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Home > Women and Maternal Health Care Providers’ Perceptions, Beliefs and Attitudes Towards Use of Epidural Analgesia for Labour Pain Relief

Women and Maternal Health Care Providers’ Perceptions, Beliefs and Attitudes Towards Use of Epidural Analgesia for Labour Pain Relief

Thesis Info

Author

Njenga, Stella

Department

Obstetrics and Gynaecology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728075557

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Background: Epidural analgesia (EA) is considered the gold standard for relief of labour pains due to its effectiveness, safety and flexibility of use. There is a disparity of utilization between high and low & middle income countries with lack of knowledge and resources implicated. Aga Khan University Hospital Nairobi is a well-resourced facility with a well-established EA service. This study explores the perceptions, beliefs and attitudes of women seen at the facility towards EA and how these affect their decision to use the method. It also explores health care providers’ views on the method and how they influence the women’s choice. Finally, it considers the perspectives of the women and health workers on what approaches could be taken to improve uptake of the method. Objectives: Primary Objectives 1. To explore women’s perceptions, beliefs and attitudes towards epidural analgesia use in labour. 2. To explore obstetric healthcare providers’ perceptions, beliefs and attitudes towards epidural analgesia use in labour. Secondary objective 1. To explore the views of women and health care providers on what approaches would increase uptake of epidural analgesia in labour. Methodology: This exploratory qualitative study involved in-depth interviews (IDIs) conducted among pregnant women, consultant and resident obstetricians and anaesthesiologists and two focused group discussions (FGDs) conducted among midwives, at the Aga Khan University Hospital, Nairobi (AKUHN). Interviews were carried out to theoretical saturation after which verbatim transcription of the audio recordings into textual form was done followed by thematic content analysis using the framework method proposed by Ritchie and Spencer. Results: Six main themes emerged from the study; factors determining perceptions, beliefs and attitudes to epidural analgesia; knowledge of participants regarding epidural analgesia; actual perceptions, beliefs and attitudes regarding epidural analgesia; usual practice by health care providers regarding labour pain relief; barriers to the use of epidural analgesia and the views of women and health care providers on how to improve uptake of epidural analgesia. Conclusion: Misperceptions exist among women and healthcare providers regarding epidural analgesia. Awareness needs to be raised to dispel the myths and disseminate accurate information regarding the method. Cost is a significant barrier to uptake of the method and measures to improve affordability should be taken into consideration.
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غزل

کل کے سکھ تو گروی رکھے, پچھلے بوجھ اتارے

اندر اندر سلگوں لیکن نکلوں زلف سنوارے

 

جانتی ہوں میں تیز ہوا ہے راہ میں رستہ روکے

کون  ہے ,خوشبو کے لہجے میں جا کر اسے پکارے

 

ایسے لگتا ہے میں خود ہی اس پہ جھولنا چاہوں

مجھ کو درد کی سولی سے اب آکے کون اتارے

 

اسی لیے تو نیند کی دیوی سے میں چھپنا چاہوں

روز مری آنکھوں سے کوئی آگ سے خواب گزارے

 

دیکھ دیکھ کے ان کو حوصلہ ملتا تو ہے مجھ کو

میری طرح سے جاگتے ہیں یہ شب بھر چاند ستارے

 

ایک اداسی کے دھاگے میں خود ہی بندھتی جاؤں

میری سوچوں پر یہ کون ہے خوف کے چھینٹے مارے

 

درد کے پیکر میں ڈھل جاتے ہیں معلوم نہیں

میری غزلیں, میری نظمیں, میرے

Review of the Jihadi and Mystical Services of Maulana Muhammad Shoaib Tordheri

Allah has promised to protect Islam. That is why Allah created scholars and Sufis in different periods that served Islam and preached Islam. The preaching and propagation of Islam in India is due to these Sufis. They left their territories and came to India. One of these scholars and Sufis is Maulana Muhammad Shoaib Tordheri, known as Shaikh Sahib. He was the Shaikh of Moulana Abdul Ghafoor (Swat Babaji), that is the most famous Sufi in Swat Khyber Pakhtonkhwa and Shaikh of the Moulana Abdul Rahim Saharan Puri.  Moulana Muhammad Shoaib was not a scholar and sufi, he was also a mujahid. He was martyred while fighting against the Sikhs in 1823 A.D. He wrote a book about Sufism. In his book he wrote about seeratul Nabi and companion of Prophet Muhammad S.A.W. After that he discussed circumstances and sayings of Sufis of the all four series (Naqshbandia, Qadria, Cheshtia and Saharwardia) of Sufism. He also described the attributes of the perfect Peer.

Study of Watermarking for Image and Text Based Applications

Due to the rapid development of multimedia and communications technologies, issues related to data vulnerability and copyrights violation has increased. Digital content can be manipulated and reproduced effortlessly. Consequently, there is a considerable requirement for techniques aimed at content protection and authentication. Watermarking techniques can provide copyrights enforcement and authentication to prevent the illegitimate use of digital content. These techniques can be classified into two categories i.e. robust watermarking and reversible watermarking. In this thesis, research work is carried out in three phases. The first phase proposes a robust watermarking technique, which is resilient against the geometrical attacks. It is helpful in executing copyright protection. In robust watermarking, watermark is able to survive in case of attack on the digital content and can be successfully retrieved on extraction. The proposed technique exploits both the robust image feature points and local Zernike moments for embedding secret information. Delaunay tessellation is employed to divide an image into distinct triangular segments based on robust features identified using Harris detector. Zernike moments are calculated for each selected triangular segment, and then the watermark is embedded in the magnitude of Zernike moments using dither modulation. In the second phase, a reversible watermarking technique is proposed. Reversible watermarking is a special type of watermarking technique in which watermark is extracted along with restoration of the host media. Whereas, in case of robust watermarking, we are not able to retrieve the original image. Such watermarking system finds its application in medical and law enforcement, etc. The proposed watermarking scheme is based on pixel value ordering. Image is divided into sub blocks and each block is assessed using a threshold value. If the block belongs to the smooth category, watermark bit is embedded. In contrast, if it is classified as rough block, then the sub block is left unchanged. This technique does not require a location map since it uses histogram shifting. In third phase, the watermarking approaches and their applications for the protection DNA sequences are explored. In DNA watermarking, which is type of text watermarking; watermark information should be embedded in DNA sequence in such a way that it should not raise any functional disorders in the living organism. A watermark is embedded in a DNA sequence through synonymous substitution of nucleotides. The proposed approach ensures Amino Acid conservation, efficient utilization of the available embedding space in DNA sequences, and achieves mutation resistance by since it employs Reed-Solomon codes. The performance of these techniques has been evaluated on the standard test datasets. In some of the cases, the proposed watermarking approaches performed better than the recent existing approaches and showed comparable performance in other cases. The first technique finds its application in protecting the copyrights of the owner. The second watermarking technique can be used in applications where significant amount of data needs to be embedded e.g. information related to the patient in medical images. The third technique related to the DNA watermarking can be used for protection of DNA sequences and also to provide biological data storage as large amount of data can be stored.