Estimating age in women living in rural areas of Papua New Guinea can be inaccurate and subject to observer bias. Parity is often used, but this means that survey results cannot be used to examine the effect of childbearing on nutrition. We describe a method for estimating age in women independent of their parity developed during studies of women's health in the Wosera Subdistrict of Papua New Guinea. The tool, appropriately modified, may be useful to others conducting surveys requiring an estimate of maternal age.
Adolescent ; Adult ; Algorithms ; female ; Maternal Age ; Parity ; Women' ; s Health

We explored village maternal deaths in an area of the East Sepik Province of Papua New Guinea where most women delivered at home. Postpartum haemorrhage, retained placenta and puerperal sepsis were common causes of death. Follow-up of a group of pregnant women showed that abnormal labour was frequent. 24% of multigravidae (95% CI 17-33) reported a labour that lasted longer than 24 hours. In 9% of all births (95% CI 5-15) the third stage lasted longer than one hour, or products were retained. Despite a high proportion of obstetric complications in apparently low-risk villages births, few women attend a health facility for delivery. Health centre attenders were a relatively privileged group. Some hospital users complained about staff attitudes. A poor reputation means that women are less likely to use health services for delivery. Providers need to improve the acceptability of the care provided, and communities should be encouraged to help with transport for their women to go to a health facility when they are in labour.
Community Health Services - statistics & ; numerical data ; Female ; Health Facilities - statistics & ; numerical data ; Health Services Accessibility ; Maternal Mortality ; Papua New Guinea

This cross-sectional study of women was conducted in a deprived area of Papua New Guinea with an estimated infant mortality rate of 133/1000 live births. Mortality patterns derived from birth histories showed that neonatal deaths contribute proportionally more to infant mortality than postneonatal deaths, emphasizing the need for better care at delivery. To examine possible mechanisms for intervention, pregnant women were interviewed to determine patterns of antenatal clinic use, antimalarial drugs and micronutrient supplements given, and how much the women smoked. The results showed that the health system was failing to implement current routine supplementation and prophylaxis regimens, and that there was a need to revise national guidelines. A large proportion of pregnant women smoked during pregnancy, and this behaviour could be a target for future public health campaigns and health worker promotion advice to women. PIP: A cross-sectional study conducted in 20 randomly selected villages in the impoverished Wosera Subdistrict, East Sepik Province, Papua New Guinea, in 1989 assessed infant mortality, antenatal attendance, and smoking during pregnancy in 1008 women. 60% of respondents had never attended school. The total fertility rate was 5.7/woman. The infant mortality rate was 133/1000 live births. Of the 3074 births reported by respondents, 52 were stillbirths (rate, 17/1000 births). The perinatal mortality rate was 80/1000, the neonatal mortality rate 88/1000, and the postneonatal mortality rate 45/1000. The finding that neonatal deaths contributed proportionately more to infant mortality than postneonatal deaths indicates a need for better care at delivery. Bacterial sepsis related to umbilical infection was common. Of the 109 women pregnant at the time of the survey, only 33 (30%) had been seen at the antenatal clinic. Few of these women were complying with chloroquine treatment (given every 6 weeks). 69% of pregnant women were current smokers of locally cultivated sun-dried tobacco and 68% chewed betel nut during pregnancy. Overall, these findings indicate a need for major changes, including improved implementation of routine supplementation and prophylaxis regimens during pregnancy, health education around the dangers of smoking during pregnancy, improved attendance at antenatal care, and attention to the major causes of infant mortality.