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Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana. 评估加纳博诺地区苏亚尼和苏亚尼西市镇医疗机构的新生儿死亡率及相关医院因素。
IF 2.8 Q2 Medicine Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241258836
Kassim Tawiah, Killian Asampana Asosega, Samuel Iddi, Alex Akwasi Opoku, Iddrisu Wahab Abdul, Richard Kwame Ansah, Francis Kwame Bukari, Eric Okyere, Atinuke Olusola Adebanji

Objectives: Ghana's quest to reduce neonatal mortality, in hospital facilities and communities, continues to be a nightmare. The pursuit of achieving healthy lives and well-being for neonates as enshrined in Sustainable Development Goal three lingered in challenging hospital facilities and communities. Notwithstanding that, there have been increasing efforts in that direction. This study examines the contributing factors that hinder the fight against neonatal mortality in all hospital facilities in the Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana.

Methods: The study utilized neonatal mortality data consisting of neonatal deaths, structural facility related variables, medical human resources, types of hospital facilities and natal care. The data was collected longitudinally from 2014 to 2019. These variables were analysed using the negative binomial hurdle regression (NBH) model to determine factors that contribute to this menace at the facility level. Cause-specific deaths were obtained to determine the leading causes of neonatal deaths within health facilities in the two municipal assemblies.

Results: The study established that the leading causes of neonatal mortality in these districts are birth asphyxia (46%), premature birth (33%), neonatal sepsis (11%) and neonatal jaundice (7%). The NBH showed that neonatal mortality in hospital facilities depend on the number of incubators, monitoring equipment, hand washing facilities, CPAPb machines, radiant warmers, physiotherapy machines, midwives, paediatric doctors and paediatric nurses in the hospital facility.

Conclusions: Early management of neonatal sepsis, birth asphyxia, premature birth and neonatal infections is required to reduce neonatal deaths. The government and all stakeholders in the health sector should provide all hospital facilities with the essential equipment and the medical human resources necessary to eradicate the menace. This will make the realization of Sustainable Development Goal three, which calls for healthy lives and well-being for all, a reality.

目标:加纳在医院设施和社区降低新生儿死亡率的努力仍然是一场噩梦。要实现可持续发展目标 3 中规定的新生儿健康生活和福祉,医院设施和社区仍面临挑战。尽管如此,人们仍在朝着这个方向不断努力。本研究探讨了阻碍加纳博诺地区苏亚尼和苏亚尼西市所有医院设施降低新生儿死亡率的因素:研究利用了新生儿死亡率数据,包括新生儿死亡人数、结构性设施相关变量、医疗人力资源、医院设施类型和产科护理。数据收集时间为 2014 年至 2019 年。利用负二项阈值回归(NBH)模型对这些变量进行了分析,以确定在设施层面导致这一威胁的因素。研究还获得了具体死亡原因,以确定两个市议会医疗机构中新生儿死亡的主要原因:研究发现,这些地区新生儿死亡的主要原因是出生窒息(46%)、早产(33%)、新生儿败血症(11%)和新生儿黄疸(7%)。NBH 显示,医院设施中的新生儿死亡率取决于医院设施中的保温箱、监测设备、洗手设施、CPAPb 机、辐射加热器、理疗机、助产士、儿科医生和儿科护士的数量:要减少新生儿死亡,就必须及早治疗新生儿败血症、出生窒息、早产和新生儿感染。政府和卫生部门的所有利益相关者应为所有医院设施提供必要的设备和医疗人力资源,以消除这一威胁。这将使呼吁人人享有健康生活和福祉的可持续发展目标三成为现实。
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引用次数: 0
Willingness to Pay for Social Health Insurance Among Public Health Workers in Gedeo Zone, Southern Ethiopia. 埃塞俄比亚南部 Gedeo 区公共卫生工作者的社会医疗保险支付意愿。
IF 2.8 Q2 Medicine Pub Date : 2024-06-07 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241258854
Abdene Weya Kaso, Minasse Merkeb, Girma Worku Obsie, Getachew Assefa Zenebe, Gebi Agero, Abdurehman Kalu Tololu, Alemayehu Hailu

In Ethiopia, Social Health Insurance (SHI) implementation was delayed repeatedly due to employees' unwillingness to pay 3% of their monthly salary and fear related to the scheme's healthcare coverage. However, provisions of comprehensive training for health workers on health insurance and inclusion of healthcare financing methods in health practitioner education curriculum make their level of willingness to pay for SHI schemes uncertain. Thus, this study aimed to assess willingness to pay for the SHI scheme and its determinant factors among Healthcare providers in the Gedeo zone. From July 1 to 15, 2022, we carried out an institution-based cross-sectional study among 430 healthcare providers recruited using a multistage sampling technique. A multivariable logistic regression model was used to determine the factors associated with willingness to pay for Social Health insurance. Adjusted odds ratio (AOR) and P values of <.05 with 95% confidence intervals (CIs) were used to declare statistical significance. Out of 73.4% (95% CI: 68.8%, 77.6%) healthcare providers willing to join the SHI program, only 47.3% (95% CI: 41.5%, 53.2%) were willing to pay for the proposed 3% premium of their monthly salary. Healthcare providers who had >10, 000 Birr monthly salary (AOR = 2.45, 95% CI: 1.14, 5.26), difficulty in paying for healthcare (AOR = 3.55, 95% CI: 1.22, 10.29), history of chronic conditions (AOR = 4.61, 95% CI: 2.41, 8.82), positive attitude (AOR = 3.16, 95% CI: 1.62, 6.18), and good knowledge of the social health insurance scheme (AOR = 2.35, 95% CI: 1.17, 4.72) were more likely to pay for the social health insurance. More than half of the healthcare providers expressed a lack of willingness to pay for the social health insurance scheme. So, the government should provide an awareness creation program on the concepts and principles of the SHI scheme to improve the willingness to pay for the scheme.

在埃塞俄比亚,社会医疗保险(SHI)的实施被一再推迟,原因是雇员不愿支付其月薪的 3%,以及对该计划医疗保险范围的担忧。然而,为卫生工作者提供有关医疗保险的全面培训以及将医疗筹资方法纳入卫生从业人员教育课程,使得他们为社会医疗保险计划付费的意愿水平并不确定。因此,本研究旨在评估 Gedeo 地区医疗服务提供者对社会医疗保险计划的支付意愿及其决定因素。2022 年 7 月 1 日至 15 日,我们采用多阶段抽样技术对 430 名医疗服务提供者进行了一项以机构为基础的横断面研究。我们使用多变量逻辑回归模型来确定与社会医疗保险支付意愿相关的因素。月薪 10,000 比尔(AOR = 2.45,95% CI:1.14, 5.26)、医疗支付困难(AOR = 3.55,95% CI:1.22, 10.29)、慢性病史(AOR = 4.61,95% CI:2.41,8.82)、积极态度(AOR = 3.16,95% CI:1.62,6.18)和对社会医疗保险计划的良好了解(AOR = 2.35,95% CI:1.17,4.72)更有可能支付社会医疗保险。超过一半的医疗服务提供者表示不愿意为社会医疗保险计划付费。因此,政府应就社会医疗保险计划的概念和原则开展宣传活动,以提高该计划的支付意愿。
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引用次数: 0
Rising Unscheduled Healthcare Utilisation of Children and Young People: How Does the Rise Vary Across Deprivation Quintiles in UK Nations? 儿童和青少年非计划医疗使用率的上升:英国不同贫困五分位数国家的上升情况如何?
IF 2.8 Q2 Medicine Pub Date : 2024-05-29 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241245235
Josip Plascevic, Joseph Ward, Russell M Viner, Dougal Hargreaves, Steve Turner

This retrospective population-based analysis assessed variations in urgent healthcare use by children and young people (CYP) across UK nations (England, Scotland and Wales) between 2007 and 2017. The study focused on urgent hospital admissions, short stay urgent admissions (SSUA) and Emergency Department (ED) attendances among CYP aged <25 years, stratified by age groups and Index of Multiple Deprivation (IMD) quintile groups. A linear mixed model was used to assess trends in healthcare activity over time and across deprivation quintiles. Urgent admissions, SSUA and ED attendances increased across all deprivation quintiles in all studied nations. Increasing deprivation was consistently associated with higher urgent healthcare utilisation. In England, the rise in urgent admissions and SSUA for CYP was slower for CYP from the quintile of greatest deprivation compared those from the least deprived quintile (respective mean differences 0.69/1000/y [95% CI 0.53, 0.85] and 0.25/1000/y [0.07, 0.42]), leading to a narrowing in health inequality. Conversely, in Scotland, urgent admissions and SSUA increased more rapidly for CYP from all deprivation quintiles, widening health inequality. Understanding the differences we describe here could inform changes to NHS pathways of care across the UK which slow the rise in urgent healthcare use for CYP.

这项基于人口的回顾性分析评估了 2007 年至 2017 年间英国各地区(英格兰、苏格兰和威尔士)儿童和青少年(CYP)使用紧急医疗服务的变化情况。研究重点关注以下年龄段儿童和青少年的紧急入院、短期紧急入院(SSUA)和急诊室就诊情况
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引用次数: 0
The Needs of Patients With Chronic Disease in Transitional Care From Hospital to Home in Sudan: A Qualitative Study. 苏丹慢性病患者从医院到家庭的过渡护理需求:定性研究。
IF 2.8 Q2 Medicine Pub Date : 2024-05-14 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241249282
Asma Mohamedsharif, Mayada Bastawi, Armin Gemperli

The growing burden of chronic non-communicable diseases demands improved post-discharge care. The Sudanese healthcare system faces challenges in providing coordinated care for patients with chronic conditions after hospital discharge. This qualitative study explored the experiences of patients with chronic disease in transitional care from hospital to home to identify improvement targets. Purposive sampling was used to interview 17 participants from different hospitals in Khartoum, Sudan. Audio recordings were transcribed and analyzed using principles of content analysis to identify themes and the relationship between them. Thematic analysis revealed 4 main themes describing the perceived needs of the patients. These were (1) feeling well-informed about post-discharge care goals and plans; (2) feeling cared for during hospital admission and follow-up visits; (3) feeling safe during the transitional care process; and (4) having access to follow-up services. This study highlights the importance of improving hospital patient education through effective communication to facilitate care transitions.

慢性非传染性疾病的负担日益加重,需要改善出院后的护理。苏丹医疗系统在为慢性病患者提供出院后的协调护理方面面临挑战。这项定性研究探讨了慢性病患者从医院到家庭的过渡护理经验,以确定改进目标。研究采用了目的取样法,对来自苏丹喀土穆不同医院的 17 名参与者进行了访谈。采用内容分析原则对录音进行了转录和分析,以确定主题和主题之间的关系。主题分析揭示了描述患者感知需求的 4 大主题。这四个主题分别是:(1)对出院后的护理目标和计划有充分的知情感;(2)在入院和复诊期间有被照顾的感觉;(3)在过渡性护理过程中有安全感;以及(4)能获得后续服务。本研究强调了通过有效沟通改善医院病人教育以促进护理过渡的重要性。
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引用次数: 0
Strengthening Public Financing of Primary Healthcare in India: A Perspective. 加强印度初级医疗保健的公共筹资:透视。
IF 2.8 Q2 Medicine Pub Date : 2024-05-10 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241249289
Rahul Sankrutyayan Reddy Kadarpeta, Jaidev Singh Anand, Grace Achungura

Resilient and high-performing health systems that can respond to the global polycrisis hinge upon the effectiveness of their primary healthcare (PHC) system. This requires adequate and sustainable financing for PHC, which should be predominantly government financed. The recent Ayushman Bharat health reforms in India aim to ensure comprehensive PHC services and enhance financial risk protection through increased government financing. The government has augmented investments to fortify the PHC system by establishing Health and Wellness Centers (HWCs), equipped with an expanded benefit package for PHC services & human resource capacity. Aligned with the National Health Mission's targeted and flexible financial mechanisms, this offers States the opportunity to contextualize solutions and offer incentives to healthcare workers. However, aligning public financing arrangements to service delivery complexities and health outcomes pose intricate challenges in shaping the required reforms. The economic growth and room for increased taxation on health products provide an avenue for increased funding. Smart and efficient payment mechanism with improved accountability should complement increased investment.

能够应对全球多重危机的具有复原力和高绩效的卫生系统取决于其初级卫生保健(PHC)系统的有效性。这就需要为初级卫生保健提供充足且可持续的资金,而初级卫生保健应主要由政府资助。印度最近进行的 Ayushman Bharat 医疗改革旨在确保提供全面的初级保健服务,并通过增加政府资助来加强财务风险保护。政府通过建立卫生与健康中心(HWCs),扩大初级保健服务的福利包和人力资源能力,加大了对初级保健系统的投资力度。根据国家卫生使命的目标和灵活的财政机制,这为各州提供了因地制宜的解决方案和激励医疗工作者的机会。然而,使公共财政安排与提供服务的复杂性和卫生成果相一致,对形成所需的改革构成了复杂的挑战。经济增长和增加保健产品税收的空间为增加资金提供了途径。精明高效的支付机制和更强的问责制应与增加的投资相辅相成。
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引用次数: 0
Understanding the Barriers and Facilitators of Digital Health Technology (DHT) Implementation in Neurological Rehabilitation: An Integrative Systematic Review. 了解神经康复领域实施数字健康技术(DHT)的障碍和促进因素:综合系统综述》。
IF 2.8 Q2 Medicine Pub Date : 2024-04-29 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241229917
Kathryn Jarvis, Clare Thetford, Edward Turck, Kelly Ogley, Rachel C Stockley

Background: Digital Health technologies (DHT) have potential to deliver intensive, novel and engaging rehabilitation for people with neurological conditions, yet health services lack a strong track record in embedding DHT into practice. The aim of this review was to synthesise factors that have been shown to influence implementation of DHT into neurological rehabilitation.

Method: An integrative review was undertaken. An extensive search of MEDLINE, CINAHL, AMED, EMBASE was undertaken. The title and abstract of all retrieved sources were screened against pre-defined criteria. Retained sources underwent full text review. The quality of all included sources was assessed. A meta-ethnographic synthesis explored commonalities and contradictions of the included studies.

Results: Fourteen studies (1 quantitative, 8 qualitative and 5 mixed methods) were included. Eleven implementation theories/models/frameworks were used across the 14 studies. Five themes were identified: (i) individual factors; (ii) user experience of the technology; (iii) the content of the intervention; (iv) access to the technology and (v) supporting use.

Conclusions: Key factors which appear to influence the implementation of DHT into clinical settings are highlighted. Implementation theories, models and frameworks are under-utilised in DHT rehabilitation research. This needs to be addressed if DHT are to realise their potential in neurological rehabilitation.

Registration: The protocol was registered and is available from PROSPERO (CRD42021268984).

背景:数字健康技术(DHT)具有为神经系统疾病患者提供密集、新颖和参与性康复的潜力,但医疗服务机构在将 DHT 融入实践方面却缺乏良好的记录。本综述旨在综合已被证明会影响神经康复中 DHT 实施的因素:方法:进行综合综述。对 MEDLINE、CINAHL、AMED 和 EMBASE 进行了广泛检索。根据预先设定的标准对所有检索到的资料的标题和摘要进行筛选。对保留下来的资料进行全文检索。对所有纳入资料的质量进行了评估。荟萃-人种学综述探讨了所纳入研究的共同点和矛盾点:结果:共纳入 14 项研究(1 项定量研究、8 项定性研究和 5 项混合方法研究)。14 项研究中使用了 11 种实施理论/模式/框架。确定了五个主题(i) 个人因素;(ii) 技术的用户体验;(iii) 干预内容;(iv) 获取技术和 (v) 支持使用:结论:强调了影响在临床环境中实施 DHT 的关键因素。在 DHT 康复研究中,实施理论、模型和框架未得到充分利用。要想发挥 DHT 在神经康复中的潜力,就必须解决这一问题:该方案已注册,可从 PROSPERO (CRD42021268984) 获取。
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引用次数: 0
Educational Nutritional Intervention Program for Adolescents Based on Social Cognitive Theory: Pilot Study of a Cluster Randomized Controlled Trial. 基于社会认知理论的青少年教育营养干预计划:集群随机对照试验的试点研究。
IF 2.8 Q2 Medicine Pub Date : 2024-04-26 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241249011
Ana Silvia Flores-Vázquez, Norma Patricia Rodríguez-Rocha, Gabriela Macedo-Ojeda

The eating habits of adolescents are often inadequate, with high consumption of unhealthy foods and low consumption of healthy foods. It is necessary to design and implement effective interventions to improve eating habits at this age and evaluate their feasibility, acceptability, and effectiveness. The use of theories for behavior change in health interventions favors the adoption of healthy behaviors. Due to this, the objective was set to determine the feasibility, acceptability, and effect on food consumption of a new educational nutritional intervention program for adolescents based on the Social Cognitive Theory (SCT) and supported by the Trans-theoretical Model (TTM) and identify areas of improvement in study design and intervention for future larger-scale studies. A pilot study of a cluster randomized controlled trial was conducted in adolescents of both sexes, 12 to 15 years of age, students from a public secondary school in Tonala, Jalisco, Mexico. The results show that a nutritional education intervention for adolescents, based on SCT and supported by the TTM, is feasible, acceptable, and with positive results in the modification of the consumption of ultra-processed foods, vegetables/fruits, and water. This pilot study identified some aspects that could be improved to enhance the effectiveness of the interventions in future studies.

青少年的饮食习惯往往不够好,不健康食品吃得多,健康食品吃得少。有必要设计和实施有效的干预措施来改善这个年龄段的饮食习惯,并评估其可行性、可接受性和有效性。在健康干预中使用行为改变理论有利于采纳健康行为。因此,我们的目标是确定一项基于社会认知理论(Social Cognitive Theory,SCT)并得到跨理论模型(Trans-theoretical Model,TTM)支持的新的青少年营养教育干预计划的可行性、可接受性和对食物消费的影响,并为未来更大规模的研究确定在研究设计和干预方面需要改进的地方。在墨西哥哈利斯科州托纳拉一所公立中学的 12 至 15 岁男女青少年中开展了一项分组随机对照试验的试点研究。结果表明,基于 SCT 并得到 TTM 支持的青少年营养教育干预是可行的、可接受的,并在改变超加工食品、蔬菜/水果和水的消费方面取得了积极成果。这项试点研究发现了一些可以改进的方面,以便在今后的研究中提高干预措施的效果。
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引用次数: 0
Exploring the Potential of a Multi-Level Approach to Advance the Development of the Medical Tourism Industry in Indonesia. 探索多层次方法的潜力,推动印度尼西亚医疗旅游产业的发展。
IF 2.8 Q2 Medicine Pub Date : 2024-04-09 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241245231
Supriadi, Badra Al Aufa, Ari Nurfikri, Ibrahim Isa Koire

Nowadays, the global medical tourism market size has grown quite rapidly, with a projected increase of 21.1% between 2021 and 2028. This study aimed to explore barriers and potential strategies for the development of medical tourism in Indonesia. A qualitative case study design was employed, where 8 respondents were selected using an expert sampling method from various groups according to the helix framework, including academics, government, professional organizations, the private sector, and the media. Data was collected through document analysis and in-depth interviews, and was analyzed manually using an inductive thematic content analysis approach. Limitations to the development of Indonesian medical tourism are related to regulations concerning medical tourism, the number of health services, distribution, supporting resources, public trust, and competition. At the institutional level, the challenges comprise services and products, hospital facilities, supporting facilities, and marketing processes. Furthermore, at the micro level, the low competency of both health and non-health workers persist as an obstacle. The potential strategy at the macro level include the development of robust marketing and branding strategies, health infrastructure, and resources. At the institutional level, it was necessary to develop related products and services provided, improve quality, and focus on branding and marketing strategies. Additionally, improving human resource skills was needed at the micro level.

如今,全球医疗旅游市场规模增长相当迅速,预计在2021年至2028年间将增长21.1%。本研究旨在探讨印度尼西亚发展医疗旅游的障碍和潜在策略。研究采用了定性案例研究设计,通过专家抽样法从不同群体(包括学术界、政府、专业组织、私营部门和媒体)中根据螺旋框架抽取了 8 名受访者。通过文件分析和深入访谈收集数据,并采用归纳式主题内容分析法进行人工分析。印尼医疗旅游发展的局限性与医疗旅游相关法规、医疗服务数量、分布、支持资源、公众信任和竞争有关。在制度层面,挑战包括服务和产品、医院设施、配套设施和营销流程。此外,在微观层面,医务人员和非医务人员的能力低下也是一个障碍。宏观层面的潜在战略包括制定强有力的营销和品牌战略、卫生基础设施和资源。在机构层面,有必要开发所提供的相关产品和服务,提高质量,并注重品牌和营销战略。此外,还需要在微观层面提高人力资源技能。
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引用次数: 0
Prevalence of Hepatitis B Virus Infection and Associated Factors Among High School Students in Shinshicho Town, Southern Ethiopia. 埃塞俄比亚南部 Shinshicho 镇高中生乙型肝炎病毒感染率及相关因素。
IF 2.8 Q2 Medicine Pub Date : 2024-04-08 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241245232
Desta Tadewos, Sebsibe Tadesse, Tekle Ejajo, Tegegn Tadesse

Background: Early identification of people living with hepatitis B virus infection is required to initiate treatment and care, prevent community transmission, and expand vaccination. However, only an estimated 10% of people living with chronic hepatitis B infection are diagnosed, and only 2% are on treatment globally. This study aimed to assess the prevalence of hepatitis B virus infection and its associated factors among high school students in Shinshicho Town, southern Ethiopia.

Methods: An institutional-based cross-sectional study was conducted among 380 high school students in Shinshicho Town, southern Ethiopia, from September to October 2022. A laboratory investigation of hepatitis B surface antigen was done to determine infection status. An odds ratio with a 95% confidence interval was used to declare statistical significance.

Results: The prevalence of hepatitis B virus infection among high school students in Shinshicho town was observed to be 7.6% (95% CI: 5.5, 10.5%). Age 20 to 24 years [AOR: 2.7; 95% CI: (1.0-7.0)], rural residence [AOR: 3.4; 95% CI: (1.3-8.9)], and history of unprotected drug injection [AOR: 11.3; 95% CI: (3.7-34.8)] were independently associated with hepatitis B virus infection.

Conclusion: A high prevalence of hepatitis B virus infection was observed among high school students in this study. Therefore, strengthening the school-based screen-and-treat program, especially targeting students from rural areas and young adults, and conducting awareness campaigns about the importance of practicing safe behaviors, such as avoiding unprotected drug injections, could contribute to the prevention and control of hepatitis B virus infection among high school students.

背景:要启动治疗和护理、防止社区传播并扩大疫苗接种范围,就必须及早发现乙型肝炎病毒感染者。然而,估计只有 10% 的慢性乙型肝炎感染者得到诊断,全球仅有 2% 的感染者在接受治疗。本研究旨在评估埃塞俄比亚南部新市镇高中生的乙型肝炎病毒感染率及其相关因素:方法:2022 年 9 月至 10 月,在埃塞俄比亚南部 Shinshicho 镇的 380 名高中生中开展了一项基于机构的横断面研究。对乙肝表面抗原进行了实验室调查,以确定感染状况。结果显示,乙型肝炎感染率为0.5%,而乙型肝炎表面抗原感染率为0.5%:新市町镇高中生的乙肝病毒感染率为 7.6%(95% CI:5.5%-10.5%)。20-24岁[AOR:2.7;95% CI:(1.0-7.0)]、农村居民[AOR:3.4;95% CI:(1.3-8.9)]和无保护注射毒品史[AOR:11.3;95% CI:(3.7-34.8)]与乙型肝炎病毒感染独立相关:结论:本研究观察到高中生中乙肝病毒感染率较高。因此,加强以学校为基础的筛查和治疗计划,尤其是针对农村地区的学生和青壮年,并开展有关安全行为重要性的宣传活动,如避免无保护的药物注射,将有助于预防和控制高中生的乙型肝炎病毒感染。
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引用次数: 0
Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis. 埃塞俄比亚医疗服务提供者对安全堕胎护理态度的决定因素:系统回顾与元分析》。
IF 2.8 Q2 Medicine Pub Date : 2024-04-06 eCollection Date: 2024-01-01 DOI: 10.1177/11786329241245218
Bikila Balis, Habtamu Bekele, Tegenu Balcha, Sisay Habte, Adera Debella, Ahmed Mohammed Husen, Ibsa Mussa, Fila Ahmed, Deribe Bekele, Abdi Amin, Addisu Alemu, Amalshet Getachew, Getachew Amare, Elias Yadeta, Abraham Negash, Magarsa Lami, Addis Eyeberu, Mohammed Abdurke Kure, Tamirat Getachew, Bajrond Eshetu

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia.

Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed.

Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias.

Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

背景:在包括埃塞俄比亚在内的发展中国家,不安全堕胎是一个严重的生殖健康问题。医护人员对人工流产的态度是导致不安全人工流产的因素之一。本研究旨在确定埃塞俄比亚医护人员对安全人工流产护理的态度及其决定因素的综合影响:使用 Scopus、CINAHL、EMBASE、PubMed、Web of Science 和 CAB Abstracts 等搜索引擎查找已发表的研究,并使用 Google 和 Google Scholar 查找未发表的研究。使用了《系统综述和元分析首选报告项目》(PRISMA)指南。使用 STATA 14 进行分析,并使用随机效应模型计算医务人员对安全堕胎服务态度的几率比。使用 I2 和 P 值评估研究的异质性。为了分别评估汇总值对异常值和发表偏倚的稳定性,还进行了敏感性分析和漏斗图:本综述共纳入了 15 篇已发表和未发表的文章,样本量为 4060 个。本研究汇总的总体患病率为 56%(95% CI:45-67)。参与者的性别(AOR:2.37;95% CI:1.57, 3.58)、是否接受过培训(AOR:2.86;95% CI:1.58, 5.17)、专业类型(AOR:1.55;95% CI:1.04, 4.46)和对堕胎法的了解(AOR:2.26;95% CI:1.14, 4.46)是与医护人员对安全堕胎护理的态度显著相关的决定因素。敏感性分析表明,在所有的荟萃分析中,汇总的几率比始终保持稳定,漏斗图显示没有证据表明存在出版偏倚:结论:在汇总研究中,有一半的医疗服务提供者对埃塞俄比亚的人工流产服务持赞成态度,这可能会阻碍妇女获得安全的人工流产护理。性别、培训、职业类型和对堕胎法的了解是医护人员对安全堕胎服务态度的决定因素。利益相关者应重视改善医护人员对安全堕胎护理的态度,这对降低孕产妇死亡率至关重要。此外,努力改变可改变的因素,如培训、指派专业与服务相符的人员、向医护人员提供有关堕胎法的最新信息等,也是改善医护人员提供服务意愿的关键点。
{"title":"Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Bikila Balis, Habtamu Bekele, Tegenu Balcha, Sisay Habte, Adera Debella, Ahmed Mohammed Husen, Ibsa Mussa, Fila Ahmed, Deribe Bekele, Abdi Amin, Addisu Alemu, Amalshet Getachew, Getachew Amare, Elias Yadeta, Abraham Negash, Magarsa Lami, Addis Eyeberu, Mohammed Abdurke Kure, Tamirat Getachew, Bajrond Eshetu","doi":"10.1177/11786329241245218","DOIUrl":"https://doi.org/10.1177/11786329241245218","url":null,"abstract":"<p><strong>Background: </strong>Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia.</p><p><strong>Methods: </strong>Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using <i>I</i><sup>2</sup> and <i>P</i>-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed.</p><p><strong>Results: </strong>A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias.</p><p><strong>Conclusion: </strong>Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10999111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Health Services Insights
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