Determinants of Pelvic Organ Prolapse at Public Hospitals in Hawassa City, Southern Ethiopia, 2020: Unmatched Case Control Study

Introduction: Even though the Pelvic organ prolapse (POP) is outstanding gynecologic problem, most private and asymptomatic nature of the illness makes it the “hidden epidemic.” The aim of this study was to identify the determinants of POP. Methods: Facility based unmatched case control study was conducted from June 15 to September 10, 2020. All cases diagnosed with POP were enrolled in the study by using consecutive random sampling method by assuming that patient flow by itself is random until the required sample size was obtained. Then 1:2 cases to control ratio was applied. A structured interviewer-administered questionnaire and chart review for type and degree of prolapse was used. Epi-data and SPSS were used for analysis. Chi square test and binary and multivariable logistic regression analysis was employed. Multicolinearity was checked. Result: On multivariate logistic regression, heavy usual work load(AOR=2.3, CI(1.066-4.951), number of pregnancy ≥ 5(AOR=3.911, CI(1.108-13.802), birth space of <2 years(AOR=2.88, CI(1.146-7.232), history of fundal pressure (AOR=5.312, CI(2.366-11.927) and history of induced labor (AOR=4.436, CI(2.07-9.505) were significantly associated with POP with P value <0.05 and 95% CI after adjusting for potential confounders.Conclusion: Heavy usual work load, having pregnancy greater than five, short birth space, history of induced labor, and history of fundal pressure are independent predictors of pelvic organ prolapse. Hence the responsible body and obstetric care providers should counsel the women about child spacing. The obstetric care providers also avoid fundal pressure and the hospital officials set a law to ban fundal pressure during labor.

Maternal Risk Factors of Low Birth Weight Neonates in a Military Hospital of Bangladesh

Introduction: Low birth weight (LBW) is an index of our status of public health, maternal health and nutrition. LBW is a multi-factorial problem. The major challenge in the field of public health is to identify the factors influencing LBW and to institute remedial measures. Objective: To find out the maternal risk factors of low birth weight neonates. Materials and Methods: A descriptive cross sectional study was conducted at Combined Military Hospital (CMH), Ghatail from January 2018 to June 2019. A total of 707 mothers were included in this study who delivered live infants during study period; among them, 122 were LBW neonates. All the mothers of LBW neonates were evaluated and data were collected by using structured questionnaire. Results: A total 707 live birth occurred during the study period of which 122 were LBW and the incidence of LBW was 17.3%. Out of 122 mothers 18(14.8%) were <20 years, 69 (56.6%) were between 20-30 years and 35(28.7%) were >30 years of age; 19(15.6%) were underweight, 83 (68.0%) were normal weight and 20(16.4%) were overweight and obese; 34(27.9%) took inadequate antenatal check up and 88(72.1%) mother took adequate antenatal check up. Among 122 mothers 25(20.5%) were para 01, 47(38.5%) were para 02 and 50(41%) were para ≥ 03; 16(13.1%) had birth space <2 years and 106(86.9%) had birth space >2 years; 09(7.4%) educated upto primary school, 73(59.8%) educated upto high school and 40(32.8%) educated upto college & above. Regarding maternal illness 30(24.6%) mothers had premature rupture of membranes (PROM), 20(16.4%) had hypertension (HTN), 12(9.8%) had diabetes mellitus (DM), 05(4.1%) had severe oligohydramnios, 05(4.1%) had chronic anaemia and 06 had other illness (4.9%). Conclusion: The risk factors for LBW babies identified in this study are modifiable. In order to reduce this menace, holistic approaches such as health education, maternal nutrition and increasing the quality and quantity of the antenatal care services are of paramount importance. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 55-58

Determinant of Mother’s Health Promotional Measures Practice of Infant with Age 6–12 Months in a Tertiary Hospital of Nepal

Background. Promotion of health is vital for the optimal growth and development of every infant. Globally, many infants died due to common problems such as diarrhoea and respiratory infection; most of these problems are related to inadequate breast feeding, improper complimentary feeding, lack of immunization, and home accident. Infant and child health status depends upon mothers’ knowledge and practice regarding health promotional measures. This study aimed to determine practice and its determinants regarding health promotional measures of infant with 6–12 months age amongst the mothers attending Pediatrics Outpatient Department of Universal College of Medical Science and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Methods. Hospital-based cross-sectional study was conducted in Universal College of Medical Science, Bhairahawa, Rupandehi, Nepal, among 414 mothers attending pediatrics outpatient department from September 2019–March 2020. Purposive sampling technique was used to select mothers of infants aged 6–12 months. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated in bivariate analysis with p < 0.05 were entered into a multivariable logistic regression model to identify associated factors of health promotional measures. The goodness of fit of multivariate logistic regression was checked by Nagelkerke R square and variation inflation factor. Results. The mean age and family size was 25.89 ± 4.81 years and 5.94 ± 2.48, respectively. A total of 71.5% mothers have good practice of health promotional measures. Mothers from Dalit caste (adjusted odds ratio = 0.04, confidence interval: 0.005–0.30), mothers with below school leaving certificate education (AOR = 0.08, CI: 0.02–0.27), fathers engaged in nonagricultural work (AOR = 7.21, CI: 2.59–20.11), birth space of index child greater than 2 years (AOR = 12.88, CI: 3.49–47.58), and family monthly income greater than 20000 Nepalese rupees (AOR = 3.29, CI: 1.16–13.32 were significantly associated with good practice of health promotional measures. Conclusions. More than one-fourth of the mothers have poor practice of health promotional measures. Ethnicity, mothers’ education, fathers’ occupation, birth space of index child, and family monthly income were found to be independent determinants of practice of health promotion measures. Thus, policy makers should provide specific education regarding health promotional measures to both parents.

Decision-making in the birth space

Susann Huschke discusses how communicating with birthing people in the current technocratic maternity systems in Ireland and elsewhere can inhibit the birthing person's meaningful involvement in decision-making

Knowledge Regarding Health Promotional Measures of Infant among Mothers Attending Pediatric OPD of Universal College of Medical Sciences

INTRODUCTION Infant and child health status depends upon knowledge of mothers regarding health promotional measures. This study aimed to determine knowledge and its associated factors regarding health promotional measures of infants amongst the mothers attending pediatrics outpatient department of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Rupandehi, Nepal. MATERIAL AND METHODS Hospital based cross-sectional study was conducted in Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Rupandehi, Nepal among 414 mothers attending pediatrics outpatient department from June 2019 to March 2020. Bivariate and multivariate logistic regressions were used to explore associations between different factors with health promotional measures. RESULTS The mean age and family size was 25.89 ±4.81 and 5.94 ±2.48 respectively. A total of 73.2% mothers have good knowledge of health promotional measures. Mothers greater than 20 years (AOR =8.13, CI: 2.16-30.67), Dalit (AOR=0.02, CI: 0.003-0.16), living in rural area (AOR=0.27, CI: 0.08-0.61), family size greater than 5 (AOR =3.99, CI: 1.37-11.59), below SLC education (AOR=0.29, CI: (0.09-0.88) and fathers with SLC and above education (AOR=25.40, CI: 4.54-142.0), fathers engaged in non-agricultural work (AOR =4.78, CI: 1.80-12.68) and birth space of index child greater than two years (AOR =5.88, CI: 1.48-23.55) were significantly associated with knowledge of health promotional measures. CONCLUSIONS Mothers’ age, caste, residence, family size, education of parents, occupation of father and birth space of index child were found to be independent associated factors of knowledge. Thus policy makers should provide specific education regarding health promotional measures to both parents focusing rural area. Similarly, local Government needs to subsidize in reducing teenage marriage.

Mothers satisfaction on delivery service and associated factors among mothers who gave birth at Gondar University specialized and teaching hospital, Northwest Ethiopia 2018.

Abstract Background: Assessing maternal satisfaction level on maternal health care services is agreeable proxy to improve the quality of health care service, maternal health service utilization and providing client centered care. Therefore, the aim of this study was to assess the mothers’ satisfaction level and associated factors on delivery care of Gondar specialized teaching hospital, Northwest Ethiopia. Methods: A Hospital based cross-sectional study with an exit interview was conducted in Gondar university referral hospital, from November 1 to 31 2018. Total of Four hundred seventy-one postpartum mothers were participated in the study. Systematic random sampling method was employed to recruit study participants. The collected data was checked visually for incompleteness and entered to Epi-info version 7 statistical software and exported to SPSS version 20 software to descriptive, bi-variable and multivariable logistic analysis. Finally, the result was presented in tables and graphs. Results: The magnitude of mothers’ satisfaction on delivery service was 21.2%, with 95% Cl (17.6, 25.1). In multivariable logistic analysis, Residence being Urban with odd ratio 0.34 (AOR=0.34; 95% CI 0.17, 0.68), Spontaneous vaginal delivery with odd ratio 0.28 [AOR=0.28; 95%; Cl (0.14, 0.57] and Child birth space interval of 12-24 months with odd ratio 0.22 [AOR=0.22; 95%; Cl (0.08,0.55)] were inversely associated with mothers’ satisfaction. while, short waiting time to see health care providers with odd ratio 9.69 [AOR=9.69; 95% Cl: (3.16,29.76)] was positively associated with mothers’ satisfaction on childbirth care services. Conclusion and Recommendation: The overall satisfaction of mothers on facility based child birth care is low when compared with other studies. Urban dwellers, mode of delivery and short child birth space interval and short waiting time to see health care providers were significantly associated with mother’s satisfaction level of facility delivery care services. Therefore, to elating the faced maternal health care services quality difficulty, the policymakers and quality improvement program designers need to give attention on activities that change wrong perceptions of mothers on mode of delivery and intervention that ensure normal healthy child birth space time interval.

Early hominids may have been weed species

Panid, gorillid, and hominid social structures appear to have diverged as dramatically as did their locomotor patterns as they emerged from a late Miocene last common ancestor (LCA). Despite their elimination of the sectorial canine complex and adoption of bipedality with its attendant removal of their ready access to the arboreal canopy, Australopithecus was able to easily invade novel habitats after florescence from its likely ancestral genus, Ardipithecus sp. Other hominoids, unable to sustain sufficient population growth, began an inexorable decline, culminating in their restriction to modern refugia. Success similar to that of earliest hominids also characterizes several species of macaques, often termed “weed species.” We here review their most salient demographic features and find that a key element is irregularly elevated female survival. It is reasonable to conclude that a similar feature characterized early hominids, most likely made possible by the adoption of social monogamy. Reduced female mortality is a more probable key to early hominid success than a reduction in birth space, which would have been physiologically more difficult.