RESUMO
BACKGROUND: Despite the significance of postnatal care for maternal health, the attendance rate of mothers at postnatal clinics (PNCs) in primary healthcare (PHC) centers in Bahrain is low. This study aims to identify factors influencing women's attendance at PNC in PHC centers in the Kingdom of Bahrain and to propose strategies for service improvement. METHODS: In January 2023, we conducted a cross-sectional study. We selected mothers who gave birth between six and 12 months before the survey and met inclusion criteria using systematic simple random sampling and obtained consent (n = 319). Data collection utilized an electronic, structured, interviewer-administered questionnaire, and analysis was carried out using SPSS version 28 (IBM Corp., Armonk, NY). RESULTS: Out of the 319 participants, 31% were unaware of the existence of PNC, 42% were aware but did not attend, and 27% were aware and had attended the clinic. Mother and child department clerks, doctors, health education boards, and midwives served as the primary sources of information about the PNC for only 34%, 16%, 16%, and 11% of participants, respectively. Understanding the importance of PNC, the services offered by a healthcare worker, the booking process, having a vaginal delivery, and prior experience with a PNC visit were significantly associated with PNC attendance (p = 0.0046, p = 0.027, p < 0.001, p = 0.028, and p < 0.001, respectively). The attendance of 81 mothers, representing 94% of the total women who attended the clinic, was driven by their acknowledgment of the service's importance. Childcare responsibilities, perception of the visit as unimportant, and reluctance to undergo a pelvic examination were the top reasons for not attending the clinic, despite 41%, 38%, and 37% of participants being aware of it. CONCLUSION: Postnatal care attendance remains suboptimal for mothers in Bahrain. Awareness of the clinic's presence, counseling by healthcare providers, and prior experience with PNC visits were found to be significant determinants of attendance.
RESUMO
BACKGROUND AND OBJECTIVES: Women can experience physical abuse, mental, sexual abuse, or even controlling behavior throughout their partnership lifecycle, which must be prevented and curtailed at the early stages. Therefore, this study explores intimate partner violence (IPV) prevalence among Bahraini women, predictors of IPV, and reliability of the Women Abuse Screening Tool (WAST) questionnaire in IPV against women. METHODS: The current prospective cross-sectional study included 810 Bahraini women meeting the inclusion criteria, who were asked to share any IPV experience witnessed during their marriage. A questionnaire comprising of 25 questions, including those of WAST-short and WAST-long, was used. The reliability of the screening tools was determined using Cronbach's alpha test. RESULTS: The prevalence of IPV among Bahraini was found to be 71.11%. During pregnancy, husbands' violent behavior towards family members, relatives or friends; escalation of violence; substance abuse; general antisocial behavior; criminality and mental health issues were significantly associated with IPV (P < 0.001). Relationship problems with the husband, individual behavior of women supporting violence, and history of violence from other family members were significantly associated with abuse (P < 0.05). WAST-short was shown to have a sensitivity of 100% and specificity of 18.8%. Cronbach's alpha coefficient for the full questionnaire, WAST-short and WAST-long were 0.82, 0.76, and 0.84, respectively. CONCLUSION: Determination of IPV is an outcome of the victim and abuser's psychosocial behaviors, and WAST-short must be complemented with WAST-long for accurate findings. Concerted efforts towards anger management and rehabilitation of the victim and abuser are imperative to end the IPV cycle.