Provision of Preconception Care by Midwives, Nurses and Doctors at Ndola Teaching Hospital in Ndola District, Zambia

Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of preconception care. Therefore, the aim of this study was to establish the provision of preconception care by midwives, nurses and doctors at Ndola Teaching Hospital in Zambia. Methods: A concurrent embedded mixed methodology utilising a descriptive explorative study design, where 107 respondents were randomly selected using the lottery technique for quantitative part and two focused group discussions for qualitative part of the study was used. A self-administered questionnaire was used to collect quantitative data and a focus group discussion guide was used for the focus group discussions. Statistical Package of Social Sciences version 26 with significance set at 0.05 and at 95% confidence level and thematic analysis were used for data analysis. Results: 75% of the respondents in this study were not providing preconception care and only 25% of respondents were providing preconception care;however, this was provided randomly because there were no guidelines to follow. Among the respondents, 81.3% had medium knowledge, 70.1% had good practices and 92.5% had positive attitudes towards preconception care. Further analysis showed that the association between preconception care and knowledge, practices and attitudes was not statistically significant (p = values 0.336;0.344;1.000 respectively). Multivariate logistic regression revealed that participants with high knowledge were five times more likely to provide preconception care (OR = 5.00, CI = 0.42 - 59.7, P = 0.203). Generally, all the participants acknowledged that preconception care was an important package that could prevent maternal and child morbidities and mortalities. Conclusions: The study revealed that most of the respondents were not providing preconception care. Provision of preconception was done by a small fraction of the respondents and it was done in an unorderly manner due to lack of set standards and guidelines. Despite medium levels of knowledge and generally good practices and positive attitudes towards preconception care, its random provision indicates a need for established standards to enhance maternal and child health outcomes.

A review of guidelines,recommendations,and framework of men’s preconception care

The focus of men’s health is within the context of preconception health and primary care,which involves a new method of engaging men’s attention to their preconception and general health.The aim of this review research is to offer health care practitioners a complete framework for men’s preconception care.From 2000 to October 2021,researchers examined electronic databases such as Web of Science,PubMed,Scopus,ScienceDirect,ProQuest,Cochrane,SAGE,Springer,UpToDate,and Google Scholar for published papers on men’s preconception care.Two independent authors assessed the quality of the included studies using techniques suitable for this type of investigation.Only 14 of the 835 studies that were found in the original search matched the inclusion criteria.Individual responsibility across the life span(evaluation of reproductive life plan,acquiring information about contraception)and risk assessment(age,medical and surgical history,medications,family history and genetic risks,social history,sexual health assessment,physical examination,laboratory testing,mental health,and intimate partner violence)are the two main topics of preconception care in men according to a review of studies.Our findings clearly demonstrated the critical components of a comprehensive preconception care approach for men.Therefore,preconception care for men remains a developing concept.Further research is required to develop standards for evaluating males during the preconception period.

Seroepidemiology of Syphilis Infection among 2 Million Reproductive-age Women in Rural China：A Population-based, Cross-sectional Study

Background：Quantifying syphilis prevalence is important for planning interventions and advocating for resources on syphilis.However,data on large sample studies regarding the prevalence of syphilis among reproductive-age women in rural China were not available for analysis.The aim of the study was to determine the prevalence,epidemiological characteristics,and related factors of syphilis infection among reproductive-age women in rural China.Methods：Data were obtained from a nationwide,population-based,cross-sectional study under the National Free Preconception Health Examination Project which covered all the 31 provinces in China's Mainland.Women intending to get pregnant within the next 6 months were enrolled between January 1,2010,and December 31,2012.Sociodemographic,gynecological and obstetric characteristics,and other relevant information were obtained through face-to-face interviews.Treponema pallidum particle agglutination assay test was used to detect positive samples of syphilis.Univariate and multivariate logistic regressions were performed to assess the associations between syphilis seropositivity and related factors.Results：The overall seroprevalence of syphilis （SPS） among the 2,044,126 women who received syphilis screening test during 2010-2012 was 0.37% （95% confidence interval [CI]：0.36-0.37%）.The SPS appeared 0.24% （95% CI：0.23-0.26%） and 0.66% （95% CI：0.59-0.72%） in women at 21-24 and 40-44 years of age,respectively,showing an increase of SPS,parallel with age,and the difference was significant.SPS was significantly higher in ethnic minorities than that in Han nationality （0.58% vs.0.35%,respectively,odds ratio [OR] =1.41,95% CI：1.30-1.53） and higher in workers than that in farmers （0.45% vs.0.36%,respectively,OR =1.27,95% CI：1.14-1.41）.Women with primary school or below level had a higher SPS as compared to those with college or above educational level （0.61% vs.0.32%,respectively,OR =2.49,95% CI：2.14-2.89）,and the increase reversely correlated with the levels of education.Women whose spouses were syphilis seropositive had significant greater risk （OR =48.26,95% CI：44.38-52.48） as compared those whose spouses were seronegative.Women who reported having had a history of sexually transmitted infections were more likely to be tested positive for serological syphilis （OR =27.17,95% CI：20.44-36.11） as compared to those without.Conclusions：High SPS is seen among reproductive-age women in rural China that calls for targeted interventions on syphilis prevention and control in this target population,with emphasis on those who are 35 years of age and above,less educated,being minor ethnicity,workers,and living in the western regions of China.

Menstrual cycle characteristics as an indicator of fertility outcomes:evidence from prospective birth cohort study in China

OBJECTIVE:To evidently assess the applicability of regulate menstrual cycle(MC)characteristics in Traditional Chinese Medicine(TCM)as an indicator for fertility.METHODS:A community-based prospective cohort study was conducted in China.Between January 2010 and December 2012,women who were willing to conceive within 2 years were enrolled in the study.Other than the MC length pattern,a well-adopted MC characteristic,menstrual blood color and clots were specifically concerned for women enrolled.All participants were followed up in 2 years by trained nurses.Pregnancy rate,fecundability odds ratio(FOR)and risk of miscarriage were assessed as fertility outcomes.RESULTS:A total of 2109 women were effectively included in this cohort for analysis.Results show that women with irregular MC length were less likely to achieve conception(FOR_(irregular)=0.59;95%CI=0.45-0.77,P<0.001).Menstrual blood in bright red color was also associated with decline in likelihood of conception(FOR=0.79;95%CI=0.63-0.98,P=0.04).Women with menstrual blood in light red were at higher risk of miscarriage(OR=2.39;95%CI=0.91-6.28,P=0.08).No significant impact was found between menstrual blood clots and fertility outcomes(FOR=1.02,95%CI=0.83-1.25,P=0.88;OR=1.2695%CI=0.77-2.07,P=0.35).CONCLUSIONS:MC characteristics can be an effective and simple indicator for women’s fertility.Increasing the knowledge of MC characteristics for women in reproductive ages would bring great benefits to their preconception health conditions.