Spouse Occupation Research Articles

Dietary Quality and Its Impact on Maternal Nutritional Status in Ondo State, Nigeria

Background: Malnutrition is one of the major problems that have bewildered human health in developing countries Objective: The study aimed to assess maternal diet quality and nutritional status of in Ondo state. Methods: This was a community based descriptive and cross-sectional study that consisted of 420 respondents (mothers). Respondents were drawn using multistage sampling procedure. Pre-test, semi-structured Interviewer administered questionnaire was used to elicit information from the respondents while anthropometric indices such as height, weight, waist circumference, hip circumference were measurement and Waist hip ratio, mid upper arm circumference were computed according to standard. Body Mass Index (BMI) was calculated from weight and height measurements and classified into underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9) and obesity (≥30.0). Data were analysed using descriptive and inferential statistics while level of significant was set P (<0.05). Results: The nutritional status of the women shows that there was a double burden of malnutrition indicating 10.7% under nutrition, 29.0% overweight and 4.8% obese. BMI was significantly associated with mothers’ age (p= 0.000), place of residence (p= 0.009), marital status (p= 0.017), mothers’ occupation (p= 0.026), occupation of spouse (p= 0.009), and monthly income (p = 0.008). Conclusion: There were existence of a double burden of malnutrition and high prevalence of overweight and obesity in the study area. Household food insecurity contributed greatly to the malnutrition observed in many mothers in the study. Nutrition and health promotion education intervention is recommended in the study area.

EXPLORING VITAMIN D-RELATED KAP INFLUENCING FACTORS IN MIDDLE-AGED AND ELDERLY PATIENTS WITH ANKLE FRACTURES: A LOGISTIC REGRESSION AND DECISION TREE MODEL-BASED STUDY

This study aimed to analyze the factors influencing vitamin D (VD)-related knowledge, attitude, and practice (KAP) in middle-aged and elderly patients with ankle fractures using the binary logistic regression and decision tree models, thereby providing scientific evidence for VD-related recovery strategies. A Chinese version of the nutrition KAP questionnaire was administered in a Grade III A Hospital using random sampling for the investigation. Meanwhile, the factors influencing KAP were analyzed using the aforementioned two models. The results of the binary logistic regression model showed that the patient age [odds ratio [Formula: see text]; 95% confidence interval (CI): 0.117–0.295], spouse education ([Formula: see text]; 95% CI: 0.267–0.422), and spouse occupation ([Formula: see text]; 95% CI: 1.078–1.693) were the factors influencing VD-related KAP. The decision tree chi-squared automatic interaction detector (CHAID) algorithm showed that spouse education, patient age, and living room lighting were the influencing factors, among which spouse education was the most important. VD in middle-aged and elderly patients with ankle fractures was affected by the age and the education level of the spouse. These two models can analyze the influencing factors of knowledge and practice, and can be used together to complement each other.

INVESTIGATION OF NULLIPAROUS WOMEN'S ATTITUDES TOWARD FERTILITY AND CHILDBEARING

Purpose: The aim of this study is to determine the attitudes of nulliparous women toward fertility and childbirth.
 Material and Method: The research was carried out as a cross-sectional descriptive method with improbable sampling technique. Recruitment for participation in the study took place with power analysis and consisted of 213 nulliparous women who had never been pregnant before. Data were collected with the Personal Information Form and the Attitudes Toward Fertility and Childbearing Scale.
 Findings: 54% of the women are between the ages of 19-26 and the mean age is 26.51±5.19. It was determined that 76.5% of the women were married for 1-3 years and 65.7% of them used contraception. The total score of the Attitudes Towards Fertility and Childbearing Scale is 69.54±8.28, and the mean subscale score current obstacle 21.57±7.08; importance in the future 28.42±4.63; female identity is 19.55±3.82. It has been determined that women have a positive attitude to fertility and childbearing. In comparison with the total score of the scale and the variables, it was determined that there was a significant difference between variables of age, occupation status, spouse's age, spouse's occupation status, spouse's smoking status, consanguineous marriage, family type, financial status, spouse's age at marriage and mean value of total scale score.
 Result: The fact that nulliparous women's attitudes to fertility and childbearing are affected by many factors such as age, occupation status, spouse's age shows that there are many variables that should be considered during the evaluation of nulliparous women by midwives. It is very important for pregnancy planning that women in the preconceptional period have positive attitudes to fertility and childbearing.

Factors for Decision to C-section Delivery in Indonesia: Insights from IDHS 2017

Introduction: Cesarean delivery (C-sections) showed 17.6% of all deliveries in Indonesia, which exceeded the WHO standard of 15%. C-sections in government hospitals reached 20-25%; in private hospitals, the number was higher, above 30%. Purpose: The study aimed to determine the factors influencing the decision of cesarean section delivery in Indonesia. Method: The study used a cross-sectional design. Data came from the Indonesian Health Demographic Survey (IDHS) 2017. The population and samples were 2,464 women aged 15-49 years—data analysis using chi-square test and multiple logistic regression. Result: The study found that the proportion of cesarean delivery in private hospitals reached 53.8%. Factors related to the decision to c-section delivery (p<0.05) were maternal education, place of residence, domicile island, spouse's occupation and education, wealth index, health insurance, and antenatal care history. Conclusion: The wealth index was the dominant factor for the decision to c-section delivery. The government is expected to be able to improve the quality of services and facilities in cesarean section delivery by government hospitals so that it can be the alternative decision for the community with a variety of wealth index and education backgrounds.

Exploring the impact of household, personal, and employment characteristics on dentistry’s income gap between men and women

BackgroundThis study provides an update on the income gap between men and women in dentistry, evaluating the impact of dentists’ household, personal, and employment characteristics on income differences. MethodsThis cross-sectional study used data from the US Census Bureau’s 5-year American Community Survey (2014-2018). Data were analyzed using descriptive statistics and regression analysis (ordinary least squares regressions, Oaxaca-Blinder regression decomposition on logged personal income). ResultsFemale dentists were less likely to be White and born in the United States and more likely to be bilingual than male dentists. Adjusted estimates indicated that male dentists earned 22% more than female dentists (risk ratio, 1.22; 95% CI, 1.15 to 1.29). Black dentists earned 24% less (risk ratio, 0.76; 95% CI, 0.68 to 0.85) and other race non-Hispanic dentists earned 17% less (risk ratio, 0.83; 95% CI, 0.70 to 0.97) than non-Hispanic White dentists, after adjustment for covariates. Dentists with a nondentist partner or spouse earned more than those without a partner or spouse, and dentists with 3 or more children earned 19% more than those who were childless (P < .001; 95% CI, 1.09 to 1.31). The income gap between sexes was $51,784 (in 2018 dollars); 27.2% of this gap was explained by observable personal (that is, race and ethnicity, bilingualism), employment (for example, hours worked and employee or ownership status), and household (for example, partner or spouse occupation and education) characteristics. ConclusionsThe dental workforce is diversifying, but sex and racial disparities in income persist. The income gap between sexes, although reduced over time, is now less explainable than in the past. Practical ImplicationsThe diversification of the dental workforce is a promising sign for an increasingly diverse population’s present and future oral health, but it is important that existing income gaps between men and women are addressed.

Income Shock and Coping Strategies of Government Workers in Southwest Nigeria: Evidence from the Survey Data

Abstract Consumers’ response to income shock have been a source of concern over the years. Unexpected negative income shock, such as nonpayment of salaries, or salary reduction may cause an individual to react differently. Coping may be easy if an individual is well-prepared and has fully insured coping strategies prior to the income shock, hence, a negative income loss would have less impact. Otherwise, an income shock could be deleterious and leave an individual vulnerable. Therefore, ability to cope during negative income shock is determined by consumers’ preparedness as well as the effectiveness and appropriateness of available coping strategies. This study, therefore, examines the coping mechanisms of government employees in southwest Nigeria during the unexpected nonpayment of salary between 2015 and 2018. Both quantitative and qualitative methods using a structured questionnaire and FDGs are employed. The data is analyzed using descriptive statistics and OLS methods. The findings suggest that durable and service goods are substituted for food consumption, while the impact of coping strategies varies across the states. Empirical results from the OLS show that workers use personal savings and credit-purchases to smooth-out consumption, borrow and reallocate resources from durables and service for food consumption. Education, spouse occupation and age also have a positive impact on consumption. Evaluation of the coping strategies indicates that they are insufficient to satisfy the needs of the workers during the shock. The study, therefore, recommends that governments should provide a flexible working environment, formulate a policy that will allow workers to diversify into businesses, provide business loans and encourage mandatory saving for uncertainty.

Determinants of cesarean delivery in Indonesia: An analysis of the 2017 Indonesia demographic and health survey

Background: According to a statement by the World Health Organization (WHO), the optimal proportion of sectio caesarea (SC) is considered to be between 10-15%. In Indonesia, based on survey data for deliveries using the sectio caesarea (SC) method, the cases increased from 9.8% in 2013 and 17.6% in 2018.Purpose: To determinants of cesarean delivery in Indonesia: An analysis of the 2017 Indonesia demographic and health surveyMethod: This type of research is a quantitative study with a cross-sectional design. The population and sample in this study were 14,087 women of childbearing age 15-49 years who had complete variables. Data analysis used chi-square and multiple logistic regression.Results: Found that there was a significant relationship between sectio caesarea with maternal age, mother's occupation, wealth index, place of residence, spouse's occupation, partner's education, type of birth, history of ANC visits, baby size, health facilities, history of pregnancy complications and delivery, history of miscarriage with p-value &lt; 0,001. And there is no relationship between sectio caesarea and maternal education with a p-value of 0.862. The dominant factor that affects mothers giving birth by cesarean section is the type of birth with an OR of 2.854 times (CI 95% 1,932 – 4,206).Suggestion: It is expected that people who have undergone IVF or pregnancy insemination will carry out the fertilization alone in order to reduce the risk of giving birth by cesarean section and women who are already pregnant with multiple pregnancies are expected to be more diligent in conducting ante-natal care visits so that they can better detect the progress of their pregnancy and prevent complications. which will allow delivery by cesarean section.

Correlates of exclusive breast feeding among nursing mothers attending child health clinic at a general hospital in Rivers State Nigeria

Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF)&#x0D; Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05.&#x0D; Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF.&#x0D; Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.

Predictors of Pregnancy Timing among Women in the Reproductive Age attending Maternal and Child Health Clinics in Kajiado County, Kenya

Maternal age during pregnancy has an influence on the pregnancy outcome. The objective of the study was to investigate the predictors of pregnancy timing among women in the reproductive age attending maternal and child health clinics in Kajiado Central Sub-county. The study employed a cross-sectional analytical study design that used a quantitative approach for data collection. A total of 248 systematically selected women attending maternal and child health clinics participated. The Chi-square test was used to analyze the association between the independent and dependent variables; P &lt; 0.05 was considered significant. Data analysis was based on the USAID recommendation that, to prevent the adverse maternal and child health outcomes; women should delay the first pregnancy until at least the age of 18 years. The predictors of pregnancy timing were found to be; study participant’s formal education level (χ2 = 47.493; df = 4; p = 0.000), spouse formal education level (χ2 = 39.399; df = 4; p = 0.000), study participant’s occupation (χ2 = 22.966; df = 6; p = 0.000), spouse occupation (χ2 = 16.429; df = 5; p = 0.006), female genital mutilation (χ2 =22.757; df = 1; p = 0.000) and spouse approval (χ2 =15.234; df = 1; p = 0.000). The study concludes that there were individual and sociocultural factors that influence the age at which pregnancies occurred. Therefore, the need for reproductive health care stakeholders to design, plan and implement interventions with consideration to the predictors of pregnancy timing.

Reasons for Obstetric Scan Among Pregnant Women in Keffi, Nigeria: A Cross-Sectional Study of a Low-Cost Ultrasound Centre

Ultrasound is a safe diagnostic tool used in pregnancy to detect significant causes of foeto-maternal mortality. We explored the reasons for an obstetric scan in 400 randomly selected pregnant women attending a low-cost ultrasound centre in Nigeria. We used a cross-sectional analysis using a structured interviewer-administered questionnaire.The results showed that the participants were aged 27.37±5.96 years, 76% literate, 68.5% Muslims, 50.5% small-scale self-employees, and 31.45% grand-multiparous. The reasons for an obstetric scan were foetal well-being (44.2%), referral by a health worker (34%), gender determination (9.7%), vaginal bleeding (4.8%), confirmation of pregnancy (2.6%), due-date determination (2.5%), foetal weight estimation (2.1%), and foetal number (0.1%). Spouse education with foetal wellbeing (p = .001), gender determination (p = .002), and dating of gestation (p = .002); participants’ occupation with referral by a health worker (p = .026) and confirmation of pregnancy (p = .044); spouse occupation with foetal wellbeing (p = .004) and vaginal bleeding (p &lt; .001); daily household income with referral by a health worker (p &lt; .001) and pregnancy dating (p = .005); and religion with gender determination (p = .007). Health education and improved access to ultrasound services will go a long way in improving maternal/child health.

أسالیب المعاملة الوالدیة وأثرها على جودة الحیاة لدى عینة من الأسر فی مدینة جدة ( دراسة تطبیقیة )

أسالیب المعاملة الوالدیة وأثرها على جودة الحیاة لدى عینة من الأسر فی مدینة جدة ( دراسة تطبیقیة )

Individual and organizational factors related to social vitality of women working in Birjand University of Medical Sciences, Iran, in 2020

Background and Aims: Happiness and vitality are among the most important and effective components in the process of human life, without which activity, creativity, initiative, invention, and healthy life cannot be created. Happiness is a valuable tool for improving the personality and job performance of employees; meaning that happy people are more successful in the workplace. The creation of social vitality is the priority for comprehensive intervention in South Khorasan Province, Iran, for comprehensive intervention. Therefore, this study aimed to investigate the individual and organizational factors related to the social vitality of women working at the Birjand University of Medical Sciences, Birjand, Iran. Materials and Methods: This descriptive-analytical cross-sectional study was performed on 214 females working at Birjand University of Medical Sciences selected using a systematic random sampling method in 2019. The 29-item Oxford Happiness Standard was used to collect data to measure social vitality. Results: The mean score of the females' happiness was estimated at 73.55±12.32 and the majority of the subjects had moderate happiness (60.3%). Moreover, most of the cases had not participated in happiness courses before (85.6%). The results also showed that happiness had no significant relationship with age, educational level, marital status, education level of the spouse, and occupation of spouse among the women (P&gt;0.05); however, happiness showed a significant relationship with income and place of residence (P&lt;0.05). Conclusion: It seems that the social vitality of working women was moderate; in this respect, it is recommended to officials and planners implement educational interventions to improve the vitality of employees.

Predictors of Payment Methods for Health Care, Perception and Use of the National Health Insurance Scheme among Pregnant Women in Nigeria

Objective: To determine the predictors of payment methods for health care, perception and use of National health insurance scheme (NHIS) among pregnant women in a low income country. Methods: An adapted, pretested, semi-structured, interviewer administered questionnaire was used to collect data from 770 pregnant women attending antenatal care (ANC) services in the two selected tertiary health institutions in south-east Nigeria. All consenting pregnant women attending ANC in the facilities irrespective of age and reason for visit were included. Data analysis was by SPSS version 25. Logistic regression model was used to predict the factors influencing perception and use of NHIS. Statistical significance was accepted when P- value was <0.05. Results: Up to 70.9% of the respondents pay for health care out of their pockets for health services while only 20.0% use the NHIS. Fifty-two percent practice a monthly budget while 67.0% were aware of NHIS. The women had varied perceptions and concerns about NHIS which ranged from inability of the scheme to cover healthcare costs, and reduce hardships from high cost of health care to use of poor quality drugs. Eight (5.2%) of the 154 women that registered with the scheme had never used it. There were statistically significant association between level of education (x2= 107.7, p<0.001), respondents’ occupation (x2=49.6, p<0.001), respondents’ spouse occupation (x2=103.3, p<0.001), monthly income (x2=55.0, p<0.001) as well as age of the respondent (x2=8.2, p=0.004) and the awareness of NHIS in both facilities. Respondents aged less than 39 years were 0.46 times less likely to use NHIS compared to those 39 years and above (AOR=0.46, p< 0.022, 95%CI = 0.236 –0.900). Use of NHIS was significantly associated with educational level (x2=19.0, p<0.001) and occupation of spouse (x2=24.0, p<0.001) in both facilities. There was a significant difference in the method of use of NHIS between the two hospitals (x2=14.83, p<0.001). Conclusion: Majority of pregnant women still pay for health care by out-of-pocket method and awareness about the NHIS was fair and a good number of the women were willing to enrol in the scheme if offered the opportunity. Significant predictors for NHIS use were maternal age, occupation of spouse and income.

Socio-demographic factors associated with HIV prevalence among pregnant women attending antenatal clinics in six Southern States of India: Evidences from the latest round of HIV sentinel surveillance.

HIV/AIDS is a global public health issue and its transmission in a defined geographic region is influenced by the interplay of sociodemographic and behavioral factors. Better understanding of sociodemographic characteristics of HIV-positive individuals is required to prevent the spread of HIV among the general population. The objective of the study was to find the association between HIV prevalence and sociodemographic characteristics of pregnant women aged 15-49 years attending the antenatal clinics (ANCs) in six Southern states of India. The data from the latest round of HIV sentinel surveillance, a cross-sectional study, conducted during January-March 2017 among ANC attendees were considered for this analysis. Blood samples along with other relevant information were collected from 98,634 pregnant women from 248 sites across the states. The association between HIV prevalence and sociodemographic variables was examined using multivariable logistic regression. The highest HIV prevalence was reported in Karnataka (0.38%) and Andhra Pradesh (0.38%), followed by Telangana (0.33%), Odisha (0.28%), Tamil Nadu (0.27%), and Kerala (0.05%). In all states, the prevalence was highest among illiterate pregnant women exception being Kerala, wherein the prevalence was highest in pregnant women with schooling up to primary education. A significant association was found between HIV prevalence and spouse occupation in Karnataka and Odisha and spouse migration in Andhra Pradesh and Karnataka. Need for improvising the interventions for the young, illiterates, having a migrant spouse, and spouse occupation as truckers/hotel staff is recommended to the stakeholders involved in HIV management of the six southern states of India.

Prevalence, Morphological Classification, And Factors Associated With Anemia Among Pregnant Women Accessing Antenatal Clinic At Itojo Hospital, South Western Uganda.

PurposeThe study aimed to determine the prevalence, morphological classification, and risk factors of anemia among pregnant mothers attending antenatal clinic at Itojo hospital, Ntungamo district, southwestern Uganda.Patients and methodsAfter obtaining an informed consent, 5mL of blood was collected from the vein of each participant for complete blood count (CBC) and peripheral film report. The CBC was performed using HumaCount 80 hematology analyzer (HUMAN Gesellschaft für Biochemica und Diagnostica mbH Max-Planck-Ring 21 65,205 Wiesbaden Germany). Peripheral blood smears were made and stained using Wright’s Romanowsky stain and examined under ×1000 magnification for morphological classification of anemia. Structured questionnaires were administered to each participant to collect information on patients’ demography and risk factors of anaemia in pregnancy. The data generated were prepared in EXCEL and later transferred to SPSS version 20 for analysis. Univariate logistic regression and multivariate logistic regression were used to evaluate the association of socio-demographic characteristics of the participants with anemia. A 95% confidence level was used and statistical significance was reached at p<0.05.ResultsOne hundred and sixty-three participants (n=163) were recruited for the study with the median age of 25 years and range of (17 to 40 years). The overall prevalence of anemia was 12 (7.4%), the morphological classification was 1 (8.3%) normocytic normochromic anemia, 6 (50%) microcytic hypochromic anemia, and 5 (41.7%) macrocytic anemia. Spouse occupation (p=0.03), household income (p=0.04), use of insecticide-treated mosquito nets (p=0.001), history of urinary tract infection (p=0.002), use of haematinics (p≤0.001), and history of postpartum hemorrhage (p=0.03) were significantly associated with anemia in pregnancy.ConclusionDespite the reported high prevalence of anemia in pregnancy in other areas within the country, anemia prevalence was low in this study. Routine screening for anemia at all antenatal care clinics countrywide is recommended.

Fertility Motivations and Its Related Factors in Women of Reproductive Age Attended Health Centers in Sabzevar, Iran

Background & aim: The severe reduced fertility rate and growing increase of older population in Iran have led to economic and social consequences in the country. Therefore, the purpose of this study was to investigate the fertility motivations and some of its related factors in women of reproductive age referring to urban health centers. Methods: This cross-sectional study was performed on 450 women. The population consisted of fertile women within the age range of 18- 35 years referring to urban health centers of Sabzevar, Iran in 2016, who were selected by cluster sampling. Data collection tools included demographic and Miller’s Childbearing Questionnaire. Data analysis was performed in SPSS (version 22) using descriptive statistics, Pearson correlation test, Spearman correlation test, the Kruskal Wallis, and regression test. Results: The means of positive and negative fertility motivation were 22.64±0.33 and 17.1±3.85, respectively. There was a significant negative correlation between positive fertility motivation with educational level (P=0.01), as well as negative fertility motivation with income level (P=0.001). Moreover, positive fertility motivation correlate positively with age (P=0.01), number of pregnancies, childbirth and children (P=0.001). There was a significant relationship among child gender, accommodation, and spouse occupation (P=0.01). Conclusion: The results of this study showed that factors including age, educational level, number of pregnancies and children, income level, spouse occupation and accommodation can affect fertility motivation. It is suggested that population policies can increase fertility rate by enhancing fertility motivations.

Reproductive tract infections in rural India - A population-based study.

Context:Reproductive tract infections (RTI) occupy the second position among public health problems.Aims:To find out the prevalence of RTI and its associated conditions among ever married women in the reproductive age group (15–49 years).Settings and Design:This cross-sectional study was conducted among 330 women in a rural area of Poonamallee block at Thiruvallur district in Tamil Nadu from August 2013 to January 2014.Materials and Methods:In this cross-sectional study, the selection of participants was done through cluster sampling and data on symptoms by questionnaires.Statistical Analysis Used:For descriptive prevalence, statistics was used. Using Chi-Square, categorical data were analyzed and using the odds ratio P value associations were assessed.Results:About 21% had anyone symptom of RTI. Occupation of women (OR2.0), occupation of spouse (OR1.9), anemia (OR 2.0), dysuria (OR51.5), burning micturition (OR15.9), frequency (OR3.3)/the urgency of urination (OR2.7), and incomplete urination (OR5.4)/defecation (OR3.6) were significantly associated with RTI. The prevalence rate of abnormal vaginal discharge was more (12%) than any other symptoms (each < 4%) of RTIs.Conclusions:The prevalence of RTI was high. Moreover, women with dysuria, burning micturition, incomplete urination/defecation, frequency/the urgency of urination, and anemia are at a higher risk of developing RTI.

Determinants of Choice of Place of Delivery among Women Attending Two Referral Hospitals in Kano North-West Nigeria.

Background:Women are often unable to choose for themselves when, where, and from whom to seek care. This study was undertaken to determine factors that influence a woman's choice of place of delivery among women attending immunization clinics in two referral hospitals in Kano, Nigeria.Materials and Methods:A hospital-based cross-sectional descriptive study conducted among 314 women who delivered in Kano, Nigeria. Stratified random sampling was done. Pretested, interviewer-administered questionnaires were used to obtain responses about sociodemographic characteristics, choice of place of delivery, and factors that influenced their choice of place of delivery. Ethical approval was obtained from an ethical committee. Women who gave birth within the past 12 months and gave informed consent were recruited. The data were analyzed using SPSS statistical software version 22.Results:About 218 (69.4%) women had their previous delivery in the health facility, whereas 96 (30.6%) had theirs outside the health facilities. The level of satisfaction in health facility care was also high. For those who had their deliveries outside the health facility, 37 (38.5%) of the deliveries were monitored by a nurse/midwife. The respondents level of education (P ≤ 0.001), spouse level of education (P < 0.001), spouse occupation (P ≤ 0.015), human influence (P = 0.025), and total cost of each visit (P = 0.010) were associated with the choice of place of delivery; however, at multivariate logistic regression, only human influence and respondents level of education were determinants of the choice of place of delivery.Conclusion:Most of the respondents had their previous deliveries in the health facilities and had a high level of satisfaction with the health facilities where they delivered compared to other studies. Utilization of the health facilities for childbirth may increase if there is involvement of relations, especially husbands and mothers and if the clients' level of education is improved.

Factors Affecting the Place of Delivery among Mothers Residing in Jhorahat VDC, Morang, Nepal.

In Nepal, the maternal mortality ratio is 281 per thousand live births, among which 40% mortality occurs during home delivery. Home delivery increases the risk of maternal and neonatal mortality and morbidity due to the birth not assisted by skilled attendant. This study was carried out to determine the factors affecting the place of delivery among the mothers residing in Jhorahat VDC, Morang district, Nepal. A mixed method study using interviews based on semi-structured questionnaire (n=93) among mothers and two focus group discussion among decision makers of the house and female community health volunteers was conducted between November to December 2012. For quantitative data, Chi-square test and Fischer's Exact test were used to examine the association between the selected variables and place of delivery. More than half (58.1%) of the mothers had institutional delivery and 41.9% of them had home delivery. The most common reason for home delivery was easy and convenient environment (66.7%) and that for institutional delivery was safety (77.8%). There was a significant association between caste, education of mothers, education of spouse, occupation of spouse, per capita income, time to reach the nearest health center, parity, previous place of delivery, number of antenatal visit, knowledge about place of delivery, planned place of delivery, and place of delivery. Maternal health services, such as prenatal care, skilled assistance during delivery and post-natal care, along with adequately equipped health institutions, play a major role in the reduction of maternal morbidity and mortality. Concerted efforts should be made both at community and government levels to increase institutional delivery.

Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: a cross-sectional study

BackgroundLow knowledge of danger signs has been shown to delay seeking obstetric care which leads to high maternal mortality and morbidity worldwide. In Tanzania about half of pregnant women are informed about obstetric danger signs during antenatal care, but the proportion of those who have full knowledge of these obstetric danger signs is not known. This study assessed the knowledge of obstetric danger signs and its associated factors among recently-delivered women in Chamwino District, Tanzania.MethodsA community-based cross-sectional study was conducted in January 2014 in Chamwino District, Tanzania. A woman was considered knowledgeable if she spontaneously mentioned at least five danger signs in any of the three phases of childbirth (pregnancy, childbirth and postpartum) with at least one in each phase. Multistage cluster sampling was used to recruit study participants. Descriptive and bivariate analyses were conducted. Multivariable logistic regression analyses were performed to control for confounding and other important covariates.ResultsA total of 428 women were interviewed. The median age (IQR) was 26.5 (22–33) years. Only 25.2% of respondents were knowledgeable about obstetric danger signs during pregnancy, childbirth/labour and postpartum. Significant explanatory variables of being knowledgeable about obstetric danger signs were found to be maternal education (AOR = 1.96; 95% CI: 1.01, 3.82), maternal occupation (AOR = 2.23; 95% CI; 1.10, 4.52), spouse occupation (AOR = 2.10; 95% CI: 1.02, 4.32) and counseling on danger signs (AOR = 3.42; 95% CI: 1.36, 8.62) after controlling for the clustering effect, confounding and important covariates.ConclusionA low proportion of women was found to be knowledgeable about obstetric danger signs in Chamwino district. Therefore, we recommend the Ministry of Health to design and distribute the maternal health booklets that highlight the obstetric danger signs, and encourage antenatal care providers and community health workers to provide frequent health education about these danger signs for every pregnant woman in order to increase their level of knowledge about obstetric danger signs.