IntroductionIn sub-Saharan Africa, referral hospitals are important sources of key maternal health services, especially during a crisis such as the COVID-19 pandemic. This study prospectively assessed the effect of the COVID-19 pandemic on maternal health service utilisation in six large referral hospitals in Guinea, Nigeria, Tanzania and Uganda during the first year of the pandemic.MethodsMixed-methods design combining three data sources: (1) quantitative data based on routine antenatal, childbirth and postnatal care data collected March 2019–February 2021, (2) qualitative data from recurring rounds of semi-structured interviews conducted July 2020–February 2021 with 22 maternity skilled heath personnel exploring their perceptions of service utilisation and (3) timeline data of COVID-19 epidemiology, global, national and hospital-level events. Qualitative and quantitative data were analysed separately, framed based on the timeline analysis and triangulated when reporting.ResultsThree periods including a first wave, slow period and second wave were identified. Maternal health service utilisation was lower during the pandemic compared with the prepandemic year in all but one selected referral hospital. During the pandemic, service utilisation was particularly lower during the waves and higher or stable during the slow period. Fear of being infected in hospitals, lack of transportation, and even when available, high cost of transportation and service closures were key reasons affecting utilisation during the waves. However, community perception that the pandemic was over or insinuation by Government of the same appeared to stabilise use of referral hospitals for childbirth.ConclusionUtilisation of maternal health services across the continuum of care varied through the different periods and across countries. In crisis situations such as COVID-19, restrictions and service closures need to be implemented with consideration given to alternative options for women to access and use services. Information on measures put in place for safe hospital use should be communicated to women.

IntroductionReferral hospitals in sub-Saharan Africa are located in crowded urban areas, which were often epicentres of the COVID-19 pandemic. This paper prospectively assesses how maternal healthcare was provided in six referral hospitals in Guinea, Nigeria, Tanzania and Uganda during the first year of the COVID-19 pandemic.MethodsMixed-methods design using three data sources: (1) qualitative data from repeated rounds of semi-structured interviews conducted between July 2020 and February 2021 with 22 maternity skilled heath personnel (SHP) on perceptions of care provision; (2) quantitative monthly routine data on caesarean section and labour induction from March 2019 to February 2021; and (3) timeline data of COVID-19 epidemiology, national and hospital-level events. Qualitative and quantitative data were analysed separately, framed based on timeline analysis, and triangulated during reporting.ResultsWe identified three periods: first wave, slow period and second wave. The first wave was challenging for SHP given little knowledge about COVID-19, lack of infection prevention and control training, and difficulties reaching workplace. Challenges that persisted beyond the first wave were shortage of personal protective equipment and no rapid testing for women suspected with COVID-19. We noted no change in the proportion of caesarean sections during the pandemic, and a small increase in the proportion of labour inductions. All hospitals arranged isolation areas for women suspected/confirmed with COVID-19 and three hospitals provided care to women with suspected/confirmed COVID-19. Breastfeeding was not discouraged and newborns were not separated from mothers confirmed with COVID-19. Care provision was maintained through dedication of SHP, support from hospital management and remote communication between SHP.ConclusionRoutine maternal care provision was maintained in referral hospitals, despite first wave challenges. Referral hospitals and SHP contributed to guideline development for pregnant women suspected/confirmed with COVID-19. Maternity SHP, women and pregnancy must always be included in priority setting when responding to health system shocks, including outbreaks.

This paper presents an on-chip step-wise ramp stimulus generator aimed at static linearity test applications for ADCs. The proposed ramp stimulus generator is based on a simple switched-capacitor integrator with a constant DC input. The integrator has been conveniently modified to produce a very small integration gain proportional to the capacitance difference of two capacitors, in such a way that the resulting step-wise ramp signal at the output has a step size below the LSB of the target ADC under test. In order to verify the feasibility of the proposed ramp generation technique, this paper details the design and experimental characterization of a proof-of-concept step-wise ramp generator in a 65 nm CMOS technology. Experimental results on 15 fabricated samples show an average linearity of 14.5 effective bits in a differential output range of ±2 V. Moreover, a discrete-time static linearity measurement strategy is proposed and, as a proof-of-concept validation, it is verified on an offthe-shelf 11-bit ADC using the fabricated generator samples. Experimental results show an accuracy of ±0.3 LSB in the measurement of the INL of the ADC under test.

In the context of highly data-centric applications, close reconciliation of computation and storage should significantly reduce the energy-consuming process of data movement. This paper proposes a Computational SRAM (C-SRAM) combining In-and Near-Memory Computing (IMC/NMC) approaches to be used by a scalar processor as an energy-efficient vector processing unit. Parallel computing is thus performed on vectorized integer data on large words using usual logic and arithmetic operators. Furthermore, multiple rows can be advantageously activated simultaneously to increase this parallelism. The proposed C-SRAM is designed with a two-port pushed-rule foundry bitcell, available in most existing design platforms, and an adjustable form factor to facilitate physical implementation in a SoC. The 4kB C-SRAM testchip of 128-bit words manufactured in 22nm FD-SOI process technology displays a sub-array efficiency of 72% as well as an additional computing area of less than 5%. The measurements averaged on 10 dies at 0.85V and 1GHz demonstrate an energy efficiency per unit area of 35.6 and 1.48TOPS/W/mm² for 8-bit additions and multiplications with 3ns and 24ns computing latency, respectively. Compared to a 128-bit SIMD processor architecture, up to 2x energy reduction and 1.8x speed-up gains are achievable for a representative set of highly data-centric application kernels.

In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management. Patients and Method: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from

No abstract

No abstract

No abstract