Healthcare in Low-resource Settings <p><strong>Healthcare in Low-resource Settings</strong> is an open access, peer-reviewed journal which aims to publish high quality, outcome-based research conducted in or applicable to low-resource settings. Potential topics of interest are also: comparison of different medical procedures in terms of their effects on the healthcare resources; education of health professionals in rural areas; strategies to formulate effective health policies in those areas, and guidelines targeted specifically to them; advances in healthcare resource management. <strong>Healthcare in Low-resource Settings</strong> publishes <em>editorials, research articles, reviews </em>(narrative, systematic and meta-analysis),<em> case reports, debate articles, short reports, letters to the Editor</em>, and <em>study protocols</em>. The Journal also publishes thematic issues focusing on a single topic within the scope of the journal. Contextually relevant announcements, book reviews and abstracts from scientific meetings may also be hosted. Every article published in the Journal will be peer-reviewed by experts in the field and decided on by members of the editorial board.</p> PAGEPress Scientific Publications, Pavia, Italy en-US Healthcare in Low-resource Settings 2281-7824 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Assessment of nutritional status and its associated factors among people affected by human immune deficiency virus on antiretroviral therapy: A cross sectional study in Siltie zone, South Ethiopia <p>Ethiopia is among the countries most affected by malnutrition and nutrition-related complications remain a challenging issue for Human Immunodeficiency Virus (HIV)- infected patients and those involved in their care. The aim of this study was to assess nutritional status among HIV positive adults in South Ethiopia and assess risk factors for malnutrition in this population. Institution based cross sectional study was conducted among 428 HIV positive adults who are taking ART at 12 health centers, Silte zone, Ethiopia. Convenience sampling technique was used to select the study participants. Structured questionnaire and anthropometric measurements were used to collect data. Data were analyzed using SPSS version 20.0 software. Bivariate and multivariate analyses were used to identify predictors of malnutrition. P-value less than 0.05 were used as cut of point to declare statistical significance. Prevalence of chronic energy deficiency was 24.1%. Food insecurity [AOR= 0.35, 95% CI (0.21, 0.62)], feeding ≤ 2 meals/day [AOR= 0.29, 95% CI (0.29, 0.13)], ambulatory functional status [AOR= 3.4, 95% CI (1.67, 6.98)] and absence of dietary counseling [AOR= 1.7, 95% CI (1.05, 2.78)] were found to be independent predictors of chronic energy deficiency among HIV positive adults. Prevalence of malnutrition was high among HIV infected adults who are on ART in the study area. Regular nutritional assessment of the patients and dietary counseling should be integrated with routine care for HIV/AIDS patients. HIV/AIDS prevention and control programs need to involve nutritionists or trained health care provider to integrate nutritional care services.</p> Mewuba Shamil Saliya Telake Azale Atinkut Alamirew Dawit Jember Tesfaye ##submission.copyrightStatement## 2018-05-17 2018-05-17 6 1 10.4081/hls.2018.6361 Increased waist circumference as an independent predictor of hypercholesterolemia in community-dwelling older people <p>Hypercholesterolemia is a worldwide public health problem, contributing to cerebrovascular and ischemic heart diseases as one of the major cardiovascular risk factors, and associated with approximately 4.4 million deaths each year worldwide. This study aimed to evaluate the association and predictive value of increased waist circumference (WC) to identify hypercholesterolemia in community-dwelling elderly people. In a cross-sectional, homebased epidemiological survey, 296 community-dwelling old adults consented to capillary blood collection and anthropometric evaluation. Total cholesterol was quantified, and the population was stratified as normal or high (≥200 mg/dL). WC was used to stratify the population into normal or elevated values (men: ≥90 cm; women: ≥80 cm). The association was investigated using logistic regression. Increased WC was associated with a greater probability of hypercholesterolemia (OR=2.82, 95%CI 1.68 to 4.74). Thus, the widely used WC cutoff was demonstrated to be significantly associated with hypercholesterolemia in community-dwelling elderly people and could serve as a useful screening tool for hypercholesterolemia in older adults.</p> Claudineia Matos de Araujo Marcos Henrique Fernandes José Ailton Oliveira Carneiro Raildo da Silva Coqueiro Rafael Pereira ##submission.copyrightStatement## 2018-06-29 2018-06-29 6 1 10.4081/hls.2018.6468 Impoverishing effect of household healthcare expenditure in semi-rural communities in Yenagoa, Nigeria <p>Inequity in the payment mechanism for healthcare systematically affects poorer households more than the rich. This article examines the impoverishing effect of healthcare expenditure on households in Yenagoa. Data was obtained from a crosssectional survey of households in 2 communities in Yenagoa selected by simple random sampling. A pretested, structured, interviewer-administered questionnaire was used to obtain information on household (HH) income, general expenditures and financing for healthcare. Two international poverty lines designed by World Bank were employed to classify households as poor, extremely poor and to determine the impoverishing effects of households’ healthcare expenditures. Responses were received from 525 HHs with 9.2% of HHs falling below poverty line, another 9% pushed deeper into poverty after healthcare spending. A 12.3% and 16% increase in the poverty and extreme poverty gaps respectively were attributable to health payment. A significant percentage of households who were non-poor were pushed into poverty after healthcare spending. There is need for increased public spending and implementation of innovative pre-payment mechanisms and social insurance that assures financialrisk protection and equity in health financing in Yenagoa.</p> Adedotun Daniel Adesina Daprim Samuel Ogaji ##submission.copyrightStatement## 2018-08-06 2018-08-06 6 1 10.4081/hls.2018.7464 Awareness and reporting of notifiable diseases among private laboratory scientists in Lagos, Southwest Nigeria <p>The availability of accurate, up-to-date, reliable and relevant health information on disease notification by medical laboratory practitioners is essential to detecting and responding to epidemic outbreaks. However, information on notification practices of private laboratory scientists are not well documented. This study was conducted to assess the level of awareness and knowledge of Integrated Diseases Surveillance and Response (IDSR), as well as its practice by private laboratory scientists in Lagos State, Nigeria. In a cross-sectional study, 190 respondents from 14 chapters of the Association of Medical Laboratory Scientists in Lagos state were interviewed using a pretested self-administered semistructured questionnaire to collect information on socio-demographic characteristics, awareness of IDSR and its policy, knowledge of notifiable diseases, practice of IDSR and constraints to reporting notifiable diseases. Data was analyzed using descriptive statistics, Chi-square test and logistic regression at P = 0.05. The mean age of the respondents was 34.0 years with a standard deviation (sd) of ±8.5 years and 65.3% were males. Half (50.0%) of them have ≤5 years of working experience with a mean of 7.5±5.8 years. About 8.9% had ever heard of IDSR. About 9.5% had ever seen a disease notification form and 51.1% had good knowledge of IDSR guidelines for the country. Most (86.3%) had never reported a notifiable disease. Lack of knowledge on how to report (56.8%) and inefficiency of the health department (44.7%) were the major reasons given for not reporting. A significant predictor of disease notification was awareness of IDSR (OR= 5.7, CI=1.9-16.7). Private medical laboratory practitioner’s awareness and practice of disease notification is poor. A range of interventions including awareness campaign, IDSR training, feedback and logistic support for reporting is recommended to improve reporting practices by private medical laboratory scientists.</p> Magbagbeola D. Dairo Salewa Leye-Adebayo Abimbola F. Olatule ##submission.copyrightStatement## 2018-08-24 2018-08-24 6 1 10.4081/hls.2018.7106 Training interventions on Helping Babies Breathe among health workers in tertiary hospital of the Republic of South Sudan: A non-randomized quasi-experimental study <p>This study aimed to examine the effects of the Helping Babies Breathe (HBB) training interventions program on the knowledge, psychomotor skills, and competency of health workers in managing birth asphyxia and reducing mortality of newborns experiencing asphyxia within 24 hours. This study used pre- and post-test design (quasi experimental study). Purposive sampling was employed, and a computer-generated number was used to select the participants. Health workers from Juba Teaching Hospital comprised the intervention group. They were evaluated before and after the training from February to June 2017. A post training skill and competency evaluation was performed using a NeoNatalie newborn simulator and was repeated after three months of implementation for intervention and control group. Seventy health workers were enrolled; 40 were in the intervention group and 30 in the control group. Early newborn mortality due to asphyxia within 24 hours in intervention and control measure at pre and post implementation showed a significant reduction within the intervention than the control. Knowledge, psychomotor and competency of health care workers improved immediately after training and early newborn mortality reduced by half at the end of three months. It is recommended that training of health workers on HBB should be scaled up in most of the health facilities in South Sudan.</p> Christopher Vunni Draiko Khemika Yamarat Alessio Panza Judith Draleru Martin Taban Joseph Onyango Regina Akur Rose Aliru Omega ##submission.copyrightStatement## 2018-10-02 2018-10-02 6 1 10.4081/hls.2018.7276 Perception of rural communities in Akoko North West local government area of Ondo State, Nigeria, towards the Ikaram Millennium Village Project The Millennium Village Project (MVP) is designed to harness the progress of the time-bound Millennium Development Goals. This study aimed to assess the perception of the Ikaram Millennium Village Project by the residents of Akoko North West local government area of Ondo State. A descriptive cross-sectional study of 496 residents of five of the seven communities that make up the Ikaram MVP was done. The perception of the respondents were rated poor or good by scoring their responses to 8 validated questions. Chi square test was used to assess significant association. The mean age of the respondents were 42.20±17.1 years. Half were female (50.4%), 311 (62.7%) were married. The majority of the respondents (82.1%) reported a poor perception of the MVP. Among the Yorubas only 79 (17.1%) had good perception compared to 7 (46.7%) from other ethnic groups (p=0.003). Contributory factors to poor perception about the Ikaram MVP were the far location of the health facility from the community, lack of communication and community ownership of the project. For community orientated health projects to be successful community participation is important. Olayinka Ilesanmi Adesola Kareem ##submission.copyrightStatement## 2018-05-17 2018-05-17 6 1 10.4081/hls.2018.6239