Background: The phenomenon of social determinants to maternal death reduction in the continent of Africa is a global health problem of increasing concern. Every region had shown progress, although levels of maternal mortality remain unacceptably high in Africa. 1 Objectives: This narrative literature review study was conducted for exploring the key social determinants and ways of coping mechanisms, for the reduction of maternal mortality, among African women living inside the African continent. Methods: A narrative literature review design was applied using a variety of search engines employing a Boolean search strategy to retrieve research publications, "grey literature", and expert working group reports. Key findings: The review recognized different social determinants among African countries, which affect women's health negatively. The commonly reported include, health care provider attitude, economic/financial inequity, geographical (transportation problems), insecurity, marital status and age, education, gender equity, material and human resources, socio-cultural factors and health care system delivery. Whereas common strategies to cope with maternal health care services were found to be good dress, good reliance on social network, maternal health education, gender equality and male involvement in reproductive health activities. Conclusion: The continental maternal death trend did not reduced as it was intended by Millennium Development Goals (Goal-5) and still continues with Sustainable Development Goals (Goal-5), "Achieve gender equality and empower all women and girls"; therefore the importance of social determinants and coping strategies still remains crucial in accelerating maternal mortality reduction among many African countries.
Neural Tube Defects (NTDs) are congenital structural abnormalities of the brain (anencephaly) and vertebral column (spina bifida) that represented as one of the most common congenital malformations of neonates worldwide. A fouryear and eight months (January 1 st , 2007 to August 31 st , 2011) retrospective record review study on prevalence, trend, and associated demographic factors of NTD was conducted at Orotta National Referral Maternity Hospital, Asmara, Eritrea. The prevalence, trend and associated demographic factors were assessed by data extraction from hospital delivery register and patient cards. Associations between variables of maternal age, parity, and infant gender and primary outcomes were determined using χ 2 analyses and Poisson regression modeled cumulative incidence and controlled for confounders. Out of 39, 803 total deliveries 185 neonates were found to have NTDs related abnormalities, but 156 neonates identified with complete and welldocumented registers, medical records and charts showing a prevalence of 3.9 per 1000 deliveries. The most commonly identified NTDs were Anencephaly 75(48.1%), Hydrocephalus 29 (18.6%), Spina bifida 27 (17.3%), and Multiple NTDs 25 (16.0%). Marital status, ethnicity, religion, and maternal history of abortion were found to have no enough evidence, but women who delivered neonates with NTDs who had parity less than four 125 (80.1%) and age below 30 years 108 (69.2%)were observed to have higher chances. All the Anencephalic neonates were delivered by vaginal delivery, Majority (66 (88%)) with a weight of less than 2000 grams and were female by sex 55(74.3%); whereas 13(44.8%) Hydrocephalic neonates were delivered by Caesarian section and 26 (92.9%) had a weight greater than 2000 grams. The Appearance Pulse Grimace Activity Respiration(APGAR) score results were founded to be zero for all anencephalic neonates and for 17 (74%) of multiple NTD; while 40 percent of and 46 percent of neonates with spina bifida and hydrocephalus, respectively, had no APGAR at five minutes. Over the years of the study a significant increase in the trend of NTDs were observed, mainly that of anencephaly. The increase was 1.5 percent (p < 0.05). The results of Poisson analysis indicated an exceptional statistically significant increase of anencephaly only. The trend of NTDs in neonates was observed to increase significantly, mainly anencephaly. The study findings noted younger women (less than 30 years) and with parity less than four were at higher risk than those of older age and higher parity. NTDs can be prevented and reduced with folic acid supplementation and fortification of principal foods.
Background: Non-communicable diseases (NCDs) are noninfectious diseases that are not transmitted through personal contact, biological vectors, vehicles, and are not airborne. The major NCDs include diabetes, cardiovascular diseases (CVDs), cancer, chronic respiratory disease, injuries (accidents) and mental illness. These are the world's growing causes of preventable illness, disability, morbidity and mortality. Objectives: This literature review study conducted for exploring the social determinants of Non-Communicable Disease. Methods: A literature review was done by using a variety of search engines; a Boolean search strategy to retrieve research publications, "grey literature", and expert working group reports. Key findings: This review paper tried to explain globalization and its impacts on NCDs, focusing on global and regional structural and intermediary determinants of health inequalities and disparities, human right, gender and relevance of human right based approach (HRBA) on NCDs, Sustainable Development Goals (2015-2030) which are post 2015 (MDGs) and others. Conclusion: The paper focused on human development; by discussing the components of SDGs, and the social, economic, and environmental domains that affect its achievement. NCDs are embedded in the post-2015 development agenda, since they are leading causes of death and disability, through their effects on the societal, economic, and environmental domains that affects negatively to the sustainability of human development. Some drives of unsustainable development, such as the transport, food and agriculture, and energy sectors, also increase the risk of NCDs.
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