Chifundo Msokera, D. Jumbam, Ibrahim Nthalika, Meredith Corner, Ernest Gaie, Ruben Ayala, T. Chokotho, U. S. Kanmounye, D. Mhango
Power asymmetries between global health actors based in low and middle-income countries (LMICs) and those based in High-Income Countries persist. Often actors in low-resource settings are seen solely as implementers of projects designed in High-Income Countries and are often not involved in the decision-making. To tackle the problem of power imbalances, a human-centered framework of design thinking was used for inclusive strategy development. This paper discusses how design thinking was used as a framework for the co-creation of Operation Smile Malawi’s (OSM) long-term strategy in a collaborative environment with in-country and international partners. The strategic planning process included a situation analysis, priority setting workshop and participant feedback. A four-question design thinking framework was used to frame the three-day priority setting sessions; ‘what is’, ‘what if’, ‘what wows’, and ‘what works’. Design thinking tools that were used during the priority setting workshop included; visualization, journey mapping, mind mapping, brainstorming and concept development. At the end of the priority-setting sessions, an e-survey was used to assess the participants’ understanding and perception of the use of design thinking for strategic planning. The product of the process was a long-term strategy with goals, activities and strategies that were understood and agreed upon by all stakeholders. The post-workshop e-survey revealed that all participants responded that the design thinking process fostered team spirit during the entire process. The design thinking process also made the strategic planning workshop more productive and enabled participants to incorporate their own ideas into the five-year strategy. Furthermore, participants reported learning something outside their area of expertise. As global health organizations increasingly recognize the need for equitable partnerships in the design and implementation of global health programs, the human-centred approach of design thinking can be used to create open and collaborative program design.
{"title":"Applying design thinking for collaborative strategic planning in global health partnerships: the Operation Smile experience","authors":"Chifundo Msokera, D. Jumbam, Ibrahim Nthalika, Meredith Corner, Ernest Gaie, Ruben Ayala, T. Chokotho, U. S. Kanmounye, D. Mhango","doi":"10.29392/001c.84862","DOIUrl":"https://doi.org/10.29392/001c.84862","url":null,"abstract":"Power asymmetries between global health actors based in low and middle-income countries (LMICs) and those based in High-Income Countries persist. Often actors in low-resource settings are seen solely as implementers of projects designed in High-Income Countries and are often not involved in the decision-making. To tackle the problem of power imbalances, a human-centered framework of design thinking was used for inclusive strategy development. This paper discusses how design thinking was used as a framework for the co-creation of Operation Smile Malawi’s (OSM) long-term strategy in a collaborative environment with in-country and international partners. The strategic planning process included a situation analysis, priority setting workshop and participant feedback. A four-question design thinking framework was used to frame the three-day priority setting sessions; ‘what is’, ‘what if’, ‘what wows’, and ‘what works’. Design thinking tools that were used during the priority setting workshop included; visualization, journey mapping, mind mapping, brainstorming and concept development. At the end of the priority-setting sessions, an e-survey was used to assess the participants’ understanding and perception of the use of design thinking for strategic planning. The product of the process was a long-term strategy with goals, activities and strategies that were understood and agreed upon by all stakeholders. The post-workshop e-survey revealed that all participants responded that the design thinking process fostered team spirit during the entire process. The design thinking process also made the strategic planning workshop more productive and enabled participants to incorporate their own ideas into the five-year strategy. Furthermore, participants reported learning something outside their area of expertise. As global health organizations increasingly recognize the need for equitable partnerships in the design and implementation of global health programs, the human-centred approach of design thinking can be used to create open and collaborative program design.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46229007","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}
E. Evens, Dieudonné Bidashimwa, Gwatiena Yina, R. Homan, G. A. Konseimbo, J. Tchupo
The COVID-19 pandemic imposed challenges to HIV service provision in Africa. The Ending AIDS in West Africa project (#EAWA), implemented in Burkina Faso and Togo, took measures to mitigate service provision disruptions due to COVID-19. We document the project’s strategies for ensuring an uninterrupted service provision to people living with HIV (PLHIV) during the COVID-19 pandemic. Using reports from project staff, we summarized #EAWA’s service provision strategies during the pandemic. This finding was complemented by a descriptive analysis of routine program data collected from December 2019 to April 2021 to evaluate how well these measures performed. COVID-19-related travel restrictions, lockdowns, logistical challenges, and fear of health facilities restricted access to HIV care. Building on shifting policy environments in both countries, #EAWA adopted a contingency plan to accelerate the multi-month dispensing of ARVs (MMD) and differentiated drug delivery (DDD). Quantitative results show that the pandemic briefly disrupted ARV refills and MMD dispensation. The implementation of EAWA’s contingency plan corresponded to a rapid increase in drug refills and MMD in both countries. Examination of programmatic data from this HIV program shows that COVID-19 provided the impetus to embrace MMD to ensure continuity of care. Despite an extremely challenging and shifting environment, the #EAWA project was able to respond nimbly to ensure clients stayed on treatment.
{"title":"Creating opportunities out of challenges: assessment of adaptations to maintain uninterrupted access to antiretroviral therapy for HIV clients in West Africa during the first year of the COVID-19 pandemic","authors":"E. Evens, Dieudonné Bidashimwa, Gwatiena Yina, R. Homan, G. A. Konseimbo, J. Tchupo","doi":"10.29392/001c.81915","DOIUrl":"https://doi.org/10.29392/001c.81915","url":null,"abstract":"The COVID-19 pandemic imposed challenges to HIV service provision in Africa. The Ending AIDS in West Africa project (#EAWA), implemented in Burkina Faso and Togo, took measures to mitigate service provision disruptions due to COVID-19. We document the project’s strategies for ensuring an uninterrupted service provision to people living with HIV (PLHIV) during the COVID-19 pandemic. Using reports from project staff, we summarized #EAWA’s service provision strategies during the pandemic. This finding was complemented by a descriptive analysis of routine program data collected from December 2019 to April 2021 to evaluate how well these measures performed. COVID-19-related travel restrictions, lockdowns, logistical challenges, and fear of health facilities restricted access to HIV care. Building on shifting policy environments in both countries, #EAWA adopted a contingency plan to accelerate the multi-month dispensing of ARVs (MMD) and differentiated drug delivery (DDD). Quantitative results show that the pandemic briefly disrupted ARV refills and MMD dispensation. The implementation of EAWA’s contingency plan corresponded to a rapid increase in drug refills and MMD in both countries. Examination of programmatic data from this HIV program shows that COVID-19 provided the impetus to embrace MMD to ensure continuity of care. Despite an extremely challenging and shifting environment, the #EAWA project was able to respond nimbly to ensure clients stayed on treatment.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49206387","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}
Guyana is among the countries committed to achieving the sustainable development goals. This research assessed the patterns of change in reproductive, maternal, newborn, and child health (RMNCH) in Guyana. Four nationally representative surveys conducted from 2009 to 2019 were assessed. Temporal trends in RMNCH indicators were assessed at the national level, by place of residence, and by wealth index. The slope index and concentration index of inequality were calculated to assess trends in inequalities over time. The average absolute annual change (AAAC) of the indicators was calculated using a weighted variance regression. From 2006 to 2019, we observed an increase in the coverage of institutional delivery (from 82.6% to 97.7%), and exclusive breastfeeding (from 21.4% to 31.0%), among others. Likewise, antenatal care with four or more visits increased from 77.4% in 2009 to 84.7% in 2019. The opposite was observed for coverage of current contraceptive use (modern methods) (from 32.7% to 28.2%), family planning needed satisfied (from 49.6% to 43.8%), tetanus toxoid in pregnancy (from 31.7% to 8.2%) and full vaccination coverage (from 82.0% to 63.4%). Under-five stunting prevalence decreased from 18.0% to 9.2% and the under-five mortality rate from 40.4 to 29.3 per 1,000 live births. The gap between the poorest and richest women tended to decrease for seven out of the 16 intervention indicators, as well as for under-five stunting prevalence and under-five mortality rate. Institutional delivery was the best performer in increasing coverage and decreasing inequality over time, while immunization with measles was the worst performer. Guyana has made great progress in improving its RMNCH indicators. However, the observed decline in the coverage of several RMNCH indicators can be seen as a warning sign to redouble efforts to achieve sustainable development goals, SDGs 1 and 2, by 2030 and to reduce inequalities by lagging no one behind.
{"title":"Socioeconomic inequalities in reproductive, maternal, newborn and child health in Guyana: a time trends analysis","authors":"Gary Joseph, L. Vidaletti, C. Boston","doi":"10.29392/001c.84527","DOIUrl":"https://doi.org/10.29392/001c.84527","url":null,"abstract":"Guyana is among the countries committed to achieving the sustainable development goals. This research assessed the patterns of change in reproductive, maternal, newborn, and child health (RMNCH) in Guyana. Four nationally representative surveys conducted from 2009 to 2019 were assessed. Temporal trends in RMNCH indicators were assessed at the national level, by place of residence, and by wealth index. The slope index and concentration index of inequality were calculated to assess trends in inequalities over time. The average absolute annual change (AAAC) of the indicators was calculated using a weighted variance regression. From 2006 to 2019, we observed an increase in the coverage of institutional delivery (from 82.6% to 97.7%), and exclusive breastfeeding (from 21.4% to 31.0%), among others. Likewise, antenatal care with four or more visits increased from 77.4% in 2009 to 84.7% in 2019. The opposite was observed for coverage of current contraceptive use (modern methods) (from 32.7% to 28.2%), family planning needed satisfied (from 49.6% to 43.8%), tetanus toxoid in pregnancy (from 31.7% to 8.2%) and full vaccination coverage (from 82.0% to 63.4%). Under-five stunting prevalence decreased from 18.0% to 9.2% and the under-five mortality rate from 40.4 to 29.3 per 1,000 live births. The gap between the poorest and richest women tended to decrease for seven out of the 16 intervention indicators, as well as for under-five stunting prevalence and under-five mortality rate. Institutional delivery was the best performer in increasing coverage and decreasing inequality over time, while immunization with measles was the worst performer. Guyana has made great progress in improving its RMNCH indicators. However, the observed decline in the coverage of several RMNCH indicators can be seen as a warning sign to redouble efforts to achieve sustainable development goals, SDGs 1 and 2, by 2030 and to reduce inequalities by lagging no one behind.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46712364","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}
Cervical cancer (CC) is the second leading cause of cancer among women in the Philippines, mainly caused by a persistent human papillomavirus infection (HPV). We aimed to determine the prevalence of HPV and compare screening methods within a socio-economically deprived rural community in the Philippines. We conducted a retrospective audit of the medical records of 872 women from the free Women’s clinic in a regional Philippines community over the period, 2013-2019. All participants were screened for CC using the VIA/VILI method, with only 284 women tested for HPV using the HPV-polymerase chain reaction (HPV-PCR) method. For the 284, we compared their HPV-PCR and VIA/VILI results. Data was de-identified and descriptively analysed. Thirteen different HPV subtypes, all oncogenic, exist in the community. HPV was detected in 32 (11%) of the 284 women tested. Of note, 28 patients who had an oncogenic HPV infection had a normal VIA/VILI inspection result. The bivalent vaccine protects only 6% of the HPV-positive cases in the clinic. This study suggests HPV-PCR testing is superior at detecting HPV before cervical changes occur. The different oncogenic HPV strains reflect the low coverage of the bivalent HPV vaccination in the community – a key area for practice and policy reforms. Further studies on the prevalence of oncogenic HPV strains will be vital in designing suitable preventive care programs for CC.
{"title":"Cervical screening using HPV-DNA cytology in a low-income setting: an audit within a socio-economically deprived rural community in the Philippines","authors":"Elena C Harty, S. Carr, Zelda Doyle, C. Hespe","doi":"10.29392/001c.83912","DOIUrl":"https://doi.org/10.29392/001c.83912","url":null,"abstract":"Cervical cancer (CC) is the second leading cause of cancer among women in the Philippines, mainly caused by a persistent human papillomavirus infection (HPV). We aimed to determine the prevalence of HPV and compare screening methods within a socio-economically deprived rural community in the Philippines. We conducted a retrospective audit of the medical records of 872 women from the free Women’s clinic in a regional Philippines community over the period, 2013-2019. All participants were screened for CC using the VIA/VILI method, with only 284 women tested for HPV using the HPV-polymerase chain reaction (HPV-PCR) method. For the 284, we compared their HPV-PCR and VIA/VILI results. Data was de-identified and descriptively analysed. Thirteen different HPV subtypes, all oncogenic, exist in the community. HPV was detected in 32 (11%) of the 284 women tested. Of note, 28 patients who had an oncogenic HPV infection had a normal VIA/VILI inspection result. The bivalent vaccine protects only 6% of the HPV-positive cases in the clinic. This study suggests HPV-PCR testing is superior at detecting HPV before cervical changes occur. The different oncogenic HPV strains reflect the low coverage of the bivalent HPV vaccination in the community – a key area for practice and policy reforms. Further studies on the prevalence of oncogenic HPV strains will be vital in designing suitable preventive care programs for CC.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46213535","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}
Gaire Sampada, D. Bhandari, C. Yamamoto, Tianchen Zhao, M. Tsubokura
Coronavirus Disease 2019 (COVID-19), a global pandemic, has resulted in millions of deaths worldwide and severely impacted health service delivery systems. Developing countries, including Nepal, faced the risk of health system failure due to limited infrastructures. During the pandemic, Nepal experienced a decline in medical service utilization by pregnant women and a decrease in national child immunization rates. Maternity services and child immunization services had significant consequences, serving as a warning for future pandemics. This article examines the effects of pandemic-induced stay-at-home policies on maternal and child immunization in Nepal. A comprehensive literature search was conducted to identify relevant articles on PubMed, Scopus, and Google Scholar. The search terms employed were “maternal mortality in Nepal during COVID-19”, “maternity service utilisation in Nepal during COVID-19”, and “child immunisation in Nepal during COVID-19”. The search was limited to articles published between 2019 and 2022, research conducted in Nepal, and that included maternal mortality, utilisation of maternity services, and child immunisation in the title of the full text. Factors such as the closure of public transportation and service centres and fear of contamination contributed to a decline in antenatal care visits. The disruption of programs aimed at reducing the Maternal Mortality Rate (MMR) and decreased activities of Female Community Health workers in most parts of the country led to an increase in the maternal mortality rate during the stay-at-home policies. Institutional delivery decreased by 52.4% during the stay-at-home policies compared to the period before. The neonatal mortality rate increased from 13 to 40 per 1000 live births during the pandemic stay-at-home policies. Immunization centres were also closed in Nepal during the early stages of stay-at-home policies, with 50% of centres ceasing services. Measles outbreaks were reported in some parts of the country during the pandemic. To mitigate future damage, specific guidelines should be established based on regional factors and infrastructure development. Measures such as providing protective equipment and maintaining communication with pregnant women via telephone can help reduce the impact of future pandemics.
{"title":"A scoping review of maternal and neonatal health services impacted during COVID-19 in Nepal","authors":"Gaire Sampada, D. Bhandari, C. Yamamoto, Tianchen Zhao, M. Tsubokura","doi":"10.29392/001c.84490","DOIUrl":"https://doi.org/10.29392/001c.84490","url":null,"abstract":"Coronavirus Disease 2019 (COVID-19), a global pandemic, has resulted in millions of deaths worldwide and severely impacted health service delivery systems. Developing countries, including Nepal, faced the risk of health system failure due to limited infrastructures. During the pandemic, Nepal experienced a decline in medical service utilization by pregnant women and a decrease in national child immunization rates. Maternity services and child immunization services had significant consequences, serving as a warning for future pandemics. This article examines the effects of pandemic-induced stay-at-home policies on maternal and child immunization in Nepal. A comprehensive literature search was conducted to identify relevant articles on PubMed, Scopus, and Google Scholar. The search terms employed were “maternal mortality in Nepal during COVID-19”, “maternity service utilisation in Nepal during COVID-19”, and “child immunisation in Nepal during COVID-19”. The search was limited to articles published between 2019 and 2022, research conducted in Nepal, and that included maternal mortality, utilisation of maternity services, and child immunisation in the title of the full text. Factors such as the closure of public transportation and service centres and fear of contamination contributed to a decline in antenatal care visits. The disruption of programs aimed at reducing the Maternal Mortality Rate (MMR) and decreased activities of Female Community Health workers in most parts of the country led to an increase in the maternal mortality rate during the stay-at-home policies. Institutional delivery decreased by 52.4% during the stay-at-home policies compared to the period before. The neonatal mortality rate increased from 13 to 40 per 1000 live births during the pandemic stay-at-home policies. Immunization centres were also closed in Nepal during the early stages of stay-at-home policies, with 50% of centres ceasing services. Measles outbreaks were reported in some parts of the country during the pandemic. To mitigate future damage, specific guidelines should be established based on regional factors and infrastructure development. Measures such as providing protective equipment and maintaining communication with pregnant women via telephone can help reduce the impact of future pandemics.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42569337","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}
The prevalence of type 2 diabetes mellitus (T2DM) in Britain is rising, with south-Asians being particularly vulnerable. This is attributed to cultural differences affecting south-Asians’ health behaviours in the risk and management of T2DM. Understanding cultural influences on eating practices is therefore vital in improving health behaviours in the South-Asian community and combatting the increasing burden of T2DM. A scoping literature review was conducted for primary studies conducted in Britain, qualitatively examining South-Asians’ attitudes, beliefs and behaviours regarding their eating practices in the risk and management of T2DM. searches were conducted between January 2000 and December 2022 on PubMed, Applied Social Sciences Index & Abstracts, Scopus, and International Bibliography of the Social Sciences. An inductive grounded theory approach was applied for data synthesis and analysis. 19 primary studies were identified. Stigma, lack of awareness, gender and food norms and culturally inappropriate healthcare advice prevented healthy eating behaviours. Family involvement and tailoring advice to south-Asian lifestyles enabled healthy eating. Varying attitudes existed between participants of differing age, generation, and education levels. A multi-interventional approach is needed to improve awareness, mitigate stigma, and make healthy eating more accessible to south-Asians. Health professionals require improved understanding of the cultural context. Further research is recommended to explore social factors affecting South-Asians’ health behaviours and ensure interventions are contextually suitable.
{"title":"Cultural factors influencing the eating behaviours of type 2 diabetes in the British South-Asian population: a scoping review of the literature","authors":"Sobia Iqbal","doi":"10.29392/001c.84191","DOIUrl":"https://doi.org/10.29392/001c.84191","url":null,"abstract":"The prevalence of type 2 diabetes mellitus (T2DM) in Britain is rising, with south-Asians being particularly vulnerable. This is attributed to cultural differences affecting south-Asians’ health behaviours in the risk and management of T2DM. Understanding cultural influences on eating practices is therefore vital in improving health behaviours in the South-Asian community and combatting the increasing burden of T2DM. A scoping literature review was conducted for primary studies conducted in Britain, qualitatively examining South-Asians’ attitudes, beliefs and behaviours regarding their eating practices in the risk and management of T2DM. searches were conducted between January 2000 and December 2022 on PubMed, Applied Social Sciences Index & Abstracts, Scopus, and International Bibliography of the Social Sciences. An inductive grounded theory approach was applied for data synthesis and analysis. 19 primary studies were identified. Stigma, lack of awareness, gender and food norms and culturally inappropriate healthcare advice prevented healthy eating behaviours. Family involvement and tailoring advice to south-Asian lifestyles enabled healthy eating. Varying attitudes existed between participants of differing age, generation, and education levels. A multi-interventional approach is needed to improve awareness, mitigate stigma, and make healthy eating more accessible to south-Asians. Health professionals require improved understanding of the cultural context. Further research is recommended to explore social factors affecting South-Asians’ health behaviours and ensure interventions are contextually suitable.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47777838","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}
M. I. Nisar, M. Amin, N. Ansari, F. Khalid, Najeeb Rehman, A. Hotwani, U. Mehmood, A. Memon, J. Iqbal, A. Saleem, D. Larremore, B. Fosdick, F. Jehan
Antibody-based serological tests which target households and communities can estimate the true extent of infection in a population. It minimizes the biases of facility-based selective testing and generates scientific data on disease transmission through household asymptomatic cases. The objective of this study was to determine the seroprevalence and trend of SARS-CoV-2 in a densely populated urban community of Karachi. Three serial cross-sectional surveys were conducted in November 2020, February 2021, and December 2021 in Karachi’s District East. Households were selected to provide serum samples for Elecsys® immunoassay for the detection of SARS-CoV-2 antibodies. All household members were eligible to participate regardless of age and infection status. Bayesian regression was used to adjust for assay performance and estimate seroprevalence. We enrolled 1506 participants from 501 households. In November 2020, adjusted seroprevalence was estimated as 24.0% (95% confidence interval, CI=18.0-31.0), compared to 53.9% (95% CI=45.5-63.2) in February. In December 2021, it increased to 84.9% (95% CI=78.5-92.3). The conditional risk of infection was 41% (95% CI=29.9-51.6), 56.7% (95% CI=50.4–62.6) and 77.8% (95% CI=73.0-81.7) in surveys 4, 5, and 6 respectively. Only 18.7% of participants who had reactive antibodies for COVID-19 were symptomatic. An increase in seroprevalence estimates in Karachi’s District East was observed over time. Community-based seroprevalence studies help to estimate the true proportion of the population that has been infected and predicts the spread of the disease in similar settings.
{"title":"Community-based seroprevalence of SARS CoV-2 in an urban district of Karachi, Pakistan","authors":"M. I. Nisar, M. Amin, N. Ansari, F. Khalid, Najeeb Rehman, A. Hotwani, U. Mehmood, A. Memon, J. Iqbal, A. Saleem, D. Larremore, B. Fosdick, F. Jehan","doi":"10.29392/001c.84241","DOIUrl":"https://doi.org/10.29392/001c.84241","url":null,"abstract":"Antibody-based serological tests which target households and communities can estimate the true extent of infection in a population. It minimizes the biases of facility-based selective testing and generates scientific data on disease transmission through household asymptomatic cases. The objective of this study was to determine the seroprevalence and trend of SARS-CoV-2 in a densely populated urban community of Karachi. Three serial cross-sectional surveys were conducted in November 2020, February 2021, and December 2021 in Karachi’s District East. Households were selected to provide serum samples for Elecsys® immunoassay for the detection of SARS-CoV-2 antibodies. All household members were eligible to participate regardless of age and infection status. Bayesian regression was used to adjust for assay performance and estimate seroprevalence. We enrolled 1506 participants from 501 households. In November 2020, adjusted seroprevalence was estimated as 24.0% (95% confidence interval, CI=18.0-31.0), compared to 53.9% (95% CI=45.5-63.2) in February. In December 2021, it increased to 84.9% (95% CI=78.5-92.3). The conditional risk of infection was 41% (95% CI=29.9-51.6), 56.7% (95% CI=50.4–62.6) and 77.8% (95% CI=73.0-81.7) in surveys 4, 5, and 6 respectively. Only 18.7% of participants who had reactive antibodies for COVID-19 were symptomatic. An increase in seroprevalence estimates in Karachi’s District East was observed over time. Community-based seroprevalence studies help to estimate the true proportion of the population that has been infected and predicts the spread of the disease in similar settings.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48919500","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}
College admissions policies are complex and fast-changing in South Korea (hereinafter, Korea). The Korean Disease Control and Prevention Agency and the Ministry of Education have jointly conducted adolescent health behavior surveys every year since 2005. Mental health is included in the survey as an important category. We examined the effects of the current complicated college admissions process on the mental health and well-being of middle- and high-school students in Korea, to serve as a guide for future educational policy reforms. We performed secondary statistical analyses on varied data collected between 2017-2021. The data are obtained from Korean Statistical Information Service, Korean Disease Control and Prevention Agency, Korean Ministry of Education, National Youth Policy Institute, and other related Korean government branches. We used the proportional allocation method, which took account of the size of the 17 cities and provinces in South Korea, as well as the population numbers in those regions. Our statistics are reliable owing to the robustness of the official source data and the large sample size. Notably, middle- and high-school students generally spend several hours in private classes (because public schools are insufficient to prepare for the college admissions process) and on their daily homework, leaving limited leisure time. Parents spend a significant portion of their household income on private education. Moreover, middle-and high-school students suffer greatly from severe mental health issues such as with suicide, depression, anxiety, and similar indicators. Middle- and high-school students are experiencing mental health problems that are not merely stress. A secondary analysis of the collected data suggests that the complex college admission process and over-loaded mental health issues among Korean middle- and high-school students are quite serious. The results can further serve as a guide for policymakers to evaluate and plan youth health policies and health promotion projects for students in South Korea.
{"title":"Problems with complex college admissions policies and overloaded after-school private education on middle- and high-school students’ mental health in South Korea","authors":"Jingyi Xu, Sun Goo Lee","doi":"10.29392/001c.84099","DOIUrl":"https://doi.org/10.29392/001c.84099","url":null,"abstract":"College admissions policies are complex and fast-changing in South Korea (hereinafter, Korea). The Korean Disease Control and Prevention Agency and the Ministry of Education have jointly conducted adolescent health behavior surveys every year since 2005. Mental health is included in the survey as an important category. We examined the effects of the current complicated college admissions process on the mental health and well-being of middle- and high-school students in Korea, to serve as a guide for future educational policy reforms. We performed secondary statistical analyses on varied data collected between 2017-2021. The data are obtained from Korean Statistical Information Service, Korean Disease Control and Prevention Agency, Korean Ministry of Education, National Youth Policy Institute, and other related Korean government branches. We used the proportional allocation method, which took account of the size of the 17 cities and provinces in South Korea, as well as the population numbers in those regions. Our statistics are reliable owing to the robustness of the official source data and the large sample size. Notably, middle- and high-school students generally spend several hours in private classes (because public schools are insufficient to prepare for the college admissions process) and on their daily homework, leaving limited leisure time. Parents spend a significant portion of their household income on private education. Moreover, middle-and high-school students suffer greatly from severe mental health issues such as with suicide, depression, anxiety, and similar indicators. Middle- and high-school students are experiencing mental health problems that are not merely stress. A secondary analysis of the collected data suggests that the complex college admission process and over-loaded mental health issues among Korean middle- and high-school students are quite serious. The results can further serve as a guide for policymakers to evaluate and plan youth health policies and health promotion projects for students in South Korea.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44902105","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}
N. Olajide, B. Jani, C. Niedzwiedz, C. Johnman, K. Robb
Cervical cancer incidence and mortality are high in Africa. We assessed cervical cancer and screening awareness in two West African countries. We used data from the Demographic and Health Surveys (DHS) in Benin (2017-2018) and Cameroon (2018). Women (n=21322) aged 15-49 were interviewed on awareness of cervical cancer and cervical cancer screening. Descriptive statistics and logistic regression analysis were employed. Awareness of cervical cancer was low among women in Cameroon (46.1%) and very low in Benin (9.5%). Among those aware of cervical cancer, 51.4% in Benin and 59.7% in Cameroon were also aware of cervical screening. In the adjusted analysis, women in Cameroon aged 45+ had the highest awareness odds of both cervical cancer (adjusted odds ratio, aOR=2.91, 95% confidence interval, CI=2.36-3.60) and screening (aOR=1.75, 95% CI=1.33-2.29). In Benin, women aged 45+ had the highest cervical cancer awareness (aOR=1.89, 95% CI=1.23-2.91) while screening awareness was highest in women aged 25-34 years (aOR=1.98, 95% CI=1.20-3.27). Women with higher education were six to nine times more aware of cervical cancer and three to four times more aware of cervical screening than women with no education in Benin and Cameroon respectively. Additionally, cervical cancer awareness was approximately four times higher in the richest wealth quintile in Cameroon. In Benin, the odds of awareness of cervical cancer were increased with daily internet use (aOR=3.61, 95% CI=2.45-5.32) and radio listening once a week (aOR=1.73, 95% CI=1.04-2.88) compared to no internet and no radio listening respectively. In Cameroon, both awareness of cervical cancer and screening increased with daily internet use (aOR=1.95, 95% CI=1.61-2.35) and (aOR=1.35, 95% CI=1.10-1.67) respectively. There is a need to increase awareness of cervical cancer and screening in Benin and Cameroon and extend to other West African countries. The internet and radio appear to be important potentially effective means for raising awareness.
{"title":"Awareness of cervical cancer and screening in Benin and Cameroon: an analysis of the Demographic and Health Survey, 2017-2018","authors":"N. Olajide, B. Jani, C. Niedzwiedz, C. Johnman, K. Robb","doi":"10.29392/001c.82158","DOIUrl":"https://doi.org/10.29392/001c.82158","url":null,"abstract":"Cervical cancer incidence and mortality are high in Africa. We assessed cervical cancer and screening awareness in two West African countries. We used data from the Demographic and Health Surveys (DHS) in Benin (2017-2018) and Cameroon (2018). Women (n=21322) aged 15-49 were interviewed on awareness of cervical cancer and cervical cancer screening. Descriptive statistics and logistic regression analysis were employed. Awareness of cervical cancer was low among women in Cameroon (46.1%) and very low in Benin (9.5%). Among those aware of cervical cancer, 51.4% in Benin and 59.7% in Cameroon were also aware of cervical screening. In the adjusted analysis, women in Cameroon aged 45+ had the highest awareness odds of both cervical cancer (adjusted odds ratio, aOR=2.91, 95% confidence interval, CI=2.36-3.60) and screening (aOR=1.75, 95% CI=1.33-2.29). In Benin, women aged 45+ had the highest cervical cancer awareness (aOR=1.89, 95% CI=1.23-2.91) while screening awareness was highest in women aged 25-34 years (aOR=1.98, 95% CI=1.20-3.27). Women with higher education were six to nine times more aware of cervical cancer and three to four times more aware of cervical screening than women with no education in Benin and Cameroon respectively. Additionally, cervical cancer awareness was approximately four times higher in the richest wealth quintile in Cameroon. In Benin, the odds of awareness of cervical cancer were increased with daily internet use (aOR=3.61, 95% CI=2.45-5.32) and radio listening once a week (aOR=1.73, 95% CI=1.04-2.88) compared to no internet and no radio listening respectively. In Cameroon, both awareness of cervical cancer and screening increased with daily internet use (aOR=1.95, 95% CI=1.61-2.35) and (aOR=1.35, 95% CI=1.10-1.67) respectively. There is a need to increase awareness of cervical cancer and screening in Benin and Cameroon and extend to other West African countries. The internet and radio appear to be important potentially effective means for raising awareness.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42270846","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}
Elizabeth K. Stierman, S. Shiferaw, Saifuddin Ahmed, Mahari Yihdego, A. Seme, L. Zimmerman, A. Creanga
Facility readiness is an important prerequisite for providing safe, effective childbirth care. This study assesses the readiness of health facilities in Ethiopia to provide childbirth services, describes variations in geographic access to service-ready facilities, and evaluates how facility readiness relates to childbirth service usage with a lens on equity. The study used cross-sectional data from a nationally representative sample of households in Ethiopia linked with data from health facilities serving the same areas. We explored variation in childbirth service readiness across facilities and classified facilities as “service-ready” if they had a readiness score of 0.75 or higher on a 0-1 scale. We used logistic regression modeling to examine the odds of residing within 10 kilometers of a service-ready facility by socioeconomic and geographic characteristics, and the odds of a facility delivery given the readiness of nearby facilities. Childbirth service readiness was generally high for hospitals (median score: 0.92) with minimal variation (interquartile range, IQR: 0.88 to 0.96). Health centers and clinics displayed lower and more variable readiness (median: 0.75, IQR: 0.66 to 0.84). In both crude and adjusted regression analyses, odds of residing within 10 kilometers of a service-ready facility were significantly greater for women with higher education levels, greater wealth, and urban residence. We found the adjusted odds of using facility childbirth services were 1.23 (95% CI: 1.03, 1.48) times greater for each 0.10-unit increase in the readiness level of nearby facilities. Access to childbirth care is not equal for Ethiopian women. Those living in rural areas and the poor must travel farther to reach facility childbirth services, and the nearest facilities serving these women were less prepared to provide quality care. This may contribute to lower service utilization by such disadvantaged groups of women.
{"title":"Readiness, access, and use of facility childbirth care in Ethiopia: results from nationally representative linked household and health facility surveys","authors":"Elizabeth K. Stierman, S. Shiferaw, Saifuddin Ahmed, Mahari Yihdego, A. Seme, L. Zimmerman, A. Creanga","doi":"10.29392/001c.81640","DOIUrl":"https://doi.org/10.29392/001c.81640","url":null,"abstract":"Facility readiness is an important prerequisite for providing safe, effective childbirth care. This study assesses the readiness of health facilities in Ethiopia to provide childbirth services, describes variations in geographic access to service-ready facilities, and evaluates how facility readiness relates to childbirth service usage with a lens on equity. The study used cross-sectional data from a nationally representative sample of households in Ethiopia linked with data from health facilities serving the same areas. We explored variation in childbirth service readiness across facilities and classified facilities as “service-ready” if they had a readiness score of 0.75 or higher on a 0-1 scale. We used logistic regression modeling to examine the odds of residing within 10 kilometers of a service-ready facility by socioeconomic and geographic characteristics, and the odds of a facility delivery given the readiness of nearby facilities. Childbirth service readiness was generally high for hospitals (median score: 0.92) with minimal variation (interquartile range, IQR: 0.88 to 0.96). Health centers and clinics displayed lower and more variable readiness (median: 0.75, IQR: 0.66 to 0.84). In both crude and adjusted regression analyses, odds of residing within 10 kilometers of a service-ready facility were significantly greater for women with higher education levels, greater wealth, and urban residence. We found the adjusted odds of using facility childbirth services were 1.23 (95% CI: 1.03, 1.48) times greater for each 0.10-unit increase in the readiness level of nearby facilities. Access to childbirth care is not equal for Ethiopian women. Those living in rural areas and the poor must travel farther to reach facility childbirth services, and the nearest facilities serving these women were less prepared to provide quality care. This may contribute to lower service utilization by such disadvantaged groups of women.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45839916","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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