Objective: Effective antenatal care is important for the health and wellbeing of pregnant women and infants. However, in Saudi Arabia, attendance rates are low, increasing the risk of negative birth outcomes. The aim of this research is to understand the beliefs of pregnant women and health professionals about the factors leading to these low attendance rates. Methodology: A qualitative exploratory study-using semi structured face-to-face interviews. Interviews were conducted exploring (a) attitudes to the use of antenatal care by pregnant Saudi women, (b) beliefs of women regarding the value of antenatal care and (c) perceived barriers to attendance. Setting: Data were collected from three hospitals in two regions of Saudi Arabia. Participants: Women at any stage of their pregnancy attending for antenatal care or ultrasound, women attending postnatal clinic, and health professionals (obstetricians) who support women during pregnancy and birth. Findings: Although mothers viewed antenatal care as important for maternal and infant health, several barriers to attending care were identified by mothers and professionals. These factors were classified into three themes: physical barriers (e.g. lack of transport), low maternal education, and inadequate healthcare facilities (including negative staff attitudes and poor communication). These factors were exacerbated by the beliefs of partners and family. Notably, the theme of low maternal education was raised only by health professionals, whilst the theme of staff attitudes and communication was raised only by mothers. Key conclusions: Barriers to antenatal care exist at the personal, social, socioeconomic and health services level. Some health professionals may be unaware of the importance of their communication style. Interventions to improve attendance must be multifaceted rather than focussing on individual women alone. Implications for practice: Barriers for women attending antenatal healthcare must be addressed in order to increase attendance rates. Specific practice-based interventions may involve changing the time or location of services and exploring changes to staff communication with women.

Background: The World Health Organisation recommends women have at least four antenatal care visits (ANC) during a low risk pregnancy. However, in Saudi Arabia, many mothers miss these appointments, placing their health and that of their baby at risk. Limited research which has explored why this is happening has focused on low maternal education or personal barriers such as lack of transport. The aim of the current research was therefore to understand what factors at the individual and healthcare systems level were associated with missing antenatal care in Saudi Arabia. Methods: Two hundred and forty-two pregnant women in their third trimester completed a questionnaire examining their care attendance (appointments missed, planned future attendance, timing of first appointment) alongside barriers to attending care. These included maternal demographic background, health literacy, personal barriers, health care system factors and staff communication). Results: Over half of women surveyed had missed at least one appointment and a third had delayed their care. Mothers who had missed or delayed appointments blamed health care system factors such as poor clinic facilities and waiting times. Attending care was not associated with maternal education or literacy, although mothers with a lower level of literacy were more likely to delay care. However, perceptions of staff communication, consistency and care were lower amongst mothers who had missed at least one appointment. Conclusions: Although in previous research health professionals believe it is maternal education that leads to poor attendance, in our sample at least, perceptions of staff communication and clinic facilities were instead associated with attendance. Making changes at the health care level e.g. through adapting clinic times and investing in staff training may increase antenatal care attendance in Saudi Arabia.

With the recent increased prevalence of human outbreaks, monkeypox has been recognized for decades as an infectious disease with substantial pandemic potential. The majority of cases of this virus have been observed in the European region (11,865), with few cases in the Western Pacific (54). Various governing health agencies are striving to restrain the fatal monkeypox virus (MPXV). Health practitioners around the world are learning about the many clinical manifestations of this infection, and its potential therapies. Despite the plethora of new evidence and rising cases, the essential questions remain unsolved. Thus, in this review, we have modernized the outlook for monkeypox, which will be helpful for various medical practitioners. In the light of continuing outbreaks around the world, we have also presented our assessment of the readiness of India against this outbreak, with a special focus on its effects on oral health.

Background The World Health Organisation recommends women have at least 4 antenatal care visits (ANC) during a low risk pregnancy. However, in Saudi Arabia, many mothers miss these appointments placing their health and that of their baby at risk. Limited research exploring why this is happening usually focuses on low maternal education or personal barriers such as lack of transport. The aim of the current research was therefore to understand what factors at the individual and healthcare systems level were associated with missing antenatal care in Saudi Arabia.Methods Two hundred and forty two pregnant women in their third trimester completed a questionnaire examining their care attendance alongside barriers to attending care. These included maternal demographic background, health literacy, personal barriers, health care system factors and staff communication).Results Over half of women had missed at least one appointment and a third had delayed their care. Mothers who had missed appointments blamed health care system factors such as poor clinic facilities and waiting times. Attending care was not associated with maternal education or literacy. However perceptions of staff communication, consistency and care were lower amongst those who had missed at least one appointment.Conclusions Although in previous research health professionals believe it is maternal education that leads to poor attendance, in our sample at least, it is in fact perceptions of staff communication that affect attendance. Making changes at the health care level e.g. through adapting clinic times and investing in staff training may increase antenatal care attendance in Saudi Arabia.