Improving reproductive health services: Is integration with primary healthcare better than vertical programmes?

This paper draws upon data generated during a qualitative study of male involvement in reproductive health during pregnancy, childbirth and the postnatal period in rural districts of Malawi. One of the key themes drawn from this research was information and support for pregnant women, evidence from this research suggested that women’s health during pregnancy, childbirth and the postnatal period would benefit women if they were given information and support during pregnancy, delivery and the postnatal period. A total of 48 men and 45 women between the ages of 20-87 years from four rural districts were interviewed: The research answered the following questions:
• What information is required for pregnant women to stay healthy?
• What support do you think women need from others/services during pregnancy, childbirth and postnatal care?
The results indicate that women should be given information early in pregnancy about health practices and behaviours, birth preparedness, place of delivery and contraceptive methods. The support that women need during pregnancy, childbirth and postnatal care included neighbour’s instrumental support of household labour, and neighbour’s support with caring for the baby.

The HIV epidemic is a serious public health concern globally. South Africa is home to the largest population living with HIV in the world (UNAIDS, 2010). Migration is an important factor in the study of the spread of HIV as the process of migration increases migrants’ susceptibility to HIV (IOM: 2010). There are approximately 1.6 million cross-border migrants in South Africa; this is equivalent to 3.4% of the total population (CoRMSA, 2009). Knowledge of one’s status is a crucial first step in management of the disease; however HIV testing remains a challenging aspect of public health programmes due to various social determinants of health, especially amongst key at risk populations such as migrants (WHO, 2010). Therefore, in order to expand our understanding of Migration and HIV testing; this quantitative study aims to investigate the determinants of HIV testing amongst migrants living in Johannesburg. Secondary data analysis will be conducted using the RENEWAL survey of 2008 comprising of 441 people stratified into international (n=293) and internal (n=150) migrants. Analysis will be done at three levels: Univariate, Bivariate and Multivariate; Logistic Regression being the main model.
Key Words: Migration; South Africa; HIV testing; Determinants.

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Title; Rural community care in HIV/AIDS management in west Africa: The case of Nigeria
Author: Bob, B. B and Bob,B.B (2012)Journal: The 1st African Regional Educational HIV/AIDS submits,Abuja, ICEDCP. 2011, Nov (1) 12-20)
Source: African Journal: The 1st African Regional Educational HIV/AIDS Submit/ICEDCP

Abstract: Poster
Human Immunodeficiency virus(HIV) and Acquired Immunodeficiency syndrome(AIDS) affect many people, all experiencing their own individual devastating tragedy, the epidemic in Nigeria and many other African sorties is largely invisible and insidious when it begins, is now seen in what once were considered unlikely sites - the rural communities people with HIV/AIDS continue to fight illness and die in appalling conditions and ruin many rural villages, towns, and cities, a mixture of politics, culture and other sensitive still prevent effective high impact education programmed and other strategies to enhance effective response to the disease

Background: Though, education has positive impact on health but education alone will not help in recognizing, reporting health problems and utilization of health care. Similarly, in case of maternal health, women need proper health knowledge to recognize health problems and opting for health care; otherwise misconception may lead to adverse health outcomes. The study assesses the level of health knowledge of women and its systematic association with the reporting of maternal health problems and health care utilization by Indian women.
Methods: Indian Human Development Survey (IHDS-2005) data is used. Simple bivariate and multivariate analyses: binary logistic regression, multinomial regression, principal component analysis and significance test are used.
Results: Though socio-economic factors ar important predictors of reporting of maternal health problems and utilization of maternal health care, the study found a huge variation in reporting of maternal health problems and health care utilization within same socio-economic groups by level of health knowledge. Increasing level of health knowledge is positively associated with reporting of greater pregnancy and post-natal complications and greater level of ante-natal, institutional delivery and post-natal care seeking by women.

Objectives are to create enabling environment for promotion of birth spacing and to improve access and provide selected contraceptives. The data generated through routine monitoring is used to study the immediate effect and progress of the intervention. MIS was designed to record whole process diligently. The baseline and evaluation were conducted through randomized sampling based on whole districts. An innovative approach was introduced through CBVs in non-LHW areas. The mobilization was linked with services, referral to public or private sector facilities, and additionally CBVs were supplied Condoms and pills to provide to the clients as a replenish dose. Total 304 CBVs (160 male & 144 females) from 9 union councils of 03 districts selected. They reached 97% of the target families and deliver messages and information. The intervention was continued in 5 UCs through 78 female CBVs. In 3 months follow up, 2503 clients referred for FP services and 2344 new clients have adopted one of the birth spacing service. Hence 21% eligible women have adopted FP method within 6 months through MSU (1769 clients) and through private LHV(575). 1060 Condoms and pills were provided to clients as a follow up. Where there is no LHW or any other health facility, CBVs model may be one of the effective approach to reach under privileged communities

Introduction: It has been shown that there is a relationship between mother’s health and fertility behavior and her birth’s health and survival. A mother is to fall in any of the high-risk fertility groups if she gives birth at age less than 18 years or 35 and above, when she is giving the fourth birth or above or when she is giving a birth after less than 24 months since she gave her previous one.
Study Rationale: Recent data from PAPFAM surveys show that in some Arab countries infant and child mortality rates are still high and that women still tend to marry at younger ages and almost 90% of women went through early marriage tend to have their first child soon after marriage. On the other hand age at first marriage reached 30 years in some other countries implying that women might give births after reaching 35 years or with short intervals in between.
Objectives: This study aims at investigating the high-risk fertility behavior prevalence, differentials and determinants in some Arab countries and its impact on infant and child mortality.
Methodology and Data Sources: The study will apply both descriptive and multivariate analyses using mainly PAPFAM surveys data.

The rising trend of caesarean section (CS) delivery throughout the world has become a serious public health issue. In India the rate of CS has increased from 3% to 10% between 1992-93 and 2005-06 (IIPS, 2007). The present study seeks to explore the level and trend of caesarean section delivery in India. It also attempts to identify the causes of alarming growth rate of CS in some parts of India. The analysis is based on third District Level Household and Facility Survey and three rounds of National Family Health Survey conducted in India. Logistic regression model is used to understand the net impact of various explanatory variables on woman’s experience of CS. A number of doctors and patients from different public and private institutions were interviewed to identify the underlying causes of high growth rate of CS. Besides the profit maximization tendency of the private medical institutions, rise in institutional deliveries and patients’ choice for CS, poor doctor-population ratio, 24 hours unavailability of obstetricians in the medical institutions, poor infrastructural support for normal delivery, constant threat of case suits and physical harassment against doctors are cited as some of the important causes of increase in caesarean section delivery.

In many developing countries, adolescents’ reproductive health has given a significant attention and emphasized the lack of knowledge causes to experience higher risks of vulnerabilities. Gender is vital in determining quality of reproductive health especially accessing health education and services. We examine the gender differentials of knowledge and attitude towards reproductive health using data from 110 secondary school children in colombo district. The findings reveal that female students had better awareness on reproductive health education than their male counterparts. Furthermore, it revealed that friends and peers were more influential sources of obtaining reproductive health information than school teachers and parents irrespective of their gender and sector where they live. Attitudes on pre-marital sex show that urban students tend to favour premarital sexual relationships as a source of gaining experience irrespective of gender. Majority of students in all sectors had agreed that providing reproductive health knowledge is an essential and it need to be included as a subject in the school curriculum. These findings suggest that policies and programmes should be more focused on educating male students and also awareness programmes need to implement further for all students to address their issues.

Objective: To assess the knowledge, attitude and practice regarding pre-marriage counseling among young women in Punjab province of Pakistan.
Study Design: Cross sectional Study in Punjab province, Pakistan
Methodology: The Primary tool in this study was a designed and pretested questionnaire to elicit women’s knowledge and attitudes about pre-marital counseling in Punjab, Pakistan

The Study was conducted to assess the Knowledge, attitude and practices (KAP) of women regarding pre-marriage counseling and to evaluate the correlation between this KAP and indicators of reproductive health and family planning.
Education system is the major factor for not being exposed to pre-marriage counseling. In this study, we tried to fund the reasons for lack of pre-marriage counseling and found that 1) poor literacy rate in Pakistan, and poor coordination and corporation among the participating. 2) cultural barriers and lack of family support to enable to find platforms which women get counseling facilities . 3) Lack of discipline and skill among counselors in performing their responsibilities. 4) lack of interest among counsels. 5) Need to focus on Pre-marriage and relationships during pre-marriage counseling sessions. Need for Pre-Marriage Counseling Program (PMCP) which correlate to reproductive health and family planning

The complication of the postpartum complications started with the delivery and it is severe after the two month of the delivery and it is related to a variety of personal, family and social economic variables. This paper makes an attempt to present a model that describes women’s health over the first/last postpartum year and the relationships between health changes and other variables. The core model’s dependent variable is combination of the two variables which describes PPC i.e., high vaginal bleeding and high fever after two months. The independent variables within the model include, social/health support, complication of the child birth, mother use of alcohol and chewing tobacco, beetle leaf, smoking cigarettes, and the economic and demographic characteristics. This model proposed as a research tool for future investigation in Postpartum Complications and as a conceptual framework to enhance our understanding of the relationships between Postpartum Complication and other important variables.

Key words: Age of the mother, Body Mass Index, Wealth, Habit, Religion, Delivery Complications, Region.