Number Of Eligible Women Research Articles

Effectiveness of modular approach in ensuring data quality in large-scale surveys: Evidence from National Family Health Survey – 4 (2015–2016)

This study aims to examine the effect of administration of shorter and longer versions of questionnaires on key indicators such as age displacement, birth displacement, age heaping, and skipping questions on antenatal care (ANC) visits and use of contraceptive methods in India using National Family Health Survey (NFHS)-4 data. At the individual level, the effect of the adoption of the shorter and longer versions of the questionnaires on the age displacement of women and children and skipping of the key questions is insignificant. However, the results from the two-level logistic regression model reveal that at the primary sampling unit (PSU) level, work pressure, depending on the number of eligible women in a household, emerges as a confounder in skipping certain questions, namely ANC [1.18 (p < 0.09)] and contraceptive use [AOR = 1.17 (p < 0.05)]. To expand the coverage of NFHS in providing state- and district-level estimates since 2015, the overall sample size was increased from 88,562 households and 89,777 eligible women in 1992–93 to 6,01,509 households and 6,99,686 eligible women in 2015–16. As a strategy to reduce workload and non-sampling errors during the survey, a nested design and modular approach were adopted to provide estimates of maternal and child health indicators at the district/state level and sexual behaviour, HIV/AIDS, and women's empowerment at the state level. It was hypothesised that a longer version of the questionnaire canvassed in the state module may be detrimental to data quality issues. The findings of this study establish the effectiveness of adopting a modular approach in large-scale surveys, depending on the scale of investigation. However, the differential workload calls for expanding the duration of surveys in PSUs, where the number of eligible women is higher. State level variation in the key data quality indicators may be partially explained by differentials in the training of investigators by the agency and use of translators.

Factors influencing the use of emergency contraceptives among reproductive age women in the Kwadaso Municipality, Ghana.

Unintended pregnancy leads to unsafe abortion, which is one of the commonest causes of maternal deaths in developing countries including Ghana. Lots of unintended pregnancies can be avoided using emergency contraceptives (EC). Emergency contraceptives are mostly used after unprotected sexual intercourse and have a ninety-nine percent chance of preventing unintended pregnancy when taken correctly. However, unlike other modern contraceptives such as condoms, emergency contraceptives cannot prevent sexually transmitted infections. This study aimed at assessing the factors influencing the use of emergency contraceptives among reproductive-age women in the Kwadaso Municipality, Ghana. A community-based descriptive cross-sectional study design was conducted in three sub-municipalities of the Kwadaso Municipality. A multistage sampling method was used to select 312 women in their reproductive age within households. A simple random sampling method was first used to select the sub-municipalities (Kwadaso Central, Asuoyeboah, and Agric-Nzema). Participants were selected from households through a systematic sampling procedure and responses were solicited from women who consented to participate in the study. The selection was strictly dependent on the number of eligible women in a household, that is, in an event where more than one woman was found in a household, a simple random sampling method was used to select only one woman from that household. STATA 15.0 was used to analyse the data. Binary logistic regression was used to find the adjusted estimates and associations between EC use and the exposure variables. P-values ≤ 0.05 were considered statistically significant at 95% Confidence Interval (CI). The findings showed that 79.67% of the women had ever used EC. Amongst them, 59.83% used EC following unexpected unprotected sex, and 24.69% used EC following failed coitus interruptus. Women's attitude towards EC (AOR = 8.52, p<0.001), religion (AOR = 4.56, p = 0.004), and monthly income (AOR = 0.29, p = 0.030) were found to have significant influence on their use of EC. The level of EC use among the women was high. Women's attitude towards EC, religion, and monthly income were the major factors influencing the use of EC. Thus, strategies to promote EC use should emphasize on addressing the attitude of women towards EC through sex education in schools, various religious institutions, and the community at large with the services of health authorities and support from governmental and non-governmental organizations whose focus is to address the need for reproductive health services in order to reduce the misconception regarding the use of EC.

NEWS

An average of nine promotional claims can be found on the packaging of individual UK baby foods, finds research based on a selection of products and published The Department of Health and Social Care has launched a new national campaign to increase the number of eligible women attending their cervical screening in England Despite a decline in stillbirths across the UK in recent years, rates among black and South Asian communities are still around double those of the rest of the population

\u2018When she rises, we all rise\u2019: a crowdsourcing challenge to increase women\u2019s participation in an infectious diseases research fellowship

BackgroundWomen are under-represented in many mid-career infectious diseases research fellowships, including a TDR fellowship for low- and middle-income country (LMIC) researchers. TDR solicited creative ideas as part of a challenge contest to increase the number of women fellowship applicants. The purpose of this study is to examine themes from submitted ideas and the impact of implementing the top three ideas on the number of women applicants.MethodsWe solicited ideas for modifying the TDR fellowship using a crowdsourcing challenge. Then we used a mixed methods approach to evaluate texts submitted in response to the challenge. The qualitative analysis identified themes from eligible submissions. The quantitative analysis examined the mean score (1–10 scale) assigned to submitted ideas and also the number of eligible women applicants before (2014–7) and after (2018) implementing the top three ideas.ResultsWe received 311 ideas on improving women’s participation in this fellowship from 63 countries. Among all ideas, 282 (91%) were from women and 286 (92%) were from low- and middle-income countries (LMICs). Thirty-three (17%) ideas received an overall mean score of 7.0 or greater. The top three ideas included enhanced social media communication targeting women, improving career mentorship, and creating a nomination system to nudge women applicants. These ideas were implemented as part of the 2018 fellowship application cycle. The number of eligible women applicants increased from 11 in 2016 to 48 in 2018. The number of eligible men applicants increased from 55 in 2016 to 114 in 2018. Women represent 44% (8/18) of the 2018 cohort.ConclusionThis suggests that the challenge contest resulted in strong participation from women in LMICs. The three top ideas likely contributed to a greater number of women applicants to this mid-career fellowship. Further ways of enhancing women’s participation in global health training are needed.

Development and clinical evaluation of a 3-step modified manipulation protocol for MRI-guided high-intensity focused ultrasound of uterine fibroids

The clinical applicability of magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) treatment of uterine fibroids is often limited due to inaccessible fibroids or bowel interference. The aim of this study was to implement a newly developed 3-step modified manipulation protocol and to evaluate its influence on the number of eligible women and treatment failure rate. From June 2016 to June 2018, 165 women underwent a screening MRI examination, 67 women of whom were consecutively treated with MR-HIFU at our institution. Group 1 (n = 20) was treated with the BRB manipulation protocol which consisted of sequential applications of urinary bladder filling, rectal filling, and urinary bladder emptying. Group 2 (n = 47) was treated using the 3-step modified manipulation protocol which included (1) the BRB maneuver with adjusted rectal filling by adding psyllium fibers to the solution; (2) Trendelenburg position combined with bowel massage; (3) the manual uterine manipulation (MUM) method for uterine repositioning. A comparison was made between the two manipulation protocols to evaluate differences in safety, the eligibility percentage, and treatment failure rate due to unsuccessful manipulation. After implementing the 3-step modified manipulation protocol, our ineligibility rate due to bowel interference or inaccessible fibroids decreased from 18% (16/88) to 0% (0/77). Our treatment failure rate due to unsuccessful manipulation decreased from 20% (4/20) to 2% (1/47). There were no thermal complications to the bowel or uterus. Implementation of the 3-step modified manipulation protocol during MR-HIFU therapy of uterine fibroids improved the eligibility percentage and reduced the treatment failure rate. Registry number NL56182.075.16 KEY POINTS: • A newly developed 3-step modified manipulation protocol was successfully implemented without the occurrence of thermal complication to the bowel or uterus. • The 3-step modified manipulation protocol increased our eligibility percentage for MR-HIFU treatment of uterine fibroids. • The 3-step modified manipulation protocol reduced our treatment failure rate for MR-HIFU treatment of uterine fibroids.

A predictive model and socioeconomic and demographic determinants of under-five mortality in Sierra Leone

Sierra Leone is among the countries that recorded high under-five child mortality rate in the world. To design and implement policies that can address this public health challenge, the present study developed a predictive model of factors that explained under-five mortality in Sierra Leone using the 2008 and 2013 Sierra Leone Demographic and Health Survey (SDHS) datasets. LASSO regression technique was used to select the predictors to build the under-five predictive single-level logit and multilevel logit models. Statistical analyses were performed in the R freeware version 3.6.1. About 588 (10.4%) and 1320 (11.1%) children under five were reported dead in 2008 and 2013, respectively. The significant predictors of under-five mortality in Sierra Leone were the total number of children ever born, number of children under five in the household, mother's birth in the last five years, mother's number of living children, and number of household members, household wealth, maternal contraceptive use and intention, number of eligible women in the household, type of toilet facility, sex of the child, and weight of the child at birth. The study identified certain predictors that deserve policy attention and interventions to strengthen the efforts of creating child welfare and survival atmosphere in Sierra Leone.

Prevalence and Factors Affecting Women with Uterine Prolapse in Lekhnath, Kaski, Nepal

Background: Uterine prolapse is the main public health problem of reproductive age women in Nepal. Uterine prolapse (UP), which affects about 10% of women of reproductive age in Nepal, is the most frequently reported cause of poor health in women of reproductive age and postmenopausal women. Currently, women’s awareness of UP is unknown, and attempts to unravel the UP problem are inadequate.Objectives: The objectives of this study was to determine prevalence of uterine prolapse, to explore factors affecting women with uterine prolapse and to find association between selected variables and prevalence of uterine prolapse.Methods: A community based cross sectional study was conducted from 7th July, 2016 to 7th of August, 2016 among married women with at least one child in the Ritthepani, Ward No 2, Lekhnath. Participants were selected by purposive sampling techniques, and data were collected through structured interview schedule. Frequency, percentage, mean, SD and chi-square test was performed to identify factors associated with prevalence of uterine prolapse.Results: The major findings were majority 35 (35%) of women were in the age group of 20 to 30 years, followed by 89 (89%) Hindu religion, 48 (48%) belonged to janajati and religious minority which included Newar, Magar, Gurung, Tamang and Muslims. Most of the women 35 (35%) were Illiterate, 44 (44%) earn their living by working in agriculture, 57 (57%) respondents had ≥Rs1500 per month income in the family, 58 (58%) belonged to nuclear families, 76 (76%) of the respondents had knowledge about uterine prolapse and they got information mostly from 24 (24%) friends. The prevalence rate of women with uterine prolapse was found to be 13% whereas mean and standard deviation were 0.87 ±0.33. The findings of association between the prevalence of uterine prolapse with age at first child birth, abortion, sexual intercourse immediate after delivery and constipation were found to be significantly associated. Almost all respondents replied that uterine prolapse can be prevented by avoiding strenuous activities during antenatal and postnatal period followed by avoiding giving birth to too many babies, taking nutritious diet, deliver the baby in health institution by health personnel, avoiding long term coughing and chronic constipation.Conclusion: Uterine prolapse was observed among women of Ritthepani ward no 2; among them most of them were age group between 20 - 30 year early married Illiterate. The perceived service was taken by less number of eligible women. Women awareness towards the problem, limiting frequent pregnancies and provision of educational opportunities are recommended for the prevention of uterine prolapse. Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December 2016, Page: 47-51

The Effects of a Nutrition‐Sensitive Agricultural Intervention on Social Support, Food Security and Maternal Self‐Efficacy in Complementary Feeding

IntroductionNutrition‐sensitive agriculture has been the subject of much recent global interest, however, the empirical evidence of the individual pathways to improved nutrition is scant. Care behaviors are recognized as central to child nutrition, yet caregiver resources to perform feeding behaviors are understudied, generally, and specifically in the context of agricultural interventions. Self‐efficacy is an important caregiver resource that influences maternal behaviors around young child feeding practices. We evaluated the impacts of a multi‐faceted intervention (homegardening, gender sensitization) with and without nutrition education on maternal self‐efficacy in complementary feeding. We further explored the mediating roles of spousal support and household food security.MethodsRealigning Agriculture for Improved Nutrition (RAIN) was a four year homegardening intervention targeting rural women in the Central province of Zambia who were pregnant or had a child under two years of age. The intervention was implemented by Concern Zambia and evaluated using a cluster‐randomized design by the International Food Policy Research Institute. The unit of randomization was the census survey area, within which a number of women's groups consisting of 15–20 member were created based on the number of eligible women. Bi‐monthly group meetings, led by community agricultural educators and community health volunteers (CHV), served as the main platform for intervention delivery and were supplemented by home visits. We administered a mid‐term survey, two years after the intervention began, to a random sample of 759 women with children under two years of age in intervention and control groups. We conducted both intention‐to‐treat and per‐protocol analyses using SEM in STATA 13.0.ResultsThe agricultural intervention significantly improved maternal self‐efficacy (β = 0.82; p &lt;0.001) and this was partially mediated by increasing gains in spousal support (β = 0.43; p &lt;0.001) and food security (β = 0.78; p &lt;0.001). We found similar results in women who additionally received nutrition education, but there were no additional gains in self‐efficacy when compared to women who received the agricultural intervention without nutrition education. We discovered substantial variability in the delivery of nutrition education due to low CHV participation. Only 73% of CHVs attended their last meeting, compared to 98% of agricultural educators and 25% of women could not recall their CHV's name. The average number of home visits performed by CHVs was 1.6 compared to 7.5 by agricultural educators. Our per protocol analysis showed additional gains to self‐efficacy for women with high levels of delivery and participation in the agricultural intervention (β = 0.97; p &lt;0.001) with the greatest gains in women who also received nutrition education (β = 1.10; p &lt;0.001). The difference in selfefficacy between women who did and did not receive nutrition education was not significant.ConclusionThis home‐gardening intervention improved maternal self‐efficacy in complementary feeding through improvements in spousal support and food security. The addition of nutrition education provided no additional gains to self‐efficacy in complementary feeding. Leveraging existing health infrastructure, notably community health volunteers, to add nutrition education to an agricultural project presented challenges to delivery in this setting.Support or Funding InformationNSF‐IGERT and USAID

Abstract S5-01: The Connecticut experiment: 4 years of screening women with dense breasts with bilateral ultrasound

Abstract OBJECTIVE: To determine if the addition of screening breast ultrasound in women with mammographically normal but dense breasts has increased breast cancer detection over the 4 years since the legislation was first enacted in 2009. METHODS: The study utilized a retrospective chart review. Data collected included: (1) total number of screening mammograms; (2) total number of dense breast screening ultrasounds; (3) screening ultrasound Breast Imaging Reporting Data System (BI-RADS) code results; (4) biopsy results; and (5) demographic data on women with malignant biopsies. Data was obtained from included sites from October 2009 through December 2013. FINDINGS: Data was collected from 2 Radiology practices with a total of 5 sites. In year 1, 30670 mammograms and 2706 screening ultrasounds were performed. In year 2, 32050 mammograms and 3351 ultrasounds; in year 3, 32230 mammograms and 4128 ultrasounds and in year 4, 27937 mammograms and 3331 ultrasounds were performed. In year 1, 151 ultrasounds were BIRADS 4 or 5 with 11 cancers detected. The PPV was 7.1%; the detection rate was 4/1000 and 22% of eligible women had the study (assuming 40% of women have dense breasts). In year 2, 180 ultrasounds were BIRADs 4 and 5 with 11 cancers detected. The PPV was 6.1% and the cancer detection rate was 3.2/1000 with 26% of eligible women having the study. In year 3 148 ultrasounds were BIRAD 4 and 5 with 13 cancers detected. The PPV was 8.1% and the cancer detection rate was 3.2/1000 with 32% of eligible women having the study. In year 4, 53 ultrasounds were BIRAD 4 and 5 with 11 cancers. The PPV was 17.2% with the cancer detection rate of 3.3/1000 and 28% of eligible women having the study. Four Years of Screening Breast Ultrasound Data Year 1Year 2Year 3Year 4Screening Mammograms30670320503223027937Breast Ultrasounds for Dense Breasts2706335141283331BIRAD 4 and 5 Ultrasounds15118017853Cancers11111311PPV7.16.18.117.2Number Cancers per 1000 Screened4.03.23.23.3% Eligible Screened22.126.132.028.3 CONCLUSIONS: Based on the data collected from these sites, screening breast ultrasound in women with dense breast parenchyma detects mammographically occult malignancy. Over the 4 years studied, the PPV improved from 7% to 17.2% indicating that the selection of lesions biopsied was more accurate with fewer false positives. The rate of detection in the first year was 4.0/1000 and then remained stable at 3.2/1000 in the three subsequent years. Of concern, the number of eligible women who elect to have the additional test remains low at about 30% which is due to several factors including education and cost. Citation Format: Jean M Weigert. The Connecticut experiment: 4 years of screening women with dense breasts with bilateral ultrasound [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr S5-01.

Antenatal perineal massage: Part 2

Antenatal perineal massage was introduced as a new service for women and the aim of the audit was to evaluate the effect of the service on subsequent perineal trauma sustained at delivery. Data was collected from the maternity notes and a convenience survey of postnatal women. The midwives’ views were obtained through questionnaires and focus group discussions. Although the number of eligible women receiving information on perineal massage was well below the audit target, a 6% reduction in perineal trauma was noted in women who had a vaginal delivery. Compliance with the massage instructions varied, but women were generally positive about perineal massage and would repeat it in a subsequent pregnancy. The maternity unit will continue to offer antenatal perineal massage as a service for women.

A Study of Depression in Women: A Reply to Keith Hope's Critical Note

We welcome Dr. Hope's detailed comments on our paper, 'Social Class and psychiatric disturbance among women in an urban population* in Sociology , May 1975, and here take the opportunity of clarifying briefly, and in so far as we can with our present data, the questions he has raised. We shall deal with each of Dr. Hope's numbered points in turn: the first deal with the technical points concerning sampling etc. and the later ones with more fundamental issues. i(i) and (ii). We would not claim that our sampling procedure gives a completely representative sample. The register used as a sampling frame was that drawn up by the local authority for rating purposes. In about 7 per cent of instances the rateable unit was found to contain more than one household (defined by communal eating arrangements). In these cases a household was chosen at random. In 33 (15 per cent) of the 220 selected households there was more than one woman aged between 18 and 65 (the target population). In these cases a woman was selected at random from those eligible. There are two sorts of bias here: (a) women from households at multiple-household addresses (rateable units) would be expected to be underrepresented and those at one-household addresses over-represented, and (b) the procedure would also be expected to result in the under-representation of women in larger-than-average households since the sample was based on a frame unstratified by the number of target subjects in each sampling unit (household size here refers to the number of eligible women in the household). At this stage it is difficult to correct our overall estimates of event and disturbance rates etc. for these biases. These are in any case less critical than the causal model we have outlined and this would suffer only if the sample's shortcomings have resulted in spurious associations or in obscuring real links between the variables examined. We have no reason to believe that this has happened. The sample is too small to allow the sort of detailed examination of household composition Dr. Hope suggests in this regard, but we would point out that in our sample the distribution of the occupations of any male 'head of household' was very close to that provided by the 1961 census for men in Camberwell (see fn. 2, Brown et al., 1975). The defects of the sampling procedure are indeed unfortunate but, in the absence of a complete frame, could be avoided only by the use of more cumbersome methods having their own specific, and equally unwelcome, sources of bias. i (iii). The figure of 18 per cent in owner-occupied houses compares with 19 per cent for the Inner London boroughs, 36 per cent for the Greater London district as a whole, and 50 per cent for England and Wales (G.R.O., 1961). There is no reason to believe that the middleclass group in the old borough of Camberwell, who are concentrated largely around Dulwich, is in any way atypical of middle-class women in South London, although it might well be possible to find districts in London where middle-class women show higher rates of psychiatric disturbance (e.g. areas with heavy concentration of rented accommodation housing separated or divorced women). Their relatively low frequency of disturbance must not be interpreted as representing the frequency of 'psychiatric symptoms' among middle-class women. The 'cases' were, as is pointed out on p. 228 and fn. 3, the more severely disturbed among those having