Patient satisfaction has been increasingly recognized as an important outcome for the health care delivery system and is increasingly studied in developing countries. Many women report lower levels of satisfaction with care and support they receive during the postnatal period than any other phase of their maternity care. The objectives of the study were; determining the level of women’s satisfaction with postnatal care, determining the influence of socio-demographic characteristics on satisfaction with postnatal care. Descriptive cross-sectional research design was used. The study population was postpartum women aged 15-49 years who had delivered in Embu hospital. The study employed systematic random sampling method to come up with a sample size of 205 respondents. A structured client exit questionnaire, focused group discussions and key informant interviews were used to collect data. Data was analyzed using SPSS version 20 and presented in percentages, frequencies and cross tabulations. The study findings revealed that majority of the women 54.6% were satisfied with postnatal care services provided. Findings from this study also showed that socio-demographic variables like age, marital status, education level, occupation and monthly income did not have a significant relationship with women’s satisfaction with postnatal care. The study concluded that there is still a percentage of women 45.4% who were still dissatisfied with the postnatal care services provided. The study recommended that the county government together with the hospital administration should help in installation of Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) to help seek feedback from customers hence improve the satisfaction level of clients. The study also recommended that the same study should be done in other hospitals within the Sub Counties and in the rest of 47 Counties to enable generalization of results.
Introduction: Heart failure is a serious and costly condition. Health expenditures related to heart failure continue to increase. In Madagascar, the failure of the social and health insurance system prompted us to estimate these expenses in order to assess the impact on patients’ financial status. The objective of our study was to evaluate the direct costs of managing heart failure.
Methodology: This was a cross-sectional descriptive study in the Intensive Cardiological Care Unit of the Befelatanana Teaching Hospital from February to April 2019. All patients admitted for heart failure who responded to the questionnaires were included. Patients with incomplete records or who have filed out against medical decision have been excluded.
Results: Thirty cases were selected. Mean age was 52.33 +/- 17.11 years with a gender-ratio was 1. Average cost of hospitalization was 1, 536, 066,66 Ariary for an average hospital stay of 14.96 +/- 12.28 days. This cost represented 9.8 times the Malagasy Guaranteed Minimum Interprofessional Salary. The breakdown of this cost is as follows: pharmaceutical costs and consumables: 39.06%, fees for acts and additional examinations: 31.27%; living expenses: 20.15%; expenses for accompanying persons: 5.58%. More than 80% were the responsibility of accompanying persons and/or families.
Conclusion: Heart failure is a condition that is very expensive in Madagascar. It is essential to have a good health insurance system and focus on prevention.
Tuberculosis and intestinal parasitosis with their coinfection are among public health problems in developping countries. This preliminary study aims to determine the prevalence of coinfection, investigates relationship between infestation of parasites and age, gender, residence, occupation or BMI of patients and to identify the parasites species. A prospective study was then conducted at the Pneumology and Phthisiology hospital unit in collaboration with the UHC PZaGa laboratory from December 2015 to October 2016. Patients with tuberculosis to whom was performed parasitological examination of stool were included in the study. In whole, 60 TB patients were investigated. The prevalence of the coinfection was 15%. All the infested patients were male (p < 0.05). The age of TB patients varied from 17 to 68 (p>0.05). A large majority of them were from rural area (67%). This result was statistically significant (p<0.05). Patients from rural area were mostly hit by the infection (p<0.05). The parasitic infestation was not associated to the body mass index of TB patients (p>0.05). Four species of parasites were identified, namely Ancylostoma duodenale, Strongyloides stercoralis, Giardia intestinalis and Entamoeba coli, respectively with 45%, 22%, 22% and 11%.
Few TB patients were screened with parasitological examination of stool. This study showed how significant the analysis was before improving therapy and care.
Toxoplasmosis is a public health concern mostly among pregnant women in developping countries. The study aims to determine the seroprevalence of the infection on pregnant women, to identify whether it is a recent or an old infection and to assess risk factors.
A prospective and detailed survey was then conducted from July to October 2016 at the the integrated health centre of Mahabibo and the basic health centre of Tanambao Sotema in Mahajanga which is a west north city of Madagascar. The blood specimens were collected and then sent to the University Hospital Center Zafisaona Gabriel laboratory.
In whole, 49 subjects were investigated with a mean age of 25 years old. The seroprevalence of the old infection (IgG+ and IgM-) was of 61% (n=30), non-immunized pregnant women (IgG- and IgM-) represented a rate of 39% (n=19). None of them was diagnosed with an acute infection (IgG+ and IgM+). No significant relation was associated between the infestation of Toxoplasma gondii and household cats, neither with housekeeping occupation nor with education level, whether being aware or not of the infection (p>0.05).
Toxoplasmosis is poorly known at Malagasy people. The seroprevalence in non-immunized pregnant women and those at risk is revealed to be high.