scholarly journals Cost of Deliveries among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers Accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 244-254
Author(s):  
Taofeek Adedayo Sanni
Keyword(s):  
Health Insurance ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
P Value ◽  
Cross Sectional ◽  
Health Institution ◽  
Total Cost ◽  
Caesarean Section Delivery ◽  
Southwest Nigeria ◽  
The Mean

Maternal Mortality Is Currently High And Remains One Of The Most Important Public Health Problems In Developing Countries. This Study Determined The Cost Of Vaginal And Caesarean Section Deliveries Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women {(133 Vaginal And 57 Caesarean Section Deliveries Among Each Of HI Enrollees And OOP Payers)} Who Accessed Delivery Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. P-Value <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 36.5 ± 4.7years Among The Vaginal Delivery Respondents And 35.8 ± 3.6 Years Among Caesarean Section Delivery Respondents. The Mean Total Cost Of Vaginal Delivery For HI Enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} Is Lesser Than For OOP Payers {₦37,928.5 ± 19,813.0 ($99.8 ± 52.1)}. Furthermore, The Mean Total Cost Of Caesarean Section Delivery For HI Enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} Is Lesser Than For OOP Payers (₦37,928.5 ± 19,813.0 ($99.8 ± 52.1}. 94.1% Of The Non-Insurance Enrollees Were Willing To Join Health Insurance Scheme. It Was Concluded That The Total Cost Of Vaginal And Caesarean Section Deliveries Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Intervention To Increase Awareness On Health Insurance Is Recommended.

scholarly journals Cost of Ante-natal Care among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 11-22
Author(s):  
Taofeek Adedayo Sanni
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Healthcare Services ◽  
Reproductive Age ◽  
P Value ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Health Institution ◽  
Total Cost ◽  
Southwest Nigeria

Maternal Mortality Remains A Leading Cause Of Death Among Women Of Reproductive Age Group. This Study Determined The Cost Of Antenatal Care Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers Accessing Maternal Healthcare Services In A Tertiary Health Institution In Southwest Nigeria. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women (190 HI Enrollees And 190 OOP Payers) Attending Antenatal Care Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. Chi-Square And Binary Logistic Regression Were Used To Assess The Association Between Dependent And Independent Variables And A P-Value Of <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 33.8 ± 5.0 Years (HI Group: 34.1 ± 4.9 Years And OOP Group: 33.6 ± 5.0 Years). The Mean Total Cost Of Antenatal Care (ANC) Is Lesser For HI Enrollees (₦5,095.2 ± 1,753.1 Equivalent To $13.3 ± 4.6) As Compared With OOP Payers (₦15,050.6 ± 5,548.9 Equivalent To $39.6 ± 14.6). Predictors And Enablers For HI Uptake Are Marital Status, Family Size, Level Of Education, Occupation, Appropriate And Quality HI Package, And Trust In The HI Scheme. It Was Concluded That The Total Cost Of Antenatal Care Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Interventions To Increase Awareness And Designing More Enticing HI Packages Are Recommended.

scholarly journals The relationship of the application of guided imagery therapy techniques towards pain intensity of maternal post caesarian section operation in postnatal care at the maternity hospital in the city of Padang

2021 ◽  
Vol 8 (12) ◽  
pp. 5736
Author(s):  
Silfina Indriani ◽  
Ika Yulia Darma ◽  
Titin Ifayanti ◽  
Ledya Restipa
Keyword(s):  
Caesarean Section ◽  
Guided Imagery ◽  
Post Partum ◽  
Sampling Technique ◽  
Maternity Hospital ◽  
Labor Pain ◽  
P Value ◽  
Homogeneity Test ◽  
Cross Sectional ◽  
Caesarean Section Delivery

Background: Most of the maternity mothers experience discomfort disorders due to the pain felt by the mother after caesarean section surgery. The pain causes disruption of the mother’s activities after giving birth, the mother has difficulty breastfeeding her baby, and has difficulty doing physical activities. The pain results from surgical wounds on the abdominal wall and uterine wall of the mother. The pain experienced by each mother is different, ranging from low pain levels to severe pain levels.Methods: This type of comparative analytic research with a cross sectional study approach with one group pretest and posttest design. As many as 30 samples of post caesarean section delivery mothers were taken by purposive sampling technique. Marginal homogeneity test was used for research analysis.Results: The study showed that there was a decrease in the level of post-partum labor pain before and after the intervention of guided imagery therapy. Before the intervention, most of the respondents (46.7%) had moderate pain levels (4-6), after giving the intervention some respondents (43.3%) had mild pain levels. Statistical test showed a significant relationship with a significance value of 0.000 (p value <0.05).Conclusions: Giving guided imagery therapy to post caesarean section delivery mothers is able to reduce the level of pain that the mother experiences without causing additional risk for the mother. This therapy provides a sense of comfort and relaxation for the mother through the imagination generated by the mother in her mind so that it diverts and reduces the pain that the mother is experiencing. 

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

scholarly journals POS0548 OPTIMAL ASSESSMENT OF THE RHEUMATOID ARTHRITIS ANKLE AND HINDFOOT: A COMPARATIVE STUDY BETWEEN CLINICAL EXAMINATION AND ULTRASONOGRAPHY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Examination ◽  
Demographic Data ◽  
Power Doppler ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Therapeutic Decisions ◽  
The Mean ◽  
Foot Disease

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared

Satisfaction and Adherence to Biological Treatment in Patients with Rheumatic Diseases

2021 ◽  
Vol 18 ◽  
Author(s):  
Marwa Hammad ◽  
Huny Bakry
Keyword(s):  
Rheumatic Diseases ◽  
Biological Treatment ◽  
Formal Education ◽  
Biological Therapy ◽  
Cross Sectional Study ◽  
P Value ◽  
Inflammatory Rheumatic Diseases ◽  
Cross Sectional ◽  
New Era ◽  
The Mean

Background: Autoimmune inflammatory rheumatic diseases have long been treated by conventional disease-modifying anti-rheumatic drugs. Biological therapy is a new era in the treatment of rheumatic diseases, but satisfaction and adherence to it is still not well tested. Aim: To assess the satisfaction and adherence to biological treatment among patients with autoimmune inflammatory rheumatic diseases. Methods: A cross sectional study was conducted among 56 patients suffering from inflammatory rheumatic diseases using Morisky 8 questionnaire and Treatment Satisfaction Questionnaire for Medication (TSQM) over a period of one month Results: About 76.8% of the patients had medium adherence and the underlying cause of missing doses was the unavailability of the drugs. The mean satisfaction with biological treatment was 62.7±6.9. Patients who did not receive formal education had significantly higher satisfaction with the biological treatment than others 64.94±5.01 at a P value 0.04 (<0.05). Conclusion: Patients with inflammatory rheumatic diseases in our study showed medium adherence and satisfaction. Authorities in the medical field are providing great help to these patients in need of biological therapy, but ensuring the availability of all doses of the biological treatment regimen is still necessary. Patient, family and nurse education programs are also necessary to maximize adherence and satisfaction.

scholarly journals Tooth Loss and Its Association With Frequency of Pregnancy: A Cross-Sectional Study Among Yemeni Women

2021 ◽  
Author(s):  
Anas Shamala ◽  
Ebtesam Al-Maimooni ◽  
Salsbeel Al-Matari ◽  
Ryhana Hiyat ◽  
Mohammed Al-wesabi ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Tooth Loss ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Khat Chewing ◽  
Number Of Children ◽  
Hygiene Practices ◽  
The Mean

Abstract Backgrounds: The present study sought to assess tooth loss and oral hygiene practices among a sample of Yemeni women in association with giving births (parity).Subjects and Methods: This cross-sectional study included a sample of 644 Yemeni women. They were interviewed to gather socio-demographic (age, education, number of children) and behavioral data (oral hygiene practices, khat chewing and smoking). Additionally, they were examined clinically to assess number of tooth loss. Data were analyzed using SPSS with a P-value < 0.05 was considered statistically significant. Results: The participating women aged between 16 and 51 years. Only one fifth of the sample reported brushing their teeth regularly (i.e, at least once a day), and around 36.8% reported using dental aids occasionally. Additionally, 52% and 21% of the sample reported they were khat chewers and smokers, respectively. The mean number of tooth loss was 4.7. The mean number of children was 4.15, with approximately 54% of the participating women had more than 3 children. The results of the logistic regression revealed a significant association between number of children and tooth loss. Conclusion: Yemeni women had poor oral hygiene practices and high prevalence of tooth loss increased proportionally with the increased number of children. This emphasizes the importance of an effective oral hygiene motivation and health education among female patients during pregnancy periods.

scholarly journals Cross-sectional study to compare the biochemical parameters in low normal versus high normal plasma glucose levels in euglycemic individuals

2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma
Keyword(s):  
Uric Acid ◽  
Total Cholesterol ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Normal Group ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.

scholarly journals Hubungan Pemberian Anestesi Regional Dengan Kelancaran ASI Pada Ibu Post Partum Sectio Caesarea Di Rumah Sakit Muhammadiyah Gresik

2020 ◽  
Vol 7 (2) ◽  
pp. 42
Author(s):  
Vina Rahmatika ◽  
Musa Ghufron ◽  
Nenny Triastuti ◽  
Syaiful Rochman
Keyword(s):  
Breast Milk ◽  
Caesarean Section ◽  
Post Partum ◽  
Secondary Data ◽  
Sampling Technique ◽  
Primary Data ◽  
Sectio Caesarea ◽  
P Value ◽  
Cross Sectional ◽  
Anesthetic Drugs

Background: The birth rate by caesarean section method is getting higher. Risk data for 2013 shows the method of birth with the operation method of 9.8 percent of the total 49,603 births during 2010 to 2013. Being in practice the mother must be given anesthetic before the surgery begins. This anesthesia will later affect the pain that will occur after SC. Purpose: The purpose of this study was to determine the correlation between regional anesthetic drugs and the smoothness of breast milk in women born in sectio caesarea at Muhammadiyah Gresik Hospital. Method: Method with Cross Sectional approach. The population in this study mothers who gave birth in a caesarean section at Muhammadiyah Hospital Gresik in December 2019 to January 2020. The sampling technique in this study is probability / random simple sampling. The sample in this study was a portion of mothers who gave birth in a caesarean section at Muhammadiyah Gresik Hospital. The instrument used was primary data collection in the form of questionnaires and secondary data in the form of patient medical records. Result: The data obtained in this study were processed using spearman correlation statistics. From the statistical test the Correlation coefficient value was 0.807, and obtained P-Value equal to 0,000 this value is less than 0.05. Conclusion: The conclusion of this study is that there is a correlation between the administration of a regional anesthetics and the smoothness of breast milk in mothers of post partum caesarea at Muhammadiyah Gresik Hospital.

scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

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