Do Early Antenatal Booking Predicts Maternal Services Utilization? An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey

2020 ◽  
Author(s):  
Fabiola Vincent Moshi
Keyword(s):  
Pregnant Women ◽  
Cost Effective ◽  
Reproductive Age ◽  
Services Utilization ◽  
Effective Strategies ◽  
Maternal And Neonatal Health ◽  
To Come ◽  
Donated Blood ◽  
Separate Regression ◽  
Antenatal Services

Abstract Background Optimizing maternal and neonatal health requires adequate use of antenatal services which have both curative and preventive services. Little is known on the influence of early antenatal booking on maternal services utilization in Tanzania. Method: The study used data from the 2015-16 Tanzania HIV Demographic and Health Survey and Malaria Indicators Survey (2015-16 TDHS-MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the association between early antenatal booking and maternal services utilization. Separate regression analysis was done for each antenatal service to establish the influence of early antenatal booking on antenatal services. Results Only 1586(22.9%) of pregnant women had early antenatal booking. After adjusting for confounders, there was a significant association between early antenatal booking and ever took iron supplement AOR = 1.603 at 95% CI = 1.362–1.887; ever took anti malaria, AOR = 1.495 at 95% CL = 1.306–1.712; ever took de-worming drugs; AOR = 1.404 at 95% CI = 1.24–1.59; adequate TT vaccination, AOR = 1.393 at 95% CI = 1.234–1.571, p < 0.001; ever checked blood pressure, AOR = 1.496 at 95% CI = 1.297–1.726; ever donated urine sample, AOR = 1.728 at 95% CI = 1.513–1.975; ever donated blood sample, AOR = 1.596 at 95% CI = 1.312–1.942 and adequate antenatal visits, AOR = 6.260 at 95% CI = 5.433–7.212. Conclusion The majority of pregnant women in Tanzania initiate antenatal clinics late in their pregnancy. Early antenatal booking showed a significant association with the utilization of maternal services during pregnancy. Innovative interventional studies are highly recommended to come up with cost-effective strategies which will improve timing for antenatal booking and hence use of the available maternal services in Tanzania

scholarly journals The Cost-Effectiveness of Existing and Hypothetical Iron Fortification Programs in Haiti

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 621-621
Author(s):  
Katherine Adams ◽  
Stephen Vosti ◽  
Michael Jarvis ◽  
Yves-Laurent Régis ◽  
Ruth Climat ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Pregnant Women ◽  
Wheat Flour ◽  
Cost Effective ◽  
The United States ◽  
Reproductive Age ◽  
Iron Fortification ◽  
Iron Intake ◽  
Effective Coverage ◽  
The Cost

Abstract Objectives Our objectives were to estimate apparent intake of iron in Haiti, to assess the adequacy of iron intake among women of reproductive age (WRA), and to model the cost-effectiveness of fortifying alternative food vehicles for reducing inadequate intake. Methods We analyzed the most recent Haiti household food consumption data (2012 ECVMAS) to estimate adequacy of apparent iron intake from dietary sources (using the adult male equivalent method; assuming 10% absorption) and modeled the impacts of fortifying currently mandated (wheat flour, applying local data on current compliance) and hypothetical (bouillon and rice) food vehicles on reductions in the prevalence of inadequate iron intake (effective coverage). We built activity-based cost models to estimate large scale food fortification (LSFF) program establishment and management costs, based on key informant interviews and on published cost estimates from other settings adapted to fit the Haitian case. Results The prevalence of inadequate dietary intake of iron among WRA was 79% (100% among pregnant women). Iron-fortified wheat flour was the most cost-effective vehicle: $4.32 and $4.75 per WRA-year effectively covered at current (75% of flour fortified to the standard of 30 mg/kg) and target (90% fortified to the standard) fortification levels. Fortified wheat flour effectively covered 11–13% of non-pregnant WRA, but almost no pregnant women. Although bouillon was consumed by &gt; 98% of households, low estimated iron absorption from fortified bouillon (2%) led to low effective coverage. Iron-fortified rice (90% fortified at 120 mg/kg) was predicted to effectively cover the largest number of WRA (reducing inadequate intake to ∼30%), but at a cost of $7.80 per WRA-year effectively covered. Conclusions Of the food vehicles modeled, wheat flour was the most cost-effective for reducing inadequate iron intake. Modeling iron fortification of individual and combinations of food vehicles showed that well-designed LSFF programs can contribute to improving iron status among non-pregnant women, but eliminating inadequate iron intake among all WRA will require complementary iron interventions. Funding Sources This work was supported by grants to UC Davis from the Global Alliance for Improved Nutrition (GAIN) and to Partners of the Americas from the United States Agency for International Development (USAID).

scholarly journals The Rate of Asymptomatic COVID-19 Infection: A Systematic Review and Meta-analysis Including 12,713 Infections from 136 Studies

2020 ◽  
Author(s):  
Xiao C hen ◽  
Ziyue Huang ◽  
Jingxuan Wang ◽  
Shi Zhao ◽  
Martin CS Wong ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Meta Analysis ◽  
Score Test ◽  
Cost Effective ◽  
Asymptomatic Infection ◽  
Control Measures ◽  
Effective Strategies ◽  
Geographical Regions ◽  
Community Transmission ◽  
Asymptomatic Infections

Abstract Background: Asymptomatic infection of SARS-CoV-2 may lead to silent community transmission and compromise pandemic control measures of COVID-19. We aimed to estimate the rate of asymptomatic COVID-19 infection from published studies, and compare this rate among different patient groups. Methods: The electronic databases including Medline, Embase, PubMed, and three Chinese electronic databases (The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, and VIP) were searched. Studies with sample size (or number of subjects) not less than 5 were included. The STATA command ‘Metaprop’ was implemented to conduct meta-analysis for the pooled rate estimates of asymptomatic infections with exact binomial and score test-based 95% confidence intervals (CIs). Results: A total of 12,713 COVID-19 patients in 136 studies were included in the meta-analysis, including 2,785 asymptomatic infections. The overall rate of asymptomatic infection was 15.1% (95% CI: 12.0%-18.4%). Subgroup analysis showed that the rate was significantly higher in pregnant women (36.3%, 95% CI: 15.7%-59.6%), children (29.4%, 17.4%-42.9%), and studies for screening settings (25.3%, 15.4%-36.5%) conducted on or after 01 March 2020 (27.8%, 15.7%-41.7%). In terms of geographical regions, the rate was the highest in Asia (excluding China) (27.4%, 14.3%-42.6%), followed by Europe (22.7%, 6.3%-44.9%), the US (15.9%, 8.9%-24.3%), and China (13.1%, 10.2%-16.3%). Conclusions: High proportion of asymptomatic infection were observed in pregnant women, children, European residents, screening programmes, and in studies conducted in and after March 2020. Our findings help inform the true burden of COVID-19 among different groups of cases, and provide information on cost-effective strategies of identifying and tracing asymptomatic infections.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

Inadequate Dietary Intakes: Among Pregnant Women

2012 ◽  
Vol 73 (2) ◽  
pp. 72-77 ◽  
Author(s):  
Jennifer K. Fowler ◽  
Susan E. Evers ◽  
M. Karen Campbell
Keyword(s):  
Pregnant Women ◽  
Food Group ◽  
Reproductive Age ◽  
Dietary Intakes ◽  
Food Groups ◽  
Eating Behaviours ◽  
Prenatal Health ◽  
Canadian City ◽  
Minimum Number ◽  
Health Project

Purpose: Eating behaviours were assessed among pregnant women in a mid-sized Canadian city. Methods: As part of the Prenatal Health Project, we interviewed 2313 pregnant women in London, Ontario. Subjects also completed a food frequency questionnaire. Recruitment took place in ultrasound clinics at 10 to 22 weeks of gestation. The main outcome measures were number of daily servings for each food group, measured against the minimum number recommended by the 2007 Eating Well with Canada’s Food Guide (CFG), the proportion of women consuming the recommended number of servings for each and all of the four food groups, and factors associated with adequate consumption. We also determined the number of servings of “other foods.” Analysis included descriptive statistics and logistic regression, all at p<0.05. Results: A total of 3.5% of women consumed the recommended number of servings for all four food groups; 15.3% did not consume the minimum number of servings of foods for any of the four food groups. Women for whom this was their first pregnancy were less likely to consume the recommended number of servings from all four food groups (odds ratio=0.41; confidence interval=0.23, 0.74). Conclusions: Very few pregnant women consumed food group servings consistent with the 2007 recommendations. Strategies to improve dietary behaviours must focus on the establishment of healthy eating behaviours among women of reproductive age.

Factor Analysis among the variables relating to purpose of using social media websites and nonacceptance of social media in recruitment

2020 ◽  
pp. 245-248
Keyword(s):  
Social Media ◽  
Factor Analysis ◽  
Social Science Research ◽  
Cost Effective ◽  
Science Research ◽  
Recruitment Strategies ◽  
Job Seeking ◽  
Hiring Process ◽  
To Come ◽  
New Strategies

In the era of Globalization, advancement of technology and stiff competition, particularly, in the I.T. Industry, companies have to adopt new H.R. strategies and practices so as to constantly evolve and grow. In this context, existing recruitment strategies have to be replaced by new strategies. Many companies are now extensively depending on the internet to connect to larger audiences globally. Organizations are in a position to attract profiles, resumes from potential candidates by announcing their vacancies on their own websites. E-recruitment is evoking interest among the companies typically over the last few years. The spread of information technology and growth of Internet has paved way for companies willing to hunt for talent on the job seeking websites. In the years to come, social networking will soon be an indispensable part of the hiring process. It is cost effective, does not require setting up an office and forms an effective tool for recruiters. The main purpose of this study was to understand the application of factor analysis in social science research and to reduce a large number of variables into manageable smaller factors for further analysis of the employers’ perception on social media recruitment with reference to the I.T. Sector in Bangalore.

Bioavailability of phosphorus as a tool for efficient P reduction schemes

1998 ◽  
Vol 37 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Peter Gerdes ◽  
Sabine Kunst
Keyword(s):  
Sewage Treatment ◽  
Cost Effective ◽  
Effective Management ◽  
Lower Saxony ◽  
Effective Strategies ◽  
P Balance ◽  
Different Sources ◽  
Total P ◽  
P Sources ◽  
P Bioavailability

The bioavailability of phosphorus from different sources has been evaluated in the catchment area of the River Ilmenau (Lower-Saxony, Germany) by using algal assays. The P bioavailability describes the different potential of P from various sources of supporting eutrophication. Effluents from sewage treatment plants were highly bioavailable (72% of TP) whereas rainwater (26%) and erosion effluents (30%) showed a low bioavailability. In order to develop effective strategies to minimize P inputs into the river, source specific P bioavailability indices were determined and combined with a P balance to calculate inputs of vioavailable P (BAP) instead of total P (TP). It could be shown that the relative importance of the different P sources changes when applying BAP. Measures to reduce P inputs into the River Ilmenau will take P bioavailability into consideration and therefore lead to a more cost-effective management.

scholarly journals Platforms for Production of Protein-Based Vaccines: From Classical to Next-Generation Strategies

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1072
Author(s):  
Raquel Cid ◽  
Jorge Bolívar
Keyword(s):  
Infectious Diseases ◽  
Mammalian Cells ◽  
Vaccine Development ◽  
Low Cost ◽  
Cost Effective ◽  
Insect Larvae ◽  
Subunit Vaccines ◽  
Effective Strategies ◽  
Alternative Systems ◽  
Inactivated Vaccines

To date, vaccination has become one of the most effective strategies to control and reduce infectious diseases, preventing millions of deaths worldwide. The earliest vaccines were developed as live-attenuated or inactivated pathogens, and, although they still represent the most extended human vaccine types, they also face some issues, such as the potential to revert to a pathogenic form of live-attenuated formulations or the weaker immune response associated with inactivated vaccines. Advances in genetic engineering have enabled improvements in vaccine design and strategies, such as recombinant subunit vaccines, have emerged, expanding the number of diseases that can be prevented. Moreover, antigen display systems such as VLPs or those designed by nanotechnology have improved the efficacy of subunit vaccines. Platforms for the production of recombinant vaccines have also evolved from the first hosts, Escherichia coli and Saccharomyces cerevisiae, to insect or mammalian cells. Traditional bacterial and yeast systems have been improved by engineering and new systems based on plants or insect larvae have emerged as alternative, low-cost platforms. Vaccine development is still time-consuming and costly, and alternative systems that can offer cost-effective and faster processes are demanding to address infectious diseases that still do not have a treatment and to face possible future pandemics.

scholarly journals Innovating on Inhaled Bioequivalence: A Critical Analysis of the Current Limitations, Potential Solutions and Stakeholders of the Process

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1051
Author(s):  
Jonattan Gallegos-Catalán ◽  
Zachary Warnken ◽  
Tania F. Bahamondez-Canas ◽  
Daniel Moraga-Espinoza
Keyword(s):  
New Technologies ◽  
Innovation Process ◽  
Cost Effective ◽  
Regulatory Agencies ◽  
Drug Products ◽  
Effective Strategies ◽  
Rate Analysis ◽  
Orally Inhaled Drug Products ◽  
Next Generation Impactor ◽  
First Time

Orally inhaled drug products (OIDPs) are an important group of medicines traditionally used to treat pulmonary diseases. Over the past decade, this trend has broadened, increasing their use in other conditions such as diabetes, expanding the interest in this administration route. Thus, the bioequivalence of OIDPs is more important than ever, aiming to increase access to affordable, safe and effective medicines, which translates into better public health policies. However, regulatory agencies leading the bioequivalence process are still deciding the best approach for ensuring a proposed inhalable product is bioequivalent. This lack of agreement translates into less cost-effective strategies to determine bioequivalence, discouraging innovation in this field. The Next-Generation Impactor (NGI) is an example of the slow pace at which the inhalation field evolves. The NGI was officially implemented in 2003, being the last equipment innovation for OIDP characterization. Even though it was a breakthrough in the field, it did not solve other deficiencies of the BE process such as dissolution rate analysis on physiologically relevant conditions, being the last attempt of transferring technology into the field. This review aims to reveal the steps required for innovation in the regulations defining the bioequivalence of OIDPs, elucidating the pitfalls of implementing new technologies in the current standards. To do so, we collected the opinion of experts from the literature to explain these trends, showing, for the first time, the stakeholders of the OIDP market. This review analyzes the stakeholders involved in the development, improvement and implementation of methodologies that can help assess bioequivalence between OIDPs. Additionally, it presents a list of methods potentially useful to overcome some of the current limitations of the bioequivalence standard methodologies. Finally, we review one of the most revolutionary approaches, the inhaled Biopharmaceutical Classification System (IBCs), which can help establish priorities and order in both the innovation process and in regulations for OIDPs.

scholarly journals High burden of anemia among pregnant women in Tanzania: a call to address its determinants

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Pregnant Women ◽  
Reproductive Age ◽  
Gis Mapping ◽  
Demographic And Health Surveys ◽  
Health Coverage ◽  
Nutritional Knowledge ◽  
Women Of Reproductive Age ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.

scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

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