Biomedical subjects

Tamar Kabakian-Khasholian

Publications and source records attributed to Tamar Kabakian-Khasholian.

7 recordsLinked to original sources

PubMed2006

The policy environment encouraging C-section in Lebanon.

OBJECTIVE: This study aims to analyse the environment encouraging C-section in Lebanon and to reveal approaches that could be adopted for the reduction of this practice, by considering the attitudes, opinions and actions of different stakeholders. METHODS: Semi-structured interviews were conducted with 20 selected key players, including hospital directors, midwives, insurance bodies, syndicates and scientific societies, ministries, international agencies, medical schools, media representatives and women's groups. In addition, a group discussion was conducted with 10 obstetricians. Semi-structured interviews were conducted with a convenience sample of 36 women who had a C-section within 4 months preceding the study. Data was analysed using the Policy Maker software version 2.3. RESULTS: Findings of the study point to the role of multiple factors in shaping the current practices related to C-section deliveries, among which are the organisation of the health care system, the dominance of the private sector, the lack of physician accountability, the minimisation of midwives' roles in the process and women's misconceptions about C-sections. CONCLUSIONS: Involvement of the diversity of players is important to change practices in maternity care in Lebanon, after considering their position and power. Different strategies making use of available opportunities to improve the current situation are discussed.

Cesarean Section↗

PubMed2006

What is happening during the postnatal visit?

The authors' purpose in this study is to describe attendance, timing, and content of the postnatal visit in three communities in Lebanon. Data are collected with a household survey in three economically disadvantaged suburbs of Beirut, Lebanon. The sample was chosen using probability proportional to size sampling design. About half of the women attended their postnatal visit. Timing of the visit and the services provided varied tremendously. Underutilization and major deficiencies in the quality of postnatal services exist. Raising providers' and women's awareness about the postnatal period and focusing on women's postnatal psychosocial needs can improve the quality of maternity services.

Attitude to Health↗

PubMed2006

Raising awareness and providing free screening improves cervical cancer screening among economically disadvantaged Lebanese/Armenian women.

Women need to practice cervical screening regularly to reduce morbidity and mortality. The purpose of this study was to examine the impact of an intervention program on knowledge, attitude, and practice of cervical screening in the population of Lebanese/Armenian women. The design was a cross-sectional, quasi-experimental posttest survey following a year long intervention program. The sample included 176 women, who were members of the Armenian Relief Cross in Lebanon. Interventions consisted of educational classes, media messages, and free screening. The instrument was a self-administered questionnaire. Knowledge of women with intervention was higher (p > .05) and practice rate increased between intervention and comparison groups. No difference in attitude was noted. The study was successful in raising awareness and increasing screening in the sample. It is recommended to continue helping women to overcome barriers for cervical screening.

Adolescent↗

PubMed2005

A simple way to increase service use: triggers of women's uptake of postpartum services.

OBJECTIVE: To examine the socio-demographic and service-related determinants of utilisation of postpartum services. DESIGN: Data were used from a single-blind, randomised controlled trial aimed at changing women's knowledge, attitude and behaviour regarding certain postpartum health issues by providing written information via a specially prepared booklet. SETTING: Four private hospitals, two in Beirut and two in the Bekaa region, were selected. All were privately owned and one in Beirut was a teaching hospital. SAMPLE: All women delivering a live birth in the designated hospitals during a three- to four-month period were recruited into the study. Of the 503 eligible women, 450 agreed to complete the initial questionnaire and 378 completed the postpartum interviews. METHODS: Eight trained female interviewers collected the baseline data. On discharge, interviewers handed each woman a sealed and numbered envelope containing the intervention booklet or the placebo leaflets. Interviewers were blind about the allocation group of women. Interviewers conducted follow up assessment at women's residence 6-20 weeks after delivery. MAIN OUTCOME MEASURES: Any postpartum visit with or without a preset appointment. RESULTS: Multivariable analysis with adjusted ORs show that women given an appointment for their postpartum visit were more likely to having had that visit (OR = 6.8, 95% CI 6.2-7.4). In the absence of such an appointment, university education (OR = 3.6, 95% CI 2.6-4.7), information on maternal health (OR = 4.9, 95% CI 4.0-5.8) and the intervention booklet (OR = 2.9, 95% CI 2.0-3.9) were important determinants of a postpartum visit. CONCLUSION: Giving women appointments for postpartum visits, or written or verbal information on maternal health can increase their use of health services.

Adult↗

PubMed2004

Determinants of caesarean section in Egypt: evidence from the demographic and health survey.

This paper examines the impact of near birth complications and socio-demographic, healthcare and spatial characteristics of caesarean section in Egypt, using data on 4032 births from the 2000 Egypt Demographic and Health Survey. The hospital caesarean section rate was 22% in Egypt. Fever/vaginal discharge around delivery, birth weight, mother's age and education, birth order, residence and antenatal visits were important determinants of caesarean section. Variations by place of delivery were evident, although complications were more significant determinants of caesarean section in public settings and demographic characteristics were more important in private facilities. Unexpectedly, long labour and bleeding around delivery were not associated with caesarean section, particularly, in private hospitals. In view of the high and rising caesarean section rate in Egypt, monitoring the quality of maternity services in Egypt is imperative. An investigation of the forces sustaining the differential in determinants by place of delivery is needed.

Adolescent↗

PubMed2004

Rising trends in cesarean section rates in Egypt.

BACKGROUND: Cesarean section rates have been increasing worldwide, but little research exists on trends of cesarean section delivery for any country in the Arab world. The purpose of this study was to document recent levels and trends of cesarean section rates in Egypt, and to estimate trends in cesarean section by type of hospital from three population-based national surveys. METHODS: This descriptive study used merged data files from three nationally representative samples of ever-married women aged 15 to 49 years. RESULTS: A significant rise in cesarean deliveries occurred for all births, from a low of 4.6 percent in 1992 to 10.3 percent in 2000. However, hospital-based cesarean deliveries were much higher in 1987-1988 (13.9%), increasing to 22.0 percent in 1999-2000. Although the cesarean section rate was slightly higher in private hospitals, the rate also increased consistently in public hospitals. CONCLUSIONS: The high and unprecedented increase in cesarean section rates reported in this study may be partly due to cesarean sections that are not medically indicated, and suggest that physician practice patterns, financial incentives or other profitability factors, and patient preferences should be explored.

Adult↗

PubMed2003

Measuring gynecological morbidity: evaluating two different data sources from Beirut.

The lack of consensus over the most appropriate source to use in assessing reproductive morbidity could, in part, explain the inadequacy of available information on the subject. To outline this situation, gynecological morbidity data collected from two different sources in Beirut, Lebanon, namely, population-based health interviews (779 ever-married women aged between 15 and 49) and private gynecologists' clinics (867 women with similar characteristics), are described. Although neither source is likely to represent the true prevalence of gynecological conditions, both agree sufficiently to shed light on the importance of some conditions such as menstrual disturbances (15% in both samples), infections/inflammations (17% in the households sample), and infertility-related concerns (12% in the clinics sample). Interestingly, despite the demographic differences, the most common conditions that the women complained about and the most common diagnoses that the gynecologists offered were similar for both samples. Therefore, given that the logistics in the gynecologists' clinic survey were easier, we recommend the use of health service data in settings where a representative sample of providers can be identified and service use is high.

Adolescent↗