BackgroundIndoor residual spraying (IRS) is known to reduce malaria transmission. In northern Uganda, a high endemic area, IRS has been implemented since 2006. Limited data however, exists on the effect of IRS on the malaria burden. This study sought to assess the effect of IRS on malaria morbidity in the high intensity area of northern Uganda. Retrospective routine data from ten health facilities in three districts which had received at least five rounds of IRS in northern Uganda was analysed. The primary outcome of interest was malaria morbidity, measured by the slide positivity rate (SPR). Descriptive statistics were used to describe the malaria morbidity stratified by age and sex. The average change in the malaria morbidity, measured by the SPR was assessed according to time, measured as calendar months. A fixed-effects linear regression model was used which included a polynomial function of time and controlled for malaria seasonality and variations between districts/facilities.ResultsThe total out-patient department attendance in the ten health facilities for the study period was 2,779,246, of which 736,034 (26.5%) malaria cases were diagnosed with 374,826 (50.9%) cases of under 5 years and an overall SPR of 37.5%. The percentage point (p.p.) changes in SPR according to time measured as calendar months following IRS, revealed a decreasing trend in malaria morbidity in the first 3 months following each round of IRS. The highest percentage point decrease in the SPR was observed in the second month following IRS (9.5 p.p., CI −17.85 to −1.16, p = 0.026), among patients above 5 years. The SPR decline however waned by the fourth month following IRS, with an increase in the SPR of 8.4 p.p. at district level by the sixth month, p = 0.510.ConclusionThe study results show that IRS was associated with a significant reduction in malaria morbidity in northern Uganda in the first 3 months following IRS. The malaria reduction however waned by the fourth month following IRS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1652-4) contains supplementary material, which is available to authorized users.

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Several studies have been conducted in Ghana on issues of health service satisfaction and quality, but this is about the first, critically looking at satisfaction with child birth services in Ghana.

Female genital mutilation (FGM) still remains one of the challenges facing women in many countries around the world. Efforts to eradicate the practice are on going but the results are still modest due to, among other things, ingrained cultural traditions that expose women to serious health consequences. In Africa where FGM is practiced in more than 28 countries, males have been found to perpetuate the practice. Using baseline data on FGM collected in 1998 by the Navrongo Health Research Centre in Ghana, we examined factors that influence males' choice of marrying circumcised women. Results from regression analysis show that the illiterate and those who have been to primary school are more likely to prefer circumcised women than those with secondary and higher education. In addition, ethnicity and religion are also significant factors that influence males' preference to marry circumcised women. A number of policy implications are discussed. RÉSUMÉLa préférence chez les hommes pour les femmes excisées au Ghana du nord. La mutilation génitale feminine (MGF) demeure encore un des défis auxquels font face les femmes dans plusieurs pays partout dans le monde. Les tentatives pour éliminer la pratique sont en cours, mais les résultats ne sont encore que modestes dû, entre autres, aux traditions culturelles enracinées qui exposent les femmes aux graves conséquences sur la santé. En Afrique où la MGF est pratiquée dans plus de 28 pays, il a été découvert que les hommes perpétuent la pratique. A l'aide des données de lignes de base sur la MGF recuellies en 1998 par Narrengo Health Research Centre (Centre de Recherche sur la santé de Navrengo) au Ghana, nous avons étudié les facteurs qui influent sur le choix des hommes pour épouser les femmes excisées. Les résultats tirés de l'analyse de regression montrent que les hommes illétrés et celles qui ont été à l'école primaire avaient plus la possibilité de préférer les femmes excisées que ceux qui ont fréquenté les écoles secondaires ou tertiaires. En plus, l'ethnicité et la religion constituent des facteurs importants qui influent sur les préférences chez les hommes pour se marier avec les femmes excisées. Nous avons discuté un certain nombre d'implications de la politique. (Rev Afr Santé Reprod 2006; 10[2]:37-47)

Background Perinatal deaths account for 7% of the global burden of disease, with developing countries contributing about 98% of deaths. The aim of this study was to describe the prevalence and factors contributing to adverse pregnancy outcomes, particularly perinatal death, among women at Sakubva hospital, Mutare district, Zimbabwe from January to June 2014. Methods We conducted a retrospective review of 346 patient records, of women who delivered at Sakubva hospital and those referred from Mutare district facilities to Mutare Provincial Hospital, between January and June 2014. Descriptive statistics was used to explore the contributors to stillbirths and early neonatal deaths in Mutare. Results Of the 346 women, 54 (15.61%) experienced an adverse pregnancy outcome (stillbirth or early neonatal death). Contributing factors to adverse pregnancy outcomes included birthweight, gestational age, delivery complications and delivery methods. These factors are preventable if quality focused antenatal care, intrapartum care is provided. Identification of pregnancy complications and facilitation of proper method of delivery is key to improve quality of care. Caesarean section provision to all women who need it improves outcomes. Conclusions High prevalence of adverse pregnancy outcomes in Mutare district could be reduced through the provision of quality antenatal care throughout the continuum of care, pre-, intra and postpartum. Further studies to explore risk factors associated with high adverse outcomes are recommended.

BackgroundRisks of severe, avoidable maternal and neonatal complications at birth are increased if the birth occurs before arrival at the health facility and in the absence of skilled birth attendants. Birth Before Arrival (BBA) is a preventable phenomenon still common in modern-day practice despite extensive improvements made in obstetric care and in accessibility to healthcare in South Africa. This study aimed to determine the risk factors and outcomes in mothers and babies associated with being born before arrival at hospitals.MethodsA prospective case control study design was conducted. All BBAs presenting to the hospitals in Nkangala District between November 2015 and February 2016 were included and compared to a consecutive hospital delivery occurring immediately after the arrival of each BBA. T-tests and chi square tests were used to analyse the differences between the groups and a binary logistic regression analysis used to determine predictors of BBAs. All statistical analysis were done using STATA version 14 using a 5% decision level and a 95% confidence interval.ResultsDuring the study period, 4397 in-facility births and 201 BBAs were recorded, 78 BBAs and 75 controls were investigated in this study. The district BBA prevalence was 4.6%. Risk factors identified in mothers of BBAs were: single mothers (83.3% vs 69.3%; p = 0.04); residing in an informal settlement (23.1% vs 5.3%; p = 0.002); and higher gravidity with plurigravida significantly more (60.3% vs 32.5%; p < 0.0001). A prevalent maternal complication in cases was haemorrhage due to retained placenta. Most neonates were born alive with a higher proportion of cases experiencing perinatal complications such as respiratory distress, hypothermia and asphyxia. No significant differences in maternal age, employment status and immediate birth outcomes were found. Residing in informal settlements, higher gravidity, unplanned pregnancy, low birth weight and unbooked were found to predict the occurrence of BBAs.ConclusionAlthough no significant numbers of mortalities were recorded in this study, service delivery interventions targeting the reduction of BBAs are needed so as to minimise the morbidity experienced by the group.

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