Abstract:

Prevention of mother to child transmission of HIV (PMTCT) programme in Nigeria started in July 2002 with the goals of providing effective PMTCT services for women in the reproductive age group in selected health facilities while providing useful information for policy formulation and decision on intervention for comprehensive PMTCT in Nigeria. However, most of the health workers documenting the PMTCT programmes in the health facility lack the required skills and capacity in offering PMTCT services and effecting efficient documentation of programme activities. Information on the knowledge and practice of PMTCT documentation among health workers in Oyo State was obtained through administration of close-ended questionnaires to the respondents in 113 health facilities. The study concluded that most of the health workers have good knowledge of PMTCT documentation with those working in the public facility having better understanding than those in the private facility. In addition, most of the respondents lack proper understanding of PMTCT HIV testing algorithms. However, private facility will benefit tremendously from further training on documentation and serial HIV testing.

Keywords: HIV; PMTCT; Nigeria; Knowledge; Practice; Health workers; Public; Private; Facility

References:

[1] Adewole, I, Oluwole, O & Sagay, A. (2006). Prevention of Mother-to-Child transmission of HIV: The Nigerian PMTCT Programme. AIDS in Nigeria, 1(1), 349-84.

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http://www.avert.org/preventing-mother-child-transmission-hiv.htm.

[4] Balogun, M & Odeyemi, K. (2010). Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria. Pan Afr Med J, 5(1), 7.

[5] Coetzee D, Hilderbrand K, Boulle A, Draper B, Abdullah F and Goemaere, E. (2005). Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa. Bull World Health Organ, 83(7), 489-94.

[6] Dabis, F, Leroy, V & Castebonk, E. (2000). Prevention of Mother to Child Transmission of HIV-1 in Africa. AIDS, 14(1), 1017–1026.

[7] De cock, K. M., Fowler, M. K., Mercier, E., De Vincenzi, I., Saba, J., Hoff, E., Alnwick, D. J., Rogers, M., and Shaffer, N. (2000). Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA, 283(1), 1175–1182.

[8] Federal Ministry of Health. (2008). Technical Report on the National HIV/Syphilis Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria. NASCP Abuja: Nigeria.

[9] Joint United Nations Programme on HIV/AIDS (UNAIDS). (2011). Countdown Zero. UNAIDS. Geneva.

[10] Jurgens, R, Cohen, J & Beyrer, C. (2007). Increasing access to HIV testing and counselling while respecting human rights. HIV AIDS Policy Law Rev, 12(2-3), 63-6.

[11] Mirkuzie, A. H. (2008). Utilization of PMTCT services in Awassa town Ethiopia. Center for Internal Health, Faculty of Medicine and Dentistry, University of Bergen, Norway.

[12] National AIDS/STIs Control Programme Federal Ministry of Health. (2014). Integrated National Guidelines for HIV Prevention, Treatment and Care.

[13] Olaniyan, F.A. (2013). Spatial Inequalities in the Provision of Private Health Facilities in Oyo State. Indonesian Journal of Geography, 45(1).

[14] Owoaje, E, Omidokun, A & Ige, O. (2012). Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria. Afr J Prim Health Care Fam Med, 4(1), 32.

[15] Schmidt, C. O & Kohlmann, T. (2008). When to use the odds ratio or the relative risk? International Journal of Public Health, 53(3), 165-167.

[16] Swamy, M. (2007). UN agencies issue new guidelines for HIV testing. HIV AIDS Policy Law Rev, 12(2-3), 39-40.

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http://data.unaids.org/pub/Report/2010/nigeria_country_progress_report_en.pdf.

[18] World Health Organization. (2007). Guidance on provider-initiated HIV testing and counseling in health facilities.

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Abstract:

Introduction: Asylum seekers and refugees are identified as those who did not make voluntary choice to leave their origin country and cannot return home safely. Internally displaced persons and refuges are extremely vulnerable to human rights abuses, especially the absence and denial of mental and physical health care. For more than 50years, the fundamental framework of refugee protection has been established and accepted globally. The lack of respect to human rights of refugees and failure to provide adequate humanitarian help such as health care. The Geneva Conventions, the Universal Declarations of Human Rights, Statute of the office of the United nations High Commissioner for Refugees, and the Convention Relating to the Status of Stateless Persons, all establish international standards for private and governments organizations that set guidelines for assimilation and repatriation of refugees that create international standards.

Methods: The study was conducted through a systematic literature review of articles dating between 2001 and 2015 on Embase, PsychInfo, Medline and Cochrane Controlled Trials, UNHCR, IOM and World Health Organization databases. The study decided on the articles to review by reading abstracts to determine inclusion of data about the health status of either the internally displaced person or the refugees. The abstracts were selected randomly and independently. A limited random search of the reference lists of all included studies was also undertaken. And also few English language studies of evaluated primary health care models of care for refugees in developed countries of resettlement were included.

Results: The internally displaced people’s and refugees are extremely vulnerable to human rights abuses From the research, it is clear that across the globe, access of primary healthcare amongst the refugees is overwhelmingly shaped by the regulations of the migration process and legal frameworks of individual states and nations. The study discusses that there is a primary need for advanced communication with refugees and coordination of activities between agencies either public or private within and beyond the health care structure. The study seeks to unveil the channels that create the neglect of refugees’ right to a chance of survival. The study recommends that improved data are imperative towards supporting inter-sectorial work in addressing health care needs of refugees.

Keywords: Refugee health, public health, migration health, healthcare, global

References:

[1]. Akresh, I. R., & Frank, R. (2008). Health selection among new immigrants. American Journal of Public Health, 98(1), 2058-2064.

[2]. Bergen, D. D., Heredia, M. A., & Schouler-Ocak, M. (2014). Suicidal behavior of immigrants and ethnic minorities in Europe.

[3]. Bowers EJ, Cheng I-H: Meeting the primary health care needs of refugees and asylum seekers. Primary Health Care Research and Information Service: Research Roundup. 2010, 16.

[4]. Clark RC, Mytton J. Estimating infectious disease in UK asylum seekers and refugees: a systematic review of prevalence studies. Journal of Public Health 2007 Dec;29(4):420-428 (open access)

[5]. Department of Immigration and Border Protection: Fact sheet 60 - Australia’s refugee and humanitarian program. 2010, Canberra: Australian Government, Department of Immigration and Border Protection Harris MF, Telfer BL: The health needs of asylum seekers living in the community. Med J Aust. 2001, 175: 589-593.

[6]. Evans, J. (1987). Introduction: migration and health. International Migration Review, 21(3), v-xiv.

[7]. Feldman R: Primary health care for refugees and asylum seekers: a review of the literature and a framework for services. Public Health. 2006, 120

[8]. Furman, R., In Epps, D., & In Lamphear, G. (2016). Detaining the immigrant other: Global and transnational issues.

[9]. Fazel M., Reed R., Panter-Brick C., Stein A., Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors The Lancet 2011 379(9812):266-282.

[10]. Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 2005 Apr 9-15;365(9467):1309-1314

[11]. Filges T., Montgomery E., Kastrup M., Klint Jørgensen A.M. The impact of detention on the health of asylum seekers: A systematic review Campbell Collaboration Library 2015-09-01 Volume 11, number 13.

[12]. Gagnon AJ, Merry L. and Robinson C. (2002). A systematic review of refugee women’s reproductive health. Refuge: Canada’s Journal on Refugees 2002; 21(1):6-17

[13]. Gebreiyosus, Y. (2014). Women in African Refugee Camps. Hamburg: DiplomicaVerlag.

[14]. Harris MF, Harris E, Roland M: Access to primary health care: three challenges to equity. Aust J Prim Health. 2004, 10 (3): 21-29.

[15]. Hadgkiss EJ, Renzaho AMN. The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature. Australian Health Review 2014 May;38(2):142-159 (open access)

[16]. Hyman, I., & Jackson, B. (2010). The healthy immigrant effect: a temporary phenomenon. Health Policy Research Bulletin, 17, 17-21.

[17]. Janmyr, M. (2014). Protecting civilians in refugee camps: Unable and unwilling states, UNHCR and international responsibility. Leiden: Martinus Nijhoff Publishers.

[18]. Kemp, C., & Rasbridge, L. A. (2004). Refugee and immigrant health: A handbook for health professionals. New York: Cambridge University Press.

[19]. Le Feuvre P: How primary care services can incorporate refugee health care. Med ConflSurviv. 2001, 17: 131-136.

[20]. Muggah, E., Dahrouge, S., & Hogg, W. (2012). Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada. BMC Family Practice.

[21]. Nair, P. M., & Sen, S. (2007). Trafficking in women and children in India. New Delhi: Orient Longman.

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Abstract:

Bipolar disorder, also known as manic depressive illness, is a complex, chronic and severe mental health disorder that is characterized by episodes of mania, depression or a combination of both. The study seeks to examine the plethora of current and prevalent misconceptions perceived by members of the general population within the Caribbean country of Barbados. Different research methodologies were employed for the purpose of the study, including the conduction of the survey, which illustrates the general misconceptions, held by the Barbadian public, as well as interviews with local mental health professionals to discredit these misapprehensions. Four hundred people completed the survey. Results indicate that there is a percentage of the population which understood the disease, but which believes that effective knowledge dissemination was the key to the increase of awareness and the reduction of the misconceptions, as well as the fact that females were susceptible to the disorder, especially during the ages of 25-29.

Keywords: Bipolar Disorder, Misconceptions, Barbados

References:

[1] Almeida, Oswaldo P and Fenner, Stephen. Bipolar Disorder: Similarities and Differences Between Patients With Illness Onset Before and After 65 Years of Age in International Psychogeriatrics, Volume 14, Issue 3, pp. 311-322 (2002).

[2] American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders (1952)

[3] Bowden, Charles L. Bipolar Disorder and Work Loss (2005)

[4] Craddock, Nick and Jones, Ian. Genetics of Bipolar Disorder in J Med Genet, Issue 36, pp. 585-594 (1999)

[5] Ghaemi, S Nassir and Dally, Shannon. The Bipolar Spectrum: Conceptions and Misconceptions (2015)

[6] Gitlin, M. Treatment- resistant Bipolar Disorder in Molecular Psychiatry, Issue 11, pp. 227-240 (2006)

[7] Hlastala, Stephanie A, Frank, Ellen, Kowalski, Jeanne, Sherrill, Joel T, Tu, Xin M, Anderson, Barbara and Kupfer, David J. Stressful Life Events, Bipolar Disorder and the “Kindling Model” in Journal of Abnormal Psychology, Volume 109, Issue 4, pp. 777-786 (2000)

[8] Post, Robert M, Leverich, Gabriele S, Kupka, Ralph W, Keck Jr, Paul E, McElroy, Susan L, Altshuler, Lori L, Frye, Mark A, Luckenbaugh, David A, Rowe, Michael, Grunze, Heinz, Suppes, Trisha and Nolen, William A. Early Onset Bipolar Disorder and Treatment Delay are Risk Factors for Poor Outcome in Adulthood in The Journal of Clinical Psychiatry, Volume 71, Issue 7, pp. 864-872 (2010)

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[10] Shamsaei, Farshid, Kermanshahi, Sima Mohammed Khan, Vanaki, Zohreh and Holtforth, Martin Grosse. Family Care-giving in Bipolar Disorder: Experiences of Stigma in Iran J Psychiatry, Volume 8, Issue 4, pp.188-194 (2013)

[11] Vann, Madeline. Are People with Bipolar Disorder Dangerous? (2010)

Abstract:

Background: Individuals working in healthcare settings occasionally are at risk of infections as a result of exposure to certain diseases causing agents. However, in most developing countries attention on prevention is mainly focused on skilled healthcare workers (HCWs) with “neglect” of auxiliary health workers (AHWs) who may not be knowledgeable on job health hazard and carries high risk of exposure to infectious agents.

Objective: To assess knowledge of auxiliary healthcare workers on injection safety and biological waste handling as well as attitude towards post exposure prophylaxis in the event of any exposure.

Methods: A descriptive cross-sectional study conducted among AHWs on knowledge on injection safety and biological waste handling in June 2016. Participants included ward orderlies (WOs), lab attendants (LAs), compound laborers (CLs), theater attendants (TAs) and laundry personnel (LPs) randomly selected. A semi structured questionnaire administered to consented respondents. Data was presented as descriptive analysis and percentage compared using Chi-square test with significant level 0.05 at 95% Confidence interval.

Results: A total of 68 auxiliary healthcare workers consisting of male 44.1% (n=30) and female 55.9% (n=38) were interviewed. Respondent’s mean ± (SD) age was 31± 5.30 years and ranged from 27- 55 years. Knowledge on injection safety and biological waste handling among AHWs showed (WOs) 42/68 (61.7%), (LAs) 5/68 (7.4%), (CLs) 9/68 (13.2%), (TAs) 5/68 (7.4%) and (LWs) 7/68 (10.3%). A significant difference in knowledge on injection safety and biological waste handling among AHWs was observed. (X²= 1.56, df 4, critical value 9.488 at 95% confidence level.

Conclusion: There is low level of knowledge on needle stick injury (NSI), biological waste handling and poor attitude towards PEP among auxiliary healthcare workers in GH Wukari and GH Zing.

Keywords: Knowledge, Auxiliary, Biological, Injection, Waste, Safety

References:

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[16]. Musa B, Bussell S, Borodo M M, Samaila A A, Femi O L. Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: A systematic review and meta-analysis. Niger J ClinPract 2015;18:163-72

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[18]. OS Elkanah, AL Okoye, OE Debby-Sambo. Prevalence of Hepatitis-B Surface Antigen among Blood Donors in Jalingo, Taraba State, Nigeria Nigerian Journal of Parasitology Vol 34, No 2 (2013

[19]. OguamanamOkezieEnwere, Kevin ChiekulieDiwe 2014: Knowledge, perception and practice of injection safety and healthcare waste management among teaching hospital staff in south east Nigeria: an intervention study Pan Afr Med J. 2014; 17: 218.

[20]. RuhiToraman, FatmaBattal, Kirstin Ozturk&BetulAkcin (2011) Sharps Injury Prevention for Hospital Workers, International Journal of Occupational Safety and Ergonomics, 17:4, 455-461, DOI: 10.1080/10803548.2011.11076908

[21]. Soad A. HabibaGhadeer A. Alrashidi, Afaf E.M. Al-otaibi, Ghizayel R. Almutairi, Gamal Makboul and Medhat K. El-Shazl (2012): Knowledge, attitude and behavior of health care workers regarding hepatitis B infection in primary health care, Kuwait. Greener Journal of Medical Sciences Vol. 2 (4), pp. 077-083. Taraba State strategic health development plan (2010 – 2015)

Abstract:

Health communication is essential in providing avenue for effective dissemination of health information in order to improve healthcare delivery. Lack of effective communication between healthcare providers and their clients especially in secondary health facilities has impeded the effective and efficient delivery of quality healthcare. The objective of this study is to demonstrate effective communication as a solution for clients to accept quality healthcare services.

A descriptive cross-sectional study of three secondary health facilities in Northern Cross River, Nigeria. Population of 2050 in 3 facilities with sample size (n) of 335 allocated 147, 57, 98 and 33 among the 3 facilities and staff categories respectively. Systematic sampling technique was used and semi-structured self-administered questionnaire for data collection. Data analysis was done using statistical package for social science. Non-parametric statistics was used in the analysis as data was categorical and not normally distributed.

Out of 335 respondents, 278 completed the questionnaire giving a response rate of 83%. Modal Age group is 25-34 (29.5%) and Modal level of education is tertiary (38.5%). Majority of clients (53.6%) concurred to good communication skills (listening skills and allowing feedback from patient) from healthcare providers improved acceptance to healthcare delivery (P=0.019). Majority (45.3%) who confirmed friendly approach of health workers maintained them as their health providers.

Effective communication is key to acceptance of services rendered to clients by healthcare personnel and also, for clients to have a positive perception of services rendered.

Keywords: Communication barriers, communication tools, acceptance, healthcare delivery, healthcare provider, cross river,

References:

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Abstract:

In the world in 2013, Diabetes affected 382 million of people, and 316 million were at risk of developing it. Diabetes was responsible for the dead of 5 million persons aged 20-79, that was 8,4% of the world’s mortality for this age range (1). Type 2 diabetes is the most common type and is the challenge of the 21st century for health (2). Its risk factors like obesity and complications like limbs amputations and others cost much (3). It therefore presents a severe health problem for the population with low socio-economic level and disfavored groups. Described by the WHO, the minority « Autochthones », « Aborigines » or « Indigenous » people know the abnormal high of prevalence, complications, risk factors, and a high mortality compared to non autochthones of the same age group (4),(5). In 2007, the United Nation Organization launched the declaration of the right of these 5% of the world’s population who experiencing many Burden (6).

In the Sub Sahara Africa, the word « Indigenous » is contested (7),(8) and the scarcity of data on diabetes in this « indigenous « community makes the situation of diabetics complex in the « massai » of Kenya, « pygmies » and Mbororo » of Cameroon, and « San » of South Africa; these could compromise the effectiveness of the health services (9) and the stable development(10).

In Cameroon, the prevalence of diabetes moved from 1, 5% in 1990, to 6.6% in 2003. 80% of patients are still undiagnosed (11). Diabetes is one of the first causes of the mortality amongst patients on hemodialysis (12). As pastoralist, the Mbororo minority group is not well censored (13); they live a « complex » social relationship hence always considered as « strangers » (14). Most of the Mbororo of the East region has lost their « cheptel » due to conflicts, epidemics, climatic changes, and soil degradation. They progressively practice agriculture on borrowed soil (15). Health care is frequently inaccessible. Women, children and the old are suffering in their Camps; they could therefore develop type 2 diabetes. With our actual knowledge, no study has been carried out to determine the prevalence and the magnitude of diabetes among Mbororos. It is then necessary to investigate on their needs and risk of developing diabetes and Blood pressure like others « indigenous » populations in the world.

As to respond to this need, a project was initiated to ameliorate the access to diabetic health care in 5 villages of the Adamaoua and East region, in order to propose strategic health management of « indigenous ». As part of this project, we conducted a study based on the prevalence and risk factors of the type 2 diabetes amongst adults Mbororo in the Guiwa –Yangamo village.

To present this experience, we will explore the generalities on topic, followed by the method used and results, at the end, conclusion, recommendations and some perspectives. 

References:

[1.] Aguiree F, Brown A, Cho NH, Dahlquist G, Dodd S, Dunning T, et al. IDF Diabetes Atlas : sixth edition [Internet]. International Diabetes Federation; 2013 [cited 2016 Oct 26]. Available from: http://dro.deakin.edu.au/view/DU:30060687

[2.] American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2010 Jan 1;33(Supplement 1):S62–9.

[3.] Almutairi N, Alkharfy KM. Direct medical cost and glycemic control in type 2 diabetic Saudi patients. Appl Health Econ Health Policy. 2013 Dec;11(6):671–5.

[4.] Boutrais J. Les savoirs pastoraux des Mbororo de l’Adamaoua : évolution et rapports au développemment. In: Holtedahl L, Gerrard S, Njeuma MZ, Boutrais J, Le Rôle du Savoir dans le Développement Régional : Conférence Internationale, Tromso (NOR), 1993/09/19-21, editors. Le pouvoir du savoir : de l’Arctique aux Tropiques = The power of knowledge: from the Arctic to the Tropics [Internet]. Paris: Karthala; 1999 [cited 2016 Oct 26]. p. 146–66. (Hommes et Sociétés). Available from: 

http://www.documentation.ird.fr/hor/fdi:010017690

[5.] Brimblecombe J, Mackerras D, Garnggulkpuy J, Maypilama E, Bundhala L, Dhurrkay R, et al. Leanness and type 2 diabetes in a population of indigenous Australians. Diabetes Res Clin Pract. 2006 Apr;72(1):93–9.

[6.] Bhowmik B, Afsana F, My Diep L, Binte Munir S, Wright E, Mahmood S, et al. Increasing prevalence of type 2 diabetes in a rural bangladeshi population: a population based study for 10 years. Diabetes Metab J. 2013 Feb;37(1):46–53.

[7.] Fouda H, Muna W, Ashutangtang, al. Mortalité chez les Hemodialysés chroniques au Cameroun. University of Yaounde I; 2006.

[8.] Hadley L, Kooijmans M. Pour lee diabete et le developpement. point de Vue 4 nouvelles En Bref 61A. cAmpAgne mondiAle. 58th ed. 2013;8.

[9.] Health of Population in Transition (HoPiT) Research Group. Cameroon Burden of Diabetes (CAMBoD) Baseline survey Report. Yaoundé; 2004.

[10.] International Diabetes Federation, World Diabetes Foundation. Expert Meeting on Indigenous people, Diabetes and development. Copenhagen; 2012 March.

[11.] Jago C. American Diabetes Association - 66th scientific Sessions. Washington DC, USA; 2006.

[12.] Kufe CN, Klipstein-Grobusch K, Leopold F, Assah F, Ngufor G, Mbeh G, et al. Risk factors of impaired fasting glucose and type 2 diabetes in Yaoundé, Cameroon: a cross sectional study. BMC Public Health. 2015 Jan 31;15:59.

[13.] Ministère des Affaires sociales. Annuaire statistique du Cameroun de juin 2012. Yaounde Cameroun; 2012.

[14.] Nakashima D., Galloway Mclean K, Thulstrup H., Ramos Castillo A, Rubis J. Weathering Uncertainty: Traditional knowledge for climate change assessment and adaptation. UN University and UNESCO; 2012.

[15.] Nicolaisen I. Les populations indigènes atteintes de diabète: négligées ou en danger. diabetes voice. 51st ed. 2006;34–6.

[16.] Ohenjo N ’ori, Willis R, Jackson D, Nettleton C, Good K, Mugarura B. Health of Indigenous people in Africa. Lancet Lond Engl. 2006 Jun 10;367(9526):1937–46.

[17.] Pelican M. Mbororo on the move: from pastoral mobility to international travel. J Contemp Afr Stud. 2011 Oct 1;29(4):427–40.

[18.] Pink B, Allbon P. The health and welfare of Australia’s Aboriginal and Torres Atrait Islander peoples. Commonwealth of Australia. 2008;

[19.] Scott J, Gavin J, Egan AM, Avalos G, Dennedy MC, Bell M, et al. The prevalence of diabetes, pre-diabetes and the metabolic syndrome in an Irish regional homeless population. QJM Mon J Assoc Physicians. 2013 Jun;106(6):547–53.

[20.] World Health Organization. Health of indigenous peoples. 2007.

Abstract:

Background: Ghana is one of the countries associated with high maternal deaths and near-miss events. This country has adopted the millennium development goals including reducing maternal mortality by three-quarters, and put improvement in maternal health as one of the health sector development programme performance indicators. The purpose of the study was to review maternal mortality and near-miss events in Kintampo Municipality in the Brong Ahafo Region of Ghana in the past 5 years.

Objectives: The measurement of the study were antenatal and postnatal services family planning and abortion practices, delivery care, education and information services, delay in reaching health facility and facility delay

Methods: Study participants were 196. Secondary data was used to collect information at facility level of which 16 health staff took part. In all, 30 maternal deaths and 45 near-misses from 2007 to 2011 were reviewed. Verbal autopsy was used on 180 participants from 5 communities.

Results: 92% of maternal deaths occurred among young adults. 73% were in critical condition upon arriving at the hospital. 97% of the death occurred at the health facility. Attitude of health staff and inadequate maternal health services were significantly associated with maternal deaths. 90% were not practicing family planning. 48% of them have practiced unsafe abortion before. Facility delay is significantly associated with maternal death and near-miss events

Conclusion: The results of the study can stimulate a change in clinical practice. The study can be used as a quality improvement tools in facilities. 

References:

[1] Arkutu, (1995). Activities carried out during PNC include management of the normal puerperium, identification and management of complications, micronutrient supplementation, immunization of baby, counselling and testing and STI prevention, family planning counselling and services.

[2] Brong Ahafo Region Annual Performance Meeting Report (2011) on 21st February, 2012, Sunyani

[3] British Medical Journal report, (2003)

[4] Christian, P. (2009). Prenatal Origins of undernutrtion. Nestle Nutr Workshop Ser Pediatr Program 63: 59; 74 – 77.

[5] Family Planning Acceptor Rate by Region, (2007-2009)

[6] Galadance H.S., Ejembi, C.L. Iliyasu, Z., Alagh, B. and Umar, U.S., (2007). Maternal health in Northern Nigeria: a far cry from ideal. BJOG 114 (40: 448 – 552

[7] Ghana Health Service (2007) Indicators in measuring ANC and Influence of Delivery Care on Maternal Health

[8] GDHS (2008)

[9] GHS road map for accelerating the attainment of the MDGs related maternal and neonatal health in Ghana (2007-2011)

[10] Ghana Demography and Health Survey, (2008)

[11] Ghana MDG Acceleration Framework Action Plan (CAP) (August 2010)

[12] Ghana Maternal Health Survey (2007)

[13] Ghana Statistical Services, (2003). Ghana Demographic and Health Survey Report

[14] Ghana Statistical Service (2005, 2008) Report

[15] Ghana Statistical Service (2005, 2008), Ministry of Health (2006) quality of care during delivery

[16] Health Information Department, Kintampo Municipal Directorate

[17] Hecht, R., Alban, A., Taylor, K., Post, S., Andersen, N.B., Swarz, R. (2006). The Millennium Development Goals. PLoS Med. 3(11): e455

[18] Initiative for Maternal Mortality Programme Assessment (IMMPACT) in Accra on Wednesday, 6th of February, (2003)

[19] Maternal and Neonatal Health in Ghana (2007-2011)

[20] Ministry of Health (2006) Annual Report

[21] Ministry of Health (2008) Annual Report

[22] Ministry of Health (2010) Programme of Work

[23] National Research Council, (2000) Consequences of maternal mortality and morbidity

[24] Onah, H.E., Ikeako, L.C., Iloabachie, G.C. (2006). Factors associated with the use of maternity services in Enugu, southeastern Nigeria. Soc Sci Med. 63 (7): 1870 – 78

[25] Thaddeus and Maine, (1994), distance from a health centre, quality of care expected at the health centre and ability to pay for services also can affect the decision to seek care

[26] United Nations, (2009) Millennium Development Goal five Annual Report

[27] World Health Assembly Report, May (2004)

[28] World Health Organisation (1993) Report

[29] World Health Organisation, (2004); Fillippi et al., (2005) Definition of Maternal near-miss events

[30] World Health Organisation (2004), Maternal Mortality Rates

[31] World Health Organisation (2007), Annual Report

[32] World Health Organisation, (2008) Annual Report. Geneva.

[33] World Health Statistics, (2010) Report

Abstract:

Adherence to sickle cell crisis preventive-practices is a major problem in at-risk population. Evidenced-based studies on factors associated with adherence to crisis prevention are few. This study sought to explore how the Information-Motivation-Behavioural Skill (IMB) model can provide understanding of underlying factors associated with adherence to crisis-preventive-practices behaviour among youths with sickle cell disease in Abeokuta, Nigeria.

This cross-sectional descriptive study employed a validated 43-item questionnaire to collect information from 84 participants who consented about crisis-risk prevention. Variables in the study were information, motivation, self-efficacy and adherence behaviour and measured on a 10-, 36-, 15- and 21- point scale respectively. Correlation and regression analysis was used to test for association, significance and prediction of best pathway to adherence with a cut-off at p≤0.05 level of significance.

The Mean Age of the participants was 20.07(0.69) ± 6.28 with 40.5% males and 59.5 % females. Majority were Yoruba and single with minimum of secondary school education. The sample mean scores reported for knowledge about crisis-prevention in sickle cell disease was 7.93±1.22, motivation was 30.07 ± 4.67 and self-efficacy skills were 11.88 ±2.88. The Adherence behaviour mean score was 11.23 ±3.30 giving a behaviour prevalence rate of 53.5%. Motivation was significantly associated with self-efficacy skills and adherence behaviour, while information was not significantly associated with either. Self-efficacy skills were significantly correlated with adherence behaviour. Path-analysis showed that the combined motivation and self-efficacy adherence behaviour (r2=0.34).

Findings showed that an informed and motivated sickle cell youth with good self-efficacy skills will adhere better to the crisis prevention-practices. The study recommends that counselling that provides information should be motivational to build self-efficacy that promotes crisis-prevention behaviour.

Keywords: Sickle cell crisis, preventive-practices, Information, Motivation, Adherence behaviour, Self-efficacy skill. 

References:

[1] Al – Nasir F, Niazi G (1997). Sickle cell disease: patients' Awareness and management. Journal of Saudi Medicine. 18(1): 63 – 65

[2] Butler, Dennis, J, Beltran, Lou, R. (1993) Functions of an adult sickle cell group: Education, task orientation, and support. Health and Social Work, 18(1): 49 – 56

[3] Bandura Albert, (1977) Self efficacy: Toward a unifying theory of Behavioural change: Psychological Review vol 84, no 2,191-215

[4] Babwah F, Baksh S, Blake L, Cupid-Thuesday J, Hosein I, Sookhai A, Poon-King C, Hutchinson G (2006). The role of gender in compliance and attendance at an outpatient clinic for type 2 diabetes mellitus in Trinidad. Rev Panam Publication, 19(2); 79-84

[5] Fisher Colleen M. (2011): Adapting the Information-Motivation-Behavioral Skills Model: Predicting HIV-Related Sexual Risk among Sexual Minority Youth Health Education & Behavior, published online 21 June 2011.

[6] Fisher WA, Fisher JD, Harman J (2003), The Information–Motivation–Behavioral skills model as a general model of health behavior change: Theoretical approaches to individual-level change. In: Suls J, Wallston K, editors. Social psychological foundations of health. Blackwell Publishers; London:127–153.

[7] Fisher, Jeffrey D.; Fisher, William A.; Bryan, Angela D.; and Misovich, Stephen J., J (2002) "Information-Motivation-Behavioral Skills Model-Based HIV Risk Behaviour Change Intervention for Inner-City High School Youth" Health Psychology;2002;21 (2); 177-86.

[8] Fisher JD, Fisher WA. (1992) Changing AIDS-Risk Behavior. Psychological Bullettin, 111(3):455-74.

[9] Gil, KM, Abrams MR, Phillips G, Keefe FJ (1989). Sickle cell disease pain: Relation of coping strategies to adjustment. Journal of Consultant Clinical Psychology 57: 725 – 731

[10] Jaffer DE, Amrallah FK, Ali KM, Mohammed NA, Hasan RA and Humood ZM (2009) Adult Sickle cell disease patients’ knowledge and attitude toward the preventive measures of sickle cell disease crisis. International Journal of Nursing and midwifery 1(2), 010-018. Journal of Intravenous Nursing, 21(1), 27–39

[11] Jungling Gao, Jingli Wang, Yaocheng Zhu and Jinming Yu, (2013): Validation of an Information-Motivation-Behavioural skills model of self-care among Chinese adults with type 2 diabetes. Biomed Central Public Health 13:100

[12] Lozano, (2010) Haematological parameters among sickle cell anaemia

[13] Locke E. A & Latham, G.P (1990). A theory of goal setting and task performance Upper Saddle River, NJ: Prentice Hall.

[14] Michele L.Ybarra, Josephine Korchmaros, Julius Kiwanuka, David R. Bangsberg and Sheana Bull (2013)Examining the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda. AIDS Behaviour 17(3)1116-1128

[15] Mentzer, W. C., Heller, S., Pearle, P. R., Hackney, E., &Vichinsky, E. (1994). Availability of related donors for bone marrow transplantation in sickle cell anemia. American Journal of Pediatric Hematology/Oncology, 16(1), 27–29.

[16] Ogamdi S (1994). African American Students’ awareness of sickle cell disease. J.A m. Coll. Health 42 (5):234-236

[17] Okpala, Thomas, Westerdale, Jegede, Raj, Daley, Costello-Binger, Mullen, Rochester- Peart, Helps, Tulloch, Akpala, Dick, Bewley, Davies, and Abbs, 2002

[18] Simon, K., Lobo, M. L., & Jackson, S. (1999). Current knowledge in the management of children and adolescents with sickle cell disease. Part 1: Physiology issues. Journal of Pediatric Nursing, 14(5), 281–295.

[19] World Health Organization, 2006

[20] World Health Organization, 2012

[21] Walters, M. C. (1999). Bone marrow transplantation for sickle cell disease: Where do we go from here? Journal of Pediatric Hematology/Oncology 2(6),

[22] Zhu, C., Cai Y., Ma, J., Li, N., Zhu, J., He, Y., Redmon, P., and Qiao, Y. (2013) Predictors of Intention to Smoke among Junior High School Students in Shanghai, China: An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model. PLoS ONE, 8(11).

Abstract:

Diabetes mellitus is amongst the largest health emergencies of the 21^st century. However studies have reported that a substantial proportion of people with diabetes mellitus had not previously been diagnosed. On the other hand hypertension prevalence has been reported to be on the increase. Hypertension has also been associated with the development of diabetes mellitus. The study sought to determine the prevalence of undiagnosed diabetes mellitus in hypertensive patients attending an outpatient clinic in Harare, Zimbabwe.

A cross sectional study was conducted at Parirenyatwa Group of Hospitals Outpatient Clinic. All hypertensive patients attending the outpatient during the study period were given the information about the study. All hypertensive patients who were previously not diagnosed of diabetes mellitus who consented to participate in the study were consecutively enrolled. A questionnaire was administered and blood samples were collected for Glycosylated hemoglobin analysis. Glycosylated hemoglobin was analysed using a Mindray BS800 Chemistry Analyser.

One hundred and four hypertensive patients were enrolled into the study whose mean age was 60.91(± standard deviation of 14.06) years. Patients with duration of hypertension greater than 10 years constituted 34% (35) of the study population. The prevalence of undiagnosed diabetes mellitus was 22.1% (23). Among the previously undiagnosed diabetic patients 56.5% (13) were females and 43.5% (10) males.

The prevalence of undiagnosed diabetes mellitus was found to be 22, 1% among hypertensive patients which is higher than that reported in Kenya but lower than that reported in Uganda. Diabetes mellitus can be highly prevalent in hypertensive patients thus there is need for constant monitoring for the development of diabetes mellitus and further research using a national representative sample.

Keywords: Diabetes mellitus, pre-diabetes, glycosylated haemoglobin

References:

[1] Bruno RM, Taddei S. New-onset diabetes in hypertensive patients and mortality: timing is everything. Eur Heart J. 2016 Mar 21;37(12):975–7.

[2] International Diabetes Federation. International Diabetes Federation Diabetes Atlas Seventh Edition [Internet]. 2015 [cited 2016 Jul 20]. Available from: www.diabetesatlas.org

[3] Iloh GUP. Risk Factors of Pre-Diabetes among Adult Nigerians with Essential Hypertension in a Resource-Constrained Setting of a Primary Care Clinic in Eastern Nigeria. Am J Health Res. 2013;1(3):56.

[4] Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U, et al. Prevalence of Diagnosed and Undiagnosed Diabetes and Hypertension in India—Results from the Screening India’s Twin Epidemic (SITE) Study. Diabetes Technol Ther. 2012 Jan;14(1):8–15.

[5] Korhonen P, Aarnio P, Saaresranta T, Jaatinen P, Kantola I. Glucose Homeostasis in Hypertensive Subjects. Hypertension. 2008 Apr 1;51(4):945–9.

[6] Lüders S, Hammersen F, Kulschewski A, Venneklaas U, Züchner C, Gansz A, et al. Diagnosis of impaired glucose tolerance in hypertensive patients in daily clinical practice. Int J Clin Pract. 2005;59(6):632–8.

[7] Ministry of Health and Child Welfare Republic of Zimbabwe. 6th Essential Medicines list and standard treatment guidelines for Zimbabwe. 2011.

[8] Mutebi E, Nakwagala FN, Nambuya A, Otim M. Undiagnosed diabetes mellitus and impaired glucose tolerance among hypertensive patients in Mulago Hospital, Kampala, Uganda. Afr J Diabetes Med [Internet]. 2012 [cited 2016 Oct 28];20. Available from: http://www.africanjournalofdiabetesmedicine.com/articles/May_2012/AJDM%20MAY%20PP%2020-23.pdf

[9] Meme N, Amwayi S, Nganga Z, Buregyeya E. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study. Pan Afr Med J [Internet]. 2015 [cited 2016 Oct 28];22. Available from: http://www.panafrican-med-journal.com/content/article/22/286/full/

[10] Organisation mondiale de la santé. Global status report on noncommunicable diseases 2014: attaining the nine global noncommunicable diseases targets; a shared responsibility. Geneva: World Health Organization; 2014.

[11] Organization WH, others. Use of glycated haemoglobin (HbA1c) in diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. 2011 [cited 2016 Oct 28]; Available from: http://apps.who.int/iris/handle/10665/70523

[12] Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2008 [cited 2016 Oct 28]. Available from: http://doi.wiley.com/10.1002/14651858.CD003054.pub3

[13] The International Expert Committee. International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care. 2009 Jul 1;32(7):1327–34.

Abstract:

The objective of this study is to find out how unused, expired, damaged and unwanted medicines are handled and disposed of in health facilities in Lagos State, South West Nigeria. An average hospital stocks between 2000 to 4000 drug items for use by patients at any point in time. Hospitals and households have been identified as the largest source of Pharmaceutical waste going into the sewer system.

A large quantity of Pharmaceutical Waste generated in hospitals include regulated hazardous and non-regulated hazardous Pharmaceutical waste and a significant amount of these have been found in underground water and drinking water.

195 health facilities made up of 5 tertiary teaching/specialist hospitals, 25 secondary healthcare facilities and 165 primary healthcare centres were evaluated using structured questionnaires to collect data. Data were analyzed using SPSS version 20.

Results show that 85% of disposal of pharmaceutical waste was done by open burning, a method that causes air pollution. There was no significant association between category of Health Facility and method of disposal of pharmaceutical waste. Less than 10% of Health Facilities had Pharmaceutical Waste Disposal(PWD) programmes in place.15% of respondents see the need for designated drug take – back centres and will consider establishing one. The need for additional training on PWD was identified.

Keywords

1.      PHARMACEUTICAL WASTE:- Solid, liquid or gas waste from Pharmaceutical products that can pose a substantial hazard to human/animal health and the environment when not properly managed (40 CFR part 261).

2.      HAZARDOUS WASTE:- Wastes with properties that make the product dangerous or potentially harmful to human health or the environment.

3.      HAZARDOUS WASTE LANDFILL:- A disposal facility where hazardous waste is placed in a land treatment facility, a surface impoundment, an underground injection well, a salt dome formation, a salt bed formation, an underground mine, a cave or a corrective action management unit (40 CFR 260.10)

4.      DRUG TAKE –BACK EVENTS: - Any programme or series of programmes organized by the Drug Enforcement Administration (DEA).Drug takes back initiative on which the public can return unwanted, unused or expired drugs.

5.      LISTED HAZARDOUS WASTES:- Materials specifically listed by regulatory authorities as waste from non-specific sources, specific sources or discarded chemical product.

6.      OTC MEDICINES:– Over -the- counter drugs that can be sold directly to a client without a prescription from a healthcare professional.

References:

[1] 40 CFR 261

[2] Barbalace, Roberta Crowell (2003 – 08-01). The History of Waste” Environmental Chemistry.com. Retrieved 2013 -12-09

[3] Chaudhary R, Rachana M.,2006. “Factors affecting hazardous waste solidification/stabilization”. A review in Journal of Hazardous Materials B137pp.267-276

[4] Encyclopedia Britannica

[5] Guidelines for the safe Disposal of unwanted Pharmaceuticals in and after Emergencies

[6] Glossary of Environment Statistics: Series F. No.67/Department for Economic and Social Information and Policy Analysis, United Nations. New York: UN 1997

[7] Hazardous Waste Landfills

[8] Land Disposal Restrictions for Hazardous Waste

[9] RESEM Waste Tyre Pyrolysis Plant in USA, retrieved 2011-10-24

[10] “Resource conservation and Recovery Act” US EPA

[11] The US. EPA’s Hazardous Waste Cleanup Information System.

[12] United Nations Environmental Programme (2013) “Guidelines for National Waste Management Strategies Moving from Challenges to Opportunities”. ISBN 978-92-807-3333-4.

[13] Waste Management (2013). “Editorial Board/Aims & Scopes”. Waste Management 34:IFC.doi:10.1016/so956-053x (14) 000 26 – 9.

[14] www.who.int/water-sanitation-health/medicalwaste/unwantpharm.pdf

[15] 

www.usecology.com/services/field-services/pharmaceutical-waste-management.aspx

Abstract:

Need in relation to health care, has generally been defined as the amount of medical care that medical experts believe a person should have to remain or become as healthy as possible, based on a current medical knowledge. This is also true for the individual and for the entire community. Thus, if a problem, a barrier or difficulty continues to exist on the path to accession to a higher level of health, the need exists. In “The definition and identification of need for health care^[1],” Acheson stated that there exist four phenomena underlying health needs including: - the risk of pain and illness (in the sense of discomfort, or "malaise") - the risk of sickness - the inadequacy and deficiency - the mortality risk. Finally, although certain health needs are expressed, they do not correspond to real needs. This would provide different areas related to health interventions, including:

· The ideal zone (a need corresponds to an expressed demand and adequate health action);

· The area of ​​non-use (a health action not corresponding to any demand);

· Non-use of family planning services in both high population growth areas but also high poverty

· The waste area (a health action corresponding to a demand but with no corresponding need);

· The prescription of laboratory tests and other unnecessary medical procedures in response to public solicitation, especially persons holding health insurance

· The discontent area (a demand triggered by a real need, but to which no health action is taken);

· The recurrence of malaria cases in one region, and the desire by local residents, to have currently non-existent measures, to be taken by health and government authorities, on the environmental and sanitation plan.

References:

[1]. Accorsi, S., Kedir, N., Farese, P., Dhaba, S., Racalbuto, V., Seifu, A., & Manenti, F. (2009a). Poverty, inequality and health: the challenge of the double burden of disease in a non-profit hospital in rural Ethiopia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103(5), 461‑468. https://doi.org/10.1016/j.trstmh.2008.11.027

[2]. Acheson, R. M. (1978). The definition and identification of need for health care. Journal of Epidemiology and Community Health, 32(1), 10‑15.

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[5]. Burgess, P. I., Msukwa, G., & Beare, N. A. V. (2013). Diabetic retinopathy in sub-Saharan Africa: meeting the challenges of an emerging epidemic. BMC Medicine, 11, 157. https://doi.org/10.1186/1741-7015-11-157

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[12]. Mukadi, Y. D., Maher, D., & Harries, A. (s. d.). Tuberculosis case fatality rates in high HIV prevalence popu... : AIDS. Consulté 25 septembre 2016, à l’adresse http://journals.lww.com/aidsonline/Fulltext/2001/01260/Tuberculosis_case_fatality_rates_in_high_HIV.2.aspx

[13]. Nguku, P., Oyemakinde, A., Sabitu, K., Olayinka, A., Ajayi, I., Fawole, O., … Nasidi, A. (2014). Training and service in public health, Nigeria Field Epidemiology and Laboratory Training, 2008 - 2014. The Pan African Medical Journal, 18 Suppl 1, 2. https://doi.org/10.11694/pamj.supp.2014.18.1.4930

[14]. Noubiap, J. J. N., Jingi, A. M., & Kengne, A. P. (2014). Local innovation for improving primary care cardiology in resource-limited African settings: an insight on the Cardio Pad(®) project in Cameroon. Cardiovascular Diagnosis and Therapy, 4(5), 397‑400. https://doi.org/10.3978/j.issn.2223-3652.2014.10.01

[15]. Olmsted, S. S., Moore, M., Meili, R. C., Duber, H. C., Wasserman, J., Sama, P., … Hilborne, L. H. (2010). Strengthening laboratory systems in resource-limited settings. American Journal of Clinical Pathology, 134(3), 374‑380. https://doi.org/10.1309/AJCPDQOSB7QR5GLR

[16]. Omondi Aduda, D. S., & Mkhize, N. (2014). Ethical issues evolving from patients’ perspectives on compulsory screening for syphilis and voluntary screening for cervical cancer in Kenya. BMC Medical Ethics, 15, 27. https://doi.org/10.1186/1472-6939-15-27

[17]. Prentice, A. M. (2006). The emerging epidemic of obesity in developing countries. International Journal of Epidemiology, 35(1), 93‑99. https://doi.org/10.1093/ije/dyi272

[18]. Roux, V., & Raoult, D. (1999). Body lice as tools for diagnosis and surveillance of reemerging diseases. Journal of Clinical Microbiology, 37(3), 596‑599.

[19]. Selman, L., Higginson, I. J., Agupio, G., Dinat, N., Downing, J., Gwyther, L., … Harding, R. (2009). Meeting information needs of patients with incurable progressive disease and their families in South Africa and Uganda: multicentre qualitative study. BMJ (Clinical Research Ed.), 338, b1326.

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[21].Unwin, N., Setel, P., Rashid, S., Mugusi, F., Mbanya, J.-C., Kitange, H., … Alberti, K. G. M. M. (2001). Noncommunicable diseases in sub-Saharan Africa: where do they feature in the health research agenda? Bulletin of the World Health Organization, 79(10), 947‑953. https://doi.org/10.1590/S0042-96862001001000008

Abstract:

The objective of this study is to determine the sexual patterns among their school and out of school adolescents in Kavango region, Namibia and identify the association between the socio-demographic characteristics of the adolescents and their sexual behaviors.

A cross-sectional analytical study was conducted using mixed methods - quantitative and qualitative approaches among 350 school learners (grade 6 to grade 12) and 150 school dropout adolescents (aged 12 to 18 years). The stratified random sampling techniques were used in the selections of the circuit and the schools. Structured questionnaires were used in face-to-face interviews, and in depth interviews were conducted among the key informants (teachers). The following variables include the demographics (age, grade, parent marital status, and school drop-out status), sexual behavior (age at first sexual intercourse, number of sexual partners, abortion, and age at abortion), economic (employment, financial support).

Descriptive statistics was used to summarise the above-mentioned variables. Cross-tabulations of demographic, sexual and economic variables were used to describe the relative frequencies.

The associations between different categorical variables were assessed using Chi-square test whilst the identification of different determining factors was analyzed with the epidemiological methods using odds ratios and/or estimated relative risks. The means, standard deviation and 95 % confidence interval were computed. The differences between different variables or factors were considered to be statistically significant for p-values less than 0.05.

The study found that early sexual debut, first sexual intercourse, number of sexual partners, relationship with sexual partners older than 5 years and dropping out of schoolwere associated with adolescent pregnancy in Kavango region.

Keywords: Adolescence, Adolescents, Reproductive health, Sexual behaviors, Sex education.

References:

[1]. Lillian P; Mumbango T. (2015). Statistical Modeling of Adolescent Pregnancy in Namibia. J Nurs Care, 4, 262. doi:10.4172/2167-1168.1000262

[2]. Ministry of Health & Social Services (MoHSS). (2013). Namibia Demographic Health Survey 2013.

[3]. Nomhle Kangootui. (2016). Pregnancy statistics in Namibia. Namibian Newspaper, p. 14 July 2016.

[4]. Omar, K., Hasim, S., Muhammad, N. A., Jaffar, A., Hashim, S. M., & Siraj, H. H. (2010). Adolescent Pregnancy Outcomes and Risk factors in Malaysia. International Federation of Gynecology and Obstetrics, 111(3), 220–223. doi:http://doi.org/10.1016/j.ijgo.2010.06.023

[5]. The United Nations Children’s Fund (UNICEF). (2012). Progress for Children: A Report Card on Adolescents.

[6]. UNFPA. (2013). World Population Day the United Nations Population Fund.

[7]. USAID. (2011). Teenage Pregnancy in Kavango Region. Contributing Factors and Program Recommendations.

[8]. WHO. (2014). Adolescent Pregnancy Fact Sheet. Geneva, Switzerland.

Abstract:

The objective is this study is to determine the potential risk characteristics among the in-school and out of school adolescents in Kavango region, Namibia.

A cross-sectional analytical study was conducted using mixed methods - quantitative and qualitative approaches among 350 school learners (grade 6 to grade 12) and 150 school drop-out adolescents (aged 12 to 19 years). The stratified random sampling techniques were used in the selections of the circuit and the schools. Structured questionnaires were used in face-to-face interviews, and in depth interviews were conducted among the key informants (teachers).

The following variables include the potential risk characteristics alcohol used, drug used, marijuana used, more than one sexual partner in past 12 months, partner older than 5 years, orphan, abortion, sex regularly, mothers education, contraceptive used, current pregnancy and outcome of birth.

Descriptive statistics was used to summarise the above mentioned variables. Cross-tabulations of demographic, sexual and economic variables were used to describe the relative frequencies.

The associations between different categorical variables were assessed using Chi-square test whilst the identification of different determining factors was analyzed with the epidemiological methods using odds ratios and/or estimated relative risks. The means, standard deviation and 95 % confidence interval were computed. The differences between different variables or factors were considered to be statistically significant for p-values less than 0.05.

Keywords: Adolescence, Adolescents Contraceptives, First intercourse, Sexual health, Sexual partner.

References:

[1]. Chisembu K.C., Siziya.S. Muula. A.S. (2008). Prevalence and Social Correlates of Sexual Intercourse among School going Adolescents in Namibia.

[2]. Department of Reproductive Health and Research World Health Organization. (2011). Adolescent Pregnancy. Avenue Appia 20, CH-1211 Geneva 27, Switzerland E-mail: reproductivehealth@who.int.

[3]. Liang, E.L.M. (2013). Adolescent Pregnancy: A Review of the Evidence. UNFPA New York, 2013

[4]. Lillian P, Mumbango T (2015) Statistical Modeling of Adolescent Pregnancy in Namibia. J Nurs Care 4: 262. doi: Volume 4 • Issue 4 • 10.4172/2167-1168.1000262.

[5]. Mufune. P. (2003). Changing Patterns of sexuality in Northern Namibia: Implication a for the transmission of HIV/AIDS.

[6]. Minesota Department of Health. (2010). Adolescent Pregnancy Prevention Interventions. Website:http://www.advocatesforyouth.org/storage/advfy/documents/sspregnancies.pdf.

[7]. Mmari, K. & Blum, R.W. (2009). Risk and Protective Factors that Affects Adolescents Reproductive health in Developing Countries: A structured Literature review. Global Public Health.

[8]. Nomhle Kangootui. Namibian Newspaper, 14 July 2016. Pregnancy statistics in Namibia. Windhoek.

[9]. National Statistical Office United Nations Children’s Fund. (2008). Teenage Pregnancy and Motherhood. Malawi.

[10]. Olumide, A. O., Robinson, A. C., Levy, P. A., Mashimbye, L., Brahmbhatt, H., Lian, Q., Blum, R. W. (2014). Predictors of Substance use among Vulnerable Adolescents in five cities: findings from the well being of Adolescents in Vulnerable Environments Study. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 55(6 Suppl), S39–47. http://doi.org/10.1016/j.jadohealth.2014.08.024.

[11]. Omar, K., Hasim, S., Muhammad, N. A., Jaffar, A., Hashim, S. M., & Siraj, H. H. (2010). Adolescent Pregnancy Outcomes and Risk factors in Malaysia. http://doi.org/10.1016/j.ijgo.2010.06.023

[12]. Thornberry, T. P., Krohn, M. D., Augustyn, M. B., Buchanan, M., & Greenman, S. J. (2015). The impact of Adolescent risk behavior on Partner Relationships. Advances in Life Course Research. http://doi.org/10.1016/j.alcr.2015.04.002

[13]. UNICEF. (2012). Progress for Children: A Report Card on Adolescents, No 10, April 2012.

[14]. UNFPA(2013). World Population Day the United Nations Population Fund.

[15]. USAID (2011). Teenage Pregnancy in Kavango Region. Contributing Factors and. Program Recommendations.

[16]. WHO (2014). Adolescent Pregnancy Fact Sheet, Department of Reproductive Health and Research, Geneva, Switzerland.

Abstract:

Introduction: A review of Nyanga District malaria weekly surveillance data showed that malaria cases had surpassed the thresholds from week 4 confirming that an outbreak was underway. We investigated the outbreak to determine risk factors associated with contracting malaria.

Methods: A 1:1 Unmatched Case control study was carried out in Nyanga district. Interviewer administered questionnaires and WHO adapted Integrated Disease Surveillance and Response (IDSR) checklists were used to collect information on risk factors and on outbreak response. Data were analysed using Epi-Info 7 statistical software.

Results: Eighty three cases and 83 controls were enrolled into the study. Most (76%) of the under 5 year cases came from villages across the border in Mozambique. Presence of stagnant water bodies near home [OR= 11.06; 95%CI (2.32; 52.68)] was associated with contracting malaria. Consistently sleeping under a net [OR= 0.13; 95% CI (0.03; 0.59)] Use of mosquito repellents [OR= 0.16; 95% CI (0.04; 0.58)] and having received health education on malaria in the past year [OR= 0.19; 95% CI (0.07; 0.52)] were protective against contracting malaria.

Conclusion: The district was not prepared for the outbreak and the outbreak mainly affected children under five years from Mozambique. The risk factor for contracting malaria during the outbreak was presence of stagnant water bodies near homes which facilitated breeding of the vector. Consistently sleeping under a mosquito net, use of mosquito repellents and reported history of receiving health education on malaria in the past year were protective. As a result of this study health education was given to the community.

References:

[1] Chikwanha TM, Chinhengo TP, Hanyana N : Malaria Outbreak Investigation Mazowe District Mashonaland Central Province, Zimbabwe 2010 (Unpublished)

[2] Centre for Disease Control and Prevention. Malaria accessed from www.cdc.gov/malaria/about/facts.html on 14/02/13

[3] Dhege C, Zizhou S T, Muyengwa P. Malaria Outbreak investigation in Mudzi District 2012.(unpublished)

[4] Ministry of Health and Child Welfare, Zimbabwe: Preliminary Malaria Stratification Report, 2002 accessed from www.rbm.who.int/countryaction/.../naZimbabwe.pdf on 14/02/13

[5] Marape G, Mpeta ET, Ndlovu N: Factors associated with contracting malaria at Mbembeswana, 10 March to 25 April 2008, Zimbabwe (Unpublished)

[6] Mpofu M, Nkomo B.M.M, Kulkarni R, Mabaera B: Malaria Outbreak in Tsholotsho District in Matabeleland North Province, Zimbabwe, 2006 (Unpublished)

[7] Ministry of Health and Child Welfare Zimbabwe: World Health Organisation, United Nations Development Programme and the Global Fund. Guidelines for Management of Malaria in Zimbabwe, Revised December 2009.

[8] Ministry of Health and Child Welfare, World Health Organisation, united nations Development Programme and the Global Fund. Guidelines for management of malaria in Zimbabwe, revised December 2009.

[9] Maenzanise S R, Kusangaya O, Chirenda J, Tshimanga M : Malaria Outbreak Investigation In Msampakaruma, Kariba District, 2004 (Unpublished)

[10] Rasheed S. et al (2000), Economic impact of febrile morbidity and use of permethrin-impregnated bed nets in a malarious area II, Determinants of febrile illness and the cost of their treatment and malaria prevention,. AMJ Trop. Med Hyg. 62: 181-6

[11] WHO: Guidelines for treatment of malaria, Second edition, WHO Library Cataloguing in Publication Data, 2010.

[12] WHO: A commitment to supporting national programs for greater coverage of Malaria control interventions, Annual Report 2006, World Health Organization, 2006

[13] WHO: Malaria Case Management Operational Manual, World Health Organization, Geneva, 2009

[14] World Health Organization :World Malaria Report, 2011, Geneva, 2011

[15] World Health Organization, Global Malaria Action Plan, Roll Back Malaria Partnership, World Health Organization, Geneva, 2008 accessed from http://rbm.who.int/gmap/2-3.html on 14/01/13

Abstract:

Introduction: Malaria is the commonest endemic disease, and the most vulnerable group of persons affected by malaria is the pregnant women. This has posed serious public health challenge in Nigeria; it is with these considerations that the Nigerian Government in the past few years has renewed efforts towards controlling malaria. Several interventions have been introduced amongst which were the introductions of Artemisinin-based combination therapies (ACTs) and massive distribution of long lasting insecticidal nets. Statistic has shown that 8 million women are pregnant every year in Nigeria and about 545 women out of every 100,000 die as a result of pregnancy-related complications.

Objectives: This study was done to ascertain the Diagnosis and treatment characteristics of malaria in pregnant women and assessed the training, work experience, knowledge, and perception of health workers regarding malaria in pregnancy, in North Western Nigeria.

Method: Arandom sampling method was carried out across 10 local governments and 15 health facilities in North Western Nigeria. Two participants from each facility gave a total of 300 health care workers recruited into this study.

Results: 91% of the participant believe that RDT /microscopy is the appropriate test for malaria; 38% of them agree that the test miss malaria cases while 14% believe that treatment should be given to a client that test Negative to either of the test. 37% of the participant prescribed Quinine, while 48% of the participant will prefer ACT and the least 2% will still go for Chloroquine.

Conclusion: This study exposed the under-diagnosis as well as miss treatment of malaria in pregnancy and the need for training and retraining of health care workers as well as establishing the malaria diagnosis quality assurance program to ensure the accuracy of malaria microscopy and RDT results at all levels.

References:

[1]. Bouyou-Akotet M. K., Adegnika A. A., Agnandji S. T., Ngou-Milama E., Kombila M., Kremsner P. G. (2005). Cortisol and susceptibility to malaria during pregnancy. Microbes and Infection. 1217-23.

[2]. Chukwuma Muanya. (2013). National Malaria Elimination Programme, FCA, Total renew commitment towards disease eradication.

[3]. Desai M., Kuile F., Nosten F., McGready R., Asamoa K., Brabin B., Newman R. (2007). Epidemeology and burden of malaria in pregnancy. Lancet of infectious diseases.93-104 Okpere E. E. Malaria in pregnancy. In Okpere E (Ed): Clinical Obstetrics. Uniben Press. 2004:56-63.

[4]. Federal Ministry of Health (FMOH). National Antimalarial Treatment Policy. FMOH, National malaria and Vector Control Division, Abuja, Nigeria 2005.

[5]. Federal Ministry of Health Nigeria (2015). National Malaria Elimination Programme,

[6]. Federal Ministry of health, (2015). National guidelines and strategies for malaria prevention and control during pregnancy, second edition

[7]. James F. Entwistle. (2016). Ending Malaria in Nigeria for good.

[8]. Jelinek T, Grobusch MP, Harms G, 2001. Evaluation of a dip-stick test for the rapid diagnosis of imported malaria among patients presenting within the network TropNetEurop. Scand J Infect Dis 33: 752–754.

[9]. Kalilani-Phiri LV, Lungu D, Coghlan R (2011) Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals. Malar J 10: 279. doi: 10.1186/1475-2875-10-279

[10]. Kalilani-Phiri, L.V. Lungu, D. Coghlan R. (2011) Knowledge and malaria treatment practices using artemisinin combination therapy (ACT) in Malawi: survey of health professionals. Malaria Journal, 10 p. 279

[11]. Kwansa-Bentum B, Ayi I, Suzuki T, Otchere J, Kumagai T, et al. (2011) Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment. Trop Med Int Health 16: 1215–1224.

[12]. Leke, R.F.G., R.R. Djokam, R. Mbu, R.J. Leke and J. Fogako et al., 1999. Detection of the Plasmodium falciparum antigen histidine-rich protein 2 in blood of pregnant women: Implications for diagnosing placental malaria. J. Clin. Microbiol., 37: 2992-2996.

[13]. Luz, T.C.B., Suárez-Mutis, M.C., Miranda, E.S., Moritz, A.F., Freitas, L.F., Brasil, J.C., Osorio-de-Castro, C.G. (2013). Uncomplicated malaria among pregnant women in the Brazilian Amazon: Local barriers to prompt and effective case management. Acta Tropica, Volume 125, Issue 2, February 2013, Pages 137-142

[14]. Malaria situation analysis document. Abuja, Nigeria: Federal Ministry of Health; 2000. Federal Ministry of Health; pp. 14–26.

[15]. Manirakiza A, Soula G, Laganier R, Klement E, Djalle D, et al. (2011) Pattern of the antimalarials prescription during pregnancy in Bangui, Central African Republic. Malar Res Treat 2011: 414510

[16]. Marx A, Pewsner D, Egger M, Nuesch R, Bucher HC, Genton B, Hatz C, Juni P, 2005. Meta-analysis: accuracy of rapid tests for malaria in travelers returning from endemic areas. Ann Intern Med 142: 836–846.

[17]. Murray, C.K., R.A. Gasser Jr., A.J. Magill and R.S. Miller, 2008. Update on rapid diagnostic testing for malaria. Clin. Microbiol. Rev., 21: 97-110.

[18]. Okonta PI (2011) How many physicians prescribe quinine for the treatment of malaria in the first trimester of pregnancy? Ebonyi Med J 10: 105–111.

[19]. Okoro RN, Nwambu JO (2012) Evaluation of physicians' prescribing patterns of antimalarial drugs during pregnancy at the obstetrics and gynaecology department of a teaching hospital in Maduguri, Borno State, Nigeria. Int J Pharm Biomed Sci 3: 39–46.

[20]. Okpere, E.E., Enabudoso, E.J. Osemwenkha, A.P. (2010). Malaria in Pregnancy. Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria Med J 51:109-13.

[21]. Onwujekwe OC, Soremekun RO, Uzochukwu B, Shu E, Onwujekwe O (2012) Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria. BMC Res Notes 5: 211. doi: 10.1186/1756-0500-5-211

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Abstract:

Background: Prompt malaria diagnosis and effective treatment, is a key malaria control strategy which reduces morbidity and mortality in many settings. However, in Zambia studies show that, only 19% caretaker of children under five years of age accessed prompt and effective treatment in 2010 at health facilities. The factors contributing to this problem are not well understood in Zambia. The objective of this study is to determine barriers to prompt diagnosis and effective malaria treatment among children under the age of five years in Mpika district.

Methods: An analytical cross section study was conducted in Mpika district of Zambia using both the quantitative and qualitative methods with sample size was 380 caregivers and 8 Focused Group Discussions (FGDs) respectively.

Results: The study found that only 13.9% of children diagnosed with malaria received prompt malaria treatment. The following variables were found to significantly predict uptake of prompt malaria treatment; distance of less than five kilometers to the health facility (Adjusted OR 2.45 95%CI: 1.22 – 5.11 P = 0.012, adequate household income (AOR 2.27 95%CI: 1.18 – 4.39 P = 0.014), first action being; taking the child to the health facility (AOR 2.45 95%CI: 1.26 – 4.76 P = 0.008 and having health education (IEC) done in the community (AOR 2.14 95%CI: 1.10 – 4.13 P = 0.024). Non availability of antimalarial drugs at health facilities and self-treatments with antipyretics or herbal medication were reported in FGDs to be associated with delays in seeking appropriate malaria treatment.

Conclusion: The findings of this study highlight the barrier that exits in accessing prompt malaria treatment in a rural setting of Zambia. It underscores the need to formulate and implement interventions aimed at fostering appropriate health seeking behaviors in caretakers of under five children through community health education and addressing socio-economic barriers that exits in rural setting.

References:

[1] Ahorlu C K, Koram K A, Ahorlu C, De Savigny D & Weiss M G (2006) Socio-cultural determinants of treatment delay for childhood malaria in southern Ghana. Tropical Medicine and International Health 11, 1022–1031.

[2] Becher H, Muller O, Jahn A, Gbangou A, Kynast-Wolf G & Kouyate B (2004) Risk factors of infant and child mortality in rural Burkina Faso. Bulletin of the World Health Organization 82, 265–273.

[3] Baume, C. (2002). A Guide to research on care-seeking for childhood malaria. Arlington, Virginia: Sara, Basics ii. 46(30): 256-59.

[4] Central statistical office Zambia (CSO, 2010).

[5] Chibwana AI, Mathanga DP, Chinkhumba J, Campbell CH (2009) Socio-cultural predictors of health-seeking behaviour for febrile under-five children in Mwanza-Neno district, Malawi. Malaria Journal 8: 219.

[6] Chuma J, Okungu V, Molyneux C. (2010) Barriers to prompt and effective malaria treatment among the poorest population in Kenya. Malar J 9: 144.

[7] Halwindi, H, S. Siziya, P. Magnussen, and A. Olsen (2013). Factors Perceived by Caretakers as Barriers to Health Care for Under-Five Children in Mazabuka District, Zambia. ISRN Tropical Medicine. 10.1155

[8] Hetzel M, Iteba N, Makemba A, Mshana C, Lengeler C, et al. (2007) Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: The ACCESS Programme. Malar J 6: 83.

[9] Hetzel M W, Obrist B, Lengeler C, Msechu J J, Nathan R, et al. (2008) Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health. 8: 317. [PMC free article] [PubMed

[10] McCombie SC. (2002) Self-treatment for malaria: the evidence and methodological issues. Health Policy Plan.17:333–344. doi: 10.1093/heapol/17.4.333. [PubMed]

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[12] Ministry of Health (MoH). Actions for Scale-up for Impact on Malaria in Zambia. National malaria strategic plan 2006 – 2010.

[13] Muller O, Traore C, Becher H, Kouyate B. (2003) Malaria morbidity, treatment seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso. Trop Med lnt Health. 8(4):290-296. PubMed Abstract

[14] Rutebemberwa E, Kallander K, Tomson G, Peterson S & Pariyo G (2009) Determinants of delay in care-seeking for febrile children in eastern Uganda. Tropical Medicine and International Health 14, 472–479.

[15] Schellenberg J. R. M. A., Victora C. G., Mushi A., De Savigny D., Schellenberg D., Mshinda H., Bryce J. (2003) Inequities among the Very Poor: Health Care Children in Rural Southern Tanzania. Lancet. 361:561–66. [PubMed]

[16] Tarimo D S, Lwihula G K, Minjas J N, Bygbjerg I C. (2000) Mother's perceptions and knowledge on childhood malaria in the holoendemic Kibaha district, Tanzania: implications for malaria control and the IMCI strategy. Trop Med Int Health. 5:179–84.

[17] Tarimo, D. S., Urassa, D. P., Msamanga, G. I. (1998). Caretakers’ perceptions of clinical manifestations of childhood malaria in holo-endemic rural communities in Tanzania. East African Medical Journal. 5(3), 93-96.

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[20] Mpika DHMT Action Plan 2010.

[21] Masiye, F. & Rehnberg, C. (2005). The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey. Malaria Journal. 4:60

[22] Ministry of health bulletin (MoH 2010).

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[26] Zambia malaria indicator survey, (ZMIS 2010)

Abstract:

A strong healthcare system is known by efficiency in service delivery through its individual components. The poor quality service delivery by any of these components is a reflection of the degree of its weakness. To achieve a strong health system that will provide efficient and effective health services, there must be a deliberate effort towards strengthening the system and continuous improvement of quality of services in each component at all levels. Previous studies in some hospitals in central and southern parts of Nigeria revealed poor knowledge and waste management practices. The study was undertaken to assess healthcare waste handling practices in some selected hospitals in Jalingo Taraba state and appraise how the poor health system is reflected in this area of service delivery. The assessment was conducted by extensive review of literature on Nigerian health system as relates to healthcare waste management practices; and by direct observation of waste handling practices in those hospitals, compared to standard practices of healthcare waste management. The results revealed that the healthcare waste management in those health facilities is far below WHO standards. This is attributable to the weak and poor healthcare system in the state and the country. Having an implementable hospital waste management plan, training healthcare workers of all cadres on proper waste management and regular supervision by health facility management were recommended as measures to improve healthcare waste management in the state, which is also a way of health system strengthening through this aspect of service delivery.

Keywords: Healthcare, Inefficiency, Waste Management, Quality Service, System Strengthening.

References:

[1] Abah SO, Ohimain EI (2010). Assessment of Dumpsite Rehabilitation Potential using the Integrated Risk Based Approach: A case study. Online at http://www.academicjournals.org/jphe. Accessed October 9, 2015.

[2] Abah, S. O., Ohimain, E. I (2011). Healthcare waste management in Nigeria: A case study. Journal of Public Health and Epidemiology Vol. 3(3), pp. 99-110, March 2011. Available online at http://www.academicjournals.org/jphe ISSN 2141-2316 ©2011 Academic Journals. Accessed October 19, 2015.

[3] Abdulraheem I. S., Olapipo A. R. Amodu M. O. (2012). Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. Journal of Public Health & Epidemiology Vol. 4(1), pp. 5-13, January 2012. Available online at http://www.academicjournals.org/JPHE DOI: 10.5897/JPHE11.133 ISSN 2141-2316.

[4] Adegbita M. A, Nwafor S. O, Afon A, Abegunde A. A, Bamise C. T (2010). Assessment of dental waste management in a Nigerian tertiary hospital. Waste. manag. Res., 28: 769-777.

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Abstract:

In Namibia, palliative care service is necessitated by the situation of progressive life limiting illnesses, which demand access to psychosocially appropriate holistic palliative care. Little is known about the knowledge and practice of healthcare workers on the psychosocial aspects of holistic palliative care.

This study was conducted to critically analyze the knowledge and practice of healthcare workers on psychosocial aspects of holistic palliative care and identify their training needs.

A cross-sectional analytical study was conducted in the public health facilities in Ohangwena region, amongst the randomly selected sample of 56 healthcare workers. Structured questionnaires were self administered to capture the respondent’s knowledge and skills.

Respondents mean age was 36.2 ± 9.81.Male respondents were 20 (35.71%) while female were 36 (64.29%). Of the 56 healthcare workers who participated in the study, 2 (3.6%) were medical practitioners, 44 (78.6%) nurses, 1 (1.8%) physiotherapists, 3 (5.4%) social workers and 6 (10.7%) pharmacists. Mean years of professional experience was 9.43± 9.62. Most healthcare workers 39 (69.6%) indicated not received any training on holistic palliative care.

Knowledge of correct classification for morphine was associated with access to internet (p<0.05). There was a significant association between those confronted by palliative care situation and knowledge of morphine (p<0.05). Knowledge of pain intensity among children was significantly associated with access to internet (p=0.01). Healthcare workers lack knowledge in the psychosocial aspects of holistic palliative care which can implicate the quality of care to patients. This study suggested training of healthcare workers as well as internet access.

Keywords: Palliative care, healthcare workers, knowledge, psychosocial care, pain, training

References:

[1]. African Palliative Care Association. (2009). Palliative care situational analysis report. Ministry of Health and Social Services. Windhoek.

[2]. African Palliative Care Association. (2011). African palliative care association standards for providing quality palliative care across Africa. Retrieved from www.africanpalliativecare.org

[3]. African Palliative Care Association. (2012). Palliative care core curriculum. Uganda. Retrieved from www.africanpalliativecare.org

[4]. African Palliative Care Association. (2013). Palliative care for women living with HIV and cervical cancer. Kampala, Uganda. Retrieved from www.africanpalliativecare.org

[5]. Andershed, B., Sims, M. T., Authors, F., Davison, G., Davidson, J. E., Powers, K., … Fish, A. (2007). Palliative care teams and organisational capability. Palliative Medicine, 24(1), 60–67. http://doi.org/10.1108/13527590210433357.

[6]. APC. (2014). Effective methods of teaching palliative care. A guide for educators and trainers in Africa. Kampala, Uganda. Retrieved from www.africanpalliativecare.org

[7]. Back, A. L., Steinhauser, K. E., Kamal, A. H., & Jackson, V. A. (2016). Building resilience for palliative care clinicians : An approach to burnout prevention based on individual skills and workplace factors. Journal of Pain and Symptom Management. http://doi.org/10.1016/j.jpainsymman.2016.02.002.

[8]. Bronheim, S. M., Can, E., & Anthony, B. J. (2015). Improving care coordination for African American and Hispanic children with special healthcare needs. Journal of Children’s Services, 10(1), 45–56. http://doi.org/10.1108/JCS-04-2014-0023.

[9]. Chipare, M. (2015). A health education programme to enhance knowledge and communication skills of health care workers serving people living with HIV/AIDS on HAART in Namibia. University of Namibia. Retrieved from www.unam.na

[10]. Davidson, J. E., Powers, K., Hedayat, K. M., Tieszen, M., Kon, A. a, Shepard, E., … Armstrong, D. (2007). Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005. Critical Care Medicine, 35(2), 605–622. http://doi.org/10.1097/01.CCM.0000254067.14607.EB.

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Abstract:

Tobacco kills nearly 6 million people each year. Passive smoking is a major hazard to the health of millions of children worldwide. Globally, an estimated 40% of children are reported to be exposed to passive smoke. Adverse effects of smoking in rural population are well studied in any parts the world. But the impact of passive smoking on the children is not widely studied.

Objectives: This study was carried out with the following two objectives: 1) To determine the prevalence of passive smoking among children in a rural population in South India and 2) To find out the effects of passive smoking on children in the study population.

Methodology: This is a community based cross sectional study. It was carried out in Marappadi village in Kulasekharam Panchayat, Kanyakumari District, Tamilnadu in October 2014. 150 children under 15 years in the village were approached at their houses, with questionnaire for socio demographic details and passive smoking history. Apart from this the history of Low birth weight, Growth retardation, and number of URTIs, LRTIs, Ear Infections, Allergy and Asthma episodes were elicited. Data collected was entered in Excel spreadsheet and Analysis was done using SPSS version 16.

Results: There were 150 under 15 children in the study which were collected from 96 households. They were 82 (54.7%) males and 68 (45.3%) females. Passive smoking was present in 32 (21.3%) children. Overcrowding was present in 61 (40.7%) children’s houses. 64 (42.7%) children didn’t have adequate ventilation. Smoke from kitchen was present in 126 (84.0%) houses. 40 (26.7%) of the households were having anti mosquito usage in their house. The number of URTIs was significantly more with children having history of passive smoking as denoted by significant p- value is 0.002. Asthma was present in 20 (13.3%) of children; ear infection was there in 6 (4.0%) children and Allergy was present in 18 (12.0%) children at the time of study. They were more with children having history of passive smoking by looking at the simple percentages. But they were not statistically significant (p – value > 0.05).

Conclusion: 1) The prevalence of Passive Smoking in the study population is 21.3%. 2) Environmental risk factors like Overcrowding, Lack of adequate ventilation, Smoke from kitchen and Anti Mosquito smoke are significantly more associated with children having Passive Smoking. 3) Upper Respiratory Infections are more significantly associated with those who have history of Passive Smoking.

Keywords: Passive Smoking, Rural Population, Smoking among Children, Smoking complications, Rural India.

References:

[1.] ASH Research Report – March 2014:Secondhand Smoke: the impact on children. Available for download from: http://www.ash.org.uk/files/documents/ASH_596.pdf

[2.] Abolhassan Seyedzadeh, Forough Hashemi, Akram Soleimani. Relationship between Blood Pressure and Passive Smoking in Elementary School Children. Iranian Journal of Pediatrics, Volume 22(Number 3), September 2012, Pages: 351-356.

[3.] Amany Abdel-Fattah El-Shazly, Walid Mohamed Abd El Raouf El-Zawahry, Ahmad Mohamed Hamdy, Manal Basyouni Ahmed. Passive Smoking as a Risk Factor of Dry Eye in Children. Journal of Ophthalmology Volume 2012, Article ID 130159, 5 pages. doi:10.1155/2012/130159.

[4.] Burke H, Leonardi-Bee J, Hashim A, Pine-Abata H, Chen Y, Cook DG, et al. Prenatal and Passive Smoke Exposure and Incidence of Asthma and Wheeze: Systematic Review and Meta analysis. Pediatrics. 2012;129(4):735-44.

[5.] Centre for Community Child Health 2006. Preventing Passive Smoking Effects On Children Practice. Available for download from: 

http://www.rch.org.au/uploadedFiles/Main/ Content/ccch/PR_Smoke_Effects_S2.pdf.

[6.] D Gupta, AN Aggarwal, SK Jindal. Pulmonary effects of passive smoking: the Indian experience. Tobacco Induced Diseases 2002, 1:129-136 doi:10.1186/1617-9625-1-2-129.

[7.] Giorgos S. Metsios, Andreas D. Flouris, Manuela Angioi, Yiannis Koutedakis1. Passive Smoking and the Development of Cardiovascular Disease in Children: A Systematic Review. Cardiology Research and Practice. Volume 2011, Article ID 587650, 6 pages. doi:10.4061/2011/587650.

[8.] Gupta D, Aggarwal AN, Kumar R, Jindal SK. Prevalence of Bronchial asthma and association with environmental tobacco smoke exposure in adolescent school children in Chandigarh, North India. Journal of Asthma 2001, 38:501-507.

[9.] Jyoti Sanghvi, Ravindra Kumar, Mithun Somani. Effectiveness of Discontinuation of Passive Smoking on Lung Function of Children by Peak Expiratory Flow Rate (PEFR). Int. J. Bioassays, 2013, 02 (11), 1457-1461.

[10.] Laura L Jones, Ahmed Hashim, Tricia McKeever, Derek G Cook, John Britton, Jo Leonardi-Bee. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respiratory Research 2011 12:5.

[11.] Novaily Zuliartha, Ridwan M. Daulay, Melda Deliana, Wisman Dalimunthe, Rini Savitri Daulay. Association between passive smoking and Mycobacterium tuberculosis infection in children with household TB contact. Paediatr Indones, Vol. 55, No. 1, January 2015. Pages 29-34.

[12.] Royal College of Physicians. Passive smoking and children. A report of the Tobacco Advisory Group of the Royal College of Physicians. London: Royal College of Physicians; 2010.

[13.] Regina M. V. Gonçalves-Silva, Joaquim G. Valente, Márcia G. F. Lemos-Santos, Rosely Sichieri. Household smoking and respiratory disease in under-five children. Cad. Saúde Pública [online]. 2006, vol.22, n.3, pp. 579-586.

[14.] The Global Adult Tobacco Survey (GATS) India, 2009-2010. Ministry of Health and Family Welfare 2010, Government of India, New Delhi. Available for download at: http://mohfw.nic.in/WriteReadData/l892s/1455618937GATS%20India.pdf

[15.] U.S. Department of Health and Human Services. Let’s Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General’s Report on Smoking and Health. Available for download at: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/consumer-guide.pdf

[16.] Vork K, Broadwin R, Blaisdell R. Developing asthma in childhood from exposure to secondhand tobacco smoke. Health Perspect. 2007;115(10):1394-400.

Abstract:

Tobacco addiction is most widespread addiction and it is the most important cause of death in the world. A cross sectional community based study was conducted in Buxar district of Bihar to assess knowledge, attitude and practice regarding Cigarette and Other Tobacco Products Act (COTPA) and tobacco related health problems in rural setting of Bihar, India. Data regarding awareness about tobacco control law in India, tobacco related health problems, attitude regarding tobacco control law and information on tobacco use were collected by interview method using a questionnaire.

The study shows that awareness of COTPA is low, although knowledge and perception about certain components of the COTPA is relatively higher. Attitude and beliefs of participants regarding COTPA showed that at least half of the participants agreeing that provisions were successful in curbing the consumption of tobacco. The mean scores for knowledge, attitude and practice section did not show any statistically significant difference between tobacco users and non-tobacco users after adjusting for sex, age group, occupation. The data shows significant difference in mean score of attitude section between tobacco users and non-users after adjusting for the education status of the individual, no such difference in seen in knowledge and practice totals.

The survey has pinpointed clear areas where a huge gap in knowledge exists; which could be fixed by effective public private partnership. The availability of adequate knowledge and information will lead to change in the attitude regarding consumption of tobacco products in rural India.

A cross Sectional Study in rural population for knowledge, Attitude and Practice of Cigarettes and Other Tobacco Products Act among population of Simri village of Simri Block in Buxar district of Bihar in India.

References:

[1] Guindon GE et al. The cost attributable to tobacco use: a critical review of the literature. Geneva, World Health Organization, 2006.

[2] https://www.rit.edu/research/hsro/informed_consent_document_sample_tips

[3] Mackay, Judith / Eriksen, Michael (2002): The Tobacco Atlas. Geneva, The World Health Organization (WHO).

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[5] Tobacco control foundation of India, Tobacco facts, [cited 2013 Sep 1] available from http://tobaccoindia.org/Tobacco-Facts.html

[6] The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act, 2003. New Delhi, India: Government of India;2003.

[7] The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act, Amendment Bill, 2007. New Delhi, India: Government of India;2007.

[8] Walton J, Barondess JA, Lock S. The Oxford Medical Companion. 1st ed. USA: Oxford University Press: 1994.

[9] WHO Framework Convention on Tobacco Control, WHO, Geneva, Switzerland. [cited2013Sep1]available from http://www.who.int/tobacco/framework/WHO_FCT C_english.pdf

Abstract:

Introduction: Provision of Sexual reproductive health (SRH) to people living in complex humanitarian emergencies is quite challenging. According to World Health Organization (WHO), addressing the health needs of adolescents living in crisis and fragile settings is a fundamental step on the pathway to both sustain the gains of the millennium development goals and achieve the new 2030 sustainable development goals. South Sudan’s humanitarian situation remains fragile, precarious, complex and uncertain. The capacity of the nation to respond to the health of its people is crumbled. More than 4.9 million People are in dire need of humanitarian assistance, maternal mortality rate is 789, 33% of the population is youth under 24years. There remain uncertainties as to whether the humanitarian response efforts are taking account of adolescent needs. This project will assess the accessibility, utilization and compliance of adolescents (aged 10-19 years) to health services provision within WHO set standards from selected camps in South Sudan. The study results shall inform advocacy and programming of SRH services by humanitarian partners.

Methodology: The search criteria will include; Cochrane libraries, PubMed, and others. Literature will be organized and referenced by research software like Mendeley. A cross-sectional study using qualitative and quantitative approaches will be conducted. Results will be analyzed using WHO recommended expand-net framework.

Ethics: Participation in an assessment will be voluntary. Parental consent for minors will be obtained before participating in the study. Approval from South Sudan Ministry of Health ethical committee shall be sought.1951 conventions of rights of refugees will be respected.

Foot note: The cross-section, Complex. Humanitarian, Adolescent, sexual Reproductive Health, Refugees, South Sudan

References:

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[2]. Denno DM, Hoopes AJ, Chandra-Mouli V. Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support. J Adolesc Heal. 2015;56(1):S22-S41. doi:10.1016/j.jadohealth.2014.09.012.

[3]. Bill F, Foundation MG. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016:1813-1850. doi:10.1016/S0140-6736(16)31467-2.Accessed on 23/09/2016

[4]. United Nations, Conference I. A /69/62. 2014;22369(February):1-286.

[5]. Laski L, Wong S. Addressing diversity in adolescent sexual and reproductive health services. Int J Gynaecol Obstet. 2010;110 Suppl:S10-S12. doi:10.1016/j.ijgo.2010.04.011.

[6]. Who. Quality Assessment Guidebook-A guide to assessing health services for adolescent clients. Circuit World. 2009;5(1):14-14. doi:10.1108/eb043585.

[7]. Nove A, Matthews Z, Neal S, Camacho AV. Maternal mortality in adolescents compared with women of other ages : evidence from 144 countries. 1990:155-164. doi:10.1016/S2214-109X(13)70179-7.

[8]. Hindin MJ. “Setting research priorities for adolescent sexual and reproductive” - Google Search. 2015:1-14. http://www.google.com/search?hl=en&client=safari&tbo=d&rls=en&q=%22Setting+research+priorities+for+adolescent+sexual+and+reproductive%22&oq=%22Setting+research+priorities+for+adolescent+sexual+and+reproductive%22&gs_l=serp.3...4523.11357.0.11566.3.3.0.0.0.0.52.12.

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Abstract:

Background: The purchase of counterfeit drugs by consumers is a serious public health problem and there are no sufficient researches dedicated to understanding the problem of drug counterfeiting from the consumers’ perspective.

Aim: The aim of this study to assess factors influencing the purchase of counterfeit drugs among consumers in rural community using the concept of planned behavior (TPB) as a guide.

Methodology: This study is a cross-sectional descriptive research, using pretested questionnaire for data collection to ensure validity and reliability of instrument. A sample size of 236 was used for this study. Data was analyzed using SPSS version 20.0.

Results: The respondents mean age is 30.51years (SD=11.46). Findings from this study showed that 139(58.9%) of the respondents were males while 97(41.1%) were females. Majority of the respondents 56(23.7%) reported the cost of the drug as frequently used means of identification of counterfeit drugs in the community. Respondents perceived associated risk of counterfeit drugs includes: unexpected side effects 33(14%), allergic reactions 38(16.1%), worsening of their medical condition 48(20.3%), death 46(19.5%) and overdose 19(8.1%). Findings from this study also showed a correlation between behavioural intention and attitude (R= 0.64). Subjective norms were associated with behavioural intention (R=0.65) but was not significant at 0.005. There was also an observed significant relationship between behavioural intentions and motivation (R = 0.52).

Conclusion: Drug consumers mainly use cost of drugs as a means of identification of counterfeit drugs. Consumers behavior, intention and attitude towards counterfeit drugs are correlated.

Keywords: counterfeit drugs, consumers perspectives, planned behavior.

References:

[1] Akunyili, D.N., 2007. Couterfeiting medicines: A serious crime against humanity. Proceedings of the Directora General of the National Agency for Food and Drug Administration and Control (Nafdac), April 10, 2007, Nigeria to the European Parliament in Brussels, pp: 1-7.

[2] Ajzen I. (1991). The Theory of planned behavior. Organizational Behavior and Human Decision Processes.;50:179–211

[3] Akpan N.U. (1972). The struggle for secession, 1966-70: Personal Account of the Nigerian Civil War. ISBN-10: 0714629499. Frank Cass Publishers, London.

[4] Ajayi J.O. (2003). The HIV/AIDS Epidemic in Nigeria: Some Ethical Considerations. ISBN 88- 7652-955-1. Gregorian University Press, Rome Italy

[5] Abubakr A. Alfadl, Mohamed Izham M. Ibrahim and Mohamed A. Hassali (2012). Consumer behaviour towards counterfeit drugs in adeveloping country. Journal of pharmaceutical health service.

DOI 10.1111/j.1759-8893.2012.00095.x ISSN 1759-8885

https://www.researchgate.net/publication/259648430

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[8] Engle, R.L., Dimitriadi, N., Gavidia, J.V., Schlaegel, C., Delanoe, S., Alvarado, I., He, X., Buame, S. and Wolff, B. (2010). “Entrepreneurial intent: a twelve-country evaluation of Ajzen’s model of planned behavior”, International Journal of Entrepreneurial Behavior & Research, Vol. 16 (1), pp. 35-57. Emerald Group Publishing Limited. 1355-2554 DOI 10.1108/13552551011020063.

[9] Liñán, F., and Chen, Y. (2009). Development and cross-cultural application of a specific instrument to measure entrepreneurial intentions. Entrepreneurship Theory & Practice, 5, 593-617.

[10] Mhando Linus, Jande Mary, Anthony Liwa, Mwita Stanley, & Marwa Karol (2016). Public Awareness and Identification of Counterfeit Drugs in Tanzania: A View on Antimalarial Drugs.

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[12] National Bureau of Statistics (2006). Federal republic of Nigeria 2006 population census. www.nigerianstat.gov.ng/

[13] Newton PN, Lee SJ, Goodman C, Fernández FM, Yeung S, Phanouvong S, Kaur H, Amin A, Whitty C, Kokwao G, Lindegardh N, Lukulay P, White L, Day N, Green M, White N (2009) Guidelines for field surveys of the quality of medicines: a proposal. PLoS Med 6

[14] Odili, Valentine U., Osemwenkha Sylvia, Eke Esther U. and Okeri Henry A (2006). Identification of Counterfeit Drugs by Community Pharmacists in Lagos State. Tropical Journal of Pharmaceutical Research, 5(1), pp. 545-550

[15] Thogersen, J. (2009). The motivational roots of norms for environmentally responsible behavior. Basic and Applied Social Psychology, 31, 348-362. http://www.textcheck.com/certificate/FKgpLo

[16] Sandhu, M. S., Sidique, F. S., and Riaz, S. (2011). Entrepreneurship barriers and entrepreneurial inclination among Malaysian postgraduate students. International Journal of Entrepreneurial Behaviour & Research Vol. 17 No. 4, 2011 pp. 428-449 Emerald Group Publishing Limited 1355-2554

[17] Sekaran, U. (2003). Research Methods for Business: A Skill-Building Approach. John Wiley & Sons, New York, NY.

[18] World Health Organization. Substandard and counterfeit medicines. Fact sheet No. 275, 2012. Available at http://www.who.int/mediacentre/factsheets/2012/fs275/en/ (last accessed 14, September 2016).

[19] Yankus W (2006). Counterfeit Drugs: Coming to a Pharmacy Near You. American Council on Science and Health. Available: www.acsh.org/publications/pubID.1379/pub_detail.asp

Abstract:

Background: Health care is one of the most important services that every one desires to be of high quality and safety, but in real practice, this is not always the case. In the event of seeking health care, many patients are harmed and some get serious disabilities or even death. System failures and blame for errors committed are the ones that mostly promote occurrence of medical errors hence resulting into unsafe healthcare. Blame prevents health care providers from reporting errors for future prevention of re occurrence.

Patient safety, which is a component of quality healthcare, is defined as the absence of avoidable harm to patients during the process of health care, (Carmen A. n.d.). To achieve 100% absence of avoidable harm to patients is hard to realise as `to err is human` but efforts to avoid harm are of great importance. In developed countries, thousands of patients are reported to suffer serious harm and death in the event of receiving health care services. In 1999, Institute of Medicine in the USA estimated 44,000 to 98,000 preventable deaths annually due to medical errors in USA hospitals, (IOM 1999). In Uganda`s healthcare system, many patients are harmed and many even die during the event of seeking for healthcare but due to poor reporting systems there is limited information on the magnitude of preventable harmful medical errors.

The study to determine patient safety culture of Iganga, Kakira and Kamuli Mission in south eastern Uganda, had five objectives of; assessing the knowledge of health workers on patient safety, the role of the hospital management in promotion of patient safety culture, determine patient safety culture practices, point prevalence of common inpatient safety incidents, and causal pathways.

Methodology: The study was an observational, descriptive and cross-sectional survey. A sample of 144 health workers were interviewed using a questionnaire, three focus group discussions with hospital managers were conducted, and 169 inpatient records were reviewed. Data was entered in SPSS 16. 0 software then into Excel for further analysis and later presented in graphs.

Results: The study revealed that the knowledge of health workers on patient safety in the study hospitals was just above average at 55.8%. Under and over dosing of patients, dispensing of wrong drugs and poor infection control being the most common medical errors known, where as Uganda clinical guideline was found to be the most known guideline for patient safety. The study also showed that, the majority of health workers would not report errors due to ignorance and fear of blame. The study showed existence of team work and channels for communication of patient safety issues between management and staff. However, management role in promotion of patient safety is still demanding as there was limited availability of policies and guidelines, lack of patient safety incident record books and patient safety committees. There existed fairly good patient safety practices as communication, hand washing, dispensing and team work were all above average. However it was found out that poor reporting, fear of blame, under staffing and inadequate waste disposal practices did exist. Incidents of failure to monitor vital signs and delayed investigations were more prevalent in over 70% of all records studied. The majority of the surgical operations were done without pre-operative investigations and had inadequate post operative notes increasing the chances of harm to surgical patients. Causal pathways for medical incidents were mainly lack of guidelines and policies, poor monitoring of adherence to guidelines, limited skills and training of staff, understaffing, heavy workloads, lack of logistics and faultiness of equipments and lack of reporting procedures for patient safety.

Conclusion: In conclusion, the level of knowledge on patient safety culture is just average as awareness is still limited. There is a significant lack and limited availability of policies and guidelines, incident record books and committees that promote patient safety. The bad practices of fear to report incidents, under-staffing and fear of blame for errors committed need improvement. Failure to monitor vital signs, difficulty to access high skilled staff especially the medical officers and inadequate post operative notes also need serious attention as they are part of the causal pathways for patient safety incidents in the study hospitals. Provision of policies and guidelines, training of health worker, management leadership and effective communication and monitoring of patient safety in the study hospitals are highly recommended.

References:

[1] AHRQ (2007). Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies. Volume 7, Number 9. www.ahrq.gov. Stanford University–UCSF Evidence-based Practice Center, Stanford, CA.

[2] BATEGANYA MOSES, AMY HAGOPIAN, PAULA TAVROW, SAMUEL LUBOGA AND SCOTT BARNHART 2009. Incentives and barriers to implementing national hospital standards in Uganda. International Journal for Quality in Health Care 2009; Volume 21, Number 6: pp. 421 –426 10.

[3] CARMEN AUDERA. n.d. WHO Patient Safety Programme-Meeting the challenges Faced by Emerging Countries in the Provision of Quality Primary Health Care Cape Town. WHO.

[4] CARMEN AUDERA-LOPEZ 2011. WHO patient safety programme 3rd annual conference on safety, standards and customer services lagos 13th and 14th october 2011. WHO.

[5] DEPARTMENT OF HEALTH EXPERT GROUP 2000. "An organisation with a memory". Department of Health, United Kingdom.

[6] DONABEDIAN A. 2005. Evaluating the Quality of Medical Care. The Milbank Quarterly, Vol. 83, No. 4. Milbank Memorial Fund. Published by Blackwell Publishing

[7] EU-PSWG 2007. Recommendations on patient safety by patient safety working group. European commission health and consumer protect general. Accessed on http://ec.europa.eu/health/archive/ph_systems/docs/ev_20080617_rd01_en.pdf on 8/5/2012.

[8] IAPO (2008a), Uganda Health News: IAPO Launches Patient Safety Toolkit. Kampala, Uganda. Accessed from http://www.ugpulse.com/uganda-news/health/iapo-launches-patient-safety-toolkit/7054.aspx 24/4/2010

[9] IAPO (2008b). Addressing global safety issues. An advocacy toolkit for patients` organization

[10] INSTITUTE OF MEDICINE (IOM). 2000. "To Err Is Human: Building a Safer Health System." In L.T. Kohn, J.M. Corrigan and M.S. Donaldson, eds. Washington, DC: National Academy Press.

[11] LUWEDDE M 2011. Uganda Catholic Medical Bureau Bulletin Jan - Dec 2011. Page 13-15

[12] MOH (2009), Uganda National Health Policy II 2011-2020

[13] MOH (2011), Health Sector Quality Improvement Framework and Strategic Plan 2010/11 – 2014/15.

[14] MOH (2005), Injection safety and appropriate health care waste management. MMIS.

[15] ROSS BAKER, PETER G. NORTON, ET AL. (2004). "The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada". Canadian Medical Association Journal 170.

[16] WHO (2004), World Alliance for Patient Safety, Forward programme 2005. Accessed on 

http://www.who.int/patientsafety/en/brochure_final.pdf on 8/3/2012.

[17] WHO (2008a), Better knowledge for safe care, Global Priorities for Research in Patient Safety (first edition) The Research Priority Setting Working Group.

[18] WHO (2008b), World Alliance for Patient Safety WHO Guidelines for Safe Surgery.

[19] WHO (2009a pp106-147), Conceptual Framework for the International Classification for Patient Safety Version 1.1 Final Technical Report.

[20] WHO (2009c). Medicines use in primary care in developing and transitional countries. Fact Book summarizing results from studies reported between 1990 and 2006.

[21] WHO (2009d). African partnership for patient safety: working for safer health care … together. World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland

[22] WHO (n.d. b). 

http://www.who.int/patientsafety/research/evidence_of_unsafe/en/index.html

Abstract:

Background: Climate change has had a profound effect on socioeconomic, cultural, political, technological and even biological nature of man and plants in the world. This study is aimed at investigating the relationship between climate change and health of adult residents of Ile-Ife, Nigeria.

Methods: A sample survey method was used with structured questionnaire and oral interview. Random sampling technique was employed to get the sample size of 142. Informed consent of participants was obtained before commencement of the study. 142 questionnaires were duly completed and returned. Data were analyzed using frequencies, mean, standard deviation and percentages. Pearson Product Moment Correlation was employed to find the relationship between the test variables of the hypotheses.

Findings: Majority of respondents (48.6%) had tertiary education, 20.4% had secondary education, while 18.3% are illiterate. 42.3% got their information on climate change through radio, while only 4.9% got theirs through research institutes. 54.9% had adequate knowledge about climate change and only 9.2% had very inadequate knowledge. 37.3% experienced malaria and headache together due to climate change, while few (0.7%) experienced skin rashes. Significant relationship existed between the socioeconomic characteristics of the respondents and their present health status (r = 0.348, p = 0.001, α = 0.05). Significant relationship was similarly found between the socioeconomic characteristics of respondents and their perception of the effect of climate change on their health (r = 0.392, p = 0.001, α = 0.05).

Conclusion: Climate change had negative impacts on the health of adult residents of Ile-Ife. Governments should ensure preservation of the ozone layer and also increase awareness of the citizens on climate change and the effects on human health.

Keywords: Climate, Climate change, Health, Relationship, Adult residents, Knowledge.

References:

[1]. Adesiji GB, Tyabo LS, Ibrahim M, Fabiyi JO, and Oladele OA (2013). Effect of climate Change on the Health of Rural Farmers in Offa, Kwara State, Nigeria. Ethiopian Journal of Environmental studies and Management, 6(3).

[2]. Awosika LF, French GT, Nicholls RT, Ibe CE (1992). The impact of sea level rise on the coastline of Nigeria [O’ Callahan J. (E.d.)] In: Global climatic change and the rising challenge of the sea. Proceedings of the IPCC workshop of Margarita Island Venezuela, 9-13. National Oceanographic and Atmospheric administration, Silver Spring, M.D., USA, pp. 690.

[3]. Canadian Institute of Actuaries (2015). Climate Change and Resource Sustainability: An Overview for Actuaries. Document 215068.

[4]. Climate change and health, Fact sheet Number 266 (2015). who.int/mediacentre/factsheets/fs266/en. Report. Summary for Policy Makers, IPCC, 2007.

[5]. Haines A, Kovats RS, Campbell-Lendrumb C, & Corvalan, C (2006). Climate Change and Human Health: Impacts, Vulnerability and Public Health. Journal of the Royal Institute of Public Health, 120, pp. 585-596.

[6]. Idowu AA, Ayoola SO, Opele AI, Ikenweiwe NB (2011). Impact of climate change in Nigeria. Iranica Journal of Energy and Environment, 2(2): 145-152.

[7]. Odafivwotu O (2015). Public Perception of Climate Change in Yenagoa, Bayelsa State, Nigeria. Geography Journal, Article ID 208154. http://dx.doi.org/10.1155/208154.

[8]. Ojo MA and Muhammed US. (2008). Resource used efficiency in maize production among small scale farmers in Lavun Local Government Area of Niger State. International Journal of Tropical Agriculture and Food System 2(1), pp. 170-174.

[9]. Sanusi O. (2013). Climate Change: the impacts and potential benefits for the developing Nations. International Journal of Agricultural Research and Review. 1, pp. 002-012.

[10]. Tunde AM, Adeleke EA and Adeniyi EE (2013). Impact of climate variability on human health in Ilorin, Nigeria. Environment and Natural Resources Research, 3(1): pp. 488-496. 

Abstract:

The aim of this paper was to explore and present the impact or power of the academic research for innovation in practice and policy, that is, the academic research collaboration in the progress of policy in government and innovation in professional practices with particular emphasis on northern Nigerian region. It is a systemic review type of study design.

As a matter of fact, universities and other higher institutions like polytechnics schools, have been serving our societies for virtually a thousand years and we have no doubt in our minds that over that period of time, universities, schools of polytechnic, colleges of higher education and the world have undergone significant transformation mainly due to advancement in research that influence policy formulation and its implementation.

It is obviously clear to everyone that, the world is now more complex, more interwoven or inter-connected and changing more rapidly and that we also live in an environment that is coerced by news cycles, passing manners and uncertainty in the futures. Moreover, social structures are changing, as well as values and attitudes. There are also competition that is growing, people are increasingly mobile and the global economic becomes centre of gravity that is changing at a speed not seen before. As such, governments have to address such problems as climate change, potential pandemics of diseases and food insecurity that are global in scope and require a coordinated global response. These are achieved through research (both academic and other form of researches)

Natural and man-made disasters are becoming more common and their consequences greater. People everywhere feel under pressure. Change is inevitable and one of the important roles of universities and other higher institutions has been to make some of these changes possible through mostly academic researches that create new understanding, new technologies and the potential for action; and by providing a store of knowledge and capabilities that society as a whole has been able to draw upon.

In this paper, therefore, the author reviewed some papers written by other authors on the subject and then expressed the situation obtainable here in Nigeria, the gaps and challenges in the use of academic research in policy development and practice in the area under review. Some recommendations were also made.

Keywords: Academic Research, Innovation, Growth and Development, Policy Development.

References:

[1] A.K.Yusuf (2012), “An Appraisal of Research in Nigeria’s University Sector”. JORIND 10 (2), June, 2012. ISSN 1596 - 8308. 

www.transcampus.org./journals, www.ajol.info/journals/jorind

[2] E.H. Kwon-Ndung et al (2014), “Research and Innovation Strategies for Economic Competitiveness and Industrial Growth: Lessons for Nigeria”. European Journal of Business and Innovation Research Vol.2,No.6, pp.56-76, December 2014

[3] Stéphan Vincent-Lancrin (2006), “What is changing in Academic Research? Trends and Futures Scenarios”. Forthcoming in the European Journal of Education, 41, 2, June 2006.

[4] Group of Eight (2013), “The Role and Importance of Research Intensive Universities in the Contemporary World”(Discussion Paper). The Group of Eight Group of Eight House Level 2, 101 Northbourne Avenue Turner ACT 2612. www.go8.edu.au

[5] Prof. Ilberto Stocchi et al (2015), “Increasing the Power of Academic Research through the Insitutional Research and Innovation Development on Macroregione Adriatico-Ioniana”. E-ISSN 2281-4612 ISSN 2281-3993 Academic Journal of Interdisciplinary Studies MCSER Publishing, Rome-Italy Vol 4 No 2 S2 August 2015

[6] OECD (2007), “Innovation and growth rationale for an innovation strategy”. Organization for Economic Co-Operation and Development.

[7] Lennart E, – VINNOVA (2014), “Innovations and new technology - What is the role of Research? Implications for Public Policy”. VINNOVA - Swedish Governmental Agency for Innovation Systems / Verket för Innovations system ISBN 978-91-87537-16-5

[8] Betsy Beacom (2016) eHOW, “Definitions of Academic Research and Process of Writing Academic Research”. http://www.ehow.com

[9] Dr. Donald (2015), Study Modules “Research Methodology”. Master Public Health, School of Public Health, Texila American University.

Abstract:

HIV infection is still associated with a lot of stigmatization and discrimination, which makes it difficult for infected individuals to disclose their status. Many studies have shown different rates of disclosure of HIV status with average of 71% in the developed world and 52% in the developing world (WHO 2004)). Different reasons were attributed to non-disclosure of HIV status which included fear of abandonment, fear of rejection and discrimination, fear of violence and fear of upsetting family members.

Counseling is integral to guiding the infected persons to disclosure and a study by Alemayehu et al (2014) in Northern Ethiopia support that counseling is important to HIV disclosure. In ANC in Nigeria, opt out counseling and testing is practiced as recommended by WHO which focused on group counseling, it is however recommended that HIV positive individuals should be privileged to have one on one counseling with counselors to avail them of the opportunity to be properly counseled on the benefits of disclosure and other HIV care (FHI, 2008).

Counseling is an intervention that gives one the opportunity to confidentially discuss his or her situation in a dialogue with the aim of helping the person to explore and work out possible solutions in a reasonable manner. Disclosure is essential to achieving good HIV care especially in PMTCT for many reasons. It motivates sexual partners to go for testing, change risky behaviors and provide support to the infected partners as showing in several studies which reported high support rate for infected persons who disclosed their status to their sexual partners. Other benefits are that it increased the opportunities for improved access to appropriate medical treatment and care and to plan HIV risk reduction with sexual partners (WHO, 2004).

Scogmar et al (2006) in the study in South Africa did not show correlation between HIV counseling and disclosure and likewise Adeyemo et al (2011) in Lagos, South west Nigeria reported low disclosure to counseling even though there was improvement in the attitude change towards disclosure after counseling. This study is therefore aimed at determining the role of counseling in the disclosure of HIV status to sexual partners among HIV positive women in PMTCT programme.

References:

[1] Adeyemo, A, Adediran, A, Akinbami, A, Unigwe, O &Akanmu, A 2011, ‘Psychosocial impact of disclosure of HIV serostatus min heterosexual relationship at the Lagos University teaching hospital, Nigeria’ Nigerian Medical Journal, vol. 52, no.1, pp 55-59. Available from: < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180759/>

[2] Almayehu, M, Aregay, A, Kalayu, A &Yebyo, H 2014, ‘HIV disclosure to sexual partner and associated factors among women attending ART clinic at Mekelle hospital, Northern Ethiopia’ Biomedical Central Journal of Public Health, vol. 14, pp. 746. Available from: [7 August 2016]

[3] Deribe, K, Woldemichael, K, Wondafrash, M, Haile, A & Alemayehu, A 2008, ‘Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia’, Biomedical Central Journal of Public Health, vol. 8, pp.18. Available from: http://www.biomedcentral.com/1471-2458/8/81[7 August 2016]

[4] Edo State Ministry of Health 2010, Edo State Government strategic health development plan 2010-2015. Available from:

www.mamaye.org.ng/.../Edo%20SSHDP%20revised%2005.0.11_0.pdf. [7 August 2016]

[5] Federal Ministry of Health [FMOH] 2014, Integrated national guidelines for HIV prevention treatment and care. National AIDS/STIs Control Program, Nigeria. Available from: . [7 August 2016]

[6] King, R, Katuntu, D, Lifshay, J, Packel, L, Batamwita, R & Nakayiwa, S 2008, ‘Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda’, AIDS Behavior Journal, vol. 12 no. 2, pp 232-243. [7 August 2016]

[7] Kiula, ES, Damian, DJ &Msuya, SE 2013, ‘Predictors of HIV serostatus disclosure to partners among HIV positive pregnant women in Morogoro, Tanzania’, Biomedical Central Journal of Public Health, vol. 13 no. 433, pp. 1-9. Available from: < www.scirp.org/journal/PaperDownload.aspx?issueID=6099 >. [7 August 2016]

[8] Ogoina, D, Ikuale, P, Ebuenyi, I, Harry, T, Inatimi, P & Chukwueke, O 2015, ‘Types and predictors of partner reactions to HIV status disclosure among HIV infected adult Nigerians in a tertiary hospital in the Niger Delta’, African Health Sciences Journal, vol. 15, no. 1, pp. 10-18. Available from: <

http://www.ajol.info/index.php/ahs/article/view/114004>. [7 August 2016]

[9] Sethosa, E & Peltzer, K 2005, Evaluation of HIV counseling and testing, self-disclosure, social support and sexual behavior change among a rural sample of HIV reactive patients in South Africa, ‘PubMed Journal of Medicine, vol. 28, no. 1, pp.29-41. Available from: < http://www.ncbi.nlm.nih.gov/pubmed/15850151>[7 August 2016]

[10] Skogmar, S, Shakely, D, Lans, M, Danell, J, Andersson, R, Tsandu, N, Oden, A, Roberts, S & Francois, V 2006, ‘ Effect of antiretroviral treatment and counseling on disclosure of HIV sero-status in Johannesburg, South Africa, ’ PubMed Journal of Medicine, vol. 18, no. 7, pp. 725- 730. Available from: < http://www.ncbi.nlm.nih.gov/pubmed/16971281>[7 August 2016]

[11] Walcott, M, Hatcher, A, Kwena, Z &Turan, J 2013, ‘Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study’, Biomedical Central Journal of Public Health, vol. 13, no. 1115, pp. 1-13.

[12] World Health Organization 2015, Prevention of mother to child transmission: situation and trends, Global Health Observatory data. Available from: <

http://www.who.int/gho/hiv/epidemic_response/PMTCT_text/en/ >. [7 August 2016]

[13] World Health Organization 2004, Gender dimensions of HIV status disclosure to sexual partners: rates, barriers and outcomes. Department of Gender and Women Health. Available from: < http://apps.who.int/iris/bitstream/10665/42717/1/9241590734.pdf >. [7 August 2016]

[14] World Health Organization 2003, ‘Preparing a research project proposal: guidelines and forms’, UNDP/UNFPA/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction. 4th Ed. Available from: < http://www.gfmer.ch/SRH-Course-2011/research-methodology/pdf/WHO-proposal-guidelines-forms-2003.pdf>. [7 August 2016]

Abstract:

Mother to child transmission of HIV is the major route of HIV infection in children and is responsible for nearly 90% of childhood infections. International guidelines on infant feeding for HIV- positive mothers promote exclusive replacement feeding (ERF) or exclusive breastfeeding (Laar and Govender, 2013). In spite of these guidelines, poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Korogocho, with potential detrimental effects on child growth and survival. Rates of exclusive infant feeding, both breast-feeding and formula-feeding, are suboptimal in Korogocho slums with exclusive breastfeeding for the first six months being at about two per cent. (Kimani-Murage et al., 2013). This study was thus carried out with the main objective of assessing the infant feeding challenges of HIV positive mothers in this slum which leads them to practice poor infant feeding. Purposive sampling was used to select the study site and simple random sampling was used to select a sample of 103 calculated using Fischer’s method from a target population of 140. Data was collected using interviewer administered questionnaires and three focus group discussions were conducted. Quantitative data was cleaned, coded, entered and analyzed using SPSS Version 16. Qualitative data was analyzed using a three stage thematic approach through transcription of the tape recordings, summarization, thematical description and direct reporting where necessary. Quantitative data was presented in the form of tables and textual summaries. Results from this study showed poor knowledge of appropriate infant methods as only 46 (44.7%) mothers were satisfied with the infant feeding counseling they had received from the health personnel. Poor clinic attendance by 61(59.2%) of the mothers may have led to short and few sessions and it also affected the time of infant feeding thus the poor quality of counseling. Most of the mothers were aware of mother to child transmission (MTCT) of HIV through breastfeeding and 62(60.2%) knew that it could be prevented through exclusive breastfeeding, 60 (58.3%) through replacement feeding and 54 (52.4%) through early and abrupt cessation of breastfeeding though quite a number lacked this knowledge. The concerns raised by breastfeeding mothers included; 29(56.9%) inability to produce sufficient milk, 23 (45.1%) infections in the baby’s mouth, 19 (37.3%) breast infections and 9(11.8%) inability to control the feeding due to the influence of the extended family. Feelings of guilt 33(94.3%) and cost of replacement feeding 26(74.3%) were the major concerns among replacement feeding mothers. Though 17 (16.5%) had ceased breastfeeding early, up to 15(88.2%) of them lacked advice on the appropriate feeding methods after breastfeeding cessation. Mothers in this study were aware of the WHO recommendations on infant feeding and MTCT through breastfeeding and its prevention. However, they faced several challenges which include poor knowledge on appropriate infant feeding methods, inability to produce sufficient milk, high cost of replacement food and lack of knowledge on appropriate infant feeding practices after cessation of breastfeeding. More emphasis should be put on proper clinic attendance by the mothers as this will provide additional time for the health personnel to provide full information infant feeding. Provision of information on appropriate infant feeding practices after cessation of breastfeeding should be enhanced. Further investigations are required to determine the cause of insufficient milk production by the mothers.

References:

[1] Aidam BA, Pérez-Escamilla R, Lartey A. (2005) Lactation counseling increases exclusive breast-feeding rates in Ghana. Journal of Nutrition. 33: 1691-1695. jn.nutrition.org/content/135/7/1691.full

[2] Aika AAO, Luo C, Kankasa C, Bhat GJ, Bunn J. (2003) Infant-feeding practices of mothers of known HIV status in Lusaka, Zambia. Health Policy and Planning; 18: 156-162.)

[3] Alcala M. (2005) State of the world population. UNFPA Publication. New York, USA

[4] Asefa A, Beyene H. (2013) Awareness and knowledge on timing of mother-to-child transmission of HIV among antenatal care attending women in Southern Ethiopia: a cross sectional studyJournal of Reproductive Health10: 66

[5] Background. Korogocho Slum Upgrading Programme (KSUP http://www.ksup.org

[6] Becquet R, Ekouevi DK, Viho I, Sakarovitch C, Toure H, Castetbon K. (2005b). Acceptability of exclusive breast-feeding with early cessation to prevent HIV transmission through breast milk, ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d’Ivoire. Journal of Acquired Immune Deficiency Syndrome, 40 (5): 600-608.

[7] Bezner KR, Dakishoni L, Shumba L, Msachi R, Chirwa M. (2008) “We grandmothers know plenty:” breastfeeding, complemantary feeding and the multifaceted role of grandmothers in Malawi. Soc. Sci. Med.66 (5):1095-105

[8] Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK.(2003). Effect of community-based promotion of exclusive breastfeeding on diarrhoeal illness and growth: a cluster randomized controlled trial. Lancet, 361 (9367): 1418-1423.

[9] Bland RM, Rollins NC, Coutsoudis A, and Coovadia HM. (2002). Breastfeeding practices in an area of high HIV prevalence in rural South Africa. Acta Paediatrica, 91 (6): 704-711.

[10] Burr C K. (2011) Reducing Maternal-Infant HIV Transmission http://hab.hrsa.gov/deliverhivaidscare/clinicalguide11/cg-402_pmtct.html

[11] Chopra M, Doherty T, Jackson D, Ashworth A. (2005) Preventing HIV transmission to children: quality of counseling of mothers in South Africa. Journal of Paediatrics94: 357-363.

[12] Chopra M, Rollins N. (2007) Infant feeding in the time of HIV: Assessment of infant feeding policy and programs in four African countries scaling up prevention of mother to child transmission programs. Global Health Sciences Literature Digest. Available at:http://hivinsite.ucsf.edu/InSite?page=jl-20-02. Accessed September 15, 2013.

[13] Coutsoudis A, Pillay K, Kuhn L, Spooner E, Tsai WY, and Coovadia HM.(2001). Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. AIDS, 15 (3): 379-387.

[14] Coutsoudis A. (2005). Infant feeding dilemmas created by HIV: South African experiences. Journal of Nutrition, 135 (4): 956-959.

[15] Desclaux A, Alfieri C. (2009) Counseling and choosing between infant-feeding options: Overall limits and local interpretations by health care providers and women living with HIV in resource-poor countries (Burkina Faso, Cambodia, Cameroon) Journal of Social Science and Medicine.30:203-210

[16] De Paoli MM, Manongi R, and Klepp KI. (2001). Counsellor’s perspectives on Antenatal HIV testing and infant feeding dilemmas facing women with HIV in northern Tanzania. Reproductive Health Matters, 10 (20): 144-156.

[17] De Paoli MM, Manongi R, Helsing E, and Klepp KI. (2002). Exclusive Breastfeeding in the era of AIDS. Journal of Human Lactation, 17 (4): 313-320.

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Abstract:

Introduction: In most developing countries, Nigeria in particular, there is little equity and a clear lack of universal coverage of health care. Majority of the health seeking people first visit the community pharmacies when they are ill, before visiting the hospitals, yet a large percentage of Community Pharmacies are not registered with the National Health Insurance Scheme. The objective of the study was to assess the Knowledge, Attitude, Perception and Practice of the Health Insurance Scheme among Community Pharmacists in Lagos State, with the hope that it would serve as a baseline study towards improving Community Pharmacists’ involvement in the implementation of the Health Insurance Scheme.

Method: A cross-sectional descriptive study was carried out on 200 Community Pharmacists in Lagos State using a multi-staged stratified random sampling method and structured questionnaire. Analysis was done with Statistical Package for Social Sciences (SPSS) version 14.0 to obtain the frequencies, percentages and descriptive statistical results.

Result: Majority of the respondents were females (60%), in the age range of 41years and above (47%), without additional qualifications (70%), and 73% with more than 16 years post qualification experience. More than 80% had poor knowledge of the major guidelines and activities in Health Insurance Scheme while 86% were neither registered nor participating. Lack of integration among health care providers, lack of prescription from hospitals, need for cumbersome data, inadequate funding and training, lack of capitation for pharmacists were seen as the major hindrances to their participation.

Conclusion: The study revealed poor knowledge, attitude, perception and practice of the Health Insurance Scheme, among Community Pharmacists. Adequate training of community pharmacists and funding of the scheme, modifying the payment system to capitation as well as improving coordination, integration and standard of operation of the Health Insurance Scheme will improve their involvement.

Keywords: Community Pharmacists, Knowledge, Attitude, Perception, Practice, Health Insurance

References:

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Abstract:

This article investigates the benefit of workplace wellness programs, their prevalence, their impact on employee’s health and medical cost, facilitators of their success in each programs (Workplace Wellness Programs Study Soeren Mattke, et.al.)

References:

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3 World Health Organization, Preventing Chronic Disease:

[13]. A Vital Investment (2005), p. 2: 

http://www.who.int/chp/chronic_disease_report/en/index.html 4 Ibid., p. 18. 5

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http://www.who.int/nmh/publications/ncd_report_full_en.pdf 6 World Economic Forum/Harvard School of Public Health,

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Abstract:

Self-medication can potentially do well and also harm people. It is a common practice and internationally has been reported as being on the rise. Studies have observed self-medication as a common practice among group of health workers that included dental, midwifery and nursing students. Hence, this study assessed the knowledge and practice of self-medication among students of school of nursing in selected schools in Osun State. It was a descriptive cross-sectional survey. Samples of two hundred nursing students were included in the study using purposive sampling.

The result in this study showed that majority (91%) of the nursing students had high level of knowledge and about two third (64.5%) indulge in high practice of self medication respectively. More than half of them signified that presence of minor ailments and having enough knowledge about drugs were the factors that always make them to self-medicate, while more than forty percent indicated that financial constraint, previous experience, time saving, advertisement and unavailability of health care services as factors that sometimes influence self-medication. Significant relationship existed between knowledge and practice of self medication (t = -3.116, df = 198, P < 0.05).

Nursing students demonstrated high level of knowledge about medication and its effects. Majority indulge in self-medication practices. Those with high level of knowledge practice of self medication less. It would be safer if those who self-medicate have sufficient knowledge to prevent serious effects. It is recommended that policies be formulated to control the purchase and use drugs.

Keywords: Practices of self-medication among nursing students

References:

[1]. Al-Hussaini M, Mustafa S, and Ali S. (2014). Self-medication among Undergraduate Medical Students in Kuwait with reference to the Role of the Pharmacist. Journal of Research Pharmacy Practice; 3 (1): 23-27.

[2]. Ali S. E., Ibrahim M. I. M., and Palaian S. (2010). Medication storage and self-medication behaviour amongst female students in Malaysia. Pharmacy Practice; 8(4): 1-7.

[3]. Arikpo G., Eja M., and Enyi-Idoh K. (2009). Self-Medication in Rural Africa. The Internet Journal of Health: 11 (1).

[4]. Auta A., Shalkur D., Omale S. and Abiodun A. H. (2012). Medicine Knowledge and Self-Medication Practice Among Students. JPRD; 4 (1): 6-11.

[5]. Awosusi and Konwea (2015). Self-medication Practice among Secondary School Students in Ekiti State, Southwest Nigeria. JAMPS, 3(2): 61-68.

[6]. Banerjee I, and Bhadury T. (2012). Self-Medication Practice among Undergraduate Medical Students in a tertiary care medical college, West Bengal. J. Postgrad. Med. 58(2):127.

[7]. Bernal B. S. R., and Silva N. N., (2010). Self-Medication in Low-Income Adults in South-Eastern Brazil. Rev SauePulica; 44(6): 1-6.

[8]. Dimabayao C. G. and Mohammad E. K. (2016). Prevalence of Self Medication Practice among Nursing Students in Jazan University, Kingdom of Saudi Arabia. IOSR-JNHS; 5 (1): 11-16

[9]. Ehigiator O., Azodo C.C., Ehizele A.O., Ezeja E.B, Ehigiator L, et al (2013). Self medication practices among dental, mid- wifery and nursing students. Eur J Gen Dentistry 2:54–57.

[10]. El-Nimr, N.A., Wahdan, I.M.H, Wahdan, A.M.H. and Kotb R.E. (2015) Self-medication with drugs and complementary and alternative medicines in Alexandria, Egypt: prevalence, patterns and determinants. East Mediterr Health J.; 21(4):256-65.

[11]. Emmanuel A., Daniel G., Achema G., Afor B., Onyejekwe G., and Gimba SM. (2011). Self-Medication practice among undergraduate nursing students of University of Jos, Nigeria. Nigerian Journal of Pharmaceutical Sciences; 10 (2): 22-26.

[12]. Fadare J. O. and Tamuno I. (2011). Antibiotic Self-Medication among University Medical undergraduates in Northern Nigeria. J Public Health Epidemiol; 3 (5): 217–220.

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[14]. Joshi M.C., Shalini, and Agarwal S. (2011). A questionnaire based study of self-medication practices among young population. Res. J. Pharm., Biol. Chem. Sci.; 2:761–6.

[15]. Lukovic J. A., Miletic V., Pekmezovic T., Trajkovic G., Ratkovic N., et al. (2014). Self-Medication Practices and Risk Factors for Self- Medication among Medical Students in Belgrade, Serbia. PLoS ONE 9(12): e114644. doi:10.1371/ journal.pone.0114644

[16]. Olayemi O. J., Olayinka B. O., Musa A. J., (2010). Evaluation of antibiotic self-medication: Pattern amongst undergraduate students of ABU (Main Campus) Zaria. J Appl Science Res.; 2(1):35-38.

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[19]. Sontakke S.D., Bajait C.S., Pimpalkhute S.A., Jaiswal K.M, Jaiswal SR. (2011). Comparative study of evaluation of self medication practices in first and third year medical students. Int J Biol Med Res.; 2(2): 561-564.

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[23]. Vizhi S. K., Senapathi R., (2010). Evaluation of the perception, attitude and practice of self-medication among business students in 3 select Cities, South India. International Journal of Enterprise and Innovation Management Studies (IJEIMS); 1 (3): 40–4.

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Abstract:

In early Roman Society, a woman was deemed the property of the husband and was therefore subject to his control.

The Catholic Church’s endorsement of “the Rules of marriage” in the 15^th century exhorted the husband to stand as ‘judge of his wife. He was, to beat her with a stick upon her commission of an offense. According to the rules, beating showed a concern for the wife’s soul.

In 18^th century France, if it became public that a wife had beaten the husband, he was forced to wear an outlandish costume and ride backwards around the village on a dnkey.

It was not until the 1870s that the first states in the US banned a man’s right to beat his family.

Violence against women, whether pregnant or not occurs commonly around the world especially the developing world. The act cuts across all ages, cultures, ethnicity religion and educational barriers.

Domestic violence refers to any harmful behaviour directed at women or girls because of their sex it is also known as gender based violence.

The violence can take various forms, and could be physical, psychological, (emotional) sexual, economic or a combination or even neglect. It can also be in the form of threats of such acts, coercion, or arbitrary deprivation of liberty whether occurring in public or private life. A new dimension has been added now in the form of acid baths used by men especially to discipline women, girls.

The prevalence of domestic violence against women ranged between 17-37% with considerable regional variation. Domestic violence can broadly be classified into domestic abuse, spousal abuse, child abuse, intimate partner violence (IPV), elder mistreatment.

Domestic violence or spousal Abuse in this content is a form of violence against women and when it involves pregnant women, it calls for a closer attention because of the greater danger it entails. Both the world health organization WHO and international federation of obstetricians and gynecologists (FIGO) recognize the scourge of violence against women and starting train the nineties passed various declarations on the elimination of violence against women. The factors which lead to domestic violence are a legion and range from no offence, minor to major offences.

Most countries and various religions from against domestic violence but because the cultures of the people of these countries do not frown at it, the problem has persisted it hence explains the attitude of the women to domestic violence with some even justifying it. Domestic violence may start or escalate with pregnancy.

Domestic violence is not caused by illness, gentiles, or gender, alcohol or other drugs, anger, stress victim’s behaviour or relationship problems, it is a learned behaviour by batterers, and it has enormous impact on pregnant women. It is a recognized public health issue that has serious consequences on physical and mental health. Domestic violence has been associated with psychiatric illnesses, depress, anxiety, posttraumatic stress disorderattempted suicide and also important implications for the fetus as low birth weight, miscarriages, a bleeding, prematurity, abruption, or even death of either or both fetus and mother.

There is paucity of data on domestic evidence mainly because of under reporting by the victims, but quite sequent.

References:

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[12] T T Wopkoma, M. Jampala, H Bexhell, R Sutbn’e S Lindar A comparative study of the prevalence of domestic violence in women requesting a termination of pregnancy and those attending the antenatal clinic BJOG 2014.

[13] Unicef (2005) violence at home (achieve) voices of youth forum. Retrieved Oct. 2008 from http.//www.unicef.org/roy/discussions/archive/index.

[14] Unicef 2001.children and women’s rights in Nigeria. A wakeup call. Situations assessment and analysis. Edited by Hodege Abuja: National Population Commission and unicef.

[15] Violence against women during pregnancy systematized revision. Science Direct May-August 2014 vol.29 (2) pages 71-79.

Abstract:

Public health measures are strictly required to prevent increase in the spread of Ebola virus disease and that includes identifying cases and quarantining persons who are suspected to have come in contact with the disease or its agent. Though quarantine restricts freedom of movement of those affected, the reasons may be justified based on the fact that health of the public needs to be protected. But though the personal rights and liberties of individuals may be expected to be lost in international outbreaks, it should not be totally taken away. There ought to be a balance between preserving individual rights and maintaining public health. Thus a legal and political framework is needed while research for therapy and vaccine are encouraged.

Keywords: Ebola virus disease, ethical challenges, international outbreaks.

References:

[1] Abha S. Ebola Virus Disease Outbreak- Incorporating Ethical Analysis into the Health System Response. Indian Journal of Medical Ethics 2014, Vol 11; 4.

http://www.who.int/csr/disease/ebola/one-year-report/nigeria/en/

[2] Center for Disease Control and Prevention: Ebola (Ebola Virus Disease): 2014 Ebola Outbreak in West Africa. Atlanta, Georgia; 2014 [http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html].

[3] Ebola Virus Disease- Legal and Ethical considerations for Indiana. Improving Community Health through Policy Research, Center for Health Policy 2014.

[4] Global Forum on Bioethics in Research (GFBR). Meeting report: Emerging epidemic infections and experimental medical treatments. Annecy, France. 3-4 November 2015. Available from: http://www.gfbr.global/wp-content/uploads/2016/03/GFBR-2015-meeting-report-emergingepidemic-infections-and-experimental-medical-treatments.pdf (Accessed October 22 2016).

http://www.dictionary.com/browse/ethics

[5] Ibrahim W. Ethical concerns regarding Ebola control measures in Uganda, Makerere University School of Public Health 2013.

[6] Kevin G. Ebola, Epidemics and Ethics- what we have learned. Donovan philosophy, Ethics and Humanities in Medicine 2014, 9:15.

[7] Nduka UC, Igwe-Omoke A, Ogugua C. The use of social media in combating the Ebola virus in Nigeria- a review. International Journal of Medicine and Health Development.2014 19 (1/2): 97-108

[8] Osterholm MT, Moore KA, Gostin LO. Public Health in the Age of Ebola in West Africa. JAMA Intern Med. 2015; 175(1):7-8.

[9] Pan American Health Organization. Zika Ethics Consultation: Ethics Guidance on Key Issues Raised by the Outbreak. Washington, DC: PAHO, 2016. Document Number: PAHO/KBR/16-002. Available at 

http://iris.paho.org/xmlui/bitstream/handle/123456789/28425/PAHOKBR16002_eng.pdf (Accessed October 22 2016).

[10] WHO (2010). Research Ethics in International Epidemic Response, Geneva 2009.

Abstract:

Middle East respiratory syndrome (MERS) is a highly lethal respiratory disease caused by a novel single-stranded, positive-sense RNA beta coronavirus (MERS-CoV). Dromedary camels, hosts for MERS-CoV, are implicated in direct or indirect transmission to human beings, although the exact mode of transmission is unknown. The virus was first isolated from a patient who died from a severe respiratory illness in June, 2012, in Jeddah, Saudi Arabia. As of May 31, 2015, 1180 laboratory-confirmed cases (483 deaths; 40% mortality) have been reported to WHO. MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). Both community-acquired and hospital-acquired cases have been reported with little human-to-human transmission reported in the community. Although most cases of MERS have occurred in Saudi Arabia and the United Arab Emirates, cases have been reported in Europe, the USA, and Asia in people who travelled from the Middle East or their contacts. Clinical features of MERS range from asymptomatic or mild disease to acute respiratory distress syndrome and multiorgan failure resulting in death, especially in individuals with underlying comorbidities. No specific drug treatment exists for MERS and infection prevention and control measures are crucial to prevent spread in health-care facilities. MERS-CoV continues to be an endemic, low-level public health threat. However, the virus could mutate to have increased interhuman transmissibility, increasing its pandemic potential.

References:

[1]. https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome_coronavirus

[2]. http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx

[3]. http://www.moh.gov.sa/en/CCC/informationcenter/pages/healthguidelines4.aspx

[4]. http://www.cdc.gov/coronavirus/mers/about/transmission.html

[5]. http://www.cdc.gov/coronavirus/mers/infection-prevention-control.html

[6]. 

http://www.thelancet.com/action/showFullTextImages?pii=S0140-6736%2815%2960454-8

[7]. http://www.cdc.gov/coronavirus/mers/faq.html

[8]. http://www.cdc.gov/coronavirus/mers/about/symptoms.html

[9]. http://www.uptodate.com/contents/image?

imageKey=ID/90331&topicKey=ID/89705&source=outline_link&search=&utdPopup=true

[10]. 

odate.com/contents/image?imageKey=ID/90331&topicKey=ID/89705&source=outline_link&search=&utdPopup=true

[11]. https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome#Treatment

Abstract:

Background: It has been shown that nearly all pediatric seropositive HIV cases were infected via their seropositive mothers, as well; almost all of these cases can be prevented through a robust PMTCT service that provides extremely effective Anti-retroviral therapy and prophylactic intervention (FMOH, 2010).

As we work towards elimination of MTCT of HIV in our country, the importance of this review of PMTCT services cannot be over emphasized.

Objectives: The objectives of the study were; to assess the prevalence of HIV among pregnant women who attended ANC at the Health center (January –December, 2015). 2. To evaluate the percentage of HIV positive pregnant women who were placed on ART in the review period. 3. To ascertain the percentage of babies born to HIV positive mothers who were given ART in the review period.

Methods: Secondary data review was employed in this descriptive cross-sectional study. It involved data extraction from ANC booking registers, PMTCT HIV screening registers, ART administration registers and case/delivery notes of HIV positive mothers, covering the review period of January-December 2015, in the study center.

Results: All the 1,418 ANC clients reviewed were screened for HIV with a sero-prevalence of 2.8%. However, the percentage of seropositive clients who were placed on ART was 75%, while, 25% were lost to follow-up. Furthermore, only 33% of the babies born to seropositive mothers received ART prophylaxis in this center.

Conclusion: An ANC sero-prevalence of 2.8% with below average ART initiation for positive pregnant women and babies born to them portends great danger towards elimination of MTCT of HIV. Therefore the study recommends urgent strengthening of PMTCT in this center and other similar centers across the country.

Keywords: PMTCT, Ante-Natal Care, HIV, Prevalence, Anti-Retroviral Therapy, Primary Health Centre

References:

[1] AIDSINFO (2016). Education materials: HIV-1. Accessed from:

https://aidsinfo.nih.gov/education-materials/glossary/314/hiv-1

[2] FMOH of Nigeria, (2010). National Guideline for Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS. Pp 1

[3] FMOH, of Nigeria, HSS (2014). 2014 National HIV Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria. pp 2.

[4] Ghana AIDS commission GAC (2013). Summary of the 2013 HIV sentinel survey report. Accessed from: http://ghanaids.gov.gh/gac1/aids_info.php

[5] IATT, (2015). Inter-agency Task Team on the Prevention and Treatment of HIV Infection in Pregnant Women, Mothers and Children. Monitoring & Evaluation Framework for Antiretroviral Treatment for Pregnant and Breastfeeding Women Living with HIV and Their Infants. (IATT M&E Option B+ Framework). CDC, WHO and UNICEF. New York. Accessed from: http://www.emtct-iatt.org/wp-content/uploads/2015/05/IATT-Framework-May-2015.pdf

[6] Kenya AIDS Response Progress Report (2014). Progress towards zero. Accessed from http://www.unaids.org/sites/default/files/country/documents/KEN_narrative_report_2014.pdf

[7] Kiptoo M., Mpoke S., Ng'ang'a Z., Mueke J., Okoth F., Songok E. (2009). Survey on prevalence and risk factors on HIV-1 among pregnant women in North-Rift, Kenya: a hospital based cross-sectional study conducted between 2005 and 2006, 9: pp10. doi: 10.1186/1472-698X-9-10.

[8] National Agency for the Control of AIDS (NACA) (2014). Federal republic of Nigeria Global AIDS Response. Country Progress Report, Nigeria GARPR 2014. p.13 Accessed from: http://www.unaids.org/sites/default/files/country/documents/NGA_narrative_report_2014.pdf

[9] Okerentugba P.O., Uchendu S.C., Okonko I.O. (2015). Prevalence of HIV among Pregnant Women in Rumubiakani, Port Harcourt. Nigeria. Public Health Research. 5(2): 58-65.doi:10.5923/j.phr.20150502.03

[10] Sagay A.S., Kapiga S.H., Imade G.E., Sankale J.L., Idoko J., Kanki P. (2005). HIV Infection among pregnant women in Nigeria. International journal of Gynecology and Obstetrics, 90: (1). Pp 61-67. Doi 10.1016/j.jigo.2005.30.030

[11] Thailand National AIDS Committee (NAC). (2015). Thailand AIDS response progress report, 2015. Accessed from http://www.unaids.org/sites/default/files/country/documents/THA_narrative_report_2015.pdf

[12] United Nations. (2015). Sustainable Development Goals (SDGs). Accessed from: http://www.un.org/sustainabledevelopment/sustainable-development-goals/

[13] WHO₁ (2016). HIV/AIDS, online Q & A. (updated July, 2016). Accessed from: http://www.who.int/features/qa/71/en/

[14] WHO₂ (2016). HIV/AIDS, Mother-to-child transmission of HIV (updated June, 2016). Accessed from: http://www.who.int/hiv/topics/mtct/en/

[15] WHO₃ (2016). Thailand is first country in Asia to eliminate mother-to-child transmission of HIV and syphilis. Accessed from: http://www.searo.who.int/mediacentre/releases/2016/1627/en/index.html

[16] WHO₄ (2016). WHO validates elimination of mother-to-child transmission of HIV and syphilis in Armenia, Belarus and the Republic of Moldova. (Updated June, 2016). Accessed from: http://www.euro.who.int/en/media-centre/sections/press-releases/2016/06/who-validates-elimination-of-mother-to-child-transmission-of-hiv-and-syphilis-in-armenia,-belarus-and-the-republic-of-moldova.

[17] WHO₅ (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Summary of Recommendations. Accessed from: http://www.who.int/hiv/pub/arv/summary-recommendations.pdf

Abstract:

Background: Worldwide, gender differences are reported in diagnosis and treatment outcome of TB and TB HIV patients. Religious and socio-cultural factors are responsible but largely controversial. This study assessed gender issues in diagnosis and treatment outcome of TB and TB HIV patients.

Objective: To assess gender differences in diagnosis and treatment outcome of TB and TB HIV infected patients.

Methodology: We did a cross sectional retrospective analysis of 980 TB patients treated in 6 out of 21 randomly selected local government areas of Anambra state Nigeria between 2008 and 2012. Information on age, sex, HIV status, case notification, treatment outcome was evaluated from TB treatment cards and TB registers. Treatment outcome was recorded as cured, completed treatment, failed, defaulted, died.

Results: The male female ratio among the 980 TB patients was 57.4% vs 42.6%.. The study HIV prevalence is 27.7%; women contributed 52.6% of this population. Women had better treatment success rate than men (85.7% vs. 80.5%). TB treatment outcome in women compared to men were Cured (50.4% vs 40.7%, p = 0.063), treatment completed (35.3% vs 39.8%, p= 0.330), died (5.5% vs5.5%, p=0.8812), defaulter (6.55 vs10.5%, p = 0.042), failure (1.6% vs 1.5%, p=0.749).

Conclusion: We conclude more TB cases in males but females are more prone to TB HIV confection, have better treatment outcome and lower default rate.

Gender-specific strategies, including active case finding among women, increased tracking and adherence for male, are warranted to optimize TB management.

Keywords: Gender, Nigeria, Tuberculosis, HIV, Co infection, NTBLCP.

References:

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[3] Bello S I. Challenges of DOTS implementation strategy in the treatment of tuberculosis in a tertiary health institution, Ilorin, Nigeria. African journal of pharmacy and pharmacology, 2010 ; 4(4): 158- 164.

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[6] Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi. TB India 2012. RNTCP Status Report. 2012:7–17.]

[7] D. Chan-Yeung M, Noertjojo K, Chan SL, Tam CM. Sex differences in tuberculosis in Hong Kong. Int J Tuberc Lung Dis 2002;6:11-8.

[8] Diwan VK, Thorson A. Sex, gender, and tuberculosis. Lancet. 1999;353:1000–1. [PubMed]

[9] Frank-Peterside N, Onwuka A P, Okonko I O. Epidemiology of Pulmonary Tuberculosis in University of PortHarcourt Teaching Hospital: age related disparities. Science pub.net/report; 2012, 4(5).

[10] Glynn J, Sonnenberg P, Nelson G, Bester A, Shearer S, Murray J. Increasing risk of TB with increasing duration of HIV infection: results from 2000 men followed for 12 years. International journal for TB and lung disease, 2007; 11 (11):112.

[11] Gidado M, Ejembi C L. Tuberculosis case management and treatment outcome: Assessment of the effectiveness of public private mix of tuberculosis programme in Kaduna state, Nigeria. Annals of African medicine.2009; 8 (1): 25-31.

[12] G = Karim F, Islam MA, Chowdhury AM, Johansson E, Diwan VK. Gender differences in delays in diagnosis and treatment of tuberculosis. Health Policy Plan. 2007;22:329–34. [PubMed]

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

[16] K.= Yamasaki-Nakagawa M, Ozasa K, Yamada N, Osuga K, Shimouchi A, Ishikawa N, et al. Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal. Int J Tuberc Lung Dis. 2001;5:24–31. [PubMed]

[17] Karim F, Islam MA, Chowdhury AM, Johansson E, Diwan VK. Gender differences in delays in diagnosis and treatment of tuberculosis. Health Policy Plan. 2007;22:329–34. [PubMed]

[18] Khatri GR, Frieden TR. The status and prospectus of tuberculosis control in India. Int J Tuberc Lung Dis 2000;4:193-200. ]

[19] L=. Begum V, de Colombani P, Das Gupta S, Salim AH, Hussain H, Pietroni M, et al. Tuberculosis and patient gender in Bangladesh: Sex differences in diagnosis and treatment outcome. Int J Tubercu Lung Dis. 2001;5:604–10. [PubMed]

[20] Long NH, Johansson E, Diwan VK, Winkvist A. Fear and social isolation as consequences of tuberculosis in Vietnam: A gender analysis. Health Policy. 2001;58:69–81. [PubMed]

[21] Long NH, Johansson E, Diwan VK, Winkvist A. Fear and social isolation as consequences of tuberculosis in Vietnam: A gender analysis. Health Policy. 2001;58:69–81. [PubMed]

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[31] Nigerian Stop TB Partnership Strategic Plan 2011

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[40] World Health Organisation, Global TB Report, Geneva;2014.

[41] Waisbord, S., Behavioral Barriers in Tuberculosis Control: A Literature Review, The CHANGE Project/Academy for Educational Development, Washington, DC, 2005, http://pdf.usaid.gov/pdf_docs/Pnadf406.pdf.

[42] United Nations General Assembly. United Nations millennium declaration. A/RES/55/2. 2000 Sep 8 [cited 2 Aug 2016]. Available: http://www.un.org/millennium/declaration/ares552e.htm.

[43] Yamasaki-Nakagawa M, Ozasa K, Yamada N, Osuga K, Shimouchi A, Ishikawa N, et al. Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal. Int J Tuberc Lung Dis. 2001;5:24–31. [PubMed]

[44] Zachariah R, Fitzgerald M, Massaquoi M, Acabu A, Chiloma D, Salaniponi F M L, Harries A D. Does antiretroviral treatment reduce case fatality among HIV positive patients with Tuberculosis in Malawi. International journal for TB and lung disease, 2007; 11 (8):848 -853.

Abstract:

Interventions to Prevent Mother to Child Transmission in the world have evolved over the years. Cameroon like every other country has been conforming to new recommendations from WHO based on evidence for better quality of service. Option B+ which entails provision of lifelong Antiretroviral Therapy (ART) to each pregnant and breastfeeding woman was recommended as the standard for PMTCT in 2012⁽¹⁾. Cameroon adopted these guidelines and set out for implementation in October 2013. The purpose of this study is to evaluate the effectiveness of task shifting from nurses to doctors in the rapid scale up of option B+ in Cameroon. Results show that within a period of fifteen months, a total of 520 nurses from 266 PMTCT sites in the South West region were trained on the provision of ART at MCH (maternal and child health) units. They were able to adequately provide ART to 1,754 women by December 2015 (Mvogo, 2016). These results set the pace for the scale up of Option B+ to other sites and regions across the country without putting pressure on the limited number of doctors in the country.

Keywords: Task shifting, PMTCT, Option B+, ART, MCH, HIV.

References:

[1] CDC. (April 2016). CDC in Cameroon. Atlanta: Center for Global Health.

[2] Mary B Morris, Bushimbwa Tambatamba Chapula, Benjamin H Chi, Albert Mwango, Harmony F Chi, Joyce Mwanza, Handson Manda, Carolyn Bolton, Debra S Pankratz, Jeffrey SA Stringer and Stewart E Reid. (2009). Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka Zambia. BMC Health Services Research.

[3] Mvogo. (2016). Rapport Annuel 2015. Yaounde.

[4] WHO. (2008). Train, treat, retain. Task Shifting: rational redistribution of tasks among health workforce teams; global recommendations and guidelines. Geneva, Switzerland: WHO Document Production Services.

[5] WHO. (2016, October 11). Country Cooperation Strategy. Retrieved from World Health Organization: http://www.who.int/countries/en

Abstract:

Low coverage of household latrines in the Kagera Region of Tanzania continues to exist despite past and current interventions to improve the situation. A limited understanding of the reasons for the low coverage restricted solving of this problem. The research which aimed to explore the perceptions of community members and latrine promoters was sought to increase understanding of this problem.

Methods: Study designed was an exploratory qualitative approach that employed two qualitative research methods: focus group discussions and in-depth interviews. Focus groups discussion involved elderly community members and Ward Development Committee members who are leaders and latrine promoters. In-depth interviews involved key informants whose job descriptions includes the promotion of household latrines. Ethical approval was obtained from University of Western Cape and authorisation to conduct the study from the Kagera Regional Administrative Secretary.

Results: Content analysis revealed a thick description of respondent’s perceptions in relation to factors which affect the coverage of household latrines in the Kagera Region. Interlinked factors were revealed including low community involvement and participation, poverty, cultural beliefs and taboos, gender disparity, low technical capacity of latrine promoters and poor packaging.

Conclusion: This study revealed myriad factors which affect the coverage of household latrines in Kagera Region of Tanzania. Recommendations were put forward including adoption of an integrated approach, empowerment of members, and provision of capacity building interventions for the key latrine promoters. Insights gained through this study could contribute towards improving the coverage of household latrines in the Kagera Region of Tanzania.

Keywords: Low coverage, household, latrine, sanitation, factors, promotion, perception, Muleba District, Kagera Region, Tanzania

References:

[1] Africa Minister’s Council on Water, EUWI and UNDP, (2006). On Track to Meet the MDGs on Water and Sanitation: A Status, Overview of Sixteen Africa Countries.

[2] Cameron, L., (2009). Household pit latrine and child health in rural Ethiopia. Department of International Development, Young Lives, University of Oxford, United Kingdom.

[3] Chaggu, E., (2009). Sanitation Sector Status and Gap Analysis. Dar es Salaam, Tanzania.

[4] DFID, (2002). Water supply and Sanitation in DFID Programme and Project Cycle. [Online]. Available: www.lboro.ac.uk/well/resources/publications/guidance/overview.pdf‎ [Accessed: 12/04/2012: 6.22 PM]

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[13] Muleba District Council, (2011). Council Comprehensive Health Plan 2011/12. Tanzania.

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[15] Pattanayak, J. K., Yang J.C., Dickinson, K. L., Poulos, C. V., Patil, S. R., Mallick, R. K., Blitstein, J. L. and Praharaj, P. (2009). Shame or subsidy revisited: social mobilization for sanitation in Orissa, India. [Online]. Available: www.who.in/entity/bulletin/volumes/

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[19] Santakar, C. (2010). Achieving one hundred per cent individual household latrines coverage. [Online]. Available: www.unicef.org/india/reallives_6129.htm [Accessed: 5/06/2012 3.00 PM]

[20] Schaay N. and Sander, D., (2006). International Perspective on Primary Health Care over the past 30 years. School of Public Health, University of the Western Cape, South Africa.

[21] Stitt.T. (2005). Evaluation of rural sanitation program in Vanuatu with management recommendations. Journal of Rural and Tropical Public Health 4: 1-9 (2005)

[22] Tibaijuka. A, (2010). Gender Equity and Sanitation. Opening Statement at the UNHABITAT Gender Quality Action Assembly. Brazil.

[23] UNIAIDS, (2011). UN-Women Gender Equality and HIV/AIDS, New York. Email: genderandaids@ unwomen.org

[24] UNDP Human Development Report, (2006). Beyond scarcity, Power, poverty and global waste. [Online], Available: http://hdr.undp.org/en/media/HDR_2006_Chapter_1.pdf [Accessed: 19/12/2012 8.40 PM]

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Abstract:

Background: It is essential to cater to unmet needs of contraception among the adolescent group if meaningful strides are to be achieved in the uptake of contraception and prevention of unwanted pregnancies in the society.

Objective: The main objective of the study is to assess the extent of knowledge and unmet needs of family planning among adolescents aged 15-20 years.

Methodology: Secondary data from the 2013 NDHS will be used. The sample was selected using a stratified three-stage cluster design consisting of 904 clusters, 372 in urban areas and 532 in rural areas.

A representative sample of 40,680 households was selected for the survey, with a minimum target of 943 completed interviews per state. A complete listing of households and a mapping exercise were carried out for each cluster over two months. The resulting lists of households serving as the sampling frame for the selection of regular households. A fixed sample take of 45 households were selected per cluster.

Data analysis: Analyses of quantitative data will be done in SPSS version 20. Chi-square test will be used to measure the strength of associations between the various variables where a p value of = or < 0.05 will be considered statistically significant.

References:

[1]. Australas Med J. 2011; 4(1): 43–48. Published online 2011 Jan 31. doi: 10.4066/AMJ.2011.499

[2]. Attitude of Parents and Adolescents Towards Contraceptive Use by Adolescents in Alajo, Ayawaso Central Submetro of Accra Maya, E.T. --hdl.handle.net/123456789/5150- www.prb.org/Publications/Articles/2013/adolescent-fertility.aspx

www.who.int/maternal_child_adolescent/topics/maternal/adolescent_pregnancy/en/

[3]. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa (1993)- www.nap.edu/catalog/2220/social-dynamics-of-adolescent-fertility-in-sub-saharan-africa

[4]. Panday, et al., 2009, UNICEF, 2005

[5]. Marcen and Bellido, 2013;

www.iiste.org/Journals/index.php/JEDS/article/viewFile/10699/10904

[6]. Sonfield, et al, 2013; 

www.iiste.org/Journals/index.php/JEDS/article/viewFile/10699/10904

[7]. Barcena, 2013; www.iiste.org/Journals/index.php/JEDS/article/viewFile/10699/10904

[8]. Chau-Kuang, 2013; 

www.iiste.org/Journals/index.php/JEDS/article/viewFile/10699/10904

[9]. National Population Commission and ICF Macro2009;

www.iiste.org/Journals/index.php/JEDS/article/viewFile/10699/1090

[10]. www.guttmacher.org/about/journals/ipsrh/2009/patterns-and-trends-adolescents-contraceptive-use-and-discontinuation

[11]. Mundo, F. D. (2012) Primary Maternal and Neonatal Health: A Global Concern. Chicago: Springer Science & Media Centre

[12]. who.int/mediacentre/factsheets/fs351/en/

[13]. Contraception and Adolescents; Revised. 104(5):1161PediatricsNovember 2007, VOLUME 120/ISSUE 5

[14]. Carroll, J. (2015) Sexuality Now: Embracing Diversity. Boston: Cengage Learning

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[17]. Amanuel Alemu Abajobir and Assefa Seme; BMC Health Services Research201414:138; DOI: 10.1186/1472-6963-14-138

[18]. The Pan African Medical Journal. 2016;23:74. doi:10.11604/pamj.2016.23.74.8688

[19]. Use of contraceptives among adolescents in Kintampo, Ghana: a cross-sectional study by Boamah EA, Asante KP, Mahama E, Manu G, Ayipah EK, Adeniji E, Owusu-Agyei S; DOI https://dx.doi.org/10.2147/OAJC.S56485

[20]. Contraception and Adolescents; Revised. 104(5):1161PediatricsNovember 2007, VOLUME 120/ISSUE 5

[21]. Amanuel Alemu Abajobir and Assefa Seme; BMC Health Services Research201414:138; DOI: 10.1186/1472-6963-14-138

[22]. Use of contraceptives among adolescents in Kintampo, Ghana: a cross-sectional study by Boamah EA, Asante KP, Mahama E, Manu G, Ayipah EK, Adeniji E, Owusu-Agyei S; DOI https://dx.doi.org/10.2147/OAJC.S56485

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[24]. Contraceptive knowledge and practice among senior secondary schools students in military barracks in Nigeria UC Chimah, TO Lawoyin, AL Ilika, CC Nnebue

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Abstract:

Teenage pregnancy is an enormous challenge in Swaziland. The Nkalashane clinic (Lubombo region) observed a growing number of teenage pregnancies. In 2014 alone, 49% of pregnancies were among women who had their first child before their 19th birthday. The objective of this study was to investigate risk factors of teenage pregnancy among teenage mothers (TM), teenage fathers (TF), and services needed by the at-risk youth (ARY) to prevent teenage pregnancy. Participants were identified from the clinic’s registers, snowball sampling, and the 3 schools in the area. Participants completed questionnaires and focus group discussions (FGDs). Data was summarized using descriptive statistics. 43 TM, 8 TF and 73 ARY participated. TM had a family history of teenage pregnancy (42%), had guardians with only a primary education (63%), and had older partners (mean age difference 5.2 years). Only 44% of TM and 38% of TF reported using contraception at the time of first pregnancy. Reasons for not using contraception included: lack of knowledge on pregnancy (47%) and contraception (38%). TM reported engaging in transactional sex due to peer pressure or lack of money. In FGDs, lack of knowledge, peer pressure, difficult access to contraception, and lack of parental guidance were discussed as risk factors. The main risk factors were: lack of knowledge; peer pressure; intergenerational sex; and difficult access to contraceptives. Recommendations include: offering comprehensive sexual education to both youth and adults; strengthening the relationship between schools, communities, and clinics; training clinic staff on youth-friendly services.

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Abstract:

Human immunodeficiency virus (HIV) is the virus that causes AIDS. It attacks the body’s immune system by weakening the human body’s defence against disease and consequently makes one vulnerable to a number of potentially life-threatening infections and cancers. HIV is transmitted through exposure to infected blood and blood products and from infected mother to child during childbirth. This study is a cross sectional study on HIV Prevalence in South Sudan. The study reveals a prevalence rate of 2.7 % for the whole country and about 14 % in some areas with the most vulnerable being between the ages of 15 to 49. It also reveals that social factors like poverty and prevailing gender relations contribute to infection and reinfection among People Living with AIDS and their partners. This study identified that Non-Governmental Organizations (NGO) and the United Nations (UN) are key in the fight against HIV in South Sudan; as the Government of South Sudan (GOSS) is battling with basic life need such as food and shelter for the population of South Sudan. There is therefore a need for a renewed campaign against HIV/AIDS.

Keywords: HIV, AIDS, Prevalence, NGO, UN, GoSS

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