THE RISK FACTORS OF MATERNAL AND PERINATAL HEALTH PROBLEMS IN KISUMU DISTRICT

Auteur:

KENNEDY NYABUTI ONDIMU

Date de publication:

30 Avril 2000

Mots-clefs:

Risk factors
Facteurs de risque
health
santé
Salud
Risk
riesgos
femme
mujer
Women
femmes
Mujeres
death
mort
Muerte
Kenya
tiempo (cronología)
Time
Time (périodique. - New York)
temps
Tiempo
Developed countries
Pays industrialisés
rate
Perinatal death
Mort périnatale
Mortalité périnatale
Mortalidad perinatal
Rates
Tarifs
Methods
méthodes
Analysis
Analyse
Medical centers
Nursing homes
Hospitals
Hôpitaux
Els Hospitals (Espagne. - site archéologique)
Hospitales
Area
Superficie
barrio
Ability
Motherhood
Maternité
Maternidad
Standards
normes
Health facilities
Équipements sanitaires
Servicios de salud
muestro
Sampling
Échantillonnage
Toma de muestras
act
Territoire fédéral de Canberra (Australie)
Cases
Jurisprudence
Months
mes
información
History
histoire
Historia
Pregnancy
Gestation
Grossesse
Embarazo
Mothers
Mères
Madres
Homes and haunts
Résidences et lieux familiers
Dwellings
Habitations
Viviendas
housing
logement
Vivienda
Day
Jour
accouchement
Infants
Jeunes
Nourrissons
petite enfance
Lactantes
Variation
Variation linguistique
Variabilité
Logistic regression analysis
major risk
Manufacturers' agents
Représentants de commerce
Commission merchants
Commissionnaires et courtiers
Investigación
research
recherche
Public health
Care
Théorie du care
Soins
Facilities
Installations
discrimination
Discriminación
Drugs
Médicaments
Medicamentos
equipment
Équipement
armement (bateau)
empuñadura
Reproductive health
Santé de la reproduction
Salud reproductiva
Anemia
Anémie
Hemorrhage
Hémorragie
Hémoptysie
Hemorragias
Labor
travail
Trabajo
Eclampsia
Éclampsie
Sexually transmitted diseases
Preeclampsia
Abortion
avortement
Aborto
deaths
Mortality
Mortalité
Mortalidad
Work
Determinants
Déterminants (mathématiques)
Determinantes
cribado
Programs
Programmes
Programas
éducation
educación
Pédagogie
Administration scolaire
Mesozoico
escuela
infraestructuras
Services
necesidad
Metropolitan areas
Agglomérations urbaines
Áreas metropolitanas
Cities and towns
Villes moyennes
Petites villes
villes
Ciudades
Addition
Communities
communauté
Comunidad
Revolving funds
Fonds renouvelables
Transportation
transport
Transport durable
Politique des transports
Assurance-transport
Transportes
Costs
Coût
Frais
Political science
science politique
Politics (périodique)
Idées politiques
administration
Modes d'administration
gouvernement
Rection
Política
gobierno
Government
Units of measurement
Unités de mesure
Prenatal care
Soins prénatals
Cuidados prenatales
bief
Areas
pozo
pozos
Possibility
Possibilité
Posibilidad
Maternal health services
Demografía
population
Demography
démographie
Medical care
Soins médicaux
Asistencia sanitaria
health care
Humanities
Lettres classiques (enseignement supérieur)
Humanidades
Villa romaine dels Hospitals (Espagne)
Mois
Meses
sciences humaines

Publié ici :

03 Février 2016

Mis à jour le :

11 Août 2017

Langue de publication:

Anglais

The risk of a woman dying in Kenya each time she becomes pregnant is estimated to be 1 in 20 times. This compares unfavorably with the industrialized countries where the rate is estimated to be as low as 1 in 1850. Perinatal health conditions have equally lagged behind in Kenya with a perinatal mortality rate estimated to be 45 per 1,000 live births compared to rates of 6 to 10 per 1,000 live births experienced in developed countries.This study examines the major maternal and perinatal health problems and risk factors associated with these health problems in Kisumu district. To achieve this, the study applied two methods. First, a situation analysis was conducted on all registered health centers, nursing homes and hospitals in the study area to establish their ability to offer safe motherhood according to WHO standards. Second, four health facilities were further selected by purposive sampling to act as sentinel centers from which a prospective study was conducted and data collected on maternity cases handled there for an uninterrupted period of six months. Information pertaining to respondents' obstetric history, health status during current pregnancy, background characteristics, pregnancy outcome and early neonatal health status was obtained. Postpartum mothers were followed to their respective homes on the seventh day after delivery to establish their health status and that of their infants during early neonatal period. In total 1455, cases were recorded out of which 59 percent experienced an obstetric problem and 41 percent never experienced any problem. Frequency distributions and cross-tabulations have been used to establish the variation in the occurrence of these problems along maternal socioeconomic, demographic, biomedicaland environmental characteristics. Multivariate case-control logistic regression analysis was applied to isolate the major risk factors of each of the reported problems.The main findings of this research reveal that there exists a major flaw in the public health care facilities in Kisumu district which are very few and therefore overcrowded, under-staffed, unevenly distributed with an urban bias, and at the same time inadequately supplied with basic drugs and equipment. This compromises the capability of the health facilities to adequately handle all maternal and perinatal cases in Kisumu District. There is a high prevalence of various reproductive health problems including low birth-weight (42%), anaemia (22%), antepartum haemorrhage (21%),caesarean deliveries (18%), obstructed labor (16%), eclampsia (14%), postpartum haemorrhage (12%), still-births (11%), sexually transmitted diseases (10%), pre-eclampsia (9%), abortion (9%), other operative deliveries, maternal deaths, and early neonatal mortality. The risk factors to these health problems lie in a complex web of socioeconomic, demographic, biomedical, and environmental variables that work together to determine pregnancy outcome.The study suggests short-term, medium-term and long term integrated policies that address the above proximate determinants of maternal and perinatal health. These policies should target the populations at risk through effective screening, promotion of public health care programs, promotion of female education up to secondary school levels, improvement of health infrastructure and availability of emergency obstetric care services to those in need by upgrading and equipping health centres in the both rural and urban areas. In addition, there is urgent need to encourage communities to establish revolving funds to cater for drugs and transport costs. Moreover, the government should set up mobile units for prenatal care to reach the rural areas that are not well covered by existing facilities, and to explore the possibility of starting maternity waiting homes for mothers from inaccessible areas with transport problems. There is need to develop a culturally accepted and scientifically valid community based maternity care that can be relied on for early diagnostic and therapeutic care.

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THE RISK FACTORS OF MATERNAL AND PERINATAL HEALTH PROBLEMS IN KISUMU DISTRICT

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