The Status of Emergency Obstetric and Newborn Care in Post-Conflict Eastern DRC: A Facility-Level Cross-Sectional Study.

Abstract Background Pregnancy-related mortality remains persistently higher in post-conflict areas. Part of the blame lies with continued disruption to vital care provision, especially emergency obstetric and newborn care (EmONC). In such settings, assessment of EmONC is essential for informed interventions needed to improve maternal and neonatal survival. In the North Kivu Province (NKP), the epicentre of armed conflict in eastern Democratic Republic of the Congo (DRC) between 2006-2013, the post-conflict status of EmONC is unknown. We assessed the availability, use, and quality of EmONC in 3 health zones (HZs) of the NKP.Method A cross-sectional survey of all 42 public facilities designated to provide EmONC in 3 HZs (Goma, Karisimbi, and Rutshuru), purposively selected based on their relative proximity to previous conflicts and their respective locations encompassing the entire economic landscape of the province, was conducted in 2017. Interviews, reviews of maternity ward records, and observations were used to assess the accessibility, use, and quality of EmONC against WHO standards.Results The 3 HZs fell short of WHO standards. Only three referral facilities (two faith-based facilities in Goma and the MSF-run referral hospital of Rutshuru) met the criteria for comprehensive EmONC, i.e., 1.5 EmONC facilities per 500,000 population. None of the health centres qualified as basic EmONC, nor could offer obstetric and neonatal care services 24 hours, 7 days a week (24/7). Assisted vaginal delivery was the least performed signal function, followed by parenteral administration of anticonvulsants, mostly due to policy restrictions and lack of demand. Moreover, none of the HZs could achieve a direct-obstetric case facility rate of at most 1% and, the met need for EmONC was as low as 6.5% and 5.4% in Goma and Rutshuru, respectively. However, the proportion of births by caesarean section in EmONC facilities met the minimum standard in both HZs. Overall, the intrapartum and very early neonatal death rate was 1.5%.Conclusion This study provides grounds for the development of coordinated and evidence-based programming, involving local and external stakeholders, as part of the post-conflict effort to improve maternal and neonatal health in the NKP. Particular attention to basic EmONC is required, focusing on strengthening human resources, equipment, supply chains, and referral capacity, on the one hand, and on tackling residual insecurity that might hinder 24/7 staff availability, on the other.

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The status of emergency obstetric and newborn care in post-conflict eastern DRC: a facility-level cross-sectional study

Conflict and Health ◽

10.1186/s13031-021-00395-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Serge-André Mizerero ◽

Calistus Wilunda ◽

Patou Masika Musumari ◽

Masako Ono-Kihara ◽

Gerrye Mubungu ◽

...

Keyword(s):

Newborn Care ◽

Case Fatality ◽

Newborn Health ◽

Neonatal Morbidity ◽

Maternal And Newborn Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Post Conflict ◽

Who Standards

Abstract Background Pregnancy-related mortality remains persistently higher in post-conflict areas. Part of the blame lies with continued disruption to vital care provision, especially emergency obstetric and newborn care (EmONC). In such settings, assessment of EmONC is essential for data-driven interventions needed to reduce preventable maternal and neonatal mortality. In the North Kivu Province (NKP), the epicentre of armed conflict in eastern Democratic Republic of the Congo (DRC) between 2006 and 2013, the post-conflict status of EmONC is unknown. We assessed the availability, use, and quality of EmONC in 3 health zones (HZs) of the NKP to contribute to informed policy and programming in improving maternal and newborn health (MNH) in the region. Method A cross-sectional survey of all 42 public facilities designated to provide EmONC in 3 purposively selected HZs in the NKP (Goma, Karisimbi, and Rutshuru) was conducted in 2017. Interviews, reviews of maternity ward records, and observations were used to assess the accessibility, use, and quality of EmONC against WHO standards. Results Only three referral facilities (two faith-based facilities in Goma and the MSF-supported referral hospital of Rutshuru) met the criteria for comprehensive EmONC. None of the health centres qualified as basic EmONC, nor could they offer EmONC services 24 h, 7 days a week (24/7). The number of functioning EmONC per 500,000 population was 1.5. Assisted vaginal delivery was the least performed signal function, followed by parenteral administration of anticonvulsants, mainly due to policy restrictions and lack of demand. The 3 HZs fell short of WHO standards for the use and quality of EmONC. The met need for EmONC was very low and the direct obstetric case fatality rate exceeded the maximum acceptable level. However, the proportion the proportion of births by caesarean section in EmONC facilities was within acceptable range in the HZs of Goma and Rutshuru. Overall, the intrapartum and very early neonatal death rate was 1.5%. Conclusion This study provides grounds for the development of coordinated and evidence-based programming, involving local and external stakeholders, as part of the post-conflict effort to address maternal and neonatal morbidity and mortality in the NKP. Particular attention to basic EmONC is required, focusing on strengthening human resources, equipment, supply chains, and referral capacity, on the one hand, and on tackling residual insecurity that might hinder 24/7 staff availability, on the other.

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The Quality of Life of Coronavirus Disease Survivors Living in Rural and Urban Area of Riau Province, Indonesia

Infectious Disease Reports ◽

10.3390/idr14010005 ◽

2022 ◽

Vol 14 (1) ◽

pp. 33-42

Author(s):

Suyanto Suyanto ◽

Shashi Kandel ◽

Rahmat Azhari Kemal ◽

Arfianti Arfianti

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

The Status ◽

Rural And Urban Area

This study assesses the status of health-related quality of life (HRQOL) among coronavirus survivors living in rural and urban districts in Riau province, Indonesia. The cross-sectional study was conducted among 468 and 285 Coronavirus disease (COVID-19) survivors living in rural and urban areas, respectively in August 2021. The St. George Respiratory Questionnaire (SGRQ) was used to measure the HRQOL of COVID-19 survivors. A higher total score domain corresponds to worse quality of life status. Quantile regression with the respect to 50th percentile found a significant association for the factors living in rural areas, being female, having comorbidities, and being hospitalized during treatment, with total score of 4.77, 2.43, 7.22, and 21.27 higher than in their contra parts, respectively. Moreover, having received full vaccination had the score 3.96 in total score. The HRQOL of COVID-19 survivors living in rural areas was significantly lower than in urban areas. Factors such as living in rural areas, female sex, having comorbidities, and history of symptomatic COVID-19 infection were identified as significant predictors for lower quality of life. Meanwhile, having full vaccination is a significant predictor for a better quality of life. The results of this study can provide the targeted recommendations for improvement of HRQOL of COVID-19 survivors.

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Evaluating the Quality of Health-Related WeChat Public Accounts: Cross-Sectional Study

JMIR mhealth and uhealth ◽

10.2196/14826 ◽

2020 ◽

Vol 8 (5) ◽

pp. e14826 ◽

Cited By ~ 1

Author(s):

Fuzhi Wang ◽

Zhuoxin Wang ◽

Weiwei Sun ◽

Xiumu Yang ◽

Zhiwei Bian ◽

...

Keyword(s):

Health Information ◽

Code Of Conduct ◽

Cross Sectional Study ◽

Washington Dc ◽

Cross Sectional ◽

Suitability Assessment ◽

Significant Difference ◽

The Status ◽

Health Related

Background As representatives of health information communication platforms accessed through mobile phones and mobile terminals, health-related WeChat public accounts (HWPAs) have a large consumer base in the Chinese-speaking world. However, there is still a lack of general understanding of the status quo of HWPAs and the quality of the articles they release. Objective The aims of this study were to assess the conformity of HWPAs to the Health on the Net Foundation Code of Conduct (HONcode) and to evaluate the suitability of articles disseminated by HWPAs. Methods The survey was conducted from April 23 to May 5, 2019. Based on the monthly (March 1-31, 2019) WeChat Index provided by Qingbo Big Data, the top 100 HWPAs were examined to evaluate their HONcode compliance. The first four articles published by each HWPA on the survey dates were selected as samples to evaluate their suitability. All materials were assessed by three raters. The materials were assessed using the HONcode checklist and the Suitability Assessment of Materials (SAM) score sheet. Data analysis was performed with SPSS version 17.0 (SPSS Inc, Chicago, IL, USA) and Excel version 2013 (Microsoft Inc, Washington DC, USA). Results A total of 93 HWPAs and 210 of their released articles were included in this study. For six of the eight principles, the 93 HWPAs nearly consistently did not meet the requirements of the HONcode. The HWPAs certified by Tencent Corporation (66/93, 71%) were generally slightly superior to those without such certification (27/93, 29%) in terms of compliance with HONcode principles. The mean SAM score for the 210 articles was 67.72 (SD 10.930), which indicated “adequate” suitability. There was no significant difference between the SAM scores of the articles published by certified and uncertified HWPAs (P=.07), except in the literacy requirements dimension (tdf=97=–2.418, P=.02). Conclusions The HWPAs had low HONcode conformity. Although the suitability of health information released by HWPAs was at a moderate level, there were still problems identified, such as difficulty in tracing information sources, excessive implicit advertisements, and irregular usage of charts. In addition, the low approval requirements of HWPAs were not conducive to improvement of their service quality.

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Association between maternal satisfaction and other indicators of quality of care at childbirth: a cross-sectional study based on the WHO standards

BMJ Open ◽

10.1136/bmjopen-2020-037063 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037063

Author(s):

Marzia Lazzerini ◽

Ilaria Mariani ◽

Chiara Semenzato ◽

Emanuelle Pessa Valente

Keyword(s):

Multivariate Analysis ◽

Quality Of Care ◽

Cross Sectional Study ◽

Maternal Satisfaction ◽

Sectional Study ◽

Cross Sectional ◽

Correlated Variables ◽

Care Experience ◽

Who Standards

ObjectivesThis study aimed to explore the association between maternal satisfaction and other indicators of quality of care (QoC) at childbirth, as defined by WHO standards.DesignCross-sectional study.SettingReferral hospital in Northeast Italy.Participants1244 consecutive mothers giving birth in the hospital participated in a survey.Data collection and analysisUnivariate analyses were performed to evaluate the association between maternal satisfaction and 61 variables, including measures of ‘provision of care’, ‘experience of care’, ‘availability of resources’ and other maternal characteristics. Exploratory factor analysis was performed to create groups of correlated variables, which were used in multivariate analysis.ResultsOverall, 509 (40.9%) of women were >35 years of age, about half (52.7%) were highly educated, most (95.2%) were married/living with partner and employed (79.3%) and about half (52.9%) were primiparous. Overall, 189 (15.2%) were not born in Italy and 111 (8.9%) did not have Italian citizenship. Most women (84.2%) were highly satisfied (score ≥7/10) with the care received. Among the 61 variables explored, 46 (75.4%) were significantly associated with women’s satisfaction, 33 with higher satisfaction and 13 with lower satisfaction. Multivariate analysis largely confirmed univariate findings, with six out of eight groups of correlated variables being statistically significantly associated with women’s satisfaction. Factors most strongly associated with women’s satisfaction were ‘effective communication, involvement, listening to women’s needs, respectful and timely care’ (OR 16.84, 95% CI 9.90 to 28.61, p<0.001) and ‘physical structure’ (OR 6.51, 95% CI 4.08 to 10.40, p<0.001). Additionally, ‘victim of abuse, discrimination, aggressiveness’ was inversely associated with the wish to return to the facility or to recommend it to a friend (OR 0.35, 95% CI 0.17 to 0.70, p<0.003).ConclusionThis study suggested that many variables are strongly associated with women’s satisfaction with care during childbirth and support the use of multiple measures to monitor the QoC at childbirth.

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Factors associated with antenatal depression among pregnant women in Vietnam: A multisite cross-sectional survey

Health Psychology Open ◽

10.1177/2055102920914076 ◽

2020 ◽

Vol 7 (1) ◽

pp. 205510292091407

Author(s):

Mai Thi Hue ◽

Nguyen Hang Nguyet Van ◽

Phung Phuong Nha ◽

Ngo Tuan Vu ◽

Pham Minh Duc ◽

...

Keyword(s):

Pregnant Women ◽

Antenatal Depression ◽

Cross Sectional Study ◽

Tobit Regression ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Screening Programs ◽

Factors Associated ◽

The Status ◽

Structured Questionnaire

This study aimed to describe the status of antenatal depression and its associated factors among pregnant women in Vietnam. A cross-sectional study was conducted in four obstetric hospitals in Vietnam from January to September 2019. A total of 1260 pregnant women were interviewed using a structured questionnaire. A Tobit regression model was used to determine factors associated with antenatal depression. Results showed that pregnant women were at high risk of antenatal depression (24.5%). Women with fetus abnormalities and higher education were at higher risk of antenatal depression. We highlighted the need for implementing formal screening programs to early detect antenatal depression.

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Fibromyalgia Is Common and Adversely Affects Pain and Fatigue Perception in North Indian Patients with Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.090157 ◽

2009 ◽

Vol 36 (11) ◽

pp. 2443-2448 ◽

Cited By ~ 31

Author(s):

VARUN DHIR ◽

ABLE LAWRENCE ◽

AMITA AGGARWAL ◽

RAMNATH MISRA

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Functional Disability ◽

Health Assessment ◽

Cross Sectional Study ◽

Cross Sectional ◽

The North ◽

Indian Patients

Objectives.Fibromyalgia (FM) has been shown to be common in patients with rheumatoid arthritis (RA), but studies on Asian patients are lacking. It remains unclear whether FM has an adverse influence on pain, fatigue, quality of life, and mood in these patients, and what its relationship is with disease activity. We studied prevalence and effects of FM in North Indian patients with RA and associations of RA with disease activity.Methods.This cross-sectional study included 200 RA patients and an equal number of controls. Presence of FM was defined using the American College of Rheumatology 1990 criteria. Pain and fatigue scores were assessed using a 10 cm visual analog scale. Quality of life and presence of depression/anxiety were determined using validated questionnaires. Disease activity and functional disability in RA patients was assessed using the Disease Activity Score 28-3 and Health Assessment Questionnaire, respectively.Results.FM was present in 15% of patients with RA compared to 2.5% of controls in the North Indian population. RA patients with FM did not differ from those without FM in terms of age, gender, current disease-modifying agents, or steroid use. RA patients with FM had higher disease activity and worse functional disability. The number of tender and swollen joints was higher in patients with FM, but correlated poorly with each other. RA patients with FM had higher pain and fatigue scores but were not different in the quality of life or mood.Conclusion.FM is more common in North Indian patients with RA compared to controls. It adversely affects the pain and fatigue felt by RA patients. Disease activity and FM influence each other.

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Professional Commitment and Career Maturity of Full-Time Nursing Postgraduates in China: A Cross-Sectional Study

10.21203/rs.3.rs-55952/v1 ◽

2020 ◽

Author(s):

kejimu sunzi ◽

cheng lei ◽

jun pan ◽

mei ju

Keyword(s):

Response Rate ◽

Career Planning ◽

Survey Design ◽

Career Maturity ◽

Cross Sectional Study ◽

Professional Commitment ◽

Full Time ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Status

Abstract Background: Nursing is becoming ever more demanding, and is regarded as a stressful occupation because of manpower shortages and various other challenges associated with nursing practice.This article describes the students’ professional commitment and career maturity, and students establish their career objectives during the early stages of their graduate study. Methods: A cross sectional，survey design was conducted at universities in China. A sample of 184 students was selected using the professional commitment scale and career maturity scale to investigate the status quo of professional commitment and career maturity of full-time nursing postgraduates. Data was collected using self-designed demographic characteristics of the student, professional commitment scale, career maturity scale in 2019.Data was analyzed using correlation coefficient test(α < 0.05 ).Results: Participants returned 184 surveys (response rate, 100%) . Career maturity (105.12±11.13), Specialty commitment(90.0 ±12.09),Career maturity was positively correlated with Professional Commitment (r=0.20).Conclusions: The career maturity and professional commitments of full-time nursing postgraduates were of an average level. Career planning courses could be useful to strengthen the vocational education of the post-graduate students.

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Urinary Incontinence in Competitive Women Powerlifters: A Cross-Sectional Survey

Sports Medicine - Open ◽

10.1186/s40798-021-00387-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Lolita Wikander ◽

Marilynne N. Kirshbaum ◽

Nasreena Waheed ◽

Daniel E. Gahreman

Keyword(s):

Urinary Incontinence ◽

Pelvic Floor ◽

Online Survey ◽

Severity Index ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Pelvic Floor Exercises ◽

Body Mass Index Score

Abstract Background Urinary incontinence (UI) can negatively affect a woman’s quality of life, participation in sport and athletic performance. The objectives of this study were to determine the prevalence of UI in competitive women powerlifters; identify possible risk factors and activities likely to provoke UI; and establish self-care practices. Methods This international cross-sectional study was conducted using an online survey completed by 480 competitive women powerlifters aged between 20 and 71 years. The Incontinence Severity Index (ISI) was used to determine the severity of UI. Results We found that 43.9% of women had experienced UI within the three months prior to this study. The deadlift was the most likely, and the bench-press the least likely exercise to provoke UI. ISI scores were positively correlated with parity (τ = 0.227, p < 0.001), age (τ = 0.179, p < 0.001), competition total (τ = 0.105, p = 0.002) and body mass index score (τ = 0.089, p = 0.009). There was no significant correlation between ISI and years strength training (τ = − 0.052, p = 0.147) or years powerlifting (τ = 0.041, p = 0.275). There was a negative correlation between ISI score with having a pelvic floor assessment (η = 0.197), and the ability to correctly perform pelvic floor exercises (η = 0.172). Conclusion The prevalence of UI in this cohort was at the upper limit experienced by women in the general population. Women who had undergone a pelvic floor examination or were confident in correctly performing pelvic floor exercises experienced less severe UI.

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Predictors of quality of life of older persons in rural Uganda: A cross sectional study

AAS Open Research ◽

10.12688/aasopenres.12874.2 ◽

2018 ◽

Vol 1 ◽

pp. 22 ◽

Cited By ~ 1

Author(s):

Fred Maniragaba ◽

Betty Kwagala ◽

Emmanuel Bizimungu ◽

Stephen Ojiambo Wandera ◽

James Ntozi

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Older Persons ◽

Cross Sectional Study ◽

Poor Quality ◽

Hiv And Aids ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.

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Quality of Pre-Service Midwifery Education in Public and Private Midwifery Schools in Afghanistan: A Cross Sectional Survey

10.21203/rs.3.rs-755494/v1 ◽

2021 ◽

Author(s):

Partamin Manalai ◽

Sheena Currie ◽

Massoma Jafari ◽

Nasratullah Ansari ◽

Hannah Tappis ◽

...

Keyword(s):

Clinical Practice ◽

Assessment Tool ◽

Rapid Assessment ◽

Newborn Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Public And Private ◽

Midwifery Education ◽

Quality Aspects

Abstract Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. Aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders priorities for improving quality of midwifery education. Methods A cross-sectional assessment was conducted from September 12–December 17, 2017, using a modified Midwifery Education Rapid Assessment Tool to assess education quality aspects related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students in 29 midwifery schools. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

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