ABSTRACT
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
ABSTRACT
Evidence showed that Egypt possesses risk determinants that play a crucial role in the persistence of communicable diseases. The present study is a healthy system research study that aims at identifying the challenges to best practice for prevention and control of group A communicable diseases which includes 15 diseases, according to MOHP surveillance system] at the education [Faculty of Medicine], and health system level [MOHP]. It focuses on situation analysis for the policies and strategies related to prevention and control of communicable diseases in Egypt. Study tools included a structured questionnaire designed to interview physicians and sanitarians working in the District Surveillance Units in Giza and Cairo governorates about prevention and control measures of communicable diseases under the study. In-depth interviews with professors at the Community Medicine Department in faculty of Medicine, Cairo University as well as staff of MOHP-Head Quarters. Content analysis for the community medicine book, MOHP guidelines and WHO publications was also performed. The main results of the in-depth interviews with community medicine department staff, addressed the institutional strengths within the medical schools in terms of enough staff and space and accessibility to field visits. The weaknesses within the medical education are related to overlap/ repetition of the same information. The practical training is not sufficient with shortage in facilities for transportation of students to the field visits. Challenges facing the medical schools include the big examination marks allocated to clinical medicine, compared to community medicine marks. The results of in-depth interviews with the staff of MOHP-HQ indicates the presence of political and institutional support for prevention and control of communicable diseases' programs. The surveillance unit [ESU] suffer many shortcomings. Opportunities are great for MOHP due to favourable change to work with international organizations. Challenges are related to the inadequate response of the private sector, non governmental organizations [NGOS] and the community to communicable diseases' prevention and control programs. The retained knowledge and skills of MOHP-CDC [including ESU] staff at the district level in prevention and control of communicable diseases are influenced to a great extent by the specific political support directed to some diseases [e.g. poliomyelitis] compared to other diseases which are not occupying a priority position in the policy makers' agenda. Additionally, some incorrect knowledge about national standard guidelines for prevention and control of communicable diseases with knowledge gaps between physicians and sanitarians were obvious. The study recommends regular revision and updating of community medicine curricula regarding prevention and control of communicable diseases and developing National Committee for continuous reviewing and updating of the guidelines for prevention and control of communicable diseases in MOHP. It also recommends periodic evaluation of the performance of MOHP-CDC [including ESU] staff at the district level