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Albrecht Jahn

Publications and source records attributed to Albrecht Jahn.

10 recordsLinked to original sources
PubMed2004

Malaria and anemia prevention in pregnant women of rural Burkina Faso.

BACKGROUND: Pregnant women are a major risk group for malaria in endemic areas. Only little information exists on the compliance of pregnant women with malaria and anaemia preventive drug regimens in the rural areas of sub-Saharan Africa (SSA). In this study, we collected information on malaria and anaemia prevention behaviour in pregnant women of rural Burkina Faso. METHODS: Cross-sectional qualitative and quantitative survey among 225 women of eight villages in rural northwestern Burkina Faso. Four of the villages had a health centre offering antenatal care (ANC) services while the other four were more than five kilometers away from a health centre. RESULTS: Overall ANC coverage (at least one visit) was 71% (95% in health centre villages vs 50% in remote villages). Malaria and anaemia were considered as the biggest problems during pregnancy in this community. ANC using women were quite satisfied with the quality of services, and compliance with malaria and anaemia prevention regimens (chloroquine and iron/folic acid) was high in this population. Knowledge on the benefit of bed nets and good nutrition was less prominent. Distance, lack of money and ignorance were the main reasons for women to not attend ANC services. CONCLUSIONS: There is an urgent need to improve access of rural SSA women to ANC services, either through increasing the number of rural health centres or establishing functioning outreach services. Moreover, alternative malaria and anaemia prevention programmes such as intermittent preventive treatment with effective antimalarials and the distribution of insecticide-treated bed nets need to become implemented on a large scale.

Journal Article↗
PubMed2004

Risk factors of infant and child mortality in rural Burkina Faso.

OBJECTIVE: The aim of the study was to quantify the effect of risk factors for childhood mortality in a typical rural setting in sub-Saharan Africa. METHODS: We performed a survival analysis of births within a population under demographic surveillance from 1992 to 1999 based on data from a demographic surveillance system in 39 villages around Nouna, western Burkina Faso, with a total population of about 30000. All children born alive in the period 1 January 1993 to 31 December 1999 in the study area (n = 10 122) followed-up until 31 December 1999 were included. All-cause childhood mortality was used as outcome variable. FINDINGS: Within the observation time, 1340 deaths were recorded. In a Cox regression model a simultaneous estimation of hazard rate ratios showed death of the mother and being a twin as the strongest risk factors for mortality. For both, the risk was most pronounced in infancy. Further factors associated with mortality include age of the mother, birth spacing, season of birth, village, ethnic group, and distance to the nearest health centre. Finally, there was an overall decrease in childhood mortality over the years 1993-99. CONCLUSION: The study supports the multi-causation of childhood deaths in rural West Africa during the 1990s and supports the overall trend, as observed in other studies, of decreasing childhood mortality in these populations. The observed correlation between the factors highlights the need for multivariate analysis to disentangle the separate effects. These findings illustrate the need for more comprehensive improvement of prenatal and postnatal care in rural sub-Saharan Africa.

Adult↗
PubMed2002

Can mothers afford maternal health care costs? User costs of maternity services in rural Tanzania.

Following the difficult economic situation various countries introduced health sector reforms, including user charges to finance the system. The assessment of user costs for maternity services in Tanzania was part of a larger study, which covered inputs, outputs and efficiency of services. The study was carried out from October 1997 to January 1998 in Mtwara urban and rural district in South Tanzania. One hundred and seven women attending a quarter of government health facilities were randomly selected and interviewed. Twenty one key informants were also interviewed and service procedures observed. Users of maternity services pay mainly for admission, drugs, other supplies and travel costs. Travel costs represent about half of these financial costs. The average total costs vary between US$11.60 for antenatal consultation and US$135.40 for caesarean section at the hospital. Unofficial payments are not included in the calculation. The amounts vary and payment is irregular. We therefore conclude that time costs are constantly higher than financial costs. High direct payments and the fear of unofficial costs are acute barriers to the use of maternity services. User costs can substantially be reduced by the re-organisation of service delivery especially at antenatal consultation.

Cost-Benefit Analysis↗
PubMed2002

[Ultrasound screening in pregnancy: evidence and maternity care reality].

Since 1980 maternity care in Germany has included ultrasound screening. The aim of this review is (1) to assess the benefit of ultrasound screening on the basis of randomised, controlled trials in accordance with the criteria of evidence-based medicine, (2) to examine current screening practice and the quality of German maternity care in everyday clinical practice, and (3) to indicate priorities for further screening developments. We reviewed Cochrane reviews, health technology assessment reports and relevant individual studies. The three essential effects that may be achieved by ultrasound screening include: (1) earlier detection of multiple pregnancies, (2) better dating of pregnancy and reduction in induced labour by 40%, and (3) more frequent and earlier detection of foetal malformations including the option for an abortion. Yet, early detection does not increase the rate of successful pregnancies. The effects mentioned are only incompletely achieved with standard maternity care in Germany. For example, there is no evidence for an essential reduction of the frequency with which labour is induced. Detection rates in routine preventive care are markedly lower than described for trial conditions. Only multiple pregnancies can be identified more or less completely; detecting other target diagnoses remains unsatisfactory: placenta praevia 57% (without signs of bleeding 14%), postmaturity 46%, malformations 30-40% and intrauterine growth retardation 30%. Also, high rates of false positive findings can be observed that might lead to follow-up examinations and unnecessary treatment procedures. Quality of maternity screening is low and is not subjected to substantial quality assurance. We suggest the following priority measures: (1) to improve the quality of screening by modifying the previous three-step concept with the aim of promoting accessibility of highly qualified examiners for all pregnant women, (2) to strengthen quality assurance, (3) to assist the pregnant woman with her informed decision by offering independent and non-directional counselling concerning the advantages and disadvantages of screening and (4) to focus maternity care on effective interventions according to the criteria of evidence-based medicine.

Evidence-Based Medicine↗