المؤلفون: Courtney A. Schreiber, Arden McAllister, Jessica Fishman, Ernest Maya, Danielle Schurr, Richard Adanu, Roseline Doe, Kareem Mumuni, Mary E. Gaffield, Sarita Sonalkar, Svetlin Kolev, Ali Samba

المصدر: Int J Gynaecol Obstet

مصطلحات موضوعية: medicine.medical_specialty, Attitude of Health Personnel, Pilot Projects, World Health Organization, Ghana, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Baseline (configuration management), mHealth, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, General Medicine, Monitoring and evaluation, Mobile Applications, Compendium, Family planning, Family Planning Services, Family medicine, Feasibility Studies, Female, business, Inclusion (education), Postpartum period, Qualitative research

الوصف: OBJECTIVE: To assess the feasibility, functionality and acceptability of a mobile application (app), the World Health Organization (WHO) Postpartum Family Planning (PPFP) Compendium, in clinical care. METHOD: This prospective qualitative study was conducted among family planning providers routinely delivering PPFP care in Accra, Ghana. We conducted in-depth interviews at baseline and 3 months after app introduction. We elicited expected technological, psychological and environmental barriers to use, actual use in clinical settings, and feedback for app improvement. With inter-coder reliability, we analyzed the content of interview transcripts. RESULTS: Twenty providers participated in baseline interviews, and 19 participated in follow-up interviews. At baseline, providers did not have significant technological barriers to its use and felt the app was acceptable, but were concerned about the appropriateness of using an app during clinical care. At 3-month follow-up, 18 out of 19 participants reported using the app weekly, and found the app acceptable for use in clinical care. Providers recommended expanding clinical content and including similar guidance relevant to times outside the postpartum period. CONCLUSIONS: Use of a PPFP counseling app to aid family planning providers in clinical care delivery is feasible and acceptable. Providers recommended inclusion of similar guidance relevant to times outside the postpartum period.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0b8644f1456cd0ff0b2f1bc070096d56Test
https://doi.org/10.1002/ijgo.13631Test

المؤلفون: Temitope Ojo, Franklin N. Glozah, Isaac Ampomah, Philip Baba Adongo, Noa Appleton, Joel Birkemeier, Richard Adanu, Nessa Ryan, Bernadette Boden-Albala

المصدر: Implementation Science Communications, Vol 1, Iss 1, Pp 1-14 (2020)
Implementation Science Communications

مصطلحات موضوعية: Intervention adaptation, lcsh:R5-920, Research, Psychological intervention, Health services research, Exploratory research, Qualitative methods, Focus group, Ghana, Health administration, Pre-implementation, Stroke, 03 medical and health sciences, Cultural adaptation, Proctor’s taxonomy of implementation outcomes, 0302 clinical medicine, Nursing, Community health, Hypertension, 030212 general & internal medicine, Thematic analysis, Psychology, lcsh:Medicine (General), 030217 neurology & neurosurgery, Qualitative research

الوصف: Background Stroke is a major cause of death in Ghana. Evidence-based interventions for stroke prevention have been successful in the US; however, in low- and middle-income countries (LMICs), such interventions are scarce. The “Discharge Education Strategies for Reduction of Vascular Events” (DESERVE) intervention led to a 10-mmHg reduction in systolic blood pressure (SBP) among Hispanic survivors of mild/moderate stroke and transient ischemic attack (TIA) at 1-year follow-up. Our objectives were to capture the perceptions of a diverse set of stakeholders in an urban community in Ghana regarding (1) challenges to optimal hypertension management and (2) facilitators and barriers to implementation of an evidence-based, skills-based educational tool for hypertension management in this context. Methods This exploratory study used purposive sampling to enroll diverse stakeholders in Accra (N = 38). To identify facilitators and barriers, we conducted three focus group discussions: one each with clinical nurses (n = 5), community health nurses (n = 20), and hypertensive adults (n = 10). To further examine structural barriers, we conducted three key informant interviews with medical leadership. All interviews were audio recorded and transcribed. Thematic analysis was carried out via deductive coding based on Proctor’s implementation outcomes taxonomy, which conceptualizes constructs that shape implementation, such as acceptability, adoption, appropriateness, cost, and feasibility. Results Findings highlight facilitators, such as a perceived fit (appropriateness) of the core intervention components across stakeholders. The transferable components of DESERVE include: (1) a focus on risk knowledge, medication adherence, and patient–physician communication, (2) facilitation by lay workers, (3) use of patient testimonials, (4) use of a spirituality framework, and (5) application of a community-based approach. We report potential barriers that suggest adaptations to increase appropriateness and feasibility. These include addressing spiritual etiology of disease, allaying mistrust of biomedical intervention, and tailoring for gender norms. Acceptability may be a challenge among individuals with hypertension, who perceive relative advantage of alternative therapies like herbalism. Key informant interviews highlight structural barriers (high opportunity costs) among physicians, who perceive they have neither time nor capacity to educate patients. Conclusions Findings further support the need for theory-driven, evidence-based interventions among hypertensive adults in urban, multiethnic Ghana. Findings will inform implementation strategies and future research.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0cf46b3cf7ff231eccdab07da6a832beTest
http://link.springer.com/article/10.1186/s43058-020-00084-8Test

المؤلفون: Raphael E. Arku, Richard Adanu, Ayaga A. Bawah, Allan G. Hill, Rosemary B. Duda, Sierra N. Clark, Günther Fink, R. Darko, Richard B. Biritwum, James E. Bennett, Majid Ezzati

المصدر: PLoS Medicine, Vol 18, Iss 11, p e1003850 (2021)
PLoS Medicine
PLoS Medicine, Vol 18, Iss 11 (2021)

مصطلحات موضوعية: Percentile, Physiology, Social Sciences, Blood Pressure, 030204 cardiovascular system & hematology, Vascular Medicine, Ghana, Body Mass Index, Geographical Locations, 0302 clinical medicine, Diastole, 11. Sustainability, Medicine and Health Sciences, Public and Occupational Health, 030212 general & internal medicine, 10. No inequality, education.field_of_study, Geography, 1. No poverty, Censuses, General Medicine, Census, Socioeconomic Aspects of Health, 3. Good health, Physiological Parameters, Research Design, Small-Area Analysis, Medicine, Female, Research Article, Adult, medicine.medical_specialty, Systole, Population, Research and Analysis Methods, Human Geography, Urban Geography, 03 medical and health sciences, medicine, Adults, Humans, Obesity, Cities, education, Socioeconomic status, Behavior, Spatial Analysis, Survey Research, business.industry, Public health, Body Weight, Biology and Life Sciences, Bayes Theorem, medicine.disease, Health Surveys, Health Care, Blood pressure, Socioeconomic Factors, Age Groups, People and Places, Africa, Earth Sciences, Population Groupings, business, Body mass index, Demography

الوصف: Background Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana. Methods and findings We combined a representative survey of adult women’s health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated. Conclusions We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra.
Sierra N. Clark and colleagues analyze spatial variations of blood pressure and body mass index, and associated factors in Ghanaian women.
Author summary Why was this study done? The social, physical, and food environment influence the spatial distribution of noncommunicable diseases and their risk factors such as blood pressure (BP) and body-mass index (BMI) within and across neighbourhoods in cities. In sub-Saharan Africa (SSA), where cities are growing rapidly and BMI and BP have risen, there is limited information on within-city variation in cardiometabolic risk factors. This information could inform targeted and equitable public health programmes. What did the researchers do and find? We combined data from an epidemiological study that had randomly sampled women in Accra and geospatial data on roads and community biomass fuel use to understand how individual and household factors as well as residence predict BMI and BP. Data were analysed in a Bayesian spatial model and then used together with the data from the census to predict BP and BMI levels for all women in Accra. Local area variation in BMI and BP is large within Accra, similar to patterns seen in other cities and regions around the world. Average BMI was higher among women with higher socioeconomic status (SES), as measured by ownership of assets and household infrastructure. What do these findings mean? The spatial variations in BMI and BP across neighbourhoods in Accra were almost as high as variation seen between countries. Localised public health actions can help address these disparities and reduce the resulting overall public health burden.

وصف الملف: text; application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8eb84dbac590ef0323bdcc09a37c8a07Test
https://eprints.soton.ac.uk/452299Test/

المؤلفون: Richard Adanu, Vanessa Zubach, Adolf Kofi Awua, Alberto Severini, E K Wiredu, Edwin Afari

المصدر: Advances in Preventive Medicine
Advances in Preventive Medicine, Vol 2020 (2020)

مصطلحات موضوعية: Non vaccine type, medicine.medical_specialty, education.field_of_study, Article Subject, Cross-sectional study, business.industry, Population, General Medicine, Multiple infections, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, Genotype, Epidemiology, medicine, 030212 general & internal medicine, Public aspects of medicine, RA1-1270, Epidemiologic data, Human papillomavirus, education, business, Research Article

الوصف: Background. Population-specific epidemiologic data on human Papillomavirus infection, which are limited in most of the SubSaharan African countries, are necessary for effective cervical cancer prevention. This study aimed to generate population-specific data on human Papillomavirus infections, and determine which of these, self-collected and provider-collected specimens, gives a higher estimate of the prevalence of human Papillomaviruses, including vaccine and non-vaccine-type human Papillomavirus. Methods. In this cross-sectional study, following a questionnaire-based collection of epidemiological data, self-, and provider-collected specimens, obtained from women 15−65 years of age, were analysed for human Papillomavirus types by a nested-multiplex polymerase chain reaction, and for cervical lesions by Pap testing. HPV data were categorised according to risk type and vaccine types for further analysis. Results. The difference between the overall human Papillomavirus infection prevalences obtained with the self-collected specimens, 43.1% (95% CI of 38.0–51.0%) and that with the provider-collected samples, 23.3% (95% CI of 19.0–31.0%) were significant (p≤0.001). The prevalence of quadrivalent vaccine-type human Papillomaviruses was 12.3% with self-collected specimens, but 6.0% with provider-collected specimens. For the nonavalent vaccine-types, the prevalences were 26.6% and 16.7% respectively. There were multiple infections involving both vaccine-preventable and nonvaccine preventable high-risk human Papillomavirus genotypes. Conclusion. The Akuse subdistrict can, therefore, be said to have a high burden of human Papillomavirus infections, which included nonvaccine types, as detected with both self-collected and provider-collected specimens. These imply that self-collection is to be given a higher consideration as a means for a population-based high-risk human Papillomavirus infections burdens assessment/screening. Additionally, even with a successful implementation of the HPV vaccination, if introduced in Ghana, there is still the need to continue with the screening of women.

وصف الملف: text/xhtml

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ff52971a2937b2506afd45c109494866Test
https://doi.org/10.1155/2020/8343169Test

المؤلفون: Chelsey R Canavan, Ayoade M.J. Oduola, Anne Marie Darling, Till Bärnighausen, Said A. H. Vuai, Yemane Berhane, Christopher R. Sudfeld, Ali Sié, David Guwatudde, Richard Adanu, Yadeta Dessie, Mary Mwanyika Sando, Japhet Killewo, Justine Bukenya, Wafaie W. Fawzi

المصدر: Tropical Medicine & International Health. 25:15-32

مصطلحات موضوعية: Male, Adolescent, Health Status, Sexual Behavior, Health Behavior, 030231 tropical medicine, Adolescent Health, Psychological intervention, Poison control, Violence, Suicide prevention, Occupational safety and health, Interviews as Topic, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Pregnancy, Risk Factors, Injury prevention, Humans, Medicine, Body Weights and Measures, Child, Exercise, Africa South of the Sahara, Depression (differential diagnoses), Reproductive health, business.industry, Age Factors, Public Health, Environmental and Occupational Health, Diet, Cross-Sectional Studies, Mental Health, Infectious Diseases, Socioeconomic Factors, Pregnancy in Adolescence, Female, Parasitology, business, Demography, Adolescent health

الوصف: To measure health-related behaviours and risk factors among sub-Saharan African adolescents.Cross-sectional study in nine communities in Burkina Faso, Ethiopia, Eswatini, Ghana, Nigeria, Tanzania and Uganda between 2015 and 2017. Community-representative samples of males and females 10-19 years of age were selected. All communities used a uniform questionnaire that was adapted from the WHO Global School-based Student Health Survey. Weighted prevalence estimates and 95% confidence intervals were calculated for each indicator and stratified by age and sex using SAS version 9.4. All prevalence estimates were pooled across communities through random-effects meta-analyses in Stata version 14.A total of 8075 adolescents participated in the study. We observed a high prevalence of inadequate fruit consumption (57-63%) and low physical activity (82-90%); a moderate prevalence of inadequate vegetable consumption (21-31%), unprotected last sex (38-45%), age at first sex15 years (21-28%) and bullying and physical fighting (12-35%); and a low prevalence of mental health risk factors (1-11%) and alcohol and substance use risk factors (0-6%). We observed a moderate to high prevalence of daily soft drink consumption (21-31%) for all adolescents. Among sexually active adolescents 15-19 years, 37% of females reported ever being pregnant and 8% of males reported to have ever made someone pregnant. Bullying (23%) and physical fighting (35%) were more common among younger male adolescents . The prevalence of low mood was generally higher among older (15-19 years) than younger adolescents (10-14 years). The proportion of adolescents reporting alcohol, drug or cigarette use was very small, with the exception of khat use in Ethiopia.Overall, diet and physical activity, violence, sexual and reproductive health, and depression are important risk factors for these sub-Saharan African communities. These findings suggest that more evidence is needed including novel efforts for the collection of sensitive information, as well as a need to move towards community-tailored interventions to reach adolescent populations with varying needs.Mesurer les comportements liés à la santé et les facteurs de risque chez les adolescents africains subsahariens. MÉTHODES: Etude transversale dans neuf communautés au Burkina Faso, en Ethiopie, à Eswatini, au Ghana, au Nigéria, en Tanzanie et en Ouganda entre 2015 et 2017. Des échantillons représentatifs de la communauté composés d'hommes et de femmes âgés de 10 à 19 ans ont été sélectionnés. Toutes les communautés ont utilisé un questionnaire uniforme adapté de l'Enquête Mondiale sur la Santé des Elèves de l'OMS. Les estimations de prévalence pondérée et les intervalles de confiance à 95% ont été calculés pour chaque indicateur et stratifiées par âge et sexe à l'aide de la version 9.4 de SAS. Toutes les estimations de prévalence ont été poolées dans les communautés via des méta-analyses à effets aléatoires dans Stata, version 14. RÉSULTATS: 8.075 adolescents ont participé à l'étude. Nous avons observé une prévalence élevée de consommation insuffisante de fruits (57-63%) et de faible activité physique (82-90%); une prévalence modérée de consommation insuffisante de légumes (21-31%), du dernier rapport sexuel non protégé (38-45%), du premier rapport sexuel à moins de 15 ans (21-28%) et de l'intimidation et des combats physiques (12-35%), une faible prévalence de facteurs de risque pour la santé mentale (1-11%) et de facteurs de risque pour la consommation d'alcool et de substances (0-6%). Nous avons observé une prévalence modérée à élevée de consommation quotidienne de boissons gazeuses (21-31%) chez tous les adolescents. Parmi les adolescents sexuellement actifs âgées de 15 à 19 ans, 37,0% des femmes ont déclaré avoir déjà été enceintes et 8,0% des hommes ont rapporté avoir déjà enceinté une femme. L'intimidation (23%) et les combats physiques étaient plus fréquents chez les adolescents plus jeunes (35%). La prévalence de la mauvaise humeur était généralement plus élevée chez les adolescents d’âge plus élevé (de 15 à 19 ans) que chez les plus jeunes (de 10 à 14 ans). La proportion d'adolescents déclarant avoir consommé de l'alcool, des drogues ou des cigarettes était très faible, à l'exception de la consommation de khat en Ethiopie.Dans l’ensemble, le régime alimentaire et l’activité physique, la violence, la santé sexuelle et reproductive et la dépression sont des facteurs de risque importants pour ces communautés d’Afrique subsaharienne. Ces résultats suggèrent que davantage de données sont nécessaires, notamment de nouveaux efforts pour la collecte d'informations sensibles, ainsi que la nécessité de passer à des interventions adaptées aux communautés pour atteindre les populations adolescentes avec des besoins variés.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1bef83c54f63e01836b03f3c3e89be37Test
https://doi.org/10.1111/tmi.13339Test

المؤلفون: Özge Tunçalp, Mamadou Dioulde Balde, Thae Maung Maung, Hedieh Mehrtash, Adeniyi K Aderoba, A. Olusoji Adeyanju, Sihem Landoulsi, Chris Bambey Guure, Richard Adanu, Joshua P. Vogel, Theresa Azonima Irinyenikan, Soe Soe Thwin, Bukola Fawole, Ernest Maya, Boubacar Diallo, Nwe Oo Mon, Meghan A. Bohren, Anne Marie Soumah, A Metin Gülmezoglu, Alpha Oumar Sall, Kwame Adu-Bonsaffoh

المصدر: Obstetrical & Gynecological Survey. 75:219-221

مصطلحات موضوعية: Adult, Adolescent, Cross-sectional study, medicine.medical_treatment, Social Stigma, Psychological intervention, Nigeria, Myanmar, 030204 cardiovascular system & hematology, Verbal abuse, Violence, Ghana, Health Services Accessibility, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, Environmental health, Surveys and Questionnaires, Medicine, Childbirth, Humans, Caesarean section, Social inequality, 030212 general & internal medicine, Prospective Studies, Reproductive health, Community based, Labor, Obstetric, business.industry, Parturition, Obstetrics and Gynecology, General Medicine, Cross-Sectional Studies, Socioeconomic Factors, Marital status, Female, Guinea, business, Demography, Labor observations

الوصف: Summary Background Women across the world are mistreated during childbirth. We aimed to develop and implement evidence-informed, validated tools to measure mistreatment during childbirth, and report results from a cross-sectional study in four low-income and middle-income countries. Methods We prospectively recruited women aged at least 15 years in twelve health facilities (three per country) in Ghana, Guinea, Myanmar, and Nigeria between Sept 19, 2016, and Jan 18, 2018. Continuous observations of labour and childbirth were done from admission up to 2 h post partum. Surveys were administered by interviewers in the community to women up to 8 weeks post partum. Labour observations were not done in Myanmar. Data were collected on sociodemographics, obstetric history, and experiences of mistreatment. Findings 2016 labour observations and 2672 surveys were done. 838 (41·6%) of 2016 observed women and 945 (35·4%) of 2672 surveyed women experienced physical or verbal abuse, or stigma or discrimination. Physical and verbal abuse peaked 30 min before birth until 15 min after birth (observation). Many women did not consent for episiotomy (observation: 190 [75·1%] of 253; survey: 295 [56·1%] of 526) or caesarean section (observation: 35 [13·4%] of 261; survey: 52 [10·8%] of 483), despite receiving these procedures. 133 (5·0%) of 2672 women or their babies were detained in the facility because they were unable to pay the bill (survey). Younger age (15–19 years) and lack of education were the primary determinants of mistreatment (survey). For example, younger women with no education (odds ratio [OR] 3·6, 95% CI 1·6–8·0) and younger women with some education (OR 1·6, 1·1–2·3) were more likely to experience verbal abuse, compared with older women (≥30 years), adjusting for marital status and parity. Interpretation More than a third of women experienced mistreatment and were particularly vulnerable around the time of birth. Women who were younger and less educated were most at risk, suggesting inequalities in how women are treated during childbirth. Understanding drivers and structural dimensions of mistreatment, including gender and social inequalities, is essential to ensure that interventions adequately account for the broader context. Funding United States Agency for International Development and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4435dda27687ec25a271b37aec2a4051Test
https://doi.org/10.1097/01.ogx.0000659624.79175.0cTest

المؤلفون: April J. Bell, Richard Adanu, Samuel A. Obed, Joseph Adu, Samuel A. Oppong, Cheryl A. Moyer, Ashura Bakari, C.A. Turpin, Yemah Bockarie

المصدر: BJOG: An International Journal of Obstetrics & Gynaecology. 126:755-762

مصطلحات موضوعية: Adult, medicine.medical_specialty, Cross-sectional study, Population, Near Miss, Healthcare, Maternal Fever, Ghana, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Maternal near miss, Humans, Medicine, Maternal Health Services, education, education.field_of_study, 030219 obstetrics & reproductive medicine, Eclampsia, business.industry, Obstetrics, Incidence, Incidence (epidemiology), Pregnancy Outcome, Obstetrics and Gynecology, medicine.disease, Pregnancy Complications, Cross-Sectional Studies, Maternal Mortality, Standardized mortality ratio, Case-Control Studies, Female, Maternal death, business

الوصف: Objective To explore the incidence and factors associated with maternal near-miss. Design Cross-sectional study with an embedded case-control study. Setting Three tertiary referral hospitals in southern Ghana. Population All women admitted to study facilities with pregnancy-related complications or for birth. Methods An adapted version of the WHO Maternal Near Miss Screening Tool was used to identify maternal near-miss cases. These were compared with unmatched controls (uncomplicated deliveries) in a ratio of 1:2. Main outcome measures Incidence of maternal near-miss, maternal near-miss to maternal mortality ratio, and cause of and factors associated with maternal near-miss. Results Out of 8433 live births, 288 maternal near-miss cases and 62 maternal deaths were identified. In all, 454 healthy controls were recruited for comparison. Maternal near-miss and maternal death incidence ratios were 34.2 (95% CI 30.2-38.1) and 7.4 (95% CI 5.5-9.2) per 1000 live births, respectively with a maternal near-miss to mortality ratio of 4.6:1. Cause of near-miss was pre-eclampsia/eclampsia (41.0%), haemorrhage (12.2%), maternal sepsis (11.1%) and ruptured uterus (4.2%). A major factor associated with maternal near-miss was maternal fever within the 7 days before birth (OR 5.95, 95%CI 3.754-9.424). Spontaneous onset of labour was protective against near-miss (OR 0.09 95% CI 0.057-0.141). Conclusion For every maternal death, there were nearly five maternal near-misses. Women having a fever in the 7 days before delivery were six times more likely to experience a near-miss than women not having fever. Tweetable abstract Maternal near-miss exceeds maternal death by 5:1, with the leading cause of maternal near-miss was pre-eclampsia/eclampsia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bc986ddd2d96135c50f50f5fc8b9f632Test
https://doi.org/10.1111/1471-0528.15578Test

المؤلفون: Ernest Maya, Musah Salifu Mahama, Kwasi Torpey, John Kuumuori Ganle, Abubakar Manu, Richard Adanu

المصدر: The International Journal of Health Planning and Management. 34:727-743

مصطلحات موضوعية: Adult, Adolescent, Psychological intervention, Context (language use), Home deliveries, Midwifery, Logistic regression, Ghana, User fee, Young Adult, 03 medical and health sciences, Environmental health, Health insurance, Humans, Medicine, Retrospective Studies, business.industry, 030503 health policy & services, Health Policy, Age Factors, Middle Aged, Delivery, Obstetric, Health Surveys, Fees, Medical, Educational Status, Health survey, 0305 other medical science, business, Insurance coverage

الوصف: User-fee exemption for skilled delivery services has been implemented in Ghana since 2003 as a way to address financial barriers to access. However, many women still deliver at home. Based on data from the 2014 Ghana Demographic and Health Survey, we estimated the prevalence of home delivery and determined the factors contributing to homebirths among a total of 622 women in the Northern region in the context of the user-fee exemption policy in Ghana. Binary and multivariate logistic regression analyses were employed. Results suggest home delivery prevalence of 59% (365/622). Traditional birth attendants attended majority of home deliveries (93.4%). After adjusting for potential confounders, making less than four antenatal care visits (aOR = 2.42; CI = 1.91-6.45; p = 0.001), being a practitioner of traditional African religion (aOR = 16.40; CI = 3.10-25.40; p = 0.000), being a Muslim (aOR 2.10; CI = 1.46-5.30; p = 0.042), not having a health insurance (aOR = 1.85; CI = 1.773-4.72; p = 0.016), living in a male-headed household (aOR = 2.07; CI = 1.02-4.53; p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4f51a317bdc62688b325c3d9e081df94Test
https://doi.org/10.1002/hpm.2731Test

المؤلفون: Kwame Adu-Bonsaffoh, Phyllis Dako-Gyeke, Ernest Maya, Richard Adanu, Meghan A. Bohren, Joshua P. Vogel, Caroline D Badzi

المصدر: Reproductive Health Matters, Vol 26, Iss 53, Pp 70-87 (2018)

مصطلحات موضوعية: Gender-Based Violence, Verbal abuse, lcsh:RC870-923, Ghana, Health Services Accessibility, Respect, verbal abuse, 0302 clinical medicine, Pregnancy, Childbirth, 030212 general & internal medicine, Qualitative Research, media_common, 030219 obstetrics & reproductive medicine, Human rights, Age Factors, Obstetrics and Gynecology, Professional-Patient Relations, Middle Aged, facility-based childbirth, Physical abuse, Female, Psychology, Autonomy, Adult, medicine.medical_specialty, Adolescent, Attitude of Health Personnel, media_common.quotation_subject, Organizational culture, Interviews as Topic, Young Adult, 03 medical and health sciences, medicine, Humans, Maternal Health Services, Mistreatment of women, lcsh:HQ1-2044, Patient Acceptance of Health Care, Delivery, Obstetric, medicine.disease, abuse and disrespectful care, lcsh:Diseases of the genitourinary system. Urology, Organizational Culture, Socioeconomic Factors, Reproductive Medicine, physical abuse, Family medicine, lcsh:The family. Marriage. Woman, Women's Health, Pregnant Women, Qualitative research

الوصف: Mistreatment of women during childbirth at health facilities violates their human rights and autonomy and may be associated with preventable maternal and newborn mortality and morbidity. In this paper, we explore women's perspectives on mistreatment during facility-based childbirth as part of a bigger World Health Organization (WHO) multi-country study for developing consensus definitions, and validating indicators and tools for measuring the burden of the phenomenon. Focus group discussions (FGDs) and in-depth interviews (IDIs) were used to explore experiences of mistreatment from women who have ever given birth in a health facility in Koforidua and Nsawam, Ghana. Interviews were audio-recorded, transcribed and thematic analysis conducted. A total of 39 IDIs and 10 FGDs involving 110 women in total were conducted. The major types of mistreatment identified were: verbal abuse (shouting, insults, and derogatory remarks), physical abuse (pinching, slapping) and abandonment and lack of support. Mistreatment was commonly experienced during the second stage of labour, especially amongst adolescents. Inability to push well during the second stage, disobedience to instructions from birth attendants, and not bringing prescribed items for childbirth (mama kit) often preceded mistreatment. Most women indicated that slapping and pinching were acceptable means to "correct" disobedient behaviours and encourage pushing. Women may avoid giving birth in health facilities in the future because of their own experiences of mistreatment, or hearing about another woman's experience of mistreatment. Consensus definitions, validated indicators and tools for measuring mistreatment are needed to measure prevalence and identify drivers and potential entry points to minimise the phenomenon and improve respectful care during childbirth.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b53b8441d12f7dcaccf7c24e8901ec30Test
https://doaj.org/article/21308a3efd3a451a85929d8fa9ca250eTest

المؤلفون: Özge Tunçalp, Richard Adanu, Joshua P. Vogel, Theresa Azonima Irinyenikan, Kwame Adu-Bonsaffoh, Anne-Marie Soumah, A. Olusoji Adeyanju, Adeniyi K Aderoba, Ernest Maya, Thae Maung Maung, Chris Bambey Guure, Mamadou Dioulde Balde, Boubacar Diallo, Nwe Oo Mon, Hedieh Mehrtash, A Metin Gülmezoglu, Soe Soe Thwin, Anayda Portela, Emma Sacks, Meghan A. Bohren

المصدر: The Lancet Global Health, Vol 9, Iss 1, Pp e72-e80 (2021)

مصطلحات موضوعية: Child abuse, education.field_of_study, medicine.medical_specialty, business.industry, lcsh:Public aspects of medicine, 030231 tropical medicine, Population, Breastfeeding, lcsh:RA1-1270, General Medicine, Infant mortality, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Family medicine, Medicine, Childbirth, Marital status, 030212 general & internal medicine, education, business, Reproductive health

الوصف: Summary: Background: Amid efforts to improve the quality of care for women and neonates during childbirth, there is growing interest in the experience of care, including respectful care practices. However, there is little research on the prevalence of practices that might constitute mistreatment of neonates. This study aims to describe the care received by neonates up to 2 h after birth in a sample of three countries in west Africa. Methods: Data from this multicountry, facility-based, observational study were collected on 15 neonatal care practices across nine facilities in Ghana, Guinea, and Nigeria, as part of WHO's wider multicountry study on how women are treated during childbirth. Women were eligible if they were admitted to the participating health facilities for childbirth, in early established labour or active labour, aged 15 years or older, and provided written informed consent on behalf of themselves and their neonate. All labour observations were continuous, one-to-one observations of women and neonates by independent data collectors. Descriptive statistics and multivariate logistic regressions were used to examine associations between these neonatal care practices, maternal and neonate characteristics, and maternal mistreatment. Early neonate deaths, stillbirths, and higher order multiple births were excluded from analysis. Findings: Data collection took place from Sept 19, 2016, to Feb 26, 2017, in Nigeria; from Aug 1, 2017, to Jan 18, 2018, in Ghana; and from July 1 to Oct 30, 2017, in Guinea. We included data for 362 women–neonate dyads (356 [98%] with available data for neonatal care practices) in Nigeria, 760 (749 [99%]) in Ghana, and 558 (522 [94%]) in Guinea. Delayed cord clamping was done for most neonates (1493 [91·8%] of 1627); other practices, such as skin-to-skin contact, were less commonly done (1048 [64·4%]). During the first 2 h after birth, separation of the mother and neonate occurred in 844 (51·9%) of 1627 cases; and was more common for mothers who were single (adjusted odds ratio [AOR; adjusting for country, maternal age, education, marital status, neonate weight at birth, and neonate sex] 1·8, 95% CI 1·3–2·6) than those who were married or cohabiting. Lack of maternal education was associated with increased likelihood of neonates not receiving recommended breastfeeding practices. Neonates with a low birthweight (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::77bc9b188acda461b3e239d23ab05d10Test
http://www.sciencedirect.com/science/article/pii/S2214109X20304228Test