| 1. |
- Agardh, Anette, et al.
(författare)
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Experience of sexual coercion and risky sexual behavior among Ugandan university students
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Growing worldwide evidence shows that the experience of sexual coercion is fairly prevalent among young people and is associated with risky sexual behavior thereafter. The causal mechanisms behind this are unclear but may be dependent on specific contextual determinants. Little is known about factors that could buffer the negative effects of coercion. The aim of this study was to assess the association between the experience of sexual coercion and risky sexual behavior among university students of both sexes in Uganda. Methods: In 2005, 980 (80%) out of a total of 1,220 students enrolled in Mbarara University of Science and Technology in Uganda participated in a self-administered questionnaire covering socio-demographic and religious factors, social capital, mental health, alcohol use, and sexual behavior. A validated scale of six items was used to assess the experience of sexual coercion. Logistic regression analyses were applied to control for confounders. Potential buffering factors were analyzed by testing for effect modification. Results: Fifty-nine percent of those who responded had previously had sexual intercourse. Among the male students 29.0%, and among the female students 33.1% reported having had some experience of sexual coercion. After controlling for age, gender, and educational level of household of origin, role of religion and trust in others sexual coercion was found to be statistically significantly associated with previously had sex (OR 1.6, 95% CI; 1.1-2.3), early sexual debut (OR 2.4, 95% CI; 1.5-3.7), as well as with having had a great number of sexual partners (OR 1.9, 95% CI; 1.2-3.0), but not with inconsistent condom use. Scoring low on an assessment of mental health problems, reporting high trust in others, or stating that religion played a major role in one's family of origin seemed to buffer the negative effect that the experience of sexual coercion had on the likelihood of having many sexual partners. Conclusion: The findings of this study suggest that the experience of sexual coercion is common among youth/young adults in Uganda and is subsequently associated with risky sexual behavior in both sexes. The existence of individual and contextual factors that buffer the effects mentioned was also demonstrated. In the Ugandan context, this has implications for policy formulation and the implementation of preventive strategies for combating HIV/AIDS.
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| 2. |
- Asamoah, Benedict Oppong, et al.
(författare)
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Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988-2008
- 2014
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth. Methods: A database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization. Results: The rural-urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income-and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003. Conclusions: The increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education-and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be inoculated with the appropriate health messages.
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| 3. |
- Asp, Gustav, et al.
(författare)
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Associations between mass media exposure and birth preparedness among women in southwestern Uganda: a community-based survey.
- 2014
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 7:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background : Exposure to mass media provides increased awareness and knowledge, as well as changes in attitudes, social norms and behaviors that may lead to positive public health outcomes. Birth preparedness (i.e. the preparations for childbirth made by pregnant women, their families, and communities) increases the use of skilled birth attendants (SBAs) and hence reduces maternal morbidity and mortality. Objective : The aim of this study was to explore the association between media exposure and birth preparedness in rural Uganda. Method : A total of 765 recently delivered women from 120 villages in the Mbarara District of southwest Uganda were selected for a community-based survey using two-stage cluster sampling. Univariate and multivariate logistic regression was performed with generalized linear mixed models using SPSS 21. Results : We found that 88.6% of the women surveyed listened to the radio and 33.9% read newspapers. Birth preparedness actions included were money saved (87.8%), identified SBA (64.3%), identified transport (60.1%), and purchased childbirth materials (20.7%). Women who had taken three or more actions were coded as well birth prepared (53.9%). Women who read newspapers were more likely to be birth prepared (adjusted OR 2.2, 95% CI 1.5-3.2). High media exposure, i.e. regular exposure to radio, newspaper, or television, showed no significant association with birth preparedness (adjusted OR 1.3, 95% CI 0.9-2.0). Conclusion : Our results indicate that increased reading of newspapers can enhance birth preparedness and skilled birth attendance. Apart from general literacy skills, this requires newspapers to be accessible in terms of language, dissemination, and cost.
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| 4. |
- Asp, Gustav, et al.
(författare)
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Challenges of immediate newborn care in maternity units in Lagos, Nigeria: An observational study.
- 2011
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Ingår i: Journal of Obstetrics and Gynaecology. - : Informa UK Limited. - 1364-6893 .- 0144-3615. ; 31:7, s. 612-616
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Tidskriftsartikel (refereegranskat)abstract
- Substandard newborn care has been identified as a major contributor to the estimated annual 4 million neonatal deaths and 1 million fresh stillbirths. Low-income countries, including Nigeria account for more than 95% of all cases. A cross-sectional comparative study utilising non-participant observation methods was used to study perinatal care at two maternity centres in Lagos, Nigeria. Data on 63 mother-baby pairs were included in the study. Two stillbirths and two early neonatal deaths occurred during the study period, equally divided between the two hospitals. The partograph, a crucial tool for monitoring progress of labour, was in use in 77.4% vs 50% of cases at the two centres. The only interventions utilised for the prevention of hypothermia were drying and covering newborns with towels. Hygiene routines were poor and caring procedures did not demonstrate adequate knowledge related to a newborn's health. An enabling environment and supportive supervision is urgently required.
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| 5. |
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| 6. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Swedish women's experiences of seeking care and being admitted during the latent phase of labour : A grounded theory study
- 2007
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Ingår i: Midwifery. - Edinburgh : Churchill Livingstone. - 0266-6138 .- 1532-3099. ; 25:2, s. 172-180
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to gain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour.Design: a qualitative interview study using the grounded theory approach.Setting: the study was conducted at a hospital in the southwestern part of Sweden with a range of 1600-1700 deliveries per year. The interviews took place in the women's homes two to six weeks after birth.Participant: eighteen Swedish women, aged 22-36, who were admitted to the tabour ward while they were stilt in the latent phase of tabour.Findings: 'Handing over responsibility' to professional caregivers emerged as the core category or the central theme in the data. The core category and five additional categories formed a conceptual model explaining what it meant to women being admitted in the early stage of tabour and their experiences of the Latent phase of tabour. The categories, which all related to the core category, were labelled: (1) 'longing to complete the pregnancy,' (2) 'having difficulty managing the uncertainty,' (3) 'having difficulty enduring the stow progress,' (4) 'suffering from pain to no avail' and (5) 'oscillating between powerfulness and powerlessness.'Conclusions and implications for practice: findings indicate that women being admitted to the tabour ward in the latent phase of tabour experienced a need for handing over responsibility for the tabour, the welt-being of the unborn baby, and for themselves. Midwives have an important role in assisting women with coping during the latent phase of tabour, and in giving the women opportunity to hand over responsibility. This care should include validation of experienced pain and confirmation of the normality of the slow process, information and support. © 2007 Elsevier Ltd. All rights reserved.
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| 7. |
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| 8. |
- Christensson, Kyllike, et al.
(författare)
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The Challenge of Improving Perinatal Care in settings with Limited Resources : Observations of Midwifery Practices in Mozambique
- 2006
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Ingår i: African Journal of Reproductive Health. - Benin City, Edo State, Nigeria : Women's Health and Action Research Centre. - 1118-4841. ; 10:1, s. 47-61
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to observe and analyze midwifery care routine related to asphyxia and hypothermia during the perinatal period and to investigate the effect of an in-service education program. A direct non-participant pre-and post intervention observation study of midwifery a performance during childbirth was conducted at a labour ward in Maputo. The observed groups consisted of 702 and 616 midwifery –attended deliveries. Examination was also conducted of the partographs (702 vs. 616). The quality of midwifery care related to prevention and early detection of asphyxia and hypothermia was found to be inadequate and the intervention had no significant effect upon the midwives' performances. This could be attributed to the quality of the intervention itself or to failure of implementing managerial decisions such as transfer to partograph documentation from obstetricians to midwives. Change in professional performance does not automatically follow awareness of evidence-based midwifery practices, but requires behavioural change, which may be more difficult to achieve.
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| 9. |
- Entsieh, Angela Afua, et al.
(författare)
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Learning the ABCs of pregnancy and newborn care through mobile technology.
- 2015
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- The diffusion of mobile phones in low- and middle-income countries has taken place faster than any other infrastructural development. Mobile Midwife, a mobile application implemented in Ghana in 2010, sends timely messages in local languages to registered expectant mothers and new parents. The field of mobile health (mHealth) is severely underresearched, yet it can be an alternative for improving health systems and the ways in which health services are delivered.
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| 10. |
- Ezechi, Oliver, et al.
(författare)
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Evaluation of direct visual inspection of the cervix in detecting cytology diagnosed squamous intraepithelial lesion in women of known HIV status. A randomized trial (CANHIV study)
- 2016
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Ingår i: African Journal of Reproductive Health. - 1118-4841. ; 20:4, s. 77-88
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Tidskriftsartikel (refereegranskat)abstract
- A two-arm, open label, randomized study, evaluated the test characteristics of visual inspection of cervix with Acetic acid (VIA) and Lugol’s Iodine (VILI) in detecting cytology diagnosed squamous intraepithelial lesion (SIL) in 1160 women of known HIV status in southwestern Nigerian. Using SIL as reference standard and the HIV status masked, VIA and VILI had similar test characteristics except for the positive predictive value in which VIA value of 91.5% was significantly higher than 77.7% for VILI (p=0.01). Among HIV positive women, VILI performed poorly across all the 4 test characteristics compared to VIA. Among severely immuno-compromised HIV positive participants VILI performance was consistently below 80% across all test characteristics (sensitivity-70.0%; specificity-66.9%; positive predictive value-46.7%; negative predictive value (NPV) -50.0%) compared to VIA (Senstivity-71.3%; specificity-88.2%; positive predictive value-83.3%; negative predictive value-88.2). Our study shows that VILI is insufficiently sensitive and specific in the presence of HIV infection especially in those with severe immunosuppression. Based on VIA’s acceptable sensitivity and NPV in all situations, it is recommended for cervical cancer screening in HIV positive women and in settings of high HIV burden.
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