Medicine and Health Sciences Commons^™

Factors Associated With Anaemia Among Pregnant Women In Rwanda: An Analysis Of The Rwanda Demographic And Health Survey Of 2020, Lilian Nuwabaine, Joseph Kawuki, Livingstone Kamoga, Quraish Sserwanja, Ghislaine Gatasi, Linet M Mutisya, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda.

Methods: Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26).

Results: Of the 435 pregnant …

Sexual Violence And Associated Factors Among Women Of Reproductive Age In Rwanda: A 2020 Nationwide Cross-Sectional Survey, Lilian Nuwabaine, Joseph Kawuki, Earnest Amwiine, John Baptist Asiimwe, Quraish Sserwanja, Ghislaine Gatasi, Elorm Donkor, Humphrey Atwijukiire

School of Nursing & Midwifery, East Africa

Background; Sexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda.

Methods: We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25).

Results: Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0–14.1) had …

Breast Cancer Molecular Subtype Classification According To Immunohistochemistry Markers And Its Association With Pathological Characteristics Among Women Attending Tertiary Hospitals In Tanzania., Allyzain Ismail

Theses & Dissertations

Background:

Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and categorised into 4 subtypes, Luminal A, Luminal B, Human Epidermal Growth Factor Receptor 2 (HER2) enriched and Triple Negative Breast Cancer (TNBC).

Objectives:

To determine the prevalence of each molecular subtype of breast cancer and determine their association with pathological and demographic characteristics.

Methods:

A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015-2022 and had a breast tissue biopsy confirming primary breast …

"Women Are Again Unsafe": Preventing Violence And Poor Maternal Outcomes During Current Floods In Pakistan, Sarmad Muhammad Soomar, Abir Arefin, Salman Muhammad Soomar

School of Nursing & Midwifery

No abstract provided.

Jam – Winter 2022, Rafat Jan, Edwin Van Teijlingen, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.

Hypertension In Women: A South-Asian Perspective, Fatima Farrukh, Amin Abbasi, Misbah Jawed, Aysha Almas, Tazeen Jafar, Salim S. Virani, Zainab Samad

Medical College Documents

Introduction: Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women.
Materials and methods: Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women.
Results: The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the …

Factors Associated With Utilization Of Quality Antenatal Care: Asecondary Data Analysis Of Rwandan Demographic Health Survey 2020, Quraish Sserwanja, Lilian Nuwabaine, Ghislaine Gatasi, Julius N. Wandabwa, Milton W. Musaba

School of Nursing & Midwifery, East Africa

Background

Over the last decade, progress in reducing maternal mortality in Rwanda has been slow, from 210 deaths per 100,000 live births in 2015 to 203 deaths per 100,000 live births in 2020. Access to quality antenatal care (ANC) can substantially reduce maternal and newborn mortality. Several studies have investigated factors that influence the use of ANC, but information on its quality is limited. Therefore, this study aimed to identify the determinants of quality antenatal care among pregnant women in Rwanda using a nationally representative sample.

Methods

We analyzed secondary data of 6,302 women aged 15–49 years who had given …

Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja

School of Nursing & Midwifery

Background: Violence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.
Methods and findings: We conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa …

Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto

Community Health Sciences

Background: Lack of early risk detection, diagnosis, and treatment of pregnant women at high risk for pre-eclampsia can result in high maternal mortality and morbidity not only in Pakistan but also in other low- to middle-income countries (LMICs). A potential tool for supporting pregnant women at high risk for pre-eclampsia for early detection is telemonitoring (TM). However, there is a limited body of evidence on end-user needs and preferences to inform the design of the TM programs for pregnant women at high risk for pre-eclampsia, specifically in LMICs such as Pakistan.
Objective: This study aims to explore the needs of …

Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem

Community Health Sciences

Objective: Unintended pregnancy has become a substantially growing reproductive health concern in South Asian region. The objective of this survey was to assess the magnitude of unintended pregnancy along with its correlates among currently pregnant women residing in Karachi.
Methods: A community based, multistage, cross-sectional study was carried out among 612 currently pregnant women from squatter settlements of Karachi, inquiring for "unintended pregnancy", outcome of interest. Multivariable logistic analysis was done using SPSS v.19 to determine associated factors.
Results: Of 612 pregnant women interviewed, 168(27.4%) reported their pregnancies as unintended. The multivariable regression identified a high likelihood of unintended pregnancy …

Desire To Limiting Child Birth And The Associated Determinants Among Married Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Sumera Aziz Ali, Zahid Abbasi, Sarah Saleem

Community Health Sciences

Objective: High rates of population growth negatively influence the social and economic development of a country. This study aimed to determine the women's desire to limiting child birth in future (fertility intention) and its determinants among Pakistani women of reproductive age resident of Karachi.
Methods: A community-based, multistage cross-sectional study was carried out among residents of the squatter settlements in Karachi. The were 4,485 married residents, and currently non-pregnant females of 18 to 49 years old. Framework adapted has been based on "Pullum 1980" to operationalize the outcome of determining the desire to limiting childbearing and the factors related with …

Barriers To Access Of Healthcare Services For Rural Women – Applying Gender Lens On Tb In A Rural District Of Sindh, Pakistan, Shifa Salman Habib, Wafa Zehra Jamal, Syed Muhammad Asad Zaidi, Junaid Ur-Rehman Siddiqui, Hira Mustafa Khan, Jacob Creswell, Srichand Batra, Anna Versfeld

Community Health Sciences

Background: Women in rural districts of Pakistan face numerous barriers to healthcare, rendering gender-responsive health programming important, including for Tuberculosis (TB). This study was conducted to assess the general understanding of TB and of access to healthcare for women, as a first step towards implementation of a gender responsive TB programme in TandoAllayar, a rural district of Pakistan.
Methods: A total of 36 participants were interviewed. The focus group discussion guide comprised of questions on: (1) family/household dynamics (2) community norms (3) healthcare system (4) women’s access to healthcare (5) TB Awareness;, and (6) women’s access to TB Care.
Results: …

Essential Package Of Palliative Care For Women With Cervical Cancer: Responding To The Suffering Of A Highly Vulnerable Population, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa

Department of Anaesthesia

Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of …

Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi

Department of Anaesthesia

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.
Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying …

Demand Satisfied By Modern Contraceptive Among Married Women Of Reproductive Age In Kenya, Peter Gichangi, Michael Waithaka, Mary Thiongo, Alfred Agwanda, Scott Radloff, Amy Tsui, Linea Zimmerman, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Demand for family planning met/satisfied with modern contraceptive methods (mDFPS) has been proposed to track progress in Family Planning (FP) programs for Sustainable Development Goals. This study measured mDFPS among married women of reproductive age (MWRA) in Kenya to identify which groups were not being reached by FP programs.

Materials and methods: Performance, Monitoring and Accountability 2020 (PMA2020) survey data from 2014–2018 was used. PMA2020 surveys are cross-sectional including women 15–49 years. PMA2020 used a 2-stage cluster design with urban/rural regions as strata with random selection of households. Univariate and multivariate analysis was done using stata V15.

Results: Of …

Intimate Partner Violence Against Women: A Comprehensive Depiction Of Pakistani Literature, Tazeen Saeed Ali, Rozina Karmaliani, Rida Farhan, Syeda Hussain, Fatima Jawad

School of Nursing & Midwifery

Background: Intimate partner violence against women is a significant problem in Pakistan associated with an alarming set of mental health issues.
Aims: To identify the prevalence of intimate partner violence in Pakistan and the causes, health effects and coping strategies used by women.
Methods: A comprehensive search based on the identified keywords was conducted using Google Scholar and PubMed. Relevant literature was also searched and included. Abstracts were then shortlisted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and 25 studies were selected. Quantitative studies on intimate partner violence were included in the review. The review comprises …

Rising Trend Of Women In Gastroenterology: A Paradigm Shift, Lubna Kamani, Jeanin E Van Hooft

Section of Gastroenterology

No abstract provided.

Risk Factors Of Breast Cancer Among Patients In A Tertiary Care Hospitals In Afghanistan: A Case Control Study, Zekrullah Baset, Jamshid Abdul Ghafar, Yasmin Parpio, Ahmed Maseh Haidary

School of Nursing & Midwifery

Background: Breast cancer is the second most common causes of women's death, worldwide. Data on risk factors associated with female breast cancer in the Afghan population is very limited. The aim of our study was to identifying risk factor associated with female breast cancer in Afghanistan.
Methods: A retrospective case-control study was conducted with inclusion of 201 cases and 201 controls. Patient information was collected by interviewing the patient through a structured questionnaire. Histopathological information was collected from the hospital integrated laboratory management system. The data was analyzed by using logistic regression with univariate and multivariable analyses to determine the …

Challenges During Colonoscopy In Women With A Prior Hysterectomy, Lubna Kamani, Nazish Butt, Hanisha Khemani

Section of Gastroenterology

No abstract provided.

Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon

Woman and Child Health

Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We …

Critical Social Determinants Of Childbirth Outcomes In Remote Mountains: Voices Of Women From Nepal, Sabitra Kaphle, Lareen Newman

Journal of Asian Midwives (JAM)

Objectives: Despite efforts made by the Government of Nepal to reduce maternal and newborn mortality nationally, the rate is still significantly higher in remote mountain areas. This research aimed to fill a gap by asking women about socio-cultural factors influencing childbirth outcomes in remote mountain areas of Nepal.
Methods: This study used a qualitative approach guided by the principles of social constructionist and feminist critical theories to derive factors influencing women’s experiences of giving birth and childbirth outcomes. In-depth interviews were conducted with 25 pregnant and postnatal women. A thematic approach was used for data analysis.
Results: Childbirth outcomes in …

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Thatta Pakistan: Findings From A Cross-Sectional Study, Sumera Aziz Ali, Zahid Abbasi, Babar Shahid, Ghazal Moin, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. Mcclure, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Anemia is a major public health concern among women of reproductive age leading to high maternal mortality in low- and middle-income countries. Of the prior studies conducted in Pakistan, most focused on large urban areas and did not explore the determinants of anemia among women of reproductive age (WRA) across socio-demographic, dietary, reproductive, and biological domains. Thus, we aimed to study the prevalence and determinants of anemia among WRA in rural Pakistan.
Methods: We conducted a cross-sectional study in the Thatta district of Pakistan from September 2018 to January 2019 and enrolled 150 non-pregnant, married women. Data collectors administered …

Redesigning The Landscape For Women And Leadership: Insights Gained From The Covid-19 Pandemic. On Behalf Of Women In Gastroenterology Network Asia Pacific (Wignap) And Women In Endoscopy (Wie), Lubna Kamani, Nonthalee Pausawasdi, Jeanin E Van Hooft, Amrita Sethi, Sharmila Sachithanandan

Section of Gastroenterology

No abstract provided.

C'Est Vraiment Compliqué: A Case Study On The Delivery Of Maternal And Child Health And Nutrition Interventions In The Conflict-Affected Regions Of Mali, Anushka Ataullahjan, Michelle F. Gaffey, Moctar Tounkara, Samba Diarra, Seydou Doumbia, Zulfiqar Ahmed Bhutta, Diego G. Bassani

Woman and Child Health

Background: Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering services in these geographies must navigate the complex environment created by conflict. This study aimed to understand how humanitarian actors make decisions around health service delivery within this context.
Methods: The current case-study utilized a mixed methods approach and focused on Mopti, Mali's fifth administrative region and fourth largest in population. Latent content analysis was used to analyze interview transcripts guided by our research objectives and new concepts …

Investigating The Delivery Of Health And Nutrition Interventions For Women And Children In Conflict Settings: A Collection Of Case Studies From The Branch Consortium, Anushka Ataullahjan, Michelle F. Gaffey, Samira Sami, Neha S. Singh, Hannah Tappis, Robert E. Black, Karl Blanchet, Ties Boerma, Ana Langer, Paul B. Spiegel, Ronald J. Waldman, Paul H. Wise, Zulfiqar Ahmed Bhutta

Woman and Child Health

Globally, the number of people affected by conflict is the highest in history, and continues to steadily increase. There is currently a pressing need to better understand how to deliver critical health interventions to women and children affected by conflict. The compendium of articles presented in this Conflict and Health Collection brings together a range of case studies recently undertaken by the BRANCH Consortium (Bridging Research & Action in Conflict Settings for the Health of Women and Children). These case studies describe how humanitarian actors navigate and negotiate the multiple obstacles and forces that challenge the delivery of health and …

Midwives’ And Women’S Perception On Moyo Fetal Heart Rate Monitor For Intrapartum Fetal Heart Rate Monitoring; A Cross-Sectional Study, Paschal Mdoe, Anita Yeconia, Fanuel Buu, Simeon Kusulla, Ladislaus Blacy, Estomih Mduma, Godfrey Guga, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Background: The annual global neonatal mortality stands at 2.5 million deaths, 1 million of them dying within the first day of life. An additional 2.6 million are stillborn globally, the majority of them due to intrapartum events. Optimal fetal heart rate (FHR) monitoring has the potential to timely detect fetuses at risk and, if coupled with timely obstetric responses may save more newborns. Moyo is a new Doppler with nine crystals capable of monitoring FHR both intermittently and continuously.

Aim: To assess women’s and midwives’ opinions on the use of Moyo for intrapartum FHR monitoring.

Methods: We conducted a cross-sectional …

Psychosocial Implications In Breast Cancer, Daniyal Aamir, Yamna Waseem, Mustafa Saleem Patel

Medical College Documents

No abstract provided.

A Multicenter Case Control Study Of Association Of Vitamin D With Breast Cancer Among Women In Karachi, Pakistan, Uzma Shamsi, Shaista Khan, Syed Iqbal Azam, Aysha Habib, Amir Maqbool, Mohammad Hanif, Tiffany Gill, Romaina Iqbal, David Callen

Community Health Sciences

Background: The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan.
Methods: A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information …

The Burden Of Urinary Incontinence Among African Diabetic And Non-Diabetic Women Seeking Care At The Aga Khan University Hospital, Nairobi, Martin Kimemia Mbuthia

Theses & Dissertations

Introduction: Female urinary incontinence is a common and chronic condition with devastating psychosocial effects. It can occur at any age and is specifically more common in older women. It has a prevalence of up to 55% depending on the age-group and the target population studied. About 9% of adults globally have diabetes and a greater number live in LMICs. Diabetes is twice as prevalent in blacks and three to four times higher in South-Asian populations compared to Caucasian populations. In women with Type 2 DM, urinary incontinence is 30% to 70% more common than among women with normal glucose levels. …

Coronary Heart Disease, Hypertension And Use Of Biomass Fuel Among Women: Comparative Cross-Sectional Study, Zafar Fatmi, Georgia Ntani, David Coggon

Community Health Sciences

Objectives: To explore the associations of hypertension and coronary heart disease (CHD) with use of biomass fuel for cooking.
Design: Comparative cross-sectional study.
Setting: Rural villages in Sindh, Pakistan.
Participants: Women aged ≥40 years who had used biomass fuel for cooking for at least the last year (n=436), and a comparison group (n=414) who had cooked only with non-biomass fuel during the last year were recruited through door-to-door visits. None of those who were invited to take part declined.
Primary and secondary outcome measures: Hypertension was determined from blood pressure measurements and use of medication. CHD was assessed by three …