Health-seeking Practices Research Articles

Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention.

Local perceptions and understanding of the causes of ill health and death can influence health-seeking behaviour and practices in pregnancy. We aimed to understand individual explanatory models for stillbirth in Afghanistan to inform future stillbirth prevention. This was an exploratory qualitative study of 42 semi-structured interviews with women and men whose child was stillborn, community elders, and healthcare providers in Kabul province, Afghanistan between October-November 2017. We used thematic data analysis framing the findings around Kleinman's explanatory framework. Perceived causes of stillbirth were broadly classified into four categories-biomedical, spiritual and supernatural, extrinsic factors, and mental wellbeing. Most respondents attributed stillbirths to multiple categories, and many believed that stillbirths could be prevented. Prevention practices in pregnancy aligned with perceived causes and included engaging self-care, religious rituals, superstitious practices and imposing social restrictions. Symptoms preceding the stillbirth included both physical and non-physical symptoms or no symptoms at all. The impacts of stillbirth concerned psychological effects and grief, the physical effect on women's health, and social implications for women and how their communities perceive them. Our findings show that local explanations for stillbirth vary and need to be taken into consideration when developing health education messages for stillbirth prevention. The overarching belief that stillbirth was preventable is encouraging and offers opportunities for health education. Such messages should emphasise the importance of care-seeking for problems and should be delivered at all levels in the community. Community engagement will be important to dispel misinformation around pregnancy loss and reduce social stigma.

Community-level impacts of the coronavirus pandemic on malaria prevention and health-seeking behaviours in rural Benin: A mixed methods study.

Globally, negative impacts of the COVID-19 pandemic on malaria prevention and control efforts have been caused by delayed distributions of long-lasting insecticidal nets (LLIN), decreased outpatient attendance, and disruptions to malaria testing and treatment. Using a mixed methods approach, we aimed to evaluate the impact of COVID-19 on community-level malaria prevention and health-seeking practices in Benin more than one year after the start of the COVID-19 pandemic. We collected data through community-based cross-sectional surveys with 4200 households and ten focus group discussions (FGDs). Mixed effect logistic regression models accounting for a clustered sampling design were used to identify variables associated with main outcomes (good COVID-19 knowledge, LLIN usage and access, and avoidance of health centres). Consistent with the experiences of FGD participants, receiving information from radios or televisions was significantly associated with good COVID-19 knowledge and avoiding health centres because of the pandemic (p<0.001 for both). Qualitative findings also revealed varying and polarizing changes in health-seeking behaviours with participants noting that they either did not change their health-seeking behaviours or went to health centres less or more often because of the pandemic. LLIN usage and access did not decrease in the study area because of the pandemic (LLIN usage: 88% in 2019 to 99.9% in 2021; LLIN access: 62% in 2019 to 73% in 2021). An unexpected change and unintended challenge for sustained malaria prevention included families socially distancing in their homes, resulting in a shortage of LLINs. Our findings showed that there were minimal community-level impacts of the coronavirus pandemic on malaria prevention and health seeking behaviours in rural Benin, which highlights the importance of efforts to sustain malaria prevention and control interventions in the context of the COVID-19 pandemic.

Community Mapping And Health Seeking Practices Among Residents of an Indonesian Village

Community Mapping And Health Seeking Practices Among Residents of an Indonesian Village

Effects of Health Education Intervention Programme On Health Seeking Practices and Treatment Preferences for Mothers of Under-Five Children with Febrile Illness in Ogbomoso

This study determined the effect of health-education intervention programme on health-seeking practices and treatment –preferences for mothers having under-five children with febrile-illness .Quasi Experimental research design was conducted among mothers of under-five children attended primary health care centres for immunization in selected Primary Health Care s in Ogbomoso Pre and Post intervention self-structured questionnaire were used to collect data from 191 mothers using purposive sampling technique. One third of respondent (28.0%) have heard about febrile illness during pre-intervention while most (98.4%) have heard about it in the post intervention. Majority (74.2%) during pre-intervention declined to take their child to health facility when sick while during post-intervention over half (51.1%) do it often. Health education intervention programme improved health seeking practices and treatment preferences for mothers of under five.

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Awareness of Stroke Among Hypertensive Patients Residing at Selected Urban Area of Vijayapur

Problem statement: The study on “A study to assess the effectiveness of planned teaching program on knowledge regarding awareness of stroke among hypertensive patients residing at selected urban areas of Vijayapur” Objectives of the study: To assess the self reported health seeking practices among hypertensive patients, knowledge about Awareness of Stroke among hypertensive patients, to plan and implement planned teaching program on awareness of stroke among hypertensive patients residing at selected urban areas of Vijayapur, to evaluate the effectiveness of planned teaching program on knowledge regarding Awareness of stroke among hypertensive patients residing at selected urban areas of Vijayapur,to determine the association between pretest knowledge scores of hypertensive patients with their selected demographical variables. Study approach: Descriptive approach was adopted for this study. Design: pre experimental one group pre-test post-test design was adopted for this study. Settings: The study was conducted at urban areas of PHC Ganesh Nagar. Sampling Method: 80 samples, non probability purposive sampling technique was used to select the samples. Method of data collection procedure: Data was collected from the hypertensive patients to assess the level knowledge and awareness of stroke. The collected were tabulated and analyzed by descriptive and inferential statistic. Results: The result showed that, there was a significant difference between pre-test and posttest level knowledge regarding awareness of stroke among hypertensive patients. The obtain t-value (7.54) was greater than the table value at 0.05 level of significant. Conclusion: This study concludes that planned teaching module was effective in improving the level of knowledge regarding awareness of stroke among hypertensive patients. Keywords: [Knowledge, awareness of stroke, Health seeking practice, stroke, planned teaching programme]

Community stressors and coping mechanisms in accessing the health system during a double crisis: a qualitative case study from Yangon Region, Myanmar

BackgroundDue to the COVID-19 pandemic and political crisis, Myanmar’s health system has suspended routine services while struggling to respond to the pandemic. Many people who need continuous care, like pregnant women and people with chronic illnesses, have been facing challenges in seeking and receiving essential health services. This study explored community health seeking practices and coping mechanisms, including their views on health system stressors.MethodsThis was a cross-sectional qualitative study based on 12 in-depth-interviews with pregnant people and persons with pre-existing chronic health conditions in Yangon. Sampling was purposive, convenience-based and snowball sampling was also used. The 3-delays framework was used to understand how persons were interacting with and accessing health care services; community and health system stressors and coping mechanisms in relation to COVID-19 were also identified.ResultsFindings showed that Yangon region was the hardest hit with both the pandemic and political crisis and its health system was greatly affected. People were unable to access essential health services on time. The health facilities were not available to see patients, with serious shortages in human resources, medicines and equipment, resulting in interruption of essential routine services. The prices of medicines and consultation fees, and transportation costs, increased during this period. Limited options for accessing care were available due to travel restrictions and curfews. It became challenging to receive quality care because of unavailable public facilities and private hospitals being costly.Despite these challenges, the Myanmar people and health system have shown resilience. Cohesive and organized family support structures and extended and deep social networks played an important role in accessing health care. At times of emergency, people relied on community-based social organizations for transportation and accessing essential medicines. The health system also showed resilience through establishing new service provision options, such as teleconsultations, mobile clinics, and sharing medical advice through social media.ConclusionsThis is the first study in Myanmar to explore peoples’ perceptions on COVID-19, the health system and their healthcare experiences during political crisis. Although there is no easy way to cope with this dual hardship, the people and the health system, even in a fragile and shock-prone setting like Myanmar, stayed resilient by developing alternative pathways for seeking and providing health services.

Impact of mystical belief and traditional healing on the health-seeking practice of conversion disorder in middle- and low-income countries.

Conversion disorder is a somatoform condition in which patients present with a range of neurologic deficits and sensorimotor loss with no obvious pathology. There has been a rising trend in the incidence of conversion disease in countries with low socioeconomic backgrounds, accounting to be one-third of ambulatory visits in middle and low-income countries (MLIC). However, even with such a high prevalence health-seeking practice for conversion disorder is low in MLIC. One possible reason for such behavior could be the high prevalence of mystical beliefs and traditional healing in MLIC. Existing economic distress with limited healthcare resources convinces people to opt for traditional and local healers who make use of mystical and superstition beliefs prevalent in those regions to offer prospering and cheaper methods of treatment. In this scenario, addressing and counseling mythological fallacies and the use of an economically friendly 'holistic model' of treatment should be adopted in these countries.

An exploratory study on the perceptions of rabies and ill-health causations and health seeking behaviours of school children and local communities in southern Bhutan

BackgroundThe perception of illness and health-seeking behaviours, including rabies differ from one culture to another. Depending on the cultural setting of the society in which people live, the definition of the causal factors of illness may range from natural biological causes to supernational causes which greatly influence subsequent health-seeking behaviour. To ensure best health practices and plan effective health interventions for the control of dog-mediated-human rabies, we explored how school children and adult communities perceive and respond to illnesses, including rabies in southern Bhutan.MethodsWe collected quantitative data related to the causes of illness and health-seeking practices of school children using a questionnaire survey (QS). Qualitative data were collected through focus group discussions (FGDs) and in-depth interviews (IDIs) with older members of communities (≥ 18 years) that work closely with school children. Descriptive analysis was performed for the quantitative data and thematic analysis was performed for the qualitative data.ResultsThe participants during the FDGsand IDIshave linked the illnesses to past actions, spirits, energy channels, planetary movement, sorcery, black magic, food, physical or environmental factors, individual habits and social factors. The survey of the school children reported microorganisms (75%), past actions (16.8%), spirits (9.6%) and black magic (9.1%) as causal factors for illnesses. Health seeking behaviours reported by the participants included visiting hospitals, performing spiritual or religious rituals and local treatments. Similarly, school children also mentioned that illnesses can be treated by visiting hospitals (98%), performing rituals (59.1%), and seeking traditional treatments practices (18.8%). Both school children and adult members of the communities that we interviewed were well aware on the causes of rabies and need for allopathic treatments rather than seeking spiritual or local treatments.ConclusionThere is a need for the consideration of the socio-cultural context in the planning and implementation of health-related policies, including the rabies prevention programs in Bhutan, by involving traditional healers and religious entities with “One Health” public health sectors.

Health seeking behaviour among caregivers of under-five children in Edo State, Nigeria

Aim: Timely and appropriate healthcare seeking behaviours if practiced by caregivers of under-five children can have a significant impact on child survival. This study assessed the knowledge of, and general health seeking practices among mothers of under-five children in Nigeria. Methods: This descriptive cross-sectional study was carried out among caregivers of under-five children in Edo State, Nigeria, in 2013. A multi-staged sampling technique was used to recruit respondents. Data collection was done by means of a structured interviewer-administered questionnaire adapted from UNICEF/IMCI household baseline survey questionnaire. Results: A total of 370 caregivers (mean age: 31.1±5.9 years) participated in the study. Almost all of them were females 368 (99.5%), 234 (63.2%) had secondary education and 283 (76.5%) were in the unskilled social class. Over 70%, 76%, 72%, 76% and 82% of participants did not know that being unable to eat/drink, fast breathing, blood in stool and convulsion, respectively, were symptoms of a child not feeling well. The place of primary care of children by caregivers was at home 142 (38.4%), chemist shop 91 (24.6%) and health facility 80 (21.6%). Cost and long waiting time were major reasons for not seeking care in health facilities. Conclusion: This study showed poor health seeking practices among caregivers of under-five children in Edo State, Nigeria. There should be continuous education of caregivers on recognition of danger signs in children and the need to seek appropriate medical care in health facilities.

Does sexuality matter? A cross-sectional study of drug use, social injecting, and access to injection-specific care among men who inject drugs in Melbourne, Australia

BackgroundGay, bisexual and other men who have sex with men (GBMSM) are overrepresented in cohorts of people who inject drugs. GBMSM’s substance use is usually explored in the context of its contribution to sexual risk. We examined drug use practices, connectedness to other people who inject drugs, peer-to-peer injecting, and access to care among men who inject drugs in Melbourne, Australia. We aim to describe similarities and differences in these parameters for GBMSM and other men.MethodsData were drawn from a prospective cohort study of people who inject drugs conducted in Melbourne, Australia, since 2009. This cross-sectional study used data collected between 2016 and 2021. Descriptive statistics were used to assess differences between GBMSM and other men.ResultsOf 525 men who injected drugs over the study period, 48 (9%) identified as gay or bisexual, or reported sex with other men in the past 12 months. GBMSM and other men reported similar socio-demographics, drug practices (age of injecting initiation, most injected drug, peer-to-peer injecting, receptive syringe sharing) and access to injecting-specific care (drug treatment, source of needle-syringes). A significantly greater percentage of GBMSM reported past 12-month hepatitis C testing (69% vs. 52%, p = 0.028) and preferring methamphetamine (31% vs. 16%, p = 0.022). A higher percentage of GBMSM reported knowing > 50 other people who inject drugs (46% vs. 37%), but this difference was not statistically significant. Both groups primarily obtained injecting equipment from needle-syringe programs; a minority had accessed injecting-specific primary care.ConclusionMen who injected drugs in this cohort and those who identified as GBMSM reported similar drug and health-seeking practices. The higher prevalence of methamphetamine injecting among GBMSM may warrant different harm reduction support for this group. Health promotion should utilise opportunities to connect men who inject drugs in Melbourne to injecting-specific primary health care.

Rural mothers' beliefs and practices about diagnosis, treatment, and management of children health problems: A qualitative study in marginalized Southern Pakistan.

Appropriate health-seeking beliefs and practices are indispensable for the survival and development of children. In this study, we explore childcare beliefs and practices of rural mothers and analyze the different ways childhood illness is diagnosed and managed in a marginalized rural community in Southern Pakistan. Using purposive sampling, in-depth interviews are conducted to obtain qualitative data from 20 illiterate and rural mothers in addition to 15 healthcare providers in the district Rajanpur of South Punjab. The findings reveal that rural mothers' access to healthcare and therapeutic programs is impeded due to geographical isolation, structural inequalities, poverty, and illiteracy. Consequently, evil eyes, witchcraft, and spirits are recognized as potential threats to children's health and nutrition. Therefore, the treatment of childhood morbidity and malnutrition is mostly performed with folk, domestic, herbal, magico-religious remedies, and spiritual healing methods. The current study also highlights that many low-income and rural mothers tend to normalize childhood illness when they become unable to advocate for their children's health and nutrition. Besides improving low-income mothers' access to healthcare facilities, health education and risk communication at the field level through field health staff could be most effective for health promotion.

Health-seeking Behavioural Practices of the Elderly in Rural Community of Ekiti State, Southwestern Nigeria

Abstract Background: The aging process increases the risks of contracting a disease among elderly people. Health-seeking behaviour is poor among the aged in sub-Saharan countries like Nigeria, escalating the burden of noncommunicable diseases and the cost of health care which further impact the utilisation of orthodox medicine. Aim: This study aims to assess the health-care-seeking behavioural practices and associated factors among elderly people in Ido-Ekiti. Materials and Methods: A descriptive cross-sectional study was conducted among 420 elderly respondents in Ido-Ekiti. An interviewer-administered semi-structured questionnaire was used to collect information. The data collected were analyzed using SPSS version 25 and results were presented in the form of tables and bar charts. Chi-square tests were used to test for associations. All data analysis was done at a 5% level of significance. Results: The age range of respondents was between 65 and 95 years, with a mean age of 73.88 ± 6.84 years and 64.0% within the age range of 65–75 years. About 63.3% of the respondents have had an episode of illness in the last year preceding the study and only 35.3% consulted a doctor for treatment (good health-seeking behaviour); however, 57.9% of the respondents admitted utilising any of the following: self-medication, consult spiritualist, and use of herbal medicine (poor health-seeking behaviour). The factors statistically significantly associated with respondents’ health-seeking behavioural practices are employment status (P &lt; 0.001), educational level (P &lt; 0.002), cost of health care, access to the health facility, length of time before consultation, beliefs, and lack of support from relations (P &lt; 001). Conclusion: This study shows that the majority of the elderly had poor health-seeking behaviour due to educational and economic factors. Making the free or subsidized cost of health care for the elderly in rural communities and the provision of monthly financial support to the aged by the government will promote and encourage good health-seeking behaviour of old people.

The social dimensions of community delivery of intermittent preventive treatment of malaria in pregnancy in Madagascar, Mozambique, Nigeria and the Democratic Republic of the Congo

IntroductionIntermittent preventive treatment in pregnancy with sulphadoxine pyrimethamine (IPTp) is a key malaria prevention strategy in sub-Saharan African countries. We conducted an anthropological study as part of a project aiming...

A Review on the Use of the HPV Vaccine in the Prevention of Cervical Cancer.

The main risk factor for invasive cervical carcinoma is persistent infection by the high-risk human papillomavirus (HPV). HPV is the most prevalent sexually transmitted infection (STI) and has been linked to 15 different cancers. Cervical cancer is one of the most frequent cancers among women, particularly in resource-limited countries. Cervical cancer is an HPV disease with the highest worldwide burden in resource-limited nations. With improved medical care and nationwide screening programmes, the mortality rate from cervical cancer has decreased in the past 40 years. Many developing nations have been shown to have inadequate knowledge and health-seeking practices, making proper awareness and immunisation programmes necessary. The best strategy to reduce the incidence of cervical cancer is through the administration of HPV vaccines along with routine cervical screening. The HPV vaccine is crucial for public health. Vaccinations against all HPV subtypes, namely, bivalent, quadrivalent, and nonavalent, are available. Financial issues are the main barrier to HPV vaccination. The framework for behavioural and social drivers of vaccination, which includes practical concerns, motivation, social processes, thoughts, and feelings, is widely used to uncover important aspects linked with HPV vaccination. The burden of cervical cancer due to HPV and the advantages of HPV vaccination are summarised in this review article.

Diagnosis as Subculture: Subversions of Health and Medical Knowledges in the Orthorexia Recovery Community on Instagram

Diagnoses are powerful tools that fulfill various practical and symbolic functions. In this paper, I examine how a contested diagnosis called orthorexia nervosa has been taken up by users on Instagram, where tens of thousands of posts engage with the topic, many of them from individuals who identify with the condition. I put scholarship on medicalization and diagnosis in conversation with literature on subcultures to foreground the subversive work that is enabled through this diagnosis. Drawing on more than 350 hours of online ethnographic fieldwork and 34 in-depth interviews, I examine how participants construct a shared identity, draw on common language and norms, and undertake collective practices, as they negotiate dominant understandings of health. I show how they draw on the legitimacy endowed by the diagnostic label to validate and make sense of experiences of suffering but also to counter dominant health-seeking discourses, practices, and aesthetics in an online space where these are highly visible and valued. I also discuss some ways Instagram as a digital platform shapes its uptake by this community in meaningful ways. On the one hand, participants draw heavily on the language and framing of medicine to make sense of their fraught experiences with food and their bodies, effectively advocating for the medicalization of their own suffering while also creating a sense of community and shared identity. However, on the other hand, they actively use the diagnosis and the recovery process enabled through it to effectively resignify dominant beliefs, values, and practices that are experienced as injurious, including some that are particularly prevalent on Instagram.

Health seeking behaviors and childcare patterns in an informal settlement of Nairobi, Kenya: A cross-sectional study.

Children in urban informal settlements experience high risks for poor health and development. Understanding health seeking behaviors and childcare patterns of caregivers in urban informal settlements is important for devising effective interventions. This study describes household characteristics and aspects of nurturing care among caregivers of children aged 0-2 years in Dagoretti informal settlement, Nairobi-Kenya. In this cross sectional study, data were collected on household socio-demographic characteristics, antenatal care and child delivery practices, infant and young child feeding practices, activities that promote play, learning and school readiness, and on childcare and protection practices. Descriptive statistics of proportions and means were used to summarize the data. The study covers a total of 458 Kenyan and 118 immigrant households. Caregivers from immigrant households, with low education and from the younger age-group (less than 20 years) were vulnerable to sub-optimal caregiving and health seeking practices, including relatively lower rates of age-appropriate breastfeeding and poor dietary diversity. Seventy-five percent of expectant mothers attended less than four antenatal care visits. Households surveyed had limited possession of children's books (2% with three or more books), limited access to play materials (43% had two or more play materials), and low paternal involvement in child stimulation and early learning activities (14%). One-third and half of the children were left with inadequate care and disciplined using both violent and non-violent methods, respectively. Our findings highlight the urgent need for contextually appropriate and integrated interventions anchored in the WHO's nurturing care framework. These interventions can benefit from extensive involvement of caregivers, facility and community-based healthcare workers, policy makers, and other relevant stakeholders.

Multi-Level Factors Are Associated with Uptake of Cervical Cancer Screening in Sexual and Gender Diverse Adults Residing in Arizona

Introduction: Despite availability of effective screening practices for early detection and prevention of invasive cervical cancer, emerging research suggests lesbian, bisexual, and transgender (LBT) individuals are less likely to undergo routine cervical cancer screening (CCS). Systematically examining factors for low CCS uptake in this population using a socioecological lens is key to designing and implementing effective interventions to reduce cancer-related death and disease. As the first step to this approach, the purpose of the study was to examine multi-level factors associated with CCS in LBT adults residing within the state of Arizona. Methods: Self-identified LBT adults with a cervix between the ages of 18-50 were invited to complete a one-time online survey assessing sociodemographic characteristics, health seeking practices, and CCS behaviors. Results: Of the 273 participants who completed the study; 62.5% identified as cisgender, 28.7% as transgender/gender nonconforming. Over 35% were gay/lesbian, and 30.8% identified as bisexual. Almost a quarter of participants reported never having received a Pap test. Fifty-four percent of all participants reported feeling uncomfortable discussing their health needs with a healthcare provider and over 60% were unsure of proactively asking their primary care provider for a Pap test. While 75% of participants who reported never receiving a CCS were sexually active in the past 12 months (a risk factor for cervical cancer), 53% were not sure if getting a Pap test was important (vs. 10% of those who received a CCS). Compared to those who had received a CCS, those who had never been screened had significantly lower cancer screening self-efficacy scores (t=5.18; p&amp;lt;.001) and were less likely to know someone in their social network who had received CCS (70% vs 38%; p&amp;lt;.001) suggesting that social norms may impact screening behaviors in this population. Conclusion: Interventions to increase CCS in this population may need to target proximal (knowledge, self-efficacy) and distal factors (social support, and strategies to improve provider communication strategies) while taking into consideration community-partnership guided participatory and implementation science approaches.

Analysis of the Knowledge, Attitudes, and Practice Model of Healthcare Professionals on Hearing Loss at Elderly Dementia Residences in Korea.

Due to a lack of knowledge about age-related hearing loss, its early identification and appropriate intervention are not being carried out in the field of dementia care. Since the untreated hearing loss of the elderly leads to a more rapid cognitive decline, the present study aimed to understand the hearing-related knowledge, attitudes, and practices of healthcare professionals in long-term care (LTC) facilities in Korea. A total of 557 workers (104 facility managers and 453 healthcare professionals) in residential LTC participated in this cross-sectional multicenter survey study. The Korean version of the knowledge, attitudes, and practice (KAP) on-line survey with a five-point scale or yes/no response was applied as the experimental tool. The results of structural equation modeling showed that knowledge significantly affected the attitudes and health-seeking practices of the facility manager, and allied healthcare professionals demonstrated similar results, which showed the significant effects of that knowledge on attitudes and health-seeking practices. This clearly indicated that sufficient knowledge is the driving force for the health-seeking practices and positive attitudes of both the facility manager and the healthcare professionals. Thus, we suggest that a further step, such as the development of comprehensive and professional guidelines regarding hearing care information for these professionals in residential LTC facilities, should be followed, and believe that this effort could lead to improving hearing-related knowledge, attitudes, and practices in order to clinically and politically care for the elderly population.

‘Swallow medicine, eat rice, pray about health’: health, health care and health-seeking experiences of South-East Asian older refugees

AbstractSouth-East Asian refugees have lived in the United States of America for nearly four decades, with early refugee immigrants experiencing ageing and later life within the refugee context. As refugees age, health concerns of this older population grow, highlighting the need for ongoing assessment of refugee health and health-seeking behaviours. This study builds on previous literature that assessed the health and health-seeking patterns of South-East Asian refugees in the early years following resettlement, exploring how health and health-seeking is understood among older refugees 40 years after immigration. This paper includes a subset of 37 older refugees from a larger, community-based participatory, mixed-methods intergenerational study of Cambodian and Laotian refugee families conducted over four years (quantitative N = 433; qualitative N = 183). Thematic analysis of 34 semi-structured interviews with these older refugees in coastal Alabama revealed trends in health and health-seeking practices. Older refugees reported high rates of diabetes and hypertension within their generational cohort, and indicated a shift in health-seeking behaviours, whereby Western biomedicine is sought first for such chronic concerns, followed by traditional medicines for mild ailments such as headaches or colds. Older refugees underscored barriers of language, finances and transportation as limiting access to Western health care. Implications for engaging in community health practices and incorporating services to specifically meet the needs of the ageing refugee population are discussed.

Knowledge and health seeking practice of mothers on neonatal danger signs and its associated factors at East Belesa Woreda, Northwest Ethiopia 2020

Introduction: neonatal mortality rate is remaining unchanged globally including Ethiopia in 2019, 54.55% of under-five death was in the neonatal period. Neonatal danger signs are predictors of neonatal death. The aim of this study was to assess mother´s knowledge and health seeking practice about neonatal danger signs and its associated factors at East Belesa Woreda Northwest Ethiopia 2020.