scholarly journals Trend Analysis of Vesico-vaginal Fistula among Attendee’s in Fistula Centres in Kano State, Nigeria

2020 ◽  
pp. 1-10
Author(s):  
Onyeugo Glory Ugochi ◽  
Chimezie Iwuala ◽  
C. R. Nwufo ◽  
Sally Ibe ◽  
Obinna Godwin Udujih ◽  
...  
Keyword(s):  
Medical Care ◽  
Trend Analysis ◽  
Rural Areas ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Vaginal Fistula ◽  
Traditional Practice ◽  
Hospital Records ◽  
Access To Medical Care ◽  
Vesico Vaginal Fistula

A study on the trend analysis of VVF among attendee’s in fistula centers, Kano State, Nigeria was carried out using ten (10) years hospital records. Results showed three peaks in prevalence in year 2010 (73.8%), 2015 (77.2%) and 2017 (59.3%). The highest peak was in the year 2015 while the lowest prevalence occurred in 2014 (46.0%). Overall, there is a decline in prevalence for the ten years studied. It was observed in this study that most of the patients reside in the rural area of the state, where lack of access to appropriate emergency obstetric care and strong hold to traditional practice is obtained. Therefore, there is need to expand the current strategies employed in the fight against VVF to include initiating a men-targeted programme to enlighten and educate men, especially those living in rural areas on the need to allow their women access to medical care during pregnancy to avoid complications that could result to Vesico-vaginal fistula.

scholarly journals Vesico-Vaginal Fistula a leading cause of Traumatic Stress In sufferers

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Sadaf Ahmed ◽  
Shamoon Noushad ◽  
Shershah Syed ◽  
Faiza Ahmed
Keyword(s):  
Mental Health ◽  
Traumatic Stress ◽  
Mental Health Treatment ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Early Years ◽  
Vaginal Fistula ◽  
Post Traumatic Stress ◽  
Timely Access ◽  
Vesico Vaginal Fistula

Aims: To evaluate psychological constraints among patients presenting with vesico-vaginal fistula (VVF). Methods: An Observational exploratory study was carried out to explore the experiences of women suffering from VVF. The study included 16 women hospitalized with the diagnosis of VVF at Kohi Goth Women's Hospital, Karachi, Pakistan. All patients presenting with VVF were administered a structured questionnaire followed by an in-depth interview while Sadaf Stress Scale was utilized for the evaluation of psychological condition. Results: The average age of patients was 25.4 years, range 24-30 years. A total of 5 patients were diagnosed with severe traumatic stress, only 1 patient was found in moderate level. While non to of the patients were unable to find proper mental health treatment due to poverty & illiteracy. Severity of traumatic stress was found greater in early years of the disease. All patients were affected by untrained Midwives. Conclusions: VVF is leading to traumatic stress, if not treated in early stages could lead to post traumatic stress disorder. The need to empower patients to timely access standard maternity and emergency obstetric care & mental health care is recommended.

scholarly journals Region wise referrals to a tertiary care centre: a retrospective analysis

2019 ◽  
Vol 8 (12) ◽  
pp. 4678
Author(s):  
Sirisha Paidi ◽  
Aashritha Thonangi
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Urban Rural ◽  
King George Hospital ◽  
Tribal Areas

Background: Emergency obstetric care in health care requires a linked referral system to be effective in reducing maternal morbidity and mortality. This review is aimed at summarizing the proportion of referrals from urban, rural and tribal areas of surrounding districts to tertiary care centre, King George Hospital, Visakhapatnam for a 6 month period; from May 2018 to October 2018.Methods: Retrospective study done at a tertiary care teaching hospital, including 3157 cases referred from the surrounding urban, rural and tribal areas.Results: Out of the 3157 referred cases, most of them (1658) were from rural areas, 1030 from urban and 469 from tribal areas. Referrals done in view of post caesarean pregnancies were more in urban and rural areas whereas more preeclampsia and anaemia cases were referred from tribal areas. Various indications of referral are documented. Majority of them were unbooked cases.Conclusions: Specific guidelines regarding whom to refer, how to refer and when to refer would be helpful in making timely referral. These would also help to decrease the burden on the tertiary care centers which deal with a huge caseloads in spite of limited infrastructure and manpower. Adequate attention and better care can be given to complicated cases if the total case load is reduced. Stringent documentation in referral slip and better co-ordination are required for a strong health care system.

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals Healthcare workers’ knowledge and attitude towards prompt referral of women with postpartum haemorrhage in Nigeria: a community-based study

2019 ◽  
Vol 9 (1) ◽  
pp. 335
Author(s):  
Adekemi Eunice Olowokere ◽  
Aanuoluwapo Omobolanle Olajubu ◽  
Ifeoluwa Eunice Ayeni ◽  
Olayinka Olaitan Aremu
Keyword(s):  
Rural Areas ◽  
Healthcare Workers ◽  
Postpartum Haemorrhage ◽  
Early Recognition ◽  
Post Partum ◽  
Emergency Obstetric Care ◽  
Estimate Blood Loss ◽  
Obstetric Care ◽  
Community Based ◽  
Knowledge And Attitude

Background: Postpartum Haemorrhage (PPH) is a major contributor to maternal mortality in developing countries most especially in the rural areas where Emergency Obstetric Care (EmOC) are not available. Delay in referring women from rural health facilities to settings where EmOC services are available have been reported. This study assessed community-based healthcare workers’ (CHWs) knowledge and attitude towards the prevention, early recognition and prompt referral of women with Post-Partum Haemorrhage (PPH) for Emergency Obstetric Care (EmOC).Methods: Descriptive cross-sectional design was used. Structured questionnaire was used to collect data from 200 CHWs recruited from community-based healthcare. Data analysis was done in SPSS version 20 at significance level of 0.05.Results: Findings show that 86.5% (n=173) of the respondents had good knowledge while 12% (n=24) and 1.5% (n=3) had moderate and poor knowledge respectively. Negative attitude towards prompt referral of women affected with PPH was found among 51% (n=102) of the respondents. Unavailability of blood drapes to estimate blood loss [χ2 (1, n=200) = 4.51, p=0.03], lack of ambulance [χ2 (1, n=200) = 4.46, p=0.03], and poor state of the roads [χ2 (1, n=200) = 4.44, p=0.03] were factors linked to poor attitude of CHWs towards prompt referral of affected women.Conclusions: The study concluded that there is a need for intervention that can help improve community healthcare workers’ attitude towards prompt referral of women affected with postpartum haemorrhage. There is also a need for general overhaul of community-based facilities to effectively support prompt referral.

scholarly journals Rising Rates of Caesarean Section in Urban Nepal

2019 ◽  
Vol 16 (41) ◽  
pp. 479-480 ◽  
Author(s):  
Sulochana Dhakal Rai ◽  
Pramod Raj Regmi ◽  
Edwin van Teijlingen ◽  
Juliet Wood ◽  
Ganesh Dangal ◽  
...  
Keyword(s):  
At Risk ◽  
Caesarean Section ◽  
Rural Areas ◽  
Emergency Obstetric Care ◽  
Health Resources ◽  
Obstetric Care ◽  
The Other ◽  
Sharp Rise ◽  
Private Hospitals

The rising rate of caesarean section in urban Nepal is alarming as the lack of access for women in rural areas to emergency obstetric care, putting lives at risk. The latter is referred to as ‘Too little too late’. At the same time, the sharp rise in caesarean section rates in cities presents the other extreme: “Too much too soon”. The overuse of caesarean section causes harm, unnecessary costs, and misuse of health resources. Availability of private hospitals and increasing hospital childbirth may contribute to the rising rate of caesarean section. This article highlights the rising rate of caesarean section in urban Nepal.Keywords: Caesarean section; emergency obstetric care; Nepal.

scholarly journals TELEMEDICINE IN THE CONTEXT OF ACCESSIBILITY OF MEDICAL AID IN RUSSIA

2018 ◽  
Vol 2 (2) ◽  
pp. 110-128
Author(s):  
E. Rozhkova
Keyword(s):  
Medical Care ◽  
Rural Areas ◽  
Medical Services ◽  
Educational Institutions ◽  
Economic Relations ◽  
Network Cooperation ◽  
Medical Prevention ◽  
Scientific Substantiation ◽  
The Subject ◽  
Access To Medical Care

The urgency of the topic is determined by the need to significantly increase the level of accessibility of medical services, first of all — of an innovative nature. The purpose of the article is to identify and characterize the development of telemedicine in contemporary Russia and therefore, propose the tools to improve accessibility of telemedicine services to the population.. Management decisions and organizational and economic relations that arise within the development of telemedicine are the subject of the study. The main results are: analysis of accessibility of medical services to the population as a whole was conducted; directions of using telemedicine technologies as an instrument for increasing access to medical care were identified; problems in the development of the domestic telemedicine market were outlined; differentiated accessibility of telemedicine services by different criteria were identified; directions for solving identified problems were suggested. The author suggests development of network cooperation between medical prevention centers, telemedicine centers and educational institutions located in rural areas. The materials of the article can be useful both for further scientific substantiation of ways for development of healthcare and for elaboration of practical solutions for the development of the market of innovative medical services.

scholarly journals Tanzanian lessons in using non-physician clinicians to scale up comprehensive emergency obstetric care in remote and rural areas

2011 ◽  
Vol 9 (1) ◽  
Author(s):  
Angelo S Nyamtema ◽  
Senga K Pemba ◽  
Godfrey Mbaruku ◽  
Fulgence D Rutasha ◽  
Jos van Roosmalen
Keyword(s):  
Rural Areas ◽  
Scale Up ◽  
Emergency Obstetric Care ◽  
Obstetric Care

scholarly journals Review of obstetric fistulas in a rural hospital in South-South Nigeria

2011 ◽  
Vol 25 (1) ◽  
pp. 7
Author(s):  
Aniefiok J. Umoiyoho ◽  
Aniekan M. Abasiattai ◽  
Okon E. Akaiso
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Formal Education ◽  
Health Workers ◽  
Medical Condition ◽  
Obstetric Fistula ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Medical Personnel ◽  
Health Facilities

<em>Background</em>. Obstetric fistula is a devastating medical condition associated with adverse social, psychological and reproductive health consequences. This study was carried out to review the pattern of presentation and outcome of patients with obstetric fistulas in a rural health facility in South-South Nigeria. <em>Design and Method</em>. A retrospective review of case notes of 51 patients with obstetric fistula that were managed at the Family Life Center, Mbribit Itam, in Itu, Local Government Area of Akwa Ibom State. <em>Results</em>. During the study period, 51 obstetric fistulas were repaired in the hospital. The ages of the patients ranged from 15 to 50 years with median age of 25.8 years and modal age group of 21-30 years (45.1%). The majority of the patients were of low parity (72.5%), 56.9% had no formal education and 27.5% were traders. Thirty four patients (66.7%) had their fistulas for between 1 and 6 years, 19.6% of the patients had juxta-cervical fistulas, while eight (15.7%) had circumferential loss of the urethra. Thirty-seven (72.5%) of them where unbooked and thus had no antenatal care, while 4 (7.8%) booked and had antenatal care in conventional health facilities. Thirty-four patients (66.7%) remained dry twenty-one days after surgery, thirteen (23.5%) were still wet, while 4 patients (7.8%) had stress incontinence despite repair. <em>Conclusion</em>. Obstetric fistulas are found most commonly among young, poorly educated women of low parity who do not avail themselves of orthodox ANC in our environment. Government, community and religious leaders must make concerted efforts to ensure women obtain formal education and when pregnant, have access to emergency obstetric care even if resident in the rural areas. Government, relevant non-Governmental organisations, community leaders and health workers should through relevant health messages enlighten women in the community about obstetric fistulas and the dangers of delivering in unorthodox health facilities. More medical personnel should be trained as the first attempt at repair is the one that is most likely to succeed.

scholarly journals What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal

2020 ◽  
Vol 5 (3) ◽  
pp. e001915
Author(s):  
Francesca L Cavallaro ◽  
Lenka Benova ◽  
El Hadji Dioukhane ◽  
Kerry Wong ◽  
Paula Sheppard ◽  
...  
Keyword(s):  
Rural Areas ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Public Facilities ◽  
Facility Births

IntroductionIncreases in facility deliveries in sub-Saharan Africa have not yielded expected declines in maternal mortality, raising concerns about the quality of care provided in facilities. The readiness of facilities at different health system levels to provide both emergency obstetric and newborn care (EmONC) as well as referral is unknown. We describe this combined readiness by facility level and region in Senegal.MethodsFor this cross-sectional study, we used data from nine Demographic and Health Surveys between 1992 and 2017 in Senegal to describe trends in location of births over time. We used data from the 2017 Service Provision Assessment to describe EmONC and emergency referral readiness across facility levels in the public system, where 94% of facility births occur. A national global positioning system facility census was used to map access from lower-level facilities to the nearest facility performing caesareans.ResultsBirths in facilities increased from 47% in 1992 to 80% in 2016, driven by births in lower-level health posts, where half of facility births now occur. Caesarean rates in rural areas more than doubled but only to 3.7%, indicating minor improvements in EmONC access. Only 9% of health posts had full readiness for basic EmONC, and 62% had adequate referral readiness (vehicle on-site or telephone and vehicle access elsewhere). Although public facilities accounted for three-quarters of all births in 2016, only 16% of such births occurred in facilities able to provide adequate combined readiness for EmONC and referral.ConclusionsOur findings imply that many lower-level public facilities—the most common place of birth in Senegal—are unable to treat or refer women with obstetric complications, especially in rural areas. In light of rising lower-level facility births in Senegal and elsewhere, improvements in EmONC and referral readiness are urgently needed to accelerate reductions in maternal and perinatal mortality.

scholarly journals Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041746
Author(s):  
Ryan Proos ◽  
Hanna Mathéron ◽  
Jonathan Vas Nunes ◽  
Abdul Falama ◽  
Patricia Sery Kamal ◽  
...  
Keyword(s):  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Rural Areas ◽  
Healthcare Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Structured Interviews

ObjectivesSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes factors affecting timely and adequate referral of women with obstetric complications in rural areas of Sierra Leone as viewed by health workers in rural health facilities.DesignQualitative research with semi-structured interviews using open-ended questions. Data were analysed by systematic text condensation.SettingInterviews were held in nine peripheral health units in rural Sierra Leone.Participants19 health workers including nurses, midwives and clinical health officers participated in nine interviews.ResultsFrom the interviews, four major themes describing possible factors of delay in referral of women in need of emergency obstetric care emerged: (1) communication between healthcare workers; (2) underlying influences on decision-making; (3) women’s compliance to referral and (4) logistic constraints.Several factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among healthcare workers for having maternal deaths or severe obstetric complications occurring at their own facilities. Furthermore, decision-making of healthcare workers whether to refer a woman or not is negatively influenced by a hierarchical culture with high power distance between healthcare workers.ConclusionFactors identified that complicate timely and adequate referral of women in need of emergency obstetric care must be considered in efforts to reduce maternal mortality. Possible interventions that may reduce delay in referral include increased communication by mobile phones between health workers for advice and feedback regarding referrals, involvement of influential stakeholders to increase women’s compliance to referral, and consistent use of standardised management protocols.

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