Interventions to reduce HIV-related stigma in the healthcare settings: a scoping systematic review

HIV-related stigma will discourage the efforts in preventing new infections and engaging people to receive treatment, care and support programmes. Identifying the valuable interventions programmes to reduce HIV-related stigma in a healthcare setting is vital in order to deliver the best health services. A scoping systematic review was conducted. Articles were searched based on Pubmed and ScienceDirect search engines. The key words used were HIV stigma, intervention and healthcare. Published English articles in the past ten years involving HIV stigma intervention studies, and studies that involved healthcare workers in a healthcare setting were included. Reviewed articles, systematic review and meta-analysis articles were excluded. Primary screening of titles and abstract of 85 articles were done. Secondary screening of 19 articles resulted in 8 articles, included in this manuscript. Most of the reviewed articles showed, application of the Integrated Theoretical Model in the intervention programme as a guide and utilising combined intervention components are effective tools in delivering the intervention programme. The stigma reduction-intervention programme should focus on the intervention components as a whole including training of HCW, role plays, group discussions, games, sharing of information and contacts with PLHIV as well presentations and lectures. An integrative model of behavioural prophecy is perceived and it is particularly essential for interventions that focus on creating and fortifying the aim in conducting the chosen behaviour

Methodological approaches of health policy analysis in developing countries

Background: Policy analysis is the process of identifying problem, defining and analyzing process, qualitative and quantitative analysis, evaluation, recommendation, aiming to inform choices leading to an improved healthcare system. In developing country, the analysis of health policy has been given limited attention. As health is influenced by many external sectors and the dynamic in healthcare system, it is a challenging task in health policies analyses. The aim of this manuscript is focusing on health policy analysis in developing countries using the methodological approaches of theories, frameworks and study designs. Materials and Methods: Scoping systematic review was used for this manuscript writing. Recent ten year articles were searched from public domains with keywords of “health policy”, “developing countries”, “theory”, “framework” and “study design”. A total of 18 articles were finalized to be included, six for each methodological approaches. Result: Theories such as Group Theory, Multiple Implementation Theory, and Kingdon Multiple Stream Theory are among the commonest theories used in policy analysis. In translating framework approach into health policy analysis, Policy Triangle Framework, 3-i Framework (idea, interest and institution) and Social Determinant of Health Framework are also widely used. The mixed method of qualitative and secondary data based quantitative; and cross-country comparative case study are frequently adopted for study design approach. Conclusion: A common methodological approaches in health policy analyses were used an established theoretical approach, a feasible approach of study design and a comprehensive framework. However evidenced based approach is also use as a fundamental approach in health policy analysis especially in developing countries with limited resources

Factors associated with human immunodeficiency virus stigma (HIV) among health care workers in Hulu Langat, Selangor

Introduction: Globally, stigma towards people living with HIV will cause less effectiveness towards HIV prevention, testing and treatment. In the health facilities setting, this problem is a very serious barrier to access the health care. The stigma towards HIV was significantly predicted by several factors such as personal perception, behaviour and environment. Objective: The objectives of this study are to determine the factors associated with HIV stigma and the predictors among health care workers in Hulu Langat, Selangor, Malaysia. Methodology: This cross sectional study was carried out among health care workers in Hulu Langat, Selangor, Malaysia. The sample size involved 413 respondents. Study population consisted of all the health care workers from all the health clinics in Hulu Langat Health District Office. Simple random sampling was applied, whereby professional group and supporting group one staff in Hulu Langat Health Clinics was selected randomly using random number generator. Comprehensive Questionnaire: Self administered questionnaire based on Stigma Index Tool was used. All data were analysed using IBM Statistical Package for Social Science (SPSS) version 22 involving descriptive, chi square and Multiple Logistic Regression analysis. Result/Conclusion: The response rate was 81.6%. The level of HIV stigmatising behaviour among the health care workers in Hulu Langat, Selangor was 54.5%. Out of seven factors, three of them had a significant association with level of HIV stigmatising behaviour which were age (p = 0.038), current job status (p = 0.014) and personal perception (p = 0.001). The key findings from the analysis were that the personal perception of healthcare workers predicted their stigmatising behaviour (R2= 0.078, p < 0.05). There was, however, no significant relationship between environmental factors and stigmatising behaviour as well as between personal perception and environmental factors. The social change implications may be to reduce stigma among healthcare workers toward people living with HIV and in turn increase the willingness of healthcare workers to engage with people living with HIV and provide quality service to them

A study on the prevalence of hypertension and factors affecting it among adults aged 25 and above at Nanga Selaut and Nanga Sebirah in Julau district, 19 June to 5 August 2000 : a cross- sectional study

Hypertension is so far the commonest cardiovascular disorder, posing a major public health challenge to societies in socioeconomic and epidemiological transition. It is one of the major risk factors for cardiovascular mortality, which accounts for 20-50% of all deaths) A cross-sectional study on the prevalence of hypertension amongst residents aged 5 and above and factors affecting it was carried out in Rumah Changgan and Rumah Selan of Nanga Selaut and Rumah Luke Lipa of Nanga Sebirah in Julau. A total of 115 respondents were universally selected for the questionnaire interview and measurements of both blood pressure and body mass index. The overall prevalence of hypertension was found to be 61.7% with 69.6% of men and 56.5% of women were found to be hypertensive. Significant associations between age, educational level, occupation and body mass index with the prevalence of hypertension were found. Nevertheless, there was no statistically significant link between the prevalence of hypertension and positive family history, smoking, excessive dietary salt and alcohol intake. The overall knowledge on hypertension amongst the respondents is poor that 61.7% were proved to have inadequate knowledge. Knowledge of the respondents on risk factors and signs and symptoms of hypertension are generally good (67.0% and 61.7% respectively). Nevertheless, knowledge on complications of hypertension had shown 68.7% of inadequacy among the respondents. The knowledge on signs and symptoms of hypertension is significantly associated with the prevalence of hypertension (p0.05). Although majority of the respondents (113 or 98.3%) has good attitude and practice towards hypertension, it was found not to be statically significant with the prevalence of hypertension as well (p>0.05)