Abstract:

Despite increasing knowledge of potential benefits of research utilization in improving quality of healthcare management decision (HMDs) outcomes and practice, the use of research evidence by healthcare authorities continues to be a global concern. We examined individual predictors of research utilization in management decisions of healthcare authorities in a local government’s context of Arua district in West Nile Uganda. The observational cross-sectional survey design was used, involving 225 questionnaires and nine key informant interviews, and the extent of influence of individual variables on research uptake was determined by estimation of predicted probabilities, and the corresponding odds ratios and coefficients using the binary logistic regression model. The results reveal that research utilization was significantly influenced by individual characteristics, whose overall predicted probability was 0.030 (p<0.05) with attitudinal variables being most significant, whereby belief in research-based HMDs (p= 0.020) or improved quality of HMDs (p= 0.012) recorded high corresponding odds ratios. Hence, the study substantiates the multifactorial nature of research utilization, being influenced to varying extents by individual factors, and emphasizes attitudinal change, information sharing and capacity building to increase uptake.

Key words: Research utilization, individual characteristics, research evidence, healthcare authorities, and healthcare management decisions.

References:

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Abstract:

Background: Any delay in diagnosis and consequently treatment of TB patients not only increases the infectivity of the disease in the community, but may lead to more advance disease state, which may result in more complications and expose patients to higher risk of death. Objectives To assess delays in diagnosing new TB patients and the factors associated with these delays in NTBLTC Zaria, Nigeria. Methods: The study population was TB patients attending the NTBLTC, Zaria. Analysis of contingency tables was done and Chi-square statistics were used to test for association between variables and level of significance. Logistic regression was used to calculate the odd ratio. Results: Age, marital status, economic status, sex, education, and alcohol consumption were significantly (P<0.05) associated with patient delays while smoking and CD4 count were statistically not significant with patient delays. Female (OR=1.046; 1.04-2.17), literacy (OR=1.02; 0.29-1.98) and single (OR=1.00; 0.14-4.67) were the major determinants that influence extended patient delay. Age, economic status, education, smoking and alcohol consumption were significantly (P<0.05) associated with health system delays while sex, marital status and CD4 count were statistically not significant with health system delays. Conclusion: Factors associated with delay in seeking health care for more than 30 days included age, sex, marital status, economic status, education, smoking and alcohol intake while for patient delay includes age, sex, marital status, economic status, education and alcohol intake. This factor should be taken into consideration for policy planning to help the containment of the spread of the disease.

Keywords: Health care service delay, cross-sectional, odd ratio, tuberculosis, Logistic regression, patient delay.

References:

[1].     Atre SR et al. (2004). Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India. Trop Med Int Health, 9(11):1228–38.

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[6].     Lawn S. D, Afful B, Acheampong J. W. (1998). Pulmonary tuberculosis: diagnostic delay in Ghanaian adults. Int J Tuberc Lung Dis, 2(8):635–40.

[7].     Maluwa VM1, Andre J, Ndebele P, Chilemba E. (2012). Moral distress in nursing practice in Malawi. Nurs Ethics. Mar; 19 (2):196-207. doi: 10.1177/0969733011414968.

[8].     Mardiah, F. P. & Basri, M.H., (2013). The Analysis of Appointment System to Reduce Outpatient Waiting Time at Indonesia’s Public Hospital: Human Resource Management Research 3(1): 27-33, doi:10.5923/j.hrmr.20130301.06

[9].     Musinguzi, C., (2015). Patient waiting time and associated factors at the Assessment Center, General out-patient Department Mulago Hospital Uganda. (October).

[10]. Ngadaya S. E, Mfinanga S. G, Wandwalo R. E, Morkve O. (2009): Delay in Tuberculosis case detection in Pwani region, Tanzania, a cross-sectional study. BMC Health Services Research. 9:196 https://doi.org/10.1186/1472-6963-9-196

[11]. Oche, M. & Adamu, H. (2013). Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria.
Annals of medical and health sciences research, 3(4), pp.588–592

[12]. Odusanya O. O, Babafemi J. O. (2004). Patterns of delays amongst pulmonary tuberculosis patients in Lagos, Nigeria. BMC Public Health, 4:18.

[13]. Okotie, O.T., Patel, N. & Gonzalez, C. M., (2008). The effect of patient arrival time on overall wait time and utilization of physician and examination room resources in the outpatient urology clinic. Advances in urology, p.507436.

[14]. Umar, I., Oche, M. O., & Umar, A. S. (2011). Patient waiting time in a tertiary health institution in Northern Nigeria. Journal of Public Health and Epidemiology, 3(2), pp.78–82. Available at: http://www.academicjournals.org/jphe.

[15]. Storla, D. G., Yimer S, Bjune G. A. A. (2008). Systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. I8:15.

[16]. Shuster, J.J. (1990). Handbook of Sample Size Guidelines for Clinical Trials, Boca Raton, FL: CRC Press

[17]. Wandera M. N., Onyango R., & Kakai R. (2014). Determinants of Clients’ Satisfaction with healthcare Services at Pumwani Maternity Hospital in Nairibi-Kenya. International Journal of Social & Behavioural Sciences. Vol. 2 (1), pp. 011 – 017.

[18]. Wanyenze RK1, Wagner G, Alamo S, Amanyire G, Ouma J, Kwarisima D, Sunday P, Wabwire-Mangen F, Kamya M. (2010) Evaluation of the efficiency of patient flow at three HIV clinics in Uganda. AIDS Patient Care STDS. 2010 Jul; 24 (7):441-6. doi: 10.1089/apc.2009.0328.

[19]. WHO. (2006). Diagnostic and treatment delay in tuberculosis. An in-depth analysis of the health-seeking behaviour of patients and health system response in seven countries of the eastern mediterranean region. Regional Officer for the Eastern mediterranean, Cairo, World Health Organization.

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[22]. Whyte, E. & Goodacre, S. (2016). Patient expectations of emergency hospital admission: a cross-sectional questionnaire survey. European journal of emergency medicine:
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Abstract:

Background: Report at the lunch of 1^st Nigeria, National Strategic Plan for TB Control report opined that, at the current rate of transmission and development of Tuberculosis, over four million cases are forecasted to occur in Nigeria between 2015 and 2020 (WHO, 2015). Objectives: A study was conducted to examine diagnostic accuracy of GeneXpert, smear microscopy and TB LAM Rapid Urine Antigen Screening Assay for TB and HIV co-infected Population. Methods: 323 specimens from approximately 400 patients were enrolled using probability sampling technique. Selection intensity (CD4 count < 100, critical symptoms of TB and HIV) with stringent conditions was set to reduce eligible population for TB-LAM test. Differences between two groups was tested using t-test in SPSS-24 statistical package. Sensitivity, specificity, NPV and PPV were computed using Diagnostic or Screening Test Evaluation 1.0 using OpenEpi (version 2.3). Results: There were significant differences (P<0.05) among diagnostic accuracy for sensitivity, specificity, PPV, NPV and prevalence rate. The highest sensitivity was in GeneXpert (86.2%, 25/29) while TB-LAM the least sensitivity (57.5%, 46/80). EMS-AFB was significant (P<0.05) and more sensitive than Spot-AFB and TB-LAM. Specificity was significant (P=0.04) and slightly lower in the group tested with GeneXpert (90.8%) as compared to TB-LAM (100%), EMS-AFB (93.1%) and Spot-AFB (92.7%). The proportion of total study population with TB-LAM decreased linearly (23.2% - 7.4%) as the grades increases. Conclusion: This clearly suggest that TB-LAM might not be a robust testing for point of care diagnostics among TB-HIV co-infected Population using Zaria Metropolis of North Western, Nigeria.

Keywords: GeneXpert, Lipoarabinomannan, Tuberculosis, Human Immunodeficiency Virus, Sensitivity.

References:

[1].     Bowles, E.C, Freyee, B., van Ingen, J., Mulder, B., Boeree, M.J & van Soolingen, D. (2011). Xpert MTB/RIF(R), a novel automated polymerase chain reaction-based tool for the diagnosis of tuberculosis. Int J Tuberc Lung Dis; 15: 988-9.

[2].     Corbett, E.L, Marston, B., Churchyard, G.J & De Cock, K.M. (2006). Tuberculosis in sub Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet; 367: 926-37.

[3].     Davies, G.R, Pillay, M., Sturm, A. & Wilkinson D. (1999). Emergence of multi-drug resistant tuberculosis in a community-based directly observed treatment programme in rural South Africa. Int J Tuberc Lung Dis; 3: 799-804.

[4].     Davies, N.E, Homfray, M & Venables, E.C. (2013). Nurse and manager perceptions of nurse initiated and managed antiretroviral therapy (NIMART) implementation in South Africa: a qualitative study. BMJ Open; 3: e003840.

[5].     Dye, C., & Williams, B.G. (2008). Eliminating human tuberculosis in the twenty-first century.
J R Soc Interface; 5: 653-62.

[6].     Dye, C., Glaziou, P., Floyd, K & Raviglione, M. (2013). Prospects for tuberculosis elimination.
Annu Rev Public Health; 34: 271-86.

[7].     Lawn, S.D, Kerkhoff, A.D, Vogt, M & Wood, R. (2012). Diagnostic accuracy of a low-cost, urine antigen, point-of-care screening assay for HIV-associated pulmonary tuberculosis before antiretroviral therapy: a descriptive study. The Lancet infectious diseases; 12(3):201-9.

[8].     Moodley, P., Shah, N.S, Tayob, N., Connolly, C., Zetola, N., Gandhi, N. (2011). Spread of extensively drug-resistant tuberculosis in KwaZulu-Natal province, South Africa. PLoS One; 6: e17513.

[9].     Peter, J.G, Theron, G., Muchinga, T.E, Govender, U & Dheda, K. (2012). The diagnostic accuracy of urine-based Xpert MTB/RIF in HIV-infected hospitalized patients who are smear-negative or sputum scarce. 27.

[10]. Theron, G., Peter, J., van Zyl-Smit, R., Mishra, H., Streicher, E & Murray, S. (2011). Evaluation of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis in a high HIV prevalence setting. Am J Respir Crit Care Med 2011; 184: 132-40.

[11]. Theron, G., Zijenah, L., Chanda, D., Clowes, P., Rachow, A & Lesosky, M. (2014) Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing for tuberculosis in primary-care settings in Africa: a multicentre, randomised, controlled trial. The Lancet; 383(9915):424-35.

[12]. Wells, C.D, Cegielski, J.P, Nelson, L.J, Laserson, K.F, Holtz, T.H, & Finlay A, (2007). HIV infection and multidrug-resistant tuberculosis: the perfect storm. J Infect Dis; 196 Suppl 1: S86-107.

[13]. World Health Organization (2015). The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV. WHO Library Cataloguing-in-Publication Data.

Abstract:

Background: Proper feeding with supplement is a vital means for compensating health deficits and enhancing the nutritional status of children. However, documentation about child-feeding practices and the nutritional status among ethnic communities like the Chepang is limited.

Objective: The present study therefore aims at exploring the feeding practices and nutritional status of Chepang children in two municipalities of the Dhading district of Nepal.

Method and material: The study was cross-sectional in nature. It approached mothers of children aged 6-24 months. A quantitative study was conducted between February and March 2018. Height, weight and mid-upper arm circumference (MUAC) of the children were measured and analyzed according to WHO cut-offs.

Results: A total of 347 mothers (238 from Benighat Rorang and 109 from Gajuri Rural Municipalilty) participated in the study. It was found that 26.8% children were underweight, 66% were stunted and 6.6% were suffering from wasting. There was no significant association between exclusive breast-feeding and nutritional status, dietary diversity, malnourishment, minimum meal frequency and health-related status.

Conclusion: It was observed that parents of Chepang children were aware of the benefits of exclusive breast feeding, dietary diversity and meal frequency, but there was no difference in their exclusive breast feeding practices with nutritional food items for the children. So further study is needed to explore other factors to promote healthy growth and development of the children.

Keywords: Chepang, nutrition, stunting, underweight, wasting.

References:

[1].     Abera, L., Dejene, T., & Laelago, T. (2017). Prevalence of malnutrition and associated factors in children aged 6-59 months among rural dwellers of damot gale district, south Ethiopia: Community based cross sectional study. International Journal for Equity in Health, 16(1), 1–8. https://doi.org/10.1186/s12939-017-0608-9.

[2].     Aggarwal, T., & Srivastava, S. (2017). Nutritional status and its correlates in under five children of labour population in urban slums of Lucknow , Uttar. International Journal of Contemporary Pediatrics, 4(4), 1253–1258.

[3].     Akombi, B. J., Agho, K. E., Merom, D., Renzaho, A. M., & Hall, J. J. (2017). Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS ONE, 12(5). https://doi.org/10.1371/journal.pone.0177338.

[4].     Betebo, B., Ejajo, T., Alemseged, F., & Massa, D. (2017). Household Food Insecurity and Its Association with Nutritional Status of Children 6 – 59 Months of Age in East Badawacho District, South Ethiopia. 2 Journal of Environmental and PublicHealth, 2017. https://doi.org/10.1155/2017/6373595.

[5].     Biadgilign, S., Shumetie, A., & Yesigat, H. (2016). Does economic growth reduce childhood undernutrition in Ethiopia? PLoS ONE, 11(8), 1–14. https://doi.org/10.1371/journal.pone.0160050.

[6].     Derso, T., Tariku, A., Biks, G. A., & Wassie, M. M. (2017). Stunting, wasting and associated factors among children aged 6-24 months in Dabat health and demographic surveillance system site: A community based cross-sectional study in Ethiopia. BMC Pediatrics, 17(1), 1–9. https://doi.org/10.1186/s12887-017-0848-2.

[7].     Humphries, D. L., Dearden, K. A., Crookston, B. T., Woldehanna, T., Penny, M. E., Behrman, J. R., & Lives, Y. (2017). Economics and Human Biology Household food group expenditure patterns are associated with child anthropometry at ages 5, 8 and 12 years in Ethiopia, India, Peru and Vietnam, 26, 30–41. https://doi.org/10.1016/j.ehb.2017.02.001.

[8].     International Food Policy Research Institute. (2016). Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Global Nutrition Report 2016. https://doi.org/10.2499/9780896295841.

[9].     Katepa-Bwalya, M., Mukonka, V., Kankasa, C., Masaninga, F., Babaniyi, O., & Siziya, S. (2015). Infants and young children feeding practices and nutritional status in two districts of Zambia. International Breastfeeding Journal, 10(1). https://doi.org/10.1186/s13006-015-0033-x.

[10]. Ministry of Health, N. N. E. and I. (2017). Nepal Demographic and Health Survey 2016: Key Indicators.

Smith, L. C., & Haddad, L. (2015). Reducing Child Undernutrition: Past Drivers and Priorities for the Post-MDG Era. WORLD DEVELOPMENT, 68, 180–204. https://doi.org/10.1016/j.worlddev.2014.11.014.

Abstract:

Substance Abuse is not a new phenomenon worldwide but experts believe that the rate at which college students are abusing drugs is so alarming to an extent that it (Substance Abuse) is now one of the major global public health concerns. The National Survey (2010), reported that more of today’s college students are abusing prescription drugs than was the case in the early 1990s and that the number of students involved in the daily use of marijuana doubled to more than 4 percent. Literature review revealed that not only is there an increase of Substance Abuse among college students but also an increase of adverse effects due to binge drinking. It also revealed that higher levels of education i.e. diploma or higher was associated with greater levels of drug abuse. However, despite these concerns, very few studies have in-depth analyzed, let alone prescribe the measures of addressing the problem. A number of studies conducted in the United States of America (U.S.) have indicated that SA is becoming a serious public health problem nationwide as well as globally. However, not much has been done to address this problem. The main objective of this study was to establish the extent of the problem of Substance Abuse in order to have a basis of prescribing measures to address the issue among college students. The study brought to light the extent and effects of Substance Abuse and as such, will benefit not only college authorities and students but parents and policymakers in order to come up with mitigation strategies.

References:

[1].Afzali, S., et al (2013). Frequency of Alcohol and Substance Abuse Observed in Drivers Killed in Traffic Accidents in Hamadan, Iran. Arch Iran Med. 2013; 16(4): 240 - 242.

[2].Fink, B., Landthaler, M., & Hafner, C., (2011). Skin Alterations due to Abuse of Illegal Drugs. DOI: 10.1111/j.1610-0387.2011.07699.x

[3].Gillespie et al., (2012). The Brisbane Longitudinal Twin Study: Pathways to Cannabis Use, Abuse, and Dependence Project—Current Status, Preliminary Results, and Future Directions Volume 16 Number 1 pp. 21–33 C _ The Authors 2012 doi:10.1017/thg.2012.111

[4].Iannotti, R. J., (2000). Health Behavior in School-Aged Children (HBSC), 2005-2006ICPSR 28241. United States Department of Health and Human Services. National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development from: http://www.icpsr.umich.edu/icpsrweb/SAMHDA/series/64/studies?q=data+set+address

[5].Kim et al. (2012). Validation of key behaviorally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use. BMC Health Services Research 2012, 12:18 http://www.biomedcentral.com/1472-6963/12/18

[6].Linskey, et al., (2012). An Australian Twin Study of Cannabis and Other Illicit Drug Use and Misuse, and Other Psychopathology Volume 15 Number 5 pp. 631–641 C _ The Authors 2012 doi:10.1017/thg.2012.41

[7].Lisha et al. (2012). An Evaluation of Immediate Outcomes and Fidelity of a Drug Abuse Prevention Program in Continuation High Schools: Project towards no Drug Abuse (Tnd) J. Drug Education, Vol. 42(1) 33-57, 2012

[8].MedlinePlus (2013) Drug Abuse from: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm

[9].MedlinePlus (2013) Drug dependence from: http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm

[10]. National Institute on Drug Abuse (NIDA) (2012). Understanding Drug Abuse and Addiction from http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction

[11]. Oshri, A., Tubman, G. J., & Burnette, M. L., (2012). Childhood Maltreatment Histories, Alcohol and Other Drug Use Symptoms, and Sexual Risk Behavior in a Treatment Sample of Adolescents. Supplement 2, 2012, Vol 102, No. S2

[12]. Rhodes, W. A., Singleton, E., & McMillan, B. T., et al., (2005). Does Knowledge of College Drinking Policy Influence Student Binge Drinking? Journal 0f American College Health, Vol. 54, No. 1

[13]. Samouei, R., (2013). Why Some Previous Drug Abuse Preventive Programs Had Low Effectiveness? DOI: 10.5455/medarh.2013.67.68-72 Med Arh. 2013 Feb; 67(1): 68-72 Received: January 01st 2013 | Accepted: February 20th 2013

[14]. WebMD (2013). Mental Health. Substance Abuse downloaded from http://www.webmd.com/mental-health/substance-abuse

[15]. Wickizer, T., (2013). State-Level Estimates of the Economic Costs of Alcohol and Drug Abuse Health Care Finance 2013; 39(3):71–84 Copyright © 2013 CCH Incorporated

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Abstract:

A high average prevalence rate of 11-13.7% for viral hepatitis B exists in Nigeria among the general population (National AIDS/STIs Control Program (2016). This study was the first of its type however, to examine the prevalence of hepatitis B among a specific target group, the senior secondary school students in Jos, Plateau state in Nigeria. It was conducted in six public day secondary schools located in Jos South Local Government Area, Plateau state, findings of which would help determine interventions for the prevention and control of hepatitis B Virus (HBV) infection among this important age group. The study was primarily carried out to determine the effect of peer education, an intervention, on knowledge and belief levels of hepatitis B in Jos but in the process of achieving this, the prevalence of hepatitis B was also identified.

A quasi-experimental study was carried out on six hundred students selected by a multistage sampling technique. Testing for hepatitis B was offered post intervention to only three hundred students, who were in the intervention group of three schools in the study. A pre-tested formal self-administered questionnaire (SAQ) was used to collect data pre and twelve weeks post intervention. Chi- square and students t-test was done to compare intervention and control groups on outcome variables. Results showed the age distribution of the respondents was 10-24 years with majority of respondents (86.7%) in the age group 15-19 years. One hundred and ten (110) students agreed to the test and 10 students were found positive for hepatitis B.

Keywords: Peer education, positivity rate, prevalence, hepatitis B, secondary school student.

References:

[1].     AIDS Info (2016). HIV/AIDS related opportunistic infections and co-infections. Retrieved from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/26/89/hiv-and-hepatitis-b.

[2].Chingle, M. P., Osagie, I.A., Adams, H., Gwomson, D., Emeribe, N., & Zoakah, A.I. (2017). Risk perception of hepatitis B infection and uptake of hepatitis B vaccine among students of tertiary institution in Jos. Annals of African Medicine, 16(2), 59-64. Retrieved from http://www.annalsafrmed.org/article.asp?issn=1596-3519;year=2017;volume=16;issue=2;spage=59;epage=64;aulast=Chingle.

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[5].     Itelima, J.U. (2017). Prevalence of hepatitis B and C in Jos, Plateau state, Nigeria. 12th World Congress on Virology. Journal of Antivirals and Antiretrovirals. Retrieved from https://www.omicsonline.org/proceedings/prevalence-of-hepatitis-b-and-c-in-jos-plateau-state-nigeria-75267.html.

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Abstract:

This study identified the intervention gaps in Adolescents Sexual and Reproductive Health (ASRH) Programs in Nigeria through a desk review of the ASRH program being implemented currently in Nigeria. Adolescent health is influenced by an intricate set of social and biological factors as adolescents discover their identities and their probability of risky behavior increases. Many young people experience their sexual debut at the adolescent stage and this sexual experience may result in adverse reproductive health outcomes. Quite a number of donor-funded Adolescent Sexual and Reproductive Health Programs are currently being implemented in Nigeria to reduce the risk of unsafe sexual practices. However, some gaps have been identified in the program implementation approach. This paper highlights the major gaps in implementation of adolescent sexual and reproductive health programs in Nigeria identified through exploratory analysis and recommendations are proffered to bridge the gaps.

Keywords: adolescents, health care, reproductive health, sexual health, sexual and reproductive health care.

References:

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[2]. Anderson R et al., Demystifying Data: A Guide to Using Evidence to Improve Young People’s               Sexual Health and Rights, New York: Guttmacher Institute, 2013.

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[4]. Blanc AK, Winfrey W and Ross J, New findings for maternal mortality age patterns: aggregated results for 38 countries, PLoS ONE, 2013, 8(4):e59864.

[5]. Coles MS, et al. If you do not ask, they will not tell: evaluating pregnancy risk in young women in pediatric hospitals. J Adolesc Health. 2016;58(3):251–2.

[6]. Conde-Agudelo A, Belizán JM and Lammers C, Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study, American Journal of Obstetrics & Gynecology, 2005, 192(2):342–349.

[7]. Darroch JE et al., Adding It Up: Costs and Benefits of Meeting the Contraceptive Needs of Adolescents, New York: Guttmacher Institute, 2016,     https://www.guttmacher.org/report/adding-it-meeting-contraceptive-needs-.... Darroch JE, Sedgh G and Ball H, Contraceptive Technologies: Responding to Women’s Needs, New York: Guttmacher Institute, 2011.

[8].  Family Planning High Impact Practices, Adolescent-friendly contraceptive services: mainstreaming adolescent-friendly elements into existing contraceptive services, brief, Washington, D.C.: U.S. Agency for International Development, 2015, www.fphighimpactpractices.org/afcs.

[9]. Hardee K and Wright K, Expanding the Role of Evidence in Family Planning, Program, and Practice Decision-Making: Working Paper, Washington, D.C.: Population Council Evidence Project, 2015.

[10]. Hardee K, Wright K and Boydell V, Development and validation of an index to assess a rights-based approach to family planning service delivery, poster presented at the annual meeting of the Population Association of America, Washington, D.C., Mar. 31–Apr. 2, 2016.

[11]. Hussain R, Ashford LS and Sedgh G, Unmet Need for Contraception in Developing Countries: Examining Women’s Reasons for Not Using a Method, New York: Guttmacher Institute,        2016 (forthcoming).

[12]. International Institute for Population Sciences (IIPS) and Population Council, Youth in India:Situation and Needs 2006–2007, Mumbai: IIPS, 2010.

[13]. Kato-Wallace J et al., Adolescent Boys and Young Men: Engaging Them as Supporters of Gender Equality and Health and Understanding Their Vulnerabilities,Washington, D.C.:            Promundo; and New York: UNFPA, 2016.

[14]. Lindstrom DP et al., Nonmarital sex and condom knowledge among Ethiopian young people: improved estimates using a nonverbal response card, Studies in Family Planning,2010, 41(4):251–262.

[15]. Lloyd CB, ed., Growing Up Global: The Changing Transition to Adulthood in Developing Countries, Washington, D.C.: National Academies Press, 2005.

[16]. Luke N, Clark S and Zulu EM, The relationship history calendar: improving the scope and quality of data on youth sexual behavior, Demography, 2011, 48(3):1151–1176.

[17]. MacQuarrie K., Men and Contraception: Trends in Attitudes and Use, DHS Analytical            Studies, 2015, Rockville, MD, USA: ICF International, No. 49.

[18]. Neal SE and Hosegood V, How reliable are reports of early adolescent reproductive and sexual             health events in Demographic and Health Surveys? International Perspectives on Sexual and Reproductive Health, 2015, 41(4):210–217.

[19]. Nove A et al., Maternal mortality in adolescents compared with women of other ages: evidence             from 144 countries, Lancet Global Health, 2014, 2(3): e155–e164.

[20]. Say L et al., Global causes of maternal death: a WHO systematic analysis, Lancet Global Health, 2014, 2(6):e323–e333.

[21]. Sedgh G et al., Insights from an expert group meeting on the definition and measurement of  unsafe abortion, International Journal of Gynecology and Obstetrics,2016, doi:10.1016/j.ijgo.2015.11.017.

[22]. Singh S, Remez L and Tartaglione A, eds., Methodologies for Estimating Abortion Incidence and Abortion-Related Morbidity: A Review, New York: Guttmacher Institute, 2011.

[23]. Tanabe M, Schlecht J and Manohar S, Adolescent Sexual and Reproductive Health Programs in Humanitarian Settings: An In-Depth Look at Family Planning Services, New York: The Vogel JP et al., Millennium Development Goal 5 and adolescents: looking back, moving        forward, Archives of Disease in Childhood, 2015, 100(Suppl. 1):S43–S47.

[24]. Way A, Youth data collection in DHS surveys: an overview, DHS Occasional Paper,Rockville, MD, USA: ICF International, 2014, No. 9.

[25]. WHO, Adolescent Health Research Priorities: Report of a Technical Consultation, Geneva: WHO,2015 http://apps.who.int/iris/bitstream/10665/203564/1/WHO_FWC_MCA_15_7_eng.....

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[27]. Woan J, Lin J and Auerswald C, The health status of street children and youth in low- and middle-income countries: a systematic review of the literature, Journal of Adolescent Health, 2013, 53(3):314–321.

Abstract:

This article on adolescent sexual and reproductive health is based on the ecological framework and it identifies the core elements for building and maintaining a conducive climate for Adolescent Sexual and Reproductive Health (ASRH). The ecological framework approach is hinged on the key elements that are necessary in the creation of an enabling environment for ASRH. The components of the ecological framework include individuals, relationships, the community and the society as a whole. At the individual level, adolescents are empowered to boost their self-esteem and improve their decision-making capacity. At the level of relationship, parental support and communication with peers and significant others are encouraged to create support networks for the adolescents. At the level of the community, the community stakeholders are engaged to create an enabling environment foe ASRH programs. Finally, at the highest level, which is the society, efforts to influence policies and regulations that protect and promote the adolescents’ rights on ASRH issues should be put into consideration.

References:

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[7].Browne E, Oddsdottir F. 2013. Safe spaces for girls: Six-country mapping (GSDRC Helpdesk Research Report 937). Birmingham, UK: GSDRC, University of              Birmingham; 2013.

[8].Cortez R., Seemeen S., Edmore M., Odutolu O. 2015. Adolescent Sexual and Reproductive Health in Nigeria. Health, nutrition and population global practice knowledge brief; World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/21626 License: CC BY 3.0 IGO.”

[9].Denno D, Hoopes A, Chandra-Mouli V. 2015 Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support. J Adolesc Health 2015;56: S22e41.

[10]. Dunkle K, Khandekar R, Brown H, 2014. Transactional sex among women in Soweto, South Africa: Prevalence, risk factors and association with HIV infection. Social Sci Med 2014; 59:1581e92.

[11]. Erulkar A & Muthengi E. 2103 Evaluation of Berhane Hewan: A program to delay child marriage in rural Ethiopia. Int Perspect Sex Reprod Health 2009; 35:6e14.

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Abstract:

Zimbabwe is implementing a micronutrient powder program, which was designed to improve micronutrient supplementation to children aged 6-23 months. One year after program inception, there are reports of low uptake of micronutrient powders. The study sought to understand the importance of social and behaviour change communication in promoting uptake of micronutrient powders. The study was conducted in Makoni rural district of Zimbabwe. Key informant and focus group discussions were employed to explore the significance of social and behaviour change communication in promoting uptake of micronutrient powders. Qualitative data analysis methods of transcribing, organizing, categorizing, and coding were used to sift themes and emerging issues. Out of 81 community participants in this study, we found that social and behaviour change communication approaches employed increased knowledge, positive attitude and infant feeding practices among caregivers. On the other hand, we found that lack of adequate information on side effects of micronutrient powders may hinder optimal uptake of micronutrient powders. Social mobilization and capacity building approaches were used utilized to disseminate information on micronutrient powders. We found that few community engagement platforms, limited advocacy and mass media to disseminate information on MNPs may hinder optimal uptake of micronutrient powders. We suggest that nutrition programs in Zimbabwe should consider utilizing an integrated social and behaviour change communication approach and provide adequate information to caregivers on side effects to promote uptake of Micronutrient Powders.

Keywords: Social and behaviour change communication, Micronutrient powders, Uptake, Nutrition, Infant and young child feeding, Zimbabwe.

References:

[1].     Akoto Osei, A. S. (2014). Using Formative Research to Inform the Design of a Home Fortification with Micronutrient Powders (MNP) Program in Aileu District, Timor-Leste. Food and Nutrition Bulletin, 68-82.

[2].     Best C, N. N. (2011). Can multi micronutrient food fortification improve the micronutrient status, growth, health, and cognition of schoolchildren? A systematic review. Nutrition Reviews. International Life Sciences Institute, 69 (4): 186-204.

[3].     Bilukha, J. H. (2012). Program Experience with Micronutrient Powders and Current Evidence. The Journal of Nutrition, Volume 142, Pages 191S–196S.

[4].     Clements, R. J. (2011). Spatial heterogeneity of haemoglobin concentration in preschool-age children in sub-Saharan Africa. Bulletin of the World Health Organization, 2011;89:459-468.

[5].     Halati S, V. H. (2013). Home fortification in refugee camps: micronutrient powder supplementation program for Bhutanese refugee children in Jhapa and Morang districts, Nepal. Geneva: The HF-TAG website (http://hftag.gainhealth.org/).

[6].     Hilary Creed-Kanashiro, R. B. (2015). Promoting multi‐micronutrient powders (MNP) in Peru: acceptance by caregivers and role of health personnel. Maternal and Child Nutrition, 152-163.

[7].     Ietje Reerink, S. M. (2017). Experiences and lessons learned for delivery of micronutrient powders interventions. Maternal and Child Nutrition, 13(S1):e12495.

[8].     Jee Hyun Rah, S. d. (2012). Program Experience with Micronutrient Powders and Current Evidence. Journal of Nutrition, 142: 191S–196S, 2012.

[9].     Jefferds ME, M. K. (2015). of micronutrient powder sachet coverage in Nepal. Maternal Child Nutrition, 11:77-89.

[10]. Jefferds ME, O. L. (2010). Formative research exploring acceptability, utilization, and promotion in order to develop a micronutrient powder (Sprinkles) intervention among Luo families in western Kenya. . Food Nutrition Bulletin, S179-85.

[11]. Kodish S, R. J. (2011). Understanding low usage of micronutrient powder in the Kakuma Refugee Camp, Kenya: findings from a qualitative study. Food Nutrition Bulletin, 32: 292-303.

[12]. Kristina Michaux, A. A. (2014). Home Fortification with Micronutrient Powders: Lessons learned from formative research across six countries. Sight and Life, 25-35.

[13]. Letje Reerink, S. M. (2017). Experiences and lessons learned for delivery of micronutrient powders interventions. Maternal and Child Nutrition 13(S1) , 1-20.

[14]. Mahama Saaka, P. A.-l. (2017). The effect of social behavior change communication package on maternal knowledge in obstetric danger signs among mothers in East Mamprusi District of Ghana. Bio-Med Central, 13-19.

[15]. Mirak Raj Angdembe, N. C. (2015). Adherence to multiple micronutrient powder among young children in rural Bangladesh: a cross-sectional study. BMC Public Health, 15:440.

[16]. Mirkovic KR, P. C. (2016). Predictors of micronutrient powder intake adherence in a pilot programme in Nepal. Public Health Nutrition, 19:1768–76.

[17]. Neufeld, M. V. (2017). Experiences and lessons learned for programme improvement of micronutrient powders interventions. Maternal and Child Nutrition.

[18]. Organization, W. H. (2016). Use of multiple micronutrient powdersfor point-of-use fortification of foods consumed by infants and young children aged 6-23 months and children aged aged 2-12 years. World Health Organization.

[19]. Organization, W. H. (2017). Multiple micronutrient powders for point-of-use fortification of foods consumed by children 6–23 months of age. Geneva: e-Library of Evidence for Nutrition Actions (eLENA).

[20]. Osei A, S. A. (2014). Using formative research to inform the design of a home fortification with micronutrient powders (MNP) program in Aileu District, Timor-Leste. Food Nutrition Bulletin, 35:68–82.

[21]. Parminder S Suchdev, O. Y.-A. (2016). Effects of community-based sales of micronutrient powders on morbidity episodes in preschool children in Western Kenya. American Journal Clinical Nutrition, 1-16.

[22]. Rehana A Salam, C. M. (2013). Effectiveness of Micronutrient Powders (MNP) in women and children. BioMed Central Public Health, S22.

[23]. Stephen Kodish, J. H. (2011). Understanding low usage of micronutrient powder in the Kakuma Refugee Camp, Kenya: Findings from a qualitative study. Food and Nutrition Bulletin, 292-303.

[24]. Survey, Z. N. (2018). Food and NUtrition Council of Zimbabwe.

Abstract:

Leprosy is an infectious disease which feared by the community. This disease can be transmitted from one person to another with an inclusion period of 40 days to 40 years, an average of 3-5 years. This study aims to analyze environmental factors and host factors related to the incidence of leprosy in Jeneponto District. This research used a case control design. A total of 31 leprosy patients and 31 non lepers were sampled in this study. The primary data consists of data on environmental factors variables obtained through observation at the house of lepers (cases) and houses non lepers (control). Host factor variable data were obtained through questionnaires. Statistical analysis of Chi square test was used to determine the relationship between environmental factors and host factors with the incidence of leprosy.

The results showed that there was a significant relationship between environmental factors namely environmental hygiene with the incidence of leprosy (p value = 0.002 <0.05) and the room temperature with leprosy (p = 0.004 <0.05). In addition, there was a significant relationship between host factors, namely the contact history with the incidence of leprosy (p = 0.007 <0.05). but different with knowledge variable. the knowledge did not have a significant relationship with the incidence of leprosy, (p = 0.203> 0.05). There needs to be attention to environmental factors to prevent leprosy transmission in the community. Health promotion is needed to educate people to better protect the environment to improve their health.

Keywords: environment factors, host factors, leprosy.

References:

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[7].Mukhlis. (2010). Relation of Family Knowledge and Attitude to the Healing Process in Leprosy Patients in Bengkalis Regency, Riau. University of North Sumatra: Medan.

[8].Manyullei Syamsuar, Utama Deddy Alif, Birawida Agus Bintara. (2012). Gambaran Faktor Yang Berhubungan Dengan Penderita Kusta Di Kecamatan Tamalate Kota Makassar. Indonesian Journal of Public Health, 1 (1) : 10 – 17

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