Displaying publications 21 - 40 of 145 in total

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  1. Tew SP, Ahmad Fauzi A
    Child Care Health Dev, 2020 09;46(5):585-590.
    PMID: 32410244 DOI: 10.1111/cch.12773
    BACKGROUND: Neurodevelopmental disabilities are amongst the main conditions encountered in our paediatric rehabilitation centre. To identify the necessary actions to achieve family-centred care in the tertiary healthcare division, we explored the perceptions of parents on the paediatric rehabilitation services received by their children with neurodevelopmental disabilities.

    METHOD: A cross-sectional study involving 200 parents of children with neurodevelopmental disabilities aged 1-18 years was carried out. The Malay version of the Measure of Process of Care (MPOC-20) questionnaire was used to measure the perceptions of parents on the services. Descriptive statistical analysis was done to describe the mean score of each MPOC-20 scale. Univariate and bivariate analyses were used to examine the associations between the characteristics of parents and children as well as the sociodemographic and environmental factors with the MPOC-20 scales.

    RESULTS: The mean score of the MPOC-20 scales ranged from 4.50 to 5.65 (SD 0.93-1.51). Amongst the MPOC-20 scales, parents ranked enabling, having good partnership and being comprehensive (EP) the highest, whereas the provision of specific information (PS) received the lowest score. Amongst all the MPOC-20 scales, significant differences were shown in parent's employment, between children's age groups and between ethnic groups.

    CONCLUSIONS: The Malay MPOC-20 is a validated tool that can be used in evaluation of services among the Malay-speaking community, and therefore, it is recommended for our clinical use to improve family-centred practice in paediatric rehabilitation.

    Matched MeSH terms: Child Health Services/organization & administration*
  2. David AM, Mercado SP, Klein JD, Kaundan MSK, Koong HN, Garcia E
    Child Care Health Dev, 2017 09;43(5):774-778.
    PMID: 28480578 DOI: 10.1111/cch.12472
    BACKGROUND: Non-communicable diseases (NCDs) are generally considered diseases of adulthood, but NCD risk factors like tobacco use often are taken up during childhood and adolescence, and second-hand smoke exposure affects child survival and development.

    METHODS: At a regional meeting of the Asia Pacific Child and Family Health Alliance for Tobacco Control, members reviewed existing good practices of child-focused tobacco control approaches using health promotion strategies. These interventions were implemented nationally in Malaysia, the Philippines and Singapore.

    RESULTS: Three good practice national examples were identified that focused on creating supportive tobacco-free environments and upgrading cessation skills among paediatricians. These country examples highlight strategic areas to protect children and families from the harms of tobacco, as part of NCD prevention and control. Training paediatricians in brief cessation advice has enabled them to address tobacco-using parents. Fully enforcing smoke-free public areas has led to an increase in smoke-free homes. The Tobacco Free Generation is a tobacco control 'endgame' strategy that taps into a social movement to deglamorize tobacco use and empower youth born in and after year 2000 to reject tobacco and nicotine addiction.

    CONCLUSION: Tobacco control is pivotal in the fight against NCDs; health promotion strategies to protect children and youth from tobacco have a critical role to play in NCD prevention and control. Frontline health workers, including primary care paediatricians, need to step up and actively advocate for full implementation of the WHO Framework Convention on Tobacco Control, including tobacco tax increases and smoke-free areas, while monitoring patients and their parents for tobacco use and second-hand smoke exposure, preventing adolescent smoking uptake, and offering cessation support. A life-course approach incorporating child-focused efforts to prevent initiation of smoking and second-hand smoke exposure with measures promoting cessation among parents will offer the greatest chance of overcoming future tobacco-related NCD burden.

    Matched MeSH terms: Child Health*
  3. Abdul Halim SH, Mohd Zulkefli NA
    Child Care Health Dev, 2021 07;47(4):509-516.
    PMID: 33660312 DOI: 10.1111/cch.12863
    BACKGROUND: Use of a child health record book has long been established in Malaysia. The objective of the study was to determine the proportion of optimum child health record book utilization and its associated factors among parents attending government child health clinics in Putrajaya, the administrative capital of Malaysia.

    METHODS: A cross-sectional study was conducted among randomly selected group of 450 parents using a self-administered questionnaire. Optimum utilization of the book was defined as respondents reading all sections and recording comments in the book. Independent variables studied were sociodemographic characteristics; antenatal and breastfeeding history; child health and immunization status; perceptions and level of knowledge on the book and child health; and healthcare providers' performance. A multiple logistic regression analysis was used to identify the associated factors of optimum utilization.

    RESULTS: Out of 450 study participants, 415 completed the questionnaire and 150 (36.1%) were found to optimally utilized the book. Participants who read all sections totalled 245 (59.0%), and 242 (58.3%) respondents reported to record some comments in the book. Optimum utilization of the book was associated with older parents' age (adjusted odds ratio [AOR]: 1.06, 95% confidence interval [CI] 1.01-1.11) and higher education attainment (AOR: 2.21, 95% CI 1.24-3.91), with a good level of knowledge on child health record books and general child health (AOR: 3.87, 95% CI 2.27-6.61; AOR: 2.05, 95% CI 1.25-3.36) and among parents who delivered their children in government hospitals (AOR: 2.93, 95% CI 1.11-7.73).

    CONCLUSIONS: The prevalence of child health record book utilization was low at 36.1% but difficult to compare with other studies. Based on the findings, improving the parents' knowledge of the book and general child health, particularly among younger parents with lower educational levels, and delivering the book to institutions outside government hospitals might be useful to increase the utilization.

    Matched MeSH terms: Child Health*
  4. Arifin SRBM, Cheyne H, Maxwell M, Yousuf A
    PMID: 34040649 DOI: 10.2174/1745017902117010010
    Objectives: Early detection and intervention for Maternal Postnatal Depression (PND) are imperative to prevent devastating consequences for mothers, babies, and families. However, there are no guidelines that explicitly focus on the management of PND in Malaysia. Consequently, it is unclear whether women with PND are receiving proper care and treatment. Therefore, this study aimed to explore Malaysian Women's experience in managing PND symptoms.

    Methods: A qualitative study was conducted among 33 women attending Maternal and Child Health (MCH) clinics in Kuala Lumpur. Data were obtained through a face-to-face semi-structured interview and analysed using framework analysis.

    Results: The women considered PND as a personal and temporary issue. Therefore, professional care was deemed unnecessary for them. Additionally, all Malay women considered religious approach as their primary coping strategy for PND. However, this was not the case for most Indian and Chinese women.

    Conclusion: The findings of this study indicated that women did not acknowledge the roles of Healthcare Practitioners (HCPs) in alleviating their emotional distress.Also, they perceived PND as a personal problem and less serious emotional condition. It is due to this perception that the women adopted self-help care as their primary coping strategy for PND. However, the coping strategy varied between different cultures. These findings underscore the importance of HCPs' proactive action to detect and alleviate PND symptoms as their attitude towards PND may influence Women's help-seeking behaviour.

    Matched MeSH terms: Child Health
  5. Kitatani K
    Earthwatch, 1991;?(41):5-6.
    PMID: 12284002
    PIP: At the Population and Natural Resources Workshop of the World Conservation Union (IUCN) General Assembly in Perth, Australia, December 1990, population and quality of life issues were stressed as one of the central items to be placed on the 1992 Agenda of the UN Conference on Environment. The pace of environmental degradation is quickening, the causes are becoming more entrenched, and indecision will narrow our options. Poverty and population growth are making development unsustainable. Technological miracles will not appear to restore balance. Deforestation, soil erosion, decertification and loss of water resources are fueling urbanization. Therefore the World Commission on Environment and Development, known as the Brundtland Commission, ranks human resources development as a top priority in sustainable development and quality of life. Human resources can be improved by providing maternal and child care, family planning and improving the status of women. Successful family planning programs as seen in Thailand and Malaysia can show results very quickly once national population policies, institutions and capacity are in place.
    Matched MeSH terms: Maternal-Child Health Centers*
  6. Tan SY, Praveena SM, Abidin EZ, Cheema MS
    Environ Sci Pollut Res Int, 2018 Dec;25(34):34623-34635.
    PMID: 30315534 DOI: 10.1007/s11356-018-3396-x
    This study aimed to determine bioavailable heavy metal concentrations (As, Cd, Co, Cu, Cr, Ni, Pb, Zn) and their potential sources in classroom dust collected from children's hand palms in Rawang (Malaysia). This study also aimed to determine the association between bioavailable heavy metal concentration in classroom dust and children's respiratory symptoms. Health risk assessment (HRA) was applied to evaluate health risks (non-carcinogenic and carcinogenic) due to heavy metals in classroom dust. The mean of bioavailable heavy metal concentrations in classroom dust found on children's hand palms was shown in the following order: Zn (1.25E + 01 μg/g) > Cu (9.59E-01 μg/g) > Ni (5.34E-01 μg/g) > Cr (4.72E-02 μg/g) > Co (2.34E-02 μg/g) > As (1.77E-02 μg/g) > Cd (9.60E-03 μg/g) > Pb (5.00E-03 μg/g). Hierarchical cluster analysis has clustered 17 sampling locations into three clusters, whereby cluster 1 (S3, S4, S6, S15) located in residential areas and near to roads exposed to vehicle emissions, cluster 2 (S10, S12, S9, S7) located near Rawang town and cluster 3 (S13, S16, S1, S2, S8, S14, S11, S17, S5) located near industrial, residential and plantation areas. Emissions from vehicles, plantations and industrial activities were found as the main sources of heavy metals in classroom dust in Rawang. There is no association found between bioavailable heavy metal concentrations and respiratory symptoms, except for Cu (OR = 0.03). Health risks (non-carcinogenic and carcinogenic risks) indicated that there are no potential non-carcinogenic and carcinogenic risks of heavy metals in classroom dust toward children health.
    Matched MeSH terms: Child Health*
  7. Esa R, Savithri V, Humphris G, Freeman R
    Eur J Oral Sci, 2010 Feb;118(1):59-65.
    PMID: 20156266 DOI: 10.1111/j.1600-0722.2009.00701.x
    The aim of this study was to investigate the relationship between dental anxiety and dental decay experience among antenatal mothers attending Maternal and Child Health clinics in Malaysia. A cross-sectional study was conducted on a consecutive sample of 407 antenatal mothers in Seremban, Malaysia. The questionnaire consisted of participants' demographic profile and the Dental Fear Survey. The D(3cv)MFS was employed as the outcome measure and was assessed by a single examiner (intraclass correlation = 0.98). A structural equation model was designed to inspect the relationship between dental anxiety and dental decay experience. The mean Dental Fear Survey score for all participants was 35.1 [95% confidence interval (34.0, 36.3)]. The mean D(3cv)MFS score was 10.8 [95% confidence interval (9.5, 12.1)]. Participants from low socio-economic status groups had significantly higher D(3cv)MFS counts than those from high socio-economic status groups. The path model with dental anxiety and socio-economic status as predictors of D(3cv)MFS showed satisfactory fit. The correlation between dental anxiety and dental decay experience was 0.30 (standardized estimate), indicating a positive association. Socio-economic status was also statistically significantly associated with the D(3cv)MFS count (beta = 0.19). This study presented robust evidence for the significant relationship between dental anxiety and dental decay experience in antenatal mothers.
    Matched MeSH terms: Maternal-Child Health Centers
  8. Vinothini A, Khoo EM, Kamarulzaman A
    Family Physician, 2005;13(1):10-15.
    Introduction. The aim of this study is to determine pregnant women's knowledge regarding AIDS and to identify factors affecting their knowledge This information would provide some baseline data in designing health education measures for this target group.
    Methods. A face-to-face interview was carried out on one-hundred pregnant women attending an urban antenatal clinic in Malaysia between October and November 1999.
    Results. The mean age of the women was 27.8 years old (SD = 5.0, range 20 - 40 years). In general, these women had good knowledge of HIV and AIDS. More than 80% of them were aware of the main modes of HIV transmission. However, only half knew that HIV could be transmitted through breastfeeding. Sixty percent of women had the misconception that the virus could be acquired through blood donation. There was a lack of knowledge regarding the symptoms and the progression of AIDS. More than 90% of the women knew that AIDS is incurable. Three quarters of them were aware that early treatment can slow down the progression of the disease, but only 16% knew that maternal HIV transmission can be reduced by treatment. Good knowledge was positively correlated with higher level of education (p<0.05).
    Discussion. Although health education programs in Malaysia have succeeded in educating pregnant women regarding AIDS in general, certain important information is still not being disseminated. Future health education should formulate targeted strategies to overcome this problem.
    Matched MeSH terms: Maternal-Child Health Centers
  9. Lim BK, Sivalingam N, Aza Mirandan AR
    Family Physician, 1996;8:11-14.
    A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
    Matched MeSH terms: Maternal-Child Health Centers
  10. George J
    Family Practitioner, 1988;11(1):71-72.
    Matched MeSH terms: Maternal-Child Health Centers
  11. Lubis SH, Hisham JH, Abdul Aziz S
    Family Practitioner, 1986;9(2):41-45.
    A study was undertaken to evaluate the efficiency of health services at two maternal and child health (MCH) clinics in Kuala Lumpur. The time spent for individual patient care by the clinic staff was used as an indicator for the evaluation. The main objective was to derive a model of ideal operation time for specific patient care activities at a MCH clinic. Primary data was collected through systematic random sampling of patients between 25/7/1985 and 31/7/1985. Secondary data was obtained from available clinic records for July, 1985. The time a patient spent at the clinic and the time she spent at each examination station and waiting between stations was recorded with digital watches. Results show tha patients spent 80% of their time at the clinics waiting. The actual time spent on each patient was found to be considerably less than the ideal time measured under ideal conditions. Various recommendation are presented in the paper to reduce waiting time and extend examination time. The ideal patient capacity for the two clinics was also calculated.
    Matched MeSH terms: Maternal-Child Health Centers
  12. Gupta ML, Aborigo RA, Adongo PB, Rominski S, Hodgson A, Engmann CM, et al.
    Glob Public Health, 2015 Oct;10(9):1078-91.
    PMID: 25635475 DOI: 10.1080/17441692.2014.1002413
    Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.
    Matched MeSH terms: Maternal-Child Health Services/utilization*
  13. Fassil H, Borrazzo J, Greene R, Jacobs T, Norton M, Stanton ME, et al.
    Health Policy Plan, 2017 Sep 01;32(7):1072-1076.
    PMID: 28407108 DOI: 10.1093/heapol/czx018
    Reflecting on Storeng and Béhague ("Lives in the balance": the politics of integration in the Partnership for Maternal, Newborn and Child Health. Health Policy and Planning Storeng and Béhague (2016).) historical ethnography of the Partnership for Maternal, Newborn and Child Health (PMNCH), this commentary provides a more current account of PMNCH's trajectory since its inception in 2005. It highlights PMNCH's distinct characteristics and how it is positioned to play an instrumental role in the current global health landscape.
    Matched MeSH terms: Child Health Services/organization & administration*
  14. Ng CW, Shahari MR, Mariapun J, Hairi NNM, Rampal S, Mahal A
    Health Syst Reform, 2017 Jul 03;3(3):159-170.
    PMID: 31514671 DOI: 10.1080/23288604.2017.1342746
    An analysis of population coverage of hypertension treatment services can be used to make inferences about the performance of primary care services within health systems. Malaysia, an upper middle-income country, has a well-established primary care system but one that favors rural populations and provision of services for maternal and child health and infectious diseases. Demographic factors including rapid aging, urbanization, as well as lifestyle changes characteristic of a modernizing society have led to an increase in noncommunicable diseases, including hypertension. In this article, we used data from a nationally representative household health survey to develop service coverage indicators for hypertension screening and treatment services. The age-standardized prevalence of hypertension was estimated to be 33.9% (95% confidence interval [CI], 33.9, 33.9). Only 39.0% (95% CI, 37.5, 40.6) of adults with hypertension had been diagnosed by a medical practitioner, 35.7% had been on treatment, and 9.6% had blood pressure controlled under treatment. The diagnosis, treatment, and controlled treatment coverage were higher for older persons compared to younger persons. There were no differences in the diagnosis and treatment coverage between urban and rural areas and between ethnic groups. However, controlled treatment coverage was higher among Chinese and those living in urban areas. Our findings suggest that primary care services in Malaysia may need to intensify health education activities to promote screening services. There is also a need to reprioritize activities to provide regular community health screening of adults and increase access to affordable primary care services, especially in the urban areas.
    Matched MeSH terms: Child Health
  15. Balbir Singh HK, Badgujar VB, Yahaya RS, Abd Rahman S, Sami FM, Badgujar S, et al.
    Hum Vaccin Immunother, 2019;15(11):2544-2551.
    PMID: 31070987 DOI: 10.1080/21645515.2019.1612666
    Aim: Mothers knowledge and attitude toward childhood vaccination influence uptake is the most adequate tool and preventive aspects to infectious disease epidemics. The present study assesses and measures knowledge and attitude of postnatal mothers toward vaccination.Methods and results: The present study adopted a cross-sectional study design, whereby 200 postnatal mothers were identified during their postnatal visit to clinics. The subjects were accessed using questionnaire to assess the level of knowledge and attitude of mothers regarding vaccination. The objectives were to study the level of knowledge, the attitude, and to find the association between knowledge and attitude of the study subjects. The data were analyzed using SPSS version 16. The results was analyzed through chi-square test. The association between age (p = .031), education (p = .021), occupation (p = .013), and knowledge score toward vaccination was found to be statistically significant. However, ethnicity (p = .127), employment (p = .197), and mode of delivery (p = .750) toward mothers vaccination knowledge were not significant for the study. Mothers education, age, and occupation were found to be associated with attitude toward childhood vaccination. No association was found between ethnicity, employment, and mode of delivery with attitude of childhood vaccination.Conclusion: More than half of the studied mothers had good knowledge scores on vaccination, more than two-thirds of the studied mothers had good attitude scores on vaccination. However, the religious misconception and fear of autism was the main cause of vaccine resistance in Malaysia.
    Matched MeSH terms: Child Health*
  16. Siti Mariam Muda, Nurul Akma Jamil
    MyJurnal
    In Malaysia, breastfeeding was dominantly practiced among Malay whose deeply believe in Islam and any decision should abide by Islamic teachings. Existing literature appear to have limited evidence on Malay mothers’ interpretation and construction of this practice. The decision to breastfeed was believed to be influenced by social and cultural context. Therefore, in order to explore life experience of breastfeeding mothers on their beliefs related to religious and sociocultural, qualitative study design was used. A minimal guidance of phenomenological approach adopted as the methodological framework. Semi structured interviews were carried out among 15 mothers whose were recruited from four Maternal and Child Health Clinic in Kuantan using purposive sampling. The experience of researchers thorough out their journey will be shared in terms of challenges; barriers and solution to overcome the concerned that exist while conducting in-depth interview session.
    Matched MeSH terms: Maternal-Child Health Centers
  17. Abai G, Henry J, Lian CB, Wee ASF, Bili H, Ratu I
    Int J Public Health Res, 2011;1(2):92-99.
    MyJurnal
    Introduction Neonatal jaundice occurs in about 60% of newborns. If not managed properly, it can progress to severe neonatal jaundice (SNNJ) leading to death or permanent disability. The incidence of SNNJ in Kuching District increased from 119.3 per 100,000 live births in 2005 to 123.3 per 100,000 live births in 2008, which was above the Standard National QAP Indicator of 100 per 10,000 live births. SNNJ can be prevented by early detection and proper management of neonatal jaundice. The objective is to increase the knowledge and practise of early detection of neonatal jaundice by nurses in Kuching District. Methods This was an interventional study covering a period of six months. The sample comprised 113 nurses of all categories working in urban and rural maternal and child health clinics in Kuching District. Tools used in the study were self-administered questionnaires in English and Bahasa Malaysia. The preintervention survey started in July 2009 while the post-intervention survey was done in January 2010. The interventions were done through Continuing Nursing Education sessions and included new nursing formats and new reporting procedures. New vehicles were also provided for home nursing. Data was collected and analyzed using MS Excel program. Results The pre-intervention survey on nurses showed that only 56.6% were able to identify the risk of factors causing jaundice; 94.6% able to define jaundice; 41.5% able to detect jaundice while 70.8% knew sign of Kernicterus. In term of recommended post natal nursing schedule only 40.7% able to practice the schedule while only 69.0% able to give advice on management of jaundice. Post intervention; 63.2% of nurses were able to identify the risk factors causing jaundice; 97.2% able to define jaundice while 97.2% were able to detect jaundice and 88.6% know sign of Kernicterus. On recommended post natal nursing schedule, 49.9 % practice the recommended schedule while 92.0% were able to give advice to mother on management of jaundice. The incident of jaundice of Severe Neonatal Jaundice dropped to 78 per 100,000 live births in 2010.
    Conclusions The study shows that the interventions taken helped to improve the knowledge and practice of recommended measures to detect neonatal jaundice early. Stronger emphasis must be placed on using the new reporting procedures and new nursing sheets. Continuous monitoring through regular nursing audits by clinic supervisors is also essential to reduce the incidence of SNNJ. Provision of vehicles for all busy maternal and child health clinics for home nursing care is highly recommended.
    Matched MeSH terms: Child Health
  18. Haslina Hassan, Rosnah Sutan, Nursazila Asikin Mohd Azmi, Shuhaila Ahmad, Rohana Jaafar
    Int J Public Health Res, 2013;3(1):241-248.
    MyJurnal
    The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children's health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
    Matched MeSH terms: Child Health
  19. Jiee SF, Safii R, Hazmi H
    Int J Public Health Res, 2018;8(2):956-964.
    MyJurnal
    INTRODUCTION: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
    METHODS: This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
    RESULTS: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
    CONCLUSION: Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
    Study site: Maternal and Child Health Clinics, Lundu, Sarawak, Malaysia
    Matched MeSH terms: Child Health; Maternal-Child Health Centers
  20. Lim KK, Chan YY, Mahmud NA, Ismail H, Tan BC, Chua BK, et al.
    Int J Public Health Res, 2018;8(2):980-986.
    MyJurnal
    Introduction Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.
    Methods A total of 508 first trimester PW attending government Maternal and Child Health Care clinics in all 11 divisions in Sarawak between 1st April and 15th June 2015 were recruited. Urine samples were obtained and analysed for urinary iodine concentration (UIC) using the modified Sandell-Kolthoff reaction method. For pregnant women, an adequate iodine intake was defined as a median UIC between 150-249 µg/L according to the WHO/UNICEF/ICCIDD’s criterion. For further analyses, the 11 divisions were then combined into 3 regions, namely Northern (Miri, Bintulu, Limbang), Central (Kapit, Mukah, Sibu, Sarikei, Betong) and Southern (Kota Samarahan, Kuching, Sri Aman).
    Results TThe median UIC of the PW in Sarawak was 105.6 µg/L, indicating iodine deficiency. A total of 330 (65.0%) PW had UIC<150 µg/L. In terms of urinary iodine levels by region, the median UIC in Northern, Central and Southern regions were 136.3 µg/L, 85.5 µg/L and 97.4 µg/L respectively. The differences in median UIC between regions were significant. In addition, the Northern region (p = 0.001), Malay/Melanau ethnicity (p = 0.015) and parous parity (p = 0.014) were significantly associated with higher median UIC. No significant association was found for locality, age nor gravida.
    Conclusions This study indicates inadequate iodine status among PW in Sarawak despite seven years of mandatory USI. In fact, the majority of PW appear not to be protected against IDD and its consequences. In future, a comprehensive study should be carried out to determine the levels of iodine in salt at the retail outlets, villages and households in Sarawak.
    Keywords Iodine deficiency disorders - Pregnant women - Mandatory USI - Sarawak
    Matched MeSH terms: Maternal-Child Health Centers
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