Impact of husbands' participation in antenatal health education services on maternal health knowledge.

INTRODUCTION: A randomized controlled trial was designed to test the impact of involving husbands in antenatal health education on women's maternal health knowledge. METHODS: Total 442 women receiving antenatal services at a hospital in Kathmandu, Nepal were randomized into three groups: women who attended education sessions with their husbands, women who attended education sessions alone, and women who attended no education sessions (controls). At baseline and after delivery, women's maternal health knowledge and change in knowledge levels were compared between the groups. RESULTS: Compared to control group women, women educated with husbands increased their knowledge scores by an average of 0.61 points (95% CI=0.32-0.89, P<0.001), while women educated alone increased their scores by only 0.34 points (95% CI=0.04-0.65, P<0.05). Women educated with partners could identify more pregnancy complications and family planning methods than women in both other groups. CONCLUSIONS: These findings suggest that women learn and retain the most information when they are educated with their partners.

"Brought Dead" - cases of maternal mortality.

Seven cases that were brought dead on the way to the hospital in 2057 BS (2000-2001 AD) have been presented in this study. Among seven, two cases were young primiparas, one was a grand multipara and four were between ages 20-25 years. Of these, one had post abortion complications, two were complicated by non-delivery and four had third stage complications. The information that the patient was dead on arrival to the hospital was received by the attendants in all cases with shock and disbelief so that it was very difficult to take proper history. An important point noted by this study was that only four maternal deaths occurred in the hospital and were recorded in the hospital statistics in that year, so that the number of deaths that occurred in transit to the hospital and were technically excluded from the hospital statistics exceeded the number of maternal deaths recorded in the hospital statistics. Another interesting point was that none of the seven women who expired on the way to the hospital were living at a distance greater than 15 Km from the hospital and yet had not attended antenatal clinic, implying that inadequate use of health services even in areas with relatively easy access to proper heath care is a major contributor to maternal death.

Maternal morbidity among women admitted for delivery at a public hospital in Kathmandu.

PIP: A needs assessment of 274 women admitted for delivery to the Maternity Hospital in Kathmandu, Nepal, in a 1-week period in 1994 revealed an alarming incidence (94.1%) of maternal morbidity during pregnancy and delivery. 90.9% of women were under 30 years of age and 47.2% were primiparous; 75.5% were urban residents and 49.6% had no formal education. 89.4% of women reported at least one problem during pregnancy and, of these, 82.0% experienced multiple morbidities. These illnesses included dizziness (60.9%), excessive vomiting (56.2%), swelling of the hands and feet (36.9%), fever exceeding 3 days' duration (26.3%), blurred vision (24.1%), and urinary problems (19.7%). 62.0% of women sought medical care, primarily from a government hospital, for at least 1 pregnancy-related illness. Delivery-related problems included labor exceeding 18 hours (17.6%), heavy bleeding (25.2%), and fainting (10.9%). Among the 136 women who had at least 1 delivery prior to the index pregnancy, 16.9% experienced urinary canal damage or infection, 38.2% had uterine pain, and 33.1% reported breast pain. Although most of the problems recorded in this study were not life-threatening, it is reasonable to assume that so large a morbidity burden affected the pregnant women's productivity and the well-being of their families. A larger, more comprehensive study of the nature and magnitude of maternal morbidity in Nepal is planned.^ieng