臺灣博碩士論文加值系統

Background: Prematurity affects not only the baby, but also the immediate family and a wide network of people around them.Data from around the world shows that in 2014, one in ten babies born worldwide were premature, making almost 14.84 million preterm babies.In poor resource countries, many of these babies die because of lack of appropriate medical care. Eswatini is committed to ending preventable deaths of newborns and children under five years of age.
Purpose: This study seeks to find out factors that are associated with preterm births in Eswatini
Method:This wasa retrospective case design study conducted at a hospital in Eswatini between 1 February 2018 and 28 February 2019.Data was extracted from the antenatal card and the maternity charts of 455 women. For each preterm birth, we included a term birthas a control in a ratio of 1:1.5.(179/276).Chi-square and t test were used to compare the distribution of variables between the preterm and term groups. All variables displaying significant relationships with preterm birth in the univariate analysis were entered intothe logistic regression model. Subsequent resultsare reported as odds ratios with 95% confidence intervals along with pvalues.
Results:Factors associated withprematurity were found to be the number of antenatal visits (OR 4.22, 95% CI: 2.46 -7.23,p = 0.001); mid-upper arm circumference (OR=3.05, 95% CI: 1.22 - 7.61, p = .017); not receiving a second dose of albendazole (OR = 2.59, 95% CI: 1.51 - 4.44,p = .001); not receiving multivitamins (OR = 2.59, 95% CI: 1.51- 4.44, p = .001); lack of education about danger signs (OR = 1.70, 95% CI: 1.00 - 2.56, p = .049); and premature rupture of membranes (OR =1.70, 95% CI: 1.07 - 2.69, p = .024).
Conclusion:Identifying women who are at risk, managing their risks, offering health education, and health workers making informed decisions through research and practice could pave a way forward in reducing factors associated with preterm births in Eswatini.

Contents i
List of Tables iv
List of figures iv
Abbreviations/Acronyms v
Chapter 1: Introduction 1
1.1 Background of Research and Motivation 1
1.2 Problem Statement 2
1.3 Purpose of the study 3
1.4 Research Questions 3
1.5 Significance of the study 3
Chapter 2: Literature Review 5
2.1 Country’s profile 5
2.1.1 Location of Eswatini 5
2.1.2 Eswatini’s demographic characteristics 5
2.1.3 Population distribution 7
2.2 The Medical and Health system 7
2.3 The Sexual Reproductive Health (SRH) program 9
2.4 Raleigh Fitkin Memorial Hospital (RFMH) 10
2.5 Antenatal care in Eswatini 11
2.6 Preterm Births 12
2.6.1 Impact of preterm births in Eswatini 12
2.6.2 Impact of preterm births on society 15
2.6.3 Factors related to premature births in different countries 16
2.7 Treatment of preterm labour and tocolysis globally 25
2.8 Improving the Quality of mother’s health and Neonatal care 26
2.9 Summary 31
Chapter 3: Methodology 32
3.1 Introduction 32
3.2 Conceptual framework 32
3.3 The research design 33
3.3.1 Subject sampling 34
3.3.2 Setting of the study 34
3.4 Definitions of major variables 36
3.4.1 Preterm Birth 36
3.4.2 Gestational age 36
3.4.3 Obstetric history 36
3.4.4 Medical and surgical conditions 37
3.4.5 Neonatal outcome 37
3.4.6 Supplements 37
3.4.7 Health education. 38
3.5 Instrument 38
3.6 Data collection 40
3.7 Ethical Consideration 41
3.8 Data analysis 42
3.9 Dissemination 44
Chapter 4: Results 45
4.1 Background and socio demographic characteristics 45
4.2 Antenatal characteristics 47
4.3 Health and physiological status 48
4.4 Supplements and health education 51
4.5 Factors associated with preterm births 53
4.6 Summary of results 55
Chapter 5: Discussion 56
5.1 The socio-demographic characteristics of women 56
5.1.1 Maternal age 57
5.1.2 Marital status 57
5.1.3 Education 58
5.1.4 Employment status 59
5.1.5 Residence 60
5.2 Health or physiological characteristics associated with preterm births 60
5.2.1 Less than four antenatal care visits 60
5.2.2 Small mid upper arm circumference (MUAC) 62
5.2.3 Not taking multi vitamins 63
5.2.4 Not taking the second dose of Albendazole 64
5.2.5 Lack of education on Danger signs in pregnancy 65
5.2.6 Premature rupture of membranes 66
Chapter 6: Implications, Recommendations, and Conclusion 68
6.1 Implications 68
6.1.1 Practice 68
6.1.2 Policy 69
6.1.3 Education 71
6.2 Strengths and Limitations 72
6.3 Recommendations 72
6.4 Conclusion 73
REFERENCES 75
Appendix 1: Map of Eswatini 85
Appendix 2: Map of Africa 86
Appendix 3: Structure of Eswatini’s health service delivery system 87
Appendix 4: Growth chart for estimated fetal weight 88
Appendix 5: The Antenatal Card 89
Appendix 6: The data collection tool 91
Appendix 7: RFM hospital letter of approval 95
Appendix 8: IRB approval 96

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