RESUMO
BACKGROUND: This study was part of a project funded under the Grand Challenges Explorations initiative to engage adolescent girls living in the main slums of Nairobi. This involved an innovative co-creation initiative through jointly designing and testing the feasibility of a toolkit of information, skill, and confidence-building, and coping mechanisms that can effectively shield them and their peers against the risks of mental stress during pregnancy and early motherhood. METHODS: Qualitative interviews and discussions from visual methodologies including Photovoice, digital storytelling, and public service announcements were conducted with 30 pregnant and adolescent mothers aged 14-19 years in four informal settlements either pregnant or having a child less than 2 years. The aims included; to generate an inventory of mental stressors during pregnancy and early motherhood; understand how mental stress affects the ability to seek care for themselves and their child, and understand individual coping strategies. RESULTS: The psychosocial challenges identified in order of importance included: chased from home by the parents; economic hardship; neglect and abandonment by the person responsible for the pregnancy; stigmatization by family, friends, and the community; feelings of shattered dreams; and daily stress related to living in poor and unhygienic conditions. During the pregnancy and early motherhood, the participants experienced feelings of embarrassment, shame, hopelessness, and to the extreme, suicidal thoughts clouded their minds. Main coping strategies included social isolation for some, socializing with other pregnant and adolescent mothers, and negative behaviors like the uptake of illicit drugs and alcohol and risky sexual relationships. CONCLUSION: The unpreparedness for early motherhood infused with inadequate psychosocial support led to increased mental stress and risk of depression. The interconnection between the triggers to mental stress showed the need to focus on a multifaceted approach to address the wellbeing of pregnant and adolescent mothers.
Assuntos
Adaptação Psicológica , Mães Adolescentes/psicologia , Áreas de Pobreza , Gravidez na Adolescência/psicologia , Estresse Psicológico , Adolescente , Feminino , Humanos , Quênia/epidemiologia , Masculino , Gravidez , Pesquisa Qualitativa , Condições Sociais , Estigma Social , Apoio Social , Adulto JovemRESUMO
BACKGROUND: Intimate partner violence (IPV) refers to a violation of women's reproductive rights as it impacts on their sexual and reproductive health autonomy. AIM: In this study, we aimed at assessing the pattern of IPV and the socio-cultural determinants and predictors of partner violence in a rural community setting where the bulk of the abuse prevails. SETTING: This study was conducted in a rural community in Southern Nigeria. METHODS: This study employed a mixed method comprising seven focus group discussions (FGDs) and quantitative components. The cross-sectional survey was conducted amongst 209 ever married or cohabited females in 2018 using the World Health Organization (WHO) multi-country survey questionnaire adapted to the study objectives. Data analysis was conducted by using IBM SPSS v21.0. The level of significance was set at p 0.05. RESULTS: The overall IPV prevalence was 79.4%. The prevalence of partner's controlling behaviour, emotional IPV, physical IPV and sexual IPV was 62.6%, 55.98%, 49.3% and 2.6%, respectively. Membership of an interest group was protective against IPV (OR = 0.430, 95% CI = 0.193-0.957) whilst the belief that a good wife obeys her partner even if she disagrees (OR = 9.201, 95% CI = 1.299-65.194) and the belief that it is the wife's obligation to have sex with the husband even if she doesn't feel like (OR = 2.356, 95% CI = 1.049-5.288) were risk factors. CONCLUSION: The burden of IPV in the studied rural community is enormous. There should be public enlightenment to desensitise people regarding the erroneous views that encourage partner violence. We encourage women to become a part of social groups that can enhance their education and empowerment.
Assuntos
Violência por Parceiro Íntimo/etnologia , População Rural , Parceiros Sexuais/psicologia , Determinantes Sociais da Saúde , Adulto , Estudos Transversais , Feminino , Grupos Focais , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de RiscoRESUMO
OBJECTIVE: To determine the serum calcium-magnesium ratio in pre-eclampsia and compare with normotensives. METHODS: A case-control study was conducted in a tertiary hospital between October 2017 and March 2018 among 81 pregnant women (27 cases and 54 controls matched for age, gestational age, and parity). An interviewer-administered questionnaire was used to obtain data on demography/clinical history. Venous blood was collected without stasis and sent for biochemical analysis. Statistical analysis used IBM SPSS 21.0. RESULTS: The levels of serum Ca2+ (7.73 + 1.24 vs 9.17 + 0.77; P<0.001), Ca2+ -Mg2+ ratio (3.36 + 0.60 vs 3.83 + 0.41; P=0.001), and Mg2+ (2.35 + 0.35 vs 2.41 + 0.16; P=0.469) were lower among cases. Serum Ca2+ level correlated negatively with systolic (r=0.45, P=0.05) and diastolic blood pressure (r=0.50, P=0.010) among the cases. Hypocalcemia was a risk factor (adjusted odds ratio [AOR] 7.63, 95% confidence interval [CI] 1.64-35.37) while social classes 2 and 3 were protective factors (AOR 0.01, 95% CI 0.00-0.46 and AOR 0.01, 95% CI 0.00-0.24, respectively) against pre-eclampsia. CONCLUSION: The result of this research supported the implication of micronutrients in pre-eclampsia and may help to understand the pathophysiological process of pre-eclampsia. It will also help to establish and enhance existing preventive strategies for the condition. The recommendation by WHO on calcium supplementation in pregnancy as a step in preventing the occurrence of pre-eclampsia should be practiced.
Assuntos
Cálcio/sangue , Magnésio/sangue , Pré-Eclâmpsia/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Nigéria/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez , Fatores de Risco , Inquéritos e Questionários , Centros de Atenção Terciária/estatística & dados numéricosRESUMO
Background: Eclampsia is a serious obstetric complication with attendant high maternal and perinatal morbidity and mortality especially in the developing countries. This study aims to assess the maternal and perinatal outcomes of eclampsia and suggest ways to improve them.Methods: This was a 5-year retrospective study (2009-2013) of cases of eclampsia managed at the University of Benin Teaching Hospital, Benin City, Nigeria. The number of cases managed was obtained from records at the emergency room, labour ward, theatre, lying-in wards and special care baby unit and case notes of patients satisfying the inclusion criteria retrieved from the medical records library.Results: The prevalence of eclampsia was 1.99% of total deliveries. It was highest in teenagers (29%), nulliparous (3.1%) and the unbooked (8.5%). Antepartum eclampsia accounted for 69.6% of the cases and a majority (74.6%) was delivered by emergency caesarean section. Eclampsia resulted in 27.78% of total maternal mortality, case fatality rate of 15.96% and eclampsia-related maternal mortality ratio of 318/100,000 deliveries. Perinatal mortality rate was 131/1000 eclamptic deliveries.Conclusions: The maternal outcome worsened with increasing blood pressure, number of convulsion episodes prior to presentation, the time interval between 1st convulsions to delivery, level of proteinuria on dip stick and reduced urine output. Vaginal delivery was associated with more early neonatal deaths and birth asphyxia. More awareness and enabling factors should be created for more women to access antenatal facilities. The government should be committed to providing emergency obstetric care facilities in our hospitals for effective management of eclampsia.