Factors associated with reproductive health care utilization among Ghanaian women

Background This study investigates factors determining the timing of antenatal care (ANC) visit and the type of delivery assistant present during delivery among a national representative sample of Ghanaian women. Method Data for the study was drawn from the women questionnaire (N=4,916) of the 2008 Ghana Demographic and Health Survey among 15–49-years-old women. Multivariate logistic regression analysis was used to explore factors determining the type of delivery assistance and timing of ANC visit for live births within five years prior to the survey. Results Majority of Ghanaian women attended ANC visit (96.5%) but many (42.7%) did so late (after the first trimester), while 36.5% had delivery without the assistance of a trained personnel (30.6%) or anyone (5.9%). Age (OR=1.5, CI=1.1-1.9, OR for 25-34-year-olds compared to 15-24-year-olds), religion (OR=1.8, CI=1.2-2.8, OR for Christians versus Traditional believers) wealth index (OR=2.6, CI=1.7-3.8, OR for the richest compared to the poorest) were independently associated with early ANC visit. Likewise, age, place of residence, education and partner’s education were associated with having a delivery assisted by a trained assistant. Also, Christians (OR=1.8, CI=1.1-3.0) and Moslems (OR=1.9, CI=1.1-3.3) were more likely to have trained delivery assistants compared to their counterparts who practised traditional belief. Furthermore, the richer a woman the more likely that she would have delivery assisted by a trained personnel (OR=8.2, CI= 4.2-16.0, OR for the richest in comparison to the poorest). Conclusions Despite the relatively high antenatal care utilisation among Ghanaian women, significant variations exist across the socio-demographic spectrum. Furthermore, a large number of women failed to meet the WHO recommendation to attend antenatal care within the first trimester of pregnancy. These findings have important implications for reducing maternal mortality ratio by three-quarters by the year 2015. Keywords: Antenatal care; Maternal health; Timing of antenatal care visit; Type of delivery assistanceBioMed Central open acces

Newborn health interventions and challenges for implementation in Nepal

Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services

Effects of intervention on lifestyle changes among coronary artery disease patients : A 6-month follow-up study

Aim: The main aim of the study was to investigate the effects of a nurse-led lifestyle-related risk factor modification intervention on multiple lifestyle behaviours among coronary artery disease patients over six months. Design: A pre-test post-test control group design was conducted in a single clinical centre in Nepal. Methods: A total of 224 eligible patients were randomly assigned to either the usual care group or the intervention group at baseline. The lifestyle intervention consisted of a brief counselling session supplemented with informational leaflets. Standard questionnaires were used to collect self-reported data from patients on multiple lifestyle behaviours: diet, physical activity, adherence to medication, stress, body mass index, smoking and alcohol consumption. General linear model repeated measure analysis was used to estimate the effect of intervention. Results: A statistically significant effect of study group-by-time interaction for diet, adherence to medication, physical activity, and perceived stress was found at 6-month follow-up. Overall, greater improvement in lifestyle habits was found in the intervention group compared with the control group at 6-month follow-up.publishedVersionPeer reviewe

Perceived Work Ability during Enforced Working from Home Due to the COVID-19 Pandemic among Finnish Higher Educational Staff

Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees’ work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher education employees in a one-year follow-up during the enforced WFH. Secondly, we investigated demographic, organizational, and ergonomic factors associated with the developmental profiles. Methods: A longitudinal web-survey was conducted with four measurement points (April 2020–February 2021). Employees of a Finnish university who answered the questionnaire at baseline and at least at two follow-up surveys (n = 678) were included (71% women, 45% teachers/research staff, 44% supporting staff, 11% hired students). Perceived work ability was measured on a scale of 1–5 in all timepoints. Latent class growth curve analysis was used to identify profiles of work ability. Multinomial logistic regression was used to determine the associations of demographic factors, perceived stress, musculoskeletal pain, functionality of home for work, and organizational support with the work ability profiles. Results: Six distinct work ability profiles were identified. For most (75%), work ability remained stable during the follow-up. A total of 17% had a favourable trend (very good-stable or increasing) of work ability, and 8% had non-favourable (poor-stable or decreasing). Poor ergonomics at home, low organizational support, high stress, and musculoskeletal pain were associated with non-favourable development of work ability. Conclusions: Heterogeneity in development of work ability during forced WFH was found. Several factors were identified through which work ability can be supported.publishedVersionPeer reviewe

Educational Differences in Decline in Maximum Gait Speed in Older Adults over an 11-year Follow-up

Background: This study examined educational differences in decline in maximum gait speed over an 11-year follow-up in the general Finnish population aged ≥55 years, and assessed the contribution of lifestyle factors, body mass index, physical workload and chronic conditions on the association.Methods: Data from the nationally representative Health 2000 Survey and it's 11-year follow-up was used. Participants aged 55 years and older with maximum gait speed measured at both time-points were included (n=1128). Information on education, age, sex, lifestyle factors, body mass index, physical workload and chronic conditions was collected at baseline. General linear model was used to examine differences in decline in maximum gait speed between education groups. Mediation analyses using the product method was conducted to partition the total effect of education on decline in maximum gait speed into direct effect and indirect effect acting through mediators.Results: Decline in maximum gait speed was greater in low and intermediate education groups in comparison to the high education group [0.24 m/s, 95% confidence interval (0.21, 0.26), 0.24 m/s (0.21, 0.28), 0.10 m/s (0.07, 0.14), respectively]. The most important mediators were higher body mass index and lifetime exposure to physical workload among the less educated, accounting for 10% and 11% of the total effect, respectively.Conclusions: Education-based disparities in objectively measured mobility increase with age as lower education is associated with greater decline in gait speed. Higher body mass index and physical workload among less educated contributed most to the educational disparities in age-related decline in maximum gait speed.</p

Evaluation of Lifelong Work Satisfaction among Former Postal Service Workers

While policymakers emphasize the need to delay retirement age, numerous traditional industries, among them postal services, emphasize the need for employee downsizings. These can be contradictory needs. Downsizings can reduce work life satisfaction (WLS) among workers, and reduced WLS can decrease willingness to delay retirement age. In this cross-sectional study, we explore WLS trajectories of former postal service workers by analyzing quantitative survey data (N = 201) and qualitative interview data (N = 40). In the data, workers aged 50–67 years evaluate their lifelong work satisfaction. The results of the quantitative and the qualitative study complement and mirror each other. Same trajectories of WLS were identified in both data. One-third of the survey respondents reported decreasing WLS, which according to the qualitative data relates to employee downsizings. The article highlights the importance of acknowledging contextual elements of work satisfaction measurement and the benefits of combining methodological traditions to understand the longer-term dynamics involve