of interventions to address social needs in pregnancy care. Hypothesis: We assessed the hypothesis that most existing interventions addressing the social needs of pregnant women would focus only on identifying social risks, while fewer would connect patients with resources in the community. We expected that most studies would not provide evaluations of effectiveness. Methods: We conducted a database search of MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and Web of Science to capture literature published between January 1970 and April 2019. A team of reviewers screened titles and abstracts for interventions that were issued in a clinical setting and addressed at least one SDoH as defined by the World Health Organization. Results: Preliminary results revealed 25 studies. All consisted of some form of risk screening and four included a referral process. Interventions addressing intimate partner violence were most numerous followed by psychosocial factors and cigarette smoking. Financial needs were assessed in one study. Eight studies included an evaluation process. Staff carrying out the interventions were primarily research staff, nurse practitioners or nurse midwives. Conclusions: In conclusion, more must be done to connect pregnant women with social resources. As unmet social needs put women at higher risk for poor outcomes in pregnancy, action should be taken to more seamlessly integrate social needs interventions into clinical workflows. Focus should expand beyond traditional social risk screening to capture a wider range of needs including financial stability, housing, and transportation. These are particularly important during pregnancy because adequate prenatal care requires women to be more engaged with the health care system than they would to maintain baseline health.


2021 ◽  
Vol 58 (S1) ◽  
pp. 32-32
Author(s):  
J. Torres‐Torres ◽  
R.J. Martinez‐Portilla ◽  
S. Espino‐y‐Sosa ◽  
G. Estrada‐Gutierrez ◽  
J. Solis‐Paredes ◽  
...  

2019 ◽  
Vol 13 ◽  
Author(s):  
Carolina Gabriele Gomes da Rocha ◽  
Ivonete Heideman Teresinha Schulter Buss Heidemann ◽  
Pamela Camila Fernandes Rumor ◽  
Fabiano Oliveira Antonini ◽  
Michelle Kuntz Durand ◽  
...  

Objetivo: conhecer como são trabalhados os Determinantes Sociais da Saúde na consulta de Enfermagem do pré-natal na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo, exploratório, com 15 enfermeiras, mediante a realização de entrevistas semiestruturadas, prosseguindo-se com a análise temática dos dados. Resultados: limita-se a compreensão sobre os Determinantes Sociais da Saúde a fatores relacionados à situação socioeconômica e à rede familiar da gestante. Revelou-se a atuação da equipe multiprofissional e enfatizou-se a necessidade de envolver ações intersetoriais. Identificaram-se limites e dificuldades relacionados à atuação dos enfermeiros sobre os determinantes e condicionantes que interferem na vida das gestantes. Conclusão: revela-se que, apesar de os enfermeiros não compreenderem o conceito de modo amplo, a atuação mostra-se como uma realidade durante o pré-natal. Acrescenta-se, no entanto, que são múltiplas as barreiras enfrentadas pelas gestantes e são muitos os limites e dificuldades encontrados pelos profissionais para atuar amplamente sobre os Determinantes Sociais de Saúde. Descritores: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Cuidado Pré-natal; Equidade em Saúde.ABSTRACTObjective: to know how the Social Determinants of Health are dealt with in the Prenatal Nursing consultation in Primary Health Care. Method: this is a qualitative, descriptive, exploratory study, with 15 nurses, through semi-structured interviews, continuing with the thematic analysis of the data. Results: the understanding about the Social Determinants of Health is limited to factors related to the socioeconomic situation and the pregnant woman's family network. The performance of the multiprofessional team was revealed and the need to involve intersectoral actions was emphasized. Limits and difficulties related to the performance of nurses on the determinants and conditions that interfere in the lives of pregnant women were identified. Conclusion: it is revealed that, although nurses do not understand the concept broadly, acting is a reality during prenatal care. However, there are multiple barriers faced by pregnant women and there are many limits and difficulties encountered by professionals to act broadly on the Social Determinants of Health. Descriptors: Health Promotion; Social Determinants of Health; Primary Health Care; Nursing; Pré-natal Care; Health Equity.RESUMENObjetivo: conocer cómo se abordan los Determinantes Sociales de la Salud en la consulta de Enfermería Prenatal en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo, exploratorio, con 15 enfermeras, a través de entrevistas semiestructuradas, continuando con el análisis temático de los datos. Resultados: la comprensión de los Determinantes Sociales de la Salud se limita a factores relacionados con la situación socioeconómica y la red familiar de la mujer embarazada. Se reveló el desempeño del equipo multiprofesional y se enfatizó la necesidad de involucrar acciones intersectoriales. Se identificaron los límites y las dificultades relacionadas con el desempeño de los enfermeros sobre los determinantes y las condiciones que interfieren en la vida de las mujeres embarazadas. Conclusión: se revela que, aunque los enfermeros no entienden el concepto en general, la actuación es una realidad durante la atención prenatal. Sin embargo, las mujeres embarazadas enfrentan múltiples barreras y los profesionales enfrentan muchos límites y dificultades para actuar ampliamente sobre los Determinantes Sociales de la Salud. Descriptores: Promoción de la Salud; Determinantes Sociales de la Salud; Atención Primaria de Salud; Enfermería; Atención Prenatal; Equidad en Salud.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0243924
Author(s):  
Mariah Jorda ◽  
Bradley J. Conant ◽  
Anne Sandstrom ◽  
Marilyn G. Klug ◽  
Jyoti Angal ◽  
...  

Identifying social determinants of tobacco and alcohol use during pregnancy is critical to improving health outcomes for the next generation. This is especially important on a rural Tribal Nation where influences such as isolation, cultural barriers, and historical trauma have made it uniquely challenging to prevent substance use during pregnancy. The purpose of this study is to identify population-specific factors that are protective against smoking and drinking during pregnancy. We used data from 421 pregnancies collected as a part of the Safe Passages study from a rural Tribal Nation in the central United States. Pregnant women were classified as women who did not smoke (n = 84), women who quit during pregnancy (n = 23), women who smoked during pregnancy (n = 314), and women who both smoked and drank alcohol during pregnancy (n = 149). Demographic data revealed that 28.8% of the mothers were currently employed, and 91.8% of mothers reported a household income of less than $3,000 per year. Substance use rates were higher than national averages: 74.6% smoked during pregnancy and 35.4% of the women both smoked and drank alcohol during pregnancy. Five factors were identified as being protective against substance use during pregnancy: 1) living with someone (81% less likely to smoke and 92% less likely to smoke and drink), 2) having at least 12 years of education (128% less likely to smoke, and 126% less likely to smoke and drink), 3) having over 12 years of education (235% less likely to smoke, and 206% less likely to smoke and drink), 4) being employed (158% less likely to smoke, and 111% less likely to smoke and drink), and 5) not being depressed (214% less likely to smoke, and 229% less likely to smoke and drink). These social determinants should be considered for intervention research to decrease rates of substance use during pregnancy.


Author(s):  
Garima Sharma ◽  
Gowtham R. Grandhi ◽  
Isaac Acquah ◽  
Reed Mszar ◽  
Shiwani Mahajan ◽  
...  

Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.


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