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...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.展开更多
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 corre...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.展开更多
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 th...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.展开更多
文摘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.
文摘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.
基金This work was supported by China Medical Board(No.CMB-15-243)Haomin Yang is supported by grant from China Scholarship Council(No.201406010275)The funding agencies have no role in the study design,data analysis or manuscript writing.
文摘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.
