Mother And Child Health Research Articles

Exploring Adolescent Pregnancy Expectations in Continuity of Midwifery Care: A Qualitative Study in Indonesia

Introduction: Adolescent pregnancy presents a significant challenge to global reproductive health, including in Indonesia. The unique obstacles that young pregnant women encounter when seeking appropriate and supportive healthcare services call for a deeper understanding to improve maternal care. Purpose: This study aims to explore the expectations of young pregnant women regarding continuous midwifery care in Indonesia. Method: This research employed an exploratory qualitative approach, conducting 13 face-to-face interviews between January and June 2022. Participants included midwives, young mothers, a coordinating midwife, and Mother and Child Health (MCH) program holders. Interviews, lasting 1-1.5 hours, were conducted, and the interview data were rigorously analyzed thematically by the research team, strengthening data reliability through triangulation. Results: Continuity management emphasizes friendly service, privacy, clear communication, and comprehensive health assessments. Informational continuity involves comprehensive information, direct communication, attractive aids, and health education evaluation. Relational continuity highlights comprehensive maternal care, family tradition approval, reminders, and efficient care. The study underscores the importance of tailored, holistic, and culturally sensitive midwifery care for young pregnant women's overall well-being. Conclusion: This study highlights adolescent pregnant women's unique needs, focusing on continuity management, informational continuity, and relational continuity. Proposed strategies include tailored health services, comprehensive maternal education, cultural sensitivity training for healthcare providers, policy integration, and diverse research. Successfully implementing these measures can significantly enhance maternal care outcomes for Indonesian adolescents.

Assessment of gestational age at antenatal care visits among Kenyan women to inform delivery of a maternal respiratory syncytial virus (RSV) vaccine in low- and middle-income countries.

Background: Maternal respiratory syncytial virus (RSV) vaccines that are likely to be implementable in low- and middle-income countries (LMICs) are in final stages of clinical trials. Data on the number of women presenting for antenatal care (ANC) per day and proportion attending within the proposed gestational window for vaccine delivery, is a prerequisite to guide development of vaccine vial size and inform vaccine uptake in this setting. Methods: We undertook administrative review and abstraction of ANC attendance records from 2019 registers of 24 selected health facilities, stratified by the level of care, from Kilifi, Siaya and Nairobi counties in Kenya. Additional data were obtained from Mother and Child Health (MCH) booklets of women in each of the Health and Demographic Surveillance System (HDSS) areas of Kilifi, Nairobi and Siaya. Data analysis involved descriptive summaries of the number (mean, median) and proportion of women attending ANC within the gestational window period of 28-32 weeks and 24-36 weeks. Results: A total of 62,153 ANC records were abstracted, 33,872 from Kilifi, 19,438 from Siaya and 8,943 from Nairobi Counties. The median (Interquartile range, IQR) number of women attending ANC per day at a gestational age window of 28-32 and 24-36 weeks, respectively, were: 4 (2-6) and 7 (4-12) in dispensaries, 5 (2-9) and 10 (4-19) in health centres and 6 (4-11) and 16 (10-26) in county referral hospitals. In the HDSS areas of Kilifi, Siaya and Nairobi, pregnant women attending at least one ANC visit, within a window of 28-32 weeks, were: 77% (360/470), 75% (590/791) and 67% (547/821), respectively. Conclusions: About 70% of pregnant women across three distinct geographical regions in Kenya, attend ANC within 28-32 weeks of gestation. A multidose vial size with about five doses per vial, approximates daily ANC attendance and would not incur possible wastage in similar settings.

Factors influencing men’s involvement in maternal and child health: men’s experiences and religious leader’s support in Central Java, Indonesia

Background: The maternal mortality rate is still high in Indonesia and has not significantly decreased, including in Central Java. One indirect cause of maternal death is low husband involvement in improving mother and child health (MCH). This is due to cultural barriers and a lack of knowledge about the MCH problems. Therefore, this research aims to examine the significant factors influencing men’s involvement in MCH. We recommend an appropriate intervention model to engage them in MCH, primarily for their families and communities.

Validity test of pre-screening developmental questionnaire (PDQ) and mother and child health (MCH) handbook for determining children's readiness to enter elementary school

Introduction: Many experts have tried to invent appropriate measures for deciding children’s school readiness, one of which is the Nijmeegse Schoolbekwaamheids Test (NST). Unfortunately, it conveys several troubles such as being time-consuming, expensive, and uncomfortable for children. Meanwhile, the majority of parents have been accustomed to the pre-screening developmental questionnaire (PDQ) and mother and child health (MCH) handbook to monitor their children's development. The present study aimed to examine the PDQ and MCH handbook’s validity for determining children’s readiness to enter elementary school based on sensitivity, specificity, positive predictive value, and negative predictive value. Methods: The study used a descriptive-observational research approach with a cross-sectional research design conducted from March to May 2022. Data were obtained from the completed PDQ, MCH handbook, and NST forms. The data were analyzed using the Chi-squared test to contrast the results of sensitivity, specificity, positive predictive value, and negative predictive value between variables to reveal whether the PDQ and MCH handbook were valid to be used besides the NST. Results: There was a relationship between children’s readiness to enter elementary school based on PDQ and NST (p < .05) and the MCH handbook and NST (p < .05). The sensitivity of children’s readiness to enter elementary school based on PDQ was 96.2% with the specificity of 50%, the positive predictive value of 96.2%, and the negative predictive value of 50%. Moreover, the sensitivity of children’s readiness to enter elementary school based on the MCH handbook was 80% with a specificity of 75%, a positive predictive value of 97.7%, and a negative predictive value of 23.1%. Conclusion: The PDQ and MCH handbook can help Indonesian parents define their children’s readiness to enter elementary school as it is more reachable and applicable.

The Determinants of Stunting Incidence in Children Aged 24-59 Months

Majene Regency has the second highest prevalence of stunting in West Sulawesi by having the highest number of cases found in the village of Rangas. Due to these reasons, it is necessary to research the determinants of stunting, so the studies are expected to provide input to the Majene district government in conducting interventions related to stunting. A case-control study design was used. The subjects were the children aged 12-59 months who lived in the Rangas Village which the children under five years diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. Meanwhile, the controls were children under five years who had not been diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. The samples were 72 respondents with a ratio of 1:1, and the under-five children's mothers as the research respondents. Purposive sampling was used. The stunting data was obtained from the health office, while the identity of the respondents, the characteristics of the mothers, and the characteristics of the children under five years were carried out directly by interview using a questionnaire and strengthened by Mother and Child Health (MCH) Book. Data analysis used the chi-Square test and multiple logistic regression tests. Multivariate analysis results showed that the incidence of stunting was influenced by several factors, including parity (OR=30.40; 95%CI: 3.86-239.43), Maternal Mid-Upper Arm Circumference (MUAC) history < 23.5 cm during pregnancy (OR=2.41; 95%CI: 1.04-5.56) and not exclusive breastfeeding (OR=3.21; 95%CI: 1.29-7.94). The conclusion of this study is parity, a history of maternal MUAC during pregnancy, and not exclusive breastfeeding are risk factors for stunting in children under five years in Banggai District. Therefore, it is necessary to improvement of health promotion strategy for pregnant women by maximizing the first 1000 days of life and campaign two healthy children needs to be maximized.

Mother and Child Health (MCH) Book Increasing Mother's Knowledge About Breast Milk Complementary Food (MP-ASI)

Background: In accordance with the Technical Guidelines for the Use of the MCH Handbook (Kemenkes, 2016), mothers of children under five are expected to understand and use the MCH handbook as a guide in caring for maternal and child health, and always strive to obtain health services according to standards as stated in the MCH handbook. Mothers of toddlers can use the MCH handbook for daily care of toddlers, including by utilizing information on how to feed according to the age of toddlers, how to care for children when they are sick, how to stimulate growth and development of toddlers, also being able to monitor the nutritional status of toddlers at any time after getting measurements. nutritional status both in posyandu and other health facilities.
 Methods: The research is Quasy Experimental Design with One Group Pretest Posttest Design and purposive sampling technique as many as 35 respondents. The research instrument used a questionnaire
 sheet. Data analysis using Wilcoxon test.
 Results: There was a significant difference between before and after health Education with KIA Book of mothers knowledge about complementary foods with a p-value of 0.000 less than 0.05
 Conclusion: Health education with KIA Book about complementary food can be carried out routinely so that mothers understand better and can be practiced at home.

Posyandu Application in Indonesia: From Health Informatics Data Quality Bridging Bottom-Up and Top-Down Policy Implementation

The community’s mother and child health (MCH) and nutrition problems can be overcome through evidence-based health policy. Posyandu is an implementation of community empowerment in health promotion strategies. The iPosyandu application (app) is one of the health informatics tools, in which data quality should be considered before any Posyandu health interventions are made. This study aims to describe and assess differences in data quality based on the dimensions (completeness, accuracy, and consistency) of the secondary data collected from the app in Purwakarta Regency in 2019–2021. Obstacles and suggestions for improving its implementation were explored. This research applies a mixed-method explanatory approach. Data completeness was identified as the number of reported visits of children under five per year. Data accuracy was analyzed using WHO Z-score anthropometry and implausible Z-score values. Data consistency was measured using Cronbach’s alpha coefficient, followed by qualitative research with focus group discussions, in-depth interviews, and field observation notes. The quantitative study results found that some of the data were of good quality. The qualitative research identified the obstacles experienced using the iPosyandu app, one of them being that there were no regulations governing the use of iPosyandu to bridge the needs of the government, and provided suggestions from the field to improve its implementation.

Body weight at 1.5- and 3-year health checks and body fat at 14 years of age: a population-based retrospective cohort study using dual-energy X-ray absorptiometry

BackgroundIn Japan, height and weight measurements, taken for all children at birth and 1.5- and 3-year health checks, are recorded in the Mother and Child Health (MCH) Handbook, as required by the law. The present population-based retrospective cohort study aimed to evaluate the diagnostic performance of height and weight records in the Handbook for predicting excessive adiposity in adolescents.MethodsThe source population consisted of 8th grade students (800 students aged 14 years) registered at two public junior high schools. Of these, we excluded students who were born at a gestational age < 37 weeks or > 42 weeks. The present analyses included 435 participants who provided complete information. Body mass index (BMI) was calculated using height and weight records. Body fat mass at 14 years of age was measured by dual-energy X-ray absorptiometry (DXA). Diagnostic performance of BMI calculated from the MCH Handbook records to discriminate between the presence and absence of excessive adiposity at 14 years of age was evaluated using receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) was used to quantify the diagnostic accuracy of BMI.ResultsWith regard to the prediction of excessive fat at 14 years of age, AUCs and 95% confidence intervals for BMI at 1.5 and 3 years of age were greater than 0.5. Meanwhile, the AUC of BMI at birth was not significantly greater than 0.5.ConclusionThe present study findings indicate that BMI values calculated using MCH Handbook data have potential ability to distinguish between the presence and absence of excessive fat at 14 years of age.

Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

BackgroundPreconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya.MethodsA qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota sampling, at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The interviews were thereafter transcribed verbatim and analyzed thematically.FindingsA total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH).Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. The twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.ConclusionFrom this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of the later.

Understanding mobile application development and implementation for monitoring Posyandu data in Indonesia: a 3-year hybrid action study to build \u201ca bridge\u201d from the community to the national scale

BackgroundLimited information is available on how mobile health (mHealth) application (app) technology on mother and child health (MCH) is developed. This research aimed (a) to explore the process of developing mobile apps for MCH community-based services in the Indonesian setting of Pos Pelayanan Terpadu (Posyandu/Integrated Health Service Post), (b) to determine the feasibility of using the app by community health workers (CHWs), and (c) to evaluate the scalability of the mobile app at the national level in Indonesia.MethodsA hybrid method was used to synergistically combine the action research principles and mixed methods comprising qualitative and quantitative methods. This study was conducted in the Pasawahan District, Purwakarta, Indonesia, from 2017 to 2019. Content analysis, coding, and categorizing were performed using NVivo 12 Pro for transcribed data. The Wilcoxon test (2018 and 2019) was conducted using STATA 15 Special Edition.Results(1) The use of a CHW notebook for data entry into the Posyandu Information System book delayed the data reporting process, resulting in the need to develop a mobile app. (2) There were significant differences in CHWs’ knowledge (p = 0.000) and skills (p = 0.0097) on training (2018) and Posyandu phases (2019). (3) A total of 964 Posyandu have been registered in the Posyandu mobile app from almost all provinces in Indonesia.ConclusionsThe three-year hybrid approach includes the crucial phases that are necessary to develop a mobile app that is more user-friendly and can act as a substitute for CHWs’ book. Hence, its implementation is promising for use at the national level.

PERSPECTIVE IMPORTANCE OF MEDICINAL PLANTS IN MCH AND RCH CARE IN PRESENT SCENARIO – A BIRD’S EYE VIEW

Medicinal plants are emerging issue in global scenario now. The plants are used for various disease conditions from time immemorial before upcoming of modern medicine. Though today modern medicine is capable to control major issues in medical emergencies but leaves certain lacunae due to it’s post management hazardous situations. Several fields are still unattended completely by modern medicines. Interestingly, traditional system of medicine like Ayurveda, Siddha etc., plays a vital role till today in remote areas for managing several medical issues exclusively by using medicinal herbs as a tradition of Ayurveda &amp; Siddha. Both the systems advocate, numerous medicinal plants for various disease conditions. It was the interest to document the medicinal plants used for Reproductive Child Health (RCH) along with Mother and Child Health (MCH) as a small component of great Ayurvedic and Siddha ocean. Usually these medicinal plants have important role in the management of RCH &amp; MCH issues. Such claims of advocating its perspective importance possibly to meet the need by extensive research in future. We do not claim its positive assessment but such prevailing claim are only documented here for future research. Medicinal plants have been presented here with scientific preview in every RCH &amp; MCH issues.

Preconception Care among Pregnant Women in an Urban and a Rural Health Facility in Kenya: A Quantitative Study.

Preconception care (PCC) aims to improve maternal and fetal health outcomes, however, its utilization remains low in developing countries. This pilot study assesses the level and determinants of PCC in an urban and a rural health facility in Kenya. Unselected pregnant women were recruited consecutively at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The utilization of PCC was defined as contact with any health care provider before current pregnancy and addressing pregnancy planning and preparation. A cross-sectional approach was employed and data were analyzed using SPSS version 22. 194 participants were recruited (97 in each setting) of whom, 25.8% received PCC. Age, marital status, education, parity and occupation were significant determinants of PCC uptake. There was also a significant difference in PCC uptake between the rural (16.5%) and urban (35.1%) participants (p < 0.01), OR of 0.3 (0.19–0.72, 95% CI). The low level of PCC in Kenya revealed in this study is consistent with the low levels globally. However, this study was not powered to allow firm conclusions and analyze the true effects of PCC determinants. Therefore, further research in the field is recommended in order to inform strategies for increasing PCC utilization and awareness in Kenya.

Developing a national health research agenda for Lao PDR: prioritising the research needs of stakeholders

ABSTRACT Background Currently the health research system in Lao PDR is fragmented and largely donor led. Capacity among national public health institutes is limited to select priority research questions for funding. Objective The objective of this capacity building and practice-oriented study is to describe the process and outcome of the first National Health Research Agenda for Lao PDR and how the agenda contributes to institutional capacity of the Ministry of Health, in order to contribute to evidence-informed public health policy making. Method This activity used a mixed-methods approach. The overall design is based on principles of the interactive Learning and Action approach and consists out of 6 phases: (1) identification of needs, (2) shared analysis and integration, (3) nation-wide prioritization of research domains, (4) exploring specific research questions, (5) prioritization of research avenues, (6) dialogue and planning for action. The process involved interviews with experts in health policy and research (n = 42), telephone-based survey with district, provincial and national health staff (n = 135), a two-round Delphi consultation with experts in health policy and research (n = 33), and a workshop with policymakers, researchers, international organisations and civil society (n = 45) were held to gather data and conduct shared analysis. Results 11 research domains were identified and prioritised: Health-seeking behaviour; Health system research; Health service provision; Mother and child health (MCH); Sexual & reproductive health; Health education; Non-communicable diseases (NCDs); Irrational drug use; Communicable diseases (CDs); Road traffic accidents; Mental health. Within these domains over 200 unique research questions were identified. Conclusion Our approach led to a comprehensive, inclusive, public health agenda for Lao PDR to realise better informed health policies. Questions on the agenda are action-oriented, originating in a desire to understand the problem so that immediate improvements can be made. The agenda is used within the MoH as a tool to fund and approve research.

Utilization of Primary Health Care and Its Associated Factors among Women of Childbearing Age Living in Mogadishu-Somalia

Background: The Somali people have some of the worst health indicators in the world, with women and children most affected. Despite modest improvements in maternal and child mortality rates in the last five years, inequities amongst communities meant that some children and mothers are disproportionately exposed to otherwise avoidable and treatable diseases. The broad aim of this study is to assess utilization of Primary Health Care (PHC) and Its associated factors among Women of Childbearing age living In Mogadishu Somalia. Methodology: Descriptive and Analytical cross-sectional community-based study was conducted among Women of Childbearing age that were living in two districts (Hodan and Abdul-Aziz Districts)-Mogadishu-Somalia-From May 2019 to September 2019. A total of 395 of Women of Childbearing age were targeted during the study period. Descriptive and analytical statistics was used using Statistical package for social science (SPSS) version 20 statistical software. The data were showed tables, figures and graphs for describing the data. Results: The study found that Most of respondents were between 15 to 25 years 41.5% (395 sample sizes), while the age of group of >45 to 55 was only 6% (395 sample size). According to the district 76.5% of respondents were from Hodan, while 23.5% (395 sample size) of respondents were from Abdul-Aziz district. According to awareness to the need of a pregnant mother to be vaccinated at the Mother and child health (MCH) Most respondents 48.2% (395 Sample size) said that pregnant women may or may not need to be vaccinated. According to health-seeking decisions only 3% of ever married respondents were made by themselves whilst 97% of them were made by their husband. Age group was not significantly associated with the level of utilization of Primary Health Care (PHC); this is different from study in Kenya showing that age is an important factor in determining the use of skilled assistance, early antenatal care visits and more than four antenatal visits. Conclusion: The study concluded and recommended that the level of utilization of primary health care is poor and lower than other studies around Somalia as well as World Health Organization (WHO). recommendation And the study recommended that enhancing awareness importance of primary health care (PHC) utilization and empowering women Health care-seeking behavior and their husbands.

Reducing carious lesions during the first 4 years of life: An interprofessional approach

BackgroundCaries in Peruvian 0- through 3-year-olds is high. The dental profession should collaborate with nurses at mother and child health (MCH) clinics for reducing the disease. In this randomized clinical trial, the authors tested an integrated intervention program implemented by nurses and dentists. MethodsThe authors developed age-specific (0-3 years) oral health–related information and activity record cards and validated them for nurses to use after being educated about oral health issues and mouth inspection. The authors trained dentists in atraumatic restorative treatment. The active intervention group (AG) participated in the integrated intervention program, the passive intervention group (PG) received only the oral health–related information and activity record cards, and the control group (CG) received only a lecture. The examiners assessed caries status according to the Caries Assessment Spectrum and Treatment instrument. The authors used analysis of variance and the Tamhane method to analyze the data. ResultsThe sample consisted of 368 children with a mean age of 3.1 years. The 3-year dropout percentage was 40.5%. The prevalence of cavitated dentin carious lesions was statistically significantly lower in the AG (10.0%, confidence interval [CI] 4.1 to 19.5) than in the PG (60.5%, CI 48.6 to 71.5) and CG (63.0%, CI 50.9 to 74.0) after 3 years (P < .001). Enamel carious lesions (62.9%) were most prevalent in the AG, whereas carious lesions were most prevalent in the PG (28.9%) and CG (32.9%). ConclusionsIncorporation of specific oral health care activities into the existing MCH program, implemented by trained nurses and supported by health center dentists, reduced the burden of caries in 3-year-olds substantially. Practical ImplicationsThe oral health care professionals in Peru should collaborate with personnel of MCH clinics to curb caries in 0- through 3-year-olds.

NCDs in Nepal: Burgeoning Burden amid Low Priority and the Ways Forward

DOI: http://dx.doi.org/10.3126/hprospect.v11i0.7420Health Prospect 2012 Vol.11

Assessment of Health Problems, Needs and Cultural Beliefs of Women in a Rural Area of Karnataka, India: A Participatory Rural Appraisal Method

Introduction: Mothers and children are not only a vulnerable group but even a major group consuming health services. In Indian society, Mother and child health (MCH) is surrounded by a wide range of customs and beliefs. Possible attention is necessary to focus on wrong practices and beliefs to prevent health systems to suffer from inefficiency and poor utilization. One of the methods to involve community in identifying and analyzing the problem is participatory rural appraisal (PRA), which helps in drawing framework to understand, analyze and develop programs with communities. Objectives: (1) To determine the health problems and needs of women in a rural area. (2) To assess the cultural beliefs related to mother and child health in the rural community. Methodology: Participatory rural appraisal (PRA) was conducted with women of a rural village, Giriyapura in Davangere taluk. The methods used in the PRA technique were village mapping, village transect, and focus-group discussion. All the women of the village were informed about the objective of the study and those who came voluntarily (n=37) to participate were included in the study. Results: PRA resulted in empowering community involvement among the participants. The participants took charge of identification of health problems and their perceived causes for the same. The health needs were identified and prioritized. Need of transportation was the main priority of the participants. Cultural practices related to mother and child health were charted out. Conclusion: The most important perceived need of villagers was transport facility. Many cultural beliefs surrounded the mother and child health, of which some were unscientific. PRA was successful to an extent in obtaining information about health problems and needs of the community.

Dentists' perception of primary health care services in family health and mother and child health clinics in Alexandria, Egypt.

This study compared dentists' perceptions of provided services in Family Health (FH) and Mother and Child Health (MCH) clinics. A questionnaire was distributed to 120 dentists in 7 FH and 4 MCH clinics in Alexandria, Egypt in 2012. The questionnaire assessed personal and professional background, perceptions of primary health care (PHC) role, types of services provided, patient recall and referral systems and perception of service quality. The response rate was 100%. More FH dentists perceived their role to include providing care for children and pregnant women. Restorations and scaling were provided by 90% of all dentists. More FH dentists reported providing simple extractions, paediatric extractions and multi-rooted endodontic treatment (P = 0.03, 0.001 and 0.001). In FH clinics, where the performance-based incentive system was implemented, a greater number of patients was served and there was a shift in the type of services provided although dentists had a less positive perception of quality aspects. Thus, there is a need for the establishment of a mission and clear guidelines for the FH clinics to guide service provision.

Birth Weight for Gestational Age Centile Charts for Low-risk Population of Islamabad Capital Territory: A Hospital-based Study and Cross-country Comparison

ABSTRACTObjectiveTo establish birth weight percentile charts for gestational age based on prospectively collected data for Islamabad Capital Territory (ICT) urban/rural low-risk population presenting at Mother and Child Health (MCH) Center, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, and crosscountry comparison.Place and duration of studyThe study was conducted for a period of 6 months (January 2014—June 2014) at MCH Center Unit II, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences (SZABMU-PIMS), Islamabad, Pakistan.Study designComparative cross-sectional study.Materials and methodsData of low-risk women from ICT urban/rural population presenting at MCH Center, PIMS were prospectively maintained, entered in Excel sheet, and later analyzed using Statistical Package for the Social Sciences version 21. The confounding factors that affect the fetal growth including gestational diabetes, hypertension, history of intrauterine growth restriction, and medical disorders were excluded. The 5th, 10th, 50th, 90th, and 95th centile birth weight charts were calculated for gestational age between 32 and 41 weeks and were compared with those of other countries. The gestational age was calculated by clinical obstetrician or estimates by early ultrasound if available.ResultsA total of 1,744 singleton live births were analyzed. The birth weights at 5th, 10th, 50th, 90th, and 95th centile were calculated at 32 to 41 weeks of gestation. Cross-country comparison of birth weight at 50th centile of ICT population is comparable with other countries till 37 weeks and lower after 37 weeks, except Indian population. The birth weight at 90th centile at all gestations (32—41 weeks) was comparable with other populations. However, the birth weight at 10th centile for ICT population is far below than the other countries except Indian population.ConclusionThe updated birth weight for gestational age centile charts may be utilized as reference charts for ICT population and may be extrapolated to Pakistani population until the availability of national database.How to cite this articleTasnim N, Hanif A, Aziz H. Birth Weight for Gestational Age Centile Charts for Low-risk Population of Islamabad Capital Territory: A Hospital-based Study and Cross-country Comparison. J South Asian Feder Obst Gynae 2017;9(2):169-172.

Impact of Refugees on Local Health Systems: A Difference-in-Differences Analysis in Cameroon.

Hosting refugees may represent a drain on local resources, particularly since external aid is frequently insufficient. Between 2004 and 2011, over 100,000 refugees settled in the eastern border of Cameroon. With little known on how refugee influx affects health services of the hosting community, we investigated the impact of refugees on mother and child health (MCH) services in the host community in Cameroon. We used Cameroon’s 2004 and 2011 Demographic and Health Surveys to evaluate changes in MCH indicators in the refugee hosting community. Our outcome variables were antenatal care (ANC) coverage, caesarean delivery rate, place of delivery and child vaccination coverage; whereas the exposure variable was residence in the refugee hosting community. We used a difference-in-differences analysis to compare indicators of the refugee hosting community to a control group selected through propensity score matching from the rest of the country. A total of 10,656 women were included in our 2004 analysis and 7.6% (n = 826) of them resided in the refugee hosting community. For 2011, 15,426 women were included and 5.8% (n = 902) of them resided in the hosting community. Between 2004 and 2011, both the proportion of women delivering outside health facilities and children not completing DPT3 vaccination in the refugee hosting community decreased by 9.0% (95% Confidence Interval (CI): 3.9–14.1%) and 9.6% (95% CI: 7.9–11.3%) respectively. However, ANC attendance and caesarean delivery did not show any significant change. Our findings demonstrate that none of the evaluated MCH service indicators deteriorated (in fact, two of them improved: delivery in health facilities and completing DPT3 vaccine) with the presence of refugees. This suggests evidence disproving the common belief that refugees always have a negative impact on their hosting community.