Utilization Of Health Facilities Research Articles

Social and Health Determinants of the Families of Children Under Two Years of Age with Stunting in Sigi District

Social aspect is a determinant of stunting. Stunting in children is an indicator of well-being and an accurate reflection of social inequality. This study aims to analyze the social and health determinants of the families of children under two years of age with stunting in Sigi District. This was an analytical study with cross sectional design which involved a population of children aged 6-23 months. A sample size consisted of 380 people were selected through cluster simple random sampling technique. Respondents involved the mothers of children under two years of age. Data collection was conducted in February-June 2022. The dependent variables was stunting incidence. The independent variables were maternal age, parity, birth spacing, maternal education, child's gender, child's age in months, length of birth, early initiation of breastfeeding, exclusive breastfeeding, breastfeeding status, child condition at the time of study, history of ARI, diarrhea, pulmonary tuberculosis, measles, Helminth Infection, utilization of health facilities, growth and development stimulation, complementary food, water sources, ownership of family latrines, food insecurity, housing, and smoking family members. Stunting data was obtained by measuring body length using the Length Measuring Board (LMB) and measuring age by reading the birth certificate or MCH book of the child. Other data were obtained by filling out the kobocollect questionnaire. Data were analyzed using SPSS version 22.00. The WHO-Antro 2005 software was applied to determine the Z-Score. Height-for-Age data were analyzed using univariate, bivariate and multivariate analysis using Backward logistic regression method. Ethical clearance was obtained from the ethics committee of Palu Health Polytechnic number 0011/KEPK-KPK/IV/2022. The results showed that children aged 12-24 months had a 4.1 times higher risk of experiencing stunting compared to children aged 0-6 months (AOR=4.1; 95% CI: 2.0-8.4). Furthermore, children aged 7-11 months had a 2.2 times higher risk of experiencing stunting compared to children aged 0-6 months (AOR=2.2;95%CI: 1.2-3.9). Children who had a length of birth of <48 cm had a 2.1 times higher risk of experiencing stunting compared to children who had a length of birth of ≥48 cm (AOR=2.1; 95% CI: 1.2-3.6). Children of women with education of <9 years had a 2.7 times higher risk of experiencing stunting compared to children of women with education of ≥9 years (AOR=2.7; 95% CI: 1.4-5.0). Children from families with food insecurity had a 1.6 times higher risk of experiencing stunting compared to children from families with no food insecurity (AOR=1.6; 95% CI: 0.9-2.7). Social and health determinants of children under two years of age with stunting in Sigi District were child's age, length of birth of <48 cm, maternal education and food insecurity.

Assessment of Referral Patterns and Utilization of Basic Health Facilities in the Outpatient Department of a Tertiary Care Hospital: A Cross Sectional Study

The main reason behind poor healthcare delivery is malfunctioning of effective referral system. Objective: To determine the frequency of patients referred through proper channel in medical outpatient department of tertiary health care facility and to determine the causes of not utilizing basic health facilities by employing modified WHO questionnaire on Rapid Assessment of Referral Care System. A Cross-sectional descriptive study conducted in Medical Outpatient Department of Bacha Khan Medical Complex Swabi from 21st April to 21st September. Methods: Up to 400 participants going to medical outpatient department were selected through non-probability convenience sampling. Patient data like socio-demographic variables and questions with respect to referral was documented using a modified version of the Rapid Assessment of Referral Care System questionnaire from the World Health Organization. Percentages and frequencies were computed. Results: Amongst 400 participants who were included in the study, 244(61%) were female participants. About 365(91.3%) participants came to tertiary care hospital while (35) (8.8%) participants were referred. About 79(19.8%) participants were having chronic illness like Diabetes, hypertension, COPD, IHD, Asthma etc. 166(41.5%) participants choose this government facility due to presence of experienced doctors here in this facility. 159(39.8%) participants choose this facility due to presence of better care in this facility. Rest of them 75(18.7%) had other reasons. Conclusions: Most of the patients visited tertiary care hospital directly, with very minor health issues, not utilizing health facilities at the primary and secondary levels of care are overworked, which affects tertiary care facilities.

Outcomes of Postoperative Overnight High-Acuity Care in Medium-Risk Patients Undergoing Elective and Unplanned Noncardiac Surgery

Postoperative complications are increasing, risking patients' health and health care sustainability. High-acuity postoperative units may benefit outcomes, but existing data are very limited. To evaluate whether a new high-acuity postoperative unit, advanced recovery room care (ARRC), reduces complications and health care utilization compared with usual ward care (UC). In this observational cohort study, adults who were undergoing noncardiac surgery at a single-center tertiary adult hospital, anticipated to stay in hospital for 2 or more nights, were scheduled for postoperative ward care, and at medium risk (defined as predicted 30-day mortality of 0.7% to 5% by the National Safety Quality Improvement Program risk calculator) were included. Allocation to ARRC was based on bed availability. From 2405 patients assessed for eligibility with National Safety Quality Improvement Program risk scoring, 452 went to ARRC and 419 to UC, with 8 lost to 30-day follow-up. Propensity scoring identified 696 patients with matched pairs. Patients were treated between March and November 2021, and data were analyzed from January to September 2022. ARRC is an extended postanesthesia care unit (PACU), staffed by anesthesiologists and nurses (1 nurse to 2 patients) collaboratively with surgeons, with capacity for invasive monitoring and vasoactive infusions. ARRC patients were treated until the morning after surgery, then transferred to surgical wards. UC patients were transferred to surgical wards after usual PACU care. The primary end point was days at home at 30 days. Secondary end points were health facility utilization, medical emergency response (MER)-level complications, and mortality. Analyses compared groups before and after propensity scoring matching. Of 854 included patients, 457 (53.5%) were male, and the mean (SD) age was 70.0 (14.4) years. Days at home at 30 days was greater with ARRC compared with UC (mean [SD] time, 17 [11] vs 15 [11] days; P = .04). During the first 24 hours, more patients were identified with MER-level complications in ARRC (43 [12.4%] vs 13 [3.7%]; P < .001), but after return to the ward, these were less frequent from days 2 to 9 (9 [2.6%] vs 22 [6.3%]; P = .03). Length of hospital stay, hospital readmissions, emergency department visits, and mortality were similar. For medium-risk patients, brief high-acuity care with ARRC allowed enhanced detection and management of early MER-level complications, which was followed by a decreased incidence of subsequent MER-level complications after discharge to the ward and by increased days at home at 30 days.

Navigating the challenges of neuro-oncology in Africa: addressing diagnostic and treatment barriers in the region: a correspondence

Navigating the challenges of neuro-oncology in Africa: addressing diagnostic and treatment barriers in the region: a correspondence

Health facility utilization and Healthcare-seeking behaviour of the elderly population in India.

The increasing elderly population in India has generated an unmet need for healthcare services concerning them. To address some of those needs, the study aims to provide the current status of health facility utilization, health-seeking behaviour (HSB), and factors influencing them. Data from the Longitudinal Ageing Study in India (LASI)-Wave I was used to conduct multivariate analysis to assess the association between health facility utilization (inpatient and outpatient) and HSB across all age groups of the elderly. The likelihood of utilizing public health facilities increased with age for OPD and decreased with age for IPD. HSB was 23% less in the 80 years and above elderly as compared to other age groups. Healthcare service uptake was higher in the elderly with health insurance in a public health facility. Improving health insurance coverage among the Indian elderly may potentially improve healthcare service uptake in public health facilities.

Disparities and barriers of health facility delivery following optimal and suboptimal pregnancy care in Nigeria: evidence of home births from cross-sectional surveys

BackgroundDespite uptake of antenatal care (ANC), 70% of global burden of maternal and child mortality is prevalent in sub-Saharan Africa, particularly Nigeria, due to persistent home delivery. Thus, this study investigated the disparity and barriers to health facility delivery and the predictors of home delivery following optimal and suboptimal uptake of ANC in Nigeria.MethodologyA secondary analysis of 34882 data from 3 waves of cross-sectional surveys (2008–2018 NDHS). Home delivery is the outcome while explanatory variables were classified as socio-demographics, obstetrics, and autonomous factors. Descriptive statistics (bar chart) reported frequencies and percentages of categorical data, median (interquartile range) summarized the non-normal count data. Bivariate chi-square test assessed relationship at 10% cutoff point (p < 0.10) and median test examined differences in medians of the non-normal data in two groups. Multivariable logistic regression (Coeff plot) evaluated the likelihood and significance of the predictors at p < 0.05.Results46.2% of women had home delivery after ANC. Only 5.8% of women with suboptimal ANC compared to the 48.0% with optimal ANC had facility delivery and the disparity was significant (p < 0.001). Older maternal age, SBA use, joint health decision making and ANC in a health facility are associated with facility delivery. About 75% of health facility barriers are due to high cost, long distance, poor service, and misconceptions. Women with any form of obstacle utilizing health facility are less likely to receive ANC in a health facility. Problem getting permission to seek for medical help (aOR = 1.84, 95%CI = 1.20–2.59) and religion (aOR = 1.43, 95%CI = 1.05–1.93) positively influence home delivery after suboptimal ANC while undesired pregnancy (aOR = 1.27, 95%CI = 1.01–1.60) positively influence home delivery after optimal ANC. Delayed initiation of ANC (aOR = 1.19, 95%CI = 1.02–1.39) is associated with home delivery after any ANC.ConclusionsAbout half of women had home delivery after ANC. Hence disparity exist between suboptimal and optimal ANC attendees in institutional delivery. Religion, unwanted pregnancy, and women autonomy problem raise the likelihood of home delivery. Four-fifth of health facility barriers can be eradicated by optimizing maternity package with health education and improved quality service that expand focus ANC to capture women with limited access to health facility.

‘I believe respect means providing necessary treatment on time’ - a qualitative study of health care providers’ perspectives on disrespect and abuse during childbirth in Southwest Ethiopia

BackgroundThe majority of maternal deaths occur in low-income countries, and facility-based childbirth is recognised as a strategy to reduce maternal mortality. However, experiences of disrespect and abuse during childbirth are reported as deterrents to women’s utilisation of health care facilities. Health care providers play a critical role in women’s experiences during childbirth; yet, there is limited research on service providers’ views of disrespect and abuse in Ethiopia. Therefore, this study aimed to explore providers’ perspectives on disrespect and abuse during childbirth in a teaching hospital in Southwest Ethiopia.MethodQualitative study was conducted in a tertiary teaching hospital in Jimma Ethiopia. In-depth interviews were conducted with 32 purposefully selected health care providers, including midwives, obstetrics and genecology resident’s, senior obstetricians and nurses. Interviews were audio-recorded, transcribed and thematically analysed using the qualitative data analysis software program MAXQDA.ResultsThree major themes were identified from the health care providers’ perspectives: (1) respectful and abuse-free care, (2) recognised disrespect and abuse; and (3) drivers of women’s feelings of disrespect and abuse. The first theme indicates that most of the participants perceived that women were treated with respect and had not experienced abuse during childbirth. The second theme showed that a minority of the participants recognised that women experienced disrespect and abuse during childbirth. The third theme covered situations in which providers thought that drivers for women felt disrespected.ConclusionMost providers perceived women’s experiences as respectful, and they normalized, and rationalized disrespect and abuse. The effect of teaching environment, the scarcity of resources has been reported as a driver for disrespect and abuse. To ensure respectful maternity care, a collaborative effort of administrators, teaching institutions, professional associations and researchers is needed. Such collaboration is essential to create a respectful teaching environment, ensure availability of resources, sustained in-service training for providers, and establishing an accountability mechanism for respectful maternity care.

PREGNANT WOMEN WITH SEVERE ANAEMIA IN LABOUR: PREVELENCE, SOCIODEMOGRAPHIC DETERMINANT AND OBSTETRICS OUTCOME

Background: Anaemia is most common hematological issue encountered during pregnancy and one of the major cause for maternal and perinatal morbidity due to disturbed physiological milieu. Our objective was to study the pregnancy outcome in women with severe anaemia in labour. Method: A Prospective observational study was conducted by collecting data from medical records of around 100 consecutive consenting women with severe anaemia in labour with &gt;28weeks of pregnancy which admitted in a labour room of a tertiary health care center of south Gujarat over a period of one year after HREC approval. Results: In our study Majority of the subjects (73 %) were in the age group of 19 – 29 years, Majority (70%) subjects were unbooked. 75% subjects were with severe anaemia (Hb = 4 – 7 gm/dl) and 25% subjects were of very severe anaemia (Hb &lt; 4 gm/dl). Majority of the (69 %) subjects were multipara and (31%) subjects were primipara. In multipara, majority (73.91%) subjects were having &lt; 2 years of birth spacing interval. 84% subjects had microcytic hypochromic anaemia. 62% subjects had vaginal delivery and 36% subjects were undergone for Emergency LSCS. Conclusion: Increasing utilization of healthcare facility at every step(rural/urban) by needy women can improve obstetric &amp; perinatal outcome associated with maternal anaemia. To overcome complications of anemia during pregnancy &amp; in labour early detection of cases &amp; early catching of mild to moderate cases of anaemia &amp; their timely management required. All these can improve our clinical &amp; Reproductive outcome

Factors Contributing to Rapidly Increasing Rates of Caesarean Section in Andhra Pradesh, India: A Case-Control Study.

Introduction In some obstetric situations, a caesarean section (CS) can be a crucial, life-saving treatment for both the mother and the infant. Nonetheless, unnecessary CS can raise the risk of morbidity for both. The present study was conducted to study the factors associated with CS deliveryand to study the patterns of utilization of health facilities by pregnant women in the state of Andhra Pradesh in India. Materials and methods A community-based case-control study was done in Mangalagiri mandal, Guntur district, Andhra Pradesh, India in 2022. A total of 268 mothers (134 CS and 134 normal vaginal childbirth) who delivered between 2019 to 2022with at least one biological child less than three years of age were studied. The data was collected using a structured questionnaire. Robson's 10-Group Classification was used to differentiate the type of deliveries of the participants.A p-value less than 0.05 was considered to be significant. Results The mean age of the 268 women studied was 25.49±3.73 years. We found that 47 of the 82 (57.3%) women who went to government healthcare facilities and 87 of the 181 (48.1%) women who went to private healthcare facilities had a CS. Of the total CS studied, approximately 83.5% were emergency CSs. All four mothers who had twins had undergone CS. All women with oblique or transverse fetal lie underwent CS irrespective of parity. On multivariate analysis, participants' education status less than or equal to 10th standard was positively associated withCSandidentification of complications in the third trimester by healthcare provider was significantly protective for CS. Conclusion CS rate reduction necessitates a multi-faceted strategy that includes a variety of programming initiatives. Audits of CS performed as part of health programs and other creative monitoring techniques can be useful tools for assessing the standard of maternity care, particularly emergency CS.

Health facility delivery service utilization and its associated factors among women in the pastoralist regions of Ethiopia: A systematic review and meta-analysis.

Utilizing health facility delivery services is one of the pillars of lowering maternal mortality. However, the coverage of health facility delivery service utilization continues to be uneven around the world. In Ethiopia, particularly among pastoralist regions, health facility delivery service utilization is less common. Therefore, the purpose of this study was to determine the pooled prevalence of health facility delivery service utilization and identify the associated factors among women in the pastoralist regions of Ethiopia. A comprehensive systematic search was carried out in PubMed/MEDLINE, Hinary, Cochrane Library, Google Scholar, Google, and Ethiopian online university repositories. Studies were appraised using the JBI appraisal checklist. The analysis was done using STATA version 16. The pooled analysis was conducted using DerSimonian and Laird random-effects model. I 2 test and Eggers & Begg's tests were used to assess the heterogeneity and publication bias, respectively. p < 0.05 was set to determine the statistical significance of all the tests. The pooled prevalence of health facility delivery service utilization was 23.09% (95% CI: 18.05%-28.12%). Have ANC visit during pregnancy (OR = 3.75, [95% CI: 1.84-7.63]), have information regarding maternal health service fee exemption (OR = 9.51, [95% CI: 1.41-64.26]), have a nearby health facility (OR = 3.49, [95% CI: 1.48-8.20]), and women attend secondary and above education (OR = 3.06, [95% CI: 1.77-5.29]) were found to be significant associated factors. Health facility delivery service utilization is very low in pastoralist regions of Ethiopia, and ANC follow-up, distance from the health facility, women's educational status, and information regarding maternal health service fees were identified as significant associated factors. Consequently, strengthening ANC services, introducing free health services to the community, and constructing health facilities for the nearby residents are recommended to improve the practice.

Socio-Economic Analysis and Ownership of Health Insurance in the Utilization of Health Facilities for Elderly with Hypertension

Hypertension is the most common occurrence for the elderly in Jambi City with an increasing trend in the last three years. However, the utilization of health facilities, especially for outpatient hypertension, has had its ups and downs. This study aims to analyze the effect of socioeconomic, and insurance ownership on the utilization of health facilities for outpatient hypertension in the work area of Simpang IV Sipin Health Center Jambi City in 2022. This study is a quantitative study using a cross-sectional design. The sample amounted to 110 respondents who were selected using accidental sampling technique. The instrument used is a questionnaire. Data processing using statistical software with univariate analysis stage, bivariate analysis with chi-square test, and multivariate analysis with multiple logistic regression test. The results of the study show that there is an effect of employment status, income, costs and ownership of health insurance on the utilization of health facilities for the elderly with hypertension in Jambi City in 2022. The conclusion of the study is that income and ownership of health insurance are the main triggers that affect the use of health facilities for outpatient treatment elderly with hypertension in Jambi City.

The Health-Seeking Behavior of the Elderly with Non-Communicable Diseases in Coastal Areas of Vietnam

This study aimed to analyze the utilization of health care facilities and the health-seeking behavior of elderly people with non-communicable diseases and find the factors that affect them. A cross-sectional study was conducted in seven coastal areas of the Thua Thien Hue province, Vietnam, using a sample of 370 elderly people aged over 60 years. Chi-square and multiple logistic regression analyses were used to examine the factors associated with the utilization of health care services. The participants' average age was 69.70 (SD), and 18% of them reported having ≥ two non-communicable diseases (NCDs). The results of the study showed that 69.8% of the total participants exhibited health-seeking behaviors. The findings also revealed that elderly people living alone, and those with an average or above-average income, had higher utilization of health care services. Participants with multiple NCDs exhibited more health-seeking behaviors than those with only one (OR: 9.24, 95% CI: 2.66-32.15, p = <0.001). The presence of health insurance and the need for health care counseling were also relevant ([OR: 4.16, 95% CI: 1.30-13.31, p = 0.016], [OR: 3.91, 95% CI: 2.04-7.49, p < 0.001], respectively). Health-seeking behavior is one of the most important positive implications for the aged population, as it encompasses one's physical, mental, and psychological wellbeing. Future studies can aim at gaining an in-depth understanding of the same results, helping improve the health-seeking behavior of elderly people, and enhancing their quality of life.

Women empowerment indices and utilization of health facilities during childbirth: evidence from the 2019 Sierra Leone demographic health survey

BackgroundWomen empowerment is recognized as a potential enabling factor to the utilization of health facilities during childbirth. However, the association between women empowerment and utilization of health facilities is poorly studied, especially in counties with high maternal mortality. Therefore, we investigated the association between women empowerment indices and the utilization of health facilities during childbirth in Sierra Leone.MethodsWe analyzed secondary data from the 2019 Sierra Leone Demographic and Health Survey (SLDHS). We included 5,997 married women who had given birth in the five years before the survey, and had been sampled for the women empowerment questionnaire. The study employed the gender roles framework developed by the Harvard Institute for International Development in the selection and classification of women empowerment indices, which include influencing, resource and decision-making factors. We conducted logistic regression analyses using SPSS version 25.0 complex samples package to determine the association between women empowerment indices and utilization of health facilities.ResultsThe overall prevalence of health facility utilization during childbirth was 84.1% (5,042/5,997): 95% CI: 83.6 to 85.4. Among the influencer domain variables, women from the southern (aOR = 2.25, 95% CI: 1.34–3.78), northern (aOR = 1.69,95% CI: 1.01–2.82) and eastern regions (aOR = 3.71, 95% CI: 2.03–6.77) had higher odds of health facility utilization compared to women in the western region, while women in polygamous marriages (aOR = 0.82, 95% CI: 0.69–0.98) had lower odds of utilizing health facilities compared to their counterparts in monogamous marriages. Furthermore, women who had their first birth when they were less than 18 years, had higher odds of utilizing health facilities (aOR = 1.22, 95% CI: 1.02–1.45) compared to those who were 18 years and above. Among the resource domain variables, women with post-primary education (aOR = 1.58, 95% CI: 1.21–2.06) had higher odds of utilizing health facilities compared to their counterparts with no education and women who belonged to the richest wealth quintile (aOR = 2.42, 95% CI: 1.31–4.46) had higher odds of utilizing health facilities compared to their counterparts belonging in the poorest quintile. None of the variables in the decision making domain was significantly associated with health facility utilization.ConclusionThese findings emphasize that, successful implementation of health facility utilization interventions should prioritize women empowerment with more pragmatic efforts. Policies and programme should aim at all women with more focus on those having lower education (primary and below), belonging to the poorest wealth quintile, give birth before reaching18 years and in polygamous marriages.

The study of healthcare facility utilization problems faced by pregnant women in urban northIndia.

Sub-Saharan African countries account for nearly half of maternal deaths, and Southern Asian countries are second in the 85% of deaths that occur worldwide. Despite this fact, there is a rapid enhancement in the number of skilled health workers. There has been a sharp increase of 53% in 1990 and 61% in 2007 in trained birth attendant utilization shows that attention is being paid tothe management of labor services. But surprisingly, still, the births take place without the assistance of trained health personnel in Southern Asian countries and Sub-Saharan Africa. The objective of this study is the assessment of barriers to health care facility utilization and its management concerning labor problems in urban North India. A sample of "300" pregnant urban women was taken for study and analysis. A convenience sampling method was used. The factor analysis was applied for the interpretation and analysis of the data. It was found that there were inadequacies in services as well as unawareness of services in almost all urban areas among pregnant women. The tremendous increase in the cost of services and corrupt behavior among the service providers rampantly found in the urban locations, inaccessibility ofproper means of communication and also economic backwardness and low literacy became the impediment tothe utilization of maternal healthcare services in North-India.

Challenges in moving toward universal health coverage: rising cost of outpatient care among Vietnam's insured rural residents, 2006–2018

ObjectivesThe aim of this study was to assess temporal trends in out-of-pocket (OOP) expenditures per outpatient contact by the insured residents in rural Vietnam. Study designThis was a repeated cross-sectional study. MethodsSeven biennial waves from the Vietnam's Household Living Standard Survey covering the period 2006–2018 and a two-part model were used to assess temporal trends in OOP expenditures and its variations across various health facilities while controlling for a wide array of individual- and household-specific characteristics. ResultsThe pattern of health facility utilization shifted steadily from commune health centers toward higher level government hospitals and private health facilities between 2006 and 2018. The regression results indicated an upward trend in the amount of OOP expenditures, with the amount of OOP expenditures incurred per outpatient contact being 40.3% higher in 2010–2012 than in 2006–2008 and by as much as 155.5% higher in 2018. These high-cost pressures were attenuated by 63%–65% when accounting for the types of health facility contacted. The cost inflation was more pronounced for care sought at higher level government hospitals and private hospitals than at other health facilities. ConclusionThe cost of accessing outpatient care rose sharply between 2006 and 2018, particularly for visits involving higher level government hospitals and private hospitals. These findings suggest that beside expanding the coverage over the transition path to universal coverage, efforts should be directed at reforming Vietnam's hospital-centric and fragmented delivery system as a way of containing costs and ensuring financial sustainability of social health insurance system.

Utilization of primary health care facilities in Lagun Community of Lagelu Local Government Area of Oyo State Nigeria

Poor funding and mismanagement were identified as a major setback to healthcare service delivery in Nigeria and of which is a prominent factor affecting its coverage and quality. This study examined the gap in the utilization of primary healthcare facilities in Lagun Community of Lagelu Local Government Area of Oyo State Nigeria. A cross-sectional study design using multi-stage random sampling technique to select 80 respondents that met the criteria were given the opportunity to participate in the study. A semi-structured questionnaire was used to collect information from respondents. Descriptive statistics and Chi-square were used for data analysis at 0.05 significance level, results showed that mean age of respondents was 30.5±17.0, where majority (97.4%) speaking indigenous Yoruba language. More than half (56.2%) were Christians, 56.6% had secondary education, and two-fifth (40.0%) of respondents being traders. Relationship between utilization and other factors at (X2=1.000, df=1, p=0.183) showed that awareness and availability were good, while accessibility and affordability were below the expectation as recommended by World Health Organization. Also, utilization of facilities that embraced health-for-all projected for the year 2020 millennium development goal would have assisted better improvement in achieving an holistic medical architecture through government and other health agencies proactive approaches if more enlightenment, intervention, health insurance accessibility, unalloyed cooperation of the dwellers with various health professionals anticipating in promoting utilization of health facilities in the community.

The Effect of a Facility Level Intervention on Disrespect and Abuse during Childbirth: A Controlled Before and After Comparison of Two District Hospital in Abuja, Nigeria

Disrespect and abuse of women by health care workers during pregnancy and childbirth is very common especially in developing countries like Nigeria. This is a deterrent to the utilization of available maternal health-care facilities with resultant high maternal morbidity and mortality. Hence there is a need for interventional strategies to reduce the prevalence. This study examines the effectiveness of an educational intervention on the prevalence of disrespect and abuse in two district hospitals in Nigeria. It employed a quasi-experimental design as a control before and after with a comparison to measure the effect of a single intervention on the prevalence of disrespect and abuse experienced by women during childbirth, using two health facilities. A total of three hundred and seventy four (374) women experiencing childbirth, one hundred and eighty seven from each health facility were randomly selected as research participants for a baseline study while the same total number of women were selected after a 3 days training on respectful maternity care targeted at health workers in only one of the hospitals. The overall prevalence of disrespect and abuse among the women at baseline was 92.33%. The results from the logistic regression analysis conducted at post intervention and the z-score comparison of proportion test indicates a significant reduction in the overall prevalence of disrespect and abuse at the intervention site, from 88.2% to 46% with no significant change in the overall prevalence of disrespect and abuse at the control site. It was concluded that there is a significant relationship between educational intervention and prevalence of disrespect and abuse hence recommendations were made for relevant stakeholders to implement strategies that will improve respectful maternity care.

Impact of the decision to use healthcare facilities among farming households on labour productivity in Ogun State, Nigeria

Abstract Productivity of agricultural labour is central to the improvement of livelihoods of rural population. This study used an instrumental variable approach to examine the impact of healthcare facilities use on household labour productivity using distance to healthcare facilities as an instrument. A multistage sampling procedure was used in selecting 200 households comprising 96 users and 104 non-users of healthcare facilities. The result revealed that the agricultural productivity of users of healthcare facilities was ₦652.34 (USD 1.65) per man-day higher than non-users. The result further showed that age (p &lt; 0.1), sex (p &lt; 0.05), contact with health extension worker (p &lt; 0.01), incapacitation due to illness (p &lt; 0.05) and distance to healthcare facilities (p &lt; 0.01) significantly influenced the decision to use healthcare facilities while membership of cooperative society (p &lt; 0.05), area cultivated and use of health care facilities (p &lt; 0.1) significantly influenced labour productivity. The study concluded that increased distance to healthcare facilities reduces its utilisation while being member of cooperative society and utilisation of healthcare facilities increases labour productivity. This study recommended that health extension workers need to intensify their efforts in educating the households on the need to use healthcare facilities when they are sick; this is expected to improve the healthy time of the households which will invariably increase their productivity.

A Systematic Review of Factors Associated with Under-Five Child Mortality.

Preventing the life of the newborn and reducing the entrenched disparity of childhood mortality across different levels is one of the crucial public health problems, especially in underdeveloped and developing countries in the world. Sustainable development goals (SDGs)-3.2 is aimed at terminating all preventable under-five child mortality and shrinking it to 25 per 1000 live births or lower than this by 2030. Several factors have been shown to be linked with childhood mortality. This review is aimed at pointing out the significant determinants related to under-five child mortality by a systematic review of the literature. EMBASE, PubMed, Scopus database, and Google Scholar search engine were used for the systematic search of the literature. Special keywords and Boolean operators were used to point out the relevant studies for the review. Original research articles and peer-reviewed papers published in the English language till August 10, 2022, were included in the analysis and synthesis of the results. As per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, out of 299 studies identified from different sources, only 22 articles were ascertained for this study. Eligible articles were appraised in detail, and relevant information was extracted and then integrated into the systematic review. Mother's education, size of child at birth, age of mother at childbirth, place of residence, birth interval, sex of child, type of birth (single or multiple), and birth order, along with other socioeconomic, maternal, child, health facility utilization, and community level variables, were observed as important covariates of under-five mortality. Women's education and easy access to quality healthcare facilities should be the apex priority to lessen childhood mortality.

Improving access to and use of maternal health services during COVID-19: Experience from a health system strengthening project in Guinea.

The purpose of this study was to document the experience of health providers' capacity strengthening during health crises and the contribution of such to the health system and the population resilience in the face of the COVID-19 pandemic in Guinea. We conducted a cross-sectional study using routine data collected from 41 health facilities in the project intervention areas, including associative health centers, community health centers, and district hospitals,. These data covered the period between 2019 and 2021. Results showed that all the community health centers (CMCs) had a clean internal and external environment, compared to health centers (95.2%) and district hospitals (33.3%). Hand washing was systematic among visitors attending CMCs and district hospitals (HPs). However, 28.6% of visitors attending associative health centers (AHCs) did not wash their hands. Temperature taking for visitors was not carried out in all CMCs and in 90.5% of the AHCs; unlike in the HC and HP where the temperature of each patient was taken before entering the consultation room. The obligation to wear masks was higher in the HP and in the HC, compared to the CMC and AHC where the order of non-compliance with the wearing of masks was, respectively 36.4 and 19%. Non-compliance with social distancing in the waiting rooms and between users was observed in all facilities. The project's interventions mainly contributed to improving the utilization of prenatal consultation and institutional delivery services; the beginning of the interventions was marked by an increase of an average of 17 ANC1 per month in CMCs and 116 ANC1 in health centers. Ongoing training on capacity strengthening for providers in infection prevention and control, followed by the offering of delivery kits and materials during epidemics, would contribute to the improvement and utilization of health facilities by the population.