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The timing and quality of antenatal care received by women attending a primary care centre in Iquitos, Peru: A facility exit survey.

ABSTRACT: BACKGROUND:Maternal mortality is high in Loreto, Peru, but can be reduced by high quality antenatal care. Indicators for the quality of antenatal care received include the timing (with respect to gestational age) and number of antenatal appointments attended, the delivery of antenatal services and health information, and women's perceptions about their care. This study investigated these indicators amongst women receiving antenatal care in predominantly the San Juan Bautista district of Iquitos, Loreto. This was to identify areas for improvement through comparison with antenatal guidelines published by the Ministry of Health, Peru, and the World Health Organization. METHODS:A total of 134 women were recruited at the Centro de Salud, San Juan-a primary care centre in Iquitos. Information about the delivery of antenatal services and the number of and gestational ages at appointments attended was collected from 121/134 women's hand-held antenatal cards. The delivery of health information and women's perceptions about their antenatal care were investigated through questionnaires (133/134 completed). Descriptive statistics, such as frequencies and valid percentages, were determined. RESULTS:Hand-held antenatal cards revealed that 52.9% of participants began their antenatal care in the first trimester. Compared to national guidelines, 42.1% attended appointments at recommended gestational ages and no women received all recommended antenatal services. Most women received information about identifying complications in pregnancy and health and lifestyle topics. Over 85% of women reported satisfaction with their antenatal care. CONCLUSIONS:Timely antenatal attendance and delivery of services should be encouraged to meet national and global standards. Although all services were not delivered in a combined manner according to national guidelines, individual services were mostly delivered to a high standard and therefore a high proportion of women were satisfied with their antenatal care.

SUBMITTER: Wynne SJ

PROVIDER: S-EPMC7058332 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The timing and quality of antenatal care received by women attending a primary care centre in Iquitos, Peru: A facility exit survey.

Wynne Sara Jabeen SJ Duarte Rui R de Wildt Gilles G Meza Graciela G Merriel Abi A

PloS one 20200305 3

<h4>Background</h4>Maternal mortality is high in Loreto, Peru, but can be reduced by high quality antenatal care. Indicators for the quality of antenatal care received include the timing (with respect to gestational age) and number of antenatal appointments attended, the delivery of antenatal services and health information, and women's perceptions about their care. This study investigated these indicators amongst women receiving antenatal care in predominantly the San Juan Bautista district of ...[more]

PMID: 32134987

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Project description:BackgroundReceiving quality antenatal care (ANC) from skilled providers is essential to ensure the critical health circumstances of a pregnant woman and her child. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care and the number of items of antenatal care content received from skilled providers in recent pregnancies among mothers in Ethiopia.MethodsThe data was extracted from the Ethiopian Demographic and Health Survey 2016. A total of 6645 mothers were included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with the timing and items of the content of ANC services. The 95% Confidence Interval of Odds Ratio/Incidence Rate Ratio, excluding one, was reported as significant.ResultsAbout 20% of the mothers initiated ANC within the first trimester, and only 53% received at least four items of antenatal care content. Being rural residents (IRR = 0.82; 95%CI: 0.75-0.90), wanting no more children (IRR = 0.87; 95%CI: 0.79-0.96), and the husband being the sole decision maker of health care (IRR = 0.88; 95%CI: 0.81-0.96), were associated with reduced items of ANC content received. Further, birth order of six or more (IRR = 0.74; 95%CI: 0.56-0.96), rural residence (IRR = 0.0.41; 95%CI: 0.34-0.51), and wanting no more children (IRR = 0.61; 95%CI: 0.48-0.77) were associated with delayed antenatal care utilization.ConclusionsRural residences, the poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision-making power, and considerable distance to the nearest health facility have a significant impact on delaying the timing of ANC visits and reducing the number of items of ANC received in Ethiopia. Mothers should start an antenatal care visit early to ensure that a mother receives all of the necessary components of ANC treatment during her pregnancy.

Project description:Background:Depression affects approximately 10 to 20% of pregnant women globally, and one in ten and two in five women in developed and developing countries develop depression during pregnancy, respectively. However, evidence regarding its magnitude and predictors in Southern Ethiopia is limited. The present study is aimed at assessing the magnitude and predictors of antenatal depression among pregnant women attending antenatal care in Sodo town. Methods:A facility-based cross-sectional study was conducted among 403 antenatal care attendants in Sodo town from November 2 to January 30, 2017. Systematic random sampling was used to select the study population, and data were collected by using a pretested and structured questionnaire. Data were entered using Epi-data 4.2 and then exported and analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were used to assess the association between the dependent variable and independent variables. Variables with P value less than 0.05 were considered as statistically significant. Results:A total of 400 pregnant women were interviewed. The magnitude of antenatal depression was 16.3% (95% CI (12.8%, 19.9%)). Husband's educational status, at the college and above (AOR: 0.09; 95% CI (0.03, 0.34), regular exercise (AOR: 0.16; 95% CI (0.07, 0.36)), planned pregnancy (AOR: 0.16; 95% CI (0.06, 0.44)), use of family planning (AOR: 0.31; 95% CI (0.14, 0.66)), previous history of anxiety (AOR: 2.96; 95% CI (1.30, 6.74)), previous history of obstetric complications (AOR: 19.03; 95% CI (5.89, 61.47)), and current obstetric complications (AOR: 30.38; 95% CI (3.14, 294.19)) were significant predictors of antenatal depression. Conclusion:Nearly one in six pregnant women had antenatal depression. The husband's educational status, regular exercise, planned pregnancy, use of family planning, previous history of anxiety, previous history of obstetric complications, and current history of obstetric complications were significant predictors of antenatal depression. Screening for depression during routine antenatal care could be essential and recommended to identify early and prevent further morbidities and mortalities due to antenatal depression.

Project description:Background:A pregnancy is described unintended if it is either unwanted or mistimed. The former occurs when no child or no more children are desired, and the latter is when the conception occurs earlier than the desired time, but wanted later. Unwanted pregnancy causes a serious health, economic, and social problem to the woman and her family. In the study area, there is limited data on unintended pregnancy. Therefore, this study fills this gap by studying the magnitude of unintended pregnancy and its associated factors among pregnant women attending antenatal care in the study area. Methods:A facility-based cross-sectional study was done from 1 March to 1 April 2019, among 612 randomly selected pregnant women attending antenatal care at Bako Tibe district public health facility. The data were collected via interview using a structured and pretested questionnaire. They were entered into EpiData Version 3.1 and SPSS Version 23 for cleaning and analyses. The variables, which were significant at P ? 0.2 in the bivariate logistic regression, were included in the multivariable analysis. The direction and strength of statistical association were measured by an odds ratio with 95% CI. A variable with a P value < 0.05 was considered a significantly associated factor with the outcome one. Results:In this study, the prevalence of unintended pregnancy was 33.3%, at 95% CI (29.8, 37.3). The factors that had significant association with unintended pregnancy were family?size ? 6 (AOR = 8.0, 95% CI: 1.38-46.66), women who did not communicate about family planning with their husbands (AOR = 2.8, 95% CI: 1.50-5.20), and parity ? 5 (AOR = 3.0, 95% CI: 1.34-6.8). Conclusion:About one-third of the pregnant women reported that their pregnancy was unintended. Parity, family size, and lack of spousal communication showed a significant association with the problem. To decrease the current level of unintended pregnancy in the area, the Bako Tibe District Health Bureau and the health workers should work harder to scale up spousal communication on family planning.

Project description:IntroductionLong-term disease surveillance data provide a basis for studying drivers of pathogen transmission dynamics. Dengue is a mosquito-borne disease caused by four distinct, but related, viruses (DENV-1-4) that potentially affect over half the world's population. Dengue incidence varies seasonally and on longer time scales, presumably driven by the interaction of climate and host susceptibility. Precise understanding of dengue dynamics is constrained, however, by the relative paucity of laboratory-confirmed longitudinal data.MethodsWe studied 10 years (2000-2010) of laboratory-confirmed, clinic-based surveillance data collected in Iquitos, Peru. We characterized inter and intra-annual patterns of dengue dynamics on a weekly time scale using wavelet analysis. We explored the relationships of case counts to climatic variables with cross-correlation maps on annual and trimester bases.FindingsTransmission was dominated by single serotypes, first DENV-3 (2001-2007) then DENV-4 (2008-2010). After 2003, incidence fluctuated inter-annually with outbreaks usually occurring between October and April. We detected a strong positive autocorrelation in case counts at a lag of ? 70 weeks, indicating a shift in the timing of peak incidence year-to-year. All climatic variables showed modest seasonality and correlated weakly with the number of reported dengue cases across a range of time lags. Cases were reduced after citywide insecticide fumigation if conducted early in the transmission season.ConclusionsDengue case counts peaked seasonally despite limited intra-annual variation in climate conditions. Contrary to expectations for this mosquito-borne disease, no climatic variable considered exhibited a strong relationship with transmission. Vector control operations did, however, appear to have a significant impact on transmission some years. Our results indicate that a complicated interplay of factors underlie DENV transmission in contexts such as Iquitos.

Project description:BACKGROUND:Khat (Catha edulis) is a fresh green leave commonly chewed for recreational purpose and its euphoric effect as a result of dopamine activities stimulation effect of Khat. Women may use Khat during their pregnancy to tolerate their pregnancy related distress. Khat has biological, social or psychological complications; adverse pregnancy outcomes and negatively affects the health of the mother and the fetus. However, magnitude, pattern and associated factors of Khat use are not well addressed among pregnant women in Ethiopia. The aim of this study was to address this gap by assessing the magnitude and associated factors of Khat use among women attending antenatal care service at Gedeo zone rural health centers. METHODS:This was a facility based cross-sectional study conducted at rural health centers in Gedeo zone from June 1st to August 1st, 2017. The data were collected through structured interview using an interview guide developed from different literatures. A total of 718 pregnant women attending antenatal care service participated in the study using multi stage sampling technique. Bivariable and multivariable analysis were used to identify associated factors of Khat use among women during their current pregnancy period. In the multivariable analysis, variables with P-Values of less than 0.05 were considered as statistically significant correlates of Khat use. The strength of the association was also measured with adjusted odds ratio at a corresponding 95% confidence interval. RESULTS:The lifetime and current prevalence of khat use among pregnant women were 11.0% (95%CI: 8.8-13.2) and 9.9% (95% CI: 7.7-12), respectively. The odds of being khat user was higher among those who had khat user partner [AOR?=?3.450, 95% C.I (1.907-6.244)], respondents with alcohol use behavior [AOR?=?3.235, 95% C.I (1.573-6.659)] and mental distress [AOR?=?3.575, 95% C.I (2.067-6.189)]. CONCLUSION:Significant proportions of pregnant women were experiencing khat chewing during pregnancy. Having khat user partner, alcohol use behavior and metal distress were significantly associated with khat use of pregnant women. This demonstrates a need to integrate the prevention, early identification and intervention of Khat use as a component of treatment modality for pregnant women during their antenatal visit.

Project description:IntroductionA pregnancy that has been complicated with Hepatitis B virus (HBV) infection results in typical management problems for both the mother and the newborn. One of the universal efforts in tackling the impact of chronic HBV is the prevention of mother-to-child transmission during Antenatal care via prompt screening as the majority of chronic infections globally harbored during this period. Rewarding result have been achieved in reducing this problem at this period of life through maternal screening programs and universal vaccination of infants. This study was aimed at assessing the seroprevalence and associated risk factor of HBV among pregnant women attending Antenatal Care (ANC) in Dilla University Referral Hospital (DURH), Southern Ethiopia.MethodA facility- based cross- sectional study was conducted from December 01 to May 30, 2017 among pregnant women attending ANC. A total of 236 pregnant women were included in this study. All Pregnant women who were attending antenatal clinic and were volunteer during the study period were included, whereas those women who were unable to communicate due to any problem, and not volunteer to give informed consent were excluded. Volunteer participants were asked to complete a questionnaire and had offered to test for HBsAg infection. The data was analyzed using SPSS version 20 software. Logistic regression was used to determine the association between dependent and independent variables.ResultsFrom 215 pregnant women attending ANC, the prevalence of HBsAg by the rapid test was found to be 11 (5.1%). Among the study participants, 91.1% (215) were tested for HIV antibody during the ANC visit, with the positivity rate of 4.5%. The result showed 1.86% of the study participants who were tested for HIV were also positive for HBsAg. Among those factors affecting the transmission of HBV infection, multiple partners and HIV confection have significant association at P-value less than 0.05.ConclusionThe Seropositivity of Hepatitis B Virus among Pregnant Women was found to be significant and hence, routine screening of pregnant mother at Antenatal care for this virus, and subsequent management according to the guideline for both the mother and child is recommended.

Project description:Anemia is a major cause of morbidity and mortality of pregnant women and increases the risks of fetal and neonatal morbidity and mortality. Approximately 50% of all anemia is estimated to be caused by low dietary intake of iron, poor absorption of dietary iron, or blood loss. The objective of the present study was to determine the prevalence of and assess the dietary habits associated with anemia in pregnant women receiving antenatal care (ANC) in Unguja Island, Tanzania. A cross-sectional study was conducted to select 338 pregnant women at Kivunge, Mwembeladu, and Mnazimmoja hospitals from March to June 2018. Hemoglobin concentration was measured using a HemoCue photometer on capillary blood. Sociodemographic data and dietary habits were collected using a structured questionnaire. Multivariate logistic regression analysis was carried out to determine the predictors of anemia in pregnant women. The overall prevalence of anemia was 80.8%. Of these 68.64% had mild anemia, 11.24% had moderate anemia, and 0.89% had severe anemia. Anemia was significantly associated with inadequate dietary diversity [adjusted OR (AOR): 1.16; 95% CI: 0.57, 2.36; P < 0.05], drinking tea or coffee with a meal (AOR: 0.06; 95% CI: 0.03, 0.13; P < 0.001), consuming <3 meals/d (AOR: 2.92; 95% CI: 1.60, 5.84; P < 0.001), higher education level (AOR: 3.4; 95% CI: 1.6, 7.2; P < 0.0001), birth interval <2 y (AOR: 3.6; 95% CI: 1.1, 11.9; P < 0.05), and multigravida status (AOR: 1.2; 95% CI: 0.3, 4.4; P < 0.0001). The prevalence of anemia in this study demonstrates a severe public health problem among pregnant women. Inadequate dietary diversity coupled with inadequate daily meal intake and consumption of tea or coffee were the dietary habits predicting anemia in pregnant women. Other predictors of anemia were higher education level, multigravida status, and birth interval <2 y. Nutrition policy interventions are needed to complement ANC services by providing important information on healthy eating habits during pregnancy.

Dataset Information

The timing and quality of antenatal care received by women attending a primary care centre in Iquitos, Peru: A facility exit survey.

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The timing and quality of antenatal care received by women attending a primary care centre in Iquitos, Peru: A facility exit survey.

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