Maternal, neonatal and child healthcare Research Papers (original) (raw)

Objective: to explore the attitudes of first-time mothers towards antenatal education from the perspective of attenders and non-attenders. Design: a qualitative approach was utilised using focus group interviews to collect the data. Setting: the study was conducted in one local health office area of the Health Service Executive-South East, Ireland. Participants: a purposive sample of first-time mothers was interviewed to explore the area of antenatal education. These women included both attenders and non-attenders at antenatal education. Key conclusions: the findings suggest there are many strengths, weaknesses, opportunities and barriers to antenatal education. Strengths of antenatal education included the facilitator of antenatal classes, the information and preparation received, and the social aspect of meeting other expectant mothers. Barriers to attendance at antenatal education included working night shifts, no interest, transport difficulties, inflexible employer, and partner not attending. A move away from didactic teaching methods and greater participation and involvement of parents was identified as necessary. Implications for practice: fundamental issues related to the provision and of antenatal education were identified. A need for promotion and advertising of antenatal education was identified by the participants. Mothers identified specific needs such as the provision of postnatal classes and peer mentoring, flexible availability of classes, and facilitators utilising the principles of adult learning to guide classes. The mothers alluded to the importance of father's attendance and inclusion at classes. In view of the poor uptake of antenatal classes in Ireland, it is imperative that an approach to antenatal education is parent centred and needs driven.

- by
- •
- Maternal, neonatal and child healthcare, Antenatal Education

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection or transfusion of contaminated blood or blood products, sharing unsterilized injection equipment that was previously used by an infected person and maternal-fetal transmission during pregnancy, at birth or through breastfeeding. Transmission of HIV from an infected patient to a health-care worker has been documented after parenteral or mucous membrane exposure to blood. Oral manifestations are one of the earliest clinical indicators of HIV infection which is independent of CD4 status has a prognostic value. By the way, screening of the AIDS associated manifestations in the oral cavity is a noninvasive and feasible approach, these oral lesions should be used to help diagnose, prevent and intervene in the progression of HIV infection to AIDS. This review includes studies that investigate the impact of HIV infection on personal life and importance of oral lesion in early diagnosis of HIV infection in children. Articles were identified through searches of PubMed MEDLINE from 1970 to 2015, using the MESH based key words.

- by Enliven: Pediatrics and Neonatal Biology and +1
- •
- Pedodontics (Pediatric Dentistry), Pediatrics, Pediatric Psychology, HIV and AIDS education
- by Christian Munthe
- •
- Health Sciences, Applied Philosophy, Ethics, Applied Ethics

This cross-sectional analytic study was conducted to develop a statistical model to predict birth weight based on anthropometric measurements of baby namely, thigh circumference (TC), calf circumference (CC), mid-upper arm circumference (MUAC) and head circumference (HC), and selected maternal characteristics such as age, gravida, height and inter-pregnancy interval in Central Women Hospital, Mandalay during 2008 and 2009. The subjects were 991 babies delivered during study period and their mothers. The anthropometric measurements were taken within 24 hours after delivery. Mean birth weight was 3.12 kg ± 0.48 kg. The anthropometric measurements of babies were strongly correlated to his/her birth weight. The present study found out that maternal height and baby’s sex, gestational age, TC, CC, MUAC and HC were significant predictors of birth weight. The final model containing these variables can explain about 84% of variation of baby’s birth weight. The separate predictive models were also developed using each anthropometric measurement of a baby as a predictor. A predictive model using TC along with gestational age, sex and maternal height explains about 77% of baby’s birth weight. A similar model containing CC, gestational age, sex and maternal height explains about 72% of birth weight of a baby. The MUAC along with gestational age, sex and maternal height can also explain about 71% of birth weight of a baby. A model containing HC, gestational age and maternal height can explain about 60% of baby’s birth weight. These models can be used to predict birth weight of a baby in areas where there is no facility to measure birth weight.

The aim of this study was to find out the extent to which the bonding of mother and newborn effects incidence of postpartum mood disorders and formation of mother´s feelings to the child. The three-phase longitudinal research was carried out from February to December 2015, and studied yet not reviewed effect of the quality of bonding and it´s particular course on psychological experiencing of mothers, whether it concerns the feelings for the newborn or the intensity of depressive symptoms in the postpartum period. The sample consisted of 37 women planning the delivery in Brno and surroundings. We used methods EDPS, PDPI, PBQ, TBQ and MIBS, created for postpartum period. Results: Using linear regression analysis, we found that the quality and the length of bonding following immediately after the delivery significantly reduces the incidence and severity of depressive symptoms in the postpartum period. We also confirmed an effect the quality of the bonding has on intensity of emerging maternal bond to the child and negative effect for the possible mother-infant bonding disorders. The main finding of this study is that immediate and good quality contact with newborn influences the emotional and physical level in a protective way and benefits not only the recovery from childbirth, but also psychological changes associated with entrance into the motherhood. Impact of good quality bonding may provide healthier entry into the motherhood and improved feeling of the relationship to the newborn in women who are in a difficult life situation and are within the risks of developing postpartum mood disorders.

- by Anna Madill
- •
- Psychology, Clinical Psychology, Social Psychology, Developmental Psychology

This descriptive correlational study was conducted to determine the maternal profile, awareness and utilization of Basic Emergency Obstetrics and Newborn Care (BEmONC) among women of reproductive age (WRA) in a rural municipality in Iloilo. The 346 respondents were selected using stratified random sampling technique. Data were gathered using a structured interview schedule prepared and validated prior to the actual data collection. For univariate, frequency, percentage, and mean were utilized to describe the data while Chi-square, Gamma, and Cramer’s V were used to analyze and determine relationships between variables. The results revealed that most of the respondents were highly aware of the Rural Health Unit (RHU) as a BEmONC facility and its services. However, most of them have utilized only the prenatal package but not the childbirth and postnatal services. Hypothesis testing found a significant relationship between utilization of BEmONC services and employment status, income level, educational status, OB score, pregnancy status and awareness of BEmONC services. Increasing awareness about maternal and child health care and facility-based services and educating women planning for safe childbirth to deliver in a BEmONC facility that is attended by a skilled medical health professional are essential for the survival of the mother and the newborn.

Congenital diaphragmatic hernia (CDH) is a condition where abdominal content protrudes through a defect in the diaphragm which occurs as a result of incomplete fusion of pleuroperitoneal membrane during fetal development. CDH is normally diagnosed prenatally which has proven to improve the prognosis, but failure to do so can lead to serious cardiorespiratory implications in newborns. Early management after birth includes bowel decompression and prevention of development of pulmonary hypertension along with maintaining adequate oxygenation. Surgery is the only definitive treatment. We present this case report of a 4 hour old male child with severe respiratory distress who was referred from another facility requiring urgent care.

- by Ankush Maheshwary
- •
- Pediatrics, Neonatology, Maternal, neonatal and child healthcare, Neonatal

Maternal health litigations have become a public concern. Necessarily, various strategies are to be established to manage litigations and improve quality of care. The study explored the experiences of midwives on maternal health litigations in a rural district hospital in South Africa. Data was collected through eight (8) individual unstructured face to face interviews of midwives on maternal litigations in a rural district hospital in Eastern Cape, South Africa. A qualitative research design was utilised, which was explorative, descriptive, and contextual. Data analysis revealed three themes: (1) the experiences of midwives on litigations, which emanated from poor working conditions; (2) midwives' lack of competence, which is a leading cause of maternal incidences; (3) shortage of midwives and high admission of pregnant women, which contribute to poor recording. The study revealed that the experiences of midwives were conceptualised negatively, although the interview questions were intentionally neutral. This is believed to be due to the fact that the subject of the topic is a daily song in maternal health; indeed, there are many litigations and midwives are so negative in government delays to manage litigation issues. It is recommended that primary health care be strengthen as sources of these patients delivering in public hospitals. This will would help to minimise late bookings and unnecessary incidences in the maternal health facilities that later turn into litigations. Lastly, the study recommended that staff coverage should be considered such as employment of highly skilled midwives and in-service trainings to the current ones to improve their skills which hoped in reducing the medical malpractice and litigations.

Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbreast, covered only with a cap, sheet or gown.Objective: To determine the effect of skin-to-skin contact in the breastfeeding of infants in theNational Institute of Perinatology.Material and methods: Prospective, descriptive, observational, and cross-sectional study wasperformed, including a search for the information in the database of the Immediate Care Unitfor the Newborn from 1 August 2015 to 31 July 2016. The data obtained were Gestational age,weight, Apgar, maternal pathology, skin-to-skin contact, duration, and feeding.Results: There were 3175 births, with 2228 term neonates. CPP was performed in 1486 neona-tes (78.95%), with a weight of 2,045 to 4,200 g. The majority of patients who were breastfed(78.7%) had had skin-to-skin contact. Likewise, it was observed that CPP signiﬁcantly favouredbreastfeeding (RR=143.28; 95% CI: 75.5-271.7).Discussion: CPP favours breastfeeding (99.2%), making the ﬁrst food human milk, and reducingthe use of substitutes.Conclusions: Skin-to-skin contact is the best opportunity for the initiation of breastfeeding.The separation of mothers and their children at birth has become a common practice in thedelivery and operating rooms, due to hospital routines, placing the infant in a cradle of radiantheat, and initiating breastfeeding after one hour of life.

- by Agnes Pello
- •
- Maternal, neonatal and child healthcare

NICE guidelines (2007) state that active management for the third stage of labour should be recommended preferentially to physiological management. If these guidelines are followed inflexibly by midwives, they may be in danger of not providing the women in their care with informed choice. This essay explores the ways in which midwives can deliver safe care whilst advocating for their clients' wishes.

- by Eliza Jones
- •
- Women's Health, Women, Midwifery, Maternal Health

Bounding Attachment terhadap bayi baru lahir berdampak penting bagi perkembangannya

- by Fepy Sisiliay
- •
- Psychology, Analytical Chemistry, Science Education, Midwifery

Women procreate everyday to sustain the continuity of the society. Therefore they deserve to be given adequate care during pregnancy, delivery and postpartum periods. Such care will not only prevent them from risks embedded in pregnancy and delivery, but also assures a healthy start for the infant. This study seeks to examine the determinant of maternal health car facilities utilization and to ascertain the quality of healthcare facilities available in the rural communities. Theoretically, the study made use of Rational Choice Theory (RCT) and Health Belief Model. A descriptive research design was employed for the study, using both quantitative and qualitative methods of data collection. The quantitative data was computer processed and analyzed with statistical package for Social Science (SPSS v18.0). The outcome of the study indicates that Most of the respondents agreed that they had not utilized health facility due to determining factors

Setelah Mengikuti pelajaran ini mahasiswa diharapkan dapat :
1. Menjelaskan dan memahami konsep dasar resusitasi
2. Menjelaskan dan memahami tindakan resusitasi baik pada orang dewasa dan bayi
3. Menjelaskan dan melaksanakan persiapan alat dalam tindakan resusitasi
4. Menjelaskan dan memahami konsep pertolongan pertama kegawatdaruratan
5. Menjelaskan dan memahami konsep bantuan hidup dasar

- by vQ beibi
- •
- Maternal, neonatal and child healthcare, Kebidanan, Keperawatan, RESUSITASI BAYI TERBARU

Ministry of Health and Family Welfare Government of the People's Republic of Bangladesh-Oct 2009-This strategy paper is the result of intensive discussions of five technical working groups, under the National Core Committee, of MOHFW, and consultations at sub national and national levels. It represents a synthesis based on situation analysis, review of documents, and selection of evidence based interventions. It further proposes strategic directions and priorities for the Government to consider for improving maternal and neonatal health at all levels of service delivery.
The document is organized into two main sections.
Section I: National Neonatal Health Strategy: provides overall context,
goal and objectives and key issues to be addressed. It also
includes descriptions of critical intervention areas following
the continuum of care from pre-pregnancy through postpartum care.
Section II: Guidelines for National Neonatal Health Strategy: This
section consists of a series of tables and flow charts that
provide overview of interventions, summary by continuum of
care, detail guidelines for the interventions, human
resources for different service levels, information on
logistics supply and details on supervision, monitoring and
evaluation. It also includes some annexes that narrate
information and tables related to the strategy. A broad based
Action Plan for the Strategy is also included as annex.

- by Anupoma Haque
- •
- Maternal, neonatal and child healthcare

Advances in medical care have dramatically improved survival rates in preterm and critically ill newborns. Nonetheless, the patient experience of neonatal intensive care exposes these vulnerable individuals to numerous sources of stress, to include noxious environmental stimuli, painful procedures, and prolonged separation from mother. This early life adversity, although medically necessary, alters the infant’s developmental trajectory through epigenetic, neuroendocrine and psychosocial mechanisms. Providing trauma-informed, neuroprotective care consistently and reliably in the neonatal intensive care setting offers clinicians an effective, evidence-based framework to transform the culture of care and improve short term and long term outcomes.

- by Mary Coughlin RN, MS, NNP
- •
- Neuroscience, Neonatal Nursing, Trauma-Informed Care, Neonatology

El onfalocele gigante es un defecto de pared abdominal mayor de 6cm, asociado o no a herniación del hígado. El tratamiento ha sido muy controversial, no existe evidencia suficiente, ni consensos que indiquen que técnica quirúrgica tiene mejores resultados. Basados en nuestra experiencia, este reporte propone un algoritmo de manejo con distintas opciones paso a paso, con soluciones para estos defectos de pared abdominal en pacientes pediátricos, dentro de los cuales se incluyen manejo minimamente invasivo como el silo adherente, y la separación de componentes como alternativa.

Neonatal mortality remains high in Nepal. Improvement in immediate essential newborn care practices such as "use of clean instrument to cut the umbilical cord ", "drying and wrapping the baby before placenta was delivered", "initiation of breastfeeding within an hour of delivery" and "first bathing of neonate after 24 hours of delivery" can reduce neonatal deaths. However, this can only be accomplished if factors associated with reduced neonatal mortality can be identified. A regional study was carried out with 252 randomly selected women having child aged 11 months or younger; of which about 70 percent, 18 percent and 20 percent had received delivery assistance with skilled birth attendant, trained health professional and untrained friend/relatives respectively. Skilled Birth Attendant appeared as the determinant of the use of clean instrument to cut the umbilical cord (OR=164.33), first bathing of neonate after 24 hours of delivery (OR= 5.14) and drying and wrapping the baby before placenta was delivered (OR= 50.75) whereas Trained Health Professionals turned out to be the determinant of the use of clean instrument to cut the umbilical cord (OR=3.81) and first bathing of neonate after 24 hours of delivery (OR=3.14) only (Reference: Untrained relatives/friends). Maternal age (OR= <20:10.59 and 20-30: 6.39; Ref: >30 years) and education appeared the determinant of initiation of breastfeeding within an hour of delivery. The time gap between delivery and the mother receiving the baby was also significantly positively associated with initiation of breastfeeding within an hour of delivery. This result indicates the need to increase the coverage of health facilities which can provide SBA, empower women to involve a SBA in delivery and provide newborn care education to women and family members. In order to better understand how to decrease neonatal mortality, further study should focus on understanding why there were better newborn care practices in births assisted by a SBA than THPs.

Early life experiences have long-lasting influence on a child. For an infant, the quality of caregiving is one of the most critical factors supporting growth and development. Adverse social events in infancy have the potency to alter the child’s developmental trajectory and elevate the lifetime risk for a range of psychiatric disorders. Although clinical studies associate early childhood adversities with lifetime risk for mental disorders, the knowledge of underlying neural and molecular alterations leading to these disorders comes mostly from animal studies. In this article, we overview selected animal models of early life social adversity, including maternal abuse and neglect, and maternal trauma and fear. We first characterize the major behavioral and neural changes normally occurring in early life. We then present several animal models of maternally mediated early life adversity that contribute to reorient the developmental changes toward pathological outcomes. These models yielded to recently identified neurobiological mechanisms, including epigenetic alterations, through which these adversities lead to a lasting dysregulation of the stress response system, aberrant fear learning and memory, and increased anxiety or depression-like behaviors.

- by Julie Boulanger Bertolus and +2
- •
- Psychology, Clinical Psychology, Developmental Psychology, Health Psychology

A mi juicio, el valor más significativo de este libro es el claro posicionamiento de las/los autores y en particular de las editoras, de que la SM es un derecho, que como tal es responsabilidad de los gobiernos proteger, promover y garantizar, mientras que es responsabilidad de la ciudadanía vigilar su cumplimiento. La misma perspectiva, por supuesto, aplica a diferentes temáticas, de salud y desarrollo, y los ejemplos de contraloría social que se presentan pueden aplicarse a otras políticas y programas.

The novel coronavirus disease, COVID-19 caused by Severe Acute Respiratory SyndromeCoronavirus-2 (SARS-CoV-2), has resulted in thousands of critically ill patients and poses a serious
threat globally. To investigate if SARS-CoV-2 can affect early human embryos, we analysed scRNAseq datasets of human embryos for the SARS-CoV-2 receptors ACE2 and BSG (CD147), the serine
protease TMPRSS2 for viral spike protein priming, and the endosomal protease CTSL for spike protein
activation via the endosomal route. The results reveal that ACE2 and TMPRSS2 are co-expressed in a
proportion of epiblast cells, and both BSG and CTSL are expressed in all the stages of embryonic
development. The cells of the blastocysts express genes encoding for other coronavirus receptors such
as DPP4 and ANPEP as well. Interestingly, the cells of the epiblast also express genes involved in
viral endocytosis and replication. We further identified 194 genes that are differentially expressed in
ACE2- and TMPRSS2-positive cells as compared to ACE2- and TMPRSS2-negative cells of the
epiblast. Our results show that developing human embryos express the receptors for SARS-CoV-2 and
other coronaviruses; embryos also harbour the necessary machinery for viral internalization and
replication. We suggest that couples be advised to avoid conceiving during the pandemic and that IVF
procedures be kept to a minimum to prevent any possible hazard to the developing embryos.

Background: For every neonate who dies, many others experience a near miss event that could have but did not result in death. Neonatal near miss is three to eight times more frequent than neonatal deaths and, therefore, is more useful for assessing the determinants of adverse neonatal outcomes. The aim of this study was to assess the incidence and determinants of neonatal near miss in south Ethiopia.

- by Tesfalidet Beyene and +1
- •
- Maternal, neonatal and child healthcare

Background: Skilled birth attendant defined as Obstetrician, physician, nurse or midwife. IDHS 2012 showed physician's utilization on intra partum only 1%. Objective: to examine the physician's role in maternal care on Puskesmas and their perceptions and opinions on maternal care. Methods: a descriptive analytic design through a mixed method by cross sectional approach. Quantitative data collection by questionnaire to 53% of physician's population on 18 Puskesmas as respondents on Yogyakarta City. The physician's role stately by perception of regulation, perception of resources/equipment, and perception of workload as variables. Qualitative data retrieved from midwife and obstetrician performed on their opinion of physician's role in maternal care on Puskesmas. Results: 8.3% of respondents good in criteria, 47.2% is fair, and 44.4% unfavorable. Physicians never do assessment for ANC, INC and PNC on the Puskesmas. Conclusion: The physician's role in maternal has decreased in Yogyakarta's Puskesmas initiated by government regulation, role perception of the clinical competence by pre-service training and in-service training deficit effects, insufficiency remuneration, lack of role definition by HR policies outcomes on maternal neonatal care.

Objectives Neonatal jaundice (NNJ) is a common newborn disorder globally which is preventable and easily treatable. However, when detected late and/or poorly managed, it is a leading cause of hospitalization, neurological complications and death in newborns. Since mother's knowledge of newborn jaundice is crucial to prompt recognition, intervention and prevention of morbidity and mortality associated with this condition, we sought to determine the knowledge, perception and care seeking behaviours of NNJ among mothers/caregivers. Methods This mixed method study enrolled four hundred and twenty one respondents attending infant welfare clinic in a community health centre in Nenwe town in Enugu state using pretested semi-structured questionnaire. Determinants of knowledge and health seeking behaviour of respondents for newborn jaundice were determined using chi-square and fisher's exact test where appropriate. Results Majority of the respondents had poor knowledge and incorrect perception of the causes and management of NNJ. Use of glucose water and instillation of breast milk into the eye of the newborn were some of the harmful home practices used by respondents in management of newborn jaundice. Educational attainment, experience in newborn care and type of occupation significantly determined knowledge, correct description of NNJ and seeking for care in a hospital among respondents. Conclusion There is poor knowledge and perception of NNJ among respondents. Targeted education during antenatal and infant welfare clinics by health professionals is needed to help mothers and care giver recognise NNJ, refrain from potentially harmful home interventions and promptly seek healthcare.

Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007-08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (OR = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers' education increased. The odds of neonatal death were lower for infants born to unemployed mothers (OR = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (OR = 0.72, p = 0.00) or 'Others' caste group (OR = 0.87, p = 0.04) and to the households with access to improved sanitation (OR = 0.87, p = 0.02), pucca house (OR = 0.87, p = 0.03) and electricity (OR = 0.84, p = 0.00). The odds were higher for male infants (OR = 1.21, p = 0.00) and whose mother experienced delivery complications (OR = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (OR = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity of Tetanus Toxoid (TT) injections by pregnant mothers, targeting vulnerable groups like young, first time and Scheduled Caste mothers, and improving overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India. Any public health interventions aimed at reducing neonatal death in rural India should consider these factors.

- by Aditya Singh
- •
- Child health, Child Development, Children's Rights, Neonatology

"To accommodate the symbolic moment of birth, there used to be a female-only “birth-society” around a mother and her newborn. This environment is today replaced by midwifes and child care assistants. To become a mother herself, a woman... more

- by Anne Villand and +1
- •
- Psychology, Psychoanalysis, Psychiatry, Collaboration

Background: India contributes a large proportion to global under-fi ve child mortality. One of the determinants of child morbidity and mortality is the "child rearing practices." Socio-economic environment, child rearing practices and nutritional status play a synergistic role. Materials and Methods: Information was collected by exit interviews from married women attending out-patient departments of three primary health centers. Data was collected during December, 2009 using pretested questionnaire Married women in reproductive age group with youngest child in the age group of 1-5 years were eligible for inclusion. To assess the child rearing knowledge and practices (CRKP), a composite score was calculated based on 10 variables and categorized into satisfactory and unsatisfactory. Results: A total of 100 eligible married women were included in the study. About half of the women were in the age group of 25-35 years, 80% belonged to social class V and VI majority (63%) were literate and 70% had ≥2 children. With the increase in literacy status, there was the increase in proportion of women who had satisfactory CRKP and decrease in proportion of women who had given pre-lacteal feed. Among women who had three children, 15 out of 39 (38%) had fully immunized their fi rst child as compared with 25 out of 39 (64%) for the second child and 38 out of 39 (97%) for the third child. Immunization coverage increased as the birth order increased. Conclusion: Mothers' education has a signifi cant role in determining her child rearing practices, which in turn would lead better child survival.

- by Rizwan SA
- •
- Primary Health Care, Maternal Health, India, Maternal and Child Health

The worldwide network of internet of things (IOT) combined with advancements in sensor networks, FID and software platform connects objects of various application fields and technology. IOT is most commonly described as an ecosystem of technologies but it requires necessary components to enable communication between devices and objects. Components being RFID and sensors. Many organization have already implemented IOT. Healthcare industry too have adopted IOT and can be extensively used in the future for the benefit of patients, elderly people and caregivers. A new concept named 'Health Internet of Things (HIOT)' was proposed to exploit sensor technologies and wireless networks in monitoring medical conditions. Also advancements in E textile technologies make the textile multifunctional, adaptive and responsive system which combined with IOT performs functions such as communication, computation and health care benefits. Cloud is used to store, control and retrieve or transform or classify information. The use of cloud based application in healthcare industries is constantly growing to benefit patients so that they can monitor their health, store and share records. This paper aims at developing a dependable, productive, high performance and assured smart healthcare system to deliver service to patients avoiding health risks using e textile technologies.

- by IJIRIS Journal Division and +1
- •
- Simulation in healthcare, Healthcare workers, IT in healthcare, Healthcare design

In this study, we investigated the quality of Comprehensive Emergency Obstetric and Neonatal care (CEmONC) in level IV
health facility of Ankole region in Western Uganda. Specifically, we looked at the inputs, proxy measures of processes (CEmONC signals), outputs and outcomes of CEmONC care. In this descriptive cross-sectional study, we employed triangulation-mixed-methods research approach. CEmONC service points (level IV health facilities) of Ankole region were the target while level IV health facilities actively providing CEmONC services formed the study population. We purposively selected 11 health workers with presumed experience and “knowledge” on delivery of CEmONC services forinterview. We found that human resource for health met the 75% ofthe staffing norms in most of the health facilities. However, critical cadres like laboratory staff, anesthetic officers, nursing officer-midwifery were lacking in some health facilities. In addition, critical CEmONC staff like doctors and nursing officers-midwifery had a big chunk of their time on administrative duties. The staff did not receive relevant (CEmONC-related) trainings in recent times. The health facilities generally did not meet the equipment and infrastructure standards for provision of CEmON. All the deficiencies in inputs resulted into poor delivery of CEmONC signals – only one health facility of the 11 provided all the nine CEmONC signals. The interaction between poor inputs and processes resulted into either referrals of conditions needing certain procedure or mortality. We concluded that, despite global human resource for health meeting the Uganda Ministry of Health minimum level of 75% in virtually all the health facilities, lack of relevant in-service trainings, poor attitude and non-professional assignments hampered their provisionof CEmONC in Ankole. As a result (of inadequate inputs), many CEmONC signals were majorly not provided or of poor quality and these most probably resulted into poor neonatal outcomes though we could not make direct attribution. It is imperative that, district local governments, Uganda Ministry of Health, and health development and implementing partners devise means to provide the required inputs, rationalize the deployment of CEmONC personnel to non-technical work; monitor and respond to occurrence of unwanted events like fresh still births; and maternal and neonatal deaths in real time.

- by Gaudy Kyomuhendo and +2
- •
- Obstetrics, Quality of Healthcare Services, Maternal and Child Health, Maternal, neonatal and child healthcare

Background: The incidence of early hypocalcemia in extremely low birthweight (ELBW) infants is unknown because the distribution of serum calcium values in this population is not defined. Objective: To determine the range of serum calcium values in ELBW infants during the first 48 h of life and the risks associated with low values. Design/methods: Retrospective analysis of all ELBW infants admitted on day 1 of life from April 2004 to October 2006. Demographic variables, therapy, serum calcium (Ca), pH, albumin, and blood ionized Ca were recorded. Results: There were 381 Ca levels obtained from 111 patients. Mean Ca was 6.90 mg/dL (1.73 mmol/L) (5 th -95 th percentile: 5.16-8.80). Ca levels rose after 24 h of life. Almost one quarter (23.1%) of the Ca levels were low by current standards. The majority of subjects (59.9%) had at least one hypocalcemic value. Conclusions: Serum Ca values are lower in ELBW infants and inconsequential. Thus, hypocalcemia should be re-defined for ELBW infants.

- by Stephen Forsythe
- •
- Microbiology, Infectious Diseases, Food Microbiology, Clinical Virology

Tulisan ini mengisahkan pengalaman SurfAid mengelola program SIMBO (Sehat Ibu dan Anak MBOjo) yang merupakan program pemberdayaan Posyandu dan Puskesmas di Kabupaten Bima, NTB, pada 2014-2016 lalu. Dikisahkan berdasarkan dokumentasi laporan dan cerita-cerita lapangan yang dihimpun oleh SurfAid, tulisan ini memperkaya referensi program untuk meningkatkan kesehatan ibu dan anak.

- by Putri Yunifa
- •
- Social Work, Maternal, neonatal and child healthcare, Posyandu, Puskesmas
- by Stephen Forsythe
- •
- Microbiology, Applied microbiology, Food Microbiology, Clinical Microbiology

ere is a lack of direct recognition of children with disabilities and the importance of early screening and identi cation of disability, particularly within Africa. Within the South African healthcare setting, the role of screening for disability within a neonatal or paediatric nursery could be facilitated by the nurse. Hearing loss is a disability that can be identi ed early through the availability of screening equipment, and for which bene cial outcomes have been associated. e diversity of roles performed by the nurse will be discussed with reference to early detection of hearing loss and concomitant intervention for children who are identi ed with hearing loss.

- by Claudine Storbeck
- •
- Nursing, Early Intervention, Hearing screening, Neonatal Nursing

BJECTIVE:
The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes.
STUDY DESIGN:
Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE, ScienceDirect.com, MEDSCAPE, and the Cochrane Central Register of Controlled Trials with the use of a combination of key words and text words related to antibiotics, premature rupture of membranes, term, and trials from inception of each database to September 2014. We included all randomized trials of singleton gestations with premature rupture of membranes at 36 weeks or more, who were randomized to antibiotic prophylaxis or control (either placebo or no treatment). The primary outcomes included maternal chorioamnionitis and neonatal sepsis. A subgroup analysis on studies with latency more than 12 hours was planned. Before data extraction, the review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42014013928). The metaanalysis was performed following the Preferred Reporting Item for Systematic Reviews and Meta-analyses statement.
RESULTS:
Women who received antibiotics had the same rate of chorioamnionitis (2.7% vs 3.7%; relative risk [RR], 0.73, 95% confidence interval [CI], 0.48-1.12), endometritis (0.4% vs 0.9%; RR, 0.44, 95% CI, 0.18-1.10), maternal infection (3.1% vs 4.6%; RR, 0.48, 95% CI, 0.19-1.21), and neonatal sepsis (1.0% vs 1.4%; RR, 0.69, 95% CI, 0.34-1.39). In the planned subgroup analysis, women with latency longer than 12 hours, who received antibiotics, had a lower rate of chorioamnionitis (2.9% vs 6.1%; RR, 0.49, 95% CI, 0.27-0.91) and endometritis (0% vs 2.2%; RR, 0.12, 95% CI, 0.02-0.62) compared with the control group.
CONCLUSION:
Antibiotic prophylaxis for term or near-term premature rupture of membranes is not associated with any benefits in either maternal or neonatal outcomes. In women with latency longer than 12 hours, prophylactic antibiotics are associated with significantly lower rates of chorioamnionitis by 51% and endometritis by 88%.

- by Gabriele Saccone and +1
- •
- Preterm, Maternal, neonatal and child healthcare, Pregnancy, Neonatal

This paper mainly focuses on the prospects and problems of privatization of healthcare sector in India. Indian healthcare industry is at growing stage and is thereby not subjected to strict regulations by the government. There are very low levels of government funding for health care in India, with less than 4-5% of total government resources being allocated. Nearly 80 percent of the expenditure on healthcare is funded by the private individuals or institutions from their own pockets and the rest is funded by the government. There is a need to understand how the healthcare is performing in India. The government has put only a little stress on the importance of healthcare system and its requirements in India. Further the study emphasis on the vast scope for growth and development of healthcare sector in the future.

- by MARIMUTHU KN and +1
- •
- Tourism Studies, Tourism Marketing, Tourism Management, Medical Education