"Back to Basics" Approach for Improving Maternal Health Care Services Utilization in Lao PDR.

Earlier studies claim inadequate knowledge and understanding of maternal health care service among women and families account for low demand and utilization of these services. This study explores maternal service utilization in Lao PDR by interviewing women, families, health service providers, and community members in Xiengkhuang province. In general, women's attitude and acceptance of maternal health care were positive, with many expressing appreciation and need for maternal health services. Nevertheless, utilization of maternal health services remained poor largely due to dissatisfaction with services: inaccessibility, irregular services, fund shortage, poor facilities, and problems dealing with male health service providers. It appears that utilization of maternal health care services in Lao PDR is as much a health system concern as it is a user preference issue. This article advocates a "back to basics" approach for reviewing maternal health care infrastructure systems in developing countries to improve community health services and utilization.

Smoking among Lao medical doctors: challenges and opportunities for tobacco control.

BACKGROUND: Smoking is an increasing threat to health in low-income and middle-income countries and doctors are recognised as important role models in anti-smoking campaigns. OBJECTIVES: The study aimed to identify the smoking prevalence of medical doctors in Laos, their tobacco-related knowledge and attitudes, and their involvement in and capacity for tobacco prevention and control efforts. METHODS: This was a cross-sectional national survey by a researcher-administered, face-to-face questionnaire implemented at provincial health facilities throughout the central (including national capital), northern and southern regions of Laos in 2007. Both descriptive and inferential statistics were used. RESULTS: Of the 855 participants surveyed, 9.2% were current smokers and 18.4% were ex-smokers; smoking was least common in the central region (p<0.05) and far more prevalent in males (17.3% vs 0.4%; p<0.001). Smoking was concentrated among older doctors (p <0.001). Over 84% of current smokers wanted to quit, and 74.7% had made a recent serious attempt to do so. Doctors had excellent knowledge and positive attitudes to tobacco control, although smokers were relatively less knowledgeable and positive on some items. While 78% of doctors were engaged in cessation support, just 24% had been trained to do so, and a mere 8.8% considered themselves 'well prepared'. CONCLUSION: The willingness of doctors to take up their tobacco control role and the lower smoking rates among younger respondents offers an important window of opportunity to consolidate their knowledge, attitudes, skills and enthusiasm as cessation advocates and supports.

Oral Health of Pregnant Women Attending ANC of Central Hospitals, Vientiane Capital, Lao PDR / Lao Medical Journal

Rational and Background: Pregnant women are more likely to be at risk of oral disease compared to those who are not pregnant. Oral disease during pregnancy affects not only maternal but also child health. Very little is known about the oral health problems among Lao pregnant women. Methodology: In this descriptive, cross-¬sectional study we described the oral health problems and identified factors related to the oral diseases among Lao women with > 12 weeks of pregnancy who visited the two central hospitals (Mother and Child Health and Mahosot) in Vientiane, Laos between January and February 2010. Oral health was checked by a dentist and an interview was conducted with pregnant women using pre¬designed questionnaires. Data were analyzed using STATA 8.0 and logistic regression was applied to determine factors associated with oral diseases. Results: Five hundred pregnant women aged between 15 and 42 years [Mean (SD) = 26.7 (5.0)] were studied. The proportion of oral disease was 64.6% [dental carries (43%), gingivitis (8.4%), and both carries + gingivitis (13.2%)]. Half of the pregnant women (52.8%) had poor oral health care (brush teeth 2,000,000 LAK/month [OR = 1.8, 95%CI = 1.0 ¬3.0, P = 0.04], teeth brushing 2 pregnancies in their lives [OR = 2.6, 95%CI = 6.0 ¬10.0, P 2 deliveries in their lives [OR = 5.4, 95%CI = 1.2 ¬2.1, P < 0.001], and those with history of oral disease before pregnancy [OR = 2.5, 95%CI = 1.7 ¬3.8, P < 0.001]. Conclusion: This study showed that more than half of Lao pregnant women had oral disease and their oral health self¬-care behavior was low. Poor oral health self-¬care behavior, multiple pregnancies and deliveries, and history of oral disease before pregnancy were factors significantly related with oral disease during pregnancy. Health education on oral health self¬-care and oral health check during ante¬natal clinic visits by the pregnant women should be provided and urgently implemented.

Smoking prevalence, determinants, knowledge, attitudes and habits among Buddhist monks in Lao PDR.

BACKGROUND: This cross-sectional study, the first of its kind, uses baseline data on smoking prevalence among Buddhist monks in Northern and Central provinces of Lao PDR. FINDINGS: Between March and September 2006, 390 monks were interviewed, using questionnaires, to assess smoking prevalence including determinants, knowledge and attitudes. Data entry was performed with Epi-Info (version 6.04) and data analysis with SPSS version 11. Descriptive analysis was employed for all independent and dependent variables. Chi-square or Fisher's exact test were used for categorical variables to compare smoking status, knowledge, attitudes and province. Logistic regression was applied to identify determinants of smoking. Daily current smoking was 11.8%. Controlling for confounding variables, age at start of monkhood and the length of religious education were significant determinants of smoking. The majority of the monks 67.9% were in favor of the idea that offerings of cigarettes should be prohibited and that they should refuse the cigarettes offered to them (30.3%) but, in fact, 34.8% of the monks who were current smokers accepted cigarettes from the public. CONCLUSION: Some monks were smokers, whilst they, in fact, should be used as non-smoking role models. There was no anti-smoking policy in temples. This needs to be addressed when setting up smoke-free policies at temples.