Part Of Maternal Health Services Research Articles

Evidence on point-of-care diagnostics for assessment of nutritional biochemical markers as an integral part of maternal services in low- and middle-income countries: systematic scoping review protocol

BackgroundMalnutrition affects a third of the global population with low- and middle-income countries (LMICs) being the most affected. Most of those affected by malnutrition have limited means of determining their nutritional status. Recent developments of point-of-care (POC) diagnostics promise to enable early diagnosis of nutritional deficiencies or disease risk through biochemical indicator assessment. This provides potential opportunities for relatively simple interventions before the emergence of clinical symptoms. The main objective of this systematic scoping review is to map evidence on accessibility to POC diagnostic tests for the assessment of nutritional biochemical markers as an integral part of maternal health services in LMICs.Methods and analysisWe will search for relevant literature from the following databases: PubMed, Science Direct, EBSCOhost (Academic search complete, CINAHL with full text, MEDLINE with full text, MEDLINE), Google Scholar and World Health Organization library database. We will also search reference lists of included studies and existing networks such as organisations and conferences to source relevant literature. Primary research articles, published in peer-reviewed journals; review articles and grey literature that address the research question will be included. We will also search clinical trial registers to find relevant studies. Two independent reviewers will screen abstracts and full articles in parallel, from the included studies, using specific inclusion and exclusion criteria. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be used for reporting the screening results. NVivo version 10 will be employed to enable content thematic analysis of the review findings. A narrative summary of the results will be presented according to the emerging themes.DiscussionWe anticipate finding relevant literature on point-of-care diagnostic services for assessment of biochemical indicators as part of maternal services in low- and middle-income countries. The evidence obtained from the included studies when summarised will help to guide future research.

Prevalence and determinants of folate deficiency among urban Indian women in the periconception period

Maternal folate insufficiency is of particular concern in developing countries due to its association with various adverse pregnancy outcomes. This study aimed to determine the prevalence of folate deficiency and its determinants among urban Indian women in the periconception period. Serum folate concentrations were measured in 584 women in early pregnancy (11 ± 3 weeks of gestation) using microbiological assay. Folate deficiency was detected in 24% women and possible deficiency was detected in 21% women. Multigravidity (aOR 1.84, 95% CI 1.16-2.92) and low education (aOR 1.67, 95% CI 1.06-2.62) emerged as determinants of folate deficiency while prenatal folic acid supplementation was favorable in decreasing the odds of folate deficiency (aOR 0.17, 95% CI 0.06-0.43). No association was observed between folate levels and adverse pregnancy outcomes including neural tube defects. The high prevalence of folate deficiency underlines the need for implementation of preconception folic acid supplementation as part of maternal health services in India.

Integration of TB-HIV services at an ANC facility in Frances Baard District, Northern Cape, South Africa.

Integrated tuberculosis-human immunodeficiency virus (TB-HIV) service delivery as part of maternal health services, including antenatal care (ANC), is widely recommended. This study assessed the implementation of collaborative TB-HIV service delivery at a hospital-based ANC service unit. A record review of a random sample of 308 pregnant women attending the ANC service between April 2011 and February 2012 was conducted. Data were extracted from registers and patient case notes. Outcomes included the proportion of women who underwent HIV counselling and testing (HCT), CD4 count testing, antiretroviral treatment (ART), cotrimoxazole preventive treatment (CPT), TB screening and isoniazid preventive treatment (IPT). Analysis measured variations in patient characteristics associated with service delivery. All women underwent HCT; 80% of those who tested HIV-positive were screened for TB. Most (85.9%) of the HIV-positive women received a CD4 count. However, only 12.9% of eligible women received ART prophylaxis onsite, only 35.7% were referred for initiation of ART, only 42.3% commenced IPT and none received CPT or further investigations for TB. HIV-negative women had 2.6 higher odds (95%CI 1.3-5.3) of receiving TB screening than their HIV-positive counterparts. Although the identification of HIV-positive women and TB suspects was adequate, implementation of other TB-HIV collaborative activities was sub-optimal.

Family planning as a part of maternal health services in a metropolitan health department.

Family planning as a part of maternal health services in a metropolitan health department. R M White, M Tayback, and S HetheringtonCopyRight https://doi.org/10.2105/AJPH.56.8.1226 Published Online: August 29, 2011