title: Community survey on awareness and use of obstetric ultrasonography in rural Sarlahi District, Nepal.
abstract: OBJECTIVE
  To assess levels of awareness and use of obstetric ultrasonography in rural Nepal.
  
  
  METHODS
  Between March 2014 and March 2015, a cross-sectional survey was conducted among married women aged 15-40years residing in rural Sarlahi District, Nepal, regarding their knowledge and use of obstetric ultrasonography during their most recent pregnancy. Regression analyses were conducted to identify reproductive health, socioeconomic, and other characteristics that increased the likelihood of undergoing an obstetric ultrasonographic examination.
  
  
  RESULTS
  Among 6182 women, 1630 (26.4%) had undergone obstetric ultrasonography during their most recent pregnancy, of whom 1011 (62.0%) received only one examination. Odds of receiving an ultrasonographic examination were higher among women with post-secondary education than among those with none (≥11years' education: adjusted odds ratio [aOR] 10.28, 95% confidence interval [CI] 5.55-19.04), and among women whose husbands had post-secondary education than among those with husbands with none (≥11years' education: aOR 1.99, 95% CI 1.47-2.69). Odds were lower among women younger than 18years than among those aged 18-34years (aOR 0.72, 95% confidence interval 0.59-0.90).
  
  
  CONCLUSIONS
  Utilization of obstetric ultrasonography in rural Nepal was very limited. Further research is necessary to assess the potential health impact of obstetric ultrasonography in low-resource settings, while addressing limitations such as cost and misuse.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kozuki
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: jkatz1@jhu.edu.
authors.forename: Joanne
authors.initials: J
authors.lastname: Katz
authors.affiliation: Nepal Nutrition Intervention Project - Sarlahi, Lalitpur, Nepal.
authors.forename: Subarna K
authors.initials: SK
authors.lastname: Khatry
authors.affiliation: Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Nepal Nutrition Intervention Project - Sarlahi, Lalitpur, Nepal.
authors.forename: Steven C
authors.initials: SC
authors.lastname: LeClerq
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Luke C
authors.initials: LC
authors.lastname: Mullany
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D009390:Nepal; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D012044:Regression Analysis; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Global health; Intrapartum-related complications; Maternal health; Neonatal health; Ultrasonography