Open Access Original Research Article

Assessing the Knowledge, Use and Perception of Contraceptives among Senior High School Students in the Kumbungu District of Northern Ghana

Frimpong Manso Patricia, Aloba Nelsi, Edem Kojo Dzantor, Theophilus Adjeso, Yaa Nyarko Agyeman

Asian Journal of Pregnancy and Childbirth, Page 1-12

 

Background: Senior high school students are faced with several sexual and reproductive health challenges and make decisions and choices based on their knowledge and perceptions of available sexual and reproductive health services. The study, therefore, assessed the knowledge, use, and perception of contraceptives among senior high school students in the Kumbungu District of the Northern Region of Ghana.

Methods: We conducted a cross-sectional study involving 299 study participants through a multiple sampling approach comprising purposive, proportionate, and simple random sampling techniques.  A pretested structured questionnaire was used to collect the data from the study participants. A descriptive and Pearson’s chi-square analyses were performed.

Results: The prevalence of contraceptive use was 23.2% with 55.9% of the study participants incorrectly defined contraceptives. The major source of information on contraceptives was from their peers (53.3%). Apart from condoms, knowledge on the remaining contraceptives methods was poorly understood by the participants. Common misperceptions on contraceptive use included infertility (50.0%), interference with sexual pleasure (37.9%), and promotion of promiscuity (32.3%). Statistically, we found significant differences between ever users of contraceptives and sex (P< 0.001) and religion (P=0.026). There was a significant difference between knowledge and perception (P=0.010).

Conclusion: The study findings describe a seemly poor knowledge and misconceptions on the use of contraceptives among study participants. This is likely to affect the usage of contraceptives among adolescents and students in the Kumbungu District with a resultant effect on the rise of teenage pregnancies. Addressing the poor knowledge and misconception by stakeholders, including the Ghana Health Services and other NGO’s is therefore recommended.

Open Access Original Research Article

Antenatal Lived Experiences of Women who Delivered Preterm Babies at a Referral Hospital in Harare, Zimbabwe

Rachael Longwe, Judith Rukweza, Virgininia Mawerewere, Clara Haruzivishe

Asian Journal of Pregnancy and Childbirth, Page 13-28

Introduction: A lived experience is normally an undervalued and complex phenomena in nursing and midwifery despite its crucial influence on maternal and birth outcomes. During antenatal  care,  health  care  providers  tend  to  concentrate  on  the  pregnancy  at  the  expense  of experiences that women go through. Research studies have also bias towards the medical perspective leaving out the experiences that occur during the antenatal period.

Aim: The aim of this study was to explore the antenatal lived experiences of women who delivered preterm babies.

Study Design: A descriptive phenomenological research design was employed to understand the diverse antenatal lived experiences.

Setting and Duration: Parirenyatwa Mbuya Nehanda Maternity Hospital was the study site.

Methodology: All accessible women who delivered preterm babies between October, 2016 and March, 2017 with babies admitted in neonatal intensive care unit, Kangaroo care unit and those coming to preterm outpatient clinic were included in this study. Purposive sampling method was used to select the eligible participants. Audio recorded in-depth interviews using semi-structured interview guide were used to collect data. Thematic analysis was used to analyze data manually.

Results: Eleven women participated in this study. Their ages ranged from 17 to 42 years. The lowest level of education was primary (9%, n = 1) and highest being secondary (91%, n = 10). Three major themes came out, which included stressful life events, perceived mismanagement of physical problems and care and support. Support during antenatal period is crucial as it helps pregnant women to adjust and cope with life stressors and it helps them to have a smooth journey of pregnancy which leads to a healthy pregnancy outcome.

Conclusion: Pregnant women are experiencing a variety of stressful life events. A holistic individualized approach comprising comprehensive history on experiences during pregnancy should be adopted to capture and detect adverse health symptoms early.

Open Access Original Research Article

Maternal Characteristics and Outcomes of Obstetric Complications at a Tertiary Heath Facility in Northern Ghana

Rosina Darcha, Margaret Kukeba

Asian Journal of Pregnancy and Childbirth, Page 29-40

Introduction: Ghana has recorded improved access to skilled care during pregnancy (4+ visits) 89% and labour 78%, yet maternal mortality is 310 per 100 000 live births. This research was conducted to identify the socio-demographic and obstetric characteristics of women with obstetric complications in a tertiary health facility in northern Ghana to gain sight to reduce maternal deaths.

Materials and Methods: This study was a cross-sectional quantitative retrospective study. We collected data from 384 women using a structured questionnaire and analysed it using SPSS version 20.0. Inferences were made using cross-tabulations with corresponding significance set at P= .05

Results: This study revealed that, the typical woman with obstetric complication is 20-35 years old, mean age 27.7 and standard deviation of 6.2; married to a salaried worker; Dagomba by tribe; no formal education; petty trader; earn below the minimum wage of Ghana ($ 2.07); Moslem; resides in an urban setting; pregnant and delivering for the first time; gestational age of 37-42 weeks at labour and birth spacing of 2-3 years. Cross-tabulations revealed associations between three socio-demographic and four obstetric characteristic all with large effects sizes as follows; X2 (3, N = 69) = 13.50, P = .004; X2 (65, N = 67) =1.11, P = .000; X2 (2, N = 69) = 9.17, P = .010; X2 (12, N = 68) = 26.1, P = .010; X2 (3, N = 384) = 17.15, P= .001; X2 (4, N = 69) = 19.8, P = .001; X2 (65, N = 65) = 1.12, P = .000; X2 (1, N = ) = 72.9, P = .000 respectively.

Conclusion: Obstetric complications are universal; improving poor outcomes in the study setting will take identifying and filling gaps in the skill needs of maternal health care workers and addressing health facility challenges.

Open Access Original Research Article

What Does Mass-media have to do with Contraceptive Uptake among Nigerian Women? Evidence from Performance Monitoring and Accountability 2020

Amadou Barrow, Kayode R Fowobaje, Godson Tudeme, Samson Olorunju, Adeyinka Onikan, Michael Ekholuenetale

Asian Journal of Pregnancy and Childbirth, Page 41-58

Background: Mass media plays an important role in information dissemination in Nigeria and studies have shown that the interrelationship that exists between reproductive health behaviour and mass media campaigns on the use of modern contraceptives have resulted in the improvement of reproductive health outcomes. There is a need to examine the differentials in mass media-related behaviour change communication for family planning among Nigerian women of reproductive age with respect to their wealth index and educational status using nationally represented sample.

Methods: We used data from the most recent round of publicly available data from Performance Monitoring and Accountability 2020 (PMA2020) in Nigeria with nationally representative samples. The prevalence of lifetime contraceptive use was computed to provide the context in which birth dynamics are occurring across all variables and to examine the statistical significance of cross-tabulation results. We then conducted multivariable logistic regression to determine the factors associated with contraceptive use.

Results: The proportion of women in low wealth quintile were slightly higher (53%) than the rich women (47%). The mass media related behaviour change communication showed that women who had heard of family planning on radio were 60.7%, television, 38.2%, and on newspaper/magazine was 18.2%. Also, use of mass media in receiving information about family planning increases by increasing level of women’s education. Women from lowest household wealth quintile, and have heard about family planning on television were 1.63 (OR= 1.63; 95%CI: 1.13, 2.34) times as likely to use any contraceptive method, compared with those who did not hear about family planning on television.

Conclusion: Our findings revealed that Radio, followed by the television, were reportedly the main sources of family planning messages. Also, the use of mass media and socioeconomic status are associated with contraceptive utilization, and leads to increased use of a FP product.

Open Access Original Research Article

Prevalence of Low Birth Weight (LBW) and Associated Maternal Factors in a Tertiary Hospital in Gombe Metropolis, Nigeria

Mela Danjin, Liona Buba, Ebisike J. O. Kelechi, Rose M. Danjin, Vivian J. O. K Ebisike, Haruna M. Moda

Asian Journal of Pregnancy and Childbirth, Page 59-67

Aim: This study was aimed at determining the prevalence of Low Birth Weight (LBW) and its association with some maternal factors in the study area.

Materials and Methods: A cross sectional study of 108 consenting and parturient mothers who had their antenatal bookings and singleton baby live deliveries in the State Specialist Hospital Gombe, Nigeria; was conducted in the month of August 2016. The mother-neonate pairs were selected using purposive sampling technique and key variables of interest about the subjects were harvested on structured pro-forma. Simple descriptive statistics were computed, Chi square and two-sided Fisher’s Exact Test (FET) were used to test association between Birth Weight (BW) and some maternal factors. Level of significance was set at P<0.05.

Results: Majority (85.2%) of the mothers who aged between 15 and 40 years (23.90+6.327) were below the age of 31. Most of them were housewives (77.8%) and 75.0% were Hausa-Fulani by tribe. Eighty (74.1%) of them had parity and gravidity of <4 and <5 respectively. Fifty-three of the infants (49.1%) had Low Birth Weight (LBW) and a mean of 2.54±0.641kg. About a quarter of the mothers (25, 23.1%) had a Body Mass Index (BMI) of <18.50 kg/m2while well over a half (65) of them had low Packed Cell Volumes (PCVs) (<33%). When Birth Weight (BW) was cross tabulated against various maternal parameters, significant association could only be found with maternal weight (P = 0.000) and BMI (P=0.000).

Conclusion: A very high prevalence of LBW (49.1%) related to a compromised maternal nutritional status as indicated by poor BMI and weight indicators is quite worrisome. Although this might require further confirmation by more rigorous large sample-size multicentre follow up studies, this finding calls for the institution of effective intervention measures by all concerned authorities.

Open Access Original Research Article

Exploring Parents Needs Among Newborn Babies at Tamale Teaching Hospital

Keren-Happuch Twumasiwaa Boateng, Vida Nyagre Yakong, Nicholas L. Yombei

Asian Journal of Pregnancy and Childbirth, Page 68-75

Background: The progress made in neonatal intensive care delivery worldwide has resulted in optimal health outcomes of neonates, however, newborns and infants still die. Majority of these infant and neonatal deaths, occur in Neonatal Intensive Care Units. The experiences of many parents following a poor prognosis of their newborns requiring end of life care suggest that parents usually need support from health care professionals who render direct services to their child, however, the extent and nature of this support is perceivably unknown.

Purpose: The purpose of this study was therefore to explore parents’ needs among newborn babies in Neonatal Intensive Care Unit at Tamale Teaching Hospital.

Methods: The researchers adopted a phenomenological qualitative design using a semi-structured interview guide to collect data. Ethical approval was sought from Tamale Teaching Hospital ethics review committee which is the final authority to give approval for the data collection. A sample size of 8 participants were drawn for the study. The participating parents completed an informed consent form prior to their participation in an interview. The results were analyzed using content analysis.

Results: Effective communication and the provision of continuous, concise and complete information about child’s condition were important to parents during the end-of-life care of their newborns in Neonatal Intensive Care Units; Parents had limited understanding of the nature and benefits of palliative care; Parental support in terms of information and communication, emotional, psychological and spiritual support, as well as shared decision-making are essential for quality end-of-life care at the Tamale Teaching Hospital.

Conclusion: The study focused on parental support during end of life and a major finding was that provision of adequate and complete information, effective and frequent communication, emotional and psychological support for parents, support from spouses and extended family for parents, involvement in child’s care and shared decision making about child’s condition are the most important parental needs during the end-of-life care of their newborns at the Neonatal Intensive Care Unit of Tamale Teaching Hospital.

Open Access Original Research Article

Experiences of Mothers with hospitalized Preterm Babies in Tamale Central Hospital, Ghana

Lukman Amadu, Keren-Happuch Twumasiwaa Boateng, Adam Fuseini

Asian Journal of Pregnancy and Childbirth, Page 76-93

Background: Admission of a baby into the Neonatal Intensive Care Unit (NICU) is highly traumatic and stressful for parents especially mothers. This leads to a breakdown of the family unit due to the impediments undermining the family routine. When a baby is born premature, preparations for the baby is interrupted and the mother of the premature baby might feel as if she is missing out on something. There is an observation of maternal challenges regarding the management of preterm babies at the Tamale Central Hospital. These challenges range from social, economic, physiological and psychological in nature. Physiologically, preterm babies encounter numerous problems such as respiratory, maintenance of body temperature, exposure to infection and difficulty in feeding. 

Purpose: This study seeks to determine the maternal experiences of hospitalized preterm babies.

Methodology: A phenomenological qualitative design was used. Fifteen mothers with hospitalized preterm babies were interviewed. Interviews were audio recorded and transcribed verbatim. This allowed for consistency and reliability. After transcribing and reading the interviews, meaningful units were identified and grouped by similarity, giving rise to thematic categorization. 

Results: The study found that the involvement of mothers in the care of their preterm babies in NICU was helpful though they experienced fear in interacting with their babies initially due to adverse barriers such as fear of hurting the preterm baby and fear of equipment in the NICU. 

Conclusion: The factors which led to mothers’ anxiety such as fear in interacting with their babies, fear of equipment in the neonatal intensive care unit and non-explanation of the baby’s condition would be reduced if mothers get the support from staff, other mothers from the NICU and the participants' families assisted them to cope.

Open Access Original Research Article

Demand and Significance of Informal Postnatal Care Support System in Lagos State: A Feasibility Study

Noimot Balogun, Ademola Ade-Serrano, Rashidat Ososanwo, Toyosi Oyewole, Oyindamola Otejusola, Emeka Ajanwachukwu

Asian Journal of Pregnancy and Childbirth, Page 94-105

Aims: To make a research case for an innovative intervention by evaluating the demand and determinants of informal postnatal care and support.

Study Design: This was a descriptive cross-sectional study.

Place and Duration of Study: The study was carried out in Itire and Yaba in Lagos State, Nigeria. Data collection lasted for two weeks.

Methodology: A semi-structured questionnaire was used for data collection. A total number of 249 women were chosen using estimated extrapolations from secondary data that had been collected on women of reproductive age. Respondents were recruited based on convenience and willingness to take part. We carried descriptive statistics and correlation coefficient tests on the cleaned data..

Results: More than half of the respondents, 54% were from Itire while 46% were from Yaba; 90% were between 25–44 years. Seventy-eight percent of the women had vaginal delivery, and 26% underwent a caesarian section; about 13% reported delivery complications. More than half (52%) of respondents’ families gave postnatal support, 37% received postnatal support from in-laws and 8% from multiple sources. During the postnatal period, 65% of the respondents reported doing exclusive breastfeeding, while 35% reported giving milk and other feeds. Only 9% of women used chlorhexidine gel for newborn cord care. Majority of the respondents, 76% used methylated spirit and 15% used herbal mix heated on kerosene lanterns or various kinds of toothpaste and other substances. Only 19% of the women had begun family planning. Though the majority (94%) found the postnatal support received helpful; 65% were open to professional help. Willingness to use professional postnatal support was significant among respondents who had delivery complications (p=0.02) and those who were from the Yaba axis (p=0.03).

Conclusion: The findings revealed an information gap when compared to standard recommended postnatal practices and a demand for professional guidance hence the need for innovative approaches to equip women and their informal support with adequate postnatal information.

Open Access Original Research Article

The Effect of Father – Infant Skin to Skin Contact on Father’s Attachment and in Marital Adjustment: A Randomized Controlled Trial

Merve Turemen, Hulya Demirci

Asian Journal of Pregnancy and Childbirth, Page 106-116

Background: Preterm birth often negatively influences mother–infant and father-infant interaction. Skin-to-skin contact (SSC) post birth has positive effects on maternal and paternal feelings toward their preterm infants and on infant development and family interaction.

Methods: The aim of this study designed to investigate the effects of skin-to-skin contact of the father with newborn babies in the neonatal intensive care unit to the attachment of father-infant and in marital adjustment. The study is a randomized controlled trial using pre-test and post-test design. A private hospital in the central district of Manisa in Turkey. The sampling involved 60 fathers (30 intervention group-30 control group). The data were collected by using ‘‘Demographic Data Form”, “The Marital Adjustment Scales (MAS)” and “Postnatal Paternal-Infant Attachment Questionnaire (PPAQ)’’.

Results: The fathers who participated in this study were in similar ages, education, occupation, income, and marriage period (p>0.05). Total average score for MAS was 49.20±6.58 for intervention group and, is 50.37±5.36 in control group (p>0.05). The total average score for MAS after the intervention was 50.47±7.78 in intervention group and 50.37±4.78 in control group. PPAQ average score after intervention in the intervention group was 78.96±5.94 and 76.82±5.21 in control group. However, the average score was higher for the intervention group than the control group, there was not any statistically significant difference between two groups (p>0.05). Post-intervention; there was a moderate and significant positive correlation between father's total point averages of MAS and total point averages of PPAQ and total point averages of Pleasure in Interaction Subscale found in the correlation analysis conducted (p<0.05).

Conclusion: It was concluded that SSC doesn’t have any influence on father-infant attachment and marital adjustment, but after the intervention, there were a significant positive relationship between father-infant attachment and marital adjustment.

Open Access Original Research Article

An Exploratory Study to Identify the Factors Affecting Breastfeeding Practices among Mothers with Caesarean Section Delivery

Neha Parmar, Aesha Macwan, Jay Desai, Aniruddhsinh Sodhaparmar, Sifa Vahora, Zalak Prajapati, Khushbu Rana, Nency Patel

Asian Journal of Pregnancy and Childbirth, Page 117-126

Introduction: The study was conducted to explore the factors affecting Breastfeeding practices among mothers with Caesarean section delivery in selected maternity hospitals of Anand-Kheda district, Gujarat.

Objectives: 1) To identify the factors affecting breastfeeding practices among mothers with Caesarean section delivery. 2) To verify the existence of an association between breastfeeding practices and socio demographic variables.

Research Methodology: Research design of the study was Non-Experimental Descriptive Exploratory Design. The study employed Non-probability Consecutive sampling technique to recruit a sample of 100 women. The tool used in the study were demographic questionnaire, obstetric data, breastfeeding data and breastfeeding practice assessment by using standardized Jenson, Wallace, Kelsay’s “LATCH SCALE.” Validity of the tool was assessed by the 7 experts. Reliability of the tool was 0.76 and ascertained by using Karl Pearson’s co-relation coefficient formula. The result of the study is analysed on the basis of frequency as the values do not fit in the criteria of normal distribution, thus, the result is not generalized.

Results: On analyses, it was found that the factors which may affect the breastfeeding practice in mothers with caesarean section deliveries included preterm delivery of the baby (74%), mothers whose babies were admitted to NICU (28%), breastfeeding initiation in more than 6 hours (46%), mothers who had severe incision pain (21%). Moreover, babies who did not have skin to skin contact with their mother (15%) and also who were given pre-lacteal feed (26%) contributed to the factors that affected. Many factors which were found to improve the practice included the mothers who had proper antenatal care (48%), mother whose baby met her in less than 1 hour (46%) and initiated breastfeeding in that same time. Family support to breastfeed (75%) also lent towards good practice. The findings indicated that demographic variable paternal education (calculated value=23.33; table value=15.51) shows the significant association with breastfeeding practice.

Conclusion: The study suggests that, preterm delivered baby, admission of baby in NICU, more time in the recovery room, severe incision pain, lack of skin-to-skin contact, availability of pre-lacteal feed and lack of support from the maternity ward staff were perpetuated breastfeeding practices in mothers with Caesarean section delivery in this particular study.

Open Access Original Research Article

Levels of Oxidative Stress Marker Malondialdehyde and Some Lipid Fractions in Women Diagnosed with Pre-Eclampsia in a Rural Hospital in South East Nigeria

Nnamdi J. J. Chinonso, Amah U. Kalu, Myke-Mbata K. Blessing, Anikwe C. Christian, Okeke C. Stellamaris, Ahams E. Chika, Iwuagwu G. Obioma, Oti D. Chukwudi, Ogbonnaya V. Ifunanya

Asian Journal of Pregnancy and Childbirth, Page 127-134

Background: In this modern era, the incidence in the prevalence of pre-eclampsia keep increasing globally and Nigeria in particular, even in the face of extensive researches there are still un-collaborating results on the association between lipid peroxidation product (malondialdehyde) and the disease of imprecise etiology (pre-eclampsia). The disturbance in the metabolism of antioxidants and excess lipid peroxidation because of stress and other co-factors during pregnancy may be a contributing factor in the development of preeclampsia.

Aim: This investigation was carried out to compare the serum MDA status and some lipid fractions in women with preeclampsia and normal pregnancy in a rural hospital of Imo State Nigeria.

Methods: A cross sectional study was carried out on 50 pre-eclampsia and 50 normotensive pregnant women attending the Department of Medicine and Antenatal clinic of specialist Hospital Umuguma, Owerri Imo State. The ethics committee and participants gave their consent, (HMB/IM/VOL.30/110/2019/007) after the study protocol was detailed to them and approved.

Results: The mean serum MDA TG, VLDL-C, LDL were significantly higher in pre-eclamptic patients when compared to the controls (P<0.05). The mean HDL-C was lower in pre-eclamptic subjects when compared with the control (P<0.05). There was no significant difference in the level of the mean Total Cholesterols between the groups (P>0.05).

Conclusion: This current investigation showed significant increase in lipid per oxidation activities and alteration in lipid metabolism in pregnant women with pre-eclampsia and which may be due to the failure of compensatory antioxidant functions in pregnant women with this disorder.