The strategy of community counselling combined with health education in reducing the maternal mortality rate

The current health-care delivery in Bangladesh only considers pharmacological approach to every/curing patient with physical illness. The effectiveness of community counselling on public health outcome is undeniable. In addition to associated heath and socio-economic factors, this complication contributes to increased maternal mortality rate in Bangladesh significantly. The objective was to find beside therapeutic treatment can “effective counselling and health education” reduce maternal mortality rate due to eclampsia/pre-eclampsia. This was a cross-sectional study with a sample size of 110 aged between 15 and 35 years were interviewed with a semi-structured questionnaire. The frequencies of the different variables were analyzed using SPSS 20 software, and the Chi-square test was done to observe the associations. The average age of the participants was 23 years. Over 40% of the women had their first delivery between the ages of 16–18 years and the same percentage of them had never taken antenatal checkup during their pregnancy. Gestational hypertension/pre-eclampsia was found in nearly 35% and eclampsia in 20% of the women. Previous maternal mortality cases before March, 2017 due to eclampsia in the sample community was 8 cases. Over a period of five months by early detection of cases, no maternal death was recorded due to eclampsia/ pre-eclampsia among the studied community after extensive counselling and health education. Despite the common therapeutic treatment for gestational hypertension, pre-eclampsia/eclampsia community counseling demonstrates significant impact on reducing mortality rate and strongly supports the association of community counselling and health education on reducing maternal mortality cases.

Randomized controlled trial of emergency department initiated smoking cessation counselling and referral to a community counselling service

ObjectiveWorldwide, tobacco smoke is still the leading cause of preventable morbidity and mortality. Many smokers develop chronic smoking-related conditions that require emergency department (ED) visits. However, best practices for ED smoking cessation counselling are still unclear.MethodsA randomized controlled trial was conducted to determine whether an “ask, advise, and refer” approach increases 12-month, 30-day quit rates in the stable adult ED smoking population compared to usual care. Patients in the intervention group were referred to a community counselling service that offers a quitline, a text-based program, and a Web-based program. Longitudinal intention-to-treat analyses were performed.ResultsFrom November 2011 to March 2013, 1,295 patients were enrolled from one academic tertiary care ED. Six hundred thirty-five were allocated to usual care, and 660 were allocated to intervention. Follow-up data were available for 70% of all patients at 12 months. There was no statistically significant difference in 12-month, 30-day quit rates between the two groups. However, there was a trend towards higher 7-day quit attempts, 7-day quit rates, and 30-day quit rates at 3, 6, and 12 months in the intervention group.ConclusionIn this study, there was a trend towards increased smoking cessation following referral to a community counselling service. There was no statistically significant difference. However, if ED smoking cessation efforts were to provide even a small positive effect, such an intervention may have a significant public health impact given the extensive reach of emergency physicians.