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PREGNANT WOMEN AND ALCOHOL USE IN THE BOSOMTWE DISTRICT, ASHANTI

PREGNANT WOMEN AND ALCOHOL USE IN THE BOSOMTWE DISTRICT, ASHANTI. Yaw Adusi-Poku. OUTLINE OF PRESENTATION. INTRODUCTION PROBLEM STATEMENT RESEARCH QUESTIONS OBJECTIVES METHODS RESULTS DISCUSSIONS CONCLUSIONS RECOMMENDATIONS. INTRODUCTION(1).

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PREGNANT WOMEN AND ALCOHOL USE IN THE BOSOMTWE DISTRICT, ASHANTI

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  1. PREGNANT WOMEN AND ALCOHOL USE IN THE BOSOMTWE DISTRICT, ASHANTI Yaw Adusi-Poku

  2. OUTLINE OF PRESENTATION • INTRODUCTION • PROBLEM STATEMENT • RESEARCH QUESTIONS • OBJECTIVES • METHODS • RESULTS • DISCUSSIONS • CONCLUSIONS • RECOMMENDATIONS

  3. INTRODUCTION(1) • Although the existence of alcohol-induced fetal damage is well documented, 6-20% of women have been reported to drink alcohol ‘heavily’ pregnancy (Flynn et al,2003) • In Africa, eg Namibia, home-brewed beverages are the main source of alcohol and the producers are women acting as a bait to drinking (WHO, 2004) • In Ghana, a study conducted by GOFAS, an NGO in 3 regions of Ghana, revealed that 86% of pregnant women drank various forms of alcoholic beverages (Kunateh, 2007)

  4. INTRODUCTION (2) • Alcohol has profound effects on the unborn baby by a mother who drinks. • It is a spectrum of constellation of physical and cognitive abn. Severest form- FAS; minor forms-FAE ( Kunateh, 2000) • Physical effects- small stature, small head, small eyes, small chin etc • Cognitive defects: intellectual disability (Meck manual, 2005)

  5. PROBLEM STATEMENT • Anecdotal claims of alcohol ingestion in the reproductive years in Bosomtwe District • Claims that Lake Bosomtwe provides a conduit for alcohol ingestion • Claims that women take unstandardised locally brewed alcohols- akpeteshie, pito etc • Lack of data to support these claims

  6. Lake Bosomtwe

  7. A woman brewing Pito in Ghana

  8. CONCEPTUAL FRAMEWORK • Petty thefts • Absence from work • Reduced job performance • Alcohol Spectrum Disorders (ASD) • Low birth weight • Spontaneous abortions • Preterm delivery Social Problems Foetal Problems Maternal Problems Pregnant Women and alcohol use Economic factors Social Factors Perceptions • Advertisement targeted at women • Social acceptability • Higher disposable income • Unemployment • It reduces stress • It helps to interract effectively with others. Conceptual framework Source-Author’s own construct, 2010

  9. RESEARCH QUESTIONS • What are the demographic characteristics of pregnant women who drink alcohol attending ANC in the study district ? • What is the level of knowledge about the general effects of alcohol among pregnant women attending ANC in the district? • What types of alcoholic beverage are consumed? • What are the socio-demographic factors that influence alcohol consumption?

  10. General Objective • To assess alcohol consumption among pregnant women attending antenatal clinics in the Bosomtwe District

  11. Specific objective 1. • To assess the level of knowledge of pregnant women attending ANC about the general effects of alcohol on pregnant women in the Bosom. District (15-44 yrs)

  12. Specific objective 2. To determine the types of alcoholic beverage and average volume consumed among pregnant women

  13. Specific objective 3 • To identify Socio-demographic factors that influence alcohol consumption: >Age >Marital Status >Educational level >Occupation >Religious affiliation

  14. METHODOLOGY(1)

  15. METHODOLOGY(2)

  16. RESULTS(1) Socio-demographic Characteristics of Drinkers Socio-demographic Characteristics of Drinkers

  17. Results(2) Assessment of level of knowledge (spontaneous answers to detrimental effects of alcohol) Answers to detrimental effects of alcohol ( options)

  18. RESULTS (3) . Type of alcohol, freq. and % of consumers

  19. Uni-variate Analysis of Alcohol consumption and Socio-demographic variables

  20. Logistic Regression Analysis of Socio-demographic variables and Alcohol Consumption

  21. Discussions(1)-Prevalence • Prevalence of alco drinkers: 20.4% high compared to BRFSS, 2005, USA- 12.0%; (Thanh & Johnsson, 2010), 5.8% in Canada • However, highest drinking group(25-30yrs) consistent with (IAS, 2008), mostly in their 20’s and 30’s • Highest drinkers : JHS and married. Differ from BRFSS, 2005, found college-educated and unmarried

  22. Discussions(2) Level of knowledge • Two-thirds (57.0%) of 78.0% gave spontaneous wrong ans consistent with Env. Research Grp Ltd, 2000, a national survey in Canada, Two-thirds knew alcohol could be harmful but did not know what the effects really were. • Close-ended multiple response variable about 80.0% gave at least one or more answers on the effects on the mother similar to the effects on the fetus (81.0%) consistent with the national survey in Canada about 89.0% believed alc could cause life-long disability in the child and some effects on the mother.

  23. Discussions(3) Level of knowledgewhere received education? • About 33.0% received health education of the detrimental effects of alcohol at ANC. A proportion, about 11.0 % received both radio and TV • Few 0.9% received educ via print media • In contrast to a more literate society such as Canada, 72.0 % had received health edu in the print media compared to ANC/TV/Radio (Env Research Grp Ltd, 2000)

  24. Discussions(4) Type and average vol alcohol consumed • A lot of the one-type-alcohol-drinkers preferred akpeteshie (half-tot-15mls) followed by Ginsing/Kasapreko/Pusher(one-tot) • The above preference is similar with WHO report (2004). Traditional local drinks are very popular in Africa. • Contrary to preferences Albertsen and others found that in Denmark, most preferred wine followed by mixed (Albertsenet al, 2004)

  25. Discussions(5)- Influence of Socio-demographic factors • Marital status influenced alcohol consumption consistent with a study by Precott and Kendler (2001) • Religious affiliation influenced alcohol consumption consistent with (Ayers et al, 2009)

  26. CONCLUSIONS & RECOMMENDATIONS • Health Staff Majority received education at ANC. Hence H.E. campaign embarked with strict M&E @ ANC . • DHMT (i) Training & Retraining programs should be organized regularly on how to deliver effectively, the harmful effects of alcohol pregnancy (ii) I E & C via Local Information centres , mobile health vans • DHMT & GES collaboration to educate school pupils & students. Programs should be inspected for content & quality • District Administration (i) Should take advantage of the FCUBE to increase girl-child formal education (ii) Gain and regulate informal production of locally brewed alcohol to introduce standards

  27. REFERENCES • Albertsen K, Anne-Marie N. A, Olsen J, Grønbæk M. (2004). Alcohol Consumption during Pregnancy and the Risk of Preterm Delivery. Am J Epidemiol January 15, 2004 vol. 159 no. 2 155-161 • Ayers W. J, Hofstetter R. C, Hughes C. S, Irvin L. V, Sim K. E, Hovell F. M. (2009). Exploring Religious Mechanisms for Healthy Alcohol Use: Religious Messages and Drinking Among Korean Women in California. J Stud Alcohol Drugs, 2009 November: 70(6): 890–898. Accessed at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776119/. Retrieved 6th January, 2011 • Bursac Z, Gauss H. C, Williams K. D, Hosmer D.(2007). A Purposeful Selection of Variables Macro for Logistic Regression. SAS Global Forum Statistics and Data Analysis. Paper 173-2007. Accessed at http://www2.sas.com/proceedings/forum2007/173-2007.pdf. Retrieved, 12th January, 2011 • Flynn H. A, Marcus S. M, Barry K. L and Blow F. C. (2003). Rates and Correlates of Alcohol Use Among Pregnant Women in Obstetrics Clinics, Alcoholism: Clinical and Experimental Research, 27: 81–87. doi: 10.1111/j.1530-0277.2003.tb02725. Accessed at http://onlinelibrary.wiley.com/doi. Retrieved January 9th 2011 • Institute of Alcohol Studies - IAS, (2008).Women and Alcohol factsheet.Accessed at http://www.ias.org.uk/resources/factsheets/women.pdf-6. . Retrieved January 5th 2010 • Kunateh M. A. (2007). Ghanaians Consume 30 Million Litres of Alcohol Yearly. Accessed at: http://www.ghanadot.com/social_scene.feature.kunateh.alcohol.012309.html. Retrieved 10th January, 2010 • The Merck Manual, 2009. The Merck Manual of Diagnosis and Therapy. Retrieved, http://www.merck.com/mmpe/sec19/ch274/ch274i.html#sec19-ch274-ch274i-696. Retrieved, January 5th 2011

  28. REFERENCES cont’d • Prescott and Kendler. (2001). Associations between Marital Status and Alcohol Consumption in a Longitudinal Study of Female Twins. J. Stud. Alcohol 62: 589-604, 2001. Accessed at http://www.jsad.com/jsad/article/Associations_between_Marital_Status_and_Alcohol_Consumption_in_a_Longitudin/1354.html. Retrieved 6th January, 2011 • Sullivan G. M. (2009). Too many pregnant women still drink alcohol. OB/GYN News. Accessed at http://findarticles.com/p/articles/mi_m0CYD/is_9_44/ai_n32429083/. Retrieved, January 25th 2011. • World Health Organisation, (2004). Global Status Report on Alcohol 2004. Pp21-24. Accessed at: http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf. Retrieved, 5/01/11

  29. ACKNOWLEDGEMENTS • My academic supervisor, Dr. A.K Edusei • Then DDHS- BOSOMTWE-Dr.(Mrs) AkuaBonney • All lecturers of the department and associated staff • All health workers, Bosomtwe District • All pregnant women, Bosomtwe district

  30. . • THANK YOU

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