Improve Community Health Research Articles

Navigating diagnostic and therapeutic challenges in ocular manifestations of Hansen's disease and trachoma: A narrative review.

Neglected tropical diseases (NTDs) encompass a group of approximately 20 diseases prevalent in tropical and subtropical regions, closely associated with poverty, affecting over a billion people in low-income countries. This manuscript aims to explore the ocular manifestations and burden of two significant NTDs, namely Hansen's disease and trachoma while addressing gaps in understanding and management. Hansen's disease, caused by Mycobacterium leprae , has a long history and presents with diverse neurological and ocular manifestations. Despite the availability of treatment, ocular complications persist, leading to significant visual impairment in some cases. The manuscript emphasizes the importance of early diagnosis, regular ophthalmic examinations, and follow-ups to prevent and control ocular complications, reducing the burden of visual impairment and blindness. Trachoma, caused by Chlamydia trachomatis , remains the leading infectious cause of blindness in underdeveloped and remote areas. The manuscript highlights the clinical diagnosis and implementation of the World Health Organization's (WHO's) SAFE (surgery, antibiotics, facial hygiene, and environmental sanitation) strategy to prevent transmission and associated blindness. However, challenges in health surveillance tools and underreporting of trachoma cases are addressed, emphasizing the need for improved strategies to combat the disease effectively. Through a comprehensive review of the ocular manifestations and management of Hansen's disease and trachoma, this manuscript contributes to the existing knowledge base and enhances a deeper understanding of these NTDs. Addressing gaps in understanding and management emphasizes the importance of implementing WHO's strategies and collaborative efforts to achieve the global goal of reducing the burden of NTDs and improving community health and well-being. The manuscript underscores the significance of early intervention, preventive measures, and technological advancements, providing valuable insights for policymakers, healthcare professionals, and researchers working in the field of NTDs.

Conservation and Exploration of the Potential of Rare Medicinal Plants in the Tropical Rainforest of Bukit Barisan, Sumatra, Indonesia: An Effort Towards Sustainable Herbal Medicine

The Bukit Barisan tropical rainforest in Sumatra, Indonesia, is one of the most biodiverse areas in the world. It is estimated that there are more than 10,000 plant species in this forest, and many of them have potential as herbal medicines. However, deforestation and overexploitation threaten the preservation of medicinal plants in the Bukit Barisan tropical rainforest. This causes loss of valuable natural resources and hinders research and development of new herbal medicines. This research was conducted in several tropical rainforests in Bukit Barisan, Sumatra. Field surveys were conducted to document rare medicinal plant species. Plant samples were collected and analyzed for their phytochemical content. Bioassay tests were carried out to evaluate antibacterial, antioxidant and anti-inflammatory activities. Strategies for conservation and sustainable exploration of rare medicinal plants are developed based on research results. Field surveys found 27 species of rare medicinal plants. Phytochemical analysis shows that this plant contains various bioactive compounds, such as alkaloids, flavonoids and terpenoids. Bioassay tests show that this plant has significant antibacterial, antioxidant and anti-inflammatory activity. In conclusion, the Bukit Barisan tropical rainforest has great potential for the development of herbal medicine. Sustainable conservation and exploration of rare medicinal plants in the Bukit Barisan tropical rainforest is important to ensure the preservation of these valuable natural resources and to improve community health.

Commentary: Community Health Workers and Peace Building Through Health in the Israeli-Palestinian Conflict After October 7th.

Health professionals, despite increasing challenges, with notable exceptions, always pursue peace through health because it is who we are-we are here to heal both at the individual and the community level. This applies to the long-standing Israeli-Palestinian conflict. Unfortunately, till now, nongovernmental organizations have had minimal impact on the conflict. This commentary makes 2 recommendations for donor countries after the fighting subsides: Do not insist on Israeli-Palestinian joint ventures at least for the short term and focus as much as possible your funding on interventions that improve community health.

Youth Are the Experts! Youth Participatory Action Research to Address the Adolescent Mental Health Crisis.

Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health.

COVID-19 related health literacy and preventive behaviours of the older person in Perak state, Malaysia: A qualitative study

IntroductionHealth literacy is crucial in controlling the spread of SARS-CoV2 and preventing infection, as well as preparing healthcare systems for situations that require immediate response. The aim of this study was to evaluate older people's health literacy towards disease prevention, as well as the motivators and barriers they experienced when adopting preventative measures. MethodsWe conducted in-depth interviews with 16 participants aged 65 and beyond. Purposive sampling was used to recruit participants, accounting for variability in gender, age and educational level. The transcripts were analysed using thematic analysis methods. The interview guide was developed using Sørensen's conceptual model of health literacy. ResultsFive main themes and 16 sub-themes were identified in this study. Knowledge and perception on preventive measures (with two sub-themes), sources of Covid-19 information (with two sub-themes), appraise the health information (with two sub-themes), perceived practice (with five sub-themes), barriers and motivators (with five sub-themes) were the major themes. This study discovered aspects of SEM may influence preventive measure adoption and the impact of different levels of SEM on seniors' decision-making for preventive measure adoption. ConclusionThis study examined older adults' experiences with CoviD-19-related health literacy (access, comprehend, assess, and apply), as well as their preventative behaviours, barriers, and motivators. Future disease outbreak mitigation measures should consider the SEM approach in order to improve health communication and promote healthy behaviour.

Training on Making Hand Washing Liquid Soap from Green Tea at PKK Mothers in Kranggan Village, Polanharjo, Klaten as an Effort to Improve Community Health and Economy

Abstract: Green tea is a plant that contains phytochemicals, namely polyphenols, alkaloids, volatile oils, polysaccharides, amino acids, lipids, and vitamin C. Flavonoids have antioxidant, anti-inflammatory, anti-allergic, and antibacterial activity. These advantages can be increased in terms of benefits and economic value by making it in the form of liquid soap. The addition of green tea is expected to increase the antioxidant effect of the soap preparations made. The study aims to provide training on making liquid hand-washing soap from steeping green tea leaves. The training activity for making liquid hand-washing soap with the addition of green tea was carried out as an effort to increase health independence and provide entrepreneurial provisions for the PKK community in Kranggan Village, Polanharjo, Klaten. The training was attended by 20 participants with presentation methods and practice in making liquid hand-washing soap. The result of this service activity is that the community knows how to make hand-washing soap from green tea and knows the function of the ingredients used in the process of making hand-washing soap. Keywords: training, devotion, liquid soap, green tea

Text-Mining and Video Analytics of COVID-19 Narratives Shared by Patients on YouTube.

This study explores how individuals who have experienced COVID-19 share their stories on YouTube, focusing on the nature of information disclosure, public engagement, and emotional impact pertaining to consumer health. Using a dataset of 186 YouTube videos, we used text mining and video analytics techniques to analyze textual transcripts and visual frames to identify themes, emotions, and their relationship with viewer engagement metrics. Findings reveal eight key themes: infection origins, symptoms, treatment, mental well-being, isolation, prevention, government directives, and vaccination. While viewers engaged most with videos about infection origins, treatment, and vaccination, fear and sadness in the text consistently drove views, likes, and comments. Visuals primarily conveyed happiness and sadness, but their influence on engagement varied. This research highlights the crucial role YouTube plays in disseminating COVID-19 patient narratives and suggests its potential for improving health communication strategies. By understanding how emotions and content influence viewer engagement, healthcare professionals and public health officials can tailor their messaging to better connect with the public and address pandemic-related anxieties.

Exploring the impact of health education on medication adherence and health outcomes in low-income neighborhoods: An observational study

Background: Medication adherence and health outcomes are influenced by multiple factors, including patient education. Aims and Objectives: The aims and objectives of the study are to explore the impact of health education on medication adherence and various health outcomes in low-income neighborhoods. Materials and Methods: An observational study was conducted involving 100 participants from low-income neighborhoods, aged 18–65, who were prescribed at least one chronic medication. Participants underwent a comprehensive health education program focusing on medication adherence, potential side effects, dietary habits, and physical activity. Outcomes were measured using the Morisky Medication Adherence Scale (MMAS-8), biometric values (e.g., blood pressure, blood sugar levels, cholesterol, and body mass index [BMI]), self-reported health status, hospitalization records, medication side-effects awareness, and dietary habits. Results: Post-education, there was a significant improvement in MMAS-8 scores (5.3 pre to 6.8 post, P<0.001). Biometric outcomes revealed a decrease in average blood pressure (from 145/90 mmHg to 130/85 mmHg), fasting blood sugar (from 150 mg/dL to 130 mg/dL), cholesterol levels (from 210 mg/dL to 180 mg/dL), and BMI (from 28.5 to 27.3), all with a statistical significance of P<0.01. Participants reporting “Good” or “Very Good” health increased from 45% to 65%, and those reporting regular physical activity increased from 25% to 45% (P<0.05). Hospitalizations/medical visits decreased from an average of 2.1–1.3 over 6 months (P<0.01). The proportion of participants with awareness of their medication's side effects significantly increased from 30% before the health education program to 70% afterwards (P<0.001). In addition, participants reporting adherence to dietary guidelines rose from 20% to 50% (P<0.01). Conclusion: Health education appears to have a substantial positive impact on medication adherence, biometric health outcomes, and overall well-being in low-income neighborhoods. Structured health education interventions may play a pivotal role in improving community health.

Pemberdayaan Ibu Kader PKK dalam Upaya Pencegahan Stunting di Desa Sari Gadung Kabupaten Tanah Bumbu Kalimantan Selatan

In South Kalimantan, the stunting incidence rate in 2022 will be 24.6%, more significant than the national prevalence rate of 21.6%. Tanah Bumbu is one of the districts located in South Kalimantan Province, with the incidence of stunting in Tanah Bumbu district, according to SSGI data, reaching 16.1%. Sari Gadung Village is one of the villages in Simpang Empat District, Tanah Spice Regency. This village has a potentially productive group, namely Posyandu Cadres. Data on the incidence of stunting in Tanah Spice Regency reached 16.1%. Providing health supplements to the community is needed to improve community health in Sari Gadung village and prevent stunting. This community service activity aims to prevent stunting by providing health checks, including checking Hb, glucose, uric acid, and blood pressure, and providing blood supplements. The method is that adult female patients are given drug information regarding the use of iron and folic acid drugs, and then their Hb, glucose, uric acid, and blood pressure are checked. The results of this activity showed that the number of patients who took part in the activity was 37, the average Hb value was 15.9 g/dL, the average uric acid was 8.6 mg/dL, the mean glucose was 112.5 mg/dL, and the blood pressure was 122/82 mmHg. The conclusion is that the results of the health examination at the posyandu in Sari Gadung village are still in the normal category.

Introducing a Measure of Hospital Community Orientation.

Policymakers have long sought to encourage hospitals to assume a more collaborative role in improving community health. By urging hospitals to interact with community stakeholders, more integrative relationships may result that can better address local health issues. This study establishes a composite measure of hospital community orientation, defined as the extent to which a hospital uses community resources and knowledge in its community benefit (CB) work, based on an expansion of CB regulations that require nonprofit hospitals (NPHs) to develop strategies to address prioritized health issues. We collected data on each proposed intervention from 125 randomly selected NPHs over three reporting periods. Confirmatory factor analysis was used to assess how well a single-factor model approximated community orientation. We conclude that using hospital community orientation measurement is a useful metric to assess the effects of expanded CB regulations, as well as to determine how NPHs have interacted with communities over time.

Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity

BackgroundCommunity health improvement plans (CHIPs) are strategic planning tools that help local communities identify and address their public health needs. Many local health departments have developed a CHIP, yet there is a lack of research on the extent to which these plans address root causes of health disparities such as the social determinants of health. This study aims to inventory the social determinants of health included in 13 CHIPs and examine facilitators and challenges faced by local health departments and partners when trying to include the social determinants of health.MethodsWe conducted a comparative plan evaluation by scoring 13 CHIPs on their inclusion of equity orientation, inclusive planning processes, and five social determinants of health: health care access and quality, the neighborhood and built environment, economic stability, social and community context, and education access and quality. To supplement the plan evaluation, we conducted 32 in-depth interviews with CHIP leaders and stakeholders to understand the factors contributing to the inclusion and exclusion of the social determinants of health in the planning process.ResultsCHIPs received an average score of 49/100 for the inclusion of the social determinants of health. Most plans addressed health care access and quality and the neighborhood and built environment, but they often did not address economic stability, the social and community context, and education access and quality. Regarding their overall equity orientation, CHIPs received an average score of 35/100, reflecting a relative lack of attention to equity and inclusive planning processes in the plans. Interviews revealed that challenges engaging partners, making clear connections between CHIPs and social determinants, and a lack of capacity or public and partner support often led to the exclusion of the social determinants of health. Recommendations to improve planning processes include improving data infrastructure, providing resources for dedicated planning staff and community engagement incentives, and centering equity throughout the planning process.ConclusionsAlthough local health departments can leverage CHIPs to improve population health and address health disparities, they face a range of challenges to including the social determinants of health in CHIPs. Additional resourcing and improved data are needed to facilitate broader inclusion of these determinants, and more work is needed to elevate equity throughout these planning processes.

Peranan Kepemimpinan Kepala Desa Untuk Meningkatkan Partisipasi Masyarakat Dalam Pembangunan Desa Kadujangkung Kecamatan Mekarjaya

This research aims to determine the leadership role of the Village Head in increasing community participation in implementing development in Kadujangkung Village, Mekarjaya District, Pandeglang Regency. Data collection was carried out through observation data, interviews, and field studies, documentation, recordings. , Mekarjaya District, Pandeglang Regency, leadership is really needed to increase community participation so that local communities contribute more to development. There are still local village communities who do not have a sense of responsibility to work together to advance the village where a village will be able to progress if there is participation from own society.In realizing the vision and mission led by the village head, it takes the form of realizing Kadujangkung Village as an independent village to achieve a healthy, intelligent and more prosperous society based on faith and piety. For this reason, it is necessary to create a village government apparatus that is honest, clean, transparent and authoritative. Apart from that, improving the community's economy by empowering the community by empowering the role of BUMDES, improving community health, increasing infrastructure development, especially village road access in a sustainable manner, so that it will facilitate transportation to support the community's economy.

Impact of Comorbidities as Predictors on Hospital Length of Stay (LOS) and Mortality in Hip Fracture (HF) Patients in a Rural Community

Purpose: Studies on HF at a rural health system area are rare. The research question is “Which demographic, preoperative variables would be independent predictors of outcomes on mortality and hospital LOS?”
 Methods: The design is a community-based cross-sectional study with risk factor analyses. We ascertained HF cases from hospital trauma center registry and Epic software. We employed both descriptive and analytic approaches including multivariable regression analyses of predictors on outcomes.
 Results: Of 201 HF patients, 85.6% occurred in 65 and above years (seniors). Among seniors, females consisted of 64.0% with mean age ± SD: 83.72 ± 7.56 years; extracapsular HF, 55.2%; specified falls, 51.7%; obesity, 15.2%; complication, 3.5%; surgery interventions, 80.8%; mortality within 1, 9.3%; 3, 11.6%; 6, 15.1%; and 12 months, 22.1% after hospital admission. Holding all other variables constant, no surgical intervention increased mortality risk within 1-month (OR=28.87, 95% CI: 4.43; 188.16), 3-months (OR=33.47; 95% CI: 5.24; 213.88), 6-months (OR=21.78; 95% CI: 3.67; 129.48), and 12-months (OR=4.17; 95% CI: 1.33;13.04) compared to surgical intervention; obesity increased 1-month mortality risk (OR=6.00; 95% CI: 1.06; 34.09) compared to no obesity; and patients transferred from community hospital compared to those who were not had an increased 1-month (OR= 8.54; 95% CI: 1.25; 58.13), 3-month (OR=15.31; 95% CI: 2.21; 106.16), 6-month (OR=21.19; 95% CI: 3.34; 134.43), and 12-month (OR=5.14; 95% CI: 1.85; 14.28) mortality risk. Hospital LOS was 3.06 days higher in obese patients than non-obese patients and 2.11 days higher in surgery greater than 48 hours when compared to surgery within 48 hours, holding all other variables constant.
 Conclusions and Potential Impact: We believe that surgical intervention decreases, and obesity increases HF mortality. Obesity and delayed surgical intervention increase hospital LOS. The results of this study have the potential benefit for improving community health of rural, elderly populations in northeast Indiana.

Generating a Novel Artificial Intelligence-Based Decision-Making Model for Determining Priority Strategies for Improving Community Health

Improving public health affects society in many ways. Improved public health can lead to a longer and healthier life. Policymakers cannot address all these criteria at the same time due to both time and budget constraints. Therefore, priority strategies need to be formulated by determining the importance weights of these criteria. Accordingly, the purpose of this study is to evaluate the significance of the strategies determined for the development of public health. For this purpose, analytic hierarchy process (AHP) method is considered to define the importance of the strategies. Within this scope, artificial intelligence methodology is integrated with the Spherical fuzzy sets. In this framework, the decision matrix of AHP is obtained by artificial intelligence system. Next, the steps of Spherical fuzzy sets are implemented. The main contribution of this manuscript is considering artificial intelligence methodology to create decision matrix. Hence, the weights of the experts can be computed based on their qualifications. By the help of this condition, it may be possible for the opinion of experts with better qualifications to be taken into consideration with a higher coefficient. This situation has a positive contribution to increase the accuracy of the findings. The findings indicate that accessibility is the most important strategy to improve public health. Similarly, vaccination and preventive services also play a significant role for this situation.

Vibrio cholerae and Salmonella Typhi culture-based wastewater or non-sewered sanitation surveillance in a resource-limited region.

In resource-limited regions, relying on individual clinical results to monitor community diseases is sometimes not possible. Establishing wastewater and non-sewered sanitation surveillance systems can offer opportunities to improve community health. We provide our experience of establishing a wastewater and non-sewered sanitation surveillance laboratory in Malawi, a resource-limited region, for Vibrio cholerae and Salmonella serotype Typhi. Three locations (inclusive of 8 discrete sample collection sites in total) in the Blantyre District were studied for nine weeks, from September 6 to November 1, 2022. Grab samples were collected weekly. We piloted locally available culture-based medical diagnostic methods for V. cholerae and S. Typhi in wastewater, followed by confirmation analysis of the isolates using reverse transcription polymerase chain reaction (RT-PCR). Bacterial counts ranged from up to 106 colony-forming units/mL for V. cholerae and up to 107 colony-forming units/mL for S. Typhi. RT-PCR of the isolates showed that the available culture-based medical diagnostic methods were successful in detecting V. cholerae but were less accurate for S. Typhi in wastewater. This experience serves as a catalyst for the development and validation of alternative wastewater surveillance analytical methods that are not dependent solely on RT-PCR. In this field trial conducted in Africa, new data-driven approaches were developed to promote early-level wastewater research and expand analysis options in resource-limited settings. Although culture-based methods are labor-intensive and have some limitations, we suggest initially leveraging the overlap with the locally available medical testing capacity for V. cholerae, whereas S. Typhi with RT-PCR may still be required. Wastewater analysis may be acceptable for V. cholerae and S. Typhi, which have a high degree of clinical case underreporting, fecal shedding, short incubation periods, and clear outbreak trends, predominantly in low- and middle-income countries.

Escherichia coli: Epidemiology, Impact, Antimicrobial Resistance and Prevention: A review

Public health aims to protect and improve community health by preventing and controlling infectious diseases. This includes surveillance, policy development, health education, immunization, research, and collaboration. Escherichia coli (E. coli) is a bacterium found in the intestines of humans and animals, with harmless and pathogenic strains causing serious illnesses. Pathogenic E. coli, like Shiga toxin-producing E. coli (STEC), can lead to severe food poisoning and outbreaks, making it a major public health concern. E. coli is transmitted through contaminated food, water, and direct contact with infected animals or individuals. It can survive in various environments and acquire antibiotic resistance. Vulnerable populations, such as children, elderly, and immunocompromised individuals, are at higher risk of severe infections. Studies in Egypt show high resistance rates to commonly used antibiotics in both clinical and food samples.E. coli isolates from various sources in Egypt and Tunisia demonstrated high resistance to commonly used antibiotics, limiting treatment options and posing a public health risk. E. coli isolates from patient urine in Nigeria showed high resistance to most antibiotics tested except newer drugs, indicating misuse of antibiotics in healthcare. The typical symptoms of infection include diarrhea, abdominal pain, symptoms of urinary tract infection and fever. The most serious complication is hemolytic uremic syndrome (HUS), which can cause acute kidney failure and be life-threatening, especially in young children and elders. Long-term consequences of infection and HUS can include chronic kidney disease and neurological impairment. The present review article summarizes the current knowledge, highlights the challenges and gaps and provides recommendations and solutions.

Social Determinants of Health for Positive Mental Health of Iranian Adults

Objectives Considering the importance of positive mental health promotion for preventing psychosocial disorders and increasing physical health and productivity, it is necessary to identify the social determinants of health (SDH) to implement the necessary interventions to improve community health. The present study aims to identify the SDH of positive mental health in Iranian adults. Methods This is a quantitative and correlational study that was conducted on adults aged 30-60 years living in Tehran, Iran. The sample size was estimated to be 547 people using G*Power software. The samples were selected using a multi-stage random sampling method. After reviewing the literature and meeting with a panel of experts, the SDH list was extracted, and the conceptual model was plotted. The criteria for entering the model was a significance level (P≥0.2). At the end, the structural equation modeling method was applied. The tools used included the mental health continuum–short form, the socioeconomic status questionnaire, multidimensional scale of perceived social support, perceived stress scale-10 items, international physical activity questionnaire-short form, Neissi’s job security questionnaire, Ten Horn’s job security questionnaire, the visual analogue scale for occupational stress assessment, the neighborhood status checklist, Internet use checklist, and social security insurance checklist. The data was analyzed in SPSS software, version 21 and LISREL version 8.8. Results The data of 607 questionnaires were analyzed. The mean age of participants was 44.04±9.4 years. The mean score of positive mental health was 45.96±8.65. Among structural determinants, the social class (B=0.181), socio-economic status (B=0.114), job position (B=0.08), building volume per capita (B=0.092) had positive effect on positive mental health, while education (B=-0.071) had negative effect. Among intermediary determinants, job satisfaction (B=0.16), social support (B=0.23) and insurance (B=0.14) had positive effect on positive mental health, while perceived stress (B=-0.62) had negative effect. Conclusion Improving socioeconomic status by increasing social support and job satisfaction can increase Iranian adults' positive mental health. On the other hand, the reduction of perceived stress can determine the positive mental health of Iranian adults both directly and indirectly.

Convergence of Stunting and Diarrhoea among Children in Peri-Urban Lusaka: A Cross-Sectional Study of Prevalence and Predictors

Background: In Zambia, stunting and diarrhoea—largely avoidable conditions—are significant contributors to death in children under five years of age. Large-scale studies commonly compare these variables between urban and rural settings, although they frequently neglect to consider the substantial socio-economic differences present within urban populations. This study sought to investigate the prevalence and co-occurrence of stunting and diarrhoea in peri-urban regions of Lusaka. Method: A cross-sectional study approach was utilized, focusing on 239 homes in Lusaka East, a peri-urban area of Zambia's capital city. The research concentrated on homes with a minimum of one kid between the ages of 6 and 23 months. Data collection utilized structured questionnaires distributed to guardians, documenting socio-demographic variables and sanitation practices. Children's anthropometric measures were standardized utilizing height-for-age z-scores (HAZ). The research employed bivariate and multivariable logistic regression analysis to investigate factors associated with malnutrition and diarrhoea. Results: The study included 232 children, with 53.8% (n=125) identified as female and 46.2% (n=107) as male. The median age of the children was 13 months (IQR ±8), whereas the median age of their guardians was 26 years (IQR ±9.5). The prevalence of stunting and diarrhoea was 24.1% (95% CI: 18.7–30.2%) and 19.4% (95% CI: 14.5–25.1%), respectively, with the highest rates observed in children aged 12 to 23 months. Significant predictors of stunting were identified as child gender (aOR: 0.45, 95% CI: 0.23–0.89), sanitation type (aOR: 2.35, 95% CI: 1.08–4.52), and the marital status of the guardian (aOR: 1.17, 95% CI: 1.01–2.88). In children with diarrhoea, gender (aOR: 0.41, 95% CI: 0.18–0.89) and the guardian's marital status (aOR: 2.80, 95% CI: 1.14–6.89) were identified as significant predictors. Conclusion: In conclusion, the study identified a significant prevalence of stunting, alongside a high incidence of diarrhoea in stunted children, potentially elevating the risk of childhood mortality. This highlights the necessity of strengthening primary healthcare services and improving community health education, with an emphasis on the early detection of stunting and the prevention of diarrhoea, especially in economically disadvantaged peri-urban areas in Zambia.

Implementation of the Information Motivation Behavior Skill Model on Cadre's Performance in Surakarta: A Structural Equation Model

Background: Integrated service post cadres are individual volunteers at the community level who are selected by residents based on their ability, integrity, loyalty and commitment to improving community health and playing a role in developing strategies to overcome stunting. This research aims to determine whether there is an effect of implementing the Information-Motivation-Behavior Skill Model on the performance of Integrated services post cadres. Subjects and Method: This was a cross-sectional study conducted in Surakarta, Central Java, form November to December 2023. A sample of 210 integrated services post cadres was selected using stratified random sampling. 25 integrated service posts in 3 community health centers The data were collected using a structural equation modeling (SEM). Results: Performance was positively and significantly influenced by behavioral skill (b= 0.26; 95% CI= 0.13 to 0.38; p< 0.001), information (b= 0.16; 95% CI= 0.03 to 0.28; p= 0.014), and motivation (b= 0.18; 95% CI= 0.05 to 0.32; p= 0.008). Goodness of fit of SEM model indicated fit (p= 0.190; RMSEA= 0.037; CFI= 0.99, TLI= 0.98, SRMR= 0.03; CD= 0.92). Conclusion: The Information-Motivation-Behavioral Skill Model can be used to predict work performance of integrated health post cadres. Performance is positively and significantly influenced by behavioral skill, information, and motivation Keywords: structural equation model, work performance, information-motivation-behavioral skills, integrated health post cadres Correspondence: Chelsy Sumardi Saputri. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: chelsysumardisaputri@gmail.com. Mobile: +6285819861946.

Perspectives of patients with osteoarthritis for using digital technology in rehabilitation at a public community centre in the Cape Metropole area: A qualitative study.

To explore the perspectives of people with osteoarthritis (OA) on the use of digital technology into their rehabilitation program, including their awareness, views on accessibility, affordability and willingness to accept digital modalities for rehabilitation delivery. A qualitative, descriptive design was conducted. Patients with OA who receive care at a public community rehabilitation centre in the Western Cape, South Africa were eligible to participants. Semi-structured interviewed were conducted and Atlas.ti 23 software was used for thematic analysis. The findings showed that the participants had limited awareness and exposure to telerehabilitation (TR), along with minimal digital literacy and skills. They were sceptical about the effectiveness of TR and concerned about the inherent lack of physical interactions with health professionals. However, some acknowledged TR's potential benefits for accessibility, convenience, family involvement and long-term community health improvement. Participants were willing to learn more about TR. Considering the benefits of TR in lower resource settings such as South Africa, investment to increase awareness and patient education and training in TR may assist in enhancing access and quality of care. Resources dedicated to TR and management buy-in in low-and-middle income countries (LMICs) is necessary to facilitate the fit-for-context roll-out of TR.