Journal of Public Health Research最新文献

Introduction: South Africa's National School Nutrition Programme (NSNP) was created in 1994 to reduce poverty and unemployment and improve children's learning. It aims to aid disadvantaged children and strengthen poor communities, especially in rural areas.

Objectives: The study examined challenges in implementing Total Quality Management (TQM) in the South African National School Nutrition Programme.

Methods: A qualitative case study design was used based on document analysis extracted through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The documents were analysed using thematic analysis.

Results: Key TQM challenges affecting the implementation of the NSNP include Customer focus-lack of funding from the Department of Basic Education to accommodate increased enrolment; Employee involvement-role ambiguity due to lack of communication, and at times, the roles of the NSNP players are not clearly defined; Process-centric approaches-lack of school-level infrastructure to store and cook for students, Continuous improvement and training-lack of education curriculum on nutrition education and Relationship management-lack of coordination of the stakeholders on funding, political landscape, nutrition policies, community involvement, programme adaptability.

Conclusion: Effective monitoring systems should be established to guarantee that students receive the necessary quality and quantity of food. These systems should also oversee food supply, storage, preparation, and hygiene. Additionally, the current targeting system, the quintile system, requires evaluation. This should involve assessing the school's location, available resources, and individual students' social context.

Background: HPV vaccination coverage is important to prevent cervical cancer and other HPV-related diseases. This study estimated the vaccination coverage rate among adolescent schoolgirls aged 12-18 in Greece and identified factors affecting parental vaccination decisions.

Design and methods: A cross-sectional study was conducted from September 2021 to March 2022. A nationwide representative sample of 3205 parents/guardians of schoolgirls from 48 schools was selected through a probabilistic multistage sampling. Besides descriptive statistics, estimation, exploration and inferential methods were used, including 95% CI to estimate the vaccine rate, exploratory factor analysis to emerge the factors of HPV knowledge and multiple logistic regression analysis to identify the crucial parameters associated with vaccination, after adjusting for mutual confounding.

Results: About 62.5% [95% CI: 61.1-63.9] of the girls were fully vaccinated. Mother's HPV vaccination (OR [95% CI] = 2.90 [1.77, 4.73]), parental education level (OR [95% CI] = 2.50 [1.65, 3.79]), child's attendance at the Upper secondary school (OR [95% CI] = 2.36 [1.83, 3.03]) and the level of HPV vaccine knowledge (OR [95% CI] = 1.59 [1.37, 1.84]) influenced parents' decision to vaccinate their daughters.

Conclusions: A significant increase in HPV vaccination coverage was recorded in Greece, compared to previous estimations. The identified determinants of parents' vaccination decisions, especially HPV vaccine knowledge, can feed into targeted public health policies, to achieve the WHO's goal to vaccinate 90% of adolescent girls by 2030. Policies may include the implementation of school-based awareness programmes for students and parents, state incentives for parents and expert recommendations for vaccination.

Background: Community-based health insurance (CBHI) plays a crucial role in achieving universal health coverage. This study investigates the determinants, challenges, and opportunities related to CBHI in Tigray, Ethiopia.

Design and methods: A mixed-methods approach was employed. In 2020, a cross-sectional survey was conducted involving 800 rural households in Tigray, combined with semi-structured key informant and in-depth interviews. Multistage random sampling and logistic regression analyses were also applied.

Results: Enrollment was strongly associated with having a chronic illness (AOR = 64.5, p ≤ 0.01), primarily due to a policy that permits indigents with chronic conditions to enroll without payment. Other factors included membership in a political party (AOR = 3.76, p ≤ 0.01), holding formal positions (AOR = 1.55, p = 0.03), receiving aid (AOR = 1.62, p ≤ 0.01), and membership in Edir (AOR = 1.66, p ≤ 0.01). Conversely, enrollment was negatively impacted by low trust (AOR = 0.66, p = 0.04), limited awareness (AOR = 0.4, p ≤ 0.01), poor healthcare quality (AOR = 0.51, p ≤ 0.01), bureaucracy (AOR = 0.02, p ≤ 0.01), being widowed (AOR = 0.34, p ≤ 0.01), and working as a daily laborer (AOR = 0.23, p ≤ 0.01). Key barriers included structural inefficiencies, substandard healthcare service quality, and inadequate awareness.

Conclusion: To facilitate equitable expansion of CBHI, it is essential to address administrative obstacles, enhance trust and awareness, and provide support to vulnerable groups, in addition to leveraging traditional risk-pooling mechanisms.

Background: Oral health significantly affects the overall well-being of the elderly, influencing nutrition, communication, and quality of life. Poor oral hygiene can cause infections and dental issues. In Thailand, promoting oral hygiene among the aging population remains a pressing and ongoing public health challenge.

Design and methods: This study explores the factors influencing oral health care behaviors among elderly individuals at the Phitsanulok Health Center (Buddhachinaraj Hospital) as a case study of lower Northern Thailand. A total of 365 elderly participants were surveyed using a structured questionnaire.

Results: Multiple regression analysis showed that general employment (β = -0.227, p < 0.001), business (β = -0.300, p < 0.001), and government service (β = -0.205, p < 0.001) were negative predictors of oral health care behaviors. In contrast, enabling factors (β = 0.204, p < 0.001), average monthly income (β = 0.200, p < 0.001), and supporting factors (β = 0.142, p = 0.005) had positive effects. These factors together explained 20.02% of the variation in behaviors (p < 0.001), with enabling factors having the strongest influence.

Conclusions: This study emphasizes the importance of financial security, access to dental care, and social support in maintaining oral health among the elderly. Enhancing affordable dental services is crucial for low-income seniors. The findings suggest further research into factors influencing elderly oral health and strategies to improve care access. Recommendations include reducing dental costs, creating family-centered health initiatives, involving families in oral hygiene, and enacting policies to support low-income elderly individuals.

Background: The decriminalization of cannabis in South Africa has sparked growing concern within the medical community, particularly among medical students. As future healthcare providers, they must navigate evolving legal and professional landscapes while forming beliefs about the health effects of cannabis use. This legal shift has intensified debates surrounding the benefits, risks, and health consequences of cannabis, especially in relation to mental well-being, academic performance, and professional identity.

Objective: This systematic qualitative review aimed to synthesize existing literature on South African medical students' perceptions of cannabis decriminalization and their views on its health-related impacts. The review seeks to clarify how medical students interpret the effects of cannabis use on mental and physical health and how these beliefs shape their professional attitudes and behaviors.

Design and methods: A systematic search and thematic synthesis were conducted across databases including PubMed, Scopus, PsycINFO, and ScienceDirect for literature published between 2010 and 2024. Studies were eligible if they focused on cannabis or marijuana use, included South African medical students, and discussed perspectives or health impacts in the context of decriminalization. Data were extracted, coded line-by-line, and synthesized to generate descriptive and analytical themes.

Results: Four studies met inclusion criteria. Thematic analysis identified four key themes: (1) Health impacts (Mental and Physical); (2) perceptions and attitudes toward decriminalization; (3) educational influences and awareness; and (4) access to support services.

Conclusion: This study emphasized the need for more focused research on the impact of cannabis decriminalization on medical students in South Africa. Current literature suggests that while there are diverse opinions on the subject, the decriminalization of cannabis may influence both attitudes and behaviors.

Background: The study investigated health professionals' understanding and risk perception of climate change in the Sunyani Municipality by focusing on health professional's knowledge on climate change, examining health professional's risk perception of climate change on health and identifying the co-benefits of climate change mitigation.

Methods: This quantitative oriented cross-sectional study randomly selected 400 health professionals across the Regional Hospital, SDA Hospital and Municipal Hospital as respondents. Quantitative data was analyzed using SPSS Version 25.

Results: From the study, the results indicate that Health professionals are fully aware of the concept of climate change. Health professionals do not have knowledge pertaining to the scientific aspects of climate change. There was a statistical relationship between respondent's perception that climate change can lead to death (p < 0.001) and their awareness of the risk of climate change impact on health. There was a general likelihood of an increase in malaria (Mean = 2.98), Dengue fever (Mean = 3.16), Cholera (Mean = 3.18), schistosomiasis (Mean = 3.27), Meningococcal meningitis (Mean = 3.85) and Influenza (Mean = 3.73) due to climate change. These actions positively affect health and climate and they include: Giving up red meat (Mean = 3.21), Walking and cycling instead of using cars (Mean = 3.27), Reducing rural-urban migration (Mean = 3.46), Reducing air pollution from emission of fossil fuel (Mean = 3.63). A majority of 65% of respondents agreed to the incorporation of climate change related course work into nursing/medical school curricula as a policy to mitigate climate change.

Conclusions: The study concludes that health professionals are fully aware about climate change but lack a thorough understanding of the scientific aspects of climate change. The general risk perception of health professionals towards climate change impact on health was high. Climate change mitigation is beneficial to human populations.

Introduction: The long-term impact of COVID-19 on Quality of Life (QoL) is a growing concern, particularly in low- and middle-income countries (LMICs) like Nepal. However, there is limited evidence on how post-COVID-19 health conditions affect daily life in Nepalese communities. This study assesses the QoL among COVID-19 survivors in Pokhara Metropolitan City, Nepal.

Methods: A community-based cross-sectional study was conducted among 271 post-COVID-19 patients discharged from hospitals in Pokhara Metropolitan City. Participants were selected using systematic random sampling, and data were collected through face-to-face interviews using the WHOQOL-BREF questionnaire. Multivariable logistic regression was applied to determine factors associated with QoL.

Results: The mean HRQoL score was 61.29 ± 12.54, with the physical health domain scoring the highest (65.58 ± 21.53) and the environment domain the lowest (57.50 ±11.52). Among participants, 82.3% had good QoL, while 17.7% had poor QoL. Living in a nuclear family (aOR = 2.61, 95% CI: 2.14-6.00), being employed (aOR = 4.10, 95% CI: 1.87-9.21), and engaging in regular exercise (aOR = 3.32, 95% CI: 1.36-8.06) were significant positive factors for good QoL among post-COVID-19 patients. Conversely, chronic disease was the strongest negative predictor of QoL, with those without chronic conditions being 6.15 times more likely to report good QoL (aOR = 6.15, 95% CI: 2.65-14.24).

Conclusion: COVID-19 survivors in Nepal experience varying degrees of QoL impairment, particularly in the environmental and psychological domains. Employment status, exercise, and family structure play crucial roles in post-COVID well-being, while chronic illness remains a significant barrier.

Background: The prevalence and characteristics of falls among community-dwelling Cantonese-speaking older adults in Southern China have not been previously investigated.

Design and methods: The observational study enrolling 212 community-dwelling Cantonese-speaking older adults was conducted via self-administered questionnaire. Participants' demographics, fall characteristics, and the belief and attitude score regarding falls were collected and analyzed.

Results: The prevalence of falls was 30.66%. Poor self-care ability and the linguistic barrier during fall prevention education were associated with history of both single fall and multiple falls. Fall prevention education combining text, video, interviews, and consultation delivered in Cantonese was protective factor associated with single fall and multiple falls. Population experiencing multiple falls expressed unconcern for the fall-prone attire, fall-prone indoor environments and fall risk-increasing drugs.

Conclusion: The community-dwelling Cantonese-speaking older adults demonstrated distinct fall characteristics and notably high fall prevalence. Linguistic barrier could be the noteworthy risk factor for falls, which should be improved with tailored fall prevention programs and thoughtful health policies.

Background: During the COVID-19 pandemic in Peru, primary health care services redistributed personnel to hospitals. In this context, Antenatal care (ANC) could have been limited in the general population, especially among indigenous communities.

Objective: To determine differences in compliance with adequate ANC based on ethnic groups in Peru prior to and throughout the COVID-19 pandemic.

Methods: Observational, retrospective study, secondary analysis of the Demographic and Family Health Survey conducted in the course the period 2017-2022. The sample consisted of women of childbearing age from 15 to 49 years and considered the variables of ethnicity, ANC, and sociodemographic factors. For statistical analysis, generalized linear models from the Poisson family utilizing a logarithmic link function were used. Crude and adjusted Prevalence Ratios were calculated along with their 95% confidence intervals.

Results: A total of 20,165 records were reviewed. Before the pandemic, the frequency of inadequate ANC was 57.91%, and during the pandemic, it increased to 64.91%. Compared to mestizos, belonging to the Quechua ethnic group (PR: 1.08; 95% CI: 1.04-1.13), Aymara (PR: 1.21; 95% CI: 1.12-1.30), natives of the Amazon (PR: 1.15; 95% CI: 1.04-1.27), and those belonging to other races (PR: 1.15; 95% CI: 1.02-1.29) had a higher prevalence of inadequate ANC. During the pandemic, only Aymara women maintained a higher prevalence of inadequate ANC (PR: 1.18; 95% CI: 1.06-1.31).

Conclusions: Before the pandemic, there were ethnic differences in the prevalence of inadequate ANC, and during the pandemic, only Aymara pregnant women maintained a higher prevalence of inadequate ANC.

Background: Medical students in Egypt are increasingly susceptible to higher levels of stress and anxiety compared to their peers. The current study aimed to assess the effect of stress management intervention in decreasing their stress and anxiety levels.

Design and methods: A randomized controlled study was conducted on two phases survey and intervention phase using perceived stress scale to assess stress and Beck Anxiety Inventory to assess anxiety. Students with moderate/severe stress in the survey stage were stratified randomized to intervention or control group (140 in each group). The program was composed of 12 sessions for 12 weeks. Stress and anxiety were re assessed immediately after and in 3 months post intervention.

Results: There was no significant difference between the means of perceived stress between the intervention and control groups at the baseline (25.03 ± 3.18, 24.40 ± 3.15, p = 0.098). There was a significant higher mean score of perceived stress in the control group compared to intervention group immediately post intervention (33.39 ± 9.47, 24.40 ± 3.46, p < 0.001) and 3 months later (33.03 ± 9.40, 23.76 ± 3.37, p < 0.001). While there is no significant difference between the mean score of perceived anxiety between the intervention and control groups at the baseline, post intervention and in the follow up.

Conclusions: The stress management program was effective in decreasing perceived stress level among medical students. The widespread implementation of the study program could help medical students for coping with their stress levels.