Factors associated with late antenatal care attendance in selected rural and urban communities of the copperbelt province of Zambia

Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural districts make their first ANC visit by 4th months of pregnancy. A number of factors have been found to contribute to late initiation of Antenatal care among pregnant women and these may vary between rural and urban areas. Therefore, a study aimed at examining factors associated with late ANC attendance amongst pregnant women in selected communities of the Copperbelt Province was conducted.Methodology: A cross- sectional study using a semistructured questionnaire was conducted in selected health facilities of Mpongwe and Ndola districts. A total number of 613 women attending antenatal clinic, distributed evenly between Mpongwe rural district (51% (307/613) and Ndola urban district (49% (306/613) were included in the study. Data from the completed questionnaires was entered using Epi InfoTM 3.5.1 and finally analyzed with SPSS version 16.0.Results: The prevalence of late ANC attendance was 72.0 % (n=221) and 68.6% (n=210) in rural and urban districts respectively. However, the difference between two districts was not statistically significant [OR 0.851 (95% CI=0.6, 1.2), p=0.363]. In the rural district, nulliporous women were 59% (AOR 0.411, 95% CI 0.238, 0.758) less likely to initiate ANC late compared to multiparous women, while the proportion the urban was 48% (AOR 0.518, 95% CI 0.316, 0.848). Inadequate knowledge about ANC resulted into 2.2 times high odds for late ANC attendance (AOR 2.205, 95% CI 1.021, and 4.759) than women who had adequate knowledge in urban district. Women who fell pregnant unintentionally had a higher odds of starting ANC late in both rural [4.2 times (AOR 4.258, 95% CI 1.631, 11.119)] and urban [3.1 times (AOR 3.103, 95% CI 1.261, 7.641)] respectively. The perception of no benefits derived from commencement of ANC early was associated with 4 times (AOR 3.983, 95% CI 1.365, 11.627) likelihood of late attendance in the urban district. Compared to lack of privacy at health institutions, pregnant women in rural were 3.4 times (AOR 3.377, 95% CI 1.180, and 9.660) more likely to initiate ANC late because of long distance to health facilities. Compared to misconceptions on ANC, pregnant women in rural areas were 2.2 times (AOR 2.211 95% CI 1.049, 4.660) more likely to start ANC late because of community norm(less value attached to ANC); while in urban late ANC attendance was 2.9 times (AOR 2.899, 95% CI 1.372, 6.083) higher due to cultural beliefs than misconceptions.Conclusion: Late antenatal care attendance remains high in both rural and urban districts indicating the need for intensified and more focused utilization of resources aimed at increasing sensitization of the importance of early attendance for high risk groups, such as women with unplanned pregnancies, inadequate knowledge about ANC, cultural beliefs and women who are multiporous

HIV and infant feeding : choices and decision-outcomes in the context of prevention of mother-to-child transmission among HIV-positive mothers in Zambia.

Doctor of Philosophy in Nursing. University of KwaZulu-Natal, Howard College 2015.Mother-to-child transmission of HIV is one of the key drivers of the HIV pandemic in Zambia and impacts infant feeding for HIV-exposed infants. The aim of infant feeding counselling is to facilitate informed decision on method of feeding in relation to prevention of mother-to-child transmission of HIV. However, HIV-positive mothers are faced with uncertainty on how best to feed their infants. While exclusive breastfeeding has potential to contribute to a reduction in infant and under-five mortality, the practice is not widespread in resource-poor settings of sub-Saharan Africa. The overall aim of this study was to analyse choices and decision-outcomes on infant feeding in the context of prevention of mother-to-child transmission of HIV to enhance safer feeding practices during the first six months of the infant’s life. The study was conducted using qualitative triangulation through participant observations, focus group discussions and individual interviews. The study included HIV infected mothers (n=30), health care workers (n=6), HIV infected men (n=7) and community based volunteers (n=20). The field work was conducted from January to September 2014. Data were managed in QRS NVivo 10 and analysed using framework analysis. While recognising promotion of exclusive breastfeeding as a public health approach in Zambia, the results showed that implementation was influenced by factors beyond the health care system. The findings highlight five thematic areas that explained and gave meaning to behavioural processes that determine decision-outcome on infant feeding in relation to prevention of mother-to-child transmission. Participants described breastfeeding as a cultural norm based on practices passed from generation to generation that impacted the understanding and behaviour change to practice exclusive breastfeeding for HIV-exposed infants. Therefore, choosing to exclusively breastfeed depended on how well mothers were counselled on infant feeding and prepared to practice exclusive breastfeeding in the first six months of the baby’s life. Although, health care workers reported that they supported mothers to choose and practice exclusive breastfeeding, mothers in this study lacked the necessary skills needed to successfully feed their HIV-exposed infants. Drawing on theories of behaviour change, the findings accordingly informed the development of a model that provides nurses, midwives and other front-line health care workers with simplified steps for consideration during infant feeding counselling of HIV-positive mothers

Prevalence and correlates of being bullied among in-school adolescents in Beijing: results from the 2003 Beijing Global School-Based Health Survey

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Occupational risk factors for HIV infection among traditional birth attendants in Copperbelt province, Zambia

A cross sectional survey was conducted among traditional birth attendants (TBAs) in order to determine occupational risk factors associated for HIV infection. All together 370 female TBAs were recruited into the study of whom 67 (18.1%) were trained. The median age was 50 (Q1=42, Q3=55) years. The use of mouth to mouth resuscitation was reported by 22 (6.0%) of the 365 TBAs. A total of 220 (59.6%) TBAs reported washing hands with soap and water after every contact with mothers and babies during labour and delivery. Only 42 (11.5%) TBAs used gloves all of the time when caring for women and babies during labour and delivery. Totals of 156 (42.3%) and 88 (23.8%) TBAs wore anything to protect their clothes and shoes during labour, respectively. Forty-four (11.9%) of the 369 TBAs were positive for human immunode\ufb01ciency virus (HIV) infection. After adjusting for age, TBAs who used mouth to mouth resuscitation were 6.02 (95%CI 1.97, 18.42) times more likely to be HIV positive than TBAs who did not use this method of resuscitating babies. We conclude that adherence to universal precautions was poor and that use of mouth to mouth to resuscitate babies should be discouraged

INFLUENCE OF FORMULATION PARAMETERS ON DISSOLUTION RATE ENHANCEMENT OF ACYCLOVIR USING LIQUISOLID FORMULATION

Objective: The objective of this research work is to explore the use of liquisolid technique in enhancement of acyclovir dissolution rate. This current study was planned to assess the impact of different formulation variables, such as non-volatile liquid type and concentrations of acyclovir on its dissolution rates profile. Method: Acyclovir liquisolid tablets were prepared with Tween 60 (liquid vehicle), Microcrystalline cellulose PH 102 (acted as a carrier to turn liquid medication into free-flowing powder) and Syloid XDP (coating material). In vitro, drug dissolution rate of liquisolid formulations of acyclovir was performed and compared with pure acyclovir drug using USP dissolution apparatus (Type II) for 60 min at a paddle speed of 50 rpm and filled with 900 mL of distilled water. Results: The dissolution study showed that 94.1% of the drug was released in 60 min of ratio 10 while only 66% of the pure drug acyclovir was released in 60 min. Hence, present work concluded that the acyclovir dissolution rate profile has been improved with the formation of liquisolid formulations. Conclusion: From the present study, it may be ratified that the drug dissolution rate of acyclovir has been improved with the utilization of liquisolid formulations approach.Â

Parenting behavior and the risk of becoming a victim and a bully/victim : a meta-analysis study

Objective: Being bullied has adverse effects on children's health. Children's family experiences and parenting behavior before entering school help shape their capacity to adapt and cope at school and have an impact on children's peer relationship, hence it is important to identify how parenting styles and parent–child relationship are related to victimization in order to develop intervention programs to prevent or mitigate victimization in childhood and adolescence. Methods: We conducted a systematic review of the published literature on parenting behavior and peer victimization using MEDLINE, PsychINFO, Eric and EMBASE from 1970 through the end of December 2012. We included prospective cohort studies and cross-sectional studies that investigated the association between parenting behavior and peer victimization. Results: Both victims and those who both bully and are victims (bully/victims) were more likely to be exposed to negative parenting behavior including abuse and neglect and maladaptive parenting. The effects were generally small to moderate for victims (Hedge's g range: 0.10–0.31) but moderate for bully/victims (0.13–0.68). Positive parenting behavior including good communication of parents with the child, warm and affectionate relationship, parental involvement and support, and parental supervision were protective against peer victimization. The protective effects were generally small to moderate for both victims (Hedge's g: range: −0.12 to −0.22) and bully/victims (−0.17 to −0.42). Conclusions: Negative parenting behavior is related to a moderate increase of risk for becoming a bully/victim and small to moderate effects on victim status at school. Intervention programs against bullying should extend their focus beyond schools to include families and start before children enter school

Gender specific factors associated with having stopped smoking among in-school adolescents in Ukraine: results from the Global Youth Tobacco Survey 2005

<p>Abstract</p> <p>Background</p> <p>The prevalence of cigarette smoking in Ukraine is different between genders and is among the highest in the world. There is need to identify gender-specific factors that are associated with having stopped smoking among adolescents.</p> <p>Findings</p> <p>We used data from the Ukraine Global Youth Tobacco Survey 2005. We carried out a backward stepwise logistic regression analysis with having stopped smoking as the outcome.</p> <p>Altogether, 2800 adolescents reported having ever smoked cigarettes. Overall 64.1% (63.4% male, and 65.5% female) adolescents reported having stopped smoking. Male adolescents who stated that smoking decreases body weight were 25% more likely, while female adolescents were 9% less likely to stop smoking. While male adolescents who received support on how to stop smoking from a family member were 7% less likely, female adolescents were 60% more likely to stop smoking. Furthermore, while male adolescents who received a lecture on the harmful effects of smoking were 10% less likely, female adolescents were 9% more likely to stop smoking. Finally both male and female adolescents who were sure or most probably that they would not smoke a cigarette offered to them by their best friends were more likely, and those adolescents who were sure that smoking is harmful to health were less likely to stop smoking.</p> <p>Conclusions</p> <p>Our study has identified some factors that are associated with having quit smoking that are gender-specific. We believe public health programs targeting adolescent smoking should consider these factors in their design and implementation of gender sensitive interventions.</p

‘Mankind owes to the child the best that it has to give’: Prison conditions and the health situation and rights of circumstantial children incarcerated in Sub Saharan African prisons.

Background: In recent times, sub-Saharan African (SSA) prisons have seen a substantial increase in women prisoners, including those incarcerated with children. Methods: A scoping review mapped what is currently known about the health situation and unique rights violations of children incarcerated with their mothers in SSA prisons. A systematic search collected and reviewed all available and relevant published and grey literature (2000-2018). Following application of exclusion measures, 64 records remained, which represented 27 of the 49 SSA countries. These records were charted and thematically analysed. Results: Four main themes were generated as follows: 1) the prison physical environment; 2) food availability, adequacy and quality; 3) provision of basic necessities and 4) availability and accessibility of health services for incarcerated children. Conclusions: The review highlights the grave situation of children incarcerated with their mothers in SSA prisons, underpinned by the lack of basic necessities, inadequate hygiene, sanitation and safe drinking water, exposure to diseases in overcrowded cells, inadequate nutrition, lack of provision of clothing and bedding, and difficulties accessing paediatric care. Reported paediatric morbidity and mortality associated with such prison conditions is deeply concerning and contrary to international mandates for the rights of the child, right to health and standards of care