Introduction The use of dietary supplements had risen over the years among chronic
disease patients with most of it were of patients' own initiative. This study
aimed to describe the supplements use, assess the knowledge and attitude
towards supplements and its interaction with prescribed medication, and
determine whether knowledge and attitude towards supplements could
influence treatment adherence in chronic disease patients.
Methods A cross-sectional study was conducted among chronic disease patients in
Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur from
September to November 2016 upon their written informed consent. This
study consists of a collection of validated instruments that measured the use
of dietary supplements and its reason; the knowledge and attitude on dietary
supplements and supplements-drug interaction and medication adherence.
Results A total number of 250 respondents were interviewed and 72.4% was found to
use supplements of own initiatives. Most of the respondents were using
supplements to maintain health (78.8%), prevent health problems (72.4%)
and improve overall health (63.2%). It was found that respondents'
knowledge on supplement-drug interactions were not at the satisfactory level.
The treatment adherence was found not to be associated with knowledge and
attitude towards supplements nor numbers of supplements use.
Conclusions Chronic disease patients mainly knew on the purpose of supplements for
health and wellness, but had less knowledge on supplement-drug interactions,
warranting patients' education on that particular field.
Introduction Pneumococcal disease causes considerable morbidity and mortality,
including among adults. Adult pneumococcal vaccines help to prevent these
burdens, yet, they are underutilized. Our objective is to systematically collect
and summarize the available evidence on the potential factors that lead to
pneumococcal vaccination acceptance among of adult community.
Methods A systematic literature search was conducted involving studies published
from January 1999 to December 2015. The studies were identified by
searching electronic resources (PubMed/MEDLINE and Pro Quest database)
and manual searches of references. The keywords “vaccine/ immunization”,
“uptake/ coverage”, “determinant/ factor”, and “Streptococcus pneumoniae/
pneumococcus/ pneumococcal” were used. Final studies result and data were
reviewed by two independent authors. Disagreement was resolved through
discussion and consensus.
Results A total of 171 studies were identified, only 17 studies were included in final
discussion with 10 domains identified in the paper. 7 studies (41%) had
reported that the provider domain, patients’ perception and
socio-demographic factor have had the most effect on the pneumococcal
vaccination acceptance rate. In addition, only 18% (3) of reviewed papers had
highlighted that socio-economic was a factor influenced the pneumococcal
vaccination acceptance while 24% (4 studies) were attributed to the comorbid
domains.
Conclusions Healthcare provider and patients’ perception about pneumococcal vaccination
for adult population are significant domains which influence the acceptance
towards vaccination. Strong recommendations from healthcare provider for
pneumococcal vaccination would be an important step to increase vaccination
acceptance among the population.
Introduction Strongyloides stercoralis is an intestinal helminth that infects humans
through contact with soil containing the larvae.
Methods A systematic search was performed for relevant titles, abstract and keywords
in database from Cochrane Library, PLOS One, PubMed and several other
sources in October 2017 based on PICO strategy. Out of 511 papers that were
evaluated for possible inclusion, final assessment for eligibility has yielded a
total of 17 papers to be included which were found suitable for analysis
covering period from 2012 till 2016.
Results A major challenge of giving an overview of prevalence data for S. stercoralis
lies in the low sensitivity of diagnostic method used which resulted in very
low prevalence in certain countries. Cambodia and Laos presented with high
prevalence ranging from 17.4% to 45.9% by using high sensitivity of
diagnostic methods. The current prevalence situation of S. stercoralis in
Southeast Asia still have wide gaps remains due to several reasons.
Conclusions The information we have today only scratches the surface which cannot truly
reflect the true burden of S. stercoralis in Southeast Asia The main risk factor
is personal hygiene practices especially amongst males.
Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
Introduction Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s disease (AD) and the most frequent sub-cortical degenerative disease, characterized by universal progressive disorder of the
nervous system that affects movement. This cross sectional study aimed to determine the prevalence and correlates of PD among elderly attending the neurology clinic in Serdang Hospital.
Methods A total of 150 records of patients attended the clinic from January to December 2016 were randomly selected. Data was collected using a proforma form seeking information related to age, gender, race, locality, and presence of comorbidity particularly diabetes mellitus. The data was analysed using the Statistical Package for Social Science (IBM SPSS) version 22.0.
Results The prevalence of PD among the elderly involved in the study was 34%. Majority of the respondents were aged 60 to 70 years old (54.7%), male (53.3%), Chinese (56.7%), from urban locality (93.0%) and were not diabetic (69.3%). The inferential statistics showed no significant association between all the factors with PD. However, the associations between age and diabetes mellitus with PD were almost significant with p values of 0.07 and 0.08 respectively.
Conclusions Overall, the prevalence of PD among elderly who attended the neurology clinic in year 2016 was less than half with none of the factors under study were significantly associated with PD. However with bigger sample size, possible significant association may be obtained between age and diabetes mellitus.
Introduction The Acquired Immuno Deficiency Syndrome (AIDS) is caused by Human Immunodeficiency Virus (HIV) infection and a disease with high morbidity and mortality.Young mothers are sub-populations that are at high risk for HIV through sexual activity. In addition, information on the level of knowledge, attitude and practice among young mothers in Malaysia regarding HIV/AIDS prevention is still limited.Therefore, the objective of this study is to examine the level of knowledge, attitudes and practices towards the prevention of HIV/AIDS among young mothers and the factors that influence them.
Methods A cross-sectional study was conducted at a tertiary hospital in a city center among 147 young mothers aged 18-30 years old at the Post Natal and Obstetrics and Gynecology Ward (O & G). Data collection was conducted in April-November 2014 and the respondents' selection was based on simple random sampling. A questionnaire containing validated instruments was used in this study. Approval for conducting research has been obtained from the UKM Research Ethics Committee before the data collection procedure is implemented.
Results Majority of the young mothers have good knowledge (78.8%) and practice (71.2%) towards HIV/AIDS prevention. While more than half of them (56.7%) have positive attitude towards the prevention of HIV/AIDS. Living in the urban area and being married are significantly associated with having good knowledge and positive attitude towards HIV/AIDS prevention. While, mothers who are 5 years older compared to the younger ones and being married are significantly associated with having good practice towards HIV/AIDS prevention.
Conclusions The level of knowledge, attitudes and practices as well as the associated factors could be the baseline to formulate health intervention to prevent HIV/AIDS among this vulnerable group.
Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.
Study site: Penawar Reflexology Center, Kuala Terengganu, Malaysia
Introduction There is an increasing trend of obesity in children and adolescent globally. The objectives of this study were to identify the prevalence of overweight and obesity among students from secondary schools and to determine the mean random blood sugar (RBS) for the overweight and obese students.
Methods This was a cross sectional study. Two secondary schools that were scheduled for visit by the School Health Team, Taiping in July 2016 were included. A standardized data collection sheet was used to collect the data. Overweight and obesity were defined based on WHO 2007 reference for BMI-for-age criteria. Random blood glucose was checked for overweight and obese students.
Results A total of 184 school students consented and participated. 128 (69.6%) were female and 90 (48.9%) were Malays. The mean weight and height were 56.21 kg and 1.61 m respectively with BMI of 21.49 kg/m2. Overall, the prevalence of obese and overweight were 12.5% and 10.9% respectively. Among the 4 BMI groups, there were no significant difference found in sex (p=0.849) and races (p=0.536). However, there was significant difference (p=0.042) in mean RBS for obese and overweight students between races. RBS readings among overweight and obese students were within normal range with mean of 5.95 (0.67) mmol/l (range between 4.60 – 7.70 mmol/l).
Conclusions The overall prevalence of overweight and obesity were comparable with other studies done in Malaysia. Nevertheless, there was no prevalence of Type II diabetes mellitus among them.
Emotional and behavioural problems among children have been increasing in many western as
well as the eastern countries. Although the problem has been given attention and priority in
terms of early detection, many children with early symptoms of emotional and behavioural
problems has still not been detected at the early stages. This phenomenon is worrying as mental
health problems were shown to be stable in the long run and if left undetected it may manifest
into various problems in adulthood. This paper explores the issues on emotional and
behavioural problems in terms of its definition, prevalence, aetiology, long term consequences
and treatment. It also explores on mental health problems in a non-western country, i.e.
Malaysia including its prevalence and intervention strategies which has been carried out in
overcoming this worrying issue. Finally this review paper stresses the importance of providing
a well-designed epidemiological study in Malaysia in assessing the current prevalence of
emotional and behavioural problems in young children and adolescent
Introduction A study was conducted to determine the level of mothers' perception on children with cleft deformity and its associated factors
Methods This was a cross sectional study involving 110 mothers with children attending the Plastic And Reconstructive Surgery Clinic. Data was gathered from a face to face interview based on a questionnaire that assesses the level of perception and its associated factors. The level of perception was evaluated from a scoring method and divided into four domains namely psychosocial, care management, treatment and education.
Results The level of perception was high in all four domains ranged from 62% for treatment and 80% for education. Factors that were significantly associated with the level of perception were ethnicity, religion, type of cleft deformity and level of information.
Conclusions Information regarding cleft deformity must be tailored toward mothers’ personal characteristics and type of cleft deformity to improve mothers' perception on this problem.
Study site: Plastic And Reconstructive Surgery Clinic, Hospital Kuala Lumpur, Malaysia
Introduction The quality of education is one of the controversial topics and vital issues that
requires more emphases from researchers due to the current challenges in
education at the university level. Involvement and participation from the
studentis essential to implement quality assurance and to reach for academic
accreditation. The aim of this study is to assess knowledge, attitudes, and
practices (KAP) of students towards TQM in education and its influencing
factorsatHigh Institute of Health Sciences (HIHS) in Sana'a, Yemen.
Methods A cross-sectional study using a self-administered questionnaire was
conducted in 2016. A total of 208 students from second and third study levels
in HIHS had participated from 268 students were observed (study
population). Descriptive statistics, chi-square, and one-way ANOVA were
used to determine the association between students’ KAP towards TQM in
education with its influencing factors.
Results Mean age of the students were 22.44(SD±2.027) year old. Majority of HIHS
students were male 135 (64.9%) and 108 (51.9%) were from the third
studying level. The highest students' KAP scores were 53.4%, 65.4%, and
41.3% for good knowledge, good attitudes, and moderate practices
respectively. Education Department was found to be significantly associated
with students' knowledge and practices with p
Introduction Tong Nibong is a Bidayuh village located at Sarawak Kalimantan border.
Since the year 2004 to 2009, a total of 537 cases of malaria were recorded in
Serian District of which 14 cases were reported from Kampung Tong
Nibong. Community empowerment programme for malaria infection
prevention showed tremendous improvement in implementation. This
intervention study aims to gauge the effectiveness of community
empowerment approach in malaria elimination programme in Kampung Tong
Nibong Serian.
Methods An intervention study was conducted with pre and post data collection. Data
was collected using validated questionnaire by face to face interview.
Universal sampling method was used to select respondents from head of
household and post data was collected after intervention activities were
carried out within a year of study period.
Results The study showed significant difference on level of knowledge of
respondents on vector of malaria between pre and post data with a P < 0.05.
There was significant difference between pre and post data on practices on
control and prevention of malaria with a P < 0.05. The same goes to level of
positive attitude of respondents towards malaria control.
Conclusions In conclusion, the study can be considered successful because there is
significant difference in knowledge, attitude and practice among the
respondents between pre and post data. This indicates that community
empowerment (voluntary participation) measures can be implemented in high
risk or endemic areas where malaria is a persistent problem to the community
and health institutions faces many limiting factors.
Introduction: Most health advisories related to outdoor physical activity during haze are general in nature. The advisories normally advise everyone to reduce or limit prolonged exertion or heavy exertion without mentioning the acceptable duration for performing outdoor physical activity causing difficulty for public to decide to stop or cancel a particular outdoor or sport event. The aim of this paper is to determine the acceptable duration for performing outdoor physical activity pattern during haze based on API level.
Methods: Health risk assessment approach that comprises of hazard identification, exposure assessment, dose-response, and risk characterization steps was used to determine the potential inhaled dose and risk associated with performing the physical activity during haze. We have considered many factors that include time spent for physical activity patterns for Malaysian adult, age and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. A hypothetical exposure scenario of PM10 was created using the breakpoints of PM10 concentration for the calculation of respective API levels during haze.
Results: The association between physical activity pattern, API level and risk quotient were presented in the form of risk radar diagram. Based on the 50th percentile inhalation rate, all prolonged exertion and heavy exertion should be avoided when API reach >201 (very unhealthy) and >175 (unhealthy) respectively. Below the said API, the duration for performing prolonged exertion and heavy exertion should be reduced according to the API level. When API reaches 140, high intensity physical activity should be limited to < 90 minutes. A football match which requires 90 minutes, should be postponed of cancelled if API > 140. Whereas, for the same API level, prolonged exertion (moderate intensity physical activity) should be limited to 4 hours.
Conclusions: Reducing the physical activity is an effective strategy to lower the dose of inhaled pollutants and reduce the health risk during poor air quality. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed all prolonged exertion should be avoided when API reach very unhealthy status (>201). Below the said API level, outdoor physical activity should be reduced according to the level of API respectively. The recommendation is not applicable for the sensitive groups. The computed risk radar provide a valuable guide for the public to organize or considering postponing an outdoor event during haze.
Introduction The most effective and affordable public health strategy to prevent
hypertension, stroke and renal disease is by reducing daily salt consumption.
Therefore, this study aims to determine the association of knowledge, attitude
and practice on salt diet intake and to identify foods contributing to high
sodium intake.
Methods Secondary data analysis was performed on MySalt 2016 data. It was
conducted from November 2015 until January 2016 which involving Ministry
of Health Staff worked at 16 study sites in Malaysia. Salt intake was
measured using 24 hours urinary sodium excretion. Food frequency
questionnaire was used to determine the sodium sources. Knowledge, attitude
and practice of salt intake were assessed using a validated questionnaire
adapted from WHO. Demographic data and anthropometric measures also
were collected. Sodium levels of more than 2400mg/day was categorised as
high sodium intake. Data were analysed using SPSS software version 21.
Results The mean sodium intake estimated by 24 hours urinary sodium excretion was
2853.23 + 1275.8 mg/day. Food groups namely rice/noodles (33.8%),
sauces/seasoning (20.6%), meat and poultry (12.6%) and fish/seafoods
(9.3%) were the major contributors of dietary sodium. In multiple logistic
regression analysis, being a male (aOR=2.83, 95% CI 2.02 – 3.96) and obese
(aOR=6.78, 95% CI 1.98 – 23.18) were significantly associated with high
urinary sodium excretions. In addition, those who were unsure that high salt
intake can cause hypertension (aOR=1.24, 95% CI 0.65 – 2.36), those who
think that they consumed too much salt (aOR=2.10, 95% CI 1.13 – 3.87) and
those who only use salt rather than other spices for cooking (aOR=2.07, 95%
CI 1.29 – 3.30) were significantly associated with high urinary sodium
excretion.
Conclusions This study showed that the main sources of sodium among Malay healthcare
staff is cooked food. Poor knowledge and practice towards reducing salt
consumption among them contributes to the high sodium consumption. The
practice of healthy eating among them together with continuous awareness
campaign is essential in order to educate them to minimize sodium
consumption and to practice healthy eating.
Introduction: Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables.
Methods: Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014.
Results Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001).
Conclusions: CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia.
Keywords: Congenital malformations - Child death - Neonatal - Neural tube defects - ICD-10.
Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis
BACKGROUND: The aim of the study was to assess the knowledge and attitude of secondary school students in Sana'a Yemen related to exposure to second-hand smoking.
METHODS: A cross-sectional study was conducted in Sana'a city. The total sample size was 336 students in which 63 were males and 273 were females. These students were stratified random sampling . Data were collected by using Questionnaire comprising of 3 parts: Part 1- consists of socio-demographic data. Part 2- consists of the knowledge regarding smoking and second-hand smoking and Part 3-consists of adolescents' attitude in relation to second-hand smoking.
RESULTS: Out of 336 students, majority were between 14-18 years old (75.9%), males (81.2%) , (55.7%)of them was fathers' occupation private employee and low educated mother was (86.3%).The students who do not have smoking habit were (94.3%),and those who do not have friends with the habit of smoking was (57.4%). (57.10) having some one else at home who smokes beside them .The reaction of non printed mass media for SHS warning was (83.3%) . The exposed to smoke out door was (60.1%) . In this study, the majority of students had inadequate knowledge about the second-hand smoke was (52.7%). A higher percentage of students who had unfavorable attitudes toward secondhand smoke was(86.6%).
CONCLUSION: We concluded that The level of knowledge and attitude about the second-hand smoke is relatively low among the secondary school student in Sana'a Yemen .The finding of this study emphasized the need of effective awareness programs to increase level of consciousness and knowledge regarding SHS. Keywords: Second-hand Smoking, Secondary School, Adolescent, Sana'a .
Rheumatic heart disease is still endemic in developing countries and among the indigenous population in developed countries. However, there is no comprehensive data on rheumatic heart disease patients in Malaysia. The Cardiology Department of Queen Elizabeth ll Hospital (QEH ll), Sabah started this hospital-based registry in 2010. The objective of this analysis was to report the demographic profile, severity of disease, types of valve involvement and the practice of secondary prophylaxis among these patients.
Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.
Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.
Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.
Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.
Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
workshops.