Care Visits Research Articles

Prevalence and Factors Associated with Adherence to Iron-Folic Acid Supplementation Among Pregnant Women in Eastern Sudan: A Cross-Sectional Study.

The present study was conducted to determine the prevalence and factors associated with adherence to iron-folic acid supplementation (IFAS) among pregnant women in eastern Sudan. A cross-sectional survey was conducted among pregnant women who obtained antenatal care (ANC) at Gadarif Maternal Hospital in eastern Sudan between May 1 and August 31, 2023. Face-to-face interview questionnaires were used to gather sociodemographic, obstetric, and clinical data (age, parity, education, residence, and previous medical diseases). Knowledge of anemia and IFAS was assessed. Multivariate analysis was performed to adjust for confounders. A total of 568 pregnant women were enrolled in the present study. Among them, 449 (79.0%) adhered to the IFAS. The multivariate analysis showed that the adjusted odds ratio (AOR) of IFAS adherence increased with ANC visits > 4 (AOR = 1.68, 95.0% CI = 1.01-2.77) and knowledge of anemia (AOR = 2.06, 95.0% CI = 1.437-3.276). In the univariate analysis, maternal occupation and knowledge of IFAS adherence were the only factors associated with IFAS adherence. Maternal age, parity, gestational age, education, residence, occupation, medical insurance, medical disease, and husband's occupation were not associated with IFAS. Forgetfulness (71.0%), frustration from taking many drugs (54.6%), and unpleasant tests of the supplement (50.7%) were the main reasons for not taking the IFAS. About four out of five pregnant women adhered to the IFAS, indicating a good level of adherence, especially among women who attended more than four ANC visits and those with good knowledge of anemia. More attention is needed to encourage ANC to increase adherence to IFAS.

Risk factors of children's low birth weight and infant mortality in Bangladesh: Evidence from binary logistic regression and Cox PH models.

Low birth weight is recognized as a pivotal risk factor affecting child survival and growth. Although Bangladesh has made commendable progress in public health, an infant mortality rate of 38 per 1000 live births and a 16% prevalence of low birth weight remain significant concerns compared to other developing countries. This situation poses a significant challenge for the formulation of future health policies in Bangladesh. As a result, this study aims to identify potential risk factors contributing to low birth weight and infant mortality among children in Bangladesh. The data is extracted from the 2014 Bangladesh Demographic and Health Survey. The response variables are infant mortality and low birth weight. In the bivariate analysis, Log-rank tests and Chi-square tests of independence were conducted. Cox proportional hazards and binary logistic regression models were utilized to determine the impact of risk factors on infant mortality and low birth weight. This study identified several significant factors associated with children's low birth weight, including wealth index, parental education, birth order, twin births, mother's body mass index, and child sex. Additionally, wealth index, parental education, twin status, media exposure, birth order, antenatal care visits, prenatal care assistance, and low birth weight were identified as potential risk factors for infant mortality in Bangladesh. This study revealed that maternal and child characteristics, along with knowledge about child health care during pregnancy, can potentially reduce the risk of low birth weight and infant mortality among children in Bangladesh. To improve child health and survival, policymakers should prioritize community-based health education programs, and encourage parents to seek healthcare information from institutional medical facilities during pregnancy and after birth.

The risk factors of infant mortality in Somalia: evidence from the 2018/2019 Somali health & demographic survey

BackgroundGlobally, infant mortality is one of the major public health threats, especially in low-income countries. The infant mortality rate of Somalia stands at 73 deaths per 1000 live births, which is one of the highest infant death rates in the region as well as in the world. Therefore, the aim of this study was to ascertain the risk factors of infant mortality in Somalia using national representative data.MethodIn this study, data from the Somali Health and Demographic Survey (SHDS), conducted for the first time in Somalia in 2018/2019 and released in 2020, were utilized. The analysis of the data involved employing the Chi-square test as a bivariate analysis. Furthermore, a multivariate Cox proportional hazard model was applied to accommodate potential confounders that act as risk factors for infant death.ResultsThe study found that infant mortality was highest among male babies, multiple births, and those babies who live in rural areas, respectively, as compared to their counterparts. Those mothers who delivered babies with small birth size and belonged to a poor wealth index experienced higher infant mortality than those mothers who delivered babies with average size and belonged to a middle or rich wealth index. Survival analysis indicated that mothers who did use ANC services (HR = 0.740; 95% CI = 0.618–0.832), sex of the baby (HR = 0.661; 95% CI = 0.484–0.965), duration of pregnancy (HR = 0.770; 95% CI = 0.469–0.944), multiple births (HR = 1.369; 1.142–1.910) and place of residence (HR = 1.650; 95% CI = 1.451–2.150) were found to be statistically significantly related to infant death.ConclusionThe study investigated the risk factors associated with infant mortality by analyzing data from the first Somali Health and Demographic Survey (SHDS), which included a representative sample of the country’s population. Place of residence, gestational duration, infant’s gender, antenatal care visits, and multiple births were identified as determinants of infant mortality. Given that infant mortality poses a significant public health concern, particularly in crisis-affected countries like Somalia, intervention programs should prioritize the provision of antenatal care services, particularly for first-time mothers. Moreover, these programs should place greater emphasis on educating women about the importance of receiving antenatal care and family planning services, in order to enhance their awareness of these vital health services and their positive impact on infant survival rates.

Predicting adverse birth outcome among childbearing women in Sub-Saharan Africa: employing innovative machine learning techniques

BackgroundAdverse birth outcomes, including preterm birth, low birth weight, and stillbirth, remain a major global health challenge, particularly in developing regions. Understanding the possible risk factors is crucial for designing effective interventions for birth outcomes. Accordingly, this study aimed to develop a predictive model for adverse birth outcomes among childbearing women in Sub-Saharan Africa using advanced machine learning techniques. Additionally, this study aimed to employ a novel data science interpretability techniques to identify the key risk factors and quantify the impact of each feature on the model prediction.MethodsThe study population involved women of childbearing age from 26 Sub-Saharan African countries who had given birth within five years before the data collection, totaling 139,659 participants. Our data source was a recent Demographic Health Survey (DHS). We utilized various data balancing techniques. Ten advanced machine learning algorithms were employed, with the dataset split into 80% training and 20% testing sets. Model evaluation was conducted using various performance metrics, along with hyperparameter optimization. Association rule mining and SHAP analysis were employed to enhance model interpretability.ResultsBased on our findings, about 28.59% (95% CI: 28.36, 28.83) of childbearing women in Sub-Saharan Africa experienced adverse birth outcomes. After repeated experimentation and evaluation, the random forest model emerged as the top-performing machine learning algorithm, with an AUC of 0.95 and an accuracy of 88.0%. The key risk factors identified were home deliveries, lack of prenatal iron supplementation, fewer than four antenatal care (ANC) visits, short and long delivery intervals, unwanted pregnancy, primiparous mothers, and geographic location in the West African region.ConclusionThe region continues to face persistent adverse birth outcomes, emphasizing the urgent need for increased attention and action. Encouragingly, advanced machine learning methods, particularly the random forest algorithm, have uncovered crucial insights that can guide targeted actions. Specifically, the analysis identifies risky groups, including first-time mothers, women with short or long birth intervals, and those with unwanted pregnancies. To address the needs of these high-risk women, the researchers recommend immediately providing iron supplements, scheduling comprehensive prenatal care, and strongly encouraging facility-based deliveries or skilled birth attendance.

Faktor-Faktor yang Berhubungan dengan Kunjungan Antenatal Care (K4) pada Ibu Hamil di Wilayah Kerja Puskesmas Tarus Kupang

The Maternal Mortality Rate (MMR) is an important measure of a country's health sector progress. Governments aim to lower MMR through initiatives like safe motherhood programs, which include antenatal care (ANC) services. ANC consists of regular pregnancy check-ups to prevent maternal fatalities, with six visits being the minimum recommended number. Although Tarus Community Health Center has reached the K4 service goal, it has not yet met the necessary standards.Based on the data from the Tarus Community Health Center PWS report over the past three years, the National Health Sector SPM target of 100% has not been met. The average K4 coverage was 73.10% in 2020, 70.48% in 2021, and 74.9% in 2022. The underutilization of ANC services by pregnant women at Tarus Health Center is the primary factor contributing to this low performance.This research aims to identify factors related to ANC visits in pregnant women at Tarus Community Health Center in Kupang Regency. The study utilized a quantitative descriptive research method with an analytical survey and cross-sectional approach, analyzing data from 43 individuals using the chi-square test. The findings suggest a correlation between maternal knowledge (p=0.030), parity (p=0.014), culture (p=0.000), and accessibility (p=0.014) with ANC visits. However, the study did not find a significant relationship between mother's attitude (p=0.551) and ANC visits in the research area.The community health center should improve maternal and child health education through electronic and print media. Regular visits and counseling for pregnant women can motivate them to attend antenatal care appointments.

Geospatial determinants and spatio-temporal variation of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2011 to 2019, a multiscale geographically weighted regression analysis

BackgroundBreastfeeding offers numerous benefits for infants, mothers, and the community, making it the best intervention for reducing infant mortality and morbidity. The World Health Organization (WHO) recommends initiating breastfeeding within one hour after birth and exclusively breastfeeding for the first six months. This study investigated the trend, spatio-temporal variation, and determinants of spatial clustering of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Ethiopia from 2011 to 2019.MethodsData from the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2011, 2016, and 2019, were analyzed utilizing a weighted sample of 10,616 children aged 0–23 years for EIBF and 2,881 children aged 0–5 months for EBF. Spatial autocorrelation analysis was used to measure whether EIBF and EBF were dispersed, clustered, or randomly distributed and Kriging interpolation was employed to predict the outcome variables in the unmeasured areas. Spatial scan statistics were used to identify spatial clusters with a high prevalence of cases. Both global and local regression modeling techniques were employed to examine the spatial relationships between the explanatory variables and the dependent variables.ResultsThe trend analysis revealed a notable increase in the prevalence of EIBF from 51.8% in 2011 to 71.9% in 2019. Similarly, the prevalence of EBF increased from 52.7% in 2011 to 58.9% in 2019. Spatial analysis demonstrated significant spatial variation in both EIBF and EBF throughout the country. Cold spots or clusters with a low prevalence of EIBF were observed consistently in the Tigray and Amhara regions, and significant cold spot areas of EBF were observed consistently in the Afar and Somali regions. Multiscale geographically weighted regression analysis revealed significant predictors of spatial variations in EIBF, including the religious affiliation of being a follower of the orthodox religion, parity of 1–2, absence of antenatal care visits, and delivery via cesarean section.ConclusionsDespite the increase in both EIBF and EBF rates over time in Ethiopia, these rates still fall below the national target. To address this issue, the government should prioritize public health programs aimed at improving maternal healthcare service utilization and maternal education. It is essential to integrate facility-level services with community-level services to achieve optimal breastfeeding practices. Specifically, efforts should be made to promote breastfeeding among mothers who have delivered via cesarean section. Additionally, there should be a focus on encouraging antenatal care service utilization and adapting maternal healthcare services to accommodate the mobile lifestyle of pastoralist communities. These steps will contribute to enhancing breastfeeding practices and achieving better outcomes for maternal and child health.

PARTISIPASI SUAMI DALAM KUNJUNGAN ANTENATAL CARE DI INDONESIA: SYSTEMATIC REVIEW

Maternal Mortality Rate is an indicator of public health status. Maternal death can be prevented by maximizing antenatal care (ANC) visits.Participation of husband is very important to assist pregnant women access ANC. The aim of this study was to determine the factors that influence husbands' involvement in antenatal care visits. This research is a systematic review by searching literaturs on Google Scholar based on the purpose of this research. The articles selected in this research are articles published in 2015-2023. The resuls of this study revealed that husband and wife's age, husband and wife's education, husband and wife's occupation, income, knowledge, pregnancy status, area of residence, social status/wealth, and parity are factors that influence husbands' participation in ANC visits. Based on the results of this research, it is necessary to provide information to husbands regarding the benefits of ANC and the importance of carrying out ANC as an effort to prevent maternal death.

Socio-economic Factors Associated with Desired Number of Antenatal Care Visits in Tanzania

This study analyses socioeconomic factors associated with the desired number of Antenatal Care (ANC) visits in Tanzania. The data are extracted from the Tanzania Demographic Health Survey and Malaria Indicator. The study employed Multilevel Logistic Regression analysis using TDHS-MIS 2022. The findings show that more than two-thirds of women attended at least 4 visits (desirable), while one-third of women attended less than 4 visits (undesirable). Over half of women attained primary education, while the majority had health insurance. About half of women were aged between 25 and 34 years, and 41.2% were economically classified as poor. Furthermore, the study revealed that the place of residence, educational level, distance to the health facility, access to health insurance, marital status, husband/partner's education level, birth order, women’s age, wealth index, work status, and family size indicated associations with the number of ANC visits. The study findings recommend that policymaking should focus on formulating policies and programmes that address factors reducing maternal and infant morbidity and mortality during pregnancy and birth. There is a need to carry out a qualitative survey to assess how and why social, cultural, and community factors influence desired number of ANC visits among women.

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p<0.001), more positive attitudes towards these behaviors (p<0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p<0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022-2023.

Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy. We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata. Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women's higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births. Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women's social status.

Spatial distribution of inadequate meal frequency and its associated factors among children aged 6-23 months in Ethiopia: Multilevel and spatial analysis.

More than two-third of global child death is occurred due to inappropriate feeding practice that happened during early childhood period. Evidence on meal frequency status among infant and young children at national level can be used to design appropriate interventions to improve the recommended feeding frequency. Therefore, this study was aimed to explore the spatial distribution and identify associated factors of inadequate meal frequency among children aged 6-23 months in Ethiopia. Secondary data analysis was conducted using the 2019 mini Ethiopian Demographic and Health Survey data. A total weighted sample of 1,532 children aged 6-23 months were included. To identify significant factors associated with of inadequate meal frequency, multilevel binary logistic regression model was fitted. Variables with p-value < 0.25 from the bi-variable model were exported to multivariable analysis. In the multivariable model, variables with p-value < 0.05 were declared as significantly associated factors and adjusted odds ratio (AOR) with its 95% confidence interval were reported. Multilevel models were compared using deviance and log-likelihood. Spatial analysis tools were utilized to visualize the distribution of inadequate meal frequency. Bernoulli model was fitted using SaTScan V.9.6 to identify most likely clusters and ArcGIS V.10.8 was used to map the hotspot areas. Ordinary least square and geographic weighted regression models were used and compared using information criteria and adjusted-R2. Local coefficients of factors associated with hotspots of inadequate meal frequency were mapped. The prevalence of inadequate meal frequency was 47.03% (95% CI: 44.54%, 49.53%) in Ethiopia. Age of the child, sex of the household head, timely initiation of breastfeeding, current breastfeeding status, number of antenatal care visit, maternal education, and region were significantly associated with inadequate meal frequency. The spatial distribution of inadequate meal frequency was showed significant variation across Ethiopia (Global Moran's I = 0.164, p-value <0.001). A total of 38 significant clusters were detected through SaTScan analysis, from these the 22 primary clusters were located in Somali and Harari. The prevalence of inadequate meal frequency was high in Ethiopia and had significant clustering patter. Significant hotspot clusters were located in Somali, northern Afar, Harari, Amhara, Gambela, and eastern South nation nationalities and peoples' region. Therefore, public health interventions which enhance breastfeeding practice, optimal number of antenatal care visits, educational empowerments should target hotspot areas to decrease inadequate meal frequency practice.

Impact of Diabetes in Pregnancy on Stage II Lactogenesis among Postpartum Diabetic Women Compared to Non-Diabetics

Abstract Background Diabetes in pregnancy -whether preexisting or gestational can have negative impact on pregnancy, labor and lactation. Infants of diabetic mothers benefit most from early establishment of breastfeeding as it helps them regulate their blood glucose levels on the short term and decrease their risk of developing diabetes later on life. Aim of the Work This study aims to compare diabetic and non-diabetic pregnant women regarding the onset of stage II lactogenesis at 72 hours postpartum and to associate the degree of diabetes control in antepartum period with the delay in stage II of lactogenesis. Subjects and Methods This study is an observational prospective cohort study, carried out on 203 pregnant women aged from 18 to 40 years old during their routine antenatal care visits in the third trimester of pregnancy at Ain-Shams University Maternity hospital outpatient clinic from December 2020 to August 2021, Cairo, Egypt. Results We found that Diabetes in pregnancy can cause a delay in the onset of Lactogenesis stage II regardless of the degree of control. We can also say that diabetes can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother and delayed initiation of first breastfeed which was found to cause DOLII. And early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers. Conclusion Diabetes can cause series of unfortunate events in pregnancy, labor, and lactation. Many of diabetes implications on peripartum health can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother, delayed initiation of first breastfeed and other birth complications. All these can cause DOL II. Diabetes itself is a risk factor for delayed onset of lactogenesis II which can cause further neonatal hypoglycemia and/or early introduction of infant formula. The cascade of these events can hinder the breastfeeding establishment when it is most needed. The control of diabetes was not found to have impact on DOL II. Further research needs to be done in this regard. Early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers.

The influence of parental occupational status on under-five mortality in Ethiopia

ABSTRACT Few studies have examined the mediators of the association between parental occupational status and under-five mortality risk in Ethiopia. We examine the association between parental occupational status and under-five mortality risk in Ethiopia and the role of two mediating variables, antenatal care visits and delivery by a health professional, in this relationship. Using birth data from the nationally representative 2016 Ethiopia Demographic and Health Survey, the study finds that parental occupation, antenatal care visits, and delivery by a health professional are associated with under-five mortality risk. The study also finds that after controlling for mediating variables, parents engaged in professional, agricultural, and manual labor still have lower odds of under-five mortality risk than children of non-working parents. Future research should focus on the pathway from parental employment to child mortality risk, not through access to antenatal care and delivery by health professionals.

PEMODELAN GEOGRAPHICALLY WEIGHTED NEGATIVE BINOMIAL REGRESSION (GWNBR) PADA KEJADIAN STUNTING DIiKABUPATEN BARITO KUALA TAHUN 2022

Stunting is a condition of malnutrition in toddlers that causes their height to be lower than other children their age. In 2022, South Kalimantan Province has a stunting prevalence of 24.6% and ranks fifteenth in Indonesia. Barito Kuala Regency, one of the regions in South Kalimantan Province, has the highest stunting rate at 33.6% which is included in the Chronic- Acute category (≥ 20%). This study uses the GWNBR model to characterize the factors that cause stunting in Barito Kuala Regency. The GWNBR model will make it easier for researchers to find out the factors that affect stunting in each sub-district. The weight matrix used is a fixed kernel function and an adaptive kernel function. The predictor variables used were the percentage of infant history of complete basic immunization, history of exclusive breastfeeding in infants &lt;6 months, history of low birth weight babies, new visits to pregnant women (K1), sixth antenatal care (ANC) visit (K6), history of pregnant women who received blood supplement tablets, history of infants 6-11 months who received vitamin A, active posyandu and households with access to appropate sanitary facilities.(healthy latrines). The best model results obtained with adaptive gaussian weighting with an AIC value of 167.25. Keywords: Stunting Cases, GWNBR model.

An assessment of factors associated with full vaccination coverage rate among children aged 12-23 months in Masvingo district; Zimbabwe. A cross-sectional study

Introduction: Immunization is one of the most cost-effective nursing interventions aimed at reducing ill health and premature death among children. Despite tremendous efforts by governments, vaccination coverage remains low, especially in developing countries. Masvingo district is one of the districts with low vaccination coverage in the country. Objectives: This study sought to assess immunization coverage, identify determinants of vaccination coverage and assess factors associated with low full immunization coverage in Masvingo district, Zimbabwe. Methods: An analytical cross-sectional study design was conducted between January 2019 and February 2019. Masvingo province was purposively selected due to its low vaccination coverage (60.3%) according to the Zimbabwe Demographic and Health Survey 2015. WHO cluster sampling was used to select households. A total of 354 children and their mothers residing in Masvingo district were recruited for the study. Pre-tested interviewer-administered questionnaires were used to collect data. Bivariate analysis was employed to assess factors associated with low vaccination coverage. Results: An estimated 89.5% of children aged 12-23 months were fully vaccinated by card or mothers’ recall. Factors significantly associated with full vaccination coverage rates (P&lt;0.001) included birth order, distance to the nearest health facility, waiting time, place of birth, number of Antenatal care visits, possession of a vaccination card, place of residence, mother/caregiver’s highest level of education, household expenditure per month, and overall knowledge of the vaccination schedule. After controlling for all these factors, only household expenditure per month (P=0.001), having a vaccination card (P=0.047), and overall knowledge of the vaccination schedule (P=0.002) were statistically significant predictors of full vaccination coverage rates. Conclusion: Although full vaccination coverage is improving, it is still below the Global Vaccine Action Plan target. Factors associated with low full vaccination coverage include marital age, marital status, level of education, religion, household expenditure, distance to the health center, waiting time, and Antenatal Care and Post-natal Care care utilization. There is no single factor solely responsible for low vaccination coverage; rather, it is influenced by a combination of multiple factors. Nursing interventions at community level should focus on increasing community mobilization strategies that foster saturation coverage to achieve herd immunity for all vaccine preventable child diseases.

The Relationship Between Knowledge and Motivation of Pregnant Women with the Implementation of Integrated ANC at UPTD Plaosan Health Center

Antenatal care (ANC) is an important component in maternal health services to reduce maternal and infant mortality rates in Indonesia, which are still high. Every pregnancy in its development has a risk of complications, therefore ANC services must be carried out routinely, integrated, and according to quality antenatal service standards. In fact, not all pregnant women make regular ANC visits, so the coverage of K1, K4 and K6 is low, including at the Plaosan Health Center. The general objective of this study was to determine the relationship between knowledge and motivation of pregnant women with the implementation of Integrated ANC at UPTD Puskesmas Plaosan in 2024. The type of research used in this study was an analytic survey with a cross sectional design. Data analysis using primary data. The number of samples used was 37 pregnant women using purposive sampling technique. The independent variables in this study were knowledge and motivation while the dependent variable in this study was the implementation of integrated ANC. Data analysis was performed with chi-square test. The results showed that the variable of knowledge with the implementation of integrated ANC obtained significance with a p value = 0.014 while the motivation variable obtained a p value = 0.001 so that there is a significant relationship between knowledge and motivation with the implementation of integrated ANC. Therefore, knowledge and motivation need to be considered to be a reference in the implementation of integrated ANC..

The Impact of Telehealth Implementation on Increasing Antenatal Care Visits: A Literature Review

Antenatal care is an essential service in reducing maternal mortality. However, several studies have shown that distance, cost, time and quality of service affect the decline in ANC visits. For this reason, technology-based innovation (telehealth) is needed to overcome this. The aim was to evaluate the impact of using telehealth on increasing the number of antenatal care visits. The method used was PRISMA from electronic databases: Scopus, Clinical Key Nursing, Science Direct and Proquest. The results showed that telehealth can expand the range of services, is effective, efficient and flexible in terms of cost and time, and there is no significant difference in the quality of the examination results. In conclusion, through easy access and more efficient costs offered by telehealth, it has a positive impact on increasing the number of antenatal care visits. This also has implications for the world of nursing, not only expanding maternity services but continuing to adapt to the massive development of technology to welcome the era of Society 5.0

Implementing a clinical decision support tool to increase early peanut introduction guidance

BackgroundGeneral pediatric providers are the frontline for early peanut introduction discussions, but many feel ill-equipped to handle such discussions as guidelines have quickly changed. ObjectiveWe hypothesized that a clinical decision support (CDS) tool could improve peanut introduction discussions. MethodsCDS tools were designed by stakeholders, improved through usability testing, and integrated into the current note templates. Based on queries of electronic health record (EHR), we did a pre-post performance evaluation of peanut introduction conversations, barriers for introduction, and percentage of 12-month WCC visits that had successfully introduced peanut. Providers completed surveys before and after intervention to assess awareness of early peanut introduction and comfort using CDS. ResultsProviders’ awareness of early peanut introduction guidelines increased from 17.8% to 66.7% after the CDS tool was implemented. 79.1% were comfortable using the tool. The CDS tool improved peanut introduction conversations at the 4-month well-child (WCC) care visit from 2.4% to 81.2%, at the 6-month WCC visit from 3.0% to 84.2%, and at the 12-month WCC visit from 2.7% to 82.9%. 56.6% of families had a plan to introduce peanut at the 4-month WCC visit. Of those who did not have a plan, the most common barrier was family's unawareness of the benefits of early peanut introduction. At the 12-month visit, 62.8% of families had introduced peanut without concerns. ConclusionA point-of-care CDS tool encouraged more discussions by general pediatric providers on early peanut introduction to all patients. CDS tools should be considered in quality improvement projects as an implementation method for the most up-to-date guidelines.

Magnitude and Determinants of Pregnancy Induced Hypertension in Selected General Hospitals in Lusaka, Zambia: A Cross-Sectional Study

Background:Hypertension in pregnancy continue to be among the major causes of maternal and perinatal morbidity and mortality, affecting 5-6% of pregnancies globally and contributing to a significant diseaseburden. Aims and objectives: To assess prevalence and factors associated with pregnancy induced hypertension among pregnant women aged 15 to 49 years at three general hospitals of Lusaka District. Methodology:Conducted cross sectional study with 413 systematically selected pregnant women attending antenatal clinics at Chawama, Chipata and Matero general hospitals from January 2019 to July 2020. The sample size for each hospital was determined proportionally based on twelve months of antenatal care visit data. Blood pressure, heights, weights, Body mass index and urinalysis were measured on all the study participants. A structured questionnaire collected data on social demographic and economic factors, reproductive and medical history. Data was analyzed using STATA version 13. Chi-square and fisher’s exact tests identified association between PIH and various variables with multiple logistic regression used to control for confounders. Statistical significance was set at &lt;0.05. Results:The prevalence of Pregnancy induced hypertension was found to be 21%. Significant predictors of PIH included Stress during pregnancy (AOR = 2.28, 95% CI =1.35-3.85, p=0.002), lack of exercise (AOR = 0.48, 95% CI =0.28-0.81, p=0.007), high BMI (AOR = 1.57, 95% CI =1.12-2.19, p=0.007) and consuming alcohol (AOR = 2.29, 95% CI =1.03-5.09, p=0.042).Conclusion:The prevalence of PIH was 21% with significant association observed between PIH and stress, alcohol consumption, lack of exercise and high BMI during pregnanc. Keywords: Pregnancy Induced hypertension; Prevalence; Associated factors, Antenatal mothers.

THE CORRELATION BETWEEN THE RISK OF ANEMIA IN PREGNANT WOMEN AND THEIR ADHERENCE TO PRENATAL CARE VISITS

The prevalence of anemia in pregnant women is still quite high, namely (48.9%). The aim of this study was to determine the relationship between Antenatal Care visits and the risk of anemia in pregnant women in Bima Regency, West Nusa Tenggara. This research is Correlative Analytical with a cross-sectional approach. where the population is 202 pregnant women for the period January-June 2023, while the sample is 51 pregnant women in the third trimester using a total sampling technique. The dependent variable of the research is the risk of anemia in pregnant women, while the independent variable is Compliance with Antenatal Care Visits for Pregnant Women. Data was obtained by looking at the results of examinations in the KIA book for pregnant women and checking hemoglobin with digital Hb. In this study, primary data was obtained by examining the KIA books of pregnant women and checking hemoglobin. Meanwhile, secondary data consists of data on the number of pregnant women in the third trimester. Data analysis in this study consisted of univariate analysis and bivariate analysis. Bivariate analysis uses the chi-square statistical test. The results of the study showed that there was a relationship between pregnant women's compliance with antenatal care visits and the risk of anemia with a value of P = 0.000.