Services In Public Health Facilities Research Articles

Pay for a free service, access to cesarean section in the slums of Dakar

BackgroundIn sub-Saharan Africa, equitable access to cesarean section remains a major challenge for reducing maternal and neonatal mortality, particularly among disadvantaged populations. This situation is further exacerbated in slums, where women face significant financial barriers to accessing expensive healthcare services, such as cesarean. Within this context, this paper aims to study access to emergency cesarean services among women living in the slums of Dakar, considering the free cesarean policy implemented in Senegal since 2005.MethodQuantitative data were collected using a cross-sectional retrospective approach, from 18 health facility managers and 260 women living in slums in Dakar who had undergone cesarean delivery between July and December 2022. The surveys aimed to collect socio-demographic data on women and the costs they paid to have a cesarean section, as well as on the application of the policy of free caesarean sections by public health facilities. The data were processed using Stata.ResultsThe results indicated that poor women residing in Dakar slums do have access to emergency cesarean section services in public health facilities. However, a significant portion of these women come from impoverished households and lack higher education, making them more vulnerable to financial constraints when seeking a C-section. Despite cesarean sections being performed primarily based on medical necessity, regardless of the woman's economic status, ethnicity, or educational background, women often find themselves having to pay substantial amounts to undergo the procedure. This is particularly concerning, as cesarean sections are intended to be entirely free in public health facilities in Senegal. Health facility managers attribute this financial burden to the State, which recurrently delays reimbursements for cesarean sections, forcing them to charge women higher prices for the procedure.ConclusionA more rigorous enforcement of the policy for free cesarean section could greatly enhance access to this obstetric practice for women living in the slums of Dakar.

Utilisation of maternal healthcare services and influencing factors in public health facilities in Addis Ababa, Ethiopia.

Ethiopian maternal mortality remains high, despite the implementation of extensive health programmes. This indicates that the full potential of maternal health services is not being effectively utilised. This study aimed to evaluate the utilisation and factors influencing maternal healthcare services in public health facilities in Addis Ababa. This study was conducted in five public hospitals and 10 public health centres of Addis Ababa city administration from 31st August 2023 to 13th October 2023. The study's design utilised a cross-sectional quantitative technique, which involved interviewing 354 women from each group who received visits throughout their pregnancy, delivery and postpartum period. The data were analysed using SPSS version 26. This study analysed maternal health service utilisation indicators, revealing a 70.8% overall utilisation of services, with antenatal care (ANC) at 85.5%, delivery at 71.58% and family planning services (PNC) at 55.4%. The study found that the length of time spent travelling to public health facilities significantly impacts the use of maternal health services. Pregnant women who travelled less than 30 min used services 2.29 times more than those over 2 h. The average client wait time also influenced service usage. Pregnant women with four or more prenatal care visits were more likely to use services. The study conducted in Addis Ababa's capital city revealed that the utilisation of maternity health care services is not optimal, despite the concentrated resources. The findings of the study could be beneficial for the Addis Ababa Health Bureau, Ministry of Health, legislators, and other stakeholders. It can help in the development of affordable intervention programmes, filling knowledge gaps and updating scientific understanding.

Use of Maternal and Reproductive Health Services During and After Donor Funding in Nzega District, Tanzania

One of the United Nations’ Sustainable Development Goals (SDG) is to ensure healthy lives and promote well-being for all at all ages. Therefore, maintenance of the application of maternal and reproductive health practices to Women of Reproductive Age (WRA) is crucial throughout women’s lifetime. To find out whether this was happening, the study on which this paper is based examined the socio-demographic characteristics of women who had received maternal and reproductive health services in public health facilities and the extent of application of the maternal and reproductive health practices. A clinic-based descriptive cross-sectional study was conducted on women attending reproductive and child health clinics. Data were collected in 2023 from 121 respondents, mainly using a questionnaire that included a 54-point index summated scale to determine the extent of application of various maternal and reproductive health practices during and after donor funding. The points scored on the scale were expressed as per cents and compared using a paired samples t-test. The results showed an increase in the application of maternal and reproductive health practices after donor funding (49.1% during donor funding and 52.7% after donor funding), but the extents did not differ significantly (p = 0.308; effect size, r = 0.093). Among other things, the results were influenced by the women’s socio-demographic characteristics. The increase shows that the application of the practices is likely to increase. Based on the findings and conclusion, it is recommended that the Government of Tanzania and other relevant stakeholders at all levels should take necessary measures to intervene with respect to various socio-demographic characteristics including age, gender, and marital roles, so that they cannot compromise the application of maternal and reproductive health practices in the research area

Factors associated with human papillomavirus infections among women living with HIV in public health facilities in Western Oromia, Ethiopia

BackgroundHuman Papillomavirus infection (HPV) is among the most common sexually transmitted infections with the highest incidence and prevalence worldwide. HPV has been established as the main cause of cervical cancer and remains a public health problem globally. In Western Oromia, Ethiopia cervical screening remains a major issue because of limited resources, and shortage of HPV testing technology. As a result, the prevalence of HPV and associated factors remain unknown among HIV-positive women. This study aimed to assess the prevalence of HPV and associated factors among women living with HIV attending Antiretroviral Therapy (ART) services in public health facilities of East Wollega and West Showa Zones, Ethiopia, 2022.MethodUsing a cross-sectional study design, a total of 415 women ≥ 18 years old were enrolled using systematic random sampling from five public health facilities. Cervical specimens were collected by a trained nurse from April 01 2022, to May 30, 2022, and tested at Nekemte Public Health Research and Referral Molecular Biology, a certified/accredited laboratory for HPV-DNA Polymerase Chain Reaction by expertise using Abbott m2000rt-PCR assays. Finally, Epi data version 4.6 was used for data entry and SPSS version 24.0 were used for data cleaning and analysis, and frequencies and prevalence of HPV were computed. Variables were identified using the multivariable model and statistically significant associations of variables were determined based on the adjusted odds ratio (AOR) with its 95% CI and P-value < 0.05 to determine the strength of association.ResultThe prevalence of HPV was 30.4% [95% CI: 26.0, 34.9]. Of HPV-infected women, 11.9% were positive for HPV-16, 9.5% for HPV-18, and 65.9% were positive for other hr-HPV . The odds of HPV infection among women aged beyond 48 years are 2.85 times the odds of HPV among people who were aged 18–27(AOR = 2.85, 95% CI: 1.16, 5.58). The odds of HPV infection among women who had three or more sexual partners is 4.12 times the odds of HPV infection among women with a single sexual partner(AOR = 4.12, 95% CI: 2.34–8.62). The odds of HPV infection among women who didn’t use condom during sexual intercourse are 4.73 times the odds of HPV among women who used condom during sexual intercourse. (AOR = 4.73, 95% CI: 1.98–9.33). The odds of HPV infection among women who had history of is 4.52 times the odds of HPV infection among women with no history of abortion. [AOR = 4.52, 95% CI: 2.04, 6.89] The odds of HPV infection among women with history of Sexually Transmitted Infection (STI) 3.62 times the odds of HPV among women with no history of STI (AOR = 3.62, 95%CI: 1.75, 5.83). The odd of HPV among women with abnormal vaginal discharge is 3.31 times the odds of the disease among women with normal vaginal discharge [AOR = 3.31, 95% CI: 2.87,7.35).Conclusion and recommendationThe prevalence of HPV infection among HIV-infected women was high in the study area. Given the above-associated factors, we recommend that the stakeholders integrate HPV prevention strategies into HIV /AIDS services. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections, which may explain the high prevalence among HIV-infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV-infected people.

Factors affecting antenatal care attendance in Soweto, Johannesburg: The three-delay model.

Antenatal care remains critical for identifying and managing complications contributing to maternal and infant mortality, yet attendance among women in South Africa persists as a challenge. This study aimed to understand the challenges faced by women attending antenatal care in Soweto, Johannesburg, using the three-delay model. This study was conducted in Soweto, Johannesburg. An exploratory, descriptive and qualitative research design was used, and in-depth interviews were conducted with 10 pregnant women and four women who had recently given birth. Findings indicate delays in seeking care due to factors such as pregnancy unawareness, waiting for visible signs, and fear of human immunodeficiency virus (HIV) testing. Challenges such as transportation difficulties, distance to clinics, and facility conditions further impeded the initiation of antenatal care. Late initiation often occurred to avoid long waits, inadequate facilities, language barriers and nurse mistreatment. From this study, we learn that challenges such as unawareness of pregnancy, cultural notions of keeping pregnancy a secret, fear of HIV testing, long waiting lines, high cost of transportation fees, clinic demarcation, shortage of essential medicines, broken toilets and verbal abuse from nurses have delayed women from initiating antenatal care early in Soweto, Johannesburg.Contribution:Challenges of women with antenatal care attendance in South Africa must be addressed by implementing community-based health education interventions, institutionalising HIV psycho-social support services and improving quality of antenatal care services in public health facilities.

Patient satisfaction with pharmacy services among users and non users of community based health insurance scheme at public health facilities in Gamo Zone, South Ethiopia: a comparative cross sectional study

BackgroundPatient satisfaction is a crucial humanistic outcome metric in pharmacy services. There was a lack of evidence on patients’ satisfaction with pharmacy services in Gamo zone among users and nonusers of the CBHI scheme. Therefore, the aim this study is to compare the level of patient satisfaction with pharmacy services among users and nonusers of community based health insurance scheme at public health facilities in Gamo zone, South Ethiopia.MethodA facility based comparative cross sectional study design with mixed approach was conducted from June 1 to 30, 2023. A total of 522 study participants and 16 key informants were included as the sample size for quantitative and qualitative study, respectively. The quantitative data was gathered from the study participants who visited the outpatient pharmacy department during the study period by using a simple random sampling technique, while the purposive sampling technique was used to select clients and key informants for the qualitative study. The adjusted odds ratio (AOR) was used to measure the association between independent variables and patient satisfaction toward outpatient pharmacy services at the P values < 0.05 and 95% confidence interval (CI).ResultsFrom the total of study participants, 195 (73.9%) of insured and 175 (67.8%) of noninsured clients were satisfied with pharmacy services offered at public health facilities. The gender of insured (95% CI = 2.00-12.36, (p 0.01)), and noninsured (95% CI = 0.658–2.881, (p 0.02)), waiting time of insured (95% CI = 0.057–0.766, (p 0.0027)), and noninsured (95% CI = 0.084–0.925, (p 0. 0021)) and premium affordability of insured (95% CI = 0.0605-4.860, (p 0.00)) were significantly associated factors with client satisfaction at p < 0.05 and 95% CI. Based on qualitative finding, as member of the CBHI scheme, the members had a greater opportunity to receive a good pharmacy services, because they were more familiar with the physicians and the institutions.ConclusionThe clients with insurance perceived high level of satisfaction with pharmacy services in public health facilities than noninsured. The gender and waiting times at outpatient pharmacy department for both groups of study participants and the premium affordability for the insured groups of clients were factors affecting client satisfactions with pharmacy services.

Health related quality of life and its predictors among postpartum mother in Southeast Ethiopia: A cross-sectional study

BackgroundPost-childbirth, woman's health-related quality of life (HRQOL) is significantly impacted, leading to decreased daily activity, reduced self-care, challenges with breastfeeding and baby weaning, and increased medical costs for both mother and newborn.This study aimed to assess the HRQOL and its predictors among postpartum women in Southeast Ethiopia. MethodsA cross-sectional study was conducted in Southeast Ethiopia between March and May 2022, involving randomly selected sample of 794 postpartum women attending immunization services in public health facilities. Data was collected using a validated questionnaire, and descriptive statistics were computed. A bivariable and multivariable logistic regression model was fitted to predict HRQOL, with odds ratios and 95% confidence intervals used to estimate associations. ResultsThe study revealed that the overall HRQOL, physical component summary, and mental component summary of quality of life had mean scores of 43.80 ± 27.88, 45.39 ± 28.58, and 42.20 ± 28.15(mean ± SD) respectively. Walking to the health facility (AOR = 2.09; 95% CI: (1.31,3.31); using public transport (AOR = 2.58; 95% CI = 1.69–3.93); having the fear of COVID-19 (AOR = 1.46; 95% CI = 1.08–1.99); having health facility admission history during the recent pregnancy (AOR = 1.62; 95% CI = 1.08–2.44); having postpartum depression (PPD) (AOR = 2.13; 95% CI = 1.57–2.89) were predictors of a lower level of overall HRQOL among postpartum women. ConclusionThe study found that nearly half of postpartum women in Ethiopia have lower HRQOL, with factors such as transport use, recent baby's pregnancy admission history, and postpartum depression (PPD) significantly affecting their overall, physical, and mental HRQOL. Fear of COVID-19 was found to be significantly associated with lower overall and physical HRQO. The implementation of appropriate strategies addressing identified factors is crucial for enhancing the HRQOL among postpartum women in Ethiopia.

Barriers in utilization of ante natal care services among Lodha populations: A study from Eastern India

ABSTRACT There are various factors that may operate at the individual, household, or community level and control the supply of public health service facilities. These factors acted as barriers of non-acceptance of skilled antenatal care service (ANC). This study made an attempt to examine the interdependent relationship of supply/contextual side and demand side variables which are responsible for non-utilization of ANC among indigenous population. This cross-sectional study was conducted on 248 married Lodha (Particularly Vulnerable Tribal Groups) women of West Bengal, Eastern India. Participants were aged between 15 and 44 years, had pregnancy during the last five years prior to the time of the fieldwork. Supply/contextual side and demand side barrier of ANC care were collected. Hierarchical Cluster analysis was done to find out the interdependent relationship among the barriers of non-utilization of skilled ANC. Two hierarchical clusters (HC), one for supply/contextual side and other for demand side barriers, were formed. Dendogram resulted from hierarchical clusters revealed several individual and household characteristics as demand side barriers forming one cluster. Another cluster was formed by factors that controlled health service facilities. We conclude from this study that the utilization of maternal health care is still a challenge in India.

Leadership Commitment and the Quality of Adolescent-Friendly Sexual Reproductive Health Services in Public Health Facilities Among Pastoral Districts of Guji Zone, Ethiopia.

Accessible and high-quality sexual and reproductive health services are essential for adolescents. However, there is a need for more knowledge about the role of leadership and the quality of these services in Ethiopia, where a significant proportion of the population consists of adolescents. Inadequate quality of friendly health services may lead to underutilization and higher rates of unintended pregnancies and sexually transmitted infections. This study aimed to evaluate the leadership role and quality of friendly health services in the pastoral community of East Guji Zone, Ethiopia. We implemented in-depth interviews and focus group discussions with eight key informants and fifty participants. Study design: We used a programmatic qualitative research design. Data were collected using 22 semi-structured questions and analyzed using ATLAS.ti7. The findings indicate significantly less commitment to health sector leadership and substandard quality of adolescent-friendly sexual and reproductive health services. Inadequate achievement of the quality of care frameworks, including accessibility, equitability, availability, acceptability, and appropriateness, contributed to the insufficient quality of friendly health services. Poor commitment of health facility leaders influenced the quality of adolescent-friendly sexual and reproductive health services in the pastoral community of the East Guji Zone, according to the study. We recommend enhancing organizational and provider readiness, ensuring equitability, and redesigning services through improving leadership commitment, which is crucial to improving the quality of adolescent-friendly health services. The Ministry of Health Ethiopia and relevant stakeholders should consider these recommendations to improve the quality of friendly health services for adolescents in Ethiopia.

Implementasi Algoritma Floyd Warshall pada Pencarian Lokasi Puskesmas di Kabupaten Karanganyar

One of the key public health service facilities is Public Health Center (Puskesmas). For new residents, it is very important to have information about the location of the puskesmas or hospital as well as information about the shortest path to the puskesmas or hospital. The size of the region and the volume of traffic present a challenge for people who are unfamiliar with the Karanganyar Regency's routes. The aim of this research is to enable the community to easily locate the health center and to provide access for numerous individuals who require assistance in locating the health center in Karanganyar Regency. Floyd-Warshall research methodology was used in this study to create this system while data collection from Karanganyar District Health Office is then required in this study. The results of this study are in the form of the closest route that is connected to Google Maps, which is information about the location of the health center in Karanganyar Regency which is beneficial for people outside Karanganyar Regency. This study's test findings, which used Floyd Warshall's results approach, further ensure its success in identifying the closest path. The test scenario and the available observations matched 91.6% of the 12 test components, according to the system functionality test. Based on the validity test, it has an average error in predicting the distance from the starting point to the search location of 98%.

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Non-communicable diseases (NCDs) are increasing among people living with HIV (PLHIV), especially in Sub-Saharan Africa (SSA). We determined the prevalence of NCDs and NCD risk factors among PLHIV in SSA to inform health policy makers. We conducted a systematic review and meta-analysis on the prevalence of NCDs and risk factors among PLHIV in SSA. We comprehensively searched PubMed/MEDLINE, Scopus, and EBSCOhost (CINAHL) electronic databases for sources published from 2010 to July 2023. We applied the random effects meta-analysis model to pool the results using STATA. The systematic review protocol was registered on PROSPERO (registration number: CRD42021258769). We included 188 studies from 21 countries in this meta-analysis. Our findings indicate pooled prevalence estimates for hypertension (20.1% [95% CI:17.5-22.7]), depression (30.4% [25.3-35.4]), diabetes (5.4% [4.4-6.4]), cervical cancer (1.5% [0.1-2.9]), chronic respiratory diseases (7.1% [4.0-10.3]), overweight/obesity (32.2% [29.7-34.7]), hypercholesterolemia (21.3% [16.6-26.0]), metabolic syndrome (23.9% [19.5-28.7]), alcohol consumption (21.3% [17.9-24.6]), and smoking (6.4% [5.2-7.7]). People living with HIV have a high prevalence of NCDs and their risk factors including hypertension, depression, overweight/obesity, hypercholesterolemia, metabolic syndrome and alcohol consumption. We recommend strengthening of health systems to allow for improved integration of NCDs and HIV services in public health facilities in SSA. NCD risk factors such as obesity, hypercholesterolemia, and alcohol consumption can be addressed through health promotion campaigns. There is a need for further research on the burden of NCDs among PLHIV in most of SSA. This study did not receive any funding.

Implementation Evaluation of HIV/AIDS Voluntary Counseling and Testing (VCT) Service at Public Health Facilities of Akaki Kality Sub-City, Addis Ababa, Ethiopia.

Voluntary Counseling and Testing (VCT) is widely acknowledged globally as an effective method for preventing and treating HIV/AIDS. It allows people to understand their HIV status, make informed choices about getting tested for it, evaluate their personal risk of contracting HIV, and create plans to reduce that risk. The study aimed to evaluate the process of VCT services in public health facilities of Akaki Kality sub-city, Addis Ababa, Ethiopia. A case study evaluation design with a mixed method was employed from May 12 to June 12, 2021. A total of 244 clients were interviewed during the study period. Furthermore, 12 direct observations, a review of documents from the past six months to the study period, and 12 key informant interviews were conducted. Quantitative data were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Univariate analysis was done and presented in tables and texts. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall service implementation process was measured on the basis of pre-determined judgmental criteria. The overall level of VCT service implementation was 83.84%, to which the availability of resources (84.8%), compliance of service providers with the national guidelines (85.38%), and client satisfaction (76.93%) contributed. One facility had stock-outs of test kits in the last three months, and all VCT counseling and testing rooms lacked audio-visual privacy. Supportive supervision, the use of IEC materials during counseling, linking all HIV-positive clients to treatment and care services, and sending complete reports were practiced in a way that needs some improvement. Overall, the service implementation was deemed satisfactory, but further action is required to improve resource availability, ensure provider compliance with national guidelines, and enhance the status of the service. In addition, the Woreda Health Office and Addis Abeba Health Bureau should regularly supervise and provide feedback.

Provision of adolescent and youth-friendly services in public health facilities in Migori County, Kenya

Background: Global and national guidelines on provision of adolescent and youth-friendly services (AYFS) exist. However, the extent to which these services are provided in developing countries, including Kenya, is unknown. Therefore, this study aimed to assess provision of AYFS in public health facilities in Migori County, Kenya. Methods: A cross-sectional study design was employed. The study setting was public health facilities in Migori County. The county has 275 health facilities, of these 159 are government owned/public health facilities. A multistage sampling of 114 public health facilities was done from which 210 healthcare providers (HCPs) were sampled using simple random sampling. Three facility in-charges were purposively selected to represent each of the county's three Levels of healthcare delivery system. Data was collected using structured questionnaires, key informant interviews guide, and Health facility observation checklists. Results: Majority 153 (74%) practiced nursing and 148 (71%) had worked at their current workstation between 1-5 years. Equitable, accessible, acceptable, appropriate, and effective AYFS are provided in the government owned public health facilities. Conclusion: Inadequate AYFS training of healthcare providers and poor implementation of existing policies including weak engagement of young people in AYFS significantly hinder the effective provision of AYFS in public health facilities.

A Community-Oriented Accessibility Index of Public Health Service Facilities: A Case Study of Wuchang District, Wuhan, China

Public health service facilities are the fundamental component of urban medical and health services, and they are critical for realizing urban residents’ enjoyment of equitable and convenient medical services in sustainable smart cities. Spatial accessibility is an important indicator for evaluating the rationality of the layout of medical facilities from the perspective of sustainability. This study introduces a community-oriented accessibility (CA) index of public health service facilities, which considers a weighted average time model and the 15 min living circle standard for constraint, and even the service capacity of medical facilities. This study uses the proposed index to investigate the spatial accessibility of public health service facilities in the study area of Wuchang, Wuhan, China. Compared with the E2SFCA model, the proposed CA model joins the construction concept of an urban living circle, which is consistent with the domestic urban construction goals. The main findings include the following: (1) The community-oriented accessibility index of public health service facilities in the study area showed a gradual decline in the middle to sides under the walking mode and a high index in the north and low index in the south under the vehicle travel mode. (2) The calculated CA accessibility results are quite different between the walking and vehicular modes, and they are mainly affected by the allocation of the number of facilities and the distribution of the population. (3) Compared to the previous method, the calculated CA index results are more reflective of the actual situation and could be useful in guiding the spatial layout of the facilities more finely. This research explores the sustainable utilization of land resources in the planning of medical facilities and promotes the healthy and sustainable development of cities. In future studies, the population’s actual traffic conditions, weather, and holidays will be considered to further research on the accessibility of different groups and the specific impact of these factors on accessibility so as to promote people-friendly accessibility for sustainable smart cities.

Validation of the Adolescent Health Quality of Care (AHQOC) index for mystery client studies.

The Adolescent Health Quality of Care (AHQOC) index is a tool designed to evaluate the quality of facility-based adolescent sexual and reproductive health (ASRH) services. This descriptive cross-sectional study aimed to validate the AHQOC index in 27 primary and secondary public health facilities located in a rural and an urban local government area (LGA) of Ogun State, Nigeria. To conduct the study, 12 mystery clients (MCs) were recruited and performed 144 visits to the health facilities. The MCs were young males and females who were seeking information on premarital sex, pregnancy prevention, sexually transmitted infections (STIs), and contraception. The validity, and reliability of the AHQOC index were evaluated using exploratory factor analysis, Cronbach's Alpha, and intra-class correlation coefficient tests. The Kaiser-Meyer-Olkin test result for the initial 37-item pool was 0.7169, and the final tool retained 27 items with a Cronbach's Alpha of 0.80. Two subscales of the index had Cronbach's Alpha of 0.76 and 0.85. The intra-rater consistency assessed by the intra-class correlation coefficient was 0.66 (0.10-0.92) p = 0.001 for the urban LGA and 0.72 (0.37-0.91) p = 0.001 for the rural LGA. Positive and statistically significant relationships were observed between the full scales and subscales and the validity item (MC ranking of health worker on proficiency from 1 to 10). The results of this study demonstrate that the validated AHQOC index is a valuable tool for assessing the quality of ASRH services in public health facilities.

Key informant perspectives on policy- and service-level challenges and opportunities for delivering adolescent and youth-friendly health services in public health facilities in a Nigerian setting

Key informant perspectives on policy- and service-level challenges and opportunities for delivering adolescent and youth-friendly health services in public health facilities in a Nigerian setting

POTENTIAL INSTRUMENTS FOR COMMUNITY NURSES TO MEASURE CONDUCT PROBLEMS OF MIDDLE ADOLECENTS: A SYSTEMATIC REVIEW

Conduct problems are prevalent in middle adolescents. There are many available instruments that can be used to measure conduct problems. However, limited information is available regarding which instruments are more suitable for this population in the community. This study aimed to investigate frequently used instruments to evaluate conduct problems in regard to their purposes and psychometric properties. This systematic review design study was performed from August 2021 to March 2022 to search for published articles from five databases, such as ProQuest, PubMed, PsycINFO, Science Direct, and Scopus. The PRISMA guidelines were applied to report the selection process of articles. The quality of the selected articles was evaluated by critical appraisal tools of the Joanna Briggs Institute (JBI). Of 7254 records, 23 studies met the inclusion criteria and were reviewed for psychometric properties. Findings indicated that there were nine instruments used in 23 studies for conduct problems among middle adolescents in the community, with the following purposes such as screening, assessment, clinical diagnosis, and outcome evaluation. The coefficient of Cronbach’s alpha of the instruments varies in the range of .53 to .95. Meanwhile, 65% of the studies were reported to use the Strengths and Difficulties Questionnaire – Conduct Problems (SDQ-CP), especially for screening, assessment, and outcome evaluation. It is suggested for community nurses use SDQ-CP to examine and evaluate conduct problems for middle adolescents who visit public health service facilities in the community.&#x0D; &#x0D;

Key informants’ perspectives on policy- and service-level challenges and opportunities for delivering adolescent and youth-friendly health services in public health facilities in a Nigerian setting

BackgroundIntegrating the care of adolescents and young people into existing public health facilities requires deliberate efforts to address challenges related to policy and service provision. This study assessed key informants’ perspectives on policy- and service-level challenges, and opportunities, for implementing a strategic framework for adolescent and youth-friendly health services (AYFHS) in public health facilities in a Nigerian setting.MethodsSeventeen key informants were interviewed including members of the Adolescent sexual and reproductive health (ASRH) Technical Working Group (TWG), program managers of non-governmental organizations (NGO), State and local level health officials, and youth representatives, in Ogun State, Southwest Nigeria.ResultFindings from this study indicate that some health workers continue to have a negative attitude toward young people’s sexual and reproductive health. There was some level of inclusion of adolescents and young people living with disabilities in ASRH programming which is welcome and extremely important. Some of the challenges in ASRH service provision included insufficient coordination of activities of donors/partners working in the adolescent health space. Also found was the missed opportunity to strengthen policy implementation with research, and the need for increased focus on mental health, substance use, and other aspects of adolescent and young people’s health. There was noted the opportunity to explore the Basic Health Care Provisions Funds (BHCPF) as a new source of funding for health services for AYP in Nigeria.ConclusionThis study provided the context of the implementation of a strategic framework for adolescent reproductive health in a Nigerian setting from the perspectives of policy and service-level stakeholders. Opportunities for improving program delivery identified include ensuring research-based policy implementation and seeking program sustainability through tapping into new sources of funding.

“They will judge you more like a parent instead of like a health practitioner”: Perceptions and preferences of young people regarding sexual and reproductive health services in Southwest Nigeria

Adolescents and young people (AYP) experience many barriers in the utilization of sexual and reproductive health (SRH) services. These barriers can be cultural, structural, personal or health worker-related. In this study, we explored the perceptions and preferences of AYP in receiving SRH services at public health facilities in a Nigerian setting. We conducted 16 focus group discussion (FGD) sessions with adolescents and young people allowing for maximum variation by sex (male, female), age (15-19 years and 20-24 years), and marital status (married and unmarried). We applied a thematic framework analysis to explore the data collected. Our findings included both positive and negative attitudes of health workers at public health facilities, non-involvement of AYP in activities relating to the planning, implementation, or evaluation of SRH programs for AYP, and non-awareness among AYP of some of the rights that AYP have with respect to SRH services in public health facilities. Many participants preferred younger health workers or those living within their neighborhood. Some older health workers were said to often act as (strict) parents, not health workers. We conclude that the role ascribed to ‘neighborhood’ nurses in this study is instructive and deserves more attention. Also, there is a need to increase the awareness of the young people about the type of SRH services they can obtain in the public health facilities, as well as, a need for health workers to be trained and retrained in providing SRH services to AYP.

Preconception care practices among primary health care nurses working in public health facilities in KwaZulu-Natal

ABSTRACT Background Preconception care (PCC) is necessary to identify and deal with all the risk factors before conception. Some aspects of PCC, like folic acid supplementation, would be relevant to people desiring a pregnancy. Alternatively, PCC could provide contraceptive support to those with no pregnancy intention. In South Africa, primary healthcare nurses provide a comprehensive package of essential services in public health facilities to about 90% of the population at no cost. Therefore, they are the key providers of promotive, preventive, and curative services, including PCC. Objective This study aimed to determine the level of PCC practice among primary healthcare nurses and identify determinants of effective practice. Methods This cross-sectional descriptive survey was conducted among 196 nurses undertaking a specialisation Primary HealthCare program in a selected higher education institution. A pretested questionnaire was used to collect data that were analysed with SPSS version 27 software. Results The overall practice of PCC was 87.8%. Older participants were significantly less likely to exhibit good PCC practice than their younger counterparts. Female participants were also less likely to have good PCC practices than their male counterparts. Married participants were significantly more likely to practice PCC than their unmarried counterparts. Participants practicing in rural areas were also less likely to have good PCC practices than their urban counterparts. Conclusion The PCC practice of most primary healthcare nurses in the study is relatively high. The study also identified the determinants of good PCC practice that can enhance its practice. There is a need to revisit the PCC training of healthcare workers, as most indicated the need for further training.