Visited Health Facilities Research Articles

Assessing the Impact of Healthcare Quality on Facility Utilization among Rural Dwellers in Bauchi State Nigeria

Rural areas in Nigeria, including Bauchi State, face significant healthcare challenge, with limited access to quality healthcare services. This study as aimed at assess the impact of healthcare quality on facility utilization among rural Dwellers in Bauchi State Nigeria. A cross sectional design was used for this study. Simple random sampling technique was used to select three local government areas from each senatorial district. A total of 1344 respondents were sampled for the study. The questionnaires were administered by the researcher and some research assistants. The reliability index as determined using Cronbach’s alpha test of internal consistency stood at 0.89. The data from the study were presented using descriptive statistics of mean and percentages for the research questions. The analysis was carried out using SPSS version 25. The results obtained showed that the quality of healthcare services influences the utilization of health care facilities by rural dwellers in Bauchi State. However, the r2 value of 0.29 indicates that the quality of healthcare services have 8% influence on the utilization of health care facilities by rural dwellers in Bauchi State. Therefore, the stake holders in the health sector, in collaboration with Government and healthcare workers should ensure that the quality of services offered in the health care facilities is improved upon. This will in turn encourage the rural dwellers to regularly visit healthcare facilities in Bauchi State Nigeria.

Characteristic of Holy Water (Mai Tselot) Users in Tigray Region, Northern Ethiopia, Cross-Sectional Study, 2019

Holy water is a traditional medicine used in Tigray region of Ethiopia. Holy water in the form of a drink and a shower is the main treatment used by people who face health problems, together with other spiritual practices. The study aimed to assess the characteristics of people using holy water (Mai Tselot) in Tigray. Descriptive cross-sectional quantitative study design was conducted in Mekelle City, Tigray region, Ethiopia, and eight holy water institutions located in Mekelle City 5 were selected using the lottery method. Second, 200 holy water users were selected purposely and proportionally. Descriptive analysis was performed using the SPSS software version 23. Chronic non-communicable diseases in patients 124 (67.81%) were the most dominant holy water users. Out of these 90 (49.18%) had mental-health problems. A total of 144 (78.68%) patients visited the health facilities for treatment before opting for a holy water institution. Two third 25 (64.1%) of the holy water users did not believe in modern medicine, and 167 (83.5%) of the holy water users did not believe that they would get disease from other individuals in the holy water place. The leading health problem of holy water users was chronic not-communicable diseases, and most of them visited health facilities before opting for holy water. This finding suggests that health education and counseling should be strengthened in health care facilities. Improve health facility quality service delivery status, strengthen health insurance and conduct extensive research concerning holy water users and institutions.

Risk Prediction of Emergency Department Visits in Patients With Lung Cancer Using Machine Learning: Retrospective Observational Study.

Patients with lung cancer are among the most frequent visitors to emergency departments due to cancer-related problems, and the prognosis for those who seek emergency care is dismal. Given that patients with lung cancer frequently visit health care facilities for treatment or follow-up, the ability to predict emergency department visits based on clinical information gleaned from their routine visits would enhance hospital resource utilization and patient outcomes. This study proposed a machine learning-based prediction model to identify risk factors for emergency department visits by patients with lung cancer. This was a retrospective observational study of patients with lung cancer diagnosed at Seoul National University Bundang Hospital, a tertiary general hospital in South Korea, between January 2010 and December 2017. The primary outcome was an emergency department visit within 30 days of an outpatient visit. This study developed a machine learning-based prediction model using a common data model. In addition, the importance of features that influenced the decision-making of the model output was analyzed to identify significant clinical factors. The model with the best performance demonstrated an area under the receiver operating characteristic curve of 0.73 in its ability to predict the attendance of patients with lung cancer in emergency departments. The frequency of recent visits to the emergency department and several laboratory test results that are typically collected during cancer treatment follow-up visits were revealed as influencing factors for the model output. This study developed a machine learning-based risk prediction model using a common data model and identified influencing factors for emergency department visits by patients with lung cancer. The predictive model contributes to the efficiency of resource utilization and health care service quality by facilitating the identification and early intervention of high-risk patients. This study demonstrated the possibility of collaborative research among different institutions using the common data model for precision medicine in lung cancer.

Assessing the Determinants of Compliance with Contribution Payments to the National Health Insurance Scheme among Informal Workers in Indonesia

This study aimed to investigate the determinants of compliance with contribution payments to the National Health Insurance (NHI) scheme among informal workers in Bogor Regency, West Java Province, Indonesia. Surveys of 418 informal workers in Bogor Regency from April to May 2023 were conducted. Multivariate logistic regression analyses were performed to assess the factors associated with informal workers’ compliance with NHI contribution payments. The results revealed that being female, having lower secondary education or below, perceiving good health of family members, having negative attitudes toward and poor knowledge of the NHI, experiencing financial difficulties, preferring to visit health facilities other than public ones, and utilizing fewer outpatient services were significantly associated with the noncompliance of informal workers with NHI contribution payments. It was concluded that economic factors alone cannot contribute to informal workers’ payment compliance and that motivational factors (knowledge, attitudes toward the insurance system, and self-related health status) also encourage them to comply with contribution payments. Improving people’s knowledge, especially on the risk-sharing concept of the NHI, should be done through extensive health insurance education using methods that are appropriate for the population’s characteristics.

Prevalence of Cerumen Impaction and Associated Factors Among Primary School Pupils at an Urban District in Northern Tanzania.

Cerumen impaction is a public problem of great concern due to associated hearing impairment. Despite cerumen impaction being one of the commonest causes of hearing loss among primary school children, there is no any published study to date from northern Tanzania focused on this topic. This study aimed to address this gap. A cross-sectional study design was used where 307 primary school pupils were recruited using a multistage cluster sampling technique and it was conducted from January to July 2023. Data was collected using Swahili translated semi-structured questionnaires. The prevalence of cerumen impaction was 10.7% with the right ear being mostly affected (57.6%). A statistically significant association was found between prevalence of cerumen impaction and mother's education level though no association was found between sex, residence, father's education level and mother's occupation status. Predisposing factors like history or presence of ear infection, habit of cleaning ears and using hearing aids or earphones showed a statistically significant association The commonest clinical presentation was otalgia (36.4%) and washing ears with water (71.5%) was the commonly applied method of cleaning the ears apart from hospital based interventions. The commonest method of wax removal for those who visited health facilities was ear syringing (42.9%). Lesser prevalence of cerumen impaction was found in this study though majority had previous history of impacted wax. Cotton bud was the commonest predisposing factor for cerumen impaction. The commonest clinical presentation among those with impacted cerumen was otalgia though some pupils reported asymptomatic cerumen impaction.

Assessment of Primary Health care Facilities on readiness for Antenatal Care and Childhood Immunization Services in Zamfara State, Nigeria

Effective maternal and child healthcare delivery centers on availability of essential medical equipment, drugs and trained medical personnel in health facilities. Poor funding, inadequate supply of physicians, essential equipment and drugs as well as mismanagement characterized healthcare delivery system in Nigeria. This study assessed public primary health care facilities on readiness of Antenatal Care (ANC) and childhood immunization services in Zamfara State, Nigeria. Based on theoretical orientation of Political Economy of Health Care, quantitative and qualitative data were used for the study. Descriptive statistic was used for quantitative data analysis using Statistical Package for Social Sciences (SPSS), while ATLASti8 software was used for qualitative data. The study found most of the visited health facilities offered various components of ANC and childhood immunisation services but did not comply with the current eight (8) ANC visits as recommended by WHO. Other essential services including hepatitis B tests, breast examination, Fansida for malaria prevention, free folic acid and iron supplements, insecticide treated nets, weight scale, ROTA vaccine and midwives were grossly inadequate in most health facilities. The study also found urban bias in terms of distribution of healthcare staff in Zamfara State. This study recommends that Zamfara State government, non-governmental organisations and donor agencies should urgently channel their efforts to PHC centers and address the challenges confronting primary health care centers in Zamfara State.

Lower 6-minutes walk test result and presence of cardiovascular risk factors linked to healthcare facility visits of pilgrims: the importance of fitness in hajj pilgrimage

Abstract Background Hajj pilgrimage, a mandatory religious practice for the Muslims, is a physical rite attributed heavily on the fitness of the participants due to increased workload in performing its activities. The 6-minutes walk test is a simple assessment to predict candidates’ fitness level. Objective We sought to determine the association between pilgrim candidate fitness level, determined by 6-minutes walk test result during predeparture preparation, as well as pre-existing potential risk factors of hajj pilgrim participants. Method In this retrospective cohort, we obtained the data of 2022 pilgrimage participants from Indonesian Ministry of Religious Affairs, consisting of demographic characteristics, anthropometric indexes, medical history, physical examination, and functional exercise capacity predicted by 6-minute walk test conducted during pre-departure preparation. Baseline demographic, bivariate tests for each variable, and multivariate test were analyzed by IBM SPSS 26. Result There was significant correlation between age of ≥60 (p < 0.001), hypertension (p < 0.001), diabetes mellitus (p < 0.001), 6-minutes walk test (p < 0.001), smoker status (p = 0.008), high LDL-C (p = 0.026), obesity (p =0.033), female sex (p = 0.043) and healthcare visit episode of pilgrims. The risk ratio value for low result group of 6-minutes walk test (< 500 meters) against outpatient incidence during hajj period was 1.08 (95% CI; 1.04 -1.12). It indicated that the inability of reaching >500 meters in 6-minutes walk test is related to outpatient incidence by 1.08 times. Conclusion There is a slight increase in healthcare visit incidence in pilgrims with low result of 6-minutes walk test. The 6-minutes walk test, a simple and reproducible assessment of fitness level, may provide useful information to improve preparation of pilgrimage.

Disease awareness and healthcare utilization in rural South Africa: a comparative analysis of HIV and diabetes in the HAALSI cohort

BackgroundStudies from rural South Africa indicate that people living with HIV (PLHIV) may have better health outcomes than those without, potentially due to the frequent healthcare visits necessitated by infection. Here, we examined the association between HIV status and healthcare utilization, using diabetes as an illustrative comparator of another high-burden, healthcare-intensive disease.MethodsOur exposure of interest was awareness of positive disease status for both HIV and diabetes. We identified 742 individuals who were HIV-positive and aware of their status and 305 who had diabetes and were aware of their status. HIV-positive status was further grouped by viral suppression. For each disease, we estimated the association with (1) other comorbid, chronic conditions, (2) health facility visits, (3) household-level healthcare expenditure, and (4) per-visit healthcare expenditure. We used log-binomial regression models to estimate prevalence ratios for co-morbid chronic conditions. Linear regression models were used for all other outcomes.ResultsVirally suppressed PLHIV had decreased prevalence of chronic conditions, increased public clinic visits [β = 0.59, 95% CI: 0.5, 0.7], and reduced per-visit private clinic spending [β = -60, 95% CI: -83, -6] compared to those without HIV. No differences were observed in hospitalizations and per-visit spending at hospitals and public clinics between virally suppressed PLHIV and non-PLHIV. Conversely, diabetic individuals had increased prevalence of chronic conditions, increased visits across facility types, increased household-level expenditures (β = 88 R, 95% CI: 29, 154), per-visit hospital spending (β = 54 R, 95% CI: 7, 155), and per-visit public clinic spending (β = 31 R, 95% CI: 2, 74) compared to those without diabetes.ConclusionsOur results suggest that older adult PLHIV may visit public clinics more often than their HIV-negative counterparts but spend similarly on a per-visit basis. This provides preliminary evidence that the positive health outcomes observed among PLHIV in rural South Africa may be explained by different healthcare engagement patterns. Through our illustrative comparison between PLHIV and diabetics, we show that shifting disease burdens towards chronic and historically underfunded diseases, like diabetes, may be changing the landscape of health expenditure inequities.

Formula Feeding Practice and Associated Factors Among Mothers Who Visited Health Facilities for Their Infants Aged Below 6 Months in Bahir Dar City, Northwest Ethiopia, 2020.

Even though breastfeeding for infants and young children provides the ideal food for healthy growth and development, nowadays the use of infant formula feeding has increased worldwide. In developing countries, 1.3 million to 1.45 million childhood deaths are attributed to suboptimal breastfeeding practices. This study aimed to assess infant formula feeding practice and associated factors among mothers who visited health facilities for their infants aged less than 6 months in Bahir Dar city in 2020. An institution-based cross-sectional study was conducted in March-May 2020. Data were collected from 593 randomly selected mothers with infants less than 6 months of age. A multivariable logistic regression analysis was performed to identify associated factors of formula feeding practice with an a p-value of less than 0.05 and an adjusted odds ratio of 95% confidence interval. The prevalence of infant formula feeding practices was 25%. Maternal age group of 25-34 years [AOR = 2.388; 95% CI: 1.295, 4.406], mother's occupation of private employee [AOR = 6.726; 95% CI: 2.756, 16.413], government employee [AOR = 4.726; 95% CI: 1.895, 8.700] and merchant [AOR = 2.798; 95% CI: 1.066, 7.345], positive attitude to infant formula [AOR = 2.10; CI: 1.09, 4.06], delayed breast milk initiation after delivery [AOR = 3.73; 95% CI: 1.504, 9.252], mothers who had 3 antenatal care [AOR = 2.294; 95% CI: 1.317, 3.997] and source of formula milk information from supermarket/pharmacy [AOR = 6.57; 95% CI: 1.48, 29.16] and from families/friends [AOR = 2.24; 95% CI: 1.24, 4.03] were independent predictors of infant formula feeding practice. This study's findings revealed that one-fourth of mothers fed infant formula before the age of 6 months. Therefore, we recommended promoting behavior change communication, focusing on attitude change in formula feeding practice and its health consequences, promoting exclusive breastfeeding practice, and strengthening ANC service provision.

Uptake of and intention to use oral pre-exposure prophylaxis for HIV among pregnant and post-natal women in Eswatini: a cross-sectional survey.

In Eswatini, HIV incidence among women of childbearing age is 1.45%. Eswatini introduced oral pre-exposure prophylaxis (PrEP) for HIV prevention in 2016 and requires that all HIV-negative pregnant and post-natal women (PPW) visiting health care facilities be offered PrEP. Between September-November 2021, we conducted a survey among HIV-negative PPW from 16 purposively selected healthcare facilities in the Hhohho and Shiselweni regions in Eswatini. We interviewed consenting HIV-negative PPW using a structured questionnaire to collect data on PrEP knowledge, attitudes, intentions, and practices, as well as information on partner HIV status and stigma. Multivariate logistic regression was used to determine predictors of PrEP use and intention, adjusted for significant covariates. Of 1,484 PPW women approached, 1,149 consented and were interviewed, of whom 704 (61.3%) were post-partum and 445 (38.7%) pregnant. The median age was 25 years [Interquartile Range (IQR) = 21-30 years], with 533 (46.4%) 18-24 years old. Among the 1,149 women, 930 (80.7%) had ever heard about PrEP; 635 (55.3%) had knowledge about PrEP; 183 (15.9%) were currently using PrEP; and 285 (24.8%) had ever used PrEP. Increased odds of PrEP use were associated having HIV-positive male partner (aOR:7.76, 95%CI 3.53- 17.04); positive attitudes to PrEP (aOR:1.56, 95%CI: 1.02-2.40); and high self-efficacy (aOR:1.49, 95%CI:1.13-1.98). Among 864 women who never used PrEP, 569 (65.3%) intended to use PrEP in the future. Odds of intention to use PrEP were higher among women with low levels of education (aOR:2.23, 95% CI: 1.32-3.77); who ever heard about PrEP (aOR:1.69, 95%CI: 1.12-2.56); and had high self-efficacy (aOR:1.57, 95%CI: 1.31-1.87). Regarding stigma, among all women, 759 (66%) either agreed or strongly agreed that people would think they have HIV if they were to use PrEP; 658 (57.3%) reported they would be labelled as having multiple sex partners; 468 (40.7%) reported that their partner would think they are having risky sex with other people. Of 102 women who had discontinued PrEP, a majority stopped due to side effects 32 (35.2%). Only about 50% of women had knowledge of PrEP, and PrEP uptake among PPW was low, though intention to use appeared high. More efforts to reduce stigma and promote PrEP use, including adequate information on side effects, are needed.

Developing a home-based pulmonary rehabilitation programme for patients with chronic respiratory diseases in Malaysia: A mixed-method feasibility study.

The COVID-19 pandemic has underscored the importance of remote healthcare and home-based interventions, including pulmonary rehabilitation, for patients with chronic respiratory diseases (CRDs). It has also heightened the vulnerability of individuals with underlying respiratory conditions to severe illness from COVID-19, necessitating exploration and assessment of the feasibility of delivering home - pulmonary rehabilitation (home-PR) programmes for CRD management in Malaysia and other countries. Home-based programmes offer a safer alternative to in-person rehabilitation during outbreaks like COVID-19 and can serve as a valuable resource for patients who may be hesitant to visit healthcare facilities during such times. We aimed to assess the feasibility of delivering a home-PR programme for patients with CRDs in Malaysia. We recruited patients with CRDs from two hospitals in Klang Valley, Malaysia to a home-PR programme. Following centre-based assessment, patients performed the exercises at home (five sessions/week for eight weeks (total 40 sessions)). We monitored the patients via weekly telephone calls and asked about adherence to the programme. We measured functional exercise capacity (6-Minutes Walking Test (6MWT) and Health-Related Quality-of-Life (HRQoL) (COPD Assessment Test (CAT)) at baseline and post-PR at nine weeks. We conducted semi-structured interviews with 12 purposively sampled participants to explore views and feedback on the home-PR programme. The interviews were audio recorded, transcribed verbatim, and analysed thematically. We included 30 participants; two withdrew due to hospitalisation. Although 28 (93%) adhered to the full programme, only 11 (37%) attended the post-PR assessment because COVID-19 movement restrictions in Malaysia at that time prevented attendance at the centre. Four themes emerged from the qualitative analysis: involvement of family and caregivers, barriers to home-PR programme, interactions with peers and health care professionals, and programme enhancement. Despite the COVID-19 pandemic, the home-PR programme proved feasible for remote delivery, although centre-based post-PR assessments were not possible. Family involvement played an important role in the home-PR programme. The delivery of this programme can be further improved to maximise the benefit for patients.

Machine learning algorithms' application to predict childhood vaccination among children aged 12-23 months in Ethiopia: Evidence 2016 Ethiopian Demographic and Health Survey dataset.

Childhood vaccination is a cost-effective public health intervention to reduce child mortality and morbidity. But, vaccination coverage remains low, and previous similar studies have not focused on machine learning algorithms to predict childhood vaccination. Therefore, knowledge extraction, association rule formulation, and discovering insights from hidden patterns in vaccination data are limited. Therefore, this study aimed to predict childhood vaccination among children aged 12-23 months using the best machine learning algorithm. A cross-sectional study design with a two-stage sampling technique was used. A total of 1617 samples of living children aged 12-23 months were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 70% and 30% of the observations were used for training, and evaluating the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. All the included algorithms were evaluated using confusion matrix elements. The synthetic minority oversampling technique was used for imbalanced data management. Informational gain value was used to select important attributes to predict childhood vaccination. The If/ then logical association was used to generate rules based on relationships among attributes, and Weka version 3.8.6 software was used to perform all the prediction analyses. PART was the first best machine learning algorithm to predict childhood vaccination with 95.53% accuracy. J48, multilayer perceptron, and random forest models were the consecutively best machine learning algorithms to predict childhood vaccination with 89.24%, 87.20%, and 82.37% accuracy, respectively. ANC visits, institutional delivery, health facility visits, higher education, and being rich were the top five attributes to predict childhood vaccination. A total of seven rules were generated that could jointly determine the magnitude of childhood vaccination. Of these, if wealth status = 3 (Rich), adequate ANC visits = 1 (yes), and residency = 2 (Urban), then the probability of childhood vaccination would be 86.73%. The PART, J48, multilayer perceptron, and random forest algorithms were important algorithms for predicting childhood vaccination. The findings would provide insight into childhood vaccination and serve as a framework for further studies. Strengthening mothers' ANC visits, institutional delivery, improving maternal education, and creating income opportunities for mothers could be important interventions to enhance childhood vaccination.

Adolescents' satisfaction with abortion services received and factors associated with satisfaction at reproductive health centres.

This study assessed adolescents' satisfaction with services received during their most recent abortion and the factors associated with satisfaction at reproductive health centres in the Greater Accra region of Ghana. A facility-based cross-sectional survey was used for this study. Overall, 254 adolescent girls aged between 15 and 19 years, who had an abortion within 1 week of the study period were recruited for the study. All the 254 respondents were recruited consecutively as they visited health facilities for abortion services from March 2019 to February 2020. Written informed consent was signed by respondents, and data were collected using the Patient Satisfaction with Nursing Care Quality Questionnaire, and the data were analysed using Stata version 15.0. Univariate, bivariate and multivariate logistic regression analyses were conducted. A majority of adolescents reported being satisfied with the abortion services they received. Ample waiting space and the system of 'first-come-first-served' were the highest rated elements of service satisfaction. Adolescents were least satisfied with the inadequacy of instructions and lack of information on medications received and their therapeutic or side effects. Ethnicity, having a stable intimate partner and perceived adequacy of staff were the factors associated with satisfaction with abortion services. Adolescents are unique group of people with peculiar health needs. If they are treated with respect and dignity, they are likely to be satisfied with services received from the reproductive health centres offering comprehensive abortion care. The study addresses adolescent satisfaction with abortion care received; if health providers treat adolescent seeking abortion care with respect, friendly and non-judgemental attitude, it will enable adolescents to seek abortion care from qualified professionals instead of unskilled service providers to reduce maternal mortality. Patients from 11 reproductive centres responded to the questionnaire used for the data collection.

Proportion of Respiratory Syncytial Virus, SARS-CoV-2, Influenza A/B, and Adenovirus Cases via Rapid Tests in the Community during Winter 2023-A Cross Sectional Study.

Respiratory infections constitute a major reason for infants and children seeking medical advice and visiting health facilities, thus remaining a significant public threat with high morbidity and mortality. The predominant viruses causing viral respiratory infections are influenza A and B viruses (Flu-A, Flu-B), respiratory syncytial virus (RSV), adenovirus and coronaviruses. We aimed to record the proportion of RSV, SARS-CoV-2, influenza A/B and adenovirus cases with rapid antigen tests and validate the results with RT-PCR assays of upper respiratory specimens with a wide range of viral loads and (co)-infection patterns in children. Clinical samples were collected from early symptomatic children (presenting with fever and/or cough and/or headache within 5-7 days). The surveillance program was conducted in five private pediatric dispensaries and one pediatric care unit, from 10 January 2023 to 30 March 2023 in central Greece. The total sample of specimens collected was 784 young children and infants, of which 383 (48.8%) were female and 401 were male (51.2%). The mean age of participants was 7.3 + 5.5 years. The sensitivity of the FLU A & B test was 91.15% (95% CI: 84.33-95.67%), and the specificity was 98.96% (95% CI: 97.86-99.58%). The sensitivity and specificity of the adenovirus and RSV test was {92.45% (95% CI: 81.79-97.91%), 99.32% (95% CI: 98.41-99.78%)} and {92.59% (95% CI: 75.71-99.09%), 99.47% (95% CI: 98.65-99.86%)} respectively. Lastly, the sensitivity of the SARS-CoV-2 test was 100.00% (95% CI: 79.41-100.00%) and the specificity was 99.74% (95% CI: 99.06-99.97%). We recorded a proportion of 14.3% and 3.44% for influenza A and B, respectively, followed by a proportion of 6.9% for adenovirus, a proportion of 3.7% for RSV, and finally, a proportion of 2.3% for SARS-CoV-2. The combination of a new multiple rapid test with multiple antigens will probably be a useful tool with a financial impact for health systems targeting the early detection and appropriate treatment of respiratory infections in emergency departments in primary health care facilities.

Barriers to Utilization of Postnatal Care Services within the First 48 Hours of Birth in North West Syria: A Barrier Analysis Study

Objectives: The objective of this study is to identify barriers to the utilization of postnatal care services among mothers and neonates in a conflict-affected area. Methods: This study involves a cross-sectional survey utilizing the Barrier Analysis (BA) approach, which is based on the Health Belief Model and the Theory of Reasoned Action. It explores up to 12 recognized determinants of behavior adoption. The survey was conducted in six communities located in Idlib and western rural Aleppo, representing both urban and rural areas for host and displaced populations in northwest Syria (Selwa, Abin Samaan, Sahara, Tal Elkaramej, Boz Ghaz, Koknaya). Data collection took place from 7th to 11th November 2021. Initially, screening questions were used to verify participants' eligibility for the survey. The interviewed mothers were then classified into two main groups: the first group consisted of mothers of newborns who attended postnatal care within the first 48 hours after birth (DOERS), while the second group comprised mothers of newborns who did not attend postnatal care within the first 48 hours after birth (NON-DOERS). From both groups, a random sample of 90 mothers of newborns aged 0-6 months was selected (45 DOERS and 45 NON-DOERS) out of a total of 418 respondents. Their answers were analyzed based on the 12 determinants included in the questionnaire. All collected data, including coded qualitative data and closed-ended questions, along with their frequencies, were entered into the Standard Barrier Analysis Tabulation Sheet Excel (SBATS). The odds ratio and P-value were calculated, considering results to be "significant" if the P-value was less than 0.05. Results: All demonstrated significant results are being compared between doers (mothers who attend postnatal care within the first 48 hours after birth) and non-doers (mothers who did not attend postnatal care within the first 48 hours after birth) according to the determinants and based on their recurrence, not their percentage. A total of 90 mothers with newborns aged 0-6 months (45 DOERS and 45 NON-DOERS) were interviewed, the findings revealed that 68% of the interviewed mothers had a normal delivery at health facilities, while 20% had a cesarean delivery, and 12% had a normal delivery at home. The barriers to PNC services included the long distance of the health facilities and the absence of transportation, social norms and traditions that prevent women from leaving home after childbirth, overcrowding at health facilities, fear of COVID-19 infection when visiting health facilities, absence of accompanying people, and the perception among mothers that they were unlikely to experience immediate post-birth problems. On the other hand, the enablers for accessing postnatal care services included community-based health support through community health workers, awareness of the available services, the mother's level of education, and a perceived understanding of the risks associated with medical complications that may arise after birth. Additionally, the availability of transportation and economic resources played a facilitating role in accessing postnatal care services. Conclusion: This study examines the low uptake of postnatal care (PNC) services for mothers and neonates in a conflict-affected area. Findings highlight barriers including limited maternal knowledge, inadequate health service coverage, transportation challenges, and social norms.

Positif Correlation of Anxiety and the Interest of Elderly in Visiting Health Facilities During the COVID-19 Pandemic

Anxiety about dealing with the infectious nature of COVID-19 could influence the elderly to avoid visiting health facilities due to concerns about the rapid transmission of the disease. The impact of decreasing interest in visiting the elderly with comorbidities to health facilities causes repeated recurrences, and they do not get treatment to improve their health. This research aimed to determine the correlation between anxiety and interest in visiting health facilities for the elderly with comorbid diseases during the COVID-19 pandemic. The variables in this research were anxiety and interest in visiting health facilities. A questionnaire was used for data collection. The design of this research was a correlation with a cross-sectional approach, a sample of 32 respondents, and a purposive sampling technique. The result showed that most of the respondents (53.1%), 17 respondents, experienced moderate anxiety. Most of the respondents (62.5%), 20 respondents, had sufficient interest in visiting. Based on the Spearman's rank test, a p-value of 0.032 (α = 0,05) was obtained, meaning that there was a correlation between anxiety in comorbid elderly people and interest in visiting health facilities during the COVID-19 pandemic with a weak correlation category (r = 0.380). The elderly's anxiety about visiting health facilities during the pandemic could be because the elderly are getting tired of the comorbid disease process they experience; the elderly also feel vulnerable to infection due to information related to COVID-19 transmission; the elderly were afraid to die when confirmed with COVID-19; the elderly worried about the health of their families and the elderly as well. Worried that they have contracted the COVID-19 virus. It recommended for respondents not be afraid or anxious about coming to health facilities during the COVID-19 pandemic. The elderly could visit health facilities during the COVID-19 pandemic safely by always complying with health protocols

COVID-19 pandemic hits differently: examining its consequences for women’s livelihoods and healthcare access – a cross-sectional study in Kinshasa DRC

ObjectivesThe emergence of the COVID-19 pandemic led to multiple preventive actions as primary interventions to contain the spread of the virus. Globally, countries are facing enormous challenges with consequences for...

Influence of type of cooking fuel on risk of hypertension among reproductive-age women in sub-Saharan Africa: insights from nationally representative cross-sectional surveys.

Nearly one-third of the world's population (2.4 billion people) rely on unclean cooking fuel sources. The study assessed the association of the type of cooking fuel and hypertension risk in sub-Saharan Africa (SSA). The study analysed pooled data from 97 942 individuals in the Demographic and Health Survey (DHS) between 2014 and 2021 in 10 SSA countries. Univariate, bivariate and multivariate analyses were performed, including basic descriptive statistics and binary logistic regression. The independent variable of interest was the type of cooking fuel, while hypertension served as the outcome variable. Women using unclean cooking fuel were 1.21 times more likely to be hypertensive compared with those using clean cooking fuel (adjusted odds ratio [aOR] 1.21 [95% confidence interval {CI} 1.11 to 1.31]). Older age (aOR 5.78 [95% CI 5.04 to 6.62]), higher education (aOR 1.14 [95% CI 1.05 to 1.23]), being married (aOR 1.64 [95% CI 1.49 to 1.80]), working in sales and services occupations (aOR 1.34 [95% CI 1.24 to 1.44]), frequent health facility visits (aOR 1.59 [95% CI 1.51 to 1.68]), higher wealth index and exposure to media were significantly associated with hypertension risk. Efforts to reduce reliance on unclean cooking fuel at both the household and population levels need to be intensified in SSA countries. Promoting the use of clean cooking technologies and fuels and implementing supportive policies for transitioning from unclean cooking fuels are crucial. Targeted interventions to reduce hypertension risk in SSA should focus on women using unclean cooking fuel, older women, individuals from wealthier households and those with higher education levels.

Knowledge on sexually transmitted infections among HIV-pre-exposure prophylaxis users in Nairobi city county, Kenya

Background: Sexually transmitted infections remain a significant public health problem mainly in low-income countries. Despite the high efficacy of HIV-PrEP, an upsurge of STIs is recorded globally after HIV-PrEP introduction due to sexual behaviour change among the users. Nairobi has the highest rate of HIV-PrEP uptake and large number of HIV-PrEP users visit health facilities to get treatment for STIs. This study aimed to assess knowledge on STIs among HIV-PrEP users in Nairobi, Kenya. Methods: Analytical cross-sectional research design was employed. Simple random sampling technique was adopted to obtain a sample size of 357 respondents seeking HIV-PrEP service in five health facilities in Nairobi, from July to November 2022. The study used primary data which was collected using structured questionnaire and secondary data (laboratory results). Results: Most of the respondent were knowledgeable about STIs occurrence. 56.7% of the respondents knew that STIs could be transmitted through sex without using condom, 43.3% knew that sex with sex workers could make one get STIs, 58.7% of the respondents were aware that STIs could be transmitted through sexual contact with multiple partners. A statistically significant association was found between STI related level of knowledge and STIs prevalence among HIV-PrEP users in Nairobi. Conclusions: The knowledge about STIs among HIV-PrEP users in Nairobi does not translate into safe sexual behaviour against STIs. The study recommends that the facility management and service providers should encourage HIV-PrEP users to undertake routine STIs screening tests and treatment as well as frequent safe sexual behaviour awareness creation education.

COMMUNITY ACCESS TO HEALTH SERVICES DURING THE COVID-19 PANDEMIC

During the current Covid-19 pandemic, public visits to health facilities such as hospitals, health centers and clinics have decreased. People are increasingly worried about visiting health facilities for fear of contracting it. The purpose of this study was to measure the level of public concern about visiting a health facility during a pandemic when experiencing health problems. This research is a quantitative research using an analytical approach and study designcross sectional. The population in this study were all Indonesian people and the number of samples in this study were 118 people. The analytical method used is univariate about the respondent's identity (gender, age, occupation, and education) and bivariate to determine the correlation of the independent variables with the dependent variable using the test chi square. The sampling technique uses the technique accidental sampling. The results of the study showed that there was no relationship between the level of knowledge and the level of public concern about visiting health facilities p-value 0.421.