Abstract:

Background: Mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains the major source of HIV infection in young children. Targeting pregnant women attending antenatal clinics provides a unique opportunity for the implementing prevention of mother-to-child transmission (PMTCT) programs against HIV infection of newborn babies.

Objective: To identify factors affecting Knowledge of prevention of mother to child transmission of HIV services among pregnant women attending antenatal clinic in Bungoma County Referral Hospital.

Methodology: A cross-sectional study was conducted among pregnant mothers attending antenatal care clinic at Bungoma County Referral Hospital. A systematic random sampling technique was used to select 50 respondents, using Fisher et al, 1999. The data was collected using structured interviewer administered questionnaire prepared to address knowledge, and associated factors on PMTCT services. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20.

Findings: A big number (40%) of the mothers did not know about PMTCT services which were being offered in the hospital. It was noted that the respondents who had little or no knowledge of the services were mostly below 25 years of age and those with low education levels. On the attitude towards PMTCT services it was found that (44%) reported that it is good to take on PMTCT services if reactive and (56%) of respondents reported that PMTCT services are wastage of time because AIDS has no cure.

Conclusion: The educational level was the most important factor in understanding PMCTC services

Recommendation: To improve and increase sensitization and awareness to the communities on what PMTCT program entails.

Keywords: Prevention of mother to child transmission, Human immunodeficiency virus, Acquired immunodeficiency syndrome, Antenatal clinic.

References:

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Abstract:

This is a review of the article titled "The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria" written by the duo of Alphonsus Rukevwe Isara & Patrick Otamere Okundia as published in the journal Pan African Medical Journal of February, 2015, volume 20: page 103, with DOI number; doi:10.11604/pamj.2015.20.103.5619, and accessed from, http://www.panafrican-med-journal.com/content/article/20/103/full/. The review covered the evaluation of related literature, the structure of the article, authority, currency, accuracy, relevance, objectivity and stability. Furthermore, appraisal of the tables, recent advances, credibility and accessibility of the article were carried out. The objective of the original article was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. Chronic diseases such as hypertension, diabetes & obesity evidently had been on the increase and now are of public health importance in rural communities of developing countries, where it has been shown to complicate the outcome of cardiovascular diseases. The authors employed a cross- sectional survey method to screen adult residents of the selected rural communities in Southern Nigeria. Blood pressure, random blood sugar, weight, and height were measured and Body Mass Index was calculated from height /weight, as well, the respondents were interviewed with the aid of a structured interviewer-administered questionnaire. The result showed one-third of the participants had hypertension, one–third were obese/ overweight, while about 4% had diabetes amongst others. Overall, this is an objectively written article, credible in all ramifications and has contributed to the body of knowledge on the topic especially in this part of the world. The challenge of hypertension, diabetes, and obesity is enormous and requires urgent intervention to forestall the rising trend of these disease conditions and its attendant complications in developing countries.

Keywords: Hypertension, Diabetes, Obesity, Overweight, Prevalence, Rural Communities.

References:

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Abstract:

The objective of this study was to determine the views and perceptions of teachers and adolescent’s on adolescent’s pregnancy in school in Kavango Region, Namibia.

A cross-sectional analytical study was conducted using mixed methods - quantitative approaches among 350 school learners (grade 6 to grade 12) and 150 school dropout adolescents (aged 12 to 19 years). For the qualitative approaches 15 school learners and 25 teachers went through an in-depth interview. In total a sample of 540 was utilized.

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).

Themes and subthemes were identified and discussed: Challenges for learners in grasping or understanding the concept on reproductive health towards; Poverty – early marriages, bribe from men. Identified cultural barriers on reduction of the prevalence of adolescent pregnancy, towards; Culture – uncomfortable and shy to talk about sex.

The study found that the following aspects/factors: lack of parental supervision; poverty; lack of knowledge and communication skills to talk to their children regarding sex & contraceptives; parental irresponsibility; lack of sex education; were associated with adolescent pregnancy in Kavango region.

Keywords: Adolescents, Teachers, Reproductive health, Sexual health.

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Abstract:

Background: Every pregnant woman faces a risk of life-threatening obstetric complications. It is estimated that 398 women every year die in Zambia from pregnancy related complications out of every 100,000 live births. The primary cause of this high maternal mortality is lack of access to professional delivery care. A birth-preparedness package promotes active preparation and assists in decision-making for healthcare seeking in case of such complications. Examining the role of the family, particularly the husband, during pregnancy and childbirth is important to understanding women’s access to and utilization of professional maternal health services that can improve maternal health outcomes and prevent maternal mortality. However, in Zambia, the relationship between birth preparedness and decision-making on location of birth and assistance by skilled birth attendants in regard to male involvement is one subject that has not been studied. The purpose of this study was therefore to evaluate the impact of male partner involvement in childbirth preparation and contribute to the prevailing board of evidence on male involvement in addressing the high maternal mortality.

Methods: This paper was written through desk review of key policy documents, technical reports, publications and available internet-based literature. Primary analysis included studies from randomised controlled trials (RCT) whilst secondary analysis involved studies of non-randomised control trials, observational studies descriptive studies and key government reports.

Results: The study established that women have higher chances of delivering at the health facility and access skilled delivery care if they consulted and made the decision with their spouses. The proportion of women making savings for birth preparedness plan, including savings for emergencies and transport was very low without male partner involvement whereas involvement of male partners in ANC services increased the number of women attending antenatal care (ANC) services and resulted into a higher likelihood of expectant mother receiving not only skilled delivery services but also postpartum care.

Conclusion: This study provides novel evidence about male involvement during childbirth. The findings could have important implications for program planners, who should pursue all avenues and ways to involve husbands (male partners) in maternal health interventions and assess the effectiveness of education strategies targeted at husbands.  Therefore, it should be viewed that examining the role of the spouses, during pregnancy and childbirth is important to understanding women’s access to and utilization of professional maternal health services that can prevent maternal mortality.

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Abstract:

Background: For the last century, malaria has caused a serious developmental setback to African countries. Historically, In Uganda, the control of malaria and its eradication challenges can be traced for more than 100 years ago especially the control and elimination activities connected to research and malaria control between1892 to 1949. During the early part of the 21st century, malaria received global health priority recognition until 1998 when the World Health organization (WHO) adopted a Rollback strategy. Currently, In May 2015, The World Health Organization (WHO) adopted a global Strategy for Malaria 2016–2030. This ambitious strategy apparently challenged by the fact that current tools are not adequate to achieve the planned targets. The future challenges to eradicate malaria are also real and need urgent solutions.

Methods: We searched Cochrane Libraries, EMBASE, Google Scholar, and unpublished ministry of health Uganda reports.

Objectives: To assess the historical, current and future challenges to malaria control and eradication and propose solutions to address them.

Results: Uganda has failed to eradicate malaria in the past century, due to challenges like lack of political commitment, limited resources for eradication programs, rampant history of antimalarial drug resistance, chronic and persistent antimalarial stock-outs in public facilities, resistance by parasites to ITNs and fragmentation in the coordination. Findings reveal that the past challenges still exist and are likely to last for more than a decade unless measures are in place to mitigate them. Uganda will face challenges in implementing newer effective interventions in future as well as the history of malaria eradication challenges may keep repeating itself.

Conclusion: The historical challenges in the eradication of malaria in Uganda are still affecting the current plans to eradicate malaria. Uganda may not eradicate malaria in next the15 years, basing on its current and future challenges ahead.

Keywords: Malaria, control, eradication, Uganda, challenges, Historical, current, Future.

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Abstract:

Human Immunodeficiency Virus (HIV) which causes the disease, Acquired Immunodeficiency Diseases Syndrome, is one of the public health challenges facing both developing and developed nations.

This descriptive study was carried out to examine the effect of socio-cultural factors on the prevalence of HIV/AIDs amongst adolescent and youths attending the antiretroviral clinics of four general hospitals in Niger State, Nigeria. These were the general hospitals in Bida, Minna, Suleja and Kontagora.

In order to participate in the study, the participants must be within the age bracket of adolescent and youths and must be retroviral positive. The instrument for data collection was a pretested semi-structured questionnaire. Data analysis was carried out using both descriptive and inferential statistics.

Results: A total of 268 respondents were interviewed. More male participated in the study and majority of the participants were concentrated within the age bracket (21 – 25) years.

About 71.6 percent of respondents said alcohol intoxication did not lead them to indulge in unprotected sex whilst 79.9 percent respondents did not experience influence of watching pornographic file on their sex life.

Conclusion: The study showed, socio-cultural factors were found not to have had influence on HIV/AIDs prevalence.

From the finding, more awareness programs about HIV/AIDs should be carried out among adolescent and youths. Government and Nongovernmental organization should partner with the community, faith based organization, schools to implement these findings.

Keywords: Human Immunodeficiency Virus, Adolescent, Youth, Socio-Cultural factors.

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Abstract:

Background: Combating maternal mortality requires a functional Maternal Death Surveillance and Response system (MDSR). In Zimbabwe, maternal mortality ratio was 651 deaths per 100 000 live births in 2015. Only five out of 25 deaths were notified on time in Sanyati District 2015-2016. We evaluated the system to determine if it was serving its intended purpose.

Methods: We conducted a descriptive cross sectional study using the MDSR technical guidance and the updated CDC guidelines for evaluating public health surveillance systems. Data were collected using interviewer administered questionnaires, key informant interviews, focused group discussions and records review. Medians, proportions and frequencies were calculated using Epi Info 7. Qualitative data was analysed using word cloud.

Results: We interviewed 216 health workers out of 230 involved in MDSR. Ninety-nine percent were nurses. Sixty-two percent correctly defined a maternal death. Ninety-eight percent found the system useful. Those confident to notify a maternal death were 139(68%). Easy access to case information was reported by 91(62%). Data was analysed by 138(80%) and used to monitor maternal mortality trends. Information sharing with stakeholders was reported by 59(31%). Ninety-seven percent were willing to continue participating. The cost of notifying a single death was USD$ 246.09. All community deaths were not being captured by the system as reported by 128(59%). Key informants and focused group discussions outcomes highlighted concerns of unreported community deaths. There was no zero reporting of community maternal deaths.

Conclusion: The MDSR system was useful, acceptable, simple and not costly. The system was also unstable, unrepresentative and not timely. Minimal stakeholder and community involvement, inadequate human resources and training, hampered the systems performance. We recommend health worker training and conducting an interventional study to assess the effectiveness of community involvement in reporting maternal deaths.

Keywords: Maternal Death, Surveillance, Response, Sanyati, Zimbabwe.

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