The Prevalence and Pattern of Traditional Herbal Medicine Use during Pregnancy, Labour, and Postpartum: Implications for Prevention of Mother to Child Transmission of HIV in South Africa

The use of traditional herbal medicines (THM) is widespread among pregnant women in many African societies. Cultural beliefs and social norms largely influence the use of THM. However, its use during pregnancy is not freely discussed during antenatal care and the extent of its use remains unknown. The aim of the study was to determine the prevalence and pattern of THM use during pregnancy, labour, and post-delivery. The study was a quantitative cross-sectional design using a researcher administered questionnaire. Postnatal women enrolled in the prevention of mother to child transmission of HIV (PMTCT) were recruited from healthcare facilities in a rural South African sub-district. Summary and inferential statistics were computed using STATA 14.0 statistical package. The sample consisted of 399 women with mean age of 28 years. A high proportion (158/42.5) were receiving antiretroviral treatment. The prevalence of THM use was 23% and 76/87.4% took THM in the second trimester of pregnancy, 50/57.5% used THM throughout pregnancy, and 27/60% ingested THM when labour started. The majority (50/58.1%) used one type of THM and 35/41.5% used up to four types. The prevalence of THM use on babies was 44%, 82/54.2% were introduced to THM before three months, and 22/14.2% within their first week of life. A third 52/32.3% of babies received more than one concoction of herbal medicines. The women took THM to protect mother and baby from evil spirits as well as to increase labour pains and shorten the duration of labour. The use of THM on the baby was despite the women being enrolled in the PMTCT program which advocates exclusive breastfeeding (EBF) in the first six months. Mixed feeding practices including the use of THM on the baby before the end of the period of EBF have a negative impact on the elimination of vertical transmission of HIV.

Assessing individual factors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya.

Background: Globally, about 295,000 maternal deaths occurred in 2017 with Sub-Saharan Africa and Asia accounting for 86%. Sub-Saharan Africa alone accounted for nearly two-thirds. The rate of skilled birth attendant in Sub-African region stood at 59%. Three quarters of neonatal and maternal deaths occur outside hospital settings. Currently, the rate of maternal mortality in Kenya stands at 362 per 100,000 live births. Despite the deliberate government interventions to increase hospital deliveries, still a significant number of women deliver at home. The objective of this study was to assess the individual actors associated with choice of place of delivery among postnatal women in Marsabit County, Kenya. Methods: This was a cross-sectional descriptive study adopting both quantitative and qualitative data collection methods. A total of 416 postnatal women were systematically sampled from households at a predetermined interval of four. Key informants interviews and focused group discussions provided additional qualitative data.Results: Approximately 56.7% of postnatal women in Marsabit County delivered in health facilities. Most individual factors such as decision maker (p=0.031), myths and misconceptions (p=0.025), reduction of complications (p=0.001), hospital delivery time consuming (p=0.023) and possession of medical insurance (p=0.001) were significantly associated with choice of place of delivery. Conclusions: Approximately 6 out 10 deliveries occur at health facilities in Marsabit County. Individual factors significantly influenced choice of place of delivery. There is need for the ministry of health, County Government of Marsabit and relevant stakeholders to demystify myths and misconceptions about hospital deliveries, scale up awareness on availability of Linda Mama medical cover for pregnant women to ensure easy access of hospital delivery services.

Effect of Peppermint Water V/S Lanolin Ointment Application in Management of Cracked Nipple among Lactating Postnatal Women

Background of the study: Breast feeding is considered as the ideal method of feeding and nurturing infants. It is a dream for most mothers to have comfort in breast feeding, but sore nipples are still a common problem and pain or cracks frequently occur after breast feeding. The present study evaluated the Effect of peppermint water v/s lanolin ointment application in management of cracked nipple among lactating postnatal women. Objectives: The objectives of the study were to assess the intensity of cracked nipple in lactating post-natal mothers, to compare the effect of Peppermint water and Lanolin in the management of cracked nipple, to find out the association between the pre interventional level of cracked nipples and selected demographic variables. Methodology: The study design used was Quasi experimental two group pretest posttest design. Consecutive sampling was used to select 60 postnatal mothers with cracked nipple who met the sample selection criteria. Informed consent was obtained from the samples who fulfils the inclusion criteria. The tools used in this study were modified visual analogue scale, nipple soreness rating scale, nipple trauma scale. Out of 60 samples 30 were selected for Peppermint water application and 30 were selected for Lanolin ointment application. Results: The data when analyzed using descriptive and inferential statistics revealed a significant reduction in the level of pain, soreness and trauma after the application of Peppermint water compared to lanolin ointment. There was no association between pre interventional level of cracked nipple and selected demographic variables. Conclusion: The study concluded that Peppermint water is better than Lanolin ointment in management of cracked nipple among postnatal mothers. Cracked nipple is a prevalent problem among postnatal mothers and health care personnel should be equipped with good assessment tools and cost-effective interventions. Key words:Peppermint water, Lanolin ointment, Cracked nipple, Lactating postnatal women

Factors influencing labour and birthing positions in Malawi

Background/aims The World Health Organization encourages women in labour to ambulate and assume upright positions shown to be associated with favourable childbirth outcomes. However, the literature shows that most women in developed and developing countries, including Malawi, give birth in the supine position. There is a lack of research on factors that influence choice of birthing positions among women in Malawi. This study aimed to identify these factors. Methods A face-to-face descriptive survey was conducted on 373 low-risk postnatal women in Malawi. Bivariate and multivariate analyses were used to determine association between sociodemographic characteristics and choice of labour and birthing position, as well as to identify predictive factors. Results Walking during labour was significantly associated with age (P=0.018) and monthly family income (P=0.012). During birth, women who had received some degree of education were more likely to use the supine position than those who had not (93% vs 78%; P=0.011). However, women with a higher level of income were less likely to use the supine position than women with low income (82% vs 93%; P=0.005). Conclusions Age, income and education influence Malawian women's choices for labour and birthing position. There is a need for Malawian women to be informed about and encouraged to use different labour and birthing positions, regardless of their socioeconomic and demographic status, to promote positions that improve maternal and neonatal outcomes. Childbirth education sessions or classes during antenatal care should include information on different birthing positions.

Involving and engaging pregnant women in maternity-related research: reflections on an innovative approach

Background Meaningful public involvement in maternity research remains challenging, partly due to the transient nature of pregnancy. This paper reflects on the development, implementation and simple evaluation of an innovative and inclusive approach to engaging and involving pregnant and early postnatal women in research. Methods Between January and February 2018, a Research Fellow in Maternity Care, a Professor of Evidence Based Maternity Care, and a Patient and Public Involvement Lead convened for a number of meetings to discuss how public involvement and engagement might be improved for pregnancy-related research. A stakeholder group was created, including a local community matron, a community engagement officer at a local children’s centre, public contributors, and senior members of the Maternal and Child Health theme of the West Midlands Collaboration for Leadership in Applied Health Research and Care (CLAHRC WM). The team worked together to develop a format for Yoga for Bump sessions: a free 90-min session, offered weekly, which included research involvement/engagement, pregnancy yoga, and a ‘question and answer’ session with a midwife. Results A total of 67 women from two local communities in Birmingham attended Yoga for Bump sessions, which ran between May and December of 2018. Evaluation of the sessions suggested benefits to both women and researchers: it created mutually beneficial relationships between contributors and researchers, provided opportunities for women to engage and get involved in research that was directly relevant to them, and provided a convenient and efficient way for researchers to involve and engage pregnant women from diverse backgrounds in their research. Unintended benefits included self-reported improvements in women’s health and wellbeing. Conclusions Yoga for Bump demonstrates an innovative approach to engaging and involving pregnant and early postnatal women; combining a free exercise class with healthcare advice and opportunities to engage with and be involved in research, and demonstrating mutual benefits for those involved. This model has the potential to be replicated elsewhere to support inclusive public involvement in pregnancy-related research. Further work is needed to design and evaluate similar approaches to involvement/engagement and explore potential funding avenues to enhance sustainability.

Hong Kong Mothers and Emotional Sustainability via UN Sustainable Development Goal#3 Wellness and #16 Peace

The proposed project is expected to attract a target of 500 postnatal women (less than 3 months after delivery) for a half-year business intervention pilot project named “ Local Pui Yu” / postnatal assistant center to pilot this service with the support from IT companies on the techniques and devices to be needed to create the impacts and make the impacts transparent. And, it is expected that IT companies and/ or invited NGOs can support the total costs, for example, marketing cost, education material cost, and recruitment cost in employing midwives. Consequently, a new and easier method to deliver professional education with revenue creation business model will be created to support women and families, promote women, family and neonatal help; enhancing the awareness of women health, family and work balance issues.

Assess the Effectiveness of Self-instructional Module on Knowledge Regarding Cultural Beliefs of Dietary Habits among Postnatal Women

Background: The study of cultural factors in nutrition emerged as a distinct focus of research only recently, with the formation of the National Research Council's Committee on Food Habits in 1941. The impact of culture on nutrition has primarily been studied in the realm of "food habits," which is the second of two distinct spheres comprehended by nutrition science. The first is concerned with determining nutritional requirements and dietary standards and includes biochemistry and physiology. Objective of the study: This study aims to assess the effects of self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women. 1. To assess the existing knowledge regarding cultural beliefs of dietary habits among postnatal women 2. To assess the effectiveness of self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women 3. To associate knowledge regarding cultural beliefs of dietary habits among postnatal women with demographic variables. Material and methods: Evaluatory research approach is used to assess the effectiveness of self-instructional module on through the difference between the pre-test and post-test knowledge score. In this study a total number of 60 postnatal women who fulfil the inclusion criteria were selected. A structured questionnaire developed for assessing the knowledge of postnatal women. Result: According to the findings, 13.33% of postnatal women had an average level of knowledge, 55% had a good level of knowledge, and 31.67% had an excellent level of knowledge. Conclusion: According to findings of the study, there is an improvement in knowledge of postnatal women. Statistically, the self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women was proved to be effective.

Peran Lembaga Pemasyarakatan dalam Memenuhi Hak Narapidana Perempuan Hamil dan Pasca Melahirkan

The correctional system is a coaching effort carried out in correctional institutions in Indonesia, the guidance is intended for inmates who commit criminal acts and are sentenced to prison. In the coaching process, the inmates are protected and nurtured by correctional officers and their rights are protected as citizens. The purposes of this study are to reveal the rights of pregnant and postnatal female prisoners in the correctional facility as well as the implementation of granting the rights of pregnant and postnatal women inmates to women's prisons class II A Kerobokan. The research method used is empirical legal research with a sociological juridical approach. The technique of collecting legal materials is obtained directly through respondents or sources. Primary and secondary sources of legal materials were analyzed using descriptive analysis techniques. This study concludes that prisons have an important role in protecting and fulfilling the rights of prisoners themselves, especially pregnant and postpartum women, the protection of these rights is intended so that they receive humane treatment in prisons.

“Squeeze and Lift”: A Design Ethnography of Learning and Teaching Pelvic Floor Exercises

<p>Pelvic floor exercises are an important practice in the prevention and resolution of pelvic floor disorder. However, pelvic floor exercises are often not practiced regularly or correctly which puts women at high risk of experiencing pelvic floor disorder symptoms. These symptoms are debilitating in terms of physical and mental health, and when ignored can worsen over time. In particular, pregnant and postnatal women are at the most risk of this disorder and still do not practice the exercises as required. This study identifies the lack of correct and regular exercises being practiced as a complex social and cultural issue which is best explored with ethnographic design research. The use of semi structured interviews, narrative analysis and informational probes enabled an open ended exploration of pregnant and postnatal women‟s experiences with learning and practicing pelvic floor exercises. Health professionals experience with teaching pelvic floor exercises has also been explored and findings have shown that to assist regular and correct exercise there is a need for professional diagnosis and guidance, suitable to each women‟s health, lifestyle, and way of learning. Themes in the findings included; Safety and Professional Support, Teaching PFX with Metaphor, Integrating PFX into Daily Life and Device Concerns and Feedback. Design recommendations which correspond to each of these themes were formed. Discussion of these findings using background literature also gave crucial context to this study, underscoring overarching key themes of education and empowerment which future pelvic floor exercise designs should embrace. Finally, this study addresses the strengths and weaknesses of an ethnographic design research approach in informing the development of future designs and systems for healthcare, and opens spaces for future work.</p>