M.Cur. / 28-week premature infants are usually born with Respiratory Distress and need ventilator support in order to survive. However, because of all the associated complications of ventilation of premature infants, it is the practice in the NICU's in this studies to extubate these infants as soon as possible to either nasal continuous positive airway pressure (nCPAP) or nasal cannula (nc). For this study the choice of ventilation was High-Frequency Oscillation (HFO). It is known that during HFOV, Fi02 and MAP constitute the oxygenation needed to ventilate these infants. During weaning the Fi02 is reduced to :s 30% and the MAP gradually to :s 8-10 cm H20 to enable extubation. There are not enough guidelines as to the ideal MAP at which to extubate a HFOV 28-week premature infant to nCPAP or nco The purpose of this study was, firstly, to determine the recommended optimal MAP to successfully extubate a 28-week HFOV premature infant to either nCPAP or nc and, secondly, to formulate guidelines and recommendations for use by the attending neonatal nursing staff, doctors and clinicians for optimal nursing and management of the HFOV premature infant. This is a non-experimental quantitative study with a retrospective, descriptive survey, case study design. All 28-week premature infants that were initially ventilated on a HFOV during the period May 2000 to September 2002 in two private Neonatal Intensive Care Units in Gauteng and extubated to nCPAP or nc were incorporated into this study. The study was done in 3 phases. The first involved an in-depth literature survey in which the physiological and biographical variables that were included in the data collection instrument were identified. The second phase involved collecting the data from the infant's medical files, analysing the data and identifying any correlation of the data. In the third phase guidelines and recommendations for neonatal nursing staff, doctors and any attending clinicians were formulated. The initial settings of the HFOV, as well as the settings at a MAP of 8 cm H20, and the settings of the HFOV prior to extubation were recorded and analysed. The premature infant's initial blood gas and peripheral saturation after commencement of ventilation, as well as at a MAP of 8 cm H20 and prior extubation were recorded and analysed. The physiological stability of the premature infants, 12 hours after extubation, formed the criteria of successful extubation and any need for re-intubations was considered failure criteria. There are a lack of protocols and guidelines for neonatal nurses, doctors and clinicians as to guide them in the nursing of HFOV 28-week premature infants. The analysed data assists in drawing up guidelines for nursing the 28-week premature HFOV infant.

Maternal and child-health and health education are three major concerns of public health organisations and researchers throughout the world. Health education for mothers is a strategy many countries have adopted to improve maternal and child-health. The present study was carried out in Uganda with the objective of exploring the factors influencing the utilisation of postnatal services at Mulago and Mengo hospitals, a government and private hospital. Both hospitals are located in Kampala district in Uganda. The survey, was completed by 330 women who responded to a structured questionnaire that was given to them six to eight weeks after delivery. Questions that were asked generated demographic information about the mothers / mothers&rsquo / knowledge about postnatal services / mothers&rsquo / socio-economic status and barriers to utilisation of the postnatal services. The participants included all women who delivered in Mulago and Mengo hospitals in November 2003 except for those who had had a neonatal death. The data was analysed using descriptive and inferential statistics. Some of the key findings of the study were that most women lacked awareness about postnatal services and those who knew about these services only knew about immunisation and family planning services. The majority of the mothers did not know about other services, such as physiotherapy, counselling, growth monitoring, and physical examination. Lack of money for transport or service costs, distance from the health care facility, not being aware of the services, lack of somebody to take care of the child at home were some of the main barriers to utilisation of postnatal services. Others included, lack of education, lack of employment, lack of decision-making powers, and lack of time to go back for the service. The ministry of health should educate women and communities about the importance of postnatal care, its availability, and the importance of women having decision-making power over their own health. The health service organization should improve on the quality of care by ensuring that services are provided at convenient hours with privacy, confidentiality and respect and it should evaluate the services periodically from the users perspective to maintain the quality of service.

Maternal and child-health and health education are three major concerns of public health organisations and researchers throughout the world. Health education for mothers is a strategy many countries have adopted to improve maternal and child-health. The present study was carried out in Uganda with the objective of exploring the factors influencing the utilisation of postnatal services at Mulago and Mengo hospitals, a government and private hospital. Both hospitals are located in Kampala district in Uganda. The survey, was completed by 330 women who responded to a structured questionnaire that was given to them six to eight weeks after delivery. Questions that were asked generated demographic information about the mothers / mothers&rsquo / knowledge about postnatal services / mothers&rsquo / socio-economic status and barriers to utilisation of the postnatal services. The participants included all women who delivered in Mulago and Mengo hospitals in November 2003 except for those who had had a neonatal death. The data was analysed using descriptive and inferential statistics. Some of the key findings of the study were that most women lacked awareness about postnatal services and those who knew about these services only knew about immunisation and family planning services. The majority of the mothers did not know about other services, such as physiotherapy, counselling, growth monitoring, and physical examination. Lack of money for transport or service costs, distance from the health care facility, not being aware of the services, lack of somebody to take care of the child at home were some of the main barriers to utilisation of postnatal services. Others included, lack of education, lack of employment, lack of decision-making powers, and lack of time to go back for the service. The ministry of health should educate women and communities about the importance of postnatal care, its availability, and the importance of women having decision-making power over their own health. The health service organization should improve on the quality of care by ensuring that services are provided at convenient hours with privacy, confidentiality and respect and it should evaluate the services periodically from the users perspective to maintain the quality of service.