Preventable Childhood Diseases Research Articles

Uncovering the health system burden of pneumococcal infections in adult and elderly populations

Abstract Background Health system resources dedicated to vaccination and infectious disease prevention are often directed towards infants and children, through extensive childhood vaccination schedules. This focus has led to the near eradication of several preventable childhood diseases and had positive impacts on population health, but despite this track record of success, the ability of our health systems to make vaccinations accessible throughout the full life course has been less consistent. This project aims to address this issue by providing new data about the burden that pneumococcal infections, which are vaccine-preventable, have on adult and elderly populations. Methods This research aims to uncover the health system burden of invasive pneumococcal disease and pneumococcal pneumonia at all levels of the health system in 5 EU countries (Austria, Belgium, France, Italy & Portugal). This involves a survey of managers and care providers working in hospitals, long-term care facilities, and primary care centres who may be affected by the health system impacts of pneumococcal infections. The survey covers several dimensions of health service delivery to collect a broad range of data on existing disruptions. The survey was translated into the study country languages and its formulation was further validated through interviews with experts in each study country to ensure that it can capture context-specific health system insights. The data collected through this survey will be further enhanced through a series of in-depth interviews before being synthesised, analysed and eventually published in a detailed report. Results Data collection begins as of 15 May 2024, and full results are expected to be published and available for the EPH Conference in November 2024. The results of this research will offer valuable evidence to public health professionals, health managers and policy-makers across Europe who are working to improve life-course access to pneumococcal vaccination. Key messages • Effective vaccination programmes for adult and elderly populations require expanding focus beyond childhood. • Data about the health system burden of pneumococcal infections in adult and elderly populations improves evidence-based decision-making and public health services.

The Minhang Pediatric Biobank cohort study: protocol overview and baseline characteristics

BackgroundLittle has been done to establish biobanks for studying the environment and lifestyle risk factors for diseases among the school-age children. The Minhang Pediatric Biobank (MPB) cohort study aims to identify factors associated with health and diseases of school-aged children living in the urban or suburban area of Shanghai.MethodsThis population-based cohort study was started in all sub-districts/towns of Minhang district of Shanghai in 2014. First-grade students in elementary school were enrolled during the time of their routine physical examinations, with self-administered questionnaires completed by their primary caregivers. Additional information was extracted from multiple health information systems. Urine and saliva samples were collected during the baseline survey and follow-up visits.ResultsAt the end of 2014 academic year, a total number of 8412 children and their parents were recruited, including 4339 boys and 4073 girls. All the participants completed the baseline survey and physical examination, and 7128 urine and 2767 saliva samples were collected. The five most prevalent childhood diseases in this population were dental caries, bronchitis, pneumonia, asthma and overweight/obese.ConclusionsThe MPB cohort has been successfully established, serving as a useful platform for future research relating to the genetic, environmental and lifestyle risk factors for childhood diseases.

Childhood dental caries and obesity: Opportunities for interdisciplinary approaches to prevention.

Dental caries and obesity are prevalent and preventable chronic childhood diseases. Evidence shows a strong connection between these two diseases, with overlapping common risk factors, including diet as a key driver of risk. Dental professionals are well-positioned to perform nutritional counseling and obesity prevention in dental clinic settings, but training and clinical integration remain key challenges. This paper highlights the potential for leveraging the common risk factor approach (CRFA) framework and its principles to reduce the impact of childhood dental caries and obesity. Strategies and methods are provided to integrate meaningful didactic and clinical training experiences in dental academia, and the need to include effective and evidence-based nutritional counseling techniques in dental settings is also described. Additionally, the potential for integrating CRFA and engaging health care providers across the spectrum of care, including primary care settings, to reduce the prevalence of these diseases in pediatric populations is highlighted. Finally, theauthors propose future directions for multidisciplinary research to advance the scientific knowledge in this area and to inform effective and comprehensive interventions for dental settings.

Influence of Media Advocacy on the Knowledge of Prevention Measures and Management Strategies of Early Childhood Diseases among Nursing Mothers in Ikwo L.G.A of Ebonyi State

This study examined the influence of media advocacy on the knowledge of prevention measures and management strategies of early childhood diseases among nursing mothers in Ikwo L.G.A of Ebonyi state. The survey design was adopted in the course of the work. Data for the study was gathered through questionnaire. 850 questionnaires were distributed to the respondents. The frequency tables and percentages and the independent sample tests were used as methods of data analysis. From the analyses conducted, it was revealed that there are prevalent early childhood diseases in Ikwo local government area of Ebonyi state, there are communication intervention programs used in enhancing knowledge of prevention and management of early childhood disease among nursing mothers in Ikwo Local Government Area of Ebonyi state, and communication intervention programs on early childhood disease have not enhanced knowledge of prevention and management strategies among nursing mothers in Ikwo Local Government Area of Ebonyi state. It is the recommendation of the study that that there should be an increase in early child disease awareness among individuals, family and communities by ensuring community participation in the control and much research should be carried out to find out better ways to ensure communication intervention programs on early childhood disease enhances knowledge of prevention and management strategies among nursing mothers.

Dental Caries on Deciduous Molars among Children Visiting Dental Outpatient Department of a Tertiary Care Centre.

Dental caries is one of the most common, yet preventable childhood diseases. The aetiology of dental caries lies in the interplay between host, microorganism, substrate, and time. Risk factors for dental caries include physical, biological, environmental, behavioural, and lifestyle-related factors such as high numbers of cariogenic bacteria, inadequate salivary flow, insufficient fluoride exposure, poor oral hygiene, inappropriate methods of feeding infants, and poverty. The aim of the study was to find out the prevalence of dental caries on deciduous molars among children visiting dental Outpatient Department of a tertiary care centre. This descriptive cross-sectional study was conducted on children who visited the dental outpatient department of Kathmandu University School of Medical Sciences, Dhulikhel Hospital from 15 June 2023 to 30 July 2023. Ethical approval was taken from the Institutional Review Committee of the same institute. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. The prevalence of dental caries on deciduous molars in children was 252 (93.33%)(90.35-96.30, 95% Confidence Interval). One-third of the children had visited dental clinics for the first time. Lack of topical fluoride application was seen in the majority of the children. The prevalence of dental caries on deciduous molars among pediatric patients was found to be higher than in other studies done in similar settings. children; dental caries; molars; prevalence.

Corruption, patronage, and avertable child deaths in developing countries

AbstractMany children die of easily preventable or treatable diseases in developing countries. What are the relationships between corruption, patronage, and child mortality in low‐ and middle‐income countries? We argue that corruption and patronage affect child mortality outcomes for some causes of death, especially those that are more easily prevented or treated with affordable care. To test our hypotheses, we utilize cross‐national time‐series analysis of under‐five child mortality in developing countries between 1996 and 2016. Our study finds that patronage and corruption increase under‐five child mortality arising from easily preventable childhood diseases, but they have almost no effect on under‐five child mortality caused by more complex illnesses. Our study underscores the need to examine cause‐specific health outcomes rather than overall health outcomes in comparative health analysis, as the ability of governments to address specific health issues depends on the nature of the problems.Related ArticlesIreni‐Saban, Liza. 2013. “Give Me Children or Else I Die: The Politics and Policy of Cross‐Border Reproductive Care.” Politics & Policy 41(1): 5–38. https://doi.org/10.1111/polp.12004.Lagunes, Paul F. 2012. “Corruption's Challenge to Democracy: A Review of the Issues.” Politics & Policy 40(5): 802–26. https://doi.org/10.1111/j.1747‐1346.2012.00384.x.Tusalem, Rollin F. 2022. “Does Gendered Representation in National Legislatures Promote Substantive Representation and Human Development? Evidence from the Developing World.” Politics & Policy 50(6): 1096–137. https://doi.org/10.1111/polp.12503.

Vaccination compliance of selected childhood immunization programs and the socio-determinant factors in Nigeria

Introduction: Adherence to full vaccination is important in preventing childhood diseases. The aim of this study was to evaluate the level of compliance to full vaccination and identify the socio-cultural factors associated with full vaccination compliance in children. Methodology: The socioeconomic variables associated with each of the four binary dependent variables of whether or not a child is fully vaccinated against tetanus, BCG, measles, and pentavalent were determined using logistic regression. Results: While compliance to full tetanus and BCG vaccinations was > 60% at the national level, less than 50% and 10% full vaccination compliance were recorded for pentavalent and measles vaccinations, respectively. The South East region of Nigeria recorded the overall highest full vaccination compliance while the least performing region was the North West zone. The mother or guardian literacy level, employment status, antenatal care attendance, and internet usage were strong predictors of full vaccination compliance (p < 0.05). Conclusions: The socio-cultural factors associated with achieving full vaccination coverage in Nigeria in this study should drive the implementation of policies that will be best suited to each geopolitical zone of Nigeria.

Which month to give a birth? The analysis on birth seasonality of China

A series of medical and biological studies have identified a strong link between the season during which a child is born and early childhood development and adult health. While providing an explanation for the seasonal determinants of birth remains one of the key challenges for demographers, understanding seasonal birth peaks and troughs can inform both public health planning and efforts to prevent childhood diseases. The seasonality of births varies across and within countries. Nonetheless, there has been scant research into the seasonality of births in China. This study takes an in depth look at the seasonal fluctuations in China’s births since 1960 and investigates the effects on seasonality of several key factors such as parity, residence (urban or rural area), and changes to fertility policies. Traditionally, winter has been the peak season of births in China, while spring and summer have been lean seasons, a pattern which is quite different than patterns in Europe and the United States. After 1990, the sweeping implementation of one-child policy and the wider use of modern contraceptives among Chinese women prompted a fundamental shift in the seasonality of births, with the deviation of births from month to month gradually diminishing over time. People's self-control may serve as a key determinant accounting for such seasonal changes. First births exhibit pronounced and steady seasonality, while second and subsequent births follow a vague seasonal pattern, suggesting that later births are more likely affected by self-choice and self-intervention. The analysis also reveals that the monthly distribution pattern of second births experienced a dramatic change following the roll-out of the selective-two-child policy and the Universal Two-child Policy in 2014 and 2016, changes that reflects the adjustments people made to achieve their fertility plans under the new policy.

Children's health affected by parent's behavioral characteristics: a review.

Exposure of an individual to occupational and environmental risk factors for a certain disease affects them and their family. Children are highly vulnerable in this setting because they are family-dependent. This review discusses diseases that occur in children according to the occupational and behavioral characteristics of their parents. Toxic agents in the home environment can affect children's health. Maternal exposure to substances during pregnancy may directly affect fetal outcomes. The Industrial Accident Compensation Insurance Act in Korea was amended in 2023 to compensate for children's adverse health effects due to their parents' occupational risks. The long working hours and smoking behaviors of parents and toxic materials in the home environment are highlighted. To control for the diverse factors affecting children's health in medical research, this review introduces directed acyclic graphs. Pediatric, occupational, and environmental medicine must collaborate to prevent childhood diseases related to environmental factors.

RISK FACTORS ASSOCIATED WITH PROLONGED MECHANICAL VENTILATION IN VERY LOW BIRTH WEIGHT INFANTS

Introduction. Mechanical ventilation (MV) remains a life-saving intervention for the sickest very low birth weight (VLBW) neonates. Despite the widespread use of non-invasive respiratory support, many VLBW neonates require some duration of MV during their initial hospitalization. As prolonged exposure to MV is associated with adverse outcomes in VLBW infants, it is important to identify the factors that influence the duration of this intervention.The study aimed to determine the factors affecting the duration of MV in VLBW infants.Material and methods. Data from a prospectively created computerized database were used in a retrospective cohort study. The database included information on 1086 VLBW infants < 32 weeks' gestation who were ventilated at any time during their hospitalization at the tertiary care hospital between January 2010 and December 2020. Factors that potentially influenced the duration of MV were examined.The research was carried out in compliance with the requirements of bioethics as part of the planned scientific work of the department (state registration number 0117U001083).The data obtained were analyzed using descriptive and comparative statistics, as well as Spearman's rank correlation coefficient and one-way analysis of covariance (ANCOVA). Measurements with normal distribution are presented as mean (standard deviation). Non-parametric continuous data are presented as median (interquartile range). All values were considered significant when p <0.05.The study was carried out as a part of the planned scientific work of the department "Clinical-laboratory and instrumental substantiation of differential approaches to diagnosis, treatment and prevention of childhood diseases" (state registration number 0122U000164) without external sources of funding.Results. According to univariant analysis, bronchopulmonary dysplasia (BPD) (rS=0.32, p<0.05), severe BPD (rS=0.418, p<0.05), pneumothorax (rS=0.06, p=0.05), severe intraventricular hemorrhages (IVH) (rS=0.255, p<0.05), periventricular leukomalacia (PVL) (rS=0.15, p<0.05), sepsis (rS=0.087, p<0.05), necrotizing enterocolitis (rS=0.088, p<0.05), longer duration of antibiotic therapy (rS=0.168, p<0.05), and a lower gestational age (rS=-0.118, p<0.05) were associated with longer duration of MV in VLBW infants. At the same time, BPD (F=18.544, p<0.0001), severe BPD (F=109.810, p<0.0001), severe IVH (F=23.859, p<0.0001), PVL (F=15.031, p<0.0001), and more days of antibiotic therapy (F=13.173, p<0.0001) significantly and independently affected the duration of MV based on the results of one-way ANCOVA.Conclusion. Severe lung and brain injury and prolonged antibiotic exposure were the main risk factors that significantly and independently prolonged MV in VLBW infants.

Enhancing Competence in Preventing Childhood Diseases for Preschool Teachers in Vietnam

This study aims to evaluate the current competence of preschool teachers in preventing childhood diseases in Vietnam and provide recommendations for their development in effectively addressing these issues. The research employed consulting methods, including telephone and email consultations, as well as a Google Form questionnaire. The questionnaire utilized a 5-level rating scale (Good, Fair, Average, Weak, Poor). The study involved 25 administrators (Education and Training officers, Kindergarten Principals, and Vice Principals) and 118 preschool teachers from Lao Cai city, Lao Cai province. The research was conducted from April 2021 to November 2021.
 Results of the study revealed several limitations in the current ability of preschool teachers to prevent childhood diseases in the study area. These limitations included inadequate competence among certain members of the Board of Education and management staff, particularly the principals. Furthermore, there was incomplete awareness among some management staff and teachers regarding the significance of fostering skills in preventing contagious diseases among Kindergarten teachers. The training activities related to preventing contagious diseases in children for Kindergarten teachers in Lao Cai city and province were also found to be inadequate. The schools predominantly followed an experiential approach rather than a systematic one. Based on the research findings, the study team proposes recommendations for enhancing the competence of preschool teachers in preventing childhood diseases.

The differential predictive utility of two caregiver-targeted self-efficacy measures to promote oral health of underserved children.

Oral health self-efficacy is a modifiable determinant of early childhood caries, which is one of the most prevalent childhood diseases. Yet, two common measures of self-efficacy (i.e., context-specific and behavior-specific) lack validation and clarity in the prediction of children's oral health behaviors. This study examined the psychometric properties of two caregiver oral health self-efficacy measures and investigated the predictive ability and age-varying effects of caregiver oral health self-efficacy on child oral health behaviors. In this secondary data analysis of caregiver-child dyads (n = 754, Mchild age = 2.4, 56.2% Black or African American, 68.3% below poverty level), caregivers reported their oral health self-efficacy and their child's tooth brushing frequency, diet, and sugar-sweetened beverage (SSB) consumption at baseline and 4, 12, and 24 months. Psychometrics were examined with confirmatory factor analyses (CFAs) and the predictive ability and age-varying effects of caregiver self-efficacy on child oral health behaviors were examined with time-varying effect models (TVEMs). The context- and behavior-specific oral health self-efficacy CFA models indicated mixed model fit. In the predictive TVEM models, greater behavior-specific, but not context-, oral health self-efficacy predicted greater child tooth brushing across all ages. Greater context-specific oral health self-efficacy predicted healthier child diet throughout childhood, but greater behavior-specific self-efficacy only predicted healthier child diet in older children. Greater behavior-specific self-efficacy predicted lower SSB consumption throughout childhood while greater context-specific self-efficacy only predicted lower SSB consumption in younger children. Both caregiver oral health self-efficacy measures were psychometrically comparable and differentially predicted oral health behaviors across varying childhood ages. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Uptake and determinants of childhood vaccination status among children aged 0–12 months in three West African countries

BackgroundVaccination has long been recognized as one of the most effective ways to reduce child mortality. It has played a significant role, particularly for children, and is considered a major achievement and relevant in preventing childhood diseases worldwide. This study looks at the uptake and determinants of childhood vaccination status among children under the age of one year, for Gambia, Sierra Leon, and Liberia.MethodData from 2019 to 20 Demographic and Health Survey (DHS) data from Gambia, Sierra Leone, and Liberia were pooled for the analysis used in this study. Data were obtained from a total weighted sample of 5,368 children aged 0–12 months through a stratified two-stage cluster sampling approach. A multivariable logistic regression model was used to assess the predictors of childhood vaccination uptake at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs).ResultsThe weighted sample pooled prevalence of full vaccination among children under 12 months of age was 15.1% for males and 15.0% for females. After controlling for confounders in the regression model, factors that were found to be associated with vaccination status include children whose mothers attended postnatal care (PNC) visits had higher odds of being fully vaccinated (aOR = 1.23, 95% CI = 1.03–1.46), while children whose fathers had primary education (aOR = 0.67, 95% CI = 0.48–0.96), children whose households never watched TV (aOR = 0.68, 95% CI = 0.56–0.82) and children whose mothers attended 1–3 antenatal care (ANC) visits (aOR = 0.59, 95% CI = 0.45–0.79) had lower odds of being fully vaccinated.ConclusionChildhood vaccination uptake was low among children under 12 months of age in these countries. Hence, there is a need to promote the uptake of vaccination across these three West African countries especially among rural dwellers.

Trial-based economic evaluation of the system-integrated activation of community health volunteers in rural Ghana

ABSTRACT Background Globally, steps to revitalise programmes deploying community health workers (CHWs) on a national scale have been growing, but few economic evaluations have been done on system-integrated CHW programmes. Ghana has dual cadres of CHWs: community health officers (CHOs) and community health volunteers (CHVs). CHO plays a major role in primary health services but has suffered from chronic staff shortages. We activated CHVs in communities to mitigate the negative impact due to CHO shortages. The CHVs conducted home visits and provided health education to prevent childhood diseases. Objective We evaluated the cost-effectiveness and cost-benefit of activating CHVs. Methods In a cluster-randomised trial with 40 communities in rural Ghana, the changes in disease incidence were inferred from a statistical model using a Bayesian generalised linear multilevel model. We evaluated the total incremental cost, benefit, and effectiveness for the intervention from an economic model. In cost-effectiveness analysis, disability-adjusted life years (DALYs) were estimated using a decision tree model. In the cost-benefit analysis, the cost-benefit ratio and net present value of benefit were estimated using a decision tree model, and a standardised sensitivity analysis was conducted. The decision tree model was a one-year cycle and run over 10-years. Costs, benefits, and effectiveness were discounted at a rate of 3% per year. Results According to the cost-effectiveness analysis, the programme was highly likely to exceed the WHO-CHOICE threshold (1–3 times GDP per capita), but it was unlikely to exceed the conservative threshold (10–50% of GDP per capita). In the cost-benefit analysis, the mean and median cost-benefit ratios were 6.4 and 4.8, respectively. Conclusion We found the potential economic strengths in the cost-benefit analysis. To integrate CHW programmes with national health systems, we need more research to find the most effective scope of work for CHWs.

Comparison of Childhood Caries Levels between Children of Pediatric Dentists and Children of General Dentists: A Cross-Sectional Study

Caries development in children is a prevalent childhood disease. Factors affecting chronic teeth lesions include nutrition, parental involvement, and executing proper dental health attitude. Professional dentists are perceived as role models for the oral health and hygiene of their families. The purposes of the research were 1. To compare caries rates in the children of pediatric dentists and children of general dentists. 2. To compare children's nutrition habits between pediatric dentists and general dentists. 3. To compare children's oral health and hygiene between pediatric dentists and general dentists. 4. To compare children's usage of fluoride-containing products between pediatric dentists and general dentists. A cross-sectional study was conducted by distributing self-reporting questionnaires to pediatric dentists and general dentists via the social media "snowball" platform. The following themes were surveyed: nutrition habits and oral hygiene of the children. The sample consisted of 176 participants. Children of pediatric dentists were found to have fewer cases of caries than children of general dentists (p = 0.018). Nutrition habits did not differ between the two groups. In addition, pediatric dentists reported that their children use more fluoridated toothpaste in comparison with general dentists. Professional training of pediatric dentists contributed to shaping the oral hygiene attitude of their children.

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021).

Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.

Child Survival Crisis Due to Maternal Undernourishment During the COVID Era.

The coronavirus disease 2019 (COVID-19) pandemic caused a global crisis, creating the most challenging times faced by any country. The pandemic created a situation that shocked the whole world. It led to a condition of fear, and the ones to take the major hit were the vulnerable groups: children, pregnant women, and the elderly, as well as those belonging to low socio-economic groups who lost their source of daily income. It increased the pressure on already burdened healthcare and information systems and led to a situation where the well-being of even children and pregnant women could not be maintained. COVID-19 increased the risk of undernutrition in children. Though children are observed to be less affected by the virus, they are the hidden victims of the pandemic in terms of falling prey to undernutrition. Child undernutrition can also be linked to maternal malnutrition, starting from the preconception period through the postpartum period. The situation arose due to the rapid steps of mitigation taken to tackle the pandemic, leading to decreased food security, healthcare, and education. Maternal undernutrition leads to complications for the mother during childbirth and has long-term effects on both. It can lead to low birth weight (LBW) babies, postpartum complications, chronic child undernourishment, and even increased maternal and child mortality and morbidity. Because of the pandemic's disruption of immunization facilities, it appears that even preventable childhood diseases will worsen in the coming years. In these post-COVID-19 times, it has become necessary to take measures to improve the overall health status of the population, with special regard to these vulnerable groups. Proper maternal and child health should be targeted at community levels by introducing interventions that prioritize antenatal and postnatal care, nutritional education, immunization of both mother and child, and proper health and sanitation practices. The purpose of this narrative review is to create awareness about the child survival crisis that may occur in the coming years due to undernutrition and the failure of immunization.

Perceptions of Healthcare Workers (HCWs) towards childhood immunization and immunization services in Fiji: a qualitative study

IntroductionChildhood immunization has been globally recognized as the single most effective strategy in preventing childhood diseases and mortality. The perceptions of healthcare workers are important as their behavior and attitudes influence parental decision–making process. This research aimed to explore the factors that influence healthcare workers’ experience and perceptions about delivering childhood immunization in Fiji.Materials and methodsA qualitative study was conducted in three randomly selected health centers in Suva, Fiji from March 1st to April 5th, 2021. Five focus group discussions were conducted with healthcare workers who were chosen purposively, had worked in the health center for at least 6 months and included either gender. Those that did not consent or did not meet the inclusion criteria were excluded. The interviews were guided by semi–structured open–ended questionnaire and were recorded into a digital voice recorder. The data were coded, sorted, and then categorized into themes, and transcribed onto Microsoft Word. Thematic analysis was utilized to sort the key phrases from the recorded interviews.ResultsThere were a total of 22 participants for the focus group discussions, with their ages ranging from 25 to 51 years, included 3 medical officers, 1 nurse practitioner and 18 registered nurses. Three major themes emerged, which included: healthcare worker factors, parental factors and health system factors. Subthemes identified from the healthcare worker factors were worker knowledge and attitudes. The subtheme for parental factors that emerged were defaulters, parental attitudes, perceived behavior and religious beliefs. For health system factors the subthemes were service delivery, registration, infrastructure, staff turnover, staff training and changes to the immunization schedule.ConclusionSome of the perceived barriers reported by the healthcare workers were parental religious beliefs, parental knowledge and attitude, social or physical factors (finances, transportation, childcare and work conflicts), access to health services, immunization services and policies, hours of operation, waiting time and missed opportunities. Health workers acknowledged that they have an important role to play in immunization as they are the source of information and motivation for parents. Further studies are needed to be conducted nationally to determine the perceptions of healthcare workers towards immunization and how the services can be improved on a national level.

Providing Uroandrological Care to Children in the Republic of Uzbekistan

Currently, there is a high incidence of children and adolescents in the Republic of Uzbekistan, including in the uroandrological field with high risks of male infertility (up to 35%). The factor of male infertility takes the leading positions and is a source of childlessness in 40% of cases. These statistics inexorably indicate that this is the essence of links in one chain, namely, the absence of a specific organization of specialized medical care in the field of reproductive health of boys and adolescents. For the new Uzbekistan, solving the issues of prevention of male reproductive diseases in childhood is vital.

A study on knowledge, attitude and practices of cold chain handlers regarding cold chain management in district Kanpur

Background: Immunization is one of the most cost-effective measures to prevent childhood diseases. Vaccines are sensitive biological products and their potency can diminish irreversibly when exposed to inappropriate temperatures. Cold chain handler (CCH) is the most crucial person at a cold chain point (CCP) as his/her correct knowledge and skills regarding cold chain practices, vaccine management and handling are immensely vital for the success of universal immunization programme. Thus, this study has done to assess the knowledge, attitude, and practice of CCH in public health facilities in district Kanpur.Methods: A cross sectional study was conducted in 20 CCPs of public health facilities of district Kanpur using multistage simple random sampling technique. The data was collected by using direct personal interview method using semi-structured interview schedule based on standard Government of India (GOI) questionnaire then filled on the Microsoft excel sheet and most appropriate statistical tool applied and results were drawn accordingly.Results: Only 25% of cold chain handlers had good knowledge and 20% had poor knowledge about cold chain handling similarly 25% were showing excellent performance (in terms of attitude and practice) 50% were showing average performance and 25% were showing poor performance.Conclusions: There is need to improve the knowledge level of CCHs regarding cold chain maintenances and handling practices by regular training sessions and monitoring visits. Medical officers of the health facility supported by district immunization officer should be actively involved in the monitoring and supervision of the CCHs on regular basis.