scholarly journals The Role of Birthplace in the Mode of Delivery in Nepal

Author(s):  
Sudesh Pandit

The mode of delivery is strong-minded by diverse aspects. The available data and literature argue that the birthplace and birth orders play an imperative role in determining the mode of delivery. This study has been done with the objective to examine the association between the place of delivery and cesarean section in Nepal. A descriptive cross-sectional study was conducted among women who have delivery experience in the last five years of survey, but only the last one has been included. This study is based on the data of Nepal demographic and health survey 2016 [NDHS]. The data were collected from 19 June 2016 to 31 January 2017 through the questionnaires. The sampling frame of Central Bureau of Statistics [CBS] has been updated and used by NDHS where districts and provinces are categorized into urban and rural areas. Frequency tabulation, χ2 test and multivariate binary logistic regressions are used to analyze the data. There are 10.2 percent of women who had a cesarean section. Out of 3998 total deliveries, cesarean deliveries are 406 (10.2%) at 95 percent confidence interval (9-11). The prevalence of cesarean delivery was seen in women delivered in private hospitals 36.3 percent compared to women delivered in government health facilities 12.8 percent. Among 3998 deliveries, 57.4 percent are institutional deliveries. The place of delivery, anti-natal care visit and cesarean section delivery are related to each other. Women who go to private hospitals for anti-natal care and delivery, such hospitals are found to have performed more caesarean sections than the recommended level of World Health Organization (WHO).

2019 ◽  
Vol 1 (1) ◽  
pp. 108-113
Author(s):  
Mastina Mastina ◽  
Herlin Fitriani Kurniawati

World Health Organization (WHO) found the number of Cesarean Section delivery in the world at 25.7% in 2004-2008 which was 27.3% in Asia, 19.0% in Europe, 29.2% in Latin America and the highest number was in China at the rate of 46.2% (Wang, Hellerstein, Hou, Zou, Ruan, & Zhang, 2017). Rates determined by WHO for each country were 10-15% (WHO, 2015). WHO (2015) stated that the causative factor that can be delivered by Cesarean section is when vaginal delivery may have a risk to the mother and baby such as taking too much time for delivery and fetal disorders. Another cause was because of abnormal position. This study aims to determine the relationship between mother’s demand and Cesarean section delivery at PKU Muhammadiyah Hospital Bantul. The type of research used in this study is quantitative research with Cross Sectional approach using secondary data, namely medical record data of PKU Muhammadiyah Hospital Bantul in 2017. Chi-Square with P value 0.05 and CI 95% was used as data analysis. The bivariate results obtained were mother’s demand associated with delivery of Cesarean section with p value of 0.000 which means that the mother's demand had a significant relationship with the section Cesarean delivery. Based on the analysis of health technology assessment (HTA), the selection efforts at Cesarean section delivery were very beneficial for the mother and family, in terms of maternal health, economy and other factors.


2019 ◽  
Vol 5 (4) ◽  
pp. 85-90
Author(s):  
Arif Hussen Jamie

Background: Rising rates of cesarean delivery is becoming a concern to developing countries. Though cesarean section is a lifesaving surgical intervention, the rise in rates has resulted in significant health problems of mothers and newborns. Objective: The aim to undertaking this research is to know the prevalence, indications and outcome of cesarean section delivery In Jugal Hospital, Harari regional state, Ethiopia.Methods: Hospital based record review cross-sectional study was conducted in Jugal Hospital, Harar, Ethiopia from September 1, 2015 to September 1, 2019. Trained data collector and the principal investigator collected data employing a pre-tested extraction format. After checking the filled extraction format for completeness, data was entered, cleaned and analyzed using SPSS software Version 20.Results: In five years’ time (2015-2019), there were 6,111 deliveries, of which 1,817 were delivered by cesarean section which gives the overall rate of 29.7%. The most common indications for cesarean section were Cephalo-pelvic Disproportion (CPD) 323 (17.78%) followed by fetal distress 292(16.07%) and the least indication was pre-eclampsia 9(0.5%) and the most cause of prenatal death was birth asphyxia 38% followed by prematurity34%.Conclusion: In this study, there is a steady increase in the rates of cesarean delivery in five years’ time, the overall rate of C-section in Jugal Hospital was 29.7%. This rate is higher than the World Health Organization standard. Policies and efforts aimed at decreasing the unnecessary cesarean sections should be promoted and implemented at each health facility. 


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.


2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.


2020 ◽  
Author(s):  
Sajama Nepali ◽  
Padam Simkhada ◽  
Ian Glyyn Davies

Abstract Background: Wasting is a consequence of food insecurity, inappropriate dietary practices, and inadequate caring and feeding practices. The present study assessed association between wasting and household food insecurity among under five years old children, along with other socio-demographic characteristics.Methods: This study is a secondary analysis of the Nepal Demographic and Health Survey 2016. The survey is cross-sectional in design with use of standardized tools. The sampling frame used is an updated version of the frame from the 2011 National Population and Housing Census. The participants were children under five years of age (n= 2414). Logistic regression was carried out to identify the odds of being wasted for children belonging to different levels of food insecure households using odds ratio and 95 percent confidence intervals. Results: The prevalence of wasting increased with the level of food insecurity, from mild (9.4%) to moderate (10.8%) and to severe (11.3%). The highest proportions of wasted children were in Province 2 (14.3%), from rural areas (10.1%), born to mothers with no education (12.4%) and from a richer quintile (11.3%). Children belonging to severe food insecure households had 1.36 (95%CI 0.72-2.57) adjusted odds of being wasted and those belonging to mild food insecure and moderately food insecure households had 1.13 (95%CI 0.65-1.97) and 1.36 (95%CI 0.72-2.57) odds of being wasted respectively. Province 1 (AOR 2.06, 95%CI 1.01-4.19) and Province 2 (AOR 2.45, 95%CI 1.22-4.95) were significantly associated with wasting.Conclusion: Considering the increment in childhood wasting as per level of food insecurity, an integrated intervention should be developed in Nepal that, 1. addresses improving knowledge and behavior of community people with respect to diet and nutrition; 2. reduce the problem of food insecurity through agricultural interventions.


2018 ◽  
Vol 6 ◽  
pp. 205031211879756 ◽  
Author(s):  
Ülkü Türk Börü ◽  
Ahmet Şükrü Kulualp ◽  
Ömer Faruk Tarhan ◽  
Cem Bölük ◽  
Arda Duman ◽  
...  

Background: The population-based information on the prevalence of stroke from rural areas of Middle East countries including Turkey is unknown. Our aim is to evaluate the prevalence of stroke in those ⩾18 years in the Turkish population in a rural area of Istanbul. Methods: A cross-sectional door-to-door study was conducted in a rural area of Istanbul between 1 March and 30 March 2013. A research protocol recommended by World Health Organization for developing countries was used. Each screening teams consisted of one neurologist, one local nurse, and five surveyors. Teams were trained about the survey and questionnaire. The patients, who claimed to have suffered a stroke, were examined, and the diagnosis was confirmed by a neurologist on site. The findings and medical records were documented. Results: In total, 2906 people ⩾18 years were screened. 50 stroke cases were detected. 80% of those were found to have had an ischemic stroke, 14% of those were hemorrhagic cases, and 6% of those had an unclassified stroke type. The overall prevalence rate in those ⩾ 18 years was 1.7%. The male/female ratio was 0.92. Young (<45) stroke prevalence was found to be 0.6%. Conclusion: This study was the first of its kind to show the stroke prevalence among Turkish population ⩾ 18 years in a rural area of Istanbul. When compared to other studies which investigate people ⩾45 years from Turkey, the result (in the same age group) was moderate high. The male/female ratio was low compared to many other studies.


Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya

Abstract Background The decrease in the magnitude of stunting over the past 20 years has been slow in Ethiopia. To date, in Ethiopia, the trends in and extent of inequality in stunting have not been investigated using methods suitably developed for disparity studies. This paper investigated both the extent and overtime dynamics of stunting inequality in Ethiopia over the last 17 years. Methods Using the World Health Organization’s Health Equity Assessment Toolkit software, data from the Ethiopia Demographic and Health surveys (EDHS) were analyzed between 2000 and 2016. The inequality analysis consisted of disaggregated rates of stunting using five equity stratifiers (economic status, education, residence, region and sex) and four summary measures (Difference, Population Attributable risk, Ratio and Absolute Concentration Index). A 95% uncertainty interval was constructed around point estimates to measure statistical significance. Results The study showed that both absolute and relative inequalities in stunting exist in all the studied years in Ethiopia. The inequality disfavors children of mothers who are poor, uneducated and living in rural areas and specific regions such as Amhara. The pro-rich (R = 1.2; 1.1, 1.3 in 2000 to R = 1.7; 1.4, 2 in 2016) and pro-educated (R = 1.6; 95%UI = 1.3, 1.9 in 2000 and R = 2.3; 95%UI = 1.5, 3 in 2011) inequalities slightly increased with time. Male children bear a disproportionately higher burden of stunting, and the disparity increased between the first and the last time points (PAR = −1.5 95%UI = −2.5, −0.6 in 2000 and PAR = −2.9 95%UI = −3.9, −1.9) based on complex measures but remained constant with simple measures (R = 1; 95%UI = 0.9, 1.1 in 2000 and R = 1.1 95%UI = 1, 1.2 in 2016). Similarly, both the sub-national regional and residence-related stunting disparities generally widened over time according to some of the inequality measures. Conclusions Stunting appeared to be highly prevalent among certain sub-groups (i.e. poor, uneducated and living in rural regions). The subpopulations experiencing excessively high stunting prevalence should be the focus of policy makers’ attention as they work to achieve the WHO 40% reduction in stunting target by 2025 and the UN Agenda 2030 for Sustainable Development Goals.


2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.


Author(s):  
Anjana Verma ◽  
Dhriti Chugh ◽  
Ashish Patyal ◽  
Jitendra Kumar Meena ◽  
Medha Mathur

Background: Malnutrition continues to be a major problem in India and is rightfully described as “the silent emergency.” Sociocultural factors and rural urban disparity in health services in our country further impact the health outcomes. The effects of malnutrition are long-term and trap generations in the vicious circle of poverty. Improving nutrition is therefore essential to accelerate economic growth and development of the country.Methods: It was a community-based cross-sectional study conducted among 200 under five children residing in rural Udaipur, Rajasthan. Random sampling technique was used to select the study participants. A structured validated questionnaire was used to collect socio demographic data, birth history, Anganwadi beneficiary status etc. Mid upper arm circumference (MUAC), weight and heights were recorded and classified as underweight, wasted and stunted, using standard World Health Organization (WHO) guidelines.Results: This study revealed that 58% of the study population was stunted, 45% was wasted, 54% was underweight and 5% was overweight of the study population was overweight. Regarding the association of malnutrition parameters with other factors, it was found that malnutrition was high among female children, lower socioeconomic class, children of low educated mothers and children who were not exclusively breast fed.Conclusions: To combat malnutrition in India, there is need of multifaceted approach, taking into account the sociocultural determinants, demographic variables, especially in rural areas. In addition to providing supplementary nutrition, innovations regarding specific interventions targeted towards vulnerable population is necessary.


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