Epidemiology of cesarean delivery in Kassala, Eastern Sudan: a community-based study 2014- 2015

Background: Cesarean delivery is a main obstetrical operation and its rate should be optimized where the World Health Organization regards that a cesarean delivery rate of 5-15% is an optimal range, putting in consideration the necessity of the procedure as a lifesaving intervention for both the mother and fetus.Objectives: To investigate the epidemiology of cesarean delivery in Kassala, Eastern Sudan from December 2014 to March 2015.Materials and Methods: A stratified, multistage, household survey was carriedout. Questionnaires were applied to gather mode of delivery and its determinants.Results: Out of 303 women, 87 (28.7%), 100 (33%), 116 (38.3) were primiparous, secondiparous and multiparous, respectively, Mothers' age ranged from 13 to 48 with mean (SD) 27.79 (5.94) years. In logistic regression, elder women (OR=1.1, 95 CI= 1.01-1.34, p = 0.005), primparae (OR= 6.4, 95% CI = 1.3-31.8, p = 0.001) and women who had medical disease (OR= 2.9, 95% CI= 1.16-7.6, p= 0.023) were at higher risk to deliver by caesarean delivery.Conclusion: The rate of cesarean delivery in Kassala in the current study is17.8% and the elder women, primiapare and women with medical disorders were at a higher risk to deliver by caesarean delivery.Keywords: Cesarean, Kassala, pregnancy, Suda

Assessment of Bottle-Feeding Practices in Kassala, Eastern Sudan: A Community-Based Study

© 2019 Ahmed A. Hassan, Zainab Taha, Mohamed A. Abdulla, AbdelAziem A. Ali, Ishag Adam. BACKGROUND: The World Health Organization encourages exclusive breastfeeding up to six months and avoidance of bottle-feeding. There are few published research articles on the practice of bottle-feeding and associated factors in Sudan. AIM: The study aimed to assess the usage and factors associated with bottle-feeding practices during the first six months of life among mothers with children aged between 6 and 24 months in Kassala, Eastern Sudan. METHODS: A community-based cross-sectional study was conducted from July to September 2017. A structured questionnaire was used to collect relevant data from interviewed mothers. RESULTS: A total of 242 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children’s age was 27.13 (5.73) years and 12.2 (6.7) months, respectively. From the total, 96/242 (39.7%) used bottle-feeding for their children in the first six months of life. In multivariable analysis, urban residence (Adjusted Odds Ratio [AOR] 1.96, 95% Confidence Interval [CI] (1.06, 3.63), not receiving breastfeeding education (AOR 1.92, 95% CI 1.07, 3.45) and child hospitalization (AOR 1.83, 95% CI 1.02, 3.28) were significantly associated with bottle-feeding. CONCLUSION: There was a high usage of bottle-feeding and it was found to be associated with child hospitalisation. To avoid bottle-feeding, urgent actions are required to support and educate mothers regarding breastfeeding with special attention to urban-residence ones

Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: A community-based study

© 2018 The Author(s). Background: The World Health Organization (WHO) encourages early initiation of breastfeeding within the first hour after birth with the objective of saving children\u27s lives. There are few published research papers about factors associated with the initiation of breastfeeding in Sudan. The aim of this study was to investigate the prevalence of and factors associated with the timely initiation of breastfeeding among mothers with children two years and under in Kassala, Eastern Sudan. Methods: A community-based cross-sectional study was conducted from December 2016 to March 2017. Mothers were interviewed using a structured questionnaire. Results: A total of 250 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children\u27s age was 27.1 (5.68) years and 11.9 (6.9) months, respectively. Of the 250 mothers, 218 (87.2%) initiated breastfeeding within the first hour. In multivariable logistic regression analysis, factors associated with the delay of breastfeeding initiation were having a male baby (Adjusted Odds Ratio [AOR] 3.90, 95% Confidence Interval [CI]1.33, 11.47), and mothers with medical disorders (AOR 5.07, 95% CI 1.22, 21.16). Conclusion: There was a high prevalence of early initiation of breastfeeding. An association with delayed initiation of breastfeeding was found amongst mothers who had medical disorders and those who had a male infant. Wherever possible, early initiation of breastfeeding should be promoted for all infants, regardless of gender

EPIDEMIOLOGY OF MATERNAL MORTALITY AND POOR PERINATAL OUTCOMES IN DIFFERENT REGIONS OF SUDAN

Background: Both maternal mortality and poor perinatal outcomes (mainly; low birth weight, stillbirth and perinatal mortality) are health as well as obstetrics indicators. Thus, there is an urgent need to investigate epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Objectives: To investigate the epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Methods: Various cross- sectional, case -control, and Cohort studies were conducted during the last 7 years. Results:  Maternal mortality was ranged 442 (146/33034)-640 (63/9841) / 100000 birth in the different regions of Sudan, most of these were due to communicable diseases. Low birth weight was reported in 15.3% (80/524), 12.5% (260/2076), 12.6% (97/1224), 14.9% (64/430) 12.6% in New Halfa, Khartoum, Medani and Elfashir, respectively. Anaemia was risk factors for low birth weight in Elfashir and in Medani; it was risk factor for fetal anaemia in New Halfa and risk factor for stillbirth in Kassala. There were 21 (206/9841), 29 (981/34015), 35(46/1293)/ 1000 stillbirths and 33(44/1342)/1000 in Elfashir, Medani, Khartoum respectively and Kassala, respectively. There was 9.2% (46/500) perinatal death in New Halfa. Conclusion: More effort should be paid to reduce the high maternal and perinatal mortality. More care should be toward nutrition, malaria prevention and other communicable disease

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Use of family planning methods in Kassala, Eastern Sudan

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Factors affecting unmet need for family planning in Eastern Sudan

Abstract Background In the developing countries millions of women in the reproductive age who don’t use contraceptives prefer to postpone or limit their birth. This indicates their failure to take necessary decision to prevent and avoid unwanted pregnancy. Methods A community-based cross sectional household survey was conducted to investigate unmet need for family planning and associated factors and total demand for family planning in Kassala, Eastern Sudan between 1st May and 31st July 2012. Results A total of 812 married women were enrolled in this study. Their mean age and parity was 31.8 (7.3) and 3.4 (1.8) respectively. Ever use of contraception was 25.4% (206/812) and 26.2% (213/812) were currently using contraception. Unmet need for spacing was 15.1% while unmet need for limiting was 0.7%. The pregnant and amenorrheic women whose the pregnancy or birth was unwanted and mistimed were 105 (13%) and 130 (16%) respectively. Using Westoff model the total unmet need was estimated as 44.8%. The total demand for family planning was 71%. In logistic regression model, while age, age at marriage, parity, residence and experience of child death were not associated with total unmet need for family planning, women education P=0.00), husband education P = 0.00) and woman’s occupation; housewife (OR=4.3; CI=2.5-7.2; P=0.00) were associated with the total unmet need. Conclusions Unmet need for family planning in Eastern Sudan was significantly higher among women with less than secondary education. Also; it is influenced by couple’s educational status and woman’s occupation. The results of this study necessitate the need for the programme managers to take into account the concept of reproductive health education.</p

Use of antenatal care services in Kassala, eastern Sudan

Abstract Background Antenatal care is named as one of the four pillars initiatives of the Safe Motherhood Initiative. While many of routine antenatal care procedure have little effect on maternal mortality and morbidity, some of these have been ascertained as beneficial. The aim of this study was to investigate coverage of antenatal care and identify factors associated with inadequacy of antenatal care in Kassala, eastern Sudan. Methods A cross-sectional community-based study was carried out in Kassala, eastern Sudan during September-October 2009. Household surveys were conducted. Structured questionnaires were used to gather data from women who had been pregnant within the last year, or pregnant more than 14 weeks. Results Out of 900 women investigated for antenatal care coverage, 811(90%) women had at least one visit. Only 11% of the investigated women had ≥ four antenatal visits, while 10.0% had not attended at all. Out of 811 women who attended at least one visit, 483 (59.6%), 303 (37.4%) and 25 (3.1%) women attended antenatal care in the first, second and third trimester, respectively. In logistic regression analyses, while maternal age and residence were not associated with inadequacy of antenatal care (P = 0.01) and husband education ≤ secondary level (OR = 2.4, CI = 1.3-4.2; P = 0.002) were associated with inadequacy of antenatal care. Conclusions Antenatal care showed a low coverage in Kassala, eastern Sudan. This low coverage was associated with high parity and low husband education.</p