Severe maternal outcomes and their predictors among Pakistani women in the WHO Multicountry Survey on Maternal and Newborn Health.

OBJECTIVE: To determine the incidence of, and the demographic and obstetric factors associated with, severe maternal outcome (SMO) among women presenting at healthcare facilities in Pakistan. METHODS: A cross-sectional study was conducted in 16 healthcare facilities across Pakistan that had been selected for the WHO Multicountry Survey on Maternal and Newborn health. The hospital records of women who delivered at a participating facility or were admitted with SMO (defined as maternal death or near miss) within 7 days of delivery/abortion were reviewed for a period of 2-3 months in 2011. The incidence of SMO, its associated demographic and obstetric characteristics, and the influence of various maternal health interventions were assessed. RESULTS: Among 13 175 included women, 132 (1.0%) had an SMO (94 [0.7%] near miss and 38 [0.3%] died). The maternal mortality ratio was 299 deaths per 100 000 live births. Major causes of SMO included postpartum hemorrhage (64 [48.5%] women), hypertensive disorders (34 [25.8%]), and ruptured uterus (9 [6.8]). Illiteracy, anemia, and several obstetric complications (e.g. eclampsia) were significant contributors. CONCLUSION: Improving education, nutrition, and uniform implementation of obstetric care protocols are needed for better maternal and neonatal health in Pakistan.

A focus group study of factors influencing African-American men's prostate cancer screening behavior.

This study was conducted to identify the factors perceived by African-American men as influencing their behavior relative to prostate cancer screening. A total of 49 African-American men, age 40 and above, participated in 10 focus group discussions in Florida. Data collection was between October 12, 2001 and March 9, 2002 in Tallahassee, Tampa, and Miami. Data analysis was conducted using a comprehensive ethnographical analysis, including the use of an ethnographical retrieval program, Nonnumerical Unstructured Data Indexing Searching and Theorizing (QSR NUD*IST 4.0) software. Factors identified as influencing prostate cancer screening participation by African-American men were impediments to prostate cancer screening; positive outcome beliefs associated with prostate cancer screening; social influence; negative outcome beliefs associated with prostate cancer screening; resources or opportunities that facilitate prostate cancer screening; prostate cancer knowledge; perceived susceptibility to prostate cancer; perceived threat of prostate cancer; perceived severity of prostate cancer; positive health activities; illness experience; and prostate cancer screening intervention message concept, message source, and message channel. The results of this study may offer an excellent guide to designing effective, culturally sensitive, and relevant interventions, which would increase African-American men's participation in prostate cancer screening.