Perceived barriers to early breast cancer screening uptake and treatment as mentioned by FGD part... more Perceived barriers to early breast cancer screening uptake and treatment as mentioned by FGD participants. (DOCX 18Â kb)
Interview guide for the focus group discussions and in-depth interviews (key informants) (DOCX 44... more Interview guide for the focus group discussions and in-depth interviews (key informants) (DOCX 44Â kb)
Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third trimester stillbirt... more Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third trimester stillbirths occurring world-wide each year. Ninety-eight percent occur in low and middle income countries (LMIC), resulting in a ten-fold disparity in stillbirth rates between high and LMIC. Nevertheless, stillbirth is practically unrecognized as a health problem, either in global health metrics or within most LMIC data reports. Confusion regarding stillbirths is compounded by inconsistent definitions and over 35 different classification systems. One million or more stillbirths occur in the intrapartum period and are preventable with obstetric care that would also save the lives of mothers and newborns. The large disparities in stillbirth rates between HIC and LMIC, and those often seen in minority, disadvantaged and rural populations, are major themes among the papers in this series. Important interventions to reduce stillbirth include some components of antenatal and intrpartum obstetric care i...
Background Identifying every pregnancy, regardless of home or health facility delivery, is crucia... more Background Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children's Health study area in Kenya revealed that up to 70% of newborns did not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were born outside health facilities. Methods To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders were engaged to assist in case finding for pregnancies and...
Introduction human papilloma virus (HPV) which is preventable is the main cause of cervical cance... more Introduction human papilloma virus (HPV) which is preventable is the main cause of cervical cancer and it targets mostly young adolescents. The study was to determine the practice desire, attitude and knowledge of mothers of adolescent girls on HPV vaccination in Western Kenya. Methods this was a descriptive cross-sectional study design. Data was obtained using semi-structured questionnaires and analyzed using both descriptive and inferential statistics at 95% confidence level using the SPSS software version 22. A p-value ≤ 0.05 was considered statistically significant. Results ninety five percent of the mothers had intentions to vaccinate their daughters and also had a positive attitude and their response to HPV vaccination was significantly lower than those without intentions p=0.02, 95% CI, OR=0.48 (0.90-0.89). Vaccination against HPV was low at 9.4% with a mean age of 34 years. Our results found a high level of cervical cancer awareness (85.0%), HPV and vaccine awareness respect...
Background Since the introduction of highly active antiretroviral therapy (HAART), acquired immun... more Background Since the introduction of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) related mortality has markedly declined. As HAART is becoming increasingly available, the infection with human immunodeficiency virus (HIV+) in sub-Saharan Africa (SSA) is becoming a chronic condition. While pregnancy in HIV+ women in SSA has always been considered a challenging event for the mother and the fetus, for pregnant HIV+ women also diagnosed with epilepsy (WWE), there are additional risks as HIV increases the odds of developing seizures due to the vulnerability of the central nervous system to other infections, immune dysfunction, and overall metabolic disturbances. In light of a growing proportion of HIV+ WWE on HAART and an increasing number of pregnant women accessing mother-to-child transmission of HIV programs through provision of HAART in SSA, there is a need to develop contextualized and evidenced-based clinical strategies for the management...
Background Caesarean section (C-section) rates are often low among the poor and very high among t... more Background Caesarean section (C-section) rates are often low among the poor and very high among the better-off in low- and middle-income countries. We examined to what extent these differences are explained by medical need in an African context. Methods We analyzed electronic records of 12,209 women who gave birth in a teaching hospital in Kenya in 2014. C-section rates were calculated by socioeconomic position (SEP), using maternal occupation (professional, small business, housewife, student) as indicator. We assessed if women had documented clinical indications according to hospital guidelines and if socioeconomic differences in C-section rates were explained by indication. Results Indication for C-section according to hospital guidelines was more prevalent among professionals than housewives (16% vs. 9% of all births). The C-section rate was also higher among professionals than housewives (21.1% vs. 15.8% [OR 1.43; 95%CI 1.23–1.65]). This C-section rate difference was largely exp...
Perceived barriers to early breast cancer screening uptake and treatment as mentioned by FGD part... more Perceived barriers to early breast cancer screening uptake and treatment as mentioned by FGD participants. (DOCX 18Â kb)
Interview guide for the focus group discussions and in-depth interviews (key informants) (DOCX 44... more Interview guide for the focus group discussions and in-depth interviews (key informants) (DOCX 44Â kb)
Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third trimester stillbirt... more Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third trimester stillbirths occurring world-wide each year. Ninety-eight percent occur in low and middle income countries (LMIC), resulting in a ten-fold disparity in stillbirth rates between high and LMIC. Nevertheless, stillbirth is practically unrecognized as a health problem, either in global health metrics or within most LMIC data reports. Confusion regarding stillbirths is compounded by inconsistent definitions and over 35 different classification systems. One million or more stillbirths occur in the intrapartum period and are preventable with obstetric care that would also save the lives of mothers and newborns. The large disparities in stillbirth rates between HIC and LMIC, and those often seen in minority, disadvantaged and rural populations, are major themes among the papers in this series. Important interventions to reduce stillbirth include some components of antenatal and intrpartum obstetric care i...
Background Identifying every pregnancy, regardless of home or health facility delivery, is crucia... more Background Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children's Health study area in Kenya revealed that up to 70% of newborns did not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were born outside health facilities. Methods To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders were engaged to assist in case finding for pregnancies and...
Introduction human papilloma virus (HPV) which is preventable is the main cause of cervical cance... more Introduction human papilloma virus (HPV) which is preventable is the main cause of cervical cancer and it targets mostly young adolescents. The study was to determine the practice desire, attitude and knowledge of mothers of adolescent girls on HPV vaccination in Western Kenya. Methods this was a descriptive cross-sectional study design. Data was obtained using semi-structured questionnaires and analyzed using both descriptive and inferential statistics at 95% confidence level using the SPSS software version 22. A p-value ≤ 0.05 was considered statistically significant. Results ninety five percent of the mothers had intentions to vaccinate their daughters and also had a positive attitude and their response to HPV vaccination was significantly lower than those without intentions p=0.02, 95% CI, OR=0.48 (0.90-0.89). Vaccination against HPV was low at 9.4% with a mean age of 34 years. Our results found a high level of cervical cancer awareness (85.0%), HPV and vaccine awareness respect...
Background Since the introduction of highly active antiretroviral therapy (HAART), acquired immun... more Background Since the introduction of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) related mortality has markedly declined. As HAART is becoming increasingly available, the infection with human immunodeficiency virus (HIV+) in sub-Saharan Africa (SSA) is becoming a chronic condition. While pregnancy in HIV+ women in SSA has always been considered a challenging event for the mother and the fetus, for pregnant HIV+ women also diagnosed with epilepsy (WWE), there are additional risks as HIV increases the odds of developing seizures due to the vulnerability of the central nervous system to other infections, immune dysfunction, and overall metabolic disturbances. In light of a growing proportion of HIV+ WWE on HAART and an increasing number of pregnant women accessing mother-to-child transmission of HIV programs through provision of HAART in SSA, there is a need to develop contextualized and evidenced-based clinical strategies for the management...
Background Caesarean section (C-section) rates are often low among the poor and very high among t... more Background Caesarean section (C-section) rates are often low among the poor and very high among the better-off in low- and middle-income countries. We examined to what extent these differences are explained by medical need in an African context. Methods We analyzed electronic records of 12,209 women who gave birth in a teaching hospital in Kenya in 2014. C-section rates were calculated by socioeconomic position (SEP), using maternal occupation (professional, small business, housewife, student) as indicator. We assessed if women had documented clinical indications according to hospital guidelines and if socioeconomic differences in C-section rates were explained by indication. Results Indication for C-section according to hospital guidelines was more prevalent among professionals than housewives (16% vs. 9% of all births). The C-section rate was also higher among professionals than housewives (21.1% vs. 15.8% [OR 1.43; 95%CI 1.23–1.65]). This C-section rate difference was largely exp...
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