Federal Ministry Of Health Research Articles

Promoting research for the fragile Somali health system –

A 3-day conference was held in Garowe from the 30th of January to the 1st of February 2022 under the leadership of the Somali National Institute of Health to strengthen the foundation of health research in the country by promoting strategies for health research capacity building, sharing available evidence for action, and widening research collaborative networks. The conference was also instrumental in concretizing plans for improving the existing Somali Universities’ health research performance. It was jointly organized and supported by the National Institute of Health, the Federal Ministry of Health and Human Services, the Public Health Agency of Sweden, the Somali Swedish Researchers’ Association, and a consortium of Somali and Swedish universities. The Puntland State Ministry of Health hosted the conference. This paper summarizes topics presented at the conference and identifies gaps and opportunities for research capacity strengthening in Somalia, which would generate evidence to inform public health policies. An Organizing Committee for the management and logistics of the conference and a Scientific Committee were established, the latter providing expertise in selecting key research topics and speakers/delegates for the conference. More than 180 participants from academic institutions and the health sector service delivery network attended the conference. Twelve panel presentations and 51 abstracts were delivered, covering health system research priorities. Of the 51 presented abstracts, 35% were on communicable diseases, 26% on reproductive maternal, newborn, child, and adolescent health, 24% were on the health system, and 16% on non-communicable diseases. The conference also highlighted the need to build research capacity to support researchers and institutions to strengthen their research skills, including research methodology, data analysis, interpretation, and scientific writing. Highly relevant findings were presented that had the potential to inform health policy and scale up the community-based health services towards Universal Health Coverage and Sustainable Development Goals.

Towards a positive postnatal experience in Sub-Saharan African countries: the receipt of adequate services during the immediate postpartum period: a multilevel analysis.

Existing studies in the Sub-Saharan African (SSA) region have focused mainly on the frequency of postnatal visits, with little emphasis on the adequacy of care provided during visits. Hence, this study aimed to investigate the magnitude of receiving an adequate number of World Health Organization-recommended contents of care during the immediate postpartum visit, and its predictors in SSA countries. The appended women file of the most recent (2016-2021) standardized Demographic and Health Survey report of eighteen Sub-Saharan African countries with a weighted sample of 56,673 women was used for the study. The influence of each predictor on the uptake of adequate postnatal care has been examined using multilevel mixed-effects logistic regression. Significant predictors were reported using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (95% CI). The pooled prevalence of adequate postnatal care service uptake was found to be 42.94% (95% CI: 34.14, 49.13). Living in the southern sub-region (aOR = 3.08 95% CI: 2.50, 3.80), institutional delivery (aOR = 3.15; 95% CI: 2.90, 3.43), early initiation of ANC (aOR = 1.74; 95% CI: 1.45, 2.09), quality of antenatal care (aOR = 1.59; 95% CI: 1.42, 1.78), Caesarean delivery (aOR = 1.59; 95% CI: 1.42, 1.78), autonomy in decision-making (aOR = 1.30; 95% CI: 1.11, 1.39), high acceptance toward wife beating attitude (aOR = 0.83; 95% CI: 0.73, 0.94), and reading newspapers (aOR = 1.37; 95% CI: 1.21, 1.56) were identified as predictors of receiving adequate postnatal services during the immediate postpartum period. The findings revealed low coverage of adequate postnatal care service uptake in the region. The Federal Ministry of Health and healthcare managers in each country should coordinate their efforts to develop interventions that promote women's empowerment to enhance their autonomy in decision-making and to reduce attitudes towards wife beating. Healthcare providers ought to strive to provide skilled delivery services and early initiation of antenatal care.

Potential Impact of Public Communication on Emergency Presentations due to Headache during the Covid-19 Pandemic

Headache is a frequent presenting symptom in the emergency department. While most cases are of benign aetiology, it is crucially important to identify potentially dangerous underlying disorders. We hypothesized an increase in headache-related emergency presentations after venous thrombosis of cerebral sinuses had been identified as a rare side effect of vaccination with adenovirus vector-based Coronavirus-disease 2019 (COVID-19) vaccines and that information had been publicly communicated by the Paul Ehrlich Institute. Data from patients with the diagnosis of primary headache disorders or unspecified headache presenting to the Interdisciplinary Emergency Department of the University Medicine Mannheim were retrospectively analysed. Based on vaccination dashboard data published by the Federal Ministry of Health, calendar weeks 14-30 and 47-48, on the one hand, and 1-13 and 31-46, on the othe, were categorized into a variable "vaccination epoch" (14-30, 47-48: high vaccination activity if≥3 million weekly vaccinations in Germany; 1-13, 31-46: low vaccination activity if<3 million weekly vaccinations). The number of patients with headache was the dependent variable. A Poisson regression was performed to analyze whether the frequency of events, i. e., patient presentations, was a function of year (2019, 2021), epoch (high, low) and an interaction of year and epoch - the latter reflecting an impact of vaccination activity during the pandemic and expressed as incidence rate ratio. Compared to 2019, there was a more than 70% increase in presentations due to headache during periods of high vaccination activity in 2021 (p<0.001; 95% confidence interval 1.272-2.316), in 25% of presentations in 2021, patients considered their headache as vaccination-associated. Public communication and resulting nocebo effects may, among other factors, have contributed to our observation of increased numbers of emergency headache presentations, illustrating the impact of public distribution of medical information on practical aspects of emergency care during crises.

Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia

ObjectiveNon-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19...

Rare diseases in Germany - Developments in the status of medical care.

Rare diseases are a heterogeneous group of complex clinical patterns, which more often than not run a chronic course. The fact that they are rare complicates the provision of medical care for the specific diseases. In the field of action titled 'Care, Centres, Networks' of its National Action Plan, the National Action League for People with Rare Diseases recommends the formation of a three-level, interconnected centre model. This form of care was investigated in two large research projects. It was shown that the time to diagnosis was markedly reduced. Commissioned by the Federal Ministry of Health, the expert report on the health status of people with rare diseases in Germany issued in 2023 concludes that the medical care provided to this group of people has improved markedly since the National Action Plan was introduced. The establishment of the Centres for Rare Diseases (ZSE, Zentren für Seltene Erkrankungen) is seen as the most important development. However, it is noted that there is still a lack of coordinated care provision pathways for referring patients to the appropriate facilities. The provision of care to people with rare diseases has improved upon the implementation of the measures from the National Action Plan. In a next step, care provision pathways must be established across sector boundaries. Challenges remain in the area of psychosocial care and the long-term securing of funding for these structures.

Epidemic forecast and preparedness for explosive-cerebrospinal meningitis outbreak in Nigeria using the preventive vaccination strategy.

Within the African meningitis belt, yearly outbreaks of cerebrospinal meningitis (CSM), with incidence rates of 10-100 cases per 100 000 population, are typically punctuated by explosive epidemics occurring every 8-12 years, with incidence rates that can exceed 1000 cases per 100 000 population. From 1928 to 2018, Nigeria recorded the highest number (21%) of cases in the region. The reactive vaccination strategy, a protocol with major drawbacks, has been the vaccination method utilised in Nigeria. This review highlights the need for governments within the African meningitis belt to start preparations against the next explosive CSM epidemic expected to occur between 2024 and 2028 using the preventive vaccination strategy. We performed a literature search on the Google Scholar search engine using relevant search strings and included studies and reports between 1905 and 2022 that met set criteria. Neisseria meningitidis serogroups A, B, C, W135, X, and Y; Haemophilus influenzae serotypes a, b, c, e, and f; and Streptococcus pneumoniae serotypes 1, 4, 5, 6, 9, 19, 19F, and 20 were implicated as aetiologies. However, the reactive vaccination strategy was only used against N. meningitidis A or C, H. influenzae b, and pneumococcal conjugate vaccine. Between 2011 and 2017, a polysaccharide vaccine (ACW or ACYW) active against serogroups A, C, W and Y was used within the African meningitis belt for the first time. Varying genotypes of N. meningitidis, H. influenzae and S. pneumoniae were identified. Our results revealed a very high success rate for the preventive vaccination strategy. In order to ensure reductions in the morbidity and mortality associated with invasive CSM, the Federal Ministry of Health, Nigeria, should leverage existing knowledge of the circulating serogroups, serotypes, and genotypes of the primary bacterial aetiologies and commence the implementation of the preventive vaccination strategy.

Endemicity of Diphtheria in Some Regions of Nigeria: Chronology of a Fourteen Month Sustained Outbreak

Diphtheria in humans is caused by exotoxin produced by Corynebacterium diphtheriae which is a gram positive bacteria. The sustained endemicity of diphtheria amongst Nigerian population from May 2022 to July 2023 is significant and has not been widely reported. Secondary data was collected from the recent data base of Nigeria Centre for Disease Control, Federal Ministry of Health, and Federal Ministry of Information then analyzed applying standard procedure. The result shows in overall a total of 4,160 suspected cases of diphtheria which spanned through a period of May 2022 to July 2023. Out of these suspected cases, 1,534 were positive, yielding a total prevalence of 36.9% and mortality of 137(8.9%). In the Northern states alone, 4,061 individuals were recorded as suspected diphtheria cases; out of which 1,525(36.6%) individuals were confirmed positive with 132(8.7%) death cases. Conversely, in the southern states, a total of 40 suspected cases were recorded. Out of these, 9(22.5%) were confirmed positive with mortality of 5(55.6%). Only one state yielded a suspected case without any conclusive confirmatory evidence. The result further showed that a total of 15 states were grouped as “others”. In this group a total of 59 cases were suspected, but none yielded positive result. The prevalence was high (36.6%) in the North when compared to the south (22.5%), and mortality was high (55.6%) in the south when compared to the North where a total mortality rate of 8.7% was recorded. Amongst the Northern states affected, prevalence was highest (75.9%; 41/54) in Bauchi and least (5.0%;5/101) in Kaduna state. This present result shows that diphtheria is endemic in some parts of Nigeria leading to sporadic outbreaks overtime, predominantly in the Northern part. High spread and prevalence in the North may be that herd immunity in the North is low or inadequate. Thus, urgent attention of Government and relevant stake holders is necessitated to eliminate this negative trend.

Sudan: from a food basket to a pesticide sink

Abstract Background Sudan, a country once referred to as ‘a food basket', had an agricultural sector employing 53% of the workforce (21.8% of the GDP) in 2019. However, intensive agricultural schemes and excessive use of pesticides have plagued this sector since colonial times, resulting in negative environmental health impacts. We analyzed relevant policies to identify deficiencies and improvement opportunities. Methods The National Pesticides and Pest Control Products Act (NPPCPA 1994), Environmental Health Act (EHA 2009), and the National Occupational Health Act (NOHA 1966) were analyzed. Results The laws governing pesticide handling and use are outdated. The NPPCPA (1994) does not capture recent regulations specified in international conventions. The EHA (2009) regulates the storage of vector-control pesticides, without referring to agricultural pesticides. NOHA was promulgated in 1966, yet the occupational health (OH) functions were formalized within the Federal Ministry of Health (FMOH) in 1968. The OH unit and functions in FMOH were fully dismantled in 1993-1994 and NOHA clauses were reduced to an administrative section in the 1997 Federal Labor Act with no specific mention of pesticide exposure. The NPPCPA 1994 act stipulates the development of a multi-stakeholder national committee, yet it works in a fragmented manner and conducts pesticide analysis on an ad hoc basis. The lack of a national agricultural policy for the safe use of pesticides, and the absence of an oversight agency to monitor, inspect, and enforce safety measures, have led to unsafe exposures and high residues in crops. Conclusions Laws and policies governing pesticide use are outdated and deficient in Sudan. They fail to regulate the use of pesticides and protect workers and consumers. Evidence-based and context-specific policies and regulations are needed. A successful implementation of regulations requires revisiting governance structures, in tandem with widescale capacity-building efforts. Key messages • Sudan’s economy relies heavily on agriculture, yet the laws governing this sector are outdated and deficient. • There is a need for a national agricultural policy for the safe handling and use of pesticides.

Breast cancer awareness among Sudanese females in Omdurman city: 2021

BackgroundBreast cancer is the most commonly diagnosed malignancy among women worldwide. In contrast to Europe, it presents generally very late in Africa. As with the rest of Africa, it is the most common primary malignancy of females in Sudan, and generally presents in stage III or IV disease. This study is intended to analyse the level of breast cancer awareness among women of Sudan.ObjectiveTo assess the level of awareness of breast cancer among Sudanese females, and their attitude towards breast changes. Also, to establish possible associations between several variables: (education level, age, contact with a breast cancer patient, residence) on awareness.MethodologyA descriptive cross-sectional community-based study of 385 females in Omdurman city, selected by convenience sampling. An interview based Arabic version of Breast Cancer Awareness Measure (BCAM) was used. Data was coded and analysed using Statistical Package for Social Sciences (SPSS) v.20.ResultsA total of 385 females were included, of which 38.7% were 20–30 years, 47.8% were single, 53.8% had university education, 41% of them were currently unemployed, and 54.3% resided in Ummbadda’s locality. When asked about the signs and risk factors of breast cancer, 55.06% and 55.8% failed to name any. The cumulative percentage of correct answers of close-ended question about signs, risk factors and Federal Ministry of Health (FMoH) screening program were 42.8%, 30.7% and 44.7% in that order. Only 38.2% knew the right method BSE, 48.2% of them rarely practiced it. 38.2% noticed a change in the breast tissue but didn’t visit a doctor. The majority of them, though, said they would see a doctor if they noticed a change in the future.ConclusionThere is a severe lack of awareness of breast cancer among females of the Sudanese society. Also, there was a clear ignorant attitude practiced by a significant proportion of the candidates.RecommendationsFurther research, to address the limitations of this study is to be done. FMoH has to improve its media massage and arrange targeted awareness campaigns.

Determinants of Unsuccessful TB Treatment Outcomes Among Patients on Directly Observed Treatment Short Course in Jimma Town Health Facilities, Southwest Ethiopia: A Case-Control Study.

Even though Ethiopia's Federal Ministry of Health has been implementing several programs aimed at reducing the burden of tuberculosis (TB), It does not demonstrate adequate progress. As a result, identifying the determinants of unsuccessful outcomes of directly observed treatment, short-course (DOTS) is critical. This study aimed to assess the determinants of unsuccessful TB treatment outcomes among patients with DOTS in Jimma town, southwest Ethiopia. An unmatched case-control study using secondary data was conducted among 118 cases and 472 controls from April 1 to June 1, 2021. Cases were TB cases with unsuccessful treatment courses whereas controls were those of successful treatment. Data were collected using a standardized tool. Statistical analysis was done using SPSS version 23 software. A binary logistic regression model was used to identify the determinants. We found that the determinants including age > 35 years (AOR=1.9, 95% CI: 1.14-3.2), lack of contact person (AOR= 27, 95% CI: 15.8-46.3), being HIV positive (AOR=7.3, 95% CI: 3.7-14.2)), and being malnourished (AOR=4.5, 95% CI: 1.5-12.9) were significantly associated with unsuccessful tuberculosis treatment outcome. In this study, advanced age, being HIV positive, lack of contact person, and being malnourished were determinant factors for unsuccessful TB treatment outcomes. Hence, careful monitoring, screening, and management of risk factors are recommended.

An Assessment of Human Capital Development: Nigeria’s Experience

The study undertook an assessment of human capital development in Nigeria. Content analysis was adopted to achieve the objective of the study, which was to evaluate Nigeria's current state in terms of human capital development. The study adopted secondary data on government spending on education as a percentage of GDP, government spending on health as a percentage of GDP, life expectancy, literacy rate and per capita income with data sourced from the World Development Indicators. The study employed trend analysis to reveal the data pattern for all the variables considered in this study. Descriptive statistics was also employed using tables to display the data for all the variables, while bar charts were employed to show the position of each of the countries reviewed for each of the variables with the view of comparing the input and output variables in the study. The study concludes that Nigeria's human capital development still lags behind in Africa despite the huge human and material resources it possesses. Low literacy and life expectancy rates indicate that the level of investment in the education and health sectors of the economy is inadequate. Based on the findings, the study recommends that the Federal Government of Nigeria should dedicate more resources to the development of the education and health sectors of the economy and ensure judicious use of resources allocated to these sectors. It further recommends that the Federal Government of Nigeria, through the Federal Ministry of Health, and other relevant agencies of government, should invest in and encourage Health Insurance in Nigeria to increase access to healthcare and reduce out-of-pocket healthcare expenditure in Nigeria.

Improved leprosy elimination efforts in Somalia, 2015–2021: achievements in a challenging environment and the way forward

Background Since leprosy was eliminated as a public health problem in 2000, trends in case detection have been declining. However, from 2015, case detection in the WHO Eastern Mediterranean (EM) region increased mainly due to reports from Somalia that re-instated the national programme. As Somalia reported 57% of new cases in the EM region in 2021, we reviewed the national control programme activities and the characteristics of reported cases to understand leprosy transmission in the country. Methods From 2012 to 2021, we extracted data from WHO’s Global Health Observatory and the national leprosy control programme’s patient register in Somalia. From 2015 onwards, leprosy cases were detected by the Federal Ministry of Health through mobile teams conducting “skin camps” in 47 districts across seven regions. We analyzed data to describe the overall case detection rate and rates per period, place and person, including severity measured by grade two disability (G2D) and multibacillary (MB) cases. Results The overall case detection rate increased 11-fold between 2012 and 2021, from 6 cases per million in 2012 to 106 cases per million in 2021 in females and from 16 cases per million in 2012 to 132 cases per million in 2021 in males. Case detection among children under 15-years of age also increased from 4 cases per million in 2012 to 13 cases per million in 2021. Initially, the proportion of MB cases and G2D at the time of diagnosis increased from 60% and 11% in 2012 to 87% and 42% in 2015 respectively, when the national programme resumed leprosy control activities. By 2021, the MB proportion decreased to 45% and G2D proportion also decreased to 2%. From 2015 to 2021, four regions in Somalia reported 77% of the new cases and 83% of cases with G2D: Lower Shabelle, Middle Juba, Lower Juba and Middle Shabelle. Conclusion “Skin-camps” for case detection were effective in finding hidden leprosy cases and reducing the delay in diagnosis over time. The constant case detection rate among the female population, equal to the male population, points to sufficient programme reach. However, low disability rates persisted among this population which could be due to continued underlying stigma. Reports of new cases among children suggest ongoing transmission requiring prevention strategies such as single dose rifampicin post-exposure prophylaxis.

Register-based research and clinical studies : Possibilities, limitations and perspectives

Register-based research offers agood opportunity to generate knowledge on questions from the clinical practice. Methodologically high-quality register studies can complement clinical studies, especially for questions that cannot be answered with randomized controlled trials (RCT). The ad hoc committee on healthcare data of the German Network for Health Services Research (DNVF) has set methodological guidelines for register-based studies with a manual for methods and the use of healthcare data. The methodological advantages of both approaches can be integrated through RCTs embedded in registers. In Germany there is a diverse register landscape as shown by the register report commissioned by the Federal Ministry of Health, which, however, show avarying degree of internationally recognized quality criteria. The relevance of register-based studies for the clinical practice (e.g. guideline development) is shown in the examples of applications cited in the article. Although alot has already been done here in Germany with existing register data, sustainable coordination and promotion of the research infrastructure and research culture, especially in international comparison are necessary.

Study design and protocol of a stepped wedge cluster randomized trial using a practical implementation strategy as a model for hypertension-HIV integration — the MAP-IT trial

BackgroundAs people living with HIV (PLWH) experience earlier and more pronounced onset of noncommunicable diseases (NCDs), advancing integrated care networks and models in low-resource-high-need settings is critical. Leveraging current health system initiatives and addressing gaps in treatment for PLWH, we report our approach using a late-stage (T4) implementation research study to test the adoption and sustainability of a proven-effective implementation strategy which has been minimally applied in low-resource settings for the integration of hypertension control into HIV treatment. We detail our protocol for the Managing Hypertension Among People Living with HIV: an Integrated Model (MAP-IT) trial, which uses a stepped wedge cluster randomized trial (SW-CRT) design to evaluate the effectiveness of practice facilitation on the adoption of a hypertension treatment program for PLWH receiving care at primary healthcare centers (PHCs) in Akwa Ibom State, Nigeria.DesignIn partnership with the Nigerian Federal Ministry of Health (FMOH) and community organizations, the MAP-IT trial takes place in 30 PHCs. The i-PARiHS framework guided pre-implementation needs assessment. The RE-AIM framework will guide post-implementation activities to evaluate the effect of practice facilitation on the adoption, implementation fidelity, and sustainability of a hypertension program, as well as blood pressure (BP) control. Using a SW-CRT design, PHCs sequentially crossover from the hypertension program only (usual care) to hypertension plus practice facilitation (experimental condition). PHCs will recruit and enroll an average of 28–32 patients to reach a maximum of 960 PLWH participants with uncontrolled hypertension who will be followed longitudinally for BP outcomes.DiscussionGiven the need for integrated NCD-HIV care platforms in low-resource settings, MAP-IT will underscore the challenges and opportunities for integrating hypertension treatment into HIV care, particularly concerning adoption and sustainability. The evaluation of our integration approach will also highlight the potential impact of a health systems strengthening approach on BP control among PLWH.Trial registrationClinicaltrials.gov (NCT05031819). Registered on 2nd September 2021.

The German Influenza Gap 2021 - A Multifactorial View

The end of the 2019/2020 influenza season was already registered in early summer 2020, and in the following season. There was an nearly complete absence of influenza. So far, the sometimes strict Covid-19 containment measures with contact restrictions and the obligation to wear a mask have been mentioned as reasons. The further processing of this influenza gap showed multifactorial reasons also the lack of registration of influenza cases This study looks for further reaseons and from several perspectives in order to develop strategies for a representative recording of influenza cases derive. For Evaluation the data of GrippeWeb, the RKI’s Survstat® tool and the RKI’s reporting data on the new coronavirus were used. In addition, an evaluation of billing data from the EBM from 2017 to 2022 for the GOP 32816 as well as an evaluation of data on sick leave and illness statistics from 2019 to 2021 and the consideration of inpatient and outpatient health costs based on the data requested in writing from the Federal Ministry of Health was performed. In contrast to influenza A/B, the other viral respiratory pathogens (adenovirus, parainfluenza virus and RS virus) do not show any significant reduction. From 2020, the number of reports of respiratory infections to the RKI increased from an average of 300,000 annual reports by 2019 to 1,985,985 reports in 2020, over 5,453,017 reports in 2021 and to 29,681,158 in 2022. On the other hand cases of incapacity to work due to respiratory infections fell from 31.0% in 2019 to 15.3% in 2021. Influenza-specific diagnoses (ICD: J10.1-3) were encrypted 33,727 times in 2021, in 2020 there were still 109,846. In the outpatient sector in particular, the treatment costs are falling from 2019 to 2021. The reduction in influenza A and B from 2020 as a result of the comprehensive Covid-19 control measures, including the obligation to wear masks, cannot be considered a major reason; rather, the aspect of underreporting of influenza cases plays a significant role. Therefore, the reporting quantity of the sentinal practices should be considered and the recording of incapacity diagnoses should be taken into account.

The Evaluation of the German SARS-CoV-2 Test Strategy - A Multifactorial View

With SARS-CoV-2 in 2019 a coronavirus started circulating, for which the population showed no specific defense mechanisms of the immune system due to its clear distinction from the previously circulating coronavirus strains. Nevertheless, in 2021 there was a significant decrease in respiratory infections with a simultaneous significant increase in pandemic-related SARS-CoV-2 infections found. There is also a reduction in reported cases of respiratory diseases, especially in the pandemic year 2021. The aim of this study is to show optimizations in the test strategy during a pandemic and thus derive the improvement of civil protection. For Evaluation the data of GrippeWeb, the RKI’s Survstat® tool and the RKI’s reporting data on the new coronavirus were used. In addition, an evaluation of billing data from the EBM from 2017 to 2022 for the GOP 32816 as well as an evaluation of data on sick leave and illness statistics from 2019 to 2021 and the consideration of inpatient and outpatient health costs based on the data requested in writing from the Federal Ministry of Health was performed. The data from the Influenza Working Group shows an average of 300,000 annual reports for ARI per year. In 2019 it increased to 1,985,985 reports, in 2020 (5,453,017) and in 2021 to 29,681,158. There is also a correlation between the SARS-CoV-2 test frequency and the positive results, as well as an increase in the previously 6% positive rate for SARS-CoV-2 to over 50% in 2022. At the same time decreases the medical burden due to acute respiratory diseases (ARI) contrary to the increase of the acute respiratory diseases reported to the RKI with 2684%. What has been neglected so far is that corona viruses (HCoV) have been responsible for around 5-10% of acute respiratory infections for decades. The comprehensive Covid-19 control measures, including the obligation to wear masks, apparently had no significant impact on reducing the spread of Covid-19, since there was also no decrease in infections with the adenovirus or RS virus in 2020 and 2021. Furthermore, an infection positive rate should not be used as a criterion for infection avoidance strategies and the recording of test results should always be validated and controlled. Only the testing of symptomatic persons should be remunerated and only these validated test results should be considered in the registration. In addition, the DIVI register for the inpatient area with recording of the main admission diagnosis and the data from the electronic transmission of sick notes to the health insurance companies for the outpatient area could be used in real time to decide on containment measures in the context of the pandemic

Knowledge, Attitude, and Practices of Pregnant Women Towards Antenatal Care in Tertiary Care Hospital Somalia: A Prospective Study

Introduction: All women, regardless of their pregnancies, deserve high-quality maternal services during pregnancy, delivery, and afterward. This study aims to evaluate the knowledge and attitude of pregnant women toward antenatal care. Materials and Methods: A prospective study was carried out among pregnant women attending at obstetrics outpatient department of Mogadishu Somali Turkish Training and Research Hospital. The sample was obtained using random sampling methods. In addition, information was gathered using a structured interview schedule between August and October 2022. Results: The majority (63.3%) of respondents were aged between 20 and 24, while 21% were between the ages of 25 and 29, and 8% were between the ages of 30 and 34. One hundred sixty-five pregnant women had primary school education, 31% had secondary education, 15% had a university education, and 11% were illiterate. Only 252 (63.3%) correctly identified the first prenatal check-up within three months. Conclusion: According to the findings, most of the study's participants had a high level of knowledge and good practices, and most had a favorable opinion about ANC. The Federal Ministry of Health's public health department should strengthen national health education programs to promote antenatal care.

Building a Resilient and Sustainable Workplace: A Post-Pandemic Hazard Control and Preparedness Plan in Malaysia

Objective - This study intends to identify the post-COVID-19 safe working practices that have been established and to investigate how the workplace's culture of safety practices has evolved due to the pandemic. Methodology/Technique - The study used a conceptual development framework that used two data sources: journal publications (secondary data) and field interviews (primary data). The secondary data analysis of the literature review revealed seven post-pandemic workplace practices that are being employed in this study. These practices include workplace hazard control factors and preparedness plan factors. Findings – Based on the interviews with the 22 companies (safety personnel and practitioners) in the various industries, it was discovered that only three aspects of post-pandemic workplace safety culture were totally actual practices and adopted by all the companies, namely: following guidance from the federal state and Ministry of Health (MOH), monitor hazard control and safe work, and introduce new methods of work. On the other hand, the remaining four elements are seen as not being as crucial to several major industrial sectors. Novelty - It is seen to have a positive significance if viewed comprehensively. Disclosing the results of a study can provide a benchmark for other companies to compare their own practices and performance against. Additionally, it is necessary to conduct more comprehensive research, particularly regarding the employees' perspectives and their involvement in implementing and improving workplace safety practices. The current study only considered the employer’s viewpoint, as the safety personnel represents their interests. Type of Paper: Empirical JEL Classification: J24, J28, J81 &amp; Q50 Keywords: Post-Pandemic COVID-19; Workplace Safety Culture; Hazard Control; Preparedness Plan; Standards of Procedures (SOP); Resilient Workplace; Sustainable Workplace Reference to this paper should be made as follows: Hassam, S.F; Esa, M.M; Akbar, J; Hassan, N.D. (2023). Building a Resilient and Sustainable Workplace: A Post-Pandemic Hazard Control and Preparedness Plan in Malaysia, J. Mgt. Mkt. Review, 8(1), 09 – 16. https://doi.org/10.35609/jmmr.2023.8.1(2)

Catastrophic health expenditure and associated factors among households of non community based health insurance districts, Ilubabor zone, Oromia regional state, southwest Ethiopia

BackgroundOut-of-pocket health expenditure is the proportion of total health expenditure that is paid by individuals and households at the time of health service. Hence, the objective of this study is to assess the incidence and intensity of catastrophic health expenditure and associated factors among households in non-community-based health insurance districts in the Ilubabor zone, Oromia National Regional State, Ethiopia.MethodA community-based cross-sectional study design was employed in the Ilubabor zone on non-community-based health insurance scheme districts from August 13 to September 2, 2020, and 633 households participated in the study. A multistage one cluster sampling method was used to select three districts out of seven districts. Data was collected by using a structured mix of open and close-ended pre -tested questionnaires by face-to-face interviewing. A micro-costing/bottom up approach was used for all household expenditure. After checking its completeness, all household consumption expenditure was done by mathematical analysis using Microsoft Excel. Binary and multiple logistic were done using 95%CI and significance was declared at P < 0.05.ResultsThe number of households that participated in the study was 633, with a response rate of 99.7%. Out of 633 households surveyed, 110 (17.4%) were in catastrophe, which exceeds 10% of total household expenditure. After medical care expenses, about 5% of the households moved downward from the middle poverty line to extreme poverty. Out-of-pocket payment AOR: 31.201: 95% CI (12.965–49.673), daily income less than 1.90 USD AOR: 2.081: 95% CI (1.010–3.670), living a medium distance from a health facility AOR: 6.219: 95% CI (1.632–15.418), and chronic disease AOR: 5.647: 95% CI (1.764–18.075.ConclusionIn this study, family size, average daily income, out of pocket payment and chronic diseases were statistically significant and independent predictors for household catastrophic health expenditure. Therefore, to overcome financial risk, the Federal Ministry of Health should develop different guidelines and modalities by considering household per capita and income to improve the enrolment of community-based health insurance. Also, the regional health bureau should improve their budget share of 10% to increase the coverage of poor households. Strengthening financial risk protection mechanisms, such as community-based health insurance, could help to improve healthcare equity and quality.

Human Monkey pox virus in Democratic Republic of the Congo: a potential health threat?

Human Monkey pox virus in Democratic Republic of the Congo: a potential health threat?