Abstract:

Introduction: The third delay is the delay in receiving adequate and appropriate treatment at the healthcare facility by mothers during and after pregnancy. Many factors attribute to this; shortage of staff, insufficient training, antibiotic unavailability and equipment among others.

Objectives: The purpose of the study was to ascertain the preparedness of Arua regional referral hospital to handle referred emergency obstetrics cases.

Methods: A qualitative contextual descriptive phenomenological design was used. A sample of six (6) carefully selected mothers and four (4) midwives were used. Triangulation of methods was used to enhance quality. Transcriptions of the interviews was analyzed using descriptive thematic analysis

Findings: As per WHO criteria, Arua Regional Referral Hospital was rated as a fully functional EmOC facility. Out of the 6 respondent mothers, two had received Emergency Obstetric Care three times from the facility while the rest of them received EmOC more than 5times. When asked about history of having been referred out, non of them was referred out. Again, when asked about the outcome of all their deliveries, four out of 6 had good maternal outcomes whereas 2 had bad maternal outcomes.

Conclusion: Arua RRH remains an EmOC Health Facility, falling in keeping with the World Health Organization standard as well as the Uganda national standard, although some improvements are still wanting.

Recommendation: The hospital needs to embark on training other surrounding health facilities on EmOC.

Keywords: Third delays, Emergency Obstetric Care (Basic and Comprehensive), Signal function, triangulation of methods, phenomenological study design and member checks.

References:

[1]. Bhandari, T. R. & Dangal, G. (2014). Emergency Obstetric Care: Strategy for Reducing Maternal Mortality in Developing Countries. NJOG 9 (17):8-16. Retrieved from: njog.org.np/njog/index.php/njog/article/download/71/43/.

[2]. Bjarke, L. S., Elsass, P., Brigitte, B. N., Massawe, S., Nyakina, J., Vibeke, R. (2010). Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania. Tropical Medicine and International Health 15(8), 894-900. DOI: 10.1111/j.1365-3156.2010.02554.x.

[3]. Borgen project. (2016). the “Three Delays” at the Root of Maternal Mortality [Blog Post]. Retrieved from https://borgenproject.org/the-three-delays-maternal-mortality/.

[4]. Hannah, E. K., Alice, S., Stephen, H. K. (2013). Why Are Women Dying When They Reach Hospital on Time? A Systematic Review of the ‘Third Delay’. Plosone, 8 (5). DOI: https://doi.org/10.1371/journal.pone.0063846.

[5]. Helelo, A. Z., Zungu, L. I., & Chiegil, R. J. (2015). What creates good experiences for EmOC clients in public health facilities in Ethiopia? South African Family Practice, 57 (3), 203-207. DOI: 10.1080/20786190.2015.1024014.

[6]. Mismay, G., & morrow, R. H. (n.d.). Delay in Seeking and Receiving Emergency Obstetric Care in Eritrea. Journal of Eritrean Medical Association (JEMA). Retrieved from https://www.ajol.info/index.php/jema/article/viewFile/52700/41303.

[7]. Rodolfo, C. P., José, G. C., Mary, A. P., Maria, H. S., Samira, M. H., Maria, L. C., João, P. S., Pattinson, R. C. (2014). Delays in receiving obstetric care and poor maternal outcomes: results from a national multi-centre cross-sectional study. BMC Pregnancy and Childbirth, 14(159). DOI: 10.1186/1471-2393-14-159).

[8]. Tannia, T. (2015). Signal Functions for Emergency Obstetric Care (EmONC) as an Intervention for Reducing Maternal Mortality: A Survey of Public and Private Health Facilities in Lusaka District, Zambia (Master’s Dissertation, University of Zambia, 2015). Retrieved from http://dspace.unza.zm:8080/xmlui/bitstream/handle/123456789/4352/Final%20Dissertation.pdf?sequence=1&isAllowed=y.

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[10].  Uganda Bureau of Statistic [UBOS]. (2015). National Population and Housing Census 2014. Kampala: Author.

[11].  United Nations Development Programme [UNDP]. (2017). Sustainable Development Goal, Goal 3 targets [Blog Post]. Retrieved from http://www.undp.org/content/undp/en/home/sustainable-development-goals/goal-3-good-health-and-well-being/targets/.

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Abstract:

Objectives: To study the influence of planned exercise training in COPD patients on serum biomarkers - plasma fibrinogen, CRP, albumin.

Methods: This is a hospital based randomized control trial conducted in a tertiary care teaching hospital in northern Kerala from January 2016 to September 2017. 40 patients of COPD (GOLD category C& D) who are more than 40 years of age and without any serious other systemic diseases are divided equally into intervention and control group by random allocation. Both groups are given standard pharmacological treatment and the intervention group was taught about planned exercises which include purse lip breathing and diaphragmatic breathing and lower limb exercises to increase strength and stamina 25 times a day in morning and evening 5 days a week. All patients will be followed up for one year. Plasma fibrinogen, CRP, albumin were measured every 3 months during this one year follow up during stable disease.

Results and discussion: Present study had shown a significant improvement in biomarkers that include CRP, plasma fibrinogen and albumin.

Conclusion: The study concludes that there is an improvement in level of biomarkers following planned exercises.

Keywords: biomarkers, COPD, pulmonary rehabilitation, plasma fibrinogen, CRP, albumin.

References:

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[3]. Ipek Candemir, MD 1 , Pinar Ergun, MD 1 , Dicle Kaymaz, MD 1 , Nese Demir, phy 1 , Filiz Tasdemir,Serum C-Reactive Protein Levels In COPD Patients After Eight Week Comprehensive Pulmonary Rehabilitation Program. 2016 May (pp. A5730-A5730). American Thoracic Society.

[4]. Maria Tereza Aguiar Pessoa Morano, Mesquita R, Da Silva GP, Araújo AS, Pinto JM, Neto AG, Viana CM, De Moraes Filho MO, Pereira ED. Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC pulmonary medicine. 2014 Jul 28; 14(1):1.

[5]. Paz-Díaz H, De Oca MM, López JM, Celli BR. Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD. American Journal of Physical Medicine & Rehabilitation. 2007 Jan 1; 86 (1):30-6.

[6]. Ugur Gonlugur1,* and Tanseli E. Gonlugur.A Retrospective Analysis of Nutritional Parameters in Chronic Obstructive Pulmonary Disease between Sexes. J Clin Biochem Nutr. 2007 Nov; 41(3): 175–178.

Abstract:

Poor understanding of asthma can result in under- utilisation of available health services and reduced adherence to medications which ultimately leads to poorly controlled asthma and negatively impacts quality of life. Studies of association between asthma knowledge and asthma perceptions with socio- demographic variables (such as age, class level, ethnicity, religion, familial experiences) with and without health education intervention in Nigeria are sparse. The study identifies socio- demographic factors associated with knowledge and perceptions of asthma at the pre- test and post- test health education intervention among the secondary school students of Ile- Ife, Osun State, and South-West, Nigeria. It is a quasi- experimental design study which used a pre-tested 71- item, purpose designed, self-administered questionnaire to collect information on socio-demographic variables, knowledge and perceptions of the respondents on asthma before and after intervention. Data was collated and analyzed using appropriate descriptive and inferential study design. The results of this study showed that there were significant associations between posttest knowledge and variables of class level and religion. Another finding was that ethnicity showed a significant association between pretest perception score of the participants. It also showed there was a significant association between posttest perceptions and class level of the participants. We concluded that health education intervention influenced the association between certain socio- demographic variables (such as class level, religion and ethnicity) deployed in this study and the knowledge and perceptions of asthma among secondary school students in Ile- Ife, South- West, Nigeria.

Keywords: Asthma; Knowledge; Perceptions; Socio-Demographic variables.

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