Attitudes, Practices and Factors Affecting the Use of the Partogram by Professionals Attending to Women in Labour and Delivery in the Bafut Health District

Introduction: Given that the provision of care to the childbirth process is not purely in the hands of educated and trained midwives, the competency in application of midwifery tools may be inadequate and consequently affect the quality of care. The Partogram is the single most important tool which has been scientifically proven to reduce maternal and foetal morbidity and mortality. Though important, many healthcare providers do not use it regularly in the monitoring of labour. Objectives: Our objectives were to determine the attitudes, practices, proportion of parturients monitored using a Partogram and the factors limiting the use of the Partogram by professionals attending to women in labour and delivery (PAWLD) in the Bafut Health District. Methods: This was a cross-sectional study carried out amongst 65 Professionals attending to women in labour and delivery in the Bafut Health District that lasted 6 months. All the data were collected by our self. First through a face to face interview with a questionnaire, secondly with an observational guide used to assess Partograms filled and lastly using delivery registers to obtain the proportion of parturients monitored with a Partogram. The data analysis was done using the statistic software Epi Info version 7 and Microsoft Excel. Results: This study revealed that 47 (72.3%) of participants had good attitudes, 34 (52%) had good practices, 375 (79.3%) parturients were monitored using a Partogram, and the lack of in-service training, low number of staff and poor knowledge on Partogram use were identified as the main limiting factors to the use of the Partogram. Being a health assistant was statistically significantly associated with having a poor practice with a p-value of 0.047 and odds ratio 5.33 [1.03 - 26.45] we obtained just 1 (1.54%) filled according to the WHO standards. Conclusions and Recommendations: In the Bafut Health District, 7 out of 10 PAWLDs have a positive attitude towards the use of the Partogram, while a poor practice is predominant as a result 4 out of 5 deliveries were monitored using a Partogram with only 1.54% of the Partograms filled according to WHO standards. The lack of in-service training, lack of PAWLD and poor knowledge on Partogram usage are the major drawbacks to the use of the Partogram. We therefore recommend that continues medical education (CME) be organised on the use of the Partogram.

日本卫生发展援助及其对中国卫生合作的启示

目的梳理日本卫生发展援助现状及策略,探讨其对中国参与国际卫生合作的启示。方法使用PEST分析法,从政治(political)、经济(economic)、社会(social)和技术(technological)四方面分析日本卫生发展援助的外部环境,用近年日本卫生发展援助的统计数据分析日本卫生发展援助的特点,包括援助规模、途径、地区和领域。结果日本卫生发展援助具有有利的社会环境。2012—2016年日本卫生发展援助总额占官方发展援助总额的8.59%,卫生发展援助资金主要由多边机构提供,越南、印度等是援助资金的最大流入国,援助集中解决卫生政策、初级卫生保健等卫生问题。结论建议中国参与国际卫生合作时首先明确自身优势,注重打造国家品牌,通过双边卫生合作助力提升中国多边卫生议题的设置能力,进而提高中国全球卫生治理水平。

China’s engagement with development assistance for health in Africa

Background:As an emerging donor in health related development across the world,particularly towards Africa,the People’s Republic of China(PRC)has been increasing its influence within the field of global public health over the past few decades.Yet between the period of 2000 and 2013,little is known about the scope,scale and priority of China’s grant-making programs.Methods:Based on data sourced from the China Aid Database(version-1.2),descriptive analyses were applied to analyze the features of 531 health related projects that were undertaken between 2000 and 2013.Spearmen correlation was also performed to assess the relationship between China’s export and aid to recipient countries.Results:The total value of China’s grant-making programs in the health related sector between 2000 and 2013 was 5.67 billion USD,with 531 projects undertaken.During the five year period between 2004 and 2008,China had a contribution of 1.54 billion USD,which increased to 3.8 billion USD during the five year period between 2009 and 2013-an 146.26%increase.In terms of specific diseases,China is most concerned with building an African public health system through donations targeted towards general health(313 projects),combating Malaria(115 projects)and maternal,neonatal and child health(MNCH),(12 projects).When it comes to recipient countries,if counted in total value,Zimbabwe received the most financial assistance from China,totaling 1.08 billion USD and 19 projects,while Angola and Tanzania received more projects-30 and 29 projects respectively.In terms of the channeling of aid funding,most projects were targeted towards infrastructure,equipment and medicine(304 projects in total),followed by medical teams(189 projects).Moreover,there is a statistically significant relationship between aid to Africa and Chinese exports to Africa.Conclusion:During the past decade,Chinese aid projects played an important role in the African public health system through providing funding for infrastructure,equipment and medicine,training health professionals,as well as disease treatment.However,very limited attention was paid towards disease prevention,health promotion and awareness initiatives,and health education.Furthermore,serious questions were raised regarding the long-term financial sustainability and actual impact these projects have on health development.

意大利辅助用具免费供给残疾人体系:未来发展(英文)

The Italian care situation with regards to prostheses and aids is satisfying. The norm which establishes the ways in which aids can be supplied to disabled people goes back to 1999 and,even though it is based on correct principles and even though it has produced positive effects in the improvement of the life of disabled people,it must be updated in the light of the more recent technological and scientific innovations and of the new information instruments such as the diffusion of information and communication systems.

Determinants of China’s development assistance for health at the sub-national level of African countries(2006-2015)

Background:Despite the increasing interest in China’s development assistance for health(DAH)in African countries,little is known regarding the distribution and determinants of China’s DAH project allocation among the principle subdivisions(provinces&states)within African countries.Methods:We mapped the distribution of China’s DAH projects in 670 principle subdivisions of 50 African countries during 2006-2015 using web-based information.The political,demographic,health and socioeconomic indicators of DAH allocation were analyzed using conditional logistic regression models.The national capital city and political leader’s birth place were selected as the main political indicators,and health indicators were selected according to different fields of the DAH projects.Results:China’s DAH projects(mainly China medical teams[CMTs],hospitals and anti-malaria centers)were mostly allocated to the western and eastern coasts of Africa,although CMTs were also dispatched to northern Africa.National capital cities were significantly associated with the allocation of China’s DAH projects(P<0.001).Antimalaria centers were more likely to be allocated to principle subdivisions with larger populations(OR=1.35),and CMTs were allocated to subdivisions with high population densities(OR=79.01).No health-related indicators were identified to affect project allocation except for the facility delivery rate and under-five mortality rate,which were associated with hospital allocation.We also found an association between CMT allocation and the use of artemisinin-based combination therapy in children.Conclusions:Allocation of China’s DAH projects is strongly affected by political and demographic factors.Implementation of China’s new DAH projects should target health and socio-economic indicators and impact metrics in scaling up tailored and cost-effective programs in Africa.