183 research outputs found
Dynamic sea surface topography, gravity and improved orbit accuracies from the direct evaluation of SEASAT altimeter data
A method for the simultaneous solution of dynamic ocean topography, gravity and orbits using satellite altimeter data is described. A GEM-T1 based gravitational model called PGS-3337 that incorporates Seasat altimetry, surface gravimetry and satellite tracking data has been determined complete to degree and order 50. The altimeter data is utilized as a dynamic observation of the satellite's height above the sea surface with a degree 10 model of dynamic topography being recovered simultaneously with the orbit parameters, gravity and tidal terms in this model. PGS-3337 has a geoid uncertainty of 60 cm root-mean-square (RMS) globally, with the uncertainty over the altimeter tracked ocean being in the 25 cm range. Doppler determined orbits for Seasat, show large improvements, with the sub-30 cm radial accuracies being achieved. When altimeter data is used in orbit determination, radial orbital accuracies of 20 cm are achieved. The RMS of fit to the altimeter data directly gives 30 cm fits for Seasat when using PGS-3337 and its geoid and dynamic topography model. This performance level is two to three times better than that achieved with earlier Goddard earth models (GEM) using the dynamic topography from long-term oceanographic averages. The recovered dynamic topography reveals the global long wavelength circulation of the oceans with a resolution of 1500 km. The power in the dynamic topography recovery is now found to be closer to that of oceanographic studies than for previous satellite solutions. This is attributed primarily to the improved modeling of the geoid which has occurred. Study of the altimeter residuals reveals regions where tidal models are poor and sea state effects are major limitations
Obstetric Complications and Psychological Well-being: Experiences of Bangladeshi Women during Pregnancy and Childbirth
Women in developing countries experience postnatal depression at rates
that are comparable with or higher than those in developed countries.
However, their personal experiences during pregnancy and childbirth
have received little attention in relation to postnatal depression. In
particular, the contribution of obstetric complications to their
emotional well-being during the postpartum period is still not clearly
understood. This study aimed to (a) describe the pregnancy and
childbirth experiences among women in Bangladesh during normal
childbirth or obstetric complications and (b) examine the relationship
between these experiences and their psychological well-being during the
postpartum period. Two groups of women - one group with obstetric
complications (n=173) and the other with no obstetric complications
(n=373) - were selected from a sample of women enrolled in a
community-based study in Matlab, Bangladesh. The experiences during
pregnancy and childbirth were assessed in terms of a five-point rating
scale from 'severely uncomfortable=1' to 'not uncomfortable at all=5'.
The psychological status of the women was assessed using a validated
local version of the Edinburgh Postnatal Depression Scale (EPDS) at six
weeks postpartum. Categorical data were analyzed using the chi-square
test and continuous data by analysis of variance. Women with obstetric
complications reported significantly more negative experiences during
their recent childbirth [95% confidence interval (CI) 1.36-1.61,
p<0.001] compared to those with normal childbirth. There was a
significant main effect on emotional well-being due to experiences of
pregnancy [F (4,536)=4.96, p=0.001] and experiences of childbirth [F
(4,536)=3.29, p=0.01]. The EPDS mean scores for women reporting severe
uncomfortable pregnancy and childbirth experiences were significantly
higher than those reporting no such problems. After controlling for the
background characteristics, postpartum depression was significantly
associated with women reporting a negative childbirth experience.
Childbirth experiences of women can provide important information on
possible cases of postnatal depression
Occurrence and Determinants of Postpartum Maternal Morbidities and Disabilities among Women in Matlab, Bangladesh
The burden of maternal ill-health includes not only the levels of
maternal mortality and complications during pregnancy and around the
time of delivery but also extends to the standard postpartum period of
42 days with consequences of obstetric complications and poor
management at delivery. There is a dearth of reliable data on these
postpartum maternal morbidities and disabilities in developing
countries, and more research is warranted to investigate these and
further strengthen the existing safe motherhood programmes to respond
to these conditions. This study aims at identifying the consequences of
pregnancy and delivery in the postpartum period, their association with
acute obstetric complications, the sociodemographic characteristics of
women, mode and place of delivery, nutritional status of the mother,
and outcomes of birth. From among women who delivered between 2007 and
2008 in the icddr,b service area in Matlab, we prospectively recruited
all women identified with complicated births (n=295); a perinatal
mortality (n=182); and caesarean-section delivery without any maternal
indication (n=147). A random sample of 538 women with uncomplicated
births, who delivered at home or in a facility, was taken as the
control. All subjects were clinically examined at 6-9 weeks for
postpartum morbidities and disabilities. Postpartum women who had
suffered obstetric complications during birth and delivered in a
hospital were more likely to suffer from hypertension [adjusted odds
ratio (AOR)=3.44; 95% confidence interval (CI)=1.14-10.36],
haemorrhoids (AOR=1.73; 95% CI=1.11-3.09), and moderate to severe
anaemia (AOR=7.11; 95% CI=2.03- 4.88) than women with uncomplicated
normal deliveries. Yet, women who had complicated births were less
likely to have perineal tears (AOR=0.05; 95% CI=0.02-0.14) and genital
prolapse (AOR=0.22; 95% CI=0.06-0.76) than those with uncomplicated
normal deliveries. Genital infections were more common amongst women
experiencing a perinatal death than those with uncomplicated normal
births (AOR=1.92; 95% CI=1.18-3.14). Perineal tears were significantly
higher (AOR=3.53; 95% CI=2.32-5.37) among those who had delivery at
home than those giving birth in a hospital. Any woman may suffer a
postpartum morbidity or disability. The increased likelihood of having
hypertension, haemorrhoids, or anaemia among women with obstetric
complications at birth needs specific intervention. A higher quality of
maternal healthcare services generally might alleviate the suffering
from perineal tears and prolapse amongst those with a normal
uncomplicated delivery
Staff experiences of Providing Maternity Services in Rural Southern Tanzania -- A Focus on Equipment, Drug and Supply Issues.
The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse maternal outcomes through delaying care provision. We aim to describe staff experiences of providing maternal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures that carried potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions
Factors influencing place of delivery for women in Kenya: an analysis of the Kenya Demographic and Health Survey, 2008/2009
Background
Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2008/2009 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery.
Methods
Data on place of delivery, reasons for home delivery, and a range of potential explanatory factors were collected by interviewer-led questionnaire on 3977 women and augmented with distance from the nearest health facility estimated using health facility Global Positioning System (GPS) co-ordinates. Predictors of whether the woman’s most recent delivery was in a health facility were explored in an exploratory risk factor analysis using multiple logistic regression. The main reasons given by the woman for home delivery were also examined.
Results
Living in urban areas, being wealthy, more educated, using antenatal care services optimally and lower parity strongly predicted where women delivered, and so did region, ethnicity, and type of facilities used. Wealth and rural/urban residence were independently related. The effect of distance from a health facility was not significant after controlling for other variables. Women most commonly cited distance and/or lack of transport as reasons for not delivering in a health facility but over 60% gave other reasons including 20.5% who considered health facility delivery unnecessary, 18% who cited abrupt delivery as the main reason and 11% who cited high cost.
Conclusion
Physical access to health facilities through distance and/or lack of transport, and economic considerations are important barriers for women to delivering in a health facility in Kenya. Some women do not perceive a need to deliver in a health facility and may value health facility delivery less with subsequent deliveries. Access to appropriate transport for mothers in labour and improving the experiences and outcomes for mothers using health facilities at childbirth augmented by health education may increase uptake of health facility delivery in Kenya
Delivering at Home or in a Health Facility? Health-Seeking Behaviour of Women and the Role of Traditional birth attendants in Tanzania.
Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health
Maternal deaths in Pakistan : intersection of gender, class and social exclusion.
Background: A key aim of countries with high maternal mortality rates is to increase availability of competent
maternal health care during pregnancy and childbirth. Yet, despite significant investment, countries with the
highest burdens have not reduced their rates to the expected levels. We argue, taking Pakistan as a case study,
that improving physical availability of services is necessary but not sufficient for reducing maternal mortality
because gender inequities interact with caste and poverty to socially exclude certain groups of women from
health services that are otherwise physically available.
Methods: Using a critical ethnographic approach, two case studies of women who died during childbirth were
pieced together from information gathered during the first six months of fieldwork in a village in Northern Punjab,
Pakistan.
Findings: Shida did not receive the necessary medical care because her heavily indebted family could not afford it.
Zainab, a victim of domestic violence, did not receive any medical care because her martial family could not afford
it, nor did they think she deserved it. Both women belonged to lower caste households, which are materially poor
households and socially constructed as inferior.
Conclusions: The stories of Shida and Zainab illustrate how a rigidly structured caste hierarchy, the gendered
devaluing of females, and the reinforced lack of control that many impoverished women experience conspire to
keep women from lifesaving health services that are physically available and should be at their disposal
"Saber de SIDA" y cuidado sexual en mujeres jóvenes de sectores populares del cordón sur de la ciudad de Buenos Aires. Apuntes para la definición de políticas de prevención
Menstrual Cycle Length in Women Ages 20-30 years in Makassar
Abstract: Menstrual cycle is a naturally occurring mechanism in a reproductive aged woman.
The ability of a woman to identify the length of a menstrual cycle is important as a basis to
determine the fertile period in the subsequent menstrual cycle. This research aimed to
investigate the length of menstrual cycle of women in reproductive age. A regular menstrual
cycle occurs in a regular pattern of length which can range from 21 to 35 days in adults. A
subsequent cycle which occurs three to five days earlier or longer than the usual pattern would
still be considered as normal. Meanwhile, a menstrual cycle which occurs twice in a month or
once in more than two months would be considered as irregular cycle. The method
implemented was an exploratory method through which menstruation periods of woman in
reproductive age were recorded in three consecutive months. The research population was
Biology students who are registered in academic year 2017. The participants were students
who are registered in Reproduction and Animal Development subject. The data of menstrual
period were collected from four study group which consists of 101 students. The result of data
analysis on a total of 171 menstrual cycle showed that the average length of participants’
menstrual cycle was 30.08 days. The total of participants showed regular and irregular length
of menstrual cycle was 59.41% and 42.57% respectivel
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