Factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District, Cameroon.

INTRODUCTION: birth preparedness and complication readiness (BPCR) intervention should greatly have an impact on the reduction of maternal mortality if implemented properly at all levels. Responsibility for BPCR must be shared among all safe motherhood stakeholders-because a coordinated effort is needed to reduce the delays that contribute to maternal and newborn deaths. This study aimed to assess the factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District. METHODS: this was a cross-sectional analytic study. The study period was 30th October - 30th November, 2016. A total of 345 pregnant women of ≥ 32 weeks gestational age seen at the antenatal consultation (ANC) units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Frequency distributions were used to determine the awareness and practice and logistic regression at 95% confidence interval (CI) and p<0.05 to identify the factors that favour birth preparedness and complication readiness. RESULTS: the most likely factors that favour birth preparedness and complication readiness were monthly income (Odds Ratio (OR) = 2.94, (1.39, 6.25), p = 0.005) and the number of antenatal care visits (OR = 2.16, (1.18, 3.90), p = 0.013). CONCLUSION: majority of the women in this study were not prepared for birth/complications. The factors most associated with birth preparedness and complication readiness were monthly income and number of antenatal care visits.

Determinants to late antenatal clinic start among pregnant women: the case of Saint Elizabeth General Hospital, Shisong, Cameroon.

INTRODUCTION: To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system. The World Health Organisation (WHO) cites distance to health facility and inadequate health institutions as factors that prevent women from receiving or seeking care during pregnancy and childbirth. Specifically, we intended to determine factors associated with late start of late Antenatal Care (ANC) among pregnant women in the Saint Elizabeth General Hospital Shisong (SEGHS), Cameroon. METHODS: This was a cross sectional study carried out from the 24th October to 24th November 2016. A total of 602 pregnant women were recruited from ANC units of SEGHS and its satellite institutions. The outcome variable was gestational age at start of ANC (estimated by counting from last menstrual period to day of first ANC consultation) while the independent variables were individual, community and institutional factors. Data was analyzed using Epi info version 7. Chi square test was used to appreciate the influence of different variables on risk of late ANC initiation (> 14 weeks of pregnancy). The level of significance was set out at (p: < 0.05). RESULTS: Out of the 602 pregnant women included in our study, 75% initiated ANC late (after 14 weeks of pregnancy). Factors associated with late ANC start were; age (p = 0.001), level of education (p = 0.002), marital status (p = 0.016), religion (p = 0.034), parity (p = 0.001), having a source of income (p=0.001), cost of services (p = 0.010), distance to health facility (p = 0.021) and dissatisfaction with previous ANC services (p = 0.014). CONCLUSION: Cameroon is one of the countries with a high maternal mortality ratio. WHO estimated it to be 529 per 100000 live births in 2017. Prompt and adequate ANC services can improve on maternal and child outcomes of pregnancy. The results of this study suggest tackling issues related to cost of ANC services and improving geographical (distance) barrier to accessing ANC services (in addition to addressing other identified measures) may lead to an increase in pregnant women starting ANC early and thus potentially improve pregnancy outcomes.

Retention in HIV/AIDS Management Services: is it Really Poor? The Case of Yaounde Central Hospital in Cameroon.

BACKGROUND: After consecutively defaulting on their appointments for three months, many HIV positive patients are often reported to have defaulted on their treatment, become lost to follow-up (LTFU), or no longer in care. We sought to determine if retention in HIV/AIDS care and treatment is really poor. METHODS: Outcomes of patients with missed clinic appointments and reasons for missing appointments were studied. We sampled adult HIV positive patients on antiretroviral therapy (ART) who by clinic had missed their clinic appointments by more than four weeks between 1997 and 2019 at the HIV Care and Treatment Center (CTC) (Day Hospital) of the Yaoundé Central Hospital. We assumed that patients who missed their clinic appointment also missed some doses of their ART medications. Patients considered LTFU and those who had defaulted for two months were traced by telephone calls and home visits. Reasons for ART discontinuation were recorded for those who stopped or interrupted ART. RESULTS: Of the 1139 patients who were either LTFU or who had defaulted for two months, 247/1139 (22 %) could not be traced. Out of the successfully traced patients, 50 (4%) had died and 798/1139 (70%) were alive and 310/1139 (27%) were on ART of which 35/1139 (3%) had developed informal ways of obtaining ART through clinic personnel. A good number were brought back to and reinitiated on ART after tracking (540/1139 or 47%). Of those known not to be on treatment(ART), 27/1139 (2%) had deliberately stopped ART and 63/1139 (6%) promised to return and took an appointment with CTC pyscho-social workers. Major reasons shared for missing clinic appointments were travel out of city (39%), distance from health facility, and financial cost for getting to health facility. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Despite clinic data showing many patients had missed monthly appointments or were LTFU, we saw that a sizeable amount of such patients were actually in care and on ART. The above findings lead to the suggestion that clinic data used in program performance evaluation may not always reflect the true picture retention in care for persons in HIV/AIDS programs at hospital and national levels.

Dietary habits and nutritional status of medical school students: the case of three state universities in Cameroon.

INTRODUCTION: Malnutrition is a major risk factor of cardiovascular and metabolic diseases and therefore the importance of good dietary practices and balanced diet cannot be overemphasized. University students tend to have poor eating practices which is related to nutritional status. The objective of our study was to assess the dietary practices of medical students, determine the prevalence of malnutrition among medical students and factors associated with malnutrition. METHODS: We carried out a cross-sectional study from December 2013 to March 2014 involving 203 consenting students in the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I, Faculties of Health Sciences of the Universities of Bamenda and Buea. A three-part questionnaire (socio-demographic profile, eating practices, and anthropometric parameters). Data was analysed using SPSS 18.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD) were calculated for continuous variables. Fischer's exact test was used to compare the categorical variables. Statistical significance was set at p ≤ 0.05. RESULTS: Males constituted 44.3% of respondents. The mean age was 20.8 ± 1.6yrs. Most students had a monthly allowance of less than 20 000frs (34 USD) and 59.1% lived alone. Most students (49.8%) reported taking two meals a day with breakfast being the most skipped meal while supper was the meal most consumed by students. Snacking was common among these students as 40.8% admitted consuming snacks daily. Daily intake of milk, fruits, vegetable and meat were low (6.2%, 4.3%, 20.0% and 21.3% respectively). The BMI status of students was associated with gender (p=0.026). CONCLUSION: Our findings showed a high prevalence of malnutrition of 29.4% based on BMI (underweight 4.9%, overweight 21.6% and obesity 3.0%) among second year medical students of these three state universities. Irregular meals, meal skipping, low fruit, vegetable and milk consumption, high candy, fried foods and alcohol intakes were found to be poor eating practices frequent among these students. Our findings therefore suggest the need for coordinated efforts to promote healthy eating habits among medical students in general and female medical students in particular (and by extension youths in general) as a means of curbing malnutrition among youths.

Awareness and practice of birth preparedness and complication readiness among pregnant women in the Bamenda Health District, Cameroon.

BACKGROUND: Birth preparedness and complication readiness has as goal to reduce maternal and neonatal mortality. This concept developed by the organizations of the United Nations permits pregnant women and their families seek health care without delay in case of obstetric complications and delivery. Though its benefits have been proven in several countries, little is known of this in Cameroon and specifically in the North West Region. Therefore, the intention of the study was to assess the awareness and practice of birth preparedness and complication readiness in this health district. METHODS: This was a facility-based cross sectional study carried out in the Bamenda health district of the North West Region, Cameroon. Three hundred forty-five pregnant women of ≥32 weeks gestational age seen at the antenatal consultation units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Data collected was analyzed with SPSS and Microsoft excel. Frequency distributions were used to determine the awareness and practice of birth preparedness and complication readiness. RESULTS: Of the 345 pregnant women included in this study, 159(46.1%) were aware of birth preparedness and complication readiness. The practice of birth preparedness and complication readiness was unsatisfactory as only 65(18.8%) were considered prepared. CONCLUSION: Education and counselling on birth preparedness and complication readiness is not made available to the pregnant women resulting in poor knowledge. Thus, reflected in the low practice of preparation for birth and its complication observed.