Quality of antenatal care at outpatient department of Mandalay General Hospital: time utilization and satisfaction among users

The study was a hospital-based cross-sectional survey using recording and interviewing techniques. Average waiting time (in minutes) before seeing registration clerk, nurses, laboratory staff and medical doctors, for all first visit and follow-up visit patients, were 10,5,8 and 31 respectively. Average time in contact (in minutes) with registration clerk, nurses, laboratory staff and medical doctors, for all patients, were 2,2,11 and 3 respectively. Among first visit patients, only 21 per cent were told of their body weights, 21 per cent were told of their blood pressures, 66 per cent were told of their urine examination results, and 64 per cent were told of their baby's clinical conditions. Similar figures for follow-up patients were, 29 per cent 26 per cent, 83 per cent and 80 per cent respectively at different service point. The types of service offered and the training and performance of the service providers can be concluded as from being adequate.

Role of guardians in adolescents'reproductive health behaviors in rural area

A cross-sectional community-based study was undertaken in Taikkyi Township during July 1997, to explore the guardians' attitudes and practices relating to adolescents' reproductive health behavior. Altogether 102 guardians who have adolescents between 10 to 19 years of age involved in the study. Majority of the guardians did not favor their adolescents on choosing their fiancees by themselves and having more than one fiancee. While 52 per cent thought adolescents should know about contraceptives before their marriage, 38.2 per cent thought they should not. Most of the guardians approved that dissemination of messages about sex education for the adolescents through mass media was an appropriate way. It was found that most did not allow their teens to discuss such things either in front of them or with others. But some of them (36.3 per cent) said they would respond about those things willingly if or when they were asked. By knowing sex education and reproductive health, about 48 per cent (46.2 per cent of the mothers and 53.6 per cent of the fathers) said adolescents will gain benefits. Regarding information on Reproductive Health, this study highlights the needs for proper education and counselling for guardians, especially on adolescents.

Pathological study of coronary artery disease in Yangoon General Hospital

A descriptive, cross-sectional, histopathological study of coronary artery disease was conducted among 95 autopsied subjects (66 males, 29 females), with age ranging from 11 to 82 years. Fatty streaks and fibrous plaque were observed in the second and the third decade respectively. More severe atherosclerotic lesions were seen in males. The left anterior descending artery is the commonest artery to have coronary stenosis. The presence of significant stenosis was noted more in those who had myocardial infarction, hypertension, cerebrovascular diseases than those without these diseases. Likewise the weight of the heart was greater in those with coronary artery disease and hypertension. Sixty six percent of patients who died of tuberculosis, and 25 per cent of those who died of cirrhosis of liver were found to have coronary artery stenosis

Effectiveness of health education methods displayed at the selected health centres, Yangon Division

A clinic-based cross-sectional survey was conducted at outpatient departments of Hlegu and kungyangone Township Hospitals to explore the existing situation of effectiveness of health education (HE) methods displayed at health centres. two types of study population were involved: clinic attendants and health care providers and face-to-face interviewing method was performed by using separate questionnaires. Clinic attenders who were 13 years old and above and who have been visiting more than once were considered to be involved. During the study period of 2 weeks each at respective health centre, 99 clinic attenders (74.7 per cent) patients and 25.3 per cent their companions) were observed. Only 32.3 per cent of total attenders were aware of and noticed HE posters displayed at health centres and read them. Only 26.3 per cent said that they had seen HE activities done at health centres during their presence. Regarding the HE activities performed at health centres, 19.2 per cent were satisfied with the works of health centres and staff, whereas, about 71 per cent had no idea due to their unawareness. apart from HE talk and poster display, other HE activities were rarely observed. Due to availability during the study period, 12 health care providers could respond to our questionnaire. Their mean service year at the study place was 2.2 years. All respondents were aware of the HE activities performing at their health centres. All of them were found to be satisfied with their own performance, and only 3 (25 per cent) satisfied with their health centre's job.

Acceptability of condoms among family planning clinic attenders in Waybagi, North Okkalapa

A hundred currently married women of 20-49 years were interviewed to assess the knowledge, attitude and practice of male condoms among family planning clinic attenders of Waybagi in North Okkalapa Township and to identify their acceptance and perception towards male condoms. The majority of wives were 30 to 34 years ole and primary school level whereas the majority of husbands were between 35 to 39 years of age, educated up to high school level. Most wives (75 per cent) were dependents whereas majority of husbands (38 per cent) were semi-skilled workers. although 75 per cent have heard of condoms only 36 per cent had actually seen one. Most knew that condoms were meant for contraception (86.7 per cent). Sixty-eight per cent knew condoms could prevent transmission of sexually transmissible diseases; 8 per cent thought condoms were meant for extra-marital sex; 77.3 per cent knew that condoms were meant for single use only. Over half thought condom is important for family planning and prevention of STD, less than half thought it was good for sexual relationship, that every adult male should use it, that it was good for male use, and that it would not create any problem between husband and wife. as regards statements with negative view, more than half disagreed with statements that condoms could disturb sexual relationship and that it could not be used for monogamous marriage. Overall, the respondents seemed to regard condoms positively rather than negatively. Only 5 per cent had ever used condoms out of which only one liked it whereas one disliked it due to condom rupture. None were currently using condoms. It indicated that proper counselling and appropriate training is essential to promote condom acceptability.

Assessing the accuracy of respiratory rates at different counting periods and methods

The respiratory rates of 198 children (aged 2-59 months) suffering from acute respiratory infections (ARI) were monitored by observation, palpation and auscultation (Gold standard). Two 30-second and one 60-second counts were obtained. The difference among respiratory rate counts determined simultaneously by observation, palpation and auscultation in relation to their mean count was analyzed for 60-second counting period, 30 plus 30-second period and 30-second doubled. The variability among the different counting methods and counting periods was not significantly different whether the children were feeding, sleeping, resting and awake or awake but not resting. The data from the study suggest that respiratory rate counting either by observation or palpation are similar in accuracy and one minute's counting either at a stretch or 30-second doubled or two blocks of 30-second intervals are also similarly accurate.

Prescribing practices on contraception among general practitioners and basic health services staff in Taikkyi Township

Sixty-eight health service providers including 14 Medical Doctors (7 Full-time General Practitioners (GPs) and 7 Government Medical Officers), 4 Health Assistants (HAs), 11 Public Health Supervisors (PHS I & II), 5 Lady Health Visitors (LHVs) and 34 Midwives (MWS) practising in Taikkyi Township, were interviewed using a self administered structured questionnaire, to assess their level of knowledge and prescribing practices for contraception. All of the service providers with the exception of some PHS have prescribed some form of contraception during their practice. Among the contraceptives stated to be most prescribed by them, oral contraceptives came first with 94 percent, followed by injections with 92 percent, rhythm method in 37 percent, intra-uterine device in 30 percent, female sterilization in 21 percent, and condoms were prescribed only by 16 percent of them. The real and perceived side effects experienced with various methods are also discussed. The findings suggest that health care providers need to be trained or given refresher courses on contraceptive technology and proper counselling and use of the available methods, appropriate choice of methods suitable for the individual, the real and perceived side effects from various methods and their management. Development of appropriate health education and counselling package for use in birth spacing programmes is also indicated.

Knowledge, perception and AIDS related behaviours among currently married couples in Yangon

A community based study was conducted in 1991 in Dagon and Thakayta Townships to assess the existing level of knowledge and perception of AIDS among 594 currently married couples and to find out the type of educational needs on AIDS for married couples. Only a few study subjects believed that AIDS was a curable disease and the majority did not know some important preventive measures. Many of the studied couples could not identify those who could get AIDS within the society and the high risk group among community members. Knowledge of the source of AIDS transmission and on prevention of AIDS were also found to be low among them. Condom utilization by male having sex with spouse was also found to be low. Health education of AIDS dissemination through leaflets and health talks was found to be insufficient.

Morbidity and mortality pattern of hospitalized elderly patients in YGH (1985-1987)

A record analysis of all elderly patients admitted to YGH during 1985 to 1987 was done to determine the morbidity pattern of hospitalized elderly patients, aged 55 years and above. There was an average admission rate of 7000 patients per year constituting approximately 18 percent of all admissions. The mean duration of stay in hospital for each hospitalized person was approximately 19 to 21 days. The most common morbidity condition for admission to hospital according to International Classification of Diseases (ICD) grouping is neoplasms in 18.9 percent of admissions, followed by diseases of the circulatory system in 18.7 percent and injuries or poisonings in 16.9 percent, digestive system diseases 12.8 percent, and other ill defined causes led to be 21.8 percent. The case fatality for hospitalized elderly is 12.8 percent for the three years. Implications of the study in planning for geriatric services are discussed.

Case-control study of risk factors for cholera in Yangon

A case-control study was conducted on 100 culture-confirmed cholera cases who were admitted to Yangon Infectious Diseases Hospital during 12 July to 11 October 1993 and their age-matched controls from their neighbourhood to determine the risk factors for cholera. V. cholerae 01, El Tor Ogawa, was isolated from the drinking water sample of one case-patient. A number of factors, including poultry farming, consumption of food and iced drinks from street vendors, drinking unboiled water and lack of hygenic habits were found to be significantly associated with cholera transmission.

Access to family planning services through general practitioners

In Myanmar, private medicine now plays a significant role in delivery of health care as well as the provision of family planning services. Thirty nine general practitioners, practicing in Sangyaung township, Yangon Division were inquired to determine the present situation of the family planning services provided by them. The majority (94.9 Percent) realised the importance of the family planning services and believed that, they could help people for birth spacing. The findings will be helpful for the future planning of Family Planning Services in Myanmar.