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Fulltext Improving IUCD usage among reproductive women with Diabetes Mellitus in Health Clinics of Perlis

Muhammad Ridzwan Rafi’i

Q Bulletin, 2019;1(28):26-34.
MyJurnal

Pregnant women with diabetes mellitus pose an increased risk of maternal and infant morbidity and mortality. In Perlis, for the year of 2016, only 3 (0.3%) out of 1,114 reproductive women with diabetes mellitus were using an intrauterine device (IUCD) as their main contraceptive measure. This project aims to improve the usage of IUCD to 10% among reproductive women with diabetes mellitus in nine health clinics of Perlis.
A retrospective contraception card review was undertaken to determine the baseline in providing IUCD services. Two sets of validated questionnaires were distributed to patients and healthcare providers in the pre and post-remedial period.
Customised training sessions were organised for both doctors and nurses’ group. A quick reference for IUCD was developed to guide the healthcare providers during counselling sessions. The Model of Good Care (MOGC) was integrated into the Maternal and Child Health State Plan of Action 2016 to ease the supervision of quality improvement.
Of the 244 diabetic women who had undergone counselling, 44 (18%) agreed to use IUCD and 38 (16%) of them inserted the IUCD within two weeks. Our project was able to increase the usage of IUCD among diabetic women in nine Perlis health clinics from 3 (0.3%) to 38 (3.4%) within six months. There was a gap reduction in achievable but not achieved (ABNA) from 9.7% to 6.6%. [ABNA = Achievable benefit not achieved]
Low usage of IUCD among diabetic women is a challenging issue and patient refusal to use IUCD, lack of husband support and comfortable with the previous contraception method were among the main contributing factors. However, providing continuous awareness and new process of effort in promoting the usage of IUCD among diabetic women do improve the uptake of the approach

Matched MeSH terms: Spouses
Vulnerability, life events and depression amongst Moslem Malaysian women: comparing those married and those divorced or separated

Abdul Kadir NB, Bifulco A

Soc Psychiatry Psychiatr Epidemiol, 2011 Sep;46(9):853-62.
PMID: 20556355 DOI: 10.1007/s00127-010-0249-4

INTRODUCTION: The experiences of married and single mothers were compared in an investigation of psychosocial vulnerability, stress and depression in a community-based study of Moslem mothers in Malaysia. For the first time, a model of vulnerability-provoking agent originally developed by Brown et al. in the UK was tested in a Malaysian context.
METHODS: A cross-sectional study was carried out in the district of Johor Bahru, Malaysia. Of the 1,200 women approached from membership of community associations, 1,002 (84%) completed the questionnaires. Severe life events Recent Life Events Questionnaire (Brugha and Cragg in Acta Psychiatr Scand 82:77-81, 1990) and psychosocial vulnerability (VDQ) (Moran et al. in Br J Clin Psychol 40:411-427, 2001) were used to measure vulnerability factors. Depression was measured by the General Health Questionnaire (GHQ-30) (Havenaar et al. in Soc Psychiatry Psychiatr Epidemiol 43:209-215, 2008).
RESULTS: Single mothers had significantly higher rates of depression than those married (60.5 vs. 39.5%), as well as higher rates of severe life events and Negative Elements in Close Relationships (lack of support and conflict with children). However, married mothers had greater Negative Evaluation of Self. The two vulnerability factors were correlated to each other and to severe life events and social adversity. Logistic regression showed an interaction between severe life events in the material and relationship domains and joint vulnerability for depression outcome. The results are discussed in relation to the low recognition of psychosocial risks for depression in single mothers in Malaysia, as well as lack of appropriate services.

Matched MeSH terms: Spouses/ethnology; Spouses/psychology*
Fulltext Work-family conflict among married professional women in Malaysia

Ahmad A

J Soc Psychol, 1996 Oct;136(5):663-5.
PMID: 8942323 DOI: 10.1080/00224545.1996.9714054
Matched MeSH terms: Spouses/psychology*
Fulltext Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics

Sonkusare S, Adinegara, Hebbar S

Med J Malaysia, 2007 Dec;62(5):402-8.
PMID: 18705476 MyJurnal

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.

Matched MeSH terms: Spouses
Fulltext Factors associated with ever used of modern contraception among married men attending a primary healthcare clinic

Syahnaz MH, Rasina Nilofer JK, Azmawati MW, Harlina Halizah S

Med J Malaysia, 2018 10;73(5):301-306.
PMID: 30350809 MyJurnal

BACKGROUND: The practice of modern contraceptives still remains a sceptical issue in the society and dormant due to increasing objection of husbands who play a significant role in the family planning practice.
OBJECTIVES: This study was done to determine the factors affecting the ever use of modern contraceptive methods among married men visiting a healthcare clinic in Malaysia.
MATERIAL AND METHOD: A cross sectional study of 443 men aged over 18 years was conducted using convenient sampling from January 2016 till March 2016 at a primary care clinic. A self-administered questionnaire assessing sociodemographic characteristic, attitude towards family planning, spousal communication and ever used of modern contraceptive methods was used.
RESULTS: The proportion of ever used modern contraception was 48% (n=192). Multiple logistic regression revealed that spousal communication on family planning (Adjusted OR 15.8; 95% CI 7.0 - 35.6) and attitude towards marital relationship (Adjusted OR 1.1; CI 1.0 - 1.1) were significant predictors for ever used of modern contraception among married men.
CONCLUSION: The proportion of ever used modern contraception is still not high. Men who communicated with their spouse on modern contraception and perceived family planning as means to preserve their marital relationship were more likely to practice modern contraceptive method.
Study site: Klinik Kesihatan, Selangor, Malaysia

Matched MeSH terms: Spouses
α-thalassemia-associated hydrops fetalis: A rare cause of thyrotoxic cardiomyopathy

Tumian NR, Wong M, Wong CL

J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.
PMID: 25510540 DOI: 10.1111/jog.12648

α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.

Matched MeSH terms: Spouses
Prevalence, risk factors, and predictors of female sexual dysfunction in a primary care setting: a survey finding

Ishak IH, Low WY, Othman S

J Sex Med, 2010 Sep;7(9):3080-7.
PMID: 20584130 DOI: 10.1111/j.1743-6109.2010.01848.x

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

Matched MeSH terms: Spouses
Domestic Violence in Cross-Border Marriages: A Systematic Review

Md Said MHB, Emmanuel Kaka G

Trauma Violence Abuse, 2023 Jul;24(3):1483-1502.
PMID: 35232287 DOI: 10.1177/15248380221074321

Cross-border marriages have been found to be associated with domestic violence due to the migration experiences of the couples concerned and the stress experienced before, during, and after migration, despite local and international legislation on domestic violence. A systematic review using the PRISMA Statement was conducted to examine the relationship between domestic violence and cross-border marriages among cross-border wives from Asian countries. Six databases-Taylor & Francis Online, Wiley Online, Scopus, Web of Science, Sage Journals, and Springer Online library, were used in the research which found 179 articles for eligibility and 58 articles were finally used in the review. To be included, studies must have addressed domestic violence and cross-border marriage among Asians, report qualitative, quantitative, or mixed methods, addressed the RQs, been published in polished English between 2010 and 2020 and published in a reputable journal with high impact factor. The systematic review found that immigration status, citizenship, culture, language barrier, diversity/intersectionality, age, and economic dependence are the risk factors for domestic violence, which leads effects such as divorce or separation, racism, loneliness, loss of identity & inheritance, stigma, abandonment, and discrimination. Yet these cross-border wives resorted to NGOs, social & religious groups, and traditional beliefs as coping strategies. The review suggests that legislations on domestic violence should be amended to include a definition of the rights of immigrant women, and the plight of cross-border wives, which should be protected. It is also imperative to propose favorable laws and policies regarding immigration status and citizenship for these cross-border couples.

Matched MeSH terms: Spouses
Fulltext A complex behavioural change intervention to reduce the risk of diabetes and prediabetes in the pre-conception period in Malaysia: study protocol for a randomised controlled trial

Skau JK, Nordin AB, Cheah JC, Ali R, Zainal R, Aris T, et al.

Trials, 2016;17(1):215.
PMID: 27117703 DOI: 10.1186/s13063-016-1345-x

Over the past two decades, the population of Malaysia has grown rapidly and the prevalence of diabetes mellitus in Malaysia has dramatically increased, along with the frequency of obesity, hyperlipidaemia and hypertension. Early-life influences play an important role in the development of non-communicable diseases. Indeed, maternal lifestyle and conditions such as gestational diabetes mellitus or obesity can affect the risk of diabetes in the next generation. Lifestyle changes can help to prevent the development of type 2 diabetes mellitus. This is a protocol for an unblinded, community-based, randomised controlled trial in two arms to evaluate the efficacy of a complex behavioural change intervention, combining motivational interviewing provided by a community health promoter and access to a habit formation mobile application, among young Malaysian women and their spouses prior to pregnancy.

Matched MeSH terms: Spouses/psychology
HPV vaccination intent and willingness to pay for 2-,4-, and 9-valent HPV vaccines: A study of adult women aged 27-45 years in China

Lin Y, Lin Z, He F, Chen H, Lin X, Zimet GD, et al.

Vaccine, 2020 03 23;38(14):3021-3030.
PMID: 32127227 DOI: 10.1016/j.vaccine.2020.02.042

OBJECTIVE: This study aims to investigate acceptance and willingness to pay for HPV vaccination among adult women in China.
METHODS: An online survey was sent to mothers aged 27-45 years of primary school pupils in the Fujian province, China. Participants completed questions about HPV related knowledge and health beliefs, intention to take the HPV vaccine and the willingness to pay for bivalent vaccine (2vHPV), quadrivalent vaccine (4vHPV), and 9-valent HPV vaccine (9vHPV).
RESULTS: Of a total of 2339 complete responses, 58.3% reported intent to obtain HPV vaccine. Mothers who were younger in age, residing in urban, working in managerial or professional occupations, who knew someone with cervical cancer and who were able to make independent decisions about the HPV vaccine (vs. joint decision with spouse) were more likely to express intent to have HPV vaccination. Perceived barriers, cues to action and self-efficacy were three of the constructs in the health belief model that significantly influenced HPV vaccination intent. A higher proportion of participants expressed willingness to pay for 2vHPV (81.2%) and 4vHPV (75.9%), as compared to 9vHPV (67.7%).
CONCLUSION: Adults women expressed moderate intention to receive the HPV vaccine. Intervention to address barriers to uptake of the HPV vaccine among adult women in China is warranted.

Matched MeSH terms: Spouses
Availability, Utilization, and Health Providers' Attitudes Towards Safe Abortion Services in Public Health Facilities of a District in West Bengal, India

Pyne S, Ravindran TKS

Womens Health Rep (New Rochelle), 2020;1(1):80-88.
PMID: 33786477 DOI: 10.1089/whr.2019.0007

Background:
The provision of safe abortion services upholds the realization of justice in sexual and reproductive health. Many state-level studies in India have identified poor availability of abortion services in the public sector and negative attitudes toward abortion among health providers, as potential barriers to access.
Materials and Methods:
A cross-sectional study was done to document the availability and utilization of medical termination of pregnancy (MTP or abortion) services and to assess public sector health providers' attitudes towards safe abortion. It was carried out in a representative district of West Bengal, using a facility checklist and a validated attitude scale.
Results:
Only 11 of 42 public health facilities had both trained doctors and equipment to provide MTP services. Twelve facilities provided MTP services, of which only three urban-based secondary-level facilities provided second trimester MTPs. There were female providers in just 2 of the 12 MTP-providing facilities. Among the 64 health providers interviewed, 40% were trained to provide MTP. According to the attitude scale, 38% had a negative attitude toward the provision of safe abortion services. There was no statistically significant association between attitudes of health providers and provision of MTP. However, there appeared to be a subtle process of gatekeeping in operation, such as making MTP conditional on acceptance of contraception, requiring the husband's consent, and so on.
Conclusions:
The study shows the poor availability of abortion services in public sector facilities in a district of West Bengal, although all public health facilities from the primary health center level upwards are authorized to provide abortion services.

Matched MeSH terms: Spouses

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