Rosnah Sutan

Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia

BackgroundThis cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.MethodsA structured questionnaire was used in conducting this study involving all government health clinics in Petaling district between July and September 2006. Respondents were Malaysian women with children between the ages of six to twelve months who were formally employed. Factors studied were selected socio-demographic and work-related characteristics.ResultsFrom a total of 290 respondents, 51% discontinued breastfeeding. The majority (54%) of mothers who discontinued breastfeeding had breastfed their babies for less than three months. Compared to Malay mothers, the risk of breastfeeding discontinuation were higher among Chinese (AOR 3.7, 95% CI: 1.7, 7.8) and Indian mothers (AOR 7.3, 95% CI 1.9, 27.4). Not having adequate breastfeeding facilities at the workplace was also a risk factor for breastfeeding discontinuation (AOR 1.8, 95% CI: 1.05, 3.1).ConclusionIt is important that workplaces provide adequate breastfeeding facilities such as a room in which to express breast milk and a refrigerator, and allow mothers flexible time to express breast milk.

Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight

ObjectiveTo evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.MethodsA cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire.ResultsSixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0±5.6) years and a majority of the subjects aged between 20–34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income.ConclusionMothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not.

Psychosocial impact of perinatal loss among Muslim women

BackgroundWomen of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women.MethodsA qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy.ResultsTwo out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them.ConclusionMuslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed.

Khat chewing amongst adult Yemeni women; the role of husband and family context: a cross-sectional study

Background Chewing the ‘amphetamine like’ khat leaf in the Arabian Peninsula and East Africa communities emerges currently as a public health threat. It may impact health directly or through family dysfunction and alteration of agricultural practices. There is little information about khat chewing among Yemeni women. Understanding the context of khat chewing in women is important if preventive measures are to be laid. The objective of the study was to assess and delineate factors associated with khat chewing among women in Yemen.

Does cultural practice affects neonatal survival- a case control study among low birth weight babies in Aceh Province, Indonesia

BackgroundCultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low birth weight babies in Aceh Province Indonesia.MethodsUnmatched case control study was conducted using data from year 2010 to 2012 in 8 selected districts of Aceh Province Indonesia. A total of 500 samples were obtained. There were 250 of the samples died in neonatal period (case group) and 250 who were alive (control group). There were 26 variables studied and were grouped into 4 factors: neonatal factor, maternal factor, maternal and child health services and neonatal care practices. The data was analysed using bivariate logistic regression and multivariate logistic regression.ResultsThere were 13 out of 26 variables found as determinant factors of neonatal mortality among low birth weight babies in Aceh Province. The predictors found in this study were: boy (aOR1.80, 95% CI: 1.09-2.96), moderate low birth weight (aOR17.84, 95% CI: 6.20-51.35), preterm (aOR1.84, 95% CI: 1.07- 3.17), presence of maternal illnesses (aOR1.87, 95% CI: 1.06-3.30), too short or too long birth interval (aOR1.80, 95% CI: 1.20-2.91), inappropriate antenatal care (aOR2.29, 95% CI: 1.34-3.91), inappropriate neonatal visit (aOR7.04, 95% CI: 3.67-13.49), not practicing kangaroo mother care (aOR15.32, 95% CI: 2.85-82.56), not using warm bottle padding (aOR20.70, 95% CI: 6.32-67.80), not practicing ‘didaring’ (aOR4.33, 95% CI: 1.83-10.19), late initiation of breastfeeding (aOR2.03, 95% CI: 1.09-3.80), discard colostrums (aOR3.53, 95% CI: 1.93-6.43) and not practicing exclusive breastfeeding (aOR5.58, 95% CI: 2.89-10.77).ConclusionsCultural practices are strongly seen among Acehnese. Inappropriate antenatal care and neonatal care, late initiation of breastfeeding, discarding colostrums and not practicing exclusive breastfeeding were related to cultural practices. Improving knowledge heat preservation to prevent hypothermia using Kangaroo mother care, warm bottle padding and ‘didaring’ were proven methods to reduce neonatal mortality. Strengthening of health services in screening for high risk cases and anticipate intervention tailored to cultural practices are important to decrease neonatal mortality among low birth weight.

Prevalence and Determinants of Appropriate Health Seeking Behaviour among Known Diabetics: Results from a Community-Based Survey

Introduction. Living with diabetes requires patients to have good self-monitoring of their disease and treatment. Appropriate health seeking behavior is important to minimize complications and improve quality of life. Methodology. A community-based, cross-sectional study of disease events and experiences from diagnosis to the time of study was conducted among 460 known diabetics in Tanjong Karang district. The aim of this study was to describe the current pattern of health seeking behavior and its determinants among rural communities. Appropriate diabetic health services utilization was defined as using modern treatment either through oral hypoglycemics or insulin injections, obtained from either a public or private health facility. Result. 85.9% of respondents reported having appropriate health seeking behaviour at the time of the house-to-house community survey. Multivariate logistic regression analysis revealed that appropriate health seeking behaviour was significantly associated with age of respondent, presence of comorbidity, family history of diabetes, distance from health facilities, perceived family support, and history of early treatment seeking at diagnosis and duration of disease. Conclusion. The present population has better appropriate health seeking behavior and provision of knowledge with strong family support in diabetic care which are important in control and prevention of diabetic complication that need to be emphasized.

The Effect of Early Initiation of Breastfeeding on Neonatal Mortality among Low Birth Weight in Aceh Province, Indonesia: An Unmatched Case Control Study

Background. Early initiation of breastfeeding is the breastfeed that is received by the baby within the first hour of birth. It is recommended to reduce infant mortality and illness. Objective. To assess the effect of early initiation of breastfeeding on neonatal mortality for low birth weight in Aceh province, Indonesia. Method. In this qualitative study unmatched case controls were used as the design. Data was collected in 8 districts in Aceh province, Indonesia, between January and December 2012. The total sample for this study was 500 LBW who were born between 2010 and 2012, subdivided into 250 LBW who died in neonatal period and 250 LBW who survived during neonatal period. Result. Thermal care and hygienic practice were not significantly associated with neonatal mortality among LBW. Feeding and early initiation of breastfeeding were associated. Discussion. Early initiation of breastfeeding had an effect on neonatal mortality for the low birth weight in Aceh province, Indonesia. The risk of mortality was decreased for those neonates who accepted breast milk within the first hour after birth. Therefore it is concluded that a new strategy to promote and improve the coverage of the initiation of breastfeeding is needed.

Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015

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The Effects of Short Health Messages Intervention in Improving Knowledge and Attitude on Sexual and Reproductive Health among Late Adolescents at Colleges in Malaysia

Sexual and reproductive health problems among adolescents are increasing in trend. Inadequate knowledge of sexual and reproductive health is the main cause of problems in sexual and reproductive health. Short messages service (SMS) intervention has been implemented widely in health education and the outcomes are positive. Hence, this study was conducted to evaluate the effects of mobile phone messaging in improving sexual and reproductive health among late adolescents (age 18 - 19 years old). A quasi-experimental study was conducted in two Professional Vocasional Colleges in Malaysia. A total of 116 respondents in the intervention group and 130 respondents in the control group had completed the study. There was a series of 24 messages (SMS) sent to the respondents biweekly for 12 weeks. The adolescent girls (mean knowledge score 15.90, sd ± 3.321) in the intervention group had a significantly (P = 0.007) higher mean score in knowledge of sexual and reproductive health than boys (mean knowledge score 13.87, sd ± 4.003) at post intervention. The adolescent boys (mean knowledge scores 15.35, sd ± 4.748) in the control group had a significantly (P = 0.009) higher mean score for knowledge on HIV/AIDS than girls (mean scores 13.08, sd ± 4.325) at post intervention. In the intervention group, the number of respondents with good knowledge and good attitude on HIV/AIDS increased at 3 months post intervention. SMS intervention on knowledge of sexual and reproductive health for adolescents was accepted and effectively improved the knowledge scores and sustained even after 3 months post intervention. Therefore, the SMS intervention should be implemented as an intervention package to improve knowledge and reduce risk in developing sexual and health related problems among adolescents.

Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

BackgroundResearch on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.MethodsWe used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).ResultsPrevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband’s depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife’s depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.ConclusionBoth ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.