Primary Health Centers Research Articles

Health workers' and women's perspectives on barriers to cervical cancer screening and treatment uptake in North-Central Nigeria.

e17508 Background: Cervical cancer is a significant public health problem globally, particularly in sub-Saharan Africa (SSA), with an estimated 35 new cases per100,000 women and 23 deaths per 100,000 women occurring annually, where poor uptake of screening and late-stage presentation contributes to the disease's rising burden. This study examines barriers to cervical cancer screening and early treatment uptake in Lafia, Nasarawa State, Nigeria and explores the perspectives of health workers and women presenting at the primary health centres. Methods: In this qualitative study, in-depth interviews (IDIs) were conducted with seven primary health care providers (doctors, nurses, and community health extension workers) and 17 women aged 25–65 attending two clinics in Lafia, North Central Nigeria. Health facilities and participants were selected using convenience sampling techniques. Semi-structured interviews were conducted in English and in the local language-Hausa. These were transcribed into English and thematically analyzed using Dedoose software. Inductive and deductive approaches were used to identify key patterns and themes related to barriers to cervical cancer screening and early treatment. Results: Our findings showed that women demonstrated poor knowledge and low awareness of cervical cancer and its screening but expressed willingness to undergo screening if it was provided and accessible. Health workers identified several barriers, including the absence of routine screening programs, inadequate training, insufficient trained personnel, limited equipment and the preference for female providers. Women mentioned additional challenges such as spousal influence, fear of the procedure, costs, transportation difficulties, long waiting times, stigma, as well as cultural and religious beliefs. Both groups advocated for targeted awareness campaigns, improved accessibility and affordability of screening services, better staffing, training, provision of essential equipment, and provision of self-sampling options or private spaces for screening. Conclusions: Addressing the identified barriers to cervical cancer screening and treatment in Nigeria requires targeted interventions and policy reforms, with a focus to improve access, affordability, and awareness.

Risk Factors of Stunted Children Aged 0-23 Months at Jatibaru Public Health Center Bima, West Nusa Tenggara: A Case Control Study

Background: Nutritional status in children under-five profoundly affects linear growth, cognitive development, and long-term disease. Stunting, defined as a child being too short for their age, results from prolonged malnutrition, particularly in the first 1000 days. In West Nusa Tenggara (NTB), stunting prevalence is the fourth highest at 32.7%, with 31.2% affected in Bima. This study aims to compare previous exposure between stunted children and non - stunted children in primary health care settings in Bima. Methods: A case-control study was conducted involving children aged 0–23 months who accessed integrated health services, bring a Maternal and Child Health Book (MCH), and had recorded health data at the Jatibaru Primary Health Center. Children with congenital anomalies were excluded. Maternal and child-related risk factors were assessed through anthropometric measurements (WHO standards) and structured interviews with validated questionnaire. Bivariate analysis (Chi-square, p < 0.25) was followed by multivariate logistic regression (p < 0.05). Result: A total of 124 participants were included (62 cases, 62 controls). Multivariate analysis revealed that maternal factors significantly associated with stunted growth in children were poor nutritional status (AOR 7.519, p = 0.000) and low nutrition knowledge (AOR 6.930, p = 0.000). Among child-related factors, stunted children were significantly associated with low birth weight (AOR 17.013, p = 0.000) and inadequate breastfeeding (AOR 7.434, p = 0.006). Conclusion: The mother’s nutritional status and children’s birth weight are the main risk factors of stunted children. Targeted interventions addressing maternal education and perinatal care are recommended to reduce stunting prevalence.

Determinants of primary healthcare centers utilization: A geo-statistical study of healthcare access in Madurai district, Tamil Nadu

Health services play a pivotal role in shaping social well-being and community development. This study evaluates the performance of Primary Health Centres (PHCs) in Madurai District, Tamil Nadu, through a comprehensive spatial and statistical assessment of healthcare accessibility and utilisation patterns. A mixed-method approach integrating GIS-based spatial analysis, statistical modelling, and survey data from local populations was employed to understand the disparities in healthcare access. Key techniques include Kernel Density Estimation, Moran’s I spatial autocorrelation, factor analysis, and regression analysis. The results identified thirteen key factors, with 'Patient Access to PHC' emerging as the primary determinant influencing healthcare utilisation. Significant correlations were observed between socio-economic conditions, disease burden, and healthcare infrastructure. The spatial distribution map revealed notable urban-rural disparities in PHC accessibility. The study underscores the importance of enhancing healthcare infrastructure, economic affordability, and public awareness. The findings provide critical insights for policymakers to develop equitable and sustainable healthcare delivery systems.

Needle stick injury from epinephrine autoinjector to healthcare professionals: Two case reports

Allergic disorders are steadily increasing, and so is the incidence of anaphylaxis. Epinephrine is the drug of choice for anaphylaxis. Fatalities from anaphylaxis occur if epinephrine is not administered or delayed in administration. Epinephrine is not effective orally but works rapidly if administered intramuscularly. Epinephrine can be delivered easily via Epinephrine AutoInjector (EAI), safely and soon after the onset of anaphylaxis, and can be carried portably. There are few approved EAI brands, but EpiPen is the most commonly used brand. Accidental EAI injuries are increasing in prevalence in the community and also among the healthcare workers while administering it. Injuries occur to any part but mostly to the limb digits. According to evidence, most injuries make full recovery. We present two cases of healthcare professionals who experienced accidental EAI injury at the primary care health center. The designs of alternate EAIs compared with EpiPen are safer for both the public and the healthcare professionals while delivering the same result. Regular training in the use of EAI reduces the accidental injuries.

Medication Adherence in Patients with Diabetes Mellitus and Influencing Factors in Indonesia

BACKGROUND: Diabetes Mellitus significantly impacts the quality of human resources and substantially increases healthcare costs. Good adherence to diabetes treatment can control blood sugar levels and minimize hospitalization.AIM: To determine the medication adherence profile in patients with diabetes mellitus and the influencing factors.MATERIALS AND METHODS: A cross-sectional study was used in Kalinyamatan Primary Health Center, Central Java, Indonesia, involving 90 patients with type 2 diabetes mellitus. Primary data was collected using pretested questionnaires. This research used a total sampling technique to recruit participants. To determine the factors influencing medication adherence in patients with diabetes mellitus, we conducted a logistics regression analysis.RESULTS: The study showed that medication adherence indicated low in 22 individuals (24.4%) and high in 68 individuals (75.6%). Four factors were significantly influencing medication adherence in patients with diabetes mellitus: age (p-value 0.007), education (p-value 0.048), occupation (p-value 0.012), and family support (p-value 0.002). However, two factors, namely gender (p-value 0.259) and duration of illness (p-value 0.547), were found to have no significant impact on medication adherence.CONCLUSION: Healthcare professionals should have to motivate patients with Diabetes Mellitus to ensure adherence to their prescribed treatment regimen.

Telenursing Health Education and Lifestyle Modification Among Patients With Diabetes in Bangladesh: Protocol for a Pilot Study With a Quasi-experimental Pre- and Postintervention Design.

The global burden of chronic diseases is increasing and becoming a public health issue throughout the world. The use of telenursing is increasing significantly during and after the COVID-19 pandemic to treat and prevent chronic diseases. Telenursing is growing in many countries to reduce health care costs, increase the number of aging and chronically ill populations, and increase health care coverage to distant, rural, small, or sporadically populated regions. Among its many benefits, telenursing may help to solve increasing shortages of nurses, reduce distances, save travel time, and keep patients out of the hospital. The objective of this study is to apply the self-management telenursing program and telenursing system developed by the researchers to Bangladesh and to evaluate its feasibility and efficacy (improved diabetes control in participants). This is a pilot, quasi-experimental pre- and post-intervention study. Diabetes patients who will attend the Grameen Primary Health Centers (PHCs) in Bangladesh will be enrolled between September 2024 and August 2025. We include patients who have been diagnosed with type 2 diabetes, both sexes, ages 18-75 years old, all types of treatment, willing to participate and give us consent. We exclude patients who have been diagnosed with gestational diabetes, diabetes as a secondary cause, complication of chronic kidney disease (CKD) stage 5, Hemoglobin A1c (HbA1c) is less than 7% for the past 1 year with CKD stage 1 or 2, no complications or complications with good control, having enough knowledge (had education before) and implemented good practice regarding diabetes management assessed by the research nurses, and disabled persons who need other person's support for daily living. The sample size was calculated and found 70. Written informed consent will be obtained from all the participants. The study protocol got approval from the National Research Ethics Committee of the Bangladesh Medical Research Council (BMRC/NREC/2022-2025/336) on September 08, 2024. The outcome of this study is to evaluate the effects of telenursing intervention by controlling HbA1c. The project was funded in 2024. The enrollment of the participants started on October 26, 2024, and the required sample (n=70) enrollment was completed in February 2025. Data analysis will be started after completion of data collection and results will be expected to be submitted for publication in 2026. Diabetic patients will acquire disease-specific management skills. Setting and monitoring goals ensures the continuation of the desired behavior and gives the patients control over their lifestyle. After developing self-management skills, patients assess their lab data and lifestyles including diet, and understand their condition so that they can work with their physiological data by acquiring knowledge of both the disease and self-care. By making self-supported decisions, the patients will be able to manage their diet, exercise, and medication. ClinicalTrials.gov NCT06632652; https://clinicaltrials.gov/study/NCT06632652. DERR1-10.2196/71849.

Barriers in an East African Refugee Camp: Applying the Three Delays Framework to Pediatric Surgical Care.

In global health, the three-delays framework helps assess barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). This study applies this model to identify factors contributing to delays in surgical care among children living in a Tanzanian refugee camp. A validated surgical needs survey was administered to parents/guardians of children (0-18 years) living in Tanzania's Nyarugusu refugee camp. We quantified the number of children seeking, reaching, and receiving care for surgically-amendable concerns according to the three-delays framework. Multivariate logistic regression models identified significantly associated predictors with each delay. 721 patient surgically-amendable concerns were identified among 513 children, with 247 children (48.1%) experiencing a delay for at least one problem. Characteristics associated with delays in seeking care included older age, self-perception of good health, and not previously using a primary health center. Burns were also associated with delays in seeking and reaching care, while Congolese nationality and self-perceptions of good health were statistically significant predictors for delays in receiving care. Children in a Tanzanian refugee camp experience unmet surgical needs complicated by multifactorial delays to seeking, reaching, and receiving surgical care. Future interventions that reduce delays are essential to improve outcomes for refugee children.

Innovation through telemedicine to improve medication abortion access in primary health centers: findings from a pilot study in Musanze District, Rwanda

In 2012 Rwanda expanded legal grounds for abortion to include cases of rape, incest, forced marriage, the health of a pregnant person or fetus at risk, and for minors on request in 2018. The penal code limits abortion care to doctors in hospitals, impeding access for many women. We tested an intervention that provides first-trimester medication abortion at primary health centers, using telemedicine to connect nurses/midwives to doctors in district hospitals for authorization of services. We implemented a 15-month prospective study to assess the feasibility, effectiveness, safety, and client acceptability of a hybrid telemedicine model. In the model tested, doctors provided clinical guidance by reviewing client data and lab results, and authorized the procedure via telemedicine, while the nurses/midwives consulted with the client, provided medication at the health center, and conducted follow-up over the phone or in person. Service data record forms were completed using the REDCap online platform and client exit interviews were conducted after completion of the abortion. During implementation, 242 clients received medication abortion at the health centers, with 50% of clients interviewed during client exit interviews. The protocol ensured high adherence rates; 96% completed abortion. Post-procedure complications were rare (3%) and were largely managed at health centers with remote support from a medical doctor. Vaginal bleeding (36%) and abdominal pain (41%) were the prevalent side effects experienced by clients; only 10% of clients who reported side effects needed to see a provider for management. Overall client satisfaction with services was very high (98%) and the perceived quality of services was also very high (97–99%). We conclude that this hybrid telemedicine model for the provision of first-trimester medication abortion is feasible, effective, safe and accepted by clients. Results from this study will enable revisions to the abortion clinical guidelines to include task-sharing with mid-level providers, such as nurses and midwives, via telemedicine in health centers.

Acute Hepatitis of Unknown Origin (AHUO) in an Infectious Disease Referral Hospital: A Case Report

Background The World Health Organization (WHO) reported Acute Hepatitis of Unknown Aetiology (AHUA) occurred in children in several countries, including Indonesia. Before this study was conducted, the cause and treatment were unknown. The Ministry of Health reported 91 cases in less than 16 years old children which spread across 22 provinces in Indonesia. This is a case report which was part of a surveillance program at Sulianti Saroso Infectious Disease Hospital (SSIDH) in 2023. The treated probable AHUA case was 16 years and 10 months old, while other studies reported probable AHUA cases ≤16 years old. Case presentation Of the 17 patients suspected AHUA who were treated at SSIDH, one case was categorized as probable AHUA. The patient was a 16 years old 10 months-old Javanese boy, who was first admitted to the Primary Health Centre (PHC). Clinical symptoms were abdominal pain 7 days before hospital admission, nausea, vomiting, dizziness, diarrhoea, brownish-yellow urine, decreasing appetite, and jaundice for 3 days before hospital admission. No history of COVID-19 and he has received the COVID-19 vaccine twice. He was undernourished. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bilirubin levels were elevated. Tests for hepatitis B (HBsAg), hepatitis C virus (HCV) antibodies (Ab), hepatitis A IgM, and hepatitis E IgM were all negative. Length of Stay (LoS) hospitalisation was 12 days, and the patient has recovered. Conclusions Adequate identification and management of cases were carried out by paediatricians so that severe conditions do not occur. Bangladesh J Medicine 2025; 36(2): 142-148

Visualisation of Data Envelopment Analysis in primary health services.

Benchmark efficiency analysis in public health typically focuses on hospitals rather than primary care providers. Data Envelopment Analysis (DEA) is widely used to assess resource efficiency among decision-making units (DMUs). However, traditional DEA struggles to differentiate between efficient units and is sensitive to the selection of inputs and outputs. Methods like super-efficiency and cross-efficiency address some of these limitations but often exclude outliers and may overlook efficiency related to specialisation. DEA Visualisation integrates DEA with multivariate statistical methods allowing for the identification of inefficiency sources and specialisation patterns without losing discriminatory power or removing extreme cases from the sample. This study analyses 82 public primary health centres in Madrid serving senior citizens in 2018. The findings reveal inefficiencies such as a preference for prescribing specific rather than generic drugs, increasing public health costs. Additionally, two extreme cases (outliers or mavericks) were identified as having high infrastructure costs and disproportionate staffing. Redistributing patients from overcrowded centres could enhance efficiency, while centres focused on preventive care showed greater cost-effectiveness, particularly in reducing prescription costs.

Ocular morbidity, visual impairment and its association with social factors in children attending primary healthcare services for any health-related problem in Pavagada, India - A health facility-based cross-sectional study.

Primary eye healthcare in India has potential for improvement; enhancing it can play a role in universal health coverage, integrated people-centered eye care, and reducing the burden on overloaded secondary/tertiary facilities. To assess the unmet need for primary eye care services in Pavagada taluk, Karnataka, India, by estimating ocular morbidity, blindness, and visual impairment among children <18 years, attending primary health centers for any health-related issue, and to examine their association with social factors. Health facility-based cross-sectional study in primary health centers in Pavagada. Trained ophthalmic technicians used E charts, red reflex testing, and external examination to screen. Patients with vision <6/9, abnormal red reflex, or external examination were referred to the base hospital. The data was analyzed using STATA17. Of 965 patients screened (mean [SD] age 6.87 [4.97] years), 125 were referred to the base hospital; seventy-two (57.5%) reported. The unmet need was 54% (39/72). Only 9/39 (23%) had major ocular morbidity necessitating secondary/tertiary care. Ocular morbidity was 8.60%, with uncorrected refractive errors predominant (6.84%). Visual impairment rates were lower among children of mothers with 8-12 years of education (13.64%), housewives (7%), upper-middle-class (0%), compared to those with no formal education (25%), non-agricultural laborers (29%), middle (22%), lower-middle class (17%), respectively. Pavagada taluk has a significant unmet need for primary eye care services. Addressing this requires improving infrastructure, manpower, and training at existing health centers to provide primary eye care services and alleviate the burden on secondary/tertiary care facilities.

Malaria diagnosis among children attending some primary health care centers in Keffi, Nigeria: A cross-sectional study

Malaria is a febrile illness caused by the bite of an infected female Anopheles mosquito transmitting the Plasmodium species. It is still an endemic public health disease especially in Sub-Saharan Africa, South-East Asia and South America. Nigeria, was reported to have the highest burden of the disease with 27% of the global malaria burden. 2ml of blood samples were collected from 220 children aged 0-17 years attending five Primary Health Centers (PHCs Angwan Wuje, Kofar-Pada, Guata, Angwan- Kaswa and Yelwa) in Keffi Local Government Area (LGA) to detect malaria parasites. First response Rapid Diagnostic Test (RDT) kits were used for the initial screening while thin and thick blood films were made and stained with Geimsa stain for microscopy. The prevalence of malaria using rapid diagnostic test kits (RDT) was 34.5% (76/220) while that for microscopy was 70% (154/220). The age range most affected for RDT and microscopy was 13-17 years (27.6% vs 29.9%) followed closely by 4-6years (25% vs 20.8%) and 7-12years (25% vs 19.5%), 1-3 years were (13.2% vs 15.6%) and &lt; 1year (9.2%. vs 14.2%). Females were more infected than males at (57.9% vs 42.1%), but age and sex were not statistically significant (p&gt;0.05). The age range most infected were those between 13-17years using both methods. The younger children 0-3 years where mostly protected with physical barriers like insecticide treated nets (ITNs) and its use was significant at p&lt;0.05; 4-6years were the next with a high percentage of being infected as kids become more active and probably the uncomfortableness of ITNs make them restive. We advocate for more health promotion campaigns, enlightenment and preventive tips to be made as jingles, taught to parents and the growing children at schools, markets, health centers etc. so they don’t serve as reservoirs. More policies e.g. environmental sanitation and seasonal malaria testing, treatment and prevention practices should be made and sustained by government to enhance the fight against malaria as global aid is dwindling.

Knowledge and practice of primary healthcare workers on the routine childhood immunization schedule in Osun State

Background: Despite global progress in immunization, Nigeria continues to face challenges in achieving adequate vaccination coverage. This study examined the knowledge and practices of primary healthcare workers regarding routine childhood immunization in Osun State, where coverage exceeds national averages but remains below global targets. Methods: A descriptive cross-sectional study was conducted among 273 primary healthcare workers across 48 primary health centers in Osun State. Results: There was a significant disparity between the knowledge (86.5%) and practice of routine childhood immunization (40.6%). Key gaps included inadequate vaccine storage (with 59% failing to maintain temperature records) and inconsistent caregiver communication (only 53.7% consistently obtained consent). Training deficiencies were evident, with 12.3% of staff lacking pre-service immunization training and 60% not having received refresher training within the previous six months. Conclusions: These findings suggest that achieving better immunization outcomes requires more than just knowledge transfer. Health system strengthening should focus on improving cold chain infrastructure, implementing regular competency-based training, and strengthening supervision mechanisms. The study emphasizes the importance of ongoing support for healthcare workers to bridge the gap between knowledge and practice in routine immunization services.

Effects of Formalin Fixation on Ex Vivo Confocal Microscopy imaging: Towards Rapid Pathology.

Ex vivo confocal microscopy (EVCM) rapidly images excised tissues at near-histopathological resolution, bypassing the need for time-consuming and labor-intensive tissue processing required for conventional histopathology evaluation. Thus far, the device has been used to image only fresh or frozen tissues, which are challenging to transport, limiting its utility to specialized centers with accessibility of the device. However, this device could be extremely beneficial for the primary health centers, lacking histopathology laboratories, to get rapid pathology. For this, the tissue needs to be transported in a preservative to main its integrity. Formalin is an excellent preservative which is readily available in clinics. We tested it's impact on the EVCM images up to 7 days and compared them with the images from fresh tissue (time points: baseline, 30min, 1hr, 2hr, 4hr, 6hr, 24hr, 3 days, 5 days, and 7 days). Sixty images were acquired from normal skin tissues and tumors and analyzed by a dermatopathologist blinded to the histopathology diagnosis. Normal tissue structures and tumors were correctly identified at all the time-points. Tissue became easier to handle (even after 30 minutes in formalin) and photobleaching was not seen in fixed tissues. Using formalin would preserve tissue's morphology for ancillary studies. Our pilot work sets the stage for future large-scale studies and aid in widespread adaptation of this technique, beyond specialized centers.

Patients’ Profiles and Their Satisfaction with the Quality of Health Services Offered in Primary Healthcare Centers in Anambra State, Nigeria

Background: The primary healthcare center (PHC) is the initial point of contact for individuals seeking healthcare within their community. Its purpose is to deliver comprehensive health services that cater to patients' unique needs and expectations. However, patient satisfaction from primary health centers has received negligible attention. This study aimed to evaluate patient satisfaction levels with healthcare services provided by primary health centers in Anambra State, Nigeria. Methods and Materials: We conducted a cross-sectional study in twelve primary health centers with a descriptive design employing Chi-square, Cramér's V, and linear regression to assess the relationship between patient profile and their satisfaction. Servqual dimensions were used to investigate whether a statistically significant correlation exists between patient profile and patient satisfaction level. Result: A total of 385 individuals responded to the survey. The responsiveness dimension of the Servqual dimension had the lowest mean score among the five dimensions assessed. No significant correlations were found between patient satisfaction levels and patient profiles: sex, age, marital status, highest educational attainment, and average monthly income. Conclusion: When assessed with the Servqual dimension, patients’ satisfaction with the quality of health services offered in the PHCs in Anambra state indicated a suboptimal level of satisfaction. Enhancements in infrastructure and healthcare worker training are essential to elevating the quality of health services provided.

Low uptake and readiness of child health services in Postwar Tigray, Ethiopia: awaiting for a response

BackgroundFollowing the armed conflict in Tigray, the health system collapsed and routine health services were interrupted. However, after the Pretoria peace agreement, various health -related interventions aimed at recovery were implemented. Despite these efforts, little is known about the current status of child health services, including immunization and healthcare seeking for childhood illnesses. Therefore, this study aimed to evaluate child health services in post-war Tigray.MethodsA community and facility-based cross-sectional study was conducted from January to February 2024 to assess the uptake of child health services and service readiness among mothers of children aged 0–59 months (N = 2340). A multistage sampling technique was used, with a random selection of 24 districts and 78 sub-districts, and 30 households were considered per Tabia based on the assumption of Ethiopian Demographic Health Survey, 2019. A representative sample of health facilities (30%) including primary hospitals, health centers and health posts, was also considered. Data were collected using Open Data Kit (ODK), which was pretested, modified, and translated into the local language. The collected data were cleaned, coded, and analyzed using SPSS version 25.ResultsThe response rate of this study was 99.9%. The proportion of children who received full vaccination was 58.8%, with a significant disparity between urban and rural areas. A significant difference was noted in the full vaccine uptake among contraceptive users (65.7%) (p-value < 0.007) and by residence urban (66.8%) versus rural (56.3%) (p-value < 0.006). Cough was the leading cause of childhood illnesses, followed by fever in the rural settings accompanied by the healthcare seeking of 58.6%, 48.4%, 59.3% for diarrhea, cough and fever respectively. The overall readiness score for child health and specific EPI service were 46.4% and 37.4% respectively.ConclusionIn the post- war period, immunization coverage in Tigray was relatively low, with a notable urban–rural disparity. Utilization of healthcare for childhood illness was also low in rural communities despite the high burden of diseases. Overall, readiness score for child health and immunization services were low. Concerted efforts are needed to improve the uptake of childhood vaccines and the readiness score for child health services.

The Role of Primary Health Care in Reducing Health Inequities: A Case Study of Theni District in Tamil Nadu

Health is wealth for all living things in the world, we can’t refuse this statement. In recent days the peoples are paid more amount to the hospitals for their health issues. But all are not able to get those medical services, in this place the Primary Health Centres are occupying the service gap in health care industry. The Primary Health Care centres providing services at the initial stages of health issues. Prevention is better than cure is only possible by the services of Primary Health Care centres. Tamilnadu is the primer state in the health care system and providing valuable services to the patients. The district has a diverse population, including a significant number of people living in hilly and tribal areas, particularly around the Western Ghats. Theni’s hilly and remote areas present challenges in terms of accessibility and transportation, making it difficult in services. The present study covers the problems faced by patients of primary health care services of Theni district.

Implementation of the Extension for Community Healthcare Outcomes Model for Hypertension Education of Frontline Health Care Workers in the Federal Capital Territory, Nigeria: Explanatory Sequential Mixed Methods Evaluation.

The Extension for Community Healthcare Outcomes (ECHO) model was adapted for hypertension education of community health extension workers in the Federal Capital Territory, Nigeria, and delivered as a 7-part series. This study aims to evaluate implementation outcomes of the hypertension ECHO series mapped to the first 3 levels of the Kirkpatrick model. Outcomes included reach, appropriateness (level 1), effectiveness (level 2), and penetration (level 3). From August 2022 to April 2023, 7 hypertension ECHO sessions were delivered via Zoom (Zoom Video Communications, Inc) to a health care worker audience including targeted community health extension workers at 12 primary health centers (PHCs) in the Hypertension Treatment in Nigeria Program. Health care workers provided demographic information, engaged in pre- and postsession knowledge quizzes, and shared feedback during live sessions. Surveys were sent to health care workers at 12 PHCs approximately 1 month after each session to ask about the use of the presented material and focus group discussions were performed with these health care workers after the ECHO program concluded. Qualitative and quantitative results were evaluated using an explanatory sequential mixed methods design wherein qualitative data were used to help explain outcomes and variability among participants. Across 7 ECHO sessions, a total of 1407 live participants were documented. Participants largely found the program was acceptable, with more than 97% of respondents reporting that the session was useful. Postsession knowledge scores increased (range: 2.3%-10.5%) relative to presession scores demonstrating moderate effectiveness. Among 12 PHCs, most (more than 70%) health care workers applied information learned in each session to provide patient care. In 6 focus group discussions, with 31 health care workers (n=15; 48% community health extension workers), participants reported that network connectivity and clinical demands were barriers to live participation and expressed preferences for blended training and asynchronous resources. Results show that a hypertension ECHO program adapted for community health extension workers effectively increased knowledge among participants and was useful to a majority. Insights gained may inform the scaling of remote hypertension education programs for community health extension workers in similar settings. ClinicalTrials.gov NCT04158154; https://clinicaltrials.gov/ct2/show/NCT04158154.

Effects of Sustainable Development Goals Projects on Poverty Alleviation in the Selected Local Government Areas of Benue State

This study examined the effect of sustainable development goal projects on poverty alleviation in Benue State. The population of the study consists of 1,332,200 beneficiaries of sustainable development goals projects in selected local government areas of Benue state. The study made use of purposeful sampling to sample 400 beneficiaries drawn from six local government areas from the three senatorial zones in the state comprising of zones A, B and C. The data was sourced with the use of a structured questionnaire. The data was analysed using binary logistic regression. Findings from the study revealed that SDGs projects on water were significant as residents had access solar powered/hand pumped boreholes as their source of drinking, projects on health centres were found to be significant as residents had access to primary health centres, projects on educational facilities were found to be significant as there were improvement in the physical condition of the schools, projects on skills acquisition centres were insignificant as residents were not gainfully employed. The study recommends residents’ engagement in the formulation and implementation of SDGs-based projects.

Human Resource Compliance with Indian Public Health Standards 2022: An Assessment of Health and Wellness Centers in a District of Northwestern India

Abstract Since 1952, basic health care in India has been provided through primary health centers (PHCs). Recently, the government has expanded services with health and wellness centers (HWCs) to offer comprehensive primary care. The Indian Public Health Standards (IPHS) were last updated in 2022 to guide these enhancements. Despite concerns about insufficient human resources, no studies have assessed HR compliance with the 2022 IPHS in Punjab’s border district. An observational cross-sectional study was conducted among eight urban primary health centers (UPHCs), 17 rural PHCs (R-PHC), and 28 sub-health centers (SHCs) of Amritsar district (selected by simple random sampling), where available human resource was assessed using a checklist developed on basis of IPHS 2022. Data were collected by observation, record review and interview with medical officer and community health officer. Based on the checklist, overall scores were calculated where availability/nonavailability of HR was scored as 1 and 0, respectively. The HWCs were then classified into very good (&gt;80%), good (60–80%), average (40–60%), poor (&lt;40%). 24 * 7 UPHCs showed only 7% deficiency compared to 48% in non-24 * 7 UPHCs. SHCs demonstrated just 3% overall deficiency, while R-PHCs faced significant challenges about 45–46% deficiency in both 24 * 7 and non-24 * 7 facilities. Overall, 66% of all centers were rated very good or good. 24 * 7 UPHCs and SHCs were generally performing better than non-24 * 7 UPHCs and RPHCs. Targeted efforts should be made to address HR shortages in underperforming centers, with emphasis on equitable distribution of human resources between urban and rural areas.