83 research outputs found
Maternal mortality trends at the Princess Marina and Nyangabwe referral hospitals in Botswana
Background: Despite the fact that about 94% of pregnant women attend ANC, 95% deliver at health facilities and 99% deliveries are assisted by skilled birth attendants in Botswana, the national Maternal Mortality Rate is still high.Objectives: To determine the trend of MMR at Princess Marina and Nyangabwe referral hospitals before and after EMOC training.Methods: Retrospective longitudinal quantitative study design was used to collect data on maternal deaths. Demographic characteristics, maternal death causes, gestation at ANC registration and pregnancy risks were collected for the period before EMOC training and after training, analysed and compared. Descriptive statistics and frequency tables were used.Findings: Maternal deaths were 33 and 41 before and after EMOC training respectively. Majority of the maternal deaths, 78.8% and 70.7% before and after EMOC training respectively occurred among young women in the reproductive ages. Eclampsia wasthe commonest cause of maternal death before EMOC between training & and 58% and 66% of maternal deaths before and after EMOC training respectively occurred among women who had attended ANC services four or more times.Conclusion: Maternal deaths at the hospitals remained similar during the two periods. Qualitative studies are needed to determine why EMOC training has not resulted in significant reduction in MMR in Botswana.Keywords: Maternal mortality trends, princess Marina, Nyangabwe referral hospitals, Botswana
Knowledge about goitre among female school-going children in Wellega Province, Ethiopia
Background: About 30% of the world population is affected by Iodine Deficiency Disorder and Ethiopia is among the top ten countries in the world with severe iodine deficiency. The objective of this study was to explore the knowledge about goitre and preventive measures among female school children aimed at reducing the occurrence of goitre.Methods: Quantitative, descriptive cross-sectional study design was used to explore the knowledge about goitre among school-going children in three schools in Wellega Province, Ethiopia. Descriptive statistics was used to analyse, organise and interpret the findings.Results: A total of 364 girls aged between 15â19 years participated in the study. Overall, 71.4% did not have the knowledge about goitre, one third (28.6%) knew that goitre is caused by iodine deficiency and less than half (48.4%) knew that iodinated salt prevents occurrence of goitre. Sixty one per cent did not know which local foods aggravate goitre, 35.7% indicated that goitre affects both males and females and a small proportion identified pregnant women, children and adolescents as vulnerable groups for goitre. Only 38% received information about goitre from the schools.Conclusion: The level of knowledge about goitre among school girls in Wellega Province is low. It is recommended that concerted efforts targeting adolescents to acquire knowledge about the causes and prevention of goitre should be made and further studies should be done to explore perceptions and cultural factors that may contribute to the knowledge gap
Sexual and reproductive health among high school adolescents in West Shoa zone, Oromia region in Ethiopia
Adolescentâs sexual and reproductive health is a challenge in many low and middle-income countries. We assessed the knowledge and attitude towards sexual and reproductive health among adolescents in West Shoa zone, Oromia region, Ethiopia. The study was cross-sectional using simple multi-stage random sampling and a structured questionnaire was used to collect data among adolescents aged 15 â 19 years. Frequency distribution of dependent and independent variables were computed and Odds ratios were calculated to determine association between variables. Most participants were from poor and illiterate families. Slightly over half of them had heard about sexual and reproductive health and the knowledge of emergency contraceptive was limited. About 80% of the girls who had become pregnant ended the pregnancy with an abortion and discussion between parents and adolescents on sexuality issues were poor. Effort to empower adolescents and communities with correct sexual and reproductive health is required; academic curricula should be reviewed and health facilities should be engaged to provide sexuality education. Keywords: Adolescents, knowledge, communication on sexual and reproductive health La santĂ© sexuelle et de la reproduction des adolescents est un dĂ©fi dans de nombreux pays Ă revenu faible ou intermĂ©diaire. Nous avons Ă©valuĂ© les connaissances et les attitudes vis-Ă -vis de la santĂ© sexuelle et de la reproduction chez les adolescents de la zone de Shoa Ouest, dans la rĂ©gion dâOromia, en Ăthiopie. LâĂ©tude Ă©tait transversale et reposait sur un simple Ă©chantillonnage alĂ©atoire Ă plusieurs degrĂ©s. Un questionnaire structurĂ© a Ă©tĂ© utilisĂ© pour collecter des donnĂ©es sur les adolescents ĂągĂ©s de 15 â 19 ans. La distribution de frĂ©quence des variables dĂ©pendantes et indĂ©pendantes a Ă©tĂ© calculĂ©e et les rapports de cotes ont Ă©tĂ© calculĂ©s pour dĂ©terminer l'association entre les variables. La plupart des participants Ă©taient issus de familles pauvres et illettrĂ©es. Un peu plus de la moitiĂ© d'entre eux avaient entendu parler de la santĂ© sexuelle et de la reproduction et la connaissance de la contraception d'urgence Ă©tait limitĂ©e. Environ 80% des filles qui Ă©taient enceintes ont mis fin Ă leur grossesse par un avortement et les discussions entre parents et adolescents sur les questions de sexualitĂ© ont Ă©tĂ© mĂ©diocres. Un effort visant Ă responsabiliser les adolescents et les communautĂ©s en matiĂšre de santĂ© sexuelle et de la reproduction est nĂ©cessaire; les programmes universitaires devraient ĂȘtre revus et les Ă©tablissements de santĂ© devraient ĂȘtre engagĂ©s pour dispenser une Ă©ducation sexuelle. Mots-clĂ©s: Adolescents, connaissances, communication sur la santĂ© sexuelle et de la reproduction
Malaria, burden, HIV, Poor countries, Research Infrastructure, Tazania
Developing countries carry 90% of the global burden\ud
of disease. Infections such as malaria and HIV are\ud
debilitating their economies by killing the young and\ud
economically productive workforce. Research is essenÂ\ud
tial for health development, yet less than 10% of the\ud
annual global expenditure on health research is\ud
allocated to addressing developing countries' probÂ\ud
lems.1 Poor countries must face this challenge seriously.\ud
It is essential that they create strong national research\ud
infrastructures so that they can define priorities for\ud
health research priorities; influence national, regional,\ud
and global health agendas; and lobby for a more equiÂ\ud
table allocation of resources. This paper discusses\ud
some of the barriers to establishing coordinated health\ud
research programmes in developing countries and\ud
describes how Tanzania has developed a new research\ud
model to try and overcome these
Factors Influencing Womenâs Preferences for Places to Give Birth in Addis Ababa, Ethiopia
The main aim of this study was to examine factors determining womenâs preference for places to give birth in Addis Ababa, Ethiopia. A quantitative and cross-sectional community based study design was employed. Data was collected using structured questionnaire administered to 901 women aged 15â49 years through a stratified two-stage cluster sampling technique. Multinomial logistic regression model was employed to identify predictors of delivery care. More than three-fourth of slum women gave birth at public healthcare facilities compared to slightly more than half of the nonslum residents. Education, wealth quintile, the age of respondent, number of children, pregnancy intention, and cohabitation showed net effect on womenâs preference for places to give birth. Despite the high number of ANC attendances, still many pregnant women especially among slum residents chose to deliver at home. Most respondents delivered in public healthcare institutions despite the general doubts about the quality of services in these institutions. Future studies should examine motivating factors for continued deliveries at home and whether there is real significant difference between the quality of maternal care service offered at public and private health facilities
Cutaneous leishmaniasis a neglected tropical disease: community knowledge, attitude and practices in an endemic area, Northwest Ethiopia
Abstract
Background
Cutaneous leishmaniasis is one of the neglected tropical diseases in the Ethiopian highlands and studies on assessment of knowledge, attitude and practice of the community in endemic areas are scanty. The study aimed to assess the knowledge, attitude towards cutaneous leishmaniasis and treatment seeking practices in people living in the endemic highlands areas in the Northwest, Ethiopia and to provide evidence-based information to guide development of appropriate interventions to reduce the impact of cutaneous leishmaniasis on communities.
Methods
Quantitative cross-sectional study was conducted in cutaneous leishmaniasis endemic districts (woredas) using a semi structured questionnaire. Households were randomly selected according to probability proportional to size of households in each enumeration area. Systematic random sampling of eligible households was based on the number of households recorded during listing of households. Descriptive statistics was used to describe numerical data, organise and summarise the data in a manner that gave meaning to the numerical form. Frequency tables were used to show descriptive analysis and regression analysis was used to determine correlation between variables.
Results
Majority of respondents 321(78.7%) lived in rural areas, age ranged between 18 and 85âyears and most were farmers. Illiteracy was high (47.6%) among respondents and majority 358(87.8%) had seen patients with CL. Less than quarter (21.6%) had heard about sand flies and knowledge on the peak transmission period was low (46.3%). About 192 (47.1%) of the respondents indicated disfiguring lesions were the major clinical presentations, less than half 55(27.5%) of urban residents believed CL was treatable compared to 145(72.5%) of rural residents (P < 0.001). Traditional medicines were indicated as best treatment option by 209(51.2%) compared to 114(27.9%) for modern treatment. Major factors influencing treatment options included accessibility to treatment facilities, distance and short duration of treatment. Participants expressed negative experiential attitude and perceived control towards modern treatment because of inaccessibility and distance from where modern treatment is provided.
Conclusion
Priority should be given to primary prevention and appropriate awareness campaigns on lesion recognition. Information on modern treatment should be intensified
Health care workers experiences in emergency obstetric care following implementation of an in-service training program: case of 2 Referral Hospitals in Botswana
Background: Maternal mortality rate remains a challenge in many
developing countries. Objectives: This study explored experiences of
Health Care Workers on Emergency Obstetrics Care (EMOC) in-service
training and its effect on maternal mortality. Methods: Descriptive
qualitative study design was conducted using in-depth interviews and
focus group discussions. Participants were EMOC trained midwives and
doctors purposively selected from the 2 referral hospitals in the
country. Data were transcribed verbatim, coded, and analysed using
Grounded Theory approach. Results: Four themes emerged including
training, EMOC implementation, maternal death factors and EMOC
prioritisation. The duration of training was viewed inadequate but
responsiveness to and confidence in managing obstetric emergencies
improved post EMOC training. Staff shortage, HCWs non-adherence and
negative attitude to EMOC guidelines; delays in instituting
interventions, inadequate community involvement, minimal or no health
talk to women and their partners and communities on sexual reproductive
matters and non-prioritisation of EMOC by authorities were concerns
raised. Conclusion: Strengthening health education at health facility
levels, stakeholders\u2019 involvement; and prioritising EMOC
in-service training are necessary in reducing the national maternal
mortality
Maternal mortality trends at the Princess Marina and Nyangabwe referral hospitals in Botswana
Despite the fact that about 94% of pregnant women attend ANC, 95%
deliver at health facilities and 99% deliveries are assisted by skilled
birth attendants in Botswana, the national Maternal Mortality Rate is
still high. Objectives: To determine the trend of MMR at Princess
Marina and Nyangabwe referral hospitals before and after EMOC training.
Methods: Retrospective longitudinal quantitative study design was used
to collect data on maternal deaths. Demographic characteristics,
maternal death causes, gestation at ANC registration and pregnancy
risks were collected for the period before EMOC training and after
training, analysed and compared. Descriptive statistics and frequency
tables were used. Findings: Maternal deaths were 33 and 41 before and
after EMOC training respectively. Majority of the maternal deaths,
78.8% and 70.7% before and after EMOC training respectively occurred
among young women in the reproductive ages. Eclampsia was the commonest
cause of maternal death before EMOC between training & and 58% and
66% of maternal deaths before and after EMOC training respectively
occurred among women who had attended ANC services four or more times.
Conclusion: Maternal deaths at the hospitals remained similar during
the two periods. Qualitative studies are needed to determine why EMOC
training has not resulted in significant reduction in MMR in Botswana.
DOI: https://dx.doi.org/10.4314/ahs.v19i2.5 Cite as: Nkhwalume L,
Mashalla Y. Maternal mortality trends at the Princess Marina and
Nyangabwe referral hospitals in Botswana. Afri Health Sci.2019;19(2):
1833-1840. https://dx.doi.org/10.4314/ahs.v19i2.
Integrated management of HIV/NCDs: knowledge, attitudes, and practices of health care workers in Gaborone, Botswana
Background: The epidemiologic transition and double disease burden from chronic infections and Non-communicable diseases (NCDs) worldwide requires re-engineering of healthcare delivery systems. Healthcare workers (HCWs) need to adapt to new integrated disease management approaches and change from current disease-specific management. Objectives: The study aimed to determine HCWs knowledge, capacity and skills for management of NCDs among HIV patients and their attitudes towards integrated HIV/NCDs disease management approaches for future clinical practice. Methods: Descriptive cross-sectional survey among HCWs attending to HIV patients at selected government facilities. Results: One hundred out of 105 responses were analysed. Only 6% could fully define NCDs. Awareness levels of NCDs were high: Diabetes and hypertension 98%; cancer 96%; cardiovascular diseases 86%. However, 11.8% and 58% classified HIV and malaria respectively as NCDs. Most respondents (88%) believe that integrating HIV/NCDs care would be good use of resources while 62% disagreed with current separate facility management of HIV patients with NCDs. Over 60% routinely screened HIV patients for NCDs risk factors: Smoking (87.2%), alcohol (90.8%), diet (84.9%) and physical activity (73.5%). Conclusion: There were gaps in detailed knowledge on NCDs, but positive attitude towards routine primary care integrated HIV/NCDs management, showing likely support for implementation of such policy.Keywords: Non-communicable diseases, knowledge, attitude, HIV, integration
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