Antenatal Care Research Articles

Determinants Influencing Utilization of Antenatal Care Services in Tabora Region, Tabora Municipality, Tanzania

This study examines the determinants influencing the utilization of antenatal care services (ANC) in in Tabora region with a particular focus on Tabora Municipality, Tanzania. The study used both quantitative and qualitative methods to analyze the problem. The study uses primary and secondary data obtained from the field. Tools used for data collection were questionnaires, interviews, and observation. This study employed a cross-sectional research design. This design was preferred because the design allowed the collection of data from different groups of respondents at one point at a time. Similarly, the design had a greater degree of accuracy and precision in the data collected and used for statistical description and interpretation. The study found that there was low utilization of antenatal care services in Tabora Municipality. The study revealed that the low utilization of ANC in Tabora Municipality can be solved by addressing the determinants that are responsible for the low use of ANC services. The study identified a number of determinants that influence ANC visits such as spousal involvement in antenatal clinics, the attitudes of health service professionals, clinic opening days for the antenatal care services by client satisfaction and integrated approach to antenatal care services. The determinants that affect the use of ANC visits are not only many and complex, but they play different roles in different situations. The study revealed that men and the whole community should be included in the ANC campaign so that they understand more about potential risks for pregnant women. This would increase the level of ANC use and thus reduce the high incidence of maternal and neonatal death in Tanzania including the Tabora region that results from poor utilization of ANC services. Also, this study adds knowledge to health service providers in understanding the determinants that limit pregnant women’s utilization of antenatal services finding ways to improve the services and encourage women to utilize ANC services. The study findings will enable programme planners, policymakers, implementers and managers to come up with strategies for interventions that will enable pregnant women to start seeking and utilizing ANC services early in pregnancy and to have fewer pregnancy complications that lead to maternal and neonatal deaths

An extensive review of pre-operative nursing care for high-risk obstetric surgeries

Healthcare professionals have particular difficulties while performing high-risk obstetric procedures, such as hysterectomies for excessive bleeding, cesarean sections in complex pregnancies, and surgery for ectopic pregnancies. In order to guarantee the safety and wellbeing of the mother and the fetus, perioperative nursing is essential. The purpose of this review is to highlight important nurse interventions, possible side effects, and evidence-based procedures that enhance surgical outcomes in high-risk obstetric situations. The results highlight the significance of important nurse interventions, thorough patient evaluations, and multidisciplinary cooperation throughout the perioperative phase.

Frequency and factors associated with focused antenatal care in Guinea: Analysis of the DHS 2018.

In Guinea, despite women's recourse to antenatal care (ANC), little remains known about the use of focused antenatal care (FANC), contained in the ANC package. The aim of this study was to analyse the frequency and factors associated with FANC, using data from the Demographic and Health Survey (DHS) 2018. This study was conducted in Guinea. This was a secondary analysis of data from the DHS conducted in 2018 in Guinea. It included all women who achieved at least one ANC visit in the last 2 years prior to the survey. Multivariate logistic regression was received to identify factors associated with FANC. Stata 16 software was used for the analysis. This study shows that in Guinea, between 2016 and 2018 only 33% of women undergoing ANC received a FANC. The most commonly used service was blood pressure measurement (93%), while the least commonly used service was deworming (42%). Factors associated with FANC were living in the Kindia region (odds ratio = 1.7; 95% confidence interval: 1.04-2.97); not intending to become pregnant for this pregnancy; belonging to a poor household; and having made 3, 4 or more ANC visits. This study reports a low proportion of women receiving the full package of ANC. In order to improve this indicator, greater efforts need to be made in certain regions of the country to target pregnant women who achieve fewer ANC visits, carry pregnancies that were not intentional or belong to poorer households.

Assess the Knowledge Regarding Antenatal and Postnatal Care among Asha Worker Working in Selected Area of Etawah

Background; ASHAs form the backbone of the NRHM and are meant to be selected by and be accountable to the village. They need to provide preventive, promotive and curative health facilities in the rural community.This study was conducted to assess the knowledge regarding antenatal and postnatal care among ASHA worker working in selected area of Etawah Kanpur U.P. The aim of the study was to assess the knowledge regarding antenatal and postnatal care among ASHA worker working in selected area of Etawah with view to develop and distribute information booklet to enhance their knowledge regarding. Objective 1. To assess the knowledge of ASHA worker regarding antenatal and postnatal care. 2.To determine the association between Demographic variable and knowledge score. Material and Method: for the present study Non experimental descriptive Cross-sectional Design was used for the study. purposive sampling was used to select 108 ASHA workers. Data were collected by structured knowledge questionnaire. Result: it showed that majority of the Participants 84 (90.72%) had Moderate knowledge, 18 (19.44) had adequate knowledge and 06 (6.48%) had Inadequate level of knowledge regarding pre and postnatal care among ASHA worker.

Longitudinal analysis of growth and nutritional disparities across socio-demographics from early childhood to adolescence: Findings from the Indian cohort of the Young Lives Survey.

Previous studies generally used cross-sectional data and focused on under-five children to assess the risk factors for malnutrition among Indian children. Some recent studies have reported that recovery from or faltering in malnutrition is possible after five years of age, but socio-demographic subgroup disparities have not been explored. This study aims to find the longitudinal disparity in height-for-age Z-scores (HAZ) and body-mass-index-for-age Z-scores (BMIAZ scores) across various sub-groups of a cohort from childhood to adolescence. This study used a cohort from the Young Lives Survey, which followed children aged of 1-15 years between 2002 and 2016-17 in the states of Andhra Pradesh and Telangana, India. Mixed-effect models were applied to find the main, time, and interaction effects of HAZ scores and BMIAZ scores. In addition, an extended Kitagawa-Oaxaca-Blinder decomposition approach to assess group-based differences over time was used. The cross-sectional prevalence of stunting reduced across all subgroups, while thinness rose during the same period. The interactions of child sex, mother's education, place of residence, wealth index, and antenatal care with time were statistically significant at p <0.05. The gender disparity in adjusted HAZ score decreased from 0.214 units at 1 year to 0.011 units at 15 years, whereas BMIAZ score differential increased from 0.106 to 0.538 units over same timeframe. Disparities in scores were also observed across rural-urban, maternal education, social group, religion, socioeconomic status, maternal age at birth, antenatal care, and premature birth status. The study sheds light on the nuanced dynamics of paediatric growth, emphasising the importance of longitudinal approaches in understanding and addressing the health disparities across different stages of childhood and adolescence.

Expectation, perception, and satisfaction of antenatal care services among pregnant women attending health facilities of Lumbini province, Nepal: a cross-sectional study

Background: Antenatal care (ANC) plays a crucial role in ensuring the health and well-being of pregnant women by providing regular checkups to identify potential complications and deliver important guidance on pregnancy and childbirth. While the expectations surrounding ANC services are shaped by user's individual needs and preferences, the quality of care experienced is largely determined by the service providers. The level of service quality significantly influences the utilization of ANC service, as women are more likely to use services that satisfied their expectations. This study aimed to assess the expectations, perceptions, and satisfaction levels of pregnant women concerning the ANC services offered by health institutions in Lumbini Province. Methods: An institution-based cross-sectional analytical study was carried out involving 2,986 pregnant women, selected through multistage cluster sampling. Quantitative analysis was carried out to calculate the perception, expectation, and satisfaction score. The SERVQUAL tool was utilized to measure expectation, perception and service quality gap. Results: The study involved 2,986 pregnant women, the majority of whom (76.7%) were aged 20-30 years, 38.5% were Janajati, most of them (32.5%) had a secondary level of education, and 78.8% were housewives. The expectation score was higher than the perception. Overall, only 67% of pregnant women were satisfied with the services. Conclusions: Significant disparities exist between the expectations and actual perceptions of ANC users, indicating a lower level of satisfaction among mothers with the ANC services. The study concluded that decreased satisfaction with the service is likely to reduce the trend of service utilization.

Portable ultrasound devices for obstetric care in resource-constrained environments: mapping the landscape

Background The WHO’s recommendations on antenatal care underscore the need for ultrasound assessment during pregnancy. Given that maternal and perinatal mortality remains unacceptably high in underserved regions, these guidelines are imperative for achieving better outcomes. In recent years, portable ultrasound devices have become increasingly popular in resource-constrained environments due to their cost-effectiveness, useability, and adoptability in resource-constrained settings. This desk review presents the capabilities and costs of currently available portable ultrasound devices, and is meant to serve as a resource for clinicians and researchers in the imaging community. Methods A list of ideal technical features for portable ultrasound devices was developed in consultation with subject matter experts (SMEs). Features included image acquisition modes, cost, portability, compatibility, connectivity, data storage and security, and regulatory certification status. Information on each of the devices was collected from publicly available information, input from SMEs and/or discussions with company representatives. Results 14 devices were identified and included in this review. The output is meant to provide objective information on ideal technical features for available ultrasound systems to researchers and clinicians working in obstetric ultrasound in low-resource settings. No product endorsements are provided. Conclusions This desk review provides an overview of the landscape of low-cost portable ultrasound probes for use in obstetrics in resource-constrained environments, and provides a description of key capabilities and costs for each. Methods could be applied to mapping the landscape of portable ultrasound devices for other clinical applications, or may be extended to reviewing other types of healthcare technologies. Further studies are recommended to evaluate portable ultrasound devices for usability and durability in global field settings.

Pregnancy Preparedness and Complication Preparedness of Pregnant Women in Prenatal Clinics of Tertiary Hospitals

This study assesses the level of Birth Preparedness and Complication Readiness (BPACR) among pregnant women attending antenatal clinics at a tertiary care center. Conducted through an analytical cross - sectional approach from August to October 2023 at Rajarajeswari Medical College Hospital, Bengaluru, it involved 194 participants who were 32 weeks gestation or more. The research utilized a questionnaire covering sociodemographic characteristics, knowledge of birth preparedness, and complication readiness, with data analyzed using descriptive statistics. Results indicated a low BPACR index with significant gaps in awareness and preparedness for childbirth and emergency situations. Only a fraction of participants had initiated antenatal care in the first trimester, and a majority were unaware of severe preeclampsia signs. The study underscores the need for enhanced education and awareness programs at both community and health center levels to improve birth preparedness and complication readiness among pregnant women.

Maternal education and antenatal attendance in Georgia: A cohort study

Abstract Background Antenatal care (ANC) and maternal education are important determinants for maternal and newborn health outcomes. Understanding the impact of maternal education on ANC is crucial. Purpose To examine the association between maternal education and ANC attendance. Methods A retrospective cohort study utilized nationwide electronic medical birth registry data (2020-2022) in Georgia. the study includes pregnant women and their newborns. A randomized sample was selected, and extracted variables included maternal age, parity, body mass index, education, year of delivery, gestational age, infant sex, Apgar score, birth weight, delivery type, and newborn status. Statistical analysis via IBM SPSS v23 involved chi-square, t-tests, and logistic regression. Results The sample size contains 4976 mothers after excluding cases with missing data (n = 25). The mean maternal age was 30.5 years (SD = 5.4), with a mean BMI of 28.0(SD = 4.8), and the mean gestational week was 38.4(SD = 2.0), with a mean birth weight of 3263.0 (SD = 568.0) grams. Highly educated women had more than 3 times higher odds (OR = 3.636,95%CI:2.575-5.134) of having at least one ANC visit compared to those with Unknown education. primiparous women had significantly higher odds of having at least one ANC visit compared to Multiparous women, OR = 1.519, (95%CI:1.081-2.135). The chi-square test showed significant difference between ANC visits and the number of liveborn/stillborn (χ² = 53.026, p &amp;lt; .001). Moreover, there was a significant association between birth weight categories and ANC visits (χ² = 167.095, p &amp;lt; .001). Conclusions Our study emphasizes the role of education in improving access to ANC among women with low education levels. We can increase ANC visits and improve maternal and newborn health outcomes by focusing educational efforts on pregnant women. Additionally, focusing on high-risk populations, and using tailored interventions can further improve ANC attendance along with maternal and neonatal health. Key messages • Boosting ANC access and improving maternal and neonatal health by tailored community programs. • Conservative communities and underrepresented communities require additional resources to promote tailored healthcare. and extra effort in education about ANC.

Posttraumatic Stress Symptoms Among Obstetricians with Personal Experience of Birth Trauma.

Psychological birth trauma (BT), defined as an event that occurs during labor and delivery involving actual or threatened harm or death to the pregnant person and/or their baby, has been reported in up to one-third of births. Obstetrician-Gynecologists (OBGYNs) who personally experience BT are at a unique risk of re-traumatization upon return to work. We aimed to investigate the prevalence of personal BT among obstetricians and their perceptions of how personal BT impacts their experience of caring for obstetric patients. We performed a web-based survey of OBGYNs who had given birth. Participants were recruited from the "OMG (OBGYN Mom Group)" on Facebook. The questionnaire assessed individual's personal experience of childbirth using items adapted from the "City Birth Trauma Scale" to assess post-traumatic symptoms related to their childbirth and patient interactions following personal experience of BT. Responses were categorized by whether or not the participant considered one or more of their own births to be traumatic. Post-traumatic stress symptoms (PTSS) and symptoms of occupational re-traumatization were compared by reported BT. Bivariable analyses were used. Of the 591 OBGYNs who completed the survey, 180 (30.5%) reported experiencing BT. Ninety-two percent of OBGYNs cared for birthing patients after giving birth. There were no differences in demographic or clinical practice characteristics between those with and without BT. OBGYNs with BT experienced PTSS including flashbacks (60.6% vs 14.4%), amnesia (36.7% vs 20.9%), and insomnia (24.4% vs 1.2%) at higher rates than those without BT (p<0.001). Almost 1/3 of OBGYNs in this sample reported personally experiencing BT, mirroring data from reported BT rates in the general population. Given OBGYNs are at a high risk for occupational re-traumatization, initiatives focused on improving support for birthing OBGYNs upon returning to work should be studied to assess impact on emotional wellness among practicing OBGYNs.

The influence of education on antenatal care and nutrition of newborns in Croatia

Abstract Background Previous studies indicate differences in the nutrition of newborns. Great efforts are invests in public health education of expectant mothers in order to improve the health of their offspring. Methods An analytical study of data on the influence of social factors and the level of education of mothers on the nutrition of newborns, habits of pregnant women and antenatal care in the City of Zagreb was conduct in 2022. The paper shows analytical results expressed in percentages of the prevalence and 95% confidence interval (CI). Results The survey covered 6,358 women giving birth in the City of Zagreb in 2022. Most mothers fed their newborns in the hospital with breast milk (48.6%) or a combination of breast milk and artificial nutrition (45.8%), and only 1.4% with artificial nutrition. The share of mothers who fed their newborns exclusively with breast milk is slightly higher among highly educated women (52.4%). The majority of women had their newborn’s first feeding within one hour (81.4%), also more often in highly educated women. The first breastfeeding is most often ten (10.1%) or 15 minutes after birth (8.2%). Only 1.1% of pregnant women smoked during pregnancy, of which the largest share was women with a high school diploma (62.1%). With the increase in education, the share of women with 5 or less antenatal checks decreases (completed college 3.3%, higher school 4.6%, secondary school 6.6%, primary school 12.7%). The largest share of pregnant women who had their first antenatal examination only after 10 weeks of pregnancy is among women with a high school diploma (11.3%). Conclusions The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement. Key messages • The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. • Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement.

Maternal health in conflict-affected settings: a case study from a frozen conflict zone

Abstract Background Reproductive, maternal, newborn and child health are negatively impacted in conflict-affected settings, and may be acutely affected in frozen conflicts due to fragile health systems and uncertain geopolitical contexts. To better understand maternal health in a frozen conflict zone, we examined maternal health outcomes in Nagorno-Karabakh during a ceasefire period prior to the forced displacement of the entire population. Methods Multistage cluster sampling was used to sample 1023 households in Nagorno-Karabakh during the summer of 2022. From each household, one woman, age 18 to 49, participated in an interviewer-administered survey. Maternal health outcomes were assessed among all married women who had ever given birth. Women with at least one child under 5 years were also asked about their most recent pregnancy. Results Among all married women, 85.5% had ever given birth, 19.0% ever had a miscarriage, and 2.8% ever had a stillbirth. Of the 299 women with at least one child under 5, 97.7% received antenatal care, of which 90.4% had at least 4 visits. Over half experienced toxicosis (51.8%), 16.4% high blood pressure, 13.0% anemia, and 6.4% hemorrhage during their most recent pregnancy. The most common delivery complications were uterine scarring (19.7%), breached birth (7.0%), prolonged labor (6.4%) and hemorrhage (5.7%). Age was found to be a significant factor, with the odds of toxicosis (p = 0.039) and breached birth (p = 0.009) decreasing, yet the odds of miscarriage (p = 0.001) and hypertension (p = 0.007) increasing with age. Conclusions Almost all women reported adequate antenatal care with birth outcomes comparable to global statistics, demonstrating the ability of Nagorno-Karabakh to provide sufficient maternal healthcare while in a frozen conflict. Fortifying and ensuring access to maternal and reproductive healthcare, particularly antenatal care, is vital for ensuring the health and wellbeing of women and children in conflict-affected settings. Key messages • Women in Nagorno-Karabakh received antenatal care and experienced birth outcomes similar to global rates, demonstrating the value of access to reproductive healthcare in conflict-affected settings. • Future studies should examine the impact of forced displacement on the women of Nagorno-Karabakh to better understand the effect of conflict on reproductive and maternal health.

Co-creating the intervention ‘MAMAACT’ for improved care for pregnant migrant women in Denmark

Abstract Background The MAMAACT intervention was developed as a response to documentation of ethnic and social inequities in stillbirth in Denmark, despite free and universal access to antenatal care. The MAMAACT intervention aimed to reduce stillbirth in migrant families by improving communication about pregnancy complication during antenatal care. Methods The intervention consisted of a training program for midwives and health education materials. It was implemented at a structural level (training of midwives) and, through strengthened needs-based communication during antenatal care, the aim was to improve the health literacy of the women. 19 of the 20 Danish maternity wards participated in the study in 2018-19 and a comprehensive evaluation was conducted. The intervention was co-created with midwifery managers, midwives, and migrant women. Results The management and selected clinical midwives participated in the design of the midwifery training and the health education material as well as the intervention’s implementation and recruitment strategies for the evaluation. As representatives of the target group, a partnership with the non-profit organization Bydelsmødre was initiated. Bydelsmødre trains migrant mothers living in socially deprived areas to help vulnerable migrant women. Evening sessions were conducted with a specific group of women in their community, where the intervention components, the recruitment to the evaluation, and the interpretation of evaluation findings were discussed. A significant contribution was a video explaining the migrant experiences of becoming a mother in Denmark used in the midwifery training. MAMAACT researchers were invited to present the evaluation at the annual assembly for Bydelsmødre organization in 2019. Conclusions The partnership with Bydelsmødre provided a strong voice for migrant women, enhancing engagement with the intervention, recruitment for the trial, and its real-world relevance.

Regional disparities and socio-demographic factors associated with eight or more antenatal care visits in Ghana

BackgroundAntenatal care is vital for maternal health and wellbeing, with the World Health Organization recommending a minimum of eight visits during pregnancy. In this study, we examined the regional disparities and factors associated with eight or more antenatal care visits in Ghana.MethodsWe performed a cross-sectional analysis of data from the 2022 Ghana Demographic and Health Survey. Our study comprised 3,893 women of reproductive age with birth history in the last two years before the survey. Regional disparities in the proportion of eight or more antenatal care visits were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was conducted to determine the factors associated with eight or more antenatal care visits using a four-modeled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).ResultsThe prevalence of eight or more antenatal care visits in Ghana was 38.4% [95% CI = 36.0–41.0]. The regions with the highest prevalence were Eastern, Greater Accra, Western, and Volta. Those with the lowest prevalence were Northern, North East, Savannah, and Oti. The odds of eight or more antenatal care visits were lower among women aged 40–49 [aOR = 0.42, 95% CI = 0.18–0.96], women with four or more children [aOR = 0.57, 95% CI = 0.36–0.93], women who wanted pregnancy later [aOR = 0.63, 95% CI = 0.46–0.85], and women in five regions: Western North [aOR = 0.43, 95% CI = 0.19–0.94], Bono [aOR = 0.33, 95% CI = 0.14–0.76], Northern [aOR = 0.29, 95% CI = 0.13–0.66], Savannah [aOR = 0.30, 95% CI = 0.14–0.65] and North East [aOR = 0.33, 95% CI = 0.14–0.75]. Women in the richer [aOR = 1.99, 95% CI = 1.19–3.33] and richest [aOR = 4.82, 95% CI = 2.45–9.51] wealth index showed a higher likelihood of completing eight or more antenatal care visits relative to women in the poorest wealth index.ConclusionA significant proportion of women in Ghana fall short of the recommended eight or more antenatal care visits. Age, parity, desired pregnancy timing, wealth status, and region of residence are associated with the number of antenatal care visits. Women in five regions (Bono, Northern, North East, Savannah, and Western North) are significantly less likely to have eight or more antenatal care visits than those in the Western region. The government and policymakers should design programs to address the needs of older women, those with high parity, and women who want to delay pregnancy. Increased healthcare resources, educational campaigns, and addressing regional barriers to antenatal care access are crucial. Promoting public health initiatives to emphasise the importance of completing the recommended number of antenatal care visits for a healthy pregnancy is essential.

Abortion and Mental Health and Wellbeing: A Contemporary Review of the Literature.

This review discusses the importance of abortion care and access for mental wellbeing for people seeking abortion, abortion providers, and trainees. The recent Dobbs v. Jackson case has jeopardized the physical and mental health of millions. Much of the data regarding mental health impacts of abortion access comes from the Turnaway Study. This study supports that abortion does not cause negative mental health effects and being denied abortion is detrimental to mental health, physical health, and has negative socioeconomic impacts. Other recent studies support that the Dobbs decision continues to disproportionately harm historically marginalized groups. Additionally, there is more anxiety and depression reported in states with abortion restrictions. Many obstetrician gynecologists are moving away from restricted states and report moral distress due to restrictions. Many medical students are choosing not to apply to obstetrics and gynecology residency programs in states with abortion restrictions. Access to abortion care is important for mental and physical health, and socioeconomic well-being for people seeking abortion. Restrictive bans negatively affect people seeking abortion, as well as healthcare providers and trainees.

Trend, prevalence, and associated factors of uterine rupture at Nekemte Specialized Hospital, Oromia Regional State, Western Ethiopia

Maternal morbidity and mortality have long been among the world’s most challenging health issues. Uterine rupture is one of the peripartum complications that kills almost one in every thirteen mothers. However, there is limited evidence on uterine rupture trends, proportions, and determinants. Thus, this study assessed the trend, prevalence, and associated factors of uterine rupture at Nekemte Specialized Hospital, Oromia Regional State, Western Ethiopia. An institution-based cross-sectional study was conducted among 2661 clients selected using a systematic random selection technique among the data collected for the project between January 2014 and December 2022 at Nekemte Specialized Hospital. Data were collected through an interview-administered questionnaire and card review from March 2023 to August 2023. The collected data were checked, coded, and entered into Epi info version 7.2 and then exported to SPSS Version 27 for analysis. Logistic regression models were fitted to identify the factors of uterine rupture. Adjusted odds ratio with 95% Confidence Interval was estimated to measure the strength of the association, and statistical significance was declared at a p-value less than 0.05. The trend of uterine rupture declined from 1.54% in 2014 to 0.93% in 2022. The overall prevalence was 3.53% (95%CI: 2.7%, 4.3%). Low household income (Adjusted OR = 3.75, 95%CI: 1.97, 7.13), grandmultiparity (Adjusted OR = 7.78, 95%CI: 4.70, 12.88), having a history of obstetrics complications such as prolonged labor (Adjusted OR = 3.78, 95%CI:2.11, 6.75), a history of cesarean section (Adjusted OR = 2.49, 95%CI:1.42, 4.35), and history of uterine repair (Adjusted OR = 18.01, 95%CI: 6.81, 47.64) were significantly associated with uterine rupture. This finding showed that the trend is declining, and the proportion of uterine rupture is still higher. A more vigilant approach to increase access to lower-income mothers, prevent prolonged and obstructed labor, and maintain antenatal care with complete packages and a referral system are issues to be addressed to minimize the chance of uterine rupture among women.

Investigation of usage of antenatal care services by Syrian immigrant pregnant women and the frequency of anaemia and hypertension during the pandemic.

During the pandemic period, the use of health services by disadvantaged groups such as immigrants has deteriorated. The study aims to evaluate the use of antenatal care services by Syrian pregnant women during the pandemic. It is a cross-sectional type of study. The population consisted of 495 pregnant women who applied to the Extended Migrant Health Center (EMHC) between August 2020 and December 2022. Demographic data and pregnancy-related health records were examined through the system records, without any contact with the pregnant women. The percentage of pregnant women who had timely follow-up for each antenatal visit were 11.5% (n=56), 17.2% (n=80), 20.0% (n=88), and 17.4% (n=73), respectively. Only 17.7% (n=87) of the pregnant women made the recommended number of visits during their pregnancy period. The recommended number of follow-ups was statistically significantly higher in women with high-risk pregnancies (p=0.045). Of the pregnant women, 27.4% had anaemia and 2.4% had hypertension. The use of antenatal care in immigrant pregnant women is very low. Interventions are needed in this regard. Increasing the utilization of antenatal care services by immigrant pregnant women is extremely important for both the health of the pregnant woman and the health of the baby.

Prevalence of postpartum post-traumatic stress disorder and associated factors among postnatal mothers in West Arsi zone, South West Ethiopia, 2024: a community-based cross-sectional study.

Up to one-third of women globally experience giving birth as traumatic, which can lead to postpartum post-traumatic stress disorder. Postpartum post-traumatic stress disorders have significant health consequences for the mother, child, and other family members. Although it has tragic health impacts, little is known about this problem in the study area. The study aimed to assess the prevalence of postpartum posttraumatic stress disorder and associated factors among postnatal mothers. A community-based cross-sectional study was employed among 635 mothers in the first year after childbirth by using simple random sampling techniques from March 20 to April 20, 2024 in West Arsi zone, Ethiopia. Face-to-face interviewers administered structured questionnaires that were used to collect the data. The collected data were cleaned, coded, and entered into Epidata and exported to Statistical Package for Social Sciences for further analysis. Both bivariate and multivariable analyses were done by using binary logistic regression. Out of 635, 624 postnatal mothers participated in the study, for a response rate of 98.27%. The prevalence of postpartum post-traumatic stress disorder was 21.60% (95% CI: 18.40%, 24.87%). Primiparous mothers (AOR = 2.26, 95% CI: 1.38, 3.70), have no antenatal care follow-up (AOR = 2.48, 95% CI: 1.47, 4.20), cesarean section delivery (AOR = 2.86, 95% CI: 1.50, 5.61), instrumental delivery (AOR = 3.06, 95% CI: 1.75, 5.34), maternal morbidity (AOR = 2.94, 95% CI: 1.71, 5.05), and postpartum intimate partner violence (AOR = 7.43, 95% CI: 4.53, 12.20) were the identified factors. As identified, one out of five mothers had postpartum posttraumatic stress disorder. Thus, healthcare providers should focus on identified factors like cesarean section and instrumental deliveries while counseling, as this enhances the mothers' psychological readiness. In addition, the West Arsi Zonal Health Office should develop effective strategies to alleviate the problem by focusing on the identified factors.

Behavioral incentives on pay-for-performance schemes in primary health care: a scoping review

Abstract Background Incentivizing healthcare professionals through pay-for-performance (P4P) schemes has become an essential strategy to enhance healthcare quality and efficiency. In Portugal, a P4P framework was put in place in Primary Health Care (PHC). Understanding how these incentives influence healthcare delivery is crucial for optimizing P4P effectiveness. Objectives This scoping review aims to compare the impacts of intrinsic and extrinsic incentives of P4P schemes within PHC teams. Methods We are conducting a comprehensive scoping review following the PRISMA-ScR guidelines. The databases PubMed/MEDLINE, Scopus, Web of Science, and PsycINFO are being searched to identify experimental and quasi-experimental studies. Eligible studies focused on PHC providers organized in teams, examining the role of intrinsic and extrinsic incentives under both public and private healthcare settings. Results Preliminary findings include a Dutch study demonstrating significant improvements in adherence to prescribing guidelines through electronic health records based P4P indicator. In Ethiopia, performance-based non-financial incentives led to enhanced data quality and evidence utilization among health workers. Conversely, a study from Burkina Faso highlighted mixed results in antenatal care quality improvement despite incentive implementation. In Scotland, studies on the removal of financial incentives indicated potential declines in certain quality care metrics, suggesting the complexities involved in the direct and indirect effects of incentive withdrawal. Conclusions The preliminary evidence indicates that both intrinsic and extrinsic incentives can significantly impact the effectiveness of P4P schemes, though the nature and magnitude of these impacts vary considerably. The findings underscore the necessity of a nuanced approach to designing and implementing incentive mechanisms in PHC to foster sustainable improvements in healthcare quality. Key messages • Intrinsic and extrinsic incentives significantly influence P4P scheme effectiveness in PHC. • Designing P4P incentives requires nuanced consideration of varying impacts on healthcare quality.

Effects of eHealth literacy on maternal and neonatal outcomes

ABSTRACT eHealth literacy plays a crucial role during pregnancy, as maternal health behavior can influence health outcomes for both mother and child. This study assessed the impact of eHealth literacy on maternal-fetal health outcomes through a cross-sectional analysis of 1,265 pregnant women admitted to a tertiary maternity hospital in Turkey between April and July 2022. Data on sociodemographic information, obstetric variables, birth outcomes, Internet usage, and eHealth Literacy Scale (eHEALS) were collected. Kolmogorov-Smirnov, Mann – Whitney U, Kruskal-Wallis, and Spearman correlation were used for data analysis. The median age of women was 28 years, and the mean gestational age was 38.6 weeks. Median eHealth literacy score was 21 (range:8-40). Pregnant women who had planned pregnancies, received spousal support, attended 9–12 antenatal care visits, received vaccinations, adhered to iron and folic acid supplementation, engaged in regular physical activity, and maintained regular sleep patterns exhibited higher eHealth scores (all p < .001). eHEALS scores were higher in women who experienced normal vaginal deliveries (p < .001), while lower eHEALS scores were noted in those with comorbidities (p = .001). The study suggested that higher eHealth literacy among pregnant women was associated with improved health-promoting behaviors, more favorable health perceptions, increased utilization of health services, and better maternal and fetal outcomes.