Background: We aim to determine the prevalence of perineal pain following postpartum vaginal delivery, the requirement of paracetamol as analgesia, and its associated factors. Methods: The study was performed from December 14, 2020, until February 14, 2021, in a single tertiary centre in northwest Malaysia. The pain score was assessed immediately postpartum and every six hours for the next 48 hours, and the requirement for paracetamol as analgesia was documented. Maternal sociodemographic data and baseline clinical details associated with the requirement for paracetamol were analysed. Results: A total of 285 study participants were included. The majority (93.0%) were Malays, with a mean age of 31.0 6.08 years. Majority of the women delivered their second child (36.1%) with a first-degree tear (46.7%). The majority neither required any analgesia within the first few hours of delivery in the labour room (71.3%) nor in the next 48 hours of ward observation (54.4%). The mean pain score following spontaneous vaginal delivery in the labour room was 4.0 1.07, while the mean pain score in the ward was 2.8 ± 1.05 (p<0.001). Logistic regression analysis determined that maternal weight (cOR: 1.02, 95% CI: 1.01, 1.04) and episiotomy (cOR: 3.28, 95% CI: 1.52, 7.08) were significantly predictive of paracetamol requirement as analgesia. Conclusion: Most of our population did not require oral analgesia in the postpartum period. However, the identification of susceptible individuals may guide clinicians to have a targeted approach for early management to ensure a positive birthing experience for all mothers.

Background: Routine human papillomavirus (HPV) vaccine uptake continues to be suboptimal since its recommendation in 2006 for girls and in 2011 for boys. This paper aims to review published quality improvement (QI) methodologies on interventions to improve HPV vaccine uptake among adolescents; Methods: Science Direct and Scopus databases were searched for QI initiatives evaluating the effect of multimodal interventions to improve HPV vaccination rates (initiation and/or completion of series) among adolescents. Studies that included an outcome of interest among adolescents aged 10 to 18 years old were included. Two investigators worked independently to screen for potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes; Results: Preliminary search yielded a total of 523 articles and 13 were included in the final analysis. Common strategies were provider-specific and patient- and/or parent-specific interventions, with an emphasis on education and knowledge empowerment. System-level interventions such as policy changes and revised protocol were less commonly prescribed despite being associated with more significant weight on the overall outcome; Conclusions: Creative, sustainable, and economical multilevel interventions that focus not only on provider training and public education but also incorporate local policy and system enhancement can substantially improve HPV vaccination coverage among adolescents.