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Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018
by
Fazli, Mohammad Rafi
,
Stanikzai, Muhammad Haroon
,
Tawfiq, Essa
in
early ANC
,
Health care reform
,
Health surveys
2023
Initiating antenatal care (ANC) visits by pregnant women during first trimester, known as timely initiation of ANC visits, is crucial for wellbeing of mothers and their unborn babies. We examined whether sociodemographic characteristics of pregnant women predict timely initiation of ANC visits.
Data collected for the Afghanistan Health Survey 2018 (AHS 2018) were analyzed. A binary outcome variable was created as women with ANC visits in 0-3 months (first trimester) vs women with ANC visits in ≥4 months of pregnancy. A multivariable generalized linear model was employed.
A total of 6862 ever-married women, aged 14-49 years, with a history of pregnancy, including current pregnancy, were included. The prevalence of timely initiation of ANC visits was 55.8%. The likelihood (OR = odds ratio) of timely initiation of ANC visits was higher in women aged 30-39 years [OR 1.12 (95% CI: 1.00-1.25)], in women who could read and write [OR 1.12 (95% CI: 0.99-1.21)], in women who used public primary care facilities [OR 1.14 (95% CI: 1.01-1.28)], in women who received consultation on ANC from a doctor or midwife [OR 1.22 (95% CI: 0.72-2.08), OR 1.13 (95% CI: 0.67-1.92)] respectively, in women at fourth and highest quintiles of wealth status [OR 1.24 (95% CI: 1.04-1.48), OR 1.14 (95% CI: 0.92-1.40)] respectively, in women who intended to become pregnant [OR 1.56 (95% CI: 1.35-1.81)], in women who used the internet [OR 1.53 (95% CI: 1.13-2.06)], and in women who listened to radio [OR 1.16 (95% CI: 1.03-1.30)]. However, the likelihood was lower in women who had given birth at least twice [OR 0.67 (95% CI: 0.50-0.89)], and in women who lived in rural areas [OR 0.87 (95% CI: 0.75-1.00)].
To promote timely initiation of ANC visits, healthcare interventions to increase availability of midwives and doctors, and improve accessibility to primary care clinics, especially in rural areas, need to be implemented.
Journal Article
Contributing barriers to loss to follow up from antenatal care services in villages around Addis Ababa: a qualitative study
by
Abawollo, Hailemariam Segni
,
Desta, Binyam Fekadu
,
Mamo, Tsega Teferi
in
ANC defaulter
,
ANC dropout
,
Attended births
2021
Background
Problems during pregnancy, childbirth and postpartum are the major contributors to maternal and perinatal morbidity and mortality. Focused antenatal care is an intervention set to provide basic services for pregnant women, to reduce morbidity and mortality related to pregnancy. In Ethiopia, there is a significant loss to follow up from antenatal care services between the first and fourth visits. The aim of this study is to explore the potential contributing barriers to loss to follow up of pregnant women from antenatal care services in villages around Addis Ababa, the capital city of the country.
Methods
A qualitative research method was used, where 20 in-depth interviews (zonal, woreda and health center managers, midwives and health extension workers were the participants) and three focus group discussions (mothers who were lost to follow up, mothers who completed four sessions of antenatal care visits, and community volunteers were the participants) were conducted. A qualitative data analysis software, ATLAS.ti 8, was applied.
Results
Inability to deliver essential antenatal care services which occurs primarily due to shortage of the required medical equipment, drugs, and other supplies is a major barrier for sustainable attendance of antenatal care services followed by poor care, respect, and receptiveness of service providers. Lack and cost of transport as well as partners’ approval and support were also claimed to be part of the major barriers. Community culture and pervious maternal experiences as well as maternal sociodemographic factors like maternal age at time of pregnancy and educational status of mothers were also reported as barriers to seeking and completion of antenatal care services.
Conclusions
Both demand and supply side barriers play a significant role in the loss to follow up from antenatal care services. Availing essential antenatal care services, closer to the community by improving the infrastructure, health workforce and supply chain system is recommended.
Journal Article
Effect of high-quality antenatal care on skilled birth attendant utilization in Ethiopia: a propensity score matching analysis
2025
Background
Existing evidence suggests that access to and utilization of skilled birth attendants in Ethiopia remain suboptimal. High-quality antenatal care (ANC), adequate ANC contacts and components, is associated with an increased likelihood of receiving assistance from skilled birth attendants. However, the effect of these ANC interventions on the utilization of skilled birth attendants in Ethiopia has not been thoroughly investigated using rigorous statistical methods. Therefore, this study, aimed to assess the effects of receiving high-quality ANC services, adequate ANC contacts, and comprehensive ANC components on the utilization of skilled birth attendants in Ethiopia employing a robust analytical approach.
Methods
We utilized secondary data from the six-week postpartum survey of the second cohort, alongside the baseline information from the Performance Monitoring for Action (PMA) Ethiopia longitudinal study, which was conducted from November 2021 to October 2022. The study involved selection 1596 participants using a multistage stratified cluster sampling method. To establish rigorous causal estimates, we applied multiple analytical methods to assess the effect of high-quality ANC, adequate ANC contact, and adequate ANC components on the utilization of skilled birth attendants. The primary analysis utilized propensity score matching followed by adjusted regression to account for remaining confounders. Additionally, we performed a supplementary multivariable logistic regression analysis.
Results
After adjusting for residual confounding in the matched sample, the adjusted average treatment effect on the treated (ATT) showed that high-quality ANC was associated with a 5.7 percentage point increase in the likelihood of utilizing skilled birth attendants (adjusted ATT = 0.0575; 95% CI 0.024–0.090;
p
= 0.001). Similarly, the adjusted ATT was 0.0605 (95% CI 0.028–0.092;
p
< 0.001) for adequate ANC contact and 0.0574 (95% CI 0.024–0.090;
p
= 0.001) for adequate ANC components, reflecting 6.0 and 5.7 percentage point increases in skilled birth attendant use, respectively. In addition, the average marginal effects (AME) indicated that, on average, high-quality ANC, adequate ANC contact, and adequate ANC components increased the probability of skilled birth attendant utilization by 7.1, 6.0, and 9.2 percentage points, respectively.
Conclusion
This study provides robust evidence that high-quality ANC services increase the likelihood of skilled birth attendant utilization during delivery. It also reported a positive association between adequate ANC contacts, the receipt of adequate ANC components, and the use of skilled birth attendants. Therefore, our findings underscore that increasing the number of ANC contacts, ensuring the provision of recommended ANC components, and consistently promoting overall high-quality ANC are critical strategies for improving skilled birth attendant utilization.
Journal Article
Application of GAN-Based Data Encryption Technology in Computer Communication System
by
Li, Min
2024
With the development of information technology, it is an important issue to ensure the secure transmission and storage of data in today's society. An experimental and innovative encryption method based on selected ciphertext attacks and improved adversarial neural networks was proposed to improve the security performance of computer communication systems under various attack modes. The experiment conducted a comprehensive security analysis of the proposed encryption technology and verified its effectiveness in resisting different types of attack modes by simulating different attack scenarios. The results showed that in the comparison of convergence iterations of different models, when iterations were 38, the research model first iterated to a stable state, corresponding to a fitness value of 0.612. In the comparison of AUC values, the ROC area under the curve of the research method, Blockchain technology, X-IDEA, and image encryption algorithms based on hyperchaotic systems and improved quantum rotation gates were 0.978, 0.967, 0.951, and 0.914, respectively. The values of the research method were significantly larger. In the comparison of average classification accuracy, on dataset A, when the system iterated 75 times, the research method had the maximum classification accuracy, with a value of 98.24%. The stable average classification accuracy of Blockchain technology, X-IDEA algorithm, and image encryption algorithms based on hyper chaotic systems and improved quantum rotation gates were 93.21%, 94.57%, and 96.23%, respectively. Compared to the HS-IQRG technology, the encryption accuracy of the research method was 0.963, 0.977, 0.968, 0.979, and 0.958 when the PU power was 0.5:1, 1.0:1, 1.5:1, 2.0:1, and 2.5:1, respectively. When the system ran on dataset A 44 times, the time it took for the research method to reach a stable state was only 0.0424 seconds, which was 0.0008 seconds faster than the HS-IQRG technology. The above results all show that the research method can encrypt data. Meanwhile, this method learns a safe password generation method in the automated system, which makes certain contributions to computer communications. This experiment provides a new theoretical perspective on achieving more secure computer communication systems by combining CCA and ANC technologies. From a technical point of view, the effectiveness of the proposed method is verified through performance testing, which provides an experimental basis for the application of the technology. Meanwhile, the application potential of this technology in different network environments is discussed, providing a valuable reference for future communication security practices.
Journal Article
Factors Associated with Late Antenatal Initiation among Women in Malawi
2024
Background Early initiation of antenatal care (ANC) is critical in identifying and mitigating adverse pregnancy-related complications. However, globally, a high percentage of women initiate ANC only at a late stage of their pregnancy. In view of this, the main objective of the study is to establish the prevalence and factors associated with late ANC initiation among women in Malawi. Methods The study was based on the 2015–16 Malawi Demographic and Health Survey (MDHS). The study population consisted of 13,251 women of reproductive age who had given birth during the five years preceding the survey. The data was analyzed using the chi-square test and multivariate logistic regression. Results The prevalence of late ANC initiation in Malawi was 75.6%. The logistic regression modelling revealed increased odds of late ANC initiation attendance among women residing in the Northern Region (AOR: 1.172; 95% CI: 1.021–1.345) and the Central Region (AOR: 1.178; 95% CI: 1.074–1.291), women residing in urban areas (AOR: 1.273; 95% CI: 1.108–1.463), women with no education (AOR: 1.814; 95% CI: 1.13–1.47) or with primary education (AOR: 1.697; 95% CI: 1.13–1.47), women with less than four ANC visits (AOR: 4.155; 95% CI: 4.002–4.814), unmarried women (AOR: 1.478; 95% CI: 1.111–1.985) and those whose last birth was not by caesarean section (AOR: 1.377; 95% CI: 1.179–1.607). Reduced odds of late ANC initiation among women were observed among women in the 20–24 age group (AOR: 0.634; 95% CI: 0.456–0.881), those in the 25–29 age group (AOR: 0.645; 95% CI: 0.476–0.874) and those aged 30–34 years (AOR: 0.634; 95% CI: 0.456–0.881). Conclusions The study found that ANC initiation in Malawi is often delayed, with most first visits occurring after the first trimester. Late ANC initiation is associated with region, place of residence, marital status, and the women’s age. These are significant factors to be considered when designing new or reviewing ANC policies and strategies aimed at increasing ANC utilization and encouraging early initiation of ANC. Earlier ANC initiation among Malawian women can contribute positively towards improving maternal and child health in Malawi. Therefore, government policies and interventions should target women with no or little education, those living in poor families and other modifiable risk factors, such as young unmarried women.
Journal Article
'Now Is the Time!' The Importance of International Spaces for Women's Activism within the ANC, 1960-1976
2019
This article charts ANC women's feminist struggles in the early exile era, 1960-1976, and how the experience of exile reoriented their approach to anti-apartheid struggles and feminism. It discusses the political events and hierarchies that affected the position of ANC women within the organisation, and how international spaces helped shape their activism. I argue that although women in the ANC made progress under the influence of strong leaders in exile, the situation in South Africa and the ANC's rigid patriarchal culture meant that women's fight for political equality was far from successful in this period, both within the apartheid state and the liberation movement itself. Using the experiences of ANC women based in Sweden alongside better-known stories from the ANC headquarters in Dar es Salaam and Lusaka, the article shows that the international connections that women in exile made at this time - throughout Africa, across continents and on the international diplomatic scene - and their exposure to second-wave feminism and black pride had a direct impact on their mobilisation and ability to organise, allowing them to build strength for the late apartheid era.
Journal Article
A survey on filtered-x least mean square-based active noise control systems with emphasis on reducing computational complexity
2023
Active noise control (ANC) is gaining ever-increasing attention owing to its powerful ability to attenuate low-frequency noise. The computational complexity of an ANC system may directly affect its computational efficiency, control performance, and hardware costs. Therefore, the focus of this paper is mainly on discussing the development of ANC systems with emphasis on reducing computational complexity. The ANC systems are classified into two groups of narrowband and broadband systems. The computational complexity analysis is provided to show the computational merit of each system with respect to the conventional ANC systems. In addition, numerical simulations are performed to evaluate the convergence speed and noise reduction performance of the considered systems. The results show that, in the narrowband ANC systems, the LFE-NANC, CFX-NANC and BFX-NANC systems enjoy better overall performance in terms of the computational complexity, convergence speed and steady-state error, and in the broadband ANC systems, the DF-BANC system has the lowest computational complexity but cannot effectively attenuate the broadband noise with high spectral dynamics, whereas the DS-BANC and MDS-BANC systems can. This study provides in-depth insight into current typical low-complexity ANC systems.
Journal Article
Review of ANC Algorithm
2022
In the contemporary society, the ANC (active noise cancellation) technology has become more and more popular. It has grown from its originally military and industry fields into commercial fields, and it is still being implemented into more and more areas and fields. In this paper, we briefly introduce some principal of ANC algorithms and contrast their results with the traditional ones and focus on challenges for future applications.
Journal Article
Men in maternal health: an analysis of men’s views and knowledge on, and challenges to, involvement in antenatal care services in a Tanzanian community in Dodoma Region
by
Gibore, Nyasiro Sophia
,
Gesase, Ainory Peter
in
Childrens health
,
Clinics
,
Cross-sectional studies
2021
Promoting men’s involvement in antenatal care (ANC) requires an understanding of their views on how they ought to be involved. Their involvement in ANC services can help in reducing delay in deciding to seek care and facilitate women’s access to skilled antenatal services. This study sought to determine men’s views and knowledge on, and challenges to, involvement in ANC services in Tanzania. The cross-sectional study was carried out in four districts of Dodoma Region in November 2014 and June 2016. A multi-stage sampling strategy was used to select the study respondents. Data were collected by interviewing 966 men using a structured questionnaire. Univariate, bivariate and multivariate logistic regression analyses were used to examine the association between men’s involvement in ANC services and their background characteristics. About 63.4% of respondents accompanied their partners to ANC services. Men’s view was that they can be involved through accompanying their partner to ANC clinics and providing money for health services. Men who had poor knowledge on ANC services were two times less likely to be involved in ANC services. Similarly, long waiting times at the antenatal clinics decreased the likelihood of service utilization by their partners. Men from a two-income household were more likely to be involved in ANC services than men from households where the men’s earnings were the only source of income. Challenges encountered by men during attendance at ANC services included: perception of antenatal clinics as places only for women, financial difficulties, influence of peer pressure and lack of time due to occupational demands. There is a need to establish community outreach ANC services that offer couple-friendly services in Tanzania. Also, it is crucial to have a policy for men’s involvement in maternal health care that addresses cultural practices that hinder men’s involvement in ANC services.
Journal Article
Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter?
by
Kasaye, Habtamu Kebebe
,
Medhin, Girmay
,
Kassie, Getnet Mitike
in
ANC visit as per MOH recommendation
,
Behavior
,
Continuum of care
2021
Introduction
The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH’s recommendations of MOH for ANC visits on continuum of care rural in Ethiopia.
Methods
We used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6324 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC. Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care.
Result
Only 13.9% of eligible women completed the continuum of care, and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (β = 0.04, 95% CI = -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than health posts (HPs)) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95% CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95% CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95% CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95% CI: 1.11, 1.18) and delivery of second youngest child at HF (IRR = 1.16, 95% CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95% CI: 0.87, 0.94).
Conclusion
Completion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of second youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit.
Plain language summary
Maternal health continuum of care is an integrated service delivery of antenatal care, facility delivery and postnatal care on appropriate time and place. Continuum of care averts more maternal mortality than individual service provision. In Ethiopia a small percent of women complete continuum of care. Previous studies in Ethiopia explored the effect of time on CoC, however the effect of place of service delivery on subsequent continuum of care were not addressed. This study, therefore, assessed the effect of place of service delivery on completion of subsequent continuum of care using data from 1431 fixed cohort of women during the National HEP assessment survey.
The proportion of women who took all essential maternal health services was very low. Whether first antenatal care is at health post or at health centre did not have a significant effect on the completion of maternal health continuum of care. Adherence to the existing recommendations of Ministry of Health for antenatal care visit increases the uptake of maternal health continuum of care. Better completion of maternal health services was observed in agrarian than pastoralist areas, among those who have exposure to health extension program, who have information about danger signs, and who deliver their previous child at health facility. We can conclude that good implementation of the health extension program, and improving service quality at health facilities increase the uptakes of maternal health service. Moreover, promoting adherence of women to the ministry of health ANC recommendations increase uptakes.
Journal Article