Integrating Family Planning Training into Medical Education: A Case Study of St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa

https://deepblue.lib.umich.edu/bitstream/2027.42/148156/1/integrating-family-planning-into-medical-education-a-case.pdf-1Description of integrating-family-planning-into-medical-education-a-case.pdf : Case Study (PDF

Response to “Absence of Conclusive Evidence for the Safety and Efficacy of Gonadotropin‐Releasing Hormone Analogue Treatment in Protecting Against Chemotherapy‐Induced Gonadal Injury”

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139979/1/onco0613.pd

The relationship between facility delivery and infant immunization in Ethiopia

ObjectiveTo determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery.MethodsIn a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization.ResultsIn total, 3334 women delivered a newborn 12–24 months before the 2011 EDHS: 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5 years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT‐HepB‐Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P < 0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization.ConclusionThe impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135167/1/ijgo217.pd

Physician and patient use of and attitudes toward complementary and alternative medicine in the treatment of infertility

ObjectiveTo determine use of and attitudes toward complementary and alternative medicine (CAM) among infertility patients and subspecialty physicians.MethodsInfertility patients were asked to complete anonymous written surveys at an academic infertility practice; members of the Society for Reproductive Endocrinology and Infertility were electronically surveyed. Both groups were assessed regarding their use of and attitudes toward CAM.ResultsThe response rate was 32.1% (115/358) among patients and 22.6% (225/995) among physicians (P < 0.05). In total, 105 (91.3%; 95% confidence interval [CI], 85.8–96.2) patients used CAM, and 84 (73.0%; 95% CI, 64.9–81.1) regarded it as beneficial to their fertility treatment. However, only 30 (26.1%; 95% CI, 18.0–34.0) patients reported CAM use to physicians, with the most common reason being that they were “never asked.” Overall, 202 (89.8%; 95% CI, 85.9–93.8) physicians reported inquiring about CAM.ConclusionSignificant discrepancies exist between subfertile patients and physicians in attitudes toward the use of CAM. The current prevalence of CAM use among infertility patients requires greater physician attention and justifies further study on the risks and benefits of integrating CAM into the biomedical treatment of infertility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135333/1/ijgo253.pd

A systematic review of the evidence for complementary and alternative medicine in infertility

BackgroundThe use of complementary and alternative medicine (CAM) by patients and physicians has increased markedly in recent years. Many case reports, case series, and uncontrolled trials of varying quality have been completed; however, there is now a slowly increasing number of randomized controlled trials (RCTs) examining the use of CAM.ObjectivesTo identify, survey, and review RCTs investigating the use of CAM for infertility treatment.Search strategyThe MEDLINE and Cochrane databases were electronically searched.Selection criteriaRCTs examining modalities for treatment or improvement of health status were reviewed.Data collection and analysisRCTs were included based on use of objective measures, articles written in English, availability through the University of Michigan database, and clear published clinical outcomes.Main resultsThirty‐seven articles assessing a variety of CAM modalities met inclusion criteria. Acupuncture, selenium supplementation, weight loss, and psychotherapeutic intervention had 3 or more studies demonstrating beneficial effect. Other interventions had been studied less and evidence for them was limited.ConclusionsAlthough there is preliminary evidence of the effectiveness of some CAM interventions among infertile patients, many of these interventions require further investigation before they can be considered for routine clinical use.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135426/1/ijgo202.pd

Medical, ethical, and legal considerations in fertility preservation

The past 2 decades have seen a significant rise in cancer survival rates, and an increasing proportion of survivors at reproductive age are interested in childbearing. Although assisted reproduction provides physicians with an array of potential possibilities to help patients whose fertility is compromised by cancer treatment, there is still a dearth of regulation regarding the application of this technology. The present paper reviews the current options for fertility preservation, with a particular focus on the legal and ethical challenges that confront providers of this type of care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135176/1/ijgo11.pd

Reproductive health providers' willingness to provide comprehensive abortion services and knowledge of the abortion law in Addis Ababa, Ethiopia

In Ethiopia, the maternal mortality ratio is 676/100,000 live births with complications from unsafe abortion being the leading cause. The current study was conducted to assess the knowledge of reproductive health practitioners of the law governing abortion in Ethiopia, the willingness of providers to perform abortion procedures, and current comprehensive abortion care (CAC) practice patterns of physicians, midwives, and nurses at one teaching hospital in Addis Ababa, Ethiopia. All currently practicing obstetric/gynecologist faculty and residents, midwives, and nurses working on the obstetrics and gynecology ward at one public teaching hospital in Addis Ababa were invited to participate in this cross-sectional survey. A total of 50 participants completed the survey. 68% of the sample, reported being willing to provide abortion services, if offered the appropriate training. Participants who believe unsafe abortion is a large contributor to poor health of Ethiopian women are almost seven times more likely to be willing to provide CAC services, and physicians are more likely than non-physicians to report being comfortable currently providing CAC services. Obstetric and gynecological providers at St. Paul’s are supportive of providing abortion services, if they are trained in the procedure. Ensuring proper clinical training, as well as sensitization to the recent law change and the burden of unsafe abortion, is of the upmost importance to ensure Ethiopian women have access to safe abortions, as allowed by law.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151763/1/Rominski et al 2015.5 (3).pdfDescription of Rominski et al 2015.5 (3).pdf : Main articl