Self-reported postpartum morbidity: prevalence and determinants among women in Marrakesh, Morocco

Magnitude of postpartum morbidity and associated factors in southeast Ethiopia, 2022: A facility-based cross-sectional study

Objective

Maternal mortality in Ethiopia is estimated to be 205 per 100,000 live births, with postpartum morbidities expected to surpass maternal mortality substantially. Beside this, there is a lack of information on postpartum morbidities in the study area. Thus, the purpose of this study was to assess the magnitude of postpartum morbidities and associated factors in Bale Robe Town, southeast Ethiopia.

Method

An institution-based cross-sectional study was employed among 371 from 1 April to 30 May 2022 among postpartum women attending postnatal care service in the Bale-Robe Town public health facilities. A face-to-face interviewer administered a structured questionnaire, and the participants were selected through a systematic random sampling technique. A bivariate analysis was performed to see the association between each independent variable and dependent variable, and variables with p-values less than 0.25 in the bivariate analysis were retrieved for multivariable analyses. A p-value of less than 0.05 indicated a 95% confidence interval as the level of statistical significance.

Result

A total of 366 participants were involved in the study, giving us a response rate of 98.6%. The magnitude of postpartum morbidities among mothers was found to be 102 (27.9%), with a confidence interval of 95% CI: 23.3, 32.8. Women who hadn't had antenatal care follow-up (AOR = 2.47, 95% CI: 1.36, 4.50), instrumental delivery (AOR = 2.69, 95% CI: 1.16, 6.26), unskilled birth attendant (AOR = 3.35, 95% CI: 1.06, 10.63), rural residence (AOR = 2.21, 95% CI: 1.26, 3.89), and current pregnancy-related morbidity or abnormality (AOR = 3.81, 95% CI: 2.00, 7.25) were significantly associated factors.

Conclusion

This study revealed that the occurrence of postpartum morbidity in Bale Robe is a great health concern. Therefore, we recommend health professionals and health extension workers strengthen early detection and management of intrapartum abnormalities, give attention during instrumental deliveries, and strengthen skilled birth attendants.

Mapping maternal and infant health in Morocco: A global scoping review of themes, gaps, and the "unseen" in the published health research literature, 2000-2022

Global efforts to reduce Maternal Mortality Rates (MMR) have been significant, but researchers are exploring new approaches to address stalled progress and enduring health inequities. This scoping review offers an analytic synthesis of maternal and infant health (MIH) research in the low-middle income North African Islamic country of Morocco over 22 years, a mapping of the themes, research gaps, geographies, and methodologies, 2000-2022. Morocco is an official MIH success story with excellent health indicators, yet indicators do not address local contexts, gender issues, or health disparities. To understand how medical research has reflected social reality over the past 22 years, we explored not just what is known, but how it is known, where it is known, what remained unseen, and why. Four databases were searched: OVID: MEDLINE, Embase, APA PsycINFO, and EBSCO: CINAHL. 4590 abstracts were identified, 3131 abstracts screened, and 402 full MIH articles and 128 sub-group articles identified and subject to data extraction. The 402 full MIH articles were subject to qualitative thematic analysis, classified by 34 primary research themes and explored especially for gender, health equity, and methodology. Findings included significant geographic research disparities; four regions were the location of 75% of research and many regions remained virtually "unseen" by research. The best-equipped urban public hospitals in higher-income regions produced the most research, creating an urban, hospital-based research perspective. Maternal health articles predominated, often >50% more than articles published about infant health. Infants studied were mostly neonates. Socially marginalized women were often invisible to research, as were private healthcare, NGO care (non-governmental civic organizations), and healthcare in community. In articles, researchers recommended new policies, new laws, health system reform, and government actions to advocate for patients. Three solutions emerged to broaden the research perspective: increase geographic breadth, address missing topics and populations, and embrace interdisciplinary methods.

Scoping Review to Identify Social Determinants of Maternal Health in Morocco

To understand the mechanism of health inequities and their influence on maternal health, the Commission on Social Determinants of Health (CSDH) provides a framework to identify structural and intermediate causes of health inequity. This review maps and describes the current socioeconomic determinants of maternal health in Morocco according to the CSDH framework. A scoping study was carried out from six databases (Springer, Web of Science, Pubmed, Science Direct, Jstor, and Cochrane library) based on quantitative and qualitative research done since 1990. Structural factors such as women's employment and economic status, education level, culture, and gender equity were influenced by intermediary factors such as place of residence, age at marriage, maternal age at childbirth, and parity (either alone or in conjunction with other variables). Together these factors worked to influence maternal health service usage or affected maternal health outcomes. Power dynamics were identified in a variety of social situations that impacted access to health care for women across socioeconomic categories. Studies reveal how social determinants impact maternal health in Morocco. Addressing these determinants is required for sustainably improving maternal and infant health in Morocco.

Determinants of fertility differentials in Burundi: evidence from the 2016-17 Burundi demographic and health survey

INTRODUCTION

although fertility control remains a major priority for the Burundian government and most of its partners, few studies on Burundi´s fertility determinants are available to guide interventions. To address this gap, our study aims to examine the most factors influencing fertility differentials in Burundi by using the latest Burundi demographic and health survey data.

METHODS

using data from the 2016-17 Burundi demographic and health survey, one-way analysis of variance was performed to describe variations in mean number of children ever born across categories of correlate variables. Then univariable and multivariable poisson regression analyses were carried out to identify the most factors influencing fertility differentials in Burundi.

RESULTS

in our sample, the total number of children ever born ranged from 0 to 15 children by women with a mean number of 2.7 children (±2.8 SD). Factors such as urban residence (aIRR 0.769, 95% CI: 0.739 - 0.782, p = 0.008), increase in the level of education of both women and husbands (aIRRs of 0.718, 95% CI: 0.643 - 0.802, P<0.001 and 0.729, 95% CI: 0.711 - 0.763, p<0.001 respectively), no history of infant mortality experience (aIRR 0.722, 95% IC: 0.710 - 0.734, p<0.001) and increase in age at first marriage or first birth (aIRRs of 0.864, 95% CI: 0.837 - 0.891, P<0.001 and 0.812, 95% CI: 0.781 - 0.845, p<0.001 respectively) are associated with a low fertility rate while factors such as residence especially in Southern region (aIRR 1.129, 95% IC: 1.077 - 1.184, p<0.001), women and husband´s agricultural profession (aIRRs of 1.521, 95% CI: 1.429 - 1.568, P<0.001 and 1.294, 95% CI: 1.211 - 1.316, p<0.001 respectively), household poverty (aIRR 1.117, 95% IC: 1.080 - 1.155, p<0.001), lack of knowledge of any contraceptive method (aIRR 1.502, 95% IC: 1.494 - 1.564, p<0.001) and non-use of modern contraceptive methods (aIRR 1.583, 95% IC: 1.562 - 1.607, p<0.001) are associated with a high fertility rate.

CONCLUSION

the results of this study suggest that actions aimed at promoting education in general especially female education, improving child survival, women´s socio-economic status, agriculture mechanization and increasing number and scope of family planning services, could help reduce Burundi fertility rate.

Knowledge of hypertensive disorders in pregnancy of Moroccan women in Morocco and in the Netherlands: a qualitative interview study

Background

Hypertensive disorders in pregnancy (HDP) are the most common medical disorders in pregnancy and the greatest single cause of maternal mortality worldwide. Ethnicity appears to be a significant risk factor for pregnancy related mortality and for severe maternal morbidity. Most of the complications caused by HDP may be reduced by early detection and proper management. Health education during antenatal care attendance may play an important role in preventing the disease to aggravate. The purpose of this study was to investigate the status of knowledge that Moroccan pregnant women, both in Morocco and in the Netherlands, have of HDP in terms of symptoms, complications, treatment and management.

Methods

A qualitative research design was used to explore and describe the knowledge of HDP of pregnant Moroccan women. Interviews were held on the basis of a topic list. The interviews were recorded, transcribed, coded and analysed.

Results

Nineteen Moroccan women were interviewed, nine in the Netherlands and ten in Morocco. Half of them never heard about hypertension in pregnancy and had no knowledge of symptoms or alarm signals related to HDP. All women acknowledged the importance of knowledge of HDP because of the possibly dangerous complications. The interviewees stated that information on symptoms, alarm signs and complications is the most important information. Nearly all women stated that communicating information via movies was the most appropriate tool to inform Moroccan pregnant women about HDP.

Conclusions

The knowledge of Moroccan women, living in Morocco or in the Netherlands, of symptoms and alarm signs related to hypertensive disorders of pregnancy was very limited, if not absent. Since early detection provides the opportunity for follow-up management and/or treatment, this may reduce complications of HDP. Therefore, it is important to inform pregnant women about the signs and symptoms of HDP.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1980-1) contains supplementary material, which is available to authorized users.

Difference between Primary and Secondary Infertility in Morocco: Frequencies and Associated Factors

BACKGROUND

The main objective of this survey was to determine the difference between primary and secondary infertility in Morocco and the associated factors among women, who are referred to public and private health centers in Morocco.

MATERIALS AND METHODS

In this cross-sectional study, 619 infertile women referring to public and private health centers in Marrakech-Safi region, were selected by simple random sampling method. This study was conducted between 1 October 2013 and 31 December 2015. Socio-economic status, demographic characteristics, couple's age, nutritional status and other data related to both male and female reproductive organs were collected by a questionnaire. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05.

RESULTS

The rates of primary and secondary infertility were 67.37, and 32.63%, respectively. Multivariate analysis identified a model with three significant predictive factors of secondary infertility: duration of marriage [odds ratio (OR)=12.263: 2.289-65.685], socio-economic status (OR=3.83: 1.011-14.70) and the ages of women (OR=1.268: 1.038-1.549).

CONCLUSION

The causes of primary and secondary infertility were not always a woman's problem, but both man and woman contribute to infertility. Multiple regression analysis showed that women's age, duration of marriage, and socioeconomic status are predictive variables that decrease the chance of fertility among women with secondary infertility.