Using data from Pakistan, India, Malaysia, Thailand, and the Philippines, we explore how gender context influences (1) husband-wife concordance in the demand for children and (2) the impact of each spouse's fertility preferences on contraceptive use. We also explore whether the husband's pronatalism can explain the wife's unmet need for contraception. The results suggest that gender context has little net effect on couples' concordance, but influences the relative weight of husbands' and wives' preferences in determining contraceptive use. Analysis of women's unmet need for contraception suggests that the husbands' pronatalism contributes to wives' unmet need, but only to a relatively small degree, especially in settings where unmet need is high. This is the case because the proportion of couples with differing fertility goals is small in most communities.
This paper looks at some of the problems encountered when cases of abuse and injuries occur in children placed in child care in an urban community in Malaysia. It is based on the study of 37 children referred to our hospital's Child Protection Services over the past four years for injuries and incidents where the child-minders came under suspicion. They constituted 12% of the 285 children referred to the Child Protection Team during that period for evaluation of suspected child abuse. Twenty six children had experienced physical trauma. Fifty eight percent of these were young infants with cranial injuries or limb fractures but no history to explain their occurrence. Four had superficial injuries from accidents secondary to inadequate supervision. The other 11 children had been sexually abused. The perpetrators in 73% of cases were either the husbands or sons of the child-minder. Ninety five percent of the incidents occured at home-based nurseries. Prospects of any punitive measures were remote in most instances due to uncertainty about the perpetrator, or insufficient corroborative evidence required in sexual abuse cases. There were three documented cases where the family refused to lodge a police report or co-operate with investigations out of a reluctance to implicate or offend the child-minders who were mainly neighbours, relatives or friends in 58% of cases. Ninety seven percent of the facilities were unregistered, making surveillance for recurrent incidents and adherence to safety standards difficult. These incidents were almost certainly an underestimate of the problem. Training of child-care providers, improved legislation and enforcement as well as education of parents to choose suitable facilities are issues which need to be tackled.
The purpose of this study is to validate the English version of the Golombok-Rust Inventory of Marital State (GRIMS) in a Malaysian population. Using the test-retest method and Cronbach's alpha, we assessed reliability and internal consistency. Sensitivity to change was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.59 to 0.91) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant in majority items (ICC = 0.62 and above), and there was a high degree of sensitivity and specificity. The GRIMS is suitable, reliable, valid, and sensitive to clinical change in a Malaysian population.
Cancer of the cervix is caused by micro-organisms called Human Papilloma Virus (HPV). This virus is only transmitted to women from their partners/spouses through sexual intercourse. In Malaysia, cancer of the cervix is the second most common cancer among females after breast cancer. The incidence is 21.5 per 100,000 population, with incidence among the Chinese being highest at 33.6 per 100,000 and among Malays the lowest being 12.6 per 100,000. For the past twenty years or so the Annual Reports of Ministry of Health recorded an average of 2500 new cases per year. Cancer of the cervix is preventable. The precursor cancer cells can be easily detected provided the women do regular screening tests called Pap Smear. In nearly all cases this cancer arises from the transformation
zone of the cervix. This is the zone in the cervical mucosa in which the epithelium abruptly changes from hardy squamous epithelium of the ectocervix to the fragile columnar epithelium of the endocervix.
Cervical cancer is the first solid tumour to be shown directly induced by virus. HPV is found in virtually all cervical carcinomas and their precursors.
Iodine is an essential micronutrient for normal physical and mental development. Iodine deficiency is endemic in 130 countries worldwide, including Malaysia. This is a cross-sectional study done to determine the prevalence and risk factors of iodine dejiciency among 342 rural mothers attending antenatal clinics in Bachok, Kelantan. A self-adrninistered questionnaire on the knowledge, attitudes, practices and other risk factors relating to iodine deficiency was done. Physical examination for thyroid enlargement was carried out and urine samples were taken for urine iodine determination. The prevalence of iodine deficiency based on urine iodine Q level of less than 100 mcg/l was 63.0 % (95% CI: 57.8, 68.2). The mean urinary iodine level was 87.3 mcg/l with a median of 78.0 mcg/l. However, the goiter prevalence was only 9.4%. The total mean scores of knowledge, attitudes and practices were generally low at 58.6 (SD 7.9), 52.9 (SD 7.9) and 42.9 (SD 10.9) respectively. Logistic regression analysis found that a smoking husband is a risk for iodine deficiency (OR=2.0). In conclusion, iodine deficiency disorders among rural antenatal mothers were still prevalent in Bachok. Their level of knowledge on the causes, effects, prevention and clinical presentations of Q iodine deficiency disorders were poor. In addition, having a husband who is a smoker increases the risk of the antenatal mothers developing iodine denciency.
Study site: Antenatal clinic (klinik kesihatan), Bachok, Kelantan, Malaysia
Malaysia has undergone rapid pace of industrialization and urbanization in recent decades and this has brought about imminent changes in the lifestyle of Malaysians. This is a cross-sectional study which attempts to examine the lifestyle practices and the prevalence of obesity of a group of security guards and their spouses of the University of Malaya, Kuala Lumpur. Data collection was conducted by both the methods of face-to-face interview and self-administered questionnaire. The respondents were surveyed on lifestyle practices such as smoking habits, exercise and eating pattern. Anthropometric measurement such as weight and height were also taken to establish the extend of obesity by using Body Mass Index (BMI). This study reveals that the community did have some unhealthy lifestyle practices such as smoking (27.7%; 95%CI 20.2%, 36.2%), low prevalence of adequate exercise (13.8%; 95%CI 8.4%, 21.0%); high prevalence of overweight and obesity (64%; 95%CI 55.1%, 72.3%); and high prevalence of co-morbidities such as diabetes mellitus and cardiovascular diseases. In conclusion, the community is considered to be a vulnerable and high-risk group for morbidity and mortality with the above predisposed risk factors. KEYWORDS: Lifestyle practices, overweight and obesity
Objectives: The objectives of this study were to ascertain the prevalence of Indonesians obstetrics immigrant and to assess the fetal maternal outcome. Methodology: A prospective cohort study design was used to analyse 54 consecutive Indonesians obstetrics immigrant compared to 56 Malay women. Chi square and student t test were used where appropriate, p < 0.05 was considered to be of statistical significance. Results: There was a reducing trend in the incidence admission of Indonesians from 10.5 in 1999 to 6.5 % in 2002. The maternal mortality ratio showed an increasing trend from 1999 (40.0/100000) to 2001 (162.9/100000) but decreased to 5.8/100000 in 2002. The majority was between 20-40 years old, multiparous and booked, which was similar to the Malay population. Most Malays were in occupational class 1 to 3 and the husband has secondary and tertiary education compared to the Indonesians who were in class 4 and 5 and the husband has primary and no formal education. Significantly more immigrants were housewives compared to Malays who were working women. There was no significant difference in the antenatal complications. There were no significant difference in terms of delivery and most delivered vaginally. The perinatal outcome in terms of gestation, birth weight, Apgar score and admission to neonatal ICU were similar in both populations and there was no perinatal mortality. In conclusion, the incidence admission of Indonesian immigrant was on the decreasing trend. The outcome of these patients managed in MHKL was similar to the Malay population. Further studies with enrollment of a larger number of patients should be carried out to ascertain the significance of these findings.
Passive smoking among pregnant mothers has been associated with numerous maternal and fetal effects. The aim of this study was to determine the effects of passive smoking on the fetal outcome among women who delivered at the Maternity Hospital Kuala Lumpur. This cross sectional study was carried out at the Maternity Hospital Kuala Lumpur in July 2004. Universal sampling of the women who delivered at the hospital was used and data was collected by interview using pre-tested questionnaire and patients’ medical records. Analysis was done by SPSS version 11.5. More than 75% were Malays, between 21 to 35 years, married, received secondary education, housewives and family income between RM 1000 – RM 1999. Seventy-seven per cent of the women were exposed to environmental tobacco smoke and majority were exposed at home and for less than 1 hour a week. There were significant relationships between duration of exposure with exposure at workplace, exposure at home and exposure in the car. Most of the babies delivered were males, term, normal weight and normal. Health education of the adverse effects of smoking to the pregnant women, spouses and family members need to be intensified by the hospital and the Ministry of Health.
A cross»sectional study was conducted to determine the knowledge on family planning among Malay women who delivered at Hospital Universiti Sains Malaysia (H USM), Kelantan and their husbands. Three hundred and fifty five women were selected by systematic random sampling. An interview-guided questionnaire that included infomation on socio-demographic, obstetric and knowledge on family planning was conducted to the women and self-administered questionnaire was given to their husbands. There were 15 questions on knowledge which were validated prior to the study. More than half of the women (53.5%) and the husbands (57.7%) had poor knowledge score (less than 75%) on family planning. A majority (86.8%) of the women and 87.9% of the husbands knew the optimal age of a woman to be pregnant, but very few (3.4%) of the women and Ss 1% of the husbands could answer correctly all the questions on the effects of poor spacing. The level of knowledge on family planning among Malay women who delivered at H USM and their husbands were poor. Therefore, new and improved health education materiab and programmes are needed, to target both the women and their husbands.
The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.
The number of people worldwide living with human immunodeficiency virus/ acquired immunodeficiency virus (HIV/AIDS) is more than 40 million, among them 17.7 millions are women (UNAIDS/WHO, 2006) The latest report from the Eastern Mediterranean Region shows that at least one million people are infected with HIV; among them 30% are women. The great majority of reported cases in the Region are men. However, the ratio of men to women cases varies in different countries. It ranges between “9:1 (as for example in Egypt), to 2:1” (as in Morocco and some parts of Yemen). Due to religious, social and cultural values regarding female purity, women and girls living with HIV and AIDS are subjected to greater discrimination than men. WHO reports show that a large percentage of the infected women in Arab countries have contacted the infection from their husbands especially migrants and drug abusers. In Arab countries, studies conducted show that 86% of women choose not to disclose their status of infection for the fear of abandonment, rejection, discrimination, violence, upsetting family members, and accusations of infidelity from their partners, families, and communities. As a result, many women only seek help at the last minute when they are already been terminally ill. Violence against women and girls in its different forms increases women's vulnerability to HIV infection and undermines AIDS control efforts. The fear of violence prevents many women from accessing HIV information, from getting testing and seeking treatment. Stigma and discrimination may also prevent them from carrying out their normal life activities. When women are blamed, this can lead to heightened levels of sexual and domestic violence, abandonment by families and communities, forced abortion or sterilization, dismissal from employment and loss of livelihood opportunities. A study of AIDS-related discrimination in Arab region found that over ten percent of women had lost financial support from family members since being diagnosed as HIV positive. There is a great deal of evidence to establish the significant link between gender-based violence and rising rates of HIV infection among women and girls throughout the world. HIV-positive women must be supported to make their own reproductive choices about whether and/or when to have children. Promote male involvement in sexual and reproductive health programmes. Finally the stigma, discrimination and violations must be stopped.
This is a cross-sectional study on 218 pregnant mothers in an urban government Hospital.The study aimed to assess knowledge, attitudes and sources of information on breastfeeding. The results could be utilised to promote breastfeeding. Almost all the respondents (96.8%) intended to breastfeed their newborns. Most of them (74.8%) were knowledgeable about breastfeeding i.e. colostrum and breast milk was the best food, good for resistance against disease and allergy, filling up stomach easily, helpful in teeth development and maternal recovery after birth, increased bonding, was easy and economical. The two main misconceptions were mothers would stop breastfeeding when infant or mother was sick, and giving clear fluid to the exclusively breastfed infants to prevent dehydration. Most mothers (83.9%) responded positively towards breastfeeding i.e. it was easier than infant formula, had no negative effect on marital relationship or family care, would commence breastfeeding straight after delivery, agreeable to the banning of bottles and teats in hospital and they would not stop breastfeeding even if husband discouraged them. Only 56.9% of the mothers believed they could breastfeed their babies with modesty anywhere. The main sources of information were attained from the mass media (34.9%), antenatal class (32.1%) and other mothers with breastfeeding experiences.
Objective. This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.
Methods. A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.
Results. The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.
Conclusion. This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.
The exclusive breastfeeding rate in Malaysia is very low. However in recent years the awareness of breastfeeding among mothers has increased. A preliminary qualitative research was carried out on these motivated mothers. The objective of this study was to understand the challenges encountered by breastfeeding mothers and to explore the support and motivation received by them. Information from the motivated mothers was obtained from focus group discussion. Some obstacles faced by the mothers were lack of knowledge on breastfeeding and lack of support from health professionals, parents and siblings. Facilities to express breast milk while at work were not readily available. The main motivation to breastfeed came from the mother herself and support from the husband. A holistic approach must be used to help mothers to continue breastfeeding. This includes breastfeeding promotion and education, setting up more Baby Friendly Hospitals, availability of breastfeeding support groups and provision of enough breastfeeding facilities at work and public places.
Background : Family planning is a method to control family size and to increase the intervals between chidbirths using multiple methods of contraceptives.
Objectives : This study aims to determine the pravelance of family planning practice among married women (wife less than 55 years old) and its related factors and also to determine the husbands knowledge on family planning and their support.
Methodology : This is a cross sectional study done through direct interviews amongst 118 married couples in Kampung Sesapan Batu Mingkabau, Hulu Langat Selangor.
Results : On family planning practise, 43.2% of couples is currently practising, 22.0% have practiced but stopped and 34.8% have never used any types of family planning methods. As high as 75% of wives received support from their husband to pratice family planning. There is a significant association between family planning practice and wife’s age, husband’s age, wife’s occupation, wife’s education, wife’s knowledge and husband’s support. Husband’s knowledge , number of live children and husband’s education have no significant assocation in influencing family planning practice.
Conclusion : To achieve better knowledge and family planning practises, husband’s involvement and support must be encouraged to ensure the correct informations and support are delivered to both couples. Approach through husbands is regarded as one of the key factors to the success of rural women family planning practice.
INTRODUCTION: Female sexual dysfunction (FSD) is a highly prevalent sexual health problem but poorly investigated at the primary care level.
AIM: This article examines the prevalence of sexual dysfunction and its possible risk factors associated with women at high risk of FSD in a hospital-based primary practice.
METHODS: A validated Malay version of the Female Sexual Function Index (MVFSFI) was utilized to determine FSD in a cross-sectional study design, involving 163 married women, aged 18-65 years, in a tertiary hospital-based primary care clinic in Kuala Lumpur, Malaysia. Sociodemographic, marital profile, health, and lifestyle for women at high risk of FSD and those who were not at high risk were compared and their risk factors were determined.
MAIN OUTCOME MEASURES: Prevalence of FSD in Malaysian women based on the MVFSFI, and its risk factors for developing FSD.
RESULTS: Some 42 (25.8%) out of 163 women had sexual dysfunction. Prevalence of sexual dysfunction increased significantly with age. Sexual dysfunctions were detected as desire problem (39.3%), arousal problem (25.8%), lubrication problem (21.5%), orgasm problem (16.6%), satisfaction problem (21.5%) and pain problems (16.6%). Women at high risk of FSD were significantly associated with age (OR 4.1, 95% CI 1.9 to 9.0), husband's age (OR 4.3 95% C.I 1.9 to 9.3), duration of marriage (OR 3.3, 95% CI 1.6 to 6.8), medical problems (OR 8.5, 95% CI 3.3 to 21.7), menopausal status (OR 6.6, 95% CI 3.1 to 14.3), and frequency of sexual intercourse (OR 10.7, 95% CI 3.6 to 31.7). Multivariate analysis showed that medical problem (adjusted OR 4.6, 95% CI 1.6 to 14.0) and frequency of sexual intercourse (adjusted OR 7.2, 95% CI 2.1 to 24.0) were associated with increased risk of having FSD. Those who practiced contraception were less likely to have FSD.
CONCLUSION: Sexual health problems are prevalent in women attending primary care clinic where one in four women were at high risk of FSD. Thus, primary care physician should be trained and prepared to address this issue.
Study site: Primary Care Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Introduction: The effect of stress among correctional officers at the workplace can contribute to various health problems and this also affect their work performance and motivation.
Methodology: Study was done at a prison located at the rural district in Kedah. The study was conducted by using randomized stratified sampling method. A total of 418 self administrated questionnaires were distributed. These questionnaires included socio demographic factor, family and marriage factor, Personal Stress Inventory (using Stress Symptom Scale with 52 items), work related stressors (Job Stress Survey) and Brief COPE (Coping Orientation for Problems Experienced with 28 items).
Result: Response rate was 90.9%. Stress prevalence for correctional officers was 45.8%. Socio demographic factors which have significant relation with stress status were marital status, promotion factor, age, monthly salary, duration of service and number of children (p< 0.05). Family and marriage factor which have significant relation with stress status among married officer were pressure from relatives, clean up house, sexual frustration, conflict with spouse, conflict with children, conflict due to household work and no babysitter (p< 0.05).
Discussion: The study showed that work related stressors that have influence with stress were excessive workload, working after work hours, not enough staff, disgraced words from fellow workers, competition in carrier development and excessive work stress (p< 0.05). Multiple linear regression model was done in this study and revealed factors that explained 52% of variation in stress score distributions were behavioural disengagement, no babysitter, denial, conflict with children, replace other worker’s duty, not enough time with family, competition in carrier development, venting of emotion, positive reframing and emotional support. Coping strategies that have significant effect in reducing stress symptoms are positive reframing and emotional support.
Conclusion: Stress management programs should be implemented and emphasizing on specific stressors and coping mechanism are important to reduce the risk of occupational stress among correctional officers.
Family planning is one of the main pillars of safe motherhood initiatives. It is therefore a very crucial area that needs continuous strengthening and improvement in order to reduce maternal morbidity and mortality which will ultimately improve the general condition of women. Findings from the Confidential Enquiries into Maternal Death (CEMD) Malaysia Report 2001 - 2005 revealed that up to 70% of the maternal deaths never practiced any form of family planning. The contraceptive prevalence rate (CPR) in Malaysia for the year 2004 was 51.7% compared to Thailand, Vietnam and Singapore which was 79%, 74% and 74% respectively. One neglected area that has never been emphasized seriously in the family planning programme in Malaysia is male participation, gender awareness and sharing of responsibility by both partners. In realizing this, efforts have been made to include men as target groups in the national family planning programme. This paper will highlight the importance of optimum gender relations and sharing of responsibility with special emphasis towards the role of husbands and male medical personnel in the effort to improve family planning activities. It will also discuss the efforts put by the Ministry of Health in order to create gender awareness and encourage male participation in family planning.
Introduction: The aim of this study was to assess the overall diet quality of husbands and wives in a selected urban area in Selangor.
Methodology: This cross-sectional study was carried out in Bandar Baru Bangi, Selangor among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not practicing any special diet. Data were collected using a 2-day 24-Hour Dietary Recall and a Food Frequency Questionnaire (FFQ) to evaluate the quality of diet among husbands and wives using the Diet Quality Index Revised (DQI-R).
Result: Majority of husbands and wives in this study were in the middle-age group, had received tertiary education, had household monthly income of more than RM3, 500 and encompass household size of 3 to 5 persons. The mean DQI-R score for husbands (mean age= 43.33 + 11.16 years) and wives (mean age= 41.28 + 10.93 years) were 67.8 + 9.1 and 64.4 + 9.3 respectively and there was a significant different in scores between the husbands and wives (p < 0.001). In general, the diet quality of this study population was not satisfactory and that the diet quality of husbands was better compared to their wives.
Conclusion: This study gives an insight picture of husbands and wives’ quality of diet. It can be used as a guideline to improve health intervention programs in the future.