Knowledge Of Health Care Providers Research Articles

Transgender and Nonbinary Individuals' Perceptions Regarding Gender-Affirming Hormone Therapy and Cardiovascular Health: A Qualitative Study.

Transgender and nonbinary individuals face substantial cardiovascular health uncertainties. The use of gender-affirming hormone therapy can be used to achieve one's gender-affirming goals. As self-rated health is an important predictor of health outcomes, an understanding of how this association is perceived by transgender and nonbinary individuals using gender-affirming hormone therapy is required. The objective of this research was to explore transgender and nonbinary individuals' perceptions of cardiovascular health in the context of using gender-affirming hormone therapy. In this qualitative study, English-speaking transgender and nonbinary adults using gender-affirming hormone therapy for 3 months or more were recruited from across Canada using purposive and snowball sampling methods. Semistructured interviews were conducted through videoconference to explore transgender and nonbinary individuals' perceptions of the association between gender-affirming hormone therapy and cardiovascular health between May and August 2023. Data were transcribed verbatim, and transcripts were analyzed independently by 3 reviewers using thematic analysis. Twenty-one participants were interviewed (8 transgender women, 9 transgender men, and 3 nonbinary individuals; median [range] age, 27 [20-69] years; 80% White participants). Three main themes were identified: cardiovascular health was not a primary concern in the decision-making process with regard to gender-affirming hormone therapy, the improved well-being associated with gender-affirming hormone therapy was felt to contribute to improved cardiovascular health, and health care provider knowledge and attitude facilitate the transition process. Gender-affirming hormone therapy in transgender and nonbinary individuals is perceived to improve cardiovascular health. Given the positive associations between care aligned with patient priorities, self-rated health, and health outcomes, these findings should be considered as part of shared decision-making and person-centered care.

Factors affecting patient retention to hypertension treatment in a North Indian State: A mixed-method study.

Hypertension is a global health challenge, especially in low-to-middle-income countries, where awareness and control are suboptimal. Despite available treatments, poor medication adherence hampers blood pressure control, leading to adverse outcomes and increased costs. In response, the GOI has initiated national action plans to address noncommunicable diseases, including hypertension. The study aimed to analyze patient retention rates in hypertension treatment across healthcare levels and understand providers' and patients' perspectives on control factors. Using a mixed-method concurrent design in a North Indian district, retrospective data collection covered hypertensive patients registered from January 2020 to July 2020, followed for a year (August 2020-July 2021). Quantitative data included socio-demographic characteristics and patient follow-up rates. Qualitative data comprised focus group discussions (FGD) and in-depth interviews (IDI) with healthcare providers (HCPs) and patients. Findings identified challenges in patient retention and medication adherence, notably among females and at higher-level healthcare facilities, leading to substantial loss of follow-up. Only 63% of hypertensive outpatients maintained controlled blood pressure in the past year. Male patients exhibited more consistent attendance than females. Despite sufficient HCP knowledge, patient retention was better at Health and Wellness Centers (HWCs) levels, while blood pressure control was poorer at higher facilities. Barriers such as medication side effects, pill burden, and limited healthcare access hindered hypertension control, highlighting the need for improved primary care services, including extended clinic hours and diagnostic facilities. Improving hypertension control requires addressing medication adherence and healthcare access barriers. Strengthening primary care services and implementing patient-centered interventions are crucial steps.

Factors influencing utilization of physiotherapy services by health care providers at Busia County Referral Hospital in Kenya

BackgroundThe surging trend of noncommunicable diseases complicated by trauma and infectious diseases has left many with marked physical limitations. Physiotherapy component of primary health care could be utilized for management of both communicable and noncommunicable diseases to restore physical functions.ObjectivesTo establish the health care providers’ level of knowledge and factors that influence the utilization of physiotherapy services among community members of Busia County in Kenya. The association between level of knowledge and demographic profile of health care providers at BCRH was also established.MethodDescriptive cross-sectional quantitative study involved 192 participants (nurses, doctors, and clinical officers) who were purposively selected. They completed self-administered questionnaire between August and November 2019. They were both sexes above 18 years of age, drawn from Busia County Referral Hospital. Data was analysed by Microsoft Excel and SPSS version 25.ResultsThe majority (92%) of the health care service providers had adequate knowledge about physiotherapy from their training to working with likelihood ratio chi-square of 7.714 with p-value at 0.01 at 5% level of significant. They had excellent communication (86.03%) with physiotherapists and helped to refer patients at BCRH for physiotherapy (χ2 = 52.02 and p-value = 0.01) at 5% level of significant. They had trust (91.56%) that physiotherapists were knowledgeable enough to handle patients on their own.ConclusionThe health care service providers are knowledgeable about the importance of physiotherapy and have supported its utilization. However, there is need to integrate physiotherapy service at all levels of training and practice of the components of primary health care. This will lead to a holistic patient’s care in terms of preventive, curative, and rehabilitative. Quality of life for the community members will be enhanced for appropriate functionality to meet the population needs. Lower utilization of physiotherapy services in Busia County could be due to factors associated with dynamics within the community and the health care service providers.

Knowledge, attitude, and practice of future health care providers about self-medication in a private medical college in Lahore Pakistan

Knowledge, attitude, and practice of future health care providers about self-medication in a private medical college in Lahore Pakistan

Attitudes, Self-Confidence, and Knowledge of Primary Care Professionals towards School Bullying.

Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design without dominance between phases, data were collected concurrently, and conversion of the results from both phases was carried out during data interpretation. The quantitative phase had a cross-sectional observational design, using The Healthcare Provider's Practices, Attitudes, Self-confidence, and Knowledge Regarding Bullying Questionnaire as an instrument. Descriptive and bivariate analyses were performed, which showed a positive correlation between higher self-confidence and knowledge scores and a greater predisposition to detect cases. However, although the dimensions of attitudes and knowledge yielded generally high data, low self-confidence was evident in addressing this problem. In addition, a lack of clear guidelines in the workplace was expressed, highlighting the need to create and provide specific resources to intervene in bullying in said context, which could develop an improvement in self-confidence, leading to greater well-being for the educational community regarding bullying.

Laryngeal Mask Airway in Neonatal Resuscitation: A Survey of the Union of European Neonatal and Perinatal Societies

Introduction: Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated the knowledge and experience of healthcare providers on the use of the LMA and explored barriers and solutions for implementation. Methods: This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS). Results: A total of 858 healthcare professionals from 42 countries participated in the survey. Only 6% took part in an LMA-specific course. Some delivery rooms were not equipped with LMA (26.1%). LMA was mainly considered after the failure of a face mask (FM) or endotracheal tube (ET), while the first choice was limited to neonates with upper airway malformations. LMA and FM were considered easier to position but less effective than ET, while LMA was considered less invasive than ET but more invasive than FM. Participants felt less competent and experienced with LMA than FM and ET. The lack of confidence in LMA was perceived as the main barrier to its implementation in neonatal resuscitation. More training, supervision, and device availability in delivery wards were suggested as possible actions to overcome those barriers. Conclusion: Our survey confirms previous findings on limited knowledge, experience, and confidence with LMA, which is usually considered an option after the failure of FM/ET. Our findings highlight the need for increasing the availability of LMA in delivery wards. Moreover, increasing LMA training and having an LMA expert supervisor during clinical practice may improve the implementation of LMA use in neonatal clinical practice.

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa.

This qualitative study aimed to investigate the barriers that hinder men's utilisation of healthcare services in the Sedibeng district of South Africa. The study was conducted using flyers with questions posted on the Best Health Solutions' Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents. The authors analysed the participants' self-reported data thematically on demographics, geographic area, and reasons for men not using healthcare services. The findings revealed that sociocultural norms played a significant role in men's reluctance to seek medical help, as it was perceived as a sign of weakness. The scarcity of male healthcare professionals hinders open discussions. Stigma and discrimination were identified as substantial barriers. Convenience, trust, and confidentiality concerns, along with the influence of intimate partners, also influence men's decision-making. This study highlights the complex interplay between various barriers that impact men's utilisation of healthcare services in the district. By addressing these factors, healthcare providers and policymakers can enhance healthcare access and promote better health outcomes for men in Sedibeng district. The manuscript's primary contribution lies in uncovering multifaceted barriers to men's healthcare utilisation in Sedibeng district. It explores socio-cultural norms, healthcare worker demographics, stigma, discrimination, convenience factors, trust, confidentiality concerns, and the influence of intimate partners on men's healthcare choices. These insights illuminate the complex factors affecting men's healthcare access, providing valuable knowledge for healthcare providers and policymakers.

When addressing resources is not enough: lessons learned from a respectful maternal and neonatal care provider training intervention evaluation in Kenya and Tanzania

BackgroundRespectful Maternal and Neonatal Care (RMNC) maintains and respects a pregnant person’s dignity, privacy, informed choice, and confidentiality free from harm and mistreatment. It strives for a positive pregnancy and post-pregnancy care experiences for pregnant people and their families, avoiding any form of obstetric violence. Though RMNC is now widely accepted as a priority in obstetric care, there is a gap in resources and support tools for healthcare wproviders to clearly understand the issue and change long-established practices such as non-humanized caesarean sections. MSI Reproductive Choices (MSI) manages 31 maternities across 7 countries with a zero-tolerance approach towards disrespectful maternity care and obstetric violence. MSI developed and implemented a hybrid training package, which includes an online module and 1-day in-person workshop that allows healthcare providers to explore their beliefs and attitudes towards RMNC. It leverages methodologies used in Values-Clarification-Attitudes-Transformation (VCAT) workshops and behaviour change approaches.MethodsThe impact of this training intervention was measured from the healthcare providers’ and patients’ perspectives. Patient experience of (dis)respectful care was collected from a cross-sectional survey of antenatal and postnatal patients attending MSI maternities in Kenya and Tanzania before and following the RMNC training intervention. Healthcare providers completed pre- and post-workshop surveys at day 1, 90 and 180 to measure any changes in their knowledge, attitudes and perception of intended behaviours regarding RMNC.ResultsThe results demonstrate that healthcare provider knowledge, attitudes and perceived RMNC practices can be improved with this training interventions. Patients also reported a more positive experience of their maternity care following the training.ConclusionRMNC is a patient-centred care priority in all MSI maternities. The training bridges the gap in resources currently available to support changes in healthcare wproviders’ attitudes and behaviours towards provision of RMNC. Ensuring health system infrastructure supports compassionate obstetric care represents only the first step towards ensuring RMNC. The results from the evaluation of this RMNC provider training intervention demonstrates how healthcare provider knowledge and attitudes may represent a bottleneck to ensuring RMNC that can be overcome using VCAT and behaviour change approaches.

Exploring Knowledge, Attitudes and Perceptions of Young Women, Community Members and Health Care Providers on Legal Abortion in Lusaka District, Zambia

Background: In 1972, Zambia made abortion lawful on a broad basis. However, safe abortion services are still limited, and the necessary standards and requirements for executing an abortion remain stringent. Due to a lack of knowledge and understanding of abortion law, many women and girls continue to seek unsafe abortion methods outside of health facilities. Healthcare providers play a key role in the provision of safe abortion care to eligible girls and women, but little is known about how they handle it. The aim of this study was to Assess and Explore the Knowledge, attitudes, and perceptions of adolescent girls and young women, and healthcare providers on abortion in the Lusaka district. Data was collected from Chawama, Chilenje, Chipata Kanyama, and Matero Level 1 Hospitals in Lusaka District. Method: To answer the research topic, the study used Exploratory mixed approaches. Statistical Package for Social Science, Versioni20.0 (SPSS) was used. The matic analysis was used to examine qualitative data by extracting themes from the responses. To see if there were any differences or correlations between the variables' knowledge, perceptions, and attitudes, cross-tabulations were used. This was demonstrated using Chi-square tests, which were all done at a 95ipercenticonfidenceiinterval with ai 0.05 significance level as the crucial level. For reporting, the SPSS frequencies were exported to Microsoft Word. Results: The study indicated that the knowledge levels on abortion among participants were high (93.25%). However, some participants on the other hand did not have sufficient information regarding the legality of abortion in Zambia. The theme analysis of reasons why they do not favor abortion revealed that one of them is religious, believing that abortion is comparable to murder. The findings also reveal that a person's religious affiliation influences their decision-making and thought process regarding abortion. Conclusion: The findings of this study suggest.......

Knowledge and factors associated with active management of the third stage of labor in sub-Saharan Africa: A systematic review and meta-analysis.

Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality in sub-Saharan Africa. Implementing active management in the third stage of labor has significantly reduced the incidence of PPH. Thus, understanding the level of healthcare providers' knowledge of active management in the third stage of labor can inform guidelines, policies, and practices for effectively preventing PPH. This review aimed to assess the level of healthcare providers' knowledge and associated factors of active management in the third stage of labor in sub-Saharan Africa. We conducted a search using PubMed, Scopus, Web of Science, Google Scholar, Cochrane Library, and the African Journals online international databases. The inclusion criteria were determined before the review of the articles and adhere to the criteria of population, intervention, comparison, and outcome. Statistical analysis was performed using STATA data analysis software version 14, while Microsoft Excel was utilized for data abstraction. We checked publication bias using a funnel plot and Egger and Begg regression tests. A P value less than 0.05 was considered statistically significant, suggesting the presence of presence publication bias. The I2 statistic was used to assess heterogeneity between studies. The study's overall effect was evaluated using the random effects model. The study included 20 studies to conduct a pooled prevalence analysis. The overall prevalence of healthcare providers' knowledge of active management of third-stage labor in sub-Saharan Africa was 47.975% (95% CI: 32.585, 63.365). Having pre- and in-service training (AOR: 2.25, 95% CI: 1.00, 5.08), having a higher degree (AOR: 1.98, 95% CI: 1.39, 2.82), and having good practices (AOR: 8.91, 95% CI: 4.58, 17.40) were significantly associated with healthcare provider's knowledge regarding active management third stage of labor. The overall healthcare providers' knowledge of active management of the third stage of labor (AMTSL) was low in sub-Saharan Africa. Obstetric healthcare providers should undertake comprehensive training covering all AMTSL components through pre- and in-service diploma training programs.

Driving delivery and uptake of catch-up vaccination among adolescent and adult migrants in UK general practice: a mixed methods pilot study

BackgroundMigrants in the UK and Europe face vulnerability to vaccine-preventable diseases (VPDs) due to missed childhood vaccines and doses and marginalisation from health systems. Ensuring migrants receive catch-up vaccinations, including MMR, Td/IPV, MenACWY, and HPV, is essential to align them with UK and European vaccination schedules and ultimately reduce morbidity and mortality. However, recent evidence highlights poor awareness and implementation of catch-up vaccination guidelines by UK primary care staff, requiring novel approaches to strengthen the primary care pathway.MethodsThe ‘Vacc on Track’ study (May 2021–September 2022) aimed to measure under-vaccination rates among migrants in UK primary care and establish new referral pathways for catch-up vaccination. Participants included migrants aged 16 or older, born outside of Western Europe, North America, Australia, or New Zealand, in two London boroughs. Quantitative data on vaccination history, referral, uptake, and sociodemographic factors were collected, with practice nurses prompted to deliver catch-up vaccinations following UK guidelines. Focus group discussions and in-depth interviews with staff and migrants explored views on delivering catch-up vaccination, including barriers, facilitators, and opportunities. Data were analysed using STATA12 and NVivo 12.ResultsResults from 57 migrants presenting to study sites from 18 countries (mean age 41 [SD 7.2] years; 62% female; mean 11.3 [SD 9.1] years in UK) over a minimum of 6 months of follow-up revealed significant catch-up vaccination needs, particularly for MMR (49 [86%] required catch-up vaccination) and Td/IPV (50 [88%]). Fifty-three (93%) participants were referred for any catch-up vaccination, but completion of courses was low (6 [12%] for Td/IPV and 33 [64%] for MMR), suggesting individual and systemic barriers. Qualitative in-depth interviews (n = 39) with adult migrants highlighted the lack of systems currently in place in the UK to offer catch-up vaccination to migrants on arrival and the need for health-care provider skills and knowledge of catch-up vaccination to be improved. Focus group discussions and interviews with practice staff (n = 32) identified limited appointment/follow-up time, staff knowledge gaps, inadequate engagement routes, and low incentivisation as challenges that will need to be addressed. However, they underscored the potential of staff champions, trust-building mechanisms, and community-based approaches to strengthen catch-up vaccination uptake among migrants.ConclusionsGiven the significant catch-up vaccination needs of migrants in our sample, and the current barriers to driving uptake identified, our findings suggest it will be important to explore this public health issue further, potentially through a larger study or trial. Strengthening existing pathways, staff capacity and knowledge in primary care, alongside implementing new strategies centred on cultural competence and building trust with migrant communities will be important focus areas.

Correction: The comparison of spatial patterns and factors associated with healthcare provider knowledge in palliative care in various regions of China

Correction: The comparison of spatial patterns and factors associated with healthcare provider knowledge in palliative care in various regions of China

Attitudes, experience and practice about adverse drug reactions of dentists in republic of North Macedonia

Adverse drug reactions (ADRs) are possible with any medication that is prescribed or administered in the dental office. Evaluating the knowledge, attitudes, and practice of healthcare providers regarding pharmacovigilance and ADRs reporting can help to devise strategies for improving reporting schemes to ensure patients’ safety. The aim of this study was to investigate the attitudes, experience and practice about ADRs reporting of dentists in Republic of North Macedonia. This study included 100 dentists employed in public and private healthcare institutions in the city of Skopje. The research was conducted using an anonymous survey questionnaire intended for healthcare professionals. Our results showed that 60% of dentists responded positively, that is, that it is necessary to report ADRs, 70% of the respondents responded positively, that healthcare professionals need to be familiar with the pharmacovigilance system. 45% of dentists declared that they have observed ADRs in their patients, and only 16% reported them. 64.45% of registered ADRs are unreported by dentists, and the main factor that discourages them is the difficulty in determining whether they are ADRs or not. This study showed that majority of the dentists had positive attitude towards pharmacovigilance, and that they understand the need for ADRs reporting, but the rate of reported ADRs is very low. Greater implementation of the pharmacovigilance system and cooperation between universities, dentists, patients, manufacturers, the government and national agencies, the media, the civil society and the international organizations working on drug safety is needed.

Assessment of the Knowledge, Attitude, and Perception of Healthcare Providers Regarding Halal Pharmaceuticals

Background The intersection of religious beliefs and medical practices significantly impacts medication usage and patient adherence to treatment regimens. Emerging within this discourse is the concept of halal pharmaceuticals, emphasizing the alignment of therapeutic drugs with religious beliefs. Despite its importance, there is limited awareness among healthcare providers (HCPs) regarding their ingredients, standards, and manufacturing processes, particularly in the Middle East region. Thus, this study aimed to investigate the knowledge, attitudes, and perceptions (KAP) of HCPs concerning Halal pharmaceuticals, which are crucial for addressing the growing concerns among patients and consumers. Methods A cross-sectional survey involved diverse HCPs (physicians, pharmacists, and nurses) in Jordan. The survey encompassed demographic data, knowledge about Halal pharmaceuticals, attitudes, and perceptions. Descriptive statistics and inferential analyses were performed to examine the associations between demographic variables and KAP scores. Results A total of 381 HCPs participated in the study. While HCPs generally had a high level of knowledge, gaps existed, particularly concerning pharmaceutical composition and Halal alternatives. Attitudes and perceptions were mostly positive or neutral, though variations occurred among professions. Pharmacists exhibited significantly higher knowledge scores compared to physicians and nurses. Information sources included academic institutions, peers, religious and educational books, and online resources. Factors, such as age, marital status, religion, education type, insurance type, working place, and years of experience significantly influenced the KAP scores of participants. Conclusion Tailored educational interventions are critical for addressing knowledge gaps, fostering positive attitudes, and ensuring culturally sensitive healthcare related to Halal pharmaceuticals. Leveraging diverse information sources and tailoring education based on demographics can enhance understanding. Improved knowledge, attitudes, and perceptions enable HCPs to meet the needs of diverse patient populations and provide safe, Halal-compliant medications. Additionally, further research into the perspectives and willingness of patients to pay for Halal pharmaceuticals is essential to ensuring equitable access to pharmaceutical care services.

The Role of Trust as a Driver of Private-Provider Participation in Disease Surveillance: Cross-Sectional Survey From Nigeria.

Recognition of the importance of valid, real-time knowledge of infectious disease risk has renewed scrutiny into private providers' intentions, motives, and obstacles to comply with an Integrated Disease Surveillance Response (IDSR) framework. Appreciation of how private providers' attitudes shape their tuberculosis (TB) notification behaviors can yield lessons for the surveillance of emerging pathogens, antibiotic stewardship, and other crucial public health functions. Reciprocal trust among actors and institutions is an understudied part of the "software" of surveillance. We aimed to assess the self-reported knowledge, motivation, barriers, and TB case notification behavior of private health care providers to public health authorities in Lagos, Nigeria. We measured the concordance between self-reported notification, TB cases found in facility records, and actual notifications received. A representative, stratified sample of 278 private health care workers was surveyed on TB notification attitudes, behavior, and perceptions of public health authorities using validated scales. Record reviews were conducted to identify the TB treatment provided and facility case counts were abstracted from the records. Self-reports were triangulated against actual notification behavior for 2016. The complex health system framework was used to identify potential predictors of notification behavior. Noncompliance with the legal obligations to notify infectious diseases was not attributable to a lack of knowledge. Private providers who were uncomfortable notifying TB cases via the IDSR system scored lower on the perceived benevolence subscale of trust. Health care workers who affirmed "always" notifying via IDSR monthly reported higher median trust in the state's public disease control capacity. Although self-reported notification behavior was predicted by age, gender, and positive interaction with public health bodies, the self-report numbers did not tally with actual TB notifications. Providers perceived both risks and benefits to recording and reporting TB cases. To improve private providers' public health behaviors, policy makers need to transcend instrumental and transactional approaches to surveillance to include building trust in public health, simplifying the task, and enhancing the link to improved health. Renewed attention to the "software" of health systems (eg, norms, values, and relationships) is vital to address pandemic threats. Surveys with private providers may overestimate their actual participation in public health surveillance.

Leprosy Health Promotion during COVID-19 Pandemic in Indonesia

Introduction: The COVID-19 pandemic has forced many conventional -face-to-face health promotion events to be conducted in an adaptive manner to keep healthcare in promotion, prevention, and even curative measures delivered to healthcare providers and patients. The same applies to leprosy, where Indonesia is still ranked as the third largest country with leprosy burden. This study aims to give rise to newer methods of health promotion on leprosy during this COVID-19 pandemic. Methods: Online training and case presentation workshop in the form of a KATAMATAKU webinar [MOU1] and live streaming via YouTube were held in August 2020. There were 120 general practitioners, 30 nurses, and 35 healthcare providers who registered and joined this event.[MOU2] Pre- and post-test [MOU3] were conducted to evaluate the participants' knowledge about the topics lectured during this training[MOU4] . Pre- and post-test were conducted using an online form, and all participants needed to answer several questions from each session. Participants were evaluated before the webinar began and after all sessions. We assessed the different scores from the pre- and post-test. Results: In the general practitioner group, median scores were 68 (27 – 95) and 82 (50 – 100) for pre- and post-test scores, respectively, with a mean difference between post and pre-test of 14.23+9.72. In nurses and other health care providers, the median for the pre-test score was 56 (22-89), and the post-test was 72 (39 – 100), with a mean difference between the post and pre-test of 18.93+10.27. Conclusion: In the pandemic situation, online seminars can be chosen as an effective method for health promotion to increase health care provider's knowledge. Pre- and post-test can be performed to evaluate participant's knowledge after the training. Regular training using online methods can be held in order to maintain participants' knowledge. We hope it can impact all health providers to continue their participation in the management of leprosy.

Knowledge, attitude, and practice of healthcare providers and clients toward child abuse in Tabriz

Knowledge, attitude, and practice of healthcare providers and clients toward child abuse in Tabriz

The comparison of spatial patterns and factors associated with healthcare provider knowledge in palliative care in various regions of China

As an integral part of the overall life cycle, it is crucial to ensure equity and accessibility to palliative care services at the end of life. The knowledge of healthcare providers has a significant beneficial impact on the quality of palliative care services. This study aimed to compare the nationwide geographic distribution of healthcare providers’ knowledge of palliative care at the provincial level in China and identify the possible factors associated with its geographic disparities. A descriptive cross-sectional study was conducted in all provinces (n = 29) that implemented palliative care pilot programs in China. Data were collected online using a structured questionnaire. The possible factors associated with healthcare providers’ knowledge including economy, demographics, and health, were explored by using exploratory regression and ordinary least squares. In addition, spatial autocorrelation was also examined with Moran’s I, LISA, and Geographically Weighted Regression. A total of 18,272 participants from 903 health institutions in 87 palliative care pilot cities were included across 29 out of 31 provinces in China. The average knowledge score (mean ± standard deviation [SD]) was 8.61 ± 2.85. A positive spatial correlation was observed in healthcare providers’ palliative care knowledge level in China. The high level of knowledge was significantly associated with fewer hospitals per 10,000 population (β = −0.384, 95% CI: −0.601 to −0.168, p = 0.001), more primary healthcare institutions per 10,000 population (β = 0.220, 95% CI: 0.032–0.407, p = 0.024), and more community health center visits (β = 0.259, 95% CI: 0.054–0.465, p = 0.016), with higher coefficients being observed in the northwest and northeast regions. This study suggested that the knowledge level of palliative care among healthcare providers nationwide was relatively low, indicating the existence of a disparity between the supply and demand of palliative care services. There may be regional disparities in palliative care services based on the substantial geographical variation in healthcare provider knowledge, emphasizing the necessity of tailored interventions targeting areas with the greatest need.

Unmet need for contraception among married women in the Kyrgyz Republic using the datasets from the 2006, 2014 and 2018 Multiple Indicator Cluster Survey: a cross-sectional study.

Since the beginning of the family program in 1998, the proportion of married women who used contraception has fluctuated. An unmet need for contraception among women in Kyrgyzstan drastically increased from 2006 (1.1%) to 2014 (19.1%), and remained unchanged until 2018 (19.0%). This study aims to re-investigate the prevalence of an unmet need for contraception from 2006 to 2018 in a comprehensive manner, and examine the factors associated with an unmet need for contraception among married women over the course of 12years in the Kyrgyz Republic. This is a cross-sectional study using secondary data that derived from the Multiple Indicator Cluster Survey (MICS). The study employed three datasets from the MICS 2006, 2014, and 2018. The study included a total of 9,229 women aged 15-49 who were married and fecund, and whose status of the met/unmet need for contraception could be identified. Logistic regression was employed to estimate the relationship of an unmet need for contraception with independent factors. A P value < 0.05 was set as statistically significant. The prevalence of an unmet need for contraception was 19.9% in 2006, 20.4% in 2014, and 22.5% in 2018. Across 12years, all reversible-contraceptive methods for women constantly declined. Although intrauterine devices were the prominent contraceptive method of usage among Kyrgyz women, the trend of usage drastically decreased over time. Factors associated with unmet need for contraception included women's age, area of residence, mother tongue of household head, age of husband, and number of children ever born. The unmet need for contraception among married Kyrgyz women slightly increased, and the trend of modern contraceptive usage declined from 2006 to 2018, particularly the use of pills, injections, and intra-uterine devices. Comprehensive sexual health education for young people and youth-friendly services should be promoted. An effective and reliable supply chain of contraceptive commodities should be prioritized and strengthened. Regular supportive supervision visits are essential to improve the knowledge and skills of healthcare providers to be able to provide intrauterine device service as a contraceptive choice for Kyrgyz women.

Knowledge-attitude and practice of Anthrax and brucellosis: Implications for zoonotic disease surveillance and control in pastoral communities of Afar and Somali region, Ethiopia.

Anthrax and brucellosis are endemic national priority zoonotic diseases in Ethiopia. This study assess the possible factors explaining the current limited information available on animal and human cases in pastoral communities. Two questionnaire surveys gathered data from 509 pastoralists and 51 healthcare providers between February and April 2019 in five districts of Afar and the Somali region (SRS). Among the 51 healthcare providers, 25 (49%) and 38 (74.5%) had heard of brucellosis, and anthrax, respectively. Of those, only 3 (12%) and 14 (36.8%) knew the symptoms of brucellosis and Anthrax. None of the Health Extension Workers knew any disease symptoms. Healthcare providers recalled two human cases of brucellosis and 39 cases of Anthrax in the last 12 months, based on symptom-based diagnosis. Pastoralists had a moderate level of knowledge about diseases in their animals, with over half (52.4%; n = 267/509) understanding that animals can transmit diseases to people. Overall, 280 out of 508 (55.1%) and 333 out of 507 (65.7%) pastoralists had heard of brucellosis and Anthrax, respectively. Among the latter, 282 (51.3%) knew at least one preventive measure for Anthrax. However, disease knowledge among women was poor. Despite their knowledge, pastoralists engaged in risky unprotected animal handling, animal product consumption/usage as well as husbandry behaviors exposing them to pathogens and favoring the spread of diseases. They identified Anthrax as the most important zoonosis (47.6%) and as one of top three diseases suspected to cause mortality in their livestock. Pastoralists highlighted lack of vaccine coverage, availability and their timely administration. Both, pastoralists and healthcare providers stated the lack of disease awareness and the unavailability of drugs in the market as important challenges. Health facilities lacked protocols and standard operating procedures for managing zoonotic diseases, and did not have access to laboratory confirmation of pathogens. Our study revealed significant under-reporting of Anthrax and brucellosis, and weak prevention and response in humans, mostly associated with poor disease knowledge of healthcare providers. Ability to respond to animal outbreaks was limited by vaccine and drugs availability, timely vaccine administration and the mobility of pastoralists.