Healthcare in Low-resource Settings

Intervention model in reducing the unmet need for contraception: a systematic literature review on technology-based, community, and health worker interventions

2024-09-23T10:14:38+00:00

The unmet need for contraception is a serious public health problem, and efforts to reduce the unmet need for family planning are a challenge due to the many and complex factors that contribute to the unmet needs. The aim of this study was to systematically review scientific evidence on intervention models that effectively reduce the unmet need for contraception. This study used a systematic review to identify relevant scientific articles. The article search was based on the PICO approach and used a database from Scopus, Science Direct, PubMed, MDPI, JStor, Nature, and Springer. The reviewed material was full-text articles and open-access articles published from 2013 to 2023. Data extraction included author, country, type of intervention, research design, sample, and main research findings. Twelve studies were included in our qualitative synthesis. Technology-based interventions, such as mobile phone instant messaging apps, were implemented in countries like Tajikistan, Bolivia, and Mozambique. Community-based interventions included the Community Family Health=Family Wealth program in Uganda, the Tékponon Jikuagou (TJ) program in Benin, and the Married Adolescent Girls Club (MAG club) and Participatory Women’s Group Intervention in Bangladesh. Health worker-led interventions involved community health volunteers in Nepal, postpartum contraceptive counseling, contraceptive counseling for all ages, structured counseling for childbearing couples in Indonesia, and the “Consult and Choose” client-centered family service in Jordan. The findings underscore that varying intervention models can significantly enhance contraceptive use, tailored to specific cultural and regional contexts. These interventions, therefore, hold substantial implications for public health practices aiming to address and reduce the global unmet need for contraception. This systematic review provides valuable insights into the effectiveness of diverse interventions and suggests avenues for public health strategies to expand contraceptive access and use globally.

Distribution of episodes of kidney diseases admitted at the University Hospital Center “Mother Teresa” in Tirana, Albania, during the period 2010-2023

2024-09-16T11:56:43+00:00

Our aim was to describe the distribution of kidney diseases among hospitalized patients in Tirana, the capital of Albania, during the period 2010-2023. A case-series study was conducted including all episodes admitted with kidney diseases at the University Hospital Center “Mother Teresa” in Tirana during the period 2010-2023 (overall: 15,763 episodes; 46% females; overall mean age: 54.0±17.3 years). We found that ≈56% of the kidney disease episodes were 35-65 years old, followed by >65-year-old individuals (≈28%). Most of the kidney disease episodes (about 43%) hospitalized were from the Tirana region, followed by districts pertinent to South Albania (23%). Older patients (>65 years) were more prevalent among males compared to females (301% vs 25%, respectively; p<0.001). Patients from the Tirana region were more prevalent among females compared to males (45% vs 42%, respectively, p<0.001). This study provides evidence on the distribution of the episodes of kidney diseases admitted at University Hospital Center “Mother Teresa” in Tirana, the largest region in Albania, a country in the Western Balkans that is undergoing deep reforms in all sectors, including also the health sector.

Exploring the relationship between self-stigma and resilience among people living with HIV: a cross-sectional study

2024-10-23T14:33:12+00:00

HIV is a disease that not only affects physical health but also carries a heavy psychological burden, primarily through self-stigma. Self-stigma can lead to low self-esteem, helplessness, and social isolation, weakening resilience or an individual's ability to survive and adapt to life's challenges. However, there is a gap in knowledge regarding the specific mechanisms by which resilience can mitigate the impact of self-stigma on PLHIV. Whether resilience can completely neutralize the effects of self-stigma or only partially is a question that still requires further answers. This study aims to find out the relationship between self-stigma and resilience among people living with HIV. This research used an observational research design using a cross-sectional approach. 150 HIV patients at Six Public Health Centre of Semarang City were involved in using purposive sampling techniques. The data was gathered using the Indonesian version of CD-RISC and the Indonesian version of the Self-Stigma Questionnaire. Spearman rank correlations were used to analyze the data. The health research ethics committee of the faculty of nursing at Universitas Islam Sultan Agung has approved this study as ethically appropriate. The results found a relationship between self-stigma and resilience where a p-value of 0.006 < α (0.05) with a contingency coefficient value of 0.222. The self-stigma and resilience have a weak correlation. Self-stigma can weaken the ability to create resilience in PLHIV, although the impact may vary depending on other factors. Nurses or health workers need to pay attention to PLHIV, who experience self-stigma, to rise and be resilient while being HIV positive.

Mothers’ breastfeeding techniques and its correlation to their infants’ nutritional status: a study in a rural area

2024-10-03T14:37:00+00:00

Proper breastfeeding techniques are important to maintain adequate breast milk supply. The study aimed to determine the breastfeeding techniques of mothers in rural areas and discover the correlation with the nutritional status of their infants. This research involved 107 mothers with infants aged 0-6 months and data was collected using observation sheets. The Spearman-Rho test was used to analyze the relationship between the breastfeeding technique and the nutritional status of the infants. Most respondents were mothers aged 26 to 35 with high school-level education and daily lives as housewives. Most of the infants were 3 months old (27.1%), female (57.9%), and some of them were macrocephaly (31.8%), underweight (26.2%), stunted (16.9%), and wasted (12.3%). Additionally, most mothers had an inappropriate breastfeeding technique (60.7%) and statistically, there was no correlation with the nutritional status of their infants aged 0-6 months (ρ>0.05). The results of this study require health workers to optimize the nutritional needs of infants in rural areas by providing effective educational strategies on proper breastfeeding techniques, regardless of other factors influencing nutritional status.

Health information use and the associated factors among public health facilities of the Sidama Zone, southern Ethiopia: a facility-based cross-sectional study

2024-09-05T10:10:45+00:00

A strong Health Information System (HIS) is a foundation for evidence-based decision making in health care management. However, there is a dearth of literature with respect to health information use practice, particularly in public health facilities of Sidama Zone, Southern Ethiopia. A cross-sectional, facility-based quantitative study was conducted from 15 February to 5th of March 2018. Quantitative data was collected using a structured questionnaire and checklists from a sample of 48 health facilities and 213 health workers, and analyzed using binary logistic regression. To complement the quantitative findings, qualitative data was collected using key informant interviews. The level of information use based on standard observation checklists was 58%. Health information system’s specific supportive supervision (Adjusted Odd Ratio, AOR, 3.070; 95% Confidence Interval, CI, 1.206, 7.816), staff’s perception of data use practice (AOR=3.732, 95%CI 1.383, 10.068), and staff’s experience of root cause analysis (AOR=3.782, 95%CI 1.456, 9.819) were significant factors associated with the information use. Health information use among public health facilities was low. Strengthening supportive supervision, awareness creation on the use of available data, and improving the skill of root cause analysis of the problem is recommended.