Background
CenteringPregnancy (CP), a model of group antenatal care, was implemented in 2012 in the Netherlands to improve perinatal health; CP is associated with improved pregnancy outcomes. However, motivating women to participate in CP can be difficult. As such, we explored the characteristics associated with CP uptake and attendance and then investigated whether participation differs between health care facilities. In addition, we examined the reasons why women may decline participation and the reasons for higher or lower attendance rates.
Methods
Data from a stepped‐wedge cluster randomized controlled trial were used. Univariate and multivariate logistic regression models were used to determine associations among women's health behavior, sociodemographic and psychosocial characteristics, health care facilities, and participation and attendance in CP.
Results
A total of 2562 women were included in the study, and the average participation rate was 31.6% per health care facility (range of 10%‐53%). Nulliparous women, women <26 years old or >30 years old, and women reporting average or high levels of stress were more likely to participate in CP. Participation was less likely for women who had stopped smoking before prenatal intake, or who scored below average on lifestyle/pregnancy knowledge. For those participating in CP, 87% attended seven or more out of the 10 sessions, and no significant differences were found in women's characteristics when compared for higher or lower attendance rates. After the initial uptake, group attendance rates remained high.
Conclusion
A more comprehensive understanding of the variation in participation rate between health care facilities is required, in order to develop effective strategies to improve the recruitment of women, especially those with less knowledge and understanding of health issues and smoking habits.
Malaria in children is a serious infectious disease. In Suriname, many children died due to malaria in the past. To prevent malaria in children, anti-malaria campaigns were executed. The last campaign was implemented from 2005 to 2010. To develop a strategy for the future, the current prevalence and mortality rates are needed. Since 1955, all confirmed malaria cases were registered by the Medical Mission and this database was used to determine the prevalence rate. For the mortality rates we used the cause of death which was registered on death certificates. Since 2005 no children died due to malaria. Also the prevalence rate dropped dramatically from 7255 in 2001 to 10 in 2014. However, despite these great results, 10 children were still diagnosed with malaria and there is a need for continuous attention to bring this number down to zero. The mobile goldmine workers can impose a threat for a new malaria epidemic, if they spread the malaria infection in Suriname. Therefore, effective prevention measures and treatment are still needed.
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