Contemporary issues in women’s health

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135535/1/ijgo187.pd

Contemporary issues in women’s health

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135468/1/ijgo3.pd

Factors influencing the use of anemia preventing measures among antenatal clinic attendees in the Kintampo North Municipality, Ghana

Anemia in pregnancy is a key public health problem worldwide. It results from a wide variety of causes. The World Health Organization (WHO) has recommended specific measures to help prevent anemia during pregnancy, which countries are required to integrate into their antenatal care. This study was designed to determine the factors influencing the use of anaemia preventing measures among antenatal clinic attendees in the Kintampo North Municipality, Ghana. A cross sectional study was conducted among pregnant women attending the clinics after 36 weeks of pregnancy. Demographic data and information on use of all interventions were obtained using a structured questionnaire. The factors associated with the use of the interventions were identified using multiple logistic regression. The use of all anemia preventing interventions among pregnant women was found to be 30%. The study identified that use of all anemia preventing measures among pregnant women is quite low. Provision of antihelmithics to pregnant women and their health education on the benefits of the use of anaemia preventing measures would help increase the usage of the interventions.Keywords: Anemia in pregnancy, anemia prevention in pregnancy, Kintampo North, Ghan

Women's Sexual Empowerment and Contraceptive Use in Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93761/1/j.1728-4465.2012.00318.x.pd

The relationship between facility‐based delivery and maternal and neonatal mortality in Sub‐Saharan Africa

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135613/1/ijgo263.pd

Quality of basic maternal care functions in health facilities of fi ve African countries: an analysis of national health system surveys

Background Global eff orts to increase births at health-care facilities might not reduce maternal or newborn mortality if quality of care is insuffi cient. However, little systematic evidence exists for the quality at health facilities caring for women and newborn babies in low-income countries. We analysed the quality of basic maternal care functions and its association with volume of deliveries and surgical capacity in health-care facilities in fi ve sub-Saharan African countries. Methods In this analysis, we combined nationally representative health system surveys (Service Provision Assessments by the Demographic and Health Survery Programme) with data for volume of deliveries and quality of delivery care from Kenya, Namibia, Rwanda, Tanzania, and Uganda. We measured the quality of basic maternal care functions in delivery facilities using an index of 12 indicators of structure and processes of care, including infrastructure and use of evidence-based routine and emergency care interventions. We regressed the quality index on volume of births and confounders (public or privately managed, availability of antiretroviral therapy services, availability of skilled staffi ng, and country) stratifi ed by facility type: primary (no caesarean capacity) or secondary (has caesarean capacity) care facilities. The Harvard University Human Research Protection Program approved this analysis as exempt from human subjects review. Findings The national surveys were completed between April, 2006, and May, 2010. Our sample consisted of 1715 (93%) of 1842 health-care facilities that provided normal delivery service, after exclusion of facilities with missing (n=126) or invalid (n=1) data. 1511 (88%) study facilities (site of 276 965 [44%] of 622 864 facility births) did not have caesarean section capacity (primary care facilities). Quality of basic maternal care functions was substantially lower in primary (index score 0·38) than secondary care facilities (0·77). Low delivery volume was consistently associated with poor quality, with diff erences in quality between the lowest versus highest volume facilities of –0·22 (95% CI –0·26 to –0·19) in primary care facilities and –0·17 (–0·21 to –0·11) in secondary care facilities. Interpretation More than 40% of facility deliveries in these fi ve African countries occurred in primary care facilities, which scored poorly on basic measures of maternal care quality. Facilities with caesarean section capacity, particularly those with birth volumes higher than 500 per year, had higher scores for maternal care quality. Low-income and middle-income countries should systematically assess and improve the quality of delivery care in health facilities to accelerate reduction of maternal and newborn deaths

Increasing postpartum family planning uptake through group antenatal care: a longitudinal prospective cohort design

Abstract Background Despite significant improvements, postpartum family planning uptake remains low for women in sub-Saharan Africa. Transmitting family planning education in a comprehensible way during antenatal care (ANC) has the potential for long-term positive impact on contraceptive use. We followed women for one-year postpartum to examine the uptake and continuation of family planning following enrollment in group versus individual ANC. Methods A longitudinal, prospective cohort design was used. Two hundred forty women were assigned to group ANC (n = 120) or standard, individual care (n = 120) at their first ANC visit. Principal outcome measures included intent to use family planning immediately postpartum and use of a modern family planning method at one-year postpartum. Additionally, data were collected on intended and actual length of exclusive breastfeeding at one-year postpartum. Pearson chi-square tests were used to test for statistically significant differences between group and individual ANC groups. Odds ratios and adjusted odds ratios were calculated using logistic regression. Results Women who participated in group ANC were more likely to use modern and non-modern contraception than those in individual care (59.1% vs. 19%, p < .001). This relationship improved when controlled for intention, age, religion, gravida, and education (AOR = 6.690, 95% CI: 2.724, 16,420). Women who participated in group ANC had higher odds of using a modern family planning method than those in individual care (AOR = 8.063, p < .001). Those who participated in group ANC were more likely to exclusively breastfeed for more than 6 months than those in individual care (75.5% vs. 50%, p < .001). This relationship remained statistically significant when adjusted for age, religion, gravida, and education (AOR = 3.796, 95% CI: 1.558, 9.247). Conclusions Group ANC has the potential to be an effective model for improving the uptake and continuation of post-partum family planning up to one-year. Antenatal care presents a unique opportunity to influence the adoption of postpartum family planning. This is the first study to examine the impact of group ANC on family planning intent and use in a low-resource setting. Group ANC holds the potential to increase postpartum family planning uptake and long-term continuation. Trial registration Not applicable. No health related outcomes reported.https://deepblue.lib.umich.edu/bitstream/2027.42/146750/1/12978_2018_Article_644.pd

Intention to deliver in a healthcare facility and healthcare facility‐based delivery rates among women in Akwatia, Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135204/1/ijgo161.pd

Understanding the relationship between access to care and facility‐based delivery through analysis of the 2008 Ghana Demographic Health Survey

ObjectiveTo determine the types of access to care most strongly associated with facility‐based delivery among women in Ghana.MethodsData relating to the “5 As of Access” framework were extracted from the 2008 Ghana Demographic Health Survey and analyzed using multivariate logistic regression.ResultsIn all, 55.5% of a weighted sample of 1102 women delivered in a healthcare facility, whereas 45.5% delivered at home. Affordability was the strongest access factor associated with delivery location, with health insurance coverage tripling the odds of facility delivery. Availability, accessibility (except urban residence), acceptability, and social access variables were not significant factors in the final models. Social access variables, including needing permission to seek healthcare and not being involved in decisions regarding healthcare, were associated with a reduced likelihood of facility‐based delivery when examined individually. Multivariate analysis suggested that these variables reflected maternal literacy, health insurance coverage, and household wealth, all of which attenuated the effects of social access.ConclusionAffordability was an important determinant of facility delivery in Ghana—even among women with health insurance—but social access variables had a mediating role.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135213/1/ijgo224.pd

The physical finding of stress urinary incontinenceamong African women in Ghana

The aim of this study is to determine the proportion of women with the physical sign of stress urinary incontinence in a sample of Ghanaian women. Two hundred randomly selected women from attendants at a convenience selected ultrasound clinic were interviewed about symptoms of urinary incontinence. A paper towel test was performed to objectively demonstrate the physical sign of stress urinary incontinence as leakage on coughing. Forty-two percent of the women had a positive paper towel test. The two major symptoms reported by the women with positive paper towel test were (1) loss of urine while waiting to use the toilet (48.2%) and (2) loss of urine on coughing (43.4%) in daily life. The physical sign of stress urinary incontinence could be present in up to 42% of Ghanaian women.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45851/1/192_2005_Article_62.pd