Supplementary Services Research Articles

Utilization of Nutritional Supplementation Services and Their Predictors in Pregnant and Lactating Women Living in an Urban Resettlement Colony of Delhi, India: A Cross-Sectional Study.

Introduction Maternal undernutrition during pregnancy and lactating has adverse health consequences for the mother and her child. The Integrated Child Development Services (ICDS) scheme by the Government of India provides supplementary nutrition services to all pregnant and lactating women but its utilization is suboptimal due to inefficient distribution through the health system and beneficiary concerns regarding its usefulness. This study was conducted with the objective of assessing the utilization of nutrition-related ICDS services by pregnant and lactating women in urban poor settlements of Delhi and the sociodemographic factors associated with non-utilization. Materials and methods This was a community-based cross-sectional survey in an urban resettlement colony and slum area located in the northeast district of Delhi. The data collection was conducted from January to May 2022. Eligible participants included pregnant women in their second or third trimester of pregnancy and lactating mothers in their first six months of the postpartum period who were residents of the study setting.Data were collected using face-to-face interviews using a pre-tested and self-designed questionnaire. The primary outcome was the proportion of women utilizing ICDS take-home rations (THR) in the previous month. Results A total of 365 participants were recruited in this study including 208 pregnant and 157 lactating women having a median (IQR) age of 25 (22-28) years.A total of 211 (57.8%) participants reported a history of utilization of ICDS supplementary nutrition services during their current pregnancy or postpartumwith 154 (42.2%) having received THR in the previous month. Among the currently pregnant women, 84 (40.4%) had utilized ICDS THR while in the currently lactating women, 70 (44.6%) had utilized THR in the previous month.On adjusted analysis, multigravid women were less likely to have utilized ICDS compared to primigravida women. Reasons for non-utilization of the ICDS supplementary nutrition services by the mothers were temporary disruption due to cessation of ICDS services by protesting Anganwadi workers (over demand for increased honorarium), difficult access to Anganwadi center, the poor perceived taste of the food provided as THR, and perception by the mothers that they did not require THR. Most women reported sharing the THR with their family members. All pregnant and lactating women were found to be calorie and protein deficient in this study when applying the recommended intake values. No association was observed between the utilization of ICDS in the previous month and the presence of calorie deficiency in both pregnant (p=0.35) and lactating (p=0.24) women. Conclusions More than four in ten eligible pregnant and lactating women in an urban resettlement colony in Delhidid not utilize ICDS supplementary nutrition services with similar rates of utilization in both pregnant and lactating women. Women living in joint families and consequently larger households were less likely to utilize ICDS services. A majority of pregnant and lactating women were calorie and protein deficient even on applying non-pregnant cut-off requirements. The ICDS scheme needs to strengthen information, education, and communication (IEC) strategies and interventions to improve its acceptability and utilization by this vulnerable population.

Impacts of urban safety net on income, food expenditure and intake capacity of poor households in Addis Ababa city, Ethiopia, 2021

Although measures taken to address food insecurity and income inequality showed notable outcomes, they have continued to be major global issues mainly in urban areas of developing countries. To relieve these problems, Ethiopia started an urban safety net program in Addis Ababa city in 2017. The purpose of this study was to investigate the impacts and progress of the urban safety net program, mainly its cash transfers (CTs) on income, consumption, and food security of poor households using indicators based on elements of a theory of change and Engel's coefficient. It assessed whether the program was significant (or not) to program beneficiaries compared to situations before the start of the program, non-beneficiaries, and beneficiaries' sex. A total of 560 sample households were selected through a multi-stage sampling for household surveys. Comparative approaches, paired and independent t-tests, and linear regression were used to analyze the data. Results revealed that the CTs had a satisfactory targeting accuracy of the poor and produced positive effects on monthly income, savings, food expenditures and intake, and seed money for a business start. Since financial transfers account for a larger proportion of the income of households, current income becomes significantly bigger compared to income during the pre-program periods and non-beneficiary households. Food access, expenditure, and savings capacities of beneficiaries in post-CT became better than in pre-CT along with better food access and diet intake two to three a day than non-beneficiaries. Besides, coverage and benefits were statistically significant for women compared to men. The implementation of the urban safety net program is good in its positive impacts and progress toward nutrition and food security of poor households as a result of an increase in their income, food expenditure, intake, and access. This implies policymakers could potentially expect to see improvements in nutrition and food security, especially when targeting urban poor and female-headed households. However, delays in payments and work equipment, declining size and value of payments, and weak supplementary services are the program's shortcomings. Policy implications to improve the size of transfers, emergency aids, timely payments and equipment provisions, and interventions like regular business training, supervision, and guidance are recommended.

Integration of Unstructured Supplementary Service Data (USSD) Into A University's Portal

Integration of Unstructured Supplementary Service Data (USSD) Into A University's Portal

The use of various appointment systems among patients visiting academic outpatient centers in Kerman and the evaluation of patients’ perspective and satisfaction

BackgroundTo optimize appointment systems, it is necessary to assess their users’ perspectives. This study aims to determine the use of various appointment systems among patients in academic outpatient centers and to investigate their perspectives and satisfaction.MethodsThis survey study was conducted on 332 patients or those accompanying patients in academic outpatient centers. A five-part questionnaire consisting of (1) demographic information, (2) willingness to use systems, (3) problems when using these systems, (4) problems after reserving the appointment, (5) recommendations and critics was used. The relationship between the system of interest and the available tools was examined by the Chi-square test, and the relationship between demographic characteristics and satisfaction was assessed using multiple regression.ResultsThe participants’ overall satisfaction towards appointment systems, regardless of the type of system, was 49.12 ± 16.04 (out of 100). Satisfaction with the appointment system using Unstructured Supplementary Service Data (USSD) was significantly higher than the other two systems (p = 0.03). Web-based application and Interactive Voice Response (IVR) were the most frequently used systems with 61% and 48%, respectively. More than half of those who had access to a telephone (56%) preferred the IVR appointment system, and most of those who had Internet access (71%) preferred the web-based application (p < 0.05). Among 137 participants who had access to both the Internet and telephone, 49% (n = 67) stated that they would rather arrange their appointment through the web-based application.ConclusionThe web-based application and IVR are the most frequently used and favorable appointment system among the patients or those accompanying patients. Despite the availability of the infrastructure, the participant had moderate satisfaction with these systems due to their failures. Therefore, to have more efficient systems and increase patients or those accompanying patients satisfaction with these systems, healthcare authorities should have a plan to solve the problems of these systemes and use the capacity of information resources to inform the community regarding these systems.

Feasibility of e-commerce pharmacy provision and acceptability of levonorgestrel 1.5 mg for pericoital use in urban and peri-urban settings in Kenya: a prospective cohort study

IntroductionAn ‘on-demand’ contraceptive pill may suit women having infrequent sex. We assessed the feasibility of e-commerce pharmacy provision and acceptability of levonorgestrel (LNG) 1.5 mg for pericoital use in Kenya.MethodsA...

An Investigation of IEP Quality Associated With Special Education Placement for Students With Complex Support Needs

Students with complex support needs require individualized education programs (IEPs) to describe their present levels of academic achievement and functional performance (PLAAFP), and the annual goals and supplementary aids and services (SAS) that will be provided to enable them to make progress in the least restrictive environment. Previous research has found that IEPs do not reflect recommended practices and that IEP quality varies by educational placement in inclusive and separate class settings. The purpose of this study was to evaluate a national sample of IEPs of elementary-aged students with complex support needs to determine whether placement predicts IEP quality. We used multilevel regression to measure the extent to which placement predicts overall IEP quality as well as the quality of IEP components, including PLAAFP, goals, and SAS. We did not detect statistically significant differences in IEP quality by placement for any of these IEP components or for overall quality; instead, we found the IEPs consistently failed to meet quality indicators across all four placement types. Given these findings, we suggest implications for future research aimed at improving IEP quality for students with complex support needs.

Identifying factors affecting willingness to participate in floating population health volunteer services by Chinese volunteers based on the theory of the planned behavior expansion model.

China has the world's largest internal migrant population, called the floating population. Compared to local residents, the floating population utilizes different health services and relies heavily on health volunteer services for supplementary services. In this study, the theory of planned behavior model was used to study the willingness of volunteers to participate in floating population health volunteer services. We examined the effects of several factors on willingness to participate and found that attitude and subjective norm, but not perceived behavioral control, have significant predictive effects on willingness to participate in health volunteer services. Furthermore, altruistic values, social incentives, and personality traits not only have significant predictive effects on volunteer participation but also indirectly affect willingness through attitude and subjective norms. These findings help us understand what factors affect volunteers' willingness to provide health services to the floating population and have important implications for mobilizing volunteers for floating population health services.

Mobile Phone-based Intervention to promote un-interrupted HIV treatment during the COVID-19 pandemic.

Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence. This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART). A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients' medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians' attention. Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings.

Developing an Unstructured Supplementary Service Data-based mobile phone app to provide adolescents with sexual reproductive health information: a human-centered design approach

BackgroundAdolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information.ObjectiveThe study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app’s usability and user experience.MethodsA human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile phone. Adolescents were enrolled for the alpha and field testing of the app prototype at different time-points. The Mobile Application Rating Scale (MARS) a multidimensional mobile phone evaluation tool was used to access the functionality, engagement, aesthetics and quality of information in the app. Responses from the MARS were reported as mean scores for each category and a mean of the aggregate scores making the app’s quality score. The MARS data was also evaluated as categorical data, A Chi square test of independence was carried out to show significance of any observed differences using cumulative and inverse cumulative distribution functions.ResultsDuring the usability test, 62/109 (54.9%) of the adolescents that were followed-up had used the app at least once, 30/62 (48.4%) of these were male participants and 32/62 (51.6%) female. On engagement, the app had a mean score of 4.3/5 (SD 0.44), 4.6/5 (SD 0.38) on functionality, 4.3/5 (SD 0.57) on aesthetics and 4.4/5 (SD 0.60) on the quality of information. The overall app quality mean score was 4.4/5 (SD 0.31). The app was described as ‘very interesting’ to use by 44/62 (70.9%) of the participants, 20/44 males and 24/44 females. The content was deemed to be either ‘perfectly’ or ‘well targeted’ on sexual reproductive health by 60/62 (96.7%) adolescents, and the app was rated ‘best app’ by 45/62 (72.6%) adolescents, 27/45 females and 18/45 males, with a p-value = 0.011.ConclusionsAdolescents need on-demand, accurate and trusted SRH information. A mobile phone app is a feasible and acceptable way to deliver adolescent SRH information in resource-limited settings. The USSD mobile phone technology shows promise in the delivery of much needed adolescent SRH information on-demand..

Offline supplementary service strategies for the online marketplace: Third-party service or marketplace service?

Offline supplementary service that supports and enhances the core product is one of the key factors leading to the success of online sellers and the online marketplace. We explore the optimal supplementary service strategies for the online seller and online marketplace. We consider three kinds of supplementary service, namely unauthorised service (UAS), third-party authorised service (TAS), and marketplace authorised service (MAS). We identify that the marginal cost-revenue ratio (MCRR) shapes the service strategies of the online seller and marketplace. The seller prefers TAS when the MCRR is low but prefers UAS if it is high. However, when the MCRR is moderate, the seller provides both UAS and TAS simultaneously. In addition, we show that the marketplace offers MAS to the seller when the commission rate is relatively low or relatively high. The offering of MAS results in a win–win outcome for the seller and marketplace, and engenders a subsidising effect for the seller and consumer, as well as a revenue-enhancement effect for the marketplace. Interestingly, we find that a higher commission rate not only decreases the selling price but also increases the demand for the product-MAS bundle.

Assessing research methodologies used to evaluate inequalities in end-of-life cancer care research: a scoping review protocol

IntroductionTo provide equitable cancer care at the end of life, it is essential to first understand the evidence underpinning the existence of unequal cancer outcomes. Study design, measurement and analytical...

User Acceptability of Electronic Vaccine Registry Created using Simple Mobile Phone Technology in Nyandarua County, Kenya

Vaccination is one of the most important and effective public health interventions against vaccine-preventable diseases. Developed countries have successfully reduced mortality and morbidity due to vaccine-preventable diseases through improving vaccine coverage. This is not the case among low-income countries as vaccine coverages continue to soar below the global target of 90% coverage. Among the reasons reported for the low coverage are poor documentation and poor target setting, which could be attributed to the limited use of electronic vaccine registries. An electronic vaccine registry was created using Unstructured Supplementary Service Data (USSD) technology and registered births, vaccines administered, and sent short message reminders to mothers about their clinic dates. The registry was deployed in Nyandarua County, Kenya, between June 2018 to March 2019. We conducted a study to establish the acceptability and usability of the system to receive user feedback and explore possibilities of large-scale roll-out. All those interviewed (59) were able to log into the system during their first attempt. The majority (94.8%) reported that it was easy to manoeuvre the menu and move from one menu to the other System downtime was a rare phenomenon, and more than half (63%) reported that if it occurred, it happened at most once or twice per week. The majority of the respondents, 55 (98%), reported that the system was able to record the vaccines administered as envisioned. The cost to run the platform was quite manageable and slightly lower than internet-based systems. The system was user-friendly and can be replicated elsewhere.

Awareness and perception of mothers regarding Integrated child development services scheme for children in an urban area of Kerala

Background: Integrated child development services (ICDS) scheme was launched in India to improve the nutritional and health status of children. Perception of beneficiaries about ICDS services provided by Anganwadi centres had not being sufficiently explored. Hence the objective of this study was to assess the awareness and perception of mothers regarding Anganwadi services for children in an urban area of Kerala. Methods: A cross-sectional study was conducted in an urban area of central Kerala. Study participants were mothers having pediatric children, who were residing in the urban areas of central Kerala for at least the past one year. A total of 70 mothers were interviewed using a pre-designed semi-structured questionnaire after obtaining informed consent. Data were analyzed by SPSS software version 18.Results: Mean age of the study participants was 31.7±5.8 years. But 24.3% of children of the study participant never attended Anganwadi. The majority of study participants were aware of supplementary nutrition services (97%) provided by ICDS. Immunization services (58.6%) were the least aware service in ICDS. The perception of participants regarding adequate quantity and quality of supplementary nutrition from Anganwadi was only 58.6% and 62.9%. Only 57.1% felt that preschool non-formal education was beneficial, even though 90% were aware of this service from the Anganwadi centre.Conclusions: The participants were aware of ICDS services, but their perception regarding Anganwadi services was poor. Reasons for poor perception regarding ICDS services need to be assessed by focus group discussions and in-depth interviews with beneficiaries.

Successful Ways of Dealing with A Child with Autism Spectrum Disorder

This research is all about successfully dealing with children with Autism Spectrum Disorder (ASD). This study focused on the rate of preparation of the SPED Team members and other related services and how instructional strategies and other factors are necessary to achieve their full potential. This study had been carried out using the mixed-method research, particularly the convergent parallel design. Through the survey questionnaire conducted via google form and online interview via MS Teams, four distinct themes emerged: Academic Services, Classroom Management, Community Development, and Learner-Centered. Eleven subthemes were formulated based on the four major themes. Furthermore, majority of the respondents agree that extensive preparations must be done first by those professionals involved and being prepared intellectually, particularly with the different theories and background regarding ASD will help establish a better understanding of the child’s unique needs. The researchers created a framework that shows the things needed to be considered in educating learners with ASD. The members of the SPED Team can achieve teaching learners with ASD through the help of supplementary aids and services. The researcher also recommends that all academic institutions use the SLRE framework to deal with Filipino learners with ASD in creating the least restrictive environment.

The impact of son or daughter care on Chinese older adults' mental health

RationaleThe traditional cultural norm in China is that eldercare should be offered by a son and his family. However, several decades of family planning policies and rapid economic growth have led to low fertility rates, urbanisation, and cultural change, resulting in both reduced household size and the availability of sons. The traditional eldercare system is thus being challenged, especially in urban areas, with an increasing number of daughters supporting their parents, enabled by rising female empowerment, formal economic employment and improved financial capacities. Existing studies examine and compare the amount and types of support provided by sons and daughters, but very little is known about the differential health outcomes of parents experiencing eldercare offered by sons and by daughters. ObjectiveThis study investigates the difference in mental health outcomes of parents who receive eldercare from their sons and from their daughters. MethodWe analyse waves 2013, 2015, and 2018 of the China Health and Retirement Longitudinal Study, with mental health measured by a 10-item Center for Epidemiological Studies-Depression (CES-D-10) score. We compare the CES-D-10 score between parents with different sources of care — son's family, daughter's family or other — with multivariate statistical analysis. ResultsReceiving regular care from a son (or a daughter-in-law) is associated with a lower CES-D score than from a daughter (or a son-in-law). The difference mainly exists amongst those with a stronger son preference and those who are heavily deponent on their children, in particular rural parents, mothers, and those with less wealth. ConclusionOur study explores the evidence on mental health inequalities among parents with different sources of care, highlighting that lack of son care creates an apparent mental health disadvantage. Lowering older adults’ dependency on their children may alleviate this inequality by improving their financial independence. We also suggest the development of a long-term care system and greater facilitation of older adults to take-up supplementary services for family care.

Business Model Oriented Towards Solutions to Improve the Communication Efficiency of Deaf-Mute People

Abstract A series of supplementary services to solve communication problems between deaf-mute people and society could decrease the additional risk caused by communication impairments and break the boundaries between deaf-mute people and doctors/society. This scientific article will serve as the basis of a future application to ease the social and medical burden of hearing-impaired patients. The economic effect that the integration of deaf-mute people can have involves both decreasing the costs allocated to social and health services for this category of people, and increasing the contribution of each deaf-mute person by increasing his productivity as an employee at a company/institution.

Implementation of a peer support intervention to promote the detection, reporting and management of adverse drug reactions in people living with HIV in Uganda: a protocol for a quasi-experimental study

IntroductionPatients have contributed <1% of spontaneous adverse drug reaction (ADR) reports in Uganda’s pharmacovigilance database. Peer support combined with mobile technologies could empower people living with HIV (PLHIV) to report...

Pelatihan dan Pendampingan Lean Management dalam Memberikan Value Added Service pada Usaha Dagang Pertanian

Lean management is used as a management system and methodology to be able to organize and manage the management of the Agricultural Trading Business 'Hj. NURIMAN' against waste that does not add value to its trade production. The goal to be achieved in this community service program is provide assistance on the implementation of Lean Management by using the 5S concept to eliminate waste and improve services in providing value-added services to farmers. The result of this community service program able to eliminate of waste in the trading activities 'Hj. NURIMAN' and increasing services to farmers which include facilitating supplementary services and enhancing supplementary services

The internal market for supplementary pensions: A long and winding road

Since the beginning of the 1990s, EU initiatives have sought to gradually harmonize the activities of institutions for retirement provisions (‘IORPs’). However, thirty years later, multiple barriers to entry remain. This article will identify the current state of play, by adopting a twofold approach towards supplementary pensions in a context of EU internal market law. First, we will assess the process of negative integration of several pension policy tools in light of the free movement case law (in particular, the free provision of services). During this study, the focus will be on mechanisms of compulsory membership and collective bargaining in the field of occupational pensions. Second, we will analyse the most important legislative constraints of supplementary pension services at EU level, with an emphasis on secondary internal market law. We argue that, despite the effort of respecting national autonomy in social policy, positive integration has led to several spillovers. Finally, the article will highlight the most significant obstacles, and conclude by discussing the general attitude of EU internal market law towards supplementary pensions and social policy in general.

Towards an Integrated Mobile Technology on Animal Disease Surveillance Framework in Tanzania: A Systematic Review

Tanzanian Government, through its national audit office in March 2020, reported the prevalence decline of two animal diseases, namely; Foot and Mouth Disease (FMD) and Contagious Bovine Pleuropneumonia (CBPP). Similarly, an increase in three animal diseases, which are African Swine Fever (ASV), Contagious Caprine Pleuropneumonia (CCPP), and Lumpy Skin Disease (LSD). The national audit office mentioned inadequate animal disease surveillance system in the country was among the challenges that hinder diseases control. Therefore, this study reviews the existing animal diseases surveillance systems global and suggests measures to enhance animal diseases surveillance systems in Tanzania. This review focuses on the possibility of sharing surveillance data among livestock stakeholders (including livestock keepers) in Tanzania, considering available resources such as animal diseases existing prediction models and mobile-based surveillance systems. Also, the availability of mobile technologies such as Short Message Service (SMS), Unstructured Supplementary Service Data (USSD) and automatic voice calls (Robocalls). Reviews synthesize the previous studies to explore strengths, opportunities, weaknesses and challenges for better future interventions through proper and timely information sharing. This study selected 46 records from the 147 identified for review. The selected records include 24 from bibliographic databases, 14 from full-text journals and other non-bibliographic databases, and 8 from the open search on websites