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| 2. |
- Gustafsson, Annika, et al.
(författare)
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Predicting Non-Attendance: A Model of the Complex Relationships in Dental Care Non-Attendance among Adolescents in Örebro County, Sweden
- 2020
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Ingår i: SCIRP Psychology. ; 11, s. 1300-1314
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Tidskriftsartikel (refereegranskat)abstract
- Background: Understanding why adolescents miss dental appointments is central to promoting people’s oral health into adulthood. Studies on non-attendant adolescents are rare. Method: In our previous study using data from the 2014 population-based cross-sectional survey of schoolchildren in ?rebro County, Sweden we suggested a risk-factor model for non-attendance with five components (sociodemographic factors, self-rated health, perceived life events, health behaviour, social cohesion and social capital). The present study tested the external validity of the multivariate model for all components simultaneously developed from the 2014 study using a new population-based cross- sectional survey (n = 7576) of schoolchildren in ?rebro County, Sweden 2017. Using the predicted values from the 2014-logistic regression, we computed ROC-curves for the 2014 and 2017 study populations, respectively. Results: Of the 6 304 adolescents who answered the question of attendance to dental health care and all eleven independent items in 2017, 324 (5.1%) reported that they sought dental care only for acute pain or not at all, thus regarded as non-attendant. When using the risk model based on the 2014 data for the 2017 data, the area under the receiver operating curve (AUC) for non-attendance adolescents was 0.74 (95% CI 0.71 - 0.76). Conclusion: The present study shows that the model created from the 2014 population-based survey has excellent discriminative performance (AUC) in the 2017 population-based survey predicting non-attending adolescents. The methodology applied in this study may be useful to other health care services to develop predictive non-attending models based on their specific population.
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| 3. |
- Adane, Abyot, et al.
(författare)
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Routine health management information system data in Ethiopia : consistency, trends, and challenges
- 2021
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector.Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys.Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources.Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions.Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.
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| 4. |
- Becker-Dreps, Sylvia, et al.
(författare)
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Community Diarrhea Incidence Before and After Rotavirus Vaccine Introduction in Nicaragua
- 2013
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Ingår i: American Journal of Tropical Medicine and Hygiene. - : American Society of Tropical Medicine and Hygiene. - 0002-9637 .- 1476-1645. ; 89:2, s. 246-250
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Tidskriftsartikel (refereegranskat)abstract
- We estimated the incidence of watery diarrhea in the community before and after introduction of the pentavalent rotavirus vaccine in Leon, Nicaragua. A random sample of households was selected before and after rotavirus vaccine introduction. All children < 5 years of age in selected households were eligible for inclusion. Children were followed every 2 weeks for watery diarrhea episodes. The incidence rate was estimated as numbers of episodes per 100 child-years of exposure time. A mixed effects Poisson regression model was fit to compare incidence rates in the pre-vaccine and vaccine periods. The pre-vaccine cohort (N = 726) experienced 36 episodes per 100 child-years, and the vaccine cohort (N = 826) experienced 25 episodes per 100 child-years. The adjusted incidence rate ratio was 0.60 (95% confidence interval [CI] 0.40, 0.91) during the vaccine period versus the pre-vaccine period, indicating a lower incidence of watery diarrhea in the community during the vaccine period.
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| 5. |
- Bergström, Anna, 1983-, et al.
(författare)
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Knowledge about Sexual and Reproductive Health among School Enrolled Adolescents in Tololar, Nicaragua, A Cross-Sectional Study
- 2018
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Ingår i: Journal of Public Health International. - : Open Access Pub. - 2641-4538. ; 1:2, s. 27-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nicaragua has the highest prevalence of teenage pregnancies in Latin America. Knowledge regarding sexual and reproductive health plays an integral part in sexual behavior. The objective was to assess school going adolescents' knowledge about sexual and reproductive health and possible factors affecting it in the semi-rural community of Tololar, Nicaragua.Methods: A cross-sectional study with a self-administered questionnaire on tablets was used for data collection. All 253 registered students at the school present at the time of fieldwork who gave written informed consent were deemed eligible for the study. A total of 225 participants in the ages of 11-19 years were included. Simple linear regression and multiple linear regression were performed analyzing the outcome knowledge. A p-value <0.05 was considered significant.Results: The general knowledge about sexual and reproductive health was moderate; however, knowledge gaps were found such as prevailing myths and poor knowledge regarding human immunodeficiency virus (hiv) transmission and contraceptive methods. Being female and single were significant negative determinants of knowledge (p-value < 0.01) and knowledge increased significantly with age (p-value < 0.05). School teachers, websites, social networks, and TV were the most frequently chosen sources of information on the topic.Conclusions: Increased education on sexual and reproductive health with new interventions particularly for young females is recommended. Using IT-based materials as a complement may be an effective way to reach out to adolescents.
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- Dalmar, Abdirisak Ahmed, et al.
(författare)
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Rebuilding research capacity in fragile states : the case of a Somali-Swedish global health initiative
- 2017
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Ingår i: Global Health Action. - Abingdon : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.
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| 7. |
- Himanshu, M, et al.
(författare)
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Regional inequity in complete antenatal services and public emergency obstetric care is associated with greater burden of maternal deaths : analysis from consecutive district level facility survey of Karnataka, India
- 2017
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This equity focused evaluation analyses change in inter-district inequity of maternal health services (MHS) in Karnataka state between 2006-07 & 2012-13, alongside association of MHS inequity with distribution of maternal deaths.METHODS: Repeated cross-sectional analysis of inequity and decomposition was done on nine district level MHS indicators using Theil's T index. Data was obtained from population linked district level facility surveys and health information systems.RESULTS: Inequity in births attended by skill birth attendants decreased the most (83.16%) among six other MHS indicators. Community provision of comprehensive emergency obstetric care strategy remained stagnant. Districts with higher complete antenatal care share and C-sections in public settings had lesser share of state's maternal deaths (R2 = 0.29, p = 0.004). 5 districts suffered perpetual inequity of MHS with relatively greater burden of maternal deaths.CONCLUSION: First 6 years of national rural health mission increased coverage of MHS and decreased regional inequity albeit non-uniformly. Distribution of system driven interventions of complete ANC and C-sections appear to determine decrease of maternal mortality in Karnataka.
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| 8. |
- Huerta Munoz, Ulises, 1981-, et al.
(författare)
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Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda
- 2012
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Ingår i: International Journal of Health Geographics. - 1476-072X. ; 11:1, s. 40-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the "Health for All" doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda.METHODS:This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1 - waking; Scenario 2 - walking and cycling; and Scenario 3 - walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories.RESULTS: Scenario 2 (walking and cycling) has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation). The lowest level of accessibility can be observed in Scenario 1 (walking). The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6 % of the population in Scenario 1. In Scenario 2, the use of a bicycle greatly increases the population being served to 58 % of inhabitants. When considering Scenario 3, the total population served is 34.3 %.CONCLUSIONS: Significant spatial variations in geographical accessibility and spatial coverage were observed across the three travel scenarios. The analysis demonstrates that regardless of which travel scenario is used, the majority of the population in the Western Province does not have access to the existing primary health facility network. Our findings also demonstrate the usefulness of GIS methods to leverage multiple datasets from different sources in a spatial framework to provide support to evidence-based planning and resource allocation decision-making in developing countries.
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| 9. |
- Källestål, Carina, 1954-, et al.
(författare)
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Assessing the Multiple Dimensions of Poverty : Data Mining Approaches to the 2004-14 Health and Demographic Surveillance System in Cuatro Santos, Nicaragua
- 2020
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Ingår i: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- We identified clusters of multiple dimensions of poverty according to the capability approach theory by applying data mining approaches to the Cuatro Santos Health and Demographic Surveillance database, Nicaragua. Four municipalities in northern Nicaragua constitute the Cuatro Santos area, with 25,893 inhabitants in 5,966 households (2014). A local process analyzing poverty-related problems, prioritizing suggested actions, was initiated in 1997 and generated a community action plan 2002-2015. Interventions were school breakfasts, environmental protection, water and sanitation, preventive healthcare, home gardening, microcredit, technical training, university education stipends, and use of the Internet. In 2004, a survey of basic health and demographic information was performed in the whole population, followed by surveillance updates in 2007, 2009, and 2014 linking households and individuals. Information included the house material (floor, walls) and services (water, sanitation, electricity) as well as demographic data (birth, deaths, migration). Data on participation in interventions, food security, household assets, and women's self-rated health were collected in 2014. A K-means algorithm was used to cluster the household data (56 variables) in six clusters. The poverty ranking of household clusters using the unsatisfied basic needs index variables changed when including variables describing basic capabilities. The households in the fairly rich cluster with assets such as motorbikes and computers were described as modern. Those in the fairly poor cluster, having different degrees of food insecurity, were labeled vulnerable. Poor and poorest clusters of households were traditional, e.g., in using horses for transport. Results displayed a society transforming from traditional to modern, where the forerunners were not the richest but educated, had more working members in household, had fewer children, and were food secure. Those lagging were the poor, traditional, and food insecure. The approach may be useful for an improved understanding of poverty and to direct local policy and interventions.
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