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Biomedical subjects

Jerker Liljestrand

Publications and source records attributed to Jerker Liljestrand.

14 recordsLinked to original sources
PubMed2006

Confidentiality for adolescents seeking reproductive health care in Lithuania: the perceptions of general practitioners.

Confidentiality is a major determinant of the accessibility and acceptability of sexual and reproductive health care for adolescents. Previous research has revealed that Lithuanian adolescents lack confidence in guarantees of confidentiality in primary health care settings. This study aimed to assess the factors that affect general practitioners' decisions whether to respect confidentiality for Lithuanian adolescents under the age of 18. Twenty in-depth interviews were carried out with a purposive sample of general practitioners. The decision whether to respect confidentiality was found to be influenced by external forces, including the legislative framework and societal attitudes towards adolescent sexuality; institutional features in clinical facilities, such as the presence of a nurse during consultations and the openness of the medical record filing system; and individual factors, including GPs' relationships with adolescents' families and their personal attitudes towards sexual and reproductive health issues. The findings reflect the urgent need for a comprehensive policy to ensure adolescents' right to confidentiality in Lithuanian primary care settings, including legislative reforms, institutional changes in health care settings, professional guidelines and (self-)regulation, and changes in medical training and continuing medical education. Other ways to safeguard confidentiality in adolescent health services, such as establishing youth clinics, should also be explored.

Adolescent↗
PubMed2006

Swedish health care providers' experience and knowledge of female genital cutting.

We sought to evaluate the experiences and knowledge of health care providers in Sweden regarding female genital cutting (FGC) as a health issue. Questionnaires (n = 2,707) were sent to providers in four major cities in Sweden and evaluated by means of descriptive statistics. Twenty-eight percent (n = 769/2,707) responded, of whom 60% had seen such patients. Seven providers, including 2 pediatricians, were suspicious of patients with signs of recent genital cutting. Ten percent had been asked to perform reinfibulation after delivery. Thirty-eight providers had received inquiries about the possibility of performing FGC in Sweden.A majority of Swedish health care providers meet patients presenting with evidence of FGC performed long ago. However, very few of them have suspected recently cut patients. The results support the hypothesis that this practice is not as active among African immigrants in Sweden as in their countries of origin. If the prevalence was the same as in African countries, more pediatricians would be expected to meet current cut girls. National efforts and policy programs to prevent FGC in Sweden are recommended as effective, in accordance with current research and should especially be directed toward pediatricians.

Africa↗
PubMed2006

Factors affecting attitudes towards medical abortion in Lithuania.

OBJECTIVE: Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal. METHODS: A random sample of the adult population was asked if they supported medical abortion. The dependent variable of attitude towards medical abortion was tested against the eight independent variables reported for each respondent using Chi-square tests and odds ratios. The effects of the variables upon each other were tested with two logistic regression models. RESULTS: Among the respondents, 62.6% supported access to medical abortion. The independent variables of urban/rural residence, employment status and educational level significantly affected opinion. Overall, education level provided the strongest odds ratio for support of medical abortion. CONCLUSION: The majority of the Lithuanian population supports the legalisation of medical abortion. There is somewhat less support for it in rural areas, among those who are least educated and in certain nonworking population groups. Lithuanian policy-makers should consider responding to popular sentiment and legalising medical abortion.

Abortion, Legal↗
PubMed2006

HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark.

AIMS: This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use. MATERIAL AND METHODS: A 78-item questionnaire, divided into five thematic sections, was given to 192 purposively selected Sudanese and Somalis of both sexes, aged 18-49, who had lived in Denmark for one or more years. It was administered in Arabic and Somali in four locations and supplemented by 13 semi-structured interviews. RESULTS: Education, sex, and nationality, but not length of residence in Denmark, were positively associated with knowledge about HIV/AIDS. Less than half of both men and women scored more than 70% on the knowledge portion of the questionnaire, while Sudanese knew more than Somalis. Men had a more negative attitude towards condoms than women, but greater knowledge about them. One-third of the women reported never having seen or heard of a condom, and almost half had never received information about condoms. Both sexes preferred receiving such information from the TV or friends instead of family doctors or HIV-positive individuals. CONCLUSIONS: This study suggests that knowledge about HIV/AIDS is low in these two Danish immigrant groups, both of which are characterized by reported incidence rates that are higher than the national average. The groups receive little information, while condom knowledge is particularly low among poorly educated women, and men have a negative attitude to condom use. The findings indicate a need for targeted, culturally sensitive HIV/AIDS information and advice.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Trends in maternal health/healthcare in low-income countries and the implications on neonatal health.

Maternal health in low-income countries has received increasing attention over the last 15-20 years. Maternal mortality ratios in these countries are mainly still modelled estimates and one cannot discern trends. The introduction of registration systems-giving reliable causes of death-is essential both for monitoring maternal health and fuelling action. Countries with documented success in reducing maternal mortality have used systematic, incremental approaches, often tied to multi-sectoral efforts, including roads, communication links, education, water and sanitation. Improving maternal health requires a reasonably well-functioning health system and this typically requires the reduction of poverty and consistent investment in the health system. Increasingly, policies to improve maternal and newborn health are being implemented, but in the poorest countries the impact is still not discernible. New clinical interventions, such as effective treatment of (pre)eclampsia and post-partum haemorrhage, are often beyond reach of the majority in low-income countries. In summary, progress in maternal health, and the intimately linked perinatal and newborn health, is too slow and requires urgent efforts in poverty reduction and health system strengthening in low-income countries.

Developing Countries↗
PubMed2005

Midwifery at the crossroads in Estonia: attitudes of midwives and other key stakeholders.

BACKGROUND: Since the initiation of health sector reforms in Estonia in 1992, the Baltic state has experienced a steep decline in the number of midwives and midwife graduates. At the same time, there has been a rapid increase, first in sexually transmitted infections and then in human immunodeficiency virus. The aim of this study was to draw on the perceptions of Estonia's midwives and other health care stakeholders to delineate the current situation of midwifery in the country, in the context of a sexually transmitted infection/human immunodeficiency virus epidemic. MATERIALS AND METHODS: Data were obtained by sending a 32-question questionnaire, based on an agenda developed through semistructured interviews, to all midwives in Estonia. A nominal group technique was employed with key stakeholders to determine the extent of their agreement with the questionnaire's major findings. RESULTS: The response rate to the questionnaire was 75%. There was no significant association between work satisfaction and independent variables of age, ethnicity, work abroad, increased responsibility, and involvement in postpartum care and counseling. There was, however, a significant association between work satisfaction and salary. The group process revealed that although there is no agreement on the role of family doctors and midwives in antenatal care, there is a general agreement that midwives should be more involved in postpartum care and that their tasks need to be better defined. CONCLUSIONS: Almost half of the responding Estonian midwives are dissatisfied with their job, especially their salary. Increased responsibility for antenatal and postpartum counseling, with concurrent salary adjustments, may help stop the decline in the number of midwives, as could the opening up of new areas of work. A further reduction of the high abortion and sexually transmitted infection/human immunodeficiency virus rates is a critical challenge for Estonia, and midwives could be employed in services to do this, similar to their Nordic neighbors. Current indications suggest, however, that the number of midwives, especially new graduates, will continue to decline.

Adult↗
PubMed2004

Reducing maternal mortality: can we derive policy guidance from developing country experiences?

Developing countries are floundering in their efforts to meet the Millennium Development Goal of reducing maternal mortality by 75% by 2015. Two issues are being debated. Is it doable within this time frame? And is it affordable? Malaysia and Sri Lanka have in the past 50 years repeatedly halved their maternal mortality ratio (MMR) every 7-10 years to reduce MMR from over 500 to below 50. Experience from four other developing countries--Bolivia, Yunan in China, Egypt, and Jamaica-confirms that each was able to halve MMR in less than 10 years beginning from levels of 200-300. Malaysia and Sri Lanka, invested modestly (but wisely)--less than 0.4% of GDP--on maternal health throughout the period of decline, although the large majority of women depended on publicly funded maternal health care. Analysis of their experience suggests that provision of access to and removal of barriers for the use of skilled birth attendance has been the key. This included professionalization of midwifery and phasing out of traditional birth attendants; monitoring births and maternal deaths and use of such information for high profile advocacy on the importance of reducing maternal death; and addressing critical gaps in the health system; and reducing disparities between different groups through special attention to the poor and disadvantaged populations.

Developing Countries↗
PubMed2004

A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala.

OBJECTIVE: To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors. STUDY: design Qualitative in-depth interview study. SETTING: Rural Guatemala. SAMPLE: Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala. METHOD: Interviews with semi-structured, thematic, open-ended questions. Interview topics were: traditional birth attendants' experiences and conceptions as to the causes of complications, attitudes towards hospital care and referral of obstetric complications. MAIN OUTCOME MEASURES: Conceptions of obstetric complications, hospital referrals and maternal mortality among traditional birth attendants. RESULTS: Pregnant women rather than traditional birth attendants appear to make the decision on how to handle a complication, based on moralistically and fatalistically influenced thoughts about the nature of complications, in combination with a fear of caesarean section, maltreatment and discrimination at a hospital level. There is a discrepancy between what traditional birth attendants consider appropriate in cases of complications, and the actions they implement to handle them. CONCLUSION: Parameters in the referral system, such as logistics and socio-economic factors, are sometimes subordinated to cultural values by the target group. To have an impact on maternal mortality, bilateral culture-sensitive education should be included in maternal health programs.

Attitude of Health Personnel↗
PubMed2002

Women's experiences of smoking during and after pregnancy as ascertained two to three years after birth.

OBJECTIVE: to ascertain the significant factors that influence women to stop/not stop smoking during pregnancy and the postnatal period. DESIGN: Twenty-four women were interviewed two-three years after delivery with regard to their smoking habits during and after pregnancy. The material was analysed based on a phenomenological approach in order to provide an accurate description of lived experience. FINDINGS: women who still smoked at their first visit to the antenatal clinic often had an established smoking pattern. They had vague knowledge about the risks of smoking during pregnancy. All women interviewed stated that the midwife played an important role in their motivation to stop/reduce smoking during pregnancy. Many women, however, lacked the support from doctors, delivery and maternity ward staff and district nurses. CONCLUSION: during pregnancy midwives and doctors have a unique opportunity to influence and help women who smoke to give up smoking. It is necessary that the different personnel have a similar approach to counselling.

Adult↗
PubMedDate not supplied

Condom use: why not?

Explore the source record for details and available documents.

Adolescent↗