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Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania
Rahma Muhammad Bakari,
Damian Jeremia Damian,
Patricia Swai,
Ahmad Mohamed Makuwani,
Michael Johnson Mahande,
Sia Emmanueli Msuya
Issue:
Volume 3, Issue 3, May 2015
Pages:
43-48
Received:
20 March 2015
Accepted:
1 April 2015
Published:
10 April 2015
Abstract: Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May- June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.
Abstract: Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availabili...
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Clindamycin, Clotrimazole and Tinidazole in Mixed Vaginosis- A “Real World” Clinical Experience
Manish Maladkar,
Chitra Tekchandani,
Urja Dave
Issue:
Volume 3, Issue 3, May 2015
Pages:
49-54
Received:
17 February 2015
Accepted:
5 March 2015
Published:
23 April 2015
Abstract: Background: Vaginal infections are among the most frequent disorders affecting a woman and comprise over 95% of lower female genital tract infections. Seventy five percent of the women world-wide suffer from vaginosis resulting from bacterial, fungal and protozoal infections. Several studies have shown that mixed vaginal infections occur frequently and hence, in co-infection, each pathogen requires specific therapy for complete eradication of concurrent manifestations. Materials and Methods: A multicenter, prospective, open-label, non-comparative clinical study was carried out in 495 patients with mixed vaginosis of bacterial, fungal and protozoal origin. A fixed dose combination of Clindamycin 100 mg, Clotrimazole 100 mg and Tinidazole 100 mg was administered intravaginally for 7 consecutive nights. Results: Treatment led to significant reduction in various symptoms of vaginal infection within 3 days of treatment initiation. On day 7 of treatment, 98.6% patients had normal and odourless vaginal discharge, the mean vaginal burning and irritation score declined by 99.2% and 99.3% respectively. Also, there was remission of vulvar, cervical and vaginal erythema in more than 98% of patients. Physicians and patients rated the treatment efficacy as good to very good improvement and tolerability to the treatment was regarded as good to excellent. No serious adverse events were reported. Conclusion: The present study demonstrates that fixed dose combination of Clindamycin, Clotrimazole and Tinidazole is effective and well tolerated in the treatment of mixed vaginosis due to bacterial, fungal and protozoal infection.
Abstract: Background: Vaginal infections are among the most frequent disorders affecting a woman and comprise over 95% of lower female genital tract infections. Seventy five percent of the women world-wide suffer from vaginosis resulting from bacterial, fungal and protozoal infections. Several studies have shown that mixed vaginal infections occur frequently...
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Predictors of Timing of First Antenatal Care Booking at Public Health Centers in Mekelle City, Northern Ethiopia
Girmatsion Fisseha,
Gebremeskel Miruts,
Mulu Tekie,
Abraha W/Michael,
Dejen Yemane,
Tesfay Gerezigiher
Issue:
Volume 3, Issue 3, May 2015
Pages:
55-60
Received:
3 April 2015
Accepted:
12 April 2015
Published:
22 April 2015
Abstract: Background: Early antenatal care attendance during pregnancy is important to identify risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. But many pregnant women in sub-Saharan Africa start antenatal care attendance late, mostly in the second and third trimester. According to Ethiopian DHS 2011, Antenatal care coverage of Ethiopia is 34% and only 11% pregnant women start antenatal care timely. This indicates most pregnant mothers are not benefited from the services. Hence this study is aimed at assessing timing of first antenatal care visit and identifies factors affecting early attendance. Methods: Cross sectional descriptive study design was used. Data was collected from 410 systematically selected pregnant women who were attending antenatal care service at selected five governmental health centers of Mekelle city using pre-tested and interviewer administer structured questionnaire. SPSS version 16 was used to analyze the data. Socio demography, obstetric history and knowledge on advantage of early ANC booking and time when to start ANC were analyzed to see association with timing of antenatal care using bivarite and multivariate logistic regression analysis. Result: The proportion of respondents who made their first antenatal care within the recommended time (before or at 16 weeks of gestation) was found to be 32.7%. Multivariate analysis revealed that respondents with history of still birth, had obstetric problem for the current pregnancy, knowledge of timing of first visit and those pregnant women who had accompany to the health center for ANC visit were more likely to book ANC within the recommended time. Educational status of pregnant women and gravidity status has not significantly associated with timing of ANC booking. Conclusions: Majority of pregnant women do not practice early booking of antenatal care provided that the service is accessible. In order to improve the situation, adequate information should be provided to community.
Abstract: Background: Early antenatal care attendance during pregnancy is important to identify risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. But many pregnant women in sub-Saharan Africa start antenatal care attendance late, mostly in the second and third trimester. According to Ethiopian DHS 2011, Antenatal car...
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Correlation Between Maternal Obesity, Progress of Labour and Risk of Caesarean Delivery in a Cohort of Nigerian Parturients
Ajen Stephen Anzaku,
Adelaiye Samuel Makanjuola,
Yakubu Emmanuel Nyam,
Utoo Bernard Terkimbi,
Edem Bassey Edet
Issue:
Volume 3, Issue 3, May 2015
Pages:
61-65
Received:
13 April 2015
Accepted:
27 April 2015
Published:
11 May 2015
Abstract: Background: Maternal obesity is associated with adverse obstetric outcomes including labour complications.This study aimed at assessing the relationship between maternal obesity and course of first stage of labour and risk of caesarean delivery among women in active first stage of labour. Methods: This retrospective cohort study was a secondary analysis of data collected to assess the impacts of maternal obesity on pregnancy outcomes in a Nigerian obstetric population. We compared progress of labour and risk of caesarean delivery in 170 obese [Body mass index (BMI = ≥ 30 Kg/m2)] and 170 normal weight women (BMI = 18.5 – 24.9 Kg/m2) who were in spontaneous labour at term. They were matched for age and parity and exclusion criteria included women with height less than 1.52 metres, medical disorders, previous caesarean section, those that had augmentation of labour and infant weight > 4.0 Kg. Statistical analysis was done using SPSS version 16 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered significant. Results: Mean age and parity of the women were 30.6 ± 4.8 years and 1.9 ± 1.6 respectively. There was no significant difference between mean cervical dilatation at presentation between the two study groups (4.9 ± 1.8 versus 5.0 ± 1.7, P = 0.64). Cervical dilatation rate per hour was significantly slower in obese group compared to the controls (0.87 ± 0.4 versus 1.2 ± 0.5 cm/hr, P = 0.001). The mean duration of labour was the same in both groups (7.5 ± 3.9 versus 6.2 ± 3.4 hours, P = 0.57). Caesarean section rate increased from 8.8% in the controls to 23.5% among obese women. Obese women had three times higher risk of caesarean delivery compared to the controls (P = 0.002, OR 3.2, 95% CI 1.15 – 8.62) and this was mainly due to failure to progress in labour (P = 0.03). Conclusion: Among women in active phase of labour, maternal obesity was associated with slower rate of cervical dilatation and increased risk of caesarean delivery.
Abstract: Background: Maternal obesity is associated with adverse obstetric outcomes including labour complications.This study aimed at assessing the relationship between maternal obesity and course of first stage of labour and risk of caesarean delivery among women in active first stage of labour. Methods: This retrospective cohort study was a secondary ana...
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Haemangioma of the Cervix Micking Cervical Endometriosis: A Case Report
Jaouad Kouach,
Youssef Benabdejlil,
Hanane Raiteb,
Driss Moussaoui,
Mohammed Dehayni
Issue:
Volume 3, Issue 3, May 2015
Pages:
66-68
Received:
18 April 2015
Accepted:
29 April 2015
Published:
11 May 2015
Abstract: Haemangioma of the cervix is an extremely rare benign lesion, and only a few sporadic cases have been reported to date. In the present report we describe a case of Haemangioma of the cervix that was diagnosed in a 28-year-old patient who consulted for post coital bleeding.
