Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

Male Involvement in the Maternal Health Care: Expectations of Pregnant Women in Bolgatanga Municipality in the Upper East Region of Ghana

Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

Understanding Midwives’ Perspective on Care of Post Cesarean Section Women at the University Teaching Hospital—Women and Newborn, Lusaka

Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives’ perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital—Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital—Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the Information, Education Communication sessions on discharge (P-0.001) and home/domiciliary visits to postpartum mothers who had C-sections on postpartum were not being undertaken. Conclusion: There was need to improve the care rendered to the postpartum women who had complicated labour and delivery including caesarean sections in order to promote good health and to prevent postpartum complications.

Impact of the Changes in Women’s Characteristics over Time on Antenatal Health Care Utilization in Egypt (2000-2008)

Objectives: This study empirically assesses the impact of the changes in women’s characteristics, empowerment, availability and quality of health services on woman’s decision to use antenatal care (ANC) and the frequency of that use during the period 2000-2008. Study Design: The study is a cross-sectional analytical study using 2000 and 2008 Egypt Demographic and Health Surveys. Methods: The assessment of the studied impact is conducted using the Zero-inflated Negative Binomial Regression. In addition, Factor Analysis technique is used to construct some of the explanatory variables such as women’s empowerment, the availability and quality of health services indicators. Results: Utilization of antenatal health care services is greatly improved from 2000 to 2008. Availability of health services is one of the main determinants that affect the number of antenatal care visits in 2008. Wealth index and quality of health services play an important role in raising the level of antenatal care utilization in 2000 and 2008. However, the impact of the terminated pregnancy on receiving ANC increased over time. Conclusions: Further research of the determinants of antenatal health care utilization is needed, using more updated measures of women’s empowerment, availability and quality of health services. In order to improve the provision of antenatal health care services, it is important to understand barriers to antenatal health care utilization. Therefore, it is advisable to collect information from women about the reasons for not receiving antenatal care.

Factors Affecting the Utilization of Antenatal Care among Married Women of Reproductive Age in Merca, Lower Shebelle, Somalia

Worldwide more than thousands of women and new born are at the danger of die from pregnancy and child delivery complications. Antenatal care (ANC)/ pregnancy care is the health care where expecting mothers and new born receive medical care or medical attention. The aim of this study is to examine factors affecting the utilization of antenatal care among married women of reproductive age in Merca, lower Shebelle, Somalia. Methodology: This is a descriptive cross-sectional and qualitative study design that was carried out from June to August 2022 and this study was carried out in Merca, district lower Shabelle, Somalia. Data were collected from 325 married women of reproductive age who have at least one child and more than living in Merca district. Result: Our study found that the magnitude of antenatal care uptake was 31.1% during the examined period. Very low utilization of antenatal care in Somali women is worrying in the face of high vulnerability of maternal complications. In terms of age diverse and utilization of antenatal care, women in younger age group 15 - 30 were more to utilize antenatal care services than with women in older age group 31 years above (p-value < 0.007). Our study also identified that there is association between level of education and level of utilization among women about antenatal care services (p-value < 0.001). In terms of level of awareness about antenatal care services, it is significantly associated with the level of utilization antenatal care (p-value < 0.001). Our study identified that the number of complaining complications related previous pregnancy that have no awareness about antenatal care services was higher than number of utilized antennal care awareness about antenatal care (p-value < 0.001). Based on these results, it is recommended to improve women’s awareness about antenatal care services by using health education program.

Socio-Demographics and Late Antenatal Care Seeking Behavior: A Cross Sectional Study among Pregnant Women at Kyenjojo General Hospital, Western Uganda

Background: Late antenatal care attendance among pregnant women at health facilities remains a significant public health problem. Globally, approximately 830 women die every day due to pregnancy-related complications and 99% of these deaths occur in developing countries whereby 86% of pregnant women access Antenatal Care (ANC) services at least once. Objective: The general objective of the study was to determine factors associated with late antenatal care seeking behavior among pregnant women at Kyenjojo general hospital. Methods: This was a descriptive cross sectional study design that considered quantitative data collection methods among pregnant women attending ANC. The sample size was determined using Kish and Leslie (1969) formula using a proportion of 37% (0.37) of women who sought late ANC. A systematic sampling technique was used to sample pregnant women on daily basis. Results: A total of 283 women participated in the study. Spouse’s occupation was significantly associated with late ANC attendance (p = 0.026). On the other hand, education level of respondent (Fisher’s = 8.363, p = 0.028*), religion (Fisher’s = 5.77, p = 0.048*) and parity (Fisher’s 10.312, p = 0.026*) revealed statistically significant association with late ANC attendance. In multivariate logistic regression, on occupation, women with unemployed spouses were significantly associated with 25% increase in attendance of late ANC compared to those in formal employment (AOR = 0.25, CI: 0.073 - 0.855, p = 0.027*). Conclusion: The Majority of pregnant women sought ANC at 90.1% (n = 255). There’s a need for government to strengthen health promotion targeting women in rural communities.

Status of Equities in Prenatal Care Utilization and Changing Patterns among Women in China

Objective To assess the extent and relative changes of the equities in prenatal care utilization among women with different educational attainment in some areas of China. Methods Data were collected in 13 counties/cities covered by Perinatal Health Care Surveillance System established by Institute of Reproductive and Child Health, Peking University. The study population consisted of 103 704 women who delivered single live births in 1994 and 2000. Chi-square and multiple Logistic regression were employed to compare the administrative rates and relative risks. Concentration index was used to assess the relative changes of equities in prenatal care utilization. SPSS 11.5 and Microsoft Excel 2003 were used for analysis. Results The total systematic management rate was 22.1% in 1994 and 57.4% in 2000. The concentration index was -0.046 in 1994 and 0.066 in 2000. In northern areas, the concentration index increased from 0.015 in 1994 to 0.295 in 2000, while it increased from -0.015 in 1994 to 0.062 in 2000 in southern areas. In rural areas, the concentration index increased from O. 002 in 1994 to 0.026 in 2000, while it decreased from 0.042 in 1994 to 0.019 in 2000 in urban areas. Conclusion Inequities in prenatal care utilization in 2000 become more obvious than in 1994, especially in northern areas. More attention should be paid to solve the inequities.

Health Care Policy and Reform—Case Study on Liberia Tuberculosis among Childbearing Age Women

Objective: Liberia health care needs to focus on addressing this disease called Tuberculosis among childbearing age women in Liberia and the world;focusing on women’s health governance of Liberia should involve these three sets of actors to control a disease outbreak. The first set of state actors, including politicians, policymakers, and other government officials, need to provide health care education in every part. The public sector health bureaucracy comprising the health ministry, health, social insurance agencies, public pharmaceutical procurement and distribution entities, etc., is central. Still, non-health public sector actors also play a role. Methods: The researcher used the questionnaire method as the main instrument for the study. Results: This survey indicates that 48% of those responding to health education can reduce TB among childbearing age women showed that education could minimize the spread of TB. 25% can improve economic status. 27% said it could reduce the illiteracy rate. The instruments used were positively related to the topic to obtain the needed findings. This set comprises public, private, should not be-for-profit individuals and groups that deliver health services and organizations that support service provision: medical training institutions, health insurance agencies, the pharmaceutical industry. Health service delivery can be presenting from the health system perspective, with inputs, processes, outputs, and outcomes. WHO’re Systems Thinking for Health Systems Strengthening explaining that service delivery includes “effective, safe and quality personal and non-personal health interventions that are providing to those in need, when and where needed (including infrastructure), with minimal waste of resources”. Conclusion: Inputs for a sound health system, the need for health care delivery include financial resources, competent health care staff, adequate physical facilities and equipment, essential medicines and supplies, current clinical guidelines, and operational policies.

Analysis of Antenatal Care and its Related Factors among Married Chinese Women

Objective To explore the related factors of antenatal careMethods The data derived from National Demography and Reproductive Health Survey in1997 conducted by National Population and Family Planning Commission. 11 892 women whohad given birth to at least one survival child were involved in this study. SAS software was usedin multivariate analysis.Results The average rate of general antenatal care is 57.3% and has increased dramatically inthe recent 30 years. The major reason why most subjects didn’t have antenatal care was lackingthe recognition of the importance of antenatal care. The antenatal care was associated withresidence in rural area or urban area, age, educational level, parity of the last birth, localaverage income, distance between home and township in rural area and so on.Conclusion Women of childbearing age need to improve their health knowledge; thegovernment should increase the availability of antenatal care.

Community-Based Pregnant Women Initiative to Support Emergency Obstetric Care in Kimpese Health Zone, Province of Kogo Central, the Democratic Republic of the Congo

Background: Maternal mortality remains high in low- and middle-income countries. Many maternal deaths occur within hospitals often due to a lack of access to basic emergency obstetric care (Emoc). Aim: The study aimed to assess the effectiveness of a community-based pregnant women initiative to support emergency obstetric care in a Kimpese Health Zone (HZ). Setting: Kimpese Health Zone, Province of Central Kongo, in the South Western of the Democratic Republic of the Congo. Results: Four hundred and thirty-five women were received for Emoc between January 2008 and June 2011, 75% were aged between 18 - 34 years old. Mechanical dystocia was the first cause of emergencies (34%). The diagnosis concordance between the transfers and the reasons for the transfer was weak and not statistically significant (Kappa = 0.350, p = 0.405). After the évaluation of the newborns, a favorable outcome was noted after the 10th day of de follow-up (95.4%). In multivariate analysis, the lack of ANC visits, the waiting time > 1 hour before the visit at the referral hospital, and assisted birth were the factors associated with the unfavorable obstetric outcomes. Conclusion: Improvement in maternal health involves better preparation of the community and the healthcare system for Emergency Obstetric Care. Research is needed for innovative and effective interventions in resource constraints settings.

Women’s Perception Concerning Health Care in the Post-Partum Period: A Meta-Synthesis

This meta-synthesis presents the results of qualitative studies on puerperal perception concerning woman’s care in the post-partum period. Four databases were researched using keywords such as “postnatal care” (or) “postpartum period”, (and) “care”, “women”, “perception”, “qualitative research”, “women’s health services”, “community health services”, “allied health personnel”, “primary health care”, resulting in 9 articles for analysis. Six themes were identified: interpersonal relationship, information, communication, attending the necessities, service organization and other supports. Results report mainly on the unsatisfactory professional care for women, appreciating the form of dealing with promptness and the timing to be attended;trust;content, coherence and the way to inform;clarification of doubts;friendly conversation and clinical assistance. The professional workload was restricted on postpartum period care quality. There were gaps found in clinical practice and in dialogical communication and information on women’s health necessities.

低危孕妇孕产保健服务方案的临床实施效果评价

目的评价以助产士为主导的低危孕妇孕产保健服务方案的应用效果。方法将在上海市某三甲妇产科医院预约初诊建卡的低危孕妇随机分为干预组485例和对照组499例。对照组接受以产科医生为主导的常规孕产保健服务;干预组在对照组的基础上接受以助产士为主导的低危孕妇孕产保健服务方案,包括孕期8次助产士门诊访视、微信群组干预及电话访视、产时陪伴分娩及产后访视。结果干预组助产士门诊访视中位数为7次,分娩计划制定率和执行率分别为76.70%和84.68%。干预组剖宫产率为27.68%,显著低于对照组的35.25%(P<0.05)。干预组硬膜外镇痛率、人工破膜率、会阴切开率、新生儿转入NICU率、第三产程出血量、产后2 h出血量及总出血量显著低于对照组(均P<0.05)。干预组孕期保健服务体验、分娩体验、产后保健服务体验、孕晚期生殖健康素养、产前母乳喂养自我效能、分娩自我效能评分及出院前纯母乳喂养率显著高于对照组(均P<0.05)。结论以助产士为主导的低危孕妇孕产保健服务方案的临床实施有利于促进正常妊娠分娩,提升孕产保健服务体验,实现孕产妇和助产士之间的双重赋能。

高龄产妇参与全球群组化保健的感受与体验的质性研究

目的深入了解高龄产妇对全球群组化保健(GCG)的体验与感知,进而为增强高龄产妇参与GCG的积极性和降低孕期并发症提供参考建议。方法采用质性研究中的现象学研究方法,对福建省妇幼保健院11例参与过GCG的高龄产妇进行半结构式访谈,运用Colaizzi七步法对访谈资料进行整理与分析,提炼主题。结果高龄产妇对GCG的感受和体验可归纳为3个主题:产妇赋能、愉悦的产前护理和对GCG的建议。结论高龄产妇对GCG的整体满意度较高,认为GCG有效提升了她们的孕期知识、自我效能感和安全感。为使GCG更加完善,医护团队应考虑进一步调整其内容流程。未来的研究可以探索GCG在其他孕妇群体中的潜在益处。

糖尿病肾病合并妊娠研究进展

在世界范围内,妊娠期糖尿病孕妇的数量一直在稳步增加。这些妊娠会增加各种并发症的风险,包括流产、先天性畸形、巨大儿、胎儿生长受限、子痫前期、早产和死产。对于患有糖尿病肾病的孕妇来说,评估妊娠对肾功能的影响以及肾病对妊娠结局的影响是很重要的。肾功能和微量白蛋白尿正常的孕妇在怀孕期间肾功能丧失的风险较低,而肾小球滤过率<60 ml/min和/或蛋白尿≥3 g/24 h的孕妇在怀孕初期就有永久性肾脏损害的风险。胎儿和母亲并发症的风险与慢性肾脏疾病的严重程度和血糖控制相关。产前护理的进步改善了胎儿和产妇的结局。孕前咨询已成为所有糖尿病妇女,特别是糖尿病和慢性肾病妇女成功怀孕的关键。

无酬劳动对女性心理健康的影响

心理健康是衡量人力资本的重要指标,也是备受国家和政府关注的民生和社会问题。而长期以来,女性作为家庭中家务劳动和儿童照料的主要承担者,参与家庭无酬劳动的时间远高于男性,这可能会影响她们的心理健康水平。基于Grossman健康需求理论,使用中国家庭追踪调查(CFPS)2020年调查数据,实证检验了无酬劳动对女性心理健康的影响及传导机制。研究发现,家务劳动时间的增加会对女性心理健康水平产生显著的负向影响,而照顾孩子时间的增加虽然对女性心理健康水平有负向影响,却并不显著。异质性分析表明,家务劳动时间对农村女性、青年女性和受教育程度较高的女性群体心理健康水平的负向影响更明显,而照顾孩子时间对老年女性和未受过教育的女性群体心理健康水平的负向影响会更明显。稳健性分析表明,在控制内生性后,家务劳动和照顾孩子时间对女性心理健康水平的负向影响显著增强。传导机制分析表明,无酬劳动主要通过影响女性劳动力市场表现来影响其心理健康。随着无酬劳动时间的增加,女性倾向选择非正规就业,工资收入也随之降低,这对其心理健康水平产生了不利影响。因此,重视无酬劳动的价值、在工作场所引入家庭友好措施和倡导男女共同承担家庭劳动是提升我国女性心理健康水平的重要措施。

中西医结合围产保健对孕产妇围产期并发症的影响

目的:分析中西医结合围产保健对孕产妇围产期并发症的影响。方法:选择2021年4月—2023年4月滕州市中心人民医院收治的高龄孕产妇96例作为研究对象,基于单盲分组方式分为参照组与观察组,各48例。参照组对孕产妇施以常规围产保健,观察组在常规围产保健基础上给予孕产妇中西医结合围产保健。比较两组孕产妇的分娩方式、喂养情况、并发症发生率、产后恢复指标及心理状态评分。结果:观察组自然分娩率高于参照组,母乳喂养率高于参照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于参照组,差异有统计学意义(P<0.05)。观察组首次进食时间、初乳分泌时间以及子宫复旧时间均早于参照组,差异有统计学意义(P<0.05)。干预前,两组心理状态评分比较,差异无统计学意义(P>0.05);干预后,观察组焦虑自评量表、抑郁自评量表评分低于参照组,差异有统计学意义(P<0.05)。结论:高龄孕产妇在围产期应用中西医结合保健方式,可以降低孕产妇并发症发生率与剖宫产率,促进其机体恢复,缓解其不良情绪,有助于提升孕产妇母乳喂养率,值得临床推广。

诺丁斯关心伦理对妇女发展的价值意蕴

作为关心伦理学最重要的代表人物,内尔·诺丁斯为妇女处理好个体与自我、个体与他人、个体与社会及生态环境之间的关系提供了新视角。关心伦理对妇女的成长发展具有重要指导意义,有助于引导妇女形成对自我价值和地位的正确认知,鼓励她们发挥自身优势、实现人生理想,具有以主体意识为核心的个人成长价值;推动妇女以关心者或被关心者的角色开展社会交往,具有以建构关心关系为目标的社会交往价值;引导妇女关心公共事务和生态环境,培养社会责任意识、国际合作意识和可持续发展意识,具有以公共利益为指向的社会发展价值。

优质护理在妊高征产妇产后出血护理中的应用研究

探讨优质护理在妊高征产妇产后出血护理中的应用效果。选取江南大学附属医院2021年7月—2022年8月收治的100例妊高征产后出血产妇为研究对象,采用乱数表法将产妇分为观察组(n=50)与对照组(n=50),对照组实施常规护理,观察组实施优质护理,对比两组产妇出血量、血压调控情况、生活质量、护理满意度、出现不良事件的概率以及心理状态评分。结果显示,护理后,观察组产妇出血量显著少于对照组(P<0.05),血压指标优于对照组(P<0.05),生活质量评分和护理总满意率高于对照组(P<0.05),SAS评分、SDS评分和不良事件出现率低于对照组(P<0.05)。研究发现,在妊高征产妇产后出血护理期间,优质护理干预可显著改善产妇心理状态和生活状态,减小产妇血压波动,减少产妇出血量,优化产妇护理体验,有着较高临床应用价值。