In India, the National Health Mission (NHM) has been supporting the states in building an integrated public healthcare network across the levels of care. This effort has improved access to, and utilization of, diagnostic services at public healthcare facilities. To continually enhance citizens’ ability to seek and avail quality and affordable services, it is imperative to take stock of various components of the diagnostic ecosystem that may be common or unique to states and understand their influence on equipping the health system. The objective of the study was to understand key health system factors augmenting or limiting access to diagnostic services and outcomes. Common Review Mission (CRM) reports between 2007 and 2021 were selected for the study. Data relevant to diagnostic services were retrieved using defined search terms. The data were segregated for each Indian state and categorized under the pre-determined themes: state-specific practices, key findings, and challenges. Analysis of the data was done iteratively to identify the themes emerging from the reports over the years. Each theme was analysed further to deduce context-specific enablers and barriers influencing access to diagnostic service delivery. The major themes that emerged include (i) the approach to health systems strengthening, (ii) efficiency of procurement and distribution systems, (iii) infrastructure, (iv) modes of service delivery, (v) implementation of Free Diagnostic Service Initiative, Comprehensive Primary Health Care and Biomedical Equipment Management and Maintenance Program, and (vi) quality of care , and (vii) diagnostic service outcomes. In a complex adaptive system, access to diagnostic services depends on the concurrent strengthening of various health system components across the levels of care. The nation has strategized accessible, affordable and acceptable diagnostic services to achieve universal health coverage and care-continuum pathways. States need to leverage the existing mechanisms, assess their implementation, and arrive at feasible and sustainable solutions to strengthen access to diagnostic services.
{"title":"Understanding what really helps to ensure access to diagnostic services in the Indian Public Health System: a realist synthesis of the Common Review Mission reports (2007-2021)","authors":"E. Hannah, Nisha Basheer, Neha Dumka, A. Kotwal","doi":"10.29392/001c.77888","DOIUrl":"https://doi.org/10.29392/001c.77888","url":null,"abstract":"In India, the National Health Mission (NHM) has been supporting the states in building an integrated public healthcare network across the levels of care. This effort has improved access to, and utilization of, diagnostic services at public healthcare facilities. To continually enhance citizens’ ability to seek and avail quality and affordable services, it is imperative to take stock of various components of the diagnostic ecosystem that may be common or unique to states and understand their influence on equipping the health system. The objective of the study was to understand key health system factors augmenting or limiting access to diagnostic services and outcomes. Common Review Mission (CRM) reports between 2007 and 2021 were selected for the study. Data relevant to diagnostic services were retrieved using defined search terms. The data were segregated for each Indian state and categorized under the pre-determined themes: state-specific practices, key findings, and challenges. Analysis of the data was done iteratively to identify the themes emerging from the reports over the years. Each theme was analysed further to deduce context-specific enablers and barriers influencing access to diagnostic service delivery. The major themes that emerged include (i) the approach to health systems strengthening, (ii) efficiency of procurement and distribution systems, (iii) infrastructure, (iv) modes of service delivery, (v) implementation of Free Diagnostic Service Initiative, Comprehensive Primary Health Care and Biomedical Equipment Management and Maintenance Program, and (vi) quality of care , and (vii) diagnostic service outcomes. In a complex adaptive system, access to diagnostic services depends on the concurrent strengthening of various health system components across the levels of care. The nation has strategized accessible, affordable and acceptable diagnostic services to achieve universal health coverage and care-continuum pathways. States need to leverage the existing mechanisms, assess their implementation, and arrive at feasible and sustainable solutions to strengthen access to diagnostic services.","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":"45789322","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}
Molly R Mantus, H. Obaje, R. Piltch-Loeb, Jae Won Chung, L. Hirschhorn, M. Subah, S. Mendin, M. Siedner, J. Kraemer
Despite the availability of COVID-19 vaccines, vaccination uptake remains low in Liberia. Social norms, and in particular an individual’s family preferences can have a strong normative influence on health behavior. However, few studies across the globe have explored how behavioral intent about COVID-19 vaccination among household members affects individual vaccination acceptance, particularly in rural, resource-limited settings. We respond to this gap in knowledge by analyzing data from a household survey of women in rural Liberia with the goal of understanding how household COVID-19 beliefs and vaccine behavioral intent correlated with those of individual household members. Data was analyzed from a household survey of 2,620 women aged 15-49 in 2,201 households in rural Grand Bassa County, Liberia, from March to April 2021. The survey included a COVID-19 module on protective health behaviors and intention to accept a COVID-19 vaccine when available. Each household was defined as being concordantly vaccine-hesitant, concordantly vaccine-accepting, or discordant. A multivariable logistic regression model was fitted to identify correlates of concordant acceptance, adjusting for potential confounders. The survey found that only approximately one in three households in rural Liberia were fully COVID-19 vaccine accepting. About 42% of households had discordant views on the vaccine, while 33% had concordantly accepting views, and 25% had concordantly hesitant views. The demographic characteristics of households with different vaccine beliefs were similar. Having a household member who accepted the COVID-19 vaccine was associated with an 18.1 percentage point greater likelihood of an individual accepting the vaccine (95% confidence interval, CI=7.3-28.9%, P=0.001). Social norms around vaccine acceptance within households are strongly associated with individual acceptance. Interventions that target hesitant households and individuals could have a significant impact on vaccine acceptance rates.
{"title":"Relationship between household member vaccine acceptance and individual vaccine acceptance among women in rural Liberia","authors":"Molly R Mantus, H. Obaje, R. Piltch-Loeb, Jae Won Chung, L. Hirschhorn, M. Subah, S. Mendin, M. Siedner, J. Kraemer","doi":"10.29392/001c.81917","DOIUrl":"https://doi.org/10.29392/001c.81917","url":null,"abstract":"Despite the availability of COVID-19 vaccines, vaccination uptake remains low in Liberia. Social norms, and in particular an individual’s family preferences can have a strong normative influence on health behavior. However, few studies across the globe have explored how behavioral intent about COVID-19 vaccination among household members affects individual vaccination acceptance, particularly in rural, resource-limited settings. We respond to this gap in knowledge by analyzing data from a household survey of women in rural Liberia with the goal of understanding how household COVID-19 beliefs and vaccine behavioral intent correlated with those of individual household members. Data was analyzed from a household survey of 2,620 women aged 15-49 in 2,201 households in rural Grand Bassa County, Liberia, from March to April 2021. The survey included a COVID-19 module on protective health behaviors and intention to accept a COVID-19 vaccine when available. Each household was defined as being concordantly vaccine-hesitant, concordantly vaccine-accepting, or discordant. A multivariable logistic regression model was fitted to identify correlates of concordant acceptance, adjusting for potential confounders. The survey found that only approximately one in three households in rural Liberia were fully COVID-19 vaccine accepting. About 42% of households had discordant views on the vaccine, while 33% had concordantly accepting views, and 25% had concordantly hesitant views. The demographic characteristics of households with different vaccine beliefs were similar. Having a household member who accepted the COVID-19 vaccine was associated with an 18.1 percentage point greater likelihood of an individual accepting the vaccine (95% confidence interval, CI=7.3-28.9%, P=0.001). Social norms around vaccine acceptance within households are strongly associated with individual acceptance. Interventions that target hesitant households and individuals could have a significant impact on vaccine acceptance rates.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43400099","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. B. Persiano, E. T. Rosin, G. A. Cabrera, Fernanda Uratani, L. V. Pires, F. Luzzatto, K. Schmeler, M. Salcedo
Vulvar Paget’s disease is rare and manifests clinically as erythematous itchy skin lesion with areas of hyperkeratosis. The current report describes the diagnosis, management and outcomes data from a case series of women diagnosed with vulvar Paget’s disease in a tertiary hospital in southern Brazil. A retrospective review of medical records of women with vulvar Paget’s disease at a single institution in the period 2000-2020 was carried out. Fisher’s exact test was used to compare recurrence in relation to the status of surgical margins after primary treatment and in relation to the surgical modality. Quantitative variables were described using mean and categorical variables using absolute and relative frequencies. Ten patients were identified with the diagnosis of vulvar Paget’s disease and two of them were excluded due to lack of information in medical records, therefore eight patients are described. The majority of the patients self-identified as white (87,5%, 7/8) and the median age at diagnosis was 65 years (range 45-81). The most common clinical symptoms were vulvar pruritus (62.5%, 5/8) and burning (37.5%, 3/8). It was not possible to identify the type of initial surgery in three patients, as they started follow-up at the institution after undergoing primary treatment at other institutions. The remaining five patients underwent surgery as their primary treatment – simple vulvectomy (60%, 3/5) and radical vulvectomy (40%, 2/5). In total, 75% (6/8) of patients had disease recurrence. Radiotherapy and imiquimod were used at the time of recurrence in three patients (50%, 3/6), but surgery remained the most common treatment for recurrence (83%, 5/6). The margin status of surgical specimens from patients starting treatment at the institution was negative in four (80%, 4/5) and positive in one woman (20%, 1/5). There was no significant difference in recurrence rates in patients with negative or positive margins, nor in relation to the surgical modality of the primary treatment. There were two deaths (25%, 2/8), one of them due to complications from Paget’s disease and the other one due to metastatic urothelial adenocarcinoma. Vulvar Paget’s disease has a significant morbidity and limited data are available, especially in Brazil. Due to the rarity of the disease, no randomized clinical trials are available in the literature and therefore it is difficult to compare the results of surgical treatment and other therapeutic modalities. There is an opportunity to explore best options for adequate Paget’s disease treatment.
{"title":"Vulvar Paget Disease: a series of cases in southern Brazil","authors":"M. B. Persiano, E. T. Rosin, G. A. Cabrera, Fernanda Uratani, L. V. Pires, F. Luzzatto, K. Schmeler, M. Salcedo","doi":"10.29392/001c.77616","DOIUrl":"https://doi.org/10.29392/001c.77616","url":null,"abstract":"Vulvar Paget’s disease is rare and manifests clinically as erythematous itchy skin lesion with areas of hyperkeratosis. The current report describes the diagnosis, management and outcomes data from a case series of women diagnosed with vulvar Paget’s disease in a tertiary hospital in southern Brazil. A retrospective review of medical records of women with vulvar Paget’s disease at a single institution in the period 2000-2020 was carried out. Fisher’s exact test was used to compare recurrence in relation to the status of surgical margins after primary treatment and in relation to the surgical modality. Quantitative variables were described using mean and categorical variables using absolute and relative frequencies. Ten patients were identified with the diagnosis of vulvar Paget’s disease and two of them were excluded due to lack of information in medical records, therefore eight patients are described. The majority of the patients self-identified as white (87,5%, 7/8) and the median age at diagnosis was 65 years (range 45-81). The most common clinical symptoms were vulvar pruritus (62.5%, 5/8) and burning (37.5%, 3/8). It was not possible to identify the type of initial surgery in three patients, as they started follow-up at the institution after undergoing primary treatment at other institutions. The remaining five patients underwent surgery as their primary treatment – simple vulvectomy (60%, 3/5) and radical vulvectomy (40%, 2/5). In total, 75% (6/8) of patients had disease recurrence. Radiotherapy and imiquimod were used at the time of recurrence in three patients (50%, 3/6), but surgery remained the most common treatment for recurrence (83%, 5/6). The margin status of surgical specimens from patients starting treatment at the institution was negative in four (80%, 4/5) and positive in one woman (20%, 1/5). There was no significant difference in recurrence rates in patients with negative or positive margins, nor in relation to the surgical modality of the primary treatment. There were two deaths (25%, 2/8), one of them due to complications from Paget’s disease and the other one due to metastatic urothelial adenocarcinoma. Vulvar Paget’s disease has a significant morbidity and limited data are available, especially in Brazil. Due to the rarity of the disease, no randomized clinical trials are available in the literature and therefore it is difficult to compare the results of surgical treatment and other therapeutic modalities. There is an opportunity to explore best options for adequate Paget’s disease treatment.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47186256","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}
S. Okoroafor, C. Nwachukwu, J. Asamani, A. Ahmat, M. Osubor
Universal access to a qualified, skilled, motivated and equitably distributed health workforce is pertinent for the delivery of quality health services needed to achieve national health sector goals and sustainable development goals. However, there remains a shortage of health workers attributed to health workers’ choices of not taking up postings due to the characteristics of workplace locations, amongst other factors. This study sought to understand the factors influencing primary healthcare workers’ choice of workplace locations in Nigeria. This study applied a qualitative research design. We interviewed 41 primary healthcare workers, including nurses, midwives, and community health practitioners, in Bauchi and Cross River States in Nigeria. The interviews elicited responses on the important issues that health workers consider when thinking of taking up or staying in a work location. We found that the working conditions, living environment and human resources for health (HRH) management practices influence the choice of work location amongst health workers. For working conditions, the quality of facilities, workload concerns, the scope of practice and community support were suggested as important factors. The living environment, specifically the availability of quality housing or an allowance to pay for quality accommodation, availability of transport facilities, and quality schools for children’s education were suggested as important factors. Lastly, the HRH management practices linked to supportive management, remunerations, career advancement and continuing education were highlighted as central factors. Our study highlights the importance of work location to health workers. In practice, there is a need for policymakers and health planners to gain and apply contextual evidence on factors influencing health workers’ choice of workplace locations in health and HRH planning and management. This is pertinent in designing and implementing tailored interventions for ensuring the equitable distribution of health workers.
{"title":"Understanding the factors influencing health workers’ choice of workplace locations: a qualitative description of primary healthcare workers’ perspectives in Nigeria","authors":"S. Okoroafor, C. Nwachukwu, J. Asamani, A. Ahmat, M. Osubor","doi":"10.29392/001c.82032","DOIUrl":"https://doi.org/10.29392/001c.82032","url":null,"abstract":"Universal access to a qualified, skilled, motivated and equitably distributed health workforce is pertinent for the delivery of quality health services needed to achieve national health sector goals and sustainable development goals. However, there remains a shortage of health workers attributed to health workers’ choices of not taking up postings due to the characteristics of workplace locations, amongst other factors. This study sought to understand the factors influencing primary healthcare workers’ choice of workplace locations in Nigeria. This study applied a qualitative research design. We interviewed 41 primary healthcare workers, including nurses, midwives, and community health practitioners, in Bauchi and Cross River States in Nigeria. The interviews elicited responses on the important issues that health workers consider when thinking of taking up or staying in a work location. We found that the working conditions, living environment and human resources for health (HRH) management practices influence the choice of work location amongst health workers. For working conditions, the quality of facilities, workload concerns, the scope of practice and community support were suggested as important factors. The living environment, specifically the availability of quality housing or an allowance to pay for quality accommodation, availability of transport facilities, and quality schools for children’s education were suggested as important factors. Lastly, the HRH management practices linked to supportive management, remunerations, career advancement and continuing education were highlighted as central factors. Our study highlights the importance of work location to health workers. In practice, there is a need for policymakers and health planners to gain and apply contextual evidence on factors influencing health workers’ choice of workplace locations in health and HRH planning and management. This is pertinent in designing and implementing tailored interventions for ensuring the equitable distribution of health workers.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46545463","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}
Cultured meat is being marketed as a multi-faceted improvement over traditional meat production. Some proponents claim that cultured meat reduces the potential spread of zoonotic disease; others further claim that cultured meat can be made more nutritious than traditional meat. This paper demonstrates – through a review of citations regarding proponent claims surrounding cultured meat’s potential to reduce zoonotic disease spread and improve nutritional possibilities – that cultured meat’s alleged health benefits are not based on quantitative data, nor based on well-developed theoretical research. Claims are often based on presumptions held throughout the literature; this paper calls these presumptions into question by investigating theoretical questions related to how cultured meat will be produced. Importantly, the paper also examines the recent emergence of “exotic cultured meat,” positing that proponent ambitions for diversified food experiences are not exempt from concerns about zoonotic disease spread and nutritional value. Healthcare professionals need to be aware of the limited evidence available for health-related claims which are being used to promote cultured meat. While such a conclusion does not require dismissing cultured meat’s potential, greater scrutiny is needed at this time, especially as cultured meat inches closer to becoming publicly available. This paper develops cultured meat research further by identifying the need for: deeper consideration of the interaction between humans and animals throughout the supply chain; greater care to be taken regarding the use of various sources as definitive proof of cultured meat’s alleged health benefits; and critical consideration of the implications of exotic cultured meat production.
{"title":"Reduced zoonoses and improved nutritional profiles: interrogating cultured meat and its alleged health benefits","authors":"R. Giles","doi":"10.29392/001c.81235","DOIUrl":"https://doi.org/10.29392/001c.81235","url":null,"abstract":"Cultured meat is being marketed as a multi-faceted improvement over traditional meat production. Some proponents claim that cultured meat reduces the potential spread of zoonotic disease; others further claim that cultured meat can be made more nutritious than traditional meat. This paper demonstrates – through a review of citations regarding proponent claims surrounding cultured meat’s potential to reduce zoonotic disease spread and improve nutritional possibilities – that cultured meat’s alleged health benefits are not based on quantitative data, nor based on well-developed theoretical research. Claims are often based on presumptions held throughout the literature; this paper calls these presumptions into question by investigating theoretical questions related to how cultured meat will be produced. Importantly, the paper also examines the recent emergence of “exotic cultured meat,” positing that proponent ambitions for diversified food experiences are not exempt from concerns about zoonotic disease spread and nutritional value. Healthcare professionals need to be aware of the limited evidence available for health-related claims which are being used to promote cultured meat. While such a conclusion does not require dismissing cultured meat’s potential, greater scrutiny is needed at this time, especially as cultured meat inches closer to becoming publicly available. This paper develops cultured meat research further by identifying the need for: deeper consideration of the interaction between humans and animals throughout the supply chain; greater care to be taken regarding the use of various sources as definitive proof of cultured meat’s alleged health benefits; and critical consideration of the implications of exotic cultured meat production.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45626490","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}
Coronavirus 2019 (COVID-19) infection during pregnancy has been reported to increase the risk of adverse maternal and perinatal outcomes. Data from the general population suggests that the Delta variant infection is associated with more severe disease than the Alpha variant. However, there is limited data available on the impact of delta variant infection during pregnancy on perinatal outcomes. This study aimed to evaluate the effects of SARS-CoV-2 delta variant infection during pregnancy on maternal and neonatal outcomes. In this retrospective, single-center study, we included all infants who were born from May 2020 through October 2021 to mothers with COVID-19 infection during pregnancy. At our institution, we started inpatient testing of all obstetric patients on admission on May 29, 2020. In our region, the Delta variant accounted for more than 80% of all COVID-19 infections from July 2021. Maternal and neonatal outcomes were compared between the pre-Delta (May 2020–June2021, n = 20) and Delta groups (July 2021–October 2021, n = 52). In comparing the Pre-Delta to Delta groups, there were no significant differences in the rates of maternal chorioamnionitis, gestational hypertension, diabetes, antepartum bleeding, c-section, maternal ICU admission, maternal COVID-19 symptoms, and maternal survival. All neonates born to these mothers tested negative for COVID-19. The rates of premature birth, Apgar score of less than 5 at 5 minutes, small for gestational age, microcephaly, need for noninvasive or invasive ventilator support, hypoxic ischemic encephalopathy, culture positive sepsis, and neonatal survival were not different between the two groups. There was no difference in placental findings between the two groups. However, infants born to symptomatic mothers in the Delta group had a higher rate of preterm delivery. Based on our study, the Delta variant of COVID-19 can increase preterm birth rates among symptomatic mothers. Further meta-analysis of available studies is needed to evaluate its effect on neonatal outcomes.
{"title":"Effects of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) Delta variant (B.1.617.2) on maternal and neonatal outcomes","authors":"K. Dolma, Swati John, R. Gulati","doi":"10.29392/001c.77985","DOIUrl":"https://doi.org/10.29392/001c.77985","url":null,"abstract":"Coronavirus 2019 (COVID-19) infection during pregnancy has been reported to increase the risk of adverse maternal and perinatal outcomes. Data from the general population suggests that the Delta variant infection is associated with more severe disease than the Alpha variant. However, there is limited data available on the impact of delta variant infection during pregnancy on perinatal outcomes. This study aimed to evaluate the effects of SARS-CoV-2 delta variant infection during pregnancy on maternal and neonatal outcomes. In this retrospective, single-center study, we included all infants who were born from May 2020 through October 2021 to mothers with COVID-19 infection during pregnancy. At our institution, we started inpatient testing of all obstetric patients on admission on May 29, 2020. In our region, the Delta variant accounted for more than 80% of all COVID-19 infections from July 2021. Maternal and neonatal outcomes were compared between the pre-Delta (May 2020–June2021, n = 20) and Delta groups (July 2021–October 2021, n = 52). In comparing the Pre-Delta to Delta groups, there were no significant differences in the rates of maternal chorioamnionitis, gestational hypertension, diabetes, antepartum bleeding, c-section, maternal ICU admission, maternal COVID-19 symptoms, and maternal survival. All neonates born to these mothers tested negative for COVID-19. The rates of premature birth, Apgar score of less than 5 at 5 minutes, small for gestational age, microcephaly, need for noninvasive or invasive ventilator support, hypoxic ischemic encephalopathy, culture positive sepsis, and neonatal survival were not different between the two groups. There was no difference in placental findings between the two groups. However, infants born to symptomatic mothers in the Delta group had a higher rate of preterm delivery. Based on our study, the Delta variant of COVID-19 can increase preterm birth rates among symptomatic mothers. Further meta-analysis of available studies is needed to evaluate its effect on neonatal outcomes.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44583802","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}
A. Miyazaki, Kerry L. M. Wong, Ra-young Kim, M. Matsui
Inappropriate complementary feeding is a factor contributing to linear growth faltering in early childhood. We aimed to assess complementary feeding practice and investigate its association with linear growth faltering among children aged 6 to 23 months among children aged 6-23 months in Cambodia. This study is a secondary data analysis of the 2014 Cambodia Demographic and Health Survey (CDHS). Multivariable linear regression analysis was used to investigate associations between complementary feeding practice and linear growth faltering as length-for-age z-scores (LAZ), adjusted for all covariates. This study included 1381 children aged 6 to 23 months. The prevalence of age-appropriate complementary feeding practice was low in Cambodia. Only 23% of the children met all three criteria of minimum dietary diversity, minimum meal frequency, and age-appropriate breastfeeding. Approximately 30% of children aged 6 to 11 months met the minimum dietary diversity requirements and less than 40% of children aged 18 to 23 months were provided breastfeeding after the introduction of complementary food. This study found that there is no relationship between food diversity and feeding frequency and child linear growth. However, the provision of both complementary food and breast milk was independently and negatively associated with linear growth (β-Coefficient=-0.38, 95% confidence interval, CI=-0.60, -0.16). Positive effects on child linear growth, after controlling for all covariates, included the richer (β-Coefficient=0.36, 95% CI=0.07, 0.66) and richest (β-Coefficient=0.50, 95% CI=0.20, 0.79) quintiles of households, as well as appropriate water treatment before drinking (β-Coefficient=0.22, 95% CI=0.05, 0.40). Most Cambodian young children aged 6 to 23 months received inappropriate complementary feeding. This study suggests that from the time of conception there is a necessity to improve maternal and child nutrition educational intervention for mothers, including feeding and hygiene practices.
{"title":"The association between complementary feeding practice and linear growth faltering among Cambodian children: an analysis of the 2014 Cambodia Demographic and Health Survey","authors":"A. Miyazaki, Kerry L. M. Wong, Ra-young Kim, M. Matsui","doi":"10.29392/001c.77655","DOIUrl":"https://doi.org/10.29392/001c.77655","url":null,"abstract":"Inappropriate complementary feeding is a factor contributing to linear growth faltering in early childhood. We aimed to assess complementary feeding practice and investigate its association with linear growth faltering among children aged 6 to 23 months among children aged 6-23 months in Cambodia. This study is a secondary data analysis of the 2014 Cambodia Demographic and Health Survey (CDHS). Multivariable linear regression analysis was used to investigate associations between complementary feeding practice and linear growth faltering as length-for-age z-scores (LAZ), adjusted for all covariates. This study included 1381 children aged 6 to 23 months. The prevalence of age-appropriate complementary feeding practice was low in Cambodia. Only 23% of the children met all three criteria of minimum dietary diversity, minimum meal frequency, and age-appropriate breastfeeding. Approximately 30% of children aged 6 to 11 months met the minimum dietary diversity requirements and less than 40% of children aged 18 to 23 months were provided breastfeeding after the introduction of complementary food. This study found that there is no relationship between food diversity and feeding frequency and child linear growth. However, the provision of both complementary food and breast milk was independently and negatively associated with linear growth (β-Coefficient=-0.38, 95% confidence interval, CI=-0.60, -0.16). Positive effects on child linear growth, after controlling for all covariates, included the richer (β-Coefficient=0.36, 95% CI=0.07, 0.66) and richest (β-Coefficient=0.50, 95% CI=0.20, 0.79) quintiles of households, as well as appropriate water treatment before drinking (β-Coefficient=0.22, 95% CI=0.05, 0.40). Most Cambodian young children aged 6 to 23 months received inappropriate complementary feeding. This study suggests that from the time of conception there is a necessity to improve maternal and child nutrition educational intervention for mothers, including feeding and hygiene practices.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43694205","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}
C. Logie, S. Van Borek, Anoushka Lad, L. Gittings, Julia Kagunda, H. Evelia, Clara Gachoki, Kevin Oyugi, Mercy Wanjiru Chege, Beldine Omondi, Maryline Okuto, L. Taing
Adolescent perspectives are crucially important for developing sustainable solutions to address climate change yet remain overlooked in the literature, particularly in low and middle-income contexts. Kenya is an important context to explore youth climate solutions, as youth constitute the fastest growing population facing climate change-related challenges, such as extreme weather events (e.g., droughts) and issues of water, food, and sanitation security. This manuscript details a methodology for participatory mapping on climate-related issues that was co-developed with Kenyan youth and community-based organizations in Kenya. The aim of this paper is to describe the design of a multi-media participatory mapping tool to identify and address the interconnections between social, health, and environmental well-being with very young adolescents (aged 10-14 years) in six geographically-diverse, climate-affected regions of Kenya (Nairobi, Kisumu, Kilifi, Naivasha, Isiolo, and Kalobeyei Refugee Settlement). The authors describe methods used to develop a strengths-based multi-media participatory mapping approach that combines user-friendly geographic information system (GIS) technology with arts-based methods (dance, drawing, music, video). The aim is to share these methods and process of co-development to inform future participatory mapping approaches with youth climate-related issues.
{"title":"A creative approach to participatory mapping on climate change impacts among very young adolescents in Kenya","authors":"C. Logie, S. Van Borek, Anoushka Lad, L. Gittings, Julia Kagunda, H. Evelia, Clara Gachoki, Kevin Oyugi, Mercy Wanjiru Chege, Beldine Omondi, Maryline Okuto, L. Taing","doi":"10.29392/001c.77885","DOIUrl":"https://doi.org/10.29392/001c.77885","url":null,"abstract":"Adolescent perspectives are crucially important for developing sustainable solutions to address climate change yet remain overlooked in the literature, particularly in low and middle-income contexts. Kenya is an important context to explore youth climate solutions, as youth constitute the fastest growing population facing climate change-related challenges, such as extreme weather events (e.g., droughts) and issues of water, food, and sanitation security. This manuscript details a methodology for participatory mapping on climate-related issues that was co-developed with Kenyan youth and community-based organizations in Kenya. The aim of this paper is to describe the design of a multi-media participatory mapping tool to identify and address the interconnections between social, health, and environmental well-being with very young adolescents (aged 10-14 years) in six geographically-diverse, climate-affected regions of Kenya (Nairobi, Kisumu, Kilifi, Naivasha, Isiolo, and Kalobeyei Refugee Settlement). The authors describe methods used to develop a strengths-based multi-media participatory mapping approach that combines user-friendly geographic information system (GIS) technology with arts-based methods (dance, drawing, music, video). The aim is to share these methods and process of co-development to inform future participatory mapping approaches with youth climate-related issues.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48939281","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. Esho, Julia Scholten, Hilke Conradi, D. Kawai, B. Mbogo, D. Lugayo, Y. Opanga, S. Muhula, D. Matanda
The Amref Alternative Rites of Passage (ARP) model was initiated in 2009. To date, about 20,000 girls have been supported by their communities to denounce female genital mutilation/cutting (FGM/C) and graduate into ‘maturity’ through ARP. While this intervention has been implemented for decades, there is limited evidence of its effectiveness in ending FGM/C. In order to ascertain the effectiveness of this intervention, Amref has developed a digital tracking tool to follow up on girls who have and haven’t gone through the ARP. The key research question is: what effect does ARP have on incidences of FGM/C, teenage pregnancy and child, early and forced marriages among adolescent girls and young women? The study will adopt a stepped-wedge cluster randomised controlled trial design to assess the effectiveness of the ARP model on the incidence of FGM/C; teenage pregnancy; child, early and forced marriage; and educational attainment. We selected one cluster in Kajiado County where recent ARPs have been conducted as the intervention site at the beginning of the study and 3 wards/clusters in Narok County as control sites. Approximately 604 girls aged 10-18 years who reside in selected sites/clusters in Kajiado and Narok counties will be recruited and followed up for 3 years post-exposure. Quantitative data analysis will be conducted at bivariate and multivariate levels. Content/thematic analysis approach will be used to analyse qualitative data. The study obtained ethical approval from the Amref Ethics and Scientific Review Committee (AMREF-ESRC P1051-2021). The findings of this study will be shared with local, national and regional stakeholders working in ending FGM/C, teenage pregnancy, and child, early and forced marriages. Registration – Pan-African Clinical Trials Registry (PACTR202208731662190).
{"title":"Amref Alternative Rites of Passage (ARP) model for female genital mutilation/cutting, teenage pregnancies, and child, early and forced marriages in Kenya: a stepped-wedge cluster randomised controlled trial protocol","authors":"T. Esho, Julia Scholten, Hilke Conradi, D. Kawai, B. Mbogo, D. Lugayo, Y. Opanga, S. Muhula, D. Matanda","doi":"10.29392/001c.77597","DOIUrl":"https://doi.org/10.29392/001c.77597","url":null,"abstract":"The Amref Alternative Rites of Passage (ARP) model was initiated in 2009. To date, about 20,000 girls have been supported by their communities to denounce female genital mutilation/cutting (FGM/C) and graduate into ‘maturity’ through ARP. While this intervention has been implemented for decades, there is limited evidence of its effectiveness in ending FGM/C. In order to ascertain the effectiveness of this intervention, Amref has developed a digital tracking tool to follow up on girls who have and haven’t gone through the ARP. The key research question is: what effect does ARP have on incidences of FGM/C, teenage pregnancy and child, early and forced marriages among adolescent girls and young women? The study will adopt a stepped-wedge cluster randomised controlled trial design to assess the effectiveness of the ARP model on the incidence of FGM/C; teenage pregnancy; child, early and forced marriage; and educational attainment. We selected one cluster in Kajiado County where recent ARPs have been conducted as the intervention site at the beginning of the study and 3 wards/clusters in Narok County as control sites. Approximately 604 girls aged 10-18 years who reside in selected sites/clusters in Kajiado and Narok counties will be recruited and followed up for 3 years post-exposure. Quantitative data analysis will be conducted at bivariate and multivariate levels. Content/thematic analysis approach will be used to analyse qualitative data. The study obtained ethical approval from the Amref Ethics and Scientific Review Committee (AMREF-ESRC P1051-2021). The findings of this study will be shared with local, national and regional stakeholders working in ending FGM/C, teenage pregnancy, and child, early and forced marriages. Registration – Pan-African Clinical Trials Registry (PACTR202208731662190).","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46956284","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}
Fever in malaria-endemic countries may be caused by malaria. Malaria infection is a major public health problem with substantial risks for severe morbidity and mortality. It is the leading cause of hospital admissions in children under five years of age worldwide. Despite being managed successfully if diagnosed in a timely way, facilitation of prompt health-seeking behaviour remains a challenge with many children reaching a health facility too late or not at all. We aimed to determine factors associated with prompt health-seeking behaviour among caregivers of children under five with fever in Malawi. We used data from the 2017 Malawi Malaria Indicator Survey (MMIS). Survey records for 2314 children aged under five years were identified of which 794 had fever in the past two weeks. Multivariable logistic regression analysis was carried out to identify factors associated with prompt health-seeking behaviour, defined as seeking health care the same day or day after the onset of fever. This study reveals that 40.1% of the children under five years presented with fever in the previous two weeks out of which 30.5% were taken for treatment promptly. Public facilities are the most visited places for under five child treatment (68.1%), followed by private drug sellers/pharmacies (17.4) and private/religious facilities (14.5%). Muslims (adjusted odds ratio, aOR=0.54, 95% confidence interval, CI=0.31-0.94) and children aged four years (aOR=0.56, CI=0.34-0.93) were less likely to be taken for treatment promptly compared to Christians and those less than 1 year, respectively. In contrast, children aged two years (aOR=1.71, CI=1.02-2.86) were more likely to be taken for prompt treatment compared to those less than 1 year. Age and religion are factors associated with prompt health-seeking behaviour in Malawi. Health education programs should be intensified to raise awareness among caregivers of the importance of early treatment-seeking regardless of the child’s age. Qualitative studies should be done in Malawi to explore different religious beliefs and their influence on health-seeking behaviours.
{"title":"Promptness of health-seeking behaviour among children under five years with fever in Malawi: evidence from the 2017 Malawi Malaria Indicator Survey","authors":"Yusuf M. Salim, F. Cavallaro","doi":"10.29392/001c.77882","DOIUrl":"https://doi.org/10.29392/001c.77882","url":null,"abstract":"Fever in malaria-endemic countries may be caused by malaria. Malaria infection is a major public health problem with substantial risks for severe morbidity and mortality. It is the leading cause of hospital admissions in children under five years of age worldwide. Despite being managed successfully if diagnosed in a timely way, facilitation of prompt health-seeking behaviour remains a challenge with many children reaching a health facility too late or not at all. We aimed to determine factors associated with prompt health-seeking behaviour among caregivers of children under five with fever in Malawi. We used data from the 2017 Malawi Malaria Indicator Survey (MMIS). Survey records for 2314 children aged under five years were identified of which 794 had fever in the past two weeks. Multivariable logistic regression analysis was carried out to identify factors associated with prompt health-seeking behaviour, defined as seeking health care the same day or day after the onset of fever. This study reveals that 40.1% of the children under five years presented with fever in the previous two weeks out of which 30.5% were taken for treatment promptly. Public facilities are the most visited places for under five child treatment (68.1%), followed by private drug sellers/pharmacies (17.4) and private/religious facilities (14.5%). Muslims (adjusted odds ratio, aOR=0.54, 95% confidence interval, CI=0.31-0.94) and children aged four years (aOR=0.56, CI=0.34-0.93) were less likely to be taken for treatment promptly compared to Christians and those less than 1 year, respectively. In contrast, children aged two years (aOR=1.71, CI=1.02-2.86) were more likely to be taken for prompt treatment compared to those less than 1 year. Age and religion are factors associated with prompt health-seeking behaviour in Malawi. Health education programs should be intensified to raise awareness among caregivers of the importance of early treatment-seeking regardless of the child’s age. Qualitative studies should be done in Malawi to explore different religious beliefs and their influence on health-seeking behaviours.","PeriodicalId":73759,"journal":{"name":"Journal of global health reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43480405","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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