Mixed Method Evaluation of the Saving Mothers Project in Tanzania
Postpartum hemorrhage and sepsis are main contributors to the high maternal mortality in Tanzania. Oral misoprostol, an oral prostaglandin, has been recommended as an alternative to injectable medications for postpartum hemorrhage prevention. Between 2015 and 2017, the Saving Mothers Project trained community health workers in the Bunda and Tarime districts to distribute clean birth kits with misoprostol among pregnant women and educate them on safe birthing and the use of health care facilities. To evaluate this project, 2406 women were interviewed on their experiences at the time of childbirth. Almost all women used components of the kit, and 83% used misoprostol after delivery. Among those who did not use misoprostol, almost all received an oxytocin injection. Also, deliveries at health care facilities were high among participants (83%).
Citation. Webber GC, Chirangi BM, Magatti NJ. Challenges and successes of distributing birth kits with misoprostol to reduce maternal mortality in rural Tanzania. Afr J Reprod Health. 2019;23(3):68–78.
Occupational Heat Stress and Chronic Kidney Disease
Starting in 1970, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) has altered the health of young male agricultural workers on the Pacific coasts of Mesoamerica. Wesseling et al. examined more than 20 studies assessing the role of occupational heat stress on CKDnt; other occupational, pesticide, metal, and infectious agents; and nonoccupational risk factors. Heavy manual work in hot agricultural regions along the Pacific coast was associated with CKDnt onset. Other environmental and nonoccupational factors were not consistently associated with CKDnt. Occupational heat stress is a significant risk factor for kidney dysfunction in agricultural workers.
Citation. Wesseling C, Glaser J, Rodríguez-Guzmán J, et al. Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress. Rev Panam Salud Publica. 2020;44:e15.
The Impact of Tobacco Control Policies on Smoking Initiation
Palali and van Ours explored whether tobacco control policies in 11 European countries affected smoking initiation. The smoking data of individuals aged 15 years and older showed that increasing tobacco prices leads to decreased smoking initiation among males only, with no effect for females. Advertising bans, smoking cessation programs, and health warnings do not appear to affect smoking rates at a statistically significant level for males or females. The efficacy of tobacco control policies in limiting tobacco use among young people needs to be revisited, as not all strategies appear to be effective in curbing tobacco use.
Citation. Palali A, van Ours JC. The impact of tobacco control policies on smoking initiation in eleven European countries. Eur J Health Econ. 2019;20(9):1287–1301.
Sex-Specific Initiation Rates of Tobacco Smoking
Between 1999 and 2011, there has been an increase in the prevalence of current smoking among adult men and women living in Tehran, Iran, compared to national estimates. Parizadeh et al. examined population data from the Tehran Lipid and Glucose Study, collected between 1999 and 2018, to assess initiation rates and predictors of smoking among Tehran adults. The age- and sex-adjusted smoking initiation rate was 13.77 (95% confidence interval = 12.59, 14.94) per 1000 person-years. Up to 78% of the initiation rate was attributed to waterpipe use. The initiation rate was higher among men than women. Intermediate-level education and passive smoking were significant predictors of smoking initiation in both genders.
Citation. Parizadeh D, Moazzeni SS, Hasheminia M, et al. Sex-specific initiation rates of tobacco smoking and its determinants among adults from a Middle Eastern population: a cohort study. Int J Public Health. 2019;64(9):1345–1354.