Select a category
Maternal mortality remains a public health problem worldwide. In 2015, maternal mortality was the second leading cause of mortality among women of reproductive age worldwide [1]. Ninety four percent of these deaths occurred in developing counties, of which African countries accounted for 65% [1]. Tanzania has a high burden of maternal mortality with an estimated maternal mortality ratio of 546 deaths per 100,000 live births [2]. Most of these deaths are preventable if women receive appropriate antenatal and intrapartum care by skilled attendants [3]. Direct causes of maternal mortality contribute to up to 80% of all maternal deaths. These include severe bleeding usually after childbirth (postpartum hemorrhage), high blood pressure during pregnancy and the postpartum period (preeclampsia and eclampsia), and infection usually after childbirth or complications of abortion [1].
A ten-year retrospective study undertaken in Tanzania reported that the leading cause of maternal mortality was eclampsia (34.0%), followed by obstetric haemorrhage (24.6%) and maternal sepsis (16.7%) [4]. The main indirect causes of maternal mortality were anaemia (14.9%) and cardiovascular disorders (14.0%). The study also reported an increasing trend of maternal death due to haemorrhage and cardiovascular disorders during the study period [4]. Two-and-a-half million neonates died in 2017 worldwide [3]. Sub-Saharan Africa and South Asia were big contributors to global neonatal mortality [3]. Tanzania is among the sub-Saharan countries contributing to this rate, with an estimated 25 deaths per 1000 live births [2].
The risk of a woman to die from maternal causes in developing countries is high compared to developed countries (one maternal death for every 41 live births compared to one maternal death for every 3,300 live births respectively) [1]. A collective effort is needed to reduce the gap between the global north and the global south. Learning from developed countries is a cornerstone strategy towards decreasing the risk of maternal and neonatal mortalities in the developing countries. One of the strategies used by the developed countries is the use of skilled attendants to assist women during labour and childbirth. Almost all births in these regions are assisted by skilled birth attendants regardless of the place of birth [1]. In Tanzania, more than 30% of all births occur out of health facilities, and 96% of those births are assisted by unskilled providers such as traditional birth attendants (TBAs) or relatives or friends [2]. These birth attendants often lack the necessary skills to identify signs of complications. In most cases, there is a delay on referrals to the facilities resulting to morbidity and mortality among mothers and newborns [5].
Skilled birth attendance is defined as the process by which a delivering woman is provided with satisfactory care during labour, delivery and the early postpartum period by a trained health care provider [6]. Although the use of skilled birth attendants have shown to be an effective strategy towards the reduction of maternal and neonatal mortality, still a number of women in Tanzania end up birthing at home, where they hardly get assistance from skilled birth attendants. These birth attendants in Tanzania play an important role in reduction of maternal and neonatal mortality through maternal and neonatal health counseling and escorting woman in labor to health facility for skilled birth [7, 8]. Based on local regulations, TBAs in Tanzania are not officially allowed to assist birth. However, they are allowed to provide maternal reproductive health counselling and escorting a woman to a health facility [7, 8]. Unlike developed countries, Tanzania lacks trained birth attendants who can assist delivery outside health facilities. Hence, most births occurring outside the health facilities are assisted by unskilled providers. In this study, home birth refers to all births which occur outside health facilities including but not limited to births at home and TBA clinics.
The World Health Organization (WHO) has reported several factors that may hinder pregnant women from accessing skilled antenatal and intrapartum care. These include; poverty, distance to a health facility, lack of information of where to access services, inadequate services and cultural practices [1].
Previous studies undertaken in rural Tanzania have also reported socio-cultural factors as one of the main determinants of maternal preference regarding place of birth [9]. For example, a socio-cultural tradition in some of the tribal cultures in Tanzania requires that when a married woman becomes pregnant for the first time, she has to go back to her parent’s home and the decisions of where to deliver rest on her mother [10].
Home delivery is a risk factor for the health of both a mother and a newborn [7]. In the effort of promoting hospital delivery, the government of Tanzania has established a program of building one health facility per village to address the challenge of walking distance to a nearby health facility [11]. The government of Tanzania has also removed the financial barriers to maternity services by removing out of pocket cost-sharing for delivering services [12]. It is stated in the health policy that all direct costs associated with pregnancy care and childbirth are to be covered by the government. The ultimate goal here is to remove financial barriers to accessing maternal health care services. On top of that, there are community campaigns by both government and non-governmental organizations to encourage utilization of health facility for delivery [13].
Despite all of these efforts, a large proportion of women in Tanzania and other developing countries continue to choose home birth over health facility. This study was conceptualized to explore the determinants of choice of home childbirth over health facility childbirth among women of reproductive age in Tanzania.
Methods
Study design and data
This study is a cross-sectional analysis of a dataset from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS).
The 2015-16 TDHS-MIS
This section of the method has been published previously in the report of “Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015-16†[2].
The 2015-16 TDHS-MIS is the ninth in a series of national sample surveys conducted in Tanzania to measure levels, patterns, and trends in demographic and health indicators. The survey was undertaken by the National Bureau of Statistics (NBS) and the Office of Chief Government Statistician (OCGS), Zanzibar, in collaboration with the Ministry of Health, Community Development, Gender, Elderly, and Children on the Tanzania Mainland and the Ministry of Health, Zanzibar. The primary objective of the 2015-16 TDHS-MIS was to provide up-to-date estimates of basic demographic and health indicators. The survey collected information on fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, childhood and maternal mortality, maternal and child health, malaria, and other health-related issues.
The sample design for the 2015-16 TDHS-MIS was done in two stages and was intended to provide.
estimates for the entire country, for urban and rural areas in Tanzania Mainland, and for Zanzibar. The first stage involved selecting sample points (clusters), consisting of enumeration areas (EAs) delineated for the 2012 Tanzania Population and Housing Census. A total of 608 clusters were selected. In the second stage, a systematic selection of households was involved. A complete households listing was carried out for all 608 selected clusters prior to the fieldwork. From the list, 22 households were then systematically selected from each cluster, yielding a representative probability sample of 13,360 households for the 2015-16 TDHS-MIS. All women age 15–49 who were either usual residents or visitors in the household on the night before the survey were included in the 2015-16 TDHS-MIS and were eligible to be interviewed. Out of a total of 13,360 households selected for the 2015-16 TDHS, 12,767 were occupied. Of the occupied households, 12,563 were successfully interviewed, yielding a response rate of 98%. In the interviewed households, 13,634 eligible women were identified for individual interviews; interviews were completed with 13,266 women, yielding a response rate of 97%.
Arsenal got up to a bright start in both Premier League and Carabao Cup, the Gunners have won their first two matches of the Premier League 2020/2021season, following their well deserved win against Fulham and WestHam. Mikel Arteta side will be hoping to continue in that direction. Although their toughest fixtures awaits them in their next match, where they will face Liverpool at Anfield.
The Gunners have made quality signings this summer, with Gabriel Magalhaes arriving and Willian from Chelsea. Arsenal are not done yet in the transfer market, more signings are still expected before the transfer window shuts on 5th October.
Following their impressive victory over Leceister City in the Carabao Cup, Arsenal will face winner of tomorrow's match between Lincoln City and Liverpool. As things stands, Arsenal will likely face Liverpool in the fourth round of the Carabao Cup, considering that Liverpool are stronger than Lincoln City, they may likely go through.
Big congratulations to Arsenal for comfortably progressing to the fourth round of Carabao Cup, where they will face Liverpool or Lincoln City.
Do you think Arsenal can win the Carabao Cup this season? Kindly share your opinion with us in the comment section.
kindly share far and wide
The views expressed in this article are the writer's, they do not reflect the views of Opera News. Please report any fake news or defamatory statements to feedback-newshub@operanewshub.com
PHOTOS: Many injured, market, vehicles destroyed in Lagos explosion
The Lagos State Emergency Agency said many vehicles, an event centre and a plank market were also destroyed.
SEE PHOTOS:
View gallery (2)Advertisement
Want To Get Rid Of That Halitosis (mouth Odour)? Read This!!!
The Facts
The Facts
Halitosis is also referred to as oral malodor, but most of us know it quite simply as "bad breath." Even though it's a comparatively minor health problem, bad breath can be distressing and a bit of a social handicap. It is not a wonder that we spend millions each year on efforts to freshen our breath with various gums, sprays, and mouthwashes.
Causes
The most common cause of bad breath is the food you eat. Garlic, onions, some kinds of fish, and diets rich in fat and meat can all result in halitosis. Saliva and bacteria naturally occurring in your mouth break down small pieces of food that are caught between your teeth. This releases volatile substances or chemicals that lead to bad breath.
The breakdown products of proteins in the body used for energy are exhaled through the lungs, and therefore missing meals, hunger, fasting, starvation, and low-calorie diets can also cause bad smelling "hunger breath."
Because there is no flow of saliva during sleep, putrefaction (decomposition or rotting) of saliva and debris in the mouth can lead to bad breath in the morning.
Halitosis is also caused by:
Taking certain medications can also cause bad breath, especially those that reduce the flow of saliva and dry out the mouth (e.g., some antidepressants, antipsychotics, antihistamines, decongestants, and medications to reduce high blood pressure).
Symptoms and Complications
The awkward irony of halitosis is that many people aren't aware that they have it. This is because the cells in the nose that are responsible for the sense of smell actually become unresponsive to the continuous stream of bad odour. If you have bad breath, you may need to be told, or you may notice the negative reaction of other people when you're just too close!
Making the Diagnosis
It's easy to self-diagnose bad breath. You can lick your wrist, let it dry for a few seconds and smell the area, or cup your hands over your mouth and sniff your own breath. If you need a second opinion, ask a friend, family member, or your physician or dentist.
Treatment and Prevention
The manufacturers of mints and mouthwashes have made an industry out of the public's desire for fresh breath. These products promise that your breath can be made sweet-smelling and "minty fresh." However, they're only temporarily helpful at best in controlling breath odours. In fact, many often contain sugar and alcohol, which may lead to tooth decay or dry mouth and may aggravate certain mouth conditions.
Proper care of the mouth and teeth and regular visits to the dentist are important, and are the most effective way to control bad breath. Regular brushing, flossing, rinsing, and tongue scraping can help prevent problems.
Sometimes, halitosis may be caused by illnesses such as lung disease, impaired emptying of the stomach, liver failure, or kidney failure. In this case, treating the underlying condition can improve the halitosis as well.
Here are some tips for getting rid of bad breath:
Arsenal Keen To Make Another ‘SHOCK’ Move For £50m-rated Chelsea Star
According to Sky Sports, Arsenal are showing interest in Chelsea midfielder Jorginho as their search for midfield reinforcements continues.
Arsenal manager Mikel Arteta was assistant to Pep Guardiola when Manchester City came close to signing Jorginho from Napoli in July 2018.
Arsenal had identified Lyon’s Houssem Aouar and Atletico Madrid’s Thomas Partey as their main targets for the summer window, but they are yet to make any kind of breakthrough with either and are now willing to push for Jorginho.
Jorginho has started both of Chelsea’s Premier League games this season but has tough competition for places with N’Golo Kante, Matteo Kovacic and Billy Gilmour all specialising in the deeper-lying role too.
Jorginho joined from the Serie A side in the summer of 2018 for £50m, plus a potential £7m in add ons. He has made 100 appearances for Chelsea, scoring 10 goals.
Ghana Education Service has put in place the following lines to help Parent, Guardians, Teachers, Candidate and the general public.
All Senior High Schools, Senior High Technical and Vocational schools are all in 5 categories, namely Category A, B, C, D and E. All candidates must choose their 1st, 2nd and 3rd choice from school in category A, B, C, and E in order of preference. Each choice must have a program and accommodation.
Each student and parent must note that category A schools can be selected once and category B schools can be selected twice. All three choices can be selected from category C and E.
Additionally students are mandatory to select one school from Technical or vocational school from category E. This category consists of public Senior High Technical and Vocational schools in Ghana. Candidates must know that when placed in this category; the program of choice shall be a technical or vocational program.
Also candidates must also select schools from category D. Category D represents the Day schools options, these schools are schools candidates will prefer to attend as Day student and therefore must be located in the candidates catchment area.
In total all candidates must select 5 schools. Parent are supposed to supervise their wards in the filling and selection process, signed and then submit forms to their current Junior High School.
I hope this article finds you well.
Thank you for reading this article. Stay tuned for more sports, entertaining and latest news.
Please don’t forget to share, like, comment and follow this page for more sports and entertaining articles like this.