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

Purbalingga Regency had achieved zero indigenous malaria cases in April 2016, 3 years before the targeted deadline for elimination. Currently, the biggest threat to elimination efforts is the risk of local malaria reintroduction due to imported cases in the receptive areas. The aim of this study was to describe the implementation of village level migration surveillance and identify the areas for improvement in it. We performed the study in four malaria-free focus villages in Purbalingga Regency, i.e., Pengadegan, Sidareja, Panusupan, and Rembang, from March to October 2019. A total of 108 participants were involved in the processes. Data on malaria vector species, community mobility from malaria-endemic areas, and implementation of malaria migration surveillance (MMS) were collected. We use descriptive analysis for quantitative data and thematic content for qualitative data. Socialization of migration surveillance in Pengadegan and Sidareja villages has been carried out to the wider community, whereas in Panusupan and Tunjungmuli villages, it is still limited to neighbors. Communities in Pengadegan and Sidareja villages have participated in reporting the arrivals of migrant workers, and the village malaria interpreter conducts blood tests on all migrants. Community participation in reporting migrant workers arriving in Panusupan and Tunjungmuli villages is still low. Recording of migrant data reporting has been carried out by MMS officers, but malaria checks are only carried out before Eid al-Fitr to prevent importation of malaria cases. The program needs to strengthen the community mobilization and case-finding efforts.

Labor migrants (LMs) often work in precarious work environments and are exposed to various health risks. There is a lack of information on the health of international Nepalese LMs (NLMs). This scoping study was conducted to assess the health problems of international NLMs based on the six-stage scoping review process of Arksey and O'Malley. A literature review and stakeholders consultation related to NLMs' health information were conducted. A total of 455 studies were identified of which 38 studies were potentially relevant based on title and/or abstract screening, and a total of 16 studies were finally included and assessed. The literature showed that the health problems incurred by NLMs are mainly mental health problems; accidents, injuries, and infectious diseases. The Foreign Employment Board is the main public stakeholder which records deaths and disabilities of NLMs. The record showed that there were a total of 3,752,811 labor permits approval, a total of 7467 deaths, and a total of 1512 disabilities among NLMs during the 11 years from 2008-2018. There is a need to have a better investigation of causes of death and disability among NLMs to assign scientific causes of death. Predeparture orientation on mental health coping strategies, labor rights, health-care accessibility options in destination countries, traffic safety, and infectious diseases should be instituted.

Background: Chronic diseases are a major contributor to mortality, morbidity, and socio-economic costs globally, including in India. Quality of life (QoL) is an important patient-centered outcome for chronic disease. Measurement properties of tools for assessing QOL in the Indian context have not been assessed systematically.

Methods: A scoping review was conducted, and four major electronic databases were searched. Screening was conducted by at least two independent reviewers, with a third person acting as an arbiter. Data from the retrieved full texts were extracted by one reviewer, with a sample verified by another reviewer to reduce any data extraction errors. A narrative synthesis was done with a focus on measurement properties of tools, including but not limited to internal consistency, inter-rater reliability, test-retest reliability, validity, and acceptability.

Results: Out of 6706 records retrieved, a total of 37 studies describing 34 tools (both generic and disease-specific tools) for 16 chronic conditions were included. Most of the studies were cross-sectional (n = 23). Overall, most tools had acceptable internal consistency (Cronbach's alpha value ≥0.70) and good-to-excellent test-retest reliability (intra-class correlation coefficient = 0.75-0.9), but there was variability in acceptability. In terms of acceptability, seven tools were positively assessed (meeting psychometric property requirements), but all except the World Health Organization QoL tool were disease specific. Many tools have also been tested for local context, and many translated and tested in one or few languages only, thus limiting their usability across the nation. Women were underrepresented in many studies, and tools were not evaluated in other genders. Generalizability to tribal people is also limited.

Conclusion: The scoping review provides a summary of all QOL assessment tools for people with chronic diseases in India. It supports future researchers to make informed decisions for choosing tools. The study highlights the need for more research to develop QOL tools which are contextually applicable and enables the comparability across diseases, people, and regions within India and potentially in the South Asian region.

A smoke-free workplace is important to reduce secondhand smoke exposure, raise awareness, encourage smoking cessation, and increase productivity. This study aimed to assess indoor smoking in the workplace as part of a smoke-free policy implementation and the factors associated. This was a cross-sectional study at workplaces in Indonesia from October 2019 to January 2020. The workplaces were divided into private workplaces owned by a company for business and government workplaces that run for public services. Samples were selected using stratified random sampling. Data collection follows time and area observation guidelines, starting in the indoor area and then outdoor. The observation was conducted for at least 20 min for each workplace in 41 districts/cities. Of the 2900 observed workplaces, 1097 (37.8%) were private and 1803 (62.92%) were government workplaces. The proportion of indoor smoking at government workplaces was 34.7%, higher compared to private (14.4%). The results were consistent for each indicator such as people smoking (14.7% vs. 4.5%), electronic cigarette use (0.7% vs. 0.4%), cigarette butts presence (25.8% vs. 9.5%), and smell of cigarette smoke (23.0% vs. 8.6%). The factors associated with indoor smoking were indoor ashtray availability (adjusted odds ratio [AOR] =13.7; 95% confidence interval [CI]: 10.6-17.5), indoor designated smoking area (AOR = 2.4; 95% CI: 1.4-4.0), presence of indoor tobacco advertising, promotion and sponsorships (AOR: 3.3; 95% CI: 1.3-8.89), whereas the presence of no smoking sign was a preventive factor (AOR = 0.6; 95% CI: 0.5-0.8). Indoor smoking remains high, particularly in government workplaces in Indonesia.

India is committed to Sustainable Development Goal 3 of reducing the national maternal mortality ratio to <70/100,000 live births by 2030. This article describes women's experiences of maternity care in public health facilities in three districts of the north-eastern Indian state of Assam. Fourteen focus-group discussions were carried out among 149 married women aged 18-45 years belonging to different ethnic communities. Data were analyzed using a grounded theory approach and organized using a framework of dimensions of maternal satisfaction. The findings suggest that access and distance were important considerations determining maternal care quality, especially in the two remote districts. Women reported inadequate infrastructure, lack of cleanliness, and poor access to medicines. Lack of prompt care was identified as an important issue, and women complained about being left unattended during labor and facing obstetric violence in the labor room. Our findings point toward the need to strengthen referral transport systems and establish maternity waiting homes in remote areas. It is important to also sensitize health providers about obstetric violence and the right of women to receive prompt and respectful maternity care.

Background: Informal workers are high-risk groups for getting occupational diseases. They also have difficulties in accessing occupational health services (OHSs). The Basic OHS (BOHS) program integrates BOHS activities into existing primary health care. The study aims to describe how the BOHS program has been developed and to update the situation of BOHS in Thailand.

Methods: Four steps for the development of the program include (1) preparation, (2) model development, (3) implementation and expansion, and (4) quality assurance (QA). The program started with the study of the situation of OHS in primary care units (PCUs) and identification of the gap for OH practice among PCUs' staff. The pilot study was conducted in 19 PCUs. After that, expansion of the model and quality assurance of the services have been implemented until now.

Results: In 2019, 84% of PCUs (8242) provided BOHS, but the number decreased to 22% (2123 PCUs) in 2020. The target groups were mainly farmers. The OHS activities include an arrangement of farmers' clinics and conducting outreach activities in the field. The latest health surveillance program for farmers reported that 40.5% of 862,585 farmers had high pesticide exposure by field-kit testing. Regarding the QA audit, 75% of PCUs were certified for basic or higher levels of BOHS standards.

Conclusions: Integration of OHS into the PCUs is feasible, successful and replicable. Its sustainability requires policy support, continued empowerment of staff, and resource allocation.

Background: Stunting remains a major public health concern in Indonesia despite many interventions. This study aimed to assess the effectiveness of interventions in the form of education and demonstration on preparing complementary feeding (CF) to increase knowledge, attitude, and practices (KAP) of CF among parents living in villages with high stunting prevalence in Central Lombok, Indonesia.

Materials and methods: This is a quasi-experimental community-based study, conducted from June to August 2019. Three villages were divided into three groups, i.e., control group (CG), education alone (EA) group, and education-cum-demonstration (ED) group. We assessed KAP before and after intervention with a 4-week interval.

Results: A total of 205 participants were enrolled in this study, consisting of 67, 70, and 68 participants in the CG, EA, and ED groups, respectively. In within-group analysis, parents' attitudes (P = 0.015) and practices (P = 0.014) improved in the ED group while only parents' practices (P = 0.034) improved in the EA group. In between-group analysis, parental attitude (P = 0.039) and practices (P = 0.008) improved in the ED group when compared to the CG. In the EA group, only parents' practices improved when compared to the CG (P = 0.006). There was no significant difference in KAP score in the EA and ED groups.

Conclusion: A combined approach of education and demonstration works better to promote healthy CF practices among mothers.