shahanaz chowdhury

To find out the quality of ANC in the Upazila Health Complexes (PHC centres) of Bangladesh.This cross sectional study was done in purposively selected three upazilas among the clients receiving antenatal care (ANC). Data were collected with questionnaire cum checklist in the context of two aspects of quality issues, namely assessment of physical arrangements for ANC (input) and services rendered by the providers (process).The mean age of respondents was 24.6±4.5 years. Majority of the respondents were with primary level education (60.3%). About half (52.8%) of the families had monthly income ranging from 3000-5000 taka (38-64 US$). Nearly half (48.9%) had no child, little more than one third (42.3%) were primigravida and 528 (57.7%) were multigravida. Out of 528 multigravid respondents 360 (68.2%) took ANC in their previous pregnancy whereas 168 (31.8%) did not take ANC Pregnancy outcome was found to be associated with receiving ANC (χ2=73.599; p=0.000). Respondents receiving ANC had more good pregnancy outcome. The mean waiting time for receiving ANC was 0.77±.49 hours. Out of the 13 centers, only 3 (23.1%) have sufficient instruments to render ANC services. Findings showed that where the modes of ANC service delivery in the ANC centers are fairly satisfactory. Though some of the points of standard operation procedures (SOPs) on ANC are not covered by some ANC centers, those were not considered necessary. But, regarding the physical facilities available for rendering ANC services, it is seen that facilities are not quite satisfactory. Number of doctors and nurses are not very satisfactory. One of the centers under this study has no doctor, where ANC services are given by nurses. It can be concluded that the ANC services at the primary health care level is not adequate in Bangladesh. To ensure further improvement of the quality of ANC services, instruments used in logistics and supplies should be enhanced.

To identify the non-obstetric causes and presentation of acute abdomen among pregnant women.This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed GeneralHospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11.5 (SPSS, Inc., Chicago, IL, USA).Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst,4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain.The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings.

To assess the level of knowledge of the adolescent girls regarding reproductive health issues. A cross sectional descriptive type of study was carried out among 150 unmarried adolescent girls of Vashantek slum in Dhaka city by face to face interview using a semi-structured questionnaire from January to June 2008. The mean age of the respondents were 16.4±2.9 years ranging from 10-19 years. Out of 150 respondents, 130 had history of menstruation and their median age of menarche was 13 years. The correct knowledge was high among the adolescent having secondary level of education than the SSC and above or primary level of education and the difference was statistically significant (p<0.05). About three-fourths of the respondents had sufficient knowledge about hygienic menstrual practice. Majority of the girls could mention the legal age of marriage. Regarding the demerits of early marriage, majority mentioned some of the demerits but not all. Three-fifths of the respondents had no knowledge on importance of family planning and regarding the methods of family planning, majority of them had no knowledge. Majority of the respondents heard the disease AIDS but regarding the knowledge on causative agent half of them had no knowledge. More than two-fifths had no knowledge on mode of transmission of AIDS. It was also found that majority of the respondents had no knowledge on symptoms of AIDS and three-fifths had no knowledge on prevention of AIDS. So formal, informal and special educational program may be taken to educate the adolescent girls on reproductive health issues and government should be more concerned about this.

To ascertain the unmet needs of family planning & identify the practice of family planning among the urban to rural migrated slum dwellers. A cross-sectional descriptive study was done randomly among selected 600 slum dwellers residing in two selected slums of Dhaka city. Data collected by face to face interview using pretested semi structured questionnaire. Among the respondents 87.7% of were females, illiterate was 60% and most (79.9%) of the houses were katcha and (37.3%) of the families had 5-7 persons in each family. Most families (70%) had monthly income of less than 5000 (app.US$70) taka per month. Majority (89.3%) of the families lived in the villages before coming to Dhaka. About 31.34% were living in present slum for 5-10 years and 80% came for search for better work. It was also found that 33.7% of the couples were not using any contraceptive method. About 29% of these couples did not mention any specific cause for not using family planning method. Only 3.5% of the respondents said of any sort of difficulty in collecting contraceptives and the main difficulty was shyness. As regards knowledge of above consequence of not using contraceptive method 97.7% opined that it would cause unplanned pregnancy, which indicated their awareness towards family planning. The study found that the respondents were aware about the needs of family planning but a great number of them were not using any contraceptive method without any specific reason. Some behavior change communication activities can be run within these areas to bring them under the family planning methods which eventually enhance the population control activity of the country.

To assess the level of awareness on breast cancer among women of reproductive age. A cross-sectional descriptive study was conducted in OPD of Dhaka Medical College Hospital among the 175 respondents by face to face interview using pretested semi structured questionnaire. One forth (23%) aged 21-25 years, mostly Muslim (86.3%), housewives (72.57%), had children (81.05%) and live in urban (69%) area. One third of them were illiterate and married at 16-20 years. Slightly less than half of their family income was taka 4500 to 5500. Six of 10 respondents (64%) knew that it was common cancer in women and almost all (94.29%) mentioned that breast cancer did not occur in old age. In addition half of them said that it was not inherited, signs and symptoms of breast cancer was spontaneous clear or bloody discharge from nipple often associated with a lump (61.14%), and it could not be cured (54.3%). Majority of them (78.9%) did not know that early diagnosis improves treatment outcome and the risk factor of breast cancer (65.14%). Half of them (57.5%) had knowledge that clinical breast examination as screening method of breast cancer but vast majority did not practice clinical breast examination. Only 16.67% of the respondents did BSE regularly and among them 83.33% did not know the best time for breast self examination. Practice breast feeding was universal among them but for less than 6 months. The study found that women were not so much aware regarding breast cancer and also preventive measures, risk factors so on. So for better awareness, campaign and counseling program from both Government and NGOs is needed.