Risk Factors of Preterm Delivery in the Lao PDR: Hospital-Based Matched Case–Control Study

Objective: To describe the risk factors among mothers in four central hospitals and two provincial hospitals in the Lao PDR, a lower-middle-income country in Southeast Asia. Method: The study used a hospital-based matched case–control design study. Purposive sampling was used to select 320 mothers (80 cases and 240 controls) from the six hospitals. Cases were mothers who had delivered a live newborn between 28 and 36 weeks and 6 days, while controls were mothers who had delivered a live newborn within 37 and 40 weeks. Data were collected through a review of medical records and face-to-face interviews using a structured questionnaire. Data were entered into EPI info (Version 3.1) then exported to the STATA programme (Version 14) for univariate and conditional multiple logistic regressions to identify risk factors for PTD at p ≤ 0.05. Results: The mean maternal age of cases and controls was 25.2 (SD = 5.33) and 25.8 (SD = 4.37), respectively. In the multivariate analysis, factors with statistically significant relationships with PTD were the mother’s religion (AOR: 3.01; 95% CI 1.24–7.26), the number of antenatal care visits (AOR: 3.39; 95% CI 1.6–7.18), having a pre-pregnancy maternal weight of less than 45 kg (AOR: 3.05; 95% CI 1.66–10.5), having had a premature preterm rupture of the membrane (AOR: 7.13; 95% CI 2.44–20.8) and vaginal bleeding during pregnancy (AOR: 6.89; 95% CI 3.02–15.73). Conclusions for Practice: Improving capacity of the Laotian health system to provide quality ANC and increasing the number of ANC contacts is critical. This requires context specific strategies that also address the socio-economic factors, such as access to a nutritious diet, that contribute to PTD.</p

Health policymakers’ knowledge and opinions of physicians smoking and tobacco policy control in Lao PDR

<p>Abstract</p> <p>Background</p> <p>In 2007, a regulation on smoke-free health facilities and institutions was adopted by the Lao government. Little is known about health policymakers’ knowledge and opinions regarding tobacco policy control, including physicians’ behaviour. This paper aims to describe the knowledge of Lao health policymakers and their opinions regarding physicians tobacco use and national smoking policy control.</p> <p>Methods</p> <p>In 2007, we made a qualitative explorative study with data from a purposive sample of 18 key informants through semi-structured, face-to-face interviews. The key informants, who were heads of departments, directors of hospitals and directors of centres, mainly worked at the national level, and some provincial levels. Content analysis was used.</p> <p>Results</p> <p>Policymakers perceived the inadequate implementation of a smoke-free regulation and policy as being a barrier and that the general public may not accept physicians smoking, since they are regarded as role models. Most of the respondents mentioned that regulations or laws related to control of smoking in health institutions are available in Laos, but they lacked detailed knowledge of them probably because regulations as well as the smoke-free policy documents were not widely disseminated. The respondents agreed that anti-smoking education should be integrated in the training curricula, especially in the medical schools, and that the provision of counselling on health consequences from smoking and methods of smoking cessation was important.</p> <p>Conclusion</p> <p>This study contributes to tobacco policy evidence and to knowledge regarding factors related to the uptake of evidence into policymaking. Dissemination and implementation of a tobacco control policy nationally, and integration of tobacco cessation training programs in the curricula were found to be productive approaches for improvement.</p