Abstract: Background. Different studies presented negating findings of the association between intestinal parasite infections (IPIs) and undernutrition among early adolescents in Ethiopia. This study was aimed at assessing intestinal parasite infection and its association with undernutrition among early adolescents in four selected districts of the Sidama region. Method. An institution-based cross-sectional study was conducted in October 2020 among 792 early adolescents. The multistage stage sampling was applied to select 16 primary schools. Simple random sampling was applied to select study participants. Trained data collectors administered questionnaires. Stool samples were collected and analyzed. Anthropometric measurements were taken and indices were calculated using AnthroPlus software. Data were entered into and analyzed by SPSS version 25 software. Association between IPI and undernutrition was measured using multivariable analysis. The outputs are presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CIs). Result. The prevalence of IPI, thinness, and stunting was 32% (95% CI: 28.7%, 35.3%), 17.5% (95% CI: 14.8%, 20.2%), and 21.5% (95 CI: 18.6%, 24.4%), respectively. The higher odds of IPIs were observed among adolescents stunted (AOR = 3.61; 95% CI: 2.44–5.33), those who are thin (AOR = 3.07; 95% CI: 2.02–4.66), those who did not wash their hands after toilet (AOR = 1.89; 95% CI: 1.35–2.66), those who ate raw meat (AOR = 1.50; 95% CI: 1.03–2.14), and those whose family did not own toilet (AOR = 1.71; 95% CI: 1.18–2.46). Conclusion. The prevalence of IPI, thinness, and stunting was high and has public health significance in the study area. IPIs were associated with stunting, thinness, lack of toilets, not washing hands after a toilet visit, and eating raw meat. Strengthening nutrition interventions, deworming programs, and health education on personal and environmental hygiene and sanitation are recommended. PubDate: Fri, 15 Oct 2021 04:20:00 +000
Abstract: Background. Malaria remains a significant public health problem, especially in resource-poor settings. We aimed to forecast the year 2021 monthly confirmed malaria cases in the northwestern province of Zambia. Methods. The total number of confirmed monthly malaria cases recorded at health facilities over the past 7-years period (January 2014 to December 2020) was taken from the District Health Information System version 2 (DHIS.2) database. Box–Jenkins autoregressive integrated moving average (ARIMA) was used to forecast monthly confirmed malaria cases for 2021. STATA software version 16 was used for analyzing the time series data. Results. Between 2014 and 2020, there were 3,795,541 confirmed malaria cases in the northwestern province with a monthly mean of 45,185 cases. ARIMA (2, 1, 2) (0, 1, 1)12 was the best fit and the most parsimonious model. The forecasted mean monthly confirmed malaria cases were 60,284 (95%CI 30,969–121,944), and the total forecasted confirmed malaria cases were 723,413 (95%CI 371,626–1,463,322) for the year 2021. Conclusion. The forecasted confirmed malaria cases suggest that there will be an increase in the number of confirmed malaria cases for the year 2021 in the northwestern province. Therefore, there is a need for concerted efforts to prevent and eliminate the disease if the goal to eliminate malaria in Zambia by 2030 is to be realized. PubDate: Wed, 13 Oct 2021 07:35:00 +000
Abstract: Background. Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting high standard of patient care, but also because of its impact on government budgets for the maintenance of health services. Routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on routine basis at the various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in places to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods. A cross-sectional study was conducted in eight health facilities in Tarkwa Submunicipal health service in the western region of Ghana. The study involved routine quality assurance practices among the 90-health staff and management selected from facilities in Tarkwa Submunicipal who collect or use data routinely from 24th December, 2019, to 20th January, 2020. Results. Generally, Tarkwa Submunicipal health service appears to practice quality assurance during data collection, compilation, storage, analysis, and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%), and collection (61.1%). Conclusions. Even though Tarkwa Submunicipal health directorate engages some control measures to ensure data quality, there is the need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was significant shortfall in quality assurance practices performance especially during data collection, with respect to the expected performance. PubDate: Wed, 13 Oct 2021 02:35:00 +000
Abstract: Model pharmacy has been adopted recently to upgrade the healthcare delivery system in Bangladesh. This study was aimed to analyze and compare the effectiveness of drug dispensing patterns, practices, and knowledge of both clients and dispensers of model pharmacies over traditional retail medicine shops. Two established methods, namely, client simulated method (CSM) and provider interview method (PIM), were employed to determine the practice differences in 90 retail medicine shops and 90 model pharmacies in and around Dhaka city. The results are represented primarily in comparison with corresponding percentages. The survey results did not fully support the findings obtained from the observations of the CSM as PIM contrasted these to some extent, and the differences are statistically significant (). According to CSM, the presence of A-grade pharmacists during working hours in retail medicine shops was 0%, and 63% in model pharmacies. As reported by PIM, in the retail medicine shops, 36% of clients were ignorant of visiting doctors before purchasing medicine. On the other hand, only 18% of clients could visit doctors. As per CSM, 40% of clients did not follow doctors' recommendations for completion of the full dose of antibiotics bought from retail medicine shops and 51% did not finish full antibiotic courses collected from model pharmacies. Additionally, CSM revealed that 28% of the clients administered leftover drugs following old and obsolete prescriptions of retail medicine shops and 21% of clients followed the same practices in terms of model pharmacies. The report of CSM revealed that 95% of dispensers of retail medicine shops sold medicine without prescription except over-the-counter (OTC), and in the model pharmacies, the percentage was 77%. The qualitative findings revealed substandard practices and dispensing pattern too. Model pharmacies were established to prevent aberrant medicine dispensing patterns and ensure proper medication dispensing practices and medicine intake. This research could not verify the situation that pharmacists or owners of model pharmacies were fully abiding by the guidelines set for them by the Directorate General of Drug Administration (DGDA). PubDate: Wed, 06 Oct 2021 03:50:00 +000
Abstract: Background. This research has been conducted to assess smokers’ knowledge and behavior vis-à-vis combustible smoking cessation, prevalence, and risk, and the use of alternative nicotine delivery systems to quit smoking. Methods. A mixed-method approach utilizing cross section primary survey data and comprising descriptive and s-KAP index analysis has been adopted to ascertain the relationship between dependent and independent s-KAP variables; the principal component analysis methodology has been used to determine the use of alternative nicotine delivery systems. Results. Most of the smokers were aged between 15 and 35 years. A predominant 69.8% of the smokers came from middle-class background. Moreover, 71.3% were unaware of any alternative Tobacco Harm Reduction product. A majority of the respondents (68.2%) were keen to quit smoking. However, when asked why they had not succeeded, 52.9% reported addiction to nicotine as the main impediment. In Pakistan, lack of smoking cessation services is the weak link in the fight against the tobacco epidemic. Smokers are generally unaware of the Tobacco Harm Reduction products available in Pakistan; moreover, only 10.9% of the respondents were willing to spend more than Rs. 4000 per month on Tobacco Harm Reduction products. The average s-KAP score for young adults below the age of 20 was much lower than the national average but improved with the level of education. Interestingly, the score of smokers who had ever tried to quit smoking was slightly higher than that of those who had never tried to quit. Conclusion. There is intent to quit combustible smoking but the policy and infrastructure necessary for successful quitting are missing. Pakistan needs to concentrate on two fronts: a large scale awareness campaign against the use and harms of combustible smoking and simultaneously providing affordable and accessible smoking services across the country. Pakistan should look at the use and regulation of safer nicotine products in the UK. The country should carefully weigh the options of ensuring how to incorporate the use of safer nicotine delivery systems in its tobacco control efforts. PubDate: Fri, 24 Sep 2021 01:50:00 +000
Abstract: Background. Glaucoma is a leading cause of irreversible blindness in the world associated with characteristic damage to the optic nerve and patterns of visual field loss due to retinal ganglion cell degeneration. The main objective of this study was to investigate determinants for the variation of intraocular pressure of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Methods. A retrospective cohort study design was conducted on 328 randomly selected glaucoma patients in the ophthalmology clinic at the hospital under the follow-up period from January 2014 to December 2018. Glaucoma patients who have two and more than two visits in the study period were included in the study, but patients who are attending medications less than two visits were excluded from the study. A linear mixed-effects model for intraocular pressure change was used for data analysis. Result. The estimated coefficient of fixed effect intercept was 25.1829, which indicates that the average IOP of the patients was 25.1829 mmHg at baseline time by excluding all covariates in the model ( value 0.7 ( = 2.60, 95% CI 1.24–3.96), and follow-up time ( = −0.34, 95%CI −0.47, −0.21) were significantly associated with intraocular pressure of glaucoma patients. Conclusion. The predictor age, residence, family history of glaucoma, type of medication, cup-disk ratio, and follow-up time were significantly associated with the intraocular pressure of glaucoma patients. Therefore, healthcare providers give more attention and prioritize those identified factors and give frequent counseling about reducing intraocular pressure of glaucoma patients. PubDate: Mon, 20 Sep 2021 09:05:00 +000
Abstract: Background. Seasonal influenza is a common highly infectious disease that can affect the upper and lower airway in children and adults mainly in wintertime which is caused by many different influenza viruses and, in some cases, may cause serious complications such as pneumonia. We conducted this study to assess the knowledge and attitudes among patients and their companions in North Palestine hospitals regarding seasonal influenza and influenza vaccination and factors influencing the uptake of this vaccine so that we can identify gaps in their knowledge and give feedback to health authorities for future quality improvement projects by increasing awareness of its effectiveness and safety. Methods. A cross-sectional 17-item survey included randomly selected samples of 327 North Palestinian patients and their companions at North Palestine hospitals. Result. A total of 327 completed questionnaires were received with a response rate of 92%. Of these, 129 participants (39.4%) believed that influenza is the same as common cold. The majority of participants (85.3%) had heard of the influenza vaccine before. Although nearly half of them (53.6%) believed that the influenza vaccine is safe, only 112 (34.7%) of the participants considered vaccination an effective means in preventing serious influenza-related complications and only 89 (27.2%) participants were previously vaccinated. The main reasons for not being vaccinated included that vaccination is not necessary because flu is not a serious disease (67%), concerns about vaccine efficacy and its side effects (25.6%), fear of needles and injection (25.2%), and 17.8% of the participants believed that this vaccine is expensive. Conclusion. The uptake and knowledge of the influenza vaccine among Palestinians are low. Vaccinated participants in our survey showed a higher level of knowledge compared to nonvaccinated participants. Half of the participants believed in the safety of the vaccine and one-third of them believed in its efficacy in preventing flu illness and its complications. Extensive and sustained efforts are needed by public health programs to promote the flu vaccine among the public by increasing awareness of its effectiveness and safety. PubDate: Wed, 15 Sep 2021 16:50:00 +000
Abstract: This paper investigates the extent to which armed conflict influences the weight of young children in the Democratic Republic of the Congo. Exploiting the variation across districts in exposure to armed conflict and the within-district variation in the timing of whether the child was exposed to armed conflict due to birth timing within a difference-in-differences framework, we detect adverse impacts of conflict exposure to child weight. Specifically, experiencing armed conflict makes children weigh less for their age and weigh less for their height by 0.20 and 0.24 standard deviations, respectively. Armed conflict also increases the probability of children being underweight and wasted by 4.7 and 2.7 percentage points, respectively. Our heterogeneity analyses reveal that children of disadvantaged backgrounds, i.e., those born to low-educated mothers, poor mothers, and rural mothers, tend to be disproportionately affected. Our study calls for effective measures to mitigate the detrimental repercussions of armed conflict. PubDate: Fri, 03 Sep 2021 06:05:00 +000
Abstract: Background. Access to healthcare remains a challenge towards the achievement of the Sustainable Development Goals in Ghana. There still remain inequalities in the distribution of health services especially among vulnerable groups despite sustained efforts to strengthen the health system. This study was conducted to analyze access differentials among different vulnerable groups in the context of primary healthcare under a National Health Insurance Scheme (NHIS) in Ghana. Methods. This study was a descriptive cross-sectional study conducted among multilevel participants of vulnerable groups in Kumasi Metropolis: 710 vulnerable people constituting elderly/aged (n = 359), pregnant women (n = 117), head poters (teenage girls who migrated from the northern Ghana mainly to the capital cities of the Ashanti and Greater Accra region to help in carrying of goods for their livelihood) (n = 86), sex workers (n = 75), and other vulnerable groups (people with disabilities and street participants) (n = 73). Data were collected using a semistructured questionnaire. Poisson regression with robust variance was used to access the association between vulnerability and access to healthcare. Results. Close to a fifth, 18.5% of the study respondents were unable to access care at any point in time during the last 12 months. Reasons for the inability to access healthcare included limited funding (69.7%), poor attitude of service providers (7.6%), distance to health centers (8.3%), and religious reasons (6.2%). More than 95% of respondents were insured under the NHIS, but acceptability of service provision under the NHIS was low among the vulnerable groups. In the crude models, pregnant women had lower prevalence of access to medications as compared to the elderly (prevalence ratio (PR): 0.88; 95% CI: 0.80–0.98). Head poters and other vulnerable groups were also less likely to view healthcare as affordable as compared to the elderly. The differences in healthcare access observed were attenuated after adjustment for sociodemographic characteristics and healthcare-related factors. Conclusions. Despite the introduction of a NHIS in Ghana, this study highlights challenges in healthcare access among vulnerable populations independent of the type of vulnerability. This suggests the need for stakeholders to work to address access differentials in the NHIS and adopt other innovative care strategies that may have broader applicability for all populations. PubDate: Tue, 27 Jul 2021 07:35:00 +000
Abstract: Background. In the quest to prevent households from making catastrophic expenditures at the point of seeking healthcare, the government of Ghana introduced the National Health Insurance in 2003. However, people are reluctant to renew their membership. This study was, therefore, conducted to identify factors influencing the nonrenewal of National Health Insurance membership in the Ejisu-Juaben Municipality. Methods. A cross-sectional study was conducted among 427 respondents in the Ejisu-Juaben Municipality to ascertain factors influencing the nonrenewal of health insurance membership status. Data were entered and analyzed using Stata version 14. Univariate and multivariate analyses were performed to determine sociodemographic factors, household factors, and systemic factors influencing the nonrenewal of health insurance status. Statistical significance for all testing was set as .Results. Sociodemographic factors such as gender (AOR = 0.531; CI = 0.287–0.985) and educational level (AOR = 5.268; CI = 1.130–24.551)) were associated with the nonrenewal of health insurance membership. Income levels in Ghana Cedis were 500–1000 (AOR = 0.216; CI = 0.075–0.617) and 1001–2000 (AOR = 0.085; CI = 0.019–0.383). Systemic decision on factors such as clients’ satisfaction (AOR = 0.149; CI = 0.035–0.640), making copayment (AOR = 0.152; CI = 0,068–0.344), acquiring all prescribed drugs (AOR = 4.191; CI = 2.027–8.668), and awareness of mobile renewal (AOR = 3.139; CI = 1.462–6.739) was associated with nonrenewal of membership. Conclusions. The nonrenewal of health insurance membership was influenced by sociodemographic, household, and systemic factors. Therefore, the Municipal Health Directorate and the National Health Insurance Authority have to work on these factors to reach the target of 100% active coverage in the municipality. PubDate: Sat, 10 Jul 2021 07:20:00 +000
Abstract: Background. An integrated community case management (ICCM) program fosters child health care seeking and access to appropriate treatment for illnesses in children at the community level in Ethiopia. There is paucity of evidence to the utilization of ICCM services by mothers/child caregivers in rural Sothern Ethiopia. Hence, the aim of this study was to determine the utilization of integrated community case management (ICCM) and its factors among mothers/child caregivers in rural Southern Ethiopia. Methods. A multistage sampling technique was used to select study participants in health care facilities offering child health care services. An exit interview was conducted on 574 mothers/child caregivers in randomly selected public health centres. Data were entered using Epi Info and transported to SPSS version 20 for analysis. Results. Only less than a quarter of participants visited health posts for ICCM services during the study period. Those study participants who have not heard about ICCM service before the survey were about 6.53 times more likely not to use the services as compared to those who have heard about the service. Participants who were not members of the women’s development team were about 2.23 times more likely not to utilize ICCM services when compared to their counterparts. Conclusion. The study shows low utilization of ICCM service by children less than five years. Prior information about ICCM services and membership in the health development army was significantly associated with ICCM use. Therefore, our finding may suggest the need for advocacy to increase participation in the health development army and information education to increase the level of awareness and formal education efforts. PubDate: Mon, 31 May 2021 13:20:00 +000
Abstract: Background. There exist continuing challenges with communication medium used during health service provision. These challenges relate to clients and health institution, intra- and interhealth institution communications. This study reviewed the existing healthcare communication medium from the perspectives of clients and health professionals at a tertiary hospital in Ghana. Methods. Cross-sectional design was employed with a multilevel sampling method to select a total of 650 participants consisting of 303 clients, 303 health workers, and 44 hospital directorate managers for the study. A structured survey questionnaire was used to collect data from respondents. Results. Close to ninety percent (89.8%) of staff resort to direct means (face-to-face medium) to communicate among each other. Majority (64.4%) of them also communicated with management through meetings sections. Nearly all healthcare providers (97.4%) communicated with clients through direct means (face-to-face medium). Almost all forms of communication between the hospital management members and the general public were done through letters and official memos. Conclusions. The study revealed blended forms of communication media used by health providers and health service consumers. These differences in medium of communication could amount to possible difficulties such as lack of information and truncation of information flow. Developing a systematic way of information flow using a common information platform will improve access to health services. PubDate: Sat, 08 May 2021 12:35:01 +000
Abstract: Because health care workers are a reliable source of health information, their acceptance or rejection of COVID-19 vaccines can influence the general population's uptake of COVID-19 vaccines. In this study, we sought to determine the acceptability of COVID-19 vaccines among health care workers in Ghana. Using a cross-sectional design, we collected data from 234 health care workers through a self-administered online survey from 16 January to 15 February 2021. Descriptive, bivariate, and multivariate analyses were performed using STATA version 15. The findings revealed that 39.3% (n = 92) of health care workers intended to receive the COVID-19 vaccines. Factors such as sex (AOR = 0.451; CI 95% 0.240–0.845; ), category of health care workers (AOR = 2.851; 95 CI%: 1.097–7.405; ), relative being diagnosed with COVID-19 (AOR = 0.369; CI 95% 0.145–0.941; ), and trust in the accuracy of the measures taken by the government in the fight against COVID-19 (AOR = 2.768; CI 95%: 1.365–5.616; ) proved to be significant predictors of the acceptability of the COVID-19 vaccine. Concerns about the safety of vaccines (n = 93, 65.5%) and the adverse side effects of the vaccines (n = 23, 14.8%) were identified as the main reasons why health care workers would decline uptake of COVID-19 vaccines in Ghana. The self-reported low intention of health care workers in Ghana to accept COVID-19 vaccines necessitates an urgent call from the Government of Ghana and other stakeholders to address health care workers' concerns about the safety and adverse side effects of COVID-19 vaccines, as this would increase vaccine uptake. Interventions must also take into consideration sex and the category of health care workers to achieve the desired results. PubDate: Tue, 20 Apr 2021 11:20:00 +000
Abstract: Government departments and scholars have focused on promoting health care for older adults in response to population aging and the annual increase in the number of older adults. Old age does not necessarily involve rapid health decline, fragility, or senility. Therefore, active aging among older adults has become a major consideration worldwide. The effect of exercise participation and social support on active aging warrants investigation. This study proposes a conceptual model for understanding the effects of exercise participation and social support on active aging among older adults. Exercise participation, social support, and health literacy were integrated to hypothesize a theoretical model of active aging among older adults. Furthermore, the moderating role of health literacy in the relationship between exercise participation, social support, and active aging was analyzed. Questionnaires were administered to respondents from Northern Taiwan during face-to-face interviews. Of the 1,800 distributed questionnaires, 1,586 completed questionnaires were received (response rate = 88.1%). The data collected were analyzed using structural equation modeling. The results indicated that exercise participation (β = 0.163, ), social support (β = 0.384, ), and health literacy (β = 0.360, ) had significant positive effects on active aging. Health literacy did not moderate the effects of exercise participation and social support on active aging among older adults (β = −0.054, and 0.061, ). The current results confirm that social support has a considerable effect on active aging, which could be used as a reference for future proposals targeted at relevant institutions and older adults. PubDate: Fri, 16 Apr 2021 12:20:00 +000
Abstract: Background. The purpose of the study was to determine the prevalence of computer vision syndrome (CVS) and poor sleep quality among university students and assess the relationship between digital device usage, CVS, and sleep quality. Methods. A cross-sectional study including undergraduate students was conducted in Ghana between January–March 2020. Information on digital device use and CVS symptoms was collected using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to determine the relationship between CVS and digital device use behavior, and linear regression analysis was used to explore the association between sleep quality and digital device use behavior. Statistical significance was set at PubDate: Thu, 18 Mar 2021 11:35:00 +000
Abstract: Background. Infant and young child feeding in the context of human immunodeficiency virus- (HIV-) infected mothers has significant challenges due to the risk of transmission of the virus via breastfeeding. In Ethiopia, a number of independent studies have been conducted to assess the feeding practice of HIV-exposed infants. But, there is no concrete evidence to show the national figure in Ethiopia. Hence, this review and meta-analysis aims to estimate the pooled prevalence of feeding practices among HIV exposed infants in Ethiopia. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. Articles were searched through search engines in PubMed, Cochrane Library, Google Scholar, and direct Google search. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment. The random effects model was used to estimate the pooled prevalence of infant feeding practices. Heterogeneity and publication bias were assessed. Trim and fill analysis was performed. Additionally, meta-regression was also performed. Results. In this review, a total of 26, 22, and 22 studies and 7413, 6224, and 6222 study participants for exclusive breastfeeding, replacement feeding, and mixed feelings were included, respectively. The overall pooled prevalence of exclusive breastfeeding, replacement feeding, and mixed feeding of HIV exposed infant was 63.99 % (95% Confidence Interval (CI): 52.32, 75.66), 16.13% (95% CI: 11.92, 20.32), and 20.95% (95% CI: 11.35, 30.58)) in Ethiopia, respectively. Conclusion and Recommendations. In Ethiopia, almost three in five HIV-exposed infants were exclusively breastfed. But still, mixed feeding during the period of first 6 months was practiced in almost one-fifth of the exposed infants in Ethiopia. Additionally, replacement feeding was also practiced even though not recommended for developing countries. Therefore, the government of Ethiopia should strengthen the health institutions to implement the existing infant feeding strategies and guidelines to increase exclusive breastfeeding for the first 6 months and to avoid mixed feeding during the periods of six months. PubDate: Wed, 10 Mar 2021 06:05:00 +000
Abstract: Background. The government of Sierra Leone introduced social health insurance (SHI) scheme to provide universal health coverage to people. This study was carried out to assess the population characteristics and their implications on the benefit basket of the proposed national health insurance scheme. Methods. A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data were collected for this study through the use of semistructured questionnaires with a sample of 1,185 respondents. Data were analysed using descriptive and inferential statistics. Statistical analysis was run at 5% significant level using Stata 14.0 software. Results. The study found that most (83.54%) of the respondents affirmed that children below 18 years should be excluded from premium payments and as high as 71.65% also stated that pregnant women should be excluded as well. The majority, 63.69%, of the respondents want lactating mothers to be excluded from premium payments. Also, 79.87% of respondents wanted mentally challenged persons not to pay premium, while a significant proportion (84.26%) of respondents further affirmed that the aged (above 70 yrs) should also be excluded from premium payment. Most household heads (89.71%) preferred the accreditation of public health facilities. Regarding the level at which healthcare services should be covered by the scheme, 61.45% preferred the primary care services, 89% mentioned secondary care services, and 98.93% affirmed the provision of tertiary care under the scheme. As for the type of care that should be covered by the scheme, 98.66% and 99.73% affirmed outpatient and inpatient care, respectively. Conclusion. From the findings on population characteristics and their implications on the benefit basket for the proposed nation social health in Sierra Leone, most of the household heads want exemptions from paying premium for a section of the population. This provides a clear insight for policy makers into the formulation of the benefit basket. PubDate: Mon, 08 Mar 2021 11:50:01 +000
Abstract: Background. Human immunodeficiency virus (HIV) is a major health problem in the world, and failure to implement prevention programs results in an increased number of infections among newborns. The goal of this study was to investigate the evolution and determinants of cluster of differentiation four (CD4) cell count among HIV-infected children who were under antiretroviral therapy (ART). Methods. We follow up a cohort of 201 children aged under fifteen years from October 2013 to March 2017 at Adama Hospital in Ethiopia. To get insight into the data, exploratory data analysis was performed on the change in the longitudinal CD4 cell count. Results. At the baseline, the average number of CD4 cell counts was 468.5 cells/mm3 of blood with a standard deviation of 319.11 cells/mm3. Here, we employed the random intercept and the random slope linear mixed-effects model to analyze the data. Among predictor variables, observation time, baseline age, WHO clinical stage, the history of tuberculosis (TB), and functional status were determinant factors for the mean change in the square root of the CD4 cell count. Conclusions. The finding revealed that the change in the square root of the CD4 cell count increases with an increment of age at diagnosis. Regarding WHO clinical stages of patients, those who were in stage III and stage IV of the HIV/AIDs disease stages relatively had lower CD4 cell counts than stage I patients. This shows the change in the square root of CD4 cell counts of stage III and stage IV patients was 6.43 and 9.28 times lower than stage I patients, respectively. Similarly, we noticed that observation time, the history of TB, and functional status were significantly associated with the mean change in the square root of the CD4 cell count. PubDate: Fri, 29 Jan 2021 15:50:00 +000
Abstract: Background. Second-trimester medical abortion is the termination of pregnancy between 13 and 28 weeks of gestational age. Although the majority of abortions are performed in the first trimester, 10–15% of terminations of pregnancies have taken place in the second trimester globally. Objective. To identify the determinant factors of second-trimester safe termination of pregnancy in public health facilities of the Amhara region, northwest Ethiopia. Methods. An institution-based unmatched retrospective case-control study conducted from 01/10/2019–30/02/2020. A systematic random sampling technique was used to select 119 cases and 238 controls. An interviewer-administered questionnaire was used to collect the data. A binary logistic regression model was fitted to identify determinant factors. The odds ratio with 95% CI was computed to assess the strength and significance of the association between dependent and independent variables. Result. Rural resident (adjusted odds ratio (AOR) = 1.9; 95% CI 1.07–3.25), irregular menses (AOR = 1.8; 1.06–3.13), had no known symptoms of pregnancy (AOR = 1.9; (95% CI 1.06–3.46)), not knowing the abortion law (AOR = 3.0; (95% CI 1.63–5.60)), low level of education (1st–8th grade) (AOR = 2.7; (95% CI 1.06–6.60), opposition against abortion care (AOR = 2.6; (1.22–5.42)), delayed referral (AOR = 10.1 (95% CI 4.02–29.18)), and not undertaking pregnancy test (AOR = 2.2; (95% CI (1.21–4.04)) were determinants of second-trimester safe termination of pregnancy. Conclusion. Women being rural residents, irregular menses, not undertaking pregnancy test, not knowing the abortion law, low-level educational status, delayed referral, no knowledge about signs and symptoms of pregnancy, and opposition of safe abortion were determinants of second-trimester safe termination. The Regional Health Bureau and Health Facilities should give emphasis to women living in rural areas, and they should increase awareness towards abortion law and sign and symptoms of pregnancy and encourage female education. PubDate: Thu, 21 Jan 2021 12:20:01 +000
Abstract: Background. The health care a woman receives during pregnancy is important for her survival and baby, both at the time of delivery and shortly after that. In the context of high maternal morbidity and mortality in sub-Saharan Africa, fewer than 80% of pregnant women receive antenatal care visit services. Receiving antenatal care visits at least four times increases the likelihood of receiving effective maternal health interventions through the antenatal period. This study aimed to identify the utilization and determinants of attending at least four visits in 12 East African countries. Methods. The study used the demographic and health survey data from 12 East African countries from 2008 to 2018. The DHS program adopts standardized methods involving uniform questionnaires, manuals, and field procedures to gather information comparable across countries globally. A multivariable logistic regression model was fitted to identify the determinants of completing at least four antenatal care services. With their 95% CI obtained from the adjusted multilevel logistic regression model, the adjusted odds ratio was presented to show the magnitude of the relationship between the independent variable and completing antenatal care visits. Results. The pooled utilization of attending at least four antenatal care visit in the East African region was 52.44% (95% CI: 52.13, 52.74), with the highest attending at least four or more antenatal care visit visits in Zimbabwe (75.72%) and the lowest attending at least four or more antenatal care visit visits in Ethiopia (31.82%). The significant determinants of completing at least four ANC visits were age category (24–34 (AOR = 1.24, 95% CI: 1.18, 1.31) and 35–49 (AOR = 1.42, 95% CI: 1.32, 1.53)); being married women (AOR = 1.11, 95% CI: 1.1.05, 1.16); education levels of primary education (AOR = 1.20, 95% CI: 1.13, 1.27), secondary education (AOR = 1.24, 95% CI: 1.24, 1.47), and higher education (AOR = 1.91, 95% CI: 1.62, 2.14); birth order (2–4 (AOR = 0.75, 95% CI: 0.70, 0.79) and 5+ (AOR = 0.63, 95% CI: 0.58, 0.68)); planned pregnancy (AOR = 0.81, 95% CI: 0.75, 0.86); contraceptive utilization (AOR = 1.36, 95% CI: 1.29, 1.43); wealth status of middle (AOR = 1.11, 95% CI: 1.05, 1.17) and rich (AOR = 1.25, 95% CI: 1.18, 1.32); having no problem accessing health care (AOR = 1.0.95, 95% CI: 0.89, 0.97); and living countries. Conclusions. The coverage of completing the recommended antenatal care visit was low in the region. Age, marital status, mother’s and partner’s education, women’s occupation, birth order, planned pregnancy, contraceptive utilization, wealth status, healthcare accessibility, and living countries were the major determinants of completing recommended antenatal care visits. Therefore, intersectoral collaboration to promote female education and empowerment, improve geographical access to health care, and strengthen implementation of antenatal care policies with active community participation is recommended. In addition, creating a conducive environment in entrepreneurial activities for poor women is needed. PubDate: Wed, 13 Jan 2021 12:35:00 +000
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