Assessment of Clients Satisfaction in Family Planning Service Delivery in Port Harcourt, Nigeria

Background: Client satisfaction is considered as one of the desired outcomes of health care service delivery and it is directly related to the utilization of any health services. The family planning clinic remains one of the important health care delivery outlets where client satisfaction guarantees continuation of usage, hence this study. Objective: The objective of this study is to assess the determinants of client satisfaction with the family planning (FP) services provided in Port Harcourt. Materials and methods: This was a descriptive prospective cross-sectional study conducted between 18th of June 2018 and 18th of July 2018. The target population is women of reproductive age group (15 - 49) who visited 11 randomly selected family planning health facilities in Port Harcourt during the study period. A set of exit interviewer-administered questionnaire (pretested for reliability and validity) was used for data collection from a sample size of 195 respondents;and analyzed using SPSS 22.0. Standard deviation was used for continuous variable while categorical variables were presented in simple percentages and frequencies. The P value was set at <0.05 and confidence interval was 95%. Results: Age range 30 - 39 years constituted the largest proportion of 51.3%. A large proportion of the women (87.2%) expressed satisfaction with FP services provided. All respondents said the facilities were easily accessible, clean and were treated respectfully. However, only about half of the clients (51.3%) received their chosen contraceptive product after 1 hour. Conclusion: A huge proportion of family planning clients expressed satisfaction with family planning service delivery in Port Harcourt;not minding the longer waiting time. Implication of this is continued use and by implication improved contraceptive prevalence.

Peripartum Cardiomyopathy Complicated by Ventricular Tachycardia during Labor: A Case Report and Literature Review

Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventricular tachycardia (VT) is a major complication and contributor to sudden death. Available data on VT in patients with PPCM are limited. Aim: This case report demonstrates the clinical presentation, antenatal care, and management of labor and delivery in a patient with PPCM complicated by VT. Case report: 36-year old patient G4P3 presents at 27 weeks gestation to the emergency department complaining of chest tightness, palpitations, and profuse sweating. Peripartum cardiomyopathy was diagnosed after her last pregnancy a few years prior. Ventricular tachycardia was diagnosed at this visit and treated successfully. The remainder of the pregnancy was uneventful until she had another episode of ventricular tachycardia during labor. Treatment using antiarrhythmics (diltiazem, amiodarone, adenosine) highlights the importance of prompt intervention and the need for a range of therapeutic options. Results: This case demonstrated successful VT management during pregnancy and labor, emphasizing multidisciplinary collaboration, influencing maternal and fetal outcomes positively, providing insights into optimal care strategies. Conclusion: Peripartum cardiomyopathy complicated by ventricular tachycardia is a life-threatening combination. This case highlights the importance of timely diagnosis and management with combined care between cardiologists, maternal fetal medicine specialists and anesthesiologists to prevent morbidities and sudden maternal death.

Optimization of Manufacturing Supply Chain with Stochastic Demand and Planned Delivery Time

In this paper, a manufacturing supply chain system composed by a single-product machine, a buffer and a stochastic demand is considered. A stochastic fluid model is adopted to describe the system and to take into account stochastic delivery times. The objective of this paper is to evaluate the optimal buffer level used in hedging point policy taken into account planned delivery times, machine failures and random demands. This optimal buffer allows minimizing the sum of inventory, transportation, lost sales and late delivery costs. Infinitesimal perturbation analysis method is used for optimizing the proposed system. Using the stochastic fluid model, the trajectories of buffer level are studied and the infinitesimal perturbation analysis estimators are evaluated. These estimators are shown to be unbiased and then they are implanted in an optimization algorithm, which determines the optimal buffer level in the presence of planned delivery time. Also in this work, we discuss the advantage of the use of the infinitesimal perturbation analysis method comparing to classical simulation methods.