期刊论文详细信息
BMC Pregnancy and Childbirth
Ancillary benefits of antenatal ultrasound: an association between the introduction of a low-cost ultrasound program and an increase in the numbers of women receiving recommended antenatal treatments
Ssembatya Renny6  Michael Grace Kawooya4  Alphonsus Matovu3  Anthony Mwatha1  Sonia Souza1  Anastasia Coutinho5  Kristen K DeStigter2  Andrew B Ross2 
[1] Clinical Research Division, Philips Healthcare, 22100 Bothell Everett Hwy, Bothell 98021, Washington, USA;Department of Radiology, University of Vermont Medical Center, 111 Colchester Rd., Burlington 05401, Vermont, USA;Department of Surgery, Mubende Regional Referral Hospital, Mubende, Uganda;Ernest Cook Ultrasound Research and Education Institute, Mengo Hospital, Sir Albert Cook Rd., Kampala, Uganda;University of Vermont College of Medicine, 89 Beaumont Ave., Burlington 05405, Vermont, USA;Imaging the World Africa, Nayla-Namugongo Rd., Nayla, Uganda
关键词: Antenatal ultrasound;    Global health;    Antenatal care;    Neonatal health;    Maternal health;   
Others  :  1090652
DOI  :  10.1186/s12884-014-0424-9
 received in 2014-07-21, accepted in 2014-12-10,  发布年份 2014
PDF
【 摘 要 】

Background

In June of 2010, an antenatal ultrasound program was introduced to perform basic screening examinations at a health care clinic in rural Uganda. The impact of the program on the existing antenatal care infrastructure including the proportion and number of women receiving recommended antenatal care at clinic visits was unknown. The aim of this study was to investigate the relationship between the advent of the ultrasound program and the proportion of women receiving recommended antenatal interventions at their clinic visits. Change in the absolute numbers of antenatal services provided was also assessed.

Methods

Records at the Nawanyago clinic were reviewed to determine the total numbers of women receiving specific interventions before and after the advent of the ultrasound program including HIV testing, intermittent preventive therapy for malaria, presumptive anti-parasitic treatment, and provision of iron and folate for anemia. The rate at which these interventions were provided (number of interventions per clinic visit) was also assessed. The differences in absolute numbers of antenatal interventions before and after the introduction of the ultrasound program were assessed using the Wilcoxon rank-sum test. Differences in intervention rate were assessed using negative binomial regression modeling.

Results

The mean monthly numbers of women receiving each of these interventions increased significantly with the greatest increase seen in numbers of women receiving anemia and deworming treatments at +113% and +102% respectively (p < 0.001). The intervention rate increased for anemia treatment, deworming treatment, and 2nd dose of intermittent preventive therapy for malaria. A slight decrease in intervention rate was observed for 1st dose of malaria treatment with a rate ratio of 0.88 (0.79 - 0.98, 95% CI). Intervention rate for HIV testing was not significantly changed.

Conclusion

The introduction of a low-cost antenatal ultrasound program at a health care clinic in rural Uganda was associated with increases in the number of women receiving specific recommended antenatal care interventions. Effect on intervention rates was mixed but showed an overall increase. The use of ultrasound in this context may provide a benefit to the maternal and neonatal health of the community.

【 授权许可】

   
2014 Ross et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150128162448758.pdf 725KB PDF download
Figure 3. 32KB Image download
Figure 2. 64KB Image download
Figure 1. 31KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Chou D, Inoue M, Mathers C, Moller A, Oestergaard M, Say L, Mills S, Suzuki E, Wilmoth J, Shiner C: Trends in maternal mortality: 1990 to 2010. WHO UNICEF UNFPA and the World Bank estimates. allAfrica 2012, 12(9811):84.
  • [2]Assembly UG: United Nations Millennium Declaration. Resolution Adopted 2000, 18.
  • [3]Organization WHUnited Nations Children’s Fund: Countdown to 2015, Maternal, Newborn and Child Survival: Building a Future for Women and Children, The 2012 Report. WHO and UNICEF, Geneva; 2012.
  • [4]Haines A, Cassels A: Can the millennium development goals be attained? BMJ 2004, 329(7462):394.
  • [5]Ronsmans C, Graham WJ: Maternal mortality: who, when, where, and why. Lancet 2006, 368(9542):1189-1200.
  • [6]Graham WJ, Bell JS, Bullough CH, De Brouwere V, Van Lerberghe W: Can skilled attendance at delivery reduce maternal mortality in developing countries. Stud HSO&P 2001, 17:97-130.
  • [7]Organization WH: Making Pregnancy Safer: The Critical Role of the Skilled Attendant: A Joint Statement by WHO, ICM and FIGO. WHO, Geneva, Switzerland; 2004.
  • [8]De Brouwere V, Tonglet R, Van Lerberghe W: Strategies for reducing maternal mortality in developing countries: what can we learn from the history of the industrialized West? Tropical Med Int Health 1998, 3(10):771-782.
  • [9]Bloom SS, Lippeveld T, Wypij D: Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy Plan 1999, 14(1):38-48.
  • [10]Freedman LP, Graham WJ, Brazier E, Smith JM, Ensor T, Fauveau V, Themmen E, Currie S, Agarwal K: Practical lessons from global safe motherhood initiatives: time for a new focus on implementation. Lancet 2007, 370(9595):1383-1391.
  • [11]Uganda Bureau of Statistics website.http://www.ubos.org/onlinefiles/uploads/ubos/pdf%20documents/2010StatAbstract.pdf. Accessed 1/22/2014.
  • [12]Kabakyenga JK, Östergren P-O, Turyakira E, Pettersson KO: Influence of birth preparedness, decision-making on location of birth and assistance by skilled birth attendants among Women in South-Western Uganda. PLoS ONE 2012, 7(4):e35747.
  • [13]Villar J, Ba’aqeel H, Piaggio G, Lumbiganon P, Belizán JM, Farnot U, Al-Mazrou Y, Carroli G, Pinol A, Donner A: WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet 2001, 357(9268):1551-1564.
  • [14]Carroli G, Rooney C, Villar J: How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatr Perinat Epidemiol 2001, 15(s1):1-42.
  • [15]McDonagh M: Is antenatal care effective in reducing maternal morbidity and mortality? Health Policy Plan 1996, 11(1):1-15.
  • [16]Tann CJ, Kizza M, Morison L, Mabey D, Muwanga M, Grosskurth H, Elliott AM: Use of antenatal services and delivery care in Entebbe, Uganda: a community survey. BMC Pregnancy Childbirth 2007, 7(1):23. BioMed Central Full Text
  • [17]Geerts LT, Brand EJ, Theron GB: Routine obstetric ultrasound examinations in South Africa: cost and effect on perinatal outcome–a prospective randomised controlled trial. BJOG 1996, 103(6):501-507.
  • [18]Van Dyk B, Motto J, Buchmann E: Routine second-trimester ultrasound for low risk pregnancies in a South African community. Int J Gynecol Obstet 2007, 98(3):257-258.
  • [19]Harris RD, Marks WM: Compact ultrasound for improving maternal and perinatal care in low-resource settings review of the potential benefits, implementation challenges, and public health issues. J Ultrasound Med 2009, 28(8):1067-1076.
  • [20]DeStigter KK, Morey GE, Garra BS, Rielly MR, Anderson ME, Kawooya MG, Matovu A, Miele FR: Low-cost teleradiology for rural ultrasound. In: Global Humanitarian Technology Conference (GHTC), 2011 IEEE: 2011: IEEE; 2011: 290–295.
  • [21]Ross AB, DeStigter KK, Rielly M, Souza S, Morey GE, Nelson M, Silfen EZ, Garra B, Matovu A, Kawooya MG: A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda. PLoS ONE 2013, 8(10):e78450.
  • [22]Garra B, DeStigter K, McEathron B, Dattamajumdar A: Scan Protocols for use by Non-medical Personnel in Developing Countries: Organ Visibility and Reproducibility.Official Proceedings of the American Institute of Ultrasound in Medicine 2008.
  • [23]Bale JR, Stoll BJ, Lucas AO: Improving Birth Outcomes: Meeting the Challenge in the Developing World. National Academies Press; 2003
  文献评价指标  
  下载次数:48次 浏览次数:17次