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Using mobile phones in improving mental health services delivery in Tanzania: a feasibility study at Mirembe National Mental Health Hospital in Dodoma 利用移动电话改善坦桑尼亚的精神保健服务:在多多马的米伦贝国家精神保健医院进行的可行性研究
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E6
Perpetua Hardy Mwambingu, Damas Andrea, J. Katomero
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引用次数: 1
The role of water and sanitation, diarrheal infection, and breastfeeding on child stunting: insights from a historical analysis of the Cebu longitudinal health and nutrition survey, 1984–1986 水和卫生设施、腹泻感染和母乳喂养对儿童发育迟缓的作用:1984-1986年宿务纵向健康和营养调查历史分析的见解
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E1
Rockli Kim, S. Subramanian, E. Orav, W. Fawzi
Background: The association between improved water and sanitation (WATSAN) and child nutritional status may operate through diverse pathways and interact with other risk factors. We examined the joint association between WATSAN and child stunting in the Philippines during a historically critical period marked with substantial heterogeneity in WATSAN conditions. Methods: Data came from the Cebu Longitudinal Health and Nutrition Survey. Birth surveys and bi-monthly follow-up surveys from 1984–1986 were used for the final analytic sample of 2,584 children. We ran a series of logistic regression models for WATSAN and child stunting at age 2, before and after adjusting for a priori selected covariates. We performed stratified analysis by the child's experience of diarrhea in the first 2 years (never vs. at least 1 incidence), and tested for interaction with breastfeeding practices in the first 6 months (never vs. partial vs. predominant). Results: 53.9% of our sample were stunted at age of 2 and only 26.8% had access to improved WATSAN. In our final multivariate adjusted model, improved WATSAN was associated with a significantly reduced odds of stunting (odds ratio [OR], 0.59; P < 0.01). This was consistently found among children who have never experienced diarrheal incidence (OR, 0.38; P = 0.03) as well as those who have experienced diarrhea at least once (OR, 0.62; P < 0.05). A marginally significant interaction was found between WATSAN and breastfeeding (P = 0.10). Conclusion: Ensuring access to improved WATSAN has great potentials to reduce child stunting, and this could occur through diverse pathways that do not necessarily involve clinically detectable signs of infection. Improved WATSAN appears to be relatively more important for children who are not breastfed. Future studies should explore these associations using more recent data and in the context of other lowand middle-income countries.
背景:改善水和卫生设施(WATSAN)与儿童营养状况之间的关系可能通过多种途径起作用,并与其他风险因素相互作用。我们研究了菲律宾在WATSAN条件具有显著异质性的历史关键时期WATSAN与儿童发育迟缓之间的联合关系。方法:数据来自宿务纵向健康和营养调查。最终分析样本为2,584名儿童,使用了1984-1986年的出生调查和双月随访调查。在调整先验选定协变量之前和之后,我们运行了一系列关于WATSAN和2岁儿童发育迟缓的逻辑回归模型。我们根据儿童在前2年的腹泻经历进行了分层分析(从未与至少一次发生率),并测试了前6个月与母乳喂养的相互作用(从未、部分与主要)。结果:53.9%的样本在2岁时发育迟缓,只有26.8%的样本获得了改进的WATSAN。在我们最终的多变量调整模型中,改善的WATSAN与显著降低的发育迟缓几率相关(优势比[OR], 0.59;P < 0.01)。这在从未发生过腹泻的儿童中一致发现(OR, 0.38;P = 0.03)以及至少经历过一次腹泻的人(OR, 0.62;P < 0.05)。WATSAN与母乳喂养之间存在显著的交互作用(P = 0.10)。结论:确保获得改进的WATSAN具有减少儿童发育迟缓的巨大潜力,这可能通过多种途径发生,不一定涉及临床可检测到的感染迹象。改善WATSAN似乎对非母乳喂养的儿童更为重要。未来的研究应使用更近期的数据并在其他低收入和中等收入国家的背景下探讨这些关联。
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引用次数: 5
The role of maternal and child health (MCH) handbook in the era of sustainable development goals (SDGs) 妇幼保健手册在可持续发展目标时代的作用
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E24
Yasuhide Nakamura
The maternal and child health (MCH) handbook was published for the first time in Japan in 1948. The MCH handbook was born in Japan but is being developed and adapted around the world. MCH handbook programs have been introduced in more than 50 countries and areas. The MCH handbook is not an end goal but a starting point. It is not a tool that can directly reduce maternal and child deaths. However, it can increase knowledge and change MCH related behaviors through strengthening communication between health professionals and mothers with children. It can be utilized as a basic tool for ensuring the quality of lives of mothers, children and families around the world. Many of the MCH handbook's innovative roles also fit well within the context of the sustainable development goals which were adopted by the United Nations in 2015. In 2018, there were 2 important messages; World Health Organization recommendations on home-based records for maternal, newborn and child health and World Medical Association statement on the development and promotion of MCH handbook. MCH handbook is an indispensable tool in our efforts to crystallize the idea of leaving no one behind. Each country has its own culture and customs. We should respect the worth of each culture, share good practices and lessons learned, and promote the use of MCH handbooks for the benefit of larger numbers of people.
《妇幼保健手册》于1948年首次在日本出版。MCH手册诞生于日本,但正在世界各地发展和调整。妇幼保健手册项目已在50多个国家和地区推出。MCH手册不是一个最终目标,而是一个起点。它不是一种可以直接减少孕产妇和儿童死亡的工具。然而,它可以通过加强卫生专业人员与有孩子的母亲之间的沟通来增加知识和改变妇幼保健相关行为。它可以被用作确保世界各地母亲、儿童和家庭生活质量的基本工具。妇幼保健手册的许多创新作用也完全符合联合国2015年通过的可持续发展目标。2018年,有两个重要信息:世界卫生组织关于产妇、新生儿和儿童家庭保健记录的建议和世界医学协会关于编制和推广妇幼保健手册的声明。MCH手册是我们努力实现不让任何人掉队这一理念的不可或缺的工具。每个国家都有自己的文化和习俗。我们应该尊重每一种文化的价值,分享良好做法和经验教训,并促进妇幼保健手册的使用,使更多的人受益。
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引用次数: 14
Cost and affordability analysis of TB-LAMP and Xpert MTB/RIF assays as routine diagnostic tests in peripheral laboratories in Malawi and Vietnam 马拉维和越南周边实验室TB-LAMP和Xpert MTB/RIF检测作为常规诊断检测的成本和可负担性分析
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E22
H. Sohn, L. Puri, N. A. T. Nguyen, A. V. Hoog, V. T. Nguyen, M. Nliwasa, P. Nabeta
Background: While the incidence of tuberculosis (TB) is declining globally, the rate of decline is far too slow to meet the 2035 end TB targets. Use of rapid molecular diagnostics that can be deployed in peripheral settings has the potential to address gaps in TB care cascade, improve case detection, and ultimately limit the on-going transmission of the disease. Methods: We assessed the costs and affordability of 2 commercial nucleic acid amplification test (NAAT)—loop-mediated isothermal amplification assay for TB (TB-LAMP) and Xpert MTB/RIF (Xpert)—used at the peripheral laboratories in Malawi and Vietnam. Costs were assessed from the health service provider perspective using bottom-up method. Categorized documentation of resources uses for each diagnostic test was done using a standardized time-and-motion form directly observing each laboratory procedure. Affordability was assessed as a proportion of total first-year implementation and operational costs of respective diagnostics against the national TB program budget for 2014. Results: Unit costs of TB-LAMP and Xpert varied depending on the daily test volumes and the test kit costs were the primary cost driver. Unused equipment capacity costs were also an important cost driver at low testing volumes and was more significant for Xpert. Weighted average per-test cost of nationwide implementation of respective diagnostics was between $14.37–$15.85 for TB-LAMP and $20.06–$26.86 for Xpert for Vietnam and Malawi. Both NAATs would account for a significant portion of or exceeded the national TB program budget if complete nationwide roll-out to peripheral laboratory were considered. Conclusion: While TB-LAMP is a lower cost alternative to Xpert as an upfront NAAT for TB in peripheral settings, cost-utility against Xpert and other alternatives and optimized implementation strategies must be carefully evaluated through additional model-based studies to better inform policy and program decisions to expand the coverage of rapid diagnostics for TB.
背景:虽然全球结核病发病率正在下降,但下降速度太慢,无法实现2035年终止结核病的目标。使用可在外围环境部署的快速分子诊断有可能解决结核级联治疗中的差距,改善病例发现,并最终限制该疾病的持续传播。方法:我们评估了马拉维和越南外围实验室使用的2种商业核酸扩增试验(NAAT)的成本和可负担性- TB环介导等温扩增试验(TB- lamp)和Xpert MTB/RIF (Xpert)。采用自下而上的方法从保健服务提供者的角度评估了费用。每个诊断测试的资源使用分类文档使用标准化的时间和运动表,直接观察每个实验室程序。根据2014年国家结核病规划预算,评估了可负担性在第一年实施总额和各自诊断方法运营成本中所占的比例。结果:TB-LAMP和Xpert的单位成本取决于每天的测试量,测试套件成本是主要的成本驱动因素。在低测试量的情况下,未使用的设备容量成本也是一个重要的成本驱动因素,对Xpert来说更为重要。在全国范围内实施各自诊断方法的加权平均每次检测成本在TB-LAMP的14.37 - 15.85美元和越南和马拉维的Xpert的20.06 - 26.86美元之间。如果考虑到在全国范围内全面推广到周边实验室,这两个NAATs将占国家结核病规划预算的很大一部分或超过国家结核病规划预算。结论:虽然TB- lamp是Xpert的一种成本较低的替代方案,在外围环境中作为结核病的前期NAAT,但必须通过额外的基于模型的研究仔细评估Xpert和其他替代方案的成本效用以及优化的实施策略,以更好地为政策和规划决策提供信息,以扩大结核病快速诊断的覆盖范围。
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引用次数: 4
List of KOFIH development projects ongoing in 2019 2019年KOFIH正在进行的开发项目清单
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E28
Hyunkyong Kim
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引用次数: 0
Scaling down to scale-up: a strategy for accelerating Community-based Health Service Coverage in Ghana 从缩小到扩大:加纳加速社区卫生服务覆盖的战略
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E9
John Koku Awoonor Williams, J. Phillips, A. Bawah
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引用次数: 12
Congratulatory comment from Korean Nurses Association 韩国护士协会的贺词
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E19
K. Shin
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引用次数: 0
Congratulatory comment from Asia-Pacific Parliamentarian Forum on Global Health 亚太全球卫生议员论坛的贺词
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E18
K. Takemi
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引用次数: 0
Impact of social capital on child nutrition status: three villages case of Oudomxay province in Lao People's Democratic Republic 社会资本对儿童营养状况的影响:老挝人民民主共和国乌多姆赛省三个村的案例
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E12
Alay Phonvisay, Terukazu Suruga, D. Lucero‐Prisno
Background: The role of social capital on development, with trust, norm and networks as its attributes, has been all the more recognized to generate benefit for development. Social capital also has a positive role in improving child health. With its poor ranking on health indicators among Southeast Asian countries, the health sector in Lao PDR is set as a priority sector that urgently requires improvement. In this sector, child health is of particular significance. This paper examines social capital, in the form of kinship network, and its impacton child health outcomes such as nutrition status. Methods: Following the general definition of social capital, specifically of bonding social capital, kinship network is used in this paper as a proxy of social capital. From field survey data conducted in early 2010 in 3 villages in the Northern Province of the Lao People's Democratic Republic, a Probit regression analysis is applied to 214 samples of children under 10 years old for stunting and underweight cases. Results: It is found that kinship network as social capital plays an important role in reducing stunted and underweight levels of children in these 3 villages. The estimated coefficient for social capital shows that children, who aside from their family nucleus are surrounded bymore families of relatives in the village, are less likely to be stunted and underweight by 1.8% and 1.5% at significant levels of 10% and 5%, respectively. Conclusion: Social capital is one of the mechanisms that people in rural areas of Lao PDR use as a buffer from economic and health shocks. Based on analysis, kinship network shows an impact on improving child health status, especially for long-term child health. Also, as society moves toward urbanization, a family network tends to be smaller and more independent. Thus, a challenge for policymakers is to create an appropriate support mechanism to substitute or complement this traditional social capital.
背景:社会资本对发展的作用,以信任、规范和网络为其属性,越来越被人们认识到能够产生有利于发展的效益。社会资本在改善儿童健康方面也发挥着积极作用。由于卫生指标在东南亚国家中排名较低,老挝人民民主共和国的卫生部门被确定为迫切需要改进的优先部门。在这一部门,儿童保健具有特别重要的意义。本文以亲属关系网络的形式考察社会资本及其对儿童健康结果(如营养状况)的影响。方法:遵循社会资本的一般定义,特别是结合社会资本,本文使用亲属网络作为社会资本的代理。根据2010年初在老挝人民民主共和国北部省3个村庄进行的实地调查数据,对214名10岁以下儿童的发育迟缓和体重不足病例样本进行了Probit回归分析。结果:亲属关系网络作为社会资本在降低3个村儿童发育不良和体重不足水平中起着重要作用。估计的社会资本系数显示,在10%和5%的显著水平下,除了家庭核心之外,被村里更多亲戚家庭包围的儿童发育迟缓和体重不足的可能性分别降低1.8%和1.5%。结论:社会资本是老挝人民民主共和国农村地区人民用来缓冲经济和健康冲击的机制之一。通过分析,亲属关系网络对改善儿童健康状况,特别是对儿童长期健康的影响。此外,随着社会走向城市化,家庭网络往往更小,更独立。因此,政策制定者面临的挑战是建立一个适当的支持机制来替代或补充这种传统的社会资本。
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引用次数: 2
Perceived social support among women of reproductive age attending a public health facility in a poor area of Northern Lima, Peru 在秘鲁利马北部贫困地区公共卫生设施就诊的育龄妇女感受到的社会支持
Pub Date : 2019-05-27 DOI: 10.35500/JGHS.2019.1.E30
Yun Seop Kim, B. Sharma, Yeseul Jung, Daehwan Kim, E. Nam
Background: Perceived social support (PSS) measures an individual's beliefs about the available support in need from family and friends, which is an important indicator of subjective wellbeing. The study aimed to determine the level of PSS among women of reproductive age attending a public health facility in a poor area of Northern Lima. Methods: A total of 106 pregnant women and mothers of less than 3 years child who visited the health center for antenatal care and health education were included in the study. PSS was measured using the 12-item multidimensional scale of PSS. An independent sample t test was carried out to assess variation of PSS across characteristics of study population and health behavior. Results: Of a maximum of 60, the average score of 12 items, each measured in 5-point Likert scale for PSS was 40.68 ± 9.46, comprising of 26.34 (± 6.42) out of 40 for friends support and 14.11 (± 4.90) out of 20 for family support. The mean PSS was above 3 for all items related to family support, but it was less than 3 for half of the items related to friend support. PSS from family was slightly higher than from friends. PSS was found higher among Catholic, the respondent who was in living together with a relationship, respondents with higher monthly income and who consumed fruits ≥ 2 serving a day. Conclusion: The study revealed a satisfactory level of PSS among the women, and mean PSS varied across socio-demographic factors and a few health behaviors in the study area.
背景:感知社会支持(Perceived social support, PSS)衡量个体对家庭和朋友可获得支持的信念,是主观幸福感的重要指标。这项研究的目的是确定在利马北部贫困地区一家公共卫生机构就诊的育龄妇女的PSS水平。方法:对106例到卫生院接受产前保健和健康教育的孕妇及未满3岁儿童的母亲进行研究。PSS采用12项多维PSS量表进行测量。采用独立样本t检验来评估PSS在研究人群特征和健康行为之间的变化。结果:在满分为60的5点李克特量表中,12个项目的平均得分为40.68±9.46,其中朋友支持为26.34(±6.42)分,家庭支持为14.11(±4.90)分,满分为20分。与家庭支持相关的所有项目的平均PSS都在3以上,但与朋友支持相关的一半项目的平均PSS低于3。来自家人的PSS略高于来自朋友的PSS。在天主教徒、同居、月收入较高和每天食用水果≥2份的受访者中,PSS较高。结论:该研究表明,该地区妇女的PSS处于满意的水平,且PSS均值因社会人口因素和一些健康行为而异。
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引用次数: 1
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Journal of global health science
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