A study on preference and practices of women regarding place of delivery.

This was a cross-sectional study in Basra, and involved 353 women who had recently given birth drawn from health care institutions. The main objective was to determine the factors that helped determine the women's choice of place of delivery: hospital or home. Only 16.1% delivered at home, while 83.9% delivered in hospital. The main reasons for choosing hospital delivery were safety and security (96.6% of the women), better hygiene (66.6%) and because of medical advice (63.2%). The main reasons for the choice of home delivery were social support and privacy (98.2%). The women were consistent in their choice of delivery place across different pregnancies (previous, present and future).

A study on preference and practices of women regarding place of delivery

This was a cross-sectional study in Basra, and involved 353 women who had recently given birth drawn from health care institutions. The main objective was to determine the factors that helped determine the women's choice of place of delivery: hospital or home. Only 16.1% delivered at home, while 83.9% delivered in hospital. The main reasons for choosing hospital delivery were safety and security [96.6% of the women], better hygiene [66.6%] and because of medical advice [63.2%]. The main reasons for the choice of home delivery were social support and privacy [98.2%]. The women were consistent in their choice of delivery place across different pregnancies [previous, present and future]

Acute respiratory infections: a study on case management in Basrah health centres.

This paper reports the results of a study carried out in Basrah during 1992 on the pattern of case management as a control measure of acute respiratory infection among children aged under five years. The study involved a detailed observation of cases attending 12 health centres in Basrah city and its suburbs. A total of 392 cases were included. The cases were almost equally distributed according to sex, a fact which may reflect that acute respiratory infections do not discriminate between sexes and that our society pays the same attention for males and females when they fall ill. Regarding severity, most of the cases were mild or moderate, only 5% were severe. The doctors were generally competent to handle cases of acute respiratory infection but they had a tendency to overprescribe antibiotics. They were very good in excluding non-severe cases but they tended to miss some severe cases. The implications of these findings were discussed and it was recommended that further specific studies be carried out.

The determinants of health services utilization in southern Iraq: a household interview survey.

A household survey was conducted in 1982-83 in a sample of 324 households served by five health centres in two different areas of Southern Iraq. Information from each household was collected on socioeconomic factors, access to curative health services, sickness within the previous four weeks and the subsequent use of health services. Thirty seven per cent of people reported some sickness during the four-week recall period, giving an average of 40 episodes per 100 people per four weeks. The average consultation rate was 33 per 100 people and the annual estimated rate was 4.3 consultations per person per year. There was an average of 82 consultations per 100 sickness episodes with the highest rates for infectious and parasitic diseases (111) and hypertension and heart diseases (108), and the lowest for eye and ear diseases (52). The most important factors affecting utilization were level of perceived sickness in the household and the distance to the nearest health centre. Household income did not appear to be an important factor except for attendance at private clinics. The study suggests that the overall rate of utilization is sufficient for curative services but that now it is the quality of this care that needs to be examined.

A measure of community health needs and actions in a rural area of Iraq. The Abu-al-Khasib experience.

A longitudinal enquiry was carried out among randomly selected households in four villages in Abu-al-Khasib district of Iraq, to study health needs as perceived by the community and actions people take when the need arises. Almost three-quarters of the spells of sickness as perceived by the community were among mothers and children. Most of the morbidity was found to be within the scope of preventive services at the local health centre level. Health centre services were underutilised. Only half of the spells of sickness were reported to the local health centres for medical care; a reason for this phenomenon is the emerging preference for care at the hands of clinical specialists. The action the community takes when a health need arises depends on their perception and this is determined by rapid social and educational development. The need to increase demand for normal care, especially that of mother and child, is stressed; this care may be strengthened through introduction of a domiciliary component.

A diagnostic study of pregnancy experiences of married women in Iraq.

A pilot survey was recently undertaken among 301 married women below 50 years of age and having been pregnant at least once. These women lived in a rural environment: the first group in a peri-urban area which is developing rapidly, and the second in a traditional rural area. The survey elicited information on various aspects of the 1,476 pregnancies reported by the women in the sample, including infant mortality, complications in pregnancy, abortions, as well as the number of medical consultations. Data show that mother and child health services, on the whole, are not fully appreciated by mothers, who only visit the clinic when they have a problem. It is evident that health care is equated with curative treatment and that the positive dimensions of prevention and health maintenance are not properly perceived. The fact that in the more conservative areas 98.1% of births take place at home shows the existence of a traditional health system which is not sufficiently taken into account by health planners. In fact, local birth attendants and midwives represent for the health services untapped manpower which, if adequately trained, could help to eliminate the risks currently associated with home births.

PIP: A pilot study was undertaken to gather data on the pregnancy experiences of rural women in Iraq and the extent to which they utilize the available services. The following questions were studied: 1) total number of pregnancies and live births, pregnancy wastage and mortality experience among the live born; 2) complaints and complications as perceived by the mothers during antenatal, natal and postnatal phases with reference to the last pregnancy; and 3) extent of utilization of maternal care services locally available. The study was conducted in 4 villages of the Basrah governorate and 2 villages of the Thiquar governorate in Iraq. The number of persons interviewed reached 178 in the Abu-al-Khasib villages and 123 in Thiquar. Nearly 2/3 of the women interviewed belonged to the age groups 20-34 years, the median age being 29.5 for the Abu-al-Khasib and 29.8 for the Thiquar women. The average parity was 4.7 in Abu-al-Khasib and 4.0 in Thiquar. The pregnancy wastage was higher in Thiquar (98/1000) than in Abu-al-Khasib (89/1000). The rate of pregnancy wastage due to abortion was 80 in Abu-al-Khasib and 67 in Thiquar. The wastage due to stillbirths was 31 in Thiquar and 9 in Abu-al-Khasib. These rates were observed among women of both low and high parity. Infant mortality rates reached 89/1000 live births in Thiquar and 42/1000 live births in Abu-al-Khasib. 10.3% of the children in Thiquar and 5.7% of the children in Abu-al-Khasib die before they reach age 5. Nearly half the women in Abu-al-Khasib reported health problems during pregnancy in contrast to 1/6 of the Thiquar women. Complications during delivery were attributable to prolonged labor, abnormal presentation and bleedings, whereas during the puerperium these were due to infection, bleeding and anemia. More than half of the women in the Abu-al-Khasib sample had availed themselves of medical care during their last pregnancy as compared to a little over 2/5 of the Thiquar sample. In Abu-al-Khasib, 3/5 of the women sought medical care because of complications or complaints during pregnancy and only 1/4 came for routine check-ups. Nearly 93% of the women who used medical care in Thiquar did so for complications and for complaints. The reason for not using medical care was stated as due to "the absence of any disease" by 3/4 of the mothers and to "pressure of work," "distance," and "lack of awareness about the need for such care" by 1/4.

Demographic and health characteristics of a rural Iraqi population.

The population of 2 representative villages in Abu-al-Khasib field practice area of the College of Medicine, Basrah in Southern Iraq was surveyed during 1979 for baseline information relating to demographic and health characteristics. The total population covered was 3399. Women of child bearing age together with children under 15 years of age accounted for 68% of the population. The birth rate was 49 and death rate, 14.5 per 1000. Nearly 10% of the morbidity was evident among women of child bearing age. The enquiry revealed a general awareness concerning the existing health care facilities available in the area. Local health centres were utilised mainly for treatment of childhood illnesses. Only 12% of the mothers used them for care during pregnancy.