Abstract:

Background: Among the factors contributing to the high maternal morbidity and mortality in Uganda is the proportion of pregnant women who do not deliver under skilled supervision. There is paucity of data concerning the magnitude of patient abuse by health workers which is a main factor preventing facility delivery. This study aimed to determine the magnitude of abuse and the forms of abuse the patients in Bushenyi district in Uganda. Methods: In this cross sectional survey, 374 women who had just delivery in the health facilities were interviewed to identify any form of abuse treatment. The independent predictors of patient abuse were analysed at bivariate and multivariate level using binary logistic regression analysis. Results: The prevalence of patient abuse among the respondents was found to be 41.1% (P = 0.013). The commonest form of abuse reported was patient neglect 31.9% (p = 0.000), verbal abuse (29.3 %) and bribery (15.1%). The associated with patient abuse were; patient age 15-25years, prime gravidity and low Health center facility. Conclusions: The prevalence of patient abuses during childbirth very high and detrimental the health system. Close supervision midwives especially in the lower level facilities, as well as keeping the company of the relatives or friends to especially the younger the patients around the labour suite, Community sensitisation and empowerment through health education are suggested.

Keywords: Patient abuse, childbirth, South Western Uganda

References:

[1]                World Health Organisation. The Conceptual Framework for the International Classification for Patient Safety. Geneva: The World Health Organisation; Social Q (2009) 23:333-343.

[2]                UNICEF. The State of the World’s Children 2013. New York, NY: United Nations Publications; (2013) 13: 17

[3]                Jewkes R, Abrahams N, Mvo Z. Why do nurses abuse patients? Reflections from South African obstetric services. Soc Sci Med (2005) 47:1781-1795.

[4]                Filippi V, Ronsmans C, Campbell OM, Graham WJ, Mills A, Borghi J, Koblinsky M, Osrin D. Maternal health in poor countries: the broader context and a call for action. Lancet (2006) 368:1535-1541.

[5]                Drakles, Bowser D, Hill K (2010) Exploring evidence for disrespect and abuse in facility-based childbirth. USAID-TRAction Project, Harvard School of Public Health (2010) 2: 36

[6]                Mvo Z Abrahams N. Why do nurses abuse patients? Reflections from South African obstetric services. Soc Sci Med (2005) 47:1781-1795.

[7]                Isola A, Backman K, Voutilainen P, Rautsiala T. Family members’ experiences of the quality of geriatric care. Scand J Caring Sci (2003) 17:399-408.

[8]                Schraiber LB, Diniz SG. Violence against women in health-care institutions: an emerging problem. Lancet (2005) 359:1681-1685.

[9]                Kuffo SE, Mbaruku G, McCord CW, Moran M, Rockers PC, Galea S. Bypassing primary care facilities for childbirth: a population-based study in rural Ghana. Health Policy Plan (2009) 24:279-288.

[10]             Goergen T: A multi-method study on elder abuse and neglect in nursing homes. The Journal of Adult Protection 2004, 6:15-25.

[11]             Kyamuhendo L, Abbey M. Please understand when I cry out in pain: women’s accounts of maternity services during labour and delivery in Ghana. BMC Public Health (2005) 5:140.

[12]             Zhang Z, Schiamberg L, Oehmke J, Barboza G, Griffore R, Post L, Weatherill R, Mastin T. Neglect of older adults in Michigan Nursing Homes. J Elder Abuse Negl (2011) 23:58-74.

[13]             Eastley, R. and G.K Wilcock. “Prevalence and correlates of Aggressive Behaviors Occurring in Patients with Alzheimer’s Disease.” International Journal of Geriatric Psychiatry (1997) 12: 484-487.

[14]             Kabakyenga JK, Ostergren PO, Turyakira E, Mukasa PK, Odberg Pettersson K. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. BMC Pregnancy Childbirth (2011) 11:73.

[15]             Chirwa E, Odland JØ, Bjune G. Do Malawian women critically assess the quality of care? A qualitative study on women’s perceptions of perinatal care at a district hospital in Malawi. Reprod Health (2012) 9:30

[16]             Entwistle V, McCaughan D, Watt I, Birks Y, Hall J, Peat M, Williams B, Wright J: Speaking up about safety concerns: multi-setting qualitative study of patients’ views and experiences. Qual Saf Health Care (2010) 19:1-7.

[17]             Kabakyenga JK, Ostergren PO, Emmelin M, Kyomuhendo P, Odberg Petterss on K. The pathway of obstructed labour as perceived by community members in south western Uganda: a grounded theory study. Global Health Action (2012) 4:8529.

[18]             Maine D, Rosenfield A. Maternal mortality–a neglected tragedy. Where is the M in MCH? Lancet (2005) 2:83-85.

[19]             Lehmann, L.S., R.A McCormick, and K.W Kizer. “A Survey of Assaultive Behavior in Veterans Health Administration Facilities. “Psychiatric Services (1999) 50: 384-389.

[20]             Shanon JH, Baer HA, Singer M. Toward a critical medical anthropology. Soc Sci Med (2005) 23:95-98.

[21]             Musisi B, Berry JM. Who’s judging the quality of care? Indigenous Maya and the problem of “not being attended”. Med Anthropol (2008) 27:164-189.

[22]             Neema S. Why child birth has become a night mare: a population-based study in rural Uganda. Health Policy Plan (2004) 24:279-288.

[23]             Pombe W. The other side of caring: abuse in a South African maternity ward. J Reprod Infant Psychol (2010) 28:84-101.

[24]             Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med (1994) 38:1091-1110.

[25]             Reichenheim ME, Zylbersztajn F, Moraes CL, Lobato G. Severe acute obstetric morbidity (near-miss): a review of the relative use of its diagnostic indicators. Arch Gynecol Obstet (2009) 280:337-343.

[26]             Von Dietze E, Orb A. Compassionate care: a moral dimension of nursing. Nurs Inq (2000) 7:166-174.

[27]             Mwesigye H. Who’s judging the quality of care? Indigenous Maya and the problem of “not being attended”. Med Anthropol (2008) 27:164-189.

[28]             d’Oliveira AFPL, Diniz SG, Schraiber LB. Violence against women in health-care institutions: an emerging problem. Lancet (2005) 359:1681-1685.

[29]             Aborigo RA, Hodgson A, Engmann CM. ‘They treat you like you are not a human being’: maltreatment during labour and delivery in rural northern Uganda. Midwifery (2014) 30 (2):262-268.

[30]             Penney LM, Spector PE. Job stress, incivility, and counterproductive work behavior (CWB): the moderating role of negative affectivity. J Organ Behav (2005) 26:777-796

[31]             Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth. USAID-TRAction Project, Harvard School of Public Health (2010) 21: 64-69.

[32]             Fonn S, Xaba M. Health Workers for Change: A manual to improve quality of care. Geneva, Switzerland: World Health Organization, Special Program for Research and Training in Tropical Diseases; (1995) 7: 64- 89.

Abstract:

Objective: This study was planned to determine the prevalence of smear positive pulmonary TB among patients receiving care at a tertiary reference Hospital - National Hospital Abuja, Federal Capital Territory (FCT), Nigeria.

Background: With an estimated 9.4 million new cases globally, tuberculosis (TB) continues to be a major public health concern¹. Eighty percent of all cases worldwide occur in 22 high-burdens, mainly resource-poor settings. This devastating impact of tuberculosis on vulnerable populations is also driven by its deadly synergy with HIV. Therefore, building capacity and enhancing universal access to rapid and accurate laboratory diagnostics are necessary to control TB and HIV-TB co-infections in resource-limited countries². In low income countries (Nigeria inclusive), Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment³.

There is dearth of data on the prevalence of pulmonary tuberculosis (PTB) among patient attendees from individual Institutions and Health Care Facilities performing sputum smear microscopy in Nigeria. This retrospective study will analyze sputum smear microscopy results among pulmonary TB suspected patients presenting to National Hospital Abuja, Federal Capital Territory (FCT), Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2014 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed.

Methods: This hospital based retrospective study analyzed sputum smear microscopy results among pulmonary TB suspected patients presenting to the National Hospital Abuja, Federal Capital Territory, Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2013 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed. Data processing and statistical analysis were performed using SPSS software (Windows version 16.0). The results were expressed as percentage, with significance at 5%.

Results: The overall prevalence of sputum smear positive cases were 17.3% (63 0f 364) and most of the positive patients were within the age range 15 – 44 years. The highest percentage of TB was seen in the age group of 15 - 24 years compared with the lowest percentages in the age group below 14 years and above 45 years. A total of 63 (17.3%) suspects were found to have at least one positive. Of these, 56 (88.9% of those with one or more positive smears and 92% of those who fulfilled the case definition) were detected from the first specimen and 7 (11.1%) were positive on the second specimen but not the first. The third specimen did not have any additional diagnostic value for the detection of AFB.

Conclusion: The prevalence of sputum smear positive cases of 18.3% increases with age up to the age 44 years. Our result show that examining two sputa smears was sufficient for the detection of AFB in our laboratory. Further research involving different laboratories from all of the six geo-political groups in Nigeria is needed to reassess these findings.

References:

[1]. Borgdorff M.W., Floyd K. and Broekmans J.F. (2002) Interventions to reduce tuberculosis mortality and transmission in low- and middle-income countries. Bull World Health Organ 80, 217-227.

[2]. Burchfield J, Aderaye G, Palme IB, Bjorvatn B, Britton S, Feleke Y, Kallenius G, Lindquist L (2002). Evaluation of outpatients with suspected pulmonary tuberculosis in a high HIV prevalence setting in Ethiopia: clinical, diagnostic and epidemiological characteristics. Scand. J. Infect. Dis. 34: 331-7.

[3]. Craft DW, Jones MC, Blanchet, CN, Hopfer RL (2000). Value of examining three acid-fast bacillus sputum smears for removal of patients suspected of having tuberculosis from the "airborne precautions" category. J. Clin. Microbiol. 38: 4285-7.

[4]. Garg SK, Tiwari RP, Tiwari D, Singh R, Malhotra D, Ramnani VK, Prasad GB, Chandra R, Fraziano M, Colizzi V, Bisen PS (2003). Diagnosis of tuberculosis: available technologies, limitations, and possibilities. J. Clin. Lab. Anal. 17: 155-63.

[5]. Gopi PG, Subramani R, Selvakumar N, Santha T, Eusuff SI, Narayanan PR (2004). Smear examination of two specimens for diagnosis of pulmonary tuberculosis in Tiruvallur District, south India. Int. J. Tuberc. Lung Dis. 8: 824-8.

[6]. Harries AD, Mphasa NB, Mundy C, Banerjee A, Kwanjana JH, Salaniponi FM (2000). Screening tuberculosis suspects using two sputum smears. Int. J. Tuberc. Lung Dis. 4: 36-40.

[7]. Habeenzu C, Mitarai S, Lubasi D, Mudenda V, Kantenga T, Mwansa J, Maslow JN (2007). Tuberculosis and multidrug resistance in Zambian prisons, 2000-2001. Int. J. Tuberc. Lung Dis. 11: 1216-20.

[8]. Holmes CB, Hausler H, Nunn P (1998). A review of sex differences in the epidemiology of tuberculosis. Int. J. Tuberc. Lung Dis. 2: 96-104.

[9]. Katamba A, Laticevschi D, Rieder HL (2007). Efficiency of a third serial sputum smear examination in the diagnosis of tuberculosis in Moldova and Uganda. Int. J. Tuberc. Lung Dis. 11: 659-64.

[10]. Kolawole TM, Onadeko EO, Sofowora EO, Esan GF (1975). Radiological patterns of pulmonary tuberculosis in Nigeria. Trop. Geogr. Med. 27: 339-50.

[11]. Leonard MK, Osterholt D, Kourbatova EV, Del Rio C, Wang W, Blumberg HM (2005). How many sputum specimens are necessary to diagnose pulmonary tuberculosis? Am. J. Infect. Control. 33: 58-61.

[12]. Lonnroth K., Jaramillo E., Williams B.G., Dye C. and Raviglione M. (2009) Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 68, 2240-2246.

[13]. Mathew P, Kuo YH, Vazirani B, Eng RH, Weinstein MP (2002). Are three sputum acid-fast bacillus smears necessary for discontinuing tuberculosis isolation? J. Clin. Microbiol. 40: 3482-4.

[14]. Onadeko BO, Dickinson R, Sofowora EO (1975). Military tuberculosis of the lung in Nigerian adults. East Afr. Med. J. 52: 390-5.

[15]. Ozkutuk A, Terek G, Coban H, Esen N (2007). Is it valuable to examine more than one sputum smear per patient for the diagnosis of pulmonary tuberculosis? Jpn. J. Infect. Dis. 60: 73-5.

[16]. Van Deun A, Salim AH, Cooreman E, Hossain MA, Rema A, Chambugonj N, Hye MA, Kawria A, Declercq E (2002). Optimal tuberculosis case detection by direct sputum smear microscopy: how much better is more? Int. J. Tuberc. Lung Dis. 6: 222-30.

[17]. WHO 2013; Tuberculosis Diagnostics: www.who.int/tb

[18]. WHO, (2009) Global TB Report World Health Organization: Geneva, Switzerland.

[19]. WHO (2010) Fact Sheet: Infection and transmission. World Health Organization: Geneva, Switzerland.

[20]. WHO (2006b) The Stop TB Strategy – building on and enhancing DOTS to meet the TB related Millennium Development Goals. WHO/ HTM/TB2006.368. Geneva: World Health Organization.

[21]. World Health Organization (1998). Laboratory services in tuberculosis control. Part I: organization and management. Geneva: WHO.

[22]. WHO (2003) Toman’s Tuberculosis. Case Detection, Treatment and Monitoring., 2nd ed: WHO, Geneva.

Abstract:

Objective: To assess the knowledge, attitude and practices of contraceptives among health care providers.

Methodology: A cross sectional study was conducted from Feb 2015 to January 2016on health care providers of public Hospitals in Lahore. A total of 216 participants were selected who has 2 or more children and lies at the age of 20 above. Data was collected on a self-developed close ended questionnaire. Responses were analyzed on Statistical Package of social Sciences using descriptive statistics.

Results: Mean age 31-40 years (50 %) had secondary school certificate, 86 (39.8%) Nurse Midwife, 190 (88%) were having two children 94(43.5%). Regarding the knowledge and awareness about contraceptives 212 (98.1%) respondents had knowledge about contraceptives and 172 (79.1%) got the knowledge from professional study. 82 (38%), 50 (23.1%) said that Hospital and Family Planning Clinic respectively are the resource places for contraceptives. Overall 84.3% health care providers were using different contraceptive methods. Condom used by partners was 74 (34.3%) but the preferred method of participants was oral contraceptive pills 34 (15.7%). Moreover, 134 (62%) had no constrains in using contraceptives and constrains faced by the partner were 20 (9.3%).

Conclusion: Findings of the study shows that the knowledge and awareness of contraceptive is high among health care providers however the practice of contraceptive method was comparatively high by their husbands. There is need to motivate the health care providers for contraceptive use in order to increase the prevalence in general population.

Keywords: Health Care Providers, Contraceptives, Knowledge, Practice, Attitude

References:

[1.]   Alemayehu, M., Belachew, T., & Tilahun, T. (2012). Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia. BMC pregnancy and childbirth, 12(1), 1.

[2.]   Anjum, S., Durgawale, P. M., & Shinde, M. (2014). Epidemiological Correlates of Use of Contraceptives Methods and Appraisal of Health Education on Status of Knowledge and Practices among Married Woman. International Journal of Science and Research (IJSR), 3(2), 203-210.

[3.]   Arora, P., Bajpai, R. C., & Srivastava, R. (2013). Emergency contraception: a study to assess knowledge, attitude and practices among female college students in Delhi. Hospital, 12(6.0), 2-7.

[4.]   Avidime, S., Aku-Akai, L., Mohammed, A. Z., Adaji, S., Shittu, O., & Ejembi, C. (2014). Fertility intentions, contraceptive awareness and contraceptive use among women in three communities in Northern Nigeria. African Journal of Reproductive Health, 14(3), 65-70.

[5.]   Ayub, A., Kibria, Z., & Khan, F. (2015). Assessment of Knowledge, Attitude and Contraceptive use in Married Women of Peshawar. Journal of Dow University of Health Sciences, 9(1).

[6.]   Bulto, G. A., Zewdie, T. A., & Beyen, T. K. (2014). Demand for long acting and permanent contraceptive methods and associated factors among married women of reproductive age group in DebreMarkos Town, North West Ethiopia. BMC women's health, 14(1), 1.

[7.]   Corbin, C. M. (2013). The contraception mandate. Northwestern University Law Review, 107, 1469.

[8.]   Dawson, A., Tran, N. T., Westley, E., Mangiaterra, V., & Festin, M. (2015). Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low-and middle-income countries and recommendations for improving performance. BMC health services research, 15(1), 1.

[9.]   Desai, R. M. (2013). Knowledge, attitude and practice of contraception among women attending a tertiary care hospital in India. Parity, 41(45), 04.

[10.]   Dictionaries, O. (2014). Language matters. VERB (diets, dieting, dieted). URL http://www.oxforddictionaries.com/us/definition/american_english/diet (accessed November 5, 2014).

[11.]   Dictionary, M. W. (2014). Available at: http://www.merriam-webster.com/dictionary/ambiguous (accessed September 24, 2010).

[12.]   Harper, C. C., Henderson, J. T., Raine, T. R., Goodman, S., Darney, P. D., Thompson, K. M., & Speidel, J. J. (2012). Evidence-based IUD practice: family physicians and obstetrician-gynecologists. Family medicine, 44(9), 637.

[13.]   Kamal, S. M. (2015). Socioeconomic factors associated with contraceptive use and method choice in urban slums of Bangladesh. Asia-Pacific Journal of Public Health, 27(2), NP2661-NP2676.

[14.]   Lamidi, E. O. (2015). State Variations in Women’s Socioeconomic Status and Use of Modern Contraceptives in Nigeria. PloS one, 10(8), e0135172.

[15.]   Manzoor, I., Navied, U., Iqtidar, A., Shah, M., Waqas, A., & Naseem, M. O. (2013). Prevalence of contraceptive practices in married women of Nainsukh village near Lahore. Biomedica, 29, 82.

[16.]   Mbando, A. H. (2011). Contraceptive method choice among women attending at amtullabhai family planning clinic in Dar es Salaam (Doctoral dissertation, Muhimbili University of Health and Allied Sciences).

[17.]   Mustafa, G., Azmat, S. K., Hameed, W., Ali, S., Ishaque, M., Hussain, W., & Munroe, E. (2015). Family Planning Knowledge, Attitudes, and Practices among Married Men and Women in Rural Areas of Pakistan: Findings from a Qualitative Need Assessment Study. International journal of reproductive medicine, 2015.

[18.]   Najafi-Sharjabad, F., Yahya, S. Z. S., Rahman, H. A., Hanafiah, M., & Manaf, R. A. (2013). Barriers of modern contraceptive practices among Asian women: a mini literature review. Global journal of health science, 5(5), 181.

[19.]   Rao, A. K. (2005). Client Demand Approach (CDA) in the Revised Family Welfare Programame–A Feasibility Study. In Regional Health Forum WHO South–East Asia Region (Vol. 5, pp. 42-7).

[20.]   Relwani, N., Saoji, A., Kasturwar, N. B., Nayse, J., Junaid, M., & Dhatrak, P. (2012). Emergency Contraception: Exploring the knowledge, attitude and practices of engineering college girls in Nagpur district of central India. National Journal of Community Medicine, 3(1), 14-19.

[21.]   Ross, J., & Hardee, K. (2013). Access to contraceptive methods and prevalence of use. Journal of biosocial science, 45(06), 761-778.

[22.]   Sathar, Z. A. (2013). Family planning: a missing priority in Pakistan's health sector?. The Lancet, 381(9884), 2140-2141.

[23.]   Somba, M. J., Mbonile, M., Obure, J., & Mahande, M. J. (2014). Sexual behaviour, contraceptive knowledge and use among female undergraduates’ students of Muhimbili and Dar es Salaam Universities, Tanzania: a cross-sectional study. BMC women's health, 14(1), 1.

[24.]   Tavrow, P. (2010). Promote or discourage: how providers can influence service use. Social determinants of sexual and reproductive health: informing future research and programme implementation. Geneva: World Health Organization, 15-36.

[25.]   Thapa, S., Paudel, I. S., Bhattarai, S., Joshi, R., & Thapa, K. (2015). Factors Affecting IUCD Discontinuation in Nepal A Nested Case-Control Study. Asia-Pacific Journal of Public Health, 27(2), NP1280-NP1287.

[26.]   Tilahun, T., Coene, G., Luchters, S., Kassahun, W., Leye, E., Temmerman, M., & Degomme, O. (2013). Family planning knowledge, attitude and practice among married couples in Jimma Zone, Ethiopia. PloS one, 8(4), e61335.

[27.]   World Health Organization.(2010). World health statistics 2010. World Health Organization.

[28.]   Yadav, D., & Dhillon, P. (2015). Assessing the impact of family planning advice on unmet need and contraceptive use among currently married women in Uttar Pradesh, India. PloS one, 10(3), e0118584.

[29.]   Yoo, S. H., Guzzo, K. B., & Hayford, S. R. (2014). Understanding the complexity of ambivalence toward pregnancy: does it predict inconsistent use of contraception?. Biodemography and social biology, 60(1), 49-66.

[30.]   Zakar, R., Zakar, M. Z., Mikolajczyk, R., & Krämer, A. (2012). Intimate partner violence and its association with women's reproductive health in Pakistan. International journal of gynecology & Obstetrics, 117(1), 10-14.

Abstract:

Background: The prostate is a reproductive gland found in males. It is responsible for the production of the fluid that carries sperm during ejaculation. The prostate gland usually enlarges with age and eventually gets to a size when it causes obstruction to urine flow which is the most common symptom. A small amount of prostate enlargement is present in many men over age 40. Two common identifiable causes of prostatic enlargement are benign prostatic enlargement and prostatic cancer. Ultrasonography is a non-invasive non ionizing imaging method that uses sound waves to evaluate internal organs of the body. Aim: The main objectives of this research were to determine the percentage of population with prostatic enlargement, to ascertain relationship of prostatic enlargement with age. Method: Prospective study design was used and data collected was focus on men from the age group of 50 years and above. Results: The average age of those screened was 63.11+/-7.85years. There was a higher age average of 64.28years for those with prostatic enlargement when compared with normal subjects with average age of 62.33 years. Conclusion: Ultrasonographic evaluation of prostatic volume is an important screening tool for both benign prostatic enlargement and prostate cancer.

Keywords: Prostatic enlargement, Ultrasonogragph.

References:

[1.]   National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), September, 2014.

[2.]   Review Serenoa repens for benign prostatic hyperplasia.[Cochrane Database Syst Rev. 2009]

[3.]   Review Serenoa repens for benign prostatic hyperplasia.[Cochrane Database Syst Rev. 2012]

[4.]   Tacklind J, MacDonald R, Rutks I and Wilt T.J. (April 2009). Cochrane Database Syst Rev. 2009 Apr 15; (2):CD001423.

[5.]   Tacklind J, Macdonald R, Rutks I, Stanke J.U and Wilt T.J. (December 2012). Cochrane Database Syst Rev. 2012 Dec 12; 12:CD001423.

[6.] Wilt T.J, Macdonald R, Ishani A, Rutks I, Stark G. (May, 2011). Cochrane Database Syst Rev. 2011 May 11; (5):CD001042.

Abstract:

Introduction: Road traffic accident refers mainly to any accident involving at least one road vehicle, occurring on a road open to public circulation, and in which at least one person is injured or killed. Road traffic accidents are a recognized dominant cause of injury and death among teenagers worldwide and in Malaysia. Road traffic accidents and injuries is a public health problem worldwide. In 2002, there are 1.2 million people die as a result of road traffic accidents and 50 million are injured and disabled. It is also the 11^th cause of death in the world and accounts for 2.1% of all deaths globally.

Methods: This is a descriptive cross sectional study that targeted form six students as our population in 6 different higher secondary schools in Muar with 280 respondents. Data was collected through a 12 items of multiple structured questions and 5 items of feedback questions, which of overall 17 items of questions in our questionnaire

Results: Among 280 respondents, 84.6% of them had met with an accident. Majority of the respondents are male (90.7 %), Malay (89.9 %), and come from a low income background (97%). Surprisingly, there are 66 (90.4%) have not attended a driving lessons while 82 (94.3%) of them did not have a driving license. Among the entire respondent surveyed, 76 (96.2 %) of them did not wear seatbelts or helmets. The remaining 43 which is 15.4% of them had not met with an accident. There is a significant association between motor vehicles accidents towards driving lessons (P=0.001), driving license (P=0.001), usage of seatbelts or helmets (P=0.001)

Conclusion: Our study shows that there was a significant association between road traffic accident and injuries with not having a driving license, not attending driving lessons and usage of seatbelts or helmets.

Recommendation: Our government should implement strict rules and tough penalties such as increasing fines and summon as to curb traffic accidents. For the awareness, schools have a role to play by emphasizing the importance on road safety, like usage of seat belts, proper driving practice by organizing awareness campaigns and seminars which is given by road traffic officers. The media also needs to draw the attention of all road users both to dangers and to safe practices on the road.

References:

[1.] Begg, D. J. and Langley, J. L. (2000). Seat-belt use and related behaviours among young adults Journal of Safety Research, Vo. l31, No. 4, 211-220

[2.] Brener, N.D. and Collins, J. L. (1998). Co-occurrence of health-risk behaviours among adolescents in the United States. Journal of Adolescent. Health, Vol. 22, 209-213.

[3.] Esnizah, M. S. (2008). A study on Road Safety at High Accident Sites and the Development of Accident Prediction Model at Federal Route FT 50 Batu Pahat to Ayer Hitam. UniversitiTun Hussein Onn Malaysia: Bachelor’s Degree Thesis.

[4.] Fajaruddin, M., Ismail, Y., Ismail, R., Aziz, A. S., & Esnizah, M. S. (2008). Blackspot Study and Accident Prediction Model Using Multiple Liner Regression. Proc. of the First International Conference on Construction in Developing Countries. Karachi, Pakistan: UniversitiTun Hussein Onn Malaysia.

[5.] Fajaruddin, M. (2005). Treating Hazardous Locations at Federal Route UniversitiTeknologi Malaysia: Master’s Thesis.

[6.] Gwynn, D.W. (1967). Relationship between Road Accident and Hourly Volumes, Traffic Quartely. 14(1), pp. 407-418.

[7.] Hejar abdul rahman, Nor afiah Mohdzulkifli, Kulanthayan, subramaniam, Law teik hua, Car occupants accidents and injuries among adolescents in a state in Malaysia, 2005, Vol 5, 1867 – 1874

[8.] Helai, H. & Mohamed, A. A. (2010). Multilevel data and Bayesian analysis in traffic safety. Accident Analysis and Prevention, 42(2010), page 1556–1565. Retrieved on October 18, 2010, from www.elsevier.com/locate/aap.

[9.] Hizal, H. H. & Sharifah, A. S. M. R. (2009). The Construction of Road Accident bAnalysis and Database System in Malaysia. Proc. of IRTAD Conference, vol.4. Seoul, Korea: IRTAD.

[10.] Hispanics and Whites. Accident Analysis & Prevention, Vol 34, 523-529.

[11.] http://www.roadsafetymayo.ie/CausesofAccidents/

[12.] http://www.who.int/mediacentre/factsheets/fs358/en/

[13.] http://eprints.uthm.edu.my/1752/1/mohd_zakwan_ramli2.pdf

[14.] https://www.researchgate.net/publication/242229814_car_occupants_accidents_and_injuries_among_adolescents_in_a_state_in_malaysia

[15.] http://www.cph.org.uk/wp-content/uploads/2012/08/road-traffic-accidents-a-review-of-evidence-for-prevention.pdf

[16.] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888338/

[17.] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586788/

[18.] Institute of Transportation Engineers (2001). Traffic Engineering Handbook. 6th Ed. New Jersey: Prentice Hall Inc.

[19.] Jabatan Pengangkutan Jalan (2010). Statistik Pendaftaran Kenderaan Awam. Retrieved on May 2011 from Jabatan Pengangkutan Jalan

[20.] Koushki, P.A., Bustan, M.A., Kartam, N.(2003) Impact of safety belt use on road accident injury and injury type in Kuwait. Accident Analysis and Prevention, Vol 35, 237-241.

[21.] Mayhew, D.R. and Simpson, H.M.(2002) The safety value of driver education and training Injury Prevention, Vol 8 .Supp II:ii3-ii7.

[22.] Murray, A. (2003). Decreasing number of young license holders and reduced number of accidents. A description of trends in Sweden. Accident Analysis & Prevention, Vol 900,1-10.

[23.] Ministry of Health Malaysia 1997. Epidemiology of Injury in Malaysia

[24.] Ministry of Health Malaysia. Health Facts 2003.

[25.] Ministry of Health Malaysia. Malaysia’s Health 2002.

[26.] NHSA (1998). Motor-vehicle Occupant Safety Survey 1998

(http://www.nhsa.dot.gov/people/injury/airbags/occupant_safety/AppendixA1.htm)

[27.] Preusser, D.F., Williams, A.F., Lund, A.K. (1987) The effect of New York’s seat belt use law on teenage drivers. Accident Analysis Prevention, Vol 19, 73-80.

[28.] Proceedings of the Eastern Asia Society for Transportation Studies, Vol. 5, pp. 1867 - 1874, 2005

[29.] Royal Malaysian Police. Statistical Report Road Accident Malaysia 2002.

[30.] Sanmastri, S. (2006). Audit Keselamatan Jalan Raya Dalam Kampus Universiti Teknologi Malaysia, Skudai. UniversitiTeknologi Malaysia. Bachelor’s Degree Thesis.

[31.] Statistics Sweden, 2001a. Vagtrafikskador 2000 (Road Traffic injuries 2000). Swedish Institute for Transport and communication Analysis (SIKA), Stockholm.

[32.] Wells, J.K., Williams, A.F., Farmer, C.M.(2002) Seat belt use among African Americans,

 [33.] Williams, A.F., Rappold, V., Ferguson, S.A. (1997) Seat belt use by high school drivers and their passengers. J Traffic Med, Vol 25, 21-25.

[34.] World Health Organization 2004. World Report on Road Traffic Injury Prevention, 2004

[35.] Polis Diraja Malayisa (2009). Laporan Tahunan Polis Diraja Malaysia 2008. Retrieved on May 2011, from Polis Diraja Malaysia.

Abstract:

Typhoid fever is a systemic infection caused by the bacterium salmonella typhi. It occurs worldwide and more in developing countries. This study is a review of existing journals on typhoid fever is aimed to determine whether safe water usage or consumption and improved sanitation had an impact on the incidence/prevalence of typhoid fever globally.

A literature search is carried out reviewing current and existing journals on typhoid fever.

From the view, it was noted in most of the articles by various authors that safe water usage and improved sanitation impacted on incidence and prevalence of typhoid fever.

It is however recommended that with implementation of various public health strategies on safe water, improved sanitation and personal hygiene there will be a reduction in the incidence of typhoid fever in our environment.

Vacuration program on Typhoid should be stepped to further curb the high mortality rate from this water borne disease.

Keywords: Typhoid fever, safe water, unproved sanitation.

References:

[1.]   Condran G.A, Crimmins – Gardner E. (1978) Public Health measures and mortality in US Cities in the late nineteenth century. Human Ecology 6: 27- 54.

[2.]   Crump J.A, Luby S.P et al (2004). The global burden of typhoid fever. Bull WHO82:346 – 353.

[3.]   Cutter D, Milter G. (2005). The Role of Public Health improvement in health advances: the twentieth century United State Demographics 42: 1 – 22.

[4.]   Edelman, R and Lerine, M.M (1986) Summary of an International Workshop on typhoid fever. Rev infect Dis. 8:329.

[5.]   Esrey S.A, Feachem R.G, et al (1985). Intervention for the control of diarrheal diseases among young children; improving water supplies and excreta disposal facilities. Bull WHO 63, 757 – 772.

[6.]   Ipere Polu O.H Gntonu P.E et al (2008), A review of the disease burden, impact and prevention of typhoid fever in Nigeria West African J. Med. Jul; 27 (3); 127 – 33.

[7.]   Joe Brown, Sandy C., et al (2011). Sanitation Hygiene and Enteric Infection in children Arch Dis child 1136 - 30528

[8.]   John A Crump, Eric D Muitz, (2010), Global trends in typhoid and paratyphoid fever. Clinical infect Dis, 50 (2): 241 – 243.

[9.]   Microbewiki, (2014). Typhoid fever in China. Accessed on 28^th July, 2014.

[10.]   Mohammed H, Mirjam B. (2001). Risk factors for Clinical typhoid fever in villages, South – Sulanesi, Indonesia. Int. J. of trop Med. Vol. 4 Pg. 91–99.

[11.]   Sameen Siddiqiu (1991), Epidemiologic Patterns and Control Strategic in Typhoid Fever. JPMA pg. (143 to 146).

[12.]   Samuel Kariu K, (2008), Typhoid fever in sub-Saharan Africa: Challenge of diagnosis and management of infection J Infect Developing Countries 2 (6) 443 – 447.

[13.]   Typhoid Vaccine: Who position paper No. 6 (2008) Weekly Epidemiological Report 83: 49 – 60.

[14.]   Wikipedia, (2014). Typhoid Fever. Retrieved 30^th July, 2014.

Abstract:

The conditions in which people are born, live, grow and age are important and impact greatly on their health. However, equity is not about sameness but each and every individual deserving the same opportunity concerning health, education, housing, working and living conditions.-Health inequities are found worldwide at different levels and stem from various factors. Africans are experiencing health inequity related to the social, economic, cultural and political environment in which they live. Immediate actions, coupled with a good political will substantially reduce the existing gaps and ensure that we achieve health equity in a nearer future.

References:

[1.] Ataguba JE, Akazili J. Health care financing in South Africa: Moving towards universal coverage. Contin Med Educ [Internet]. 2010;28(2):74–8. Available from: http://www.ajol.info/index.php/cme/article/viewFile/55239/43707

[2.] Alaba O, Chola L. The social determinants of multimorbidity in South Africa. Int J Equity Health [Internet]. 2013;12(1):63. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-84884234648&partnerID=tZOtx3y1nhttp://www.equityhealthj.com/content/12/1/63

[3.] Editorial G. Towards global health equity: opportunities and threats. 2012;1:2011–3.

[4.] Gakidou E. Education, Literacy & Health Outcomes Findings. 2014;

[5.] Hardon A, Davey S, Gerrits T, Hodgkin C, Irunde H, Investigator P, et al. No Title.

[6.] Kanmiki EW, Bawah A a, Agorinya I, Achana FS, Awoonor-Williams JK, Oduro AR, et al. Socio-economic and demographic determinants of under-five mortality in rural northern Ghana. BMC Int Health Hum Rights [Internet]. 2014;14(1):24. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4144693&tool=pmcentrez&rendertype=abstract

[7.] Karlsen S, Say L, Souza J-P, Hogue CJ, Calles DL, Gülmezoglu AM, et al. The relationship between maternal education and mortality among women giving birth in health care institutions: analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health. BMC Public Health [Internet]. 2011;11(1):606. Available from: http://www.biomedcentral.com/1471-2458/11/606

[8.] Marmot M. Closing the gap in a generation. Heal Equity Through Action Soc Determ Heal [Internet]. 2008;246. Available from: http://www.bvsde.paho.org/bvsacd/cd68/Marmot.pdfnpapers2://publication/uuid/E1779459-4655-4721-8531-CF82E8D47409

[9.] MacPherson EE, Richards E, Namakhoma I, Theobald S. Gender equity and sexual and reproductive health in Eastern and Southern Africa: A critical overview of the literature. Glob Health Action. 2014;7(1):1–9.

[10.] Macpherson E, Richards E, Namakhoma I, Theobald S. Dimensions of gender equity in health in East and Southern Africa In the Regional Network for Equity in Health in Southern Africa (EQUINET). 2012;(May).

[11.] Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.

[12.] Mills A, Ally M, Goudge J, Gyapong J, Mtei G. Progress towards universal coverage: The health systems of Ghana, South Africa and Tanzania. Health Policy Plan. 2012;27(SUPPL.1):4–12.

[13.] Mo C. The Remote Area Development Programme and the integration of Basarwa into the mainstream of Botswana society. 2002;16(2):123–34.

[14.] Ohenjo N, Willis R, Jackson D, Nettleton C, Good K, Mugarura B. Indigenous Health 3 Health of Indigenous people in Africa. 2006;

[15.] Profile CH. Botswana. 2012;

[16.] Report I. The Global Gender Gap Report 2014 [Internet]. 2014. Available from: http://www3.weforum.org/docs/GGGR14/GGGR_CompleteReport_2014.pdf

[17.] Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health. Organ Mund la Salud. 2010;79.

[18.] Sheet UISF, Rates GL, Numbers P, Adults FOR. Adult and youth literacy. Unesco Inst Stat [Internet]. 2012;(26):90–3. Available from: http://www.uis.unesco.org/FactSheets/Documents/fs20-literacy-day-2012-en-v3.pdf

[19.] Session T, Forum UNP, Discussion II, Central T, Republic A, No ILOC, et al. Indigenous Peoples in the African region. 2013;(May):1–2.

[20.] Sie A. Cause-specific mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites. 2014;25362:1–10.

[21.] Whitehead M. The concepts and principles of equity and health. Int J Health Serv. 1992;22(3):429–45.

Abstract:

Introduction: Health care wastes constitute a small stream of all waste generated by human yet proper disposal of this waste is a great concern because of its hazardous nature. Most developing countries have poor culture of hospital waste management due to competing medical needs and lack of commitment by hospital management. AIDS Support and Technical Assistant Resources (AIDSTAR1) a development partner supported government of Nigeria to build capacity of health care workers in line with World Health Organization (WHO) and national guideline on HCWM.. It is expected that this support would yield the desired result of improving HCWM in Nigeria. This study is to assess the level of implementation of national guideline on HCWM in Nigeria.

Methodology: A cross sectional descriptive study was conducted using key informant interview and direct observation of HCWM practices in 5 facilities selected from 3 out of the 6 priority states supported by AIDSTAR1. The guideline on minimum package for HCWM in Nigeria was used as a tool for assessing level of implementation at each health facility.

Results: There was marked improvement in HCWM practices across the facilities compared to only 2.5% of facilities who met minimum standard for HCWM as described in the baseline assessment in 2011. All the facilities had infection prevention committee and all the various types of waste boxes were available and used in the facilities for waste segregation. Wastes were evacuated to points of final disposal even though there were some operational challenges with the process. There was high awareness of the hazardous nature of hospital waste and the need to dispose them in a sanitary manner.

Conclusion: Training of all cadres of health care workers including waste handlers, management staffs, and provision of necessary material for HCWM has lead to improved HCWM in Nigeria. It is hereby recommended that government should ensure that guideline for minimum package of healthcare waste management are continuously implemented in health facilities in line with the national policy on HCWM.

Key words: Healthcare waste management, Hazardous health waste, National healthcare waste management guideline, Healthcare waste segregation.

References:

[1] Abah, S. O. Ohimain, E. J. Healthcare waste management in Nigeria: A case study. Journal of Public Health and Epidemiology Vol 3(3). Pp. 99-110 March 2011.

[2] Assessment of injection safety in selected local government areas in five states in Nigeria. 2011 baseline study.

[3] Azuike, E. C. Adimma, E. D. Nwabueze, S. A. Azuike, E. B. Mbanazuru, V. A. Epundu, U. U. Enwonwa, K. G. Chikizie, N. I. Ajafor, C. C. Onebunne, E. M. and Obi, D. C. Healthcare waste management: what do health workers in Nigeria tertiary hospital know and practices. Science Journal of Public Health. 2015, 3(1): pp 114-118. Publish online February 2, 2015. Available at http://www.,science publishing group.com

[4] Charles, H. L. Alvin, W. M. John, P. B. and Gordon, M. Uses of incineration municipal solid waste ash. Available at www.pdci.com/journal/sustainability, July2, 2010

[5] Irish Doctors Environmental Association. Incineration and the health effect. June 15, 2006. Available at www.ideairland.org/library/incinerator-and-their-health-effect

[6] National guideline for Health Waste Management; Prepared by Healthcare waste management technical working group. Available at

www.wds.worldbank.org/…/E16340NHCWMP10sophie0version0170A

[7] Ngwuluka, N. Ochekpe, N. Odumosu P., and John, S. Waste Management in Health Establishment within Jos Metropolis, Nigeria. African Journal of Environmental Science and Technology. Vol 3(12), pp 459-465, December 2009. Available at http://www.academic Journals.org/ASEST

[8] Ogbonna, D. N. Chidah, A. and Ubani, N. Waste management options for health care waste in Nigeria: A case study of Port-Harcourt hospitals. Journal of Public Health and epidemiology. Vol. 4(6). Pp 156-169. June 2012. Available at http://www.academicjournals.org/JPHE

[9] Olubukola, B. O. (2009). Comparative analysis of health waste management practice in two general hospital in nigeria. Available at http://www.eco-web.com/edi/inedx.htm. Assessed on October 25th, 2015.

[10] WHO fact sheet No. 253 (2011); Waste from Healthcare Activities. Available at WHI.int/mediacentre/factsheets. Assessed on October 28, 2015

[11] WHO guidance for healthcare waste management in LICs. Available at www.healthcare-waste.org/home. Assessed on October 28, 2015

[12] WHO, United Nations Environment program/SBC; National Health-Care Waste Management Plan. Guidance Manual. Available at www.WHO.int/ater_sanitation_health/medicalwaste/en/guidance manual. Assessed on October 28, 2015.

[13] WHO 2007; Core principles for achieving safe and sustainable management of health-care waste “Safe management of waste from health care activities, 2^nd edition, www.healthcare-waste.org/fileadmin

Abstract:

This paper is focusing on abortion issue in Rwanda particularly the view of population living in Nyagatare District to the abortion. In this study, a quantitative descriptive design with a positivist paradigm guided the whole research process. Two levels of sampling were done. The first was random sampling for the selection of healthcare centres where five healthcare centres were selected out of a total of eighteen. The second level was probability sampling with a systematic strategy, which was used to select the participants at healthcare centres. A total of 137 women volunteered to participate in the study and completed an anonymous questionnaire. The authorisation to carry out the research was obtained from Nyagatare District and five healthcare centres. The research was approved by the University of KwaZulu-Natal Ethics Committee. The gathered data were analysed using SPSS version 19. Among participants 12.4% wish to use abortion as family planning method. The views on abortion remain different among people.

Keywords: Family planning, Abortion, spacing of births, abortion and family planning

References:

[1.] ABBOTT, P. & RWIRAHIRA, J. 2010. Millennium Development Goals: Rwanda Country Report 2010. Kigali: UNDP.

[2.] ALASUUTARI, P., BICKMAN, L. & BRANNEN, J. (Eds.). 2008. Social research methods. London: Sage.

[3.] BASINGA, P., MOORE, A., SINGH, S., AUDAM, S., CARLIN, L., BIRUNGI, F. & NGABO, F. (N.d.). Abortion incidence in Rwanda. Available from: http://paa2011.princeton.edu/download.aspx?submissionId=110387 [29 April 2011].

[4.] BRINK, H. 2006. Fundamentals of research methodology for healthcare professionals. Second edition. Cape Town: Juta.

[5.] BRISTOW, J. 2010. Abortion provision: Building on the gain. Abortion Review, 33:1-8.

[6.] BURNS, N. & GROVE, S.K. 2005. The practice of nursing research: Conduct, critique, and utilization. Fifth edition. St Louis: Elsevier: Saunders.

[7.] CAMPAIN LIFE COALITION, 2009. Canadian Abortion Facts.

http://www.campaignlifecoalition.com/shared/media/editor/file/AbortionFactSheet-CLC.pdf.

[8.] CASEY, S.E., MITCHELL, K.T., AMISI, I.M., HALIZA, M.M., AVELEDI, B., KALENGA, P. & AUSTIN, J. 2009. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo. Conflict and Health, 3:1–12.

[9.] CONSIDINE, J., BOTTI, M. & THOMAS, S. 2005. Design, format, validity and reliability of multiple choice questions for use in nursing research and education. Collegian, 12(1):19–24.

[10.] DCDP (DEVELOPMENT COMMUNITY AND DECENTRALIZATION PROJECT / MINISTÈRE DE L’ADMINISTRATION LOCALE, DE LA BONNE GOUVERNANCE, DU DÉVELOPPEMENT COMMUNAUTAIRE ET DES AFFAIRES SOCIALS). 2007. Nyagatare District Development Plan 2008–2012. Nyagatare.

[11.] DE MORA R. 2011. Eliminating Maternal Deaths from Unsafe Abortion in Uruguay. Accessed at: http://www.unfpa.org/news/eliminating-maternal-deaths-unsafe-abortion-uruguay

[12.] DO, W.D.R. 2009. The RAPID Model. Health Policy, Available from http://www.healthpolicyinitiative.com/index.cfm?id=software&get=Spectrum [19 February 2011].

[13.] DORENBOS, P.B. & VAN VUUREN, A. 2003. Abolition of abortion. Hilversum, Holland: Cry for Life International.

[14.] FORD, N., MILLS, E.J., ZACHARIAH, R. & UPSHUR, R. 2009. Ethics for conducting research in conflict settings. Conflicts and Health, 3(7):1–9.

[15.] FUREDI, A. (n.d). The causes of unplanned pregnancy. Accessed on

http://www.prochoiceforum.org.uk/ri1.php#top

[16.] GERHARDT, L.P. 2004. Research methodology explained for everyday people. http://dc435.4shared.com/doc/AT_yhLqd/preview.html [11 April 2011].

[17.] GILBERT, N. 2008. Researching social life. Third edition. Guildford: Sage.

[18.] GOLAFSHANI, N. 2003. Understanding validity and reliability in qualitative research. The Qualitative Report, 8(4):597–607.

[19.] GRIGGS, C. 2009. As family planning goes global, Haiti becomes a case in point. Available from: http://www.thecuttingedgenews.com/index.php?article=11553&pageid=&pagename [26 May 2011].

[20.] HARALAMBOS, M. & HOLBORN, M. 2000. Sociology: Themes and perspectives. Hammersmith: HarperCollins.

[21.] HARROWING, J.N., MILL, J., SPIERS, J., KULIG, J. & KIPP, W. 2010. Culture, context and community: Ethical consideration for global nursing research. International Nursing Review, 57:70–77.

[22.] HUMAN RIGHTS. N.d. Abortion and human right: Declaration of right of the child. Available from: http://www.qrtl.org.au/humanrights.htm [9 May 2011].

[23.] JONES, S. 2008. Fertility and population: Interview with John Guillebaud. South African Journal of Obstetrics and Gynaecology, 14(1):4-4.

[24.] KAHL, L. 2011. What is convenience sampling? Available from: http://www.wisegeek.com/what-is-convenience-sampling.htm [2 May 2011].

[25.] KEELE, R. 2011. Nursing research and evidence-based practice: Ten steps to success. Available from:

http://books.google.co.za/books?id=0g-f3YzPNU0C&pg=PA62&dq=Population+by+Burns+and+Grove+2010+(Nursing+Research)+book&hl=en&ei=MEq8TZaCBILB8QPO-vnKBQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CEYQ6AEwAQ#v=onepage&q&f=false [30 April 2011].

[26.] KUMAR, R. 2005. Research methodology: A step-by-step guide for beginners. Second edition. Available from:

http://books.google.co.za/books?id=x_kp__WmFzoC&pg=PA158&lpg=PA158&dq=internal+consistency+(research+methodology)&source=bl&ots=mQl7A_de-c&sig=4lLRS2aRZFAv4C_Fyj3PFzkiTc4&hl=en&ei=kXi-TYPFG8nNswa9u8j8BQ&sa=X&oi=book_result&ct=result&resnum=8&ved=0CHAQ6AEwBw#v=onepage&q&f=false [2 May 2011].

[27.] MATVEEV, A.V. 2002. The advantages of employing quantitative and qualitative methods in intercultural research: Practical implications from the study of the perceptions of intercultural communication competence by American and Russian managers. Bulletin of Russian Communication, 168(1):59–67.

[28.] MOULE, P. & GOODMAN, M. 2009. Nursing research: An introduction. London: Sage.

[29.] MUTESI, T. 2011. 2 arrested for abortion. ORINFOR. 23 April. Available from:

http://www.orinfor.gov.rw/printmedia/topstory.php?id=2761 [29 April 2011].

[30.] NAMBI, V.I. (Ed.). 2009. Abortion still a challenge to reproductive health. The New Times. Available from: http://allafrica.com/stories/200906240198.html [29 April 2011].

[31.] NDIKUBWAYEZU, G. (Ed.). 2009. Legalise abortion, members of parliaments demand. The New Times. Available from: http://allafrica.com/stories/200907310051.html [29 April 2011].

[32.] POLIT, D.F. & BECK, C.T. 2008. Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins.

[33.] STACEY, D. 2008. Natural contraceptive methods: Natural family planning options. Available from: http://contraception.about.com/od/naturalmethods/tp/behavioral.htm [8 April 2011].

[34.] THAXTON, M. 2007. Integrating population, health, and environment in Kenya. Available from: http://www.prb.org/pdf07/phe-kenya.pdf[29 December 2008].

[35.] TSUI, A.O., MCDONALD-MOSLEY, R. & BURKE, A.E. 2010. Family planning and the burden of unintended pregnancies. Epidemiologic Reviews, 32(1):152-174.

[36.] TWYCROSS, A. & SHIELDS, L. 2004. Validity and reliability – what’s it all about? Part 1: Validity in quantitative studies. Paediatric Nursing, 16(9):28-28.

[37.] UNDIE, C.C. & RAMARAO, S. 2010. Community mobilization for post abortion care in Kenya: Baseline evaluation report. The RESPOND Project Study Series: Contributions to global knowledge, report no. 2. New York: Engender Health/The RESPOND Project.

[38.] WEAVER, K. & OLSON, J.K. 2006. Understanding paradigms used for nursing research. Journal of Advanced Nursing, 53(4):459–469.

Abstract:

Objective: This paper aims to review the current literature in order to compare different ethnic groups with respect to the known racial disparities in the risk of obesity-related morbidity and mortality, thus orienting clinical practitioners for a better practice in light of evidence-based data.

Methods: Literature review using key words - obesity, metabolic syndrome, ethnic differences, BMI, cardiovascular risk - through PubMed database from 2000 to now.

Results: The prevalence of metabolic syndrome and cardiovascular diseases as complications of overweight and obesity are variable among different ethnicities worldwide. Recent studies contra-indicate the use of global cutoff points for measures like body mass index (BMI) and waist circumference (WC) as it has been demonstrated that, for similar BMI and WC values, different populations present distinct patterns of body shape and fat deposition. For instance, South Asians are at increased risk of cardio-metabolic disorders even with a lesser degree of body adiposity.

Conclusions: Instead of a direct cause-effect relationship, biologic/genetic and environmental factors like socioeconomic status, culture, religion, health habits, geographic location, and their intricate interactions form the complex basis of ethnic disparities on predisposing to obesity-related diseases, thus the importance of an individualized analysis of the obesity indexes, in order to optimize patient management and to reduce health risks.

Keywords: obesity, BMI, adiposity, ethnicities, metabolic syndrome, diabetes

References:

[1.] Coutinho T, Goel K, Corrêa de Sá D, Carter R, Hodge D, Kragelund C et al. Combining Body Mass Index with Measures of Central Obesity in the Assessment of Mortality in Subjects with Coronary Disease. J Am Coll Cardiol. 2013; 61(5):553-560. DOI: 10.1016/j.jacc.2012.10.035

[2.] Gatineau M, Mathrani S. Ethnicity and obesity in the UK. Perspectives in Public Health. 2011; 131(4):159-160. DOI: 10.1177/1757913911412478

[3.] Fernandez J, Allison D. Understanding Racial Differences in Obesity and Metabolic Syndrome Traits. Nutr Rev. 2003; 61(9):316-319. DOI: http://dx.doi.org/10.1301/nr.2003.sept.316-319

[4.] Wulan S, Westerterp K, Plasqui G. Ethnic differences in body composition and the associated metabolic profile: A comparative study between Asians and Caucasians. Maturitas. 2010;65(4):315-319. DOI: 10.1016/j.maturitas.2009.12.012

[5.] Misra A, Wasir J, Vikram N. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition. 2005;21(9):969-976. DOI: http://dx.doi.org/10.1016/j.nut.2005.01.007

[6.] WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004; 363(9403):157-163. PMID: 14726171

[7.] Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D & Munjal YP Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009; 57:163-70. PMID: 19582986

[8.] James W. Assessing obesity: are ethnic differences in body mass index and waist classification criteria justified?. Obesity Reviews. 2005;6(3):179-181. DOI: 10.1111/j.1467-789X.2005.00214.x

[9.] Zimmet P, Alberti K, Serrano Ríos M. A New International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome: the Rationale and the Results. Revista Española de Cardiología (English Edition). 2005;58(12):1371-1375. PMID: 16371194

[10.] WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. February 2000. [WWW document.] Health Communications, Australia PTY Ltd.

http://www.idi.org.au/obesity_report.htm.

[11.] Wickrama KT, Wickrama KA, & Bryant CM. Community influence on adolescent obesity: Race/ethnic differences. Journal of Youth and Adolescence. 2006; 35(4):641-651. DOI: 10.1007/s10964-006-9050-9

[12.] Wei L, Wu B. Racial and Ethnic Differences in Obesity and Overweight as Predictors of the Onset of Functional Impairment. J Am Geriatr Soc. 2014; 62(1):61-70. DOI:10.1111/jgs.12605

Abstract:

Health promotion programs have been constantly developed by the Health Surveillance Agencies of many countries aiming at tackling obesity. U.S. data revealed impressive obesity-related costs of $117 billion in 2000 - $61 billion for direct medical costs and $56 billion for indirect costs, i.e., those related to the impact of the disease on the country’s economy. In the UK, economic projections revealed that indirect costs might have reached £27 billion by 2015. The majority of the educational and preventive actions target lifestyle changes, childhood obesity and diabetes. More than making the population aware of the benefits of healthier habits and their potential savings, stakeholders and funders are looking forward to better assessing the economic impact of health education programs, which can be quantified by different methods such as the time value of money analyses, shadow pricing, and the cost-benefit and cost-effectiveness indexes. In the specific case of obesity as a risk factor for cardio-metabolic diseases, estimates obtained from different analysis reveal that great amounts of money – as high as 11.2 billion dollars – can be saved by delaying type 2 diabetes onset in 6 years, in a hypothetical population of 2 million obese adults who have effectively lost weight. Furthermore, in agreement with the ancient philosopher Virgil, who quoted “the greatest wealth is health”, by living longer and healthier, people may produce more and improve individual and familiar financial lives, thus contributing economically to their communities and countries. The aim of this paper is to briefly report how to assess and calculate the financial impact of public health programs to tackle obesity.

Keywords: obesity, public health, weight loss, economy, cost-benefit, cost-effectiveness

References:

[1.] Allison D, Zannolli R, Narayan K. The direct health care costs of obesity in the United States. Am J Public Health. 1999;89(8):1194-1199. PMC1508703

[2.] Arbex AK, Rocha DR, Aizenberg M, & Ciruzzi MS. (2014). Obesity epidemic in Brazil and Argentina: a public health concern. J Health Popul Nutr. 2014;32(2):327-334. PMC4216968

[3.] Baicker K, Cutler D, Song Z. Workplace Wellness Programs Can Generate Savings. Health Affairs. 2010;29(2):304-311. DOI: 10.1377/hlthaff.2009.0626

[4.] Cecchini M, Sassi F, Lauer J, Lee Y, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet. 2010;376(9754):1775-1784. DOI: http://dx.doi.org/10.1016/S0140-6736(10)61514-0

[5.] Centers for Disease Control and Prevention (CDC). Preventing obesity and chronic diseases through good nutrition and physical activity. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention. 2003;14(18):14.

[6.] Ibge.gov.br. IBGE | Projeção da população [Internet]. 2016 [cited 21 February 2016]. Available from: http://www.ibge.gov.br/apps/populacao/projecao/

[7.] Murphy C & Yates J. Economic comparison of weight loss programmes versus drug treatment for the management of obesity. Asia Pac J Clin Nutr. 2005;14(Suppl):S97-S105.

[8.] Noo.org.uk. The economic burden of obesity. Home :: Public Health England Obesity Knowledge and Intelligence team [Internet]. 2010 [cited 10 February 2016]. Available from: http://www.noo.org.uk

[9.] Noo.org.uk. UK and Ireland prevalence and trends :: Public Health England Obesity Knowledge and Intelligence team [Internet]. 2014 [cited 10 February 2016]. Available from: https://www.noo.org.uk/NOO_about_obesity/adult_obesity/UK_prevalence_and_trends

[10.] Njaes.rutgers.edu. The Financial Impact of Improved Health Behaviors [Internet]. [cited 10 February 2016]. Available from: https://njaes.rutgers.edu/healthfinance/health-behaviors.asp

[11.] O’Neill, B. Calculating the Economic Impact of Health Education Programs: Five Tools for Extension Educators [Internet]. Joe.org. 2008 [cited 10 February 2016]. Available from: http://www.joe.org/joe/2008february/tt4.php

[12.] O'Neill, B. Health and wealth connections: Implications for financial planners. JPF. 2005;4(2):27-38.

[13.] O’Neill B, & Richardson J. Cost-Benefit Impact Statements: A Tool For Extension Accountability [Internet]. Joe.org. 1999 [cited 10 February 2016]. Available from: http://www.joe.org/joe/1999august/tt3.php

[14.] Ons.gov.uk. UK Statistics - Population and migration - ONS [Internet]. 2014 [cited 10 February 2016]. Available from: http://www.ons.gov.uk/ons/guide-method/compendiums/compendium-of-uk-statistics/population-and-migration/index.html

[15.] van Baal P, Polder J, de Wit G, Hoogenveen R, Feenstra T, Boshuizen H et al. Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure. PLoS Med. 2008;5(2):e29. DOI: 10.1371/journal.pmed.0050029

Abstract:

This study was designed to study about the preferred health care system of the people residing at Arpookara, Kottayam district in India. In this study investigator tried to find out the common health problems, preferred place for treatment, preferred system of medicine, main obstacles to access the better treatment and expectations from government for better health care delivery, of the study population. The populations for the study were the people residing at Arpookara, Kottayam district in India which includes 410 households with 2360 members. One hundred households (samples) from the study population were selected so that findings can be generalized for the population. Simple random technique is used for samples selection. Samples include 100 households with 456 members, out of which 243 members are males and rest 213 are females. The tool used for data collection is an interview schedule which consists of 2 Performa, Performa 1 and Performa 2. Performa 1 seeks personal details while Performa 2 seeks information about common health problems, preferred place for treatment, preferred system of medicine, main obstacles to access the better treatment and expectations from government for better health care delivery, of the study population. After the data collection its analysis is done. Members of 73 (73%) households are preferring government hospital for treatment while private hospital, private practitioners and traditional healing centers are preferred by 19 (19%), 6(6%) and 2(2%) house members respectively. In 94 (94%) houses, Allopathic system of medicine is preferred while Ayurvedic and Homeopathy system of medicine are preferred by only 4 (4%) and 2 (2%) houses respectively. The major health problems of members (above age of 6 years) are Chikungunya-39 (9.51%), Jaundice-17 (4.41%), Typhoid-1 (0.24%), Bronchial Asthama-1 (0.24%), Viral fever--1 (0.24%), Coronary heart disease-2 (0.48%), Stroke- 3 (0.73%) and Diabetes-1 (0.24%). About 345 (84.14%) members were not suffered from any disease since last year. According to 56 (56%) households both the Service unavailability and financial problem are the main obstacles to access better treatment while 18 (18%) households suggests that service unavailability only and rest 26(26%) households suggested that main obstacle is financial problem. for the better healthcare delivery, 44 (44%) households expects availability of pure drinking water, regular cleaning of surroundings and primary health centre from government. About 31 (31%) households’ needs pure drinking water and rest 16 (16%) households needs regular cleaning of surroundings. Rest 9 (9%) households expects primary health center at their ward. On the basis of findings of this study, Researcher recommended his suggestions to higher healthcare administrative staff to take preventive measures for prevention and control of diseases and thus too maintain a high standard of health.

Keywords: Healthcare System; Treatment Place; Medicine System; Health Problem; Obstacle.

References:

[1.]   Aggarwal O P et al, A new instrument (scale) for measuring socioeconomic status of a family: Preliminary study. Indian Journal of Community Medicine, 30(4):10-12.

[2.]   Archana B.Patel et al, A tool for rapid socioeconomic assessment, India Journal of Pediatrics, Volume 74-April 2007.

[3.]   B.K. Mahajan, Methods in Biostatistics, 1999, Jaypee brothers Medical Publishers (P) Ltd., New Delhi.

[4.]   D.Mishra, H.P.Singh, Kuppuswamy’s socioeconomic status scale- a revision, India Journal of Pediatrics, 2003, 70(3): 273-274.

[5.]   Dutton, Diana B, Sol Levine, Socioeconomic status and health: Overview, methodological critique and formulation, 1989, The Henry J. Kaiser Family foundation, New York.

[6.]   E. Vijay, Community Medicine for paramedical students, 2002, Beacon Zen publishers, Chennai.

[7.]   Frank W. Young, Socioeconomic status and health: The problem of explanation and sociological solution, 2002, Cornell University, Ithaca, New York.

[8.]   Govt. of India (2001), Annual Report 2000-2001, Ministry of health and Family welfare, New Delhi.

[9.]   K. Park, Park’s textbook of Preventive and Social Medicine, 2007, Banarsidas Bhanot Publishers, Jabalpur.

[10.]   Kuppuswamy B. Manual of socioeconomic status (Urban), 1981, Manasayan, Delhi.

[11.]   L. Ramachandran, T.Dharmalingam, Health Education: A new approach, 2006, Vikash Publishing House Pvt. Ltd. Noida.

[12.]   Mahajan B.K., Gupta M C, Textbook of Preventive and Social Medicine, 1995, Jaypee brothers, New Delhi.

[13.]   N.Kumar et al, Kuppuswamy’s Socioeconomic status scale- updating for 2007, India Journal of Pediatrics, Volume 74-December 2007.

[14.]   National Family Health survey-2, 1998-1999, International Institute of population sciences, Mumbai.

[15.]   P.K. Goel, A handbook of practical community medicine, 2008, Asha Deep Publications, Jammu.

[16.]   P.N. Arora, Comprehensive Statistical Methods, 2007, S. Chand & company ltd. New Delhi.

[17.]   Roger et al, Oxford text book of public health, 1997, Oxford University press, Oxford, New York.

[18.]   Ross, Catherine E, Chia-Ling Wu, 1995, The link Between education and health, American Sociological review 60: 719-745.

Abstract:

The study had two main broad but related objectives. The first objective was to determine the actual causes of under detection of pulmonary TB cases in the Northern Region of Ghana. Data was collected through administering a structured questionnaire; and collection of sputum samples from the respondents. The second objective was to determine the actual causes of low smear positive rates by assessing the capacity to effectively perform sputum smear microscopy for Acid Fast Bacilli (AFBs) in the district hospitals where the study was conducted. Collection of data here involved the use of a structured checklist for the laboratory and the staff who performed Tb microscopy. In all, 26 laboratory staff who performed Tb microscopy in the study district hospital laboratories were involved. The study lasted for a period of three months. The study revealed that, 41.2% of the study participants did not go to hospital when they fell sick. Out of this figure, 20.4% (21) attributed their inability to do so to poverty, 4.9% (5) to lack of access, 35.9% (37) to stigma, 28.2% (29) to cultural beliefs and 10.6%(11) attributed it to other reasons.

References:

[1] (2005) Tuberculosis bacteriology--priorities and indications in high prevalence countries: position of the technical staff of the Tuberculosis Division of the International Union Against Tuberculosis and Lung Disease. Int J Tuberc Lung Dis 9, 355-361.

[2] Addo K., Owusu-Darko K., Yeboah-Manu D., Caulley P., Minamikawa M., Bonsu F., Leinhardt C., Akpedonu P. and Ofori-Adjei D. (2007) Mycobacterial species causing pulmonary tuberculosis at the korle bu teaching hospital, accra, ghana. Ghana Med J 41, 52-57.

[3] Addo K.K., Dan-Dzide M., Yeboah-Manu D., Owusu-Darko K., Caulley P., Minamikawa M., Bonsu F., Lienhardt C., Akpedonu P. and Ofori-Adjei D. (2006) Improving the laboratory diagnosis of TB in Ghana: the impact of a quality assurance system. Int J Tuberc Lung Dis 10, 812-817.

[4] Adeleye I.A., Onubogu C.C., Ayolabi C.I., Isawumi A.O. and Nshiogu M.E. (2008) Screening of crude extracts of twelve medicinal plants and “wonder-cure” concoction used in Nigeria unorthodox medicine for activity against Mycobacterium tuberculosis isolated from tuberculosis patients’ sputum. African Journal of Biotechnology 7, 3182-3187.

[5] Aziz M., Becx-Bleumink B.F., Bretzel G., Humes R. and Iademarco M.F. (2002) External quality assessment for AFB smear microscopy. Washington: Association of Public Health Laboratories.

[6] Aziz M. and Bretzel G. (2002) Use of a standardised checklist to assess peripheral sputum smear microscopy laboratories for tuberculosis diagnosis in Uganda. Int J Tuberc Lung Dis 6, 340-349.

[7] Aziz M.A., Rysweska K., Laszlo A. and Blanc L. (2006) Strategic approach for the strengthening of laboratory services for tuberculosis control, 2006-2009. Geneva: WHO.

[8] Baghdadi J.E., Orlova M., Alter A., Ranque B., Chentoufi M., Lazrak F., Archane M.I., Casanova J.L., Benslimane A., Schurr E. and Abel L. (2006) An autosomal dominant major gene confers predisposition to pulmonary tuberculosis in adults. J Exp Med 203, 1679-1684.

[9] Banerji D. and Andersen S. (1963) A Sociological Study of Awareness of Symptoms among Persons with Pulmonary Tuberculosis. Bull World Health Organ 29, 665-683.

[10] Barnes D.S. (1995) The Making of a Social Disease: Tuberculosis in Nineteenth-century France. . University of California Press.

[11] Bass J.B., Jr. (1989) The face of TB changes again. Hosp Pract (Off Ed) 24, 81-85, 88, 93-85, passim.

[12] Becker M.H. (1985) Patient adherence to prescribed therapies. Med Care 23, 539-555.

[13] Blaak E. (2001) Gender differences in fat metabolism. Curr Opin Clin Nutr Metab Care 4, 499-502.

[14] Bonah C. (2005) The 'experimental stable' of the BCG vaccine: safety, efficacy, proof, and standards, 1921-1933. Stud Hist Philos Biol Biomed Sci 36, 696-721.

[15] Borgdorff M.W., Nagelkerke N.J., Dye C. and Nunn P. (2000) Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection. Int J Tuberc Lung Dis 4, 123-132.

[16] Bustamante J., Picard C., Fieschi C., Filipe-Santos O., Feinberg J., Perronne C., Chapgier A., de Beaucoudrey L., Vogt G., Sanlaville D., Lemainque A., Emile J.F., Abel L. and Casanova J.L. (2007) A novel X-linked recessive form of Mendelian susceptibility to mycobaterial disease. J Med Genet 44, e65.

[17] Calippe B., Douin-Echinard V., Laffargue M., Laurell H., Rana-Poussine V., Pipy B., Guery J.C., Bayard F., Arnal J.F. and Gourdy P. (2008) Chronic estradiol administration in vivo promotes the proinflammatory response of macrophages to TLR4 activation: involvement of the phosphatidylinositol 3-kinase pathway. J Immunol 180, 7980-7988.

[18] Chrisman N. and Kleinman A. (1983) Popular health care, social networks, and cultural meanings: the orientation of medical anthropology. In Handbook of health, health care, and the health professions,, pp. 569-590 [D. Mechanic, editor]. New York: The Free Press.

[19] Comstock G.W. (1994) The International Tuberculosis Campaign: a pioneering venture in mass vaccination and research. Clin Infect Dis 19, 528-540.

[20] Curry F.J. (1968) Neighborhood clinica for more effective outpatient treatment of tuberculosis. N Engl J Med 279, 1262-1267.

[21] Daniel T.M. (1982) Selective primary health care: strategies for control of disease in the developing world. II. Tuberculosis. Rev Infect Dis 4, 1254-1265.

[22] Daniel T.M. (2004) The impact of tuberculosis on civilization. Infect Dis Clin North Am 18, 157-165.

[23] Davila S., Hibberd M.L., Hari Dass R., Wong H.E., Sahiratmadja E., Bonnard C., Alisjahbana B., Szeszko J.S., Balabanova Y., Drobniewski F., van Crevel R., van de Vosse E., Nejentsev S., Ottenhoff T.H. and Seielstad M. (2008) Genetic association and expression studies indicate a role of toll-like receptor 8 in pulmonary tuberculosis. PLoS Genet 4, e1000218.

[24] Deuschle K. and Adair J. (1960) An interdisciplinary approach to public health on the Navajo Indian reservation: medical and anthropological aspects. Ann NY Acad Sci 17, 887-905.

[25] Drobniewski F.A., Caws M., Gibson A. and Young D. (2003) Modern laboratory diagnosis of tuberculosis. Lancet Infect Dis 3, 141-147.

[26] Drobniewski F.A., Hoffner S., Rusch-Gerdes S., Skenders G. and Thomsen V. (2006) Recommended standards for modern tuberculosis laboratory services in Europe. Eur Respir J 28, 903-909.

[27] Dubos R.J. and Jean D. (1987) The White Plague: Tuberculosis, Man, and Society. Rutgers University Press.

[28] Ebara R.V.B., Madunagu E.U. and Otung I.N. (1990) Microbiological exploitation of Cardiac Glycosides and Alkaloids from Garcinia kola and Borreriaocymoides. J. Bacteriol 871, 398-401.

[29] Fortin A., Abel L., Casanova J.L. and Gros P. (2007) Host genetics of mycobacterial diseases in mice and men: forward genetic studies of BCG-osis and tuberculosis. Annu Rev Genomics Hum Genet 8, 163-192.

[30] Fox W. (1983) Compliance of patients and physicians: experience and lessons from tuberculosis-I. Br Med J (Clin Res Ed) 287, 33-35.

[31] Friemodt-Moller J. (1968) Domiciliary drug therapy of pulmonary tuberculosis in a rural population in India. Tubercle 49 (supp.), 22-23.

[32] Gangadharam P.R.J., Reichmann L.B. and Hershfield E.S. (1993) Drug resistance in tuberculosis. In A Comprehensive International Approach, pp. 293-328. [M. Deke, editor].

[33] Gordon S. and Rylance J. (2009) Where there's smoke... there's tuberculosis. Thorax 64, 649-650.

[34] Grossman C.J. (1985) Interactions between the gonadal steroids and the immune system. Science 227, 257-261.

[35] Haefner D.P. and Kirscht J.P. (1970) Motivational and behavioral effects of modifying health beliefs. Public Health Rep 85, 478-484.

[36] Hamid Salim M.A., Declercq E., Van Deun A. and Saki K.A. (2004) Gender differences in tuberculosis: a prevalence survey done in Bangladesh. Int J Tuberc Lung Dis 8, 952-957.

[37] Hargreaves N.J., Kadzakumanja O., Whitty C.J., Salaniponi F.M., Harries A.D. and Squire S.B. (2001) 'Smear-negative' pulmonary tuberculosis in a DOTS programme: poor outcomes in an area of high HIV seroprevalence. Int J Tuberc Lung Dis 5, 847-854.

[38] Hawken M.P., Muhindi D.W., Chakaya J.M., Bhatt S.M., Ng'ang'a L.W. and Porter J.D. (2001) Under-diagnosis of smear-positive pulmonary tuberculosis in Nairobi, Kenya. Int J Tuberc Lung Dis 5, 360-363.

[39] Herrera M., Senties R., Esquivel E. and Armas J. (1971) [Social problems of the tuberculosis patient in long term care hospitals]. Salud Publica Mex 13, 749-762.

[40] Hill A.V. (2006) Aspects of genetic susceptibility to human infectious diseases. Annu Rev Genet 40, 469-486.

[41] Hochbaum G.M. (1956) Why people seek diagnostic x-rays. Public Health Rep 71, 377-380.

[42] Holmes C.B., Hausler H. and Nunn P. (1998) A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis 2, 96-104.

[43] Hunt L.M., Jordan B., Irwin S. and Browner C.H. (1989) Compliance and the patient's perspective: controlling symptoms in everyday life. Cult Med Psychiatry 13, 315-334.

[44] Janele D., Lang T., Capellino S., Cutolo M., Da Silva J.A. and Straub R.H. (2006) Effects of testosterone, 17beta-estradiol, and downstream estrogens on cytokine secretion from human leukocytes in the presence and absence of cortisol. Ann N Y Acad Sci 1069, 168-182.

[45] Janz N.K. and Becker M.H. (1984) The Health Belief Model: a decade later. Health Educ Q 11, 1-47.

[46] Jasmer R.M., Roemer M., Hamilton J., Bunter J., Braden C.R., Shinnick T.M. and Desmond E.P. (2002) A prospective, multicenter study of laboratory cross-contamination of Mycobacterium tuberculosis cultures. Emerg Infect Dis 8, 1260-1263.

[47] Kendall C. and Thoits P. The impact of culture on the cognitive structure of illness. Cult Med Psychiatry 11, 465-494.

[48] Khan M.S., Dar O., Sismanidis C., Shah K. and Godfrey-Faussett P. (2007) Improvement of tuberculosis case detection and reduction of discrepancies between men and women by simple sputum-submission instructions: a pragmatic randomised controlled trial. Lancet 369, 1955-1960.

[49] Kochi A. (1991) The global tuberculosis situation and the new control strategy of the World Health Organization. Tubercle 72, 1-6.

[50] Kopanoff D.E., Snider D.E., Jr. and Johnson M. (1988) Recurrent tuberculosis: why do patients develop disease again? A United States Public Health Service cooperative survey. Am J Public Health 78, 30-33.

[51] Kumate J. (1990) Las enfermedadestransmisibles. In Salud y crisis en Mexico, pp. 17-39 [SigloVeintiuno, editor. Mexico City: I. Almada Bay.

[52] Kusznierz G.F., Latini O.A. and Sequeira M.D. (2004) Quality assessment of smear microscopy for acid-fast bacilli in the Argentine tuberculosis laboratory network, 1983-2001. Int J Tuberc Lung Dis 8, 1234-1241.

[53] Laszlo A., Rahman M., Espinal M. and Raviglione M. (2002) Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994-1998. Int J Tuberc Lung Dis 6, 748-756.

[54] Leff A.R. and Leff D.R. (1986) Tuberculosis: a reflection of political institutions and social concerns in the United States. Perspect Biol Med 30, 27-39.

[55] Leone M., Honstettre A., Lepidi H., Capo C., Bayard F., Raoult D. and Mege J.L. (2004) Effect of sex on Coxiella burnetii infection: protective role of 17beta-estradiol. J Infect Dis 189, 339-345.

[56] Lieban R.W. (1976) Traditional medical beliefs and the choice of practitioners in a Philippine city. Soc Sci Med 10, 289-296.

[57] Lienhardt C., Fielding K., Sillah J.S., Bah B., Gustafson P., Warndorff D., Palayew M., Lisse I., Donkor S., Diallo S., Manneh K., Adegbola R., Aaby P., Bah-Sow O., Bennett S. and McAdam K. (2005) Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa. Int J Epidemiol 34, 914-923.

[58] Lin C.M., Davidson T.M. and Ancoli-Israel S. (2008) Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 12, 481-496.

[59] Liu P.T., Stenger S., Li H., Wenzel L., Tan B.H., Krutzik S.R., Ochoa M.T., Schauber J., Wu K., Meinken C., Kamen D.L., Wagner M., Bals R., Steinmeyer A., Zugel U., Gallo R.L., Eisenberg D., Hewison M., Hollis B.W., Adams J.S., Bloom B.R. and Modlin R.L. (2006) Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311, 1770-1773.

[60] Marriott I. and Huet-Hudson Y.M. (2006) Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res 34, 177-192.

[61] Martin R., Hearn T.L., Ridderhof J.C. and Demby A. (2005) Implementation of a quality systems approach for laboratory practice in resource-constrained countries. AIDS 19 Suppl 2, S59-65.

[62] Martinez A., Balandrano S., Parissi A., Zuniga A., Sanchez M., Ridderhof J., Lipman H.B. and Madison B. (2005) Evaluation of new external quality assessment guidelines involving random blinded rechecking of acid-fast bacilli smears in a pilot project setting in Mexico. Int J Tuberc Lung Dis 9, 301-305.

[63] Mata J.I. (1985) Integrating the client's perspective in planning a tuberculosis education and treatment program in Honduras. Med Anthropol 9, 57-64.

[64] Maulitz R.C. and Maulitz S.R. (1973) The King's Evil in Oxfordshire. Med Hist 17, 87-89.

[65] McCarthy O.R. (2001) The key to the sanatoria. J R Soc Med 94, 413-417.

[66] McClelland C. (1909) "Galen on Tuberculosis".The Physician and Surgeon. Detroit and Ann Arbor: Keating and Bryant 31, 400-404.

[67] Miller E.N., Jamieson S.E., Joberty C., Fakiola M., Hudson D., Peacock C.S., Cordell H.J., Shaw M.A., Lins-Lainson Z., Shaw J.J., Ramos F., Silveira F. and Blackwell J.M. (2004) Genome-wide scans for leprosy and tuberculosis susceptibility genes in Brazilians. Genes Immun 5, 63-67.

[68] Moysen J.S. and Arroyo Acevedo P. (1984) Critica de la validez de los metodos de deteccion y confirmacion de la tuberculosis pulmonarcomo un problema de saludpublica. SaludPublica de Mexico 26, 546-555.

[69] Mundy C.J., Harries A.D., Banerjee A., Salaniponi F.M., Gilks C.F. and Squire S.B. (2002) Quality assessment of sputum transportation, smear preparation and AFB microscopy in a rural district in Malawi. Int J Tuberc Lung Dis 6, 47-54.

[70] Munyati S.S., Dhoba T., Makanza E.D., Mungofa S., Wellington M., Mutsvangwa J., Gwanzura L., Hakim J., Nyakabau M., Mason P.R., Robertson V., Rusakaniko S., Butterworth A.E. and Corbett E.L. (2005) Chronic cough in primary health care attendees, Harare, Zimbabwe: diagnosis and impact of HIV infection. Clin Infect Dis 40, 1818-1827.

[71] Nashold F.E., Spach K.M., Spanier J.A. and Hayes C.E. (2009) Estrogen controls vitamin D3-mediated resistance to experimental autoimmune encephalomyelitis by controlling vitamin D3 metabolism and receptor expression. J Immunol 183, 3672-3681.

[72] Ober C., Loisel D.A. and Gilad Y. (2008) Sex-specific genetic architecture of human disease. Nat Rev Genet 9, 911-922.

[73] Pamra S.P. (1980) Problems of tuberculosis in developing countries. Clin Chest Med 1, 265-271.

[74] Perkins M.D., Roscigno G. and Zumla A. (2006) Progress towards improved tuberculosis diagnostics for developing countries. Lancet 367, 942-943.

[75] Petti C.A., Polage C.R., Quinn T.C., Ronald A.R. and Sande M.A. (2006) Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 42, 377-382.

[76] Pitchenik A.E. (1984) Monitoring compliance with anti-tuberculosis therapy. N Engl J Med 311, 799.

[77] Ridderhof J.C., Williams L.O., Legois S., Shult P.A., Metchock B., Kubista L.N., Handsfield J.H., Fehd R.J. and Robinson P.H. (2003) Assessment of laboratory performance of nucleic acid amplification tests for detection of Mycobacterium tuberculosis. J Clin Microbiol 41, 5258-5261.

[78] Rieder H.L., Arnadottir T., Tardencilla Gutierrez A.A., Kasalika A.C., Salaniponi F.L., Ba F., Diop A.H., Anagonou S., Gninafon M., Ringdal T., Trebucq A. and Enarson D.A. (1997) Evaluation of a standardized recording tool for sputum smear microscopy for acid-fast bacilli under routine conditions in low income countries. Int J Tuberc Lung Dis 1, 339-345.

[79] Roberts C.W., Walker W. and Alexander J. (2001) Sex-associated hormones and immunity to protozoan parasites. Clin Microbiol Rev 14, 476-488.

[80] Roden A.C., Moser M.T., Tri S.D., Mercader M., Kuntz S.M., Dong H., Hurwitz A.A., McKean D.J., Celis E., Leibovich B.C., Allison J.P. and Kwon E.D. (2004) Augmentation of T cell levels and responses induced by androgen deprivation. J Immunol 173, 6098-6108.

[81] Rosenstock I.M. (1974) Historical origins of the health belief model. In The health belief model and personal health behavior, pp. 1-8 [M.H. Becker and C.B. Slack, editors]. Thorofare, NJ.

[82] Rubel A.J. and Garro L.C. (1992) Social and cultural factors in the successful control of tuberculosis. Public Health Rep 107, 626-636.

[83] Rubel A.J. and O'Nell C.W. (1978) Difficulties of presenting complaints to physicians: susto illness as an example. In Modern medicine and medical anthropology in the United States-Mexico border population, pp. 147-154 [B. Velimirovic, editor]. Washington, DC: Pan American Health Organization.

[84] Ryan K.J. and Ray C.G. (2004) Sherris Medical Microbiology.

[85] San Antonio-Gaddy M., Richardson-Moore A., Burstein G.R., Newman D.R., Branson B.M. and Birkhead G.S. (2006) Rapid HIV antibody testing in the New York State Anonymous HIV Counseling and Testing Program: experience from the field. J Acquir Immune Defic Syndr 43, 446-450.

[86] Schaible U.E., Collins H.L., Priem F. and Kaufmann S.H. (2002) Correction of the iron overload defect in beta-2-microglobulin knockout mice by lactoferrin abolishes their increased susceptibility to tuberculosis. J Exp Med 196, 1507-1513.

[87] Shinnick T.M., Lademarco M. and Ridderhof J.C. (2005) National Plan for Reliable Tuberculosis Laboratory Services Using a Systems Approach: Recommendations from CDC and the Association of Public Health Laboratories Task Force on Tuberculosis Laboratory Services. MMWR Morb Mortal Wkly Rep 541, 12.

[88] Slutkin G. (1986) Management of tuberculosis in urban homeless indigents. Public Health Rep 101, 481-485.

[89] Small P.M., McClenny N.B., Singh S.P., Schoolnik G.K., Tompkins L.S. and Mickelsen P.A. (1993) Molecular strain typing of Mycobacterium tuberculosis to confirm cross-contamination in the mycobacteriology laboratory and modification of procedures to minimize occurrence of false-positive cultures. J Clin Microbiol 31, 1677-1682.

[90] Styblo K. (1989) Overview and epidemiologic assessment of the current global tuberculosis situation with an emphasis on control in developing countries. Rev Infect Dis 11 Suppl 2, S339-346.

[91] Sudre N., ten Dam G. and Kochi A. (1991) Tuberculosis in the present time: a global overview of the tuberculosis situation. Geneva: World Health Organization.

[92] Tsuyuguchi K., Suzuki K., Matsumoto H., Tanaka E., Amitani R. and Kuze F. (2001) Effect of oestrogen on Mycobacterium avium complex pulmonary infection in mice. Clin Exp Immunol 123, 428-434.

[93] Tuberculosis Research Centre M., and National Tuberculosis Institute, Bangalore (1984) A controlled clinical trial of 3- and 5-month regimes in the treatment of sputum positive pulmonary tuberculosis. Ann Rev Respir Dis 130, 1091-1094.

[94] Van Deun A., Kim S.J. and Rieder H.L. (2005) Will the bleach method keep its promise in sputum smear microscopy? Int J Tuberc Lung Dis 9, 700; author reply 700-701.

[95] Van Deun A. and Portaels F. (1998) Limitations and requirements for quality control of sputum smear microscopy for acid-fast bacilli. Int J Tuberc Lung Dis 2, 756-765.

[96] Vidal S.M., Malo D., Vogan K., Skamene E. and Gros P. (1993) Natural resistance to infection with intracellular parasites: isolation of a candidate for Bcg. Cell 73, 469-485.

[97] Weiss M.G., Sommerfeld J. and Uplekar M.W. (2008) Social and cultural dimensions of gender and tuberculosis. Int J Tuberc Lung Dis 12, 829-830.

[98] WHO (1998a) Laboratory services in TB control, Part I: Organization and management. Geneva: World Health Organization.

[99] WHO (1998b) Laboratory services in TB control, Part II: Microscopy. Geneva: World Health Organization.

[100] WHO (1998c) Laboratory services in TB control. Part III: Culture. Geneva: World Health Organization.

[101] WHO (1998d) Laboratory services in tuberculosis control; part I: organization and management. Geneva.

[102] WHO (2004) The WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Anti-tuberculosis drug resistance in the world. Geneva: WHO.

[103] WHO (2005) Global Tuberculosis Control Report: World Health Organization.

[104] WHO (2006) The Stop TB Strategy. Geneva.

[105] WHO (2007) Use of Liquid TB Culture and Drug Susceptibility Testing in Low- and Medium-income Settings: World Health Organization.

[106] WHO (2008a) Policy Guidance on Drug Susceptibility Testing (DST) of Second-line Anti-Tuberculosis Drugs. Geneva: World Health Organization.

[107] WHO (2008b) Policy Statement. Molecular Line Probe Assay for Rapid Screening of Patients at Risk of Multidrug-resistant (MDR) TB. Geneva: World Health Organization.

[108] WHO (2010a) Policy Statement on Fluorescent Light Emitting Diode Microscopy for Diagnosis of Tuberculosis: World Health Organization.

[109] WHO (2010b) Policy Statement on Non-commercial Culture and DST Methods for rapid screening of Patients at Risk of Multidrug-resistant Tuberculosis. Geneva: World Health Organization.

[110] WHO (2011a) Intensifying TB case detection in Ghana.

[111] WHO (2011b) Policy Statement Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system Geneva: World Health Organization.

[112] Wolfart W. (1990) Surgical treatment of tuberculosis and its modifications—collapse therapy and resection treatment and their present-day sequelae. OffentlGesundheitswes 52, 506–511.

[113] Yamamoto Y., Saito H., Setogawa T. and Tomioka H. (1991) Sex differences in host resistance to Mycobacterium marinum infection in mice. Infect Immun 59, 4089-4096.

[114] Yamamoto Y., Tomioka H., Sato K., Saito H., Yamada Y. and Setogawa T. (1990) Sex differences in the susceptibility of mice to infection induced by Mycobacterium intracellulare. Am Rev Respir Dis 142, 430-433.

[115] Young J.C. and Garro L.Y. (1982) Variation in the choice of treatment in two Mexican communities. Soc Sci Med 16, 1453-1465.

[116] Zimmermann M.B. and Hurrell R.F. (2007) Nutritional iron deficiency. Lancet 370, 511-520.

[117] Zink A.R., Sola C., Reischl U., Grabner W., Rastogi N., Wolf H. and Nerlich A.G. (2003) Characterization of Mycobacterium tuberculosis complex DNAs from Egyptian mummies by spoligotyping. J Clin Microbiol 41, 359-367.

Abstract:

Purpose: The study examines the level of satisfaction that staff of General Hospitals in Nigeria hope to derive from the introduction and implementation of ‘New Ways of Working’ in General Hospitals in Nigeria.

Methodology: The study was conducted in a typical General Hospital in Nigeria. Satisfaction level to the introduction and implementation of New Ways of Working was assessed by self-administered and pretested questionnaire. Descriptive statistics to explain the demography of the respondents were done; mean score and standard deviation values were used to examine the variables.

Findings: The average mean score of the satisfaction level to the components of new ways of information if introduced was (3.52 ± 1.54). Respondents showed highest level of satisfaction to the component afford them a free hand to make impactful decisions on their work schedule (2.20 ± 1.18), and least level of satisfaction when they are provided with means of deriving more information about their work when they are provided with information technology within the hospital premises (4.95 ± 1.85).

Research Limitations: More General Hospitals should be involved in new studies for more generalizability.

Practical implications: Staff believe they will derive some satisfaction with the introduction of ‘New Ways of Working’.

Social implications: Staff satisfaction to the implementation of ‘New Ways of Working’ will allow patients to access care with flexibility.

Value of the Paper: The study is promoting the introduction of ‘New Ways of Working’, to afford staff and patients more flexibility.

Keywords: Satisfaction, Staff, New Ways of Working, General Hospitals.

References:

[1.]   Al-Tawfiq JA, Memish ZA: What are our pharmacotherapeutic options for MERS-CoV?. Expert Rev Clin Pharmacol. 2014, 7: 235-238. 10.1586/17512433.2014.890515.

[2.]   Baane, R. H., Houtkamp, p., Knotter, M., (2010). Het nieuwewerkenontrafeld [New ways of working figured out]. Assen: Koninklijke Van Gorcum.

[3.]   Baruch, Y. (2001). The status of research on teleworking and an agenda for future. International Journal of Management Reviews, 3(2), 113–129.

[4.]   Bass, B., Avolio, B., & Atwater, L. (1996). The transformational and transactional leadership of men and women. Applied Psychology, 45(1), 5–34.

[5.]   Bass, B., Avolio, B., Jung, D. I., & Berson, Y. (2003). Predicting unit performance by assessing transformational and transactional leadership. Journal of Applied Psychology, 88(2), 207.

[6.]   Berlowitz, D. R., Young, G. J., Hickey, E. C., Saliba, D. Mittman, B. S., Czarnowski, E., Simon, B., Anderson, J. J., Ash, A. S., Rubenstein, L. V., and Moskowitz, M. A. (2003), Quality improvement implementation in the nursing home, Health Services Research 38, Part 1, 65-80.

[7.]   Bijl, D., & Gray, M. (2011). Journey Towards the New Way of Working: Creating Sustainable Performance and Joy at Work. Par CC.

[8.]   Bijl, D., (2007). Het nieuwewerken: Op wegnaareenproductievekenniseconomie [New Ways of working: heading for a productive knowledge economy]. Den Haag: Sdu Publishers bv.

[9.]   Bijl, D., (2009). Aan de slag met het nieuwewerken [Let’s get to the new ways of working]. Zeewolde: Par CC.

[10.]      Blok, M., Groenesteijn, L., Berg, C. Van Den, & Vink, P. (2011). New Ways of Working: A Proposed Framework and Literature Review. Ergonomics and Health Aspects of Work with Computers, 3–12.

[11.]      Blok, M. M., Groenesteijn, L., Schelvis, R., & Vink, P. (2012). New ways of working: does flexibility in time and location of work change work behavior and affect business outcomes? Work: A Journal of Prevention, Assessment and Rehabilitation, 41, 5075-5080.

[12.]      Bryman, A., & Bell, E. (2011). Business Research Methods (3rd edition). New York: Oxford University Press Inc.

[13.]      Cameron, K. S., & Quinn, R. E., (2008). Onderzoekenenveranderen van organisatiecultuur [Researching and changing organizational culture]. Den Haag: Sdu Publishers bv.

[14.]      Cronbach L.J., (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297-334.

[15.]      De Leede, J., & Kraijenbrink, J. (2014). The Mediating Role of Trust and Social Cohesion in the Effects of New Ways of Working: A Dutch Case Study. Human Resource Management, Social Innovation and Technology (Advanced Series in Management, Volume 14). England. Emerald Group Publishing Limited, 14, 3-20.

[16.]      Doherty, S., Andrey, J., & Johnson, L. (2000). The economic and social impacts of telework. In Telework: The New Workplace of the 21st Century Symposium, New Orleans.

[17.]      Dooley, D. (2009). Social research methods (4th edition). Harlow: Pearson Education Limited.

[18.]      Egmond van, H., (2010). Het nieuwewerken: Van visienaarpraktijk [New ways of working: From vision to practice]. Alphen aan den Rijn: Kluwer.

[19.]      Gates, B. (2005). Digital Workstyle: The New World of Work A Microsoft White Paper.

[20.]      Gautret P, Benkouiten S, Salaheddine I, Belhouchat K, Drali T, & Parola P., (2013). Hajj pilgrims knowledge about Middle East respiratory syndrome coronavirus, August to September 2013. Euro Surveill. 2013, 18: 20604.

[21.]      Haterd van de, B., (2010). Werkennieuwestijl [Working on a new style]. Amersfoort: A.W. Bruna Publishers B.V.

[22.]      Keuning, D., (2007). Structuurdoorzien [Structure seen]. Groningen: Wolters Noordhoff.

[23.]      Kok, A. de, Koops, J., and Helms, R. W. (2014), Assessing the new way of working: bricks, bytes and behaviour. Pacis 2014 Proceedings. Paper 7. http://aisel.aisnet.org/pacis2014/

[24.]      Kuipers, H., Amelsvoort, P., & Kramer, E.H., (2010). Het nieuweorganisatie: Alternatieven voor de bureaucratie [New ways of organizing: Alternatives for bureaucracy]. Leuven: Acco.

[25.]      Memish ZA, Al-Tawfiq JA, Makhdoom HQ, Al-Rabeeah AA, Assiri A, Alhakeem RF, Alrabiah FA, Alhajjar S, Albarrak A, Flemban H, Balkhy H, Barry M, Alhassan S, Alsubaie S, & Zumla A., (2014). Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study. ClinMicrobiol Infect. 2014, 20: 469-474. 10.1111/1469-0691.12562.

[26.]      Newman, K., Maylor, U., & Chansarkar, B. (2001) "The nurse retention, quality of care and patient satisfaction chain", International Journal of Health Care Quality Assurance, Vol. 14 Iss: 2, pp.57 – 68. DOIhttp://dx.doi.org/10.1108/09526860110386500

[27.]      Nunnally, J. (1978). Psychometric theory (Second edition). New York: McGraw-Hill.

[28.]      Relf, M. (1995), Increasing job satisfaction and motivation while reducing nursing turnover through the implementation of shared governance, CriticalCare Nursing Quarterly 18, 3, 7-13.

[29.]      Saunders, M., Lewis, P., Thornhill, A., Booij, M., and Verckens, J. P., (2011). Methodenen technieken van onderzoek [Methods and techniques of research]. Amsterdam: Pearson Education Benelux.

[30.]      Slijkhuis, J. M. (2012). A Structured Approach to Need for Structure at Work. University Library Groningen.

[31.]      Stam, P., (2011). Het nieuwewerkenmeegewogen [New ways of working weighed in]. Utrecht: Utrecht University.

[32.]      Stoffers J., Kurstjens J., & Schrijver I.(2015). Leadership and New Ways of Working: A Case Study in a Financial Service Organisation. International Journal of Business and Economics Research. Vol. 4, No. 3, 2015, pp. 157-162. doi: 10.11648/j.ijber.20150403.18

[33.]      Volberda, H., Jansen, J., Tempelaar, M., & Heij, K., (2011). Monitoren van sociale innovatie: Slimmer werken, dynamischmanagenen flexible organiseren: Monitoring social innovation: working smarter, dynamic management and organising flexible. Magazine for HRM, 1, 85-110.

[34.]      Wensing, L., (2009). Technologie is enblijft de sleutel tot het nieuwewerken [Technology is and remains the key to New Ways of Working]. Retrieved from: http://hetnieuwewerkenblog.nl/technologie-sleutel-hetnieuwe- werken/

[35.]      WHO MERS-CoV Research Group, (2013). State of knowledge and data gaps of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in humans. PLoSCurr. 2013, 5

Abstract:

Introduction: Maternity services are an essential part in any and all communities. This includes care from a traditional birth attendants or a trained H W. This is aimed at improving the maternal health and reducing child mortality which in the long run will lead to development.

Problem statement: There has been a problem of overcrowding and poor quality of services already in public hospitals before the introduction of free maternity. This new change saw a rise in the number of women delivering in the hospital increase drastically causing a strain in the already tight situation. Many women hence prefer to deliver delivering in the hands of traditional birth attendants and only coming to the hospital if and when complications occur. This has led to the high mortality and maternal morbidity rates

Justification: Maternity is a crucial part in any and all societies in ensures continuity from generation to generation. It is important to ensure that all women of child bearing age can easily access the services from a skilled birth attendant.

Objectives: Broad: To assess the Uptake of free maternity services among women visiting Kisumu East District Hospital. Kisumu East District Hospital was selected for the research due to its convenience and proximity to the researcher. Descriptive study design was chosen that seeks to describe the pattern of a phenomena by person, place and time. Convenience sampling was used by drawing a representative data. People were selected because of the ease of their volunteering and units because of their availability of easy access.

Data collection: Data was collected by administration of questionnaires where key informants were interviewed. Analysis: SPSS version 20.0 used for data analysis.

Findings: Ninety four percent 94% of the respondents were aware of the free maternity services 93% of the women visited ANC clinic during their last pregnancy while only 7 % did not. A total of 76% of the respondents delivered at home while the rest 24% delivered in hospital. The most common reason for delivering at home among the women was accessibility to a health facility at 41%.

Conclusion: Most mothers were aware of the free maternity services available in Kenya hence attended attend ante-natal and post-natal clinics. Although they are aware of the services available, many of the mothers do not deliver in the hospital due to the low standards of the services caused by overcrowding, low stuffing and insufficient supply of medication.

Recommendation: Undertake a comprehensive maternal health education campaign which focuses on key causes of delay of treatment and seeks to promote gender equality in health decision-making to allocate more funds to the free maternity services implementation to improve its implementation and improve the quality of services provided in the health facilities.

Keywords: Free maternity services, maternal morbidity and mortality rates, Antenatal care and maternal deaths

References:

[1.]   Bourbonnaise, N (2013) Implementing Free Maternity Health Care in Kenya. Enhancing the Realisation of Your Rights, pp. 1-14.

[2.]   Bournnais, N (2013) Impementing free maternal health care in Kenya. KNCHR.

[3.]   Fisher A.A (1998) Handbook for family planning. Operation research design in Sampling, 40-45.

[4.]   Gathigah, M (2015) Inter Press Services. Kenya's mothers shun free maternity health care.

[5.]   Griffin s and Stevenson (2001), Utilization of Maternal Healthcare Services in India, Understanding regional differences. University of Maryland, USA

[6.]   Gyawali, K (2013) Knowledge and Practices on maternal health care among mothers. Journal of The Scientific Society, 9-13.

[7.]   HERAF (2013) policy Changes To benefit women. Ministry of Health implements free maternity services nationwide.

[8.]   Ingati, S. (2013) Kenya's free maternity services popular, but challenges remain.

[9.]   Kitui, J (2013) Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey. BMC Pregnancy Childbirth, pp. 13-40.

[10.]   Rowdon, C (2014) Respectful Maternity Care. Healthy Mothers Healthy World, pp. 12-20.

[11.]   Government Of Kenya (2010) The Constitution of Kenya. National Council for law.

[12.]   WHO (2014) Maternal Mortality in 2014. Maternal Mortality Ratios and Rates., 20-32.

[13.]   Ouma (2010) Antenatal and Delivery Care in Rural Western Kenya: The Effect of
Training Health Care Workers to Provide "Focused Antenatal Care”. MOH Kenya

[14.]   UNICEF (2008) Countdown to 2015: Tracking Progress in Maternal, Newborn and
Child Survival: Report; New York: UNICEF.

[15.]   Yashide Nakamara (2010) Maternal and Child Health Handbook in Japan. Osaka University. JMAJ 53(4)

[16.]   Bosire Boniface (2013) Kenyan Hospital Slow to Comply with Waived Maternity Fee Directive “http:sabahionline.com

Abstract:

Objective - To determine the public awareness of the National Health Insurance Scheme (NHIS) among patients accessing health care in Supreme Faith Hospital, Ado-Ekiti, Nigeria.

Study design and Setting - A cross-sectional study design that made use of quantitative survey method involving data collection and analysis.

Participants - 120 voluntary adults who access health care services at Supreme Faith Hospital, Ado-Ekiti, Nigeria.

Method - A semi-structured questionnaire was administered to participants who also consented to the survey. A cross-sectional study was deemed fit for this research because it enables any desired data to be collected at one point in time.

Results – The study revealed that a greater number of respondents i.e. 82 (68.3%) were aware of the existence of the National Health Insurance Scheme (NHIS) but only 38(31.7%) were enrolees in a hospital setting which is accredited to providing health care services under NHIS. There were more females (64.2%) than males (35.8%) among the respondents. A greater number of respondents were educated; Secondary (36.7%) and Tertiary education (48.3%), while Primary education (8.0%) and none/others (10.0%) were much lesser. There was weak statistical significant finding between education and awareness of NHIS (p=0.045).

Conclusions – The awareness of NHIS was high among patients who were accessing health care services in an accredited facility in Nigeria. However, the number of enrolees among them was much lesser than expected. It is recommended that effort should be geared towards improving the rate of enrolment process, especially in the face of the heavy burden of out-of-payment expenditure in health care.

Keywords: Enrolee, Healthcare, Health insurance, Nigeria, Out-of-pocket payment, Services.

References:

[1.]   Araoye, M. (2003) Research Methodology with statistics for Health and Social Sciences. Ilorin: Nathadex publishers.

[2.]   Awosika, L. (2005) Health Insurance and Managed care in Nigeria, [Online]. Available from: http://indexmedicus.afro.who.int/iah/fulltext/health%20insurance.pdf (Accessed: 8 April 2014).

[3.]   Ghana National Health Insurance Scheme (2010) National Health Insurance Scheme (NHIS) joint learning network, [Online]. Available at:

http://jointlearningnetwork.org/content/national-health-insurance (Accessed: 30 March 2014).

[4.]   National Health Insurance Scheme (2014) NHIS guidelines and benefit package, [Online]. Available at: http://nhis.gov.ng (Accessed: 1 April 2014).

[5.]   Omosehin, O., Odeyemi, K. A., Onajole, A. T. and Ogunnowo, B. E. (2006) Awareness and acceptance of the National Health Insurance Scheme among Health care providers in Urban local governments in Lagos State, Journal of Clinical Sciences,vol.6,No.1

[6.]   Pacific Prime (2014) Liberia Health Insurance, [Online]. Available at:

http://www.pacificprime.com/country/africa/liberia-health-insurance-pacific-prime-international/ (Accessed: 30 March 2014).

[7.]   Sabouhi, F., Babaee, S., Naji, H., and Zadeh, H. (2011) Knowledge, awareness, attitudes and practice about hypertension in hypertensive patients referring to public health care centers in Khoor & Biabanak , Iran J Nurs Midwifery Res. 2011 Winter; 16(1): 34–40. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203297/ (Accessed: 13 April 2014).

[8.]   Sanusi, R. A. and Awe, A. T. (2009) Perception of National Health Insurance Scheme (NHIS) by Health care consumers in Oyo State, Nigeria, Pakistan Journal of Social Sciences, Vol.6,issue1,pp48-53.

[9.]   Spaan, E., Mathijssen, J., Tromp, N., McBain, F., Have, A., and Baltussen (2012) the impact of health insurance in Africa and Asia: a systematic review. Bulletin of the World Health Organisation 2012; 90:685-692.doi:10,2471/BLT.12.102301.

[10.]      Texila American University (2014) Lecture notes on Health Economics. Online; Available at: Texila American University Online Education LMS (Accessed: 24 February 2014).

[11.]      World Health Organisation (2010) World health report 2010, Health systems financing the path to universal coverage. Geneva: WHO.

Abstract:

A retrospective study aimed at ascertaining the prevalence of Pulmonary TB amongst patients visiting Eastern Nigeria Medical Centre, Enugu State was conducted between September, 2015 and November, 2015. Sputum samples were obtained from one hundred and twenty patients. Samples were smeared on glass slides, stained using Ziehl Neelsen Stain and observed under light (oil immersion) microscopy. Data obtained were analysed using SPSS Statistic Base 17.0, where descriptive analyses such as sum, percent distribution, and mean, were computed. While Chi- Squared Goodness of Fit, degree of differences, p- value in order to statistically determine if any significance between variables such as age groups, sex of subjects, AFB positivity and prevalence existed. The results showed positive results for tuberculosis with prevalence of 42 (35%) out of 120 subjects. The age group 21-30 years had the highest prevalence of 18 (43%) out of 42 of PTB positive subjects. There was no significant difference between sex of subjects with PTB positivity (X²: 1.33 at P= 0.12). There was significant difference between age groups of subjects with PTB positivity (X²: 33.18 at P= 0.01). It is observed that PTB is still a serious health burden in this part of the world, thus, there is need for improved TB awareness, treatment and control programme.

Keywords: Tuberculosis (TB), Pulmonary, Ziehl Neelsen.

References:

[1.]   Alan, R.L., Dzung, T., Ann, O.F., Wendy, A.M., and Kaying, H. (2002). Prevalence of Tuberculosis, Hepatitis B virus and Intestinal Parasitic infections among refugees to Minnesota, Public Health reports, 117:69-77.

[2.]   Centers for Disease Control and Prevention (2015). TB Basic facts. CDC/TB/Basic TB Facts. Available on line at http://www.cdc.gov/tb/topic/basics/default.htm

[3.]   Centers for Disease Control and Prevention (2014). TB Basic facts. CDC/TB/Basic TB Facts/Risk Factors. Available on line at http://www.cdc.gov/tb/topic/basics/risk.htm

[4.]   Corbett, E.L, Marston, B., Churchyard, G.J and De Cock, K.M. (2006), Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet 2006; 367:926.

[5.]   deJong, B.C, Antonio, M. and Gagneux, S. (2010). Mycobacterium africa num: review of an important cause of human tuberculosis in West Africa. PLoSNegl Trop Dis 2010; 4:e744.

[6.]   D’souza, D.T., Mistry, N.F., Vira, T.S., Dholakia, Y., Hoffner, S., Pasvol, G., Nicol. M. and Wilkinson, R.J (2009): High levels of multidrug resistant tuberculosis in new and treatment-failure patients from the Revised National Tuberculosis Control Programme in an urban metropolis (Mumbai) in Western India. BMC Publ Health., 9: 211-10.1186/1471-2458-9-211.

[7.]   Gupta, S., Shenoy, V.P., Mukhopadhyay, C., Bairy, I. and Muralidharan, S. (2011): Role of risk factors and socio-economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India. Trop MedInt Health., 16 (1): 74-78. 10.1111/j.1365-3156.2010.02676.

[8.]   Jain, N.K., Chopra, K.K., Prasad, G., (1992): Initial and acquired isoniazid and rifampicin resistance to Mycobacterium tuberculosis and its implication for treatment. Indian J Tuberc. 39: 12-14.

[9.]   Khan, Q.H. (2006): Epidemiology of pulmonary tuberculosis in rural Aligarh. Indian J Community Med. (1): 39-40. 10.4103/0970-0218.54938.

[10.]      Rüsch-Gerdes, S., Pfyffer, G.E., Casal, M., Chadwick, M. and Siddiqi, S. (2006): Multicenter Laboratory validation of the BACTEC MGIT 960 technique for testing susceptibilities of mycobacterium tuberculosis to classical second-line drugs and newer antimicrobials. J Clin Microbiol. 44 (3): 688-692. 10.1128/JCM.44.3.688-692.2006.

[11.]      Sharma, S.K., Kaushik, G., Jha, B., George, N., Arora, S.K., Gupta, D., Singh, U., Hanif, M. and Vashisht, R.P. (2011): Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis. Indian J Med Res, 133: 308-311.

[12.]      Sharma, S.K., Kaushik, G., Jha, B., George, N., Arora, S.K., Gupta, D., Singh, U., Hanif, M. and Vashisht, R.P. (2011):Prevalence of multidrug-resistant tuberculosis among Category II pulmonary tuberculosis patients. Indian J Med Res, 133: 312-315.

[13.]      Shetty, N., Shemko, M., Vaz, M. and D’souza G (2006): An epidemiological evaluation of risk factors for tuberculosis in south India: a matched case control study. Int J Tuberc Lung Dis., 10 (1): 80-86.

[14.]      Taura, D.W., Sale, I.T and Mohammed, Y. (2008). The prevalence of Tuberculosis In patients attending the Infectious Disease Hospital, Kano, Nigeria. Int. Jor. P. App. Scs., 2(3): 63-69.

[15.]      USAID Health: Infectious Diseases, Tuberculosis, Countries, Sudan. Available on line at: http://www.usaid.gov/our_work/global_health/id/tuberculosis/countries/africa/ssudan_profile.html

[16.]      Vestal, A.L. (1997): Procedures for isolation and identification of Mycobacteria, CDC Atlanta, Georgia: U.S. Department of Health, Education and Welfare, Publication No CDC-77-8230, 15-19.

[17.]      Vijay, S., Bala Sangameshwara, V.J., Jagannatha, P.S. and Kumar, P. (2004): Initial drug resistance among tuberculosis patients under DOTS Programme in Bangalore City. Indian J Tuberc., 51: 17-21.

[18.]      World Health Organization (2006): Emergence of XDR-TB. WHO concern over extensive drug resistant TB strains that are virtually untreatable.

http://www.who.int/mediacentre/news/notes/2006/np23/en/index.html. Accessed 17 January 2012

[19.]      World Health Organization (2000): Tropical Diseases Research; World Health Organization, Geneva, Switzerland.

[20.]      World Health Organization (2008): TB and Children in: Communicable disease: tuberculosis fact sheet. Geneva, Switzerland.

[21.]      World Health Organization (2010): Multidrug and extensively drug-resistant TB (M/XDR-TB):, Available:http://whqlibdoc.who.int/publications/2010/9789241599191_eng.pdf. Accessed 26 March, 2013, global report on surveillance and response.

[22.]      World Health Organization (2011): Global Tuberculosis Control: WHO report, Available: http://www.who.int/tb/publications/global_report/gtbr11_full.pdf. Accessed 26 March, 2013

[23.]      World Health Organization (2012): Tropical Diseases Research; World Health Organization report, Africa.

[24.]      World Tuberculosis Day (2008). Country 3rd in Global TB Prevalence. Daily Trust (Abuja), 21 March 2008.

Abstract:

Sexually Transmitted Infections have a very serious impact on sexual and reproductive health worldwide and they rank among the top five disease categories for which young adults seek healthcare. Therefore this study assessed the health seeking behavior of undergraduate students of Tai Solarin University of Education (TASUED) towards STIs.

The study was a descriptive cross-sectional survey that applied both qualitative (focus group discussion) and quantitative methods (questionnaire) of data collection. Four hundred and thirty-one respondents participated in the study. Data was analyzed using SPSS version 21 to generate descriptive (frequency tables and charts) and inferential statistics (correlation).

Results showed that majority (74.2%) of the respondents have heard of STIs; HIV (80%) was the most commonly known, and Trichomoniasis (128; 29.7%) as least. The major source of information was television (350;81.2%); most preferred treatment source was private hospitals (205; 47.6%). Self -preference, inconvenience as a result of symptoms and knowledge of a place to get treatment were the best motivators of seeking treatment. Perceived risk of ill-health was high at 19.25 on a 28 point scale. There was a positive significant relationship between treatment options and perceived risk of ill-health (r =.318, p < .01).

Respondents had a fair health seeking behavior towards STIs, but misconceptions still exist. More synchronized actions need to be made by schools, the government, NGOs, the media and other stakeholders to enhance young people’s health seeking behavior towards STIs.

Keywords: Health seeking behavior, STIs, Youths, Ill-health, Source of care, Students

References:

[1.]   Abramson J. H., Gahlinger P. M. Computer programs for epidemiologists. Journal of Epidemiology & Community Health, 56(12):959–960. doi: 10.1136/jech.56.12.959-c.

[2.]   Adedimeji, A. A. (2005). Beyond knowledge and behavior change: The social-structural context of HIV/AIDS risk perceptions and protective behaviour among young urban slum inhabitants in Nigeria. Takemi Program in International Health 2004-2005. Pp: 1-39

[3.]   Adedimeji, A. A., Omololu, F. O., & Odutolu, O. (2007). HIV risk perception and constraints to protective behaviour among young slum dwellers in Ibadan, Nigeria. Journal of health, population, and nutrition 25(2), 146.

[4.]   Aliyu, A. A., Dahiru, T., Ladan, A. M., Shehu, A. U., Abubakar, A. A., Oyefabi, A. M.,&

[5.]   Amu, E. O., & Adegun, P.T. (2015). Awareness and Knowledge of Sexually Transmitted Infections among Secondary School Adolescents in Ado Ekiti, South Western Nigeria. Journal of Sexually Transmitted Diseases, 2015. doi.org/10.1155/2015/260126

[6.]   Dehne, K., & Riedner, G. (2005). Sexually Transmitted Infections among adolescents: The need for adequate health services.

[7.]   Ekeanyanwu, C. R. (2011). Traditional medicine in Nigeria: Current Status and the future. Research Journal of Pharmacology 5, 6: 90-94.

[8.]   Isiaka-Lawal, S. A., Nwabuisi, C., Fakeye, O., Saidu R., Adesina, K. T., Ijaiya, M. A., Jimoh, A. A., Omokanye, L. O. (2014) Pattern of sexually transmitted infections in human immunodeficiency virus positive women attending antenatal clinics in north-central Nigeria. Sahel Medical Journal, 17:145-50. DOI: 10.4103/1118-8561.146820

[9.]   Kadiri, k. k., Ahmad, M. K., & Mustaffa, C. S. (2014). Knowledge and treatment seeking behaviour of University of Ilorin students in Kwara State, Nigeria. New Media and communication, 27, 1-8

[10.]   Mmari, K. N., Oseni, O., Fatusi, A. O. (2010). STI treatment-seeking behaviours among youth in Nigeria: are there gender differences? International Perspectives on Sexual and Reproductive Health. Doi: 10.1363/ipsrh.36.072.10

[11.]   Okereke C.I. (2010). Unmet Reproductive Health Needs and Health-Seeking Behaviour of Adolescents in Owerri. Nigeria African Journal of Reproductive Health, 14(1):43-54.

[12.]   Oladepo, O. & Fayemi, M. M. (2011). Perceptions about sexual abstinence and knowledge of HIV/AIDS prevention among in-school adolescents in a western Nigerian city. BMC public health, 11, 304. DOI:10.1186/1471-2458-11-304

[13.]   Olakolu, S. S., Abioye-Kuteyi, E. A., & Oyegbade, O. O. (2011). Sexually transmitted infections among patients attending the General Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria. South African Family Practice, 53(1), 63-7

[14.]   Otwombe, K., Dietrich J., Laher F., Hornschuh S., Nkala B., Chimoyi L., Kaida A., Gray G.,& Miller C. (2015). Health-seeking behaviours by gender among adolescents in Soweto, South Africa. Global Health Action 2015, 8, 25670.doi.org/10.3402/gha.v8.25670

[15.]   Oyewole, I.O., Anyasor, G.N., & Michael-Chikezie. E.C. (2010). Prevalence of STI Pathogens in HIV- Infected and Non-Infected Women: Implications for Acquisition and Transmission of HIV in Nigeria. Asian Journal of Medical Sciences 2(3): 163-166.

[16.]   Samkange-Zeeb, F. N., Spallek, L., & Zeeb, H. (2011). Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC Public Health, 11, 727. doi: 10.1186/1471-2458-11-727

[17.]   Shittu, L.A.J., Zechariah, M.P., Ajayi, G., Oguntola, J.A., Izegbu, M.C. and Ashiru, O.A. (2007) The Negative Impacts of Adolescent Sexuality Problems among Secondary School Students in Oworonshoki Lagos. Scientific Research and Essays, 2, 23-28

[18.]   Tengia-Kessy, A., & Kamugisha, H. (2006). Levels of knowledge and sources of information on sexually transmitted infections among secondary school youth in Dar es Salaam, Tanzania. East African Journal of Public Health, 3 (2), 19-22

[19.]   World Health Organization Media Centre, Sexually Transmitted Infections, 2015

[20.]   World Health Organization. Sexually transmitted infections (STIs): the importance of a renewed commitment to STI prevention and control in achieving global sexual and reproductive health. Geneva: WHO; 2013.

[21.]   World Health Organization Media Centre, Sexually Transmitted Infections, 2013. Fact sheet N°110

[22.]   Yahaya, S. S. (2013). Knowledge, Sources of information, and Risk Factors for Sexually Transmitted Infections among Secondary School Youth in Zaria, Northern Nigeria. Journal of Medicine in the Tropics. 15 (2), 102.DOI: 10.4103/2276-7096.123582