WHO South-East Asia journal of public health最新文献

Background: Children's growth is essential to nutritional status and population health. In 2015, 18.9% of under-five children in Myanmar were underweight, and only 25% of 6-23-month-old children had the minimum dietary diversity (MDD).

Objectives: We conducted this study to assess the association between mother's dietary diversity score (DDS) and underweight among under-five children.

Materials and methods: This study analyzed data from the "Livelihood and Food Security Survey," a cross-sectional study conducted in 2016 in rural areas in Chin State, Magway, and Ayeyarwady regions. It included 2029 under-five children and used underweight as an outcome variable. We calculated DDSs for mothers of under-five children using the MDD-women methodology. The prevalence of underweight and MDD were estimated. A multivariable binary logistic regression analysis estimated odds ratios and 95% confidence intervals (CIs).

Results: The overall prevalence of underweight was 26.3% (95% CI: 23.4, 29.3), and that of the mother with a MDD score was 29.2% (95% CI: 26.0, 32.8). Multivariable binary logistic regression analysis showed that the prevalence of underweight in children was higher if maternal MDD was not met (adjusted odds ratio = 1.41; 95% CI: 1.05, 1.89).

Conclusions: The children's age, types of toilets, and region were independent predictors of being underweight. Underweight among under-five children and diverse food consumption among their mothers are critical public health challenges in rural Myanmar that require urgent action. Nutrition education for rural communities should focus on feeding children with locally available diverse foods.

COVID-19 affected Sri Lanka from early 2020, a time of considerable ignorance accompanied by wide media coverage of a devastating epidemic in Italy and Europe. Many were attracted to complementary and alternative medicine (CAM) or traditional medicine (TM) in this desperate situation. Several preparations were claimed to be effective against COVID-19 globally. Dammika Bandara Syrup© was one such preparation promoted for preventing and treating SARS-CoV-2 infection. It was based on bees' honey, pericarp and mace of Myristica fragrans (nutmeg), the seed of Foeniculum vulgare and fresh rhizome of Zingiber officinale, all believed to have anti-viral properties. Following an unpublished clinical study claiming efficacy, Dammika Bandara Syrup© gained wide media publicity and political patronage. The producer claimed of Goddess Kali revealing the formula added an anthropological, cultural, and religious complexity to the issue. The demand for the product increased rapidly as a debate raged both in public and in the parliament on utilizing such products in combating COVID-19. The Department of Ayurveda, which is statutorily responsible for regulating CAM/TM had to respond to the situation. The legislation to regulate such indigenous medicinal products was weak, and the crisis deepened as thousands converged to the production facility, defying mobility restrictions introduced to control COVID-19. This led to the Ministry of Health requesting academics to form a team and conduct a clinical trial to prove its efficacy. This paper outlines the process and issues faced during the regulatory approval for the trial in a polarized political environment. Some health professionals accused the researchers of bowing to political pressure and questioned the scientific justification for the trial. However, the team considered this as an opportunity to streamline a path for research into CAM/TM therapies in situations such as COVID-19. Several processes were identified and addressed, such as the provisional registration of CAM preparations, assessing the potential efficacy of a CAM product, confirmation of authenticity and safety, standardization and supervision of production respecting cultural identities, obtaining approval for human use, choice of comparators, and ethical issues. We believe the study has helped set standards and a benchmark for CAM and TM research in Sri Lanka.

During the recent COVID-19 pandemic, risk communication and community engagement (RCCE) were instrumental in inducing behavior change in tandem with the evolving evidence and phases of the pandemic. Infodemic management also became one of the areas where much emphasis was laid in Bhutan's response to the COVID-19 pandemic along with other critical response strategies such as surveillance, contact tracing, quarantine, isolation, and testing. Over the past 3 years of the pandemic, much has been learnt about the significance and impact of RCCE. In this article, the authors will highlight some of the methods and practices that were implemented to manage public information and also share experiences with regard to RCCE over the course of Bhutan's response to the pandemic. Furthermore, it will also outline some of the media and risk communication mechanisms that were in place before Bhutan's response to the COVID-19 pandemic.

Introduction: Health systems in developing countries suffers from both input and productivity issues. We examined the status of three domains of human resources for health, i.e., availability and distribution, capacity and productivity, and motivation and job-satisfaction, of the health-care workforce employed in the public health system of Haryana, a North Indian state.

Methodology: The primary data were collected from 377 public health facilities and 1749 healthcare providers across 21 districts. The secondary data were obtained from government reports in the public domain. Bivariate and multivariate statistical techniques were used for evaluating district performances, making inter-district comparisons and identifying determinants of motivation and job-satisfaction of the clinical cadres.

Results: We found 3.6 core health-care workers (doctors, staff nurses, and auxiliary nurses-midwives) employed in the public health-care system per 10,000 population, ranging from 1.35 in Faridabad district to 6.57 in Panchkula district. Around 78% of the sanctioned positions were occupied. A number of inpatient hospitalizations per doctor/nurses per month were 17 at the community health center level and 29 at the district hospital level; however, significant differences were observed among districts. Motivation levels of community health workers (85%) were higher than clinical workforce (78%), while health system administrators had lowest motivation and job satisfaction levels. Posting at primary healthcare facility, contractual employment, and co-habitation with family at the place of posting were found to be the significant motivating factors.

Conclusions: A revamp of governance strategies is required to improve health-care worker availability and equitable distribution in the public health system to address the observed geographic variations. Efforts are also needed to improve the motivation levels of health system administrators, especially in poorly performing districts and reduce the wide gap with better-off districts.

Dengue and leptospirosis are hyperendemic diseases in Sri Lanka. We aimed to determine the prevalence and clinical manifestations of concomitant infections of leptospirosis and acute dengue infection (ADI) in clinically suspected dengue patients. A descriptive cross-sectional study was carried out in five hospitals in the Western Province, from December 2018 to April 2019. Venous blood and sociodemographic and clinical details were collected from clinically suspected adult dengue patients. Acute dengue was confirmed by DENV NS1 antigen ELISA, IgM ELISA, IgG ELISA, and IgG quantification assay. Leptospirosis was confirmed by the microscopic agglutination test and real-time polymerase chain reaction. There were 386 adult patients. The median age was 29 years, with male predominance. Among them, 297 (76.9%) were laboratory confirmed as ADI. Concomitant leptospirosis was present in 23 (7.74%) patients. In the concomitant group, the majority (65.2%) were female, in contrast to ADI (46.7%). Myalgia was significantly more common in patients with acute dengue fever. All other symptoms were similar in both groups. In conclusion, the 7.74% of patients of ADI had concomitant leptospirosis, and it was more common in females.

Background: The purpose of this study was to use the health belief model (HBM) to predict the adoption of preventive behaviors against COVID-19 using the structural equation modeling approach.

Methods: As a descriptive-analytical study, this research was conducted on 831 men and women who were under the coverage of comprehensive health service centers in the Lorestan province of Iran in 2021. A questionnaire based on HBM was used to collect data. Data were analyzed by the SPSS software version 22 and AMOS version 21.

Results: The mean age of participants was 33.0 ± 8.5, with a range of 15-68 years. The constructs of the HBM explained about 31.7% of the variance in COVID-19-related preventive behaviors. The greatest total effect on preventive behaviors against the COVID-19 disease belonged to the constructs of perceived self-efficacy (0.370), perceived barriers (-0.294), and perceived benefits (0.270), in descending order of impact.

Conclusion: Educational interventions can be useful in promoting COVID-19 preventive behaviors by bringing about a correct understanding of self-efficacy, barriers, and benefits.

Introduction: As a validated stress questionnaire to assess ongoing adversities of adolescents in developing countries is not available, we developed a brief general checklist, the "Long-term Difficulties Questionnaire-Youth" version (LTD-Y) to measure daily stressors of adolescents and examine the psychometric properties of the instrument.

Methods: In 2008, 755 schoolchildren in Sri Lanka (54% girls), age 12-16 years, completed a self-reported questionnaire with four sections. (1) demographic information (2) daily stressors and social support (3) trauma exposures measures; different trauma exposures and tsunami impact, (4) current psychological problem measures; posttraumatic stress symptoms, emotional and behavioral problems, functional impact, happiness at home, and happiness at school. In July 2009, a subsample of 90 adolescents repeated these measures. Internal consistency factor structure, concurrent validity, construct validity, and temporal stability were assessed in the scale.

Results: LTD-Y adequately identified the ongoing adversities of adolescents. The scale showed an excellent internal consistency with Cronbach's alpha = 0.79. The principal component analysis showed two-factor solutions which concern "external" and "internal" stressors. The concurrent validity was indicated by its positive association with all measures of current psychological problems. The discriminant ability of the adversity measure was evident in cumulative trauma exposure and all variables with current psychological problems. The stability of reporting was satisfactory.

Conclusion: This school-based screening showed that the LTD-Y has sufficient validity, competency, and stability in measuring ongoing adversities of adolescents.