Distance Of Health Facility Research Articles

Does Health Literacy Predict Preventive Lifestyle on Metabolic Syndrome? A Population-Based Study in Sarawak Malaysia

Poor health literacy (HL) is a risk factor for developing metabolic syndrome. In Malaysia, about 93% of adults’ population has limited HL—a huge prevalence yet understudied phenomenon. This study aims to determine the predictors of preventive lifestyles on metabolic syndrome among adult population in Sarawak are timely. This was a population-based study, conducted from September 2016 till December 2017 using a multistage stratified sampling method. Health Literacy Scale and Simple Lifestyle Indicator Questionnaire were used to measure health literacy and preventive lifestyles respectively. Analysis of Variance and logistic regression were used to analyze the data. A total of 743 respondents were involved in this study with half of them have acceptable score for health literacy (M = 46.9, SD = 6.3) and good preventive lifestyles (M = 7.3, SD = 1.4). Critical health literacy was a significant influence of preventive lifestyles. The Malay ethnic group has the highest scores for both critical health literacy [F (3, 739) = 17.82, p < 0.001] and preventive lifestyle compared to other ethnic groups [F (3, 739) = 3.12, p = 0.025]. The other Native groups scored the lowest for critical health literacy. Individual with higher score of critical health literacy tend to perform physical activities. Gender, education level, distance of health facilities, critical health literacy and employment status were identified as predictors for preventive lifestyle in this study. Health literacy is a key to preventive lifestyle behaviors in metabolic syndrome among adult population in Sarawak. Future program should focus on improving HL status with specific program targeting ethnic minorities.

Acceptability of lifelong treatment among HIV-positive pregnant and breastfeeding women (Option B+) in selected health facilities in Zimbabwe: a qualitative study

BackgroundZimbabwe’s Ministry of Health and Child Care (MOHCC) adopted 2013 World Health Organization (WHO) prevention of mother-to-child HIV transmission (PMTCT) guidelines recommending initiation of HIV-positive pregnant and breastfeeding women (PPBW) on lifelong antiretroviral treatment (ART) irrespective of clinical stage (Option B+). Option B+ was officially launched in Zimbabwe in November 2013; however the acceptability of life-long ART and its potential uptake among women was not known.MethodsA qualitative study was conducted at selected sites in Harare (urban) and Zvimba (rural) to explore Option B+ acceptability; barriers, and facilitators to ART adherence and service uptake. In-depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with PPBW, healthcare providers, and community members. All interviews were audio-recorded, transcribed, and translated; data were coded and analyzed in MaxQDA v10.ResultsForty-three IDIs, 22 FGDs, and five KIIs were conducted. The majority of women accepted lifelong ART. There was however, a fear of commitment to taking lifelong medication because they were afraid of defaulting, especially after cessation of breastfeeding. There was confusion around dosage; and fear of side effects, not having enough food to take drugs, and the lack of opportunities to ask questions in counseling. Participants reported the need for strengthening community sensitization for Option B+. Facilitators included receiving a simplified pill regimen; ability to continue breastfeeding beyond 6 months like HIV-negative women; and partner, community and health worker support. Barriers included distance of health facility, non-disclosure of HIV status, poor male partner support and knowing someone who had negative experience on ART.ConclusionsThis study found that Option B+ is generally accepted among PPBW as a means to strengthen their health and protect their babies. Consistent with previous literature, this study demonstrated the importance of male partner and community support in satisfactory adherence to ART and enhancing counseling techniques. Strengthening community sensitization and male knowledge is critical to encourage women to disclose their HIV status and ensure successful adherence to ART. Targeting and engaging partners of women will remain key determinants to women’s acceptance and adherence on ART under Option B+.

Early Postnatal Care Service Utilization and Associated Factors among Mothers Who Gave Birth in the Last 12 Months in Aseko District, Arsi Zone, South East Ethiopia in 2016

Background: Even though early postnatal care visit is one of the strategies to reduce maternal and new-born morbidity and mortality, it is the weakest of all reproductive and child health interventions in Africa and receives much less attention from healthcare providers than pregnancy and childbirth. Objective: To assess early postnatal care service utilization and associated factors among mothers who gave birth in the last 12 months in Aseko district, Arsi zone, South East Ethiopia, 2016. Method: Community based cross-sectional study was conducted from May 10th-May 20th 2016 in Aseko district, Ethiopia. A total of 382 mothers who gave birth in the last 12 months were identified using random number generated by computer from six kebeles selected by simple random sampling techniques were included in the study. Data were collected using structured questionnaire through face to face interview and entered to Epi data version 3.1 and exported to SPPS version 20. Descriptive statistics, principal factor analysis (PCA), bivariate and multivariable logistic regression analysis were used for the analysis and a P-value<0.05 was declared a statistically significant in this study. Finally, the result was presented using texts, tables and figures. Results: The level of early postnatal care service utilization was 23.7%. The reasons for not to use early PNC services were: Having no information on the importance of early PNC services 140 (48.5%) followed by lack/no transportation access 76 (26.3%). In multivariable logistic regression analysis; experience of early postnatal care utilization for previous child (AOR=4.211; 95% CI: 1.548, 11.458), Institutional delivery (AOR=2.778; 95% CI: 1.386, 5.568), Women decision making power (AOR=4.103; 95% CI: 2.087, 8.067), Information/advise about early postnatal care services from health profession (AOR=5.049; 95% CI: 2.074, 12.289), Distance/time took to arrive health facility on foot (AOR=0.458; 95% CI: 0.231, 0.908) and Access to transportation (AOR=2.655; 95% CI: 1.322, 5.330) were found to be predictors of early PNC service utilization. Conclusion and Recommendations: Less than quarters (23.7%) of the respondents were utilizing early postnatal care services in the district. Experience of early PNC utilization, place of delivery, decision making power, information/advice from health profession, distance of health facility and access to transport were statistically significant for early postnatal care utilization. Strengthening health facilities to enhance service provision and information education and communication, decision making power of the women, improving transportation service and encouraging institutional delivery are necessary measures to enhance early PNC service utilization in the district.

TB: Barrier in access, diagnosis and treatment completion

Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries around the world. Economic barrier is one of the major problems in poor and marginalized population. Poor people mostly remain unaware of the treatment facilities and some find it difficult in seeking T.B treatment as they don’t trust the program and most of them don’t possess enough knowledge about the disease itself. Population residing in the remote areas of the countries can’t access the treatment facilities due to far distance of health facilities from there residence due to lack of roads and lack of transport. Thus difficult geography primarily in rural areas in the country acts as a barrier to access the health facility. TB infection faces add-on challenge with the advent of co-infection and possibility of increase in drug resistant TB. This is why detecting TB in its early stage would pose a number of advantages to the patient that would in turn help for early treatment. However, the challenges and barriers in early diagnosis remain that is being contributed by multifaceted factors. The lack of knowledge coupled with poor financial capacity to pay for the diagnosis especially in rural population prevents them from being diagnosed properly as well. Factors for not completing the treatment are when patient starts feeling better, lack of drugs, major side effects of the drugs and inadequate knowledge about advantages of completion of the drug treatment. The attitude of the hospital staff also in many cases leads to discontinuation of the treatment. Patient who have limited income and got financial support from their relatives explained about treatment going above their obtainable resources leading to early withdrawal from the treatment completion. Geography is one of the important issues for treatment completion as routine drug administration follow up in patient (farther from particular distance) is difficult and leads to exhaustion and withdrawal from the treatment.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.76-80

Facility-Based Delivery Service Utilisation Among Women of Childbearing Age in Nguti Health District, Cameroon: Prevalence and Predictors

Background: Maternal morbidity and mortality related to childbirth has remained a great challenge globally. One important strategy put in place to reduce maternal mortality related to childbirth is to increase number of women who deliver in a health facility. This study’s objectives were to determine the proportion of women who deliver in a health facility, assess factors influencing facility-based delivery service utilisation and determine the relationship between facility-based delivery service utilisation and participant’s socio-demographic characteristics in the Nguti Health District (NHD). Methods: A community based cross-sectional study was carried-out among women who delivered at least once in NHD. Multistage sampling technique was used to select participants and data collected using a structured interviewer administered questionnaire. Data collected was analysed using Epi Info version 3.5.4. Results: A total of 329 women took part in the study. The proportion of women who delivered in health facilities was 68.7%. Most women (59.0%) acknowledged having a health facility in their community with 145 (44.5%) women saying it takes more than 120 minutes to trek to the nearest health facility from their homes. The median monthly income of participants was 20,000FCFA (IQR: 15,000-40,000) and there was a statistical significant association with income and delivering in health facility. Conclusion: Proportion of women using health facilities during delivery was above average, factors influencing health facility utilization during delivery include low average monthly income, traditional values associated with burying of placenta held by women, distance of health facilities from women’s home, sudden onset of labour and availability of TBA’s in communities. There was a statistically significant association between having high monthly income and delivering in health facility. Women need education on advantages of delivering in health facilities. Further studies need to be conducted for much longer durations and involving larger samples of women to determine other factors associated with health facility utilisation for deliveries.

Is Health System Giving Life Year Gain to Children In India?

Background: In developing countries, specifically in India, millions of women and newborns die or experience serious health problems related to pregnancy and childbirth each year and many women do not have the good fortune to be attended by skilled personnel during childbirth. This lack of skilled attendance could be considered as one of the major factors in maternal and infantile mortality. Each year 3.3 million babies or may be even more are stillborn, more than 4 million die within 28 days of coming into the world, and a further 6.6 million young children die before their 5th birthday. From 2006 to 2012 the average complicated neonatal admissions with low birth weight children’s in virudhunagar district were 200. Also the researcher would like to found that how the Comprehensive Emergency Obstetric and New Born Care Centre (CEmONC) service gives opportunity to celebrate their 5th birthday for low birth children born in 2007 and to assess the factors determining the place of delivery and is Health system giving life year gain to Children? Methodology: The present study was undertaken in Virudhunagar District of South Tamil Nadu with primary and secondary data. The Secondary data were collected from all CEmONC Centres under Tamil Nadu Health System Project (TNHSP) and beneficiaries under Muthulakshmi Reddy Maternity Benefit Scheme (MRMBS) in 2007. Due to gives life year gain up to 5 years to children through these schemes. The primary data were collected from 200 who delivered their children with low Birth Weight (LBW) (<2.500 kg) in 2007. There are nine Public Hospitals in Virudhunagar district, namely Virudhunagar, Aruppukottai, Tiruchuli, Kariapatti, Rajapalayam, Watrap, Srivilliputtur, Sattur and Sivakasi and for the present study, Virudhunagar, Aruppukottai, Rajapalayam, Srivilliputtur, Sattur and Sivakasi government hospitals were selected as only these hospital have CEmONC services. Results: A sample of 40 (20%) attended Antenatal care (ANC) for previous pregnancy, 120 (60%) had their last delivery in private hospitals, while 80 (40%) had their last delivery at Government Hospital. Determinants of choice of delivery place include free cost of treatment (100%), friendly attitude of community health workers (75%), and good care of doctors, nurses and village health nurses (90%), distance to health care centers (80%), and cash incentive (100%). There is significant differences between age (P 0.001). There is a significant difference between consumption of Iron and Folic Acid (IFA) tablets and Low Birth Weight (LBW) in the study areas (P<0.001). There is a significant difference between mother age at birth and LBW (P<0.001). There is a significant difference between birth interval and LBW (P<0.001). There is a significant difference between income of the respondents and postnatal care (P<0.001). There were 196 children got life year gain above five year through the TNHSP and MRMBS. Lack of care and money is one of the reasons for less than five deaths in the study areas. Conclusion: Female education, female empowerment, attitude of health care workers and distance of health facilities to the people in most communities are factors to be addressed in reducing child morbidity and mortality rates and improving maternal health, thus achieving the Millennium Development Goals (MDGs) 4 and 5. To get this done, policy makers, health personal and community at large should join hands.

Assessment of knowledge, attitude, and practice related to epilepsy: a community-based study.

Religious and sociocultural beliefs influence the nature of treatment and care received by people with epilepsy. Many communities in Africa and other developing nations believe that epilepsy results from evil spirits, and thus, treatment should be through the use of herbaceous plants from traditional doctors and religious leadership. Community-based cross-sectional study designs were used to assess the knowledge, attitude, and practice related to epilepsy and its associated factors by using a pretested, semi-structured questionnaire among 660 respondents living in Sululta Woreda, Oromia, Ethiopia. According to the results of this study, 59.8% of the respondents possessed knowledge about epilepsy, 35.6% had a favorable attitude, and 33.5% of them adopted safe practices related to epilepsy. The following factors had significant association to knowledge, attitude, and practice related to epilepsy: being rural dwellers, living alone, those with more years of formal education, heard information about epilepsy, distance of health facility from the community, had witnessed an epileptic seizure, age range from 46 years to 55 years, had heard about epilepsy, prior knowledge of epilepsy, occupational history of being self-employed or a laborer, history of epilepsy, and history of epilepsy in family member. The findings indicated that the Sululta community is familiar with epilepsy, has an unfavorable attitude toward epilepsy, and unsafe practices related to epilepsy, but has a relatively promising knowledge of epilepsy.

Unit cost of providing and utilizing contraception services for newly married couples in Satara district of Maharashtra, India

Background: Since 2007, Satara district is implementing a pilot project named Second Honeymoon Package (SHP). SHP gives cash incentives to encourage postponement of first pregnancy in newly married couples. At the same time, contraception services are also provided under National family welfare program. There requires a significant amount of commitment and expenditure from the beneficiaries to avail the benefits of governmental programs, which is often overlooked by the system. The costs of these two reproductive health interventions are compared in this study. Objective: To calculate the cost of providing and utilizing contraception services for the newly-wed couples in Satara district from the perspective of the Government of Maharashtra and that of beneficiaries'. Materials and Methods: This was a cost-minimization study of two reproductive health interventions in rural part of Satara district. Information about expenditure incurred was calculated from 17th June 2010 to 16th June 2012. Cost analysis was conducted from the perspective of Government of Maharashtra and that of beneficiaries'. Costs of SHP were evaluated in comparison with those of routine family welfare program. Results: One thousand and ninety-five out of 1355 participants (80.8%) have used condoms, 125 participants (9.22%) have used oral pills while only 15 (1.1%) have used safe period method. The average distance of health facility from the homes of participants has been 4.24 km ± 6.54. Annual unit cost of implementation of SHP was Rs. 883 (16.35$/ year) during the study period while the opportunity cost of utilizing the contraception services was Rs. 383.40 (7.1$) per person per year. The annual unit cost of implementation of family planning program was Rs. 323.73 (6$). Conclusions: In districts like Satara that have a strong family planning infrastructure, reorienting the program to provide contraception services for newly married couples may be achieved with minimal additional inputs.