METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.
ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.
DESIGN/METHODOLOGY/APPROACH: The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.
FINDINGS: The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.
PRACTICAL IMPLICATIONS: This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.
ORIGINALITY/VALUE: This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.
METHODS: We conducted a community-based cross-sectional study in 15 sub-districts of Kuantan Singingi regency from May-June 2017. We selected 320 mothers from 15 sub-districts who delivered in the last 3 months (February-April 2017). Trained data enumerators collected the relevant data by using a pre-tested semi-structured questionnaire. We used Cox regression analysis to determine the factors associated with delivery at healthcare facilities. Prevalence Ratio (PR) with a 95% confidence interval (CI) for childbirth at healthcare facilities was the key outcome measure.
RESULTS: Only 54.4% (174) of the 320 mothers delivered at healthcare facilities. Knowledge about pregnancy danger signs (PR = 1.59, 95%CI:1.15-2.2), attitude towards healthcare services (PR = 0.79, 95%CI:0.33-1.89), and access to health care services (PR = 0.39, 95%CI:0.18-0.84) were the dominant factors of childbirth at healthcare facilities. There was an interaction between attitude and access to healthcare influencing delivery at healthcare facilities.
CONCLUSIONS: Utilization of healthcare facilities for childbirth was low in Kuantan Singingi regency. Knowledge of pregnancy danger signs was an independent correlate of childbirth at healthcare facilities. Also, the interaction between attitude and access to healthcare showed a significant influence on childbirth at healthcare facilities. We recommend strengthening of existing maternal and child health program with a particular emphasis on complete and quality antenatal care, health education on danger signs of pregnancy and childbirth, and promoting positive attitudes towards healthcare facilities.