This publication presents the findings of the 2000 Egypt Demographic and Health Survey (EDHS). It also presents the results of the continuous work in preparing and carrying out the activities of the EDHS including fieldwork data processing and analysis of the findings. The 2000 EDHS interviewed a nationally representative sample of 15573 ever-married women aged 15-49. The findings presented relate to fertility levels childbearing intentions family planning infant and child mortality and maternal and child health and nutrition. The report also addresses key maternal and health indicators including the extent to which mothers receive medical care during pregnancy and at delivery immunization coverage and the prevalence and treatment of diarrheal disease. Overall the findings show that family planning in Egypt continues to be successful in helping couples to plan their families. The survey also found that key maternal and child health indicators including antenatal care coverage medical assistance at delivery infant and child survival and immunization coverage among children have improved.

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Egypt Demographic and Health Survey 2000.

Beginning in 1980 a number of household surveys have been carried out in Egypt to obtain data from the community on the current health situation including a series of Demographic and Health Surveys of which the 2008 EDHS is the most recent. The results of the 2008 EDHS show that several key maternal and child health indicators including antenatal care coverage medical assistance at delivery and infant and child mortality have improved. The survey also found that family planning use is rising and fertility is continuing to decline although at a slow pace. In addition the 2008 Egypt DHS collected information relating to other health issues that Egypt is facing including knowledge and practices relating to avian influenza and the prevalence of high blood pressure among the adult population. By collecting and testing blood samples for the hepatitis C virus from respondents the survey also provides the first nation-wide data on the prevalence of infection with the hepatitis C virus among the Egyptian population age 15-59 years. The findings of the 2008 EDHS together with service-based data are very important for measuring the achievements of the health program to date as well as for planning future interventions to address Egypts health challenges. Based on the above-mentioned considerations it is very important that the results of the 2008 EDHS should be widely disseminated at different levels of health management in the central offices as well as local governments and to the community at large. (Excerpt)

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Egypt Demographic and Health Survey 2008

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)32114-7.pdf

The UCL–Lancet Commission on Migration and Health: the health of a world on the move

Background:The relationship between socioeconomic status (SES) and hypertension has been studied in a number of reviews. However, the impact of SES on hypertension has been reported in several studies with conflicting results.Methods:A systematic search was performed in PubMed, Proquest and Cochrane

Socioeconomic status and hypertension: a meta-analysis

Obesity and hypertension

he concept of unmet need has been used since the late 1970s to indicate the gap between the desire to stop or delay childbearing and women's contraceptive behavior. Women who respond that they want to postpone (spacing) or avoid childbearing (limiting) and also that they are not using contraception (including use by their partners) are defined as having an unmet need. In this paper an attempt will be made to ascertain the prevalence rate of unmet need for family planning among married women aged 15-49 years, and to find the relationship between unmet need and selected characteristics of the woman. A household survey was carried out in 19971 with the aim of collecting data on ever-married women in the age group 15-49 years. A 2-stage sampling procedure was applied to insure the representativeness of the sample. Out of 5765 eligible women, only 5548 were successfully interviewed (96%). A questionnaire was used as an instrument for the survey. The survey shows that unmet need for spacing was 7.4% and it was 6.8% for limiting (totalling 14.2%). The unmet need for spacing was inversely related to age of the woman ranging between 18.3% in the age of 15-19 years to less than 1% in women aged 45-49 years. The unmet need for limiting was highest in the age group 40-44 years (13.3%) and it was zero in the age group 15-19 years. It was also observed that unmet need for spacing was high in rural areas (11%), in the south (11.2%), and in women with better education. The unmet need for limiting was high in the following groups of women: 40-44 age group (13.3%), living in rural areas (7.7%), living in the south (9.8%), and in women with no education (15.1%). The total unmet need for family planning was high in the following groups of women: age group 15-19 years (18.3%), rural women (18.7%), southern women (20.9%), and in women with no education (20.2%) (Table 1). In all developing countries, except China, approximately 20% of married women of reproductive age have an unmet need for family planning.2 The situation in Jordan in this study looks better than many of the developing countries with few exceptions. Prevalence of total unmet need is 14.2%, which is, to some extent, divided equally between spacing and limiting. Levels of unmet need vary according to women's characteristics such age, residence, and education of the woman. The most unmet need for spacing births is in young women. This is because younger women want to have more children as early as possible. Among older women, the most unmet need is for limiting births. This is because older women have had as many children as they want, or even more. Better-educated women have less unmet need than women with little or no education. It is noteworthy that prevalence of unmet need in Jordan is increasing with the decrease in level of education, ranging between 20.2% in non-educated women to 11% in highly educated women. Less educated women probably have more obstacles to using contraception than more educated women. In most countries, unmet need is greater in rural areas than urban areas. In our study prevalence rate of unmet need is 18.7% in rural areas as compared to 13.3% in urban areas. Results of our study regarding the area of residence and education of the woman are consistent with the findings of the KAP study in Jordan in 1996,3 but the prevalence of unmet need in the KAP study is higher in all subgroups of residence and education. Establishing a link between family planning services and other health services might be needed to identify high-priority groups of women who have an unmet need for family planning. One of the approaches to increase the use of contraceptives is to provide family planning counseling at every health service contact between the woman and health care provider. In general, improving access to health services, enhancing knowledge of contraceptive methods, overcoming husbands' and family opposition to the use of contraceptives; and addressing concerns and myths about family planning; are some of the steps that might be needed to address the problem of unmet need for family planning. Further studies are needed to explore this important issue taking into account other variables and characteristics that may predict the behavior of a woman to use contraceptive methods. T Table 1 Percentage of women with unmet need for family planning by selected background characteristics, Jordan, 1997.

Unmet need for family planning.

Objectives To identify menopausal symptoms and health disorders of women aged 50–65 years in under-privileged areas of southern Jordan.Method A multistage, random-sampling design was applied to select a sample of households from three governorates. A total of 143 women were eligible to be included in the analysis. Women were asked about a list of symptoms (somatic, psychological and genitourinary) and about a list of morbidities such as hypertension, diabetes mellitus and urinary tract infection. Ever-screening by mammogram, regular breast self-examination, ever-screening by cervical smear, general medical check-up, physical activity, smoking habit, and ever-receiving information about menopause were also investigated.Results The median age of onset of natural menopause was 50 years; 77% of women were illiterate, and 59% of the couples were relatives. The most frequently reported somatic symptoms were joint aches/stiffness (89%), bone pains (74%) and paresthesia in the extremities (51%). Hot flushes were ...

Menopausal symptoms and health problems of women aged 50–65 years in Southern Jordan

OBJECTIVES 
To compare the prevalence rate of hearing loss at different levels of noise in a textile factory and to find out the levels of hearing loss according to duration (years) of employment in the factory.
 METHODS 
Seventy workers exposed to different levels of noise were matched with 70 persons in the community who were not exposed to occupational noise. Noise levels dB(A) were measured at different locations in the factory. Hearing was assessed in all participants. Few cases were excluded from the study because hearing loss was due to factors other than exposure to noise.
 RESULTS 
The prevalence rate of hearing loss was higher among the exposed group ie. 30% in the exposed group and 8% in the non-exposed group. Hearing loss increased with increasing level of noise reaching 73% in the 95dB(A) area. Average hearing loss was highest amongst those who were employed for 25 years or more, reaching 39% dB(HL).
 CONCLUSIONS 
The findings of this study highlighted the magnitude of the problem, the necessity of the application of preventive measures and the need for more studies in this field.

https://smj.org.sa/content/smj/21/1/58.full.pdf

Hearing loss in a textile factory.

OBJECTIVES 
To find out prevalence rate of urine incontinence (UI) in a representative sample of women aged 50-65 years in south Jordan. The study will also investigate the relationship between UI (stress and urge) and the following variables: age of the woman and her parity, diabetes mellitus, urinary tract infection (UTI), body mass index (BMI), medications (diuretics), menopause, past history of hysterectomy, and poor mobility.
 METHODS 
For achieving the objectives of this study, a sample of women (n=182) in the age group 50 - 65 years in south Jordan (Karak, Taffileh, Aqaba) was selected using a multistage sampling procedure to represent women in this age group in south Jordan. A questionnaire and face-to-face interviews were used as the instrument for data collection. The questionnaire was tested in a pilot study before starting data collection from the field. Data was collected from the field in July 2003. Data was analyzed using Statistical Package for Social Science (SPSS). Chi Square Test and Fisher's Exact Probability Test were used to identify the significance of associations between UI and characteristics of the respondents.
 RESULTS 
Approximately one third of respondents had urinary incontinence; 23.1% had stress UI, 26.4% had urge UI, and 18.1% had the mixed type. Prevalence rate of UI was 56.3% for women suffering from UTI and 50% for those who use diuretics. Approximately 54% of women who need help to go around inside the house were complaining of UI. High prevalence rates were also observed if parity was 5 - 6 (43.5%), women at menopause (39.7%), obese women (39.3%), and in diabetic women (35%). High prevalence rates of stress incontinence were found in women suffering from UTI (37.5%), in women using diuretics (39.5%), if parity was 5 - 6 (34.8%), and in women with past history of hysterectomy (28.6%). Stress UI was increasing with the increase in the BMI. The associations between urge incontinence, BMI, UTI, use of diuretics, and the ability to go around inside the house were all significant at the 0.05 level.
 CONCLUSIONS 
Prevalence rate of UI varied from one country to another and from one study to another study. Possible reasons for such inconsistency were discussed. Appropriate treatment of UI should be based on valid diagnosis of cases, type of UI, and the identification of contributing factors. Lines of treatment and interventions for UI were discussed. Further studies of this condition are needed in Jordan for both males and females and in all age groups. Such studies should emphasize the size of the problem, etiology and risk factors, and the cost of the problem for both the incontinent person and for the health care system.

Epidemiology of urinary incontinence in Jordanian women.

The objectives of this quantitative study were to identify factors associated with contraceptive use by Jordanian Muslim women; to estimate factors that predict the variance in contraceptive use; and recommend appropriate health and social policies to enhance quality of life of Jordanian women. A cross -sectional design was used to collect data from 487 married non-pregnant women aged 18 to 49 years who resided in three southern governorates in Jordan using a structured interview guide. Results showed that 63.2% of women used some form of contraceptive method; IUD was the most frequently used method (44.2%). The percentage of women exposed to violence was 5% and 9.2% for physical and verbal abuse respectively. Findings also showed that there was a significant relationship between psychological wellbeing of women and contraceptive use. Furthermore, no relationship between women's perceived religious stance towards contraceptives and their use. Predictors of contraceptive use were: women aged 40-45 years explained 23.3% of the variance in contraceptive use; and the woman's approval of contraceptive use for birth spacing explained 21.4% of the variance in contraceptive use. The Islamic stance towards contraceptive use was not significant in these women; however further studies are needed to confirm these findings as well as the generalizability to Muslim women in other countries. The study findings have implications for health and social policies relevant to family planning services in order to enhance and increase the use of contraceptives to reduce the TFR in Jordan. Furthermore, health care providers, social and economical policy makers need to integrate women's cultural views and contraceptive use in strategies and policies beyond health to improve women's quality of life and build on the global consensus for women and children to achieve the Millennium Development goals. Keywords: Contraceptives use, health and social policy, Jordanian Muslim women Background and Significance According to the Jordanian Population and Fertility Health Survey (JPFHS), the Total Fertility Rate (TFR) in women aged (15-49 years) continues to be high at 3.8 (Department of Statistics, 2009). The TFR decreased from 4.4 in 1997 and this decrease was attributed to the increased acceptance and use of traditional and modern contraceptive methods among women in addition to the approval of contraception by Islamic rulings. Contraceptive use by married Jordanian women has increased substantially in the last two decades, from 40% in 1990 to 57% for both traditional and modern methods in 2007 (Department of Statistics, 2007). Jordan is a middle income country with a population of over 6 million and 2.2% growth rate. Women constitute 49.6% of Jordan's population with a gender gap in illiteracy (women at 8.3% compared to 3.4% for men aged [greater than or equal to] 6 years) (Department of Statistics, 2007). Administratively, Jordan is divided into 12 governorates which are then grouped into three regions; the North, Central and South region. Until the 1990's, Jordan had no explicit official population policy. Currently the Higher Population Council (HPC) is responsible for the population challenges. The characteristics of the Southern Region (the setting of the study) shows that the south has the highest percentage of women aged 15-49 years with no education (9.9%) compared to the north and central regions (4.4% and 2.8% respectively). Furthermore, the southern region had the lowest level of current use of family planning (53 %), the lowest contact with health care providers (8.6% compared to 24.6 and 20.8% in the North and Central regions) and the highest percentage of unmet needs for family planning (16.6%). Approximately 32% of married Jordanian women aged (15-49) years in the south reported that they had been subjected to spousal abuse at some point. Women in the south also had the highest percentage of physical abuse during pregnancy (7. …

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Farouk M. Shakhatreh

Papers

Unmet need for family planning.

Menopausal symptoms and health problems of women aged 50–65 years in Southern Jordan

Hearing loss in a textile factory.

Epidemiology of urinary incontinence in Jordanian women.

Factors Associated with Contraceptive Use among Jordanian Muslim Women: Implications for Health and Social Policy