Papua and New Guinea medical journal最新文献_第8页

The contribution of church health services to maternal health care provision in Papua New Guinea. 教会保健服务对巴布亚新几内亚产妇保健服务的贡献。

Papua and New Guinea medical journal Pub Date : 2011-09-01

P Mapira, C Morgan

{"title":"The contribution of church health services to maternal health care provision in Papua New Guinea.","authors":"P Mapira, C Morgan","doi":"","DOIUrl":"","url":null,"abstract":"Access to maternal health services is one key to the reduction of maternal mortality in Papua New Guinea. Church health services (CHS) are known to administer around 45% of rural health facilities. We undertook a descriptive analysis based on health facility service provision data for 2009 from the National Health Information System (NHIS), supported by document review and interviews. We recoded NHIS data on facilities by administration by CHS or government health service, judged their capacity for emergency obstetric care (EmOC) and analysed service provision for 2009. For rural services (i.e., outside of provincial capitals), CHS were recorded as providing 58% of health facility childbirth care and 38% of first antenatal visits. Obstetric referral patterns and facility capacity suggested many facilities were likely to have only basic EmOC and limited referral options. Nationally, CHS provided 21% of temporary methods of contraception (measured in couple-year protection) but 85% of referrals for permanent contraception. There was marked variation across provinces with clear implications for where health system strengthening could be beneficial to maternal survival. Our findings also disclosed gaps in the NHIS around monitoring of complicated childbirth and inclusion of community-based care.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"139-46"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32088567","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}

引用次数: 0

Poor weight gain in late third trimester: a predictor of poor perinatal outcome for term deliveries? 妊娠晚期体重增加不佳:足月分娩围产儿预后不佳的预测因子?

Papua and New Guinea medical journal Pub Date : 2011-09-01

G D L Mola, B Kombuk, A B Amoa

{"title":"Poor weight gain in late third trimester: a predictor of poor perinatal outcome for term deliveries?","authors":"G D L Mola, B Kombuk, A B Amoa","doi":"","DOIUrl":"","url":null,"abstract":"In many parts of the world weighing women in antenatal clinics is no longer thought to be important. At Port Moresby General Hospital we noticed that failure to gain weight in the third trimester (or weight loss) was associated with poor perinatal outcomes. To investigate this issue we designed a prospective case-control study to determine whether poor weight gain in the third trimester is a useful clinical indicator of poor placental function by being associated with intrauterine growth restriction (IUGR) or inadequate placental function in labour by being significantly associated with suspected intrapartum fetal compromise, birth asphyxia, meconium aspiration syndrome and neonatal intensive care unit admission. We found that a failure to gain weight for more than three weeks preceding the onset of labour was significantly associated with intrapartum fetal compromise (OR 2.24), IUGR (OR 2.88), meconium aspiration syndrome (OR 4.19), the presence of thick meconium or the passage of meconium during labour (OR 2.26) and the need for admission to the neonatal intensive care unit for more than 24 hours (OR 2.22). Weighing women in the antenatal clinic setting is a useful way of screening for deteriorating or inadequate placental function, and is particularly relevant in settings where more sophisticated modalities of screening and diagnosis of placental function are not available.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"164-73"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32087126","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}

引用次数: 0

Outcome of infants born to unbooked mothers: a short report from Goroka General Hospital, Eastern Highlands Province, Papua New Guinea. 未预约母亲所生婴儿的结局:巴布亚新几内亚东部高地省戈罗卡总医院的一份简短报告。

Papua and New Guinea medical journal Pub Date : 2011-09-01

M Manape, G Saleu, L Vallely

引用次数: 0

Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum. 巴布亚新几内亚男性包皮环切术预防艾滋病毒:国家政策论坛后对公共卫生的研究证据和建议摘要。

Papua and New Guinea medical journal Pub Date : 2011-09-01

A Vallely, D J MacLaren, W Kaleva, J Millan, R Tommbe, W Marape, C Manineng, H Buchanan, A Amos, R Frank, A Kelly, M Kupul, H Aeno, E Trowalle, L N John, M L Redman-Maclaren, C Ryan, K Browne, A Tynan, P S Hill, R T Gray, J Murray, D P Wilson, G Law, P Siba, W J H McBride, T Farley, J M Kaldor

{"title":"Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum.","authors":"A Vallely, D J MacLaren, W Kaleva, J Millan, R Tommbe, W Marape, C Manineng, H Buchanan, A Amos, R Frank, A Kelly, M Kupul, H Aeno, E Trowalle, L N John, M L Redman-Maclaren, C Ryan, K Browne, A Tynan, P S Hill, R T Gray, J Murray, D P Wilson, G Law, P Siba, W J H McBride, T Farley, J M Kaldor","doi":"","DOIUrl":"","url":null,"abstract":"In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"91-108"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32087121","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}

引用次数: 0

Achieving control of cervical cancer in Papua New Guinea: what are the research and program priorities? 在巴布亚新几内亚实现子宫颈癌的控制:研究和规划的重点是什么?

Papua and New Guinea medical journal Pub Date : 2011-09-01

Andrew Vallely, Glen D L Mola, John M Kaldor

引用次数: 0

Sociodemographic factors associated with maternal health care utilization in Wosera, East Sepik Province, Papua New Guinea. 巴布亚新几内亚东塞皮克省沃塞拉与孕产妇保健利用相关的社会人口因素。

Papua and New Guinea medical journal Pub Date : 2011-09-01

S Maraga, E Namosha, H Gouda, L Vallely, L Rare, S Phuanukoonnon

{"title":"Sociodemographic factors associated with maternal health care utilization in Wosera, East Sepik Province, Papua New Guinea.","authors":"S Maraga, E Namosha, H Gouda, L Vallely, L Rare, S Phuanukoonnon","doi":"","DOIUrl":"","url":null,"abstract":"This retrospective study sought to describe the utilization of maternal health services in a rural community in Wosera, East Sepik Province, Papua New Guinea. Interviews were undertaken with a convenience sample of 391 women of reproductive age. We examined the relationship between socioeconomic and demographic characteristics and the use of antenatal clinic services and delivery at a health centre. Despite uptake of antenatal care services by 79% of women, two-thirds of women gave birth at home. Women's education was an independent predictor for maternal health care utilization, for both antenatal care and delivery at a health facility. At least one visit to an antenatal clinic was the strongest predictor of delivering at a health care facility. Women expressed barriers to assisted childbirth such as distance to health facilities, especially when labour came fast, and feelings of shame in presenting to a facility to give birth. This study provides important information relating to the uptake of maternal health care services. Despite the uptake of available antenatal care services, intrapartum services are not well accessed.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"154-63"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32087123","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}

引用次数: 0

Health workers, health facilities and penile cutting in papua new guinea: implications for male circumcision as an HIV prevention strategy. 巴布亚新几内亚的卫生工作者、卫生设施和阴茎切割:对作为艾滋病毒预防战略的男性包皮环切术的影响。

Papua and New Guinea medical journal Pub Date : 2011-09-01

A Tynan, A Vallely, A Kelly, M Kupul, G Law, J Millan, P Siba, J Kaldor, P S Hill

{"title":"Health workers, health facilities and penile cutting in papua new guinea: implications for male circumcision as an HIV prevention strategy.","authors":"A Tynan, A Vallely, A Kelly, M Kupul, G Law, J Millan, P Siba, J Kaldor, P S Hill","doi":"","DOIUrl":"","url":null,"abstract":"There has been increasing interest in Papua New Guinea (PNG) in male circumcision (MC) for HIV (human immunodeficiency virus) prevention following compelling evidence from ecological studies and clinical trials in Africa, and the World Health Organization's recommendation in 2007 that MC be considered part of comprehensive HIV prevention programs in high-prevalence settings. Though no national policy has been established in PNG, East Sepik Province (ESP) commenced a formal program of MC in 2006, and there is evidence that PNG health workers are involved in other penile foreskin cutting activities in many areas. As part of a wider Male Circumcision Acceptability and Impact Study in PNG, we conducted an audit at a sample of PNG health facilities to assess their suitability for implementing a national MC program, and to identify issues that may arise in any future roll-out. The clinical audits demonstrated the difficulties with procurement and availability of equipment for general services around PNG, shortage of staff and capacity, and limitations of available clinical space. Results show that the ESP program has been successful; however, the success relies heavily on commitment from key workers to volunteer their time and services. A review of penile cutting activities by health care workers outside of the ESP program showed that the PNG health system is already involved in contemporary and traditional penile cutting practices via formal and informal arrangements: for example, by responding to complications from penile cuts performed by non-health workers, assisting community members to perform penile cutting through provision of equipment and advice, or providing regular penile foreskin cutting services for contemporary and traditional practices.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"109-22"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32088565","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}

引用次数: 0

Operative vaginal delivery at Port Moresby General Hospital from 1977 to 2010. 1977年至2010年在莫尔兹比港总医院进行阴道手术分娩。

Papua and New Guinea medical journal Pub Date : 2011-09-01

G D L Mola, J Kuk

{"title":"Operative vaginal delivery at Port Moresby General Hospital from 1977 to 2010.","authors":"G D L Mola, J Kuk","doi":"","DOIUrl":"","url":null,"abstract":"This paper presents 35 years of history of operative vaginal delivery at the Port Moresby General Hospital (PMGH). From the early 1970s when Dr. G.C. Bird was appointed as Head of Obstetrics at PMGH, vacuum extraction has been the preferred method of assisted vaginal delivery. In the early 1970s, Dr Bird began to experiment with more effective configurations of the then standard metal Malmstrom vacuum extraction cup: the Bird anterior cup was introduced in 1973 and the posterior cup in 1974. These modifications to the vacuum extractor cup allowed for more effective placement of the cup on the flexion point on the fetal head thereby facilitating more successful vacuum-assisted delivery. Between 1977 and 2010 there were a total of 11,458 vacuum extractions (average rate 3.9%) performed, with an average failure rate of 2.5%. During the same period there were 565 vaginal forceps deliveries (rate 0.2%), 11,550 caesarean sections (rate 3.9%) and 182 symphysiotomies (all for failed vacuum extraction procedures) performed. Over the period trends that are noted include a slowly rising caesarean section rate from 2% in the 1970s to nearly 5% in the current decade. Over the same period the assisted vaginal delivery rate has dropped from 10-15% in the 1970s to 3-4% since 2000. The combined fresh stillbirth and early neonatal mortality rate for infants > or = 1.5 kg and > or = 2.5 kg for the period was 11.3/1000 and 9.5/1000 respectively, and compares to a combined fresh stillbirth and early neonatal mortality rate of 8.7/1000 for assisted vaginal delivery.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 3-4","pages":"174-84"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32087947","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}

引用次数: 0

The use of a forehead flap to reconstruct the soft and hard palate after cancer excision. 应用前额皮瓣重建癌切除后软硬腭。

Papua and New Guinea medical journal Pub Date : 2011-03-01

G Gende

引用次数: 0

Moresby food isn't good: food security, nutritional information and adherence to antiretroviral therapy in Papua New Guinea. 在巴布亚新几内亚，食品安全、营养信息和抗逆转录病毒治疗方面，食品质量不佳。

Papua and New Guinea medical journal Pub Date : 2011-03-01

A Kelly, A Mek, A Frankland, F Akunai, B Kepa, M Kupul, S Nosi, B Cangah, L Walizopa, L Pirpir, R Emori, H Worth, P M Siba, W Y N Man

{"title":"Moresby food isn't good: food security, nutritional information and adherence to antiretroviral therapy in Papua New Guinea.","authors":"A Kelly, A Mek, A Frankland, F Akunai, B Kepa, M Kupul, S Nosi, B Cangah, L Walizopa, L Pirpir, R Emori, H Worth, P M Siba, W Y N Man","doi":"","DOIUrl":"","url":null,"abstract":"The relationship between HIV (human immunodeficiency virus), food security and nutrition has become increasingly important to practitioners, policy makers and people living with HIV. In this paper we describe for the first time the connection between HIV and antiretroviral therapies, the extent of nutritional counselling for HIV-positive people and food security in Papua New Guinea (PNG). A total of 374 HIV-positive people who were over the age of 16 and who had been on antiretroviral therapy (ART) for more than two weeks were recruited from six provinces, using a non-probability, convenience sampling methodology. A subsample of 36 participants also completed an in-depth qualitative interview. Participants received nutritional advice when beginning ART which focused on three main domains, of which the first two were the most frequently mentioned: what foods to avoid; what foods to eat; and how frequently to eat. 72% of the sample reported that they had experienced an increase in their appetite. Of those who reported that their appetite had increased on ART 33% reported that they did not have enough food to satisfy hunger. People who lived in the capital city, Port Moresby, within the Southern Region of PNG, had significantly more difficulty with food security than those who lived in other regions of the country. Not having enough food was the third most commonly recorded reason for non-adherence to ART. Responses to the HIV epidemic in Papua New Guinea must also begin to address the phenomenon of food insecurity for people with HIV, in particular those who are receiving antiretroviral therapies and who live in the urban areas.","PeriodicalId":76302,"journal":{"name":"Papua and New Guinea medical journal","volume":"54 1-2","pages":"23-34"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31504066","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}

引用次数: 0