Kwawukume Mawumenyo Aku, K. Mensah, Peter Twum, P. Agyei-Baffour, D. Opoku, J. K. Brenyah
Background. In the quest to prevent households from making catastrophic expenditures at the point of seeking healthcare, the government of Ghana introduced the National Health Insurance in 2003. However, people are reluctant to renew their membership. This study was, therefore, conducted to identify factors influencing the nonrenewal of National Health Insurance membership in the Ejisu-Juaben Municipality. Methods. A cross-sectional study was conducted among 427 respondents in the Ejisu-Juaben Municipality to ascertain factors influencing the nonrenewal of health insurance membership status. Data were entered and analyzed using Stata version 14. Univariate and multivariate analyses were performed to determine sociodemographic factors, household factors, and systemic factors influencing the nonrenewal of health insurance status. Statistical significance for all testing was set as p ≤ 0.05 . Results. Sociodemographic factors such as gender (AOR = 0.531; CI = 0.287–0.985) and educational level (AOR = 5.268; CI = 1.130–24.551)) were associated with the nonrenewal of health insurance membership. Income levels in Ghana Cedis were 500–1000 (AOR = 0.216; CI = 0.075–0.617) and 1001–2000 (AOR = 0.085; CI = 0.019–0.383). Systemic decision on factors such as clients’ satisfaction (AOR = 0.149; CI = 0.035–0.640), making copayment (AOR = 0.152; CI = 0,068–0.344), acquiring all prescribed drugs (AOR = 4.191; CI = 2.027–8.668), and awareness of mobile renewal (AOR = 3.139; CI = 1.462–6.739) was associated with nonrenewal of membership. Conclusions. The nonrenewal of health insurance membership was influenced by sociodemographic, household, and systemic factors. Therefore, the Municipal Health Directorate and the National Health Insurance Authority have to work on these factors to reach the target of 100% active coverage in the municipality.
{"title":"Factors Influencing Nonrenewal of Health Insurance Membership in Ejisu-Juaben Municipality of Ashanti Region, Ghana","authors":"Kwawukume Mawumenyo Aku, K. Mensah, Peter Twum, P. Agyei-Baffour, D. Opoku, J. K. Brenyah","doi":"10.1155/2021/5575822","DOIUrl":"https://doi.org/10.1155/2021/5575822","url":null,"abstract":"Background. In the quest to prevent households from making catastrophic expenditures at the point of seeking healthcare, the government of Ghana introduced the National Health Insurance in 2003. However, people are reluctant to renew their membership. This study was, therefore, conducted to identify factors influencing the nonrenewal of National Health Insurance membership in the Ejisu-Juaben Municipality. Methods. A cross-sectional study was conducted among 427 respondents in the Ejisu-Juaben Municipality to ascertain factors influencing the nonrenewal of health insurance membership status. Data were entered and analyzed using Stata version 14. Univariate and multivariate analyses were performed to determine sociodemographic factors, household factors, and systemic factors influencing the nonrenewal of health insurance status. Statistical significance for all testing was set as \u0000 \u0000 p\u0000 ≤\u0000 0.05\u0000 \u0000 . Results. Sociodemographic factors such as gender (AOR = 0.531; CI = 0.287–0.985) and educational level (AOR = 5.268; CI = 1.130–24.551)) were associated with the nonrenewal of health insurance membership. Income levels in Ghana Cedis were 500–1000 (AOR = 0.216; CI = 0.075–0.617) and 1001–2000 (AOR = 0.085; CI = 0.019–0.383). Systemic decision on factors such as clients’ satisfaction (AOR = 0.149; CI = 0.035–0.640), making copayment (AOR = 0.152; CI = 0,068–0.344), acquiring all prescribed drugs (AOR = 4.191; CI = 2.027–8.668), and awareness of mobile renewal (AOR = 3.139; CI = 1.462–6.739) was associated with nonrenewal of membership. Conclusions. The nonrenewal of health insurance membership was influenced by sociodemographic, household, and systemic factors. Therefore, the Municipal Health Directorate and the National Health Insurance Authority have to work on these factors to reach the target of 100% active coverage in the municipality.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"61 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81573639","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}
Government departments and scholars have focused on promoting health care for older adults in response to population aging and the annual increase in the number of older adults. Old age does not necessarily involve rapid health decline, fragility, or senility. Therefore, active aging among older adults has become a major consideration worldwide. The effect of exercise participation and social support on active aging warrants investigation. This study proposes a conceptual model for understanding the effects of exercise participation and social support on active aging among older adults. Exercise participation, social support, and health literacy were integrated to hypothesize a theoretical model of active aging among older adults. Furthermore, the moderating role of health literacy in the relationship between exercise participation, social support, and active aging was analyzed. Questionnaires were administered to respondents from Northern Taiwan during face-to-face interviews. Of the 1,800 distributed questionnaires, 1,586 completed questionnaires were received (response rate = 88.1%). The data collected were analyzed using structural equation modeling. The results indicated that exercise participation (β = 0.163, p = 0.000 ), social support (β = 0.384, p = 0.000 ), and health literacy (β = 0.360, p = 0.000 ) had significant positive effects on active aging. Health literacy did not moderate the effects of exercise participation and social support on active aging among older adults (β = −0.054, p = 0.197 and 0.061, p = 0.066 ). The current results confirm that social support has a considerable effect on active aging, which could be used as a reference for future proposals targeted at relevant institutions and older adults.
为了应对人口老龄化和老年人数量的逐年增加，政府部门和学者一直致力于促进老年人的医疗保健。老年并不一定包括健康迅速衰退、脆弱或衰老。因此，老年人的积极老龄化已成为世界范围内的一个主要考虑因素。运动参与和社会支持对积极老龄化的影响值得研究。本研究提出了一个概念模型来理解运动参与和社会支持对老年人积极老龄化的影响。运动参与、社会支持和健康素养被整合到假设老年人积极老龄化的理论模型中。此外，我们还分析了健康素养在运动参与、社会支持和积极老龄化之间的调节作用。本研究以面对面访谈的方式，对台湾北部地区的受访者进行问卷调查。在发放的1800份问卷中，共收到完成问卷1586份，回复率为88.1%。采用结构方程模型对收集到的数据进行分析。结果表明，运动参与(β = 0.163, p = 0.000)、社会支持(β = 0.384, p = 0.000)和健康素养(β = 0.360, p = 0.000)对主动老龄化有显著的正向影响。健康素养没有调节运动参与和社会支持对老年人积极老龄化的影响(β = - 0.054, p = 0.197和0.061,p = 0.066)。目前的研究结果证实，社会支持对积极老龄化有相当大的影响，可以为未来针对相关机构和老年人的建议提供参考。
{"title":"Relationship between Degree of Exercise Participation and Active Aging among Older Adults","authors":"Yung-Tzung Chang, Chen-Wei Yu, Cheng-Min Chao, Ru Chen","doi":"10.1155/2021/3418568","DOIUrl":"https://doi.org/10.1155/2021/3418568","url":null,"abstract":"Government departments and scholars have focused on promoting health care for older adults in response to population aging and the annual increase in the number of older adults. Old age does not necessarily involve rapid health decline, fragility, or senility. Therefore, active aging among older adults has become a major consideration worldwide. The effect of exercise participation and social support on active aging warrants investigation. This study proposes a conceptual model for understanding the effects of exercise participation and social support on active aging among older adults. Exercise participation, social support, and health literacy were integrated to hypothesize a theoretical model of active aging among older adults. Furthermore, the moderating role of health literacy in the relationship between exercise participation, social support, and active aging was analyzed. Questionnaires were administered to respondents from Northern Taiwan during face-to-face interviews. Of the 1,800 distributed questionnaires, 1,586 completed questionnaires were received (response rate = 88.1%). The data collected were analyzed using structural equation modeling. The results indicated that exercise participation (β = 0.163, \u0000 \u0000 p\u0000 =\u0000 0.000\u0000 \u0000 ), social support (β = 0.384, \u0000 \u0000 p\u0000 =\u0000 0.000\u0000 \u0000 ), and health literacy (β = 0.360, \u0000 \u0000 p\u0000 =\u0000 0.000\u0000 \u0000 ) had significant positive effects on active aging. Health literacy did not moderate the effects of exercise participation and social support on active aging among older adults (β = −0.054, \u0000 \u0000 p\u0000 =\u0000 0.197\u0000 \u0000 and 0.061, \u0000 \u0000 p\u0000 =\u0000 0.066\u0000 \u0000 ). The current results confirm that social support has a considerable effect on active aging, which could be used as a reference for future proposals targeted at relevant institutions and older adults.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"27 1","pages":"1-7"},"PeriodicalIF":4.1,"publicationDate":"2021-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89898636","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 : 2021-03-12DOI: 10.1101/2021.03.11.21253374
M. Agyekum, Grace Frempong Afrifa-Anane, F. Kyei-Arthur, Bright Addo
The acceptance or otherwise of the COVID-19 vaccine by health care workers can influence the uptake of COVID-19 vaccines among the general population as they are a reliable source of health information. In this study, we sought to determine the acceptability of COVID-19 vaccines among health care workers in Ghana. Using a cross-sectional design, we collected data from 234 health care workers through a self-administered online survey from 16 January to 15 February 2021. Descriptive, bivariate and multivariate analyses using binary logistic regression were performed using STATA version 15. The results showed that 39.3% of health care workers had the intention of receiving the COVID-19 vaccine. Factors such as sex, category of health care workers, relative being diagnosed with COVID-19, and trust in the accuracy of the measures taken by the government in the fight against COVID-19 proved to be significant predictors of the acceptability of the COVID-19 vaccine. Concerns about the safety of vaccines and the adverse side effects of the vaccine were identified as the main reasons why health care workers would decline uptake of the COVID-19 vaccine in Ghana. The self-reported low intention of health care workers to accept the COVID-19 vaccine in Ghana requires the urgent call of the Government of Ghana and other stakeholders to critically address health care workers' concerns about the safety and adverse side effects of COVID-19 vaccines, as this would increase vaccine uptake. Interventions must also take into consideration sex and the category of health care workers to achieve the desired results. Keywords: COVID-19, Vaccines, Vaccine acceptance, Health care workers, Ghana
卫生保健工作者是否接受COVID-19疫苗会影响普通人群对COVID-19疫苗的接受，因为它们是可靠的卫生信息来源。在本研究中，我们试图确定加纳卫生保健工作者对COVID-19疫苗的可接受性。采用横断面设计，我们从2021年1月16日至2月15日通过自我管理的在线调查收集了234名卫生保健工作者的数据。使用STATA version 15进行描述性、双变量和多变量分析，采用二元逻辑回归。结果显示，39.3%的医护人员有接种COVID-19疫苗的意向。性别、医护人员类别、被诊断为COVID-19的亲属以及对政府在抗击COVID-19中采取的措施的准确性的信任等因素被证明是COVID-19疫苗可接受性的重要预测因素。对疫苗安全性和疫苗不良副作用的担忧被确定为加纳卫生保健工作者减少接种COVID-19疫苗的主要原因。加纳卫生保健工作者自我报告接受COVID-19疫苗的意愿较低，这要求加纳政府和其他利益攸关方紧急呼吁解决卫生保健工作者对COVID-19疫苗的安全性和不良副作用的担忧，因为这将增加疫苗的吸收率。干预措施还必须考虑到性别和保健工作者的类别，以实现预期的结果。关键词:COVID-19，疫苗，疫苗接受，医护人员，加纳
{"title":"Acceptability of COVID-19 vaccination among health care workers in Ghana","authors":"M. Agyekum, Grace Frempong Afrifa-Anane, F. Kyei-Arthur, Bright Addo","doi":"10.1101/2021.03.11.21253374","DOIUrl":"https://doi.org/10.1101/2021.03.11.21253374","url":null,"abstract":"The acceptance or otherwise of the COVID-19 vaccine by health care workers can influence the uptake of COVID-19 vaccines among the general population as they are a reliable source of health information. In this study, we sought to determine the acceptability of COVID-19 vaccines among health care workers in Ghana. Using a cross-sectional design, we collected data from 234 health care workers through a self-administered online survey from 16 January to 15 February 2021. Descriptive, bivariate and multivariate analyses using binary logistic regression were performed using STATA version 15. The results showed that 39.3% of health care workers had the intention of receiving the COVID-19 vaccine. Factors such as sex, category of health care workers, relative being diagnosed with COVID-19, and trust in the accuracy of the measures taken by the government in the fight against COVID-19 proved to be significant predictors of the acceptability of the COVID-19 vaccine. Concerns about the safety of vaccines and the adverse side effects of the vaccine were identified as the main reasons why health care workers would decline uptake of the COVID-19 vaccine in Ghana. The self-reported low intention of health care workers to accept the COVID-19 vaccine in Ghana requires the urgent call of the Government of Ghana and other stakeholders to critically address health care workers' concerns about the safety and adverse side effects of COVID-19 vaccines, as this would increase vaccine uptake. Interventions must also take into consideration sex and the category of health care workers to achieve the desired results. Keywords: COVID-19, Vaccines, Vaccine acceptance, Health care workers, Ghana","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"43 1","pages":"1-8"},"PeriodicalIF":4.1,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86304643","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}
H. Temesgen, A. Negesse, Temesgen Getaneh, Y. Bazezew, Dessalegn Haile, Wubetu Woyraw, Melaku Desta, Alehegn Aderaw Alamneh
Background. Infant and young child feeding in the context of human immunodeficiency virus- (HIV-) infected mothers has significant challenges due to the risk of transmission of the virus via breastfeeding. In Ethiopia, a number of independent studies have been conducted to assess the feeding practice of HIV-exposed infants. But, there is no concrete evidence to show the national figure in Ethiopia. Hence, this review and meta-analysis aims to estimate the pooled prevalence of feeding practices among HIV exposed infants in Ethiopia. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. Articles were searched through search engines in PubMed, Cochrane Library, Google Scholar, and direct Google search. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment. The random effects model was used to estimate the pooled prevalence of infant feeding practices. Heterogeneity and publication bias were assessed. Trim and fill analysis was performed. Additionally, meta-regression was also performed. Results. In this review, a total of 26, 22, and 22 studies and 7413, 6224, and 6222 study participants for exclusive breastfeeding, replacement feeding, and mixed feelings were included, respectively. The overall pooled prevalence of exclusive breastfeeding, replacement feeding, and mixed feeding of HIV exposed infant was 63.99 % (95% Confidence Interval (CI): 52.32, 75.66), 16.13% (95% CI: 11.92, 20.32), and 20.95% (95% CI: 11.35, 30.58)) in Ethiopia, respectively. Conclusion and Recommendations. In Ethiopia, almost three in five HIV-exposed infants were exclusively breastfed. But still, mixed feeding during the period of first 6 months was practiced in almost one-fifth of the exposed infants in Ethiopia. Additionally, replacement feeding was also practiced even though not recommended for developing countries. Therefore, the government of Ethiopia should strengthen the health institutions to implement the existing infant feeding strategies and guidelines to increase exclusive breastfeeding for the first 6 months and to avoid mixed feeding during the periods of six months.
{"title":"Feeding Practices among Human Immunodeficiency Virus-Exposed Infants in Ethiopia: Systematic Review and Meta-Analysis","authors":"H. Temesgen, A. Negesse, Temesgen Getaneh, Y. Bazezew, Dessalegn Haile, Wubetu Woyraw, Melaku Desta, Alehegn Aderaw Alamneh","doi":"10.1155/2021/9068074","DOIUrl":"https://doi.org/10.1155/2021/9068074","url":null,"abstract":"Background. Infant and young child feeding in the context of human immunodeficiency virus- (HIV-) infected mothers has significant challenges due to the risk of transmission of the virus via breastfeeding. In Ethiopia, a number of independent studies have been conducted to assess the feeding practice of HIV-exposed infants. But, there is no concrete evidence to show the national figure in Ethiopia. Hence, this review and meta-analysis aims to estimate the pooled prevalence of feeding practices among HIV exposed infants in Ethiopia. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. Articles were searched through search engines in PubMed, Cochrane Library, Google Scholar, and direct Google search. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment. The random effects model was used to estimate the pooled prevalence of infant feeding practices. Heterogeneity and publication bias were assessed. Trim and fill analysis was performed. Additionally, meta-regression was also performed. Results. In this review, a total of 26, 22, and 22 studies and 7413, 6224, and 6222 study participants for exclusive breastfeeding, replacement feeding, and mixed feelings were included, respectively. The overall pooled prevalence of exclusive breastfeeding, replacement feeding, and mixed feeding of HIV exposed infant was 63.99 % (95% Confidence Interval (CI): 52.32, 75.66), 16.13% (95% CI: 11.92, 20.32), and 20.95% (95% CI: 11.35, 30.58)) in Ethiopia, respectively. Conclusion and Recommendations. In Ethiopia, almost three in five HIV-exposed infants were exclusively breastfed. But still, mixed feeding during the period of first 6 months was practiced in almost one-fifth of the exposed infants in Ethiopia. Additionally, replacement feeding was also practiced even though not recommended for developing countries. Therefore, the government of Ethiopia should strengthen the health institutions to implement the existing infant feeding strategies and guidelines to increase exclusive breastfeeding for the first 6 months and to avoid mixed feeding during the periods of six months.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79435112","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}
Yosef Wasihun, T. Mekonnen, Anemaw A. Asrat, Samuel Dagne, Yonatan Menber, Netsanet Fentahun
Background. Second-trimester medical abortion is the termination of pregnancy between 13 and 28 weeks of gestational age. Although the majority of abortions are performed in the first trimester, 10–15% of terminations of pregnancies have taken place in the second trimester globally. Objective. To identify the determinant factors of second-trimester safe termination of pregnancy in public health facilities of the Amhara region, northwest Ethiopia. Methods. An institution-based unmatched retrospective case-control study conducted from 01/10/2019–30/02/2020. A systematic random sampling technique was used to select 119 cases and 238 controls. An interviewer-administered questionnaire was used to collect the data. A binary logistic regression model was fitted to identify determinant factors. The odds ratio with 95% CI was computed to assess the strength and significance of the association between dependent and independent variables. Result. Rural resident (adjusted odds ratio (AOR) = 1.9; 95% CI 1.07–3.25), irregular menses (AOR = 1.8; 1.06–3.13), had no known symptoms of pregnancy (AOR = 1.9; (95% CI 1.06–3.46)), not knowing the abortion law (AOR = 3.0; (95% CI 1.63–5.60)), low level of education (1st–8th grade) (AOR = 2.7; (95% CI 1.06–6.60), opposition against abortion care (AOR = 2.6; (1.22–5.42)), delayed referral (AOR = 10.1 (95% CI 4.02–29.18)), and not undertaking pregnancy test (AOR = 2.2; (95% CI (1.21–4.04)) were determinants of second-trimester safe termination of pregnancy. Conclusion. Women being rural residents, irregular menses, not undertaking pregnancy test, not knowing the abortion law, low-level educational status, delayed referral, no knowledge about signs and symptoms of pregnancy, and opposition of safe abortion were determinants of second-trimester safe termination. The Regional Health Bureau and Health Facilities should give emphasis to women living in rural areas, and they should increase awareness towards abortion law and sign and symptoms of pregnancy and encourage female education.
背景。妊娠中期药物流产是指在孕周13至28周之间终止妊娠。虽然大多数堕胎发生在妊娠的前三个月，但全球10-15%的终止妊娠发生在妊娠的第二个三个月。目标。确定在埃塞俄比亚西北部阿姆哈拉地区公共卫生设施中妊娠中期安全终止妊娠的决定因素。方法。2019年10月1日至2020年2月30日进行的一项基于机构的回顾性病例对照研究。采用系统随机抽样方法，选取119例病例和238例对照。使用访谈者填写的问卷来收集数据。二元逻辑回归模型拟合确定决定因素。计算95% CI的比值比来评估因变量和自变量之间关联的强度和显著性。结果。农村居民(调整优势比(AOR) = 1.9;95% CI 1.07-3.25)，月经不规律(AOR = 1.8;1.06-3.13)，无已知妊娠症状(AOR = 1.9;(95% CI 1.06-3.46))，不了解堕胎法(AOR = 3.0;(95% CI 1.63-5.60))，低教育水平(1 - 8年级)(AOR = 2.7;(95% CI 1.06-6.60)，反对堕胎护理(AOR = 2.6;(1.22-5.42))、延迟转诊(AOR = 10.1 (95% CI 4.02-29.18))和未进行妊娠试验(AOR = 2.2;(95% CI(1.21-4.04))是中期妊娠安全终止的决定因素。结论。农村妇女、月经不规律、不做妊娠检查、不了解堕胎法、教育程度低、转诊延迟、不了解妊娠体征和症状、反对安全堕胎是导致中期妊娠安全终止的决定因素。地区卫生局和卫生设施应重视农村地区的妇女，提高对堕胎法和怀孕体征和症状的认识，并鼓励对妇女进行教育。
{"title":"Determinants of Second-Trimester Safe Termination of Pregnancy in Public Health Facilities of Amhara Region, Northwest Ethiopia: An Unmatched Case-Control Study","authors":"Yosef Wasihun, T. Mekonnen, Anemaw A. Asrat, Samuel Dagne, Yonatan Menber, Netsanet Fentahun","doi":"10.1155/2021/8832529","DOIUrl":"https://doi.org/10.1155/2021/8832529","url":null,"abstract":"Background. Second-trimester medical abortion is the termination of pregnancy between 13 and 28 weeks of gestational age. Although the majority of abortions are performed in the first trimester, 10–15% of terminations of pregnancies have taken place in the second trimester globally. Objective. To identify the determinant factors of second-trimester safe termination of pregnancy in public health facilities of the Amhara region, northwest Ethiopia. Methods. An institution-based unmatched retrospective case-control study conducted from 01/10/2019–30/02/2020. A systematic random sampling technique was used to select 119 cases and 238 controls. An interviewer-administered questionnaire was used to collect the data. A binary logistic regression model was fitted to identify determinant factors. The odds ratio with 95% CI was computed to assess the strength and significance of the association between dependent and independent variables. Result. Rural resident (adjusted odds ratio (AOR) = 1.9; 95% CI 1.07–3.25), irregular menses (AOR = 1.8; 1.06–3.13), had no known symptoms of pregnancy (AOR = 1.9; (95% CI 1.06–3.46)), not knowing the abortion law (AOR = 3.0; (95% CI 1.63–5.60)), low level of education (1st–8th grade) (AOR = 2.7; (95% CI 1.06–6.60), opposition against abortion care (AOR = 2.6; (1.22–5.42)), delayed referral (AOR = 10.1 (95% CI 4.02–29.18)), and not undertaking pregnancy test (AOR = 2.2; (95% CI (1.21–4.04)) were determinants of second-trimester safe termination of pregnancy. Conclusion. Women being rural residents, irregular menses, not undertaking pregnancy test, not knowing the abortion law, low-level educational status, delayed referral, no knowledge about signs and symptoms of pregnancy, and opposition of safe abortion were determinants of second-trimester safe termination. The Regional Health Bureau and Health Facilities should give emphasis to women living in rural areas, and they should increase awareness towards abortion law and sign and symptoms of pregnancy and encourage female education.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73259317","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}
Background. Legal abortion is a challenge from the viewpoint of ethics and religion. The present study was conducted to investigate the frequency of fetal and maternal indications of legal abortion and also the maternal characteristics in Lorestan Province of Iran. Methods. As a descriptive cross-sectional study, all the cases with issued permits for legal abortion were selected by a census during 2017–2019. Descriptive data analysis was used to report the results. Event rates with Poisson 95% confidence intervals (CIs) were calculated based on the regional population. Results. A total of 305 cases were selected. The mean age of the mothers was 31.61 ± 7.48 years, and the mean of gestational age was 15.76 ± 2.80 weeks. Demographically, most cases were from Khorramabad city (101 cases) followed by Borujerd (51 cases) and Doroud (46 cases). The overall event rate was 1.732 per 10,000 individuals (95% CI: 1.543–1.938) of the general population of the region per 3 years. Fetal disturbance of the brain and spine was the most prevalent reason of abortion (24.92%, 95% CI: 19.63%–31.19%) followed by Down syndrome (19.34%, 95% CI: 14.73%–24.95), hydrops fetalis (12.79%, 95% CI: 9.09%–17.48%), and anencephaly (12.79%, 95% CI: 9.09%–17.48%). Conclusion. From each 10,000 individuals of the population, one to two cases of legal abortion were screened per 3 years. More than 90% of cases had fetal indication. In cities with lower event rates, we should plan for better screening.
{"title":"Characteristics and Indications of Legal Abortion among the Pregnant Women in Lorestan Province of Iran during 2017–2019","authors":"Z. Fatemi, S. Akbari","doi":"10.1155/2020/8816785","DOIUrl":"https://doi.org/10.1155/2020/8816785","url":null,"abstract":"Background. Legal abortion is a challenge from the viewpoint of ethics and religion. The present study was conducted to investigate the frequency of fetal and maternal indications of legal abortion and also the maternal characteristics in Lorestan Province of Iran. Methods. As a descriptive cross-sectional study, all the cases with issued permits for legal abortion were selected by a census during 2017–2019. Descriptive data analysis was used to report the results. Event rates with Poisson 95% confidence intervals (CIs) were calculated based on the regional population. Results. A total of 305 cases were selected. The mean age of the mothers was 31.61 ± 7.48 years, and the mean of gestational age was 15.76 ± 2.80 weeks. Demographically, most cases were from Khorramabad city (101 cases) followed by Borujerd (51 cases) and Doroud (46 cases). The overall event rate was 1.732 per 10,000 individuals (95% CI: 1.543–1.938) of the general population of the region per 3 years. Fetal disturbance of the brain and spine was the most prevalent reason of abortion (24.92%, 95% CI: 19.63%–31.19%) followed by Down syndrome (19.34%, 95% CI: 14.73%–24.95), hydrops fetalis (12.79%, 95% CI: 9.09%–17.48%), and anencephaly (12.79%, 95% CI: 9.09%–17.48%). Conclusion. From each 10,000 individuals of the population, one to two cases of legal abortion were screened per 3 years. More than 90% of cases had fetal indication. In cities with lower event rates, we should plan for better screening.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"13 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90715211","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}
Background. Many adolescent girls in developing countries lack appropriate information, means or materials, and access to the right sanitary facilities to manage menstruation. Hence, they adopted unsafe hygienic practices during menstruation that in turn has a negative impact on their dignity, health, and education. Thus, this study aimed to assess the practices of menstrual hygiene management and associated factors among secondary school girls in East Hararghe Zone. Methods. A school-based cross-sectional study was conducted from April to May 2017 among secondary school girls in East Hararghe Zone, Eastern Ethiopia. A total of 672 girls were selected randomly and interviewed using a structured interviewer-administered questionnaire. Logistic regression analysis was employed to identify predictors of good menstrual hygiene management practices. Result. Overall, 58.3% of the girls had good menstrual hygiene management practices. Around two-thirds (66.1%) of them used commercial sanitary pads as absorbents, 56.4% changed sanitary materials more than three times a day, and 68.3% cleaned their external genitalia daily during their menstruation. During multivariate analysis, living in urban areas (AOR = 2.59, 95% CI: 1.77, 3.80), having moderate (AOR = 2.78, 95% CI: 1.64, 5.28) and good knowledge about menstruation (AOR = 3.87, 95% CI: 2.21, 6.77), and mothers’ secondary and above education (AOR = 1.83, 95% CI: 1.01, 3.30) showed a positively significant association with good menstrual hygiene management practices. Conclusion. In this study, the practice of good menstrual hygiene management of secondary schoolgirls was low. Factors independently influencing menstrual hygiene management practices were girls’ place of residence, knowledge status of menstruation and its hygiene management, and mothers’ educational status. This highlights a need for targeted interventions to raise awareness of school girls especially for rural residents and the public in general to improve the knowledge and practices of menstrual hygiene management.
{"title":"Menstrual Hygiene Management Practices and Associated Factors among Secondary School Girls in East Hararghe Zone, Eastern Ethiopia","authors":"Hussein Mohammed Gena","doi":"10.1155/2020/8938615","DOIUrl":"https://doi.org/10.1155/2020/8938615","url":null,"abstract":"Background. Many adolescent girls in developing countries lack appropriate information, means or materials, and access to the right sanitary facilities to manage menstruation. Hence, they adopted unsafe hygienic practices during menstruation that in turn has a negative impact on their dignity, health, and education. Thus, this study aimed to assess the practices of menstrual hygiene management and associated factors among secondary school girls in East Hararghe Zone. Methods. A school-based cross-sectional study was conducted from April to May 2017 among secondary school girls in East Hararghe Zone, Eastern Ethiopia. A total of 672 girls were selected randomly and interviewed using a structured interviewer-administered questionnaire. Logistic regression analysis was employed to identify predictors of good menstrual hygiene management practices. Result. Overall, 58.3% of the girls had good menstrual hygiene management practices. Around two-thirds (66.1%) of them used commercial sanitary pads as absorbents, 56.4% changed sanitary materials more than three times a day, and 68.3% cleaned their external genitalia daily during their menstruation. During multivariate analysis, living in urban areas (AOR = 2.59, 95% CI: 1.77, 3.80), having moderate (AOR = 2.78, 95% CI: 1.64, 5.28) and good knowledge about menstruation (AOR = 3.87, 95% CI: 2.21, 6.77), and mothers’ secondary and above education (AOR = 1.83, 95% CI: 1.01, 3.30) showed a positively significant association with good menstrual hygiene management practices. Conclusion. In this study, the practice of good menstrual hygiene management of secondary schoolgirls was low. Factors independently influencing menstrual hygiene management practices were girls’ place of residence, knowledge status of menstruation and its hygiene management, and mothers’ educational status. This highlights a need for targeted interventions to raise awareness of school girls especially for rural residents and the public in general to improve the knowledge and practices of menstrual hygiene management.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"48 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83707225","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}
Globally, the HIV/AIDS pandemic continues to have an enormous impact on affected societies. Despite several health promotion interventions being carried out, HIV/AIDS remains a major cause of deaths in low and middle income countries. At the workplace, the pandemic has brought about reduction in productivity, increased staff turnover, increased production costs, high levels of stigma, etc. HIV stigma is one of the main reasons why the pandemic has continued to devastate a number of societies around the world. HIV stigma presents barriers to HIV prevention in different settings including the workplace. Unlike large enterprises, small-scale enterprises have received less attention in the fight against HIV/AIDS. This study’s purpose was to explore how employers and employees can overcome challenges of HIV-related stigma at the workplace. This study employed a qualitative case study design. Data were collected from eighteen participants in three small-scale enterprises in Kabale. Findings indicate that small-scale enterprises are faced with the fear of HIV testing, status disclosure, staff turnover, suicidal thoughts, gossip, etc. Implementing operative national HIV workplace policies may enable small-scale enterprises to overcome challenges of HIV-related stigma at the workplace.
{"title":"Exploring HIV-Related Stigma and Discrimination at the Workplace in Southwestern Uganda: Challenges and Solutions","authors":"B. Twinomugisha, F. G. Ottemöller, M. Daniel","doi":"10.1155/2020/8833166","DOIUrl":"https://doi.org/10.1155/2020/8833166","url":null,"abstract":"Globally, the HIV/AIDS pandemic continues to have an enormous impact on affected societies. Despite several health promotion interventions being carried out, HIV/AIDS remains a major cause of deaths in low and middle income countries. At the workplace, the pandemic has brought about reduction in productivity, increased staff turnover, increased production costs, high levels of stigma, etc. HIV stigma is one of the main reasons why the pandemic has continued to devastate a number of societies around the world. HIV stigma presents barriers to HIV prevention in different settings including the workplace. Unlike large enterprises, small-scale enterprises have received less attention in the fight against HIV/AIDS. This study’s purpose was to explore how employers and employees can overcome challenges of HIV-related stigma at the workplace. This study employed a qualitative case study design. Data were collected from eighteen participants in three small-scale enterprises in Kabale. Findings indicate that small-scale enterprises are faced with the fear of HIV testing, status disclosure, staff turnover, suicidal thoughts, gossip, etc. Implementing operative national HIV workplace policies may enable small-scale enterprises to overcome challenges of HIV-related stigma at the workplace.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"29 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77542775","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 : 2020-10-02DOI: 10.21203/rs.3.rs-85009/v1
Belay Belete Anjullo, D. Teni
Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count.
{"title":"Linear Mixed Modeling of CD4 Cell Counts of HIV-Infected Children Treated with Antiretroviral Therapy","authors":"Belay Belete Anjullo, D. Teni","doi":"10.21203/rs.3.rs-85009/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-85009/v1","url":null,"abstract":"Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"19 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88833766","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}
Nuradin Abusha Katiso, G. Kassa, G. Fekadu, Abadi Kidanemariam Berhe, A. Muche
Introduction. Low birth weight (LBW) is the most significant risk factor for neonatal and infant mortality. It is one of the major public health problems in developing countries. Although there are various studies on low birth weight, findings were inconsistent and inconclusive. Therefore, this study was conducted to estimate the national-pooled prevalence of low birth weight and its associated factors in Ethiopia. Method. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. This meta-analysis employed a review of both published and unpublished studies conducted in Ethiopia. The databases used were PubMed, Google Scholar, CINAHL, and African Journals Online. Relevant search terms for prevalence and determinants of LBW were used to retrieve articles. The meta-analysis was conducted using STATA 14 software. Forest plots were used to present the findings. The Cochran Q test and I2 test statistics were used to test heterogeneity across studies. Egger’s test was used to assess the publication bias of included studies. The pooled prevalence and the odds ratios (OR) with 95% confidence intervals (CI) were computed and were presented using forest plots. Results. A total of 28 studies, 50,110 newborn babies, were included in this meta-analysis. The pooled prevalence of LBW in Ethiopia was 14.1% (95% CI = 11.2, 17.1). Higher variation in the prevalence of LBW in different regions across the country was observed. Significant association of LBW with sex of the newborn baby, higher odds among female babies (OR = 1.5 (95% CI = 1.2, 1.7)), prematurity (OR = 4.7 (95% CI = 1.5, 14.5)), not attending prenatal care (OR = 1.7 (95% CI = 1.4, 2.2)), pregnancy-induced hypertension (OR = 6.7 (95% CI = 3.5, 12.9)), and newborn babies whose mothers were from rural areas (OR = 1.8 (95% CI = 1.2, 2.6) were the factors associated with low birth weight. Conclusions. The prevalence of LBW in Ethiopia was high. LBW was associated with several maternal and newborn characteristics. The large disparity of LBW among the different regions in the country needs targeted intervention in areas with higher prevalence. Particular emphasis should be given to mothers residing in rural areas. Community-based programs are important to increase the use of prenatal care.
介绍。低出生体重(LBW)是新生儿和婴儿死亡最重要的危险因素。它是发展中国家的主要公共卫生问题之一。尽管对低出生体重有各种各样的研究，但研究结果并不一致，也没有定论。因此，本研究旨在估计埃塞俄比亚低出生体重的全国流行率及其相关因素。方法。遵循系统评价和荟萃分析首选报告项目(PRISMA)指南。本荟萃分析对在埃塞俄比亚进行的已发表和未发表的研究进行了回顾。使用的数据库包括PubMed、Google Scholar、CINAHL和African Journals Online。使用LBW患病率和决定因素的相关搜索词检索文章。meta分析采用STATA 14软件进行。研究结果采用了森林样地。采用Cochran Q检验和I2检验统计量检验各研究的异质性。Egger检验用于评估纳入研究的发表偏倚。计算合并患病率和95%可信区间(CI)的比值比(OR)，并使用森林图表示。结果。这项荟萃分析共纳入了28项研究，50,110名新生儿。埃塞俄比亚LBW的总患病率为14.1% (95% CI = 11.2, 17.1)。观察到全国不同地区的LBW患病率差异较大。重要的激光焊与性有关的新生儿,更高的几率在女性婴儿(或= 1.5 (95% CI = 1.2, 1.7),早产(或= 4.7 (95% CI = 1.5, 14.5),不参加产前护理(或= 1.7 (95% CI = 1.4, 2.2),妊娠高血压综合症(或= 6.7 (95% CI = 3.5, 12.9),和新生婴儿的母亲在农村地区(或= 1.8 (95% CI = 1.2, 2.6)与低出生体重相关的因素。结论。埃塞俄比亚的LBW患病率很高。LBW与产妇和新生儿的一些特征有关。由于该国不同地区的低体重状况差异很大，需要在发病率较高的地区进行有针对性的干预。应特别强调居住在农村地区的母亲。以社区为基础的项目对于增加产前护理的使用非常重要。
{"title":"Prevalence and Determinants of Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis","authors":"Nuradin Abusha Katiso, G. Kassa, G. Fekadu, Abadi Kidanemariam Berhe, A. Muche","doi":"10.1155/2020/7589483","DOIUrl":"https://doi.org/10.1155/2020/7589483","url":null,"abstract":"Introduction. Low birth weight (LBW) is the most significant risk factor for neonatal and infant mortality. It is one of the major public health problems in developing countries. Although there are various studies on low birth weight, findings were inconsistent and inconclusive. Therefore, this study was conducted to estimate the national-pooled prevalence of low birth weight and its associated factors in Ethiopia. Method. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. This meta-analysis employed a review of both published and unpublished studies conducted in Ethiopia. The databases used were PubMed, Google Scholar, CINAHL, and African Journals Online. Relevant search terms for prevalence and determinants of LBW were used to retrieve articles. The meta-analysis was conducted using STATA 14 software. Forest plots were used to present the findings. The Cochran Q test and I2 test statistics were used to test heterogeneity across studies. Egger’s test was used to assess the publication bias of included studies. The pooled prevalence and the odds ratios (OR) with 95% confidence intervals (CI) were computed and were presented using forest plots. Results. A total of 28 studies, 50,110 newborn babies, were included in this meta-analysis. The pooled prevalence of LBW in Ethiopia was 14.1% (95% CI = 11.2, 17.1). Higher variation in the prevalence of LBW in different regions across the country was observed. Significant association of LBW with sex of the newborn baby, higher odds among female babies (OR = 1.5 (95% CI = 1.2, 1.7)), prematurity (OR = 4.7 (95% CI = 1.5, 14.5)), not attending prenatal care (OR = 1.7 (95% CI = 1.4, 2.2)), pregnancy-induced hypertension (OR = 6.7 (95% CI = 3.5, 12.9)), and newborn babies whose mothers were from rural areas (OR = 1.8 (95% CI = 1.2, 2.6) were the factors associated with low birth weight. Conclusions. The prevalence of LBW in Ethiopia was high. LBW was associated with several maternal and newborn characteristics. The large disparity of LBW among the different regions in the country needs targeted intervention in areas with higher prevalence. Particular emphasis should be given to mothers residing in rural areas. Community-based programs are important to increase the use of prenatal care.","PeriodicalId":30619,"journal":{"name":"Advances in Public Health","volume":"3 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79652529","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}
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