1.  Peer Reviewed Title: Community-based skilled birth attendants in Bangladesh: attending deliveries at home. Author: Ahmed T; Jakaria SM Source: Reproductive Health Matters. 2009 May;17(33):45-50. Abstract: Only 15% of births in Bangladesh in 2007 were delivered at health facilities, but the increase over previous years has been significant, and treatment-seeking from a medically trained provider for obstetric complications has also increased. A programme to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh in 2004. The training, for community-based health and family planning fieldworkers, covers 74 essential midwifery skills and danger signs for referral. Training of trainers and supervisors for the fieldworkers was also initiated. By the end of 2008 an estimated 4,000 out of a proposed 13,500 skilled birth attendants and 50 of 4,000 proposed supervisors had been trained and were working in 56 districts. There needs to be a full evaluation of the programme and whether it has reduced maternal deaths. Bangladesh now needs to decide how long to invest in this programme and/or whether to train a new cadre of fully qualified midwives, as proposed by the Nursing Council. We believe this programme can only be an interim measure, not a long-term solution, as more women decide to seek institutional delivery and professional midwifery care. For the moment, though, task-shifting seems to have yielded beneficial results and important insights into human resources planning for safe motherhood in Bangladesh. Spanish Abstract: En 2007, sólo el 15% de los partos en Bangladesh ocurrieron en establecimientos de salud. En comparación con años anteriores, este porcentaje ha aumentado considerablemente, al igual que la búsqueda de tratamiento de complicaciones obstétricas brindado por un profesional médico capacitado. En 2004, el Gobierno de Bangladesh lanzó un programa para crear una categoría de asistentes de partos calificados que ayudaran con los partos domiciliares. La capacitación de trabajadores comunitarios de la salud y de planificación familiar, abarca 74 habilidades esenciales de partería y los signos de alarma para dar referencias. También se inició la capacitación de capacitadores y supervisores de los trabajadores de campo. A finales de 2008, aproximadamente 4,000 de los 13,500 asistentes de partos calificados y 50 de los 4,000 supervisores propuestos habían recibido capacitación y estaban trabajando en 56 distritos. Es necesario realizar una evaluación completa del programa y determinar si éste ha logrado disminuir la tasa de muertes maternas. Bangladesh debe decidir por cuánto tiempo continuar invirtiendo en este programa y/o si capacitar a un nuevo grupo de parteras profesionales plenamente cualificadas, como propone el Consejo de Enfermería. Estimamos que este programa es sólo una medida provisional, no una solución de largo plazo, ya que cada vez más aumenta el número de mujeres que deciden buscar atención institucional y cuidados de partería profesionales. No obstante, por ahora la reasignación de tareas parece haber dado buenos resultados e importantes datos sobre los recursos humanos en la planificación de la maternidad sin riesgos en Bangladesh. French Abstract: Au Bangladesh, en 2007, 15% seulement des naissances avaient eu lieu dans un établissement de santé, mais la hausse par rapport aux précédentes années était sensible et le recours aux services d'un prestataire formé médicalement pour les complications obstétricales avait aussi augmenté. En 2004, le Gouvernement a lancé un programme de création d'un groupe d'accoucheuses qualifiés pour les naissances à domicile. La formation des agents de santé et de planification familiale communautaires couvre 74 compétences obstétricales essentielles et les signes de danger exigeant le transfert de la patiente. La formation des formateurs et des superviseurs des agents de terrain a aussi été lancée. Fin 2008, environ 4000 des 13 500 accoucheuses qualifiés envisagés et 50 des 4000 superviseurs prévus avaient été formés et travaillaient dans 56 districts. Il faut mener une évaluation complète du programme et déterminer s'il a diminué les décès maternels. Le Bangladesh doit maintenant décider pendant combien de temps investir dans ce programme et/ou s'il souhaite former un nouveau groupe de sages-femmes pleinement qualifiées, ainsi que l'a proposé le Conseil des infirmières. Nous pensons que ce programme ne peut être qu'une mesure provisoire et non une solution à long terme, à mesure que davantage de femmes opteront pour un accouchement institutionnel et des soins de sages-femmes professionnelles. Pour le moment, néanmoins, la délégation des tâches semble avoir produit des résultats positifs et des connaissances précieuses sur la planification des ressources humaines pour une maternité à moindre risque au Bangladesh. Language: English Keywords: BANGLADESH | PROGRESS REPORT | PILOT PROJECTS | COMMUNITY WORKERS | MIDWIVES AND MIDWIFERY | CHILDBIRTH | REFERRAL AND CONSULTATION | GOVERNMENT PROGRAMS | TRAINING OF TRAINERS | MEDICAL SUPERVISION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Program Activities | Programs | Organization and Administration | Training Programs | Education | Supervision | Management Document Number: 342014 |
| 2. Peer Reviewed Title: Women's use of private and government health facilities for childbirth in Nairobi's informal settlements. Author: Bazant ES; Koening MA; Fotso JC; Mills S Source: Studies in Family Planning. 2009 Mar;40(1):39-50. Abstract: The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | REFUGEES | TRADITIONAL BIRTH ATTENDANTS | HOUSEHOLDS | CHILDBIRTH | REFUGEE CAMPS | UTILIZATION OF HEALTH CARE | PRIVATE SECTOR | GOVERNMENT PROGRAMS | HEALTH FACILITIES | DEMOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Population | Migrants | Migration | Population Dynamics | Health Personnel | Delivery of Health Care | Health | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Health Services | Macroeconomic Factors | Programs | Organization and Administration Document Number: 341077 |
| 3. Peer Reviewed Title: Effect of previous live birth and prior route of delivery on the outcome of early medical abortion. Author: Chien LW; Liu WM; Tzeng CR; Au HK Source: Obstetrics and Gynecology. 2009 Mar;113(3):669-74. Abstract: OBJECTIVE: To determine the association between type of previous delivery (vaginal compared with cesarean) on the success of medical abortion with mifepristone-misoprostol in early pregnancy. METHODS: The records of 879 women with intrauterine pregnancies at or before 56 days of gestation who underwent medical abortions were reviewed. Medical treatment consisted of 600 mg mifepristone orally followed 48 hours later with oral misoprostol. An ultrasound examination was performed 14-21 days after treatment, and a successful medical abortion was defined as an empty uterus without surgical intervention. Univariable and multivariable logistic regressions were used to determine risk factors for failure of medical abortion. RESULTS: A total of 797 (90.7%) women had successful medical abortions; 82 (9.3%) had failed medical abortions. Multivariable logistic regression indicated that women with gestational ages greater than 42 days (odds ratio [OR] 2.53, 95% confidence interval [CI] 1.55-4.05) had higher odds of failed abortion compared with a gestational age less than 43 days. Parous women (OR> or =3.94, 95% CI 1.83-8.53) and those with prior cesarean delivery (OR 9.59, 95% CI 4.30-21.39) were more likely to have failed abortions compared with nulliparous women. Among 523 parous women (68 had failed abortion), those with gestational ages greater than 42 days (OR 2.07, 95% CI 1.22-3.50) and prior cesarean delivery (OR 3.33, 95% CI 1.95-5.69) were more likely to have failed abortions compared with those with gestational ages less than 43 days or with prior vaginal delivery. CONCLUSION: Parous women are at increased risk for failed medical abortion in comparison with nulliparous women. Prior cesarean delivery is significantly associated with failed medical abortion. Language: English Keywords: TAIWAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COMPARATIVE STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREVALENCE | CHILDBIRTH | ABORTION | CESAREAN SECTION | RU-486 | PREGNANCY, FIRST TRIMESTER | MISOPROSTOL | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Measurement | Pregnancy Outcomes | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins Document Number: 331067 Notification |
| 4. Title: Effects of prenatal micronutrient supplementation on complications of labor and delivery and puerperal morbidity in rural Nepal. Author: Christian P; Khatry SK; Leclerq SC; Dali SM Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 13; Abstract: OBJECTIVE: To examine the effect of supplemental prenatal folic acid, folic acid-iron, folic acid-iron-zinc, and multiple micronutrients on maternal morbidity in rural Nepal. METHODS: A cluster-randomized double-masked controlled trial of pregnant women who received daily supplements from early pregnancy through 3 months post partum as per the treatment allocation. Women were interviewed at birth about labor and delivery complications and for 9 days post partum to obtain 24-hour histories of morbidity. RESULTS: A total of 3986 (97.3%) women completed an interview regarding labor and delivery; morbidity history was available for 3564 (87.0%) women. Folic acid-iron reduced the risk of postpartum hemorrhage (relative risk [RR] 0.59; 95% confidence interval [CI] 0.35-0.98). Risk of dysfunctional labor increased with multiple micronutrient supplementation (RR 1.28; 95% CI, 1.01-1.60), although preterm premature rupture of membrane decreased (RR 0.40; 95% CI, 0.21-0.79). Puerperal sepsis was lower in those receiving folic acid-iron, folic acid-iron-zinc, and multiple micronutrients compared with controls (P<0.05). CONCLUSION: Prenatal folic acid-iron supplementation reduced the risk of obstetric complications in this South Asian setting. Language: English Keywords: NEPAL | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | RURAL POPULATION | PREGNANT WOMEN | CHILDBIRTH | PREGNANCY COMPLICATIONS | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | PUERPERAL DISORDERS | VITAMINS AND MINERALS | FOLIC ACID | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Physiology | Biology Document Number: 341459 |
| 5. Title: Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. Author: de Jonge A; van der Goes BY; Ravelli AC; Amelink-Verburg MP; Mol BW; Nijhuis JG; Bennebroek Gravenhorst J; Buitendijk SE Source: BJOG. 2009 Aug;116(9):1177-84. Abstract: OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321,307 (60.7%) intended to give birth at home, 163,261 (30.8%) planned to give birth in hospital and for 45,120 (8.5%), the intended place of birth was unknown. METHODS: Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics. MAIN OUTCOME MEASURES: Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit. RESULTS: No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16). CONCLUSIONS: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | PERINATAL MORTALITY | CHILDBIRTH | PREGNANCY OUTCOMES | RISK FACTORS | MATERNAL AGE | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Mortality | Population Dynamics | Pregnancy | Reproduction | Parental Age | Age Factors Document Number: 342276 |
| 6. Peer Reviewed Title: Utilization of skilled birth attendants in public and private sectors in Vietnam. Author: Do M Source: Journal of Biosocial Science. 2009 May;41(3):289-308. Abstract: The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services. Language: English Keywords: VIETNAM | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | CHILDBIRTH | PRIVATE SECTOR | PUBLIC SECTOR | PROGRAM ACCESSIBILITY | SOCIOECONOMIC STATUS | Asia, Southeastern | Asia | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Macroeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors Document Number: 341399 |
| 7. Peer Reviewed Title: Potential role of traditional birth attendants in neonatal healthcare in rural southern Nepal. Author: Falle TY; Mullany LC; Thatte N; Khatry SK; LeClerq SC; Darmstadt GL; Katz J; Tielsch JM Source: Journal of Health, Population, and Nutrition. 2009 Feb;27(1):53-61. Abstract: The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly-selected TBAs (n=93) were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. Practices, such as using a clean cord-cutting instrument (89%) and hand-washing before delivery (74%), were common. Other beneficial practices, such as thermal care, were low. Trained TBAs were more likely to wash hands with soap before delivery, use a clean delivery-kit, and advise feeding colostrum. Although mustard oil massage was a universal practice, 52% of the TBAs indicated their willingness to consider alternative oils. Low-cost, evidence-based interventions for improving neonatal outcomes might be implemented by TBAs in this setting where most births take place in the home and neonatal mortality risk is high. Continuing efforts to define the role of TBAs may benefit from an emphasis on their potential as active promoters of essential newborn care. Language: English Keywords: NEPAL | RESEARCH REPORT | RURAL AREAS | TRADITIONAL BIRTH ATTENDANTS | COMMUNITY WORKERS | KNOWLEDGE | ATTITUDES | NEONATAL MORTALITY | PERCEPTION | CHILDBIRTH | INTERVENTIONS | DELIVERY OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Health Personnel | Health | Sociocultural Factors | Psychological Factors | Behavior | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Programs | Organization and Administration Document Number: 331129 |
| 8. Title: Systematic analysis of research underfunding in maternal and perinatal health. Author: Fisk NM; Atun R Source: BJOG. 2009 Feb;116(3):347-56. Abstract: BACKGROUND: Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas. OBJECTIVES: To assess absolute and relative government and charitable funding for maternal and perinatal research in the UK and internationally. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Major research funding bodies and alliances were identified from an Internet search and discussions with opinion leaders/senior investigators. Websites and annual reports were reviewed for details of strategy, research spend, grants awarded, and allocation to maternal and/or perinatal disease using generic and disease-specific search terms. MAIN RESULTS: Within the imprecision in the data sets, < or =1% of health research spend in the UK was on maternal/perinatal health. Other countries fared better with 1-4% investment, although nonexclusive categorisation may render this an overestimate. In low-resource settings, government funders focused on infectious disease but not maternal and perinatal health despite high relative disease burden, while global philanthropy concentrated on service provision rather than research. Although research expenditure has been deemed as appropriate for 'reproductive health' disease burden in the UK, there are no data on the equity of maternal/perinatal research spend against disease burden, which globally may justify a manyfold increase. AUTHOR'S CONCLUSIONS: This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment. Language: English Keywords: UNITED KINGDOM | LITERATURE REVIEW | EVALUATION | POLICYMAKERS | GOVERNMENT | NONGOVERNMENTAL ORGANIZATIONS | CHILDBIRTH | MATERNAL-CHILD HEALTH SERVICES | FINANCIAL ACTIVITIES | ECONOMIC FACTORS | PREGNANCY | GRANTS | RESEARCH ACTIVITIES | EXPENDITURES | Developed Countries | Europe, Western | Europe | Administrative Personnel | Organization and Administration | Political Factors | Sociocultural Factors | Organizations | Pregnancy Outcomes | Reproduction | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology Document Number: 331089 |
| 9. Peer Reviewed Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7. Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 308031 |
| 10. Peer Reviewed Title: Do women increase their use of reproductive health care when it becomes more available? Evidence from Indonesia. Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W Source: Studies in Family Planning. 2009 Mar;40(1):27-38. Abstract: Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery-changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use. Language: English Keywords: INDONESIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | COMMUNITY WORKERS | UTILIZATION OF HEALTH CARE | CHILDBIRTH | WOMEN'S HEALTH | PROGRAM ACCESSIBILITY | DECISION MAKING | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | TRADITIONAL BIRTH ATTENDANTS | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Services | Pregnancy Outcomes | Pregnancy | Reproduction | Program Evaluation | Programs | Organization and Administration | Behavior | Primary Health Care | Maternal Health Services | Maternal-Child Health Services Document Number: 341081 |
| 11. Title: Knowledge about AIDS/HIV infection among women attending obstetrics and gynaecology clinic at a university hospital. Author: Haider G; Zohra N; Nisar N; Munir AA Source: JPMA. Journal of the Pakistan Medical Association. 2009 Feb;59(2):95-8. Abstract: OBJECTIVE: To determine the level of awareness about Human Immune-deficiency Virus Infection and Auto Immune Deficiency Syndrome (HIV/AIDS) among women attending obstetrics and gynaecology clinic. METHODS: A descriptive cross-sectional study was conducted in the obstetric and gynaecology clinic at Isra University Hospital Hyderabad Pakistan from April to June 2007. A total of 189 women attending the obstetric and gynaecology clinic between ages 20 and 50 years were included. Informed consent was taken and information was collected by a pre-designed questionnaire to assess the level of awareness about HIV/AIDS. Data analysis was done by computer software, SPSS version 11. RESULTS: Out of the total, 86.8% women had heard about HIV/AIDS. A large majority of women knew that it is transmitted by close sexual relationship, through infected blood, can be transmitted from mother to baby and knew that it is transmitted by reuse of infected needles while only 40.7% knew that it can be transmitted during delivery. The respondents had the knowledge that multiple sexual partners (79.4%), prostitutes and homosexual males (49.7%), drug addicts (49.7%) were high risk groups. Regarding prevention of AIDS, 70.9% mentioned avoiding homosexuality, 58.7% knew the use of condoms and 74.7% women knew that screening of blood in laboratories before transfusion can prevent AIDS. CONCLUSION: The level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among women attending the out-patient department of a gynaecology and obstetrics department. However, number of misconceptions needs to be corrected. Language: English Keywords: PAKISTAN | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | MEN HAVING SEX WITH MEN | SEX WORKERS | MULTIPLE PARTNERS | KNOWLEDGE | HIV TRANSMISSION | SEX BEHAVIOR | RISK BEHAVIOR | BLOOD TRANSFUSION | MOTHER-TO-CHILD TRANSMISSION | CHILDBIRTH | NEEDLE SHARING | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Behavior | Sexual Partners | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Transmission | Infections | Pregnancy Outcomes | Pregnancy | Reproduction Document Number: 330906 |
| 12. Title: Strong association between birth month and reproductive performance of Vietnamese women. Author: Huber S; Fieder M Source: American Journal of Human Biology. 2009 Jan-Feb;21(1):25-35. Abstract: Epidemiological studies on premodern and modern Western societies indicate that birth season may influence female reproduction. Nothing is known, however, about this effect in developing economies. Many of the latter are characterised by tropical climates with a rainy season associated with lower food availability and a greater prevalence of infectious diseases. We therefore predict that an association between birth month and reproductive output, if it exists, should be related to the rainy season. To test this prediction, we analysed census data of Vietnam obtained from IPUMS-International (Vietnam 1999 Population and Housing Census). Based on 493,853 women born between 1950 and 1977 and thus aged 22 to 49 years, we found that the time series of mean offspring count per month of birth has a highly significant period of 12 months (power = 46.871, P < 0.00001). Our results further indicate that the 12-month periodic signal has a maximum in July and a minimum in January. Accordingly, the peak corresponds to birth during the rainy season, the low if the third pregnancy month concurs with the rainy season. The month of birth is therefore clearly associated with the later reproductive performance of Vietnamese women, strongly supporting the assumption that environmental and maternal conditions during early development exert long-term effects on reproductive functioning. Provided the rainy season adversely affects developmental processes due to inadequate food and/or high infection risk, the association reported here points to a critical period of reproductive development during early pregnancy. Language: English Keywords: VIETNAM | RESEARCH REPORT | EPIDEMIOLOGY | CENSUS | WOMEN | REPRODUCTIVE BEHAVIOR | TIME FACTORS | SEASONAL VARIATION | CLIMATE | CHILDBIRTH | FOOD SECURITY | Asia, Southeastern | Asia | Developing Countries | Public Health | Health | Population Statistics | Research Methodology | Demographic Factors | Population | Fertility | Population Dynamics | Environment | Pregnancy Outcomes | Pregnancy | Reproduction | Food Supply | Natural Resources Document Number: 330492 |
| 13. Title: Andean traditional midwifery in Peru. Author: Ingar C Source: Midwifery today With International Midwife. 2009 Spring;(89):57-9. Abstract: This article provides an overview of common characteristics of the "Andean tradition" regarding conception of the body, pregnancy, and birth. It discusses the birth as ritual and the importance of the figure of the Andean midwife in that ritual. The masculine role in childbirth is also explored, as is maternal care during pregnancy, birth, and after birth. Language: English Keywords: PERU | CRITIQUE | MIDWIVES AND MIDWIFERY | TRADITIONAL BIRTH ATTENDANTS | CHILDBIRTH | TRADITIONAL HEALTH PRACTICES | PREGNANCY | MATERNAL PHYSIOLOGY | KNOWLEDGE | Developing Countries | South America, Western | South America | Latin America | Americas | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Reproduction | Culture | Sociocultural Factors | Physiology | Biology Document Number: 341185 |
| 14. Peer Reviewed Title: Comparison of domiciliary and institutional delivery-care practices in rural Rajasthan, India. Author: Iyengar SD; Iyengar K; Suhalka V; Agarwal K Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):303-12. Abstract: A retrospective cross-sectional survey was conducted to assess key practices and costs relating to home- and institutional delivery care in rural Rajasthan, India. One block from each of two sample districts was covered (estimated population--279,132). Field investigators listed women who had delivered in the past three months and contacted them for structured case interview. In total, 1947 (96%) of 2031 listed women were successfully interviewed. An average of 2.4 and 1.7 care providers attended each home- and institutional delivery respectively. While 34% of the women delivered in health facilities, modem care providers attended half of all the deliveries. Intramuscular injections, intravenous drips, and abdominal fundal pressure were widely used for hastening delivery in both homes and facilities while post-delivery injections for active management of the third stage were administered to a minority of women in both the venues. Most women were discharged prematurely after institutional delivery, especially by smaller health facilities. The cost of accessing home-delivery care was Rs 379 (US$ 8) while the mean costs in facilities for elective, difficult vaginal deliveries and for caesarean sections were Rs 1336 (US$ 30), Rs 2419 (US$ 54), and Rs 11,146 (US$ 248) respectively. Most families took loans at high interest rates to meet these costs. It is concluded that widespread irrational practices by a range of care providers in both homes and facilities can adversely affect women and newborns while inadequate observance of beneficial practices and high costs are likely to reduce the benefits of institutional delivery, especially for the poor. Government health agencies need to strengthen regulation of delivery care and, especially, monitor perinatal outcomes. Family preference for hastening delivery and early discharge also require educational efforts. Language: English Keywords: INDIA | RURAL AREAS | RESEARCH REPORT | RETROSPECTIVE STUDIES | COMPARATIVE STUDIES | WOMEN | CHILDBIRTH | FEES | TRADITIONAL HEALTH PRACTICES | OBSTETRICS | OXYTOCIN | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Demographic Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Financial Activities | Economic Factors | Culture | Sociocultural Factors | Medicine | Health Services | Delivery of Health Care | Health | Pituitary Hormones | Hormones | Endocrine System | Physiology | Biology | Data Collection Document Number: 341927 |
| 15. Peer Reviewed Title: The persistence and challenges of homebirths: perspectives of traditional birth attendants in urban Kenya. Author: Izugbara C; Ezeh A; Fotso JC Source: Health Policy and Planning. 2009 Jan;24(1):36-45. Abstract: Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants' (TBAs) accounts of the persistence of homebirths and the key challenges they present. TBAs associated the continued demand for homebirths with the wide-ranging character and quality of their services. They did not consider their lack of formal training on matters of pregnancy and birthing to be a particular challenge to their work. Rather, they identified the non-cooperative and disrespectful attitudes of their counterparts in hospital settings as the most important issue. Further efforts are needed to make TBAs realize how much better their services could become if they adopted more modern ways of assisting in deliveries, unlearnt their belief in the superiority of their particular type of practice, and understood how their lack of formal training is a key issue. Language: English Keywords: KENYA | RESEARCH REPORT | FOCUS GROUPS | TRADITIONAL BIRTH ATTENDANTS | CHILDBIRTH | OBSTACLES | QUALITY OF HEALTH CARE | MATERNAL HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Organization and Administration | Health Services Evaluation | Program Evaluation | Programs Document Number: 330475 |
| 16. Title: Birthing in South Africa. Author: Jenkins LB Source: Midwifery today With International Midwife. 2009 Spring;(89):32. Abstract: This article examines the birthing process in two South African hospitals, and contrasts the different approaches in each; in one, the midwives run the birthing unit, whereas the other is "doctor-driven." Issues of class and HIV status are also discussed in relation to types of treatment offered. Language: English Keywords: SOUTH AFRICA | CRITIQUE | MIDWIVES AND MIDWIFERY | CHILDBIRTH | HOSPITALS | CESAREAN SECTION | SOCIOECONOMIC FACTORS | HIV INFECTIONS | BREASTFEEDING, EXCLUSIVE | BOTTLE FEEDING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Health Facilities | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Economic Factors | Viral Diseases | Diseases | Breastfeeding | Infant Nutrition | Nutrition | Disease Transmission Control | Prevention and Control Document Number: 341187 |
| 17. Title: On the spatial inequalities of institutional versus home births in Ghana: a multilevel analysis. Author: Johnson FA; Padmadas SS; Brown JJ Source: Journal of Community Health. 2009;34:64-72. Abstract: Spatial inequalities related to the choice of delivery care have not been studied systematically in Sub-Saharan Africa where maternal and perinatal health outcomes continue to worsen despite a range of safe motherhood interventions. Using retrospective data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the extent of changes in spatial inequalities associated with type of delivery care in Ghana with a focus on rural-urban differentials within and across the three ecological zones (Savannah, Forest and Coastal). More than one-half of births in Ghana continue to occur outside health institutions without any skilled obstetric care. While this is already known, we present evidence from multilevel analyses that there exist considerable and growing inequalities, with regard to birth settings between communities, within rural and urban areas and across the ecological zones. The results show evidence of poor and disproportionate use of institutional care at birth; the inequalities remained high and unchanged in both urban and rural communities within the Savannah zone and widening in urban communities of the Forest and Coastal zones. The key policy challenges in Ghana, therefore, include both increasing the uptake of institutional delivery care and ensuring equity in access to both public and private health institutions. Language: English Keywords: GHANA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CHILDBIRTH | HOME CARE | HOSPITALS | INEQUALITIES | DELIVERY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Care and Support | Health Services | Health | Health Facilities | Socioeconomic Factors | Economic Factors | Primary Health Care Document Number: 340222 |
| 18. Peer Reviewed Title: Acceptability of intrapartum HIV counselling and testing in Cameroon. Author: Kongnyuy EJ; Mbu ER; Mbopi-Keou FX; Fomulu N; Nana PN; Tebeu PM; Tonye RN; Leke RJ Source: BMC Pregnancy and Childbirth. 2009;9:9. Abstract: BACKGROUND: To assess the acceptability of intrapartum HIV testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon. METHOD: The study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV. RESULTS: A total of 2413 women were counselled and 2130 (88.3%) accepted to be tested for HIV. Of the 2130 women tested, 214 (10.1%) were HIV positive. Acceptability of HIV testing during labour was negatively associated with maternal age, parity and number of antenatal visits, but positively associated with level of education. HIV sero-status was positively associated with maternal age, parity, number of antenatal visits and level education. CONCLUSION: Acceptability of intrapartum HIV testing is high and the prevalence of HIV is also high among women with unknown HIV sero-status in Cameroon. We recommend an opt-out approach (where women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested) for Cameroon and countries with similar social profiles. Language: English Keywords: CAMEROON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | VOLUNTARY COUNSELING AND TESTING | CHILDBIRTH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MATERNAL AGE | PARITY | ANTENATAL CARE | CLINIC VISITS | EDUCATIONAL STATUS | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Disease Transmission Control | Prevention and Control | Parental Age | Age Factors | Fertility Measurements | Fertility | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Service Statistics | Program Activities | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Measurement Document Number: 331239 |
| 19. Peer Reviewed Title: Women's Preferences for Place of Delivery in Rural Tanzania: A Population-Based Discrete Choice Experiment. Author: Kruk ME; Paczkowski M; Mbaruku G; de Pinho H; Galea S Source: American Journal of Public Health. 2009 Jul 16; Abstract: Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions.Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters.Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%.Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use. Language: English Keywords: TANZANIA | RESEARCH REPORT | RURAL POPULATION | PREGNANT WOMEN | CHILDBIRTH | HEALTH SERVICES | MATERNAL HEALTH | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | SATISFACTION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior Document Number: 342039 |
| 20. Title: Factors influencing women's decision to have a home birth in rural Turkey. Author: Kukulu K; Oncel S Source: Midwifery. 2009 Feb;25(1):32-8. Abstract: OBJECTIVE: to ascertain the reasons why mothers choose to have a home birth and the factors that influence these reasons. METHODS: this cross-sectional study involved 392 women and was conducted between June and September 2003 in a rural setting in Turkey. The data were collected using a questionnaire developed by the authors. The questionnaire included demographic information, obstetric background, the reasons for deciding to give birth at home as well as questions on who encouraged the decision to give birth at home and who assisted in the home births. FINDINGS: the decision to have a home birth is related to economic difficulties and the desire to benefit from the assistance of neighbours. Women who had experienced both planned and unplanned home births reported that home birth was unsafe. CONCLUSION: preliminary information is provided about women having home births that may inform practitioners' educational efforts and future research. Language: English Keywords: TURKEY | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | SOCIAL NETWORKS | FRIENDS AND RELATIVES | HOME CARE | CHILDBIRTH | DECISION MAKING | HOME ECONOMICS | PERCEPTION | SAFETY | Europe, Southeastern | Europe | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Care and Support | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Behavior | Microeconomic Factors | Economic Factors | Psychological Factors | Public Health Document Number: 331292 |
| 21. Title: Similarities more striking than differences [letter] Author: Lessa H Source: Midwifery today With International Midwife. 2009 Spring;(89):50. Abstract: A Brazilian midwife comments on birthing options and preferences of Amazonian women. Language: English Keywords: BRAZIL | SUMMARY REPORT | ETHNIC GROUPS | NURSE-MIDWIVES | WOMEN | CULTURE | DELIVERY OF HEALTH CARE | CHILDBIRTH | PREGNANCY | BREASTFEEDING | PROMOTION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Health Personnel | Health | Sociocultural Factors | Pregnancy Outcomes | Reproduction | Infant Nutrition | Nutrition | Marketing | Economic Factors Document Number: 341186 |
| 22. Peer Reviewed Title: Severe chronic morbidity following childbirth. Author: Leung TY; Chung H Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Jun;23(3):401-423. Abstract: Three special, chronic morbidities of childbirth are reviewed with the most up-to-date knowledge in this article. Firstly, obstetric fistulas secondary to prolonged obstructed labour are still prevalent tragedies in underdeveloped countries. The damage is not only physical but psychosexual and social. The surgical skill and technology required to prevent and to treat obstetric fistulas are simple, but culture-social antagonism, geographic distance, political instability and financial constraint have to be overcome before effective management can take place. Congenital brachial plexus palsy is associated with shoulder dystocia and macrosomia, and both excessive exogenous traction and strong endogenous pushing forces contribute to its occurrence. As shoulder dystocia and macrosomia are not easily predictable, regular training and drill is essential to ensure proper management of shoulder dystocia. Most of the babies with brachial palsy will recover in 3 months but a minority of patients will suffer a more severe degree of damage, requiring early micro-neurosurgical intervention. Finally, although birth asphyxia is not the major cause of cerebral palsy, brain injury resulting from acute intrapartum hypoxic-ischemic insult is potentially alleviated by early neonatal hypothermic therapy. Both clinical and radiological assessments are essential in selecting suitable candidates for this innovative neuroprotective strategy. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | CHILDBIRTH | FISTULA | OBSTETRICAL SURGERY | MORBIDITY | PREVENTION AND CONTROL | Pregnancy Outcomes | Pregnancy | Reproduction | Diseases | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341305 |
| 23. Peer Reviewed Title: Improving maternal survival in South Asia--what can we learn from case studies? Author: McPake B; Koblinsky M Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):93-107. Abstract: Technical interventions for maternal healthcare are implemented through a dynamic social process. Peoples' behaviours--whether they be planners, managers, providers, or potential users--influence the outcomes. Given the complexity and unpredictability inherent in such dynamic processes, the proposed cause-and-effect relationships in any one context cannot be directly transferred to another. While this is true of all health services, its importance is magnified in maternal healthcare because of the need to involve multiple levels of the health system, multiple types of care providers from the highly skilled specialist to community-level volunteers, and multiple technical interventions, without the ability to measure significant change in the outcome, the maternal mortality ratio. Patterns can be followed however, in terms of outcomes in response to interventions. From these case studies of implementation of maternal health programmes across five states of India, Pakistan, and Bangladesh, some patterns stand out and seem to apply virtually everywhere (e.g., failure of systems to post staff in difficult areas) while others require more data to understand the observed patterns (e.g., response to financial incentives for improving maternal health systems; instituting available accessible safe blood). The patterns formed can provide guidance to programme managers as to what aspects of the process to track and micro-manage, to policy-makers as to what features of a context may particularly influence impacts of alternative maternal health strategies, and to governments more broadly as to the factors shaping dynamic responses that might themselves warrant intervention. Language: English Keywords: ASIA, SOUTHERN | CRITIQUE | CASE STUDIES | MATERNAL MORTALITY | MATERNAL HEALTH SERVICES | CHILDBIRTH | BLOOD SUPPLY | HUMAN RESOURCES | FINANCIAL ACTIVITIES | INCENTIVES | HEALTH SERVICES ADMINISTRATION | HEALTH POLICY | Asia | Developing Countries | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Equipment and Supplies | Medical Procedures | Medicine | Economic Factors | Policy | Political Factors | Sociocultural Factors | Management | Organization and Administration Document Number: 341940 |
| 24. Peer Reviewed Title: Adolescent pregnancies and deliveries: problems encountered. Author: Nkwabong E; Fomulu JN Source: Tropical Doctor. 2009 Jan;39(1):9-11. Abstract: Teenage pregnancies are increasing and need special attention. The aim of this retrospective study, conducted from 1 January 2004 to 31 December 2004 at the maternity department of the Yaounde University Teaching Hospital, Cameroon, was to analyze the evolution of pregnancy and delivery in primiparous teenagers. The medical files of 190 teenagers and 403 patients aged between 20 and 25 years were analyzed and compared. Mean gestational age, the rate of pregnancy-induced hypertensive disease and the caesarean section rate were similar in both groups. However, there were a greater number of low Apgar scores, vaginal tears and instrumental deliveries in teenagers. Those aged 15 years or less had the additional risk of an increased rate of preterm labour, low birth weight and early neonatal death. Therefore, pregnancies and deliveries among teenagers, especially those aged 15 years or less, should be monitored regularly. Language: English Keywords: CAMEROON | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENTS, FEMALE | YOUTH | CHILDBIRTH | ADOLESCENT PREGNANCY | PRIMIPARITY | AGE FACTORS | PREGNANCY COMPLICATIONS | CESAREAN SECTION | PREMATURE BIRTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Adolescents | Pregnancy Outcomes | Pregnancy | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Parity | Fertility Measurements | Diseases | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331070 |
| 25. Peer Reviewed Title: How long could we wait for the delivery of the second twin? Author: Nkwabong E; Kamgaing Noubi N; Dadje C; Mbu R Source: Tropical Doctor. 2009 Aug 11; Abstract: There is no consensus about the safe time interval between the deliveries of twins. This retrospective study, conducted from 1 January 2000 to 31 December 2004 at the University Teaching Hospital of Yaounde, Cameroon, was designed to evaluate the safe time interval between deliveries of twins. We analysed 268 twin deliveries. The mean time interval between twin deliveries was 10.0 +/- 7.9 minutes. The mean fetal weight of the first twin was 2416 +/- 565 g and that of the second was 2395 +/- 558 g. However, in 47.7% cases, the second twin was bigger than the first. When the second twin was delivered more than 30 minutes after the first, the mean 5 minute Apgar score was low. Therefore, efforts should be made to deliver the second twin within 30 minutes after the delivery of the first baby. Language: English Keywords: CAMEROON | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDBIRTH | PREGNANCY | MULTIPLE BIRTH | TIME FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Pregnancy Outcomes | Reproduction | Population Dynamics | Demographic Factors | Population Document Number: 342543 |
| 26. Peer Reviewed Title: MALE PARTICIPATION IN PREGNANCY AND DELIVERY IN NIGERIA: A SURVEY OF ANTENATAL ATTENDEES. Author: Olayemi O; Bello FA; Aimakhu CO; Obajimi GO; Adekunle AO Source: Journal of Biosocial Science. 2009 Mar 23;41:493-503. Abstract: Summary.This was a cross-sectional study carried out on 462 pregnant women attending antenatal care in Ibadan, Nigeria. The study's aims were to assess the level of participation of Nigerian men in pregnancy and birth, the attitude of the women and likely targets for improved care delivery. Three hundred and forty-nine women (75.5%) were aware that husbands could participate in childbirth. Most women did not think it was their husbands' place to attend antenatal clinic (48.3%) or counselling sessions (56.7%). Nearly all husbands (97.4%) encouraged their wives to attend antenatal clinic - paying antenatal service bills (96.5%), paying for transport to the clinic (94.6%) and reminding them of their clinic visits (83.3%). Three hundred and thirty-five husbands (72.5%) accompanied their wives to the hospital for their last delivery, while 63.9% were present at last delivery. More-educated women were less likely to be accompanied to the antenatal clinic, while more-educated men were likely to accompanytheir wives. Yoruba husbands were less likely to accompany their wives, but Yoruba wives with non-Yoruba husbands were 12 times more likely to be accompanied. Women in the rural centre were less likely to receive help with household chores from their husbands during pregnancy, while educated women were more likely to benefit from this. Monogamous unions and increasing level of husbands' education were associated with spousal presence at delivery. It appears that male participation is satisfactory in some aspects, but increased attendance at antenatal services and delivery would be desirable. Language: English Keywords: NIGERIA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | MEN | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MEN'S INVOLVEMENT | ANTENATAL CARE | CHILDBIRTH | ATTITUDES | TRANSPORTATION | FEES | EDUCATIONAL STATUS | CULTURE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Economic Development | Economic Factors | Population Characteristics | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Psychological Factors | Behavior | Financial Activities | Socioeconomic Status | Socioeconomic Factors | Sociocultural Factors Document Number: 341481 |
| 27. Title: Pregnancy after ureterosigmoidostomy for vesicovaginal fistula. Author: Opare-Addo HS; Danso KA; Turpin CA Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 31; Abstract: This report describes a pregnancy and subsequent preterm delivery in a patient who underwent ureterosigmoidostomy for incurable vesicovaginal fistula at the Komfo Anokye Teaching Hospital, Ghana. The patient presented in 1990 at the age of 14 years with a vesicovaginal fistula caused by prolonged obstructed labor. The fistula involved the bladder neck and the distal urethra. Although the defect was successfully closed, the patient remained incontinent from a scarred "drained pipe" distal urethra and damaged bladder neck. The patient subsequently underwent a sling procedure using synthetic material but this did not improve the incontinence. In 1994, bilateral ureterosigmoidostomy was performed; although the patient regained continence, bowel movements occurred 5-6 times a day. The patient was put on oral alkalinizing agents, remained healthy, and returned to work. Four years later the patient presented with amenorrhea that had been ongoing for 3.5 months. Ultrasound confirmed an intrauterine fetus at 15 weeks of gestation. The patient's pregnancy remained uneventful until premature rupture of membranes at 33 weeks of gestation. The patient received 24 mg of dexamethasone over 24 hours in 2 divided doses and was started on a course of antibiotics. Labor began 2 days after admission and a cesarean delivery was performed because of low birth weight. The outcomew as a healthy female neonate weighing 1600 g. Ten years later, in 2008, the patient remained healthy and continent. Her daughter is alive and healthy. Published data on pregnancy after urinary diversion, especially after incurable vesicovaginal fistula, are scarce. Reporting such pregnancies and their outcomes is important to allow accumulation of data to improve counseling and patient management. Our patient, unlike in earlier reports, did not develop dilatation or infection of the kidneys and upper urinary tract, nor was the continence mechanism compromised during pregnancy. However, the patient suffered preterm rupture of membranes and subsequent preterm labor, which is a common occurrence in pregnancy after obstetric fistula repair. The potential effect of metabolic sequelae on fetal growth and preterm labor in pregnancy following ureterosigmoidostomy needs further investigation. (full-text) Language: English Keywords: GHANA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | VESICOVAGINAL FISTULA | PREGNANCY COMPLICATIONS | OBSTETRICAL SURGERY | CHILDBIRTH | AMENORRHEA | ULTRASONICS | ADMINISTRATION AND DOSAGE | TIME FACTORS | LOW BIRTH WEIGHT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Urogenital Effects | Urogenital System | Physiology | Biology | Diseases | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Menstruation Disorders | Drugs | Population Dynamics | Birth Weight | Body Weight Document Number: 341467 |
| 28. Title: Rapid testing at labor and delivery to prevent mother-to-child HIV transmission in developing settings: issues and challenges. Author: Pai NP; Klein MB Source: Women's Health. 2009 Jan;5(1):55-62. Abstract: Worldwide, approximately 2.5 million children (95% CI: 2.2-2.6) are living with HIV infection. In 2007 alone, approximately 420,000 children (95%CI: 350,000-540,000) were newly infected with HIV - a vast majority of these infections were acquired through maternal-fetal transmission. Many of these infections could have been reduced by timely diagnosis and the delivery of interventions aimed at preventing mother-to-child HIV transmission. This perspective examines the attitudes preventing women from accessing HIV testing early on during pregnancy and the issues and challenges that remain in the institutionalization of interventions to prevent mother-to-child HIV transmission at labor and delivery. Socio-cultural and economic factors prevent women from accessing testing at an opportune time during pregnancy. In addition, a lack of adequate infrastructure often prevents timely delivery of interventions to those who access testing at the last minute (i.e., during labor and delivery). In the wake of a pediatric HIV epidemic and the need for lifelong provision of antiretroviral therapy to infected children, a simple strategy for provision of round-the-clock rapid testing and counseling services in the labor rooms may be cost saving to the healthcare systems worldwide. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | ATTITUDES | MOTHERS | PREGNANT WOMEN | PREGNANCY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | CHILDBIRTH | HIV TESTING | PROGRAM ACCESSIBILITY | Psychological Factors | Behavior | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Disease Transmission Control | Prevention and Control | Diseases | Viral Diseases | Pregnancy Outcomes | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 330874 |
29.  Title: Use of traditional and complementary health practices in prenatal, delivery and postnatal care in the context of HIV transmission from mother to child (Pmtct) in the Eastern Cape, South Africa. Author: Peltzer K; Phaswana-Mafuya N; Treger L Source: African Journal of Traditional, Complementary and Alternative Medicines. 2009;6(2):155-162. Abstract: The aim of this study was as part of a baseline assessment in PMTCT in the traditional health sector: a) to determine the views of women who have used the services of traditional practitioners before, during and/or after pregnancy, and b) to conduct formative research with traditional health practitioners (THPs), i.e. herbalists, diviners and traditional birth attendants (TBAs) on HIV, pregnancy care, delivery and infant care. The sample included a) 181 postnatal care clients with a child less than 12 months interviewed at postnatal clinic visits from 20 primary care clinics in the Kouga Local Service Area (LSA), Cacadu district, Eastern Cape, and b) 54 traditional birth attendants (TBAs) and 47 herbalists and/or diviners were interviewed from Kouga LSA. Results showed that THP (in particular TBAs and to a certain extend herbalists/diviners |