Awareness about government maternal benefit schemes among pregnant women attending Anganawadi centres in North Karnataka

Background: During pregnancy and child birth women are very much vulnerable to sickness and complications. Maternal morbidity and mortality can be reduced by giving proper preventive and promotive health care specially by promoting early registration, regular antenatal check-ups and institutional deliveries. There is an improvement in care since last decade. Still there is a long way in achieving complete success out of these National programmes.Methods: A cross-sectional study was done in six Anganawadi centres in rural field practice area of medical college for a period of 4 months from 1st June 2017 to 30th September 2017. Universal sampling was adopted to include all registered pregnant women. Informed consent was taken. A pre-designed semi-structured questionnaire was used to collect data. Appropriate descriptive statistics like proportion and percentage were used describe and to draw the inferences.Results: A total of 104 pregnant women were included. Most of them were in the age group of 20 to 30 years 76 (73.1%). More than half were in third trimester 60 (57.7%), seeking antenatal care from both government and private facilities equally. Awareness about various schemes ranged from minimum of 2 (1.9%) for JSSK to maximum of 102 (98.1%) for ICDS. ASHA workers 96 (92.3%) acted as source of information for majority of pregnant women followed by Anganawadi workers 88 (84.6%).Conclusions: Knowledge was adequate but not sufficient across all schemes hence more efforts should be done to overcome this discrepancy. Health care workers like ASHA and Anganawadi worker have put efforts in creating awareness.

A radically simple way to monitor life expectancy

NOTE: this is an early registration of the research idea and findings in form of slides for a talk presented at EAPS Mort workshop on 2021-09-22 (video: https://youtu.be/rOndHnuajH4?t=2370)Period Life Expectancy is the key summary measure of current mortality. Elimination of the direct influence of population age structure allows to meaningfully compare mortality levels and changes across the populations and over time. Calculation of life expectancy demands high quality detailed data on death and population counts disaggregated by sex and age. Such data is only available for the more developed countries. Moreover, even in the most developed countries, it becomes available with a considerable time lag. And for the majority of countries across the world timely and high quality deaths statistics is not available. In situations of mortality shocks such as the COVID–19 pandemic near real time mortality level comparisons are crucial.Building on the studied regularities of human mortality, we offer a method of reliable life expectancy short-casting based only on the time series of its previous values and the time series of total deaths counts observed in the population, not disaggregated by sex and age. The radical simplicity of the method allows to monitor changes in life expectancy in near real time, if time disaggregated (daily, weekly, or monthly) total death counts are available.

Study of ANC and immediate PNC mothers admitted with severe anemia in GMC Chandrapur

Maternal mortality continues to be a major health problem in the developing world. About 20% ofcases of maternal mortality are due to anemia (preventable cause). Objectives: 1. To define thegeographical areas around Chandrapur from where the cases of anemia are referred. 2. To co-relatevariables like maternal age, gestational age, parity and the time elapsed between last childbirth andcurrent pregnancy. Materials and Methods: Hb of ANC and immediate PNC patients referred withsevere anemia was estimated with Sahli’s Haemoglobinometer. Inclusion criteria: 257 ANC andimmediate postpartum patients admitted between July 2016 to September 2016 with severe anemiaand transfused with blood. Exclusion criteria: anemia due to acute blood loss.Results: 77.8%severe anemia cases were between 21 to 30 years.22% were from Chandrapur taluka.12.8%casesfrom Rajura and10.12% from Korpana taluka,68.26% cases had gestational age more than 28weeks.59.92%cases were multipara. In 84.42% of cases last childbirth was less than 3years.20%cases were of sickle cell anemia patients. There were no cases of abruption placentae,surgical wound infection and maternal mortality. No patient had postpartum haemorrhage as weremanaged with active management of the third stage of labour and prophylactic 3 tablets ofmisoprostol per rectum. There were 12 preterm deliveries with no intrauterine deaths. Conclusion:Peripheral preventive services must be strengthened on a priority basis in Chandrapur, Ballarpur,Rajura and Korpana talukas which belong to south Chandrapur where the tribal area is predominant.Probable causes in these areas might be related to culture, ignorance, dietary habits and availabilityof medical staff which needs to be addressed. Effective counselling regarding early registration,restriction of parity, contraception for spacing births, diet and iron and folic acid supplementation isessential for preventing anemia.

ASSOCIATION OF NUMBER OF ANTENATAL CHECK-UP VISITS WITH SOCIO-DEMOGRAPHIC FACTORS AMONG PREGNANT WOMEN DELIVERING IN OBSTETRICS & GYNAECOLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL OF JHARKHAND

Background: Antenatal check- up is the routine health care of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms, and to provide information about lifestyle, pregnancy and delivery. Early registration to antenatal care is imperative for the timely diagnosis and treatment of pregnancy related morbidities. Objectives: This study aims to find the association between socio demographic factors and number of ANC visits of patients attending the Department of Obstetrics and Gynaecology, RIMS, Ranchi. Methods: This was a cross sectional hospital based study done in Obs. & Gynae. Department of RIMS, Ranchi for a duration of 3 months. All pregnant women admitted on the beds with odd numbers in ward during the data collection period were included. Total sample size during this period came out to be 160. Templates were generated in MS excel sheet and data analysis was done using SPSS software (version20.0). Results: On analysis and applying chi-square statistics test it was found that half of the respondents had their first ANC visit within 12 weeks of pregnancy. Various socio-demographic factors like husband education, residence and occupation were significantly associated (p<0.05) with number of ANC visits. It was also found that factors like motivation for ANC and type of delivery were also significantly associated (p<0.05) with number of ANC visits. Conclusions: It was concluded from the present study that number of ANC visits is significantly associated with socio-demographic and other factors.

Compliance with iron and folic acid supplementation and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

<p><strong>Background:</strong> Anaemia is one of the world’s leading cause of disability and the most serious global health issues. Globally about 38% (32 million) pregnant women are anaemic, from which 46.3% (9.2 million) are in Africa.</p><p><strong>Methods:</strong> Works of articles from PubMed, Medline and Google Scholar journal data-base were considered. Entirely articles allied to compliance and determinants of AFA supplementation were captured. The authors used modified Newcastle-Ottawa quality appraisal rule for cross-sectional works to assess the excellence of the studies for consideration and, tracked preferred reporting items for systematic reviews and meta-analysis guideline. The pooled effect size was calculated with the review manager and compressive meta-analysis software.</p><p><strong>Results:</strong> Eighteen studies with a total of 6649 pregnant women were included for analysis. Compliance of IFA supplementation in pregnancy in Ethiopia was 46.1%. Women who had experienced counselling on IFAS were 1.16 times, OR:1.16, (95% CI, 0.54, 2.50), knowledge on IFAS were 3.20 times, OR:3.20, (95% CI, 1.31, 7.85), knowledge of anaemia were five times OR:5.10, (95% CI, 1.87, 13.94), fourth visit for ANC were 1.58 times OR:1.58, (95% CI, 0.59, 3.42) and early registration for ANC were three times OR: 3.19, (95% CI, 0.77, 13.26) more likely to have compliance with IFAS compared to their counterpart.</p><p><strong>Conclusions</strong>: There is low compliance of IFAS in different parts of Ethiopia. Lack of counselling on IFAS, knowledge of IFAS and anaemia, no fourth visit for ANC and timing in ANC registration were factors that hinder compliance of IFAS.</p>

Early Assignment of Insurance Pensions to Individuals, Raising a Disabled Child: Analysis of Legislation and Directions of Legislative Renovation

The article analyzes the current pension legislation of the Russian Federation in relation to the procedure and conditions for granting the right to early registration of a pension for persons engaged in raising a disabled child. In the course of research, the authors use historical-legal and system-structural methods of cognition of the subject of scientific research, refer to international legal acts.

Early registration for antenatal care was associated with improved birth outcomes in a low-income community in Harare

Background : The World Health Organization (WHO) recommends early registration, regular and consistent attendance of antenatal care (ANC) sessions for all pregnant women. Specifically, if ANC services promote evidence-based practices this improves pregnancy outcomes and reduce maternal mortality. Yet there are worrying gaps in knowledge of antenatal care services in Zimbabwe. Objectives: To determine the relationship between early registration and frequency of ANC visits on birth weight, birth length, head circumference, Apgar score, birth complications, delivery mode, preterm birth and duration of labour among women aged 15-49 from Hatcliffe Polyclinic, Harare. Methods: This was a health facility based analytical cross-sectional study. An interviewer administered questionnaire was used to collect data. Data was entered and analysed using SPSS version 20. Descriptive statistics, and associations between dependent and independent variables were determined using Pearson’s Chi-square and Fisher’s exact test. Ethical approval was granted from the Medical Research Council of Zimbabwe (MRCZ/B/1438). Results: A total of 75 mother child pairs were interviewed. Most (77.3%) had more than four ANC visits. Only 36% registered early (during first trimester). Most of the children had normal birth weight ≥2500g (80.3%), birth length ≥47cm, (76%), head circumference ≥33cm (80%), and Apgar score ≥7 (96%). A positive association was observed between number of ANC visits and birth weight [Odds ratio (OR) 7.6; 95% Confidence Interval (CI) 1.6, 36.4 (p=0.013)], birth length [OR 6.1; 95%CI 1.8, 20.1 (p=0.010)], and head circumference [OR 4.3; 95% CI 1.3, 14.8 (p=0.013)]. Positive associations were also observed between timing of registration and birth weight [OR 1.2; 95% 1.05, 1.36 (p=0.045)], birth length [OR 0.16; 95% CI 0.03, 0.76 (p=0.012)]. Conclusions: In this study increased frequency and early registration for ANC visits had a positive relationship with birth weight, birth length and head circumference. These findings show the need for improving the uptake of ANC services, early registration for ANC in the first trimester and adoption of community wide strategies to ensure that pregnant women attend all recommended visits for improved birth outcomes in this and related settings.

Preliminary evaluation of records of antenatal care at sub-centre in Western Maharashtra

Background: Health record are essential for monitoring and evaluation of programmes and routine data collection at facility level. Antenatal care is an important intervention for preventing maternal morbidity and mortality. The aim of study is to assess the antenatal care records at sub-centre level. The objective are evaluation of antenatal registration and completeness of antenatal register.Methods: A record based cross sectional study was conducted at a sub-centre in Western Maharashtra. Study period was for 1 month. Data collection was done one year i.e., recent record from November 2017 to October 2018 is selected for study.Results: Out of 141 entries from registers, level of completeness of various data entries in the register were as follows. Mother’s name was 100% (141), mother’s ID was 69.5% (98), expected date of delivery was 97.87% (138), initial weight of mother was 16.31% (23), tetanus toxoid received by mother was 9% (13). Whereas records of address of mother, height of mother and 4 antenatal visits which includes haemoglobin, blood pressure, urine albumin/sugar details were completely lacking. Only 64.5% (91) of antenatal registration were within 12 week of pregnancy.Conclusions: Early registration of pregnancy is less and needs to be increased for proper antenatal care. Incomplete records lead to loss of important health data; hence staff should be made aware of the need to keep records updated. Sub-centre-specific reasons for incomplete records e.g., lack of training, lack of time or motivation needs to be identified for improvement.

An assessment of utilization of postnatal care services in urban area Jabalpur district

Background: Postnatal period is a vulnerable time, because most maternal and new born deaths occur during this period, especially immediately after childbirth. Postnatal care in the first hours and days after childbirth could prevent the great majority of these deaths. The objective of study was to assess the utilization of post-natal care and associated factors for low utilization in urban area of Jabalpur district.Methods: A community based cross-sectional study was carried 360 mothers who delivered in last one year in urban area of Jabalpur district. Sampling method was multistage sampling method. A total 36 wards with 10 mothers from each ward was selected. The questionnaire included information related to mode of delivery, post-natal checkups and visits of health care providers.Results: Among 360 mothers, 93.9% mothers received first postnatal check-up within 24 hrs. 1.11% of mothers between 2-3 days and 1.67% of mothers received first postnatal check-up between 4-7 days while 3.33% of mothers didn’t receive any postnatal check-up. Regarding number of post-natal visits, 58.33% mothers received 3 or more postnatal visits, 35% of mother received 2 PNC visits, while 3.3% did not receive a single postnatal visit. The education of mothers, joint type of family, high socioeconomic status, early registration of pregnancy, minimum 4 ANC visits and institutional deliveries were found significantly associated with utilization of postnatal check-up.Conclusions: Utilization of postnatal services is still poor in the urban areas even though the physical accessibility was adequate. In the present study, it was concluded that the role of education, especially of female education, is important contributing factor associated with utilization of postnatal care.