This paper investigates the antenatal care (ANC) services utilization in currently pregnant women during their visits to maternal and child health (MCH) clinics of rural (Kinabatangan) and urban (Sandakan), Sabah. A community clinic based, cross-sectional descriptive study was performed. In total, 800 currently pregnant women attending two MCH clinics, from April to September 2012, were participated using tested set questionnaires. Descriptive analysis was used for background characteristics and chi-square analysis was applied to identify the rural-urban differences among the variables.In both study areas, previous births delivered by skilled birth personnel were same. In pregnant women from rural, less income, more grand-multiparity, earlier antenatal care booking, more frequent post-natal care, more use of contraception compared to those in urban. In comparison, urban pregnant women had more anti-tetanus toxoid injection in their previous pregnancies, past history of antenatal care for at least four times, increase in household members. As this study found the differences in ANC services utilization at Rural and Urban, further study is needed to explore concrete reasons for above findings. By delivering services according to the needs of all clients, irrespective of their place of residence, it will improve ANC services utilization in both areas of Sabah and hence will improve more on existing health status of the Nation.

Stress is accepted as the accumulation of unpleasant state of physical, mental and emotion on a person. Medical education has been known as one of the most stressful academic curriculum. Hence, medical students may subjected to multiple psychological changes and challenges throughout the years of medical education. The aim of this study was to determine the prevalence of stress and its associated factors among medical students. This cross sectional study was conducted from April to May 2018 in medical school in Sabah. It involved 396 medical students through universal sampling. Self-administered questionnaires were used as an instrument for data collection. The questionnaires included were Sociodemographic Questionnaire, Depression, Anxiety and Stress Scales 21 (DASS-21) and Medical Student Stressors Questionnaire (MSSQ). Bivariate analysis (Chi Square test, Fisher’s Exact Test, Independent T test and Man-Whitney U test) were used to analyse the association. The response rate was 90.2%. The prevalence of stress among medical students were 33.3%. Significant associated factors include financial support inadequacy (p=0.010) and all categories of medical student stressors. The mean score of the academic related stressors was found to be at 2.117 (±0.758) which was the highest mean score among medical student stressors assessed by MSSQ. The result of this study can be used as a basis for implementation of preventive measures such as provision of comprehensive, integrated and responsive mental health care services in university-based settings.
Stress, stressor, medical students, medical education, mental health, DASS, MSSQ