Selected Health Facilities Research Articles

Investigating the follow-up discontinuation among people living with HIV in North Shoa Zone, Oromia, Ethiopia.

Follow-up discontinuation among people living with HIV can increase mortality and HIV spread within communities. This study investigates the impact of the COVID-19 on follow-up discontinuation among people living with HIV in Ethiopia. This longitudinal study used retrospective document review to compare follow-up status of people living with HIV during the COVID-19 pandemic with their status from 2017 to 2019. Data from selected health facilities were collected using a checklist, entered and cleaned in Excel, and analyzed in Stata. Descriptive statistics were presented in tables and line graphs. Incidence risk (IR) and incidence rate ratios (IRR) were calculated. Between 2017 and 2021, a total of 7,447 people living with HIV were registered to begin ART at selected health facilities. Annual retention rates were consistent from 2017 to 2019, ranging from 0.941 to 0.949. During the COVID-19 pandemic, they dropped to 0.837 in 2020 and 0.840 in 2021. Retention rates were significantly correlated with loss to follow-up (r: -0.959, p ≤ 0.001), death (r: -0.968, p ≤ 0.001), and transfer-out (r: -0.979, p ≤ 0.001). Moreover, the incidence of loss to follow-up (IRR: 3.00, 95%CI: 2.71-3.33, p ≤ 0.001), death (IRR: 3.61, 95%CI: 3.13-4.16, p ≤ 0.001), poor adherence (IRR: 2.27, 95%CI: 2.14-2.40, p ≤ 0.001), and severe malnutrition (IRR: 2.32, 95%CI: 2.18-2.47, p ≤ 0.001) significantly increased during the COVID-19. The study found that COVID-19 healthcare disruptions increased follow-up loss among people living with HIV and heightening the disease burden in Ethiopia.

PATIENTS’ PERSPECTIVE OF PATIENT-CENTRED CARE IN SELECTED HEALTH FACILITIES IN SOUTHERN GHANA

This research assessed patients’ perspective of factors associated with patient-centred care in selected health facilities in the Volta Region of southern Ghana. A descriptive hospital-based cross-sectional survey design was used where a structured questionnaire was administered to 403 patient participants. Regression analysis was conducted and the results reported in proportions, frequencies and odds ratios. The level of patient-centred care practice among patients in the selected health facilities was 56.8%. Patient-centred care was influenced by age (aOR=1.13; CI:1.02-1.25), educational status (aOR=0.02; CI:0.001-0.63), road network (aOR=0.09; CI:0.02-0.63) and cultural barriers (aOR=15.22; CI:1.65-139.99). Individual patient and community system factors including cultural beliefs have the potential of influencing patient-centred care satisfaction with the quality of care delivery in health facilities. Thus, there is a need for the government to address the problem of deplorable road networks in the communities.

Virological non-suppression and associated factors among adult patients receiving antiretroviral therapy at selected health facilities in uMgungundlovu district of KwaZulu Natal, South Africa: a cross-sectional study.

virological non-suppression is not only associated with increased risk of transmission of the Human Immunodeficiency virus (HIV) to others; perinatally and sexually, but it also decreases the life expectancy among the individuals who are on antiretroviral therapy (ART). This study sought to determine the level of virological non-suppression among ART patients from selected health facilities of a sub-district in uMgungundlovu district. This sub-district has high HIV transmission rates in KwaZulu Natal (KZN) and had one of the highest HIV prevalence in the district in 2018; population weighted HIV prevalence of 36.3% among men and women aged 15-49 years old, which was twice the average national prevalence of 18.8%. this descriptive, cross-sectional, and quantitative study was conducted among participants who were HIV-positive, 18 years old and above, and initiated on ART between January 2017 and January 2019 at selected PHC facilities of Vulindlela sub district. Health facility treatment registers, patient medical files and face-to-face interviews were used to collect the data and these were captured onto an Excel spreadsheet, cleaned, coded before importation into Epiinfo 17 for statistical analyses. Logistic regression analyses were conducted to investigate the factors associated with virological non-suppression. the study found a majority of participants were females (240/401 (60%)). The mean age of the participants was 38.1 (SD=11.2), with most participants who were between the ages of 29 and 39 years old (167 (41.7%)). Virological non-suppression was observed among 10% (40/401) of participants. The odds of virological non-suppression were higher among participants who were married (aOR 4.76, 95% CI 1.49-15.19; p=0.008). a virological non-suppression of 10% translates to viral suppression of 90%, which is below the target of UNAIDS 95-95-95 strategy. Hiding and skipping medication indicate how non-disclosure continues to hinder HIV treatment adherence. High odds of virological non-suppression among married participants indicate non-disclosure of the positive HIV status, or lack in spousal support.

Community voices from modern maternal waiting home users in Zambia.

This study aimed to understand community voices on factors influencing utilisation of MMWHs in Zambia. The study employed a mixed method study design in four selected health facilities across Zambia districts between January 2021 and December 2022. Purposeful sampling was used to select study participants using MMWH registers as the sampling frame for mothers who had utilised MMWHs and their spouses. Sampling of participants through face-to-face, in-depth interviews (IDIs) and focus group discussions (FGDs) was conducted to saturation in all targeted health facilities Data was transcribed verbatim and analysed thematically. Results found that the comfortable state of the MMWHs, long distances to health facilities, fear of maternal complications, availability and positive attitudes of specialized health personnel, and the information on childcare provided were major factors. Spouses supported their partners using MMWHs due to the quality of care and the availability of modern equipment and furniture. However, some spouses indicated that utilisation of MMWHs has a bearing on a household's financial resources. MMWHs are a pivotal intervention in improving maternal outcomes. All health facilities had no maternal and newborn complications or deaths over the study period.

Prevalence and Risk Factors of Low Birth Weight among Neonates Delivered in Health Facilities in Makurdi, Benue State, Nigeria

Abstract Background: Low birth weight (LBW) is an important marker of fetal health that is predictive of mortality in childhood, stunting, and adult-onset chronic conditions globally. Approximately 20 million LBW births occur every year globally with 96.5% of them in developing countries. LBW contributes to 60%–80% of all neonatal deaths globally and the rates have remained high in developing countries such as Nigeria. This study therefore aimed to determine the prevalence and risk factors of LBW among neonates delivered in health facilities in Makurdi, Benue State, Nigeria. Materials and Methods: A cross-sectional study was carried out in eight selected health facilities at different levels of care within the Makurdi metropolis. A total of 206 neonates were recruited, weighed, and examined within the first hour of life while sociodemographic data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS 23. Results: Out of the 206 neonates studied, 24 (11.7%) were LBW. Among the 24 LBW neonates, 75% (18) were term while 25% (6) were preterm. The mean weight of the LBW neonates was 2.18 ± 0.18 kg. The mean gestation was 38.52 ± 1.61 weeks. The factors that were significantly associated with LBW were; gestational age at birth (P = 0.028), type of gestation (P = 0.004), socioeconomic class of the baby (P = 0.036), nonbooking for antenatal care (ANC) (P = 0.040), place of ANC (P = 0.028), and hypertension in pregnancy (P = 0.033). Conclusion: The prevalence of LBW was lower than the national prevalence and not booking for ANC was found to be associated with increased risk for LBW. Hence, early and adequate ANC is recommended.

Patterns of availability and accuracy of risk factor data for cardiovascular diseases among people initiated on antiretroviral therapy at selected health facilities in Khomas region, Namibia: a retrospective, cross-sectional, quantitative study.

quality data is a prerequisite for timely decision-making and measuring health outcomes in public health settings. Comorbidities such as cardiovascular diseases (CVDs) among people living with HIV (PLHIV), require a robust system that ensures credible data at all data-producing levels. The study at determining the level of availability and completeness of CVDs risk factors data of PLHIV. a quantitative study was conducted to extract CVDs risk factors data retrospectively from 529 patient care booklets (PCBs) between 2004 and 2017. The analysis was done with the Statistical Package for Social Sciences (SPSS) version 25. Pearson Chi-Square was used to test for associations. The level of significance was at p ≤ 0.05. the study revealed that 72.8% of patients are at risk of CVDs due to incomplete demographics (73.72%) and other systemic data (41.18%). A significant association was found (Pearson Chi-Square test 19.907; p-value of 0.001) between average visits per year, accurate data recording, and active status of the patient. Lost to follow-up (15%) and true retention (27.2%) was significantly associated with the last Antiretroviral Therapy (ART) status of a patient (Pearson Chi-Square test 87.754; p-value of 0.001). the study that despite concerted efforts to improve data quality, the availability and completeness of data remain unsatisfactory. Lack of harmonised data screening and analysis efforts for CVDs risk factors is found to be a significant risk factor in ensuring integrated routine measuring of CVDs health outcomes for PLHIV.

Factors Affecting Performance of Nurses at Selected Health Facilities: A Cross-Sectional Study in Eritrea

Factors Affecting Performance of Nurses at Selected Health Facilities: A Cross-Sectional Study in Eritrea

Assessments of effectiveness of technologies utilizations in VIHSCM among selected health facilities in Tanzania mainland.

Immunization coverage remains a challenge in many developing countries Tanzania being no exception. The current increase in technology adoption in the immunisation supply chain promises the attainment of universal health coverage and Sustainable Development Goals (SDGs) on immunisation. This study evaluates the effectiveness of technology integration in Vaccine and Immunization Health Supply Chain Management (VIHSCM) in Tanzania. This study adopted an exploratory descriptive cross-sectional design. The study collected data using structured questionnaires from health facilities that adopted VIHSCM technologies in Arusha, Mwanza, Morogoro and Mbeya regions, Tanzania. Data were analysed using descriptive statistics and cross-tabulations with the aid of the Statistical Package of Social Sciences 23rd Edition (SPSS). The study included 37 health facilities in Tanzania, mainly district hospitals (59.5%). Respondents were mostly female (70.3%), averaging 45 years old, with 1-5 years of immunization experience. While all facilities had refrigerators, digital reporting tool usage was low, with many relying on paper forms. District hospitals and health centres had higher digital tool adoption rates compared to dispensaries. Despite the underutilization of systems like ILS, TImR, and GoTHOMIS, digital tools were deemed crucial for vaccine supply management. While District Hospitals report high relevance of digital tools, Health Centres and Dispensaries show moderate relevance. Challenges include incomplete technology adoption, inadequate infrastructure, and variable perceptions of technology effectiveness. Digital technologies significantly improve vaccine and immunization supply chain management, particularly in larger facilities. Technologies like the Tanzania Immunization Registry (TImR) and Integrated Logistics Systems (ILS) enhance data accuracy and efficiency. Addressing facility-specific challenges and increasing investment in digital tools are crucial for optimizing vaccine supply chains and achieving immunization targets in Tanzania. Future research should involve larger samples to generalize findings and further explore technology impacts on VIHSCM.

Disrespect and abuse of women during childbirth in selected health facilities in Sokoto metropolis, Nigeria

Background: The promotion of respectful care during delivery is of utmost importance if the goals of attainment of quality health care and utilization of skilled birth attendants in our health facilities are to be achieved. This study sought to assess the prevalence, forms, and factors associated with Disrespect and Abuse (D&A) of women during childbirth in Sokoto metropolis of Sokoto state.
 Method: A descriptive cross-sectional design was used to study 290 women who had facility-based delivery within the past eight weeks in Sokoto metropolis and were attending childhood immunization or family planning clinics. Data was collected using a set of structured questionnaire and was analyzed using IBM SPSS version 23 computer software. Level of statistical significance was set at p<0.05 and approval for the study was obtained from the Research Ethics Committee of Usmanu Danfodiyo University Teaching Hospital, Sokoto while written informed consent was obtained from respondents after explaining the objectives of the study to them.
 Results: A total of 57 (19.7%) of the respondents had experienced at least one form of D &A with bad attitude accounting for 75.4%, followed by Physical abuse (50.9%). Nurses and Midwives ranked highest (78.9%) among the perpetrators of D&A. Emotional distress, injury and death of baby were some of the negative effects of D&A.
 Conclusion: The incidents of D&A have wider implications for the utilization of maternity services and maternal mortality. There is an urgent need for the training and re-training of health workers about respectful maternity care in Nigeria.

Assessment of Malaria Pharmacotherapeutic Outcomes in Children under 12 Years of Age among Three Health-care Facilities, Bayelsa, Nigeria

Abstract Background: Malaria is Nigeria’s biggest public health problem, accounting for around 30% of all fatalities among children under 5 years, 25% of infant deaths, and 11% of maternal mortality. Aims and Objectives: The study aimed to identify the outcomes of malaria therapy in children under 12 who were admitted and managed at three health facilities in Bayelsa State, Nigeria, and if the treatment pattern adhered to standard guidelines. Materials and Methods: A detailed retrospective survey was designed, and a data collection instrument was utilized to obtain clinical, medical, and medication histories for children from the selected health facilities between January 2019 and June 2020. The survey collected data from 1312 children. The data were analyzed using a Chi-square test in SPSS version 23.0 and Microsoft Excel 2013. Results: From the data obtained, only 37.73% of the 1312 participants underwent a malaria parasite (MP) test. The most common diagnosis made at the Primary HealthCare Center (PHC) was acute/uncomplicated malaria (43.0%), followed by diarrhea (21.3%), and gastroenteritis (GET) with upper respiratory tract infection (15.7%). The most common diagnoses for Secondary HealthCare Center (SEC) and Federal/Tertiary HealthCare Center (FHI) were malaria with GET (22.5%) and severe malaria with meningitis (18.1%). The majority of patients were effectively handled and discharged, FHI (73.0%), SEC (91.1%), and PHC (94.0%). Other notable outcomes included patients’ task capacity and a temperature decreased to normal (TDN). Conclusion: There was a significant correlation between demographic data and treatment outcomes (P < 0.05). Although the three health facilities provided competent patient management along with appropriate prescription trends for malaria and comorbidities, there was a low proportion of patients who received an MP test, particularly at the FHI.

Predictors of Late Antenatal Care Initiation: A Multicentre Cross-Sectional Study in Ghana.

Despite free maternal healthcare, about 50% of pregnant women in Ghana initiate their antenatal clinic (ANC) late. This study aimed to identify the factors that contribute to the late initiation of ANC among pregnant women in the Jasikan District, Ghana. A cross-sectional study was conducted between December 2021 and May 2022 in multiple health facilities. Multistage sampling was employed to select 352 pregnant women attending ANC in selected health facilities. A structured questionnaire was used to collect the data. The data was analyzed using Stata version 14.0. Descriptive statistics was used to describe the study variables and multivariable logistic regression models were performed to determine the predictors of late ANC initiation at p < .05 and 95% confidence interval (CI). Approximately 45.7% of the participants initiated ANC late. Age less than 20 years, older age groups (40-49 [odds ratio (OR): 18.0, 95%CI: 3.68-88.0, p < .001]; 30-39 [OR: 6.4, 95%CI: 1.76-22.87, p = .005] and 20-29 [OR: 4.6, 95%CI: 1.30-15.98, p = .018]) were associated with late initiation of ANC. Having a higher number of children (4 [OR: 2.8, 95%CI: 1.36-5.79, p = .005] and 3 [OR: 2.5, 95%CI: 1.33-4.58, p = .004]) were predictors of late ANC initiation as compared to having one child. Women who sought for advice from women leaders (OR: 3.5, 95%CI: 1.18-10.12, p = .02) were about three (3) times more likely to initiate ANC late as compared to those who sought for advice from friends. Women who felt poorly received at ANC (OR: 7.7, 95%CI: 2.188-27.078, p = .001) were about eight (8) times more likely to initiate ANC late as compared to those who felt well received. Again, those who spent over six (6) hours during ANC visits (OR: 18.4, 95%CI: 4.246-79.734, p < .001) had an 18 times higher risk of initiating ANC late relative to those who spent less than 3 h. The study findings highlight the need for interventions that addresses the social and cultural factors, negative perceptions of ANC, and long waiting times at health facilities to improve early initiation of ANC. Such interventions can assume health education and promotion to address the sociocultural and unfavorable perceptions toward ANC. The sector ministry and the health facilities may consider expanding ANC service centers to reduce long waiting times.

Cost-Effectiveness Analysis of 6 Tyrosine Kinase Inhibitors as First-Line Treatment for ALK-Positive NSCLC in China.

Lung cancer ranks first in both cancer incidence and mortality in China. The emergence of novel treatments for ALK-positive NSCLC led to an improvement in survival and quality of life for patients with advanced ALK mutation-positive non-small cell lung cancer (NSCLC). This study sought to assess the cost-effectiveness of 6 tyrosine kinase inhibitors (TKIs)-crizotinib, alectinib, ceritinib, brigatinib, ensartinib, and lorlatinib-as first-line treatments for ALK-positive NSCLC from the perspective of the Chinese health care system. A Markov model was developed to estimate the cost-effectiveness of these 6 TKIs. In this model, ALK-positive NSCLC patients were initially simulated to receive 1 of the 6 TKIs as first-line therapy, followed by different TKIs as subsequent treatment and salvage chemotherapy as last-line treatment. Survival data were sourced from the latest published clinical trials. Costs were derived from recent national health insurance negotiations and hospital information systems of selected health care facilities. Utilities for healthy states and adverse events were obtained from the literature. One-way and probabilistic sensitivity analysis as well as scenario analysis was conducted to assess the robustness of the results. Compared to ensartinib, crizotinib, alectinib, ceritinib, brigatinib, and lorlatinib demonstrated incremental quality-adjusted life years (QALYs) of -1.13, 0.39, -0.58, -0.09, and 0.35, respectively. The corresponding incremental costs were $10 677, $33 501, -$6426, $2672, and $24 358. This resulted in ICERs of -$9449/QALY, $85 900/QALY, $11 079/QALY, $29 689/QALY and $69 594/QALY, respectively. Crizotinib was considered to be absolutely dominated by ensartinib. Under a willingness-to-pay threshold of $38 223/QALY, ceritinib and brigatinib were cost-effective compared with ensartinib, while lorlatinib and alectinib were not cost-effective when compared with ensartinib. Overall, brigatinib emerged as the most cost-effective treatment among all the options considered.

Determinants of Contraceptive Options among Postpartum Women Attending Selected Health Care Facilities in Nigeria: A Cross-Sectional Study.

Differences in availability and choices of contraceptive methods among postpartum women have been found to influence their quality of life as the fertility rate is very high, and the contraceptive usage rate persistently remains low in Nigeria. This study assessed the determinants of contraceptive options among postpartum women in Nigeria. Two Local Governments were randomly selected from the four Local Governments. Within these two local governments, five health facilities were selected. A multistage sampling technique was used to select the 240 respondents, while a structured questionnaire was used to collect data. Findings from the study indicated that 81.7% of the respondents have planned to have their current baby, and about 65.4% of the women have resumed sexual activities since delivery. Of those who have resumed sexual activities, the majority, 91.1% did so 6 weeks after delivery. Some form of contraceptive usage was prominent among 59.2% of the respondents, as the most common contraceptive method used was withdrawal (24.8%). Contraceptive prevalence was slightly lower for urban respondents than rural respondents, although the relationship was not significant. Also, there was a statistically significant relationship between the current use of contraceptives and resumption of sexual activities since delivery (p = .001), resumption of menstruation (p = .001), and information received about postpartum family planning (p = 0.013). Findings from this study emphasize the urgent need for enhanced accessibility and availability of contraceptive methods, with a parallel emphasis on targeted interventions and effective communication strategies to promote contraceptive uptake and family planning. Addressing these determinants is vital in improving postpartum women's overall quality of life in the study area.

Hodnotenie organizačnej kultúry zdravotníckeho zariadenia z aspektu behaviorálneho manažmentu

Background: The implementation of behavioral management in the personnel policy of health care facilities is a necessity. Organizational culture and behavior of employees and managers are important aspects that affect the performance and success of the organization. Objective: To assess the organizational culture of selected health care facilities from the aspect of behavioral management. Methodology and sample: 136 nurses participated in the survey. The data were collected in September - November 2022. The answers were statistically processed. Results: 78% of nurses confirmed that health care facilities have developed rules of conduct and ethical regulations. 40.4% of nurses consider themselves loyal employees. 63.2% of nurses said that working conditions, communication and relationships in the workplace, whether in a team or with a superior, significantly influence their satisfaction or dissatisfaction with work and, based on this, they perceive the organizational culture of the organization in which they are employed. Conclusion: Changes in the behavior of the management of health care facilities affect the behavior of employees and their contribution to the organization. The implementation of behavioral management will fundamentally make it possible to change the dysfunctional organizational culture and change the outdated organizational structure of our hospitals.

Factors Influencing Full Immunization Coverage of the Under-5 Children in Nangoma Constituency

After observing continued loss of lives by the children who are below the age of five years old, World Health Organisation through its branch of public health saw the needs to strengthen immunisation program for under five children among member states. This was the birth and origin of expanded program on immunisation (EPI). Owing to the scarce of data on the status of immunization in the rural parts of Zambia such as Mumbwa District. This research paper was conducted to explore, determine, as well as describing the factors that influence and the status of full coverage of immunisation of under-five children in Nangoma Constituency of Mumbwa District. A cross-sectional study comprised of 134 participants from 5 randomly selected health facilities in Nangoma Constituency was conducted. The data was collected using kobocollect toolbox and analysed using version 23.0 of SPSS and MS Excel 365. The factors that were determined to be statistically significant according to the study included marital status (0.05 &gt;p-value = 0.07), education attainment of the mother (p-value = 0.049), age of the child (0.05 &gt;p-value = 0.013) and knowledge of immunisation (p-value = 0.021). Additionally, the study established that seasons play a critical role in taking a child for immunization especially when it is planting season when families are casting their seeds in the soil which also affect the roads. Distance to the health facility or delivery point, long queues, myths, traditions and culture, as well as availability of money to access the needed health service are among the many factors that affect full immunization coverage in Nangoma Constituency.

Protocol for surveillance of antimicrobial-resistant bacteria causing community-acquired urinary tract infections in low-income countries.

The spread of drug-resistant bacteria into the community is an urgent threat. In most low-middle-income countries (LMICs) settings, community-acquired infection (CAI) is empirically treated with no data to support the choice of antibiotics, hence contributing to resistance development. Continuous antimicrobial resistance (AMR) data on community-acquired pathogens are needed to draft empirical treatment guidelines, especially for areas with limited culture and susceptibility testing. Despite the importance of addressing antibiotic-resistant pathogens in the community setting, protocols for the surveillance of AMR bacterial infections are lacking in most (LMICs). We present a protocol for surveillance of AMR in LMICs using urinary tract infection (UTI) as a proxy for CAI to enable users to quantify and establish the drivers of AMR bacteria causing UTI. The protocol intends to assist users in designing a sustainable surveillance program for AMR in the community involving children above two years of age and adults presenting to a primary health facility for healthcare. Implementation of the protocol requires initial preparation of the laboratories to be involved, surveillance areas, selection of priority bacteria and antimicrobials to be used, and the design of a coordinated sampling plan. Recruitment should occur continuously in selected health facilities for at least 12 months to observe seasonal trends of AMR. At least 10 mL of clean-catch mid-stream urine must be collected into 20 mL calibrated sterile screw-capped universal bottles lined with 0.2 mg boric acid and transported to the testing laboratory. Utilise the data system that generates standard reports for patient care to be shared internally and externally in the regions and the world through global platforms such as the Global Antimicrobial Resistance Surveillance System.

Evaluation of radiological capacity and usage in paediatric TB diagnosis: A mixed-method protocol of a comparative study in Mozambique, South Africa and Spain.

Tuberculosis remains one of the top ten causes of mortality globally. Children accounted for 12% of all TB cases and 18% of all TB deaths in 2022. Paediatric TB is difficult to diagnose with conventional laboratory tests, and chest radiographs remain crucial. However, in low-and middle-income countries with high TB burden, the capacity for radiological diagnosis of paediatric TB is rarely documented and data on the associated radiation exposure limited. A multicentre, mixed-methods study is proposed in three countries, Mozambique, South Africa and Spain. At the national level, official registry databases will be utilised to retrospectively compile an inventory of licensed imaging resources (mainly X-ray and Computed Tomography (CT) scan equipment) for the year 2021. At the selected health facility level, three descriptive cross-sectional standardised surveys will be conducted to assess radiology capacity, radiological imaging diagnostic use for paediatric TB diagnosis, and radiation protection optimization: a site survey, a clinician-targeted survey, and a radiology staff-targeted survey, respectively. At the patient level, potential dose optimisation will be assessed for children under 16 years of age who were diagnosed and treated for TB in selected sites in each country. For this component, a retrospective analysis of dosimetry will be performed on TB and radiology data routinely collected at the respective sites. National inventory data will be presented as the number of units per million people by modality, region and country. Descriptive analyses will be conducted on survey data, including the demographic, clinical and programmatic characteristics of children treated for TB who had imaging examinations (chest X-ray (CXR) and/or CT scan). Dose exposure analysis will be performed by children's age, gender and disease spectrum. As far as we know, this is the first multicentre and multi-national study to compare radiological capacity, radiation protection optimization and practices between high and low TB burden settings in the context of childhood TB management. The planned comparative analyses will inform policy-makers of existing radiological capacity and deficiencies, allowing better resource prioritisation. It will inform clinicians and radiologists on best practices and means to optimise the use of radiological technology in paediatric TB management.

Health systems' capacity in availability of human resource for health towards implementation of Universal Health Coverage in Kenya.

Kenya faces significant challenges related to health worker shortages, low retention rates, and the equitable distribution of Human Resource for Health (HRH). The Ministry of Health (MOH) in Kenya has established HRH norms and standards that define the minimum requirements for healthcare providers and infrastructure at various levels of the health system. The study assessed on the progress of Universal Health Coverage (UHC) piloting on Human Resource for Health in the country. The study utilized a Convergent-Parallel-Mixed-Methods design, incorporating both quantitative and qualitative approaches. The study sampled diverse population groups and randomly selected health facilities. Four UHC pilot counties are paired with two non-UHC pilot counties, one neighboring county and the second county with a geographically distant and does not share a border with any UHC pilot counties. Stratification based on ownership and level was performed, and the required number of facilities per stratum was determined using the square root allocation method. Data on the availability of human resources for health was collected using a customized Kenya Service Availability and Readiness Assessment Mapping (SARAM) tool facilitated by KoBo ToolKitTM open-source software. Data quality checks and validation were conducted, and the HRH general service availability index was measured on availability of Nurses, Clinician, Nutritionist, Laboratory technologist and Pharmacist which is a minimum requirement across all levels of health facilities. Statistical analyses were performed using IBM SPSS version 27 and comparisons between UHC pilot counties and non-UHC counties where significance threshold was established at p < 0.05. Qualitative data collected using focus group discussions and in-depth interview guides. Ethical approval and research permits were obtained, and written informed consent was obtained from all participants. The study assessed 746 health facilities with a response rate of 94.3%. Public health facilities accounted for 75% of the sample. The overall healthcare professional availability index score was 17.2%. There was no significant difference in health workers' availability between UHC pilot counties and non-UHC pilot counties at P = 0.834. Public health facilities had a lower index score of 14.7% compared to non-public facilities at 27.0%. Rural areas had the highest staffing shortages, with only 11.1% meeting staffing norms, compared to 31.8% in urban areas and 30.4% in peri-urban areas. Availability of health workers increased with the advancement of The Kenya Essential Package for Health (KEPH Level), with all Level 2 facilities across counties failing to meet MOH staffing norms (0.0%) except Taita Taveta at 8.3%. Among specific cadres, nursing had the highest availability index at 93.2%, followed by clinical officers at 52.3% and laboratory professionals at 55.2%. The least available professions were nutritionists at 21.6% and pharmacist personnel at 33.0%. This result is corroborated by qualitative verbatim. The study findings highlight crucial challenges in healthcare professional availability and distribution in Kenya. The UHC pilot program has not effectively enhanced healthcare facilities to meet the standards for staffing, calling for additional interventions. Rural areas face a pronounced shortage of healthcare workers, necessitating efforts to attract and retain professionals in these regions. Public facilities have lower availability compared to private facilities, raising concerns about accessibility and quality of care provided. Primary healthcare facilities have lower availability than secondary facilities, emphasizing the need to address shortages at the community level. Disparities in the availability of different healthcare cadres must be addressed to meet diverse healthcare needs. Overall, comprehensive interventions are urgently needed to improve access to quality healthcare services and address workforce challenges.

Assessing the Malaria Burden and Community Response to the Malaria Control and Management Programs in Omoro District, Northern Uganda.

Background: Malaria remains the leading cause of hospitalization and death in the healthcare system. This study explored the malaria burden and community response to government malaria control programs in Omoro district. Method: This retrospective study involved 576 patient results from purposely selected health facilities data from health center III (HCIII) of Odek, Bobi, and Lapainat and health center IV (HCIV) of Lalogi. And prospective random section study involved 288 participants from Lutori and Lagude cells and Atyang A and Lagwaya villages who consented to answer the pretested questionnaire. Results: The prevalence of malaria in Omoro district in 2018 and 2019 was 81.6% and 97.2% for hospital record positivity and community surveys, respectively. The participants had 100% knowledge of malaria signs, symptoms, and cause. The average number of malaria attacks an individual received in the district from the health facility and community data was three. Nonadherence to government control programs was associated with an increased incidence of malaria infections. From questionnaire, the proportion of people that used local herbal remedies for treatment and prevention of malaria were 21.2% of the sampled 288 participants. Conclusion: The high rate of malaria attacks indicates that the area has a high prevalence of malaria-carrying mosquitoes. The increase in the proportion of malaria attacks in 2019 suggests that the burden of malaria increased compared with that in the previous year, with approximately 21% of local herbal remedies for malaria treatment and management. The findings of this study suggest that malaria attacks are associated with household size, age, sex, occupation, and the household head. Participants who did not respond positively to government programs experienced more malaria attacks. These findings can be used to develop interventions to reduce the incidence of malaria in this population.

Identifying Sustainable Biomedical Solid Waste Management Practices in the Context of Limited Resources in Selected Healthcare Facilities in Douala Cameroon

Aims: To Identify sustainable Biomedical solid waste management practices in the context of limited resources in selected HCFs in Douala, Cameroon.&#x0D; Study Design: A cross-sectional survey with quantitative and qualitative study design was adopted for data collection from workers in the HCFs and also identifying the process of waste management.&#x0D; Place and Duration of Study: This study was carried out in the some selected HCFs in the Douala region of Cameroon between January 2023 to June 2023.&#x0D; Methodology: Study respondents were working in different sections of the HCFs and comprised of the following categories: doctors, laboratory scientists, cleaners, nurses and administrative/clerical workers. Field visitations and interactions with HCFs officials took place during the random sampling technique which was used in determining the sample size of 200 workers, Out of the sample size of 200 who were given questionnaires in order to provide data for the study, 150 valid mail questionnaires were retrieved and used for analysis. Every questionnaire was verified by validity. There’s also questions related funds, facilities availability, training and personal protective equipment. All of the data were coded and analyzed. The results were calculated based on sums and percentages of variables with SPSS vers.26 software and chi-square analysis with the level significance of p-value less than 0.05 was analyze&#x0D; Results: This finding could also indicate that imbibing sustainable biomedical wastes management practices increases with higher experience in the hospital. Furthermore, communal bin disposal of biomedical wastes was the only statistically significant category under disposal method, indicating that waste disposal may be lacking in terms of sustainable practices. [30] also identified biomedical wastes disposal in open dumps among health workers in Saudi Arabia, attributable to poor sustainable waste training and lack of regulatory frameworks. I PCA results indicate that there are two dimensions of prevalent biomedical wastes in the hospital studied, as explicated by the two components retained&#x0D; Conclusion: The limited resources and government policies and local councils influences sustainable waste management practices and this paper aimed at identifying some of the solutions towards improving Sustainable waste management policies. The practice of biomedical waste management in the study area was low. Level of education, taking training on biomedical waste management, availability of color-coded three bins, and attitude of health care workers were significantly associated with biomedical waste management practices. Hence, in-service training is recommended to improve biomedical waste management practices.