Determinants of unintended pregnancy and its impact on the health of women in some governorates of Upper Egypt

Worldwide, more than half of all unintended pregnancies end in abortion, indicating the preference for increasingly smaller families. The present work aimed to assess the determinants of unintended pregnancy and its impact on women's health in El Fayoum and Benisuef governorates. A community-based cross-sectional household survey was conducted among 827 married women of reproductive age. The study was conducted in two governorates, El Fayoum and Benisuef, for a period of 6 months. The current study revealed that 15.9% of women who participated in the study had an unmet need for family planning, with subsequent unintended pregnancy. Higher age of women and her age at the time of marriage, illiteracy, short interpregnancy spacing, exceeding the desired number of children, negative attitude of husbands toward the use of family planning methods, and absence of discussion between partners on the use of means to postpone pregnancy increased the number of unintended pregnancies. Also, women with unintended pregnancy were at a higher risk of experiencing health problems during her pregnancy. Despite the efforts taken by family planners, the problem of unintended pregnancy continues to increase in Egypt, with its adverse effect on pregnancy and maternal outcomes. Therefore, the strategy for maternal mortality reduction in Egypt should focus on addressing the unmet needs of high-parity, uneducated, nonworking women

Women's awareness of obstetric danger symptoms: is there a need to promote a preconceptional educational program?

Awareness towards the symptoms of obstetric complications will lead to timely access to appropriate emergency obstetric care. The aim of the study was to assess and compare the awareness towards obstetric danger symptoms among never-pregnant and ever-pregnant women and to identify predictors of their awareness as a measure for the need to promote a preconceptional educational program in Egypt. This study was conducted in selected villages of Alfayoum and Benisuef governorates as a comparative study between 173 newly married never-pregnant women and 827 ever-pregnant women who were randomly targeted by a structured interview during a period of 8 months. The questionnaire included personal data, social data, and data related to awareness of obstetric danger symptoms, complications, and action taken on having any of these symptoms. The scoring system was designed for women's awareness, with one degree allocated for a correct answer. The study revealed that the percent of women who gained a score of knowledge of at least 50% was higher among ever-pregnant women than among never-pregnant women [43.9 and 19.1%, respectively]. Although bleeding is the highest reported cause for obstetric complications and is one of the reported causes of maternal deaths in the studied villages, only 26.6 and 20.2% of the never pregnant and 43.9 and 34.3% of the ever pregnant groups, respectively, knew that bleeding is a danger symptom during delivery and the postnatal period. Meanwhile, better awareness about obstetric danger symptoms and exposure to health educational messages was significantly higher among ever-pregnant women [OR = 3.08 and 2.28, respectively] [P < 0.001]. This study reflects the need for intensifying antenatal health educational messages given to pregnant women and the need for the implementation of preconceptional health education programs

Influence of sociodemographic factors and environmental conditions on husbands' behavior toward maternal healthcare

Improving maternal health depends on husband's behavior which is affected by certain sociodemographic factors and environmental conditions. The study aimed to assess the husband's behavior toward maternal healthcare and emergency first aid measures for pregnancy and obstetric risks that might put life of women at risk of maternal death. The study also determined the socio-demographic factors and environmental conditions that influenced husband's behavior and attitude toward antenatal care providers and providers of assisted delivery. One thousand husbands of women in childbearing period were randomly selected through a community-based study that was conducted in 23 rural villages of four chosen districts of Benisuef and Al Fayoum governorates of Egypt. The study is a cross-sectional investigation conducted over a period of 8 months starting from July 2010 until February 2011. Data were collected from interviews of husbands on their sociodemographic characteristics, environmental conditions, and their knowledge, attitudes, intention, and practices toward maternal healthcare and services provided as well as toward providers of maternal healthcare. The study revealed that husbands who were younger than 20 years at the time of marriage, had a lower middle environmental score, and an upper middle income were nearly two or more times as likely of being unaware of the risk symptoms during pregnancy [odds ratio [OR] = 2.73, 1.37, and 1.59, respectively], during delivery [OR = 1.93, 1.31, and 1.76, respectively], and during the postnatal period [OR = 2.42, 1.36, and 1.77, respectively] compared with those older than 20 at the time of marriage, who had an upper middle environmental score, and a lower middle income. It is recommended to target husbands as an influential factor among high-risk wives by educating them on maternal health risks and by increasing their accessibility to maternal and obstetric health services, with special emphasis on younger men and those living under poor environmental conditions irrespective of their economic status

Study of the effect of maternal malnutrition and antenatal care on pregnancy outcome among women living in squatter areas of Cairo, Egypt

Adequate maternal nutrition and proper antenatal and natal care can prevent unfavorable outcome of pregnancy. The present study aims to assess the quality of antenatal care, to study the prevalence of some maternal nutritional health problems and to study their effect on the outcome of pregnancy among ever-married women in the childbearing period [15-49 years] in some squatter areas of Cairo Governorate. The study examined 1164 ever-married women in the childbearing period. The sample size was calculated according to each indicator required to be measured and according to the prevalence of the studied problems. Six unplanned poor areas of Cairo were chosen randomly. A questionnaire sheet was designed to collect data from ever married women in the childbearing period in the household. It contained information about pregnancy care and pregnancy outcome for the last five years. Weight and height were measured for the entire studied sample and detection of hemoglobin level was done for a subsample of 303 women. The results revealed that the percentage of women who received antenatal care [ANC] in their last pregnancy was 55.6% and the quality of ANC was mostly poor [62.9%] in all squatter areas. Around half of children in squatter areas were born at home [48.2%] and doctors assisted more than half [56.0%] of all deliveries whereas pregnancy or delivery complications were detected in 27.9%. The overall percentage of the unfavorable outcome of pregnancy [abortion, stillbirth and ectopic pregnancy] was 22.5%. The percentage of women who had body mass index [BMI] below 18.5 was 3.4% indicating chronic energy deficiency. There was a high prevalence of severe anemia among non-pregnant [10.5%] and pregnant women [10.3%] and all the studied squatter areas showed high prevalence of moderate anemia among pregnant [76.5%] and non-pregnant [61.5%] women. The study concludes that there are high prevalence of moderate and severe anemia and high percentage of obesity [35.2%], the quality of ANC is mostly poor [62.9%] in all squatter areas and that the significant risk factors affecting unfavorable outcome of pregnancy are: poor quality of ANC, low maternal age and height [

Upgrading of awareness, attitude and practice of rural females towards some health hazards

The objective of the present study was to assess and upgrade the level of awareness, attitude and practice of village hygiene volunteers [VHVs], rural females belonging to their correspondence villages and trusted by their communities towards certain health topics including sanitary housing, personal hygiene, indoor and outdoor health hazards, water hygiene and pollution, food safety [storage and pollution] and sanitary sewage and waste disposal. This was carried out by building the capacity of 375 VHVs located in Fayoum, Beni-Suif and El-Minia governorates through training with the basic knowledge that facilitates dissemination of what they learn to their communities. The implementation of the training courses resulted in a significant improvement in the majority of environmental topics, especially safe housing properties, sources of water pollution, proper handling of water, food hygiene, personal hygiene, preventing milk and fool transmitted diseases and the proper handling and maintenance of latrines