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Biomedical subjects

B Janowitz

Publications and source records attributed to B Janowitz.

At least 37 records · Page 2Linked to original sources
PubMed1985

Referrals by traditional birth attendants in northeast Brazil.

Between October 1980 and July 1981, 1,878 women were attended by traditional birth attendants (TBAs) at four obstetric units in rural areas surrounding the city of Fortaleza in Northeast Brazil. Of these women, 232 (12.4 per cent) were referred to a hospital in Fortaleza for delivery. The most important indicators for referral to hospital were: presence of an antenatal problem, complication of labor, or malpresentation. Based on record review, 65 referred women with none of these conditions were classified as low risk and 42 women not referred were classified as high risk (at least one such condition present). Of 1,878 deliveries, 32 (17 per 1,000) terminated as fetal deaths, and 12 infants died before discharge from hospital or obstetric unit (six per 1,000). The death rate was much higher for the high-risk cases (156 per 1,000 referrals, 95 for nonreferrals). Although some women may have been inappropriately referred while others who should have been were not referred, the system of referral has allowed TBAs to attend uncomplicated deliveries and to refer women with complications.

Adolescent↗
PubMed1984

Method of payment and the cesarean birth rate in a hospital in northeast Brazil.

This paper examines factors associated with the cesarean birth rate, including medical condition and method of payment, in the largest maternity hospital of Fortaleza, Brazil. Data were collected on 5996 women who delivered at the Maternidade Escola Assis Chateaubriand from October 1980 to July 1981. All women were classified according to how they paid for their care: private (financed at least part of their care with own funds), insured (federal or state), or indigent. Private patients were found to be far more likely than patients in the other two groups to have cesarean deliveries, due primarily to the high percentage of private patients recorded as having prolonged or obstructed labor, combined with a high rate of prior cesarean sections. From this data, it appears likely that financial incentives did play a role in physician decisions on whether to perform cesarean deliveries.

Brazil↗
PubMed1983

Infant and child survival and contraceptive use in the closed pregnancy interval.

While previous studies have examined the relationship between child survival and contraceptive use, they have not considered the impact of the sequence of child mortality on the practice of family planning. The present paper addresses this issue by considering how the birth order of nonsurviving outcomes affects the decision to contracept in the subsequent interval, using data collected from over 10,000 women at the time of hospital delivery. Results indicate that, even when gravidity and the total number of surviving children are held constant, the outcome of the penultimate pregnancy is highly associated with interval contraception.

Birth Intervals↗
PubMed1983

Sterilization in Honduras: assessing the unmet demand.

The purpose of this study was to evaluate and compare the availability of sterilization services at two hospitals in Honduras. Approximately 7,000 women who had given birth at the Hospital Materno Infantil in Tegucigalpa and the Hospital Leonardo Martinez in San Pedro Sula were asked about their desire for sterilization. Of the women who wanted to be sterilized, a considerable percentage had not been sterilized four months after they had given birth--58 percent of those who had delivered at Materno Infantil and 79 percent of those who had delivered at Leonardo Martinez. Twenty-three percent of the women who delivered at Materno Infantil and 4 percent of the women who delivered at Leonardo Martinez were sterilized before they were discharged. The difference may be attributed to the poor quality of the facilities at Leonardo Martinez.

Adolescent↗
PubMed1982

Interval sterilizations. A substitute for postpartum procedures, an example from Southeast Brazil.

From December 1979 to February 1980, data were collected on access to postpartum sterilization for all obstetric patients at a large maternity hospital in Campinas, Brazil. Of the 827 women wanting no additional children and having knowledge of sterilization, 481 (58%) reported that they wanted to be sterilized. Of these women, 226 (47%) were sterilized postpartum. One year following their deliveries, follow-up forms were administered to the women desiring sterilization, but who had not been sterilized postpartum, to determine if they had been sterilized over the course of the year. Only 13% of the women had been sterilized, but almost 75% of the women not sterilized said they were still interested in getting sterilized. Of the women interviewed, 18% either had become pregnant again since the initial survey or were currently pregnant.

Adult↗
PubMed1982

Access to postpartum sterilization in southeast Brazil.

All women hospitalized for delivery over a ten-week period at the largest maternity hospital in Campinas in the State of São Paulo, Brazil, were questioned about their interest in and plans for sterilization. Results from a categorical data analysis indicate that among the study variables, cesarean delivery was the necessary condition for postpartum sterilization and was significantly associated with the patient's ability to pay for services. Further, the variability in the proportion of women sterilized postpartum was almost perfectly explained by a linear model with main effects for parity and for the patient's ability to pay for services.

Adolescent↗
PubMedDate not supplied

Breech presentations in a sample of Colombian hospitals.

All the breech presentations that occurred in a large sample of data on obstetric deliveries from a random sample of urban hospitals in Colombia are examined. The 463 breeches are analyzed by age and parity of the mother, type of breech presentation (frank or footling) and type of delivery (vaginal or abdominal). The data suggest that abdominal delivery reduces perinatal mortality although cell values are too small to adequately control for birth weight.

Adolescent↗
PubMedDate not supplied

Impact of social marketing on contraceptive prevalence and cost in Honduras.

In 1984, the Honduran Family Planning Association launched a contraceptive social marketing program by introducing the oral contraceptive, Perla. This report examines the impact of the program on overall oral contraceptive use, use by particular subgroups, source of supply, and costs. Although use of oral contraceptives increased only slightly over the period 1984-87 (from 12.7 percent to 13.4 percent among women in union aged 15-44), the social marketing program significantly increased its share of the oral contraceptive market (from 7 percent in 1984 to 15 percent in 1987, and from 20 percent to 40 percent of sales at pharmacies). For the Honduran Family Planning Association to have realized cost savings as a result of clients switching from community-based distribution programs and commercial supply sources to contraceptive social marketing programs, the association would have had to reallocate its resources. Instead, the number of distributors in the community-based distribution program increased, while the amount of couple-years of protection from oral contraceptives decreased.

Adolescent↗