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1.
Mona; s.n; Sept. 1998. i,53 p. tab, gra.
Tese em Inglês | MedCarib | ID: med-17181

RESUMO

Maternal and child health services have been priority in Jamaica for at least seven decades. Studies have shown that early access to antenatal care by pregnant women will impact positively on the outcome of the pregnancy. This survey was carried out to identify factors affecting the time pregnant women first attend antenatal clinics, and the relationship that these factors have with variables such as age, union status and level of education. The sample of 145 was selected from pregnant women attending one rural and one urban health centre. The results revealed 54 percent of women surveyed attended antenatal clinic within the first 15 weeks of pregnancy. Age and level of education were not important determinants of time of first clinic attendance. The realization of the value of antenatal care per se, that is the minimizing of risk to the pregnant mother and foetus seemed the most important factor which influenced early antenatal clinic attendance. Facilitating factors for early attendance included shorter waiting hours, location of the health centre, the cost of the services and convenient clinic hours based on the individual's work schedule (AU)


Assuntos
Humanos , Feminino , Gravidez , Cuidado Pré-Natal/tendências , Cuidado Pré-Natal , Gravidez , Serviços de Saúde Materna/estatística & dados numéricos , Bem-Estar Materno/estatística & dados numéricos , Jamaica , Região do Caribe
2.
West Indian med. j ; 47(suppl. 2): 40, Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1855

RESUMO

The aim of this study was to determine whether high risk antenatal clinics are providing services to patients needing them most in a timely way. Of particular interest was to determine the prevalence of high risk women using the clinics; how efficiently patients were been seen, once referred; what were the reasons for referral and subsequent diagnosis and what measures were taken regarding continued care for the patients. A structured questionnaire was administered to a systematic sample of patients attending the clinics by a nurse/midwife. A minimum sample of 100 interviews per site was administered. Due to the length of the questionnaire, only eight to ten interviews could be completed in an eight hour day; thus samples were selected to enable interviewers to manage this number of patients on a given day.(AU)


Assuntos
Adulto , Feminino , Humanos , Gravidez , Gravidez de Alto Risco , Serviços de Saúde Materna , Jamaica
3.
West Indian med. j ; 47(suppl. 2): 19, Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1919

RESUMO

What do users think about the Maternal and Child Health (MCH) Services provided at government run community health facilities in Grenada? This study was done to analyse the quality of MCH services delivered, according to the perception of the users. Data were collected using a pre-tested structured questionnaire, focus group discussions and natural group interviews. 237 users of MCH services were interviewed at randomly selected community health facilities. Ninety-six percent of users were of the opinion that their health workers showed interest and understanding and were friendly and courteous. Ninety-six percent of users were comfortable with the health workers who attended to them. Ninety-two percent of users were questioned by health workers. However, 26 percent received no explanations and instructions. Forty-nine percent of users perceived consultations with health workers to be short. The hours of service delivery were inconvenient for employed persons using the service. Statistically significant differences existed in user satisfaction by location of facility and type of facility at which care was received. Areas identified for improvement include health workers' inter-personal relations and infrastructure, including the availability of sanitary facilities and supplies for users. 65 percent of users of MCH services were not gainfully employed (37 percent unemployed, 28 percent housewives). Occupational status and educational attainment levels of respondents reflected a disproportionaly higher number from lower socioeconomic groups among users of the MCH services. Rescheduling of hours for service delivery is recommended to encourage more employed persons to use the services.(AU)


Assuntos
Feminino , Humanos , Serviços de Saúde Materna , Atitude do Pessoal de Saúde
4.
Kingston; s.n; 1998. 53 p.
Tese em Inglês | MedCarib | ID: med-1679

RESUMO

Maternal and child health services have been priority in Jamaica for at least seven decades. Studies have shown that early access to antenatal care by pregnant women will impact positively on the outcome of the pregnancy. This survey was carried out to identify factors affecting the time pregnant women first attend antenatal clinics, and the relationship that these factors have with variables such as aged, union status and level of education. The sample of 145 was selected from pregnant women attending one rural and one urban health centre. The results revealed 54 percent of women surveyed attended antenatal clinic with the first 15 weeks of pregnancy. Age and level of education were not important determinants of time of first clinic attendance. The realization of the value of antenatal care per se, that is the minimizing of risk to the pregnant mother and foetus seemed the most important factor which influenced early antenatal clinic attendance. Facilitating factors for early attendance is included shorter waiting hours, location of the health centre, the cost of the services and convenient clinic hours based on the individual's work schedule.(AU)


Assuntos
Adulto , Feminino , Humanos , Gravidez , Cuidado Pré-Natal , Resultado da Gravidez , População Rural , População Urbana , Jamaica , Fatores Socioeconômicos , Serviços de Saúde Materna
5.
Midwives ; 110(1316): 218-20, Sept. 1997.
Artigo em Inglês | MedCarib | ID: med-1651

RESUMO

Trinidad and Tobago are the two southerly of the Caribbean islands off the coast of Venezuela. Trinidad is industrial, having natural deposits of oil, gas and bitumen, while Tobago is a tropical holiday island, sometimes known as Robinson Crusoe Island. The population of 1.3 million represents races from Africa, India, Europe and Asia, who live and work together harmoniously; Trinidadian women are renowned for their beauty, resulting from this rich mix. The centre of Trinidad is heavily forested and-apart from the capital, Port-of-Spain the towns are small and rural in character. Fruits grows abundantly, especially mangoes, bananas, pineapples, citrus fruits, paw-paw and coconuts.(AU)


Assuntos
Feminino , Humanos , Lactente , Aleitamento Materno , Serviços de Saúde Materna , Enfermeiras Obstétricas/educação , Inglaterra/etnologia , Trinidad e Tobago
6.
Rev. panam. salud publica ; 1(2): 104-11, Feb.1997. tab
Artigo em Inglês | MedCarib | ID: med-16887

RESUMO

The study reported here explored the influence of maternal, health care, pregnancy, and child-related factors upon the duration of total breast-feeding (DTBF) in the Dominican Republic. The data for the study, which included 1984 mother-child pairs representative of the Domonican population, came in from the National HEalth Survey of 1991. The child in each of the mother-child pairs was the mother's last-born child who had been breast-fed and was less than three years of age at the time of the survey. Interviews with the mothers were used to collect information about the duration of breast-feeding and the factors studied (including maternal age, urban/rural residence, parity, mother's socioeconomic status, maternal education, maternal employment, mother's desire for pregnancy, type of delivery, the type of health worker attending the delivery, the child's sex, the child's birth weight, the time elapsed between delivery and initiation of breast-feeding, the child's age at complete weaning, and the child's age at the time of the survey)... According to the study results, the country's breast-feeding programs should give special attention to mothers with university educations, those giving birth in private health facilities, and those with low socioeconomic status giving birth to their first child, since these groups tended to breast-feed their children for relatively short periods of time. Also, breast-feeding promotion strategies should stress the importance of delaying the introduction of foods other than breast-milk into the child's diet, as this appears to be the one factor having the greatest adverse effect on the duration of breast-feeding (AU)


Assuntos
Lactente , Pré-Escolar , Feminino , Recém-Nascido , Gravidez , Aleitamento Materno/efeitos adversos , República Dominicana , Bem-Estar Materno , Desmame , Serviços de Saúde Materna , Gravidez
7.
In. Anon. Health conditions in the Caribbean. Washington, D.C, Pan American Health Organisation, 1997. p.171-89, ilus, tab.
Monografia em Inglês | MedCarib | ID: med-561
8.
Anon.
Geneva; World Health Organization; 4 ed; 1997. 136 p. maps, tab.
Monografia em Inglês | MedCarib | ID: med-16574

RESUMO

All women should have access to basic maternity care during pregnancy and delivery. This includes quality antenatal care, clean and safe delivery whether the delivery takes place at home or in a health facility, as well as postpartum care for mother and infant. A continuum of care is essential for both mother and baby, aimed at improving their health and preventing morbidity and mortality. This document brings together, in a standard format, data on coverage of maternity care worldwide. The data presented have been collected from a variety of sources, including health service reporting and surveys. Country, regional and global estimates derived from the information available are presented. The estimated show that in the developing world only two in three women receive any antenatal care, less than 55 percent of deliveries are attended by skilled personnel and just 40 percent take place in health institutions. Thus, currently more than 45 million pregnant women annually do not receive any antenatal care, some 75 million births still take place at home and almost 60 million without a skilled attendant present. Between 90 and 100 million women do not receive postpartum care. South-central Asia and Western and Eastern Africa contribute heavily to these numbers, accounting for 45 percent of the world's births and also showing the lowest coverage of care during pregnancy and delivery. Whereas women who deliver with the assistance of skilled personnel have usually had at least one antenatal care visit, the reverse does not apply; many women who receive antenatal care do not have a skilled attendant present at delivery. Care is needed throughout delivery and the postpartum period which are prime opportunities to prevent ill health and avert deaths. Nearly all maternal deaths occur in developing countries and among the most disadvantaged population groups. Greater coverage of care during pregnancy, delivery and the postpartum period will help to reduce deaths and disabilities of mothers and infants


Assuntos
Adulto , Feminino , Humanos , Gravidez , Recém-Nascido , Serviços de Saúde Materna/normas , Região do Caribe , Bem-Estar Materno/estatística & dados numéricos , Assistência Perinatal/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , África , América Latina , América do Norte , Ásia , Europa (Continente)
9.
J Biosoc Sci ; 26(2): 165-77, Apr. 1994.
Artigo em Inglês | MedCarib | ID: med-5904

RESUMO

Data from the 1991 Belize Family Health Survey show differentials in the use of maternal and child health services between ethnic groups (Creole, Mestizo, Maya/Ketchi and Garifuna). Multivariate analysis is used to explore whether such differentials can truly be attributed to ethnicity or to other characteristics that distinguish the ethnic groups. Health services considered are: family planning, place of delivery (hospital/other), postpartum and newborn check-ups after a birth, and immunisations for children. The language usually spoken in the household is found to be important for interpreting ethnic differentials. Mayan-speaking Maya/Ketchis are significantly less likely to use family planning services or to give birth in a hospital. Spanish-speakers (Mestizos and Maya/Ketchis) are less likely to use newborn and postpartum differentials check-ups, after controlling for other characteristics. There are no ethnic differentials for immunisations. Programmatic implications of these results are discussed(Summary)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Adulto , Feminino , Serviços de Saúde da Criança/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Belize , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Inquéritos Epidemiológicos , Conhecimentos, Atitudes e Prática em Saúde , Idioma , Análise Multivariada , Razão de Chances , Saúde da População Rural
10.
Paediatr Perinat Epidemiol ; 8(suppl 1): 158-65, April 1994.
Artigo em Inglês | MedCarib | ID: med-7241

RESUMO

The Jamaican Perinatal Mortality Survey collected data that have been used in this paper to estimate: (1) the rate of multiple deliveries on the island; (2) the way in which this varies with demographic features; and (3) the causes of perinatal mortality among twins on the island. The survey consisted of two phases: a study of all births in the months of September and October 1986 (the cohort months) and a study of all perinatal deaths in the 12 months from 1 September 1986 to 31 August 1987. Among the 10408 pregnancies in the cohort months, 99 (1.0 percent) were multiple pregnancies. The Twinning rate showed statistically significant trends with maternal age and parity but no association with social factors. Among the 2020 perinatal deaths occurring in the 12-month period, 173 (8.6 percent) were twins, with particularly high contribution to the Wigglesworth group 'deaths from immaturity'. Mortality rate of twins was significantly lower if mothers resided in areas where there were good obstetric and paediatric facilities (Summary)


Assuntos
Gravidez , Recém-Nascido , Adolescente , Adulto , Humanos , Masculino , Morte Fetal , Gravidez Múltipla , Gêmeos , Mortalidade Infantil , Estudos de Coortes , Acesso aos Serviços de Saúde , Mortalidade Infantil/tendências , Jamaica/epidemiologia , Serviços de Saúde Materna , Gêmeos/estatística & dados numéricos
11.
Paediatr Perinat Epidemiol ; 8(suppl 1): 86-97, April 1994.
Artigo em Inglês | MedCarib | ID: med-7246

RESUMO

Information concerning 9919 singleton pregnancies delivered in Jamaica in the 2-month period of September and October 1986 and surviving the early neonatal period were compared with 1847 singleton perinatal deaths occurring in the 12-month period from 1 September 1986 to 31 August 1987, classified according to the Wigglesworth schema. Logistic regression was used to assess features of antenatal and intrapartum care that were associated with the different groups of perinatal death after taking account of environmental, maternal and medical factors. In Jamaica, 67 percent of all mothers took iron during pregnancy. There mothers appeared to have a lower risk of perinatal death. This does not appear to be an artefact related to the gestation at which the mother delivers, and was particularly associated with antepartum fetal deaths. Commencement of antenatal care in the first trimester appeared to reduce the risk of all perinatal deaths, and for intrapartum asphyxia in particular. It is speculated that the mechanism may involve early detection and treatment of anaemia and syphilis. Quality of perinatal care available in the area of residence, as measured by the presence of consultant obstetricians and a paediatric consultant unit, is shown to be significantly related to a reduction in deaths from intrapartum asphyxia, but it appeared no to be related to antepartum fetal deaths (Summary)


Assuntos
Gravidez , Recém-Nascido , Feminino , Humanos , Estudo Comparativo , Morte Fetal/epidemiologia , Mortalidade Infantil , Serviços de Saúde Materna/estatística & dados numéricos , Asfixia Neonatal/epidemiologia , Estudos de Coortes , Acesso aos Serviços de Saúde , Recém-Nascido Prematuro , Jamaica/epidemiologia , Modelos Logísticos
13.
Kingston; s.n; 1994. ix,48 p.
Tese em Inglês | MedCarib | ID: med-3644

RESUMO

A 13 year retrospective study was done on 792 records of attenders at the UHWI antenatal clinic, to determine changes in the population and the utilization of the clinic between 1980 and 1992. The study was conducted during the months of December 1993 and April 1994. Data was transcribed from the registration book at the clinic and the dockets of patients, to a data collection schedule. An analysis was done on the socio-demographic data, medical and obstetric history, these were cross tabulated with the number of visits to determine utilization. Findings analysed from the data collected revealed that there was an overall decrease in the number of attenders. An increase was seen in the 30-39 years age group, with a 49.1 percent decrease in those less than 20 years of age despite an increase in teenage pregnancy. The relationship between age and the number of visits were significant (p <.01). Attenders with a primary/all age level of education were the modal group until 1988, when they were displaced by those with a Secondary/Vocational/commercial level of education. The relationship between education and number of visits was significant where (p. < 0.5). The study also revealed an increase in attenders of the skilled and professional groups with a decrease in the unemployed and a 50 percent decrease in the student population, and there was no significant association between occupation and the number of visits. Of the total attenders 49.7 percent had previous obstetric complications. Hypertension was the modal group of those with medical complications, and an increase was seen in attenders with anemia, heart disease and diabetes. Eighty percent of the attenders were from the catchment area with an increase from St Catherine which was outside the catchment area. With these findings it is suggested that the area of patient health education should be reviewed to accomodate this shift toward older mothers with their attendant problems and needs. (AU)


Assuntos
Humanos , Feminino , Adolescente , Adulto , Cuidado Pré-Natal/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna , Jamaica , Estudos Retrospectivos , Fatores Etários , Escolaridade , Fatores Socioeconômicos
14.
Kingston; Oct. 1993. ix,117 p. ill.
Tese em Inglês | MedCarib | ID: med-8263

RESUMO

The parishes of Portland and St. Mary have over the past two years been experiencing a relatively high incidence of perinatal mortality compared to other parishes in the Island. A study of the assessment of maternityservices was done to ascertain the quality services being delivered to pregnant women/mothers in Western Portland and Eastern St. Mary. Questionnaires were administered to 102 mothers and pregnant women and interviews of 15 health care providers at four health districts and three hospitals respectively. Both questionnaires and interviews provided objective statements of assessment of the quality services rendered to users of maternity services in these two parishes. Results showed that although services are available to most mothers, the mitigating factor of shortage of staff hampers the delivery of these services. Strengthening of the opperational capacity in terms of manpower and [a] workable referral system appear to be the key solutions to this problem. (AU)


Assuntos
Humanos , Feminino , Serviços de Saúde Materna , Jamaica , Acesso aos Serviços de Saúde , Qualidade da Assistência à Saúde
15.
Soc Sci Med ; 37(2): 199-211, July 1993.
Artigo em Inglês | MedCarib | ID: med-8472

RESUMO

Detailed nationally representative population level data were used to investigate the pre-natal care and delivery experiences of pregnant women in Jamiaca. The results of this study show that: (a) demographic criteria (particularly first births) and self-reported clinical pregnancy complications are valid predictors of deleterious maternal health outcomes and can be used to stratify mothers into risk groups. (b) There appears to be a significant problems of under and inappropriate utilization of pre-natal care services by all women and in particular by demographically 'high risk' women, i.e. young , first time mothers. Significant proportions of the latter group report either no pre-natal care visits at all or visits which are later than the first trimester. The problem of delayed initiation of pre-natal care are specially exacerbated for poor, teenage mothers who happen to be living in the Kingston Metropolitan Area. (c) In terms of the content and quality of pre-natal care services the message is somewhat mixed. On the positive side the pre-natal care system is doing a moderately satisfactory job with regards to diagnostic tests and educational advice. On the negative side however, the fact that once women entered the health care system they all receive the same moderately adequate care (in terms of diagnostic evaluations and educational advice) with no attempt to focus particular attention on high risk mothers is troublesome. (d) With regards to appropriate delivery venues for pregnant women, pre-natal care visits do not appear to significantly influence the choice of delivery venues. Moreover, rich urban women are much more likely to deliver in a hospital than their rural peers. In conclusion, the study discusses the social and behavioral context of these results, addresses the policy implications and makes some recommendations to improve maternal health services (AU)


Assuntos
Adulto , Feminino , Humanos , Resultado da Gravidez , Cuidado Pré-Natal , Serviços de Saúde Materna , Jamaica , Idade Materna , Paridade , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Qualidade da Assistência à Saúde , Fatores de Risco , Fatores Socioeconômicos
17.
St. George's; Grenada. Ministry of Health; 1993. 14 p.
Monografia em Inglês | MedCarib | ID: med-3425

RESUMO

Presents statistical data on ante-natal services for the state. Areas covered include gravidity at first clinic visit; gestation at first clinic visit, immunization during pregnancy, and other ante-natal services to 1,863 pregnant women. This represents 81.7 percent of the 2,280 deliveries reported to the Ministry of Health in 1993


Assuntos
Humanos , Gravidez , Adulto , Feminino , Serviços de Saúde Materna , Centros de Saúde Materno-Infantil , Cuidado Pré-Natal/organização & administração
18.
Anon.
Washington; Pan American Sanitary Bureau, Regional Office of the World Health Organization; 3 ed; 1993. vi,92 p. ilus.
Monografia em Inglês | MedCarib | ID: med-16483

RESUMO

The maternal and child health strategy for the Caribbean Community came into being as a result of the deliberations of a Technical Group Meeting held in Antigua in 1975. Eight years later, in 1983, at a similiar meeting in Barbados, THE STRATEGY underwent its first revision. This was largely influenced by the universal drive towards Primary Health Care, spearheaded by the World Health Organization and other leading health institutions and agencies. In the decade that followed, health systems were virtually forced into re-thinking their strategies in the light of the "change and decay" of this period; unfavourable trends in global and national economies; crises in the financing of health care; the AIDS bombshell, alarming social problems related to child abuse and drug abuse; all occurring side by side with remarkable advances in medical technology; communications and management systems, and the promotion of healthier lifestyles. It was not surprising, therefore, that by 1992 the time had come for a further revision of THE STRATEGY. This was done by a select group of Caribbean professionals in MCH and related fields, supported by the staff of key agencies viz. PAHO, UNICEF and the University of the West Indies. This process was facilitated by the findings and recommendations contained in a report on the Assessment of the Maternal and Child Health Programme in the English-speaking Caribbean carried out under the auspicies of PAHO in March-April 1992. That Technical Group Meeting was held in Barbados, October 27-29, 1992 as a regional activity of the Project STRENGTHENING MATERNAL AND CHILD HEALTH SERVICES IN THE CARIBBEAN, funded by the GOVERNMENT OF ITALY. THE STRATEGY was reviewed in draft form by the Caribbean MCH Coordinators at their fifth meeting held in Jamaica in April 1993. The recommendations of this group have been incorporated in the current version


Assuntos
Criança , Feminino , Humanos , Serviços de Saúde Materna , Região do Caribe , Serviços de Saúde da Criança
19.
Geneva; World Health Organization; 1993. iv,76 p. ilus.
Monografia em Inglês | MedCarib | ID: med-16575

RESUMO

This document contains descriptions of efforts by grassroots women's groups, women's organizations, and other nongovernmental organizations (NGOs) in developing countries to prevent and reduce maternal mortality and morbidity within the broader context of women's reproductive health. Therefore, a wider range of issues is addressed through these projects and activities, including: pregnancy and childbirth; unwanted pregnancy; abortion; adolescent sexuality and pregnancy; quality of care; counselling; reproductive tract infections; women's rights; and HIV/AIDS. These efforts may take many forms, including: community-based research; education, information, and awareness-raising materials for women as well as men; media campaigns; public education programmes; health service delivery; local and international events, meetings and workshops; and campaigns for better laws and policies. Everyone is working directly with and for women, their families and communities, and often in collaboration with health workers, medical professionals, researchers, policymakers, and governments to achieve the joint aims on behalf of women's health and well-being. This document is intended for individuals, women's groups and organizations, and other NGOs who are interested in taking up this work and who are looking for ideas and examples to follow and adapt. Many professionals and policymakers have begun to realise the importance of cooperation, liason and joint activities with women's health groups and other NGOs for promotion of better health for women. One of the areas in which this is successfully taking place is in prevention of maternal mortality and morbidity, but much more could be done. Thus, this document is also intended for health professionals, health policymakers, programme planners, and government officials whose work in maternal and child health, obstetrics and gynaecology, fertility regulation, sexually transmitted diseases, HIV/AIDS, and other women's health services: not only to encourage work with women and women's group and organizations, but also show how it is being done successfully


Assuntos
Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Estudo Comparativo , Serviços de Saúde Materna , Jamaica , Países em Desenvolvimento
20.
Soc Sci Med ; 35(10): 1225-32, Nov. 1992.
Artigo em Inglês | MedCarib | ID: med-14390

RESUMO

Analysis of the current organization and delivery of maternity care in Jamaica profits not only from an assessment of recent health issues but from considerations of the development of maternity services over the past century. Historical analysis indicates that a critical element in public health policy has been the effort to enclourage use of biomedical obstretrical care and to eliminate the lay midwife. However, while women increasingly patronize hospitals, the delivery of services has deteriorated, resulting in widespread client dissatisfaction. Economic contigencies have contributed to the decline in maternity services, but health personnel manifest the ideology prevalent throughout the colonial era equating social irresponsibility with health complications. The cultural construction of illegitimacy and maternity is shown to be a dimension of class relations having an impact on health policy throughout Jamaica's history (AU)


Assuntos
Humanos , Maternidades/história , Serviços de Saúde Materna/história , Política de Saúde/história , Maternidades/organização & administração , Jamaica , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/tendências , Saúde Pública/história
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