scholarly journals Magnitude and determinants of self-referrals among women seeking skilled birth attendance services: a cross-sectional hospital-based study in Marsabit County, Kenya

2021 ◽  
Vol 8 (5) ◽  
pp. 2124
Author(s):  
Joseph O. Adoyo ◽  
Eliphas G. Makunyi ◽  
George O. Otieno ◽  
Alison Yoos
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Skilled Birth Attendance ◽  
Health Facilities ◽  
Public Hospitals ◽  
Systematic Sampling ◽  
P Value ◽  
Cross Sectional ◽  
Factors Associated ◽  
Birth Attendance ◽  
Referral Hospitals

Background: Self-referral to higher-level hospitals by women seeking skilled birth attendance services reflects in part their non-adherence to established referral pathways. This choice results in an inappropriate utilization of resources within health system. The Kenya Health Sector Referral Strategy aims at optimising the utilization and access of facilities. The aim of this study was to determine the prevalence and factors associated with self-referral among women seeking skilled birth attendance services in Marsabit County between 1st and 31st Oct 2019.Methods: A cross-sectional study was adopted at the maternity department in the selected public hospitals in Marsabit County, by use of interviewer-administered questionnaires to collect information from 161 women, through systematic sampling between 1st and 31st Oct 2019. Chi-square and multiple logistic regression analysis were used to test for factors associated with self-referral at 95% confidence interval.Results: Of the 161 women interviewed, 47.2% (n=76) were self-referrals. The odds of self-referral to the higher level health facilities were more likely among women: - aged 25-29 (AOR 5.174, CI 1.015-26.365, p-value 0.048); those referred for other ANC services (AOR 4.057, CI 1.405-11.720, p-value 0.010); and those, - who visited the referral facility before for delivery (AOR 5.395, CI 1.411 – 20.628, p-value 0.014). However, self-referral were less likely among women who perceived privacy and confidentiality of services at the referral hospitals (AOR 0.370, CI 0.138-0.990, p-value 0.048).Conclusions: Almost half of women seeking skilled birth attendance were self-referrals, relates to a possible implication on an unprecedented increased workload at referral hospitals and underutilization of primary health facilities.

Assessment of the Accuracy of Malaria Microscopy in Private Health Facilities in Entebbe Municipality, Uganda; A Cross-sectional Study

2021 ◽  
Author(s):  
Tobius Mutabazi ◽  
Emmanuel Arinaitwe ◽  
Alex Ndyabakira ◽  
Emmanuel Sendaula ◽  
Alex Kakeeto ◽  
...  
Keyword(s):  
Predictive Value ◽  
Malaria Diagnosis ◽  
Clinical Information ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Factors Associated ◽  
Expert Microscopy ◽  
Malaria Microscopy

Abstract Introduction: Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. We evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda.Methods: Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results: The prevalence of malaria parasitemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1% and 99.2% respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; 1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [OR] = 9.74, 95% Confidence Interval [CI] (1.06 – 89.5), p-value=0.04), and 2) who was examining less than 5 smears a day (OR = 38.8, 95% CI 9.65- 156, p-value <0.001).Conclusion: The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector.

scholarly journals Status of Home Delivery and Its Associated Factors among Women Who Gave Birth within the Last 12 Months in East Badawacho District, Hadiya Zone, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Deneke Delibo ◽  
Melake Damena ◽  
Tesfaye Gobena ◽  
Bahailu Balcha
Keyword(s):  
Maternal Education ◽  
Skilled Birth Attendance ◽  
Home Delivery ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
Birth Preparedness ◽  
Cross Sectional ◽  
Place Of Delivery ◽  
Birth Plan ◽  
Birth Attendance

Background. Home delivery is responsible to maternal mortality due to obstetric complication like hemorrhage, hypertensive disorders, and sepsis. The prevalence of home delivery is remained very high both nationally (73%) and regionally (SNNPR) with 74.5%. Efforts were made to increase institutional delivery through skilled birth attendance. But women still prefer home as a place of delivery. This study was done to determine whether home preference has association with home delivery or not and the reason why they prefer home delivery Method. A community-based cross-sectional study was conducted in East Badawacho District from January 26 to February 25/2018. A total of 552 participants were selected by systematic sampling. Data were collected using both quantitative and qualitative methods. Bivariate and multivariable analyses were carried out to identify factors associated with home delivery. Qualitative data was analyzed thematically, and results were triangulated with the data. Associations were determined by using OR at 95% CI and p value at 0.05. Result. Home delivery is found to be 73.6% (95% CI, 69.9%-77.2%). Lack of written birth plan for birth preparedness and readiness (AOR=14.965, 95% CI: 4.488-49.899), incomplete number of ANC visits (1-3)(AOR=4.455, 95% CI: 1.942-10.221), and home preference as a place of delivery (AOR=4.039, 95% CI: 1.545-10.558) were independent predictors of home delivery. Conclusion. Home delivery was high in the district. The independent factors significantly associated with home were lack of written birth plan for preparedness and readiness, incomplete number of ANC visits (1-3), and home preference as place of delivery. Actions targeting maternal education, encouraging number of ANC visits, and avoiding barriers for ID utilization were the crucial areas to tackle the problem.

scholarly journals Skilled Birth Attendance among Women in Tharaka-Nithi County, Kenya

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Eliphas Gitonga
Keyword(s):  
Family Income ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Systematic Sampling ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Skilled Attendant ◽  
Chi Square ◽  
Cross Sectional ◽  
Birth Attendance

Background. The burden of maternal mortality is concentrated in sub-Saharan Africa with an estimation of 500 000 deaths annually. In 2012, about forty million births occurred without a skilled attendant in developing countries. Skilled birth attendance improves maternal and newborn survival. The aim of this study therefore was to establish the level of skilled birth attendance and the associated factors. Methods. A cross-sectional survey was carried out using structured questionnaires as tools of data collection. Systematic sampling was used to select the respondents from the facilities that were stratified. The dependent variable was skilled birth attendance. Descriptive statistics were used to generate proportions and percentages while chi-square and Fisher’s exact tests were used to draw inferences. Association was significant if P<0.05. Results. The level of utilisation of skilled birth attendance was 77%. Skilled birth attendance was noted to be associated with age, level of education, average family income, parity, distance to the health facility, timing of initiation of antenatal care, level of facility attended during pregnancy, and birth preparedness status. Conclusion. The level of skilled birth attendance among women in Tharaka-Nithi County, Kenya, despite being higher than in some counties, requires improvement.

scholarly journals ASSESSMENT OF PROFESSIONALISM IN NURSING AND FACTORS ASSOCIATED AMONG NURSES WORKING IN ARSI ZONE PUBLIC HOSPITALS, OROMIA, ETHIOPIA

2020 ◽  
Author(s):  
Mulugeta Degefa Tola ◽  
Yibeltal Siaraneh Beleta ◽  
Fikru Tafese Jaleta
Keyword(s):  
Job Satisfaction ◽  
Formal Education ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
P Value ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Body Of Knowledge ◽  
Arsi Zone

Abstract Background: Professionals are defined in the context of a particular body of knowledge which is obtained through formal education, expanded level of skills, type of certification proving their entry into the profession; a set of behavioral norms called professionalism and attitudes representing high levels of commitment to and identification with a specific profession. Several factor affecting the development of the nursing profession. Recognizing and determining such factors can be the first step to move towards the professionalization of nursing. The objective of this study was to assess professionalism in nursing and factors associated among nurses working in Arsi zone, Public Hospitals, Oromia, Ethiopia 2018. Methods: This study used an Institutional based cross sectional study design. Self-administered structured questionnaire adapted from RNAO (Registered Nurses association of Ontario) guideline, was used to measure the level of professionalism. The sample was 420 nurses from the six Public Hospitals of Arsi Zone, Oromia, Ethiopia. Data was analyzed using SPSS 20.0. Both bivariate and multivariate analysis were carried out to identify associations. Odds ratio was calculated for related factors with 95% confidence interval (CI). A p-value < 0.05 was considered to be statistically significant. Result: Out of 420 Nurses working in six public Hospitals, 380 responded to the questionnaire, making the response rate of 90.5%. In current study level of professionalism was high among nurses (n=380) with highest percentages on accountability, advocacy, and ethics. Gender (AOR =2.489, 95% CI=1.540-4.023), nursing is indispensable (AOR=1.760, 95% CI=1.104-2.806), job satisfaction (AOR= 1.844, 95% CI = 1.143-2.975) and having up to dated training (AOR= 1.809, 95%CI=1.071-3.055 were significantly associated with overall professionalism level. Conclusion: Nurses working in public hospitals of Arsi zone have relatively had better professionalism level. Gender, nursing is indispensable, job satisfaction, presence of up-to-dated trainings were found significantly associated with professionalism in nursing. Human resource personnel and CEOs of respective hospitals should develop various training programs for nurses and provide encouraging environments for obtaining better qualities in attributes of professionalism. Keywords Attributes of professionalism, Nursing, Professionalism, associated factors

scholarly journals Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tobius Mutabazi ◽  
Emmanuel Arinaitwe ◽  
Alex Ndyabakira ◽  
Emmanuel Sendaula ◽  
Alex Kakeeto ◽  
...  
Keyword(s):  
Predictive Value ◽  
Malaria Diagnosis ◽  
Clinical Information ◽  
Health Facilities ◽  
P Value ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Factors Associated ◽  
Expert Microscopy ◽  
Malaria Microscopy

Abstract Background Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. Methods Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06–89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65–156, p-value < 0.001). Conclusions The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.

scholarly journals Factors Associated to Choice of Birth Attendance in Work Area Of Silago Health Center, Dharmasraya Regency In 2017

2017 ◽  
Vol 2 (2) ◽  
pp. 100
Author(s):  
Lailathul Husna ◽  
Abdiana Abdiana ◽  
Sunesni Sunesni
Keyword(s):  
Health Center ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Birth Attendance ◽  
Work Area ◽  
Chi Square Test

Maternal mortality in Indonesia can occur during pregnancy, labor and delivery. The biggest cause is bleeding. Bleeding can occur during labor or postpartum. Birth attendant can be an indirect determinant of the incidence in postpartum hemorrhage. The aim of this study is to determine factors associated to choice of birth attendance.An analitycal research based cross sectional study was conducted from November 2016-November 2017. The study included 66 subjects who gave birth in 2016 were selected by purposive sampling technique. Data were collected by questionnaire. The collected data were analyze with chi square test using p value <0,05The result of statistic test showed that there was a significant correlation between knowledge (p = 0,000) and attitude (p=001) with the choice of birth attendant. There was no significant correlation between age (p = 0,253), education (p=0,071), employment (p=0,227) and accesibility (p=p=1,000) with the choice of birth attendant. Meanwhile, for support of the husband  level chi square test was not performed.From the results of the study it can be concluded that knowledge and attitude were factors related to choice of birth attendance. Meanwhile, age, education, employment  and accesibility were not factors associated to choice of birth attendance in work area of Silago Health Center.

What factors are associated with forms of mistreatment during facility-based childbirth? A survey of referral health facilities in south-east Nigeria

2021 ◽  
pp. 1-16
Author(s):  
Ijeoma Nkem Okedo-Alex ◽  
Ifeyinwa Chizoba Akamike ◽  
Ugonna Igwilo ◽  
Chika Nwakanma Onwasigwe
Keyword(s):  
Rural Areas ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Rural Residence ◽  
Post Secondary ◽  
Client Care ◽  
Birth Attendance ◽  
Referral Hospitals ◽  
Type Mode

Abstract Mistreatment during childbirth in health facilities contributes significantly to suboptimal levels of skilled birth attendance. This study determined the factors associated with mistreatment during facility-based childbirth in two referral facilities in south-east Nigeria. A survey of 620 women whose childbirth occurred in two high-patronage referral hospitals of Ebonyi, Nigeria, was conducted in July–September 2018 using interviewer-administered questionnaires. Data analysis was performed using SPSS version 20. Logistic regression was used to identify predictors. The mean age of the respondents was 29.86 ± 4.4 years. Most had post-secondary education (71.0%), and had attended at least four antenatal visits (83.4%). The prevalence of any mistreatment during childbirth was 56%. Rural residence (adjusted odds ratio [AOR]: 0.53; CI: 0.35, 0.78, p = 0.002) and childbirth facilitated by a doctor (AOR: 1.7; CI: 1.14, 2.39, p = 0.007) were predictors of reporting at least one form of mistreatment during childbirth. Childbirth facilitated by a doctor (AOR: 1.66; CI: 1.05, 2.63, p = 0.031) and unemployment (AOR: 1.84; CI: 1.01, 3.07, p = 0.011) increased the odds of non-consented and non-dignified care, respectively. Rural residence (AOR: 0.57; CI: 0.37, 0.88, p = 0.011) and childbirth facilitated by a doctor (AOR: 0.65; CI: 0.45, 0.94, p = 0.020) were protective against abandonment/neglect. Vaginal birth (AOR: 0.33; CI: 0.16, 0.69, p = 0.003) reduced the odds of detention in the health facility following childbirth. Almost three-fifths of the women whose childbirths occurred in the surveyed facilities experienced at least one form of mistreatment during childbirth. Place of residence, health professional type, mode of childbirth, employment status and frequency of antenatal attendance were predictors of mistreatment during childbirth. Rights-based sensitization for women, especially in the rural areas, female empowerment, provider capacity-building on respectful client care and provision of subsidized maternal health services are recommended.

HUBUNGAN ANTARA UMUR DAN PENDIDIKAN IBU DENGAN KEJADIAN BBLR DI RUMAH SAKIT UMUM PUSAT DR. MOHAMMAD HOESIN PALEMBANG TAHUN 2010

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Yuhemy Zurizah Yuhemy Zurizah ◽  
Rini Mayasari Rini Mayasari
Keyword(s):  
General Hospital ◽  
Maternal Age ◽  
Public Hospitals ◽  
Infant Mortality Rate ◽  
P Value ◽  
Check List ◽  
Test Statistic ◽  
Chi Square ◽  
Cross Sectional ◽  
Live Births

ABSTRACT Low Birth Weight (LBW) was defined as infants born weighing less than 2.500 grams. WHO estimates that nearly all (98%) of the five million neonatal deaths in developing countries. According to City Health if Palembang Departement, infant mortality rate (IMR) in the year 2007 is 3 per 1000 live births, in 2008 four per 1000 live births, and in 2009 approximately 2 per 1000 live births. The cause of LBW is a disease, maternal age, social circumstances, maternal habits factors, fetal factors and environmental factors. LBW prognosis depending on the severity of the perinatal period such as stage of gestation (gestation getting younger or lower the baby's weight, the higher the mortality), asphyxia / ischemia brain, respiratory distress syndromesmetabolic disturbances. This study aims to determine the relationship between maternal age and educations mothers of pregnancy with the incidence of LBW in the General Hospital Dr Center. Mohammad Hoesin Palembang in 2010 This study uses the Analytical Ceoss Sectional Survey. The study population was all mothers who gave birth in public hospitals center Dr. Mohammad Hoesin Palembang in 2010 were 1.476 mothers gave birth with a large sample of 94 studies of maternal taken by systematic random sampling, ie research instument Check List. Data analysis was performed univariate and bivariate. The results of this study show from 94 mothers of LBW was found 45 people (47,9%) Which has a high risk age 26 LBW ( 27,7%) while the distance of low educations LBW (55,3%). From Chi-Square test statistic that compares the p value with significance level α = 0,05 showed a significant correlation between maternal age, where the p value = 0,002, of education mothers of pregnancy p value = 0,003 with LBW. In the general hospital center Dr. Mohammad Hoesin Palembang ini 2010. Expected to researches who will come to examine in more depth.   ABSTRAK Bayi Berat Lahir Rendah (BBLR) telah didefinisikan sebagai bayi lahir kurang dari 2.500 gram. WHO memperkirakan hampir semua (98%) dari 5 juta kematian neonatal di negara berkembang. Menurut Data Dinas Kesehatan Kota Palembang, Angka Kematian Bayi (AKB) pada tahun 2007 yaitu 3 per 1.000 kelahiran hidup, pada tahun 2008 4 per 1.000 kelahiran hidup, dan pada tahun 2009 sekitar 2 per 1.000 kelahiran hidup. Penyebab BBLR adalah penyakit, usia ibu, keadaan sosial, faktor kebiasaan ibu, dan faktor lingkungan. Prognosis BBLR tergantung dari berat ringannya masa perinatal misalnya masa gestasi (makin muda masa gestasi atau makin rendah berat bayi, makin tinggi angka kematian), asfiksia atau iskemia otak, sindrom gangguan pernafasan, gangguan metabolik. Penelitian ini bertujuan untuk mengetahui hubungan antara umur dan pendidikan ibu dengan kejadian BBLR di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2010. Penelitian ini menggunakan survey analitik Cross sectional. Populasi penelitian ini adalah semua ibu yang melahirkan di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang tahun 2010 sebanyak 1.476 ibu melahirkan dengan besar sampel penelitian 94 ibu melahirkan yang diambil dengan tehnik acak sistematik, instrumen penelitian yaitu check list. Analisis data dilakukan secara univariat dan bivariat. Hasil penelitian ini menunjukkan dari 94 ibu didapatkan kejadian BBLR 45 orang (47,9%) yang memiliki umur resiko tinggi 26 kejadian BBLR (27,7%) sedangkan yang pendidikan rendah 52 kejadian BBLR (55,3%). Dari statistik uji Chi-square yang membandingkan p value dengan tingkat kemaknaan α = 0,05 menunjukkan bahwa ada hubungan yang bermakna antara umur ibu p value (0,002) , pendidikan p value (0,003) dengan kejadian BBLR di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2010. Diharapkan bagi peneliti yang akan datang untuk meneliti lebih mendalam.

scholarly journals Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daiki Watanabe ◽  
Tsukasa Yoshida ◽  
Takashi Nakagata ◽  
Naomi Sawada ◽  
Yosuke Yamada ◽  
...  
Keyword(s):  
Older Adults ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Middle Aged ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mail Surveys ◽  
Osaka Prefecture ◽  
Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

scholarly journals Who are dying and why? A case series study of maternal deaths in Nepal

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042840
Author(s):  
Rajendra Karkee ◽  
Kirti Man Tumbahangphe ◽  
Nashna Maharjan ◽  
Bharat Budhathoki ◽  
Dharma Manandhar
Keyword(s):  
Case Series ◽  
Public Hospitals ◽  
Birth Preparedness ◽  
Framework Analysis ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Social Autopsy ◽  
Case Series Study ◽  
Referral Hospitals ◽  
Series Study

ObjectivesTo identify delays and associated factors for maternal deaths in Nepal.DesignA cross-sectional case series study of maternal deaths. An integrated verbal and social autopsy tool was used to collect quantitative and qualitative information regarding three delays. We recorded death accounts and conducted social autopsy by means of community Focus Group Discussions for each maternal death; and analysed data by framework analysis.SettingSixty-two maternal deaths in six districts in three provinces of Nepal.ResultsNearly half of the deceased women (45.2%) were primiparous and one-third had no formal education. About 40% were from Terai/Madhesi and 30.6% from lower caste. The most common place of death was private hospitals (41.9%), followed by public hospitals (29.1%). Nearly three-fourth cases were referred to higher health facilities and median time (IQR) of stay at the lower health facility was 120 (60–180) hours. Nearly half of deaths (43.5%) were attributable to more than one delay while first and third delay each contributed equally (25.8%). Lack of perceived need; perceived cost and low status; traditional beliefs and practices; physically inaccessible facilities and lack of service readiness and quality care were important factors in maternal deaths.ConclusionsThe first and third delays were the equal contributors of maternal deaths. Interventions related to birth preparedness, economic support and family planning need to be focused on poor and marginalised communities. Community management of quick transportation, early diagnosis of pregnancy risks, accommodation facilities near the referral hospitals and dedicated skilled manpower with adequate medicines, equipment and blood supplies in referral hospitals are needed for further reduction of maternal deaths in Nepal.

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