Annual distribution of births and deaths outcomes at Harare Maternity Hospital, Zimbabwe

An assessement of socio-demographic and reproductive/obstetric risk factors for stillbirth, preterm births and low birth weight (LBW). The article also aims to explore the probability of death at birth by antenatal care attendance, and by delivery with a Caesarean section in a Zimbabwe referral hospital.Information on frequency and distribution of adverse birth outcomes is important for planning of maternal Introduction and child health care services world-wide, and knowledge of local patterns of morbidity and mortality is essential for improving antenatal and obstetric care. Perinatal mortality remains a challenge in the care of pregnant women worldwide, particularly in developing countries. Stillbirths, who form the highest number of perinatal deaths, are both common and devastating, and in developed countries, about one third has been shown to be of unknown or unexplained origin. The stillbirth rate is an important indicator of the quality of antenatal and obstetric care. Understanding the distribution of stillbirths helps to identify the quality of antenatal and obstetric care available to the pregnant women and to prioritize intervention strategies appropriately. Few studies from Zimbabwe'" have examined frequency of perinatal mortality and how this outcome varies across important demographic subgroups

First catches of the African pike Hepsetus odoe (Bloch, 1794) (Pisces : Hepsetidae) in lake Kariba, Zimbabwe

Un premier exemplaire du brochet africain, #Hepsetus odoe$, a été échantillonné avec une senne lors de pêches expérimentales. Par la suite, il a été recensé trois autres spécimens capturés par des pêcheurs locaux, à l'aide de filets maillants ou de lignes. Ces captures contribuent à élargir l'aire de répartition jusqu'alors connue de l'espèce. Elles permettent en outre de compléter l'inventaire de l'ichtyofaune du lac Kariba. (Résumé d'auteur

Employment and labour markets

A position paper on the importance and need for a coherent social protection policy for the vulnerable worker in Zimbabwe.In this chapter we examine employment and labour markets; implications of the economic crisis for social protection in Zimbabwe. The chapter highlights the structure of employment in Zimbabwe and considers labour markets dynamics and employment during this period. This is followed by a discussion on social protection for the poor and vulnerable in Zimbabwe, highlighting developments on social protection. It then considers some scenarios for social protection in the future

Moving Forward in Zimbabwe.

A Discussion Paper on poverty alleviation strategies for Zimbabwe.Zimbabwe is emerging from a decade of socio-economic decline. The gains the country saw after independence in 1980; particulady the impressive progress in reducing poverty and inequality as well as the high standards in health and education; had stagnated and in some cases been reversed. Although triggered by a multiplicity of causes, the programme to redistribute land from mainly white farmers to the majority black Zimbabweans in February 2000, is often cited as the catalyst that precipitated an economic crisis which subsequently became a social crisis. Zimbabwe's economy had been in decline since the mid-1990s, initially caused by failed structural adjustment policies but later compounded by shortages of foreign exchange (see Figure 1). It became increasingly difficult to import raw materials, spare parts, and fuel, which undermined manufacturing and agriculture, and accelerated a downward economic spiral. Alongside this decline in productivity came a sharp decline in disposable incomes and employment. The economic crisis reshaped the structure of employment and formal sector employment was dwarfed by a burgeoning informal sector. By 2003,72 per cent of the population lived below the total consumption poverty line, compared to 55 per cent in 1995. Hyperinflation peaked at over 200 billion per cent in 2008, which became a year of economic and political crisis.The research presented in this publication is a the result of a project funded by Canada’s International Development Research Centre (www. idrc.ca) IDRC CRD

Maternal factors contributing to low birth weight deliveries in Tshwane District, South Africa

BACKGROUND : Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa. METHODS : We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW. RESULTS : From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population. CONCLUSION : Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.The University of Pretoria (No 4837)http://www.plosone.orghj2019Family MedicineSchool of Health Systems and Public Health (SHSPH

Relationship between maternal obesity and prenatal, metabolic syndrome, obstetrical and perinatal complications of pregnancy in Indiana, 2008-2010

BACKGROUND : Obesity is a serious medical condition affecting more than 30 % of Indiana, and 25 % of Unites States pregnant women. Obesity is related to maternal complications, and significantly impacts the health of pregnant women. The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight. METHODS : Using logistic regression models, we analyzed 2008 to 2010 birth certificate data, for 255,773 live births abstracted from the Indiana Vital Statistics registry. We examined the risk of reproductive factors, obstetrical complications and perinatal (intrapartum) complications for underweight, healthy weight, overweight and obese women for this population. RESULTS : Women who received prenatal care were more likely to be obese [adjusted odds ratio (AOR) = 1.82 (1.56–2.13)]. While women with parity of zero (0) were less likely to be obese [AOR = 0.89, 95 % CI (0.86–0.91)]. Women giving birth to twins [AOR = 1.25, 95 % CI (1.17– 1.33)], women delivering by Caesarian section [AOR = 2.31, 95 % CI ( 2.26–2.37)], and women who previously had a Caesarian section [AOR = 1.95, 95 % CI (1.88–2.02)] were more likely to be obese. There was evidence of metabolic like complication in this population, due to obesity. Obesity was significantly associated with obstetrical conditions of the metabolic syndrome, including pre-pregnancy diabetes, gestational diabetes, pre-pregnancy hypertension, pregnancy-induced hypertension and eclampsia [AOR = 5.12, 95 % CI (4.47–5.85); AOR = 3.87, 95 % CI (3.68–4.08); AOR = 7.66, 95 % CI (6.77–8.65); AOR = 3.23, 95 % CI (3.07–3.39); and AOR = 1.77, 95 % CI (1.31–2.40), respectively. Maternal obesity modestly increased the risk of induction, epidural, post-delivery bleeding, and prolonged labor [AOR = 1.26, 95 % CI (1.23–1.29); AOR = 1.15, 95 % CI (1.13–1.18); AOR = 1.20, 95 % CI (1.12–1.28); and AOR = 1.44, 95 % CI (1.30–1.61)], respectively. Obese women were less likely to have blood transfusions [AOR = .74, 95 % CI (0.58–96)], vaginal tears [AOR = 0.51, 95 % CI (0.44–0.59)], or infections [AOR = 86, 95 % CI (0.80–0.93)]. CONCLUSIONS : Our results suggest that maternal obesity in Indiana, like other populations in the USA, is associated with high risks of maternal complications for pregnant women. Pre-pregnancy obesity prevention efforts should focus on targeting children, adolescent and young women, if the goal to reduce the risk of maternal complications related to obesity, is to be reached.http://www.biomedcentral.com/bmcpregnancychildbirtham201

Maternal factors contributing to low birth weight deliveries in Tshwane District, South Africa

BACKGROUND : Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa. METHODS : We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW. RESULTS : From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population. CONCLUSION : Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.The University of Pretoria (No 4837)http://www.plosone.orghj2019Family MedicineSchool of Health Systems and Public Health (SHSPH

Maternal factors contributing to low birth weight deliveries in Tshwane District, South Africa

BACKGROUND : Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa. METHODS : We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW. RESULTS : From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population. CONCLUSION : Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.The University of Pretoria (No 4837)http://www.plosone.orghj2019Family MedicineSchool of Health Systems and Public Health (SHSPH

Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis

BACKGROUND: Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. Infant mortality remains a challenge in the care of pregnant women worldwide, but particularly for developing countries and the need to understand contributory factors is crucial for addressing appropriate perinatal health. METHODS: Using information available in obstetric records for all deliveries (17,072 births) at Harare Maternity Hospital, Zimbabwe, we conducted a cross-sectional retrospective analysis of a one-year data, (1997–1998) to assess demographic and obstetric risk factors for stillbirth and early neonatal death. We estimated risk of stillbirth and early neonatal death for each potential risk factor. RESULTS: The annual frequency of stillbirth was 56 per 1,000 total births. Women delivering stillbirths and early neonatal deaths were less likely to receive prenatal care (adjusted relative risk [RR] = 2.54; 95% confidence intervals [CI] 2.19–2.94 and RR = 2.52; 95% CI 1.63–3.91), which for combined stillbirths and early neonatal deaths increased with increasing gestational age (Hazard Ratio [HR] = 3.98, HR = 7.49 at 28 and 40 weeks of gestation, respectively). Rural residence was associated with risk of infant dying in utero, (RR = 1.33; 95% CI 1.12–1.59), and the risk of death increased with increasing gestational age (HR = 1.04, HR = 1.69, at 28 and 40 weeks of gestation, respectively). Older maternal age was associated with risk of death (HR = 1.50; 95% CI 1.21–1.84). Stillbirths were less likely to be delivered by Cesarean section (RR = 0.64; 95% CI 0.51–0.79), but more likely to be delivered as breech (RR = 4.65; 95% CI 3.88–5.57, as were early neonatal deaths (RR = 3.38; 95% CI 1.64–6.96). CONCLUSION: The frequency of stillbirth, especially macerated, is high, 27 per 1000 total births. Early prenatal care could help reduce perinatal death linking the woman to the health care system, increasing the probability that she would seek timely emergency care that would reduce the likelihood of death of her infant in utero. Improved quality of obstetric care during labor and delivery may help reduce the number of fresh stillbirths and early neonatal deaths

Maternal factors contributing to low birth weight deliveries in Tshwane District, South Africa

BACKGROUND : Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa. METHODS : We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW. RESULTS : From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population. CONCLUSION : Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.The University of Pretoria (No 4837)http://www.plosone.orghj2019Family MedicineSchool of Health Systems and Public Health (SHSPH