scholarly journals Community-Based Study of Abortion Complications and Care Sought by Rural Tribal Women of an Extremely Low Resource Setting

Author(s):  
Shakuntala Chhabra ◽  
Akanksha Suman

OBJECTIVE: Knowing about complications, care sought by women is essential for understanding the risks, services, programs, and policies for abortion care. This study aimed to know the magnitude of abortion complications and to define the care sought by rural tribal women. STUDY DESIGN: Rural community-based cross-sectional study was carried out in villages near Sewagram Wardha and Melghat, Amravati, Maharashtra, India. RESULTS: Spontaneous abortions rate was 3.30% in villages around Sewagram and 0.32% in villages of Melghat. The reported complications rate for induced abortions was 1% in Sewagram villages and 0.1%in Melghat villages. In Sewagram villages, among 24 (4.3%) women who had complications with spontaneous abortions, the reported complications were: vaginal bleeding in 33.3% (1.4% of all spontaneous abortions), abdominal pain in 33.3%, weakness in 29.16% (1.2% all spontaneous abortions), backache in16.6% (0.7%of spontaneous abortions), fever in 12.5%(0.5% of spontaneous abortions), excessive vaginal discharge in 8.33% (0.3% of spontaneous abortions), and other complications in 8.33% (0.36% of spontaneous abortions) women. Among 7 women (3.9% of all 177), who reported complications after induced abortions, 57.1% (2.2% of all induced abortions) reported, vaginal bleeding and 28.5% (1.1% of induced abortions) reported abdominal pain. In Melghat villages only 4 women reported complications with spontaneous abortions (0.32% spontaneous abortions): two (0.16% spontaneous abortions) reported abdominal pain, one (0.08% spontaneous abortions) reported vaginal bleeding, and one (0.08% of spontaneous abortions) reported backache. In villages of Melghat 2 women (3.7%) out of 27 induced abortions cases had complications: one had vaginal bleeding, discharge, pain, weakness, another only vaginal bleeding. In villages of Melghat 2 of the total 6 sought health facility care, however, no one reported to specialists despite complications. Nevertheless, there was neither abortion-related mortality nor near-miss morbidity or severe morbidity during the same duration. CONCLUSION: Research is needed about traditional therapies, reverse pharmacology, socio-behavioral issues in addition to creating awareness in women about abortion complications, long-term squeal, and the necessity of care-seeking.

2020 ◽  
Vol 2 (2) ◽  
pp. 22-29
Author(s):  
S. CHHABRA ◽  
Jain S ◽  
Thool K

Background Induced abortions are globally sought, whether permitted, or not permitted. Community based information about abortion seeking by rural tribal women is scarce. Objectives Community based study was carried out to know the magnitude, profile, reasons, places, persons performing IA for rural tribal women. Material Methods Study was conducted in 118 villages to get the study subjects . Women from every fourth house were interviewed for desired information. Results and Conclusion Of all abortions, 2.17% in Melghat and 24.38 %in Sewagram were IA. Most women who had IA were young and 19% in Melghat region, 2.6% in Sewagram region were illiterate. Majority of Sewagram region, were housewives of low middle class, in Melghat unskilled workers of low economic class. In Melghat region all women reported seeking IA at health facilities,63% Private hospitals (PH), 18.5% Sub centres (SC), 7.4% Medical College (MC), 7.4% District hospital(DH), 3.7% Primary Health Centres (PHCs) and In Sewagram region 58% PH, 23% MC, 6.7% PHCs, 3.9% DH, 3.9% SCs and 3.9% at home. Most women said they had IA for spacing with no contraceptive use or contraceptive failure, poor health, poverty, IA were done medically in 76.2%, surgically 23%. No sex–selective IA were reported and there was no evidence Many women lacked awareness and had misconceptions, more so in Melghat region. In focus group discussions, common reasons for disfavoring IA were personal beliefs (34%), practice restrictions (19%). There was extreme poverty, still PH were used. Lot of awareness is required.


2010 ◽  
Vol 43 (1) ◽  
pp. 31-45 ◽  
Author(s):  
ANN M. MOORE ◽  
GABRIEL JAGWE-WADDA ◽  
AKINRINOLA BANKOLE

SummaryAbortion is illegal in Uganda except to save the life of the woman. Nevertheless, the practice is quite common: about 300,000 induced abortions occur annually among Ugandan women aged 15–49 (Singh et al., 2005) and a large proportion of these women require treatment for post-abortion complications. In the male-dominant culture of Uganda, where men control most of the financial resources, men play a critical part in determining whether women receive a safe abortion, or appropriate treatment if they experience abortion complications. This study examines men's roles in determining women's access to a safer abortion and post-abortion care. It draws on in-depth interviews carried out in 2003 with 61 women aged 18–60 and 21 men aged 20–50 from Kampala and Mbarara, Uganda. Respondents' descriptions of men's involvement in women's abortion care agreed that men's stated attitudes about abortion often prevented women from involving them in either the abortion or post-abortion care. Most men believe that if a woman is having an abortion, it must be because she is pregnant with another man's child, although this does not correspond with women's reasons for having an abortion – a critical disjuncture revealed by the data between men's perceptions of, and women's realities regarding, reasons for seeking an abortion. If the woman does experience post-abortion complications, the prevailing attitude among men in the sample was that they cannot support a woman in such a situation seeking care because if it had been his child, she would not have had a covert abortion. Since money is critical to accessing appropriate care, without men's support, women seeking an abortion may not be able to access safer abortion options and if they experience complications, they may delay care-seeking or may not obtain care at all. Barriers to involving men in abortion decision-making endanger women's health and possibly their lives.


2005 ◽  
Vol 35 (3) ◽  
pp. 139-142 ◽  
Author(s):  
R M K Adanu ◽  
M N Ntumy ◽  
E Tweneboah

A cross-sectional study of 150 women was performed at the gynaecology department of the Korle-BuTeaching Hospital to describe the characteristics of patients with complications of induced or spontaneous abortions, and to find out the reasons behind induced abortions. In all, 31% of the study sample presented with complications of induced abortions. This group was younger, of lower parity, more educated, with lower economic potential, in less stable relationships and with a higher knowledge of modern contraceptive methods than the group with spontaneous abortions. The chief reason for procuring an induced abortion was the presence of relationship problems with the subject's partner. We conclude that measures to prevent induced abortions and their subsequent problems will yield major results if directed at women in their early 20s with at least primary education, no children, low economic potential, not in a stable relationship and who have had a previous induced abortion.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019658 ◽  
Author(s):  
Mugove Gerald Madziyire ◽  
Chelsea B Polis ◽  
Taylor Riley ◽  
Elizabeth A Sully ◽  
Onikepe Owolabi ◽  
...  

ObjectivesAbortion complications cause significant morbidity and mortality. We aimed to assess the severity and factors associated with abortion complications (induced or spontaneous), and the management of postabortion care (PAC) in Zimbabwe.DesignProspective, facility-based 28 day survey among women seeking PAC and their providers.Setting127 facilities in Zimbabwe with the capacity to provide PAC, including all central and provincial hospitals, and a sample of primary health centres (30%), district/general/mission hospitals (52%), private (77%) and non-governmental organisation (NGO) (68%) facilities.Participants1002 women presenting with abortion complications during the study period.Main outcome measuresSeverity of abortion complications and associated factors, delays in care seeking, and clinical management of complications.ResultsOverall, 59% of women had complications classified as mild, 19% as moderate, 19% as severe, 3% as near miss and 0.2% died. A median of 47 hours elapsed between experiencing complication and receiving treatment; many delays were due to a lack of finances. Women who were rural, younger, not in union, less educated, at later gestational ages or who had more children were significantly more likely to have higher severity complications. Most women were treated by doctors (91%). The main management procedure used was dilatation and curettage/dilatation and evacuation (75%), while 12% had manual vacuum aspiration (MVA) or electrical vacuum aspiration and 11% were managed with misoprostol. At discharge, providers reported that 43% of women received modern contraception.ConclusionZimbabwean women experience considerable abortion-related morbidity, particularly young, rural or less educated women. Abortion-related morbidity and concomitant mortality could be reduced in Zimbabwe by liberalising the abortion law, providing PAC in primary health centres, and training nurses to use medical evacuation with misoprostol and MVA. Regular in-service training on PAC guidelines with follow-up audits are needed to ensure compliance and availability of equipment, supplies and trained staff.


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Claudia Calvano ◽  
Petra Warschburger

Background. Pain symptoms, associated impairment, and parental perception of threat are reported to be predictors of health care utilization (HCU) in childhood chronic abdominal pain (CAP). However, mediating variables and their interrelations have not yet been systematically studied. Objectives. This study aims to identify mediating pathways of influence between child’s abdominal pain and the number of pain-related medical visits. Methods. In a multicenter study, we recruited N = 151 parent-child dyads with children aged 6–17 years suffering from CAP. A composite measure of pain symptoms was defined as predictor and the number of pain-related medical visits as outcome variable. This relation was analyzed by serial mediation, including child- and parent-reported impairment and parental threat perception as mediators. Results. Only parental threat perception significantly linked child’s pain symptoms to the number of medical visits. Measures of impairment did not have a significant effect. Conclusions. Parental pain-related threat perception is strongly related to health care seeking in childhood CAP. Addressing threat perception might be a fruitful parent-centered approach in clinical practice.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Eshetu Haileselassie Engeda ◽  
Berihun Assefa Dachew ◽  
Hiwot Kassa Woreta ◽  
Mengistu Mekonnen Kelkay ◽  
Tesfaye Demeke Ashenafie

Studies in the northern part of Ethiopia showed high prevalence of undiagnosed cluster of tuberculosis cases within the community which demanded an investigation of the health care seeking behaviour of tuberculosis suspects. A community-based cross-sectional study was conducted in Lay Armachiho district, Northwest Ethiopia. Individuals who had cough for at least two weeks and aged greater than or equal to 15 years were included in the study. Data were collected by interview using pretested and structured questionnaire. Logistic regression was computed and adjusted odds ratio with 95% confidence interval was calculated. Out of the total population surveyed (29, 735), 663 (2.2%) individuals were found to be pulmonary tuberculosis suspects. Majority of the suspects reported that they had visited a modern health care facility. Those aged 15 to 34 and aged 35–54 had secondary educational level and above; those who were civil servants, those who were farmers, those who had previous history of tuberculosis treatment, and those who perceived that they were sick were more likely to visit a modern health care facility. The proportion of respondents who had taken traditional measures was found to be higher than some other districts. Improving the socioeconomic status of the community is recommended.


1992 ◽  
Vol 29 (5) ◽  
pp. 470-474 ◽  
Author(s):  
Bente Felix-Schollaart ◽  
Jan B. Hoeksma ◽  
Jean Paul Van De Velde ◽  
Jerôme I. Puyenbroek ◽  
Birte Prahl-Andersen

The reproductive history was studied to evaluate if the three types of solitary, nonsyndromic clefts: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP) are homogeneous entities. Occurrence of fetal loss, maternal health, and drug consumption of the mother during the pregnancy were compared in cases involving three types of clefts. Data was gathered from 87 children with clefts, 55 males and 32 females. Spontaneous abortions and vaginal bleeding were found to occur significantly more often in the (older) mother of a CLP child. This suggests that the factors involved in the etiology of CLP differ from the factors involved in CL and CP. Therefore, grouping of data of the three types of clefts in studies on the etiology should be avoided.


2018 ◽  
Vol 34 (6) ◽  
Author(s):  
Thália Velho Barreto de Araújo ◽  
Estela M. L. Aquino ◽  
Greice M. S. Menezes ◽  
Maria Teresa Seabra Soares de Britto e Alves ◽  
Maria-da-Conceição C. Almeida ◽  
...  

Abstract: Around 18 million unsafe abortions occur in low and middle-income countries and are associated with numerous adverse consequences to women’s health. The time taken by women with complications to reach facilities where they can receive appropriate post-abortion care can influence the risk of death and the extent of further complications. All women aged 18+ admitted for abortion complications to public-sector hospitals in three capital cities in the Northeastern Brazil between August-December 2010 were interviewed; medical records were extracted (N = 2,804). Nearly all women (94%) went straight to a health facility, mainly to a hospital (76.6%); the rest had various care-seeking paths, with a quarter visiting 3+ hospitals. Women waited 10 hours on average before deciding to seek care. 29% reported difficulties in starting to seek care, including facing challenges in organizing childcare, a companion or transport (17%) and fear/stigma (11%); a few did not initially recognize they needed care (0.4%). The median time taken to arrive at the ultimate facility was 36 hours. Over a quarter of women reported experiencing difficulties being admitted to a hospital, including long waits (15%), only being attended after pregnant women (8.9%) and waiting for a bed (7.4%). Almost all women (90%) arrived in good condition, but those with longer delays were more likely to have (mild or severe) complications. In Brazil, where access to induced abortion is restricted, women face numerous difficulties receiving post-abortion care, which contribute to delay and influence the severity of post-abortion complications.


2021 ◽  
Vol 15 (3) ◽  
pp. e0009285
Author(s):  
Beth L. Rubenstein ◽  
Sharon L. Roy ◽  
Karmen Unterwegner ◽  
Sarah Yerian ◽  
Adam Weiss ◽  
...  

Background Guinea worm is a debilitating parasitic infection targeted for eradication. Annual human cases have dropped from approximately 3,500,000 in 1986 to 54 in 2019. Recent identification of canine cases in Chad threatens progress, and therefore detection, prevention, and containment of canine cases is a priority. We investigated associations between disease knowledge, community engagement, and canine cases in Chad to identify opportunities to improve active surveillance. Methods We surveyed 627 respondents (villagers, local leaders, community volunteers, and supervisors) across 45 villages under active surveillance. Descriptive statistics were analyzed by respondent category. Logistic regression models were fitted to assess the effects of volunteer visit frequency on villager knowledge. Results Knowledge increased with respondents’ associations with the Guinea worm program. Household visit frequency by community volunteers was uneven: 53.0% of villagers reported visits at least twice weekly and 21.4% of villagers reported never being visited. Villagers visited by a volunteer at least twice weekly had better knowledge of Guinea worm symptoms (OR: 1.71; 95% CI: 1.04–2.79) and could name more prevention strategies (OR: 2.04; 95% CI: 1.32–3.15) than villagers visited less frequently. The primary motivation to report was to facilitate care-seeking for people with Guinea worm. Knowledge of animal “containment” to prevent contamination of water, knowledge of rewards for reporting animal cases, and ability to name any reasons to report Guinea worm were each positively correlated with village canine case counts. Conclusions Community volunteers play crucial roles in educating their neighbors about Guinea worm and facilitating surveillance. Additional training and more attentive management of volunteers and supervisors could increase visit frequency and further amplify their impact. Emphasizing links between animal and human cases, the importance of animal containment, and animal rewards might improve surveillance and canine case detection. The surveillance system should be evaluated routinely to expand generalizability of data and monitor changes over time.


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