Gaps In Coverage Research Articles

The influence of demographic and socio-economic factors on non-vaccination, under-vaccination and missed opportunities for vaccination amongst children 0-23 months in Kenya for the period 2003-2014.

Vaccination is crucial in reducing child mortality and the prevalence of Vaccine-Preventable-Diseases (VPD), especially in low-and-middle-income countries like Kenya. However, non-vaccination, under-vaccination, and missed opportunities for vaccination (MOV) pose significant challenges to these efforts. This study aimed to analyze the impact of demographic and socio-economic factors on non-vaccination, under-vaccination, and MOV among children aged 0-23 months in Kenya from 2003 to 2014. A secondary data analysis of data from the Kenya Demographic Health Surveys (KDHS) conducted during this period was conducted, with a total of 11,997 participants, using a two-stage, multi-stage, and stratified sampling technique. The study examined factors such as child's sex, residence, mother's age, marital status, religion, birth order, maternal education, wealth quintile, province, child's birth order, parity, number of children in the household, place of delivery, and mother's occupation. Binary logistic regression was employed to identify the determinants of non-vaccination, under-vaccination, and MOV, and multivariable logistic regression analysis to report odds ratios (OR) and their corresponding 95% confidence intervals (CI). In 2003, the likelihood of non-vaccination decreased with higher maternal education levels: mothers who did not complete primary education (AOR = 0.55, 95% CI = 0.37-0.81), completed primary education (AOR = 0.34, 95% CI = 0.21-0.56), and had secondary education or higher (AOR = 0.26, 95% CI = 0.14-0.50) exhibited decreasing probabilities. In 2008/09, divorced/separated/widowed mothers (AOR = 0.22, 95% CI = 0.07-0.65) and those with no religion (AOR = 0.37, 95% CI = 0.17-0.81) showed lower odds of non-vaccination, while lower wealth quintiles were associated with higher odds. In 2014, non-vaccination was higher among younger mothers aged 15-19 years (AOR = 12.53, 95% CI = 1.59-98.73), in North Eastern Province (AOR = 7.15, 95% CI = 2.02-25.30), in families with more than 5 children (AOR = 4.19, 95% CI = 1.09-16.18), and in children born at home (AOR = 4.47, 95% CI = 1.32-15.17). Similar patterns were observed for under-vaccination and MOV. This information can inform strategies for bridging the gaps in immunization coverage and promoting equitable vaccination practices in Kenya.

The role of informal support systems during illness: A qualitative study of solo self-employed workers in Ontario, Canada.

Today's labor market has changed over time, shifting from mostly full-time, secure, and standard employment relationships to mostly entrepreneurial and precarious working arrangements. In this context, self-employment (SE), a prominent type of precarious work, has been growing rapidly due to globalization, automation, technological advances, and the rise of the 'gig' economy, among other factors. Employment precarity profoundly impacts workers' health and well-being by undermining the comprehensiveness of social security systems, including occupational health and safety systems. This study examined how self-employed (SE'd) workers sought out support from informal support systems following illness, injury, and income reduction or loss. Based on in-depth interviews with 24 solo SE'd people in Ontario, Canada, narrative analysis was conducted of participants' experiences with available informal supports following illness or injury. We identified three main ways that SE'd workers managed to sustain their businesses during periods of need: (i) by relying on savings; (ii) accessing loans and financial support through social networks, and (iii) receiving emotional and practical support. We conclude that SE'd workers managed to survive despite social security system coverage gaps by drawing on informal support systems.

The Olympics and the Cold War: A Historiography

Abstract This article is a historiographic review of the literature on the Olympic Games and the Cold War. The topic has been a growth area among scholars of both diplomatic history and the history of sports over the past three decades. Most of the literature has been in English, but a significant amount of work has appeared in French, German, and a few other languages. Despite the proliferation and richness of the historiography, some large gaps in coverage still exist, and some important issues still need to be explored.

The effects of essential oil scents on the behavior of laboratory mice and rats: A brief systematic review

In recent years, partially due to the COVID-19 pandemic, scientific interest in aromatherapy has increased significantly. However, many alleged effects and mechanisms of action of essential oils need to be verified by scientific methods. The search for new bioactive compounds of plant origin is also of great importance. In this regard, we turned to in vivo studies on model organisms. We performed an initial systematic literature review of the PubMed articles on the effects of essential oil odors on behavioral responses in laboratory rats and mice. We annotated the retrieved list of 77 articles considering the type of plant source, availability of data on the chemical composition of the essential oil, species/sex/age of the experimental animal, parameters of odor exposure, model of human disorders used, and types of behavioral tests. Among the main gaps in the scientific coverage, we highlighted the imbalance in the sex and age of the laboratory animals, such as the prevalence of young males. In the referenced studies, the effects of essential oil odors on depression-like, anxiety and exploratory behavior, as well as on learning and memory were presented most fully. But the effects on social behavior of animals were rarely addressed, which we also consider a gap to be filled with future studies

THE IMPACT OF CLOSING MEDICARE PART D COVERAGE GAP ON MENTAL HEALTH OF OLDER ADULTS

Abstract The ACA mandated the gradual elimination of the Medicare prescription drug coverage gap (also called the “Doughnut Hole”) beginning in 2011. This policy change can impact mental health through mechanisms such as reduction in out-of-pocket (OOP) expenses and increased access to prescription medication. However, no previous study has examined its impact on mental health outcomes of older adults on Medicare. Employing data from the Medical Expenditure Panel Survey (from 2006 to 2016), compare the mental health of Medicare beneficiaries (66-70 years; N=7,664) with that of non-Medicare beneficiaries (60-64 years; N=8,079) before versus after policy implementation. We find that the 2011 phasing out of Medicare drug coverage gap was associated with 0.86-point (p< 0.05) improvement in the Mental Component score of the Short-Form 12 Health Survey among beneficiaries. Our analysis was robust to using alternate measures of mental health outcomes (Kessler Index and PHQ-2) as well as to an alternate construction of treatment and control groups (comparing individuals aged 60-70 years on Medicare and private insurance). We find no detectable differences in the mental health of Medicare beneficiaries who already receive subsidies for costs associated with the coverage gap through the Low Income Subsidy (LIS) program. Further, we find that elimination of the doughnut hole reduced OOP expenses by $32.65 among Medicare beneficiaries in our sample. Overall, our results for mental health and OOP expenses are mainly attributable to women. This evidence highlights indirect effects of drug coverage gap elimination on mental health outcomes among Medicare beneficiaries.

Assessing the Performance of State Water Utilities in Nigeria: Towards Achieving the Sustainable Development Goal on Drinking Water

The Millennium Development Goals (MDGs) on drinking water were reported to have been achieved five years earlier than the target date of 2015 in all the continents, except Africa and Oceania. This study assessed the performance of selected state water utilities in Nigeria in Africa over a period of years to determine improvements, if any, in their service coverage and demand gap in meeting the ambitious SDG target 6.1, which aims to achieve sustainable drinking water for all by 2030. Employing the key performance indicator (KPI) methodology, encompassing operational and maintenance efficiency, investment efficiency, and financial sustainability, this research unveils a widening disparity between water supply and demand gap. Alarming is the revelation that the revenue from water sales falls short of covering operation and maintenance costs, rendering these utilities financially unsustainable. This underperformance of state water utilities signals a formidable barrier to Nigeria’s prospects of attaining the Sustainable Development Goal (SDG) target 6.1, thereby jeopardizing the nation’s ability to ensure universal and affordable access to safe drinking water by 2030.

Coverage, Trends, and Inequalities of Maternal, Newborn, and Child Health Indicators among the Poor and Non-Poor in the Most Populous Cities from 38 Sub-Saharan African Countries.

Rapid urbanization is likely to be associated with suboptimal access to essential health services. This is especially true in cities from sub-Saharan Africa (SSA), where urbanization is outpacing improvements in infrastructure. We assessed the current situation in regard to several markers of maternal, newborn, and child health, including indicators of coverage of health interventions (demand for family planning satisfied with modern methods, at least four antenatal care visits (ANC4+), institutional birth, and three doses of DPT vaccine[diphtheria, pertussis and tetanus]) and health status (stunting in children under 5 years, neonatal and under-5 mortality rates) among the poor and non-poor in the most populous cities from 38 SSA countries. We analyzed 136 population-based surveys (year range 2000-2019), contrasting the poorest 40% of households (referred to as poor) with the richest 60% (non-poor). Coverage in the most recent survey was higher for the city non-poor compared to the poor for all interventions in virtually all cities, with the largest median gap observed for ANC4+ (13.5 percentage points higher for the non-poor). Stunting, neonatal, and under-5 mortality rates were higher among the poor (7.6 percentage points, 21.2 and 10.3 deaths per 1000 live births, respectively). The gaps in coverage between the two groups were reducing, except for ANC4, with similar median average annual rate of change in both groups. Similar rates of change were also observed for stunting and the mortality indicators. Continuation of these positive trends is needed to eliminate inequalities in essential health services and child survival in SSA cities.

Enhancing Fault Detection in Wireless Sensor Networks Through Support Vector Machines: A Comprehensive Study

The Wireless Sensor Network (WSN) consists of many sensors that are distributed in a specific area for the purpose of monitoring physical conditions. Factors such as hardware limitations, limited resources, unfavourable WSN deployment environment, and the presence of various attacks on nodes can lead to the presence of Faulty Nodes in a WSN. This raises the problem of detecting Faulty Nodes and avoiding Data loss. Detecting Faulty Nodes in real-world scenarios will improve the quality of a WSN. The research was aimed at developing an algorithm to determine the location of Faulty Nodes in a WSN. The algorithm uses characteristics of Machine Learning and Support Vector Machines (SVM), which use the classification of Data into true and false. A Mathematical Model for determining Faulty Nodes using the SVM is considered. A methodology for detecting a Faulty Node is demonstrated, which consists of Data Collection, Feature Extraction, Training, and Testing the Model. The Results of simulated experiments that were conducted with different numbers of nodes from 50 to 320 are shown. The Model is tested on Data very similar to real-world sensing Data to evaluate the ability of the Model to detect failed nodes and calculate training and testing errors. As a result, the training error is 4.6667%, the accuracy of detecting faulty nodes was 97%. The simulation results demonstrate the high stability of the proposed algorithm and are suitable for network environments with irregular node distribution or coverage gaps. In real scenarios, it can provide a high level of uninterrupted operation of the WSN and lossless data transmission. Shortcomings and prospects in research on fault detection in WSN, such as studying real-world hardware issues and its security, were presented.

Algal cover as a driver of diversity in communities associated with mussel assemblages across eastern Pacific ecoregions

AbstractResearch on intertidal mussel assemblages and associated communities has revealed that complexity and structure are influenced by environmental heterogeneity and local‐scale factors affecting recruitment. Research in situ in eastern and western Pacific intertidal ecosystems has suggested drivers of species diversity and community structure encompassing large geographic scales, however, there are major gaps in geographic coverage. Our aim is to fill some of these gaps by analyzing macrofaunal functional group diversity and effects of environmental factors on intertidal mussel communities from three distinct marine ecoregions in the southern and northern hemispheres. We identified the effects of algal cover and environmental heterogeneity on species richness and evenness, and we modeled factors effecting mussel layer complexity from assemblages in three marine ecoregions. We analyzed macrofaunal species diversity within one of the austral ecoregions based on the width of the coastal shelf. Species richness was highest in samples from the northern hemisphere while evenness was highest in samples from the southern hemisphere. Similarity in functional group structure for all communities sampled was ≤55% (Bray–Curtis dissimilarity) and ≤35% (Chao–Jaccard dissimilarity). Wave exposure had a significant effect on shell length and complexity of mussel matrices on rocky bench platforms. The presence of algal cover had a strong effect on species richness in mussel matrices regardless of complexity, while algal canopies had no effect on species evenness. Overall, this study provides significant new insight on the community complexity of mussel beds in parts of the world which have been poorly studied in this regard.

Out-of-Pocket Costs and Physician Payment Variations in Abdominal Contouring: Evidence From United States Claims Data

Background: Abdominal contouring after massive weight loss has positive impacts on quality of life. There are often cost and access barriers for patients who desire these procedures. Objectives: To examine levels of access to body contouring in the era of price transparency, this study aims to characterize the out-of-pocket expenses and physician/facility payments in abdominal contouring procedures. Setting: The IBM MarketScan Commercial Databases were queried to identify patients who underwent outpatient abdominal contouring surgeries in the United States in 2021. Methods: Financial variables of interest included gross payments to the provider (facility and/or physician) and out-of-pocket costs (total of coinsurance, deductible, and copayments). Univariate analysis and mixed-effects linear regression were utilized to study the variations in costs across regions, insurance plan types, and places of service. Results: A total of 1319 abdominal contouring episodes were identified. The average age was 44.7, and the majority of patients were female (91%) and in the South region (44%). Median out-of-pocket costs were low overall ($30, IQR $768) and median total physician/facility payments for abdominal contouring was $4982.47 (IQR $7392.46). Out-of-pocket costs were highest in the South ($105) and $0 in all other regions ( P < .05). The highest physician/facility payments were in the Northeast ($6392) and the lowest was in the South ($3936). Conclusions: Patients undergoing abdominal contouring incur relatively low out-of-pocket costs overall, but there is a need for further reimbursement negotiation in regions where physician payments are lower and out-of-pocket costs are higher. Further study should explore reimbursement and payment gaps in procedural coverage.

A UAV-based coverage gap detection and resolution in cellular networks: A machine-learning approach

The use of unmanned aerial vehicles (UAVs) to extend the coverage of terrestrial base stations (BSs) in cellular communication systems has been gaining increasing interest in recent years. This is due to the ease of deploying UAV-mounted BSs within relatively short times with low associated costs. In this work, we formulate the problem of deploying UAV-mounted BSs to mitigate the coverage gaps of the terrestrial BSs of cellular networks in some geographic regions. We then devise a technique that provides the optimal bound of the solution to the coverage gap detection and mitigation problem. We also propose a machine-learning (ML) based technique to provide a real-time solution for deploying UAVs to determine and mitigate the coverage gaps. In both solutions, namely, the optimal and ML-based solutions, the deployment of the UAVs is done in such a way that addresses the coverage gaps at the minimum possible cost. Simulation results show that our ML-based technique performs quite closely to the performance of the optimal solution, at a significantly lower complexity, and hence fulfills the real-time requirements of such deployments. It also provides significantly better performance results than a common benchmark solution from the literature.

Evaluation of self-sampling-based cervical cancer screening strategy using HPV Selfy CE-IVD test coupled with home-collection kit: a clinical study in Italy

BackgroundPrimary human papillomaviruses (HPV) cervical cancer screening can be strengthened by offering home-collection of biological specimen as a valuable option to increase screening coverage. As recommended by World Health Organization (WHO), screening programs should consider whether the inclusion of HPV self-sampling as a complementary option within their existing screening algorithms could address the gaps in current coverage. However, few HPV screening tests are validated for self-sampling according to international guidelines. This study aimed to test a self-sampling-based screening strategy, complementary to the main screening program based on clinician-collected cervical samples. The study took place in Trieste, Italy, and it aimed to evaluate the feasibility of self-testing at home under an opt-in system during COVID-19 pandemic in order to exploit self-sampling to reduce the screening delay generated by the lockdown.Methods500 women, who should have received the screening call in 2020, were asked, via phone call, to participate in the study. To whom agreed, a home-collection kit, including a vaginal dry swab for specimen collection, was sent. The recipients performed the sample self-collection and sent back the swab through traditional mail using a prepaid envelope. Once received by the hospital, the samples were analyzed with HPV Selfy (Ulisse BioMed, Italy), a CE-IVD HPV screening test specifically validated for self-collection. Results were further compared using cobas® 4800 HPV (Roche, Switzerland).Results80% women sent back their swab, showing one of the highest return rate obtained in comparable studies. 34 HPV-positive women were followed up and underwent the Pap test, that revealed 8 low squamous intraepithelial lesions (LSIL) cases, later triaged to colposcopy. HPV Selfy was confirmed to be an adequate test for self-sampling-based screening.ConclusionsThis study further confirmed the feasibility of self-test at home screening strategy based on self-sampling with an opt-in system as a support method to enhance cervical cancer screening coverage in Italy. Enrolled women showed a high appreciation for this approach. HPV Selfy test demonstrated to be a valuable assay for cervical cancer screening based on home self-collection.Trial registration: ASUGI Trieste n. 16008/2018 and amendment 02-11/09/2020.

Real-time optimization for relocation and dispatching of Emergency Medical Services with balanced workload and outsourced ride-hailing services

Real-time optimization of Emergency medical services (EMS) leads to excessive and unbalanced workload unless balance is directly modeled. Online redeployment policies aim to reduce response times, compensating for the coverage gap left by busy ambulances, however, it is important to account for the additional effort required to relocate to a new position. Additionally, irregular demand patterns result in unequal distributions of workload among the personnel. In this regard, we propose a new survival-based real-time optimization framework that maximizes the survival probability of patients suffering from life-threatening emergencies while maintaining a balanced workload among the crew. Our approach implements an optimization model inside a discrete event simulation model that feeds the former with real-time vehicle utilization metrics to maintain an optimal overall relocation policy. Moreover, we evaluate the impact on the system’s congestion of a mixed dispatched policy that includes external ride-hailing services for minor emergencies. Our case study in New York City indicates that the proposed model increases the average percentage of life-threatening emergencies responded in less than four minutes in more than 10% through the use of survival functions compared to a coverage model from the literature. Furthermore, even though the fleet’s aggregated driving distances increased compared to the coverage approach, our online model effectively balanced the additional workload among the crew. Additionally, ride-hailing services’ introduction presents an important opportunity for reducing personnel workload by 13.5%, on average, and operational costs in $141,220 per day of operation for the entire system. Finally, when ambulance availability is severely reduced, outsourced services significantly help maintaining the response level for low severity emergencies.

Adjusting to a changing world while sticking to principles. International Labour Organization responses to the challenges facing social protection systems in the 21st century

Introduction: The paper analyses – basing itself on reports and other documents created by different parts of the International Labour Organisation (ILO) – the process which led to the adoption of Social Protection Floor Recommendation No. 202 and the shift in focus of social policy advice towards basic protection and to the Global South countries. We look at the actions of different actors which shape the standard setting and policy stand of the organisation.Objective: To provide a comprehensive analysis of the historical trajectory of ILO social security standards, examining the evolution of principles, conventions, and the global dynamics that have shaped the organization's approach to social protection over time.Materials and methods: The methods include examining ILO documents, relevant subject literature, and the author's participant observations from over twenty-years of service in the ILO's Social Security Department, aiming to provide insights into the decision-making processes within the organization.Conclusion: We conclude that change was brought by: 1) shift in the membership of the ILO and of its decision-making bodies towards the increased presence and powers of representatives from countries of the Global South, 2) the shift in the global development community policy priorities towards poverty reduction, 3) emergence of experimental social assistance schemes in Global South countries, with designs often ignoring principles embedded in the ILO standards.The Social Protection Floor Recommendation complements previous standards in response to the challenges of widespread poverty and informality and spreading atypical forms of employment. It provides two directions of policy responses: 1) formalizing informal employment relationships and 2) expanding universal or targeted rights-based social assistance schemes.Assistance provided by ILO to member states focuses now more on building the non-contributory schemes and on identifying the fiscal space necessary to close the coverage gaps. Nowadays, the ILO must collaborate more than before with other development partners and the main challenge is to build among them awareness and acceptance of the principles of the ILO social security standards.

Giving birth on the way to the clinic: undocumented migrant women’s perceptions and experiences of maternal healthcare accessibility along the Thailand–Myanmar border

BackgroundMillions of women give birth annually without the support of a trained birth attendant. Generally and globally, countries provide maternal health services for their citizens but there is a coverage gap for undocumented migrant women who often can’t access the same care due to their legal status. The objective of this investigation is to explore undocumented migrants’ experiences and perceptions of maternal healthcare accessibility.MethodsWe held focus groups discussions with 64 pregnant women at 3 migrant health clinics on the Thailand–Myanmar border and asked how they learned about the clinic, their health care options, travel and past experiences with birth services. In this context undocumented women could sign up for migrant health insurance at the clinic that would allow them to be referred for tertiary care at government hospitals if needed.ResultsWomen learned about care options through a network approach often relying on information from community members and trusted care providers. For many, choice of alternate care was limited by lack of antenatal care services close to their homes, limited knowledge of other services and inability to pay fees associated with hospital care. Women travelled up to 4 h to get to the clinic by foot, bicycle, tractor, motorcycle or car, sometimes using multiple modes of transport. Journeys from the Myanmar side of the border were sometimes complicated by nighttime border crossing closures, limited transport and heavy rain.ConclusionsUndocumented migrant women in our study experienced a type of conditional or variable accessibility where time of day, transport and weather needed to align with the onset of labour to ensure that they could get to the migrant clinic on time to give birth. We anticipate that undocumented migrants in other countries may also experience conditional accessibility to birth care, especially where travel is necessary due to limited local services. Care providers may improve opportunities for undocumented pregnant women to access maternal care by disseminating information on available services through informal networks and addressing travel barriers through mobile services and other travel supports.Trial registration The research project was approved by Research Ethics Committee at the Faculty of Medicine, Chiang Mai University (FAM-2560-05204), and the Department of Community Medicine and Global Health at the University of Oslo—Norwegian Centre for Research Data (58542).

GEOSCOPE Network: 40 Yr of Global Broadband Seismic Data

Abstract The GEOSCOPE observatory (Institut de physique du globe de Paris [IPGP] and École et Observatoire des Sciences de la Terre de Strasbourg, 1982) provides more than four decades of high-quality continuous broadband data to the scientific community. Started in 1982 with only two stations, the network has grown over the years thanks to numerous international partnerships. At present, 34 stations operate in 18 countries across all continents and on islands throughout the oceans, filling important gaps in global Earth coverage. Most of the first installed stations are still running today, allowing for long-term observations, and new sites are being prospected to further improve global coverage. Over the years, GEOSCOPE has contributed to defining today’s global seismology standards (data format, data quality level, instrumentation requirements), being the French contribution to the international effort for global seismic observations. The stations are instrumented with the best quality seismometers (from the very first STS-1 in the early 80s to the last STS-6A and Trillium T360 today) and digitizers (Q330HR and Centaur) to record with high fidelity the ground motions generated by all types of seismic sources. Real-time data are sent to the tsunami warning centers and both validated and real-time data are available at the IPGP, Epos-France and Earthscope data centers. The quality of GEOSCOPE data and metadata is ensured by daily and yearly validation that enables issue detection and mitigation. GEOSCOPE, in collaboration with the other global networks, has played and continues to play a crucial role in the study of Earth’s structure and global dynamics and the characterization of all types of seismic sources.

Dynamic ambulance relocation: a scoping review

ObjectivesDynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical...

Meningococcal Disease in the Post-COVID-19 Era: A Time to Prepare.

The global invasive meningococcal disease (IMD) landscape changed considerably during the COVID-19 pandemic, as evidenced by decreased incidence rates due to COVID-19 mitigation measures, such as limited social contact, physical distancing, mask wearing, and hand washing. Vaccination rates were also lower during the pandemic relative to pre-pandemic levels. Although policymakers may have shifted their focus away from IMD vaccination programs to COVID-19 vaccination programs, strong arguments support implementation and prioritization of IMD vaccination programs; IMD cases have increased in some countries and IMD rates may even have exceeded pre-pandemic levels. Additional concerns include increased susceptibility due to vaccination coverage gaps, increased incidence of other respiratory pathogens, immunity debt from lockdown restrictions, and increased IMD epidemiologic variability. The full range of benefits of widely available and effective meningococcal vaccines needs to be considered, especially in health technology assessments, where the broad benefits of these vaccines are neither accurately quantified nor captured in implementation policy decisions. Importantly, implementation of meningococcal vaccination programs in the current IMD climate also appeals to broader healthcare principles, including preparedness rather than reactive approaches, generally accepted benefit-risk approaches to vaccination, historical precedent, and the World Health Organization's goal of defeating meningitis by 2030. Countries should therefore act swiftly to bolster existing meningococcal vaccination strategies to provide broad coverage across age groups and serogroups given the recent increases in IMD incidence.

The Impact of Promotion and Basic Immunization Counseling Program on Mother’s Knowledge and Attitude

Immunization is an effort to actively create/increase the body's immunity to protect children from various diseases. However, Indonesian society's understanding of immunization still varies especially parental knowledge and behavior, which will be the main factor in immunization completeness for children, thereby reducing immunization coverage and immunity gaps. This research aims to determine the effect of promotion and counseling on the knowledge and attitudes of mothers with children over 2 years in the urban areas of Kaliombo and Manisrenggo, the working area of the Southern City Health Center. The research method is Quasi-Experimental with a one-group pre-post test approach. The sampling technique used Total Sampling with a sample size of 64 people. Data was collected in the form of knowledge and attitude questionnaires. Data were analyzed using descriptive statistical tests, Wilcoxon and multiple linear analyses. The research results related to knowledge show a p-value of 0.000 (p<0.05). In contrast, attitudes show a p-value of 0.000 (p<0.05), which means there is a significant increase in knowledge and attitudes after basic immunization counseling and education. Based on the linear regression test results, it shows that if knowledge increases by one score, then attitude also increases by 0.668. This research concludes that promotion and counseling impact knowledge and attitude.

The Influence of Information Technology on Employee Responsiveness in The Telecommunications Sector, Airtel Southeast Nigeria

Purpose: The study investigated how information technology has impacted the responsiveness of the telecommunication industry, Airtel, South East, Nigeria
 Methodology/approach: The study used a correlational survey design, with copies of the questionnaire serving as the main data collection tool. A probability simple random sampling technique was used to distribute the survey face-to-face using a five-point Likert scale. The data was tested using correlation to analyze the relationship between the variables.
 Result/Findings: The result of research hypothesis one indicates that a unit rise in teleconferencing applications results in a 0.996 increase in employee responsiveness at a 5 % level of significance. The result of research hypothesis two revealed that a unit increase in internet applications results in a 0.865 increase in service quality at a 5 % level of significance. The researchers suggest businesses provide opportunities for their employees' ongoing education and training, so they can gain the most recent credentials and expertise in their field.
 Contribution: The study established a gap in the conceptual framework relating the variables of teleconferencing software, internet, and service quality. This current study aims to close the conceptual and geographic coverage gaps in the literature.
 Practical Implications: The outcome of this study would help policymakers push for investments in opportunities for lifelong learning and promote collaborations between businesses, governments, and educational institutions.
 Novelty: This study contributed to the body of knowledge by identifying gaps in the literature and geographic coverage. 
 Keywords: Information Technology, Teleconferencing Application, Employee Responsiveness, Resource Based Theory, Pearson Correlation, Nigeria.