Facility-related Factors Research Articles

Quality of newborn care and associated factors: An analysis of the 2022 Kenya demographic and health survey.

Kenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression analyses were used to analyse the data. In this study, 32.7% (95% confidence interval [CI]: 31.0%-34.5%) of the mothers reported that their newborns had received all components of quality neonatal care after childbirth. Mothers who spent an average of one hour accessing the health facilities compared with those who spent less than half an hour were 1.33 (95%CI: 1.01-1.75) times more likely to report that their newborns had received quality newborn care. Mothers who gave birth in a non-government organization health facility were 30.37 (95%CI: 2.69-343.20) times more likely to report that their newborns had received quality newborn care compared with those who delivered from a faith-based organization. On the contrary, in terms of regions, mothers who lived in Nyanza, Eastern, and Rift Valley provinces compared with those who lived in the coastal regions were 0.53 (95%CI: 0.34-0.82), 0.61 (95%CI: 0.39-0.94), and 0.62 (95%CI: 0.41-0.93) times less likely to report that their newborns had received quality newborn care, respectively. Mothers who subscribed to other religions or faith (0.28 (95%CI: 0.10-0.76) compared with those from the Christian faith, were less likely to report that their newborns had received quality newborn care. Finally, mothers who gave birth through cesarean section were 0.44 (95%CI: 0.32-0.61) times less likely to report that their newborns had received quality newborn care than mothers who gave birth through spontaneous vaginal delivery. The study indicates that about a third of the neonates received quality newborn care and that facility-related and parental social factors were associated with receiving quality newborn care. Stakeholders need to pay more attention to newborn babies whose mothers come from certain regions of Kenya where the quality of newborn care was found to be low, minority religious faith denominations, and those who delivered by ceasearen section. Stakeholders also should focus on strengthening collaborations with NGO health facilities and achieving universal health coverage to improve the quality of newborn care provided in health facilities.

The benefits and costs of all-inclusive system from hoteliers’ point of view: a supply-side perspective

PurposeAll-inclusive (AI) packages and meal plans have been an essential component of leisure tourism and received a corresponding attention from the literature, particularly in the case of package tours. However, the existing body of research focuses on the motivations, attitudes and behaviors of tourists, thereby neglecting the supply-side perspective. Therefore, the purpose of this study is to explore the benefits and costs of AI systems from the perspective of hoteliers.Design/methodology/approachData were collected through 27 semi-structured interviews with lodging professionals through purposive sampling. This study adopted a qualitative research design and used thematic content analysis to explore the benefits and costs of AI system.FindingsThe thematic content analysis produced two main themes as facility-related factors and destination-related factors, which further classified as benefits and costs for the hotels and destinations.Originality/valueThis study extends current knowledge by providing a more comprehensive understanding of the benefits and costs of AI systems based on the hoteliers’ point of view, which reflects the supply-side perspective. The findings also offer valuable implications for industry practitioners and destinations to assess and manage the benefits and costs of the system.

Barriers and facilitators to antenatal care services utilisation in Somaliland: a qualitative study.

To explore the barriers and facilitators of antenatal care (ANC) utilisation in Somaliland. An exploratory qualitative study design. Various settings were considered for study including maternal and child health clinics, hospitals and community. 74 study participants including 33 pregnant women, 22 healthcare providers, 10 community elders and ten religious leaders were purposively selected. Data was collected via focus group discussion and in-depth interviews in the local Somali language. The data was audio recorded, transcribed verbatim, translated into English and imported into NVivo V.12 software. Thematic framework analysis was used to assess barriers and facilitators of ANC utilisation. Six main themes were identified as barriers of ANC utilisation. These include lack of awareness, long distance and lack of transportation access, economic barriers, lack of social support, beliefs and thoughts and health facility-related factors such as caregivers approach, waiting time and inadequate skill of providers. Proper dissemination of ANC information, adequate spousal support and cheap pricing of services were found to be facilitators of ANC uptake. A strategy that focuses on raising awareness about ANC, making it accessible by reducing the cost-of-service charge, encouraging partner involvement, improving the quality of services and making it customer-friendly will help to overcome the barriers of antenatal utilisation.

Impact of hospital volume and facility characteristics on postoperative outcomes after hepatectomy: A mediation analysis

BackgroundThe impact of hospital procedural volume on outcomes after hepatectomy relative to other facility-related factors remains unclear. We sought to define the comparative impact of hospital volume compared with other facility-related factors on postoperative outcomes among Medicare beneficiaries undergoing hepatectomy. MethodsData on patients who underwent hepatectomy between 2013 and 2021 were collected from the Medicare Standard Analytic Files and linked with facility-level data from the American Hospital Association Survey databases. Hospital volume was stratified into high- (top 10%) and low-volume centers. Propensity score matching was used to account for variable imbalances in patient characteristics among high-compared with low-volume centers. Mediation analysis was employed to delineate facility-related factors responsible for the impact of hospital volume on outcomes with a specific focus on incidence of complications, in-hospital mortality, and failure to rescue. ResultsThe analytic cohort included 22,969 patients from 340 institutions. After propensity score matching, receipt of surgery at a high-volume center was associated with a lower likelihood of postoperative complications (39.9% vs 41.7%, P = .01), in-hospital mortality (2.2% vs 2.8%, P = .02), and failure to rescue (5.4% vs 6.5%, P = .04) versus low-volume centers. Mediation analysis revealed that hospital capacity (bed capacity and nurse-to-bed ratio) contributed the most to the variations in risk of complications and in-hospital mortality, whereas liver transplant program status had the largest impact on failure to rescue. ConclusionsHospital volume is a significant determinant of postoperative outcomes after hepatectomy, with hospital capacity and liver transplant program status being important mediators of this effect. Centralization and optimal resource distribution are important to achieve favorable outcomes following liver resection.

Analysis of Risk Factors for the Quality of Health Services in Primary Health Facilities: An Observational Study in North Bengkulu Regency, Indonesia

Primary health care (PHC) is crucial for overall health system performance, particularly in developing nations. However, variations in the quality of PHC services in Indonesia, particularly in North Bengkulu Regency, raise concerns. This study aimed to identify and analyze risk factors associated with suboptimal quality of health services in these facilities. This observational, cross-sectional study was conducted in 20 primary health centers (PHCs) in North Bengkulu Regency. A multi-stage random sampling technique was used to select 400 patients and 80 healthcare providers. Data were collected using validated questionnaires assessing various dimensions of service quality (tangibles, reliability, responsiveness, assurance, and empathy), patient satisfaction, and potential risk factors (socio-demographic, facility-related, and provider-related). Descriptive statistics, bivariate analysis, and multivariate logistic regression were used for data analysis. The study found a significant association between perceived service quality and patient satisfaction. Socio-demographic factors (lower education and income), facility-related factors (inadequate staffing and lack of essential medicines), and provider-related factors (insufficient communication and perceived lack of empathy) were identified as risk factors for lower service quality. The quality of health services in North Bengkulu PHCs is influenced by a complex interplay of patient, facility, and provider factors. Interventions targeting these risk factors, such as community education, capacity building for providers, and improvements in resource allocation, may improve PHC service quality and patient satisfaction in this region.

Factors Affecting the Performance of Health Workers in Nsiika Health Center IV, Buhweju District

Health systems can only function with health workers improving health service coverage and realizing that the right to the enjoyment of the highest attainable standard of health is dependent on their availability, accessibility, acceptability, and quality. This study assessed the factors affecting the performance of health workers in Nsiika Health Center IV in Buhweju district. A descriptive cross-sectional study employing the quantitative method of data collection was employed with a sample size of 36 health workers working at different departments of Niika Health Center IV. They were chosen by a convenient sampling technique. Collected data were analyzed using Statistical Package for Service Solutions (SPSS) version 22.0. Data were analyzed and presented as frequency and percentage in the form of tables, figures, and charts. Out of 36 participants, 18 (50.0%) were within the age bracket of 29-34 years, 22 (61.1%) were females, and 16 (44.5 %) of the participants reported good skills in assessing patients. 22 (61.1%) indicated that they are motivated working as a team, 17 (47.2%) of the participants said their workload is high, 19 (52.8%) of the participants said they have a moderate relationship with their fellow workers, 27 (75.0 %) said equipment can sometimes be missing. In conclusion, health workers’ performance was greatly affected by both individual-related factors, health facility-related factors, and environmental factors which include; inadequate allowances, poor salary increments, and poor staff development programs, crushing workload as well as receiving inadequate feedback from supervisors. Keywords: Performance, Health Workers, Buhweju District, Health Centre

Factors Influencing Adherence to Hazardous Waste Management Policy Frameworks among Health Workers in Private Hospitals in Nairobi County – Kenya

Purpose: This study, therefore, sought to investigate the factors influencing the adherence to hazardous waste management guidelines among healthcare workers in private hospitals in Nairobi County. The specific objectives of the study included; determining the level of adherence to proper HCWM practices among health workers, identifying the individual related factors that influence adherence to proper HCWM practices among health workers, and identifying the health facility-related (institutional) factors that influence adherence to proper HCWM practices in 4 selected hospitals in Nairobi County Kenya. From the population of 900 healthcare workers from 4 levels 4 facilities, random sampling was applied to identify the 90 respondents. Methodology: Data analysis and reporting was done using appropriate quantitative methods. Findings: The findings from this study show that the level of adherence to hazardous waste management policies among healthcare workers in private level four hospitals in Nairobi County is low. Despite the high level of awareness by the health workers on the important measures of collection, segregation, treatment, transportation and disposal of waste, the level of performance on the same is low. This is greatly attributable to negligence and unfavorable attitude towards healthcare waste management practices among healthcare workers. Unique contribution to theory, policy and practice: Based on the study findings, we would recommend the improvement of hazardous waste management efficiency.

The Persistence of Mother-To-Child Transmission of HIV in Njombe Town Council in Tanzania

Abstract The HIV epidemic poses a dire threat to global public health. With an estimated 78 million people infected worldwide, and a staggering 39 million deaths attributed to HIV-related causes, the scale of this crisis demands immediate and continued action. This article examined the factors contributing to the ongoing transition of HIV from mother to their children in Njombe Town Council, Tanzania. Methods This study employed a mixed methods approach with a cross-sectional design. The data were collected from 90 participants including HIV-positive mothers’ and key informants. Participants were selected purposefully, and data were collected using interviews and focus group discussions. Data were analyzed using content analysis. Results The study identified various factors contributing to the ongoing challenge of preventing mother-to-child transmission of HIV. These factors include demographic and socioeconomic factors (age, marital status, education, occupation, spousal support), health-seeking behavior and cultural aspects (voluntary HIV testing, willingness to seek antenatal and postnatal services, stigmatization), health facility-related factors (availability of healthcare providers, their attitude towards infected mothers), and distance to health facilities. Conclusion Mother-to-child transmission of HIV in Njombe Town Council persists primarily due to demographic and socio-economic factors, cultural and healthcare-related factors, and distance to health facilities. The study identifies a multi-pronged approach to tackle mother-to-child HIV transmission. This includes securing more funding for healthcare improvements, training more medical professionals including HIV specialists, and promoting early prenatal care. It also emphasizes raising public awareness to fight HIV stigma and getting men involved in both preventing and treating the disease.

Exploring Factors Influencing the Low Utilization of Intrauterine Devices (IUDs) Among Youths Attending Family Planning Clinics: A Case Study at Kampala International University Teaching Hospital in Bushenyi District.

This study investigates the factors contributing to the low utilization of intrauterine devices (IUDs) among youths aged 18–30 attending family planning clinics at Kampala International University Teaching Hospital in Bushenyi District, Uganda. Despite the global recognition of IUDs as a safe, cost-effective, and highly efficient contraceptive method, their adoption remains disproportionately low among youths in various regions, particularly in sub-Saharan Africa. The research employs a descriptive cross-sectional study design utilizing quantitative data collection methods. Data was gathered through questionnaires focusing on demographic characteristics, individual factors, and health facility-related factors associated with low IUD utilization. Findings reveal that only a small percentage of participants (15.7%) were utilizing IUDs, with factors such as education level, parity, awareness, alternative method usage, health education, and accessibility to services significantly influencing IUD utilization. Recommendations include increasing awareness, providing comprehensive health education, and improving accessibility to IUD services to promote their uptake among youths. Keywords: Family planning, IUDs, Youths, Contraceptive methods, Mothers.

Factors Associated with Delayed Utilization of Antenatal Care Services among Pregnant Women: A Case Study at Jinja Regional Referral Hospital, Uganda

In Uganda, despite the critical benefits of early initiation of Antenatal Care (ANC) within the first trimester of pregnancy, a significant proportion of women exhibit poor attendance during this period. This study aimed to identify the factors contributing to delayed utilization of ANC services among pregnant women at Jinja Regional Referral Hospital (JRRH). A cross-sectional descriptive study was conducted, employing quantitative methods. Data were collected from 93 pregnant women who had missed their first trimester ANC visit between March 1st and April 15th, 2023, using a pretested questionnaire. The study revealed various maternal, socioeconomic, and health facility-related factors contributing to delayed ANC utilization. Maternal factors such as young age, unplanned pregnancies, and primiparity were associated with delayed ANC attendance. Socioeconomic factors including financial constraints for transport and negative sociocultural beliefs also hindered timely ANC visits. Health facility-related factors such as long distances, extended waiting times, and high service costs further contributed to delayed utilization. The findings underscore the need for targeted interventions addressing these multifaceted barriers to ensure timely access to ANC services, thereby reducing maternal and infant morbidity and mortality in Uganda. Efforts should focus on improving awareness, enhancing accessibility, and addressing sociocultural norms to promote early ANC initiation and utilization among pregnant women.

FACTORS CONTRIBUTING TO POOR HEALTH-SEEKING BEHAVIORS AMONG HIV ADOLESCENTS ATTENDING ART CLINIC AT KALAGALA HEALTH CENTRE IV, LUWERO DISTRICT. A CROSS-SECTIONAL STUDY.

Background: The purpose of the study: was to find out individual, community, and health facility-related factors contributing to poor health-seeking behaviors among HIV adolescents attending the ART clinic at Kalagala Health Centre IV, Luwero district. Methodology: A cross-sectional study design using a simple random sampling technique sampled 50 respondents. A questionnaire with open and ended questions written in English language was used as the data collection tool and data was analyzed manually by use of tally sheets and presented in tables and figures by support of narratives. Findings: The majority of the respondents were 18-19 years old (46%), female (60%), and in secondary school (52%). Many (92%) perceived ART as very important, (58%) had ever been exposed to drug adverse effects, and (38%) missed prescribed ART medications ART due to forgetfulness. Respondents (48%) affirmed that their parents don’t usually support them in taking medication, (48%) noted that community members were unfriendly towards HIV-positive adolescents, and (82%) were day scholars. When it came to the health facilities (60%) of the respondents noted the waiting time was quite long, (64%) reported that the attitudes of health workers were fair, (70%) agreed that they received adequate counseling services in regards to timely ART, (56%) reported a very far distance from their homes to the health facility. Conclusion: Exposure to drug adverse effects missed prescribed medications due to forgetfulness, unsupportive parents/caretakers, unpleasant perceptions of community members towards HIV-positive adolescents, tight school programs, long waiting times, spiteful attitudes of health workers, and distances from homes to health facilities were the foremost factors contributing to poor health-seeking behaviors among adolescents on ART. Recommendation: Kalagala Health Center IV administration should build a good client-based relationship with adolescents so that they can freely express themselves and develop their preferred mode for accessing timely ART.

FACTORS CONTRIBUTING TO IRRATIONAL PRESCRIPTION OF ANTIBIOTICS AMONG PRESCRIBERS IN CHILDREN BELOW 12 YEARS, KAWOLO GENERAL HOSPITAL, BUIKWE DISTRICT. A CROSS-SECTIONAL STUDY.

Background: Specific objectives: To determine & identify the individual and health facility-related factors contributing to the irrational prescription of antibiotics among prescribers to children below 12 years in Kawolo General Hospital. Methods: A cross-sectional study was done on only health workers of Kawolo General Hospital. A convenience sampling technique was used to obtain the sample of participants. Results: The majority of the respondents were between 30-39yrs (40%), married (60%), and nurses by profession (40%). The study findings showed that (64%) of the respondents reported having positive attitude towards irrational prescription of antibiotics, most(46%) reported working 12 hours a day, (84%) reported that there are no senior medical officers who usually approve the prescriptions, (60%) reported that junior health workers are not equipped with the knowledge about using diagnostic tools, (68%) reported that they have experienced pressure while prescribing,(92%) were not provided with the prescription guidelines, (96%) were not oriented about the use of guidelines, (72%) reported that the health facility does not engage health works in professional training,(76%) reported that there is no supervision carried out on junior health workers. Conclusion: The factors contributing to irrational prescription of antibiotics among prescribers of children below 12 years include inadequate knowledge of prescribers, pressure experienced by prescribers from patients, working for long hours, lack of continuous professional development, and failure of the hospital management to provide the prescription guidelines to prescribers. Recommendations: The Ministry of Health should enforce the use of Uganda's clinical guidelines in clinical practice to ensure proper diagnosis and treatment of prevailing diseases. The management of Kawolo General Hospital should conduct strict supervision and guidance to the junior health workers.

Client’s Experiences on Skilled Delivery Services among Women of Reproductive Age in Rural Communities in Kenya

Background: Globally Skilled delivery services are critical aspects to combat Maternal and neonatal mortality. In Kenya, skilled deliveries account for 62% of all deliveries; unskilled deliveries pose a higher risk of maternal and neonatal mortality and morbidity. The maternal mortality ratio in Kenya is currently 462 per thousand live births, with 40% of these deaths occurring at home. The main objective of the study was to explore the experiences of women of reproductive age on skilled delivery services.
 Materials And Methods: The baseline study was conducted between November 2022 and January 2023. It employed a cross-sectional research design involving 347 women of reproductive age. The study aimed to examine their current practices, challenges, and experiences with skilled delivery services. Focus Group Discussions (FGDs) were conducted with 48 recently delivered women (within one year), as well as with 48 Community Health Volunteers (CHVs) and 10 Community Extension Workers (CHEWs). In-depth interviews were also held with local health facility administrators. Quantitative data analysis was performed using SPSS version 25.0. Measures of central tendency were employed for continuous data tabulation. The analyzed data was then presented through charts, tables, and frequencies. The qualitative data underwent thematic arrangement and analysis using NVIVO version 13 and then triangulated with descriptive data.
 Results: The results revealed that (90.6%) of women's previous childbirth experiences influenced their utilization of skilled birth attendance services in subsequent pregnancies. Women who had never given birth in health facilities or had chosen home births were less likely to utilize skilled birth attendance services.
 Conclusion and Recommendations: This study identified factors influencing skilled birth attendance use in Kandara SubCounty, highlighting the role of previous childbirth experiences, health facility-related factors, and danger signs during pregnancy. To improve utilization, interventions should focus on health facility conditions, health worker attitudes, and community awareness programs.

Patterns of facility and patient related factors to the orthopedic and trauma admissions at the Kenyatta National Hospital: A qualitative assessment.

Inappropriate utilization of higher-level health facilities and ineffective management of the referral processes in resource-limited settings is increasingly becoming a concern in health care management in developing countries. This is characterized by self-referrals and frequent bypassing of nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. This situation compromises the ability and capacity of Kenyatta National Hospital (KNH) to function as a tertiary referral health facility as envisioned by Kenya Health Sector Referral Implementation Guidelines of 2014, Kenya 201 constitution and KNH legal statue of 1987. The study objective was to assess the patterns of facility and patient related factors to the orthopaedic and trauma admissions at the KNH. This was a descriptive qualitative study design. The study was conducted amongst the orthopaedic and trauma admission caseload for 2021. Data collection was done through a) data abstraction from 905 patients charts admitted during February to December 2021 and b) 10 (ten) semi-structured interviews with 10 major health facilities that refer to KNH to understand the reasons for referral to KNH. Quantitative data was analysed using Statistical Package for Social Science version 21.0 to calculate the frequency distribution. Qualitative data from the data abstraction and transcripts from the KIIs were analysed using NVivo version 12. The major facility and patient related factors to the orthopaedic and trauma admissions at KNH were inadequate human resource capacity and availability (42.7%), financial constraints (23.3%), inadequate Orthopaedic equipment's and implants availability (20.0%) and inadequate health facility infrastructure (6.3%) while the major patient related factor was patient's preference (23.4%). In conclusion, to decongest KNH requires that the lower-level health facilities need to be better equipped and resourced to handle essential orthopaedic and trauma care.

Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia

BackgroundTraditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses.MethodsA cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization.ResultsThe results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05).ConclusionsHigh non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.

Enhancing Utilization of PMTCT Services: Investigating Knowledge Factors Among Pregnant and Breastfeeding Mothers at Kiryandongo General Hospital, Western Uganda

This study aimed to determine the factors affecting the utilization of PMTCT services among mothers attending the ART clinic at Kiryandongo General Hospital. This was a facility-based cross-sectional which recruited a total of 185 pregnant and lactating mothers attending Kiryandongo Hospital. STATA software version 14.0 was used for data analysis. To identify factors affecting utilization of PMTCT services, univariate analysis and modified Poisson regression run and crude prevalence ratios with 95% confidence interval were used to determine the level of significance at bivariate meanwhile adjusted prevalence ratios were calculated at multivariate analysis to establish independent significant factors. The mean age of the study participants was 25.6 with a standard deviation of 6. Results showed that the mean score on knowledge was 5.21 with a standard deviation of 1.36. The median score was 5 with an interquartile range of 4 to 6. The majority of 59.46% (110/185) of the study participants had inadequate knowledge of PMTCT meanwhile less than of the study participants 40.54% (75/185) had adequate knowledge. The factors independently affecting utilization of PMTCT services were; Unemployment (aPR 4.05, 95%CI 2.19-7.50, P&lt;0.001), Rude and harsh attitude of health workers (aPR 2.17, 95%CI 1.38-3.44, P=0.001). Unsatisfactory services (Apr 2.40, 95%CI 1.22-4.74, P=0.011). The study has shown that there are more than half of the pregnant women and lactating mothers attending Kiryandongo Hospital have inadequate knowledge of PMTCT services. The proportion of mothers found with adequate knowledge of PMTCT in the present study is low compared to most studies done in Africa. At Kiryandongo Hospital, the utilization of PMTCT services among pregnant and lactating mothers was found to be slightly high. Employment status was the only socio-demographic factor affecting the utilization of PMTCT services meanwhile Rude and harsh attitudes of health workers and unsatisfactory services were the health facility-related factors affecting the utilization of PMTCT services. Keywords: HIV, PMTCT services, Children, Pregnant mothers, Lactating mothers.

Lived Experiences of Hospitalized Patients With Coronavirus Disease at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, North West Ethiopia, A Phenomenological Study.

Hospitalized patients with coronavirus disease experienced different challenges at treatment centers; however, there is no evidence in Ethiopia on patients' experiences at COVID-19 treatment centers. Therefore, the aim of this study was to explore the lived experiences of hospitalized patients with coronavirus disease at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, in 2021. A qualitative phenomenological study design with a heterogeneous purposive sampling technique was used. Fifteen hospitalized patients participated from March 15 to April 1, 2021. The information was gathered through an in-depth interview technique with an audio recorder. Thematic analysis was used to analyze the data using Atlas Ti version 7.09 software. Hospitalized patients with the coronavirus disease had a variety of experiences with various phenomena. Lived experiences were identified with 2 major themes: the psychoemotional theme has 2 subthemes (psychological and emotional experience), and the context-related experience has 5 subthemes (socioeconomic, patient-health care provider, health facility-related, exposure prevention, and governmental-related factors). The study identified 2 major themes: 7 subthemes and 10 categories. Study participants faced different challenges, mainly hopelessness, anxiety, a lack of caregiver, isolation, a shortage of medications, poor communication between the patient and health care provider, and a lack of health insurance. Therefore, we recommend giving psychological support, improving communication between patients and health care professionals, and ensuring health insurance.

Risk factors for anaemia among pregnant women: A cross-sectional study in Upper East Region, Ghana.

Anaemia in pregnancy (AIP) is a public health concern due to its devastating effects on women and their unborn babies, resulting in increased maternal and neonatal deaths in developing countries. Despite several Ghanaian health policies to combat AIP, AIP is still on the rise. It becomes imperative to identify geographic-specific factors for developing appropriate interventions for the management of AIP. However, Kassena Nankana West District (KNWD) in the Upper East Region of Ghana lacks a study on anaemia risk factors, therefore, this study estimated the prevalence and risk factors for anaemia among pregnant women in the district. A cross-sectional study was conducted from February to March 2023 in the KNWD. Approximately 376 pregnant women in their third trimester were randomly selected from 10 health facilities by utilizing the antenatal register as the sampling frame. Anthropometric, obstetric, sociodemographic, and health facility resource characteristics were collected using structured questionnaires and from antenatal records. Mixed-effect logistic regression was used to identify independent factors of anaemia at 95% confidence interval. Prevalence of AIP was 53.9% (95%CI:48.5%-58.8%). Mild, moderate, and severe anaemia prevalence was 16.9%, 35.3%, and 1.7% respectively. Malaria infection during pregnancy (aOR = 1.64; 95%CI:1.03-2.62) and accessing health facilities without trained laboratory personnel (aOR = 5.49; 95%CI:1.67-18.00) were associated with increased odds of AIP. Belonging to the major ethnic group (aOR = 0.52; 95%CI:0.28-0.85), accessing health facilities without laboratory services (aOR = 0.14; 95%CI:0.04-0.47), and accessing health facilities without sulphadoxine-pyrimethamine drugs (aOR = 0.22; 95%CI:0.06-0.86) in KNWD were also associated with decreased odds of AIP. KNWD has a severe burden of AIP. Maternal and health facility-related factors were associated with AIP in the district. These factors are preventable. Therefore, the provision of functional laboratory services with dedicated technical personnel, regular supply of sulphadoxine-pyrimethamine drugs to the health facilities, and enhanced community education on malaria prevention are recommended for anaemia control in the district.

Nurses' experiences of self-management support for adults with tuberculosis and human immunodeficiency virus coinfection.

Professional nurses provide self-management support to adults (18 years and older) living with tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection to enable them to mitigate its impact on their lives. However, the experiences of professional nurses providing self-management support to adults with TB-HIV coinfection remain unclear. This study explored and described the experiences of professional nurses on the provision of self-management support to adults living with TB-HIV coinfection in Greater Accra, Ghana. Three public primary health facilities in Greater Accra, Ghana. An exploratory, descriptive qualitative design was used. Twenty-two purposively sampled professional nurses were interviewed face-to-face individually using an interview guide. Interviews were recorded with participants' permission, transcribed and analysed thematically using MAXQDA software. The three themes generated revealed that the: (1) self-management problems of adults living with TB-HIV coinfection included their recurring physical, mental and social problems, (2) the support provided to adults with TB-HIV coinfection included symptom, nutritional, medication and psychosocial self-management support, (3) the factors related to providing self-management support showed that self-management support was influenced by patient, nurse and health facility-related factors but was feasible, equitable and acceptable to patients and stakeholders. Professional nurses' self-management support practice entailed improvising limited resources to address the recurring problems of adults living with TB-HIV coinfection. Nurses require adequate resources to provide comprehensive self-management support. The contextual evidence provides insight into the self-management problems of adults with TB-HIV coinfection and the factors influencing professional nurses' self-management support.

Improvement of Disaster Prevention Technology Guidance

In recent times, the strengthening of government safety regulations, such as the implementation of the Serious Accidents Punishment Act, has not succeeded in reducing industrial accidents at small and medium-sized worksites, specifically in the construction sector. The comprehensive amendment of the 2020 Industrial Safety and Health Act brought about considerable changes after 30 years, thereby impacting the safety measures of construction sites. Although the implementation of construction accident prevention technology guidance is mandated, it has not been effectively and practically applied. This study used the analytic hierarchy process analysis, considering quantitative and qualitative aspects, to recommend important factors for enhancing the construction accident prevention technology guidance system. It aims to improve safety management at small and medium-sized construction sites by emphasizing institutional, economic, company-specific, and facility-related factors. The findings of this study can help evolve strategies to improve the construction disaster prevention technology guidance system by providing essential insights and effective requirements that need to be prioritized.