scholarly journals Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia

2020 ◽  
Vol 17 (3) ◽  
pp. 720 ◽  
Author(s):  
Anna Wood ◽  
Diana MacKay ◽  
Dana Fitzsimmons ◽  
Ruth Derkenne ◽  
Renae Kirkham ◽  
...  
Keyword(s):  
Postpartum Period ◽  
Smoking Status ◽  
Health Centre ◽  
Adverse Outcomes ◽  
Remote Communities ◽  
Aboriginal Women ◽  
Primary Health ◽  
Primary Health Centres ◽  
Diabetes Status ◽  
In Pregnancy

Background: Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal women after a pregnancy complicated by hyperglycaemia. Methods: A retrospective review of the 12 month postpartum care provided by primary health centres in remote Australia in 2013–2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (n = 147), type 2 diabetes (T2D) (n = 39), and unclear diabetes status (n = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (n = 24) or diabetes (n = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, p <0.01), and smoking status documented as “discussed” (65% vs. 34%, p < 0.01). Most women (97%) accessed the health centre at least once in the 12 month postpartum period but, during these visits, only 52% of women had service provision, either structured or opportunistic, related to diabetes. Conclusion: High rates of dysglycaemia among women screened for T2D after GDM in the 12 month postpartum period highlight the need for increased screening and early intervention to prevent the development of T2D and its complications. Whilst a clear strength was high postpartum attendance, many women did not attend health services for diabetes screening or management.

scholarly journals Assessment of primary health centres of a district in North Karnataka according to Indian Public Health Standards 2012 guidelines: a cross sectional study

2019 ◽  
Vol 6 (11) ◽  
pp. 4731
Author(s):  
Shrinivas K. Patil ◽  
Shivaswamy M. S.
Keyword(s):  
Health Centre ◽  
Simple Random Sampling ◽  
Preventive Health Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
Building Area

Background: Primary health centre (PHC) is a basic health unit to provide an integrated curative and preventive health care to the rural population as close to the people as possible, with emphasis on preventive and promotive aspects of health care.Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka in India. Twenty PHCs, two PHCs from each of the 10 talukas of Belagavi district were selected by simple random sampling. The study period was from 1st January 2014 to 31st December 2014. Data was collected using a predesigned and structured questionnaire for IPHS facility survey.Results: In this study, only 60% of primary health centres covered the population as per the IPHS norms. All the PHCs were providing the regular outpatient department (OPD) services, referral services, antenatal care, family planning and in-patient services. Bed occupancy rate was less than 40% in 55% of PHCs. Building area in 75% of PHCs were inadequate according to IPHS norms. Residential facility for staff was available only in half of the studied PHCs.Conclusions: IPHS guidelines were not fully being followed at PHC level in the district. Though the requirement of medical officers and pharmacists was fulfilled in almost all the PHCs, deficiency was seen in the appointing of Ayush doctors and staff nurses at PHCs. There is an urgent need of recruiting the deficient staff for efficient functioning of the PHCs.

scholarly journals Nutrition in pregnancy and pregnancy outcome in two primary health centres, Okpanam

Kontakt ◽  
2021 ◽  
Author(s):  
Phoebe Nwamaka Kanikwu ◽  
Jessica Agada Jimmy ◽  
Anthonia Chinwendu Emesowum
Keyword(s):  
Pregnancy Outcome ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
In Pregnancy

scholarly journals Risk Factors and Timing of Acute Myocardial Infarction Associated With Pregnancy: Insights From the National Inpatient Sample

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Courtney A. Balgobin ◽  
Xiaoyue Zhang ◽  
Fabio V. Lima ◽  
Cecilia Avila ◽  
Puja B. Parikh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Postpartum Period ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Labor And Delivery ◽  
National Inpatient Sample ◽  
Cerebrovascular Events ◽  
In Pregnancy

Background Pregnancy increases the risk of acute myocardial infarction (AMI). The purpose of this study was to examine timing and risk factors for AMI in pregnancy and poor outcome. Methods and Results National Inpatient Sample (2003–2015) was screened in pregnancy, labor and delivery, and postpartum. There were 11 297 849 records extracted with 913 instances of AMI (0.008%). One hundred eleven (12.2%) women experienced AMI during labor and delivery, 338 (37.0%) during pregnancy and most during the postpartum period (464; 50.8%). The prevalence of AMI in pregnancy has increased ( P =0.0005). Most major adverse cardiovascular and cerebrovascular events occurred in the postpartum period (63.5%). Inpatient mortality was 4.5%. Predictors of AMI include known coronary artery disease (odds ratio [OR], 517.4; 95% CI, 420.8–636.2), heart failure (OR, 8.2; 95% CI, 1.9–35.2), prior valve replacement (OR, 6.4; 95% CI, 2.4–17.1), and atrial fibrillation (OR, 2.7; CI, 1.5–4.7; P <0.001). Risk factors of traditional atherosclerosis including hyperlipidemia, obesity, tobacco history, substance abuse, and thrombophilia were identified ( P <0.001). Gestational hypertensive disorders (eclampsia OR, 6.0; 95% CI, 3.3–10.8; preeclampsia OR, 3.2; 95% CI, 2.5–4.2) were significant risk factors in predicting AMI. Risk factors associated with major adverse cardiovascular and cerebrovascular events included prior percutaneous coronary intervention (OR, 6.6; 95% CI, 1.4–31.2) and pre‐eclampsia (OR, 2.3; 95% CI, 1.3–3.9). Conclusions AMI is associated with modifiable, nonmodifiable, and obstetric risk factors. These risk factors can lead to devastating adverse outcomes and highlight the need for risk factor modification and public health resource initiatives toward the goal of decreasing AMI in the pregnant population.

scholarly journals Prevalence and socio-demographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Geraldine U. Ndukwu ◽  
Paul O. Dienye
Keyword(s):  
Pregnant Women ◽  
Economic Status ◽  
Health Centre ◽  
Primary Health Centre ◽  
Factors Associated ◽  
Socio Economic Status ◽  
Primary Health ◽  
Anaemia In Pregnancy ◽  
Rivers State ◽  
In Pregnancy

Background: Anaemia, though a common problem in Nigeria, has not been adequately studied amongst pregnant women in primary health care facilities. Objective: This study is aimed at determining the prevalence of anaemia and sociodemographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria.Methodology: This is a cross-sectional study carried out in a primary health centre. Association between variables was analysed using the Chi-square test.Results: Two hundred and twenty-seven pregnant women whose ages ranged from 16 to 40 years with a mean age of 26.8 ± 4.3 years were recruited for the study. The haemoglobin concentration ranged from 6 g/dL – 15 g/dL with a mean of 10.10 ± 1.27g/dL. A total of 142 (62.6%) participants were anaemic. Anaemia was observed to be least prevalent in women within the extremes of reproductive age (≤ 20 years and 36–40 years). There was no statistically significant association between age, educational level and marital status (p > 0.05). The association of anaemia with social class was statistically significant (p = 0.000). Severe anaemia was not a common finding amongst the patients but it was significantly associated with educational status (p = 0.02) and socio-economic status (p = 0.03).Conclusion: The prevalence of anaemia amongst the pregnant participants in the primary health centre was high. Out of all the socio-demographic characteristics, only socio-economic status was significantly associated with anaemia. It is recommended that the socio-economic status of women should be enhanced in line with the Millennium Development Goals to prevent anaemia and to enhance pregnancy outcomes.

scholarly journals Diabetes Risk Status and Physical Activity in Pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017

2020 ◽  
Author(s):  
Bethany Grace Rand ◽  
Tammie M Johnson ◽  
Samantha F Ehrlich ◽  
Laurie Wideman ◽  
James M. Pivarnik ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Pregnant Women ◽  
Smoking Status ◽  
The United States ◽  
Diabetes Risk ◽  
Adverse Outcomes ◽  
Risk Status ◽  
Overt Diabetes ◽  
Diabetes Status

Abstract Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.Methods: The sample (n=9,597) included pregnant women, age 18-44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status.Results: Findings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19-0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment.Conclusions: We observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes.

scholarly journals Obstetric factors associated with anaemia in pregnancy in a primary health center in south-south Nigeria

2021 ◽  
Vol 14 (3) ◽  
pp. 042-049
Author(s):  
Ndukwu Geraldine ◽  
Dienye Paul ◽  
Adesokun Bolanle
Keyword(s):  
Developing Countries ◽  
Pregnant Women ◽  
Health Centre ◽  
Primary Health Centre ◽  
Maternal Anaemia ◽  
Factors Associated ◽  
Primary Health ◽  
Obstetric Factors ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Anaemia has been reported as one of the commonest medical complications associated with pregnancy in the developing countries. It increases maternal, fetal and neonatal morbidity and mortality significantly. In Nigeria, maternal anaemia usually predates the period of pregnancy in the life of most of the mothers. These women succumb to early unprepared marriage, give birth to many children with poor child spacing and due to poverty and ignorance they book late for antenatal. This study determines the obstetric factors associated with anaemia in pregnancy in a primary health centre in Port Harcourt in order to create awareness on maternal anaemia and the need to institute preventive and therapeutic measures. Methods: This is a cross-sectional; hospital- based study. A total of two hundred and twenty-seven pregnant women attending the antenatal clinic were enrolled into the study at booking in a primary health centre. Data was collected by administrating questionnaires. Blood sample was collected for haemoglobin estimation. Means were compared using z-test and statistical significance was set at P<0.05. Results: Out of the 227, 111(48.9%) were primigravida, most of whom were anaemic (65.8%). Majority of the women booked in the second trimester 135 (59.3%) and those that booked at the third trimester were more anaemic (70.9%). Pregnant women with birth interval of <1(66.7) and > 4years (78.6%) were mostly anaemic Conclusion: Anaemia in pregnancy especially for those living in developing countries can be reduced if women are educated on the need for proper nutrition before pregnancy and on early ante-natal booking.

scholarly journals A qualitative study of primary care physicians’ perceptions and experiences on iron-folic acid consumption

2017 ◽  
Vol 4 (4) ◽  
pp. 1081
Author(s):  
Ankur Joshi ◽  
Surya Bali ◽  
Saket Kale ◽  
Sharad Tiwari ◽  
Viswanath Arutagi
Keyword(s):  
Qualitative Study ◽  
Primary Care Physicians ◽  
Resource Constraints ◽  
Health Centre ◽  
Central India ◽  
Major Theme ◽  
Primary Health ◽  
Primary Health Centres ◽  
Acid Consumption ◽  
Iron Folic Acid

Background: A primary health centre (PHC) physician, because of his physician-provider interaction at community level and legitimate capacity to deliver and monitor health services, serves as an ideal candidate to understand the specific health/ health program related issues. Methods: This community based qualitative study was conducted in selected clusters of state of Madhya Pradesh (central India) identified through multileveled stratification. The physicians serving in primary health centres from the selected clusters were in depth interviewed through topic guides based upon conceptual construct. The data obtained through in-depth interviews was utilized for thematic framework and linkage association. Results: Two major interrelated themes emerged from the convergence of the user related and system related subthemes. The first major theme is “distorted perceptions reinforced by unpleasant encounters” which is constructed from the convergence of user concerns. The theme “system resistance and resource constraints” is assembled from convergence of system issues. Conclusions: On a policy perspective, all the attempts should be made to break the misconception around IFA supplementation and to augment the feeling of ownership in the community. 

scholarly journals Prospects of diabetes registry and standard care at primary health facilities in Nigeria: experiential note

2019 ◽  
Vol 7 (1) ◽  
pp. 144
Author(s):  
Pleasant C. Ndubueze ◽  
Eunice O. Igumbor ◽  
Otovwe Agofure ◽  
Anthonia C. Okwelum ◽  
Prince C. Ozuem ◽  
...  
Keyword(s):  
Local Government ◽  
Primary Healthcare ◽  
Medical Records ◽  
Health Centre ◽  
Local Government Area ◽  
Diabetes Registry ◽  
Primary Health ◽  
Primary Health Centres ◽  
Diabetes Register ◽  
Primary Health Facilities

Background: As part of the series to advance diabetes register, the aim of this piece of the project was to evaluate the development of a diabetes register at primary healthcare (PHC) level in Delta State Nigeria. This is with a view to determine the PHC capacity for diabetes services.Methods: This clinical observational study was carried out in Novena University health centre in Ukwani Local Government Area and Ogume primary health centre in Ndokwa West Local Government Area, Delta State. A community-based screening was carried out in three communities of Amai, Ezionum and Ogume in July to September 2018, after which a diabetes registers were developed in Novena University health and Ogume primary health centres. Cases of probable diabetes were identified during screening and entered into the diabetes register being developed, which formed the sampled population (n=42). The data were analysed using Microsoft Excel Data Analysis ToolPak 2010.Results: Glucometer, stethoscope and sphygmomanometer were the most available equipment at the two facilities. Medical records of patients were incomplete with 81% missing home addresses and 62% did not have phone numbers. Others records such as date of entry, height, weight and type of diabetes were not recorded. The study also showed 35% prevalence of hypertension in diabetes cases.Conclusions: There is capacity to run diabetes screening and service clinic at the primary healthcare levels, but the limitation was incomplete patient information in the medical records. In development of a diabetes registry at the primary healthcare level, the study recommends comprehensive patients’ documentation during screening and routine medical check-up. 

scholarly journals Determinants of Oxygen Therapy in Childhood Pneumonia in a Resource-Constrained Region

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bankole Peter Kuti ◽  
Samuel Ademola Adegoke ◽  
Benard E. Ebruke ◽  
Stephen Howie ◽  
Oyeku Akibu Oyelami ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Health Centre ◽  
Severe Pneumonia ◽  
Childhood Pneumonia ◽  
Oxygen Administration ◽  
Primary Health ◽  
Head Nodding ◽  
Primary Health Centres ◽  
Life Saving ◽  
The World

Childhood pneumonia is a leading cause of morbidity and mortality among underfives particularly in the resource-constraint part of the world. A high proportion of these deaths are due to lack of oxygen, thereby making oxygen administration a life-saving adjunctive when indicated. However, many primary health centres that manage most of the cases often lack the adequate manpower and facilities to decide which patient should be on oxygen therapy. Therefore, this study aimed to determine factors that predict hypoxaemia at presentation in children with severe pneumonia. Four hundred and twenty children aged from 2 to 59 months (40% infants) with severe pneumonia admitted to a health centre in rural Gambia were assessed at presentation. Eighty-one of them (19.30%) had hypoxaemia (oxygen saturation < 90%). Children aged 2–11 months, with grunting respiration, cyanosis, and head nodding, and those with cardiomegaly on chest radiograph were at higher risk of hypoxaemia (P<0.05). Grunting respiration (OR=5.210, 95% CI 2.287–7.482) and cyanosis (OR=83.200, 95% CI 5.248–355.111) were independent predictors of hypoxaemia in childhood pneumonia. We conclude that children that grunt and are centrally cyanosed should be preferentially commenced on oxygen therapy even when there is no facility to confirm hypoxaemia.

Abstract 14063: Circulating Levels of Collagen Formation and Degradation Biomarkers Are Prognostic for Risk of Hospitalization and Mortality in Patients With HFpEF - Results From the TRAINING-HF Cohort

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alexander Reese Petersen ◽  
Patricia Palau ◽  
Eloy Dominguez ◽  
Morten Karsdal ◽  
Federica Genovese ◽  
...  
Keyword(s):  
Heart Failure ◽  
Smoking Status ◽  
Adverse Outcomes ◽  
Type I ◽  
Significant Information ◽  
Baseline Serum ◽  
Collagen Formation ◽  
Diabetes Status ◽  
Significant Difference ◽  
Circulating Levels

Introduction: heart failure with preserved ejection fraction (HFpEF) is projected to become the dominant form of heart failure, and currently there are no viable treatment options to reduce mortality. Extracellular matrix turnover plays an important role in the pathology of heart failure. Our aim was to evaluate the association between adverse outcome in patients with HFpEF and circulating levels of novel collagen formation and degradation biomarkers in samples from HFpEF patients. Methods: fifty-nine symptomatic HFpEF patients were included for analysis. Biomarkers of formation of type III, VI, VIII, XXVIII collagens (PRO-C3, PRO-C6, PRO-C8 and PRO-C28) and degradation of type I, III and IV collagens (C1M, C3M and C4M) were assessed in baseline serum by means of competitive ELISA. Three models were generated by logistic regression with forward selection in relation to readmission and mortality, with the aim of assessing prognostic abilities for either outcome. The models were compared head to head using ROC curve analyses. Model 1 (CONF): age, sex, HDL, LDL, systolic blood pressure, diabetes status, BMI and smoking status. Model 2 (FORM): collagen formation biomarkers. Model 3 (DEGR): collagen degradation biomarkers. Results: all three models significantly predicted readmission (CONF: P<0.0001, FORM: P=0.0029, DEGR: P=0.0026). For mortality, CONF and FORM were significantly predictive, while DEGR was borderline significant (CONF: P=0.0097, FORM: P<0.0001, DEGR: P=0.059). ROC curves for mortality showed a significant difference between FORM and CONF (P=0.017), while no significant difference was seen when comparing CONF and DEGR. The CONF model was mainly driven by LDL (P=0.02) in relation to readmission, whereas no CONF variables were significant for mortality. No variables in the FORM or DEGR models were independently significant for readmission, but PRO-C6 and PRO-C8 were significant in the FORM model in relation to mortality (both P=0.028). Conclusion: in stable symptomatic HFpEF patients, turnover of collagen predicts outcome. Moreover, formation of collagens provides significant information on risk, suggesting a potential role for collagen biomarkers in stratifying HFpEF patients at higher risk of adverse outcomes.

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