Achievement Of Millennium Development Goals Research Articles

Mental Health in the Asia-Pacific Region: An Overview

Mental health problem is one of the growing major public health issues in the Asia Pacific region. It contributes to the high number of Disability Adjusted Life Years (DALYs), morbidity and mortality in the region. It is expected that leading mental health problems will occur in the low-and middle-income countries (LMICs) and majority of the countries which comes under this category are in the Asia Pacific region. In addition, mental health problem hamper the achievement of Millennium Development Goals (MDGs), particularly MDG 1, MDG 4 and MDG 5. The most common mental health problems in the region are depression, anxiety, posttraumatic stress disorder, suicidal behaviour and substance abuse disorder. Several modifiable and non-modifiable risk factors were identified for the cause of these major mental health issues. Interventions, programmes and policies need to be designed in order to curb mental health problems at all levels.

Developing a Model of Compulsory Basic Education Completion acceleration in Support of Millennium Development Goals in Magelang, Indonesia

This article reports Year One of a two-year study to develop a model to accelerate compulsory basic education completiontoward Millennium Development Goals (MDGs) in Magelang, Indonesia. The study focuses on five issues: (1) profile of MDGs in Magelang, (2) achievement of MDGs, (3) problems in MDGs implementation, (4) model of compulsary basic education completion acceleration, and (5) effectiveness of the model proposed. As R&D undertaking, the data were collected through documentation and interviews with related authorities, including focused group discussion.The initial model underwent a limited test for necessary revision. The findings showed that the Local Government has implemented the compulsary education with relatively high gross and net enrolment rates of 96.80% and low dropouts and repeaters rates. In 2013-2014, many of the students were from outside Magelang. However, such achievements have not complied with MDGs. One possible cause of the problems was a top-down management system, resulting in low participation of the society members. In conclusion, Magelang Municipality has actually been highly committed to the completion of basic education in accordance with the strategic plans 2010-2014 of the National Education Ministry. A team was established to organize relevant activities to accelerate full implementation of the program. Recommended in Year One of the study were that (1) the Local Government’s commitment to education be sustained, (2) the society members’ participation be optimized in data inventories, planning, implementation, monitoring and evaluation of the program, and (3) the optimization of the society’s participation be supported by Local Government, including the stakeholders.

Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study.

BackgroundBangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals.MethodologyBoth qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines.ResultsThe hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments.ConclusionThe quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.

Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

BackgroundImproving maternal and child health remains a top priority in Nigeria’s Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5.MethodsAt baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.ResultsFor several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.ConclusionsIntensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations need to be given to the design of strategies that address the demand for health services.

Six years of experience in entomological surveillance of indoor residual spraying against malaria transmission in Benin: lessons learned, challenges and outlooks.

BackgroundFrom 2008 to 2013, a prevention intervention against malaria based on indoor residual spraying (IRS) was implemented in Benin. From 2008 to 2012, Ficam M®, a bendiocarb-containing product was used for house spraying, in association with pirimiphos methyl EC (Actellic EC) in 2013. This operation aimed to strengthen the effectiveness of treated nets so as to expedite the achievement of Millennium Development Goals (MDGs): the reduction of morbidity and mortality due to malaria by 75 % from 2000 to 2015.MethodsMonitoring and evaluation (M&E) was implemented in order to evaluate the impact of IRS intervention on malaria transmission. Anopheles gambiae s.l. populations were sampled by human landing catch. In addition, window exit traps and pyrethrum spray catches were performed to assess exophagic behaviour of Anopheles vectors the main malaria vector in the treated areas. The residual activity of insecticide in the treated walls was also assessed using WHO bioassay test.ResultsThe purpose of this project was to draw attention to new challenges and future prospects for the success of IRS in Benin. The main strength of the intervention was a large-scale operation in which more than 80 % of the houses were treated due to the strong adhesion of population. In addition, a significant reduction of the EIR in areas under IRS were observed. However, there were many challenges including the high cost of IRS implementation and the identification of suitable areas to implement IRS. This was because of the low and short residual effect of the insecticides recommended for IRS and the management strategy for vector resistance to insecticides. This indicated that challenges are accompanied by suggested solutions. For the cost of IRS to be accessible to states, then local organizations need to be created in partnership with the National Malaria Control Programme (NMCP) in order to ensure relevant planning and implementation of IRS.ConclusionAs an anticipatory measure against vector resistance, this paper proposes various methods, such as periodic IRS based on a combination of two or three insecticides of different classes used in rotation every two or three years.

Economic evaluation of Community Level Interventions for Pre-eclampsia (CLIP) in South Asian and African countries: a study protocol.

BackgroundGlobally, hypertensive disorders of pregnancy, particularly pre-eclampsia and eclampsia, are the leading cause of maternal and neonatal mortality, and impose substantial burdens on the families of pregnant women, their communities, and healthcare systems. The Community Level Interventions for Pre-eclampsia (CLIP) Trial evaluates a package of care applied at both community and primary health centres to reduce maternal and perinatal disabilities and deaths resulting from the failure to identify and manage pre-eclampsia at the community level. Economic evaluation of health interventions can play a pivotal role in priority setting and inform policy decisions for scale-up. At present, there is a paucity of published literature on the methodology of economic evaluation of large, multi-country, community-based interventions in the area of maternal and perinatal health. This study protocol describes the application of methodology for economic evaluation of the CLIP in South Asia and Africa.MethodsA mixed-design approach i.e. cost-effectiveness analysis (CEA) and qualitative thematic analysis will be used alongside the trial to prospectively evaluate the economic impact of CLIP from a societal perspective. Data on health resource utilization, costs, and pregnancy outcomes will be collected through structured questionnaires embedded into the pregnancy surveillance, cross-sectional survey and budgetary reviews. Qualitative data will be collected through focus groups (FGs) with pregnant women, household male-decision makers, care providers, and district level health decision makers. The incremental cost-effectiveness ratio will be calculated for healthcare system and societal perspectives, taking into account the country-specific model inputs (costs and outcome) from the CLIP Trial. Emerging themes from FGs will inform the design of the model, and help to interpret findings of the CEA.DiscussionThe World Health Organization (WHO) strongly recommends cost-effective interventions as a key aspect of achieving Millennium Development Goal (MDG)-5 (i.e. 75 % reduction in maternal mortality from 1990 levels by 2015). To date, most cost-effectiveness studies in this field have focused specifically on the diagnostic and clinical management of pre-eclampsia, yet rarely on community-based interventions in low-and-middle-income countries (LMICs). This study protocol will be of interest to public health scientists and health economists undertaking community-based trials in the area of maternal and perinatal health, particularly in LMICs.Trial registrationClinicalTrials.gov: NCT01911494

Measuring and Monitoring the Achievements of the Millennium Development Goals Through Dynamic Composite Indices

The fight for development and the eradication of poverty, following the decisive shift from a unidimensional perspective grounded in a simplistic monetary approach to a multidimensional conception of the phenomena based on a multidisciplinary people-centred approach, has led to the elaboration in the year 2000 of the Millennium Development Goals (MDGs). This set of targets—agreed globally to promote human development and respond to the needs of the world’s poor—is reaching its established deadline, leaving the international community with the necessity to effectively evaluate MDG achievements and address the challenges posed by the post-2015 agenda. Contrarily to the usual practice that has so far measured such achievements goal by goal, these should be analysed as a whole to provide the picture needed, exhaustive of the level of attainment of all the MDGs. In this work, two non-compensatory dynamic composite indices, the adjusted Mazziotta–Pareto Index (ranking performances) and the Jevons index (measuring speed in time) are used to measure and monitor world regions’ performance in fulfilling the MDG objectives since their establishment. As the time available for countries to reach the targets is getting close, the findings are sought to feed the ongoing conclusions and international discourse on the effectiveness of the MDG initiative and degree of results obtained. The conclusive part explains how they could also help identifying the issues that were instrumental to both successes and failures in the implementation of the MDG framework in each sphere, from which to extrapolate potential policy indications to contribute to the post-2015 agenda.

Strategies to avert preventable mortality among mothers and children in the Eastern Mediterranean Region: new initiatives, new hope.

We conducted an assessment of maternal, newborn and child health and progress towards achieving Millennium Development Goals (MDG) 4 and 5 in the Eastern Mediterranean Region (EMR). We provide recommendations for scaling up and sustaining gains post-2015. Data were obtained from global data repositories. We constructed time trends from 1990 to 2013 and evaluated inequities across the Region. Under-5, neonatal and maternal mortality rates decreased 46%, 35%, and 50% respectively from 1990 to 2013. Pneumonia and diarrhoea accounted for 50% of all post-neonatal deaths; pregnancy- and delivery-related complications were the leading causes of neonatal and maternal deaths. Coverage of maternal, newborn and child health interventions is suboptimal, and poverty, food insecurity and conflict are pervasive across the Region. The EMR has made progress but is unlikely to attain MDG 4 and 5 targets. To sustain and further accelerate gains, the Region must reduce inequities and scale up implementation of recommendations made by the independent Expert Review Group.

Achieving Millennium Development Goals and India Vision 2020: Evidences from slums of Varanasi City

The objective of this paper is to examine the achievements of Millennium Development Goals (MDGs) and India Vision 2020 in the context of the slums of Varanasi city. India has been facing the problem of growing urban poverty due to rapid urbanisation. According to the Census of India 2011, about 65 million people live in urban slums, which are overcrowded, polluted, unhygienic, and deprived of basic services. This paper compares the goals and targets of UN MDGs and India Vision 2020 with the status of the slum dwellers of Varanasi city. The study is based on primary data, which includes survey of 150 households of five different slums of Varanasi city. The study reveals that more than 70% people are illiterate, less than 35% of population access government health facilities, only 36% household use tap water, etc. This comparison portrays a pathetic picture of slums and the inabilities to achieve both MDGs and national goals.Key words:MDGs, India Vision 2020, Slums, Poverty, Quality of life, Varanasi City, India

Factors influencing access to antenatal services and delivery care in sub-Saharan Africa

Maternal mortality is a public health concern worldwide, and especially so in developing nations. Antenatal services and delivery care are key strategies to reduce avoidable maternal deaths, and achieve Millennium Development Goal 5. This review investigated the different factors influencing access to antenatal services and delivery care among women of childbearing age in sub-Saharan Africa. The results suggested that the level of education of women and their partners, transportation difficulties, socioeconomic status, wealth, income, age, distance, quality of care, cost and religious background influenced access to antenatal services and delivery care. Inequalities in access to antenatal care services and delivery care had an impact on the health of childbearing women in sub-Saharan Africa. Improvement in the social, economic, and political environment was essential to address the multiple barriers women encounter and to promote safe motherhood.

G251 Childhood pneumonia – lessons learned from an audit of three kenyan hospitals

<h3>Background</h3> Globally 1.2 million children die every year from pneumonia and it remains amongst the leading causes of under 5 childhood mortality. Auditing current practice is an essential step in reducing the morbidity and mortality associated with childhood pneumonia and helping to achieve Millennium Development Goal 4. The Kenyan Paediatric Association (KPA) has evidence based guidelines on the management of pneumonia. The aim of this study was to compare the management of children with pneumonia to this standard. <h3>Method</h3> A retrospective audit was carried out in two government hospitals and one missionary hospital in Kenya over a 1 month period in 2013. The study population included all patients admitted with a clinical diagnosis of pneumonia and data was collected directly from patient notes. <h3>Results</h3> - 148 children admitted with pneumonia were included with a median age of 21 months and a 5% mortality. - 69% of patients were classified correctly and 55% of patients were given the correct antibiotics. - 37% of patients across all three hospitals had their observations checked 24 hly or less than 24 hly. - 35% of patients who had not improved after 5 days of treatment had their HIV status checked. <h3>Conclusion</h3> Clearly displayed guidelines and the distribution of Kenyan Paediatric Handbooks would support medical staff in classifying and managing children with pneumonia correctly. Regular observations are crucial in recognising clinical deterioration to enable early intervention to reduce mortality. As healthcare providers we are failing to check the HIV status of high risk children. All children should have their HIV status checked as good practice. While great progress has been made in the management of pneumonia, we have demonstrated the need to further improve practice, to limit the morbidity and mortality associated with pneumonia in Kenyan children. <h3>The future</h3> Our plan to improve care for children with pneumonia involves delivering the following interventions at each of the hospitals: - A targeted teaching session on childhood pneumonia to all healthcare professionals; - Ensuring each acute area has the KPA pneumonia protocol clearly displayed; - Meeting with nursing staff regarding observations of acutely unwell children; - To re-audit and complete the audit cycle.

The Role of Business in Achieving Millennium Development Goals through CSR (Corporate Social Responsibility)

The Role of Business in Achieving Millennium Development Goals through CSR (Corporate Social Responsibility)

Peran Masyarakat dalam Pencapaian Millenium Development Goals 2015 dan Tantangan Pasca 2015: Studi 8 Kabupaten Indonesia

In September 2000, the United Nations General Assembly adopted a declaration called Millennium Declaration, which has been detailed down into goals and targets of what is well-known as Millennium Development Goals (MDGs). Indonesia has committed to achieve MDGs. Until 2010 the MDGs achievements for Indonesia have been identified as mostly off-the-track. Some districts, however, have shown significant achievements and the processes of the achievements are worth noted. The process of MDGs achievements need special emphasis since this can become foundation for MDGs achievements and for sustainable performance in the districts. This paper analyzes roles of different stakeholders, including local communities, in 8 districts/cities in 8 provinces. There are success stories that are recommended to be replicated to other districts/cities in Indonesia.

Micronutrients Deficiency, a Hidden Hunger in Nepal: Prevalence, Causes, Consequences, and Solutions.

Micronutrient deficiency is a global challenge to health as in Nepal. In Nepal, the targeted beneficiaries are less aware about importance of micronutrients (MNs), which has resulted in low intake of foods rich in MNs. Micronutrient deficiencies (MNDs) have huge impact on health of vulnerable population like women and children and have jeopardized the national economy and prosperity of developing countries including Nepal. However, less attention has been paid towards MNDs, which can be prevented. Therefore, this study aims to draw attention of the concerned authorities and researchers to combat against MNDs in Nepal. This study showed that different types of MNDs with higher prevalence exist in Nepal. The major causes of MNDs were poor diet, diseases and infestations, and poor health caring practices. The results of MNDs were unwanted child and maternal mortality, impairments of lives, and reduction in productivity and intellectual capacity. School health and nutrition education and supplementation and fortification of essential MNs proved to be effective while dietary diversification and economic growth and poverty eradication seemed promising. Control and prevention of MNDs can help to achieve Millennium Development Goals as well, so studies in this sector should be emphasized.

Visceral Leishmaniasis Elimination Program in Bangladesh and Achieving Millennium Development Goal

Aims: The aim of this review is to present the status of Visceral Leishmaniasis (VL) in Bangladesh and various steps taken to achieve the Millennium Development Goal (MDG). Additionally, the review covers the related challenges and opportunities to achieve this goal. Main Body: Currently, 45 out of 64 districts of the country are endemic for VL and 20 million people, around 18% of the total population, are considered to be at risk for VL. However, there is a concern about the total number of VL reported cases. It has been mentioned that the number of cases reported in surveillance data is likely to be at least five times underestimated. The current burden of VL disease is 23.4 times higher compare to the MDG of 1 case per 10,000 populations by 2015. In order to achieve the MDG various national strategies have been taken so far to eliminate VL from Bangladesh. Government of Bangladesh constituted a national steering committee and formed a technical working group to provide support to VL elimination program. Lack of trained and efficient labour force, along with lack of knowledge among the people are big

Millennium Development Goals in Africa , Policies and Achievement Strategies : An Appraisal and Ways Forward

The major focus of this paper was on the problems associated with the achievement of Millennium Development Goals in Africa. The baseline was that, for over thirteen years of inception of the Millennium Development Goals (MDGs), Africa remains wanting in human development indices, poverty eradication, literate population, health development, economic, political, and social development. These have been the case despite the introduction of a number of strategies aimed at achieving the MDGs and associated cost estimates by the Millennium Project and the World Bank. Our aim was to appraise the extent of achievement of the MDGs in Africa, guided by the question of whether practical policy initiatives for achieving the MDGs can be identified for Africa. We would like to contribute significantly to the policy initiatives. Methodologically, we concentrated on a survey of the policy prescriptions for the achievement of MDGs in Africa and the extent to which these policies had contributed to achievement of the MDGs. The data sources were basically from: (i) the African regional development indicators; (ii) Millennium Development Goals Reports; (iii) the MDG Africa Steering Group; and, other relevant literature. The analysis of data was highly descriptive and appropriate enough for assessment of the extent of achievement of the MDGs in Africa. In a nutshell, our assessments indicate the following constraints to the achievement of MDGs in Africa: (i) discouragingly low human development indices in Africa compared to the global average; (ii) inappropriate policy recommendations for achievement of the MDGs in Africa; (iii) non-applicable predictive models; (iv) the problem of paucity of data in Africa; (v) low level of infrastructural development in rural areas; (vi) high rate of underemployment; (vii) deficiencies in policy implementation processes; and, (viii) lack of research and development culture. Based on these observations, the paper makes the following recommendations: (i) regional partnerships in development projects;(ii) development and application of country-specific strategy models; (iii) country-wide emphasis on availability of relevant data, complemented with research and development activities; (iv) emphasis on infrastructural development especially in the rural areas; and, (v) refined policy implementation processes based on the use of appropriate personnel and other policy implementation instruments, such as monitoring and evaluation. SINGAPOREAN JOuRNAl Of buSINESS EcONOmIcS, ANd mANAGEmENt StudIES VOl.3, NO.12, 2015 14 Chuks P. Maduabum, Ph. D is a professor of Public Administration and Dean of the School of Management Sciences. Onyemaechi J. Onwe, Ph. D is an associate professor of Management Economics and a Programme Leader in the School of Management Sciences.

Strategy for Achieving the Millennium Development Goals 7-10 through Knowledge-based Sustainable Design Approach

The International agreements of MDGs (Millennium Development Goals) have been responded positively by the Indonesian government as outlined in the Strategic Plan of the Ministry of Health 2010-2014 that contains eight priority focus of development and road map STBM (Community Based Total Sanitation) acceleration program 2013-2015. One of the most prominent priority focus is environmental sanitation program and a target for increasing the percentage of people who stop BABS (Open Defecation) of 71 percent in 2010 to 100 percent in 2014, that number is above the achievement of MDGs 7-10 is to decrease halve the proportion of people who do not have access to drinking water and basic sanitation that is viable continuously in 2015. The Concept of strategic formulation applied by the government to achieve these targets, including through changes in behavior, the creation of sanitation needs and improve the supply market to meet the sanitation needs by involving the communities, the government and sanitation entrepreneurs facilitated and advocated by the Non-Government Organization (WSP-Water and Sanitation Program, and APPSANI-Asosiasi Pengelola dan Pemberdayaan Sanitasi Indonesia). This research studied the role of knowledge sharing between actors who perform collaborative functions and contribute to the triple helix (demand, supply, and enabling) in relation to the achievement of the MDGs 7-10. This study resulted the proposed model of sustainable design which is useful as a strategic framework for achieving MDG targets 7-10.

Transaction Cost Reduction Models For Micro Finance Institutions

During the past ten years, the microfinance industry has established itself as a dynamic and fast-growing segment of the region's financial markets. As a result, what once was a relatively obscure grassroots movement has become a topic of major importance in many national development strategies. In developing countries, the costs for supplying financial services for a Micro Finance Institution (MFI) are high in rural areas. Often, these costs cannot be adequately covered through interest charges because usury laws or traditions prevent charging high rate of interest to clients. Therefore, MFIs tend to reduce the quality and quantity of their services, which increases transaction costs for the clients. The article discusses several area specific collection models that can be adopted in the MFI operational strategies to reduce transaction costs. Collection risks are to be considered while adopting suitable collection strategies and in optimum utilization of resources. The reduction in operational cost can be transferred to the clients by reducing the interest rate on loan products; thereby the financial services for poor households can contribute to the achievement of Millennium Development Goals.

Determinants of Skilled Institutional Delivery Service Utilization among Women Who Gave Birth in the Last 12 Months in Bako District, Oromia, Ethiopia, 2012/13 (Case-Control Study Design)

Background: High maternal mortality is a continued challenge for the achievement of millennium development goal in sub-Saharan African countries including Ethiopia. Although institutional delivery services utilization ensures safe birth and a key to reduce maternal mortality, interventions at the community or institutions were unsatisfactorily reduced maternal mortality. Institutional delivery service utilization is affected by the interaction of personal, socio-cultural, behavioral and institutional factors. Methods: A community based un-matched Case Control study was conducted in Bako district, West shoa, Ethiopia. Three hundred eighty mothers were included in the study. Data were collected by trained female data collectors via face to face interview and pretested structured questionnaire was used to collect data on different variables. Descriptive statistics, binary and multivariable logistic regression analyses were computed by SPSS version 16. Statistical significance was considered at p<0.05 and the strength of statistical association were assessed by odds ratio (OR) with 95% confidence intervals. Result: In this study, a total of 380 mothers (130 cases and 250 controls) were included in the analysis. Majority (77%) of respondents were Oromo. Ninety four percent (94%) of mothers were married where as 2.4% were singles (never married). Ten percent (10%) of mothers have attended secondary and above grade. Secondary and above education (AOR: 2.754, 95%CI: 1.51–8.91), house wife (AOR: 23, 95% CI: 2.0-25.0), private employee (AOR: 14, 95% CI: 1.04-19.0) were significantly associated with utilization of skilled institutional delivery. Similarly, ANC visit (AOR=0.19[95% CI: 0.086-0.42], joint (husband and wife) final decision where to give birth (AOR=0.25[95% CI: 0.08-0.75], access to transport (AOR=0.53[95% CI: 0.30-0.94] were independently factors affecting institutional delivery service. Conclusion: Women’s education, occupation, ANC visit, joint(husband and wife) final decision making on place of delivery and access to transport service were found to be determinant of skilled institutional delivery service utilization. Hence, intensifying education for women and strengthen decision making power of women, enhance transport accessing of women and well communicating benefit of ANC use were recommended.

Evidence-based public health: Barriers and facilitators to the transfer of knowledge into practice.

This paper underscores some of the barriers and facilitators in the practice of evidence-based public health (EBPH). A large body of evidence-based interventions (EBIs) exists, which has been generated through highly robust systematic reviews. These EBIs have been widely disseminated and promoted by public health researchers and the World Health Organization (WHO) as effective public health interventions against various preventable/treatable diseases. The inability of many low- and middle-income countries to contextually adapt and effectively implement evidence-informed interventions (EBIs) has been identified as a major obstacle to progress in achieving Millennium Development Goals (MDGs). Hence, it is imperative to identify and understand the factors that are detrimental to the successful transfer of evidence into policy as well as practice. This paper discusses how factors such as political, contextual, and organizational factors; nature of evidence; and community participation influence the practice of EBPH.