Community-based Health Education Research Articles

A Community Based Survey on Rabies Control and Prevention using KAP in Jammu, India

As per revised estimate nearly 20, 583 people die of rabies every year in India, contributing to one third of the global rabies burden. Community based surveys with respect to Knowledge, Attitude and Practices (KAP) are important both for human deaths due to rabies and for the effective control of disease in animals. The present cross-sectional survey was carried to investigate level of community knowledge as well as attitudes and perception about rabies in and around Jammu, North India. A total of 200 respondents in the age group of 18 to 29 (55%) years were interviewed using pre-tested and structured questionnaires. Location wise origin of the respondents was 130 (65%) from urban and 70 (35%) from rural areas and sex-wise 157 (76%) males and 48 (24%) were females. Dog owners and being urban respondents had good knowledge level and attitude towards rabies compared to non-dog owners and rural dwellers. Surveyed population with 77.8 and 77 percent had heard of rabies and believed it to be fatal respectively. Urban respondents (98.9%) believed rabies to be fatal and was transmitted by dogs or other species, 94 percent believed that owned dog must receive rabies vaccine, 89 to 94 percent believed reporting to hospitals or higher authorities regarding dog bite and outbreak of rabies in a community whereas 78 percent believed in killing stray dog if rabies was suspected. Good practices prevailed in respondents that owned dogs. The knowledge, attitude and practices with respect to prevention and treatment of rabies were not found adequate amongst the rural population. Thus, community based health education becomes essential in these areas to create awareness regarding rabies.

Factors associated with Schistosomiasis outbreak at Omindamba primary school, Omusati region, Namibia: a case-control study, March 2016

IntroductionOn march 2, 2016, the principal of Omindamba primary school in Outapi district notified the Outapi hospital of a cluster of students complaining of dysuria and passing bloody urine. We conducted an investigation to identify the agent, source of infection, and to determine factors associated with the outbreak.MethodsAn unmatched 1:1 case-control study was conducted. A case was defined as any student of Omindamba primary school, who passed bloody urine with or without dysuria or lower abdominal pains from 2nd- 4th March 2016, during the time of the investigation. A control was a classmate of a case. We collected demographic, clinical and environmental data.Results125 cases and 125 controls were enrolled into the study. The mean age for cases was 11.3 years and controls was 11.0 years, with standard deviation of 3.2 years in both cases and controls. The most affected age group was 11-15 years with 63 (50.4%) cases, followed by 6-10 years with 51(40.8%) cases. Schistosoma hematobium was isolated in the urine specimens examined. Swimming in the canal (adjusted OR = 3.58; 95% CI = 1.14-11.2; p-value = 0.03), and using Etaka pond as a source of water (adjusted OR = 1.95; 95% CI = 1.09-3.50, p-value = 0.02) were independent factors associated with contracting schistosomiasis.ConclusionThe Schistosomiasis outbreak among the school children was caused by Schistosoma hematobium. Swimming in the canal and using Etaka pond as a source of drinking water were the predictive factors for the infection. A community-based health education on the prevention of Schistosomiasis was implemented.

Breast Cancer Screening Disparity among Korean American Immigrant Women in Midwest

Purpose:Using three breast cancer screening methods such as mammogram, Clinical Breast Examination (CBE), and Breast Self-Examination (BSE), this study investigated breast cancer screening rates and its associated factors in Korean American immigrant women.Method:Cross-sectional data were obtained from 168 Korean immigrant women aged 40 and older in Midwest. The Andersen’s Behavioral Model (1995) theoretically guided this study and logistic regression was used to examine factors associated with screening receipt and performance.Results:Study participants reported low screening rates, specifically mammography and CBE uptake. About 71% of the women had a mammography at least once in their lifetime, while about 36% indicating receipt of a mammogram in the last three years. About 59% of the women received a CBE at least once in their lifetime, while about 32% had CBE in the past three years. About 74% of study participants have performed BSE at least once in their life time, while about 68% have done it in the past three years. Knowledge of screening method was consistently correlated with participant’s three breast cancer screening uptake. Additional factors that were positively associated with screening included older age, low barriers to mammograms, and lower educational attainment.Conclusions:Overall, study participants reported low rates of breast cancer screening receipt and performance. It is required to promote screening uptake among Korean immigrant women, especially women with young age, a lower level of education, and lack of health accessibility. A community-based language-appropriate health education program should be developed to increase health care access.

Perceived health discomfort among adolescent girls and related factors in an urban area, South India.

INTRODUCTION:Adolescence is a period of life that is a bridge between childhood and adulthood. India has the world's largest adolescent girl's population, and adolescent girls are an important vulnerable group of population. Perceived health is a predictor of morbidity and mortality in adults and has been an important marker of the health status in population health studies for decades. The aim of the study was to describe adolescent's perception of health and association between some factors such as nutrition status, socioeconomic status (SES), and health status. As their perception of health discomfort affects their health behavior and self-care, therefore, their health status is an important matter to discuss.MATERIALS AND METHODS:A cross-sectional study was conducted in urban areas from a major city in South India. Six hundred and fifty adolescent female students aged 10–19 years formed the study population. Standardized self-reporting questionnaires were used to obtain relevant data regarding demographic features, SES, and health status. BMI calculated for each individual. The data were analyzed using SPSS version 16.RESULTS:About 83.3% of participants ranked their health status as good to excellent. A majority of the girls had one or more problems related to their menstrual cycles. The most common occurring problem was headache (45.3%). 47.8% of participants exhibited symptoms of mild insomnia. Strong significant association between nutritional status and SES was found. Higher percentage of undernourished adolescents belonged to low SES.CONCLUSION:Adolescents are expected to enjoy good health, but this does not seem to be the case in the developing countries like India, where poverty, malnutrition, and repeated infection are rampant. Majority of the problems such as healthy nutrition and self-care can be solved by community-based programs, health education, and food fortification.

Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria

Introduction: Reduction of workload on pregnant women has positive effect on pregnancy outcome. However, participation in household chores among husbands of pregnant women continues to be low. This study assessed the effect of a community-based health education intervention on men’s participation in household chores during their wives’ pregnancy in a rural community. Materials and Methods: Its is a quasi-experimental study involving men whose wives were currently pregnant. Preintervention, quantitative, and qualitative data were collected from the men and selected community leaders. Then a three-component intervention was conducted in the study community as follows; interactive workshop with the men, a film show with interactive discussion, and distribution of Islamic calendar for the current year carrying messages on men’s participation in pregnancy care. Six months later, postintervention data were collected using the same approach as the preintervention survey. Quantitative data were analyzed using IBM SPSS Statistics 20.0 and qualitative data were analyzed manually. Results: Mean age of men in the study group was 37.6 ± 10.5 years, and in the control group, it was 35.8 ± 10.8 years (P = 0.275). Men’s participation in household chores was low and showed no statistically significant change between pre- and postintervention data in study (P = 0.937) and control (P = 0.941) groups. Qualitative data showed most men perceived and treated household chores as women’s responsibility. Conclusion: Participation in household chores by husbands of pregnant women was low, and health education intervention did not significantly increase it. Further studies should evaluate the effectiveness of engaging community and religious leaders in eliminating the norms of gender roles.

The Effects of a Community-Based Sodium Reduction Program in Rural China - A Cluster-Randomized Trial.

BackgroundAverage sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed.ObjectiveWe sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China.DesignThis study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces. Sixty control villages were compared to 60 intervention villages that were given access to a reduced-sodium, added-potassium salt substitute in conjunction with a community-based health education program focusing on sodium reduction. The primary outcome was the difference in 24-hour urinary sodium excretion between randomized groups.ResultsAmong 1,903 people with valid 24-hour urine collections, mean urinary sodium excretion in intervention compared with control villages was reduced by 5.5% (-14mmol/day, 95% confidence interval -26 to -1; p = 0.03), potassium excretion was increased by 16% (+7mmol/day, +4 to +10; p<0.001), and sodium to potassium ratio declined by 15% (-0.9, -1.2 to -0.5; p<0.001). Mean blood pressure differences were -1.1 mm Hg systolic (-3.3 to +1.1; p = 0.33) and -0.7 mm Hg diastolic (-2.2 to +0.8, p = 0.35) and the difference in the proportion with hypertension was -1.3% (-5.1 to 2.5, p = 0.56).ConclusionThere were clear differences in population sodium and potassium intake between villages that were most likely a consequence of increased use of salt substitute. The absence of effects on blood pressure reflects the moderate changes in sodium and potassium intake achieved.Trial RegistrationClinicaltrials.gov identifier: NCT01259700.

An epidemiological investigation of a multisource outbreak of Crimean-Congo hemorrhagic fever in Karachi, from January– 15th September 2016

Purpose: In Pakistan Crimean–Congo haemorrhagic fever (CCHF) is an emerging life-threatening viral disease with case fatality rates up to 50%. With the increase in number of CCHF confirmed cases in the Karachi by December 2015, we decided to focus attention on disease in 2016. An epidemiological investigation was conducted in District Karachi to estimate the magnitude and associated risk factors for infection. Methods & Materials: From January- September 2016 an outbreak investigation was conducted. Cases were identified through an active surveillance in health care facilities by using World Health organization recommended case definition. Information was collected by in personal interview with cases/attendant and review of hospital records. Human blood sample was collected for ELISA followed by PCR. Contact tracing was also done for identification of susceptible cases. Data were analyzed using Epiinfo version 7.0. Results: Twenty-five suspected cases were identified by using WHO recommend cases definition out of them 08 were confirmed on IgM followed by PCR. The mean age for confirmed cases was 34.6 years (range: 16-65); all were male. Persons aged 30-39 years were the most severely affected n=5 (62.5%). Overall cases fatality rate (CFR) was n=6 (75%). The most frequent clinical features was fever n=8 (100%) followed by body pain n=7 (87.5%) and hemorrhagic manifestations n=6 (75%). When the cases were evaluated in terms of risk factors, the majority of the cases (n=4; 50%) were engaged in trading of animals. (n=2; 25%) has history of contact with animals. Two cases (25%) were medical doctor had history of operation of CCHF infected patient. Fifty percent (n=4) cases were reported in the month of August. Thirty three close contacts were traced and followed for 14 days no symptomatic evidence of the disease was reported. Conclusion: Failure to implement CCHF preventive measures have contributed to the outbreak with high CFR. Community based health education campaigns were done, and strict compliance of infection control practices were instituted in the hospital. Establishment of prevention and control program on CCHF with efficient surveillance will be helpful for future outbreak.

Knowledge, attitude and practices in relation to prevention and control of schistosomiasis infection in Mwea Kirinyaga county, Kenya.

BackgroundSchistosomiasis remains a major public health problem in Kenya. Inadequate knowledge, attitudes and practices (KAP) on causative factors are some of the critical factors for the increased prevalence. The study assessed KAP on the control and prevention of schistosomiasis infection in Mwea division, Kirinyaga County-Kenya. Four hundred and sixty five house-hold heads were enrolled in this study by use of simple random sampling technique.MethodsThe study employed an analytical descriptive cross sectional design utilizing both quantitative and qualitative data collection methods. A pretested structured questionnaire, Focus Group Discusions (FGDs) and Key Informant Interviews (KII) guides were used for data collection. Descriptive statistics and Chi square tests and Fisher’s exact tests were computed where applicable. Data from the FGDs and KIIs were analyzed using NUID.IST NUIRO.6 software.ResultsSignificant associations between knowledge and demographic factors i.e. age (p = 0.011), education level (p = 0.046), were reported. Handwashing after visiting the toilet (p = 0.001), having a toilet facility at home (p = 0.014); raring animals at home (p = 0.031), households being affected by floods (p = 0.005) and frequency of visits to the paddies (p = 0.037) had a significant association with respondents practices and schistosomiasis infection. Further significance was reported on households being affected by floods during the rainy season (p < 0.001), sources of water in a household (p < 0.047) and having a temporary water body in the area (p = 0.024) with increase in schistosomiasis infection. Results revealed that respondents practices were not significantly associated with gender (p = 0.060), marital status (p = 0.71), wearing of protective gear (p = 0.142) and working on the paddies (p = 0.144).ConclusionsThis study reveals that knowledge about the cause, transmission, symptoms and prevention of schistosomiasis among the Mwea population was inadequate, and that this could be a challenging obstacle to the elimination of schistosomiasis in these communities. Due to various dominant risk factors, different control strategies should be designed. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of schistosomiasis infection. Control programs like mass drug administration need to go beyond anti-helminthic treatment and that there is a need of a more comprehensive approach including access to clean water, sanitation and hygiene. School and community-based health education is also imperative among these communities to significantly reduce the transmission and morbidity from schistosomiasis.

Factors associated with hospital admissions among registered diabetes mellitus patients in Guruve and Mazowe district- Mashonaland Central Province, 2013

The key to successful control of diabetes mellitus is owed largely but not limited to self-care practices by patients. The purpose of this study was to identify factors that are associated with the increase in hospital admissions among diabetes mellitus patients in Guruve and Mazowe districts. An analytic cross-sectional study was conducted at Guruve, Mvurwi, Howard, and Concession hospitals. A census of all the 202 registered patients attending diabetes mellitus review appointments at treatment centers was done. Interviewer-administered pretested questionnaires were used to collect data. The admission prevalence was 43.6%. Insulin medication [AOR 2.74 (95% CI: 1.22;7.27) p = 0.0168], low educational level (primary and below) [AOR 2.74 (95% CI: 1.34; 5.58) p = 0.0057], having long been diagnosed with diabetes(1 year+) [AOR 3.06 (95% CI: 1.38; 6.79) p = 0.0057], and residing in areas where there is no diabetes mellitus education at community level [AOR 3.86(95% CI: (1.60;9.32) p = 0.0026] were independent factors associated with hospital admissions due to diabetes mellitus in Guruve and Mazowe districts that remained statistically significant after logistic regression analysis. Independent predictors of hospitalization were: type of treatment, educational level, accessing community-based health education, and time duration of diabetes diagnosis. Access to services and insulin supplies for diabetic patients was not adequate. Health managers at district hospitals will need to improve access to such services for diabetic patients. Insulin medication was associated with readmissions. There is a need to improve self-care practice using an ecological approach that involves the family and community.

Interventions for improving coverage of childhood immunisation in low- and middle-income countries.

Immunisation is a powerful public health strategy for improving child survival, not only by directly combating key diseases that kill children but also by providing a platform for other health services. However, each year millions of children worldwide, mostly from low- and middle-income countries (LMICs), do not receive the full series of vaccines on their national routine immunisation schedule. This is an update of the Cochrane review published in 2011 and focuses on interventions for improving childhood immunisation coverage in LMICs. To evaluate the effectiveness of intervention strategies to boost and sustain high childhood immunisation coverage in LMICs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2016, Issue 4, part of The Cochrane Library. www.cochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 12 May 2016); MEDLINE In-Process and Other Non-Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 12 May 2016); CINAHL 1981 to present, EbscoHost (searched 12 May 2016); Embase 1980 to 2014 Week 34, OvidSP (searched 2 September 2014); LILACS, VHL (searched 2 September 2014); Sociological Abstracts 1952 - current, ProQuest (searched 2 September 2014). We did a citation search for all included studies in Science Citation Index and Social Sciences Citation Index, 1975 to present; Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 2 July 2016). We also searched the two Trials Registries: ICTRP and ClinicalTrials.gov (searched 5 July 2016) SELECTION CRITERIA: Eligible studies were randomised controlled trials (RCT), non-RCTs, controlled before-after studies, and interrupted time series conducted in LMICs involving children aged from birth to four years, caregivers, and healthcare providers. We independently screened the search output, reviewed full texts of potentially eligible articles, assessed risk of bias, and extracted data in duplicate; resolving discrepancies by consensus. We then conducted random-effects meta-analyses and used GRADE to assess the certainty of evidence. Fourteen studies (10 cluster RCTs and four individual RCTs) met our inclusion criteria. These were conducted in Georgia (one study), Ghana (one study), Honduras (one study), India (two studies), Mali (one study), Mexico (one study), Nicaragua (one study), Nepal (one study), Pakistan (four studies), and Zimbabwe (one study). One study had an unclear risk of bias, and 13 had high risk of bias. The interventions evaluated in the studies included community-based health education (three studies), facility-based health education (three studies), household incentives (three studies), regular immunisation outreach sessions (one study), home visits (one study), supportive supervision (one study), information campaigns (one study), and integration of immunisation services with intermittent preventive treatment of malaria (one study).We found moderate-certainty evidence that health education at village meetings or at home probably improves coverage with three doses of diphtheria-tetanus-pertussis vaccines (DTP3: risk ratio (RR) 1.68, 95% confidence interval (CI) 1.09 to 2.59). We also found low-certainty evidence that facility-based health education plus redesigned vaccination reminder cards may improve DTP3 coverage (RR 1.50, 95% CI 1.21 to 1.87). Household monetary incentives may have little or no effect on full immunisation coverage (RR 1.05, 95% CI 0.90 to 1.23, low-certainty evidence). Regular immunisation outreach may improve full immunisation coverage (RR 3.09, 95% CI 1.69 to 5.67, low-certainty evidence) which may substantially improve if combined with household incentives (RR 6.66, 95% CI 3.93 to 11.28, low-certainty evidence). Home visits to identify non-vaccinated children and refer them to health clinics may improve uptake of three doses of oral polio vaccine (RR 1.22, 95% CI 1.07 to 1.39, low-certainty evidence). There was low-certainty evidence that integration of immunisation with other services may improve DTP3 coverage (RR 1.92, 95% CI 1.42 to 2.59). Providing parents and other community members with information on immunisation, health education at facilities in combination with redesigned immunisation reminder cards, regular immunisation outreach with and without household incentives, home visits, and integration of immunisation with other services may improve childhood immunisation coverage in LMIC. Most of the evidence was of low certainty, which implies a high likelihood that the true effect of the interventions will be substantially different. There is thus a need for further well-conducted RCTs to assess the effects of interventions for improving childhood immunisation coverage in LMICs.

Effect of two-level community-based health education pattern on schistosomiasis control

To implement a two-level community-based health education pattern of schistosomiasis in residents of endemic areas in marshland and lake regions, so as to explore the suitable pattern of health education under hypo-endemic situation. Two schistosomiasis endemic villages in Jiangling County, Hubei Province were collected as study areas, and among which, one village was treated as an intervention group, where the two-level community-based health education pattern as well as regular control measures was implemented; the other village was a control group, where only regular control measures were implemented. The awareness rates on schistosomiasis control, the rates of correct behavior and the compliance rates of examination, treatment and chemotherapy of the two groups before and after the intervention were compared. According to the results of the baseline survey in 2014, the awareness rates of schistosomiasis control of the intervention and control groups were 84.00% and 77.45%, respectively, the correct rates of behavior of the two groups were 72.00% and 63.73%, respectively, and the compliance rates of the treatment were 80.36% and 82.28%, respectively, there were no statistically significant differences between all the above rates of the two groups (all P > 0.05). After the intervention of the two-level community-based health education, the correct rates of behavior, and the compliance rates of examination and chemotherapy of the two groups were 92.31% and 80.37%, 95.11% and 82.55%, 84.13% and 63.64%, respectively, and the differences between all the rates above of the two groups were statistically significant (all P < 0.05). When compared to those before intervention, the growing rates of the compliance rates of examination, treatment and chemotherapy of the intervention group were 20.97%, 15.33% and 23.29%, respectively, while those of control group were 14.27%, 4.17%, -3.77%, respectively, the growing rates of the intervention groups were higher than those of the control groups. Through the two-level community-based pattern of health education, the compliance rates of examination and treatment of the residents have improved, and therefore, the pattern is suitable for popularization and application in marshland and lake regions.

Sustaining health education research programs in Aboriginal communities.

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

Does Breast Cancer Risk Awareness Motivate Personal Prevention Practices: Findings from a Community-based Assessment?

Breast cancer, is the leading cause of cancer specific mortality. But nearly 80% of the mortality is preventable by early diagnosis. We assessed knowledge and practice of breast cancer prevention by women in a rural community setting. Data was collected on demographics, family history, knowledge and practice of breast cancer by interviewer administered questionnaire. Knowledge (including knowledge of risk) and practice were measured using a response-based score to a set of 9 and 10 questions respectively. Prevalence odds ratio was calculated to estimate association between independent and outcome variables. Knowledge of breast cancer risk was low (14.2%). Family history and socioeconomic status were significantly associated with knowledge; respondents with more than eight years of school were more likely to have higher knowledge (OR=2.859; CI=1.578-5.178). Practice of prevention was equally low (17.2%). Practice was significantly associated with knowledge; respondents with higher knowledge of prevention were more likely to practice prevention (OR=6.8; CI=3.308-14.104). We propose that community-based risk communication and awareness creating programs may motivate breast cancer prevention practices. Women of lower socio-economic status should especially be targeted with such interventions. There is need to develop these into a sustainable community-based health education program.

Effects of community-based health education in food glycemic index on dietary modification of patients with type 2 diabetes mellitus

Objective To evaluate the effects of dietary intervention with low glycemic index (LGI) and low glycemic load (LGL) on dietary knowledge and dietary modification of patients with type 2 diabetes mellitus (T2DM). Methods This study was a cluster randomized controlled study. From June to September 2010, 105 T2DM patients were randomly sampled from 3 residential areas (n=35 in each) in Jin Pen Ling community, Changsha, Hunan province and divided into three groups with a random number table: whole-day dietary intervention group (group A, n=35), breakfast dietary intervention group (group B, n=35), and control group (group C, n=35). Interventions included 3-month health education and dietary intervention. Dietary knowledge, dietary oils, glycemic index (GI), and glycemic load (GL) of the three groups were compared before and after intervention. Results Before intervention, all the three groups showed a low level of knowledge about GI (57.7%), and high levels of average GI value of each meal (69.71±8.55), GL value per day (132.45±16.25), and daily cooking oil intake [(39.95±20.64)g]. The average knowledge level about GI increased after intervention in both group A (96.3% vs. 57.1%, P 0.05). The reduction of daily cooking oil intake in group A was larger than those in group B and group C [(7.81±3.91)g vs. (-5.12±1.37)g, (7.81±3.91)g vs. (-3.45±5.95)g, both P<0.05]; so was the average GI value of each meal [group A, (5.95±2.27); group B (-0.85±1.87); group C, (-2.87±1.93); all P<0.05]. The changes of GL values in group A (11.31±4.31) was better than in group B (1.23±27.82) and group C (-0.43±18.40) (both P<0.05). Conclusions The average GI value, GL value, and daily cooking oil intake of T2DM patients were all at a high level before intervention, while the level of knowledge about GI was at a low level. Health education providing GI knowledge may effectively improve the knowledge about GI in T2DM patients, while LGI and LGL dietary intervention may promote diet modification. Whole-day dietary intervention may be more effective than breakfast intervention. Key words: Type 2 diabetes mellitus; Glycemic index; Glycemic load; Dietary modification

Reducing health inequalities among girls and adolescent women living in poverty: the success of Bangladesh

Background: Bangladesh has made dramatic improvements in the health of girls and women in the last 20 years. This paper examines whether gender inequalities in health are evident among older children and adolescents among extremely poor households and identifies future health challenges for improving the health of girls and women.Subjects and Methods: Gender inequalities in health were examined using data from a school health survey of school children and adolescents (n = 900, 6.5–13.5 years). Anthropometric status, household possessions and number of siblings were measured. Under-nutrition was assessed as stunting (height-for-age z-score) and thinness (BMI-for-age z-score).Results: The prevalence of under-nutrition was high (35.3% stunting; 42.4% thinness), but there were no significant differences according to gender or socio-economic indicators (via possession score). Girls had more younger siblings (p < 0.05), while boys had more older siblings (p < 0.05).Conclusions: These findings accord with the national picture of successful reductions in gender inequalities in health through low cost, community-based health programmes and education policies targeting the poorest sectors. The prevalence of under-nutrition, however, remains high. Reproductive behaviours may still be influenced by poverty and the gender of existing offspring. Future challenges lie in reducing the adverse health consequences to women and their infants associated with early age at marriage and childbirth.

Beliefs, perceptions and health-seeking behaviours in relation to cervical cancer: a qualitative study among women in Uganda following completion of an HPV vaccination campaign

BackgroundCervical cancer remains a leading cause of morbidity and mortality in Uganda. Despite earlier information campaigns to introduce human papilloma virus (HPV) vaccination, which also targeted cervical cancer, misinterpretation and misunderstanding of the subject remain high. Women in Uganda present with cervical cancer at an advanced stage due to poor health-seeking behaviours, with an associated high mortality rate. This project explored beliefs, attitudes, perceptions, and health-seeking behaviours in relation to cervical cancer among women in Uganda after an HPV vaccination project had been rolled out.DesignA qualitative study design was used, with six focus group discussions (FGDs) that included 36 women, aged 25–49 years, with no previous history of cervical cancer symptoms or diagnosis. The women were interviewed in February and March 2013. The transcribed data was analysed using content analysis.ResultsThree themes emerged: feeling unprotected and unsafe, misbelief and wondering about cervical cancer, and fear of the testing procedure. Participating women had heard of cervical cancer but preferred to wait to access cervical cancer screening until symptom debut.ConclusionsThere are still barriers to cervical cancer screening among women in Uganda, where there is a need for culture-specific, sensitive information and interventions to address the issues of improving the cervical cancer screening uptake among these women. Societal context needs to be taken into account when implementing community-based health education.

The Effect of an Integrated Savings and Community Based Health Education Program among Older Adults with Hypertension: A Quasi-Experimental Controlled Study, Bangkok Province, Thailand

Introduction: Hypertension remains as the fifth leading cause of death in both females and males in Thailand. Complications of this disease are risk factors to both cerebrovascular and coronary artery diseases. Simultaneously, there is an increase in the proportion of older adults leading to an increase in high blood pressure cases including high incidence rate of hypertension and high burden of older adults’ health care cost while their income decline with lower rate of savings. Objective: To examine the effectiveness of savings and health education model (SHE model) program, which is an integration of savings and community based health education for older adults with hypertension in Sai Mai and Klong Sam Wa districts, Bangkok, Thailand. Methodology: Mixed methods using survey, quasi-experimental and qualitative techniques were employed. We examined KAP on hypertension in a random sample of 242 people suffering from hypertension by using the survey techniques including exploring the effectiveness of savings and health education model (SHE model) program in a random sample of 59 participants using quasi-experimental techniques from 2 communities. Focus group discussion was conducted with 27 participants to explore in-depth information related to care, prevention, and the effectiveness of SHE model program. Results: Survey data found most participants had good basic knowledge regarding hypertensive care and prevention. 65.3% and 49.6% of respondents had positive attitudes and practice toward hypertension care and prevention. Data compiled from quasi-experimental study found that knowledge on hypertension had a significant difference on pre intervention. Negative attitude towards care and control had a positive correlation with practice. SBP-negative attitudes and practices were inversely related to DBP. However with knowledge, attitude, and practices, there were recorded improvements in all groups after intervention compared to the control group. Blood pressure improvements were noted post intervention. Community savings funds and effects of blood pressure control on material impact recorded from quasi-experimental study. Conclusion: Improved hypertension health education effects had the most significant impact in controlling the disease in the community.

Factors Associated with the Uptake of Cervical Cancer Screening Among Women of Reproductive Age in Homabay County, Kenya: A Case of Kanyadhiang Sub Location

Cervical cancer is the leading cause of deaths in developing countries compared with other forms of cancers. Screening for cervical cancer remains the most effective way for early detection and its management. The main aim of this study was to identify factors associated with cervical cancer screening among women of reproductive age in Kanyadhiang Sub location. A descriptive cross sectional study with interviewer administered questionnaires was conducted on 74 women of reproductive age selected through multi stage sampling method. The largest population of the respondents was composed of the married women, educated up to secondary level. Apart from the health care providers, most respondents obtain their information from media especially radio and television (60.81%). Despite a large population being aware only 39% women of Kanyadhiang sub location have ever been screened for cervical cancer which indicates a low uptake. Although the highest number is aware of the services, majority don’t seek cervical screening services and this need a multi-agency approach for initiation of programs that will promote uptake of this essential service as a means of reducing morbidity and mortality associated with cervical cancer. There is a need for community based health education programs that will help in increasing awareness on cervical cancer screening services.

Prevalence, knowledge attitude and practices associated with onchocerciasis in Enugu east and Nkanu west local government areas of Enugu state, Nigeria

Onchocerciasis is still endemic in Enugu East and Nkanu West Local Government Areas of Enugu State. In this survey, the Knowledge, Attitude and Practice (KAP) and prevalence of onchocerciasis were evaluated. For the KAP aspect of this survey, Interviewers administered questionnaire was used as instrument for collecting information from Respondents who participated in the skin snipping exercise. Skin snips were collected for the prevalence survey. A total of 149 persons participated in the prevalence survey out of which 88 participated in the KAP survey. Correct knowledge of causative agent, mode of transmission and treatment of the disease were 21.60%, 21.60%, 22.72% respectively, which is quite low; while vector control and intake of ivermectin were 77.27% and 37.50% respectively. The result of the microscopic analysis of skin snips showed zero prevalence for both communities. However, palpitation exercise conducted just before skin snipping revealed the presence of nodules on some of the participants. Therefore a community based health education intervention on vector control, cause, mode of transmission and treatment of the disease to improved KAP on onchocerciasis as well as confirmatory analysis of skin snips using Polymerase Chain Reaction (PCR) is recommended. Keywords : Onchocerciasis, Onchocerca volvulus , Mode of transmission, Disease treatment, Ivermectin, Knowledge Attitude and Practices (KAP), Skin snips

The Rise of Social Justice as a Guiding Principle in Library and Information Science Research

Next article No AccessThe Rise of Social Justice as a Guiding Principle in Library and Information Science ResearchPaul T. Jaeger, Katie Shilton, and Jes KoepflerPaul T. Jaeger Search for more articles by this author , Katie Shilton Search for more articles by this author , and Jes Koepfler Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The Library Quarterly Volume 86, Number 1January 2016 Article DOIhttps://doi.org/10.1086/684142 Views: 2108Total views on this site Citations: 22Citations are reported from Crossref © 2016 by The University of Chicago. All rights reserved.PDF download Crossref reports the following articles citing this article:Bharat Mehra Toward an impact‐driven framework to operationalize social justice and implement ICT4D in the field of information, Journal of the Association for Information Science and Technology 18 (Jun 2022).https://doi.org/10.1002/asi.24693Maria A. Pacino Libraries as Social Agencies and Transition Points: Serving Diverse Populations, (Jan 2022): 265–273.https://doi.org/10.1108/S1479-363620220000018018Amatul Momin Social Justice as It Evolves in the LAM Sector, (Jan 2022): 56–81.https://doi.org/10.4018/978-1-7998-8363-0.ch003Bharat Mehra Extending Shiyali Ramamrita Ranganathan in the 21st Century, (Jan 2022): 295–312.https://doi.org/10.4018/978-1-7998-8363-0.ch016Joseph Winberry, LaVerne Gray, Jean Hardy, Baheya Jaber, Bharat Mehra Conceptualizing Relevance of Information as a Social Justice Issue: An Interactive Panel Discussion, Proceedings of the Association for Information Science and Technology 58, no.11 (Oct 2021): 667–672.https://doi.org/10.1002/pra2.524Bharat Mehra Social Justice Design and Implementation: Innovative Pedagogies to Transform LIS Education, Journal of Education for Library and Information Science 62, no.44 (Sep 2021): 460–476.https://doi.org/10.3138/jelis-62-4-2020-0094Alex H. Poole, Denise Agosto, Jane Greenberg, Xia Lin, Erjia Yan Where Do We Stand? Diversity, Equity, Inclusion, and Social Justice in North American Library and Information Science Education, Journal of Education for Library and Information Science 62, no.33 (Jul 2021): 258–286.https://doi.org/10.3138/jelis.2020-0018Joseph Winberry, Bradley Wade Bishop Documenting social justice in library and information science research: a literature review, Journal of Documentation 77, no.33 (Jan 2021): 743–754.https://doi.org/10.1108/JD-08-2020-0136Bharat Mehra Enough Crocodile Tears! Libraries Moving beyond Performative Antiracist Politics, The Library Quarterly 91, no.22 (Apr 2021): 137–149.https://doi.org/10.1086/713046Alex H. Poole Promoting Diversity, Equity, and Inclusion in Library and Information Science through Community-Based Learning, (Mar 2021): 529–540.https://doi.org/10.1007/978-3-030-71292-1_41Marc Kosciejew Public libraries and the UN 2030 Agenda for Sustainable Development, IFLA Journal 46, no.44 (Feb 2020): 328–346.https://doi.org/10.1177/0340035219898708Alex H. Poole “Tearing the Shroud of Invisibility”: Communities of Protest Information Practices and the Fight for LGBTQ Rights in US Librarianship, The Library Quarterly 90, no.44 (Oct 2020): 530–562.https://doi.org/10.1086/710255Deborah Schachter Theory into practice:: Challenges and implications for information literacy teaching, IFLA Journal 46, no.22 (Jun 2020): 133–142.https://doi.org/10.1177/0340035219886600Zelmarie Cantillon, Sarah Baker, Raphaël Nowak A cultural justice approach to popular music heritage in deindustrialising cities, International Journal of Heritage Studies 7 (May 2020): 1–17.https://doi.org/10.1080/13527258.2020.1768579Charles R. Senteio Promoting access to health information, Aslib Journal of Information Management 71, no.66 (Nov 2019): 806–820.https://doi.org/10.1108/AJIM-02-2019-0043Loriene Roy, Elisabeth Long Incorporating Social Justice in Reference Education, The Reference Librarian 60, no.33 (Apr 2019): 226–231.https://doi.org/10.1080/02763877.2019.1597421Iyra S. Buenrostro, Johann Frederick A. Cabbab Libraries and their role in transitional justice in the Philippines, IFLA Journal 45, no.11 (Oct 2018): 5–15.https://doi.org/10.1177/0340035218805769Charles Senteio Investigating the Enduring Impact of a Community-Based Health Education Program to Promote African American Elders’ Use of Technology Designed to Support Chronic Disease Self-Management, Geriatrics 3, no.44 (Oct 2018): 70.https://doi.org/10.3390/geriatrics3040070Ryan Burns, Blake Hawkins, Anne Lauren Hoffmann, Andrew Iliadis, Jim Thatcher Transdisciplinary approaches to critical data studies, Proceedings of the Association for Information Science and Technology 55, no.11 (Feb 2019): 657–660.https://doi.org/10.1002/pra2.2018.14505501074Charles Senteio, Kristen Matteucci Addressing Racial Discrimination in the 1930s: Using a Historical Case Study to Inform Contemporary Social Justice Efforts, Journal of African American Studies 21, no.44 (Dec 2017): 621–642.https://doi.org/10.1007/s12111-017-9387-zDiana K. Wakimoto Collections, connections and change: differences in experiencing archives, Library Review 66, no.1/21/2 (Feb 2017): 2–15.https://doi.org/10.1108/LR-05-2016-0048Ina Fourie, Anika Meyer Role of libraries in developing an informed and educated nation, Library Hi Tech 34, no.33 (Sep 2016): 422–432.https://doi.org/10.1108/LHT-01-2016-0009