Utilization of Partograph and its associated factors among midwives working in public health institutions, Addis Ababa City Administration,Ethiopia,2017.

BACKGROUND: Partograph is cost effective and affordable tool designed to provide a continuous pictorial overview and labour progress used to prevent prolonged and obstructed labour. It consists of key information about progress of labour, fetal condition and maternal condition. Its role is to improve outcomes and predict the progress of labour. The aim of this study was to assess utilization of partograph and its predictors among midwives working in public health facilities, Addis Ababa city administration, Ethiopia, 2017. METHODS: An institution based cross-sectional study design was conducted in Addis Ababa, Ethiopia from 15/10/2017-15/12/2017.Simple random sampling under multistage sampling technique was applied to select a total of 605 midwives working in maternity unit of selected public health facilities. Data were collected using structured self-administered questionnaire. Checklist based direct observations were made to all midwife participants to determine the actual practical use of partograph. Data first entered in to EpiInfo version 3.5.1 and transported to SPSS Version 21.Descriptive statistics such as frequency, percentage, mean, and median were calculated. Biviriate and multivariable logistic regression analysis were applied. Any personal identification of the study participants was not recorded during data collection to ensure confidentiality of information. RESULTS: In this study, the utilization of partograph was 409(69%) out of 594 study participants. Being mentored(AOR = 3.1; 95% CI: 1.7, 5.3),received training (AOR = 2.4; 95% CI:1.5,3.6),being knowledgeable about partograph (AOR = 1.6; 95% CI: 1.1, 2.5), health center workers(AOR = 12.6; 95% CI:5.1,31.6),supportive supervision 4 times per year (AOR = 18.6; 95% CI: 6.6,25),supportive supervision twice per a year (AOR = 4.7; 95% CI: 1.9, 11.3),supportive supervision once per year (AOR =3.8;95% CI:1.7,8.8) were positive predictors of partograph utilization. Two midwives per shift (AOR = 0.101; 95% CI: 0.05, 0.65), and 4 per shift (AOR = 0.105, 95% CI: 0.03, 0.40) were protective predictors of partograph utilization. CONCLUSIONS: More than half of the respondents utilized partograph. All public health institutions avail partograph in their laboring room but didn't utilize it according to WHO recommended standard. Working facility, supportive supervision, mentoring, training on partograph, number of midwives working per shift, and knowledge were factors affecting partograph utilization. Encouraging interventions are recommended to the response of the above significantly associated factors.

Experiencias en la atención ginecológica de trabajadoras sexuales migrantes atendidas en UNACESS, Santiago de Chile, 2017 / Experiences on gynecological care of migrant sex workers, who received medical attention in UNACESS, Santiago de Chile, 2017

Objetivo: Explorar las experiencias respecto a la asistencia ginecológica de mujeres migrantes que ejercen el comercio sexual y que son atendidas en la Unidad de Atención y Control en Salud Sexual (UNACESS) del Área Norte de Santiago de Chile, correspondiente al Hospital San José, perteneciente al sistema de salud público, durante el año 2017. Métodos: Estudio cualitativo exploratorio. Se realizaron entrevistas semiestructuradas a 12 mujeres migrantes, de entre 25 y 44 años, que ejercen el comercio sexual y que reciben atención ginecológica en un centro de atención sanitaria en Santiago de Chile. Se utilizó un muestreo no probabilístico por conveniencia. Se llevó a cabo un análisis narrativo de contenido de los datos obtenidos. No se utilizó software para el análisis. Resultados: En el análisis de las entrevistas se desarrollan cuatro categorías: I) percepción del concepto de salud; II) factores culturales que intervienen en la atención ginecológica; III) experiencia en la atención ginecológica, y IV) elementos de la atención ginecológica. La experiencia de la atención ginecológica que tienen estas mujeres es calificada por ellas mismas como óptima, ya que logra satisfacer la mayoría de sus necesidades y expectativas. Las principales dificultades referidas son la escasez de tiempo y de horas en la agenda profesional disponible para la atención. Conclusiones: La calidad de la atención de esta población es considerada como satisfactoria, determinando una buena experiencia en salud sexual. Los problemas referidos por las usuarias son atribuibles a cuestiones administrativas que no guardan una relación directa con el control ginecológico

Objective: Exploring the experiences of gynecological care of women engaged in sex trade who got medical attention in UNACESS (Sexual Health Care and Control Unit) located in the northern area of San José Hospital during 2017. Methods: Qualitative exploratory study. The study included in-depth interviews with 12 sexually engaged migrant women between 25 and 44 years old who were receiving attention in the area of gynecological care of UNACESS. Method of opinion sampling of convenience, with semi-structured in-depth interviews, and a narrative content analysis of the data obtained. Without using analysis software. Results: The study focused in four elements to analyze the interviews: I) the perception of the concept of health; II) cultural factors influencing the gynecological attention; III) the experiences in gynecological attention; IV) elements of gynecological attention. The results showed that the migrant women's experiences in gynecological care are considered optimal, since most of their needs and expectations were met. The main difficulties found were the limited time available for their gynecological attentions and the insufficiency of attention schedules. Conclusions: The health care of the analyzed population was considered satisfactory, illustrated in their good experiences regarding sexual health. The problems reported by the users were manly attributed to administrative issues, that are not directly related to gynecological control

Tendo que se submeter ao exame Papanicolau regularmente: uma análise sob a ótica da desmedicalização / aving got to undergo the Pap Smear regularly: an analysis of the demedicalization perspective

Este estudo tem como objeto os significados atribuídos ao exame Papanicolau por mulheres a partir do processo de interação social. Atualmente, a estratégia mais eficaz no controle do câncer de colo de útero é o rastreamento pelo exame Papanicolau. Contudo, acredita-se que a percepção que as mulheres têm acerca deste tipo de exame, bem como os significados que são atribuídos a ele, influencia na realização do mesmo. Os objetivos deste estudo são: identificar os significados do exame Papanicolau para mulheres e analisar o processo de interação social dessas mulheres com o exame, no contexto do câncer do colo do útero, a partir dos significados por elas atribuídos. Trata-se de pesquisa descritiva e explicativa com abordagem qualitativa. A pesquisa foi realizada em locais públicos de grande circulação de pessoas, situados no município do Rio de Janeiro, devido àgrande diversidade de mulheres nesses locais. Contou com a participação de 10 mulheres que transitavam nesses locais, entre 25 a 64 anos e que já tinham iniciado a vida sexual, divididas em 2 grupos amostrais.Foram realizadas entrevistas com roteiro semiestruturado e os dados foram analisados segundo os pressupostos do interacionismo simbólico e da Grounded Theory. Projeto aprovado pelo CEP/UERJ 1.660.721. Os dados foram organizados em duas categorias que explicam o processo de interação social da mulher com o exame preventivo: "Reproduzindo o discurso de que o exame é importante para prevenção" e "Apesar das dificuldades, tendo que se submeter ao exame Papanicolau regularmente". Na primeira categoria, os dados mostram que as mulheres percebem o exame como uma forma de prevenir doenças em geral com a ideia de receio de agravo. Consideram o exame importante para diagnóstico precoce e prevenção de agravos e sustentam a importância da prevenção na perspectiva do diagnóstico para tratamento por convencimento. Na segunda categoria, as mulheres relatam os motivos que funcionam como barreiras para a realização do exame, tais como: vergonha e desconforto, falta de acesso, falta de sintomas e o impeditivo do trabalho, contudo, apesar disso, relatam realizar o exame regularmente. Emergiu no trabalho uma categoria central: "tendo que se submeter ao exame Papanicolau regularmente", em que fica evidenciado que, apesar de todas as dificuldades, a mulher realiza o exame de Papanicolau para prevenção. Desta forma, conclui-se que, mesmo que não seja de forma regular como preconizado pelos protocolos, a mulher se submete ao exame Papanicolau para prevenção de doenças. Ficou evidente, pelos dados, que é necessário promover atividades que vão além de orientações e informações sobre o câncer do colo do útero e a importância deste exame. É importante criar estratégias de promoção da saúde para estimular a autonomia das mulheres e o empoderamento do próprio corpo, para, assim, propiciar maior cobertura do exame através da adesão regular das mulheres.

This study has as its object the meanings attributed to the Pap smear by women from the process of social interaction. Currently, the most effective strategy in the control of cervical cancer is screening by the Pap smear. However, it is believed that the perception that women have about this type of examination, as well as the meanings that are attributed to it, influences itsexecution. The objectives of this study are: to identify the meanings of the Pap smear for women and to analyze the social interaction process of these women with the examination, in the context of cervical cancer, based on the meanings they assign. It is a descriptive and explanatory research with a qualitative approach. The research was carried out in public places of great circulation of people, located in the city of Rio de Janeiro, due to the great diversity of women around these places. It had the participation of 10 women who transited in these places, between 25 to 64 years and that had already begun their sexual life, separated in a 2 groups sample. Semi-structuredinterviews were conducted and the data were analyzed according to the assumptions of Symbolic Interactionism and Grounded Theory. Project was approved by CEP/UERJ 1.660.721. The data wereorganized in two categories that explain the process of social interaction of women with the Paptest: "Reproducing the discourse thatexamination is important for prevention" and "Despite the difficulties, having got to undergo the Pap smear regularly". In the first category, data showedthat women perceive the test as a way to prevent diseases in general with an idea of fear of any disorders. They consider the exam important for early diagnosis and prevention of diseases and they support the importance of prevention from the perspective of diagnosis for a treatment by professional convincing. In the second category, women reportedreasons that act as barriers to the examination, such as: embarrassment and discomfort, lack of access, lack of symptoms, and theirwork as a hampering; however, they report taking the exam regularly. A central category emerged at work: "having to undergo Pap smear regularly", which showed that despite all the difficulties women perform the Pap smear for prevention. Thus, it is concluded that, even if it is not in a regular way as recommended by the protocols, women undergo Pap smear for disease prevention. Data show that it is necessary to promote activities that would go beyond guidance, giving information about cervical cancer and the importance of this examination. It is important to create health promotion strategies to stimulate women's autonomy and body empowerment, so as to provide greater coverage of the examination through the regular adherence of women.

Prevalencia del Streptococcus agalactiae en la mujer embarazada en la ciudad autónoma de Melilla. ¿Es la cultura un factor determinante? / Prevalence of the Streptococus agalactiae in the pregnant woman from the autonomic city of Melilla: is culture a determinant factor?

Contexto. La infección neonatal por estreptococo grupo B es una de las principales causas de morbimortalidad neonatal. Por ello se realiza un cribado a todas las gestantes para detectar su presencia y, en tal caso, administrar un tratamiento antibiótico durante el trabajo de parto. El objetivo del estudio fue conocer la prevalencia de estreptococo en las gestantes de Melilla, así como sus diferencias en función de la cultura y la edad. Método. Estudio descriptivo trasversal con emplazamiento en el Hospital Comarcal de Melilla. Resultados. La muestra tomada está formada por 280 individuos; 194 son de cultura musulmana (69.3 %) y 68 son de cultura cristiana (24.3 %), con 18 individuos de cultura desconocida (6.4 %). Asimismo, se sabe que 78 tienen una edad menor o igual a 25 años (27.85 %), 158 individuos tienen una edad comprendida entre los 26 y 34 años (56.42 %) y 44 individuos tienen una edad igual o mayor a 35 años (15.71 %). Conclusiones. La prevalencia de colonización vagino-rectal por estreptococo grupo B en las gestantes de Melilla está dentro de las cifras estimadas a nivel nacional. Sin embargo, es diferente en función de si pertenecen a la cultura musulmana o cristiana, siendo mayor en la población musulmana. Ambas prevalencias se encuentran dentro de las estadísticas nacionales. Por otro lado, se observa que no existen diferencias en la prevalencia en función de la franja etárea (AU)

Background. The neonatal infection by Streptococcus group B is one of the main causes of neonatal morbi-mortality rate. For this reason a screening is made to each pregnant woman in order to detect its presence, and if it was the case, to apply an antibiotic treatment during labour. The aim of this study was to know the prevalence of this Streptococcus in the pregnant women from Melilla, as well as the differences according to culture and age. Method. A descriptive cross-sectional study located in the Hospital Comarcal from Melilla. Results. The sample is taken from 280 women: 194 are from Muslim culture (69.3 %), 68 are from Christian culture (24.3 %) and 18 women from unknown cultures (6.4 %). Also it is known that 78 of them are 25 years old or less (27.85 %), 158 are between 26 and 34 years old (56.42 %) and 44 are 35 years old or more (15.71 %). Conclusions. The prevalence of vagino-rectal colonization by Streptococcus group B in the pregnant women from Melilla is within the national estimated figures, however it is different if they are from Muslim or Christian culture, being higher in the Muslim population. On one hand both prevalences are within the national statistics, and on the other hand it is observed that there is not any difference according to age (AU)