The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study

Background Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law’s role in (a) her daughter-in-law’s ANC uptake; and (b) the decision-making process about using ANC services in Nepal. Methods In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Results Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/ encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Conclusion Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family resources

Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?

Background: Despite various international efforts initiated to improve maternal health, morethan half a million women worldwide die each year as a result of complications arising frompregnancy and childbirth. This research was guided by the following questions: 1) How doeswomen's autonomy influence the choice of place of delivery in resource-poor urban settings? 2)Does its effect vary by household wealth? and 3) To what extent does women's autonomy mediatethe relationship between women's education and use of health facility for delivery?Methods: The data used is from a maternal health study carried out in the slums of Nairobi, Kenya.A total of 1,927 women (out of 2,482) who had a pregnancy outcome in 2004–2005 were selectedand interviewed. Seventeen variable items on autonomy were used to construct women's decisionmaking,freedom of movement, and overall autonomy. Further, all health facilities serving the studypopulation were assessed with regard to the number, training and competency of obstetric staff;services offered; physical infrastructure; and availability, adequacy and functional status of suppliesand other essential equipment for safe delivery, among others. A total of 25 facilities weresurveyed.Results: While household wealth, education and demographic and health covariates had strongrelationships with place of delivery, the effects of women's overall autonomy, decision-making andfreedom of movement were rather weak. Among middle to least poor households, all threemeasures of women's autonomy were associated with place of delivery, and in the expecteddirection; whereas among the poorest women, they were strong and counter-intuitive. Finally, thestudy showed that autonomy may not be a major mediator of the link between education and useof health services for delivery.Conclusion: The paper argues in favor of broad actions to increase women's autonomy both asan end and as a means to facilitate improved reproductive health outcomes. It also supports thecall for more appropriate data that could further support this line of action. It highlights the needfor efforts to improve households' livelihoods and increase girls' schooling to alter perceptions ofthe value of skilled maternal health care

Off-target effects of c-MET inhibitors on thyroid cancer cells

10.1158/1535-7163.MCT-13-0187Molecular Cancer Therapeutics131134-143MCTO

SHARP: Harmonizing and Bridging Cross-Workflow Provenance

International audiencePROV has been adopted by a number of workflow systems for encoding the traces of workflow executions. Exploiting these prove-nance traces is hampered by two main impediments. Firstly, workflow systems extend PROV differently to cater for system-specific constructs. The difference between the adopted PROV extensions yields heterogene-ity in the generated provenance traces. This heterogeneity diminishes the value of such traces, e.g. when combining and querying provenance traces of different workflow systems. Secondly, the provenance recorded by workflow systems tends to be large, and as such difficult to browse and understand by a human user. In this paper 4 , we propose SHARP, a Linked Data approach for harmonizing cross-workflow provenance. The harmonization is performed by chasing tuple-generating and equality-generating dependencies defined for workflow provenance. This results in a provenance graph that can be summarized using domain-specific vocabularies. We experimentally evaluate SHARP i) on publicly available provenance documents and ii) using a real-world omic experiment involving workflow traces generated by the Taverna and Galaxy systems