Journal of Obstetrics and Gynaecology of Eastern and Central Africa最新文献

{"title":"EDITORIAL: COVID-19 AND PREGNANCY","authors":"M.M Obimbo","doi":"10.59692/jogeca.v32i2.239","DOIUrl":"https://doi.org/10.59692/jogeca.v32i2.239","url":null,"abstract":"","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"124 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative research to advance social norms initiatives of the RHRA: Mombasa County, HAKI Jamii, and the RHRA Study","authors":"Peter Igogo, Carol Odula","doi":"10.59692/jogeca.v36i1.159","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.159","url":null,"abstract":"\u0000Background: In Kenya, there is a general lack of knowledge on the prevention of unintended pregnancies, especially among the rural poor and women living in urban and peri-urban informal settlements. Unsafe abortion is common, and stigma directed at the woman, provider, woman’s family, and facility is common.\u0000Objective: To explore public perceptions of abortion, gather awareness of the legal provisions for abortion, and determine access to information and services.\u0000Methods: Qualitative in-depth research used four focus groups of women and men aged 18-54 years. The interactions were face-to-face and verbatim transcripts. The messages were organized, coded, and categorized into three categories using the delve software. Coding followed a mix of deductive and inductive processes.\u0000Results: There were highly resistant views on abortion across all four groups, focusing mainly on potential complications and death. Emerging voices support termination for rape, defilement, and incest. Abortion occurs more often among married women than among girls. Regarding the legal provisions, safe abortion respondents said it was illegal yet legal. It can be kept secret and influenced by one’s religion. Barriers to safe abortion access included high cost and lack of knowledge of where services are available. However, unintended pregnancies were common in informal settlements, resulting from transactional sex, sex, and gender-based violence, and lack of knowledge of and access to contraception.\u0000Conclusion: There is a need to unpack the collective social silence and the association of abortion with unpleasant social issues and to understand and target the drivers of abortion stigma, including premature death, future fertility concerns, guilt, and the murder label.","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"33 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refreshed implementation strategy for respectful maternity care through policy dialog in Kenya","authors":"Odipo Erick, Paul Odila, Shanon McNab, Isabella Ochieng, Suzanne Stalls Susan, Moffson Angeline Mutinga","doi":"10.59692/jogeca.v36i1.194","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.194","url":null,"abstract":"Background: Kenya’s Ministry of Health (MOH) has demonstrated its commitment to quality, respectful health care through the development of national RMNC/PCC policies embedded in existing RMNCAH policies. However, the MOH has identified a gap in the implementation of RMNC policies. \u0000Methods: MCGL conducted global and Kenya-specific literature reviews on topics including mistreatment, respectful newborn care, and best practices for RMNC interventions. In addition, qualitative data were obtained through three focused group discussions, and 15 key informant interviews (KIIs) at various levels.\u0000Results: Most studies have assessed manifestations, prevalence, and to, to a lesser extent, drivers of disrespect and abuse or mistreatment in facility childbirth. Respondents from the KIIs described cases of mistreatment including harassment, rudeness, denial of services, lack of privacy, and violence. In a 2017 qualitative study, participants described a lack of leadership, stewardship, and accountability toward existing RMNC policies, leading to a lack of implementation. The Kenya Free Maternity Policy recommended that despite this policy, women may still not attend health facilities for maternity care. Newborn experience has largely been excluded from the conversation of RMNC, which has an impact on women and providers with long-lasting effects on their mental health and future care seeking. KIIs were familiar with qualitative methods of measuring mistreatment through exit interviews. \u0000Conclusion: Counties are at different stages of advancing respectful care for mothers and newborns and integrating RMNC into existing primary healthcare systems. SA provides evidence regarding the development and implementation of effective RMNC policies and programs both globally and in Kenya. ","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health system barriers to access to quality sexual and reproductive health and rights in relation to family planning and contraception","authors":"A. Kihara, P. Koigi, L. Kabare, Chrisostim Barasa","doi":"10.59692/jogeca.v36i1.311","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.311","url":null,"abstract":"Background: Access to reproductive health information and services is critical to health, well-being, and the ability to achieve personal and corporate life and work goals. Within the context of sexual and reproductive health rights (SRHR), the health system should adopt a life course approach to achieve a continuum of care. This spectrum needs to span from conception to the care of the aging woman across all contexts and must encompass humanitarian crises, climate change, and environmental exposures while embracing the ongoing digital transformation narrative. Current challenges relating to family planning and contraception (FPC) within the Kenyan context typically arise from highly prevalent unfavorable sociocultural norms and traditions. \u0000Selected SRHR intervention programs: Programs that promote girls’ education and enhance community engagement to effect sociobehavioral change programing have high transformative potential. Some of these programs include the provision of contraception, adolescent, and youth-friendly programs (AYFS), intimate partner violence intervention programs, HIV prevention, use of multipurpose product technologies (MPT), prevention of abortion-related mortality, provision of access to maternity care, and continuous improvement of quality of care. \u0000Conclusion: Obstetricians and gynecologists must commit to governance leadership that focuses on SMART advocacy, the establishment of health system resilience to provide access, effective coverage, and rights-based approaches. These are vital to the provision of optimal FPC care in Kenya.","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"29 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139960653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum service package for the integration of female genital schistosomiasis in sexual and reproductive health services in Kenya","authors":"V. Gamba, Robinson Karuga, Florence Wakesho, Millicent Ouma, Leora Pillay, Christine Kalume, Delphine Schlosser, Caroline Pensoti","doi":"10.59692/jogeca.v36i1.186","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.186","url":null,"abstract":"Female genital schistosomiasis (FGS) is caused by chronic Schistosoma hematobium infection. Over 56 million women and girls in sub-Saharan Africa are estimated to be infected with FGS. However, gaps in knowledge of the symptomatology of FGS often lead to misdiagnosis and undertreatment. FGS presents with nonspecific genital symptoms and is likely to be misdiagnosed as a sexually transmitted infection (STI). Recurrent treatment for STIs may result in marital discord, intimate partner violence, and social stigma. Other FGS complications include ectopic pregnancy, infertility, urine incontinence, 3-4-fold increased susceptibility to HIV infection, and persistence of human papillomavirus infection (HPV). A minimum service package (MSP) that is acceptable and feasible for the integration of FGS and sexual and reproductive health (SRH) services is needed. A foundational literature review was conducted to identify service points for FGS and sexual and reproductive health (SRH) service integration. The final MSP was developed through collaborative efforts with stakeholders in various fields associated with FGS and SRH services. The MSP identified four key areas for successful integration of FGS into SRH services including: health literacy, screening and diagnosis, treatment and care, and social inclusion and equity at the community and healthcare facility level. A context-specific integration MSP may be the most efficient, effective, and ethical way to comprehensively address the burden of FGS faced by women and girls in Africa.","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"53 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth-led social accountability among service providers optimizing sexual and reproductive health rights outcomes in Kilifi County, Kenya","authors":"A. Kihara, Shirleen E. Wanjiku, Samuel Obara","doi":"10.59692/jogeca.v36i1.310","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.310","url":null,"abstract":"\u0000Background: The demand side of the health system is gaining traction to improve health outcomes.  Among adolescents and youths, this is needed, particularly in low- and middle-income countries (LMICs) where they account for the majority and demographic dividends require that they be healthy and productive to participate in national development. Unfortunately, at this transition age from childhood into adulthood, they experience many challenges such as malnutrition, poverty, school dropout rates, gender inequality, drug and substance abuse, mental ill-health, and menstrual hygiene and health challenges. Risky behaviors related to SRHR include unplanned pregnancies, gender and sexual orientation issues, gender-based violence, sexually transmitted infections, harmful cultural practices, and reproductive cancers. \u0000Methods: VSO PITCH Data for the youth accountability project addressed social accountability by service providers for youth-friendly information and services. The data tool used was the intersectional community scorecard collected through focused group discussion entries made at county health facilities by youth, service providers, and interface synthesis of satisfaction scores. These were uploaded onto a digital platform showing the number of FGDs, core indicators, satisfaction scores, reasons, recommendations, and action plans. This project was conducted in Kilifi County and two other counties.   \u0000Results: FGDs comprised 50% youth, 25% adults, 25% of mixed age range, and two persons with disability. All core indicators were unsatisfactory, <50%, and did not meet the global standard for quality healthcare services. The satisfaction score for the number of staff providers was grossly underserved at 10%, with the youth demanding that they serve their own. A satisfaction score of 30% was reported due to a lack of disability services, privacy, youth space, inadequate quality of care including test kits for HIV, and discriminated and stigmatized LGBTQ+ with back-biting after delivery of services.  \u0000Conclusion: Youth-led social accountability ensures service providers are responsive to the needs of adolescents and youth. The propulsion is by youth for youth who should be health literate on social accountability. More attention among service providers includes the provision of adequate competent staff, VCAT, compassionate and respectful care, and good interpersonal communication, meaningful engagement and reverse mentorship with adolescents and youth, and a focus on rights-based and intersectionality for better SRHR outcomes and youth development. ","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"34 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of maternity open days initiative to increase access to comprehensive maternal and neonatal health services at the Lwala Community Health Centre","authors":"Carren Cheronoh Siele","doi":"10.59692/jogeca.v36i1.163","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.163","url":null,"abstract":"Background: Maternity open day (MOD) is an event in which a health facility opens its doors to the community and provides a specific opportunity for pregnant women and their birth companions to interact freely with health care providers and receive antenatal care services, including obstetric ultrasound, and tour maternity units.   \u0000Objective: To increase access and utilization of MNH services, improve knowledge, promote transparency, familiarize with the environment, procedures, and maternity staff, and increase the client's knowledge and confidence on what to expect during labor and delivery.\u0000Results: It ensured an increase in the number of women seeking comprehensive antenatal care (ANC), including ANC profile care at both first and fourth ANC visits, and skilled birth attendants. The (MODs) provided a platform to expand access to affordable maternity care through client enrollment in Linda Mama services. Over 99% of pregnant women who attended MODs embraced hospital deliveries and 99% skilled births. A total of 1060 women attended MOD, and 3,903 women underwent obstetric ultrasound, with zero maternal deaths and one neonatal death recorded between 2022 and 2023.\u0000Conclusion: Maternity open day provides a platform for increasing access to comprehensive antenatal care and affordable maternity care through Linda Mama. It improved the quality of maternal and child health services, reduced defaulters in the ANC clinics, and increased access to MNH services for continuum care and built trust between women and healthcare providers.","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"32 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing global networks to drive country evidence-based reproductive health practices toward universal health coverage","authors":"G. N. Gichuhi, Michael Muthamia Mwiti, Paul Nyachae","doi":"10.59692/jogeca.v36i1.229","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.229","url":null,"abstract":"\u0000Jhpiego provides contextual evidence-based real-life solutions that contribute to saving lives, improving health, and transforming futures for women, children, and their families living in more than 42 countries. Over its 50 years of existence and a geographic footprint of more than 150 countries, this JHU-affiliated NGO has contributed to the introduction and scale-up of multiple life-saving innovations, has been a dot connector, a trusted partner to many governments and professional and local organizations, and an innovator. In Kenya, Jhpiego has worked for more than 45 years, partnering with KOGS in multiple initiatives, and has contributed to the development and review of multiple evidence-based policies and recommendations at the global, regional, and national levels. Evidence-based practice plays a critical role in improving the quality of reproductive health care. While global recommendations are important, they require adaptation to local contexts for full implementation to be practical. Introduction of heat-stable carbetocin and the scale-up of the E-MOTIVE bundle to manage PPH, respectful care, and mental health in RH, introduction and scale-up of post-pregnancy FP, introduction and scale-up of primary and secondary cervical prevention interventions, the use of blended learning that uses multiple delivery channels, including the use of AI-powered training tools that respond to the needs of health providers, and supporting the quality of services through approved pharmacies, including e-pharmacy. ","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"31 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responding to preventable causes of maternal and perinatal deaths in Homabay County","authors":"Odipo Erick, Hassan Nyawanga, Paul Odila, Salome Ndombi, Deborah Siitrin","doi":"10.59692/jogeca.v36i1.281","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.281","url":null,"abstract":"Background: The Kenya population and housing census (2019) ranked Homabay County among the 15 counties with the highest maternal mortality rate (MMR) of 516 deaths in 100,000 livebirths and neonatal mortality rate (NMR) of 26 in 1,000 livebirths. Baseline assessment reported gaps including dysfunctional maternal and perinatal death surveillance and response  system, and untimely perinatal deaths  audited. Other challenges contributing to near misses and mortality include erratic availability of blood/blood products, staff shortages affecting the offering of CEmONC services, interfacility referral challenges, not exploiting partnerships with private and faith-based health facilities in the county, and HCW knowledge and skills deficit, especially in management of common causes of death, such as postpartum hemorrhage and eclampsia\u0000Methods: MCGL’s objective was to work with the County’s leadership to revitalize the MPDSR system and work toward responding to the causes and avoidable factors contributing to the high burden of maternal and perinatal deaths in the County.  MCGL  trained HCWs on harvesting and handling of blood products, management of PPH and eclampsia,  development  of county referral strategy, linkage to  private and faith-based HFs, capabilities,  support weekly MPDSR committee meetings, develop, and roll out MPDSR of weekly monitoring tool,  formation of QI teams, and support for social accountability  activities.\u0000Results: Improved implementation of MPDSR action points included increased number of CEmONC health facilities, availability and access to blood during PPH emergencies, and point-of-care ultrasound machines in 13 health facilities. There was notable improvement of timely  perinatal deaths of audits 47% (70/152).\u0000Conclusions: Deliberate and collective effort by the leadership with close follow-up can improve timely auditing  and  response , which  improves the quality of care for mothers and newborns receiving HFs.","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"56 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139960985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of safe and respectful maternity care in exit interviews following facility childbirth at the Lwala Community Health Centre","authors":"Carren Cheronoh Siele","doi":"10.59692/jogeca.v36i1.204","DOIUrl":"https://doi.org/10.59692/jogeca.v36i1.204","url":null,"abstract":"\u0000Background: Respectful maternity care is essential for ensuring positive childbirth experiences for women. It emphasizes moral values and respect for human rights and encourages behavior that considers women's preferences and needs for pregnant women, newborns, and their families. Maternity exit interviews conducted at Lwala Hospital assessed women's experiences during labor and delivery.\u0000Methods: A survey tool, Kobo Collect, was used for data collection among women who delivered at Lwala Hospital. 64 women of an age range of 17 and 36 years who delivered between October 1, 2023, and November 30, 2023, were interviewed. All the women had already given birth at least once. \u0000Results: Most of the women in the survey felt that they were given sufficient information to make informed decisions and felt comfortable during their delivery process. 86% strongly agreed that they were encouraged to have some light food, warm fluids, or tea during labor and birth. 72% of women said staff members talked to them about the advantages, disadvantages, and alternatives to treatments or procedures. Only 49% received information about caring for their babies. 13% felt they received information about where to get follow-up care. 96% felt the staff always protected their privacy at all stages. 80% said that the staff never scolded, shouted at, insulted, or made disrespectful comments. 91% said they were never touched by a staff member in a way that caused pain or felt inappropriate or non-consensual. 95% of women said all the staff care about what matters to the mother and her family. 85% of women were encouraged to feel confident in their ability to give birth. Despite 86% of the women feeling that the staff were active during labor, only 68% of women felt competence from the staff members during labor.\u0000Conclusion: Interviews underscore the importance of maternity exit interviews in assessing and enhancing the quality of maternity care. The outcomes of this research will inform future interventions and reinforce the commitment to providing respectful and equitable maternity care. ","PeriodicalId":517202,"journal":{"name":"Journal of Obstetrics and Gynaecology of Eastern and Central Africa","volume":"46 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}