Level of healthcare Providers' Preconception Care (PCC) practice and factors associated with non-implementation of PCC in Hawassa, Ethiopia

BACKGROUND: Healthcare providers (HCPs) are at the forefront of screening and identifying preconception risk factors leading to adverse pregnancy outcomes (APOs). In Ethiopia, there is no published study that assessed the status of the implementation of PCC. This is a study conducted with the aim of determining the level of HCP's PCC practice and factors associated with non-implementation of PCC. METHODS: This institution based cross-sectional study conducted among HCPs working in public health institutions (PHI) of Hawassa. The data was collected using a validated instrument called 'Andarg-Ethio PCC-KAPQuestionnaire'. A ltistage sampling was applied to draw a sample of 634 HCPs. The data were analyzed using SPSS software, version 20. Descriptive statistics and binary as well as multiple logistic regression analysis models were used to determine the cruds and adjusted odds ratios. RESULTS: Out of the total study participants, 84.7%(537) were found not totally practising PCC. Those HCPs who do not screen their clients' reproductive life plan (RPL) had 7 times higher odds of not practising PCC (AOR=7.2 95% C.I. 3.6- 14.5), whereas those HCPs with poor PCC knowledge had 4 times higher odds of not practising PCC (AOR= 4.4, 95% C.I. 2.5-7.6). CONCLUSION: The findings of this study demonstrated the absence of standardized and consistent PCC practice which indicates that PCC is not well introduced to the area. Developing of PCC policy and guidelines plus training of HCPs are recommended

Preconception care and sickle cell anemia in pregnancy

Background: Pregnancy in women with sickle cell anemia is associated with adverse outcome for mother and child; but with improvements in medical care; the outcome has greatly improved in developed countries. Despite being the most prevalent genetic disease in Africa; sickle-cell disease; along with its serious health problems in pregnancy; is largely neglected. Objective: To determine the effects of preconceptual care on pregnancy outcome among booked patients with homozygous sickle cell disease at Aminu Kano Teaching Hospital; Kano; Nigeria. Materials and Methods: A cohort study of the pregnancy outcome; among booked 39 pregnant women with homozygous sickle cell disease (Hbss); who had preconception care; and an equal number of booked pregnant women with homozygous sickle cell disease (Hbss); who did not have preconception care (controls); at Aminu Kano Teaching Hospital; between January 2000 and December 2006. Results: There was no statistically significant difference in the occurrence of complications between the two groups; but complications occurred with less frequency among the cases compared to the controls. Conclusion: This study suggest that preconception care and effective prenatal care by a multidisciplinary team; and delivery in a hospital which is accustomed to management of sickle cell disease and its complications; is associated with good pregnancy outcome in women with sickle cell anemia in pregnancy

The Prevalence of Substance Use and its Associations amongst Students Attending High School in Mitchells Plain; Cape Town

Purpose: In South Africa; there has been an increase in illicit drug trafficking and consumption and associated problems since the 1990s. Mitchells Plain in Cape Town is seen as a community battling with crime; gangsterism; unemployment; overcrowding; substance abuse and poverty. This study evaluated the actual prevalence of substance abuse amongst high school students in this community and factors associated with substance use. In particular; the study evaluated the use of tik (crystal methamphetamine); a relatively new drug. Method: A cross-sectional study was performed amongst 12 secondary schools in Mitchells Plain; Grade 8 and Grade 11 classes were randomly selected to produce a sample of 438 learners. The students completed an anonymous questionnaire that contained enquiries on substance use; demographic and school performance details; and personal and sexual risks. Results: Lifetime and annual prevalence rates were: alcohol (50.6/41.0); tobacco smoking (49.7/36.2); cannabis (32.1/21.1); crystal methamphetamine (9.2/4.6); ecstasy (4.4/2.7); mandrax (2.1/0.9); solvents (3.0/0.9) and cocaine (0.9/0.9). Illicit substance use was significantly associated with age (OR 1.6; CI 1.2-2.2); substance use by other members of the household (OR 2.8; CI 1.2-6.3); carrying a knife (OR 10.9; CI 4.2-28.8); attempted suicide (OR 3.7; CI 1.4-9.5) and higher sexual risk (OR 1.6; CI 1.2-2.3). Conclusion: The prevalence of substance use amongst adolescent students attending high schools in Mitchells Plain; Cape Town; is high for all substances relative to national and international figures. Government officials; educators and health care workers are alerted to the need for more comprehensive interventions to prevent and treat substance abuse in this and similar communities