96 research outputs found
Identifying knowledge needed to improve surgical care in Southern Africa using a theory of change approach
Effectiveness of a training intervention in increasing the use of misoprostol in postabortion care in Malawi : A quasi-experimental study
publishedVersio
Prioritising and Mapping Barriers to Achieve Equitable Surgical Care in South Africa : A Multi-disciplinary Stakeholder Workshop
Funding This work was supported by The Academy of Medical Sciences Global Challenges Research Fund Networking Grant [grant number: GCRFNGR4\1036].Peer reviewedPublisher PD
Experiences of using misoprostol in the management of incomplete abortions : a voice of healthcare workers in central Malawi
Complications after abortion are a major cause of maternal death. Incomplete abortions
are common and require treatment with surgical or medical uterine evacuation. Even though
misoprostol is a cheaper and safer option, it is rarely used in Malawi. To improve services, an
intervention was performed to increase the use of misoprostol in post-abortion care. This study
explored healthcare providers’ perceptions and experiences with misoprostol in the Malawian setting
and their role in achieving effective implementation of the drug. A descriptive phenomenological
study was conducted in three hospitals in central Malawi. Focus group discussions were conducted
with healthcare workers in centres where the training intervention was offered. Participants were
purposefully sampled, and thematic analysis was done. Most of the healthcare workers were
positive about the use of misoprostol, knew how to use it and were confident in doing so. The
staff preferred misoprostol to surgical treatment because it was perceived safe, effective, easy to use,
cost-effective, had few complications, decreased hospital congestion, reduced workload, and saved
time. Additionally, misoprostol was administered by nurses/midwives, and not just physicians, thus
enhancing task-shifting. The results showed acceptability of misoprostol in post-abortion care among
healthcare workers in central Malawi, and further implementation of the drug is recommended.Helse Nord and The Liaison Committee for education, research, and innovation in Central Norway through the Norwegian University of Science and Technology (NTNU) and Malawi University of Science and Technology (MUST).https://www.mdpi.com/journal/ijerphSchool of Health Systems and Public Health (SHSPH
A Call for Urgent Monitoring of Food and Water Security Based on Relevant Indicators for the Arctic
This perspective paper argues for an urgent
need to monitor a set of 12 concrete, measurable indicators
of food and water security in the Arctic over time. Such a
quantitative indicator approach may be viewed as representing
a reductionist rather than a holistic perspective, but
is nevertheless necessary for actually knowing what reality
aspects to monitor in order to accurately understand,
quantify, and be able to project critical changes to food and
water security of both indigenous and non-indigenous
people in the Arctic. More relevant indicators may be
developed in the future, taking us further toward reconciliation
between reductionist and holistic approaches to
change assessment and understanding. However, the
potential of such further development to improved holistic
change assessment is not an argument not to urgently start
to monitor and quantify the changes in food and water
security indicators that are immediately available and
adequate for the Arctic context
Iodine status in Norwegian preschool children and associations with dietary iodine sources: the FINS-KIDS study
Iodine is an essential trace element necessary for thyroid hormone synthesis. Iodine deficiency is a continuing public health problem despite international efforts to eliminate it. Studies on iodine status in preschoolers are scarce. Thus, the aims of the current study were to determine the iodine status and to investigate possible associations between urinary iodine concentration (UIC) and estimated 24 h iodine extraction (UIE) and iodine-rich foods.publishedVersio
Health effects associated with measured levels of contaminants in the Arctic
Published version. Source at http://dx.doi.org/10.3402/ijch.v75.33805 The Human Health Assessment Group has over the past decade recommended that effect studies be conducted
in the circumpolar area. Such studies examine the association between contaminant exposure in the Arctic
populations and health effects. Because foetuses and young children are the most vulnerable, effect studies are
often prospective child cohort studies. The emphasis in this article is on a description of the effects associated
with contaminant exposure in the Arctic. The main topics addressed are neurobehavioural, immunological,
reproductive, cardiovascular, endocrine and carcinogenic effect. For each topic, the association between
exposure and effects is described, and some results are reported for similar studies outside the Arctic
Overview of ongoing cohort and dietary studies in the Arctic
Published version. Source at http://dx.doi.org/10.3402/ijch.v75.33803 This article gives an overview of the ongoing cohort and dietary studies underlying the assessment
of
population health in the Arctic. The emphasis here is on a description of the material, methods and
results or preliminary results for each study. Detailed exposure information is available in an
article in this journal, whereas another paper describes the effects associated with contaminant
exposure in the Arctic. The cohort descriptions have been arranged geographically, beginning in
Norway and moving east to Finland, Sweden, Russia and the other Arctic countries and ultimately to
the Faroe Islands. No cohort studies have been
reported for Alaska or Iceland
The epidemiology of multimorbidity in conditions of extreme poverty: a population-based study of older adults in rural Burkina Faso
Introduction Multimorbidity is a health issue of increasing
importance worldwide, and is likely to become particularly
problematic in low-income countries (LICs) as they
undergo economic, demographic and epidemiological
transitions. Knowledge of the burden and consequences
of multimorbidity in LICs is needed to inform appropriate
interventions.
Methods A cross-sectional household survey collected
data on morbidities and frailty, disability, quality of life
and physical performance on individuals aged over 40
years of age living in the Nouna Health and Demographic
Surveillance System area in northwestern Burkina Faso.
We defined multimorbidity as the occurrence of two or
more conditions, and evaluated the prevalence of and
whether this was concordant (conditions in the same
morbidity domain of communicable, non-communicable
diseases (NCDs) or mental health (MH)) or discordant
(conditions in different morbidity domains) multimorbidity.
Finally, we fitted multivariable regression models to
determine associated factors and consequences of
multimorbidity.
Results Multimorbidity was present in 22.8 (95%
CI, 21.4 to 24.2) of the study population; it was more
common in females, those who are older, single, more
educated, and wealthier. We found a similar prevalence
of discordant 11.1 (95% CI, 10.1 to 12.2) and concordant
multimorbidity 11.7 (95% CI, 10.6 to 12.8). After controlling
for age, sex, marital status, education, and wealth, an
increasing number of conditions was strongly associated
with frailty, disability, low quality of life, and poor physical
performance. We found no difference in the association
between concordant and discordant multimorbidity
and outcomes, however people who were multimorbid
with NCDs alone had better outcomes than those with
multimorbidity with NCDs and MH disorders or MH
multimorbidity alone.
Conclusions Multimorbidity is prevalent in this poor, rural
population and is associated with markers of decreased
physical performance and quality of life. Preventative and
management interventions are needed to ensure that
health systems can deal with increasing multimorbidity
and its downstream consequences.Support for the CRSN Heidelberg Aging Study and for TB was provided
by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award to Till Bärnighausen, funded by the German Federal Ministry of Education and Research. CFP is supported by the ANU Futures Scheme. Professor Witham acknowledges support from the NIHR Newcastle Biomedical Research Centre. MJS receives research support from the National Institutes of Health (R01 HL141053 and R01 AG 059504 and P30AI060354). GH is supported by a fellowship
copyright. on May 13, 2020 at Australian National University. Protected by http://gh.bmj.com/BMJ Glob Health: first published as 10.1136/bmjgh-2019-002096 on 29 March 2020. Downloaded from Odland ML, et al. BMJ Global Health 2020;5:e002096. doi:10.1136/bmjgh-2019-00209613BMJ Global Health from the Wellcome Trust and Royal Society 210479/Z/18/Z. JMG was supported by Grant Number T32 AI007433 from the National Institute of Allergy and Infectious
Disease
The epidemiology of multimorbidity in conditions of extreme poverty: a population-based study of older adults in rural Burkina Faso
- …