Abstract:

Hypertension is an important public health challenge because of its associated morbidity, mortality, and the cost globally. Hypertension is the leading cause for cardiovascular disease in both developed and developing countries including Botswana. Only 3 population-based studies of hypertension have been conducted in Botswana and the latest 2010 STEPS survey reported a prevalence rate of 28.6%. This study was the first of its type to examine the prevalence of Hypertension and its associated risk factors among adults in Central Botswana. The objectives of this study were to estimate the prevalence of hypertension and assess the associated risk factors among adults in Letlhakane, Boteti Sub District-Botswana. A community based descriptive cross-sectional study was carried out on 377 participants (149 males and 228 females) aged 18 years and above, using simple random sampling method. The overall prevalence of hypertension among the study population was 38.5%. Females had a higher prevalence of hypertension (55.2%) as compared to males (44.8%). Age, body mass index, waist circumference, alcohol consumption and tobacco use were found significantly associated with hypertension (p<0.05). Regular screening for hypertension among adults should be done throughout the community for knowledge regarding their individual blood pressure status. Among those who already have hypertension and are on anti -hypertensive drugs; timely blood pressure check-up, screening for cardio vascular diseases and proper self-care management need to be promoted. Intervention measures should be undertaken at the community level; particular emphasis should be placed on primary prevention through adherence to healthy life style.

Keywords: hypertension, risk factors, prevalence, cross sectional, community-based, blood pressure

References:

[1].     Addo J., Smeeth L., and Leon D. 2007. Hypertension In Sub-Saharan Africa: A Systematic Review. Available: http://hyper.ahajournals.org/content/suppl/2007/09/24/HYPERTENSIONAHA.107.093336.DC1

[2].     Appel, L. J., Stoller, J. K., & Forman, J. P. 2017. Smoking and hypertension.

[3].     Beunza, J.J., Martinez-Gonzalez, M.A., Ebrahim, S., Bes-Rastrollo, M., Nunez, J. and Martinez J.A. (2007) Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am J Hypertens; 20:1156–1162.

[4].     Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo Jr, J. L. & Roccella, E. J. (2003). Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. hypertension, 42(6), 1206-1252.

[5].     Danaei, G., Ding, E. L., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C. J., & Ezzati, M. (2009). The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS medicine, 6(4), e1000058.

[6].     Diaz, K.M. and Shimbo, D. (2013) Physical Activity and the Prevention of Hypertension. Curr Hypertens Rep; 15(6): 659–668.

[7].     Halley, C.E., Borges, G., Talavera, J. O., Orozco, R., Vargas-Aléman, C., Huitrón-Bravo, G., et al (2007).Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations. J Adolesc Health; 40 (6): 521-526.

[8].     Huffman MD and Lloyd-Jones DM.(2017). Global burden of raised blood pressure: Coming into focus. JAMA 2017 Jan 10; 317:142. (http://dx.doi.org/10.1001/jama.2016.19685)

[9].     Hunt, J. D., Van der Hel, O. L., McMillan, G. P., Boffetta, P., & Brennan, P. (2005). Renal cell carcinoma in relation to cigarette smoking: meta‐analysis of 24 studies. International journal of cancer, 114(1), 101-108.

[10]. Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. K., & He, J. (2005). Global burden of hypertension: analysis of worldwide data. The lancet, 365(9455), 217-223.

[11]. Khanam, M. A., Lindeboom, W., Razzaque, A., Niessen, L., & Milton, A. H. (2015). Prevalence and determinants of pre-hypertension and hypertension among the adults in rural Bangladesh: findings from a community-based study. BMC public health, 15(1), 203.

[12]. Macmahon, S. (1987). Alcohol consumption and hypertension. Hypertension, 9(2), 111-121.

[13]. Monego, E.T. and Jardim PCBV. (2006) Determinates derisco paradoen çascardiovascular esemescolares. Arq Bras Cardiol; 87(1):37-45

[14]. Nielsen, G.A. and Andersen, L.B. (2003). The association between high blood pressure, physical fitness and body mass index in adolescents. Prev Med; 36(2): 29-34

[15]. Pang, W., Sun, Z. and Zheng, L. (2008). Body mass index and the prevalence of prehypertension and hypertension in a Chinese rural population. Intern Med; 47:893-7.

[16]. Pileggi, C., Carbone, V., Nobille, C.G.A. and Pavia, M. (year). Blood pressure and related cardiovascular disease risk factors in 6-18-year-old students in Italy. J Paediatr Child Health; 41(1): 47-52.

[17]. Raja, T. K., & Muthukumar, T. (2017). A cross sectional study on prevalence of hypertension and its associated risk factors among rural adults in Kanchipuram district, Tamil Nadu. International Journal Of Community Medicine And Public Health, 5(1), 249-253.

Shah SMA, Luby S, Rahbar M, Khan AW, McCormick JB. Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan. J Hum Hypertens 2001; 15: 107–112.

Sreedharan, J., Mathew, E., Muttappallymyalil, J., Sharbati, S.A., Shaikh, R.B., Basha, S.A. (2010). Determinants of blood pressure among youth in Ajman, UAE. Natl J Epidemiol; 1(1):17-21.

[18]. Steven van de Vijver et al. 2013. The Pan African Medical Journal - ISSN 1937-8688.Available at: http://www.panafrican-med-journal.com/content/article/16/38/full...(Steven van de Vijver1,2,&, Hilda Akinyi1, Samuel Oti1,2, Ademola Olajide3, Charles Agyemang4, Isabella Aboderin1, Catherine Kyobutungi

[19]. Tadesse, T. and Alemu, H. (2014). Hypertension and associated factors among university students in Gondar, Ethiopia: a cross-sectional study. BMC Public Health; 14(937): 2-5

Tollman, S. M., Kahn, K., Sartorius, B., Collinson, M. A., Clark, S. J., & Garenne, M. L. (2008). Implications of mortality transition for primary health care in rural South Africa: a population-based surveillance study. The Lancet, 372(9642), 893-901.

[20]. Tshitenge, S., & Mabuza, L. H. (2015). A survey of risk factors associated with hypertension in the adult population of Kang, Kgalagadi North, Botswana. South African Family Practice, 57(3), 177-182.

Twagirumukiza M, De Bacquer D, Kips JG, de Backer G, et al. (2011). Current and projected prevalence of arterial hypertension in sub-Saharan Africa by sex, age and habitat: an estimate from population studies. J Hypertens. 2011 Jul;29 (7):1243-52. PubMed | Google Scholar

[21]. Utsugi, M. T., Ohkubo, T., Kikuya, M., Kurimoto, A., Sato, R. I., Suzuki, K., ... & Imai, Y. (2008). Fruit and vegetable consumption and the risk of hypertension determined by self-measurement of blood pressure at home: the Ohasama study. Hypertension Research, 31(7), 1435.

[22]. Van Rooyen, J. M., Kruger, H. S., Huisman, H. W., Wissing, M. P., Margetts, B. M., Venter, C. S., & Vorster, H. H. (2000). An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study. Journal of human hypertension, 14(12), 779.

[23]. Wilson, P. W., D'agostino, R. B., Sullivan, L., Parise, H., & Kannel, W. B. (2002). Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Archives of internal medicine, 162(16), 1867-1872.

[24]. Wiysonge, C. S., Blackett, K. N., & Mbuagbaw, J. N. (2004). Risk factors and complications of hypertension in Yaounde, Cameroon: cardiovascular topics. Cardiovascular journal of South Africa, 15(5), 215-219.

World Bank (2012). World Bank List of Economies and Hypertension Prevalence. Washington DC, USA: World Bank.

Abstract:

Patient satisfaction surveys are essential in obtaining a comprehensive understanding of the patient’s need and their opinion of the service received. It is a vital tool in evaluating the quality of healthcare delivery service in Primary Health Care. The current study is a cross-sectional descriptive research about assessment of patient satisfaction in Medicine Outpatient Department of Rumbek East, South Sudan. Systemic sampling technique was employed and 76 respondents were statistically calculated. Only respondents whose ages were from 18 years old were included in this study. The research tool was a pre-structured questionnaire and data collection was conducted from December 19th, 2018 to January 5th, 2019. The components of satisfaction study were the socio-demographic characteristics, the patients’ experience with medicine outpatient services, accessibility to Primary Health Care services, and patient satisfaction. This study aimed to find the levels of patients’ satisfaction and the significant relationship between independent and dependent variables. A total of 76 outpatient clients were enrolled in the assessment, all of them were showed interest to participate on the interview. Out of the 76 clients (60.5%) of them were female predominance and (84.2.5%) of the clients were age above 18 years. Considerable number of clients (76.3%) was new first visit within past 3 month. Based on the result of the study, training of code of conduct and courtesy should be given to both clinical and office staffs.

Keywords: Patient Satisfaction; Outpatient Department (OPD); Rumbek East, South Sudan, Outpatient Station.

References:

[1].   Edlund MJ, Young AS, Kung FY, Sherbourne CD, Wells KB. Does Satisfaction Reflect the Technical Quality of Mental Health Care? Health Serv Res 2003; 38:631–45.

[2].   Blenkiron P, Hammill CA. What determines patients’ satisfaction with their mental health care and quality of life? Postgrad Med J 2003; 79:337–40.

[3].   Bramesfeld A, Wedegärtner F, Elgeti H, Bisson S. How does mental health care perform in respect to service user’s expectations? Evaluating inpatient and outpatient care in Germany with the WHO responsiveness concept. BMC Health Serv Res 2007; 7:99.

[4].   Hajifathali A, Aini E, Jafary H, Moghadam NM, Kohyar E, Hajikaram S. In-patient satisfaction and its related factors in Taleghani University Hospital, Tehran, Iran. Pak J Med Sci 2008; 24:274–7.

[5].   Bleich SN, Özaltin E, Murray CK. How does satisfaction with the health-care system relate to patient experience? Bull World Health Organ 2009;87(4):271–8.

[6].   Jin J, Sklar GE, Min Sen Oh V, Chuen Li S. Factors affecting therapeutic compliance: A review from the patient’s perspective Ther Clin Risk Manag 2008;4:269–86.

[7].   DiMatteo MR. Patient adherence to pharmacotherapy: the importance of effective communication. Formulary 1995; 30:596–8, 601–2, 605.

[8].   Blendon RJ, Schoen C, DesRoches C, Osborn R, Zapert K. Common concerns amid diverse systems: health care experiences in five countries. Health Aff (Millwood) 2003;22(3):106–21.

[9].   Rao MH, Soomro IBM. Non-compliance-awareness and attitude of psychiatric patients regarding outpatient follow-up at Civil Hospital, Karachi. J Dow Uni Health Sci 2008; 2:36–40.

[10]. Baqar Raza. Effectiveness of Olanzapine treatment of Schizophrenic patient in Pakistan Med Channel 2006; 12:75–81.

[11]. Channa R, Siddiqi MN. What do patients want from their psychiatrist? A cross-sectional questionnaire based exploratory study from Karachi. BMC Psychiatry 2008; 8:14.

[12]. Arean PA, Gum AM, Tang L, Unutzer J. Service use and Outcomes Among Elderly persons with low income being treated for Depression. Psychiatr Serv 2007; 58:1057–64.

[13]. Jackson TC, Allen G, Essock SM, Felton CJ, Donahue SA. Clients’ satisfaction with Project Liberty Counselling Services. Psychiatr Serv 2006; 57: 1316–9.

[14]. Prasanna K, Bashith M, Sucharitha S. Consumer Satisfaction about Hospital Services: A Study from the Outpatient Department of a Private Medical College Hospital at Mangalore. Indian J Community Med 2009;34(2):156–9.

[15]. Danish KF, Khan UA, Chaudhry T, Naseer M. Patient satisfaction; An experience at IIMC-T Railway Hospital. Rawal Med J 2008; 33: 245–8.

[16]. Yildirim C, Kocoglu H, Goksu S, Gunay N, Savas H. Patient satisfaction in a university hospital emergency department in Turkey. Acta Medica (Hradec Kralove) 2005; 48:59–62.

[17]. Stengård E, Honkonen T, Koivisto AM, Salokangas RK. Satisfaction of caregivers of patients with schizophrenia in Finland. Psychiatr Serv 2000; 51: 1034–9.

[18]. Khan MH, Hassan R, Anwar S, Babar TS, Babar KS. Satisfaction with Nursing care. Rawal Med J 2007; 32:28–30.

[19]. Kuosmanen L, Hätönen H, Jyrkinen AR, Katajisto J, Välimäki M. Patient satisfaction with psychiatric inpatient care. J Adv Nurs 2006; 55: 655–63.

[20]. Soergaard KW, Nivison M, Hansen V, Oeiesvold T. Treatment needs and acknowledgement of illness-importance for satisfaction with psychiatric inpatient treatment. BMC Health Serv Res 2008; 8:103.

[21]. Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, et al. The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess 2002; 6:1–244.

[22]. Ruggeri M. Patients’ and relatives’ satisfaction with psychiatric services: The state of the art of its measurement. Soc Psychiatry

[23]. Psychiatr Epidemiol 1994; 29:212–27.

[24]. Thornicroft G, Leese M, Tansella M, Howard L, Toulmin H, Herran A, et al. Gender differences in living with schizophrenia. A cross-sectional European multi-site study. Schizophr Res 2002; 57:191–200.

[25]. Bjorngaard JH, Ruud T, Garratt A. Patients’ Experiences and Clinicians’ Ratings of the Quality of Outpatient Teams in Psychiatric Care Units in Norway. Psychiatr Serv 2007; 58:1102–7.

Abstract:

Introduction: Despite overall global progress and concerted efforts, MDGs 4 (reduce child mortality) and 5 (improve maternal and new born health) have been and are seriously off target for many countries. In Africa, south of the Sahara a woman has a 1 in 39 chance of dying in pregnancy or childbirth, compared to a 1 in 3,800 similar risk in developed countries. The leading causes of maternal deaths are related to obstetric complications around the time of childbirth, with three-quarters of those deaths and significant morbidity being preventable through access to a full continuum of quality reproductive health services. Evidence shows that Africa still has the highest proportion of under-five deaths, with 1 in 91 children dying before their fifth birthday (UNICEF, 2016).

Aim: To explore experiences, knowledge, beliefs, practices and attitudes of caregivers and community members associated with the causes of common childhood illnesses, prevention and treatment options.

Materials and Methods: The study adopted qualitative approaches grounded in social and health promotion theories (Berkowitz, 2004; Rosenstock, 1966; Bradley et al., 2009). Maximum variability, in combination with sampling designs employed to capture a diversity of perspectives.

Results: The study findings identified the most common childhood illnesses as; malaria, diarrhoea, measles, coughs, and colds related to increased cases of child and infant mortality. Pneumonia was rarely cited, the fear of HIV and cancer tests mentioned as key barriers of early initiation and continued use of ANC services. Side effects of vaccines prevent mothers from having their children vaccinated.

Conclusion: This study provides a contextual and evidence-based approach for the design of MNCH interventions that are effective, user-friendly and more likely to elicit optimum participation from the targeted community members in Homa Bay County.

Keywords: MNCH services, MDG 4 and 5, uptake, barriers, children/pregnant women, Homa Bay.

References:

[1].     African Union (2012). Status Report on Maternal, New Born and Child Health.

[2].     Berggren W.L, and Wray JD. (2002). Positive deviant behavior and nutrition education. Food Nutr Bull 2002;23(suppl 4):9-10.

[3].     Berkowitz A. D. (2004) The Social Norms Approach: Theory, Research, and Annotated Bibliography

[4].     Birmeta Kidist, Yohannes Dibaba and Desalegn Woldeyohannes (2013): Determinants of maternal health care utilization in Holeta town, central Ethiopia: BMC Health Services Research 2013, 13:256 doi:10.1186/1472-6963-13-256

[5].     Bradley Elizabeth H, Leslie A Curry, Shoba Ramanadhan, Laura Rowe, Ingrid M Nembhard and Harlan M Krumholz (2009): Research in action: using positive deviance to improve quality of health care: Implementation Science 4:25

[6].     Bryan (2008). Social Research Methods. New York: OUP.Carlsen Benedicte and Claire Glenton (2011) What about N? A methodological study of sample-size reporting in focus group studies. BMC Medical Research Methodology 2011, 11:26.

[7].     Carpenter, Christopher J. (2010). "A meta-analysis of the effectiveness of health belief model variables in predicting behavior". Health Communication 25 (8): 661–669

[8].     Glanz, Karen; Barbara K. Rimer, K. Viswanath (2008). Health behavior and health education: theory, research, and practice. (4th Ed.). San Francisco, CA: Jossey-Bass. pp. 45–51.

[9].     Glanz, Karen; Bishop, Donald B. (2010). "The role of behavioral science theory in development and implementation of public health interventions". Annual review of public health 31: 399–418.

[10]. Guest, G.K.M, Macqueen and E. Namey (2012). Applied Thematic Analysis. Thousand Oaks, CA: Sage

[11]. Hahn, R.A and M.C. Inhorn (Eds) (2009). Anthropology and Public Health: Bridging differences in culture and society. Oxford: OUP.

[12]. Kenya Demographic and Health Survey (2008-2009) Report.

[13]. Kirkwood, BR et al., (2008): Developing community-based intervention strategies to save newborn lives: lessons learned from formative research in five countries; Journal of Perinatology 28:2–8

[14]. Lozano R et al., (2011). Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis, Lancet 2011, 378(9797):1139–1165.

[15]. Marsh D.R, Sternin M, Khadduri R, Ihsan T, Nazir R, Bari A, et al (2002). Identification of model newborn care practices through a positive deviance inquiry to guide behavior change interventions in Haripur, Pakistan. Food Nutrition Bulletin 2002; 23(suppl 4):109-18.

[16]. McLeroy KR, Bibeau D, Steckler A, Glanz K (1988). An ecological approach on health promotion programs. Health Educ Q. 15:351–377.

[17]. Newes-Adeyi G, Helitzer DL, Caulfield LE, Bronner Y. (2000). Theory and practice: applying the Ecological model to formative research for a WIC training program in New York State. Health Educ Research. 15:283–291.

[18]. Pope C, S. Ziebland and N. Mays (2009). Qualitative Research in Health Care. BMJ, 320 (7227), 114-116.

[19]. Ritchie J.and J. Lewis (2008). Qualitative Research Practice. Thousand Oaks, CA: Sage.

[20]. Ritchter, M. (2008). Global Health: Why cultural perceptions, social representations and biopolitics matter. Tucson: University of Arizona Press.

[21]. Rosensck, Irwin M.; Strecher, Victor J., Becker, Marshall H. (1988). "Social learning theory and the health belief model". Health Education & Behavior 15 (2): 175–183.

[22]. Rosenstock, Irwin M.; Strecher, Victor J., Becker, Marshall H. (1988). "Social learning theory and the health belief model". Health Education & Behavior 15 (2): 175–183.

[23]. Sternin J, and Choo R 2000): The power of positive deviancy. An effort to reduce malnutrition in Vietnam offers an important lesson about managing change. Harv Bus Rev 2000, 78:14-25.

[24]. Stewart DW, Shamdasani PN, Rook DW (2007): Focus Groups. Theory and Practice. Thousand Oaks: Sage Publications.

[25]. UNICEF (2012). Pneumonia and Diarrhea: Tackling the deadliest diseases for the world’s poorest children, New York.

[26]. United Nations (2012). Every Woman, Every Child; UN Commission on increasing commodities for women and children. Implementation Plan. UN; New York.

[27]. Walker L.O, Sterling B.S, Hoke M.M, Dearden K.A (2007). Applying the concept of positive deviance to public health data: a tool for reducing health disparities. Public Health Nurs 2007, 24:571-576.

[28]. WHO, UNICEF, UNFPA and the World Bank (2012): Trends in maternal mortality: 1990 to 2010: Estimates developed by WHO, UNICEF, UNFPA and The World Bank.

[29]. WHO/UNICEF (2010). Countdown to 2015 Decade Report (2000–2010) with country profiles: Taking stock of maternal, newborn and child survival. Geneva.

Abstract:

The demographic background of the elderly plays a pivotal role in the health and health related aspects of the old age population. In India, where the family has an obligation to care for the elderly, the consequences of rapid declines in fertility and mortality on elderly makes living arrangements an important issue in the field of population and development. The study was conducted in the context of Kerala with the purpose of finding out the influence of family structure on the health of the aged. The data was collected through field work and it was a descriptive type of study. The analysis was carried out with definite dependent and independent variables. The study shows that the family size plays an important role in the deterioration health of the aged, the perception about their health condition, the care during their illness. It was also clear from the study that feeling of loneliness and ability of adjustment with the family members varies significantly with the family size. The analysis shows that the disease structure particularly the prevalence of both communicable, non-communicable diseases and occurrence of multiple diseases are more prone to those who belong to large families.

Keywords: Family structure, Ageing process, Geriatric health, Elderly, Old age, Living arrangements.

References:

[1].     Bhamini Mehta & Indira Mallya (2003), Self-appraisal of elderly in slums of Vadodra City, Help Age India, Research and Development Journal.

[2].     Birren J E et al, Hand book of mental health and ageing, Harcourt Brace Jovanovich Publishers, New York.

[3].     Bongaarts J and Z. Zimmer (2001), Living arrangements of older adults in the developing world: An analysis of DHS households’ surveys, Population council, New York, Policy research working papers No: 148, p-30.

[4].     Bruera E et al,Text book of palliative medicine and supportive care, 2015.

[5].     Chandra Prakash Dr. Ageing process mechanisms, In Bhatla. P. C, Lecture series in Geriatrics, Health care promotion trust, New Delhi p-3.

[6].     Damron Rodriguez J, Lubben J. E (2000), A framework for understanding community health care in ageing societies, International meeting on community health Care in ageing societies. WHO, Kobe Centre.

[7].     Elizabeth A et al, Encyclopedia of elder care, E book,2013.

[8].     Goh V. H (2005). Ageing in Asia: A cultural socio- economical and historical perspective, The ageing male 8:2, pp. 09-96.

[9].     Haldwani, Shankar R, Tondon J, Gambhir I.S, Tripathi C.B (2007), Health status of elderly population in rural area of Varanasi district, Indian journal of public health. Jan-Mar; 51 (1):pp56-58.

[10]. Hossain M.D, Ripter (2001), Demography of ageing and pattern of old age security in Bangladesh. Indian Journal of Geriatrics, 15 (1, 2): pp- 73 – 80.

[11]. Howard M fillit et al, Text book of geriatric medicine and gerontology, E book,2016

[12]. Indirani Gupta and Deepa Sankar (2003), Health of the elderly in India- A multi variate analysis, The journal of health and population in developing countries, ISSN 1095-8940.

[13]. Kalyan Bagchi, (2000) Healthy ageing, Help age India, Research and development journal, Vol-6, No. 3, June-Sept.

[14]. John M S Pathy et al Principles and practice of geriatric care, 2006.

[15]. Pappathi K and M. A, Sudhir (2005), psychosocial characteristics and problems of the rural aged, Research and development journal, Help age India, 11:1.

[16]. Park K, Preventive and social medicine, Banarsidas bhanot, 1167, Prem nagar, Jabalpur

[17]. Rodrguez. L et al, Frality in the clinical scenario ,2015.

[18]. Streiner DL Health measurement scales, 2015.

[19]. Suresh K. N (2002), The old age problems and care of senior citizen, Nursing journal of India.

[20]. Susuman A. S (2005), The health of the aged in India: Emerging problems, Presented at the 2nd Indian association of social sciences in health, National conference on Globalization and health equity, Bhaba atomic research centre, Mumbai, Feb:4-4, p-20.

[21]. Swain P and T. P. Sherin Raj (2004), Demography of ageing in India- state and district level analysis, presented at the international seminar of demographic changes and implications, Department of demography, University of Kerala, Trivandrum, India Dec. 7 -9, p12.

[22]. Thomas K et al, Advace care planning in end of life care, Oxford University press, UK.2017.

[23]. Tripathi R. M (2001), Health and health services from senior citizens- A case study of Allahabad, Man and development journal, 23:3.

Abstract:

Many researchers worldwide report that health behaviours tend to be highly clustered, and can be addressed simultaneously. Yet, more remains unknown than known about how to optimize multiple preventive health behaviour change to mitigate health risks associated with noncommunicable diseases, which currently presents major public health concerns, and represents the greatest global health security threats in the future. There are emerging shifts in epidemiology of these chronic diseases, not only by gender, socio-economic status, disability, ethnicity, but most recently by age- albeit subject characteristics, as they are increasingly causing premature deaths. Nevertheless, the problem remains a neglected public health issue in Uganda, and at Makerere University in particular.

A cross-sectional sample of 381 undergraduate female students completed the self-administered questionnaire, whose results were subjected to binary logistic regression modeling to determine extents to which subject characteristics influenced adoption of preventive health behaviours.

Multivariate regression models suggest that course of study significantly (p=.013) influenced physician visits, with adjusted odds ratio of 0.32. Pentecostal (p=.018) and Anglican (p=.002) affiliations significantly influenced screening behaviour, with corresponding odd ratios of 0.37 and 0.34. Pentecostal (p= .021), like Science course (p=.030) significantly influenced physical activity, with corresponding odds ratios of 0.34 and 0.44. With respect to multiple preventive health behaviours, only course of study showed significant (p=.036) influence on adoption of all three desired behaviours, with adjusted odds ratio of 3.15.

The study contributes to body of knowledge on multiple health behavioral change and the healthy Universities concept. Future health promotions should consider issues around equitable access to essential information, and take advantage of religious places of worship and leaders to channel messaging.

Keywords: Noncommunicable diseases, subject characteristics, multiple preventive health behavior.

References:

[1].   Arah O. A. (2008). On the relationship between individual and population health. Medicine, health care, and philosophy, 12(3), 235–244. doi:10.1007/s11019-008-9173-8.

[2].   Amin, M. F. (2005). Social Science Research: Conceptions, methodology and Analysis. Makerere University, Kampala.

[3].   Asaku, S.T., Kiguli^, J. & Agaba, J.K. (2019). Public Health Concerns and Risk Perceptions of Noncommunicable Diseases among Undergraduate Female Students at Makerere University: A qualitative study, submitted to World Journal of Healthcare Research (accepted for publishing on May 3^rd, 2019).

[4].   Beauchamp, T. L., & Childress, J. F. (2013). Principles of Bioethics (7th ed.): Oxford University press.

[5].   Benjamins, M. & Brown, C R. (2004). Religion and preventative health care utilization among the elderly. Social Science & Medicine. 58 (1):109–118. [PubMed: 14572925].

[6].   Bray, S.R., & Born, H.A. (2004). Transition to university and vigorous physical activity: Implications for health and phychological well-being. Journal of American College Health, 52(4):181-188. Doi:10.3200/JACH.52.4.181-188.

[7].   Brighenti-Zogg, S., Mundwiler, J., Schüpbach, U., Dieterle, T., Wolfer, D.P., Leuppi, J.D.& Miedinger, D. (2016). Physical Workload and Work Capacity across Occupational Groups. PLoS ONE 11(5): e0154073.doi:10.1371/journal.pone.0154073. https://doi.org/10.1371/journal.pone.0154073.

[8].   Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6(3), 73–85. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/6426380.

[9].   da-Franca, C. & Colares, V. (2008). Comparative study of health behavior among college students at the start and end of their courses, Rev. Saúde Pública, 42 (3). http://dx.doi.org/10.1590/S0034-89102008000300005.

[10].     de Souza Dantas, M., Dos Santos, M. C., Lopes, L., Guedes, D. P., Guedes, M., & Oesterreich, S. A. (2018). Clustering of Excess Body Weight-Related Behaviors in a Sample of Brazilian Adolescents. Nutrients, 10(10), 1505. doi:10.3390/nu10101505.

[11].     DiDomenico, A. & Nussbaum, M.A. (2011). Effects of different physical workload parameters on mental workload and performance, International Journal of Industrial Ergonomics, 41,(3), 255-260, https://doi.org/10.1016/j.ergon.2011.01.008.

[12].     Fagaras, S. P., Radu, L.E. & Vanvu, G. (2015). The Level of Physical Activity of University Students: 7th World Conference on Educational Sciences, (WCES-2015), 05-07 February 2015, Novotel Athens Convention Center, Athens, Greece, Procedia - Social and Behavioral Sciences, 197, 1454 – 1457.

[13].     Harrington, J., Perry, I. J., Lutomski, J., & et al. (2010). Living longer and feeling better: healthy lifestyle, self-rated health, obesity and depression in Ireland. Eur J Pub Health, 20, 91–95. doi:10.1093/eurpub/ckp102.

[14].     Jamison, D.T., summers, L.H., Alleyne, G., Arrow, K.J., Berkley, S., Binagwaho, A., et al. (2013). Global health 2035: a world converging within a generation. Lancet, 382 (9908):1898-955. http://dx.doi.org/10.1016/S0140-6736 (13)62105-4.

[15].     Kasl, S. V., & Cobb, S. (1966). “Health Behavior, Illness Behavior, and Sick-Role Behavior: I. Health and Illness Behavior. Archives of Environmental Health, 12, 246–266. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/5322534.

[16].     Kelloway, E.K. & Gottlieb, B. H. (1998). The effect of alternative work arrangements on women's well-being: a demand-control model. Womens Health, 4, 1-18. pmid:9520604.

[17].     Kim, K.H., Sobal J, et al. (2003). Religion and body weight. Int J Obes Relat Metab Disord. 27(4):469–477. [PubMed: 12664080].

[18].     Koenig, H.G., Dana E. K. & Carson, V.B. (2011. Handbook of Religion and Health. Oxford and New York: Oxford University Press.

[19].     Kwan, M.Y., Cairney, J., Faulkner, G.E., & Pullenavegum, E.E. (2012). Physical activity and other health-risk behaviours during the transition into adulthood: A longitudinal cohort study, American Journal of Preventive Medicine, 42(1), 14-20. Doi: 10.1016/j.amepre.2011.08.026.

[20].     Levin JS. Religion and health: are there an association, is it valid, and is it causal? Soc Sci Med. 1994; 38(11):1475–1482. [PubMed: 8036527].

[21].     Lim, S. S., Vos, T., Flaxman, A.D., Danaei, G., Shibuya, K., Adair-Rohani, H. et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2224−60. doi:10.1016/S0140-6736(12)61766-8.

[22].     Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15; 380 (9859):2095-128. http://dx.doi.org/10.1016/S0140-6736(12)61728-0 pmid: 23245604.

[23].     Meader, N., King, K., Moe-Byrne, T., Wright, K., Graham, H., Petticrew, M., Power, C., White., M. & Sowden, A.J. (2016). A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health. https://doi.org/10.1186/s12889-016-3373-6.

[24].     Saha, A. & Alleyne, G. (2018). Recognizing noncommunicable diseases as a global health security threat. Bulletin of the World Health Organization. 96, 792-793. Doi: http://dx.doi.org/10.2471/BLT.17.205732.

[25].     Schlundt, D.G., Franklin, M.D., Patel, K., McClellan, L., Larson, C., Niebler, S. & Hargreaves, M. (2008). Religious Affiliation and Health Behaviors and Outcomes: Data from the Nashville REACH 2010 Project. Am J Health Behav. 2008; 32(6): 714–724. doi:10.5555/ajhb.2008.32.6.714.

[26].     Sigmundova, D., Chmelik, F., Sigmund, E., Feltlova, D., & Fromel, K. (2013). Physical activity in the lifestyle of Czech university students: Meeting health recommendations, European Journal of Sport Science, 13:6, 744-750. Doi:10.1080/17461.2013.776638.

[27].     Spring, B., Moller, A. C., & Coons, M. J. (2012). Multiple health behaviours: overview and implications. Journal of public health (Oxford, England), 34 Suppl 1(Suppl 1), i3–i10. doi:10.1093/pubmed/fdr111.

[28].     Marmot, M. & Bell, R. (2019). Social Determinants and Noncommunicable disease: Time for integrated actions. BMJ 364 (1251). https://doi.org/10.1136/bmj.l251.

[29].     Marmot, M., Friel, S., Bell, R., Houweling, T. A. J., & Taylor, S. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Lancet (London, England), 372(9650), 1661–1669. https://doi.org/10.1016/S0140-6736 (08)61690-6.

[30].     Masselli, M., Ward, P.B., & Gobbi, E. (2018). Promoting Physical Activity Among University Students: A Systematic Review of Controlled Trials. American Journal of Health Promotion, 32 (7). https://doi.org/10.1177/0890117117753798.

[31].     McCullough ME, Hoyt WT, et al. Religious involvement and mortality: A meta-analytic review. Health Psychology. 2000; 19(3):211–222. [PubMed: 10868765].

[32].     UNCST. (2014). Uganda National Council for Science and Technology (UNCST): National Guidelines for Research involving Humans as Research Participants. Kampala, Uganda.

[33].     Van Ness, P.H., Kasl, S.V, et al. (2003). Religion, race, and breast cancer survival. Int J Psychiatry Med. 33(4):357–375. [PubMed: 15152786].

[34].     Walsh, F. Spiritual Resources in Family Therapy. New York: The Guilford Press; 1999.

[35].     WHO (2014). World Health Organization global status report on noncommunicable diseases. Geneva: World Health Organization. http://www.who.int/nmh/publications/ncd-status-report-2014/en/.

[36]. WHO (2010). Global recommendations on physical activity for health Geneva, http:// whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf.

[37]. WHO (2011). World Health Organization. NCD Summary report. http://www.who.int/nmh/publications/ncd_report_summary_en.pdf.

[38].     WHO (2009). Women and Health: today's evidence, tomorrow's agenda. Geneva, Switzerland: WHO Library Cataloguing-in-Publication Data.

Abstract:

Background: Health insurance scheme have been introduced with the aim of providing health insurance and making health services accessible and affordable to the average citizen in the country. Our objective is to evaluate clients’ satisfaction with National Health Insurance Scheme in Jigawa State, Nigeria. Method: This study used a mixed method (both qualitative and quantitative designs) approach and was conducted between May 2016 and September 2017. Three hundred and twenty-one (321) enrollees filled questionnaires while 8 participated in face to face interview. The questionnaires were analysed using Statistical Package for Social Science (SPSS) and descriptive statistics was used to summarize the quantitative data using means, proportions and frequencies. Qualitative data were analyzed using themes. Results: The overall satisfaction score of the respondents was 80.6%). Specifically expressed satisfaction with the associated services (e.g. lab, radiology, pharmacy) (92.2%), agreed to have easy access to the medical specialist (77.9%), agreed to get prescribed drugs in the hospital (74.1%), agreed that the amount they pay during each visit before they got drug is reasonable (85.7%), satisfied with surgical procedure under NHIS (69.8%), satisfied with the referral arrangement (77%), satisfied with the overall NHIS services in this hospital (87.3%). Conclusion: More than three quarter (80.6%) of the clients are satisfied with healthcare services provided under NHIS in the hospital. Recommendations: NHIS scheme can be improved by 24 hours availability of designated doctors for NHIS clients, regular supply of drugs and by reducing waiting time.

Keywords: Universal Coverage, Health Insurance, National health insurance scheme, Patient satisfaction, Client satisfaction.

References:

[1].   Abdulrasheed, S.S. (2009). “A study on clients’ satisfaction and quality of outpatient care under the national health insurance scheme at Barau Dikko specialist hospital Kaduna, Kaduna state”. Unpublished MPH Thesis, Ahmadu Bello University, Zaria Nigeria.

[2].   Adamu, U.H. and Mukhtar, M. (2015). “Understanding client satisfaction with national health insurance scheme in Nigeria: a case study of Gumel General Hospital, Jigawa State”. Unpublished study.

[3].   Agba, A. M. O., Ushie, E. M., and Osuchukwu, N. C. (2010) National Health Insurance Scheme (NHIS) and Employees’ Access to Healthcare Services in Cross River State, Nigeria. Global Journal of Human Social Science, 10 (7), pp.9-16.

[4].   Agba, M. S, (2010) Perceived Impact of the National Health Insurance Schemes (NHIS) Among Registered Staff in Federal Polytechnic, Idah, Kogi State Nigeria. Studies in Sociology of Science, 1 (1), pp. 44-49.

[5].   Alabi, A. N., Onuoha, F.M., Madaki A. J., Nwajei, A. I., Uwakwem, A. C., Alabi, K. M. (2017) Enrolees Perception of the Merits and Demerits of National Health Insurance Scheme in a Nigerian Tertiary Health Facility. Journal of Medical Science and Clinical Research, 5 (6), pp. 23595-23604.

[6].   Blanchet, N. J., Fink, G. and Osei-Akoto, I. (2012) The effect of Ghana’s national Health Insurance Scheme on health care utilization. Ghana Medical Journal, 46 (2), pp. 76-84.

[7].   Chima, O. (2010) National health insurance scheme in Nigeria: an analysis of constraints and enabling factors to adoption: University of Nigeria: Nsukka-Nigeria.

[8].   Glory, M. C. and Dr. Kevin, E. M. (2014) Evaluation of National Health Insurance Scheme: Benefits and challenges in Eastern Nigeria. South American Journal of Public Health, 2 (4), pp. 491-506.

[9].   Mohammed, S., Sambo, N. M. and Dong, H. (2011) Understanding client satisfaction with a health insurance scheme in Nigeria: factors and enrollees experiences. Health Research Policy and Systems, 9 (20).

[10].           (NHIS) National Health Insurance Scheme (2012) National Health Insurance Scheme Operational guideline: National Health Insurance Scheme: Abuja – Nigeria.

[11].           Onyedibe, K. I., Goyit, M. G., and Nnadi, N.E. (2012) An evaluation of the national health insurance scheme (NHIS) in Jos, a north-central Nigerian city. Global Advanced Research Journal of Microbiology,1(1), pp. 5-12.

[12].  Osungbade, K.O., Obembe, T. A. and Oludoyi, A. (2014) Users’ satisfaction with services provided under National Health Insurance Scheme in South Western Nigeria. International Journal of Tropical Disease & Health, 4 (5), pp. 595 – 607.

[13].  Owumi, B. E, Omorogbe, C. E., and Raphael, S. C. (2013)              Evaluation of the impacts of the National Health Insurance Scheme on the employees’ health status at the University of Ibadan. African Journal of Social Sciences, 3 (3), pp. 40 -52.

[14].  Shagaya, J. Y. (2015) Assessment of Student’s Satisfaction and Quality of Patient Care under the Nigerian Tertiary institutions Social Health Insurance Programme (TISHIP). European Journal of Business and Management, 7 (6), pp. 20-31.

[15].  Vanguard (2010) Jigawa State Pays NHIS N300m to reduce mortality. Nigeria: Vanguard. Retrieved from http://www.vanguardngr.com/2010/12/jigawa-pays-nhis-n300m-to-reduce-mortality/.

[16].  Yusuf, T. O., Gbadamosi, A. and Hamadu, D. (2009) Attitudes of Nigerians towards Insurance services: An Empirical Study. African Journal of Accounting, Economics, Finance and Banking Research,4(4), pp. 34-46.

Abstract:

There is always a fair amount of data collected, analyzed, stored and disseminated in various formats in the national health systems. In most cases, district and national health management teams are tasked by law to generate quality data for planning, budgeting, programmatic decision making and to respond to requests and needs from stakeholders such as donors. Valuable community health data should be ready-to-use at the point of service delivery and ideally at the household and community levels for real time decision making to improve performance and outcomes. Donors need evidence to measure progress towards the achievement of their objectives, and also to advocate for additional resources. The need for community data fluctuates temporally due to environmental, behavioral, economic, social and political factors. Data collection, management and analysis should be timely, constantly updated and tailored to reflect these fluctuations. Findings from multiple demographic and health surveys (DHS) that collated and analyzed large datasets from households, have shown the importance of collecting quality data, improving their availability and dissemination to build awareness of communities about emerging health issues, and to stimulate and increase data utilization for health programming especially in areas or contexts where there is no or little relevant information. We reviewed current community data collection and management practices, analyzed various sources of data, data usage, formats and performance indicators. We noted that community data ownership is key. Communities who generate health information, should be able to use their own data their data for self monitoring, program planning and implementation in collaboration with local health facilities.

Keywords: community data – community health -home visits – data capture - data dissemination -community health worker.

References:

[1].   Adalgisa Viola, Luc Van der Veken, Claire Cole & Julio Pacca It takes a village and data: Using routine health information to ensure safe, institutionalized births in Mozambique. March 27, 2017 Pathfinder International.

[2].   Admasu, K. The implementation of the Health Development Army: Challenges, perspectives and lessons learned with a focus on Tigray’s experience. Federal Democratic Republic of Ethiopia Ministry of Health Quaterly Health Bulletin, 5(1) 2013.

[3].   Ballard M, Bonds M, Burey JA, Foth J, Flori K, Holeman T, Schwarz R, Furth R, Sarah F, Zambruni P, Jacobs T, Kureshy N Community Health Worker Assessment and Improvement Matrix (CHW AIM) Updated Program Functionality Matrix for Optimizing Community Health Program December 2018.

[4].   Ballard M, Montgomery P. 2017. Systematic review of interventions for improving the performance of community health workers in low-income and middle-income countries. BMJ Open 7:e014216. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665298/pdf/bmjopen-2016-014216.pdf.

[5].   Chewicha, K., Azim, T. (2013). Community health information system for family-centered health care: Scale-up in Southern Nations, Nationalities and People's Region. Ethiopia Ministry of Health Quarterly Health Bulletin, 5(1):49-53.

[6].   CORE Group Polio Project - Realities: Coordinated Impact at the Country and Global Level – Summary Report - Plenary Session, Global Health Practitioner Conference Lord Baltimore Hotel, Baltimore, Maryland - CORE Group Fall 2017.

https://coregroup.org/wp-content/uploads/2017/08/CORE-Fall-Plenary-Session-9-27-Baltimore.pdf.

[7].   Dickinson FM, Pyone T, Van Den Broek N. Experiences from the field: maternal, reproductive and child health data collection in humanitarian and emergency situations Int Health 2016; 8 83-88.

[8].   Djouarka R, Kabore A. Is lymphatic filariasis transmitted in Cotonou and Porto Novo – ASTMH Conference Oral presentation Baltimore 2017.

[9].   http://www.mhenmw.org/index.php/2016/12/13/malawi-health-equity-network-mhen-2/.

[10].  https://ctb.ku.edu/en/table-of-contents/evaluate/evaluate-community-initiatives/examples-of-community-level-indicators/main.

[11].  https://ichc2017.mcsprogram.org/.

[12].  https://tciurbanhealth.org/lessons/integration-des-services-avec-lapproche-identification-systematique-des-besoins-de-la-cliente-isbcpf/.

[13].  https://www.intrahealth.org/news/uganda-takes-major-steps-professionalize-community-health-workforce.

[14].  https://www.who.int/tb/publications/tb_compendium_of_indicators/en/.

[15].  Ibe O, Morrow M, Landscape analysis of natiional community health worker programs -In 22 of 25 USAID Priority Maternal and Child Health Countries Maternal and Child Survival Program (MCSP) February 2019.

[16].  Jeremie, N., Kaseie, D., Olayo, R., Akinyi, C. (2014). Utilization of community-based health information systems in decision making and health action in Nyalenda, Kisumu County, Kenya. Universal Journal of Medical Science, 2(4): 37-42.

[17].  Kabore T District Partnerships Enhance Community Participation for RMNCH in Rwanda MCSP 2017.

[18].  Källander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH et al. Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review. Journal of Medical Internet Research. 2013;15(1):e17. Kigali, Rwanda May 2013.

[19].  Kilangalanga J, Ndjemba JM, Pitchouna NA. Uvonb F, Kibangalab M, Safari JL. Trachoma in the Democratic Republic of the Congo: Results of 46 Baseline Prevalence Surveys Conducted with the Global Trachoma Mapping Project OPHTHALMIC EPIDEMIOLOGY 2018, VOL. 25, NO. S1, 192–200 https://doi.org/10.1080/09286586.2017.1306869.

[20].  Kittur N, Binder S, Campbell CH, King CH, Kinung’hi S, Olsen A, Magnussen P, Colley DG Defining Persistent Hotspots: Areas That Fail to Decrease Meaningfully in Prevalence after Multiple Years of Mass Drug Administration with Praziquantel for Control of Schistosomiasis Am J Trop Med Hyg. 2017 Dec 6; 97(6): 1810–1817. Published online 2017 Sep 25. doi: 10.4269/ajtmh.17-0368 PMCID: PMC5805060.

[21].  Love DE1, Paita LM, Custer WS. Health Serv Res. Data sharing and dissemination strategies for fostering competition in health care.2001 Apr;36(1 Pt 2):277-90.

[22].  Mason C, WeberJ, Atasoy S, Sabariego C, Cieza A (2017) Development of indicators for monitoring Community-Based Rehabilitation. PLoS ONE 12(6):e0178418.https://doi.org/10.1371/ journal.pone.0178418.

[23].  MEASURE Evaluation A Brief Guide to Identify Information Needs and Use Data for PEPFAR Country and Regional Planning 2016.

[24].  MEASURE Evaluation Community-Based Health Information Systems in the Global Context A Review of the Literature June 2016. WP-16-161.

[25].  MEASURE Evaluation Stakeholder Data Use and Dissemination Planning Tool: An Example from a Research Study in Haiti: Final Report 2019.

[26].  MEASURE Evaluation Use of Community health data for shared accountability – Guidance – February 2018 WP 16 -161.

[27].  MEASURE Evaluation. Guinea's Readiness Response to Ebola: Strengthening Data Availability and Use June 2018.

[28].  MEASURE Evaluation. Model of a community-based information system. Essential components and functions April 2018.

[29].  MEASURE Evaluation. PIMA Best Practices in Strengthening Community Health Information Systems. 2016.

[30].  Ministry of Health - National Community Health Strategic Plan. July 2013 - June 2018.

[31].  Mutale, W., Chintu, N., Amoroso, C., Awoonor-Williams, K., Phillips, J. Baynes, C., Michel, C., Taylor, A., Sherr, K. (2013). Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative. BMC Public Health Services Research, 13(2):S9.

[32].  PMCID: PMC4924267

[33].  Sayinzoga F, Bijlmakers L, van Dillen J, et al. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study. BMJ Open 2016;6:e009734. doi:10.1136/bmjopen-201500973.

[34].  Scott K, Beckham S, Gross M, Pariyo G, Rao K, Perry H. 2017a. Systematic Review of Existing Reviews of Community-based Practitioners (Including Community Health Workers and Close-to-Community Practitioners) and Their Integration with Health Systems: Complete Report. Baltimore.

[35].  Sudhof, L., Amoroso, C., Barebwanuwe, P., Munyaneza, F., Kaamaga, A., Zambotti, G., Drobac, P., Hirschhorn, L. Local use of gepgraphic information systems to improve data utilisation and health services: mapping caesarean section coverage in rural Rwanda. Tropical Medicine and International Health (2013).; 18(1):18-26.

[36].  Tekle AH, Zouré HM, Noma M,, Boussinesq M, Coffeng L, Stolk W, Remme HF Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control: epidemiological evaluation results. Infect Dis Poverty. 2016; 5: 66. Published online 2016 Jun 27. doi: 10.1186/s40249-016-0160-7.

[37].  Tsega A, Favin M, - My Village My Home: A Tool That Helps Communities Track Vaccinations of Individual Infants USAID’s Maternal and Child Survival Program / John Snow, Inc. May 2018.

[38].  World Health Organization. WHO guideline on health policy and system support to optimize community health worker programmes 2018 - ISBN 978-92-4-155036-9.

Abstract:

The success of the third ninety in UNAIDS 90-90-90 by 2020 depends on the sustainability of antiretroviral therapy by clients on therapy. The therapy is inefficient if there is poor adherence. Due to certain factors, a fraction of the clients is lost from the clinic and they contribute to transmission of new infections. The aim is to inquire into these factors and their contribution to attrition in Anambra facilities.

A quantitative experimental study using a comprehensive purposeful sampling method. From the electronic medical record data of clients who have not been seen in the clinic for 90 completed days from May 2016 to May 2018 was accessed. These clients were disaggregated according to presence of descriptive addresses and phone contacts. Traceable clients were tracked on phone at seven different times over three weeks. Data was collected in an excel sheet and analysed using SPSS version 22.

For a total ever enrolled of 852 clients, there were 12 deaths. 265 clients (31% of total enrolment) that defaulted. 141 (53.5%) were untraceable while 124 (46.5%) were traceable. 29 clients (23.8% of traceable) were on self-transfer. 39 clients (31.7%) promised to return, while 56 clients (44.5%) were uninterested in the therapy.

The defaulter rate in these facilities is high and the fact that majority of these clients cannot be tracked due to poor contact information of clients is a source of concern. The negative effects of faith and economy were as well observed. Quality counselling and dialogues with faith leaders are recommended.

Keywords: attrition, factors, extent, anti-retroviral therapy, Anambra.

References:

[1].   Dalal RP, Macphail C, Mqhayi M, et al. Characteristics and outcomes of adult patients lost to follow-up at an antiretroviral treatment clinic in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2008; 47:101–107.

[2].   Daniel OJ. 2004. Adherence pattern to ARV drugs among AIDS patients on self-purchased drugs and those on free medications in Sagamu, Nigeria. XV International AIDS Conference. Bangkok, Thailand. 30 March ‐ 2 April 2004.

[3].   Geng EH, Bangsberg DR, Musinguzi N, et al. Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr. 2010; 53:405–411.

[4].   Nigerian AIDS Indicator Impact Survey 2018. www.naiis.ng .Accessed on 15^th May 2019.

[5].   Rosen S, Ketlhapile M. Cost of using a patient tracer to reduce loss to follow-up and ascertain patient status in a large antiretroviral therapy program in Johannesburg, South Africa. Trop Med Int Health. 2010; 15:98–104.

[6].   Weiser S et al. 2003. Barriers to antiretroviral adherence for patients living with HIV Infection and AIDS in Botswana. Journal Acquired Immune Deficiency Syndrome, 34:281–288).

[7].   www.nigeria.opendataforsfrica.org/xsp.

Abstract:

Malaria is endemic in the tropics with pregnant women at increased risk. Malaria in pregnancy causes feto-maternal morbidity and mortality. The regular use of long-lasting insecticide-treated nets is a cost-effective vector-control strategy with synergistic insecticidal and barrier-protective dual actions.

This study explored the rate and socio-demographic determinants of long-lasting insecticide-treated nets utilization in 100 randomly-selected pregnant women attending a private ultrasound center in Keffi, Nigeria. It was a quantitative cross-sectional survey using a structured interviewer-administered questionnaire. The data was analyzed using statistical package for social sciences.

The results revealed a rate of 70% of regular utilization of long-lasting insecticide-treated nets and a statistically significant association between religion and regular long-lasting insecticide-treated nets use (OR 1.51, 95% CI 0.98- 2.34, p .02). The relationship between the free distribution of long-lasting insecticide-treated nets and regular use was not significant (p .363).

Regular use of long-lasting insecticide-treated nets would prevent malaria in pregnancy, reduce feto-maternal morbidity and mortality, and improve feto-maternal survival in Nigeria and other malaria-endemic parts of the world.

Keyword: Rate, Determinants, Utilization, Insecticide-treated-Nets, Pregnancy, Malaria.

References:

[1].      Adebayo, A. M., Akinyemi, O. O., & Cadmus, E. O. (2014). Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria. Journal of preventive medicine and hygiene, 55(2), 58-64.

[2].      Adeola, A. A., & Okwilagwe, E. A. (2015). Acceptance and Utilisation of Sulphadoxine-Pyrimethamine and Insecticide-Treated Nets among Pregnant Women in Oyo State, Nigeria. Malaria Research and Treatment, 2015, 713987.

[3].      Aderibigbe, S. A., Olatona, F. A., Sogunro, O., Alawode, G., Babatunde, O. A., Onipe, A. I., … Akande, T. M. (2014). Ownership and utilisation of long-lasting insecticide treated nets following free distribution campaign in South West Nigeria. The Pan African Medical Journal, 17, 263. http://doi.org/10.11604/pamj.2014.17.263.3927.

[4].      Al-Eryani, S. M. A., Mahdy, M. A. K., Al-Mekhlafi, A. M., & Abdul-Ghani, R. (2017). Access to and use of long-lasting insecticidal nets and factors associated with non-use among communities in malaria-endemic areas of Al Hudaydah governorate in the Tihama region, west of Yemen. Malaria Journal, 16, 244. http://doi.org/10.1186/s12936-017-1894-9.

[5].      Ankomah, A., Adebayo, S. B., Arogundade, E. D., Anyanti, J., Nwokolo, E., Inyang, U., Meremiku, M. (2014). The Effect of Mass Media Campaign on the Use of Insecticide-Treated Bed Nets among Pregnant Women in Nigeria. Malaria Research and Treatment, 2014, 694863. http://doi.org/10.1155/2014/694863.

[6].      Belay, M., & Deressa, W. (2008). Use of insecticide treated nets by pregnant women and associated factors in a pre‐dominantly rural population in northern Ethiopia. Tropical Medicine & International Health, 13(10), 1303-1313.

[7].      Dalrymple, U., Cameron, E., Bhatt, S., Weiss, D.J., Gupta, S. and Gething, P.W., (2018). Correction: Quantifying the contribution of Plasmodium falciparum malaria to febrile illness amongst African children. eLife, 7, p.e38361.

[8].      Ernst, K. C., Erly, S., Adusei, C., Bell, M. L., Kessie, D. K., Biritwum-Nyarko, A., & Ehiri, J. (2017). Reported bed net ownership and use in social contacts is associated with uptake of bed nets for malaria prevention in pregnant women in Ghana. Malaria Journal, 16, 13. http://doi.org/10.1186/s12936-016-1660-4.

[9].      Eteng, M., Mitchell, S., Garba, L., Ana, O., Liman, M., Cockcroft, A., & Andersson, N. (2014). Socio-economic determinants of ownership and use of treated bed nets in Nigeria: results from a cross-sectional study in Cross River and Bauchi States in 2011. Malaria Journal, 13, 316. http://doi.org/10.1186/1475-2875-13-316.

[10].  Ezire, O., Adebayo, S. B., Idogho, O., Bamgboye, E. A., & Nwokolo, E. (2015). Determinants of use of insecticide-treated nets among pregnant women in Nigeria. International journal of women's health, 7, 655.

[11].  Fokam, E. B., Kindzeka, G. F., Ngimuh, L., Dzi, K. T. J., & Wanji, S. (2017). Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon. BMC Public Health, 17, 263. http://doi.org/10.1186/s12889-017-4155-5.

[12].  Hunter, G. C., Scandurra, L., Acosta, A., Koenker, H., Obi, E., & Weber, R. (2014). “We are supposed to take care of it”: a qualitative examination of care and repair behaviour of long-lasting, insecticide-treated nets in Nasarawa State, Nigeria. Malaria Journal, 13, 320. http://doi.org/10.1186/1475-2875-13-320.

[13].  Ikeako, L. C., Azuike, E. C., Njelita, I. A., Nwachukwu, C. C., Okafor, K. C., Nwosu, C., ... & Ofomata, U. C. (2017). Insecticide Treated Nets: Perception and Practice Among Pregnant Women Accessing Antenatal Services at A Tertiary Hospital in Awka, Nigeria.

[14].  Kateera, F., Ingabire, C. M., Hakizimana, E., Rulisa, A., Karinda, P., Grobusch, M. P., … Mens, P. F. (2015). Long-lasting insecticidal net source, ownership and use in the context of universal coverage: a household survey in eastern Rwanda. Malaria Journal, 14, 390. http://doi.org/10.1186/s12936-015-0915-9.

[15].  Kimbi, H. K., Nkesa, S. B., Ndamukong-Nyanga, J. L., Sumbele, I. U. N., Atashili, J., & Atanga, M. B. S. (2014). Socio-demographic factors influencing the ownership and utilization of insecticide-treated bed nets among malaria vulnerable groups in the Buea Health District, Cameroon. BMC Research Notes, 7, 624. http://doi.org/10.1186/1756-0500-7-624.

[16].  Manu, G., Boamah-Kaali, E. A., Febir, L. G., Ayipah, E., Owusu-Agyei, S., & Asante, K. P. (2017). Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana. Malaria Research and Treatment, 2017, 7481210. http://doi.org/10.1155/2017/7481210.

[17].  Moon, T. D., Hayes, C. B., Blevins, M., Lopez, M. L., Green, A. F., González-Calvo, L., … The Ogumaniha-SCIP Zambézia Consortium. (2016). Factors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambézia Province, Mozambique. Malaria Journal, 15, 196. http://doi.org/10.1186/s12936-016-1250-5.

[18].  Ntuku, H. M., Ruckstuhl, L., Julo-Réminiac, J.-E., Umesumbu, S. E., Bokota, A., Tshefu, A. K., & Lengeler, C. (2017). Long-lasting insecticidal net (LLIN) ownership, use and cost of implementation after a mass distribution campaign in Kasaï Occidental Province, Democratic Republic of Congo. Malaria Journal, 16, 22. http://doi.org/10.1186/s12936-016-1671-1.

[19].  Nyavor, K. D., Kweku, M., Agbemafle, I., Takramah, W., Norman, I., Tarkang, E., & Binka, F. (2017). Assessing the ownership, usage and knowledge of Insecticide Treated Nets (Long-lasting insecticide-treated nets) in Malaria Prevention in the Hohoe Municipality, Ghana. The Pan African Medical Journal, 28, 67. http://doi.org/10.11604/pamj.2017.28.67.9934.

[20].  Obol, J., Ononge, S., & Orach, C. (2013). Utilisation of insecticide treated nets among pregnant women in Gulu: a post conflict district in northern Uganda. African Health Sciences, 13(4), 962–969. http://doi.org/10.4314/ahs.v13i4.15.

[21].  Onwujekwe, O., Etiaba, E., Uguru, N., Uzochukwu, B., & Adjagba, A. (2014). Towards making efficient use of household resources for appropriate prevention of malaria: investigating households’ ownership, use and expenditures on Long-lasting insecticide-treated nets and other preventive tools in Southeast Nigeria. BMC Public Health, 14, 315. http://doi.org/10.1186/1471-2458-14-315.

[22].  Russell, C. L., Sallau, A., Emukah, E., Graves, P. M., Noland, G. S., Ngondi, J. M., … Patterson, A. E. (2015). Determinants of Bed Net Use in Southeast Nigeria following Mass Distribution of LLINs: Implications for Social Behavior Change Interventions. PLoS ONE, 10(10), e0139447. http://doi.org/10.1371/journal.pone.0139447.

[23].  Sangaré, L. R., Weiss, N. S., Brentlinger, P. E., Richardson, B. A., Staedke, S. G., Kiwuwa, M. S., & Stergachis, A. (2012). Determinants of use of insecticide treated nets for the prevention of malaria in pregnancy: Jinja, Uganda. PLoS One, 7(6), e39712.

[24].  Singh, M., Brown, G., & Rogerson, S. J. (2013). Ownership and use of insecticide-treated nets during pregnancy in sub-Saharan Africa: a review. Malaria journal, 12(1), 268.

[25].  World Health Organization (WHO), (2018). Malaria. Available at: http://www.who.int/malaria/media/world_malaria_report_2014/en/, (accessed: 21/07/2018).

Abstract:

Objective: To explore the factors influences on childhood obesity in Mongar, Bhutan to notify and alert future improvement of a childhood obesity interventions for children in Bhutan.

Study design: Qualitative study.

Methods: Interviews of a purposeful sample with primary health workers and school health coordinator in one district in Bhutan were arranged to explore their perceptions related to the factors contributing to childhood obesity. 11 Primary healthcare workers and two school health coordinators were included. All the discussions were transcribed verbatim in English and iterative thematic approach was used for data analysis.

Results: In general, the causes of childhood obesity were perceived to relate to macro-level policy influences, the school environment, sociocultural factors, and family and individual behavioral factors, acting in combination.

Conclusion: The findings suggest that primary healthcare workers and school health coordinators have their own views on the causes of childhood obesity which involved behavioral, structural and social causes. A prominent emerging theme was the need for interventions like health workers and public awareness and support for a healthy environment. Any local initiatives in Mongar Bhutan are unlikely to be successful without such support.

Keywords: Bhutan, primary health workers, school health coordinator, childhood obesity, exploratory.

References:

[1].   World Bank Health Nutrition and Population Statistics (World Bank). 2016; Retrieved July 10, 2018, from https://knoema.com/WBHNPStats2016May/health-nutrition-and-population-statistics-world-bank.

[2].   Organization WH. Global status report on noncommunicable diseases 2014. World Health Organization; 2014.

[3].   World Health Organization. Obesity and Overweight. 2017; Retrieved July 10, 2018, from http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.

[4].   World Bank. Non-Communicable Diseases in Bhutan: South Asia Human Development, Health Nutrition and, Population. 2011.

[5].   World Health Organization. Global status report on noncommunicable diseases 2014: World Health Organization. 2014.

[6].   Zangmo U, de Onis M, Dorji T. The nutritional status of children in Bhutan: results from the 2008 National nutrition survey and trends over time. BMC pediatrics. 2012;12(1):151.

[7].   Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of family medicine and primary care. 2015;4(2):187.

[8].   Karnik S, & Kanekar, A. Childhood obesity: A global public health crisis. International Journal of Preventive Medicine. 2012;3(1):1.

[9].   Lakshman R, Elks CE, Ong KK. Childhood obesity. Circulation. 2012;126(14):1770-1779.

[10].  Denzin NK. The Research Act: A Theoretical Introduction to Sociological Methods (3rd ed). Prentice Hall, Englewood Cliffs, New Jersey.

[11].  1989.

[12].  Royal Government of Bhutan. Annual Health Bulletin. 2017.

[13].  Stewart L. Childhood obesity. Medicine. 2011;39(1):42-44.

[14].  World Health Organization. Bulletin of the World Health Organization. 2017a; Retrieved July 10, 2018, from http://www.who.int/bulletin/volumes/95/7/16-187476/en/.

Abstract:

Introduction: There has been a global decline in infant mortality without an equivalent decline in newborn mortality. Several studies have investigated the influence of each disease entity on childhood mortality concluding that severity of the disease is a major contributor to outcome. However, only few studies have evaluated the influence of social factors in the outcome of newborn hospitalization. This study aimed to investigate the influence of social and some demographic factors on early neonatal hospital admission.

Methods: The study was a descriptive retrospective cross-sectional review of clinical records of 170 newborn admitted in to the Special Care Baby Unit of Federal Medical Centre Owerri form May 2014 – May 2015. Case files of all newborn admitted during this period were reviewed and data collated and analyzed using SPSS version 20. Chi-Squared and Odds Ratio were calculated.

Results: a total of 170 newborn were admitted, 10 (6.0%) died while 157 (94.0%) were discharged, the outcome of three admissions were missing. Fathers’ education and occupation play significant role in neonatal survival OR 3.23 (1.08- 10.06) p-value 0.04 and OR 6.36 (1.83 – 22.17) p-value 0.004 respectively. Newborn of fathers’ and mothers with paid employment had better outcome.

Conclusion: This study demonstrated that paid employment is associated with better outcome of newborn admission.

Keywords: Newborn Admission, Federal Medical Center Owerri.

References:

[1].   Neonatal and perinatal mortality: Country, regional and global estimates. WHO 2006. WHO Press. World Health Organisation, Geneva, Switzerland

[2].   Levels and trends in child mortality- Report 2015. Estimates developed by the UN inter agency group for child mortality estimation. UNICEF. United Nations Children’s Fund; 2015.

[3].   Survey H. Nigeria. 2013

[4].   Ijezie E, Okpokowuruk FS. Mortality audit in the paediatrics department of the University of Uyo teaching hospital, Uyo, Nigeria. Int J Res Med Sci. 2016;4(2):615–20

[5].   Morakinyo OM, Fagbamigbe AF. Neonatal, infant and under-five mortalities in Nigeria: An examination of trends and drivers (2003-2013). PLoS One [Internet]. 2017;12(8): e0182990. Available from: http://dx.doi.org/10.1371/journal.pone.0182990

[6].   Akinyemi JO, Bamgboye EA, Ayeni O. Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics. BMC Pediatr. 2015;15(1):1–12

[7].   WHO. World Health Report: Make Every Mother and Child Count (WHO) 2005.

[8].   Shah R. Sharma B. Khanal V, Pandey UK, Anu V, Malla DK. Factors associated with neonatal deaths in Chitwan district of Nepal BMJ 2015;8:818.

[9].   A.O. Oyabambi, O.A. Bolarinwa, O. Adebayo, F.C. Emerenini. Awareness and Perception About Pentavalent Vaccine and Its Determinants Among Women of Reproductive Age Group in North Central Nigeria. Trp J Health Sci. 2017:24.

[10].     R Karasek. Lower Health Risk with Increased Job Control among White Collar Workers. Journal of Organizational Behavior, 1990;11(3):171–185.

Abstract:

Background: Tuberculosis (TB) is one of the top 10 causes of death worldwide, and the leading cause from a single infectious agent (above HIV/AIDS). Globally, 10.0 million people developed TB disease in 2017 with an estimated 1.6 million deaths. We conducted this study to determine predictors of treatment outcomes among tuberculosis patients treated at specialist hospital, Sokoto State, Nigeria.

Methods: A retrospective cohort study was conducted using medical record of 1501 patients treated of tuberculosis between January, 2014 and January, 2017. Treatment outcomes and TB cases were classified according to National TB control program guidelines. Bivariate and multivariate analysis was conducted to identify predictors of unsuccessful treatment outcomes. Odds ratio (OR) and 95% confidence interval (CI) was calculated. P- value of 0.05 was considered as statistically significant.

Result: Of the 1,501 patients treated; 72.2% were males with mean age of 36.5 ±14.9 years. Pulmonary TB accounts for 1,143 (76.2%) cases. A total of 174 (11.6%) were co-infected with HIV. successful outcomes accounts for 1,229 (81.9%) cases. Previously treated cases 89 (5.9%). Of the cases, 44 (2.9%) died. Being previously treated (P < 0.001) and co-infection with HIV(p<0.001) are independent predictors of poor treatment outcomes.

Conclusion: The treatment success rate was low as compared to the national target. Therefore, targeted interventions of high-risk patients are recommended.

Keywords: Tuberculosis, Treatment outcomes, DOT, Sokoto.

References:

[1].   Agbaji, C., Ebonyi, O., Meloni, A. O., Anejo-Okopi, S. T., & Akanbi, J. A. (2013). Factors Associated with Pulmonary Tuberculosis-HIV Co-Infection in Treatment-Naive Adults in Jos. North Central Nigeria. J AIDS Clin Res, 4, 222. https://doi.org/10.4172/2155-6113.1000222.

[2].   Aniwada, E., Onodugo, O., Onwasigwe, C., & Ajayi, O. (2018). Appraising Treatment Outcomes of Cohort of Smear-positive Patients with Tuberculosis (TB) alone and TB-HIV Co-infected on Directly Observed Treatment Short Course (DOTS) at a Teaching Hospital in Enugu State, Nigeria. Journal of Advances in Medicine and Medical Research, 27(3), 1–8. https://doi.org/10.9734/jammr/2018/42909.

[3].   Atif, M., Anwar, Z., Fatima, R. K., Malik, I., Asghar, S., & Scahill, S. (2018). Analysis of tuberculosis treatment outcomes among pulmonary tuberculosis patients in Bahawalpur, Pakistan. BMC Research Notes, 11(1), 370. https://doi.org/10.1186/s13104-018-3473-8.

[4].   Babatunde, O. A., Elegbede, O. E., Ayodele, M., Fadare, J.., Isinjaye, A. O., Ibirongbe, D.., & Akinyandenu, J. (2013). Factors Affecting Treatment Outcomes of Tuberculosis in a Tertiary Health Center in Southwestern Nigeria. International Review of Social Sciences and Humanities, 4(2), 209–218.

[5].   Belay, M., Bjune, G., & Abebe, F. (2015). Prevalence of tuberculosis, HIV, and TB-HIV co-infection among pulmonary tuberculosis suspects in a predominantly pastoralist area, northeast Ethiopia. Global Health Action, 8(5), 1–7. https://doi.org/10.3402/gha.v8.27949.

[6].   Biadglegne, F., Anagaw, B., Debebe, T., Anagaw, B., Tesfaye, W., Tessema, B., … Sack, U. (2013). A retrospective study on the outcomes of tuberculosis treatment in Felege Hiwot Referral Hospital, Northwest Ethiopia. International Journal of Medicine and Medical Sciences, 5(2), 85–91. https://doi.org/10.5897/IJMMS12.142.

[7].   Choi, H., Lee, M., Chen, R. Y., Kim, Y., Yoon, S., Joh, J. S., … Cho, S.-N. (2014). Predictors of pulmonary tuberculosis treatment outcomes in South Korea: a prospective cohort study, 2005-2012. BMC Infectious Diseases, 14(1), 360. https://doi.org/10.1186/1471-2334-14-360.

[8].   Daniel Tarekegne, M. J., Tarekegne, D., Atanaw, T., Ebabu, A., Endris, M., Tessema, B., … Deressa, T. (2014). Treatment Outcomes of Tuberculosis Patients in Metema Hospital, Northwest Ethiopia: A Four Years Retrospective Study. Mycobacterial Diseases, 05(04). https://doi.org/10.4172/2161-1068.1000190.

[9].   Denegetu, A. W., & Dolamo, B. L. (2014). HIV screening among TB patients and co-trimoxazole preventive therapy for TB/HIV patients in Addis Ababa: Facility based descriptive study. PLoS ONE, 9(2), 1–7. https://doi.org/10.1371/journal.pone.0086614.

[10].  Deribew, A., HaileMichael, Y., Tesfaye, M., Desalegn, D., Wogi, A., & Daba, S. (2010). The synergy between TB and HIV co-infection on perceived stigma in Ethiopia. BMC Research Notes, 3(1), 249. https://doi.org/10.1186/1756-0500-3-249.

[11].  El-Shabrawy, M., & El-Shafei, D. A. (2017). Evaluation of treatment failure outcome and its predictors among pulmonary tuberculosis patients in Sharkia Governorate, 2013-2014 The Egyptian Society of Chest Diseases and Tuberculosis. Egyptian Journal of Chest Diseases and Tuberculosis, 66, 145–152. https://doi.org/10.1016/j.ejcdt.2015.11.002.

[12].  Fatiregun, A. A., Ojo, A. S., & Bamgboye, A. E. (2009). Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Annals of African Medicine, 8(2), 100–104. https://doi.org/10.4103/1596-3519.56237.

[13].  Fatiregun, A., Ojo, A., & Bamgboye, A. (2009). Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Annals of African Medicine, 8(2), 100. https://doi.org/10.4103/1596-3519.56237.

[14].  FEDERAL MINISTRY OF HEALTH DEPARTMENT OF PUBLIC HEALTH. (n.d.).

[15].  Gabida, M., Tshimanga, M., Chemhuru, M., Gombe, N., Bangure, D., Belay, T., … Duru, C. (2015). Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in Kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis. Journal of Tuberculosis Research, 03(04), 126–135. https://doi.org/10.4236/jtr.2015.34019.

[16].  Gadoev, J., Asadov, D., Tillashaykhov, M., Tayler-Smith, K., Isaakidis, P., Dadu, A., … Dara, M. (2015). Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study. https://doi.org/10.1371/journal.pone.0128907.

[17].  Gebrezgabiher, G., Romha, G., Ejeta, E., Asebe, G., Zemene, E., & Ameni, G. (2016). Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study. PloS One, 11(2), e0150560. https://doi.org/10.1371/journal.pone.0150560.

[18].  global. (2018).

[19].  Ifebunandu, N. A., & Ukwaja, K. N. (2012). Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: Prevalence, trend, timing and predictors. Journal of Infection and Public Health, 5, 340–345. https://doi.org/10.1016/j.jiph.2012.06.002.

[20].  Johnson, H. D., Dayalan, M. R., Wei, C. C., Kasinathan, G., Navarathnam, P., & Pillai, N. (2016). Predictors of Tuberculosis Treatment Outcome in an Urban Setting: A Retrospective Cohort Study. American Journal of Infectious Diseases and Microbiology, Vol. 4, 2016, Pages 14-21, 4(1), 14–21. https://doi.org/10.12691/AJIDM-4-1-3.

[21].  Lawn, S. D. (2009). Tuberculosis and HIV co-infection. Medicine, 37(12), 654–656. https://doi.org/10.1016/j.mpmed.2009.09.005.

[22].  Liew, S. M., Khoo, E. M., Ho, B. K., Lee, Y. K., Mimi, O., Fazlina, M. Y., … Jiloris, F. D. (2015). Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union against Tuberculosis and Lung Disease, 19(7), 764–771. https://doi.org/10.5588/ijtld.14.0767.

[23].  Malede, A., Shibabaw, A., Hailemeskel, E., Belay, M., & Asrade, S. (2015). Treatment Outcome of Tuberculosis Patients and Associated Risk Factors at Dessie and Woldiya Town Health Institutions, Northeast Ethiopia: A Retrospective Cross-Sectional Study. https://doi.org/10.4172/2155-9597.1000240.

[24].  Ofoegbu, O. S., & Odume, B. B. (2015). Treatment outcome of tuberculosis patients at National Hospital Abuja Nigeria: a five-year retrospective study. South African Family Practice, 57(1), 50–56. https://doi.org/10.1080/20786190.2014.995913.

[25].  Oshi, D. C., Oshi, S. N., Alobu, I., & Ukwaja, K. N. (2014). Profile and treatment outcomes of tuberculosis in the elderly in southeastern Nigeria, 2011-2012. PLoS ONE, 9(11), 2011–2012. https://doi.org/10.1371/journal.pone.0111910.

[26].  Santha, T., Garg, R., Frieden, T. R., Chandrasekaran, V., Subramani, R., Gopi, P. G., … Narayanan, P. R. (2002). Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. International Journal of Tuberculosis and Lung Disease, 6(9), 780–788.

[27].  Sengul, A., Akturk, U. A., Aydemir, Y., Kaya, N., Kocak, N. D., & Tasolar, F. T. (2015). Factors affecting successful treatment outcomes in pulmonary tuberculosis: A single-center experience in Turkey, 2005-2011. Journal of Infection in Developing Countries, 9(8), 821–828. https://doi.org/10.3855/jidc.5925.

[28].  Tafess, K., Beyen, T. K., Abera, A., Tasew, G., Mekit, S., Sisay, S., … Siu, G. K. H. (2018). Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data. Frontiers in Medicine, 5, 38. https://doi.org/10.3389/fmed.2018.00038.

[29].  Teshome Kefale, A., & Anagaw, Y. (2017). Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia. International Journal of General Medicine, Volume 10, 161–169. https://doi.org/10.2147/IJGM.S135305.

[30].  Treatment of tuberculosis. (n.d.).

[31].  Tuberculosis, G. (2018). Report 2018.

[32].  WHO. (2016). Global Tuberculosis Report 2016. Cdc 2016, (Global TB Report 2016), 214. https://doi.org/ISBN 978 92 4 156539 4.

[33].  Yadeta, D., Alemseged, F., & Biadgilign, S. (2013). Provider-initiated HIV testing and counseling among tuberculosis patients in a hospital in the Oromia region of Ethiopia. Journal of Infection and Public Health, 6(3), 222–229. https://doi.org/10.1016/j.jiph.2013.01.002.

[34].  Yakob, B., Alemseged, F., Paulos, W., & Badacho, A. S. (2018). Trends in Treatment Success Rate and Associated Factors among Tuberculosis Patients in Ethiopia: A Retrospective Cohort Study. Health Science Journal, 12(5). https://doi.org/10.21767/1791-809X.1000598.

[35].  Yen, Y.-F., Yen, M.-Y., Shih, H.-C., & Deng, C.-Y. (2012). Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 106(5), 303–308. https://doi.org/10.1016/j.trstmh.2012.01.011.

Abstract:

Background: The 2014 National ANC Sero-prevalence Survey result for Ekiti State, Nigeria recorded HIV prevalence rate of 2.9% for the state, yet the uptake of PMTCT services was found to be low despite the availability of services even in the remotest local government area in the State. This survey investigated factors influencing the low patronage of government facilities and the possibility of integrating TBA/MBA into the PMTCT programme in the state.

Methods: Study conducted in the sixteen local Government area of Ekiti State. The sample size was 160 women of reproductive age (18-48) years of age, 35 ABH, and their clients (122), research period of 12 months. The instruments used were questionnaire, unstructured personal interviews and documentary reports. Data were collected and analysed by the use of Statistical Package for Social Sciences (SPSS 20) Software.

Results: Of the 16 LGAs in Ekiti State, 14 participated in the survey. Reasons for patronizing TBA/MBA are spiritual assistance 40%, Low bills 10%, Church influence 5.5%, availability 3.4%, personal relationship 7.6%, and other minor reasons. Less than 45%”, 32% of the respondents have very low knowledge of HIV; its mode of transmission and prevention, and 32% also score above 79% (Very good knowledge).

76% of the respondents have linkage system with the Government health facilities, while 24% respondents (24%) said NO.

Conclusions: This study showed that integrating TBA/MBA in health care service can be very effective in promoting PMTCT in Nigeria.

Keywords: Alternative birth Attendants, HIV, PMTCT, TBA, MBA, Government facilities.

References:

[1].   Abubakar, A.; Sambo, M.N.; and Idris, S.H.; (2011). Awareness and utilisation of antenatal care services and delivery services in a rural community, Northwestern Nigeria. Kanem Journal of Medical Sciences. 5(2):43–49.

[2].   Adegoke, A.A.; and Van de Broek N. (2009) Skilled birth attendance-lessons learnt. BJOG: An International Journal of Obstetrics & Gynaecology. ;116(1):33–40.

[3].   Agbo, M.A.E. (2013). Training of traditional birth attendants: a strategy for reduction of maternal and infant mortality. West African Journal of Nursing. 42–52.

[4].   Alison, M. R., and Salihu, H.M., (2009) The impact of maternal mortality interventions using traditional birth attendants and village midwives, Journal of Obstetrics and Gynaecology 24(1)

[5].   Balogun, M.; and Odeyemi, K.; (2010). Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria. Pan African Medical Journal 5(7):1–12.

[6].   Bukar, M.; and Jauro, Y.S.; (2013). Home births and postnatal practices in Madagali, North-Eastern Nigeria. Nigerian Journal of Clinical Practice. 16(2):233–245.

[7].   Doctor, H.V.; Findley, S.E.; Ager, A.; Cometto, G.; Afenyadu, G.Y.; Adamu, F.; and Green, C.; (2012). Using community-based research to shape the design and delivery of maternal health services in northern Nigeria. Reproductive Health Matters. 20(39):104–112.

[8].   Ebuehi, O.M., and Akintujoye, I. (2012). Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria. International Journal of Women's Health. 4:25–34.

[9].   Ekanem, A.D.; Udoma, E.J.; Utsalo, S.J.; (2006). Bacterial contamination of women in the labor supervised by traditional birth attendants. International Journal of Gynecology and Obstetrics. 92:126–127.

[10].  Ekiti state AIDS Control Agency, EKSACA, (2015) Guidelines for the implementation of community based PMTCT in Ekiti State for Civil Society Organization pp1-17.

[11].     Emelumadu, O.F.; Ukegbo, A.U.; Ezeama, N.N.; Kanu, O.O.; Ifeadike, C.O.; and Onyeaonoro U.U.; (2014) Socio-demographic determinants of maternal health-care service among rural women in Anambra State, South East Nigeria. Annals of Medical and Health Sciences Research. 4(3):376–382.

[12].     Ezeonwu, M.;(2011) Maternal Birth Outcomes: Processes and Challenges in Anambra State, Nigeria. Health Care for Women International. 32(6):492–514.

[13].     Findley, S.E.; Doctor, H.V.; Ashir, G.M.; Kana, M.A.; Mani AS, Green C, and Afenyadu, G.Y.; (2015) Reinvigorating health systems and community-based services to improve maternal health outcomes: case study from northern Nigeria. Journal of Primary Care and Community Health.6(2):88–99.

[14].     Freddy Perez and Khin Aung, (2008) participation of TBAs in PMTCT of HIV services in Zimbabwe a feasibility study. BMC Public Health

[15].     Harrison, K.A. (2011). Are traditional birth attendants good for improving maternal and perinatal health? 342: d3308.

[16].     Imogie AO, Agwubike EO, Aluko K (2002). Assessing the role of traditional birth attendants (TBAs) in health care delivery in Edo State, Nigeria. African Journal of Reproductive Health. 6(2):94–100.

[17].     Inegbenebor U.; (2014). Bridging the gap between concept and reality in the Nigeria midwives service scheme. Scientific American Journal on Public Health 2:126-34.

[18].     Isichei, C.O.; and Ammann, A.J. (2015). The role of trained birth attendants in delivering PMTCT services. American Journal of Health Responses 3: 232-8.

[19].     Iyaniwura, C.A.; and Yusuf, Q.;(2009). Utilization of antenatal care and delivery services in Sagamu, south western Nigeria. African Journal of Reproductive Health. 13(2):111–122.

[20].     Kruske, S.; and Barclay, L, (2004). Effect of shifting policies on traditional birth attendant training. Journal of Midwifery & Women's Health. 9(4):306–311.

[21].     Mboho, M.; Eyo, U.; and Agbaje, A.; (2012). Services of the traditional birth attendants: how relevant in achieving millennium development goal 5? Academic Research International. 2(3):710–717.

[22].     National Agency for Control of AIDS. Federal Republic of Nigeria - Global AIDS response: country progress report. 2014. Available frm

[23].     http://www.unaids.org/sites/default/files/country/documents/NGA_narrative_report_2014.pdf

[24].     National Population Commission. (2016) Nigeria Demographic and Health Survey 2013. Rockville (MD): National Population Commission and ICF International. Joint publication of ICF International.

[25].     Nduka, I.; and Nduka, E.C.; (2014). Determinants of noninstitutional deliveries in an urban community in Nigeria. Journal of Medical Investigations and Practice. 9(3):102.

[26].     Ofili, A.N.; and Orojie, O.H.; (2005). Assessment of the role of traditional birth attendants in maternal health care in Oredo local government area, Edo State, Nigeria. Journal of Community Medicine and Primary Health Care. 17(1):55–60.

[27].     Osubor, K.M.; Fatusi, .A.O.; and Chiwuzie, J.C.; (2006). Maternal health-seeking behavior and associated factors in a rural Nigerian community. Maternal and Child Health Journal. 10(2):159–169.

[28].     Oyeledun, B.; Oronsanye, F.; and Oyeleke, T.; (2014). Increasing retention in care of HIV positive women in PMTCT services through continuous quality improvement. Journal on Acquired Immune Deficiency Syndrone 67: S125-31.

[29].     Rosskam, E.; Pariyo, G.; Hounton, S.; and Aiga, H.; (2011). Midwifery workforce management and innovation. The State of the World's Midwifery. pp1–11.

[30].     Sareminetol, I. Zuluaga, G.,and Auderson, M., (2016) Traditional Medicine used in childbirth and for childhood diarrhea in Nigeria’s Cross River State; Interview, with traditional practitioners and a state wide cross-sectional study BMJ open.

[31].     Sibley, L.M.; and Sipe, T.A.; (2006). Transition to skilled birth attendance: is there a future role for traditional birth attendants? Journal of Health Population Nutrition. 24(4):472–478.

[32].     World Health Organization. Partnership for Maternal, Newborn and Child Health. 2015. http://www.who.int/topics/millennium_development_goals/maternal_health/en/

Abstract:

By 2012, the majority of malaria cases were diagnosed and treated clinically and only 25% of the health facilities had malaria diagnostic equipment (microscopy or RDTs) in South Sudan (HMIS, 2012). In 2017, the Government of South Sudan and malaria implementing partners started implementation of mRDT at community level. This study sets out to determine the competence of community health workers under ICCM while conducting malaria diagnostic test for children under-five for malaria management in former Northern Bar El Ghazal.

Methods: A cross sectional study was conducted among 480 randomly selected CHWs. Data was collected using a questionnaire consisting of demographics, case management observation checklist, mRDT assessment checklist and competence factors and a focus group discussion guide. Analysis was done using stata V14 and thematic content analysis.

Results showed that competence of CHWs in malaria case management was skewed to right; more than 80 percent of CHWs could rightly assess the danger signs of child, classify patient’s illness correctly, gives correct treatment, counsel and records correct relation between classification, diagnosis and treatment. CHWs scored between 75 and 86 percent on the nine important mRDT procedures and a few CHWs (less than 10%) scored below 40 percent on mRDT procedure competence assessment.

In conclusion, the majority of CHWs were found to be competent in assessing and treating malaria sick children and conducting mRDTs. Therefore, use of mRDTs can be scaled at community level in South Sudan while strengthening competency determinants such as provision of equipment and supplies.

Keywords: Competence, Community Health Workers, Integrated Community Case Management, Malaria Diagnostic Test for Children Under-Five, Malaria Management, mRDT Procedure, Malaria Case Management, mRDT Competence Assessment.

References:

[1].   Agrawal PK, et al. (2012) Effect of Knowledge of Community Health Workers on Essential Newborn Health Care: A Study from Rural India. Health Policy and Planning, 27:115-126.

[2].   Bagonza, et al (2015). What Influences Availability of Medicines for the Community Management of Childhood Illnesses in Central Uganda? Implications for Scaling Up the Integrated Community Case Management Programme; Kampala Uganda: Makerere University School of Public Health.

[3].   Chinbuah, M.A, et al. (2013) Assessment of the adherence of community health workers to dosing and referrals guidelines for the management of fever in children under 5 years: a study in Dangme West District, Ghana. International Health, 5:148-156.

[4].   Counihan, H. Harvey, S. A. Sekeseke-Chinyama, M. Hamainza, B. Banda, R. Malambo, T. Masaninga, F.& Bell D. (2012). Community Health Workers Use Malaria Rapid Diagnostic Tests (RDTs) Safely and Accurately: Results of a Longitudinal Study in Zambia; American Journal of Tropical Medicine and Hygiene, 87(1) 57-63.

[5].   Gopalan, S. S., Mohanty, S., & Das, A. (2012). Assessing Community Health Workers’ Performance Motivation: A Mixed-Methods Approach on India's Accredited Social Health Activists (ASHA) programme. BMJ open, 2(5), e001557.

[6].  Hansen, K.S z, Richard Ndyomugyenyi, R, Magnussen, P, Sham, L & Sian E C. (2017) Cost-Effectiveness Analysis of Malaria Rapid Diagnostic Tests For Appropriate Treatment of Malaria at the Community Level in Uganda; Copenhagen, Denmark: University of Copenhagen.

[7].   Hay, S.I Hay, C.A Guerra, A.J Tatem, A. M Noor, and R.W Snow (2011).The global distribution and population at risk of malaria: past, present, and future Health Communication Capacity Collaborative (2015) Factors Impacting the effectiveness of Community Health Workers Behaviour change: A literature review; USAID: HCCC.

[8].   Health Management Information System-South Sudan (2012), Juba, South Sudan: Ministry of Health.

[9].   Kalyango, J.N, Elizeus Rutebemberwa E, Alfven, T, Ssali, S, Peterson, S & Charles Karamagi (2012). Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda; Department of Public Health Sciences, Division of Global Health (IHCAR), Karolinska Institute, SE 17177, Stockholm, Sweden.

[10].  Malaria Consortium, (2014) Malaria Consortium’s Approach to Malaria Diagnosis; Malaria Consortium, Development House, 56-64 Leonard Street, LondonEC2R 4LT, UK. Malaria Strategic Plan, (2017). South Sudan, Juba: National Malaria Control Programme.

[11].  Murray, CK, Gasser, R.A. Magill, A. J & & Miller, R. S.(2008) Update on Rapid Diagnostic Testing for Malaria; Infectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, Texas.

[12].  Ngeny, F.P. (2016). Factors Influencing the Performance of Community Health Workers in Nandi Hills Sub-County; Nairobi, Kenya: University of Nairobi.

[13].  USAID (2015). Factors Impacting the Effectiveness of Community Health Worker Behavior Change: A Literature Review.

Abstract:

South Sudan Government and health partners started implementation of malaria Rapid Diagnostic Test (mRDT) testing at community level through Community Health Workers in 2017 in order to reduce malaria morbidity and mortality through improvement of malaria case management among children under five. Malaria diagnostic equipment were available at only 25% of the health facilities (HMIS Report 2012). This study was conducted to determine the factors associated with adherence to mRDT test procedure among Community Health Workers (CHW) while managing malaria for under-fives in former Northern Bar El Ghazal.

Methods and materials: A cross sectional study design was conducted among 480 randomly selected CHWs. Mixed method data collection methods were conducted by using questionnaire for quantitative data which was divided into three sections; demographic, mRDT assessment checklist and adherence factors and focus group discussion guide for qualitative data. Quantitative data was analysed using stata Version 14. Pearson correlation product moment, chi-square, odds ratio and logistic regression were used to ascertain the association. Qualitative data was analysed using thematic analysis and triangulation was done.

Results showed that 30% of the CHWs adhered to mRDT test procedure 100%. Workplace environment (p=0.02), education (p=0.00) age (0.04), equipment and supplies(p=0.01) and documentation and reporting (p=0.02) tools availability were found to be significantly associated with adherence of CHWs to mRDT test procedures.

Conclusion: Education, age, workplace environment, equipment and supplies and documentation and reporting tool were significantly associated with adherence of CHWs to mRDT test procedure. Therefore, selection criteria should emphasise education and age. Also programme implementers should provide tools to facility conducting of mRDTs.

Keywords: Individual, community, program, Factors, Adherence, mRDT Test Procedure, Community Health Workers during, Management of Malaria for Under-Five, mRDT Procedures, Individual, community, program, Northern Bar El Ghazal.

References:

[1].  Agrawal PK, et al. (2012). Effect of Knowledge of Community Health Workers on Essential Newborn Health Care: A Study from Rural India. Health Policy and Planning, 27:115-126.

[2].  Altara, R et al (2016). Why Do Health Workers Give Anti-Malarial to Patients with Negative Rapid Test Results? A Qualitative Study at Rural Health Facilities in Western Uganda; Kampala, Uganda: Malaria Consortium.

[3].  Bagonza et al (2015). What Influences Availability of Medicines for the Community Management of Childhood Illnesses in Central Uganda; Implications for Scaling Up the Integrated Community Case Management Programme; Kampala Uganda: Makerere University School of Public Health.

[4].  Black, RE, Cousens, S, Johnson HL, Lawn JE, Rudan I, & Bassani DG, et al. (2010). Global, Regional, and National Causes of Child Mortality in 2008: A Systematic Analysis. Lancet. 2010; 375:1969-87. Medline: 20466419 Doi: 10.1016/ S0140-6736(10)60549-1.

[5].  Chinbuah, M.A, et al. (2013). Assessment of the adherence of community health workers to dosing and referrals guidelines for the management of fever in children under 5 years: a study in Dangme West District, Ghana. International Health, 5:148-156.

[6].  Hay,S.I Hay, C.A Guerra, A.J Tatem, A. M Noor, and R.W Snow (2011).The global distribution and population at risk of malaria: past, present, and future Health Communication Capacity Collaborative (2015) Factors Impacting the effectiveness of Community Health Workers Behaviour change: A literature review; USAID: HCCC.

[7].  Health Management Information System-South Sudan (2012). Juba, South Sudan: Ministry of Health.

[8].  Kallander, K et al (2015). Evaluating the Effect of Innovative Motivation and Supervision Approaches on Community Health Worker Performance and Retention in Uganda and Mozambique: Study Protocol for a Randomized Controlled Trial; Kallander Et Al.; Licensee Biomed Central.

[9].  Kalyango, J.N, Rutebemberwa E, Alfven, T, Ssali, S, Peterson, S & Karamagi, C. (2012). Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda; Department of Public Health Sciences, Division of Global Health (IHCAR), Karolinska Institutet, SE 17177, Stockholm, Sweden.

[10]. Rowe, S.Y, Olewe MA, McGowan JE, McFarland DA, Rochat R, Deming MS. (2007). Longitudinal analysis of community health workers’ adherence to treatment guidelines, Siaya, Kenya, 1997-2002. Tropical Medicine and International Health, 12(5):651-663.

Abstract:

Cardiovascular disease is the leading cause of death globally. Overweight, obesity, and hypertension are the top modifiable risk factors for cardiovascular diseases. Sedentary lifestyle, unhealthy eating, and stress in the banking industry predispose employees to overweight, obesity, and hypertension.

The study was a cross-sectional survey of 52 employees of a bank in Birnin Kebbi, North-East Nigeria that participated in a healthy lifestyle program. The aim of the study was to determine the prevalence and determinants of overweight, obesity, and hypertension in bank employees. The data was collected using an interview schedule, anthropometric and blood pressure measurements and analyzed with statistical package for social sciences.

The participants aged 26 to 59 years, 65.4% were youth, 34.6% middle-aged, 94.2% men, and 5.8% women. Senior staffs constituted 53.8%, junior 38.5%, and executive 7.7%. The mean weight was 77.99 ± 12.4kg, height 1.72 ± 0.07m, Body Mass Index 26.38 ± 3.93Kg/m2, systolic blood pressure 122 ± 21mmHg, and diastolic blood pressure 76 ± 14mmHg. The prevalence of overweight was 50%, obesity 15.4%, and hypertension 28.8%. Gender was significantly associated with overweight (p .037). The relationship between obesity and hypertension was not statistically significant (p 0.056).

Lifestyle modification in form of regular exercise and healthy eating would reduce overweight, obesity, and hypertension as well as cardiovascular morbidity and mortality in the banking industry. There is the need to establish workplace gymnasium and to increase public health awareness on healthy eating and regular exercise.

Keyword: Prevalence, Determinants, Overweight, Obesity, Hypertension, Bank.

References:

[1].   Adeloye, D., Basquill, C., Aderemi, A.V., Thompson, J.Y. and Obi, F.A., (2015). An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. Journal of Hypertension, 33(2), pp.230-242.

[2].   Chukwuonye, I.I., Chuku, A., John, C., Ohagwu, K.A., Imoh, M.E., Isa, S.E., Ogah, O.S. and Oviasu, E., (2013). Prevalence of overweight and obesity in adult Nigerians–a systematic review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 6, p.43.

[3].   Diwe, K.C., Enwere, O.O., Uwakwe, K.A., Duru, C.B. and Chineke, H.N., (2015). Prevalence and awareness of hypertension and associated risk factors among bank workers in Owerri, Nigeria. International Journal of Medicine and Biomedical Research, 4(3), pp.142-148.

[4].   Erem, C., (2015). Prevalence of overweight and obesity in Turkey. IJC Metabolic & Endocrine, 8, pp.38-41.

[5].   Fikadu, G. and Lemma, S., (2016). Socioeconomic status and hypertension among teachers and bankers in Addis Ababa, Ethiopia. International Journal of Hypertension, 2016. 4143962-4143962.

[6].   Ismail, I.M., Kulkarni, A.G., Kamble, S.V., Borker, S.A., Rekha, R. and Amruth, M., (2013). Prevalence of hypertension and its risk factors among bank employees of Sullia Taluk, Karnataka. Sahel Medical Journal, 16(4), p.139.

[7].   Moges, B., Amare, B., Fantahun, B. and Kassu, A., (2014). High prevalence of overweight, obesity, and hypertension with increased risk to cardiovascular disorders among adults in northwest Ethiopia: a cross sectional study. BMC Cardiovascular Disorders, 14(1), p.155.

[8].   Salaudeen, A.G., Musa, O.I., Babatunde, O.A., Atoyebi, O.A., Durowade, K.A. and Omokanye, L.O., (2014). Knowledge and prevalence of risk factors for arterial hypertension and blood pressure pattern among bankers and traffic wardens in Ilorin, Nigeria. African Health Sciences, 14(3), pp.593-599.

[9].   Sulaiman, N., Elbadawi, S., Hussein, A., Abusnana, S., Madani, A., Mairghani, M., Alawadi, F., Sulaiman, A., Zimmet, P., Huse, O. and Shaw, J., (2017). Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study. Diabetology & Metabolic Syndrome, 9(1), p.88.

[10].  WHO, (2019a). Mean Body Mass Index (BMI). Available at:

http://www.who.int/gho/ncd/risk_factors/bmi_text/en/, (accessed: 28/06/2019).

[11].  WHO, (2019b). Raised blood pressure, situations and trends. Available at:

http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/, (accessed: 28/06/2019).

[12].  Yang, L. and Colditz, G.A., (2015). Prevalence of overweight and obesity in the United States, 2007-2012. JAMA internal medicine, 175(8), pp.1412-1413.

[13].  Young, D.R., Fischer, H., Arterburn, D., Bessesen, D., Cromwell, L., Daley, M.F., Desai, J., Ferrara, A., Fitzpatrick, S.L., Horberg, M.A. and Koebnick, C., (2018). Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups. The Journal of Clinical Hypertension, 20(3), pp.532-540.

Abstract:

Congenital malformations are rare disorders, but the prevalence is on the increase globally due to access to imaging modalities, particularly ultrasound. Severe congenital abnormalities are not compatible with life leading to miscarriages while others cause fetal, neonatal, infant, and under-five morbidity and mortality. Ultrasonography provides a safe tool for the early diagnosis of congenital abnormalities in pregnancy.

This study used a quantitative cross-sectional approach to determine the factors associated with fetal congenital abnormalities in 11 pregnant women diagnosed by ultrasound between January and June 2019 in a private diagnostic center in Bauchi, North-East Nigeria. The primary data was collected using interview schedule and analyzed with statistical package for social sciences.

The most common anomaly (33%) was central nervous system abnormality (hydrocephalus - 75% and anencephaly - 25%). The congenital abnormalities were associated with fever in first trimester (100%), poverty (82%), being a housewife (82%), multigravida (73%), illiteracy (73%), 18-27 age group (55%), and ingestion of herbs in the first trimester (54%).  Hydrocephalus was associated with ingestion of drugs and herbs in first trimester and maternal occupation; anencephaly with maternal occupation, spouse occupation, and poverty; fetal ascites with advanced maternal age >38 years and grand-multiparity; and multicystic dysplastic kidney disease with spouse occupation (p .05).

Health education, avoidance of drugs and herbs in first trimester, access to healthcare, family planning, and poverty alleviation will prevent congenital abnormalities, reduce feto-maternal morbidity and mortality, and improve maternal and child health in Nigeria and other developing countries.

Keyword: Congenital Abnormalities, Factors, Pregnancy, Ultrasound, Nigeria.

References:

[1].      Adeboye, M. A. N., Abdulkadir, M. B., Adegboye, O. A., Saka, A. O., Oladele, P. D., Oladele, D. M., & Rotimi, B. F. (2016). A prospective study of spectrum, risk factors and immediate outcome of congenital anomalies in Bida, North Central Nigeria. Annals of Medical and Health Sciences Research, 6(6), 380-384.

[2].      Ahmed, S. M., Nordeng, H., Sundby, J., Aragaw, Y. A., & de Boer, H. J. (2018). The use of medicinal plants by pregnant women in Africa: A systematic review. Journal of Ethnopharmacology, 224, 297-313.

[3].      Aliyu, A. B., Oshanimi, J. A., Sulaiman, M. M., Gwarzo, U. S., Garba, Z. N., & Oyewale, A. O. (2015). Heavy metals and mineral elements of Vernonia ambigua, Vernonia oocephala and Vernonia pupurea used in Northern Nigerian traditional medicine. Vitae, 22(1), 27-32.

[4].      Chang, R. C., Wang, H., Bedi, Y., & Golding, M. C. (2019). Preconception paternal alcohol exposure exerts sex-specific effects on offspring growth and long-term metabolic programming. Epigenetics & Chromatin, 12(1), 9.

[5].      Eke, C. B., Uche, E. O., Chinawa, J. M., Obi, I. E., Obu, H. A., & Ibekwe, R. C. (2016). Epidemiology of congenital anomalies of the central nervous system in children in Enugu, Nigeria: A retrospective study. Annals of African medicine, 15(3), 126.

[6].      Foster, W. G., Evans, J. A., Little, J., Arbour, L., Moore, A., Sauve, R., & Luo, W. (2017). Human exposure to environmental contaminants and congenital anomalies: a critical review. Critical Reviews in Toxicology, 47(1), 59-84.

[7].      Frederiksen, L. E., Ernst, A., Brix, N., Lauridsen, L. L. B., Roos, L., Ramlau-Hansen, C. H., & Ekelund, C. K. (2018). Risk of adverse pregnancy outcomes at advanced maternal age. Obstetrics & Gynecology, 131(3), 457-463.

[8].      García, J., Ventura, M. I., Requena, M., Hernández, A. F., Parrón, T., & Alarcón, R. (2017). Association of reproductive disorders and male congenital anomalies with environmental exposure to endocrine active pesticides. Reproductive Toxicology, 71, 95-100.

[9].      Goetzinger, K. R., Shanks, A. L., Odibo, A. O., Macones, G. A., & Cahill, A. G. (2017). Advanced maternal age and the risk of major congenital anomalies. American journal of perinatology, 7(03), 217-222.

[10].  Igweze, Z. N., Amadi, C. N., & Orisakwe, O. E. (2019). Unsafe herbal sex enhancement supplements in Nigerian markets: a human risk assessment. Environmental Science and Pollution Research, 1-7.

[11].  Jystad, K. P., Strand, K. M., Bjellmo, S., Lydersen, S., Klungsöyr, K. A. R. I., Stoknes, M., & Vik, T. (2017). Congenital anomalies and the severity of impairments for cerebral palsy. Developmental Medicine & Child Neurology, 59(11), 1174-1180.

[12].  Kalliora, C., Mamoulakis, C., Vasilopoulos, E., Stamatiades, G. A., Kalafati, L., Barouni, R., ... & Tsatsakis, A. (2018). Association of pesticide exposure with human congenital abnormalities. Toxicology and Applied Pharmacology, 346, 58-75.

[13].  Lehtonen, L., Gimeno, A., Parra-Llorca, A., & Vento, M. (2017, June). Early neonatal death: a challenge worldwide. In Seminars in Fetal and Neonatal Medicine (Vol. 22, No. 3, pp. 153-160). WB Saunders.

[14].  Okoro, C. J., Okeudo, C., George, O. E., & Onyenwe, E. N. (2018). Retrospective study of major birth defects in Neonates Presenting at a Tertiary Health Facility in Orlu, South-east Nigeria. Journal of Advances in Medicine and Medical Research, 27(2), 1-9.

[15].  Sefidbakht, S., Dehghani, S., Safari, M., Vafaei, H., & Kasraeian, M. (2016). Fetal Central Nervous System Anomalies Detected by Magnetic Resonance Imaging: A Two-Year Experience. Iranian Journal of Pediatrics, 26(4), 41-48.

[16].  Sunitha, T., Prasoona, K. R., Kumari, T. M., Srinadh, B., Deepika, M. L. N., Aruna, R., & Jyothy, A. (2017). Risk factors for congenital anomalies in high risk pregnant women: A large study from South India. Egyptian Journal of Medical Human Genetics, 18(1), 79-85.

[17].  Warembourg, C., Cordier, S., & Garlantézec, R. (2017). An update systematic review of fetal death, congenital anomalies, and fertility disorders among health care workers. American journal of industrial medicine, 60(6), 578-590.

[18].  Welderufael, A. L., Berihu, B. A., Berhe, Y., Magana, T., Asfaw, S., Gebreselassie, K., & Mulugeta, A. (2019). Nutritional status among women whose pregnancy outcome was afflicted with neural tube defects in Tigray region of Ethiopia. Brain and Development, 41(5), 406-412.

[19].  WHO, (2019). Congenital anomalies. Available at:

https://www.who.int/topics/congenital_anomalies/en/, (accessed: 20/07/2019).

Abstract:

Objectives: Disrespect and abuse is noted to be high but poorly reported, especially in northern Nigeria. This study was undertaken to determine the proportion and nature of disrespect and abuse of women during childbirths in health facilities at selected locations in Kano, a north-west Nigerian State

Method: Ethical approval and informed consent were obtained. The study adopted quantitative and qualitative data collection methods. A sample size of 292 women who delivered in the past 1year preceding the study. Quantitative data was analyzed using descriptive statistics (frequencies, percentages, means and standard deviation) and inferential statistics (chi-square). Qualitative data was analyzed along themes using Atlas.ti. P value is ≤ 0.05 was considered statistically significant.

Results: The average age of the respondents was 28.3±6.9 years. Most of the respondents were aged 25-29 years, mostly married (96%), housewives (68.8%), of Hausa tribe (85.1%) and had primary education (52.2%). About 50.7% were urban and 49.3% were rural residents. Averagely, 46.5% said that they experienced D&A during care but it was more in urbn (76.3%), compared to rural (18.30%). More than one type of D&A occurred in most individual (76%) mainly at multiple service points, but physical abuse is the most recurrent in various mix. Among types of D&A occurring singly, non-consented care and non-confidential care were mostly reported. Downward pressure placed on the abdomen before baby was born, being blamed for something that happened to them or their babies, health workers did not provide explanations for procedures and sexual abuse were also reported.

Conclusion: D&A is common in health facilities in both rural and urban settings of Kano. However, D&A was higher in urban compare to the rural areas. The proportion among urban women was higher than that reported in a previous study in Kano. Although D&A types commonly occurred as a mix. Further studies to explore the determinants and recommendations for D&A are necessary.

Keywords: Proportion, Nature, Disrespect, Abuse, Health Facility, Nigeria.

References:

[1].      Ishola F, Owolabi O, Filippi V (2017) Disrespect and abuse of women during childbirth in Nigeria: A systematic review. PLoS ONE 12(3): e0174084. https://doi.org/10.1371/journal.pone.0174084.

[2].      Joy Orpin, Shuby Puthussery Rosemary Davidson and Barbara Burden Women’s experiences of disrespect and abuse in maternity care facilities in Benue State, Nigeria. BMC Pregnancy and Childbirth201818:213

[3].      WHO. Standards for improving quality of maternal and newborn care in health facilities. Geneva: World Health Organization; 2016. http://apps.who.int/iris/handle/10665/63192

[4].      TuncalpӦ, Were WM, MacLennan C, Oladapo OT, Gulmezoglu AM, Bahl R, Daelmans B, Mathai M, Say L, Kristensen F, Temmerman M, Bustreo F. Quality of care for pregnant women and newbornsthe WHO vision. BJOG 2015; 122: 1045-1049.

[5].      Rance S, McCourt C, Rayment J, Mackintosh N, Carter W, Watson K, et al. Women's safety alerts in maternity care: is speaking up enough? BMJ Qual Saf. 2013;22(4):348

[6].      Bowser MPH. Hill, H. In: Exploring evidence for disrespect and abuse in facility-based childbirth; 2010.

[7].      Sando, David &Ratcliffe, Hannah & Banks, Kathleen &Spiegelman, Donna & Lyatuu, Goodluck & Mwanyika-Sando, Mary & Emil, Faida& Nell Wegner, Mary &Chalamilla, Guerino & Langer, Ana. (2016). The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy and Childbirth. 16. 10.1186/s12884-016-1019-4.

[8].      Swahnberg K, Schei B, Hilden M, Halmesmäki E, Sidenius K, Steingrimsdottir T, et al. Patients experiences of abuse in health care: a Nordic study on prevalence and associated factors in gynaecological patients. J Psychosom Obstet Gynaecol. 2007;86(3):349–56.

[9].      Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6)

[10].  Bohren MA, Vogel JP, Tuncalp O, Fawole B, Titiloye MA, Olutayo AO, et al. Mistreatment of women during childbirth in Abuja, Nigeria: a qualitative study on perceptions and experiences of women and healthcare providers. Reprod Health. 2017;14(9)

[11].  Lukasse M, Schroll A, Karro H, Schei B, Steingrimsdottir T, Van Parys A, et al. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries. Acta Obstet Gynecol Scand. 2015; 94(5):508–17.

[12].  Sethi R, Gupta S, Oseni L, Mtimuni A, Rashidi T, Kachale F. The prevalence of disrespect and abuse during facility-based maternity care in Malawi: evidence from direct observations of labour and delivery. Reprod Health. 2017; 14:11.

[13].  Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2015;10(4)

[14].  Sando D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika- Sando M, et al. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth. 2016; 16:236.

[15].  Idris SH, Sambo MN, Ibrahim MS. Barriers to utilisation of maternal health services in a semi-urban community in northern Nigeria: the client’s perspective. Nigerian Medical Journal: Journal of the Nigeria Medical Association. 2013;54(1):27–32.

[16].  Moore BM, Alex-Hart BA, George IO. Utilisation of health care services by pregnant mothers during delivery: a community-based study in Nigeria. East Afr J Public Health. 2011;8(1):49–51.

[17].  Amole TG, Tukur MJ, Farouk SL, Ashimi AO. Disrespect and abuse during facility-based childbirth: The experience of mothers in Kano, Northern Nigeria. Trop J Obstet Gynaecol 2019; 36:21-7.

[18].  Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. Int J Gynaecol Obstet. 2015;128(2):110–3

[19].  Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PLoS One. 2015;10(4): e0123606.

[20].  Asefa A, Bekele D. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia. Reprod Health. 2015;12(1):1.

[21].  Kruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey, Health Policy and Planning, czu079. Available at: https://doi.org/10.1093/heapol/czu079. Accessed 2 Oct 2017.

[22].  Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.

[23].  Sando D, Abuya T, Asefa A, Banks KP, Freedman LP, Kujawski S, Markovitz A, Ndwiga C, Ramsey K, Ratcliffe H, Ugwu EO, Warren CE and Jolivet RR. Methods used in prevalence studies of disrespect and abuse during facility-based childbirth: lessons learned. Reproductive Health 2017; 14:127 DOI 10.1186/s12978-017-0389-z.

[24].  Ijadunola MY, Olotu EA, Oyedun OO, Eferakeya SO, Ilesanmi FI, Fagbemi AT, Fasae OC. Lifting the veil on disrespect and abuse in facility-based child birth care: findings from South West Nigeria. BMC Pregnancy Childbirth (2019) 19: 39. https://doi.org/10.1186/s12884-019-2188-8.

[25].  Moronkola OA, Omonu JB, Iyayi DA, Tiamiyu MA. Perceived determinants of the utilization of maternal health-care services by rural women in Kogi State, Nigeria. Tropical Doctor. 2007;37(2):94–6. pmid:17540090.

[26].  Wassihun B, Zeleke S. Compassionate and respectful maternity care during facility based child birth and women's intent to use maternity service in Bahir Dar, Ethiopia. BMC Pregnancy Childbirth. 2018;18(1):294. Published 2018 Jul 9. doi:10.1186/s12884-018-1909-8.

[27].  Mesenburg MA, Victora CG, Serruya SJ, de León RP, Damaso AH, Domingues MR, da Silveir MF. Disrespect and abuse of women duringthe process of childbirth in the 2015Pelotas birth cohort. Reproductive Health (2018) 15:54 https://doi.org/10.1186/s12978-018-0495-6.

[28].  Uzochukwu BS, Onwujekwe OE, Akpala CO. Community satisfaction with the quality of maternal and child health services in southeast Nigeria. East Afr Med J. 2004;81(6):293–9. Epub 2005/09/20. pmid:16167676.

Abstract:

Objectives: This study determined the practice and correlates of widowhood rites in a city in North-central Nigeria.

Methodology: A descriptive cross-sectional design was used for the study. Multistage sampling technique was used to recruit 450 respondents into the study. Interviewer administered questionnaire and two focus group discussions were used for data collection. Data analysis was done using Epi-info version 3.5.3. A p-value of 0.05 or less was regarded as statistically significant. The study included all males and females over 18years of age residing in Ilorin South Local Government Area.

Results: The age range of respondents was between 20 – 79 yrs. A quarter of all respondents (25.9%) were in the fifth decade of life. Widowhood rites commonly practiced in Ilorin South LGA as identified by more than 70% of the respondents include; preventing the widow from going to the farm and market during the mourning period and preventing her from doing household chores. About 16.2% of respondents had ever practiced one or more forms of widowhood rites. There was a statistically significant relationship between age, gender, religion, marital status, educational level, ethnicity and occupation of respondents and the practice of widowhood rites (p< 0.05).

Conclusion: Widowhood rites are observed across different categories of people. Age, gender, religion, marital status, educational level, ethnicity and occupation were significantly associated with practice of widowhood rites. There is a need for legislation against harmful widowhood rites by relevant stakeholders.

Keywords: Widowhood Rites, Ilorin, Nigeria.

References:

[1].      Aderibigbe, S.A., Lawal, M.O., Olatona, F.A., Sekoni, O.O., Goodman, O.O., Olubiyi, S.K., Olaosebikan, M.S. (2017). Knowledge and perception of widowhood rites among adults in Ilorin, Kwara State. Trop. J. Health Sci. 24, 1-7–7.

[2].      Aderinto, A. (2000). Wives of the grave: A study of widowhood rites and wife inheritance in Ondo and Ekiti states., in: Rights and Widowhood Rites in Nigeria. Inter African Committee on Traditional Practices Affecting the Health of Women and Children, Lagos, Nigeria, pp. 12–18.

[3].      Aransiola, J.O., Ige, A. (2010). Widowhood Practices among the Yorubas of South-West Nigeria: Are Differences in what Women Experience due to their Status. Gend. Behav. 8, 3152–3167. https://doi.org/10.4314/gab.v8i2.61939.

[4].      Fasoranti, O., Aruna, J. (2015). A cross-cultural comparison of practices relating to widowhood and widow-inheritance among the Igbo and Yoruba in Nigeria. J. World Anthropol. 3, 53–73.

[5].      Ilika, A.L., Ilika, U.R. (2017). Eliminating Gender-Based Violence: Learning from the Widowhood Practices Elimination Initiative of a Women Organisation in Ozubulu, Anambra State of Nigeria. Afr. J. Reprod. Health 9.

[6].      Izuako, O. (2003). Obnoxious Widowhood Rites in Nigeria: Looking through Gender Lens, in: Nigeria Violence Against Women. BAOBAB Tree, Lagos, Nigeria, pp. 3–4.

[7].      Kabir, Z. (1991). Widowhood Practices in Northern Nigeria.

[8].      Mezieobi, D.I., Mezieobi, S.A., Iyamu, E.O.S. (2011). Widowhood Practices among Igbos of South Eastern Nigeria as a Betrayal of the Fundamental Human Rights of Women. Lwati J. Contemp. Res. 8.

[9].      Nwadinobi, E. (2001). Fighting Back Against Prejudice and Discrimination. Presented at the Widoes Without Rights Conference, London.

[10].  Okoye, P.U. (2001). Widowhood practices: the case of Enugu State. NUCIK Publishers.

[11].  Owasanoye, B., Ubaka, C.O., Ahonsi, B., Friedrich-Ebert-Stiftung, (1997). Widowhood in Nigeria: Issues, Problems, and Prospects. Friedrich Ebert Foundation and Human Development Initiatives.

[12].  Sossou, M.-A. (2002). Widowhood practices in West Africa: the silent victims. Int. J. Soc. Welf. 11, 201–209. https://doi.org/10.1111/1468-2397.00217.

[13].  United Nations (2001). Widowhood: Invisible Women, Secluded or Excluded. United Nations, Division for the Advancement of Women, Department of Economic and Social Affairs.

[14].  Wells, Y.D., Browning, C. (2002). Widowhood. USA/UK/Germany: Macmillan Reference USA/Gale Group/Thomson Learning.

Abstract:

Objectives: This study was undertaken to explore various factors affecting disrespect and abuse (D&A) of women during childbirths in health facilities in selected locations in Kano, a north-west Nigerian State.

Method: Ethical approval and informed consent were obtained. The study adopted quantitative and qualitative data collection methods. A sample size of 292 women who delivered in the past 1year preceding the study. Quantitative data was analyzed using descriptive statistics (frequencies, percentages, means and standard deviation) and inferential statistics (chi-square). Qualitative data was analyzed along themes using Atlas. ti. P value is ≤ 0.05 was considered statistically significant.

Results: The age group 25-29years had the highest proportion of D&A (61.84%). Those who were single had more proportion of D&A (55.6%) compared to those who were married (45.7%). The women that leaved in urban setting (75.3%) had more proportion of D&A compared to those who lived in a rural setting (18.3%). The proportion of D&A was highest among parity group 7-8 (100%). D&A greater if the respondent spends 2days (95.7%) and above in the hospital compared to when they spent <2 (45.8%). 94.2% of those who will not recommend the facility for delivery had D&A compared to 22.4% of those who will recommend the facility. Health system inadequacies including lack of supervision, poor remuneration, inadequate staffing and supplies were common barriers mentioned.

Conclusion: Socio-demographic, obstetrics, level of health facility, health system inadequacy and social class affect occurrence of D&A. improved socio-demographic status and health systems can reduce the occurrence of D&A.

Keywords: Factors; Disrespect; Abuse; Health Facility; Nigeria

References:

[1].      Abuya T, Warren CE, Miller N, Njuki R, Ndwiga C, Maranga A, et al. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2015;10(4).

[2].      Amole TG, Tukur MJ, Farouk SL, Ashimi AO. Disrespect and abuse during facility-based childbirth: The experience of mothers in Kano, Northern Nigeria. Trop J Obstet Gynaecol 2019; 36:21-7.

[3].      Azhar Z, Oyebode O, Masud H. Disrespect and abuse during childbirth in district Gujrat, Pakistan: A quest for respectful maternity care. Ann Glob Heal [Internet] 2017; 83:108. Available from: http://dx.doi.org/10.1016/j. aogh. 2017.03.240.

[4].      Banks KP, Karim AM, Ratcliffe HL, Betemariam W, Langer A. Jeopardizing quality at the frontline of healthcare: Prevalence and risk factors for disrespect and abuse during facility-based childbirth in Ethiopia. Health Policy Plan. 2018; 33:317–27.

[5].      Biresaw Wassihun, Leul Deribe, Nadia Worede, Teklemariam Gultie. Prevalence of disrespect and abuse of women during child birth and associated factors in Bahir Dar town, Ethiopia Epidemiol Health 2018; 40: e2018029.

[6].      Diamond‑Smith N, Treleaven E, Murthy N, Sudhinaraset M. Women’s empowerment and experiences of mistreatment during childbirth in facilities in Lucknow, India: Results from a cross‑sectional study. 2017;17(Suppl 2).

[7].      Hameed W, Avan BI. Women's experiences of mistreatment during childbirth: A comparative view of home- and facility-based births in Pakistan. PLOS One 2018;1–17.

[8].      Igboanugo GM, Martin CH. What are Pregnant Women in a Rural Niger Delta Community's Perceptions of Conventional Maternity Service Provision? An Exploratory Qualitative Study. African Journal of Reproductive Health. 2011; 15(3):59±72. PMID: 22574493.

[9].      Ishola F, Owolabi O, Filippi V. Disrespect and abuse of women during childbirth in Nigeria: A systematic review. PLoS ONE 2017; 12(3): e0174084. https://doi.org/10.1371/journal.pone.0174084.

[10].  Iyaniwura CA, Yussuf Q. Utilization of antenatal care and delivery services in Sagamu, south western Nigeria. African journal of reproductive health. 2009; 13(3):111±22. PMID: 20690266

[11].  Kruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plan 2018; 33: e26-e33.

[12].  Lamina MA, Sule-Odu AO, Jagun EO. Factors militating against delivery among patients booked in Olabisi Onabanjo University Teaching Hospital, Sagamu. Niger J Med. 2004; 13(1):52±5. PMID: 15296109.

[13].  Mengistu Welday Gebremichael, Alemayehu Worku, Araya Abrha Medhanyie & Yemane Berhane. Mothers’ experience of disrespect and abuse during maternity care in northern Ethiopia. Global Health Action 2018; 11:1, DOI: 10.1080/16549716.2018.1465215.

[14].  Moore M, Armbruster D, Graeff J, Copeland R. Assessing the “caring” behaviors of skilled maternity care providers during labor and delivery: experience from Kenya and Bangladesh. Washington, DC: The CHANGE Project; 2002.

[15].  Moore BM, Alex-Hart BA, George IO. Utilization of health care services by pregnant mothers during delivery: a community-based study in Nigeria. East African Journal of Public Health. 2011; 8(1): 49±51.PMID: 22066284.

[16].  Moronkola OA, Omonu JB, Iyayi DA, Tiamiyu MA. Perceived determinants of the utilization of maternal health-care services by rural women in Kogi State, Nigeria. Tropical Doctor. 2007; 37(2):94±6. PMID:17540090.

[17].  Nawab T, Erum U, Amir A, Khalique N, Ansari MA, Chauhan A. Disrespect and abuse during facility-based childbirth and its sociodemographic determinants – A barrier to healthcare utilization in rural population. J Family Med Prim Care 2019; 8:239-45.

[18].  Okafor II, Ugwu EO, Obi SN. Disrespect and abuse during facility-based childbirth in a low-income country. Int J Gynaecol Obstet. 2015;128(2):110–3.

[19].  Onah HE, Ikeako LC, Iloabachie GC. Factors associated with the use of maternity services in Enugu, southeastern Nigeria. Soc Sci Med. 2006; 63(7):1870±78. https://doi.org/10.1016/j.socscimed.2006.04. 019 PMID: 16766107.

[20].  Orpin J, Puthussery S, Davidson R, Burden B. Women’s experiences of disrespect and abuse in maternity care facilities in Benue State, Nigeria. BMC Pregnancy and Childbirth 2018; 18:213.

Abstract:

The objective of this study was to measure the concentration and pattern of distribution of Cd, Cr, Co, Cu, Mn, Ni, Pb, and Zn on the leaves and stem of Amaranthus hybridus (African Spinach) one of the most consumed leafy vegetables in Nigeria with an estimated population of over 200 million people, findings from this study showed that with the exception of Cd and Co two heavy metals of public health importance, the results of the analysis for heavy metals using atomic absorption spectrophotometer were within the maximum permissible limits set by FAO/WHO Committee of the Codex Alimentarius Commission and Agency for toxic substance disease registry (ATSDR). The results showed that while the values for Cd were within acceptable limits in the leaves, the concentration in the stem ranged of 0.007 to 0.3358 ppm above the maximum limit of 0.1ppm. The result also showed the presence of Co at a concentration of range of 0.1289 to 0.3487ppm in the leaves and 0.1470 to 0.3719 ppm in the stems above the maximum permissible limit set by the Agency for Toxic Substance Disease Registry (ATSDR) of between 0.05 to 0.1 ppm. The potential consequences of exposure to harmful substances, on either a population or an individual basis, is a fundamental concern in epidemiology and public health, these findings have major public health implication for food safety and quality as the likely accumulation of Co and Cd in the body through diets over a long period of time can further complicate the current public health crisis in Nigeria.

References:

[1].   Abba, A., & Ibrahim, S. (2017). Bioaccumulation of heavy metals in Amaranthus sp. L sold at vegetable farms in Katsina Metropolis. Science World Journal, 12(1), 1-4.

[2].   Adeyeye, E. I., & Omolayo, F. O. (2011). Chemical composition and functional properties of leaf protein concentrates of Amaranthus hybridus and Telfairia occidentalis. Agric. Biol. JN Am, 3, 499-511.

[3].   Akubugwo, I. E., Obasi, N. A., Chinyere, G. C., & Ugbogu, A. E. (2007). Nutritional and chemical value of Amaranthus hybridus L. leaves from Afikpo, Nigeria. African Journal of Biotechnology, 6(24).

[4].   Amaranthus hybridus Rough Pigweed, Slim amaranth PFAF Plant Database. (n.d.). Retrieved from https://pfaf.org/user/Plant.aspx?LatinName=Amaranthus+hybridus

[5].   Aiyesanmi, A. F., & Idowu, G. A. (2012). Levels of heavy metals in leafy vegetables grown around waste dumpsites in Akure, southwestern Nigeria. FUTA Journal of Research in Sciences, 8(2), 27-35.

[6].   Atayese, M. O., Eigbadon, A. I., & Adesodun, J. K. (2008). Heavy metal contamination of Amaranthus grown along major highways in Lagos, Nigeria. African Crop Science Journal, 16(4).

[7].   Atsdr.cdc.gov. (2019). Agency for Toxic Substances and Disease Registry. [online] Available at: https://www.atsdr.cdc.gov/ [Accessed 31 Jul. 2019].

[8].   Blodgett, J. T., & Swart, W. J. (2002). Infection, colonization, and disease of Amaranthus hybridus leaves by the Alternaria tenuissima group. Plant Disease, 86(11), 1199-1205.

[9].   Cao, S., Duan, X., Zhao, X., Chen, Y., Wang, B., Sun, C., ... & Wei, F. (2016). Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China. Chemosphere, 147, 404-411.

[10].  Chunilall, V., Kindness, A., & Jonnalagadda, S. B. (2005). Heavy metal uptake by two edible Amaranthus herbs grown on soils contaminated with lead, mercury, cadmium, and nickel. Journal of Envirnomental Science and Health, 40(2), 375-384.

[11].  Elbagermi, M. A., Edwards, H. G. M., & Alajtal, A. I. (2012). Monitoring of heavy metal content in fruits and vegetables collected from production and market sites in the Misurata area of Libya. ISRN Analytical Chemistry, 2012.

[12].  Emurotu, J. E., & Onianwa, P. C. (2017). Bioaccumulation of heavy metals in soil and selected food crops cultivated in Kogi State, north central Nigeria. Environmental Systems Research, 6(1), 21.

[13].  Eze, M. O. (2014). Heavy metal concentrations in soils and accumulation in Amaranthus Hybridus grown near solid waste dumpsites in Gombe, Nigeria. International Journal of Current Research, 6(12), 10532-10536

[14].  Filipović-Trajković, R., Ilić, Z. S., Šunić, L., & Andjelković, S. (2012). The potential of different plant species for heavy metals accumulation and distribution. Journal of Food Agriculture and Environment, 10, 959-964

[15].  García, R., & Báez, A. P. (2012). Atomic absorption spectrometry (AAS). In Atomic absorption spectroscopy. InTech.

[16].  International Programme on Chemical Safety Retrieved from https://www.who.int/ipcs/assessment/public_health/cadmium/en/ on 27^th ,August 2019

[17].  Inyang, J. O., Abu, T., Emmanuel, A. U., Friday, J. O., Bobai, N., & Oise, E. (2018). Growth and performance analysis of Amaranthus hybridus L. Enriched with organic (sugarcane bagasse-based) fertilizer. International Journal of Basic, Applied and Innovative Research, 7(2), 55-61.

[18].  Izah, S. C., & Aigberua, A. O. (2017). Comparative Assessment of selected heavy metals in some common edible vegetables sold in Yenagoa metropolis, Nigeria. Journal of Biotechnology Research, 3(8), 66-71

[19].  Jaishankar, M., Tseten, T., Anbalagan, N., Mathew, B. B., & Beeregowda, K. N. (2014). Toxicity, mechanism and health effects of some heavy metals. Interdisciplinary toxicology, 7(2), 60-

[20].  Karpiuk, U. V., Al Azzam, K. M., Abudayeh, Z. H. M., Kislichenko, V., Naddaf, A., Cholak, I., & Yemelianova, O. (2016). Qualitative and quantitative content determination of macro-minor elements in Bryonia alba L. roots using flame atomic absorption spectroscopy technique. Advanced pharmaceutical bulletin, 6(2), 285.

[21].  Khan, S., Cao, Q., Zheng, Y. M., Huang, Y. Z., & Zhu, Y. G. (2008). Health risks of heavy metals in contaminated soils and food crops irrigated with wastewater in Beijing, China. Environmental pollution, 152(3), 686-692.

[22].  Khanna, P. (2011). Assessment of heavy metal contamination in different vegetables grown in and around urban areas. Research Journal of Environmental Toxicology, 5(3), 162.

[23].  Kogi State (Kogistate) Map, Weather and Photos - Nigeria: first-order administrative division - Lat:7.75 and Long:6.75. (n.d.). Retrieved from http://www.getamap.net/maps/nigeria/kogi/_kogistate/

[24].  Kogi climate: Average Temperature, weather by month, Kogi weather averages - Climate-Data.org. (2015, August 9). Retrieved from https://en.climate-data.org/africa/nigeria/zamfara/kogi-389954/

[25].  Liu, X., Song, Q., Tang, Y., Li, W., Xu, J., Wu, J. & Brookes, P. C. (2013). Human health risk assessment of heavy metals in soil–vegetable system: a multi-medium analysis. Science of the Total Environment, 463, 530-540

[26].  Mahurpawar, M. (2015). Effects of heavy metals on human health. Int. J. Res. Granthaalayah, 1(7).

[27].  Oluwatosin, G. A., Adeoyolanu, O. D., Ojo, A. O., Are, K. S., Dauda, T. O., & Aduramigba-Modupe, V. O. (2009). Heavy metal uptake and accumulation by edible leafy vegetable (Amaranthus hybridus L.) grown on urban valley bottom soils in southwestern Nigeria. Soil and Sediment Contamination, 19(1), 1-20.

[28].  Omosun, G., Markson, A. A., & Mbanasor, O. (2008). Growth and anatomy of Amaranthus hybridus as affected by different crude oil concentrations. American-Eurasian Journal of Scientific Research, 3(1), 70-74.

[29].  Oyelola, O., Banjoko, I., & Ajioshin, I. (2014). Nutritional content of common Amaranthus hybridus vegetable (Efo Tete) in Nigeria (828.4). The FASEB Journal, 28(1_supplement), 828-4

[30].  Rawar, E., & Rohman, A. (2016). Validation of atomic absorption spectrophotometry and mercury analyzer for analysis of cadmium, lead and mercury in red chili pepper. Asian J Agric Res, 10(1), 65-71.

[31].  Sahu, M., & Kacholi, D. S. (2016). Heavy metal levels in Amaranthus species from Chang'ombe-Mchicha area in Temeke District, Dar es Salaam, Tanzania. Asian Journal of Chemistry, 28(5), 1123.

[32].  Sharma, R. K., Agrawal, M., & Marshall, F. M. (2009). Heavy metals in vegetables collected from production and market sites of a tropical urban area of India. Food and chemical toxicology, 47(3), 583-591.

[33].  Tasrina, R. C., Rowshon, A., Mustafizur, A. M. R., Rafiqul, I., & Ali, M. P. (2015). Heavy metals contamination in vegetables and its growing soil. J Environ Anal Chem, 2(142), 2380-2391.

[34].  World Health Organization. (2019). Joint FAO/WHO Expert Committee on Food Additives (JECFA). [online] Available at: https://www.who.int/foodsafety/areas_work/chemical-risks/jecfa/en/ [Accessed 31 Jul. 2019].

[35].  Yahaya, M. I., Jacob, A. G., Agbendeh, Z. M., Akpan, G. P., & Kwasara, A. A. (2012). Seasonal potential toxic metals contents of Yauri river bottom sediments: North western Nigeria. Journal of Environmental Chemistry and Ecotoxicology, 4(12), 212-221.

[36].  Zeng, X., Xu, X., Boezen, H. M., & Huo, X. (2016). Children with health impairments by heavy metals in an e-waste recycling area. Chemosphere, 148, 408-415.

Abstract:

Background: Skilled birth attendance in Kenya declined from 50% in 1988 to 42% in 2003, remained the same by 2008/9 increased to 62% by 2014. By 2008/09, only 43% of births took place at HFs by SBAs while 58% occurred at home. Socio-demographic factors could be attributed to this.

Objective: To determine factors influencing mothers’ choice of place of delivery and motivating them to opt for TBA care.

Methods: Descriptive cross-sectional study of 375 women. Both quantitative and qualitative data obtained from semi-structured questionnaires and FGDs/KIIs respectively. Statistical techniques; analysis using (SPSS V.20). p<0.05 significant.

Results: Majority 340 (90.7%) delivered at home. Education (p<0.001) and religion (p<0.003) were significant predictors. Secondary level education 1.6 times more likely to choose HF delivery. Catholics 4 times and protestants 6 times more likely to deliver at HF compared to non-believers (OR; 95% CI: 3.618(0.715-18.305) and 6.162(1.401-27.102). Socio-cultural beliefs and practices were main impediment to HF delivery.

Conclusion: HF delivery found to be low (9.3%) compared 61% national. Level of education and religion impact positively HF delivery whereas socio-cultural beliefs and practices, lack of transport and availability of TBAs main bottlenecks.

Recommendation: A comprehensive program on safe motherhood by RH actors to be designed focusing on TBAs and socio-cultural beliefs and practices.

Keywords: Place of delivery, skilled birth attendance, socio-cultural beliefs.

References:

[1].   Achwal, I. and Ndede F. (2004). “Engender Health: Improving essential Obstetric care services through whole site training.” Paper presented in 2004 Kenya Obstetrical and Gynaecological Society scientific conference. Ministry of Health. Nairobi.

[2].   Bell, J. (2003). “Improving skilled attendance at delivery: a preliminary report of the Safe Strategy development tool.” Journal of Birth 30(4): 227-234.

[3].   Carlough, M. and McCall, M. (2005). “Skilled birth attendance: what does it mean and how can it be measured?” A clinical skills assessment of maternal and child health workers. Nepal. Int. J. Gynecol, Obst: 89: 200-208.

[4].   Goodburn, E. & Campbell, O. (2007). “Reducing maternal mortality in the developing world: sector wide approaches may be the key.” British medical journal (BMJ); 322: 917-920.

[5].   Kenneth, H. (2007). “Estimates of maternal mortality worldwide between 1990 and 2005: An assessment of available data”. Lancet, 370: 1311-1319.

[6].   Khan, K.W. (2006). “WHO analysis of causes of maternal death: a systematic review”.

[7].   Magadi, M. (2003). “The inequality of maternal health care in urban sub-Saharan Africa in the 1990s”. Population studies. 57(3): 347-366.

[8].   Republic of Kenya. (2004). “The Kenya National Demographic and Health Survey (KDHS)” 2003. Nairobi: The Government Printer.

[9].   Republic of Kenya: (2011). “The Kenya National Demographic and Health Survey (KDHS)” 2008-09. Nairobi: The Government Printer.

[10].  Republic of Kenya: (2014). “The Kenya National Demographic and Health Survey (KDHS)” 2014. Nairobi: The Government Printer.

[11].  Save the Children International (2015). “The state of the world’s Mother’s 2015 Report”. London: SCI (4^th May 2015).

[12].  The White Ribbon Alliance. (2004). Saving Mother’s Lives. What Works: Field Guide for Implementing Best Practices in Safe Motherhood. The White Ribbon Alliance for Safe Motherhood in India. Women” Family and Community Health, Department of Reproductive Health and Research.

[13].  World Health Organization (WHO) (2008). “Estimates of maternal mortality. A joint WHO/UNFPA/UNICEF/World Bank statement”. Geneva: WHO. Available at www.who.int/reproductive-health/publications/

[14].  World Health Organization. (2004). Making pregnancy safer: the critical role of the skilled attendant. A joint statement by the WHO, ICM and FIGO.

[15].  World Health Organization. (2006). “WHO Annual report 2006 WHO/MPS/07.08.”

[16].  “Department of making pregnancy safer, Geneva: WHO.

[17].  World Health Organization. (2011). “WHO Annual report 2010; Progress towards the health-related Millennium Development Goals.” Fact sheet No. 290 May, 2011.