Search results for: maternal roles

Authors: M. Illias Kanchan

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The death of a woman during pregnancy and childbirth is not only a health issue, but also a matter of social injustice. This study makes an attempt to explore the association between maternal death and associated factors in West Bengal using the approaches of facility-based and community-based maternal death review. Bivariate and binary logistic regression analysis have been performed to understand the causes and circumstances of maternal deaths in West Bengal. Delay in seeking care was the major contributor in maternal deaths, near about one-third women died due to this factor. The most common cause of maternal death is found to be hypertensive disorders of pregnancy or eclampsia. We believe that these deaths can be averted by reducing hypertensive disorders of pregnancy or eclampsia.

Keywords: maternal death, facility-based, community-based, review, west Bengal, eclampsia

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Authors: Anushree S. Panikkassery

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The paper analyses the pattern and trend of maternal health care in south Indian states. It studies the interstate disparities in terms of maternal health care. It also compares the trends in terms of achieving the target of sustainable development Goal is related to maternal health. The maternal health care (MHC) development is one of the key indicators for the development of health sector in the country and assumes significance from the socioeconomic and developmental perspectives. Maternal health care mainly consists of composite care during pregnancy, child birth as well as postpartum period. Antenatal care, identification, referral and management of high risk pregnancies, safe and healthy child birth and early postnatal care are some of the important issues pertaining to maternal health. Data is collected from national family health survey 1992-93, 1998-99, 2005-06, and 2015-16. A concentration index is used to study the disparities in equity of maternal health among south Indian states. The study shows that there has been an improvement in maternal health care in south Indian states with Kerala topping among the states. But there exist disparities among the south Indian states.

Keywords: antenatal care, disparities, equity, maternal health

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Authors: Tracey Estriplet-Adams

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This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

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Authors: Franziska Köhler-Dauner, Inka Mayer, Lara Hart, Ute Ziegenhain, Jörg M. Fegert

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Preventive isolation and social distancing strategies during the SARS-CoV-2 pandemic have confronted families with a variety of different restrictions and stresses. Especially during this stressful time, children need a stable parental home to avoid developmental disorders. Additional risk factors such as maternal childhood abuse and neglect (CM) experiences may influence mothers' psychosomatic health (pG) and children's physical well-being (kW) during times of increased stress. Our aim was to analyse the interaction between maternal CM, maternal pG and children's kW during the pandemic. Mothers from a well-documented birth cohort to study transgenerational transmission of CM, were included in an online 'pandemic' survey assessing maternal pG and children's physical health during the pandemic. Our mediation analysis showed a significant positive association between the extent of maternal CM experiences, mothers' psychosomatic symptoms and their children's kW. Maternal psychosomatic symptoms significantly mediate the interaction between CM and children's kW; the direct effect remains non-significant when maternal psychosomatic symptoms are included as mediators. Maternal CM appears to be a relevant risk factor for maternal pG and children's kW during the pandemic. Maternal CM experiences seem to influence the way parents cope with stressful situations and increase the risk of suffering from depressive symptoms. The latter also affect their children's kW. Our findings underline the importance of carefully assessing the specific situation of families with children and offering individually adapted help to help families survive the pandemic.

Keywords: pandemic, maternal health, child health, abuse, neglect, maternal experiences

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Authors: Maria Reichenber Arcilla

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Objective: To determine the risk factors for maternal and neonatal complications associated with operative vaginal deliveries. Methods: A retrospective chart review of 435 patients who underwent operative vaginal deliveries was done. Patient profiles – age, parity, AOG, duration of labor – and outcomes – birthweight, maternal and neonatal complications - were tabulated and multivariable analysis and logistic regression were performed using SPSS® Statistics Base. Results and Conclusion: There was no significant difference in the incidence of maternal and neonatal complications between those that underwent vacuum and forceps extraction. Among the variables analysed, parity and duration of labor reached statistical significance. The odds of maternal complications were 3 times higher among nulliparous patients. Neonatal complications were seen in those whose labor lasted more than 9 hours.

Keywords: operative vaginal deliveries, maternal, neonatal, morbidity

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Authors: Okwan Frank

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Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: economic growth, maternal mortality, pool mean group, Sub-Saharan Africa

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Authors: Osvaldo Collazo, Cristiano Valerio Dos Santos

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Early maternal separation has been shown to bring about many negative effects on behavior in rats. In the present study, we evaluated the effects of early maternal separation on risky choice in rats. One group of male and female Wistar rats was exposed to an early maternal separation protocol while a control group was left undisturbed. Then both groups were exposed to a series of behavioral tests, including a test of risky choice, where one alternative offered a constant reward while the other offered a variable reward. There was a difference between groups when they chose between a variable and a constant reward delay, but no other difference was significant. These results suggest that early maternal separation may be related to a greater preference for shorter delays, which is characteristic of more impulsive choices.

Keywords: early maternal separation, impulsivity, risky choice, variability

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Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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Authors: Maryam Ghavam Sadri, Kimia Moiniafshari

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Objectives: Autism is a neuro-developmental disorder that has negative effects on verbal, mental and behavioral development. Studies have shown the role of a maternal dietary pattern before and during pregnancy. The relation of exerting of nutritional management programs in prevention of Autism has been approved. This review article has been made to investigate the role of nutritional management strategies before and during pregnancy in the prevention of Autism. Methods: This review study was accomplished by using the keywords related to the topic, 67 articles were found (2000-2015) and finally 20 article with criteria such as including maternal lifestyle, nutritional deficiencies and Autism prevention were selected. Results: Maternal dietary pattern and health before and during pregnancy have important roles in the incidence of Autism. Studies have suggested that high dietary fat intake and obesity can increase the risk of Autism in offspring. Maternal metabolic condition specially gestational diabetes (GDM) (p-value < 0.04) and folate deficiency (p-value = 0.04) is associated with risk of Autism. Studies have shown that folate intake in mothers with autistic children is less than mothers who have typically developing children (TYP) (p-value<0.01). As folate is an essential micronutrient for fetus mental development, consumption of average 600 mcg/day especially in P1 phase of pregnancy results in significant reduction in incidence of Autism (OR:1.53, 95%CI=0.42-0.92, p-value = 0.02). furthermore, essential fatty acid deficiency especially omega-3 fatty acid increases the rate of Autism and consumption of supplements and food sources of omega-3 can decrease the risk of Autism up to 34% (RR=1.53, 95%CI=1-2.32). Conclusion: regards to nutritional deficiency and maternal metabolic condition before and during pregnancy in prevalence of Autism, carrying out the appropriate nutritional strategies such as well-timed folate supplementation before pregnancy and healthy lifestyle adherence for prevention of metabolic syndrome (GDM) seems to help Autism prevention.

Keywords: autism, autism prevention, dietary inadequacy, maternal lifestyle

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Klea Ramaj

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Objectives: There have recently been increasing calls to better understand the intergenerational transmission of adverse childhood experiences (ACEs). In particular, little is known about the links between maternal (ACEs), maternal stress, maternal depression, and child abuse against toddlers in countries in South-East Europe. This paper, therefore, aims to present new descriptive data on the epidemiology of maternal mental well-being and maternal ACEs in the capital of Albania, Tirana. It also aims to advance our understanding of the overlap between maternal stress, maternal depression, maternal exposure to ACEs, and child abuse toward two-to-three-year-old. Methods: This is a cross-sectional study conducted with a representative sample of 328 mothers of two-to-three-year-olds, recruited through public nurseries located in 8 diverse socio-economic and geographical areas in Tirana, Albania. Maternal stress was measured through the perceived stress scale (α = 0.78); maternal depression was measured via the patient health questionnaire (α = 0.77); maternal exposure to ACEs was captured via the ACEs international questionnaire (α = 0.77); and child maltreatment was captured via ISPCAN ICAST-P (α = 0.66). The main outcome examined here will be child maltreatment. The paper will first present estimates of maternal stress, depression, and child maltreatment by demographic groups. It will then use multiple regression to examine associations between child maltreatment and risk factors in the domains of maternal stress, maternal depression, and maternal ACEs. Results: Mothers' mean age was 32.3 (SD = 4.24), 87.5% were married, 51% had one child, and 83.5% had completed higher education. Analyses show high levels of stress and exposure to childhood adversity among mothers in Tirana. 97.5% of mothers perceived stress during the last month, and 89% had experienced at least one childhood adversity as measured by the ACE questionnaire, with 20.2% having experienced 4+ ACEs. Analyses show significant positive associations between maternal ACEs and maternal stress r(325) = 0.25, p = 0.00. Mothers with a high number of ACEs were more likely to abuse their children r(327) = .43, p = 0.00. 32% of mothers have used physical discipline with their 2–3-year-old, 84% have used psychological discipline, and 35% have neglected their toddler at least once or twice. The mothers’ depression levels were also positively and significantly associated with child maltreatment r(327) = .34, p = 0.00. Conclusions: This study provides cross-sectional data on the link between maternal exposure to early adversity, maternal mental well-being, and child maltreatment within the context of Tirana, Albania. The results highlight the importance of establishing policies that encourage maternal support, positive parenting, and family well-being in order to help break the cycle of transgenerational violence.

Keywords: child maltreatment, maternal mental well-being, intergenerational abuse, Tirana, Albania

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Authors: Herlena Hayati, Diyan Reni Jayathi, Hairida Anggun, Citra Amelia

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This systematic review research is aimed to find out anemia maternal during pregnancy as a risk factor of low birth weight. This research was done by searching some journals which have associated to maternal anemia during pregnancy with low birth weight that had been published in journal accreditation and scopus index. Study literature that researcher had been done by March – April 2016 through online library of UI. The journals that had been selected according to inclusive criteria and exclusive criteria had been through the critial appraisal process. This systematic review towards 4 journals that had been selected and published showed the significant result statistically that anemia maternal is one of the risk factors which causes low birth weight. Anemia maternal on the first-trimester pregnancy showed significant association with low birth weight. Moderate anemia and severe anemia also showed significant association with low birth weight. Meanwhile, mild anemia doesn’t have an association with low birth weight. The conclusion of this study is anemia maternal (as an independent risk factor) have an influence towards low birth weight.

Keywords: anemia maternal, low birth weight, pregnancy, systematic review

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Authors: Ahmed Mudi, Bala Zakar

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The paper assesses the impact of safe motherhood initiative on maternal health of women in Gumel Local Government Area of Jigawa State. The work will specifically concentrate on the background on safe motherhood scheme and maternal health of women. The objective of this paper is to assess the level of safe motherhood scheme in Gumel local government area, to find out the level of maternal health in Gumel local government as well as to determine the impact of safe motherhood scheme on maternal health on women in Gumel Local Government Area Jigawa State. Various literature on the topic are reviewed, the paper adopts survey design and use questionnaire to collect data from the respondent. The study comprises 350 women selected from six rural communities in Gumel using random sampling techniques, and the data was analysed by simple frequency and percentage. The research concluded that safe motherhood initiative has a significant impact on the maternal health of women in Gumel Local Government Area of Jigawa State. Finally, suitable recommendations were given on how to improve the scheme to ensure better maternal health in the region.

Keywords: action, assessment, maternal health, safe motherhood, surgery

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Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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Authors: D. Triana, I. N. Rachmawati, L. Sabri

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Maternal breastfeeding self-efficacy is positively associated with increased duration of breastfeeding in different cultures and age groups. This study aims to determine the effect of skin-to-skin contact immediately after the cesarean section on maternal breastfeeding self-efficacy. The research design is Posttest quasi-experimental research design only with control groups involving 52 women with consecutive sampling in Langsa-Aceh. The data collected through breastfeeding Self-Efficacy Scale-Short Form. The results of Independent t-test showed a significant difference in the mean values of maternal breastfeeding self-efficacy in the intervention group and the control group (59.00 ± 6.54; 49.62 ± 7.78; p= 0.001). Skin to skin contact is proven to affect the maternal breastfeeding self-efficacy after cesarean section significantly.

Keywords: breastfeeding self-efficacy, cesarean section, skin to skin contact, immediately

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Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando

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Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.

Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges

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Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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Authors: Divyanshi Singh

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Women’s right to have choices, sense of self-worth and their right to have access to opportunities have been a subject of serious concern. The health of women and their children in Indian society is adversely affected by the woman’s inferior status within households. The level of human development in society is a reflection of the better status of a woman, which has a clear impact on the usage of contraceptive methods and maternal health. The study is an attempt to assess the performance of Indian states on the parameters of levels of development and to see how the developmental trajectory is influencing the choice for contraception and maternal health. The objective of the paper is to study the relationship between usage of contraception, maternal health and levels of human development in Indian states. Data from NFHS-4th round, AHS (2012-13) and census 2011 is used. Three indicators of human development (effective literacy, infant mortality and gross district domestic product) have been taken. Maternal health for the study has been measured in MMR, IMR and pregnancy resulted in abortions, stillbirths and miscarriage. The multiple regression analysis has been done to analyze the relationship between them. The Developmental factor is found to be greatly influencing the choice of family planning and thus they both show strong relation with maternal health.

Keywords: human development, contraceptive usage, maternal health, effective literacy

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Arin Salamah Qudsi

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Female piety and the roles that female mystics played in Muslim landscapes of the period between the ninth and thirteenth centuries are topics that attracted many scholarly endeavors. However, personal aspects of both male and female Sufis were not thoroughly investigated. It would be of a great significance to examine the different roles of Sufi women as spouses, household supporters, and, mothers based on Sufi and non Sufi sources. Sisters and mothers, rather than wives and daughters, are viewed in anthropological studies of different cultures as women who could enjoy a high social status and thus play influential roles. Sufi hagiographies, which are our main sources, have long been regarded in a negative light, and their value for our understanding of the early history of Sufism is held in doubt. More recently, however, a new scholarly voice has begun to reclaim the historical value of hagiographies. We need to approach the narrative structures and styles of the anecdotal segments, which are the building blocks of the hagiographical body of writing. The image of a particular Sufi figure as portrayed by his near-contemporaries can provide a more useful means to sketch the components of his unique piety than his real life. However, in certain cases, whenever singular and unique appearances of particular stories occur, certain historical and individual conclusions could be sought. As for women in Sufi hagiographies, we know about sisters who acted as a solid support for their renowned Sufi brothers. Some of those sisters preferred not to be married until a late age in order to "serve" their brothers, while others supported their brothers while pursuing their own spiritual careers. Data of this type should be carefully considered and its historical context should be thoroughly investigated. The reference here is to women, mostly married women, who offered to maintain their brothers or male relatives despite social norms or generic prohibitions, which undoubtedly gave them strong authority over them. As for mothers, we should differentiate between mothers who were Sufis themselves, and those who were the mothers of Sufi figures. It seems most likely that in both types, mothers were not always unquestionably the effective lightening trigger. Mothers of certain Sufi figures denied their sons free mobility, taking advantage of the highly esteemed principle of gratifying the wishes of one's mother and the seminal ideal of ḥaqq al-wālida (lit. mother's right). Drawing on the anecdotes provided by a few sources leads to the suggestion that many Sufis actually strove to reduce their mothers' authority in order to establish their independent careers. In light of women's authority over their brothers and sons in Sufi spheres, maternal uncles could enjoy a crucial position of influence over their nephews. The roles of Sufi mothers and of Sufi maternal uncles in the lives of early Sufi figures are topics that have not yet been dealt with in modern scholarship on classical Sufism.

Keywords: female Sufis, hagiographies, maternal uncles, mother's right

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Thi V. S. Nguyen, Kevin Laws

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This study investigates the construction of higher education teachers’ roles from the perspectives of participants in a compulsory teachers’ professional development for Vietnamese higher education teachers. Constructivist grounded theory was used as methodology and analysis of the study. Fifteen program participants were semi-structured interviewed before they started the professional development program for higher education teachers. Five trainers of the program were interviewed and documents related to teachers’ standards in Vietnam were analysed to supplement participants’ perspectives. Standards and roles of higher education teachers emerged as two categories grounded from data. Standard category involves moral and professional criteria, whereas roles of higher education teachers category consists of specific roles related to guiding student learning, and advising their academic, moral and social activities. A model of higher education teachers’ conceptions of their roles in a Vietnamese context addressing both professional (techne) and moral (praxis) responsibilities is constructed from this study. A discussion on teachers’ roles in higher education is put forward and insightful implications for the design and possible restructure of teachers’ professional development for early career higher education teachers is suggested.

Keywords: higher education teachers' roles and standards, moral roles, teachers' professional development, teachers' conceptions of their roles

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Authors: Abayomi Olatoke Adejobi

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The study investigated maternal deprivation as predictor of academic performance and psychosocial adjustment of primary school pupils in Abeokuta metropolis. Three null hypotheses were formulated to guide the study. Two hundred public primary school pupils were randomly selected as subjects for the study. The instruments used for data collection were Index of Family Relations (IFR) by Hudson, modified version of Psychosocial Adjustment Scale (PAS) by O’ bailey and Academic records of the pupils from Cumulative Records Folder (CRF). The data collected were statistically treated and the three hypotheses were tested using t-test and Pearson Product Moment Correlation Confident statistical methods at 0.05 alpha level. The results of the analysis showed that there is a significant difference in the academic performance of children who suffered maternal deprivation and those who did not (t – 5.61; df = 198; P < 0.05). Also, there was a significant relationship between psychosocial adjustment of children and maternal deprivation (r = 0.37, df = 10; P < 0.05), while there was no significant difference in academic performance of boys and girls who suffered maternal deprivation (t = 0.32; df = 109; P > 0.05). Based on the results some recommendations were made.

Keywords: maternal deprivation, psychosocial adjustment, academic performance, primary school pupils

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Özge Selin Çevik, Leyla Şahin, Gülhan Örekeci Temel

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The early postnatal period is critical for the development of cognitive and emotional functions. Maternal separation is a detrimental postnatal influence, whereas environmental enrichment is a therapeutic and protective agent. It is unclear if long-term environmental enrichment can compensate for the effects of maternal separation stress on anxiety behavior. This study was designed to examine how environmental enrichment affects anxiety levels and corticosterone levels in maternally separated rats. There are six main groups in this study: control (C), maternal separation+standard cage (MS), maternal separation+enriched environment (MSE), enriched environment (E), the maternal separation that decapitated at postnatal (PN) 21 (MS21), and standard cage that decapitated at PN21 (STD21). The maternal separation procedure consisted of PN for 21 days (between 09:00 a.m and 12:00 a.m). Enriched (E, MSE) or standard cage environment rats (MS, C) spent PN (22-55) days in either enriched cages or standard cages. Anxiety and locomotor activity were examined with the open field and elevated plus-maze test. Blood corticosterone level was evaluated by the enzyme-linked immunosorbent assay (ELISA) method. Results showed that maternal separation (MS) increased locomotor activity and anxiety. An enriched environment (E) did not change the locomotor activity. MSE group’s anxiety and locomotor activity did not change. Corticosterone levels increased in the maternal separation group that decapitated at the PN 21 days. Maternal separation increases anxiety. Environmental enrichment alone was insufficient to cause alterations in the anxiety level. In addition, environmental enrichment did not ameliorate the anxiety level in maternally separated rats. However, environmental enrichment decreased the locomotor activity in the maternally separated rats.

Keywords: maternal separation, environment enrichment, stress, hippocampus, anxiety, memory, rat

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Authors: Rochelle Alviz, Kirk Johnson

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This study explores the changing nature of gender roles in two traditional island societies. The research focuses particularly on the settler populations within each community (the Filipinos in Guam and the Javanese in Bali). The research seeks to understand the influence of both the forces of globalization and the dynamics of competing cultures on gender roles. To achieve this, a qualitative research design is used, employing in-depth interviews with individuals from both communities and field notes from participant observation. The study finds that globalization and competing cultural norms have influenced traditional gender roles and expectations in two primary areas of social life: the family and the economy. The importance of these two areas of social life to both communities has led to changes and adaptations in gender roles. In the family context, individuals reconcile their traditional gender roles from their country of origin with the dominant or indigenous gender roles of their new place of residence. In the economic context, the study finds that gender roles influence economic participation, including the types of jobs individuals pursue based on their gender roles. The results of the study provide valuable insights into the complexities and nuances of gender roles and the different factors that influence their evolution and adaptation over time. The research also highlights the influence of globalization on traditional societies and settler populations and the ways in which individuals navigate the competing cultural norms and expectations surrounding gender roles. The research contributes to a better understanding of the interplay between culture, globalization, and gender roles and the implications of these changes for individuals and communities.

Keywords: gender roles, culture, settler communities, family, economy, Guam, Bali, globalization

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Authors: Tariqul Islam, Shaheen Mollah

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The study's main objective is to assess the relationship between psychological adjustment and parental acceptance-rejection, teacher acceptance-rejection, and best friend acceptance-rejection among secondary school students. This study was conducted on a sample of 300 (6th through 10th-grade students) recruited from over ten schools in Dhaka. While the schools were selected purposively, the respondents within each school were selected conveniently. The collected data were analyzed using Pearson product-moment correlation, hierarchical regression, and simultaneous regression analysis. The results showed that psychological adjustment is positively correlated with paternal, maternal, teacher, and best friend acceptance. The paternal acceptance was significantly connected with maternal acceptance. The teacher and best friend acceptance are correlated substantially with paternal and maternal acceptance. The hierarchical multiple regressions indicated that maternal, paternal, teacher, and best friend acceptance-rejection contributed significantly to students' psychological adjustment. The results revealed substantial independent contributions of maternal, paternal, teacher, and best friend acceptance on the students' psychological adjustment. The simultaneous regression analysis indicates that the maternal and best friend acceptances (but not paternal acceptance) were significant predictors of psychological adjustments. It showed that 41.7% variability in psychological adjustment could be explained by paternal, maternal, and best friend acceptance. The findings of the present study are exciting. They may contribute to developing insight in parents and best friends for behaving properly with their offspring and friend, respectively, for better psychological adjustment.

Keywords: adjustment, parenting, rejection, acceptance

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Authors: Jennifer A. Barrowclough, Caroline A. Crowther, Bridget Kool

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Fetal malposition in labour is associated with adverse maternal and infant health outcomes. Evidence for effective interventions for fetal malposition is inconclusive. The feasibility and design of a randomized controlled trial (RCT) of maternal posture to improve maternal and infant outcomes of malposition should be considered, based on the hypothesis that gravity corrects malposition. The aim was to assess pregnant women’s views on the acceptability of a future trial of maternal posture for fetal malposition in labour, and the enablers and barriers of participation. Method: An online anonymous survey of pregnant women was conducted in Auckland during 2020. Descriptive summaries of quantitative data used chi-square to assess differences in proportions. The influence of maternal characteristics on women’s responses was assessed using cross-tabulation. Free text responses were analysed thematically. Results: Respondents (n=206) were mostly aged26-35 years (75%), of 29-38 weeks gestation (71%), of European (40%) or Asian (36%) ethnicity, were evenly nulliparous or multiparous. Most women (76%) had heard of fetal malposition in labour however only 28% were aware of the use of maternal posture to correct this. Most women (86%) were interested in labour research. Although 37% indicated they would participate in a future RCT of posture for fetal malposition, nearly half (47%) were unsure and a further quarter (15%) indicated they would not participate. Comfort was the predominant concern (22%). Almost half of the respondents (49%) indicated they would consult their partner before deciding on participation in an RCT. Conclusions: Participation in a trial of maternal posture in labour can be enabled through measures to enhance maternal comfort, increased awareness of malposition and the role of posture, and the involvement of partners during trial counselling and recruitment.

Keywords: pregnant women, labour, presentation, posture, randomized controlled trial, survey

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Authors: Garba Iliyasu, Lamaran Dattijo

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Introduction: Ebola virus disease (EVD) is a disease of humans and other primates caused by Ebola viruses. The most widespread epidemic of EVD in history occurred recently in several West African countries. The burden and outcome of EVD in pregnant women remains uncertain. There are very few studies to date reporting on maternal and fetal outcomes among pregnant women with EVD, hence the justification for this comprehensive review of these published studies. Methods: Published studies in English that reported on maternal and or fetal outcome among pregnant women with EVD up to May 2016 were searched in electronic databases (Google Scholar, Medline, Embase, PubMed, AJOL, and Scopus). Studies that did not satisfy the inclusion criteria were excluded. We extracted the following variables from each study: geographical location, year of the study, settings of the study, participants, maternal and fetal outcome.Result: There were 12 studies that reported on 108 pregnant women and 110 fetal outcomes. Six of the studies were case reports, 3 retrospective studies, 2 cross-sectional studies and 1 was a technical report. There were 91(84.3%) deaths out of the 108 pregnant women, while only 1(0.9%) fetal survival was reported out of 110. Survival rate among the 15 patients that had spontaneous abortion/stillbirth or induced delivery was 100%. Conclusion: There was a poor maternal and fetal outcome among pregnant women with EVD, and fetal evacuation significantly improves maternal survival.

Keywords: Africa, ebola, maternofetal, outcome

Procedia PDF Downloads 235