scholarly journals Assessment of the Midwives Knowledge on Utilization of Partograph in Management of Labour in Public Health Facilities in Tharaka Nithi County

2021 ◽  
Vol 11 (12) ◽  
pp. 167-175
Author(s):  
Mwari P.S ◽  
Gitonga LK ◽  
Mukhwana E.S
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
World Health ◽  
Management Tool ◽  
Labor Management ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Maternal Deaths ◽  
Public Health Facilities ◽  
Obstetric Labor Complications

The World Health Organization (WHO) has recommended Partograph as a labor management tool due to its impact in reducing obstetric labor complications and maternal deaths over the years. This labor management tool is inexpensive and appropriate for use in low-resource settings, particularly in developing countries. Despite the fact that many African countries, including Ethiopia, Kenya, and Nigeria, have adopted the Partograph in labor management, there is little information on midwives' knowledge on the use of the tool in labor management. Understanding of how to use a Partograph is essential for reducing complications and maternal deaths. The purpose of this study was to determine midwives' knowledge on using the Partograph in labor management. The study adopted a cross sectional survey design. 45 midwives were randomly selected from 16 public health facilities in Tharaka Nithi County. Questionnaires were used to collect data. Focused Group Discussions were also conducted with 77 postnatal mothers who gave birth in the 16 health facilities. The collected data was analyzed using descriptive statistics (means, frequencies, and percentages) and Chi-Square tests. Thematic analysis was used to examine qualitative data. Results showed that 74% of midwives had used Partograph in labor monitoring, while 26% had never used the tool. 60% of the midwives had received Partograph training. Despite not having been trained, some midwives were using the Partograph. Findings revealed inconsistencies in the use of Partograph in labor management. A large proportion of midwives deviated from the WHO's recommended use of Partograph in the first stage of labor. The study recommended that the Tharaka Nithi County government, through the Ministry of Health, invest in Partograph utilization in-service training programs to provide nurses and midwives working in the maternity wing the necessary knowledge and skills for proper Partograph utilization. There is also a need for policy changes in institutions to ensure that nurses use of the Partograph as a strategy for reducing maternal mortality rates, improving motherhood, and labor management in the County. Key words: Partograph; labour management; public health facilities.

scholarly journals Missed Opportunities in Tuberculosis Investigation and Associated Factors at Public Health Facilities in Uganda 

2020 ◽  
Author(s):  
Keith Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baluku ◽  
...  
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional Survey ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Public Health Facilities ◽  
Factors Associated

Abstract BackgroundThe incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. A recent national TB prevalence survey revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). The objective of this study was to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda.MethodsA facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation using STATA 14.ResultsTwo hundred forty seven presumptive TB patients were recruited into this study exiting at antiretroviral therapy (ART) clinics (n=132) or general outpatient clinics (n=115) at public health facilities. Majority of participants were females (161/247, 65.2%) and the mean +SD age was 35.1 + 11.5 years. Sputum and/or CXR were not requested from 138 (55.9%) patients with symptoms suggestive of TB disease. Patients who did not inform health workers about TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio: 1.68, 95%CI; 1.36-2.08, P<0.001). Conclusion; A large proportion of patients with symptoms suggestive of TB did not have sputum and/ or CXR requested for investigation. Patients who did not inform health workers about their TB related symptoms were more likely to miss having sputum and/ or CXR requested. We recommend studies to explore barriers and facilitators of disclosure of TB symptoms to enable formulation of effective interventions to empower people to improve likelihood of disclosing TB related symptoms.

scholarly journals Missed opportunities in tuberculosis investigation and associated factors at public health facilities in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keith Twirire Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baruch Baluku ◽  
...  
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Prevalence Ratio ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Public Health Facilities ◽  
Factors Associated

Abstract Background The incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. The population-based survey on the prevalence of TB in Uganda revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). This study aimed to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda. Methods A facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to the World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB diagnosis were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation. Results Two hundred forty-seven (247) patients with presumptive TB exiting at antiretroviral therapy (ART) clinics (n = 132) or general outpatient clinics (n = 115) at public health facilities were recruited into this study. Majority of participants were female (161/247, 65.2%) with a mean + SD age of 35.1 + 11.5 years. Overall, 138 (55.9%) patients with symptoms suggestive of TB disease did not have sputum and/or CXR examinations. Patients who did not inform health workers about their TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio (aPR): 1.68, 95%CI; 1.36–2.08, P < 0.001). However, patients who reported duration of cough of 2 weeks or more were less likely to be missed for TB screening (aPR; 0.69, 95%CI; 0.56–0.86, p < 0.001). Conclusion There are substantial missed opportunities for TB diagnosis in Wakiso District. While it is important that patients should be empowered to report symptoms, health workers need to proactively implement the WHO TB symptom screen tool and complete the subsequent steps in the TB diagnostic cascade.

scholarly journals Recours À L’avortement Provoqué Chez Les Femmes En Union Des Quartiers Précaires De Yopougon À Abidjan

2016 ◽  
Vol 12 (33) ◽  
pp. 319
Author(s):  
Doumbia Mohamed
Keyword(s):  
Public Health ◽  
Traditional Healers ◽  
Health Facilities ◽  
Financial Resources ◽  
Urban Context ◽  
Maternal Deaths ◽  
Level Of Education ◽  
Primary Level ◽  
Public Health Facilities ◽  
National Statistics

In Côte d’Ivoire, 15 % of maternal deaths are related to illegal abortions. Despite the known consequences, abortion practice is increasing more and more in a restrictive legislative context. Few formal studies and national statistics on the phenomenon exist, much less at the level of precarious slums of Abidjan. This article is a contribution to the understanding of abortion practice in the unprivileged urban context of Yopougon in Abidjan. It aims to analyze the logics and conditions of abortion in the precarious slums of Yopougon. A survey of a sample of 309 women aged 15 to 49 years, living in union in six precarious slums and, an investigation in three public health facilities and five private clinics and among traditional healers were conducted. Results indicate an overall prevalence of 11%. Women who aborted are generally young (85.3%), with no education (35.30%) or primary level of education (32.35%). Proportion of women who aborted increase with parity up to three children and decreases from the fourth child. The lack of financial resources (79.41%) and the fear and stigma (47.05%) are the main reasons of abortion. The majority of abortions took place in private clinics (58.82%).

scholarly journals Availability of emergency obstetric and newborn care services at public health facilities of Sindh province in Pakistan

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramesh Kumar ◽  
Jamil Ahmed ◽  
Fozia Anwar ◽  
Ratana Somrongthong
Keyword(s):  
Public Health ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Public Health Facilities ◽  
Care Services ◽  
Sindh Province

Abstract Background Basic and comprehensive emergency obstetric care services in Pakistan remain a challenge considering continued high burden of maternal and newborn mortality. This study aimed to assess the availability of emergency obstetric and newborn care in Sindh Province of Pakistan. Methods This cross-sectional survey was conducted in twelve districts of the Sindh province in Pakistan. The districts were selected based on the maternal neonatal and child health indicators. Data were collected from 63 public-sector health facilities including district, Taluka (subdistrict) headquarters hospitals and rural health centers. Basic and comprehensive emergency obstetric newborn care services were assessed through direct observations and interviews with the heads of the health facilities by using a World Health Organization pretested and validated data collection tool. Participants interviewed in this study included the managers and auxiliary staff and in health facilities. Results Availability of caesarean section (23, 95% C.I. 14.0–35.0) and blood transfusion services (57, 95% CI. 44.0–68.0), the two components of comprehensive emergency obstetric and newborn care, was poor in our study. However, assessment of the seven components of basic emergency obstetric and newborn services showed that 92% of the health facilities (95% C.I. 88.0–96.0) had parenteral antibiotics, 90%, (95% C.I. 80.0–95.0) had oxytocin, 92% (95% CI 88.0–96.0) had manual removal of the placenta service, 87% (95%, C.I. 76.0–93.0) of the facilities had staff who could remove retained products of conception, 82% (95% C.I. 71.0–89.0) had facilities for normal birth and 80% (95% C.I. 69.0–88.0) reported presence of neonatal resuscitation service. Conclusion Though the basic obstetric and newborn services were reasonably available, comprehensive obstetric and newborn services were not available as per the World Health Organization’s standards in the surveyed public health facilities. Ensuring the availability of caesarean section and blood transfusion services within these facilities may improve population’s access to these essential services around birth.

scholarly journals EVALUATION OF DRUG-PRESCRIBING PATTERNS AT OUTPATIENT CLINICS OF PUBLIC HEALTH FACILITIES IN MIRPUR AZAD KASHMIR

2021 ◽  
Vol 71 (4) ◽  
pp. 1243-47
Author(s):  
Saman Omer ◽  
Bushra Tayyaba Khan ◽  
Omer Jalil
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
World Health ◽  
Drug Prescribing ◽  
Prescribing Practices ◽  
Prescribing Pattern ◽  
Prescribing Indicators ◽  
Public Health Facilities

Objective: To evaluate prescribing practices in public health facilities of district Mirpur, Kashmir where no previous evidence regarding drug-prescribing behaviours was available. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pharmacology and Therapeutics, Army Medical College, Rawalpindi and outpatient departments of public health facilities in district Mirpur, Kashmir, from Aug to Oct 2020. Methodology: The prescribing pattern analysis was done by objective observations of prescriptions after patient-physician encounter. World health organization defined core and complementary prescribing indicators were evaluated for all the prescriptions. Results: Among the core prescribing indicator, average number of medicines per prescription were 3.11 (World Health Organization’s standard, 1.6-1.8). Only 2% and 67% of medicines were generic and essential medicines respectively (standard, 100%). Almost half the prescriptions contained antibiotics (standard, 20-26.8%) whereas 8% had injections (standard, 13.4- 24.1%). Among the complementary indicators there was no prescription without medicines and average prescription cost was 479 Pakistani Rupees. Conclusion: This is the first study to give a snapshot of prescribing behaviours in public health facilities in Kashmir. All the prescribing indicators except injectables were below the standards. A multi-disciplinary approach involving authorities, industry and professionals is required to promote rational prescribing.

scholarly journals Partograph Utilization and Associated Factors among Obstetric Care Providers Working in Public Health Facilities of Wolaita Zone, 2017

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mesfin Markos ◽  
Aseb Arba ◽  
Kebreab Paulos
Keyword(s):  
Public Health ◽  
Job Training ◽  
Obstetric Care ◽  
Health Facilities ◽  
Favorable Attitude ◽  
Good Knowledge ◽  
Care Providers ◽  
Maternal Deaths ◽  
Public Health Facilities ◽  
Obstetric Care Providers

Background. Obstructed or prolonged labor is a major cause of maternal deaths. Prolonged and obstructed labor contributed to 13% of global maternal deaths which can be reduced by proper utilization of a partograph during labor. Obstetric caregivers’ use of the partograph during labor has paramount importance in identifying any deviation during labor. Even though partograph use is influenced by different factors as obtained from the literatures, the magnitude of partograph utilization and the factors associated with its use are not well determined in the health facilities of Wolaita Zone. Objective. To assess the magnitude of partograph utilization and factors that affect its utilization among obstetric caregivers in public health facilities of Wolaita Zone, Ethiopia, 2017. Methods. An institution-based cross-sectional study was conducted on obstetric caregivers. A pretested and structured questionnaire was used to collect data. Data was entered to EpiData version 3.01 and exported to SPSS version 23.0 for further analysis. Logistic regression analyses were used to see the association of different variables. Result. A total of 269 obstetric caregivers participated in the study. Among those who were utilizing the partograph, 193 (71.7%) routinely used it for all laboring mothers and 76 (28.3%) of participants reported that they do not routinely utilize it. Greater number of service years (AOR=4.93, 95% CI: 1.53-15.88), on-the-job training (AOR=0.16, 95% CI: 0.06-0.43), good knowledge (AOR=3.35, 95% CI: 1.61-6.97), and favorable attitude towards partograph utilization (AOR=2.99, 95% CI: 1.28-7.03) were significantly associated with partograph utilization. Conclusion and Recommendation. Partograph utilization among obstetric caregivers in the public health facilities was good. Greater years of work experience, in-service training, having good knowledge, and favorable attitude towards partograph utilization among obstetric caregivers independently determined partograph utilization. Provision of on-the-job training to make obstetric caregivers improve knowledge and skill on partograph utilization, maintaining caregivers’ retention to decrease turnover by providing different incentives to more experienced obstetric care providers, and establishing favorable attitude could improve the proper use of the tool.

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