Place of birth for unintended pregnancies in six former Soviet Union countries.

OBJECTIVE: This paper aims at exploring the association between unintended pregnancies and place of birth in six Former Soviet Union (FSU) countries. MATERIAL AND METHODS: A secondary analysis of the latest cross-sectional Demographic and Health Surveys of six FSU countries from 2005 through 2012 was conducted. Prevalence of institutional births and unintended pregnancies was estimated by country and for the pooled population. Odds ratio (OR) and 95% confidence interval (CI) were calculated to measure the country and pooled association between pregnancy intention and institutional birth. RESULTS: Institutional births occurred in 90.4% of the overall study population and ranged from 78.2% in Tajikistan to 99.7% in Ukraine Demographic and Health Survey. Around one out of 10 pregnancies resulted unintended. In the pooled analysis, unintended pregnancies were significantly associated with giving births outside health facility (aOR1.2; 95% CI 1.0-1.6). CONCLUSION: Based on the study findings we suggest that increase awareness of benefit of skilled delivery care is needed among women with poor access to family planning.

Report of the "satisfaction" survey amongst public health services nurses in Port Said.

BACKGROUND: There is a paucity of evidence regarding the job experience of nurses in Egypt. An unpublished previous pilot study conducted in the Port Said Technical Nursing Institute, which was based on 36 participants, showed that almost half of nurses were satisfied with their job; on the other hand, nurses indicated low salaries and high work-loads as main reasons for dissatisfaction. We explored job satisfaction of nurses working in public health services of the Port Said Governorate to inform future healthcare policy. METHODS: A cross-sectional study including nurses from different public health services was conducted. Questionnaires were delivered in a sample of primary health care facilities as well as in the Port Said Governorate public hospital. Following a literature review, eight components were identified as contributors to job satisfaction; two closed questions for each of the eight components and two open questions were devised for a total of 18 questions. RESULTS: The final study population consisted of 285 individuals. Almost 40.0% of the participants felt safe in their clinical environment while around 10.0% disagree on this. Almost 70.0% of participants complained about high work-load due to shortage of staff in the respective clinical area. Almost 85.0% of nurses reported that their salary did not cover living cost while only 13.0% indicated earning a fair salary. Almost 60.0% agreed with the fact that they have regular opportunities to develop in their career. CONCLUSION: Increasing job satisfaction among nurses in Egypt is critical to ensure quality of care for patients. Issues such as salary, staffing and cooperation with colleagues deserve specific attention.

Practices and Perceptions of Family Centered Care among Healthcare Providers: A Cross-sectional Study in a Pediatric Hospital.

PURPOSE: This study aimed to: (1) investigate the extent to which Family Centered Care (FCC) principles are currently applied in clinical practice by healthcare providers working in inpatient units; (2) evaluate the extent to which FCC principles are perceived as necessary; and (3) examine the associations between FCC principles and socio-demographic and job characteristics of participants. Design and Methods A cross-sectional study was conducted at a large pediatric hospital using the Italian version of the FCC Questionnaire Revised (FCCQ-R). Univariate and multivariate analyses were performed. RESULTS: Data from 469 healthcare providers were used for analysis. Scores for the FCC daily practices (Current activities) were significantly lower than those for their perceived necessity (Necessary activities) (p < .001). Participants who were male, younger, with work experience >20 years and working in rehabilitation reported a significantly higher perception of Current activities of FCC than others. The older and the more educated the participants, the greater was the perceived necessity of FCC activities. Female, older, and less experienced participants employed by the hospital but not working in the rehabilitation setting perceived a greater gap between Necessary and Current activities of FCC. CONCLUSIONS: Scores for the Current and Necessary activities of FCC were lower than those reported in other studies. The lower scores in the Current activities and the significant gap can be due to organizational barriers or lack of skills, but the lower scores in the Necessary activities should be interpreted as a deficit of knowledge about FCC. PRACTICE IMPLICATIONS: There is a need for further education about FCC in order to increase its perceived relevance in clinical practice.

Impact of intensive training on mental health, the experience of Port Said, Egypt.

BACKGROUND: Mental disorder is extremely common globally and integration of mental health in primary health services represents a critical gap especially in low- and middle-income Countries like Egypt. The World Health Organization has repeatedly called for effective training and support of primary care providers in the identification and treatment of mental health problems over the last decades. METHODS: This paper aimed to evaluate attitudes and knowledge of health care providers toward mentally ill patients and measure knowledge and retention of training messages over time. A 3-day mental health training workshop for nurses of public health facilities in the Governorate of Port Said was organized. Pre-training and post-training questionnaires (immediately after the workshop and 3 months later) were used. Significance of gain in scores was examined between baseline and following cross sectional rounds. RESULTS: The 73 participants in the study revealed a statistically significant improvement in knowledge and attitude toward mental health from the baseline (pre-training), from a general mean score for desirable answers of 10.5 (± 1.2) to 21.2 (± 0.6). However, results slightly declined three months after from the workshop (18.5 (± 0.6)). CONCLUSIONS: Intensive short-term training on mental illness could be instrumental in improving knowledge and attitudes in countries like Egypt with extensive needs in terms of quality of comprehensive healthcare at primary and secondary level. However, additional evidence is needed to improve retention of information over time and to translate knowledge into clinical practice.

Quality utilization of antenatal care and low birth weight: evidence from 18 demographic health surveys.

BACKGROUND: Low birthweight is a crucial factor in child mortality and morbidity and affects almost 20% of infants worldwide, mostly in low- and middle-income countries. AIMS: To assess the relationship between access to and quality of antenatal care and occurrence of low birth weight. METHODS: We analysed data from 18 demographic and health surveys, from 2005 to 2013, including 69 446 children. The main study outcome was birthweight < 2.5 kg, and access to and number of antematal care visits were exposure variables. Moreover, antenatal care attendants and time of visit (trimester) were considered. Multiple logistic regression adjusted for sampling at primary and country level was utilized. RESULTS: At least 1 and ≥ 4 antenatal care consultations were both associated with decreased odds of low birth weight when compared to none and < 4 antenatal care consultations, respectively. Additional benefit stemmed from having skilled antenatal care attendants and the first antenatal care consultation during the first trimester. CONCLUSIONS: Proper antenatal care coverage during pregnancy is beneficial for preventing low birth weight in low- and middle-income countries.