A 3-year retrospective review of mortality in women of reproductive age in a tertiary health facility in Port Harcourt, Nigeria

Abstract Background: Ability to utilise healthcare services is desire for everyone in need. Unfortunately, challenges to health care utilization persist and they do so inequitably amongst social groups. This study aimed to examine problems to health care utilization and residential area equity in utilization among women of reproductive age in The Gambia. Methods: Data from The Gambia 2019-20 Demographic and Health Survey comprising of 11,865 women 15 – 49 years of age was used. A systematic selection method of equal probability was employed for the data collection interviews. Visiting any health facility in the last 12 months is the outcome. Problems to health care utilization was assessed using four primary factors of interest: permission to go, money needed for treatment, distance to health facility and not wanting to go alone as independent variables. Descriptive and logistic regression analysis were used to assess the frequency distribution and the association of the four factors and health care utilization by residence. The point estimates were reported in odds (OR), 95% confidence interval (CI) and p value <0.05 signified statistical significance.Results: Most women in rural (79%) and urban (83%) residential areas utilized health care services in the last 12 months. Women in urban areas who had a big problem getting permission to go and a big problem not wanting to go alone had lower odds of health care utilization compared to women who did not have a big problem getting permission to go and not wanting to go alone for health care. Women resident in rural areas who reported distance to health facility as a big problem had higher odds of health care utilization compared to women who did not have big problem concerning distance to health facility. Conclusions: Permission to go and not wanting to go alone appear to be associated with cultural norms and inadequate social support for women utilizing health care in urban residence. Policy makers should address harmful cultural norms and inadequate social support for women during health care visits to improve equity in health care utilization towards achieving universal health coverage.

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Missed opportunity for family planning counselling along the continuum of care in Arusha region, Tanzania

PLoS ONE ◽

10.1371/journal.pone.0250988 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0250988

Author(s):

Caroline Amour ◽

Rachel N. Manongi ◽

Michael J. Mahande ◽

Bilikisu Elewonibi ◽

Amina Farah ◽

...

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Service Delivery ◽

Health Facility ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

The Past ◽

Arusha Region ◽

To Receive ◽

Missed Opportunity

Introduction Adequate sexual and reproductive health information is vital to women of reproductive age (WRA) 15 to 49 years, for making informed choices on their reproductive health including family planning (FP). However, many women who interact with the health system continue to miss out this vital service. The study aimed to identify the extent of provision of FP counselling at service delivery points and associated behavioral factors among women of reproductive age in two districts of Arusha region. It also determined the association between receipt of FP counselling and contraceptive usage. Methods Data were drawn from a cross-sectional survey of 5,208 WRA residing in two districts of Arusha region in Tanzania; conducted between January and May 2018. Multistage sampling technique was employed to select the WRA for the face-to-face interviews. FP counseling was defined as receipt of FP information by a woman during any visit at the health facility for antenatal care (ANC), or for post-natal care (PNC). Analyses on receipt of FP counseling were done on 3,116 WRA, aged 16–44 years who were in contact with health facilities in the past two years. A modified Poisson regression model was used to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counseling and current use of modern contraception, controlling for potential confounders. Results Among the women that visited the health facility for any health-related visit in the past two years, 1,256 (40%) reported that they received FP counselling. Among the women who had had births in the last 30 months; 1,389 and 1,409 women had contact with the service delivery points for ANC and PNC visits respectively. Of these 31% and 26% had a missed FP counseling at ANC and PNC visit respectively. Women who were not formally employed were more likely to receive FP counselling during facility visit than others. WRA who received any FP counseling at PNC were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.28; 95% Confidence Interval [CI]: 1.09, 1.49). Conclusion Overall, only 40% women reported that they received any form of FP counseling when they interfaced with the healthcare system in the past two years. Informally employed women were more likely to receive FP counselling, and women who received FP counselling during PNC visits were significantly more likely to use contraceptive in comparison to the women who did not receive FP counselling. This presents a missed opportunity for prevention of unintended pregnancies and suggests a need for further integration of FP counseling into the ANC and PNC visits.

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Passive Transfer Of Allo-Antibodies Following Rhig Administration Given For Rh-Mismatched Platelets Prophylaxis

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.346 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S158-S159

Author(s):

N Sostin ◽

J Hendrickson ◽

R Balbuena-Merle ◽

C Tormey

Keyword(s):

Older Women ◽

Retrospective Review ◽

Case Series ◽

Passive Transfer ◽

Human Platelets ◽

Reproductive Age ◽

New Haven ◽

Women Of Reproductive Age ◽

Antibody Screen ◽

Haven Hospital

Abstract Introduction/Objective Human platelets (PLTs) do not express any Rh system antigens; however, PLT concentrates can be contaminated with small amounts of red blood cells (RBCs), which may induce alloimmunization when transfused to Rh(D)-negative individuals. RhIG has been utilized to prevent Rh(D) alloantibody development following transfusion of Rh mismatched PLTs. RhIG is manufactured using pooled plasma of healthy Rh(D)-negative donors, with the most common Rh haplotype being ce; treated subjects are exposed to Rh (D)-positive RBCs, with the most common Rh haplotype of donors being DCe. In this report, we detail our experiences with recipients of Rh mismatched apheresis PLTs who were noted to develop anti-D + anti-C post-RhIG administration. Methods Retrospective review was conducted of all Rh mismatched PLTs between December, 2018 and May, 2019 at our facility (Yale-New Haven Hospital, New Haven, CT). Inclusion in the study required: Rh(D)-negative donor receiving one or more Rh(D)-positive apheresis PLTs, Receiving RhIG, >1 antibody screen following RhIG administration demonstrating antibodies other than anti-D Results Our retrospective review identified 8 unique recipients of Rh mismatched apheresis PLTs who acquired anti- C, in addition to the expected anti-D, following administration of RhIG. The product (Rhophylac) was administered in all cases intravenously at a dose of 1500 IU (300 mcg) within 72 hours following Rh mismatched PLTs. In all patients, routine screening following RhIG simultaneously detected anti-D and anti-C 1-3 days after administration of Rh mismatched PLTs/RhIG, the antibody screen remained positive for a range of 27-167 days for both antibodies. Conclusion Based on this case series, which represented entirely men and older women, and coupled with emerging evidence about the extremely low likelihood of D-alloimmunization following Rh mismatched apheresis PLTs,2,3,6 we have changed our practice, limiting immunoprophylaxis for Rh mismatched platelets exclusively to women of reproductive age. The blood bank and apheresis communities should be aware that passive transfer of non-D antibodies is possible when RhIG is dosed and could account for newly-detected non-D alloimmunization events. This phenomenon is another compelling reason to limit RhIG exposure to cases where it is only absolutely clinically necessary.7

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Determinants for Choice of Home Birth over Health Facility Birth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey

10.21203/rs.3.rs-18240/v3 ◽

2020 ◽

Author(s):

Fabiola Vincent Moshi ◽

Christopher H. Mbotwa

Keyword(s):

Health Facility ◽

Formal Education ◽

Home Birth ◽

Health Facilities ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Malaria Indicator Survey ◽

Birth Attendants ◽

Home Based ◽

Antenatal Visits

Abstract Background: While evidence has shown an association between place of birth and birth outcomes, factors contributing to the choice of home birth have not been adequately investigated. In Tanzania more than 30% of deliveries occur out of health facilities with more than 95% of those deliveries are assisted by non-medical providers who are often unskilled. Birth assisted by unskilled birth attendants has been cited as a contributing factor for the high maternal and neonatal mortalities in low-resources countries. This study aimed at identifying determinants of choice for home birth over health facilities in Tanzania.Method: This study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15-49 years) who gave birth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analyses were used to determine predictors for the choice of home-based childbirth over health facility.Results: A total of 805 (35.2%) women had a home birth. After adjusting for confounders, the determinants for choice of home birth were the level of education [primary education, (AOR=0.666; p=0.001); secondary and higher education, (AOR=0.417; p<0.001)]in reference to no formal education; not owning a mobile phone, (AOR= 1.312; p=0.018); parity [parity 2-4, (AOR=1.594; p=0.004); parity 5 and above, (AOR=2.158; p<0.001)] in reference to parity 1; inadequate antenatal visits, (AOR=1.406; p=0.001); wealth index [poorest, (AOR=9.395; p<0.001); poorer, (AOR=7.701; p<0.001); middle, (AOR=5.961; p<0.001); richer, (AOR=2.557; p<0.001)] in reference to richest women and zones [Southern Highlands, (AOR=0.189; p<0.001); Southern, (AOR=0.225; p<0.001); Zanzibar, (AOR=2.55; p<0.001)] in reference to Western zone.Conclusion: A large proportion of women birth at home. Unskilled providers such as traditional birth attendants (TBAs), relatives or friends attend most of them. Predictors for home-based childbirth were lack of formal education, poor access to communication, poor uptake of antenatal visits, low socio-economic status, and geographical zone. Innovative strategies targeting these groups are needed to increase the use of health facilities for childbirth, thereby reducing maternal and neonatal mortality in Tanzania.

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Obesity among women of reproductive age using contraceptive methods in Port Harcourt, Nigeria

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2020.6.1.0096 ◽

2020 ◽

Vol 6 (1) ◽

pp. 159-165

Author(s):

Njoku Patrick U ◽

Dienye Paul O ◽

Olaniyan Fatai A ◽

Iloh Gabriel UP ◽

Njoku Roseline AN

Keyword(s):

Reproductive Age ◽

Contraceptive Methods ◽

Women Of Reproductive Age ◽

Port Harcourt

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Perceived social support among women of reproductive age attending a public health facility in a poor area of Northern Lima, Peru

Journal of Global Health Science ◽

10.35500/jghs.2019.1.e30 ◽

2019 ◽

Vol 1 ◽

Author(s):

Yun Seop Kim ◽

Bimala Sharma ◽

Yeseul Jung ◽

Daehwan Kim ◽

Eun Woo Nam

Keyword(s):

Public Health ◽

Social Support ◽

Health Facility ◽

Perceived Social Support ◽

Public Health Facility ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Poor Area

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Health facility delivery among women of reproductive age in Nigeria: Does age at first birth matter?

PLoS ONE ◽

10.1371/journal.pone.0259250 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259250

Author(s):

Obasanjo Afolabi Bolarinwa ◽

Effiong Fortune ◽

Richard Gyan Aboagye ◽

Abdul-Aziz Seidu ◽

Olalekan Seun Olagunju ◽

...

Keyword(s):

Health Facility ◽

Facility Delivery ◽

Health Facilities ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Age At First Birth ◽

Health Facility Delivery ◽

Odds Ratios ◽

First Birth ◽

Women Of Reproductive Age

Background High maternal mortality ratio in sub-Saharan Africa (SSA) has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. Thus, this study, examined the association between age at first childbirth and health facility delivery among women of reproductive age in Nigeria. Methods The study used the most recent secondary dataset from Nigeria’s Demographic and Health Survey (NDHS) conducted in 2018. Only women aged15-49 were considered for the study (N = 34,193). Bi-variate and multivariable logistic regression models were used to examine the association between age at first birth and place of delivery. The results were presented as crude odds ratios and adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CIs). Statistical significance was set at p<0.05. Results The results showed that the prevalence of health facility deliveries was 41% in Nigeria. Women who had their first birth below age 20 [aOR = 0.82; 95%(CI = 0.74–0.90)] were less likely to give birth at health facilities compared to those who had their first birth at age 20 and above. Conclusion Our findings suggest the need to design interventions that will encourage women of reproductive age in Nigeria who are younger than 20 years to give birth in health facilities to avoid the risks of maternal complications associated with home delivery. Such interventions should include male involvement in antenatal care visits and the education of both partners and young women on the importance of health facility delivery.

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Multilevel analysis of factors associated with HIV among women of reproductive age (15–49 years old) in Ethiopia: Bayesian approach

Women s Health ◽

10.1177/17455065211067638 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110676

Author(s):

Yilkal Negesse ◽

Gosa Mankelkl ◽

Melsew Setegn ◽

Gossa Fetene

Keyword(s):

Multilevel Analysis ◽

Health Facility ◽

Bayesian Approach ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Reproductive Age ◽

Rural Resident ◽

Women Of Reproductive Age ◽

Long Distance ◽

Factors Associated

Background: Human immunodeficiency virus remains the leading cause of morbidity and mortality throughout the world. Sub-Saharan Africa regions are the most affected regions and accounted for 67% of HIV infections worldwide, and 72% of the world’s AIDS-related deaths. Objective: To estimate the prevalence of HIV and identify factors associated with it among women of reproductive age in Ethiopia. Methods: This study was conducted based on the 2016 Ethiopian Demographic and Health Surveys data. The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then, a total of 14,161 weighted sample women were used to investigate the study. Finally, a multilevel analysis was done based on the Bayesian approach to identify factors associated with HIV among women of reproductive age in Ethiopia. Results: This study showed the prevalence of HIV among reproductive age group women was 0.85%. Being rural resident (adjusted odds ratio = 0.20; 95% CrI = 0.1–0.4), secondary education level (adjusted odds ratio = 0.20; 95% CrI = 0.1–0.4), rich wealth status (adjusted odds ratio = 4; 95% CrI = 3–6), married women but living separately (adjusted odds ratio = 2.3; 95% CrI = 1.2–4.5), long distance from the health facility (adjusted odds ratio = 0.4; 95% CrI = 0.3–0.5), and exposure to media (adjusted odds ratio = 2.9; 95% CrI = 1.8–4.7) were significantly associated with HIV. Conclusion: Being rural residents, women whose marital status is separated, wealthy, travel a long distance to get health facility, and are exposed to media are risky to be infected by HIV. Whereas being a rural resident and educated are preventive factors for HIV. Therefore, the government of Ethiopia and the ministry of health should consider those factors when they design HIV prevention and control strategies.

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