Home > Difference in the Level of Utilization and Determinants of Preconception Care Among Pregnant Women in Aga Khan University Hospital and Maragua Level Four Hospital.
Difference in the Level of Utilization and Determinants of Preconception Care Among Pregnant Women in Aga Khan University Hospital and Maragua Level Four Hospital.
Background: Preconception care (PCC) is an important form of primary health care that aims to identify risks, offer patient education and evidence based interventions prior to conception in order to improve maternal and fetal short and long term health outcomes. Despite the benefits of PCC, the global levels of utilization are still low, more so in developing countries and in the rural settings. This study aimed to determine the difference in the level and determinants of PCC in both urban and rural settings in Kenya. Objectives: The primary objective of this study was to compare PCC among pregnant women in Aga Khan University Hospital, Nairobi (AKUH, N) (urban) and Maragua Level Four Hospital (MLFH) (rural). The secondary objective was to determine the factors affecting PCC among pregnant women in the two hospitals. Design and Methodology: Unselected pregnant women seeking antenatal care (ANC) were recruited consecutively at the Mother and Child Health (MCH) clinics in AKUH, N and MLFH. The study design was a mixed method study that employed a cross-sectional approach to determine the level of PCC, using a 5-10 minutes self-administered questionnaire, and a qualitative approach to assess factors affecting PCC using a semi-structured interview guide. Quantitative data was analyzed using SPSS version 22. Qualitative interviews were transcribed verbatim, a thematic framework was thereafter manually constructed through coding, creating categories, sub-themes and themes. Indexing, charting, mapping and data interpretation were thereafter carried out. Results: A total of 194 pregnant women were recruited, 97 in each setting (rural and urban). Of these, 21 women were selected through purposive sampling to participate in in-depth interviews for the qualitative aspect of the study. Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH) after which 4 more interviews were conducted at each site to confirm saturation. Of the total participants, 25.8% received PCC. There was a significant difference (p < 0.01) in PCC between the rural and urban participants with an OR of 0.3 (0.19-0.72, 95 % CI). Univariate analysis of possible related factors showed that age, marital status, education, parity and occupation had potential effect on PCC. Transcription, coding and thematic analysis of the in-depth interviews yielded 97 categories which were merged into 39 sub-themes and subsequently into 12 main themes. Eleven of the main themes were identified as factors affecting PCC while one theme contained suggested strategies of increasing PCC awareness and utilization. The dominant themes
Wherever person goes, he finds unless it finds advertisement tools in various shapes and sizes. These ads, which have become an important pattern in the life of traders are indispensable for them than in contemporary reality. But now companies are specializing in the production of these ads and incentives, taking advantage of all the modern means of magazines and broadcasting video and audio formats and even mobile internet services. Each of these companies have their own philosophy of it, some of which consider the legitimate controls in advertisements but other are to make money regardless of the appropriateness of these ads or following the controls of legitimacy and this research aims at highlighting the most important of these Islamic perspective controls which must be adhered when designing these commercials ads. Islam regulates the trade system and provides a sound guideline to its followers. It has forbidden all the malpractices being exercised in business and its advertisement. The research talks about the commercial advertisements, their types, aims and the opinions of Islamic experts about them. Besides, the research proves that advertisement is permissible according to shariah.
Identity and Indigenous Culture: A Study of Khushwant Singh's 'Train to Pakistan' and Bapsi Sidhwa's ' Ice-Candy-Man' Intellectuals in postcolonial societies reveal an urgent need to define themselves, both against the identity of their colonial past and against international modernism. The Partition of India was the watershed event of South Asian history. Out of the conflict grew a rich literary tradition shared by the two nations. Research is conducted to reveal how the cultural, religious and national backgrounds of authors are reflected in their works. Khushwant Singh's `Train to Pakistan' and Bapsi Sidhwa's 'Ice-Candy-Man' are an unusual passage to India which transport the reader to the hearts of the Sikh and Parsi communities respectively. The factor that postcolonial discourse theory still continues to find traces in the works of various authors and poets across the world, leads one to analyze works. This study focuses on the work of authors of the sub- continent and the theme of migration and partition. 'Ice-Candy-Man' by Bapsi Sidhwa and `Train to Pakistan' by Khushwant Singh provide one an opportunity to get close to the hearts and minds of the people who experienced Partition in the sub-continent. This thesis explores the themes of identity and indigenous culture as they have been positioned in various situations and experiences of Lenny and Juggat, the central characters of both novels, before and after partition. The narrations of the Parsee girl, Lenny, and the Sikh young man, Juggat, are situated in the wider cultural context of Muslims and Hindus, at a critical juncture of history. Their stories are coming from the peripheries of the minority society that they represent, and address the centre which takes all the decisions for them. They represent a feminist point of view and male discourse. This thesis analyzes these stories with the postcolonial discourse theory, and takes note of the use of English language by the authors; looks into reasons of writing the novels in English, as it has been appropriated and abrogated in the local context and setting. The thesis takes into account the autobiographical nature of the historical novels, and the discursive narrative by indicating similarity of events. A particular event may be seen from the perspective of history as well as from the point of view of personal experience. The differences appear concerning the beliefs of the authors, their approach towards various things, their own mental attitude or particular approach of analysis; their psychological set up or even psychological problems find expression in writing. The theme of migration and independence in subcontinent authors addresses the birth of conflicts that surround the peoples of both India and Pakistan even today. An insight into the works and backgrounds of Sidhwa and Singh contextualizes these concerns and issues, and helps pinpoint areas which need to be addressed in everyday discourse whether social, political or literal. The dissertation analyzes the standings of these works within the postcolonial literary scenario. It focuses on the use of language as a tool for representation of identity and culture through literary discourse. The research studies and enhances the dilemma faced by the postcolonial authors in using the language of the former colonizers (English) as a means to achieve recognition in the literary world. English language acts as a device for the repressed feelings and emotions of the people to be expressed. Thesis cumulates the point that the former colonized people have found a voice for their unheard and unrecognized identity, in the form of their literary discourse.