Antenatal Care Program Research Articles

IMPACTOS DA DEPRESSÃO PÓS-PARTO NA AMAMENTAÇÃO EXCLUSIVA: UMA REVISÃO INTEGRATIVA

Postpartum depression (PPD) is a psychological disorder that significantly affects the mentalhealth of women during the postpartum period, impacting, exclusive breastfeeding (EBF),which should be maintained during the first six months of the baby's life. This study aimed to identify the main symptoms of PPD that can hinder exclusive breastfeeding. The specific objectives included: evaluating the impact of PPD on the duration and exclusivity of breastfeeding; highlighting the influence of PPD on early weaning; and exposing the symptomatology associated with PPD. The methodology used was an integrative review of articles published between 2019 and 2023, analyzing the risk factors related to PPD, as well as the psychological, physical, and social impacts on women. The findings indicate that conditions such as low education levels, socioeconomic vulnerability, and lack of social and maritalsupport are strongly associated with the development of PPD, which directly compromises the mothers' ability to provide exclusive breastfeeding to their children. The results emphasize the importance of early interventions, such as adequate psychological support, family support networks, and awareness actions by healthcare professionals. In conclusion, public policies focused on maternal and child health should be strengthened, with an emphasis on the prevention and management of PPD, aiming to ensure the overall well-being of mothers and their babies. The implementation of antenatal care programs and emotional support can helpreduce the adverse effects of PPD.

Implementation and Baseline Evaluation of an Evidence-Based Group Antenatal Care Program in Two Nigerian States

Northern Nigeria has had historically low antenatal care (ANC) utilization rates with poor health outcomes. Previous studies have shown that group antenatal care (gANC) improves ANC behavior and pregnancy outcomes. The gANC has been adopted in Kaduna and Kano States, Nigeria. This paper presents baseline findings from the implementation of the gANC program in Kaduna and Kano States, Nigeria, based on data collected from 1269 and 1200 pregnant women, respectively, from March to April 2024. Analyses of sociodemographic and pregnancy behavior data were performed. Participants were mostly between the age of 19 and 31 years, married or living with a partner, with over 50% having their own businesses. Over 62% and 34% had completed secondary- or higher-level education, with 60% and 80% living in urban areas in Kaduna and Kano States, respectively. In Kano State, >60% of the women had their last delivery at home, with 41.6% not assisted by a skilled birth attendant. In Kaduna, >63% delivered in the hospital and >50% had skilled attendance during labor. Almost half had not used contraceptives previously. This study has provided baseline evaluation data for the implementation of gANC in two states in Nigeria. Subsequent longitudinal data will examine the impact of gANC utilization on perinatal outcomes and contraceptive behavior to inform the scaling of the program in the country.

Effect of an educational intervention program on pregnant women’s ability to cope with childbirth pain in Western Kenya

INTRODUCTION Childbirth pain has remained a major challenge to women of child-bearing age over the years. Studies have shown that most women are not aware of the coping strategies to employ during childbirth. Severe childbirth pain can lead to adverse maternal and neonatal outcomes. Therefore, it is imperative to develop safe and innovative methods to cope with childbirth pain. The study aimed to investigate the effects of an educational program on women's ability to cope with childbirth pain in the context of lower and middle-income countries. MATERIALS AND METHODS A Quasi-experimental design was used to assess the impact of an educational intervention built on self-efficacy theory. Pregnant mothers were recruited at antenatal care services and were assigned to either the control group or the intervention group. The intervention group received two sessions of 2 hours each of the intervention between the 32nd– 35th weeks of gestation. Follow-up and evaluation on outcome measures were conducted within 48 hours after delivery. The strength of pain was measured by the visual analogue pain scale and the Mac-Gill pain questionnaire. RESULTS Findings indicate that relative to the control group, the intervention group was significantly more likely to demonstrate lower perceived pain both on the visual analogue scale (P<0.001) and the McGill pain questionnaire (P<0.001). Further analysis revealed that the non-intervention group had increased severe pain [OR=3.099,95% CI (1.080-8.887), P=0.035], unbearable pain [OR=27.930,95% CI (9.354-83.399), P=<0001], while permanent employment reduced unbearable pain [OR=0.038 95% CI (0.003-0.549), P=0.016]. CONCLUSION AND RECOMMENDATIONS The educational intervention program was effective in decreasing pain intensity and severity during childbirth. Training programs should be integrated into the antenatal care program and offered to mothers during the third trimester of pregnancy to enhance women's coping skills during childbirth.

Double burden of gestational diabetes and pregnancy-induced hypertension in Ethiopia: A systematic review and meta-analysis of observational studies.

The coexistence of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) amplifies the risk of maternal and perinatal mortality and complications, leading to more severe adverse pregnancy outcomes. This systematic review and meta-analysis aimed to assess the double burden of GDM and PIH (GDM/PIH) among pregnant women in Ethiopia. A comprehensive systematic search was conducted in the databases of PubMed, Cochrane Library, Science Direct, Embase, and Google Scholar, covering studies published up to May 14, 2023. The analysis was carried out using JBI SUMARI and STATA version 17. Subgroup analyses were computed to demonstrate heterogeneity. A sensitivity analysis was performed to examine the impact of a single study on the overall estimate. Publication bias was assessed through inspection of the funnel plot and statistically using Egger's regression test. Of 168 retrieved studies, 15 with a total of 6391 participants were deemed eligible. The pooled prevalence of GDM/PIH co-occurrence among pregnant women in Ethiopia was 3.76% (95% CI; 3.29-4.24). No publication bias was reported, and sensitivity analysis suggested that excluded studies did not significantly alter the pooled prevalence of GDM/PIH co-occurrence. A statistically significant association between GDM and PIH was observed, with pregnant women with GDM being three times more likely to develop PIH compared to those without GDM (OR = 3.44; 95% CI; 2.15-5.53). This systematic review and meta-analysis revealed a high dual burden of GDM and PIH among pregnant women in Ethiopia, with a significant association between the two morbidities. These findings emphasize the critical need for comprehensive antenatal care programs in Ethiopia to adequately address and monitor both GDM and PIH for improved maternal and perinatal health outcomes.

Support from midwives and spouse on antenatal care visit adherence in health centers among primigravida pregnant women

Background: The maternal mortality rate in Indonesia remains high. A strategy to reduce this number is through the implementation of antenatal care (ANC) programs, which are essential for pregnant women. The issue at hand is the low number of ANC visits at the Sragen Community Health Center, where out of 1,022 targets, 896 pregnant women did not meet the minimum service standard target in 2022. ANC visits are closely related to various factors, such as knowledge, attitude, access, and external support factors. This study focuses on external support factors that influence pregnant women to attend ANC visits, including support from husbands and midwives. Purpose: To determine the relationship between husband and midwife support and antenatal care visits among primigravida pregnant women. Method: This quantitative research with a cross-sectional design was conducted in October 2023 at the Sragen Community Health Center. The study population consisted of 100 primigravida women who had ANC visits from January to August 2023, with a sample size of 84 pregnant women selected using total sampling techniques based on the Lemeshow formula. The research instrument used was a questionnaire. Data were analyzed using bivariate Chi-Square tests processed with SPSS version 20. Results: There is a significant relationship between husband support and ANC visits among primigravida women, with a P-value of <0.001. Similarly, statistical tests showed a significant relationship between midwife support and ANC visits among primigravida women, with a p-value of <0.001. Conclusion: Both husband and midwife support are highly beneficial, with average support levels above 80%. The highest percentage of husband support was in the emotional aspect (83%), and the highest percentage of midwife support was in the instrumental aspect (83.3%). High levels of husband and midwife support can promote pregnant women to attend ANC visits regularly, while low support can result in reluctance to do so.

Analysis of Risk Factors Associated with the Incidence of Placenta Accreta at an Indonesian Tertiary Hospital

Highlights:1. The increased incidence of placenta accreta is contributed significantly by parity classification, a history of cesarean section, body mass index, and interbirth interval.2. The findings of this study can be used as an additional reference in determining the risk of placenta accreta in pregnant women, specifically as an input in screening and antenatal care programs for pregnant women to provide early detection and appropriate management. Abstract The incidence of placenta accreta during pregnancy constitutes a serious problem in reproductive health. This complication has increased significantly over the last few decades, especially in developed countries where cesarean deliveries have also risen. Placenta accreta spectrum can cause very severe bleeding and potentially lead to other serious complications. The purpose of this study was to analyze the risk factors associated with the incidence of placenta accreta in women giving birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This quantitative study used an analytical observational research design, specifically the case-control approach. The study sample was all mothers who gave birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, between 2019 and 2023. In addition to a univariate analysis, the data were subjected to bivariate analysis using a two-sample independent t-test or Mann-Whitney test for ordinal data and for nominal data using the Chi-square test as well as multivariate analysis using logistic regression (p<0.05). The results showed that parity, a history of cesarean section, body mass index, and interbirth interval were the variables identified as significantly associated with placenta accreta. According to the logistic regression analysis, parity, a history of cesarean section, and a history of curettage were identified as the primary determinants of placenta accreta incidence. The classification of parity was found to have the most significant relationship to the incidence of placenta accreta. This study concluded that parity classification, a history of cesarean section, body mass index, and interbirth interval are the significant risk factors contributing to the increased incidence of placenta accreta at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

The impact of antenatal cluster management on maternal delivery and postpartum rehabilitation

ObjectivePregnancy care can improve maternal pregnancy outcomes. Cluster nursing, an evidence-based, patient-centered model, enhances pregnancy care, can provide patients with high-quality nursing services, has been widely used in clinical practice in recent years. However, most previous studies evaluated cluster nursing program only for a single clinical scenario. In this study, we developed and implemented a antenatal cluster care program for various prenatal issues faced by puerpera to analyze its application effect.MethodsThis is a historical before and after control study. 89 expectant mothers who had their prenatal information files registered in the outpatient department of a grade III, level A hospital from June 2020 to September 2021 were finally enrolled in observation group, and received prenatal cluster management. Another set of 89 expectant mothers from January 2019 to December 2019 were included in the control group and received traditional routine prenatal management. The effect of cluster nursing management on maternal delivery and postpartum rehabilitation was evaluated and compared between the two groups.ResultsCompared with the control group, the observation group had a significantly higher natural delivery rate, better neonatal prognosis, higher rates of exclusive breastfeeding, lower incidence of postpartum complications, shorter postpartum hospital stay, better postpartum health status, and higher satisfaction with nursing services. Compared with before intervention, the SAS and SDS scores of the observation group showed significant improvement after intervention.ConclusionAntenatal cluster care is beneficial to improve maternal and neonatal outcomes, and can have positive effects on natural pregnancy and breastfeeding, while improving the multimedia health education ability of medical care and emphasizing the importance of social support.

One size does not fit all: Perspectives from Swedish midwives on fetal movement counselling

ProblemMigration continues to play a role in determining health outcomes related to pregnancy and childbirth in Sweden. BackgroundMigrant women have, compared to Swedish-born women, increased risks of adverse birth outcomes. Previous research suggests that migrant women seek care for decreased fetal movements less than Swedish-born women. Given these documented risks, understanding midwives’ perspectives in this context is crucial to address maternal health inequities. AimTo explore midwives’ experiences conveying information about fetal movement to migrant women in antenatal healthcare settings. MethodsSemi-structured, individual interviews with midwives (n=15) experienced in providing information about fetal movements to migrant women. The interviews were analysed using reflexive thematic analysis. FindingsThe midwives’ efforts to compensate for the deficiencies within the antenatal healthcare organisation and to ensure that all women received access to information and care regarding fetal movements are described in four themes: (a) building a trusting relationship; (b) empowering women through guidance and support; (c) overcoming communication challenges; and d) navigating safety measures. DiscussionOur findings suggest that the standard antenatal care programme does not support midwives to provide holistic and individualised care that aligns with midwifery care philosophy. ConclusionTo reduce health inequities for migrant women, this study highlights the need for more flexible guidelines within the standard antenatal care programme. These guidelines should prioritise the individual woman’s needs over institutional protocols, acknowledge the midwife-woman relationship as the core of midwifery practice and support midwives to build a partnership with women through continuity of care.

25(OH) Vitamin D Status among Females with Preeclampsia/Eclampsia: A Long-term Plight Readdressed

Background: Preeclampsia is a life-threatening multisystem disorder of pregnancy which has been observed in 2%–10% of pregnancies. The prevalence of Vitamin D deficiency ranges from 15% to 80%. Deficiency of Vitamin D is associated with the development of preeclampsia. This study was done to find out the prevalence of Vitamin D deficiency among preeclamptic/eclamptic and normal pregnant females, to establish Vitamin D deficiency as a causal factor of preeclampsia, and to elucidate the relation between 25 (OH) Vitamin D status and the severe preeclampsia. Materials and Methods: Blood samples were collected from 50 normotensives (controls) and 50 hypertensive pregnant females with preeclampsia/eclampsia (cases), and 25 (OH) Vitamin D level was measured by chemiluminescence Immunoassay. Results: Among the preeclamptic/eclamptic group, 32 (64%) were noted with Vitamin D deficiency and 18 (36%) with Vitamin D insufficiency. In the control group, 30 (60%) pregnant women showed Vitamin D deficiency, 19 (38%) with Vitamin D insufficiency, and a sufficient level of Vitamin D was observed in one woman (2%). Conclusion: Although it is difficult to demonstrate the correlation between Vitamin D levels and preeclampsia, there is a widespread global prevalence of Vitamin D deficiency during pregnancy. Hence, Vitamin D supplementation can be included routinely in the antenatal care program in India.

Adaptation of a New Maternal Vaccination to the National Antenatal Care Program among Obstetricians and the Impact on the Patient’s Acceptance after the COVID-19 Pandemic

Adaptation of a New Maternal Vaccination to the National Antenatal Care Program among Obstetricians and the Impact on the Patient’s Acceptance after the COVID-19 Pandemic

FETO/Maternal Complications in Iron Deficiency Anemia during Pregnancy and Labor

Background: Iron deficiency anemia (IDA) is a prevalent nutritional disorder globally, especially in developing countries, impacting both maternal and fetal health. The condition exacerbates the risk of adverse pregnancy outcomes, including increased morbidity and mortality rates. Objective: This study aimed to examine the prevalence and impact of IDA on feto-maternal health during pregnancy and labor, as well as to evaluate the efficacy of antenatal care programs in managing this condition. Methods: A six-month cross-sectional study was conducted at Shaikh Zayad Hospital, Larkana, from October 2021 to March 2022. Fifty pregnant women, ranging from primigravida to multigravida, were recruited through emergency and outpatient departments. Comprehensive data collection included demographic information, clinical history, and a full spectrum of laboratory tests for IDA. The severity of anemia and related complications were assessed, and the collected data were analyzed using SPSS version 25. Results: Of the participants, 74% suffered from moderate anemia, while 12% and 14% had mild and severe anemia, respectively. Serum ferritin levels indicated iron deficiency in 40% of the women, with an elevated total iron-binding capacity (TIBC) in 60% of cases. Maternal complications were prevalent, with 52% encountering unspecified emergency conditions and 16% experiencing postpartum hemorrhage. Fetal complications included intrauterine growth restriction (30%), intrauterine death (18%), and neonatal death (10%). Conclusion: IDA presents a significant health risk during pregnancy, correlated with a high incidence of maternal and fetal complications. This study emphasizes the importance of proactive management and monitoring of iron levels throughout pregnancy. Establishing comprehensive antenatal care that includes nutritional education and iron supplementation is crucial for preventing IDA and improving pregnancy outcomes.

PENDAMPINGAN KELAS IBU HAMIL DALAM MEMBERIKAN MOTIVASI ANC BERKUALITAS, UPAYA PENINGKATAN KESEHATAN IBU DAN JANIN

Complications of pregnancy and childbirth as a cause of maternal death can be prevented by carrying out regular antenatal care (ANC) visits. Antenatal care is a comprehensive and quality antenatal service provided to all pregnant women. These services can be provided by doctors, midwives, nurses and other medical personnel who are trained and professional. The Indonesian government has made a policy for an integrated antenatal care program of quality and quantity, namely that antenatal care must implement the "7T" service standard with a minimum visit frequency of 4 times during pregnancy. Antenatal services can also be used to provide information to pregnant women and their families to carry out appropriate treatment and immediately have their pregnancy checked if there are danger signs during pregnancy. Factors that influence the health behavior of pregnant women when visiting ANC are divided into predisposing factors, enabling factors and reinforcing factors. Predisposing factors consist of age, education level, occupation, parity, knowledge and attitudes of pregnant women. Enabling factors include distance from residence, family income, and existing information media facilities. Meanwhile, strengthening factors include husband's support, family support, and attitudes and support from health workers..

Impact of the COVID-19 Pandemic on Rate of Complete Treatment for Syphilis among Pregnant Women in Indochina: A Preliminary Report

Abstract Background: The COVID-19 outbreak has had a negative influence on common public health services in a number of ways. The authors of this particular study discuss the impact of the COVID-19 pandemic on antenatal care programs used to treat syphilis in pregnant women in areas where the illness is a major problem. Materials and Methods: In Southeast Asia, where syphilis is extremely prevalent, data on the treatment of syphilis among pregnant women in accordance with normal prenatal care programs are examined. Results: The total treatment rate has decreased as compared to the period before COVID-19. Conclusion: According to the regular antenatal care program, the COVID-19 pandemic had an impact on how pregnant women were treated for syphilis in the research area. The reduced coverage is a severe issue that has to be effectively addressed.

Effect of Short, Animated Video Storytelling on Maternal Knowledge and Satisfaction in the Perinatal Period in South Africa: Randomized Controlled Trial.

Innovative mobile health (mHealth) interventions can improve maternal knowledge, thereby supporting national efforts to reduce preventable maternal and child mortality in South Africa. Studies have documented a potential role for mobile video content to support perinatal health messaging, enhance maternal satisfaction, and overcome literacy barriers. Short, animated storytelling (SAS) is an innovative, emerging approach to mHealth messaging. We aimed to measure the effect of SAS videos on maternal knowledge and user satisfaction for mothers enrolled in antenatal care programs at 2 public health facilities in the Tshwane District of South Africa. We used a randomized controlled trial with a nested evaluation of user satisfaction. Participants were randomized 1:1 into Standard-of-Care (SOC) Control, and SAS Intervention groups. The intervention videos were delivered through WhatsApp, and 1 month later, participants responded to telephone surveys assessing their knowledge. The intervention group then participated in a nested evaluation of user satisfaction. We surveyed 204 participants. Of them, 49.5% (101/204) were aged between 25 and 34 years. Almost all participants self-identified as Black, with the majority (190/204, 93.2%) having completed secondary school. The mean overall knowledge score was 21.92/28. We observed a slight increase of 0.28 (95% uncertainty interval [UI] -0.58 to 1.16) in the overall knowledge score in the intervention arm. We found that those with secondary education or above scored higher than those with only primary education by 2.24 (95% UI 0.76-4.01). Participants aged 35 years or older also scored higher than the youngest age group (18-24 years) by 1.83 (95% CI 0.39-3.33). Finally, the nested user satisfaction evaluation revealed high maternal satisfaction (4.71/5) with the SAS video series. While the SAS videos resulted in high user satisfaction, measured knowledge gains were small within a participant population that was already receiving perinatal health messages through antenatal clinics. The higher knowledge scores observed in older participants with higher education levels suggest that boosting maternal knowledge in younger mothers with lower education levels should continue to be a public health priority in South Africa. Given the high maternal satisfaction among the SAS video-users in this study, policy makers should consider integrating similar approaches into existing, broad-reaching perinatal health programs, such as MomConnect, to boost satisfaction and potentially enhance maternal engagement. While previous studies have shown the promise of animated video health education, most of this research has been conducted in high-income countries. More research in underresourced settings is urgently needed, especially as access to mobile technology increases in the Global South. Future studies should explore the effect of SAS videos on maternal knowledge in hard-to-reach populations with limited access to antenatal care, although real-world logistical challenges persist when implementing studies in underresourced South African populations. Pan African Clinical Trials Registry PACTR202203673222680; https://tinyurl.com/362cpuny.

Antenatal depression and associated factors among pregnant women attending antenatal care at public health facilities in the Gida Ayana district, Oromia Region, West Ethiopia, in 2022.

Though antenatal depression (AND) has a risk of maternal and fetal morbidity and mortality, it is a neglected component of pregnancy care in Ethiopia. Research evidence is compulsory in different parts of the country to alleviate this problem. Thus, this study was needed to assess antenatal depression and its associated factors, which can help antenatal care (ANC) providers and program coordinators focus on the mental health of pregnant mothers. This study aimed to assess antenatal depression and associated factors among pregnant women attending ANC at public health facilities in the Gida Ayana district, Oromia Region, West Ethiopia, in 2022. A facility-based cross-sectional study was conducted among 370 pregnant women attending ANC at public health facilities. Systematic random sampling techniques were used to select study participants. A standard (validated) tool, the Edinburgh Postnatal Depression Scale, was also used to assess antenatal depression. The collected data were coded, entered into Epi-data software version 4.6, and analyzed by SPSS version 23. Multivariable logistic regression analyses were used to identify associated factors with a p-value <0.05. In this study, the prevalence of antenatal depression was 62 (16.8%; 95% CI: 13, 20.5). Being single in marital status (AOR = 3, 95% CI: 1.5, 6.2), having an unplanned pregnancy (AOR = 2.7, 95% CI: 1.45, 5.1), and having partner conflict (AOR = 3.49, 95% CI: 1.79, 6.8) were the factors associated with antenatal depression. About one in five pregnant women has antenatal depression. Being single, having an unplanned pregnancy, and having a dissatisfied relationship with a sexual partner were the factors associated with antenatal depression. Therefore, women or partners are expected to plan pregnancy, and the dissemination of health information related to an unplanned pregnancy needs to be intensified by health providers. The partner ought to avoid conflict during the pregnancy, and healthcare providers or families are needed to support the single or widowed pregnant women. Further prospective cohort studies are needed to ascertain the effect of antenatal depression on fetal-maternal outcomes.

Social determination of malaria in pregnancy in Colombia: a critical ethnographic study

BackgroundThe meanings and experiences related to malaria in pregnancy (MiP) and its processes of social determination of health (PSDH) have not been reported in the world scientific literature. The objective was to understand the meanings and experiences of MiP, and to explain their PSDH in an endemic area from Colombia, 2022.MethodsCritical ethnography with 46 pregnant women and 31 healthcare workers. In-depth and semi-structured interviews, focus group discussions, participant and non-participant observations, and field diaries were applied. A phenomenological-hermeneutic analysis, saturation and triangulation was carried out. The methodological rigor criteria were reflexivity, credibility, auditability, and transferability.ResultsAt the singular level, participants indicated different problems in antenatal care and malaria control programmes, pregnant women were lacking knowledge about MiP, and malaria care was restricted to cases with high obstetric risk. Three additional levels that explain the PSDH of MiP were identified: (i) limitations of malaria control policies, and health-system, geographic, cultural and economic barriers by MiP diagnosis and treatment; (ii) problems of public health programmes and antenatal care; (iii) structural problems such as monetary poverty, scarcity of resources for public health and inefficiency in their use, lacking community commitment to preventive actions, and breach of institutional responsibilities of health promoter entity, municipalities and health services provider institutions.ConclusionInitiatives for MiP control are concentrated at the singular level, PDSH identified in this research show the need to broaden the field of action, increase health resources, and improve public health programmes and antenatal care. It is also necessary to impact the reciprocal relationships of MiP with economic and cultural dimensions, although these aspects are increasingly diminished with the predominance and naturalization of neoliberal logic in health.

Assessment of utilisation of government programmes and services by pregnant women in India.

Since the implementation of various maternal health programs, Maternal Mortality Ratio (MMR) has significantly declined in India through improvements in maternal health services. However, inequality persists at the regional and socio-economic levels. In light of this, the present study aims to assess the existing regional disparities in utilising various government initiatives for safe motherhood in India. National-level datasets such as National Family and Health Surveys (NFHS-3 (2005-06); NFHS-4 (2015-16) and NFHS-5(2019-21); Health Management Information System (HMIS), 2019-20; Sample Registrar System (SRS), 2001-2018) were used in the study. In addition, composite Index and inequality measures (Range, Ratio, and Gini) were calculated to examine inequality. At the same time, the Pearson correlation was used to investigate the correlation between various components of maternal health services and Maternal Mortality Rate (MMR). The composite index score (0.65) reflects that India is still far behind the targets of the utilisation of maternal health care services. Within the utilisation of services, the Gini coefficient reveals that the least inequality was recorded in skilled birth assistance deliveries (0.03) and institutional deliveries (0.04). In contrast, the highest inequality was recorded in receiving Iron and Folic Acid (IFA) Tablets for 100 days (0.19) and four Antenatal Care (ANC) visits (0.13) among selected states. Based on the composite score for maternal health utilisation, Kerala, Tamil Nadu, Andhra Pradesh, Odisha, and Delhi were amongst the best performers, whereas Bihar, Jharkhand, Uttar Pradesh, and Assam were amongst the worst performers. This indicates that the government's single-minded focus on enhancing institutional deliveries and skilled health-assisted deliveries has detracted from other essential interventions related to maternal health. Therefore, the states with the utilisation of maternal services need to initiate immediate action to increase the ANC and Post-natal Care (PNC utilisation with more attention towards better implementation of existing ANC programmes by the government.

MIESRA mHealth: Marital satisfaction during pregnancy.

The transition of a pregnant woman's role often causes emotional changes that have an impact on marital satisfaction. We develop MIESRA mHealth and evaluate its impact on satisfaction of husband-wife relationship during pregnancy. A quasi-experimental study was conducted on 82 couples of pregnant women and divided into control, single, and paired group. We implemented MIESRA mHealth for four weeks. In the couple group, the wife did mindfulness based on the information in the MIESRA mHealth together with her husband. In a single group, the wife sees the video as an initial guide to doing mindfulness. In the control group, respondents received programme interventions from hospitals which included education and consultation with obstetricians. Husband-wife relationship is evaluated using Compatibility of Husband-and-Wife Relationships / Kesesuaian Hubungan Suami Istri (KHSI) questionnaire and the generalised estimating equations (GEE) was used to analyse the data. The women's KHSI scores in the couple and single intervention groups (β = -7.46, p = 0.002; β = -9.11, p = 0.001) were better than the control group. The husbands' KHSI scores in the paired and individual intervention groups (β = -7.04, p<0.001; β = -3.74, p = 0.024) were better than the control group. Nursing interventions to build emotional bonds between parents and foetuses based on mHealth can be a promising intervention for marital harmony during the perinatal period. MIESRA m-Health is a promising intervention on marital satisfaction during pregnancy and can be implemented as a part of the antenatal care programme to increase marital satisfaction.

Combination HIV prevention during pregnancy and the post-partum period in Malawi and Zambia: a mathematical modelling analysis.

Despite widespread success in reducing vertical HIV transmission, most antenatal care (ANC) programmes in eastern and southern Africa have not emphasized primary prevention of maternal HIV acquisition during pregnancy and lactation/breastfeeding. We hypothesized that combination HIV prevention interventions initiated alongside ANC could substantially reduce maternal HIV incidence. We constructed a multi-state model describing male-to-female HIV transmission in steady heterosexual partnerships during pregnancy and lactation/breastfeeding, with initial conditions based on population distribution estimates for Malawi and Zambia in 2020. We modelled individual and joint increases in three HIV prevention strategies at or soon after ANC initiation: (1) HIV testing of male partners, resulting in HIV diagnosis and less condomless sex among those with previously undiagnosed HIV; (2) initiation (or re-initiation) of suppressive antiretroviral therapy (ART) for male partners with diagnosed but unsuppressed HIV; and (3) adherent pre-exposure prophylaxis (PrEP) for HIV-negative female ANC patients with HIV-diagnosed or unknown-status male partners. We estimated the percentage of within-couple, male-to-female HIV transmissions that could be averted during pregnancy and lactation/breastfeeding with these strategies, relative to base-case conditions in which 45% of undiagnosed male partners become newly HIV diagnosed via testing, 75% of male partners with diagnosed but unsuppressed HIV initiate/re-initiate ART and 0% of female ANC patients start PrEP. Increasing uptake of any single strategy by 20 percentage points above base-case levels averted 10%-11% of maternal HIV acquisitions during pregnancy and lactation/breastfeeding in the model. Joint uptake increases of 20 percentage points in two interventions averted an estimated 19%-23% of transmissions, and with a 20-percentage-point increase in uptake of all three interventions, 29% were averted. Strategies achieving 95% male testing, 90% male ART initiation/re-initiation and 40% female PrEP use reduced incident infections by 45%. Combination HIV prevention strategies provided alongside ANC and sustained through the post-partum period could substantially reduce maternal HIV incidence during pregnancy and lactation/breastfeeding in eastern and southern Africa.

Discrepancy Evaluation of 10 Antenatal Care Services (10T) at the Dinoyo Health Center, Malang City

One of the goals of the Antenatal Care (ANC) program is to identify abnormalities or complications early that may occur during pregnancy. The quality of antenatal care contributes to better outcomes for pregnant women. Meanwhile, at the Dinoyo Health Center, the coverage of antenatal care visits showed a decreased trend. Furthermore, the quality of ten antenatal care services (10T) was still unknown. This study aimed to evaluate the implementation of ten antenatal care services (10T) at the Dinoyo Health Center. This descriptive qualitative study was conducted at the Dinoyo Health Center on April 2022. Data were obtained from ten informants that were purposively selected and also from secondary data. Data analysis was carried out using the Discrepancy Evaluation Model (DEM) approach. The data triangulation process was also done. This study found that one of ten antenatal care services (10T) did not meet the standard. It was a counseling session.