Context-specific Interventions Research Articles

Food insecurity and its severity among adults receiving antiretroviral therapy in health facilities, northcentral Ethiopia: a multi-facility-based cross-sectional study

BackgroundFood insecurity plays a crucial role in predicting the spread of HIV due to the adverse effects of coping mechanisms adopted to mitigate it. However, there is a scarcity of context-specific evidence regarding food insecurity among HIV-infected adults. Therefore, this study aimed to assess the context-specific magnitude of food insecurity and associated factors among adults receiving antiretroviral therapy (ART) in health facilities in the North Shewa Zone, Ethiopia, ultimately contributing to the achievement of the 95–95-95 HIV treatment target in the local context.MethodsA multi-facility cross-sectional study was conducted among 865 HIV-infected adults receiving ART and being followed up for their treatment. We included health facilities that provide ART, including four hospitals and six health centers. A log-binomial regression model was fitted to identify the association between food insecurity and independent variables. Adjusted prevalence ratios (APRs) with a 95% confidence interval were computed to measure the strength of the association.ResultsIn this study, 290 (33.7, 95% CI: 30.60, 36.91) of the HIV-infected adults studied had food insecurity during their treatment and follow-up, of which 152 (52.41, 95% CI: 46.64, 58.13) and 110 (37.93%, CI: 32.50, 43.68) of them were found to have severe and moderate forms of food insecurity, respectively. We found that being younger (APR = 2.27, 95% CI: 1.12, 4.60), being female (APR = 1.87, 95% CI: 1.03, 3.39), lacking formal education (APR = 10.79, 95% CI: 14.74, 24.58), having lower educational status (APR = 5.99, 95% CI: 2.65, 13.54), being a daily laborer (APR = 6.90, 95% CI: 2.28, 20.85), having low monthly income (APR = 1.89, 95% CI: 1.11, 3.22), advanced WHO clinical stage (APR = 2.34, 95% CI: 1.08, 5.10), and receiving ART for less than 4 years (AOR = 2.28, 95% CI: 1.09, 4.74) were significantly associated with a high proportion of food insecurity among HIV-infected adults.ConclusionThe magnitude of food insecurity among HIV-infected adults receiving ART was high, with an extremely high magnitude of severe food insecurity. The finding suggests the need for culture- and context-specific nutritional interventions to address the gender dynamics of food insecurity, attention to the early stage of ART, and the integration of strategies to improve educational status and enhance income-generation activities of HIV-infected adults. This requires an emphasis on the link between food insecurity and HIV in Ethiopia’s national food and nutrition policy.

An update on factors affecting umbilical cord care among mothers: A review.

Umbilical cord care remains a critical aspect of newborn health, yet practices vary significantly across different cultures and healthcare settings. This paper aims to provide an updated synthesis of the factors influencing umbilical cord care among mothers. The umbilical cord is a vital link between the fetus and the placenta during pregnancy, but after birth, it requires proper care to prevent infections. Numerous factors influence a mother's approach to umbilical cord care, including cultural beliefs, socio-economic status, access to healthcare information, and traditional practices passed down through generations. Understanding these factors is crucial for healthcare providers to offer tailored guidance and support to mothers, ensuring the optimal care for newborns. This paper examines recent research and literature encompassing diverse cultural perspectives, socio-economic considerations, healthcare access, and educational interventions related to umbilical cord care. It also highlights the impact of technological advancements, such as telemedicine and digital health platforms, in disseminating crucial information to mothers, especially in remote or underserved areas. Moreover, the review delves into the role of healthcare professionals in promoting evidence-based practices and addressing misconceptions regarding umbilical cord care. It emphasizes the importance of culturally sensitive and context-specific interventions in enhancing maternal knowledge and practices related to neonatal care. In conclusion, this review presents an updated overview of the multifactorial influences on umbilical cord care among mothers. It calls for continued research and concerted efforts to bridge gaps in knowledge, cultural beliefs, and healthcare access, ultimately contributing to the promotion of optimal newborn health outcomes.

Determinants of prenatal breastfeeding knowledge, attitudes and self-efficacy among Burmese migrant pregnant mothers in Samut Sakhon Province, Thailand: a cross-sectional study

ObjectiveThe study aimed to explore the determinants of prenatal breastfeeding knowledge, attitudes and self-efficacy among Burmese migrant pregnant mothers in Samut Sakhon Province, Thailand.DesignThe data were collected as part of...

Dynamic Retention Strategies for Mitigating Health Workers Brain Drain

The departure of skilled health workers from Sub-Saharan Africa, Asia, and the Pacific poses a significant challenge for the global health workforce, exacerbating healthcare accessibility issues, labour shortages, and vulnerabilities within healthcare systems worldwide. This study aims to identify brain drain drivers and propose dynamic retention strategies tailored to the unique circumstances of each region, relying solely on secondary data. Drawing upon the Push-Pull and Social Exchange Theory frameworks, the study reviews existing literature, and it was revealed that there is an interplay of push factors, such as low pay, limited professional development opportunities, and challenging working conditions, alongside pull factors, including better income prospects and career advancement opportunities. This study advocates for dynamic retention strategies like enhancing employee engagement, implementing flexible work arrangements, promoting work-life balance, offering competitive compensation, facilitating professional development, and fostering supportive work environments tailored to each region's circumstances were imperative to mitigate the health workers brain drain syndrome. It also suggests the importance of strategic, context-specific interventions in mitigating brain drain and ensuring sustainable healthcare delivery worldwide and ongoing research and evaluation to assess their effectiveness. This can be achieved through collaborative efforts of stakeholders towards safeguarding the global health workforce and promoting equitable access to healthcare services for all. Received: 10 February 2024 / Accepted: 25 June 2024 / Published: 02 July 2024

Determinants and prevalence of zero-dose children in Somalia: Analysis of the 2020 Health Demographic Survey data.

Despite global progress in childhood vaccination coverage, fragile and humanitarian countries, with high burden of infectious diseases, continue to report a significant number of zero-dose and under-vaccinated children. Efforts to equitably reach zero-dose children remain thus critical. This study assesses the prevalence and determinants of zero-dose children in fragile context of Somalia. We used secondary data from 2020 Somali Health and Demographic Survey (SHDS) to determine status of unvaccinated children aged between 12 to 23 months. Variables related to socio-demographic, household, health seeking, and community level factors were extracted from the SHDS data. Variables that were shown to be significantly associated with zero-dose children at p< 0.05 in the single logistic regression analysis were identified and included in a final multiple logistic regression analysis. A total of 2,304 women and their children aged between 12-23 months were used to determine the prevalence and determinants of zero dose children in Somalia. Approximately 60.2% of the children were zero dose children and did not receive any dose of the four basic routine vaccines. Children living in rural and nomadic areas were more likely to be zero dose (aOR 1.515, 95% CI: 1.189-1.93). Mother with primary education and above (aOR 0.519, 95% CI: 0.371-0.725), those who attended antenatal care (aOR 0.161, 95% CI: 0.124-0.209) and postnatal care (aOR 0.145, 95% CI: 0.085-0.245) and listen frequently to radio (aOR 2.212, 95% CI: 1.106-4.424) were less likely to have children with zero dose than with their counterparts. Majority of children under two years of age in Somalia are reported to be zero dose children. Context and population specific interventions that target vulnerable mothers and their children, in rural and nomadic areas, and from lower wealth quintile index families with no education and adequate access to antenatal and postnatal care remain critical.

Antimicrobial resistance among common bacterial pathogens in Indonesia: a systematic review

The WHO Global Antimicrobial Resistance Surveillance System (GLASS) aims to describe antimicrobial resistance (AMR) patterns and trends in common bacterial pathogens, but data remain limited in many low and middle-income countries including Indonesia. We systematically searched Embase, PubMed and Global Health Database and three Indonesian databases for original peer-reviewed articles in English and Indonesian, published between January 1, 2000 and May 25, 2023, that reported antimicrobial susceptibility for the 12 GLASS target pathogens from human samples. Pooled AMR prevalence estimates were calculated for relevant pathogen-antimicrobial combinations accounting for the sampling weights of the studies (PROSPERO: CRD42019155379). Of 2182 search hits, we included 102 papers, comprising 19,517 bacterial isolates from hospitals (13,647) and communities (5870). In hospital settings, 21.6% of Klebsiella pneumoniae isolates, 18.3% of Escherichia coli isolates, 35.8% of Pseudomonas aeruginosa isolates and 70.7% of Acinetobacter baumannii isolates were carbapenem-resistant; 29.9% of Streptococcus pneumoniae isolates were penicillin-resistant; and 22.2% of Staphylococcus aureus isolates were methicillin-resistant. Hospital prevalence of carbapenem-resistant K.pneumoniae and E.coli, and penicillin-resistant S.pneumoniae increased over time. In communities, 28.3% of K.pneumoniae isolates and15.7% of E.coli isolates were carbapenem-resistant, 23.9% of S.pneumoniae isolates were penicillin-resistant, and 11.1% of S.aureus isolates were methicillin-resistant. Data were limited for the other pathogens. AMR prevalence estimates were high for critical gram-negative bacteria. However, data were insufficient to draw robust conclusions about the full contemporary AMR situation in Indonesia. Implementation of national AMR surveillance is a priority to address these gaps and inform context-specific interventions. Wellcome Africa Asia Programme Vietnam.

Connected for life: How social connectedness can help prevent suicide in American Indian and Alaska Native communities

Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.

The Prevalence of Anemia among Pregnant Women in China: A Systematic Review and Meta-Analysis.

The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese pregnant women. A total of 722 articles on maternal anemia during pregnancy published between January 2010 and December 2020 were compiled, and a systematic review and meta-analysis were conducted on 57 eligible studies including 1,376,204 pregnant women to ascertain the prevalence of anemia and the prevalence in different subgroups. The results showed that the prevalence of anemia, ID, and IDA among pregnant women in China were 30.7% (95% CI: 26.6%, 34.7%), 45.6% (95% CI: 37.0%, 54.2%), and 17.3% (95% CI: 13.9%, 20.7%), respectively. All prevalence increased with the progression of the pregnancy. There were sizable regional variations in the prevalence of anemia, ID, and IDA. Generally, lower prevalence was observed in the economically more advanced eastern region of the country, while the prevalence of ID was higher in the eastern region than that in the western region. The prevalence of anemia and IDA in rural areas was higher than that in urban areas, but ID prevalence was higher in urban areas. In conclusion, the regional differences and urban-rural disparities in the prevalence of anemia indicate the need for more context-specific interventions to prevent and treat anemia. It was found that dietary factors were one of the major causes of anemia, and iron-containing supplements and nutrition counseling could be effective interventions to reduce the prevalence of anemia, ID, and IDA among Chinese pregnant women.

The prevalence of unintended pregnancy and its influence on pregnancy experience in Tabriz, Iran, 2023: a cross-sectional study

BackgroundThere is a lack of quantitative studies that specifically measure the association between the experience of pregnancy and unintended pregnancy. The present study aims to address the prevalence of unintended pregnancy and identify its predictors. Additionally, the study explores whether unintended pregnancy is associated with pregnancy uplifts and hassles.MethodsThis cross-sectional study was conducted on 488 pregnant women between 20 to 40 weeks' gestation at the comprehensive health center in Tabriz City from February 2022 to January 2023. A cluster sampling method was used for sampling, and data were collected using socio-demographic questionnaires and the Pregnancy Experience Scale (PES). Descriptive statistics were used to describe the socio-demographic characteristics and the prevalence of unintended pregnancy. Binary logistic regression was employed to identify the predictors of pregnancy desirability. To examine the relationship between unintended pregnancy and pregnancy experience, an independent t-test was used for bivariate analysis, and a general linear model (GLM) was utilized for multivariate analysis, with control for potential confounding variables.ResultsThe prevalence of unintended pregnancies was 30.7% (24.3% unwanted pregnancies, and 6.4% mistimed pregnancies). The results of the binary logistic regression indicated that the lower age of both the woman and her spouse were significant predictors for unintended pregnancy (P < 0.05). Based on an independent t-test, the mean score for uplifts in women with unintended pregnancy was significantly lower than in women with intended pregnancy (mean difference (MD): -4.99; 95% confidence interval (CI): -5.96 to -4.02; p < 0.001), While the mean score of hassles in women with unintended pregnancy was significantly higher than women with intended pregnancy (MD: 2.92; 95% CI: 2.03 to 3.80; p < 0.001). The results of GLM showed that women who had unintended pregnancies had significantly lower scores for uplifts (B = -4.99; 95% CI: -5.96 to -4.03; P < 0.001) and higher scores for hassles (B = 2.92; 95% CI: 2.06 to 3.78; P < 0.001).ConclusionsThe high prevalence of unintended pregnancies in Tabriz highlights the importance of targeted interventions to address this issue, considering the policy framework and unique challenges faced by women. Future studies should focus on developing context-specific interventions that effectively meet the needs of women with unintended pregnancies.

Maternal misperception of under-five children weight status and associated factors: A cross-sectional study.

Maternal perceptions, about the nutritional status of their children, may have implications for timely health care seeking and feeding behaviour. Shreds of evidence are limited in this area that assessed maternal perception about the nutritional status of the children in the context of Bangladesh. The objective of this study is to assess the differences in mothers' perceptions about their children's nutritional status who are less than 5 years of age and their associated factors in the context of urban slum areas. A cross-sectional study (Quantitative approach) was conducted in two of the largest urban slums of Dhaka city. A total of 437 mother-children dyads were included in the final analysis. The outcome of interest was the mother's 'varied perceptions' regarding the nutritional status of their children under five. 'Varied perception' refers to the difference between a mother's subjective assessment of her child's nutritional condition and the anthropometrically measured nutritional status. The prevalence of mother's varied perceptions was around 46%, and among them, 37% of mothers underestimated and 9% overestimated their child's nutritional status. 'The child doesn't want to eat' (AOR = 3.69; 95% CI: 2.34-5.85; p < 0.001) and 'Feels light when carried' (AOR = 3.39; 95% CI: 1.69-6.81; p = 0.001) were the significant reasons behind the mother's perception about the nutritional status of their under-five children. About one in two mothers' perceptions about their children varied from the anthropometry-derived status. Various research findings indicate that providing health education on proper feeding practices for children, along with anthropometric measurements, can assist mothers in enhancing their understanding and assessing their child's nutritional status with greater accuracy. Further qualitative research may be instrumental in getting deeper insights into maternal perception to develop context-specific interventions.

Trends in socio-demographic characteristics and substance use among high school learners in a selected district in Limpopo Province, South Africa.

Substance use is an escalating public health problem in South Africa resulting in risky behaviours and poor educational attainment among adolescents. There is a huge battle to overcome substance use among learners as more drugs become easily available with the mean age of drug experimentation reported to be at 12 years of age. It is important to continuously understand the trends in substance use in order to assess if there are positive changes and provide evidence for the development of context-specific effective interventions. This paper outlines the prevalence of substance use among selected high schools in a district in Limpopo province. To determine the prevalence of substance use among selected high school learners in a district in Limpopo Province, a cross-sectional school survey of 768 learners was conducted. Data was analysed using SPSS v 26. Descriptive analysis was used to describe the independent and dependent variables and Chi-Square test was used to investigate associations between demographic characteristics and substance use among high school learners. The most abused substances by learners were alcohol (49%), cigarettes (20.8%) and marijuana (dagga/cannabis) (16.8%). In a lifetime, there was a significant difference (P < 0.05) in cigarette smoking with gender, school, and grade; with more use in males (14.2%) than females (7.6%); in urban schools (14.6) than peri-urban (6.7%) and more in Grade 12 (6.4%). There was a significant difference (P < 0.05) in alcohol use with more use in Grade 10 (12.6%) and varied use among male and female learners but cumulatively more alcohol use in females (27.7%). Drug use varied, with an overall high drug use in urban schools (20.7%). Substance use is rife among high school learners in the district and health promotion initiatives need to be tailored within the context of socio-demographic characteristics of learners including the multiple levels of influence such as peer pressure, poverty, unemployment and child headed families. Additional research is required to investigate the factors leading to a notable gradual increase in use among female learners and into the environmental and family settings of learners in influencing substance use.

Mapping drivers of land conversion among smallholders: A global systems perspective

CONTEXTAgriculture-driven land conversion poses a significant threat to global biodiversity conservation. Balancing agricultural expansion with conservation is a critical challenge for governments and development partners. Sustainability-oriented agriculture programs such as conservation agriculture and land intensification aim to reduce land conversion and deforestation; however, evidence of their effectiveness remains complex and elusive, especially regarding the role of smallholders. OBJECTIVEThis study addresses this knowledge gap by systematically mapping the drivers of smallholder land conversion and their interconnections across three focal biodiverse contexts including sub-Saharan Africa, Latin America, and Southeast Asia as well as from a global scale. METHODSUsing literature that focuses on the nexus of smallholder farmers and agricultural intensification, this study systematically identified the potential of distinct factors and dynamic processes to serve as system leverage points toward improved outcomes for biodiversity, food security, and smallholder livelihoods, using a combination of structural factor analysis, centrality analysis, and feedback loop analysis. RESULTS AND CONCLUSIONSThe results highlight the importance of strengthening land tenure systems, providing technical support to farmers, improving market access, and prioritizing smallholder livelihoods in mitigating land conversion. SIGNIFICANCEContextual differences emphasize the need for context-specific interventions and further research to explore factors driving land conversion more deeply within specific contextual boundaries. Future studies should map proposed policy interventions onto local systems driving land conversion and incorporate the diverse perspectives of local stakeholders to guide effective and sustainable agriculture interventions.

The embodiment of exclusionary displacement pressure: Intersections of housing insecurity and mental health in a Hispanic/Latinx immigrant neighborhood

Gentrification, growing income inequality, urban development, and the affordable housing crisis necessitate understanding the impact of the concern of displacement on health — prior to or even in the absence of a displacement event. In this paper, I use the term “exclusionary displacement pressure” to unify the literature on exclusionary displacement and displacement pressure, highlighting the disproportionate and inequitable impacts of displacement pressure among communities of color. Through following 35 residents over 2.5-years (2019–2022) in one predominantly low-income Hispanic/Latinx immigrant neighborhood in Denver, Colorado, I examine how exclusionary displacement pressure shapes their health and wellbeing over time. Through paying attention to how participants' lived experience is shaped by structural vulnerability (e.g. lack of documentation status, inadequate work, limited access to safety net systems), I identify how exclusionary displacement pressure is constantly internalized and responded to as a unique embodied health experience, wearing on individuals over time and reproducing population health inequities. The framework of embodied health experiences captures the wide range of health-related impacts, from diagnosable health conditions to idioms of distress, using participant's own language of suffering to express how they were feeling, battling, and enduring the pressure. Theorizing on structural vulnerability within specific subpopulations with intersecting identities, such as low-income immigrant Hispanic/Latinx communities, provides a bottom-up refinement to existing theories of embodied health. Understanding the place-health experiences of individuals in changing neighborhoods over time is also critically important to define time points at which context-specific supports and interventions are appropriate.

Flood‑Induced Health Vulnerability: A Case Study of Nirmal Char in Murshidabad District, West Bengal

The chars (riverine sand bars) are poorly connected to the mainland and are prone to natural hazards like floods. Char lands are occupied by people from lower-income groups who have been living in an ecologically fragile landscape. The frequent floods affect the char dwellers’ health and health infrastructures and limit access to health care services. A study has been conducted to assess the health vulnerability of char dwellers in Nirmal Char in the Murshidabad district. The current study explores the impact of floods on the health of char dwellers during pre-flood season which differs from or is similar to flood season. The health vulnerability of the char dwellers was measured in terms of flood exposure, flood sensitivity and flood adaptive capacity. The primary data collected from selected households reveals that the livelihood conditions of most of the char dwellers have been severely affected during the flood, introducing different health-related diseases (i.e. typhoid fever, malaria, diarrhea and dengue) catalysed due to the lack of accessibility to health care facilities. The present study showed that up to 97.87% of households had a high level of vulnerability and 2.13% had a moderate level of vulnerability. We concluded that early flood warning, flood prevention measures and long-term mitigation strategies must be strengthened for char dwellers as they face greater health problems. Therefore, a context-specific sustainable health policy intervention is required to improve the adaption capacity of char dwellers.

Prevalence and disparities in adolescents’ sedentary behavior from twenty-three African countries: evidence from World Health Organization Global School-based Student Health Survey

ObjectivesStudies on sedentary behavior among adolescents in Africa are limited, hindering public health initiatives. The aim of this study was to examine the prevalence, age, gender, country's income level, and sub-regional disparities of sedentary behavior among adolescents in Africa. Study designCross sectional. MethodsAdolescents who participated in the Global School-based Student Health Survey from the 23 participating African countries were included in the study. Sedentary behavior was assessed with a self-reported questionnaire. A meta-analysis using random effect modeling was used to estimate the prevalence, age, gender, country's income level, and sub-regional disparities of sedentary behavior. ResultsSixty three thousand six hundred thirty five adolescents (12–17 years) were included in the analysis. The prevalence of sedentary behavior was 30% (95% CI: 27%–34%) and significantly higher among adolescents in Southern Africa and East Africa compared to adolescents in West Africa and North Africa (Q = 25.15; P < 0.001). No disparities were found for age (Q =1.51; P = 0.22), gender (Q = 0.10; P = 0.75), country's income level (Q = 4.37; P = 0.11), and survey year (Q = 1.03; P = 0.31). The results were heterogeneous between countries. ConclusionsThe results suggest that a significant proportion of adolescents in Africa engage in sedentary behavior, with the highest prevalence found in Southern Africa and East Africa. This highlights the need for context-specific policy design and interventions to increase physical activity engagement and limit sedentary behavior among adolescents in Africa.

Theories, determinants, and intervention models and approaches on inequalities of undernutrition amongst under fives: A literature review.

One of the greatest public health problems of the 21st century is undernutrition in children under the age of 5 years (CAUFY). Globally, over 232 million CUAFY are undernourished and approximately 45% of mortality in this population are undernutrition-induced. This paper reviewed and critically explained the factors perpetuating undernutrition in CUAFY in the global space. It further explained the multi-level determinants that influence health inequalities and consequently exacerbate undernutrition amongst CUAFY globally. It also went further to explain the intervention models and approaches that can be used to tackle undernutrition in CUAFY. Demiris et al.'s approach to narrative review was utilized for this paper. Relevant articles on child nutrition were retrieved from multiple credible databases and websites of foremost health organizations. Using an iterative process, multiple combinations of search terms were done by stringing relevant key terms and their synonyms with Boolean Operators. This process was constantly refined to align search results with the study aim. Database search produced relevant and resourceful publications which were utilized to develop this review. The global burden of undernutrition remains high, especially in Oceania with the highest prevalence of stunting and wasting (41.4% and 12.5%), with Africa and Asia following closely. Malnutrition eradication is a global health issue of high priority as demonstrated by the "Goal 2" of the Sustainable Development Goals (SDGs), and the United Nations (UN) Decade of Action on Nutrition 2016-2025. The review identified no significant positive outcome from previous interventions due to the endemic health inequalities. Determinants of the multi-level health inequalities associated with undernutrition in CUAFY, and probable solutions are explained with theoretical models of health inequalities. A diagonal intervention approach was proposed as a viable solution to ending undernutrition in CUAFY. The application of relevant theoretical models and context-specific intervention approaches can be utilized by stakeholders to close the existing inequality gaps, thereby reducing undernutrition amongst CUAFY globally.

Exploring variations in IPC competencies: a cross-sectional study among healthcare professionals in Northwest China

BackgroundThis cross-sectional study investigates infection prevention and control (IPC) competencies among healthcare professionals in northwest China, examining the influence of demographic factors, job titles, education, work experience, and hospital levels.MethodsData from 874 respondents across 47 hospitals were collected through surveys assessing 16 major IPC domains. Statistical analyses, including Mann-Whitney tests, were employed to compare competencies across variables.ResultsSignificant differences were identified based on gender, job titles, education, work experience, and hospital levels. Females demonstrated higher IPC competencies, while senior positions exhibited superior performance. Higher educational attainment and prolonged work experience positively correlated with enhanced competencies. Variances across hospital levels underscored context-specific competencies.ConclusionDemographic factors and professional variables significantly shape IPC competencies. Tailored training, considering gender differences and job roles, is crucial. Higher education and prolonged work experience positively impact proficiency. Context-specific interventions are essential for diverse hospital settings, informing strategies to enhance IPC skills and mitigate healthcare-associated infections effectively.

Burnout and coping mechanisms among healthcare professionals in central Uganda.

The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care.

The double burden of malnutrition in individuals: Identifying key challenges and re-thinking research focus.

The 'double burden of malnutrition' is a global health challenge that increasingly affects populations in both low- and middle-income countries (LMICs). This phenomenon refers to the coexistence of undernutrition and overweight or obesity, as well as other diet-related non-communicable diseases, in the same population, household or even individual. While noteworthy progress has been made in reducing undernutrition in some parts of the world, in many of these areas, the prevalence of overweight and obesity is increasing, particularly in urban areas, resulting in greater numbers of people who were undernourished in childhood and have overweight or obesity in adulthood. This creates a complex and challenging situation for research experts and policymakers who must simultaneously address the public health burdens of undernutrition and overweight/obesity. This review identifies key challenges and limitations in the current research on the double burden of malnutrition in individuals, including the need for a more comprehensive and nuanced understanding of the drivers of malnutrition, the importance of context-specific interventions and the need for greater attention to the food environment and food systems. We advocate for the re-evaluation of research strategies and focus, with a greater emphasis on multidisciplinary and systems approaches and greater attention to the synergistic relationship between the biological, environmental, commercial and socio-economic determinants of malnutrition. Addressing these key challenges can enable us to better comprehend and tackle the multifaceted and dynamic issues of the double burden of malnutrition, particularly in individuals and work towards more effective and sustainable solutions.

Seeds of Change: Assessing Wheat Knowledge and Socio-profile in Rural Areas of Kharar, Tehsil of Punjab, India

This study investigates the socio-profile status, agricultural practices, and knowledge acquisition among farmers in rural villages of the Punjab region, India. Employing a cross-sectional survey design, data was collected from farmers residing in five villages through structured questionnaires and face-to-face interviews. The demographic analysis revealed a balanced gender distribution, with a significant proportion falling within the 40-60 years age bracket, highlighting the maturity of the farming population. Educational attainment varied, emphasizing the need for targeted interventions to enhance access to higher education and vocational training programs. Findings indicated a high prevalence of smartphone usage among farmers, presenting opportunities for leveraging digital technology in agricultural extension services. Family compositions leaned towards nuclear families, while landholding patterns showcased the varied socio-profile landscape within the farming community. Peer networks and institutional support emerged as significant sources of agricultural information, underscoring the importance of collaborative approaches in knowledge dissemination. A notable increase in knowledge was observed among farmers after video presentations on wheat varieties, highlighting the efficacy of multimedia approaches in agricultural education. The study aimed to assess the impact of a video presentation on wheat cultivation on farmers' knowledge. Data from 60 farmers showed significant improvements in various aspects of wheat cultivation knowledge, including identifying suitable wheat varieties, understanding sowing and harvesting timing, and recognizing common wheat diseases. The mean percentage increase in knowledge was 103%, indicating the effectiveness of the educational program. These findings underscore the importance of targeted educational initiatives in promoting sustainable agriculture and improving farmers' livelihoods. Continued support and education efforts are essential for sustaining and enhancing these positive outcomes. However, the preference for sowing previous year's seeds over newly released varieties indicates the persistence of traditional practices and the need for targeted interventions to promote varietal adoption. Overall, this study provides valuable insights for policymakers and development practitioners to design context-specific interventions aimed at enhancing agricultural productivity, promoting sustainable livelihoods, and ensuring food security for rural populations in the Punjab region and beyond.