Factors affecting utilization of antenatal care services and institutional delivery at Koghum in Jos South, Plateau State, Nigeria

Access to antenatal care services promotes safe motherhood and delivery. This study identified factors influencing the utilization of antenatal care services and health facility-based delivery. A cross sectional survey was conducted. Households were enumerated, and a systematic sampling method was deployed. A sample size of 200 was used. Of the 200 HHs, 198 women were interviewed using pretested semi-structured questionnaires. Data was collected on socio-demographics, attendance at the antenatal clinic (ANC), institutional delivery, and reasons for non-utilisation of ANC services. Data analysis was conducted using Epi Info version 3.5.3. The median age of respondents was 29 years (range: 17 - 55). Overall, 192 (97%) women had at least one ANC visit, 116 (58.6%) had ≥ 4 ANC visits and 93 (47.9%) commenced ANC in the second trimester in the last delivery. One hundred and twenty-five (63.1%) had their last delivery at home by a traditional birth attendant (TBA). The independent risk factors for utilization of ANC were partners' consent (aOR 11.5; 95% CI 1.6-82.3) and knowledge on the importance of ANC (aOR 7.4; 95% CI 1.4-38.6). Pregnant women in a polygamous union were less likely to use to ANC (aOR 0.1; 95% CI 0.0 - 0.4). Being a woman with a lower educational status was associated withassisted home delivery (aOR0.3; 95% CI 0.1-0.7). Most women utilized ANC services at least once. Community sensitization on the benefits of ANC and institutional delivery should be targeted at women in polygamous unions, with low educational level and without partner's consent for ANC

Delay and Poor Diagnosis of Down Syndrome in KwaZulu-Natal; South Africa: A Retrospective Review of Postnatal Cytogenetic Testing

BACKGROUND:Down syndrome (DS) is the most common chromosomal disorder in newborns. Until 20 years ago DS was considered rare in black African children in South Africa (SA). Lack of awareness of DS on the part of medical staff in SA; and difficulty in diagnosing it; appear to persist. OBJECTIVES:To establish an epidemiological profile of DS and investigate the ability of clinicians in KwaZulu-Natal Province (KZN); SA; to make accurate clinical diagnoses of DS.METHODS:Records at the South African National Blood Service cytogenetic laboratory in Pinetown; KZN; were examined for all tests for clinically suspected DS undertaken during January 2009 - December 2013 and all cytogenetically proven DS test results. Age at diagnosis; the hospital from where the test was sent and type of chromosomal pattern for each confirmed DS test result were recorded. RESULTS:Of a total of 1 578 tests requested; 875 confirmed DS; indicating that clinicians correctly clinically diagnosed DS 55.4% of the time. The average age of cytogenetic diagnosis of DS was 1 year and 20 days. The minimum population prevalence of DS was 0.8/1 000.CONCLUSIONS: The diagnosis of DS is a challenge in KZN; potentiating missed opportunities for early intervention. The relatively low population prevalence of DS may be attributable to a lack of confirmatory cytogenetic tests or missed clinical diagnoses. It may also be attributable to a high mortality rate for children with DS in the province