Average Monthly Family Income Research Articles

Recolhimento de Esgoto na Área de Proteção Ambiental Vargem das Flores/MG

O presente artigo retrata a destinação final dos efluentes sanitários na Área de Proteção Ambiental (APA) Vargem das Flores, importante região localizada entre os municípios de Betim e Contagem/MG, que abriga diversos exemplares nativos da flora e fauna, além de ser um manancial de abastecimento para a Região Metropolitana de Belo Horizonte (RMBH). Para isto foram analisados dados provenientes do Censo demográfico do Instituto Brasileiro de Geografia e Estatística (IBGE), da Companhia de Saneamento de Minas Gerais (COPASA), do Instituto Mineiro de Gestão das Águas (IGAM) e do Sistema Nacional de Informação sobre Saneamento (SNIS). O cruzamento dos dados permitiu identificar as regiões da APA que não possuem rede oficial de esgoto e sua correlação com o rendimento financeiro médio mensal familiar. Os resultados encontrados evidenciaram que, a contaminação pelo esgoto foi responsável pela queda do Índice de Qualidade da Água (IQA), entre os anos de 2014 e 2015, além do significativo aumento da presença da bactéria Escherichia coli, importante indicativo de contaminação fecal na água.

Analysis of caregiver burden of relative caregivers of multiple myeloma patients and its influencing factors

Objective To investigate the current situation of caregiver burden of relative caregivers of multiple myeloma patients, and to analyze its influencing factors. Methods Cross-section investigation method was used in the study. A total of 125 multiple myeloma patients and their relative caregivers, who accepted treatment in the hematology department of He'nan Provincial People's Hospital from December 2015 to March 2017 were selected by convenience sampling method. The general situation investigation questionnaire, Zarit Caregiver Burden Inventory (ZBI) , Barthel Index (BI) , Social Support Rating Scale (SSRS) and Connor-Davidson Resilience Scale (CD-RISC) were adopted in the investigation. PASW 18.0 software was adopted for statistical analysis of the data. Results The ZBI score of the relative caregivers of multiple myeloma patients was (57.01±15.36) , and 86.4% of the caregivers' scored at a moderate level and over. The differences of ZBI scores of the caregivers with different educational background, family average monthly income, caring time and the different numbers of complications in patients were statistically significant (t/F/H=3.924, 9.656, 8.062, 20.608; P<0.05) . The average score of BI in multiple myeloma patients was (53.56±8.30) , with moderate dysfunction, which was negatively correlated with the total score of ZBI and the scores of its all dimensions (P<0.01) . The average score of SSRS in the caregivers was (48.18±8.53) , with a high level of social support, and the average score of CD-RISC was (64.50±9.41) , the two of which were both negatively correlated with the total score of ZBI and the scores of its all dimensions (P<0.05) . As indicated by the results of multiple linear regression analysis, the complication number and self-care ability of the patients as well as the average monthly family income, caregiving time, social support and mental elasticity of the relative caregivers could be included in the regression equation, which explained 40.1% of the variance. Conclusions The caregiver burden of patients with multiple myeloma is relatively heavy. The complication number and self-care ability of the patients as well as the average monthly family income, caregiving time, social support and mental elasticity of the relative caregivers are the influencing factors of caregiver burden. Key words: Cross-sectional studies; Multiple myeloma; Caregivers; Caregiver burden; Influencing factors

Analysis of Family Functioning and Parent-Child Relationship between Adolescents with Depression and their Parents.

BackgroundDrug therapy combined with family therapy is currently the best treatment for adolescent depression. Nevertheless, family therapy requires an exploration of unresolved problems in the family system, which in practice presents certain difficulties. Previous studies have found that the perceptual differences of family function between parents and children reflect the problems in the family system.AimsTo explore the characteristics and role of family functioning and parent-child relationship between adolescents with depressive disorder and their parents.MethodsThe general information and clinical data of the 93 adolescents with depression were collected. The Family Functioning Assessment Scale and Parent-child Relationship Scale were used to assess adolescents with depressive disorder and their parents.Resultsa) The dimensions of family functioning in adolescents with depressive disorder were more negative in communication, emotional response, emotional involvement, roles, and overall functioning than their parents. The differences were statistically significant. Parent-child relationship dimensions: the closeness and parent-child total scores were more negative compared with the parents and the differences were statistically significant. b) All dimensions of parent-child relationship and family functioning in adolescents with depression except the time spent together were negatively correlated or significantly negatively correlated. c) The results of multivariate regression analysis showed: the characteristics of family functioning, emotional involvement, emotional response, family structure, and income of the adolescents with depressive disorder mainly affected the parent-child relationship.ConclusionsThere were perceptual differences in partial family functioning and parent-child relationship between adolescents with depressive disorder and their parents. Unclear roles between family members, mutual entanglement, too much or too little emotional investment, negligence of inner feelings, parental divorce, and low average monthly family income were the main factors causing adverse parent-child relationship. These perceptual differences have a relatively good predictive effect on family problems, and can be used as an important guide for exploring the family relationship in family therapy.

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. The mean score of parents' care burden overall was 37.74±16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR=37.500, 95% CI=4.515-311.348, P=0.001). The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

Health Problems of Elderly Patients attending Combined Military Hospital, Dhaka

Introduction: Health problems of elderly are an emerging health burden throughout the world. Bangladesh is currently undergoing a demographic transition and the proportion of the population of 60 years and older is increasing rapidly. Health care providers and policymakers are highly concerned with this burning issue.&#x0D; Objective: To know the disease pattern among the elderly patients in Combined Military Hospital, Dhaka.&#x0D; Materials and Methods: This cross-sectional study was carried out from July 2015 to June 2016 among 152 elderly patients above 60 years of age admitted in Combined Military Hospital (CMH), Dhaka Cantonment. Data were collected by face-to-face interview with semi-structured questionnaire and checklist following purposive sampling technique. Analysis of data was done by Statistical Package for Social Science (SPSS, version 20.0).&#x0D; Results: Mean age of the elderly was 72.06±4.56 years with the range of 60-80 years and majority (90.8%) of the elderly was male. Out of total 152 elderly patients, by occupation majority (31.6%) were in the business group followed by 30.3% in the retired group and 9.2 % in the housewife group. Average monthly family income was BDT 17927.63±7360.75 with the range of BDT 6000-35000. With initial complaints elderly patients reported to doctors in private chamber (38.2%), private hospital (25.6%) and Govt hospital (5.9%). Among all of the elderly patients, majority (21.1%) had Diabetes Mellitus followed by Rheumatoid Arthritis (17.6%), Asthma (12.5%), Cataract (11.2%), ENT problem (6.6%), Malignancy (5.9%) and Benign Enlargement of Prostate 8(5.3%).&#x0D; Conclusion: The number of elderly people is expanding rapidly; it also presents multifaceted health problems and thus creates unique challenges for the national healthcareservices. Early identification of problem and ensuring the availability of health with economic and social support can have a control over the elderly health problems.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 8-12

Socio-demographic Characteristics and Related Factors Affecting Children with Autism Spectrum Disorder

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social deficits, communicative difficulties and repetitive behaviors, with evidence of cognitive dysfunction. Approximately 1% of the world’s population or 67 million are affected by autism. ASD is an emerging public health issue globally which is associated with a huge burden on the family, community and the nation.&#x0D; Objective: To determine the socio-demographic characteristics and related factors affecting children with ASD to help the government and relevant organizations to take necessary steps to reduce burden of the families.&#x0D; Materials and Methods: This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique.&#x0D; Results: Majority (73.4%) of the children were male and mean (±SD) age was 6.66±2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Majority of the fathers (45.5%) and mothers (31.8%) had 'masters level'of education. Maximum (68.2%) children were from nuclear family and a few (9.1%) parents had a history of consanguineous marriage. Most (96.8%) of the children were initially treated by specialist doctors whereas, the majority (74.0%) were diagnosed in government hospitals. Most (89.6%) of the children were treated withspeech therapy.&#x0D; Conclusion: Since ASD is a growing public health problem in Bangladesh, countrywide proper early diagnostic facilities, especially in peri-urban and rural areas, should be available to measure its actual burden in the country.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 56-61

Knowledge, attitude, practices and their associated factors towards diabetes mellitus among non diabetes community members of Bale Zone administrative towns, South East Ethiopia. A cross-sectional study.

BackgroundDiabetes kills more than 4.9 million adults per year. It becomes rapidly increasing, non-communicable disease—a major threat to global public health particularly in Sub-Saharan Africa. Though previous studies among diabetic patients were focused in health institution, limited knowledge, attitude and practice were seen. There is no study conducted about diabetes related to knowledge, attitudes, practice and associated factors in the community level.Objective of the studyThe study assessed knowledge, attitude, practices, and its associated factors towards diabetes mellitus among non diabetic community members of Bale Zone, Ethiopia.MethodsCommunity based cross-sectional study was conducted from November 15 to December 15, 2015 among 605 non diabetic community members of Bale Zone administrative towns. Data was collected using pretested structured face-to-face interview after taking informed written consent. Respondents were selected by systematic random sampling. The data was entered into EPI data version 3.1 and analyzed using Statistical package for social sciences version 20. Odds ratio and 95% confidence interval were calculated and P<0.05 was considered statistically significant. Finally, multivariable logistic regression analysis was performed to indicate the independent predictors of knowledge, attitude and practice.ResultResponse rate of the study was 98.2%. About 52.5% of participants were knowledgeable, 55.9% and 56.6% had good attitude and practice respectively. Earning average monthly family income of ≤500 Ethiopian birr (AOR = 0.4, CI = 0.2, 0.6) and 501–1000 (AOR = 0.4, CI = 0.2, 0.7), heard about diabetes (AOR = 4.4, CI = 1.9, 10.2), had diabetes health education exposure (AOR = 5, CI = 2.5, 9.7) resulted to have good diabetes knowledge. Student, (AOR = 5.1, CI = 2.1,12), government/private employee (AOR = 3,CI = 1.4,6.7), merchant (AOR = 2,CI = 1.1,3.6) and Knowledgeable (AOR = 3, CI = 2.1, 4.7) subjects had positive attitude towards diabetes. Having college and above educational level (AOR = 0.33, CI = 0.16, 0.7), having good attitude towards diabetes (AOR = 2, CI = 1.3, 3) had good practiced.ConclusionConsiderable limited knowledge, attitude and practices were seen. A great emphasis on health education regarding symptoms and risk factors modification for diabetes are necessary.

Socio-demographic Characteristics and Behavioural Risk Factors in Selected Tribal Community in Bangladesh

Tribal and minority populations are increasingly exposed to risk factors as a result of urbanization. The study was conducted in the Rakhain community in Cox's Bazar district, Bangladesh, with the aims of determining the socio-demographic characteristics and behavioural risk factors. This cross-sectional study was done among 287 Rakhain individuals. Data were collected by face to face interview using pretested structured questionnaire. More than one third respondents were from the age group of 35-44 years. Their mean age was 40.66 (±11.275) years. Majority of the respondents were male 148(52%), married 222(77.4%) and educated up to primary level 179(62.4%). The highest proportion 68(23.7%) of the respondents were housewife and day laborer and lowest were unemployed 26(9.1%). Their average monthly family income were 17874.56 (±7208.553) Taka. Statistically significant association were found between their smoking status and socio-demographic characteristics (p &lt;0.001). The high burden of behavioral risk factors in Rakhain community was observed in the present study.&#x0D; CBMJ 2016 January: Vol. 05 No. 01 P: 04-08

Are Free Maternity Services Completely Free of Costs?

ObjectivesThe Government of Nepal revised free maternity health services, “Aama Surakshya Karyakram”, beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services. MethodsBetween August 2014 and December 2014, a hospital-based cross-sectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire. ResultsThe average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2−19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively. ConclusionThe free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during the hospital stay and at discharge time. Similarly, arrangements for liquid, food, and hot water, as well as clothes for mothers and newborns, should be made by the hospital in order to enhance hospital attendance.

Reproductive Characteristics and Nutritional Status of Coastal Women

Women are more vulnerable in health and family planning and this vulnerability is more in–depth in coastal area. The study was done to determine the reproductive characteristics and nutritional status of women in coastal area. It was conducted in Moheshkhali upazila of Cox’s Bazar district in 2013 among 220 purposively selected coastal women of reproductive age. Face to face interview was done through pretested questionnaire. Average age of the respondents was 26.5 years. Almost 60% of them were Muslims and 44% were illiterate. The average monthly family income and family size was Tk-6968.18 and 5.8 respectively. More than half (56%) of the respondents had history of regular use of contraceptives and oral pill was the most common type of contraceptive. Average number of children was 2.95. More than half of them (54%) had history of home delivery. More than one-third (34%) of them were under nourished. Nutritional status was significantly associated with income (p&lt;0.05). Majority of them got early marriage (70%) but early marriage was not significantly associated with their nutritional status. Age at first pregnancy and parity of the respondents were in significant state with the nutritional status of women of coastal area (p&lt;0.05). Socio-demographic disparity should be reduced to improve the nutritional status by improving the reproductive health of coastal women. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22881 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 38-41

The Association between Psycho-Socio-Demographic Factors and Substance Abuse in Iranian Male Bodybuilders

Background: This study was conducted to investigate the association between psycho-socio-demographic factors and substance abuse in Iranian male bodybuilders. Material and methods: 906 male bodybuilders from 103 randomly selected gymnasia in Tehran participated in this research. By interviews via questionnaires, the following data over age, employment, average monthly family income, family size, gymnasium area (m2), number of trainers, number of gymnasium members, initiation time (months), weekly duration of sporting activity (hours), monthly cost of sporting activity, purpose of participating in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of substance abuse were collected. Results: All samples were male bodybuilders within the age range of 14 to 56 years (25/7+/-7/1). Substance abuse was reported in 140 (15/5%) of the subjects. Amphetamine was reported as the most commonly-used illicit drug (13/2%). Monthly family income, number of family members, enhancement of self-esteem, maintaining fitness, and satisfaction over body parts were associated with substance abuse. Conclusion: Some psycho-socio-demographic factors including family income, family size, enhancement of self-esteem, maintaining fitness, and satisfaction over body parts were associated with substance abuse among male bodybuilders.

Economic Burden of Head Injury Patients Attending a Tertiary Level Hospital in a Developing Country Like Bangladesh

Objective: Objective of the study was to estimate the economic burden of head injury (HI) patients attending a tertiary level hospital. This study also tried to determine the socio-demographic characteristics, to estimate direct and indirect cost incurred by the head injury patients and to assess economic burden by different types of accidents causing head injury.&#x0D; Methods:The study was a cross-sectional descriptive study carried out to estimate the economic burden of head injury patients attending a tertiary level hospital during the period from January to June 2010, conducted at the neurosurgery department of Dhaka Medical College Hospital (DMCH). All the conscious head injury patients of both sexes, treated in Neurosurgery department of DMCH, willing to participate in the study were included in the study. Convenience type of non-probability sampling technique was followed and sample size of this study was 110. Face to face interview was conducted with the patient and / or attendant for data collection and specific pre-designed semi-structured and pre-tested questionnaire was used for the interview session. After Categorizing, coding, cleaning and summarizing, all data were analyzed by the software SPSS windows program version 12.0.&#x0D; Result: More than half (53.6%) of the patients of this study, were in younger age group (21 to 30 years) with mean (±SD) age of 29.1(±8.36) years. Majority of the patients (69.0%) were males, Average monthly family income of the patients was Tk.14,509.09 (±5762.49). Majority (36.4%) of the patients had primary level education while 20.9% were housewives. Major incidences of different types of accidents included road traffic accident (63.6%), assault (20.0%), industrial accident (8.0%) and fall from height (8.0%). Average length of the stay of the patients in the hospital was 7.43 (±3.64) days. In respect of direct cost, average travel cost incurred by the patients was Tk.3,628.18 (±2055.56), average drug cost was Tk.1,618 (±801.51), average laboratory investigation cost was Tk.2390 (±626.47) and average cost of food was Tk.2235.45 (±1208.19). Average direct treatment cost incurred by the patients was Tk.9590.10 (±4041.13). The average duration of absent from work place was 7.07 (±3.316) days and most of the patients average daily income (self) was Tk.340.65 (±158.97). Average loss of income due to illness was Tk.2415.32(±1623.68) and average cost behind giving tips to hospital staff by the patients was Tk.221.50 (±78.34). The average indirect cost of these study patients was Tk.2001.72 (±1869.27). Overall, average treatment cost incurred by the patients was Tk.12,008.05 (±5051.95). Majority (38.0%) had a cost from Tk10001 to Tk.15000.&#x0D; Conclusion: The study finding can help policy makers, public health specialists, future researchers and enthusiastic individuals to formulate specific strategies for reduction of economic burden of head injury patients by providing cost-effective health care services throughout the country.&#x0D; Bangladesh Journal of Neuroscience 2014; Vol. 30 (2): 104-111

Satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town, Jimma zone, South West Ethiopia; a facility based cross-sectional study triangulated with qualitative study

BackgroundClient satisfaction is essential for further improvement of quality of focused antenatal care and to provide uniform health care services for pregnant women. However, studies on level of client satisfaction with focused antenatal care and associated factors are lacking. So, the purpose of this study is to assess satisfaction with focused antenatal care service and associated factors among pregnant women attending focused antenatal care at health centers in Jimma town.MethodsA facility based cross-sectional study involving both qualitative and quantitative methods of data collection was used from Feb 1-30/2013. Three hundred eighty nine pregnant women those come to the health centers were included in the study. A semi-structured questionnaire and focus group discussion guide was employed to obtain the necessary information for this study. Quantitative data was analysed using SPSS for windows version 16.0. Logistic regression model was used to compare level of satisfaction by predictors’ variables. Qualitative data was analyzed based on thematic frameworks to support the quantitative results.ResultMore than half of the respondents (60.4%) were satisfied with the service that they received. As to specific components, most of the respondents (80.7%) were satisfied with interpersonal aspects, and 62.2% were satisfied with organization of health care aspect. Meanwhile, 49.9% of the respondents were not satisfied with technical quality aspect and 67.1% were not satisfied with physical environment aspect. Multivariate logistic regression analysis result showed that type of health center, educational status of mother, monthly income of the family, type of pregnancy and history of stillbirth were the predictors of the level of satisfaction. The study found out that dissatisfaction was high in mothers utilizing service at Jimma health center, in mothers with tertiary educational level, in mothers with average monthly family income >1000birr, in mothers with unplanned pregnancy and in mothers with history of stillbirth.ConclusionsEven though greater percentages of women (60.4%) were satisfied with the focused antenatal care service, the level of satisfaction was lower compared to other studies. The investigator recommends that patient feedback should be recognized as a legitimate method of evaluating health services in the health center as a whole.

A study on palmyrah (Borasus fJabellifer) utilization pattern and socioeconomic status of dependent livelihood in Mannar district of Sri Lanka

Tha palrnyrah palm (Borassusflcbelhjer L) is a multipurpose tree of great util ity, occurs extens. velyin Northern and Eastern part of Sri Lz!'b. This tree engages human labour in the industries around itirrespecti ve of t;ewkr or age. Th is survey was carried )1". to study utilization pattern of palrnyrah treeand assess the socioeconomic parameters of ra-i.iomly selected 60 families registered in five cooperativesocieties of Mannar c1i,tJict.Th:5 study revealed 1hat 93 % ormales and 7 % otfemales entirely engaged ill this industry with th-.average of 1.2 persors from each farr.ily. The average monthly family income of study populationwas RS 11320 ± 3! 8 ['J;Jees, C'JIY&gt;~5l r-Ier hizher i'1CJp..c.. 6r('L'P. When cornpa '116the family incomewith the average 1'('I)\ehold nU1Jl~er cf 5.8 ± I.l ~Ic,'(·1 Inadequacy to meetpresent expend lure.Further more, study showed that these famines did not show much interest on children education andmost cf youngsters leave school before sitting General Certificate of Education Ordinary Levelexamination. 58 % of families were living in small c r medium size cottage made up of timber andpalrnyrah leaves as roofing material.Tapping of mat ere tree was main source ofi!1C01'1e. One male tapped 14 ± 2.7 trees per day with theaverage of 8 ± 1.2 liter of toddy per tree. They did not produce sweet toddy (unfermented s-ip)because orlow demand. They normally market toddy (fermented sap) to their customers for drinking,co-operative society under palrnyrah development board and for vinegar production. The price oftoddy also varied from RS 6 to 20,00 rupees depending on quality. Apart from that, most of thetappers had to travel about 3 krn out of co-operative boundary for tapping and selling their product.During off season ":~d free time, they do timber carving, animal raring and palrnyrah tuber production.Women did not actively engage ill this industry except few workers in coir factory. Based on this study, it is concluded that this industry provides vast opportunity for further exploiting labour force inrespect to production of beverage, sugar, alcohol, fibre, fuel wood, timber and row materials forhandicrafts. As well as this study clearly stated that implementing innovative technologies with productdiversification and opening new market channels are the necessary pre requisite of this industry infuture.

Determinants of maternal health care utilization in Holeta town, central Ethiopia

BackgroundIn developing countries a large number of women are dying due to factors related to pregnancy and child birth. Implementing and assuring utilization of maternal health care services is potentially one of the most effective health interventions for preventing maternal morbidity and mortality. However, in Ethiopia the utilization of maternal health care is low.MethodsA cross-sectional study was conducted from January 20 to February 20, 2012 in Holeta town, central Ethiopia, to assess the determinants of maternal health care utilization among women who had given birth in the past three years prior to the survey. Structured questionnaire and focus group discussion guides were used for data collection. Data were collected from a sample of 422 women in the town. Descriptive, bivariate and multivariate logistic regression analyses were conducted. Statistical tests were done at a level of significance of p < 0.05.ResultsThe study revealed that 87% of the women had at least one antenatal visit during their last pregnancy. Among the antenatal service users, 33.7% had less than four antenatal visits. More than half of the antenatal care (ANC) attendants made their first visit during their second and third trimester of pregnancy although WHO recommended ANC should be started at the first trimester of the pregnancy. There was a significant association (P<0.05) between ANC attendance and some demographic, socio-economic and health related factors (age at last birth, literacy status of women, average monthly family income, media exposure, attitude towards pregnancy, knowledge on danger signs of pregnancy and presence of husband approval on ANC). The study also revealed that about 61.6% of the women had given birth in the health institutions. Parity, literacy status of women, average monthly family income, media exposure, decision where to give birth, perception of distance to health institutions (HI) and ANC attendance were found to be significantly associated (P<0.05) with delivery care (DC) attendance.ConclusionsThe utilization of ANC and DC service is inadequate in the town. The utilization of ANC and DC were influenced by demographic, socio-economic and health related factors. Improving the status of women by expanding educational opportunities, strengthening promotion of antenatal and delivery care by enhancing community awareness about the importance of ANC and DC are recommended.

Expenditure on Emergency Obstetric Care in a Federal Tertiary Institution in Nigeria

Background: Emergency obstetric care services form an integral part of the strategies for the prevention of maternal morbidity and mortality. Access is sometimes hindered by cost. This study was designed to investigate expenditure on inpatient care for obstetric emergencies. Materials: A total of 138 postpartum women attended to over a 3-month period were interviewed using a structured questionnaire. SPSS 16.0 computer package was used to analyse the data. Method: It was a cross-sectional study conducted at Federal Medical Centre, Birnin-Kebbi, Nigeria. Data on sociodemographic characteristics and expenditure on various aspects of care for the obstetric emergency was obtained from respondents and their husbands. Results: Mean age of respondents was 25.6yrs (range 14-45 yrs). Most were multiparous (65.9%, N=92) and had received no antenatal care (89.9%, N=124). Majority of them were not engaged in any income generating activity (52.9%, N=73). Average monthly family income was about N13’000 (USD 81.3). Major complications managed were prolonged/obstructed labour (31.2%, N=43), obstetric haemorrhages (26%, N=36), and eclampsia (21.7%, N=30). Average length of hospital stay was about nine days. A total of 70 women (50.7%) had an operative delivery. Mean total expenditure on care was about N39’000 (243.8 USD) (maximum N 98’000, 616.4 USD); many of the patients (46.7% N=67) had spent more than this average on care, and it was more than the monthly income of 94.4% (N=131) of families studied. Only 32.8% of the respondents could comfortably afford any expenditure that was greater than N20’000 (123.5 USD). Conclusion: Expenditure on maternity care in this study was high, and it was more than the average monthly income for most families studied. ‘Free maternity care’ programmes should be guided by available data on expenditure on care in order to make appropriate budgetary provisions if a reduction in maternal mortality is to be achieved.

O012 FACILITY BASED MATERNAL DEATH REVIEWS IN MALAWI: A REVIEW OF CAUSES OF DEATH AND CONTRIBUTORY FACTORS

were studied using a structured questionnaire. Analysis was by SPSS 16.0 computer package. Methods: It was a cross-sectional study conducted at Federal Medical Centre, Birnin-Kebbi, Nigeria. Using a structured questionnaire data were obtained on socio-demographic characteristics and expenditure on various aspects of care for the obstetric emergency from respondents and their husbands. Results: Mean age of respondents was 25.8yrs (range 14–45 yrs). Most of the patients had no antenatal care (86.7%, N=124) and were multiparous women (65.1%, N=93). Majority were not engaged in any income generating activity (53.1%, 76). Average monthly family income was about N13’000 (USD81.3). Complications managed were prolonged and/obstructed labour (23.1%, N=33), obstetric haemorrhages (21%), N =30), eclampsia (16.1%, N=23). Reasons for hospital presentation were mainly ‘labour too long’, heavy bleeding, and fitting in 30.1%, 23.8%, and 11.2% of respondents respectively, average length of hospital stay was about 9 days. A total of 42% (N=60) had an operative delivery. 62.2% (N=89) had visited one or more health facility prior to presentation thus adding to the cost of care. Mean total expenditure on care was about N39’000 (243.8USD) (maximum N 98’000, 608.7 USD); many of the patients (46.7% N=67) had spent more than this average on care, and it was more than the monthly income of 94.4% (N=135) of families studied. Mean expenditure on care was significantly higher for victims who had had surgery compared to those who had not, (c =33.2, p < 0.05). Only 32.8% of the respondent said they could comfortably afford any expenditure that was greater than N20’000 (123.5USD). Conclusions: The expenditure on maternity care in this study was high and it was more than the average monthly income for most families studied. The ‘free maternity care’ programme should take into consideration these spendings on some aspects of emergency obstetric care and budget appropriately if a reduction in maternal mortality is to be achieved.

Amphetamine use and its associated factors in body builders: a study from Tehran, Iran

IntroductionEpidemiological studies on all types of illicit drug use among athletes are essential for both the sport community and drug control achievements. Here, we investigated the prevalence and associated factors of amphetamine use in body builders in Tehran, Iran, 2007.Material and methodsThis study is a secondary analysis of a substance use survey done in 103 randomly selected gymnasia in Tehran (capital city of Iran). The survey was conducted from November 2007 to January 2008 and included 843 randomly selected bodybuilders (aged 40 years or less). By interviews via questionnaires the following data were obtained: age, job, marital status, education level, housing status, average monthly family income, number of family members, gymnasium area (m2), number of trainers, number of gymnasium members, initiation time (months), weekly duration of the sporting activity (h), monthly cost of the sporting activity, purpose of participating in sporting activity, and history of anabolic steroid and amphetamine use.ResultsOne hundred twenty (13.3%) body builders reported a history of amphetamine use. According to the results of regression analysis, being married (risk ratio – RR = 0.540), and participating in body building to enhance self-esteem (RR = 0.423) or to enhance sport performance (RR = 0.545) had protective effects on amphetamine use. However, having university qualifications (RR = 1.843), using anabolic steroids (RR = 1.803) and participating in sport to maintain fitness (RR = 2.472) were linked to increased risk of amphetamine use.ConclusionsWell-educated bodybuilders were more likely to use amphetamines, and why this is so needs to be discovered. If further studies show that they are not aware of the dangers associated with amphetamine use, providing them with information should be considered.

Factors associated with health-related quality of life among Belgrade University students

The aims of the study were to evaluate health-related quality of life (HRQoL) among students of University of Belgrade (Serbia) and to identify factors that might have associated with their HRQoL including relationship with depression. Between April and June, 2009, 1624 students were enrolled in the cross-sectional study. HRQoL was assessed by using SF-36 questionnaire and general depressive status by Beck Depression Inventory (BDI). In statistical analysis, ANOVA (Bonferroni adjustment), χ(2) test, and correlation analysis were performed. In our study, the highest SF-36 scale score was obtained for Physical Functioning. All SF-36 domains significantly (P < 0.01) negatively correlated with BDI. Students of medical sciences had the lowest scores in almost all SF-36 domains. Students who lived with parents had statistically significantly higher scores of majority of SF-36 domains. The total SF-36 score significantly correlated with average monthly family income (P = 0.002). Smokers and non-smokers significantly differed in the total SF-36 score (P = 0.001). Based on the comparison across the physical activity categories, there is a clear pattern of differences in the total SF-36 scores (P = 0.001). Our findings indicate that multiple factors are adversely associated with students' HRQoL. Appropriate health education programs to target modifiable risk factors may improve students' HRQoL.

Correlates of the immunization status of children in an urban slum of Delhi

Background: This was a community-based, observational, cross-sectional study to determine the immunization status of children living in slums in the 26 blocks of Sangam Vihar and 4 blocks of Tigri extension area of South Delhi, India. Study Population: A total of 210 children between 12 and 23 months old. Sampling Technique: 30 cluster technique approved by the World Health Organization. Primary Outcome Measures: Immunization coverage by sex, religion, type of family, occupational status of the head of the family, stated average monthly family income, and education status of the mothers. Data collection procedure: Interview technique; principal investigator Dr. Imteyaz Ahmad collected the data using a standardized structured interview schedule with the mother/caregivers of children 12 to 23 months old after permission to conduct the study was taken from the civic authority of the local government. Record analysis of antenatal care for tetanus immunization by antenatal cards and BCG scar survey by observation of scar arm in the deltoid region for scar was also done by him. Results: One hundred and six (50.4%) children in our sample were found to be fully immunized, 88(41.9%) partially immunized and 16 (7.6%) were not immunized. Amongst these associations the difference of coverage by occupation groups and mothers education were found to be statistically significant. Conclusion: There was a discernable bias in favour of male children, Hindu children, children of nuclear family, children of non manual labour occupation parents, children from higher income family and children with mothers having high school or higher level education.