Through experience and research, the Uganda government perceived the HIV/AIDS pandemic as a multi-dimensional problem and practically demonstrated that multi-sectoral and multidisciplinary interventions are the best approaches to address this. This calls for collaborative efforts among all stakeholders with respect to their mandates, areas of comparative advantage and expertise. In this study, we explored the role of ‘spaces for community dialogues’ among adults and children in the collective identification, sharing and mitigation of HIV/AIDS concerns in Uganda. This was an ethnographic study conducted between 2009 and 2015 in two purposively selected districts most hit by HIV/AIDS. We employed multiple data collection methods, including participant observation, in-depth interviews, focus group discussions, participatory rural appraisal and key informant interviews. Ethics clearance was obtained from Makerere University, College of Humanities and Social Sciences, and from the two social support agencies. Data were synthesised and analysed using thematic analysis. Findings show that bazaars, mother or father talks, testing sites and regular spaces, banana beer parties, village meetings, school settings, and community events provided safe environments for interaction about HIV/AIDS concerns among children and adults. Children expressed their views through visual techniques with the support of adults. The use of catalysts facilitated effective interactions by harmonizing experiences of those directly impacted by HIV/AIDS and those providing the needed helping skills. Dialogue is an act of creations that cannot be consumed by participants. Spaces for dialogue are real sites that societies use in their daily interactions. Children are active participants in the struggle to mitigate the adverse effects of HIV/AIDS. Despite differences in ways of sharing messages, spaces in a community settings were deemed appropriate for dialogue on HIV/AIDS issues.
{"title":"Spaces for community dialogue among adults and children in collective identification, sharing and mitigation of HIV/AIDS concerns in Uganda","authors":"Saidah Mbooge Najjuma, D. Kyaddondo","doi":"10.29392/001c.74381","DOIUrl":"https://doi.org/10.29392/001c.74381","url":null,"abstract":"Through experience and research, the Uganda government perceived the HIV/AIDS pandemic as a multi-dimensional problem and practically demonstrated that multi-sectoral and multidisciplinary interventions are the best approaches to address this. This calls for collaborative efforts among all stakeholders with respect to their mandates, areas of comparative advantage and expertise. In this study, we explored the role of ‘spaces for community dialogues’ among adults and children in the collective identification, sharing and mitigation of HIV/AIDS concerns in Uganda. This was an ethnographic study conducted between 2009 and 2015 in two purposively selected districts most hit by HIV/AIDS. We employed multiple data collection methods, including participant observation, in-depth interviews, focus group discussions, participatory rural appraisal and key informant interviews. Ethics clearance was obtained from Makerere University, College of Humanities and Social Sciences, and from the two social support agencies. Data were synthesised and analysed using thematic analysis. Findings show that bazaars, mother or father talks, testing sites and regular spaces, banana beer parties, village meetings, school settings, and community events provided safe environments for interaction about HIV/AIDS concerns among children and adults. Children expressed their views through visual techniques with the support of adults. The use of catalysts facilitated effective interactions by harmonizing experiences of those directly impacted by HIV/AIDS and those providing the needed helping skills. Dialogue is an act of creations that cannot be consumed by participants. Spaces for dialogue are real sites that societies use in their daily interactions. Children are active participants in the struggle to mitigate the adverse effects of HIV/AIDS. Despite differences in ways of sharing messages, spaces in a community settings were deemed appropriate for dialogue on HIV/AIDS issues.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42971737","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}
D. Kitara, Steven Baguma, C. Okot, D. Acullu, Denis Ochula, Pamela A Okot, P. Odong, S. G. Okot, F. Pebolo, F. W. D. Oyat, E. Ikoona, N. O. Alema, J. N. Oloya, J. Aloyo, Lawence Oballim
At the time when COVID-19 was declared a pandemic in March 2020, its spread in the African continent was slow. However, confirmed cases of the virus have since risen steadily over the years in the African continent for many reasons. This study aimed to determine factors associated with perceptions of COVID-19 vaccines among adult age-group populations in northern Uganda. We conducted this study as part of a larger study to determine factors associated with COVID-19 vaccine hesitancy/acceptance among 723 adult age-group populations selected by stratified and systematic sampling approaches from northern Uganda. We used a questionnaire with an internal validity of Cronbach’s α= 0.772. A five-point Likert scale, with responses categorized as strongly agree “SA”, agree “A”, neutral “N”, disagree “DA”, and strongly disagree “SD”, was used to assess participants’ perceptions on COVID-19 vaccines. A multivariable regression analysis was conducted with P-value set at <0.05. Overall, 723 participated in the study with a mean age of 31.4 years (standard deviation, SD, +10.1). The majority 54.5% (n=394) were males. There were no significant differences in perceptions of COVID-19 vaccines among age-group populations (adjusted odds ratio, aOR=0.99, 95% confidence interval, CI=0.98-1.01). Key finding include: (i) it was important to take a COVID-19 vaccine (aOR=1.02, 95% CI=1.00-1.04); (ii) vaccines have unlikely unforeseen side effects (aOR=0.98, 95% CI=0.97-0.99); (iii) vaccines were unlikely being promoted for commercial gains (aOR=0.98, 95% CI=0.97-0.99); and children could take COVID-19 vaccines (aOR=1.02, 95% CI=1.00-1.03). Stratified by age-groups, the 20–29-year-old perceived COVID-19 vaccines developed in Uganda as unlikely safe and effective (aOR=0.59, 95% CI=0.35-0.97), and COVID-19 vaccines have likely unforeseen side-effects (aOR=2.1, 95% CI=1.3-3.6). While the ≥50-year-old group perceived that COVID-19 vaccines were unlikely being promoted for commercial gains (aOR=0.2, 95% CI=0.1-0.6). There were no substantial differences in perceptions on COVID-19 vaccines in adult age-group populations in northern Uganda. The determinants of COVID-19 vaccine perceptions were its importance against the virus; vaccines have unlikely unforeseen side-effects, and children could take it. Stratified by age-groups, some age-groups perceived COVID-19 vaccines developed in Uganda as unlikely safe and unlikely being promoted for commercial gains.
{"title":"Perceptions of COVID-19 vaccine among different adult age group populations in Northern Uganda: a cross-sectional study","authors":"D. Kitara, Steven Baguma, C. Okot, D. Acullu, Denis Ochula, Pamela A Okot, P. Odong, S. G. Okot, F. Pebolo, F. W. D. Oyat, E. Ikoona, N. O. Alema, J. N. Oloya, J. Aloyo, Lawence Oballim","doi":"10.29392/001c.74443","DOIUrl":"https://doi.org/10.29392/001c.74443","url":null,"abstract":"At the time when COVID-19 was declared a pandemic in March 2020, its spread in the African continent was slow. However, confirmed cases of the virus have since risen steadily over the years in the African continent for many reasons. This study aimed to determine factors associated with perceptions of COVID-19 vaccines among adult age-group populations in northern Uganda. We conducted this study as part of a larger study to determine factors associated with COVID-19 vaccine hesitancy/acceptance among 723 adult age-group populations selected by stratified and systematic sampling approaches from northern Uganda. We used a questionnaire with an internal validity of Cronbach’s α= 0.772. A five-point Likert scale, with responses categorized as strongly agree “SA”, agree “A”, neutral “N”, disagree “DA”, and strongly disagree “SD”, was used to assess participants’ perceptions on COVID-19 vaccines. A multivariable regression analysis was conducted with P-value set at <0.05. Overall, 723 participated in the study with a mean age of 31.4 years (standard deviation, SD, +10.1). The majority 54.5% (n=394) were males. There were no significant differences in perceptions of COVID-19 vaccines among age-group populations (adjusted odds ratio, aOR=0.99, 95% confidence interval, CI=0.98-1.01). Key finding include: (i) it was important to take a COVID-19 vaccine (aOR=1.02, 95% CI=1.00-1.04); (ii) vaccines have unlikely unforeseen side effects (aOR=0.98, 95% CI=0.97-0.99); (iii) vaccines were unlikely being promoted for commercial gains (aOR=0.98, 95% CI=0.97-0.99); and children could take COVID-19 vaccines (aOR=1.02, 95% CI=1.00-1.03). Stratified by age-groups, the 20–29-year-old perceived COVID-19 vaccines developed in Uganda as unlikely safe and effective (aOR=0.59, 95% CI=0.35-0.97), and COVID-19 vaccines have likely unforeseen side-effects (aOR=2.1, 95% CI=1.3-3.6). While the ≥50-year-old group perceived that COVID-19 vaccines were unlikely being promoted for commercial gains (aOR=0.2, 95% CI=0.1-0.6). There were no substantial differences in perceptions on COVID-19 vaccines in adult age-group populations in northern Uganda. The determinants of COVID-19 vaccine perceptions were its importance against the virus; vaccines have unlikely unforeseen side-effects, and children could take it. Stratified by age-groups, some age-groups perceived COVID-19 vaccines developed in Uganda as unlikely safe and unlikely being promoted for commercial gains.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48183445","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}
Katelyn Spencer, R. Joshi, J. Ramji, S. Eftekharzadeh, P. Reddy, D. Canning, J. Pippi-Salle, P. Merguerian, A. Kundu, J. Frazier, D. Weiss, A. Shukla
A gap of care exists in low- and middle-income countries (LMICs) for patients with complex urogenital abnormalities, such as bladder exstrophy-epispadias complex (BEEC). A successful primary surgical repair is critical for optimal long-term outcomes for BEEC, but the availability of such a complex procedure is limited by the expertise needed to deliver a successful initial repair. We hypothesize that a long-term, multi-institutional collaboration based at a tertiary institution in a LMIC may improve outcomes for BEEC by encouraging earlier referrals for the first repair, rather than after failed repairs, and also increase the geographical catchment area by encouraging more distant referrals, once the availability of care becomes widely known. A long-term collaboration between two US academic research centers and the Civil Hospital in Ahmedabad, Gujarat, India was formed in 2009. This collaboration expanded later to include another US and one Middle Eastern hospital system. The entire post-operative cohort of the collaboration was recalled in 2019 and 2020, when epidemiology and demographic surveys were obtained from 82 patients. Since 2009, the collaboration has grown overall. The geographical catchment area for referrals and distance traveled by patients to reach the collaboration site has increased to include nine states in India and surrounding countries in Southeast Asia (P = 0.044). Patients traveling from farther distances tended to be of higher socioeconomic status than local referrals (P = 0.041). The success of the International Bladder Exstrophy Consortium to improve the care for BEEC patients in India and Southeast Asia is visible from its changing demographics. Patients, some even from families of a higher socioeconomic status, are traveling farther to receive care at a government-funded tertiary hospital. While not all positive benefits of a global surgery collaboration regarding earlier and primary referrals have been achieved, the collaboration is seeing benefits that align with a staged process of referrals. The continued commitment to creating a center of excellence is a model for sustained success for global surgery collaborations.
{"title":"Global surgical collaboration to treat bladder exstrophy-epispadias in India led to a larger geographical catchment area","authors":"Katelyn Spencer, R. Joshi, J. Ramji, S. Eftekharzadeh, P. Reddy, D. Canning, J. Pippi-Salle, P. Merguerian, A. Kundu, J. Frazier, D. Weiss, A. Shukla","doi":"10.29392/001c.74378","DOIUrl":"https://doi.org/10.29392/001c.74378","url":null,"abstract":"A gap of care exists in low- and middle-income countries (LMICs) for patients with complex urogenital abnormalities, such as bladder exstrophy-epispadias complex (BEEC). A successful primary surgical repair is critical for optimal long-term outcomes for BEEC, but the availability of such a complex procedure is limited by the expertise needed to deliver a successful initial repair. We hypothesize that a long-term, multi-institutional collaboration based at a tertiary institution in a LMIC may improve outcomes for BEEC by encouraging earlier referrals for the first repair, rather than after failed repairs, and also increase the geographical catchment area by encouraging more distant referrals, once the availability of care becomes widely known. A long-term collaboration between two US academic research centers and the Civil Hospital in Ahmedabad, Gujarat, India was formed in 2009. This collaboration expanded later to include another US and one Middle Eastern hospital system. The entire post-operative cohort of the collaboration was recalled in 2019 and 2020, when epidemiology and demographic surveys were obtained from 82 patients. Since 2009, the collaboration has grown overall. The geographical catchment area for referrals and distance traveled by patients to reach the collaboration site has increased to include nine states in India and surrounding countries in Southeast Asia (P = 0.044). Patients traveling from farther distances tended to be of higher socioeconomic status than local referrals (P = 0.041). The success of the International Bladder Exstrophy Consortium to improve the care for BEEC patients in India and Southeast Asia is visible from its changing demographics. Patients, some even from families of a higher socioeconomic status, are traveling farther to receive care at a government-funded tertiary hospital. While not all positive benefits of a global surgery collaboration regarding earlier and primary referrals have been achieved, the collaboration is seeing benefits that align with a staged process of referrals. The continued commitment to creating a center of excellence is a model for sustained success for global surgery collaborations.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44970158","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}
J. Michel, Chioma Ginikawa, Margaret Zou, O. Kapona, Danielle Agnello, Marcel Tanner
In many low- and middle-income countries (LMICs), period poverty is ubiquitous. As global poverty levels rise, period poverty is bound to rise too. The education and empowerment of women and girls particularly in LMICs are at stake. The dignity needed for menstruating people to attend to their menstrual cycle is a need rather than a luxury. Dignity is all we are asking for. Ending period poverty is no rocket science. Scotland has just spearheaded the way, demonstrating to the world, how easily period poverty can be eradicated. We encourage other countries of the world, to follow suit, particularly, governments of low-and middle-income countries. Getting rid of period poverty means getting rid of one system component, holding women and girls back, from contributing and participating fully in the economic system. The world is indeed facing unprecedented challenges, let’s not forget a parallel and equally real challenge, period poverty.
{"title":"As global poverty levels increase, let us not forget period poverty","authors":"J. Michel, Chioma Ginikawa, Margaret Zou, O. Kapona, Danielle Agnello, Marcel Tanner","doi":"10.29392/001c.71392","DOIUrl":"https://doi.org/10.29392/001c.71392","url":null,"abstract":"In many low- and middle-income countries (LMICs), period poverty is ubiquitous. As global poverty levels rise, period poverty is bound to rise too. The education and empowerment of women and girls particularly in LMICs are at stake. The dignity needed for menstruating people to attend to their menstrual cycle is a need rather than a luxury. Dignity is all we are asking for. Ending period poverty is no rocket science. Scotland has just spearheaded the way, demonstrating to the world, how easily period poverty can be eradicated. We encourage other countries of the world, to follow suit, particularly, governments of low-and middle-income countries. Getting rid of period poverty means getting rid of one system component, holding women and girls back, from contributing and participating fully in the economic system. The world is indeed facing unprecedented challenges, let’s not forget a parallel and equally real challenge, period poverty.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41618868","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}
Eshkeerat Kaur, M. Heys, C. Crehan, F. Fitzgerald, Msandeni Chiume, E. Chirwa, E. Wilson, M. Evans
Despite increasing rates of facility-based deliveries, neonatal mortality rates remain persistently high in low-resource settings (LRS). This has catalysed international focus on understanding and enabling quality newborn care. We aimed to understand persistent barriers to Quality of Care (QoC) and to identify quality improvement priorities from the perspective of a panel of neonatal experts with first-hand experience of delivering newborn care in low-resource settings (LRS). We conducted 13 semi-structured interviews with neonatal health experts via Skype. All interviews were recorded and transcribed verbatim. We adopted an inductive thematic analytical approach. Ethical approvals were not required. Twenty-two experts were invited to participate, of whom 16 responded and 13 agreed to take part (five neonatologists, six paediatricians and two advanced neonatal nurse practitioners). Participants had a mean of 13 (±7 SD) years working in LRS. Lack of physical resources including basic equipment and infrastructure such as running water, combined with limited human resources, education and specialist neonatal training were cited as key barriers to delivering quality care. In addition, weak leadership at the community, local and national level were thought to hinder progress. Poor communication within clinical teams, limited documentation and lack of standardised and locally appropriate guidelines were also identified as challenges. Digital technologies were perceived to have potential for data capture and enabling standardised care. However, some highlighted that unreliable internet access and possible stigma may hinder implementation. With less than 10 years to reach the Sustainable Development Goals (SDGs), it is critical to ensure access to quality care for all sick and vulnerable newborns admitted to health facilities. Clinical leaders in low resource settings need to be empowered to define local agendas and advocate for critical resources in order to close the gap between local and global quality of care priorities.
{"title":"Persistent barriers to achieving quality neonatal care in low-resource settings: perspectives from a unique panel of frontline neonatal health experts","authors":"Eshkeerat Kaur, M. Heys, C. Crehan, F. Fitzgerald, Msandeni Chiume, E. Chirwa, E. Wilson, M. Evans","doi":"10.29392/001c.72089","DOIUrl":"https://doi.org/10.29392/001c.72089","url":null,"abstract":"Despite increasing rates of facility-based deliveries, neonatal mortality rates remain persistently high in low-resource settings (LRS). This has catalysed international focus on understanding and enabling quality newborn care. We aimed to understand persistent barriers to Quality of Care (QoC) and to identify quality improvement priorities from the perspective of a panel of neonatal experts with first-hand experience of delivering newborn care in low-resource settings (LRS). We conducted 13 semi-structured interviews with neonatal health experts via Skype. All interviews were recorded and transcribed verbatim. We adopted an inductive thematic analytical approach. Ethical approvals were not required. Twenty-two experts were invited to participate, of whom 16 responded and 13 agreed to take part (five neonatologists, six paediatricians and two advanced neonatal nurse practitioners). Participants had a mean of 13 (±7 SD) years working in LRS. Lack of physical resources including basic equipment and infrastructure such as running water, combined with limited human resources, education and specialist neonatal training were cited as key barriers to delivering quality care. In addition, weak leadership at the community, local and national level were thought to hinder progress. Poor communication within clinical teams, limited documentation and lack of standardised and locally appropriate guidelines were also identified as challenges. Digital technologies were perceived to have potential for data capture and enabling standardised care. However, some highlighted that unreliable internet access and possible stigma may hinder implementation. With less than 10 years to reach the Sustainable Development Goals (SDGs), it is critical to ensure access to quality care for all sick and vulnerable newborns admitted to health facilities. Clinical leaders in low resource settings need to be empowered to define local agendas and advocate for critical resources in order to close the gap between local and global quality of care priorities.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46899743","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}
John Pellegrino, Mufaro Kanyangarara, B. Agbinko-Djobalar, P. Owusu, Kwame S. Sakyi, P. Baffoe, A. Sackey, I. Sagoe‐Moses, Robin B. Dail
Neonatal hypothermia is a prominent issue in low-resource settings. Preterm and low birth weight (LBW) infants are at increased risk for developing hypothermia. If left untreated, hypothermia can lead to hypoxia, sepsis, hypoglycemia, apnea, and poor weight gain in neonates, contributing to neonatal morbidity and mortality. Identifying risk factors for neonatal hypothermia is important, especially in low-resource settings, where the burden of neonatal mortality is highest. The study sought to describe the distribution of neonatal hypothermia and examine risk factors associated with neonatal hypothermia among LBW infants admitted to Korle-Bu Teaching Hospital in Accra, Ghana. Infants in the neonatal intensive care unit (NICU) at Korle-Bu Teaching Hospital, who were less than 28 days old, weighing less than <2,500 grams, and clinically stable, were enrolled. Infants of mothers under 18 years old and those expected to be discharged within 24 hours were excluded from the study. A standardized questionnaire was administered to collect information on the mother, infant, pregnancy, and birth characteristics. Axillary temperature readings were taken every 4 hours over a 24-hour monitoring period and during hypothermic events detected by the continuous temperature monitoring bracelet. Univariate and multivariate linear regression analyses with generalized estimating equations were used to examine risk factors associated with temperature. Of the 254 infants included in the analysis, 42.1% were male, 49.6% were very LBW (<1,500 grams), and 94.1% were preterm (<37 weeks). Of the 1,948 temperature readings, 44.5% were hypothermic (<36.5oC). Hypothermia occurred in 85.8% of infants during the 24-hour monitoring period. Multivariate linear regression demonstrated that being very LBW, having no skin-to-skin contact immediately after birth, not being wrapped or treated in an incubator at the time of temperature, and mixed feeding (compared to exclusive breastfeeding) were associated with lower neonatal temperatures. Neonatal hypothermia was common among infants admitted to the NICU. The findings highlight the importance of thermal practices such as wrapping, exclusive breastfeeding and skin-to-skin contact. Increased education to promote thermal care is needed.
{"title":"Occurrence of neonatal hypothermia and associated risk factors among low birth weight (LBW) infants in Accra, Ghana","authors":"John Pellegrino, Mufaro Kanyangarara, B. Agbinko-Djobalar, P. Owusu, Kwame S. Sakyi, P. Baffoe, A. Sackey, I. Sagoe‐Moses, Robin B. Dail","doi":"10.29392/001c.55766","DOIUrl":"https://doi.org/10.29392/001c.55766","url":null,"abstract":"Neonatal hypothermia is a prominent issue in low-resource settings. Preterm and low birth weight (LBW) infants are at increased risk for developing hypothermia. If left untreated, hypothermia can lead to hypoxia, sepsis, hypoglycemia, apnea, and poor weight gain in neonates, contributing to neonatal morbidity and mortality. Identifying risk factors for neonatal hypothermia is important, especially in low-resource settings, where the burden of neonatal mortality is highest. The study sought to describe the distribution of neonatal hypothermia and examine risk factors associated with neonatal hypothermia among LBW infants admitted to Korle-Bu Teaching Hospital in Accra, Ghana. Infants in the neonatal intensive care unit (NICU) at Korle-Bu Teaching Hospital, who were less than 28 days old, weighing less than <2,500 grams, and clinically stable, were enrolled. Infants of mothers under 18 years old and those expected to be discharged within 24 hours were excluded from the study. A standardized questionnaire was administered to collect information on the mother, infant, pregnancy, and birth characteristics. Axillary temperature readings were taken every 4 hours over a 24-hour monitoring period and during hypothermic events detected by the continuous temperature monitoring bracelet. Univariate and multivariate linear regression analyses with generalized estimating equations were used to examine risk factors associated with temperature. Of the 254 infants included in the analysis, 42.1% were male, 49.6% were very LBW (<1,500 grams), and 94.1% were preterm (<37 weeks). Of the 1,948 temperature readings, 44.5% were hypothermic (<36.5oC). Hypothermia occurred in 85.8% of infants during the 24-hour monitoring period. Multivariate linear regression demonstrated that being very LBW, having no skin-to-skin contact immediately after birth, not being wrapped or treated in an incubator at the time of temperature, and mixed feeding (compared to exclusive breastfeeding) were associated with lower neonatal temperatures. Neonatal hypothermia was common among infants admitted to the NICU. The findings highlight the importance of thermal practices such as wrapping, exclusive breastfeeding and skin-to-skin contact. Increased education to promote thermal care is needed.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43420222","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}
T. G. Argefa, Tyryn Carnegie, S. A. Kassa, R. Kitonyo-Devotsu, N. Mdege
Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.
{"title":"Tobacco advertising, promotion, and sponsorship (TAPS) in Ethiopia: a scoping review and narrative synthesis","authors":"T. G. Argefa, Tyryn Carnegie, S. A. Kassa, R. Kitonyo-Devotsu, N. Mdege","doi":"10.29392/001c.57372","DOIUrl":"https://doi.org/10.29392/001c.57372","url":null,"abstract":"Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43160619","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 : 2023-01-01Epub Date: 2023-03-24DOI: 10.29392/001c.72080
Patience A Muwanguzi, Paul K Otiku, Racheal Nabunya, Blessings Gausi
Background: The transgender or trans population is one of the most marginalized social groups globally, frequently experiencing ill-treatment and discrimination. This is disproportionately higher in sub-Saharan Africa where trans people experience stigma even in healthcare settings. There is limited evidence concerning the implementation and outcomes of interventions to mitigate this stigma. Therefore, this scoping review aimed to describe interventions and determine their effectiveness in reducing transgender stigma in sub-Saharan Africa.
Methods: Searches (completed November 01, 2021, and re-run May 2022) were conducted in MEDLINE (via PubMed), Cochrane Library including the Cochrane Central Register of Controlled Trials, EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of science, clinicaltrials.gov, and online grey literature sources to identify publications that described interventions to reduce transgender stigma in sub-Saharan Africa.
Results: From 877 literature search results, 23 full-text articles were assessed. Data were extracted from the four (4) eligible papers. Only one study explicitly mentioned transgender people. Second, while two studies incorporated conceptual frameworks, they did not show how the frameworks guided the study. The four studies implemented unique interventions at various socio-ecological levels to address individual and interpersonal and structural stigma. Each study utilized a different methodological approach, and the interventions were all evaluated qualitatively.
Conclusions: There is a paucity of transgender stigma reduction interventions implemented in Sub-Saharan Africa with limited evidence of interventions delivered to mitigate stigma at interpersonal and structural levels. Future anti-transgender stigma research should consider reporting details about the core components and descriptions of the interventions. Additionally, the use of validated measures of stigma and the evaluation of interventions for implementation outcomes would be helpful.
跨性别者或跨性别人群是全球最边缘化的社会群体之一，经常遭受虐待和歧视。在撒哈拉以南非洲，这一比例尤其高，在那里，跨性别者即使在医疗机构也会受到歧视。关于减轻这一污名的干预措施的实施和结果的证据有限。因此，本综述旨在描述干预措施并确定其在减少撒哈拉以南非洲跨性别污名方面的有效性。在MEDLINE(通过PubMed)、Cochrane图书馆(包括Cochrane中央对照试验注册库)、EBSCOhost、护理和相关健康文献累积索引(CINAHL)、Embase、Web of science、clinicaltrials.gov和在线灰色文献来源中进行检索(完成于2021年11月1日，并于2022年5月重新运行)，以确定描述在撒哈拉以南非洲减少跨性别污名的干预措施的出版物。从877个文献检索结果中，评估了23篇全文文章。数据从四篇符合条件的论文中提取。只有一项研究明确提到了变性人。其次，虽然两项研究纳入了概念框架，但它们并没有显示框架如何指导研究。这四项研究在不同的社会生态层面实施了独特的干预措施，以解决个人、人际和结构上的耻辱。每项研究都采用了不同的方法学方法，并对所有干预措施进行了定性评估。撒哈拉以南非洲实施的减少跨性别污名的干预措施很少，在人际和结构层面减轻污名的干预措施证据有限。未来的反跨性别污名研究应考虑报告核心成分的细节和干预措施的描述。此外，使用经过验证的污名措施和评估实施结果的干预措施将有所帮助。
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Halima Tougri, M. Yameogo, R. Compaoré, D. Dahourou, D. Belemsaga, Bertrand Meda, D. Kpebo, M. Ndour, S. Kouanda
Maternal and infant deaths can be prevented through integrated service delivery during pregnancy, postpartum, and early childhood. Our study analyses the gaps and opportunities associated with integrating maternal, newborn, and child health (MNCH) services with postpartum family planning (PPFP) and nutrition services at different points of contact in health facilities in a preintervention context in west Africa. We conducted a qualitative study from June to July 2018 in Burkina Faso, Côte d’Ivoire and Niger. The points of contact studied at the health facility level were the prenatal care, postpartum care and immunisation/growth monitoring services. Individual in-depth interviews were used to collect data from key informants (providers, community health workers and mother-child health programme managers). To measure the degree of service integration, we used the dimensions and indicators included in the Integra Initiative framework concerning four aspects of integration: physical (the availability of multiple services in the health facility), temporal (the availability of care more than one day per week), provider level, and functional (the receipt of integrated services by the client). The findings of this study show that the integrated delivery of MNCH, PPFP, and nutrition services is configured in similar ways in Burkina Faso, Côte d’Ivoire and Niger and is insufficient at all points of contact. Physical integration is high. However, the study found important gaps in temporal, functional and provider-level integration. The main barriers to integrated service delivery are the shortage of providers, the lack of training in integrated service delivery, and insufficient service organisation. However, the availability of multiple services throughout the week, the multiple points of contact between the mother-child pair and the health system, and the multiple skills of providers represent opportunities for functional integration through the establishment of a formal referral system between the different care units with follow-up and feedback among service providers. The provision of training and the development of a well-organised referral system in different health facilities, taking into account the specific characteristics of each health facility (urban/rural, primary health facility/district hospital), can improve the delivery of integrated MNCH, PPFP, and nutrition care to the mother-child pair.
{"title":"Gaps and opportunities for the integrated delivery of mother-child care, postpartum family planning and nutrition services in Burkina Faso, Côte d’Ivoire and Niger","authors":"Halima Tougri, M. Yameogo, R. Compaoré, D. Dahourou, D. Belemsaga, Bertrand Meda, D. Kpebo, M. Ndour, S. Kouanda","doi":"10.29392/001c.57370","DOIUrl":"https://doi.org/10.29392/001c.57370","url":null,"abstract":"Maternal and infant deaths can be prevented through integrated service delivery during pregnancy, postpartum, and early childhood. Our study analyses the gaps and opportunities associated with integrating maternal, newborn, and child health (MNCH) services with postpartum family planning (PPFP) and nutrition services at different points of contact in health facilities in a preintervention context in west Africa. We conducted a qualitative study from June to July 2018 in Burkina Faso, Côte d’Ivoire and Niger. The points of contact studied at the health facility level were the prenatal care, postpartum care and immunisation/growth monitoring services. Individual in-depth interviews were used to collect data from key informants (providers, community health workers and mother-child health programme managers). To measure the degree of service integration, we used the dimensions and indicators included in the Integra Initiative framework concerning four aspects of integration: physical (the availability of multiple services in the health facility), temporal (the availability of care more than one day per week), provider level, and functional (the receipt of integrated services by the client). The findings of this study show that the integrated delivery of MNCH, PPFP, and nutrition services is configured in similar ways in Burkina Faso, Côte d’Ivoire and Niger and is insufficient at all points of contact. Physical integration is high. However, the study found important gaps in temporal, functional and provider-level integration. The main barriers to integrated service delivery are the shortage of providers, the lack of training in integrated service delivery, and insufficient service organisation. However, the availability of multiple services throughout the week, the multiple points of contact between the mother-child pair and the health system, and the multiple skills of providers represent opportunities for functional integration through the establishment of a formal referral system between the different care units with follow-up and feedback among service providers. The provision of training and the development of a well-organised referral system in different health facilities, taking into account the specific characteristics of each health facility (urban/rural, primary health facility/district hospital), can improve the delivery of integrated MNCH, PPFP, and nutrition care to the mother-child pair.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49270865","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}
Alcoholism is rising in India, affecting both individuals and their families. This study explored the lived experience of women cohabiting men with alcohol use disorder (AUD) to understand the experience and coping resources they adopted from their perspective. Interpretive phenomenology design was used. Purposive sampling was employed to select women cohabiting men with AUD attending the de-addiction clinic. After explaining the study and written informed consent, in-depth interviews were conducted. By the interview of the 11th participant, data saturation was reached. Thematic analysis was undertaken. Significant statements and meaning units were identified, and codes were assigned. Three categories, namely impact on self, effect on life and coping strategies, were developed, and two main themes (faced numerous challenges and used adaptive and maladaptive coping) were generated. Women faced innumerable problems of poor health, physical misery, marital discord, emotional disturbances, strained social relations, and financial burden. Most women relied heavily on avoidance or tolerance coping like covering up, taking on extra work, withdrawing, distancing, and hiding from friends and family. Putting on a brave front and not doing anything is not productive for women and men with AUD.
{"title":"The lived experiences of the spouses of alcohol dependent partners: a phenomenological study","authors":"Mini George, N. B. Devi","doi":"10.29392/001c.57376","DOIUrl":"https://doi.org/10.29392/001c.57376","url":null,"abstract":"Alcoholism is rising in India, affecting both individuals and their families. This study explored the lived experience of women cohabiting men with alcohol use disorder (AUD) to understand the experience and coping resources they adopted from their perspective. Interpretive phenomenology design was used. Purposive sampling was employed to select women cohabiting men with AUD attending the de-addiction clinic. After explaining the study and written informed consent, in-depth interviews were conducted. By the interview of the 11th participant, data saturation was reached. Thematic analysis was undertaken. Significant statements and meaning units were identified, and codes were assigned. Three categories, namely impact on self, effect on life and coping strategies, were developed, and two main themes (faced numerous challenges and used adaptive and maladaptive coping) were generated. Women faced innumerable problems of poor health, physical misery, marital discord, emotional disturbances, strained social relations, and financial burden. Most women relied heavily on avoidance or tolerance coping like covering up, taking on extra work, withdrawing, distancing, and hiding from friends and family. Putting on a brave front and not doing anything is not productive for women and men with AUD.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44756502","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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