American Journal of Public Health Research

Fetal mortality refers to the intrauterine death of a fetus and is a major, but often overlooked public health issue in Ghana. Due in part to a paucity of knowledge of the incidence, etiology and prevention strategies, much of the public concern on reproductive loss has focused on infant mortality. Effective antenatal care, which must be evidence-based information driven, necessitates regular, updated and reviewed studies on risk factors associated with fetal mortality to help in addressing this phenomenon. In this study, using data of the 2007 Ghana Maternal Health Survey, the incidence and some pre-pregnancy risk factors of fetal mortality were studied using non-parametric procedures. The results showed that the first trimester of pregnancy was the riskiest period, accounting for over 50% of all fetal mortalities in Ghana: The third month, where over 5% of pregnancies are lost, is the riskiest month of pregnancy. Previous pregnancy outcomes, the age and education of the mother as well as her place of residence, were shown to be significantly associated with fetal mortality at the 5% significance level: Particularly, women with a history of abortion and those who have never given birth are over 4 times more likely to lose their pregnancy than their counterparts. The results highlight the adverse effects of the pressures of urban life on fetal survival, as well as the need for early antenatal care and comprehensive care for women who lose a fetus.

American Journal of Public Health Research. 2013, 1(5), 124-128. DOI: 10.12691/ajphr-1-5-3
Pub. Date: June 05, 2013

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Factors Influencing the Uptake of Intermittent Preventive Treatment for Malaria in Pregnancy: Evidence from Bungoma East District, Kenya

by Angela Chepkemoi Ng’etich Mutulei

Original Research

Malaria infection in pregnancy is highly risky for the mother and her fetus. Intermittent Preventive Treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine is a key intervention for malaria prevention during pregnancy. Bungoma East District falls within the malaria-endemic zone of Kenya, with an infection risk class of 20% or higher. Even though malaria accounts for about 41% of maternal deaths in the District, IPTp₂ coverage remains below the Roll Back Malaria target. The objective of this study was to identify and document factors influencing the IPTp₂+ uptake. To achieve this, I applied the cross-sectional survey design to guide the research process. I sourced data from 278 women who were at the 24^th week or more of gestation, aged between 15 and 49 years, had not experienced malaria during the pregnancy and were not on cotrimoxazole prophylaxis. Quantitative analysis techniques included one-way analysis of variance, cross-tabulations with Chi Square statistic and binary logistic regression. The study found that women starting antenatal visits in the second month had about 10.5 times the odds of taking IPTp₂+ as those initiating antenatal attendance in the sixth month of pregnancy. Again, women who mentioned health facilities as the main source of information were about 12.7 times as likely to take IPTp₂+ as who relied on community health worker. Women who received support from their partners towards antenatal visits had about 8.2 times the odds of taking IPTp₂+ as those who did not receive partner support. Furthermore, women dwelling within a distance of less than one hour’s walk had about 6.4 times the odds of taking IPTp₂+ as those dwelling within a distance of more than 4 hour’s walk. Based on the findings, I recommend the need for better programming and content of health education sessions at the clinic; better staffing of health facilities to reduce workload and improve service quality; training health workers on customer care and sensitization of men through the media, work place paternal programs and peer education for a more active role.

American Journal of Public Health Research. 2013, 1(5), 110-123. DOI: 10.12691/ajphr-1-5-2
Pub. Date: June 07, 2013

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An Audit of Documented Rehabilitees` Data at the Workers` Compensation Rehabilitation Centre (WCRC) in Bulawayo, Zimbabwe

by Ngwenya Bongani

Original Research

The primary objective of Workers’ Compensation Rehabilitation Centre is to provide clinical rehabilitation services to patients who have work related injuries. To do this, the centre requires complete rehabilitees’ data to be transmitted from the referrer to the centre as well as across internal departments for the centre. This is because documentation of medical records is a fundamental tool for communication between health professionals. It informs the care provided, treatment, care planned and the outcome of that care as a continuous and contemporaneous record. However, the researcher was not aware of any clinical audit of documented rehabilitees’ data with respect to compliance with this requirement. This prompted a review of rehabilitees’ data for its completeness as a vital initial step towards optimisation of rehabilitees’ care pathways. The research method was a non-participatory document review of quota sampled discharged rehabilitees’ files using a descriptive and analytical research design. Data were captured using a structured data collection instrument designed and tested by the experts in the medical fraternity. The instrument was designed from information prescribed in internationally referred documents and refined using information prescribed in the Procedures Manual for the centre. Generally, rehabilitees’ information was incomplete thereby making the referral and review of patients difficult. Clinical template forms in use at the research site had inadequate form fields and this was an important factor which modelled the level of completeness of rehabilitees’ information. These inadequate form fields resulted in important facts about the rehabilitees not efficiently transmitted across departments so much that there was practically no meaningful documented dialogue on balancing benefits with the risks to patients. There is need to revise the content of the procedure manual to prescribe that all clinicians file complete discharge rehabilitees’ information in one folder as part of improving documentation in line with the principle of medical care and international standards.

American Journal of Public Health Research. 2013, 1(5), 101-109. DOI: 10.12691/ajphr-1-5-1
Pub. Date: June 04, 2013

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