Eastern Mediterranean Health Journal最新文献

Background: Vaccination has a tremendous impact on health at the regional and global levels, however, the tendency for people to hesitate on vaccination has been increasing in the past few decades.

Aims: We assessed vaccine hesitancy and its determinants in the Gulf Cooperation Council countries.

Methods: We conducted a literature review to assess peer-reviewed articles published up to March 2021 on vaccine hesitancy in the Gulf Cooperation Council countries using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A search was conducted via PubMed and 29 articles were identified. After the removal of duplicates and irrelevant articles, 14 studies remained relevant and were used for the review.

Results: Vaccine hesitancy in the Gulf Cooperation Council countries ranged from 11% to 71%. Differences in rates were noted for vaccine type, with COVID-19 vaccine having the highest reported hesitancy (70.6%). The likelihood of accepting vaccination was associated with previous individual acceptance of vaccine, specifically the seasonal influenza vaccine. The most common determinants of vaccine hesitancy were distrust in vaccine safety and concerns about side-effects. Healthcare workers were among the main sources of information and recommendations about vaccination, but 17-68% of them were vaccine-hesitant. The majority of the healthcare workers had never received any training on addressing vaccine hesitancy among patients.

Conclusions: Vaccine hesitancy is prevalent among the publics and healthcare workers in the Gulf Cooperation Council countries. There is a need to continually monitor perceptions and knowledge about vaccines and vaccination in these countries to better inform interventions to improve vaccine uptake in the sub-region.

Background: The transition to telehealth services for mothers of preterm babies is a challenge in promoting the health of preterm infants, although telehealth allows real-time interaction and support for mothers.

Aim: To compare the experiences of mothers of hospitalized and discharged preterm infants with telehealth services in the Islamic Republic of Iran.

Methods: This qualitative study was conducted from June to October 2021 using a conventional content analysis approach. The study participants included 35 hospitalized and 35 discharged mothers of preterm infants, who received healthcare consultations through WhatsApp and Telegram applications. They were selected using purposive sampling. Data collection was done using in-depth semi-structured interviews and data analysis was performed using Graneheim and Lundman analysis.

Results: Our findings showed request for continuing healthcare support by the mothers as the main category, with 3 subcategories: willingness to connect to telehealth services, more comprehensive education about telehealth services, and opportunities to share experiences. Mothers of hospitalized and discharged preterm infants had conflicting views about the ambiguous role of nurses in telehealth and the use of telehealth as a support system.

Conclusion: Telehealth plays an important role as a supportive method in promoting infant health and boosting the confidence of mothers of preterm infants as they continuously interact with nurses.

Background: Low breastfeeding rates are a global concern, and few studies have examined breastfeeding in Oman.

Aims: We examined the associations of mothers' sociodemographic characteristics, breastfeeding knowledge, attitudes, subjective norms, perceived control, previous breastfeeding experience, and early breastfeeding support with infant feeding intention at birth and breastfeeding intensity at 8 weeks postpartum.

Methods: We used a descriptive, prospective cohort design. Data collection was in 2016. We administered a structured questionnaire to mothers at postpartum discharge from 2 hospitals in Oman and followed up once via a 24-hour dietary recall at 8 weeks. We used a path analysis model (n = 427) using SPSS, version 24.0, and Amos, version 22.

Results: During the postpartum hospitalization, 33.3% of mothers reported that their babies received formula milk. At the 8-week follow-up, 27.3% of mothers were exclusively breastfeeding. Subjective norms (measured by social and professional support) were the strongest predictors. Infant feeding intention significantly predicted breastfeeding intensity. Returning to work/school was the only sociodemographic variable to significantly correlate with breastfeeding intensity (r = -0.17; P < 0.001); mothers who planned to return to work/school had significantly lower intensity. Knowledge significantly predicted positive and negative attitudes, subjective norms and perceived control. Early breastfeeding support negatively correlated with breastfeeding intensity (r= -0.15; P < 0.001).

Conclusion: Infant feeding intention positively predicted breastfeeding intensity with subjective norms or social and professional support and had the strongest correlation with mothers' intentions.

Background: Early neonatal death is an essential epidemiological indicator of maternal and child health.

Aims: To identify risk factors for early neonatal deaths in the Gaza Strip.

Methods: This hospital-based case-control study included 132 women who experienced neonatal deaths from January to September 2018. The control group comprised 264 women who were selected using systematic random sampling and gave birth to live newborns at the time of data collection.

Results: The controls who had no history of neonatal death or stillbirth were less likely to have an early neonatal death than women who had such history. The controls who did not have meconium aspiration syndrome or amniotic fluid complications were less likely to have an early neonatal death than women who experienced these complications during delivery. The controls who had a singleton birth outcome were less likely to have an early neonatal death than women who had multiple births.

Conclusion: Interventions are needed to provide preconception care, improve the quality of intrapartum and postnatal care, provide high-quality health education, and improve the quality of care provided by neonatal intensive care units in the Gaza Strip.

Background: The urban slums of Pakistan continue to record low childhood vaccination coverage. It is therefore vital to understand the demand-side barriers to childhood vaccination in the slums to determine the required demand-generation interventions.

Aims: To document the demand-side barriers related to childhood vaccination in urban slums of Pakistan and recommend appropriate demand-generation interventions.

Methods: We investigated the demand-side barriers to childhood vaccination in 4 urban slums of Karachi, Pakistan, and disseminated the findings to the Expanded Program on Immunization and their partners. Using the findings, we made recommendations for collaborations with the various partners and for the design of demand-generation interventions to address the barriers. We then expanded the scope of the original research through a mapping exercise that gathered information on the vaccination-related research and interventions of the partners and used the information gathered to create a portfolio of activities. We present the demand-side barriers from the original research and the portfolio of demand-generation interventions.

Results: The original research showed that 412 (49.0%) children aged 12-23 months, from 840 households, were fully vaccinated. Reasons given for not receiving the recommended vaccinations were mainly related to the fear of side effects, social and religious influences, lack of awareness, and misconceptions about vaccine administration. The mapping of activities revealed 47 initiatives that aimed to generate demand for childhood vaccination in the urban slums of Pakistan.

Conclusion: Several stakeholders involved in childhood vaccination in the urban slums of Pakistan act independently, operating programmes that are disconnected. There is a need for better coordination and integration of the childhood vaccination interventions by these partners to achieve the goal of universal vaccination coverage.

Background: Maternal mortality is an indication of the health status of women in the society.

Aims: To investigate the maternal mortality ratio, causes of maternal mortality, and related risk factors among Iranian women.

Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the Peer Review of Electronic Search Strategies (PRESS) guideline, we systematically searched electronic databases, and the grey literature, for publications in Farsi and English from 1970 to January 2022 for studies that reported the number of maternal deaths and/or maternal mortality ratio and their related factors. Data analysis was conducted using Stata 16 and 2-sided P ≤ 0.05 was considered statistically significant, if not otherwise specified.

Results: A subgroup meta-analysis of studies conducted since 2000 estimated the maternal mortality ratio as 45.03 per 100 000 births during 2000-2004, 36.05 during 2005-2009, and 23.71 after 2010. The most frequent risk factors for maternal mortality were caesarean section, poor antenatal and delivery care, unskilled birth attendance, age, low maternal education level, lower human development index, and residence in rural or remote areas.

Conclusion: There has been a significant decrease in maternal mortality in the Islamic Republic of Iran during the last few decades. Mothers in the country need to be monitored more carefully by trained healthcare workers during the pregnancy, delivery and postpartum periods so they can effectively handle postpartum complications, such as haemorrhage and infection, thereby further reducing maternal mortality.

From distributing healthcare resources equitably to identifying disease outbreaks, most of the information needs of local health system decision-makers have a geographic component (1). Recognizing the value of geographic information systems for public health planning and decision-making, a 2007 resolution by the Regional Committee of the World Health Organization (WHO) Eastern Mediterranean Region (EMR) called upon Member States to develop institutional frameworks, policies, processes, and to provide the infrastructure and resources needed to support health mapping activities in EMR (2).

Background: Neither COVID-19 vaccine acceptance nor income changes among migrant workers during the pandemic has been assessed in Saudi Arabia.

Aims: To assess the correlates of willingness to take the COVID-19 vaccine and a decrease in income during the pandemic among migrant workers in Saudi Arabia.

Methods: An electronic questionnaire was administered to 2403 migrant workers from the Middle East and South Asia employed in agriculture, auto repair, construction, food service (restaurants), municipality, and poultry farms in Al-Qassim Province, Saudi Arabia. The interviews were conducted in the native languages of the workers in 2021. Chi-square was used to assess the associations, and a multiple logistic regression was used to generate the odds ratio. Data analysis was conducted using SPSS version 27.

Results: South Asian workers were 2.30 [95% confidence interval (CI): 1.60-3.32] times more likely to accept the COVID-19 vaccine than those from the Middle East (reference group). Restaurant, agriculture and poultry workers were respectively 2.36 (95% CI: 1.41-3.95), 2.13 (95% CI: 1.29-3.51) and 14.56 (95% CI: 5.64-37.59) times more likely to accept the vaccine than construction workers (reference group). Older (≥ 56 years, reference group ≤ 25 years) workers were 2.23 (95% CI: 0.99-5.03) times, auto repair 6.75 (95% CI: 4.33-10.53) times, and restaurant workers 4.04 (95% CI: 2.61-6.25) times more likely to experience a reduction in income than construction workers.

Conclusions: Workers from South Asia were more likely to accept the COVID-19 vaccine and less likely to experience an income reduction than those from the Middle East.