Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000512
Fiona Braka, E. Daniel, Joseph Okeibunor, Neema Kimambo Rusibamayila, I. Conteh, Otim Patrick Cossy Ramadan, J. Byakika-Tusiime, Chol Thabo Yur, Emmanuel Maurice Ochien, Mathew Kagoli, Annie Chauma-Mwale, D. Chamla, A. S. Gueye
Malawi—one of the low-income countries in Africa—has witnessed a series of flood-related disasters in many years. The recent tropical cyclone Freddy (TCF) has indispensable effects on the unequal distribution of the social determinants of health with tendencies for increased disease outbreaks across the districts of the country. This narrative study aimed at unravelling the consequences of the TCF and its possible relationship with the already existing cholera epidemic in the fourteen affected districts. Additionally, it aimed to document the immediate humanitarian responses in the acute phase of the disaster. We identified, used and extracted information and data from relevant documents available from the government records, WHO and other multiagency documents, which were summarised along with the humanitarian actions and the associated implications of the entire event. Areas of TCF’s main effects included health, shelter, education, nutrition, water sanitation and hygiene, agriculture and livelihood, transport and logistics including food security. The notable immediate humanitarian responses are donations, camp creation for accommodations, emergency life-saving response and essential healthcare services. Nsanje and Chikwawa districts experienced an increase in cholera cases and deaths post-TCF. The highest proportion of the disaster-impacted and intervention beneficiaries were women and children. The effects of the TCF on the social determinants of health in the affected districts and the associated negative impacts should be considered by the government and disaster management experts in evidence-based policy-making towards disaster risk reduction in the flood-prone districts using an all-hazard approach. This step might be useful in improving the vulnerable population’s standard of living and achievement of related Sustainable Development Goals in Malawi.
{"title":"Effects of tropical cyclone Freddy on the social determinants of health: the narrative review of the experience in Malawi","authors":"Fiona Braka, E. Daniel, Joseph Okeibunor, Neema Kimambo Rusibamayila, I. Conteh, Otim Patrick Cossy Ramadan, J. Byakika-Tusiime, Chol Thabo Yur, Emmanuel Maurice Ochien, Mathew Kagoli, Annie Chauma-Mwale, D. Chamla, A. S. Gueye","doi":"10.1136/bmjph-2023-000512","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000512","url":null,"abstract":"Malawi—one of the low-income countries in Africa—has witnessed a series of flood-related disasters in many years. The recent tropical cyclone Freddy (TCF) has indispensable effects on the unequal distribution of the social determinants of health with tendencies for increased disease outbreaks across the districts of the country. This narrative study aimed at unravelling the consequences of the TCF and its possible relationship with the already existing cholera epidemic in the fourteen affected districts. Additionally, it aimed to document the immediate humanitarian responses in the acute phase of the disaster. We identified, used and extracted information and data from relevant documents available from the government records, WHO and other multiagency documents, which were summarised along with the humanitarian actions and the associated implications of the entire event. Areas of TCF’s main effects included health, shelter, education, nutrition, water sanitation and hygiene, agriculture and livelihood, transport and logistics including food security. The notable immediate humanitarian responses are donations, camp creation for accommodations, emergency life-saving response and essential healthcare services. Nsanje and Chikwawa districts experienced an increase in cholera cases and deaths post-TCF. The highest proportion of the disaster-impacted and intervention beneficiaries were women and children. The effects of the TCF on the social determinants of health in the affected districts and the associated negative impacts should be considered by the government and disaster management experts in evidence-based policy-making towards disaster risk reduction in the flood-prone districts using an all-hazard approach. This step might be useful in improving the vulnerable population’s standard of living and achievement of related Sustainable Development Goals in Malawi.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000417
Damaris Ortiz, Lauren A. Magee, Zachary W Adams, Brigid R. Marriott, Reilin J Moore, Blakney Q Brooks, Malaz Boustani, Clark J Simons
There are few qualitative studies of firearm injury survivors and hospital-based violence intervention programme (HVIP) participants. The original study aimed to identify facilitators and barriers to survivors’ utilisation of mental health services. This secondary analysis aimed to identify factors that may impact engagement with an HVIP.This study was a subanalysis of an original qualitative study that used a community-based participatory research approach to conduct semistructured interviews with English-speaking, intentional firearm injury survivors aged 13 and older within Indianapolis, Indiana between 2021 and 2022. Participants were recruited by a community organisation through a snowball sampling method. Interviews were analysed using manual thematic analysis. Themes were analysed and discussed in relation to HVIPs.A total of 18 interviews were completed. The majority of participants identified as black (17/18, 94.4%). Nearly all (75%) participants were between the ages of 13 and 24 years of age at the time of their shooting. During content analysis, five themes were identified: (1) delayed readiness to change, (2) desire for independence, (3) lack of trust, (4) persistent emotional and physical effects of trauma and (5) unawareness of HVIP resources.This qualitative analysis of firearm injury survivor experiences provided insights for improved engagement with HVIPs. Continued pursuit of survivors for several years after their injury, improved dissemination of resources, establishing trust, and addressing persistent physical and psychological symptoms while respecting participants’ desire for independence may lead to increased engagement of firearm injury survivors with HVIPs.
{"title":"Qualitative study of factors affecting engagement with a hospital-based violence intervention programme in Indianapolis, Indiana","authors":"Damaris Ortiz, Lauren A. Magee, Zachary W Adams, Brigid R. Marriott, Reilin J Moore, Blakney Q Brooks, Malaz Boustani, Clark J Simons","doi":"10.1136/bmjph-2023-000417","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000417","url":null,"abstract":"There are few qualitative studies of firearm injury survivors and hospital-based violence intervention programme (HVIP) participants. The original study aimed to identify facilitators and barriers to survivors’ utilisation of mental health services. This secondary analysis aimed to identify factors that may impact engagement with an HVIP.This study was a subanalysis of an original qualitative study that used a community-based participatory research approach to conduct semistructured interviews with English-speaking, intentional firearm injury survivors aged 13 and older within Indianapolis, Indiana between 2021 and 2022. Participants were recruited by a community organisation through a snowball sampling method. Interviews were analysed using manual thematic analysis. Themes were analysed and discussed in relation to HVIPs.A total of 18 interviews were completed. The majority of participants identified as black (17/18, 94.4%). Nearly all (75%) participants were between the ages of 13 and 24 years of age at the time of their shooting. During content analysis, five themes were identified: (1) delayed readiness to change, (2) desire for independence, (3) lack of trust, (4) persistent emotional and physical effects of trauma and (5) unawareness of HVIP resources.This qualitative analysis of firearm injury survivor experiences provided insights for improved engagement with HVIPs. Continued pursuit of survivors for several years after their injury, improved dissemination of resources, establishing trust, and addressing persistent physical and psychological symptoms while respecting participants’ desire for independence may lead to increased engagement of firearm injury survivors with HVIPs.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000381
Suepattra May, M. Roach, Melissa Maravic, Rachel Mitrovich, Rozanne Wilson, Nadya Prood, Amanda L Eiden
‘Shocks’ or external stressors to vaccination programmes can lead to decreased vaccination coverage rates. The capacity of vaccination ecosystems to effectively respond and adapt to shocks demonstrates programme resilience. This study sought to describe components that contribute to resilience in national immunisation programmes.Mixed-methods study comprising in-depth interviews and surveys with n=30 vaccination programme experts in eight countries (Brazil, Costa Rica, Greece, Japan, Nigeria, Philippines, Spain and the USA). We elicited data on country-specific shocks, associated effects and factors that facilitated or impeded programme resilience. Interviews and open-ended survey responses were analysed qualitatively, with closed-ended survey questions analysed using descriptive statistics.Experts described immediate effects of shocks including decreased vaccine uptake and negative perceptions of vaccination from the public and media. Late emerging impacts included increased vaccine hesitancy and vaccine-preventable disease (VPD) rates. Stakeholder education, immunisation information systems (IIS) and programme financing were key factors to strengthening programme resilience. Appropriately trained frontline healthcare personnel can counter vaccine misinformation that otherwise erodes trust and contributes to hesitancy. The COVID-19 pandemic also exposed structural weaknesses in programme resilience, with experts highlighting the need for robust IIS and workforce support to mitigate burnout and strengthen resilience when a shock occurs.Our findings provide preliminary insights into factors that experts believe to be associated with vaccination programme resilience. Anticipating, adapting and responding to shocks is central to strengthening systems, ensuring ecosystem resilience and protecting against current and future VPD threats.
{"title":"Understanding the factors that shape vaccination ecosystem resilience: a qualitative assessment of international expert experiences and perspectives","authors":"Suepattra May, M. Roach, Melissa Maravic, Rachel Mitrovich, Rozanne Wilson, Nadya Prood, Amanda L Eiden","doi":"10.1136/bmjph-2023-000381","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000381","url":null,"abstract":"‘Shocks’ or external stressors to vaccination programmes can lead to decreased vaccination coverage rates. The capacity of vaccination ecosystems to effectively respond and adapt to shocks demonstrates programme resilience. This study sought to describe components that contribute to resilience in national immunisation programmes.Mixed-methods study comprising in-depth interviews and surveys with n=30 vaccination programme experts in eight countries (Brazil, Costa Rica, Greece, Japan, Nigeria, Philippines, Spain and the USA). We elicited data on country-specific shocks, associated effects and factors that facilitated or impeded programme resilience. Interviews and open-ended survey responses were analysed qualitatively, with closed-ended survey questions analysed using descriptive statistics.Experts described immediate effects of shocks including decreased vaccine uptake and negative perceptions of vaccination from the public and media. Late emerging impacts included increased vaccine hesitancy and vaccine-preventable disease (VPD) rates. Stakeholder education, immunisation information systems (IIS) and programme financing were key factors to strengthening programme resilience. Appropriately trained frontline healthcare personnel can counter vaccine misinformation that otherwise erodes trust and contributes to hesitancy. The COVID-19 pandemic also exposed structural weaknesses in programme resilience, with experts highlighting the need for robust IIS and workforce support to mitigate burnout and strengthen resilience when a shock occurs.Our findings provide preliminary insights into factors that experts believe to be associated with vaccination programme resilience. Anticipating, adapting and responding to shocks is central to strengthening systems, ensuring ecosystem resilience and protecting against current and future VPD threats.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000654
Kerstin Muner, Julia Kilgour, Tatiana Ometto, Ana Pérola Drulla Brandão, Andrea Pires dos Santos, Ana Marcia Sá Guimarães
Brazil has high rates of COVID-19 and tuberculosis among healthcare workers (HCWs). Personal protective equipment (PPE) is essential for their protection. We aimed to evaluate PPE use, training, and preparedness among HCWs in the early months of the SARS-CoV-2 pandemic in Brazil.A cross-sectional study was performed using questionnaires available to HCWs through a website created to provide PPE guidelines. χ2test and robust Poisson regression identified factors associated with HCWs treating COVID-19 patients (TCOVID-19), lack of training on PPE use and N95 respirator reuse. The speech content of open-ended questions was analysed.We analysed 1410 questionnaires collected from April to July 2020 representing 526 Brazilian cities. HCWs-TCOVID-19 had fewer years of work experience, were more likely to reuse PPE, and reported higher stress levels and lower biosafety at the workplace than HCWs not TCOVID-19 patients. Fearful concerns, limited PPE access and pandemic unpreparedness were common among HCWs. Lack of PPE training was associated with the profession and no N95 respirator fit tests. N95 reuse during the pandemic, common to 78% of the HCWs, was associated with the reuse of PPE during the pandemic and reuse of N95 before the pandemic.We report the unpreparedness of HCWs and institutions to handle the pandemic, with low rates of training and N95 respirator fit testing and high PPE reuse. N95 reuse was a pre-established practice. This chronic unpreparedness to deal with airborne pathogens may have contributed to one of the highest global rates of tuberculosis and COVID-19 among HCWs.
{"title":"Cross-sectional study of personal protective equipment use, training and biosafety preparedness among healthcare workers during the first months of the SARS-CoV-2 pandemic in Brazil","authors":"Kerstin Muner, Julia Kilgour, Tatiana Ometto, Ana Pérola Drulla Brandão, Andrea Pires dos Santos, Ana Marcia Sá Guimarães","doi":"10.1136/bmjph-2023-000654","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000654","url":null,"abstract":"Brazil has high rates of COVID-19 and tuberculosis among healthcare workers (HCWs). Personal protective equipment (PPE) is essential for their protection. We aimed to evaluate PPE use, training, and preparedness among HCWs in the early months of the SARS-CoV-2 pandemic in Brazil.A cross-sectional study was performed using questionnaires available to HCWs through a website created to provide PPE guidelines. χ2test and robust Poisson regression identified factors associated with HCWs treating COVID-19 patients (TCOVID-19), lack of training on PPE use and N95 respirator reuse. The speech content of open-ended questions was analysed.We analysed 1410 questionnaires collected from April to July 2020 representing 526 Brazilian cities. HCWs-TCOVID-19 had fewer years of work experience, were more likely to reuse PPE, and reported higher stress levels and lower biosafety at the workplace than HCWs not TCOVID-19 patients. Fearful concerns, limited PPE access and pandemic unpreparedness were common among HCWs. Lack of PPE training was associated with the profession and no N95 respirator fit tests. N95 reuse during the pandemic, common to 78% of the HCWs, was associated with the reuse of PPE during the pandemic and reuse of N95 before the pandemic.We report the unpreparedness of HCWs and institutions to handle the pandemic, with low rates of training and N95 respirator fit testing and high PPE reuse. N95 reuse was a pre-established practice. This chronic unpreparedness to deal with airborne pathogens may have contributed to one of the highest global rates of tuberculosis and COVID-19 among HCWs.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000580
Jean-Pierre Fina Lubaki, J. Francis, O. Omole
Glycaemic control remains suboptimal in the Democratic Republic of the Congo. Defining interventions to improve glycaemic control requires a clear knowledge of factors driving poor glycaemic control. Qualitative studies exploring the perspectives of key stakeholders on this issue are lacking in the Democratic Republic of the Congo. This study aimed to explore the perspectives of persons with type 2 diabetes and healthcare providers on ways to improve glycaemic control in Kinshasa, Democratic Republic of the Congo.This qualitative study used face-to-face, semistructured interviews on 26 purposively sampled participants: 10 persons with type 2 diabetes and 16 healthcare providers. The study used deductive, constructionist and thematic analyses. Themes were organised and integrated using the WHO Innovative Care for Chronic Conditions Framework.The healthcare providers recommended better preparation of the healthcare system for better care of diabetes. This is achieved through training of healthcare providers, equipping healthcare structures and organising a reliable drug delivery system. Healthcare providers must also act to ensure that patients get adequate support from their surroundings and the community by providing adequate information about diabetes. The policy environment must create conditions for alleviating the cost of care and prevention of diabetes. In addition, patients with diabetes identified three needs: need mainly for financial support to overcome the cost of diabetes, knowledge for better self-management of the illness and support from healthcare providers to succeed in self-management.Improving glycaemic control in persons with type 2 diabetes requires multidimensional strategies, with particular focus on empowering patients and their families for efficient self-management, strengthening the healthcare system for diabetes care and greater involvement of the government in terms of funding and adopting positive policies. To be efficient, these interventions need to be integrated into the chronic diseases management framework.
{"title":"Perspectives of healthcare providers and persons with type 2 diabetes mellitus on improving glycaemic control in Kinshasa, Democratic Republic of the Congo: a qualitative study","authors":"Jean-Pierre Fina Lubaki, J. Francis, O. Omole","doi":"10.1136/bmjph-2023-000580","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000580","url":null,"abstract":"Glycaemic control remains suboptimal in the Democratic Republic of the Congo. Defining interventions to improve glycaemic control requires a clear knowledge of factors driving poor glycaemic control. Qualitative studies exploring the perspectives of key stakeholders on this issue are lacking in the Democratic Republic of the Congo. This study aimed to explore the perspectives of persons with type 2 diabetes and healthcare providers on ways to improve glycaemic control in Kinshasa, Democratic Republic of the Congo.This qualitative study used face-to-face, semistructured interviews on 26 purposively sampled participants: 10 persons with type 2 diabetes and 16 healthcare providers. The study used deductive, constructionist and thematic analyses. Themes were organised and integrated using the WHO Innovative Care for Chronic Conditions Framework.The healthcare providers recommended better preparation of the healthcare system for better care of diabetes. This is achieved through training of healthcare providers, equipping healthcare structures and organising a reliable drug delivery system. Healthcare providers must also act to ensure that patients get adequate support from their surroundings and the community by providing adequate information about diabetes. The policy environment must create conditions for alleviating the cost of care and prevention of diabetes. In addition, patients with diabetes identified three needs: need mainly for financial support to overcome the cost of diabetes, knowledge for better self-management of the illness and support from healthcare providers to succeed in self-management.Improving glycaemic control in persons with type 2 diabetes requires multidimensional strategies, with particular focus on empowering patients and their families for efficient self-management, strengthening the healthcare system for diabetes care and greater involvement of the government in terms of funding and adopting positive policies. To be efficient, these interventions need to be integrated into the chronic diseases management framework.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000470
P. Charalampous, C. C. Maas, J. Haagsma
Measurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.We administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).In total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96–0.98, p<0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).The NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe.
{"title":"Disability weights for environmental noise-related health states: results of a disability weights measurement study in Europe","authors":"P. Charalampous, C. C. Maas, J. Haagsma","doi":"10.1136/bmjph-2023-000470","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000470","url":null,"abstract":"Measurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.We administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).In total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96–0.98, p<0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).The NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000334
Burtukan Hussien, T. B. Elema, L. Worku, Taferi Atomsa Rekiti, Amana Ogatu Luke, Addisu Tadesse Sime, Eyob Ketema Bogale
To assess the fruit and vegetable (FV) consumption, and associated factors among patients with type 2 diabetes mellitus (T2DM) attending health services at selected health centres.Institution-based cross-sectional study design was conducted. A study was conducted in selected health centres of Yeka subcity, Addis Ababa, from 2 March 2022 to 5 May= 2022. The sample comprised 285 patients with T2DM chosen by simple random sampling technique. Data collection was carried out via a structured questionnaire, followed by interviews and further analysed using SPSS V.25. Descriptive statistics were performed to describe the study population’s characteristics, while logistic regression was used to identify the factors linked to FV consumption.The study’s findings indicated that the recommended amount of FV consumption was low among study participants at 25.8%, with a range of 20.9%–31.5%. The consumption of FV was linked to various factors, including food prepared by house servants (adjusted OR (AOR) 2.23, 95% CI 1.01 to 4.97), having knowledge about FV intake (AOR 4.38, 95% CI 1.88 to 10.15), accessibility of FV (AOR 4.54, 95% CI 2.05 to 10.09), affordability to buy FVs (AOR 2.32, 95% CI 1.04 to 5.18), perceiving FVs as preferable (AOR 4.51, 95% CI 2.13 to 9.54) and awareness of WHO recommendations (AOR = 0.25,95% CI, 0.11–0.55).About one-fourth of study participants consume more than five servings of FV every day, which is the recommended quantity of servings. Eating food prepared by servants, having no information, difficulty accessing FV, not affording to buy FV, not perceiving FV as a preferable food for diabetics, having awareness about WHO recommendations on FV were factors significantly associated with FV consumption among people with T2DM. Hence health information dissemination about recommended FV consumption among people with T2DM should be strengthened.
{"title":"Magnitude of fruit and vegetable consumption and its associated factors among patients with type 2 diabetes mellitus (T2DM) attending health services at selected health centers in Yeka subcity, Addis Ababa: a cross-sectional study","authors":"Burtukan Hussien, T. B. Elema, L. Worku, Taferi Atomsa Rekiti, Amana Ogatu Luke, Addisu Tadesse Sime, Eyob Ketema Bogale","doi":"10.1136/bmjph-2023-000334","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000334","url":null,"abstract":"To assess the fruit and vegetable (FV) consumption, and associated factors among patients with type 2 diabetes mellitus (T2DM) attending health services at selected health centres.Institution-based cross-sectional study design was conducted. A study was conducted in selected health centres of Yeka subcity, Addis Ababa, from 2 March 2022 to 5 May= 2022. The sample comprised 285 patients with T2DM chosen by simple random sampling technique. Data collection was carried out via a structured questionnaire, followed by interviews and further analysed using SPSS V.25. Descriptive statistics were performed to describe the study population’s characteristics, while logistic regression was used to identify the factors linked to FV consumption.The study’s findings indicated that the recommended amount of FV consumption was low among study participants at 25.8%, with a range of 20.9%–31.5%. The consumption of FV was linked to various factors, including food prepared by house servants (adjusted OR (AOR) 2.23, 95% CI 1.01 to 4.97), having knowledge about FV intake (AOR 4.38, 95% CI 1.88 to 10.15), accessibility of FV (AOR 4.54, 95% CI 2.05 to 10.09), affordability to buy FVs (AOR 2.32, 95% CI 1.04 to 5.18), perceiving FVs as preferable (AOR 4.51, 95% CI 2.13 to 9.54) and awareness of WHO recommendations (AOR = 0.25,95% CI, 0.11–0.55).About one-fourth of study participants consume more than five servings of FV every day, which is the recommended quantity of servings. Eating food prepared by servants, having no information, difficulty accessing FV, not affording to buy FV, not perceiving FV as a preferable food for diabetics, having awareness about WHO recommendations on FV were factors significantly associated with FV consumption among people with T2DM. Hence health information dissemination about recommended FV consumption among people with T2DM should be strengthened.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000422
Temesgen Geta, Bizuayehu Atinafu, Tsiyon Kassa
Lack of awareness about the Rh-incompatibility problem is one of the factors hindering early prevention in Ethiopia. Thus, the objective of this study is to determine what was known about Rh-incompatibility disorders and their associated factors among pregnant women participating in prenatal care in southern Ethiopia.A facility-based cross-sectional study was employed in four selected hospitals during 1–30 August 2022. The systematic random sampling method was used as a technique of selecting the study participants. The study was performed using a structured questionnaire. The data were coded and entered into EPI DATA V.4.6, and then the analysis was done using SPSS V.23 software program. Adjusted OR with 95% CI was the measurement unit of association between independent variables and outcome variables. The significance level was established as p<0.05.414 women took the survey, which corresponds to a response rate of 98.1%. Of those who responded, only 48% knew their blood group. The study found that 35.3% (95% CI: 31% to 40%) of women had a good knowledge of Rh-incompatibility. Maternal educational level above secondary school, multigravida women, blood type screening in the maternity ward, early counselling on Rh status and Rh-incompatibility and a positive attitude among women were significantly associated with pregnant women’s knowledge of Rh-incompatibility.The majority of pregnant women had poor knowledge regarding Rh-incompatibility. Therefore, all responsible organisations should focus on expanding pregnant women’s knowledge of Rh-incompatibility and the factors significantly associated with knowledge of Rh-incompatibility.
{"title":"Knowledge about Rh-incompatibility and its associated factors among antenatal care recipients in public hospitals of Wolaita zone, 2022: facility-based cross-sectional study","authors":"Temesgen Geta, Bizuayehu Atinafu, Tsiyon Kassa","doi":"10.1136/bmjph-2023-000422","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000422","url":null,"abstract":"Lack of awareness about the Rh-incompatibility problem is one of the factors hindering early prevention in Ethiopia. Thus, the objective of this study is to determine what was known about Rh-incompatibility disorders and their associated factors among pregnant women participating in prenatal care in southern Ethiopia.A facility-based cross-sectional study was employed in four selected hospitals during 1–30 August 2022. The systematic random sampling method was used as a technique of selecting the study participants. The study was performed using a structured questionnaire. The data were coded and entered into EPI DATA V.4.6, and then the analysis was done using SPSS V.23 software program. Adjusted OR with 95% CI was the measurement unit of association between independent variables and outcome variables. The significance level was established as p<0.05.414 women took the survey, which corresponds to a response rate of 98.1%. Of those who responded, only 48% knew their blood group. The study found that 35.3% (95% CI: 31% to 40%) of women had a good knowledge of Rh-incompatibility. Maternal educational level above secondary school, multigravida women, blood type screening in the maternity ward, early counselling on Rh status and Rh-incompatibility and a positive attitude among women were significantly associated with pregnant women’s knowledge of Rh-incompatibility.The majority of pregnant women had poor knowledge regarding Rh-incompatibility. Therefore, all responsible organisations should focus on expanding pregnant women’s knowledge of Rh-incompatibility and the factors significantly associated with knowledge of Rh-incompatibility.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000410
Siya Aggrey, J. Pulford, John Bosco Bahungirehe, Charles Wamboga, Andrew Hope
The Ugandan Tiny Target programme is an example of an international vector control partnership that held specific capacity strengthening objectives in support of a disease elimination goal. Drawing on this experience, we sought to derive transferable lessons that may inform capacity strengthening approaches within other partnership-based vector control programmes.A longitudinal qualitative study encompassing semistructured interviews conducted with Ugandan partners working on the Tiny Target programme. Data analysis was informed by a general inductive approach.Capacity strengthening priorities evolved over time initially focusing on the immediate capacities needed to perform roles and responsibilities assigned within the partnership and then shifting towards more advanced, transferable knowledge and skills. A distinction between operational and systemic priorities was observed: the former was necessary to support successful programme implementation whereas the latter reflected fundamental limitations or complexities within the Ugandan context that were bypassed by including an international partner. Systemic priorities were fewer in number than their operational counterparts, although substantially harder to resolve. The largest apparent threat to the long-term sustainability of reported capacity gains was their concentration within a small number of individuals.Our study highlights three key lessons that may inform the design of national capacity strengthening activities conducted within the context of international vector control partnerships, including (1) Multiple approaches to strengthen capacity are needed and that can adapt to changing capacity strengthening priorities over time; (2) Balancing operational and systemic capacity strengthening priorities, the latter becoming increasingly important within longer-term partnerships and (3) Partnership members in focal country/ies should be supported to actively facilitate the transfer of newly acquired knowledge and skills to relevant colleagues/communities outside of the partnership. The generic nature of these recommendations suggests they are likely to be of benefit to many and diverse international partnerships within the wider global health space.
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Pub Date : 2024-04-01DOI: 10.1136/bmjph-2023-000810
J. Tenorio-Mucha, Corinne Jeffries-Tolksdorf, C. Burton-Jeangros, Jan-Erik Refle, Y. Jackson
We aimed to map the social determinants of meeting the healthcare needs of undocumented migrants living with non-communicable diseases (NCDs) throughout their migration journey (from the country of origin to the country(/ies) of transit and destination).We conducted a scoping review.We searched literature in Medline, Embase, Web of Science and Google Scholar.We included articles that describe interventions, programmes or policies for undocumented migrants living with cardiovascular diseases, cancer, chronic respiratory disease, or diabetes. There were no restrictions by setting (eg, hospital, community or mobile clinic) or country. We included articles published in English, Spanish, or French between 2000 to 2022.The data were structured according to the Commission on Social Determinants of Health framework, differentiated along the migration journey (country of origin, transit, departure and integration, and country of destination). A new conceptual model emerged from data synthesis.We included 22 studies out of 953 identified articles. They reported data from Italy, the USA, Spain, Switzerland, The Netherlands, France, Austria, and Sweden. They show that individual determinants (material, biological, psychosocial and behavioural) evolve throughout the migration journey and influence healthcare needs. The satisfaction of these needs is conditioned by health system-related determinants such as availability and accessibility. However, the individual and health-system determinants depend on the political and legal context of both the country of origin and the country(/ies) of destination, as well as on the socioeconomic position of undocumented migrants in the destination country.Migrant health policies should aim at better responding to NCDs-related healthcare needs of undocumented migrants throughout their migration journey, taking into account the social, economic and legal factors that underlie their health vulnerability.
我们在 Medline、Embase、Web of Science 和 Google Scholar 中检索了相关文献。我们纳入了描述针对患有心血管疾病、癌症、慢性呼吸系统疾病或糖尿病的无证移民的干预措施、计划或政策的文章。对环境（如医院、社区或流动诊所）或国家没有限制。我们收录了 2000 年至 2022 年间以英文、西班牙文或法文发表的文章。数据按照健康的社会决定因素委员会的框架进行结构化处理，并在移民过程中加以区分（原籍国、过境国、离境和融入国以及目的地国）。我们从已确认的 953 篇文章中选取了 22 项研究。这些研究报告了来自意大利、美国、西班牙、瑞士、荷兰、法国、奥地利和瑞典的数据。这些研究表明，个人的决定因素（物质、生物、社会心理和行为）在整个移民过程中不断演变，并影响着医疗保健需求。这些需求的满足受制于与医疗系统相关的决定因素，如可用性和可及性。然而，个人和卫生系统的决定因素取决于原籍国和目的地国的政治和法律环境，以及无证移民在目的地国的社会经济地位。移民卫生政策应着眼于更好地应对无证移民在整个移民过程中与非传染性疾病相关的卫生保健需求，同时考虑到导致其健康脆弱性的社会、经济和法律因素。
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