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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- Källestål, Carina, 1954-, et al.
(författare)
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Predicting poverty : data mining approaches to the health and demographic surveillance system in Cuatro Santos, Nicaragua
- 2019
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Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In order to further identify the needed interventions for continued poverty reduction in our study area Cuatro Santos, northern Nicaragua, we aimed to elucidate what predicts poverty, measured by the Unsatisfied Basic Need index. This analysis was done by using decision tree methodology applied to the Cuatro Santos health and demographic surveillance databases.METHODS: Using variables derived from the health and demographic surveillance update 2014, transferring individual data to the household level we used the decision tree framework Conditional Inference trees to predict the outcome "poverty" defined as two to four unsatisfied basic needs using the Unsatisfied Basic Need Index. We further validated the trees by applying Conditional random forest analyses in order to assess and rank the importance of predictors about their ability to explain the variation of the outcome "poverty." The majority of the Cuatro Santos households provided information and the included variables measured housing conditions, assets, and demographic experiences since the last update (5 yrs), earlier participation in interventions and food security during the last 4 weeks.RESULTS: Poverty was rare in households that have some assets and someone in the household that has a higher education than primary school. For these households participating in the intervention that installed piped water with water meter was most important, but also when excluding this variable, the resulting tree showed the same results. When assets were not taken into consideration, the importance of education was pronounced as a predictor for welfare. The results were further strengthened by the validation using Conditional random forest modeling showing the same variables being important as predicting the outcome in the CI tree analysis. As assets can be a result, rather than a predictor of more affluence our results in summary point specifically to the importance of education and participation in the water installation intervention as predictors for more affluence.CONCLUSION: Predictors of poverty are useful for directing interventions and in the Cuatro Santos area education seems most important to prioritize. Hopefully, the lessons learned can continue to develop the Cuatro Santos communities as well as development in similar poor rural settings around the world.
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| 6. |
- Massri, Camila, et al.
(författare)
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Impact of the Food-Labeling and Advertising Law Banning Competitive Food and Beverages in Chilean Public Schools, 2014-2016
- 2019
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Ingår i: American Journal of Public Health. - : AMER PUBLIC HEALTH ASSOC INC. - 0090-0036 .- 1541-0048. ; 109:9, s. 1249-1254
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To evaluate the impact of a national law banning sales of competitive food and beverages (CF&B) in schools on the availability of CF&B sold at school kiosks. Methods. This study was uncontrolled before and after study. We evaluated public schools in Santiago de Chile (n = 21; 78% response rate) in 2014 and 2016 (6 months after the law came into force). Trained personnel collected data on calories, total sugars, saturated fat, and sodium from food labels. The outcome was the percentage of foods exceeding the cutoff levels defined in the law and the mean difference between 2014 and 2016. Results. Foods exceeding any cutoffs decreased from 90.4% in 2014 to 15.0% in 2016. Solid products had a substantial reduction in calories, sugar, saturated fat, and sodium. Liquid products had a reduction in calories, total sugar, and saturated fat, whereas sodium increased. This was a result of changes in product mix. Conclusions. A ban on sales of CF&B reduced the availability of CF&B at Santiago's school kiosks. Further research should examine the impact of this ban on food intake and health outcomes.
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| 8. |
- Mohammadi, Soheila, 1967-, et al.
(författare)
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Maternal near-miss at university hospitals with cesarean overuse : an incident case-control study
- 2016
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 95:7, s. 777-786
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Cesarean section (CS) carries a substantial risk of maternal near-miss (MNM) morbidity. This study aimed at determining the frequency, causes, risk factors, and perinatal outcomes of MNM at three university hospitals with a high rate of CS in Tehran, Iran.MATERIAL AND METHODS: An incident case-control study was conducted from March 2012 to May 2014. The modified WHO near-miss criteria were used to identify cases. A control sample of 1024 women delivering at the study hospitals was recruited to represent the source population. Near-miss ratio, crude and adjusted odds ratios (aORs) with confidence intervals (CI) were assessed.RESULTS: Among 12 965 live births, 82 mothers developed near-miss morbidities and 12 died. The MNM ratio was 6.3/1000 live births. Severe postpartum hemorrhage (35%, 29/82), severe pre-eclampsia (32%, 26/82), and placenta previa/abnormally invasive placenta (10%, 8/82) were the most frequent causes of MNM. Women with antepartum CS (aOR 7.4, 95%CI 3.7-15.1) and co-morbidity (aOR 2.3, 95%CI 1.4-3.8), uninsured Iranians (aOR 3.4, 95%CI 1.7-7.1) and uninsured Afghans (aOR 4.7, 95%CI 2.4-9.2) had increased risks of near-miss morbidity. Stillbirth and extremely preterm birth were the most prominent adverse perinatal outcomes associated with MNM.CONCLUSION: Overutilization of CS clearly influenced the causes of MNM. A lack of health insurance had a measurable impact on near-miss morbidity. Tailored interventions for reducing unnecessary CS and unrestricted insurance cover for emergency obstetric care can potentially improve maternal and perinatal outcomes. This article is protected by copyright. All rights reserved.
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| 9. |
- Pallangyo, Eunice N., et al.
(författare)
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A baseline mixed methods study on postpartum care among health professionals in Tanzania
- 2017
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Ingår i: African Journal of Midwifery and Women's Health. - 1759-7374 .- 2052-4293. ; 11:3, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- Background: Globally, postpartum care (PPC) is a neglected part of maternal and neonatal health, despite 50% of maternal deaths occuring in the first weeks after childbirth.Aim: The study aimed to assess knowledge, attitudes and practices among providers of PPC in government institutions in two low-resource suburbs of Dar es Salaam: Ilala and Temeke.Methods: Health professionals ( n =149) at all levels of care completed a knowledge and attitudes questionnaire. A checklist was used to observe 25 health professionals at reproductive and child health units, and 38 mothers were interviewed on exit. χ 2 - and logistic regression tests were used to analyse the outcomes. Field notes were analysed qualitatively.Findings: Overall, 64% of health professionals had high knowledge and most had positive attitudes towards PPC. Level of education was found to be positively associated with positive attitudes towards PPC (OR=2.5 CI 95% 1.03–6.13). PPC consultations with mothers and newborns during the first week after childbirth were found to be few or nonexistent. Mothers who came with newborns for BCG immunisation were mostly satisfied with the services.Conclusion: Quality improvement is required at the structure and process levels of the health system in order to provide holistic PPC consultations.
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| 10. |
- Pallangyo, Eunice N., et al.
(författare)
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Improved postpartum care after a participatory facilitation intervention in Dar es Salaam, Tanzania : a mixed method evaluation
- 2017
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings.OBJECTIVE:To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in Dar es Salaam, Tanzania.METHODS:A before-and-after evaluation of an intervention and comparison group was conducted using mixed methods (focus group discussions, questionnaires, observations, interviews, and field-notes) at health institutions. Maternal and child health aiders, enrolled nurse midwives, registered nurse midwives, and medical and clinical officers participated. A collegial facilitation intervention was conducted and healthcare providers were organized in teams to improve PPC at their workplaces. Facilitators defined areas of improvement with colleagues and met regularly with a supervisor for support.RESULTS:The number of mothers visiting the institution for PPC increased in the intervention group. Some care actions were noted in more than 80% of the observations and mothers reported high satisfaction with care. In the comparison group, PPC continued to be next to non-existent. The healthcare providers' knowledge increased in both groups but was higher in the intervention group. The t-test showed a significant difference in knowledge between the intervention and comparison groups and between before and after the intervention in both groups. The difference of differences for knowledge was 1.3. The providers perceived the intervention outcomes to include growing professional confidence/knowledge, improved PPC quality, and mothers' positive response. The quality grading was based on the national guidelines and involved nine experts and showed that none of the providers reached the level of good quality of care.CONCLUSIONS:The participatory facilitation intervention contributed to improved quality of PPC, healthcare providers' knowledge and professional confidence, awareness of PPC among mothers, and increased PPC attendance.
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