ORCID Profile
0000-0002-3531-4400
Current Organisations
Flinders University
,
Jimma University College of Public Health and Medical Sciences
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Publisher: MDPI AG
Date: 15-08-2020
DOI: 10.3390/TROPICALMED5030131
Abstract: Female sex workers (FSWs) decision to use or not to use condoms depends on several issues, including the decision to trust their client or not, a matter given little attention in previous research. This paper explores the role of trust in consistent condom use among FSWs. We used a cross-sectional survey among FSWs in Bali, Indonesia. The outcome variable for this study was condom use, and independent variables included sociodemographic characteristics, psychosocial factors, social capital dimensions and HIV prevention practices. In total, 406 FSWs participated in the study. Of these, 48% of FSWs used condoms consistently with paying clients over the last month. The following FSWs were less likely to consistently use condoms with clients: FSWs who did not trust that their peer FSWs will use condoms (AOR = 9.3, 95% CI, 3.3–26.2), FSWs who did not feel valued by the people at their location (AOR = 3.9, 95% CI, 1.4–11.6), FSWs who did not graduate from primary or never went to school (AOR = 2.4, 95% CI, 1.03–5.6), and FSWs who have worked more than five years as FSWs (AOR = 5.8, 95% CI, 1.2–29.2). Our results highlight higher rates of inconsistent condom use related to lower trust and feelings of being valued between FSWs, identifying areas for policy and practice attention.
Publisher: Public Library of Science (PLoS)
Date: 06-03-2017
Publisher: MDPI AG
Date: 14-01-2021
Abstract: Background: Women live longer than men, even though many of the recognised social determinants of health are worse for women than men. No existing explanations account fully for these differences in life expectancy, although they do highlight the complexity and interaction of biological, social and health service factors. Methods: this paper is an exploratory explanation of gendered life expectancy difference (GLED) using a novel combination of epidemiological and sociological methods. We present the global picture of GLED. We then utilise a secondary data comparative case analysis offering explanations for GLED in Australia and Ethiopia. We combine a social determinant of health lens with Bourdieu’s concepts of capitals (economic, cultural, symbolic and social). Results: we confirmed continuing GLED in all countries ranging from less than a year to over 11 years. The Australian and Ethiopian cases demonstrated the complex factors underpinning this difference, highlighting similarities and differences in socioeconomic and cultural factors and how they are gendered within and between the countries. Bourdieu’s capitals enabled us to partially explain GLED and to develop a conceptual model of causal pathways. Conclusion: we demonstrate the value of combing a SDH and Bourdieu’s capital lens to investigate GLED. We proposed a theoretical framework to guide future research.
Publisher: Springer Science and Business Media LLC
Date: 02-11-2016
Publisher: Springer Science and Business Media LLC
Date: 20-03-2021
DOI: 10.1186/S40249-021-00822-7
Abstract: It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio ( OR ), 95% confidence interval ( CI ) and heterogeneity using I 2 tests. Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male ( OR = 1.2, 95% CI 1.1–1.3, I 2 = 59%), (ii) between 15 and 35 years old ( OR = 1.3, 95% CI 1.1–1.3, I 2 = 0%), (iii) unmarried ( OR = 1.2, 95% CI 1.2–1.3, I 2 = 21%), (iv) a rural dweller ( OR = 2.01, 95% CI 1.5–2.7, I 2 = 40%), (v) unemployed ( OR = 1.2, 95% CI 1.04–1.4, I 2 = 58%) (vi) diagnosed with behavioral factors including illegal drug use( OR = 13.5, 95% CI 7.2–25.5, I 2 = 60%), alcohol drinking ( OR = 2.9, 95% CI 1.9–4.4, I 2 = 39%), and tobacco smoking ( OR = 2.6, 95% CI 1.6–4.3, I 2 = 74%) and clinical diagnosis of mental illness ( OR = 3.4, 95% CI 2.2–5.2, I 2 = 1%), bed ridden or ambulatory functional status ( OR = 2.2, 95% CI 1.5–3.1, I 2 = 74%), low CD4 count in the last visit ( OR = 1.4, 95% CI 1.1–1.9, I 2 = 75%), tuberculosis co-infection ( OR = 1.2, 95% CI 1.02–1.4, I 2 = 66%) and a history of opportunistic infections ( OR = 2.5, 95% CI 1.7–2.8, I 2 = 75%). The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418
Publisher: Frontiers Media SA
Date: 05-05-2021
DOI: 10.3389/FPUBH.2021.630295
Abstract: Introduction: Repatriated Indonesian migrant workers are vulnerable to developing serious mental health problems during the COVID-19 pandemic. This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among these populations during the COVID-19 pandemic. Methods: Guided by the health belief model, a cross-sectional study design was employed among 335 participants, and primary data were collected through an online survey. Measured using DASS-21, anxiety, depression, and stress were the dependent variables. We performed descriptive and inferential statistical analyses—logistic regression was used to predict independently associated variables. STATA was used to execute all data analyses. Results: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers were 10.15, 9.25, and 2.39%, respectively. The risk of anxiety and depression was low among those aged 21–30 years old, who had completed a university degree, were married, and had quarantined for 14 days. Conversely, the risk of anxiety and depression was high among those who had bad perceived health status, high perceived susceptibility, and negative stigma perception. Conclusion: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers was relatively low compared to the general population. The risk of anxiety and depression was low among young people, educated people, and those under effective quarantine, but the risk was high among those who had negative perceptions about their health, stigma, and susceptibility to the disease.
Publisher: MDPI AG
Date: 05-2020
Abstract: Adequate health literacy is a necessity to enable effective decision making to seek, access and utilise appropriate health care service. Evidence exists indicating a low level of general health literacy among Black African women, especially those with a refugee background. Breast and cervical are the most common cancers, with Black African women or women with African ethnicity being disproportionately overrepresented. The level of health literacy specific to breast and cervical cancer among Black African women, especially those with a refugee background, has not been reviewed systematically. The present study describes a protocol for a systematic review of the available evidence on the level of health literacy specific to breast and cervical cancer among Black African women globally. We will perform a systematic review of the available quantitative and qualitative studies. The search will include studies that describe the level of health literacy specific to breast and cervical cancer among Black African women. We will conduct a preliminary search on Google scholar to build the concepts for search terms, and a full search strategy using the identified concepts and keywords across four databases namely PubMed, SCOPUS, CINAHL and Web of Sciences. We will use Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to schematically present the search strategy. We will use the standardized Joanna Briggs Institute quality appraisal and selection tool to recruit studies, and the data extraction tool to synthesise the information extracted from the recruited studies. We will be guided by socioecological theory and Indigenous epistemology to synthesise the non-quantifiable information thematically, and pool the quantitative information using meta-analysis, based on the availability of information.
Publisher: Public Library of Science (PLoS)
Date: 30-03-2017
Publisher: Public Library of Science (PLoS)
Date: 14-12-2020
DOI: 10.1371/JOURNAL.PONE.0243969
Abstract: This study assessed the determinants that shape HIV knowledge and attitudes among South Sudanese women by analysing a Multiple Indicator Cluster Survey collected from 9,061 women in 9,369 households. Generalised linear mixed model regression was performed. Fifty percent of respondents were aware of HIV/AIDS, with 21% and 22% exhibiting good knowledge and positive attitudes towards people with HIV/AIDS, respectively. When controlled for in idual and community-level variables, younger women (AOR = 1.28, 95% CI: 1.01–162), women with primary (AOR = 2.19 95% CI: 1.86–2.58) and secondary (AOR = 4.48 95% CI: 3.38–5.93) education, and those living in urban areas (AOR = 1.40 95% CI: 1.12–1.76) had significantly good knowledge. Women in the richer (AOR = 1.60 95% CI: 1.08–2.36) and the richest (AOR = 2.02 95% CI: 1.35–3.02) wealth quintiles had significant positive attitudes towards people with HIV/AIDS. Well-designed social and behavioural c aigns targeting uneducated women and those living in rural and remote settings will enhance knowledge of perceived risk, awareness, and ability to carry out preventive behaviours.
Publisher: BMJ
Date: 03-2022
Publisher: OMICS Publishing Group
Date: 2015
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-026595
Abstract: Percutaneous coronary interventions (PCIs) and coronary angiography are two of the treatments administered to acute coronary syndrome (ACS) patients. However, whether and how patients’ health-related quality of life (HRQoL) influences treatment decisions and subsequent risk benefit analyses is unclear. In this study, we will review the available evidence on the impact of patients’ HRQoL on physicians’ prescribing or treatment decisions and on the estimation of mortality and bleeding risk in ACS patients. We will undertake a systematic review of all quantitative and qualitative studies. The search will include studies that describe the impact of HRQoL on prescribing PCIs or angiography, and impact of HRQoL on perceived risks in terms of mortality and bleeding events. We will conduct an initial search on Google scholar and MEDLINE to build the searching terms followed by a full search strategy using all identified keywords and index terms across the five databases, namely MEDLINE, PubMed, CINAHL, SCOPUS and Web of Sciences. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocol guidelines to present the protocol. Only English language articles will be included for the review. We will use a standardised Joanna Briggs Institute data extraction tool to synthesise the information extracted from the selected studies into themes with summary findings presented in a table. We will not require a formal ethical approval as we will not be collecting primary data. Review findings will be disseminated through a peer-reviewed publication, workshops, conference presentations and a media release. CRD42018108438.
Publisher: Elsevier BV
Date: 10-2021
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2022-069308
Abstract: Armed conflicts have significant negative impacts on the entire healthcare system in general and HIV care system in particular. Sub-Saharan Africa is suffering from a disproportionate double burden of armed conflict and HIV infection. Nevertheless, the impact of the armed conflict on the HIV treatment outcomes in conflict settings in sub-Saharan Africa has not been thoroughly and systematically synthesised. This protocol outlines a review that aims to summarise the available evidence on the impact of armed conflict on HIV treatment outcomes in sub-Saharan Africa. A systematic review of all quantitative studies that assess the impact of armed conflicts on HIV treatment outcomes will be conducted. The systematic search will start with a preliminary search of Google Scholar, followed by implementation of the full search strategy across five databases (MEDLINE, PubMed, CINAHL, SCOPUS and Web of Science) and the screening of titles and abstracts then relevant full texts. Bibliographies will be reviewed to identify additional relevant studies. We will include studies conducted in sub-Saharan Africa that were published in English between 1 January 2002 and 31 December 2022. Methodological validity of the included studies will be assessed using standardised critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument. Data will be extracted using standardised JBI instruments and analysed through narrative synthesis, and meta-analyses and regression. Heterogeneity will be assessed using I 2 and Χ 2 tests. Since this study will not involve gathering primary data, formal ethical approval is not required. Journal publications, conference presentations and a media release will be used to share the study findings. CRD42022361924.
Publisher: Frontiers Media SA
Date: 30-04-2021
DOI: 10.3389/FPUBH.2021.646764
Abstract: Introduction: Before the widespread availability of an effective COVID-19 vaccine, it is crucial to control the rate of transmission by ensuring adherence to behavioral modifications, such as wearing masks, physical distancing, and washing hands, all of which can be implemented as public health measures. Focusing on the conditions in Bali, this study explored the level of compliance to public health measures targeted at COVID-19 and identified the determinants of compliance via the values, rules, and knowledge approach. Materials and Methods: This cross-sectional study conducted an online survey using the Google Form application from June 29 to July 5, 2020. The minimum required s le size was 664. Inclusion criteria were set as follows: 18 years of age or older and residing in Bali during the data collection period. Adherence was measured based on nine protocol indicators that were rated using a four-point Likert scale. A multiple linear regression analysis was then conducted to determine the associated factors of adherence to public health measures. Results: Of the 954 survey respondents, data from 743 were included for analysis. The average level of adherence to public health measures was 32.59 (range of 20–36). The linear regression analysis showed that perceived health benefits from public health measures, being female, and having COVID-19 test histories were significantly associated with adherence to public health measures. Conclusions: For public health measures targeted at COVID-19, adherence was strongly associated with perceived social norms, in which in iduals played social community roles by adapting to standardized public health measures. It is thus imperative for governments to support and monitor public health measures during the COVID-19 pandemic.
Publisher: Frontiers Media SA
Date: 23-06-2021
DOI: 10.3389/FPUBH.2021.614321
Abstract: Background: The incidence rate of coronavirus disease 2019 (COVID-19) is increasing in several countries despite that public health measures are put in place. Given that COVID-19 is a newly emerging disease, there is little knowledge about the disease. The present study aims to assess knowledge, perception, and preventive practices toward COVID-19 among health workers in Tigray, North Ethiopia. Materials and Methods: A health facility-based cross-sectional study was conducted among health professionals working in public hospitals. Data were collected between April and May 2020. The researchers included 403 participants and recruited them via a simple random s ling technique. To collect data, the researchers prepared a structured questionnaire guided by the WHO survey questions. Data were entered into Epi-info 7 and exported to SPSS version 20.00 for analysis. The researchers applied descriptive and inferential statistical analyses. Tables and graphs were used to describe data, and multivariate binary logistic regression was used to determine factors affecting knowledge, perception, and practices toward COVID-19 prevention. Results: Among the participants, 79, 88, and 64.3% of them had adequate knowledge, positive perception, and good practice toward preventing COVID-19, respectively. Besides, 92% of the study participants knew that the COVID-19 virus does not have curative treatment and vaccine. The findings revealed that 55% of the respondents did not use the necessary personal protective equipment (PPE) at all times. The result showed that being female [AOR: 2.43, 95% CI (1.50–3.94)] and having a work experience of 2–5 years [AOR: 2.44, 95% CI (1.10–5.39)], news media as a source information [AOR: 7.11, 95% CI (3.07–16.49)], social media as a source information [AOR: 4.59, 95% CI (2.15–9.84)], and governmental website as a source information [AOR: 4.21, 95% CI (2.15–8.27)] were reported as protective factors and being single [AOR: 0.15, 95% CI (0.03–0.75)] was reported as risk factor toward the prevention of COVID-19. Conclusion: Most health workers had adequate knowledge and positive attitude toward COVID-19 nevertheless, a significant proportion of health workers had poor practice toward the prevention of COVID-19, including the use of PPE. Additionally, some groups of health professional showed poor practices of implementing the public health measures, hence the call for them to improve in the prevention and control of COVID-19.
Publisher: Springer Science and Business Media LLC
Date: 08-06-2017
Publisher: Springer Science and Business Media LLC
Date: 30-01-2018
Publisher: MDPI AG
Date: 03-03-2020
Abstract: Studies on human immunodeficiency virus (HIV) prevention practices of female sex workers often examine the use of condom as a single behaviour: using or not using condom. This study explores typologies of the logic of condom use as part of exercising meaningful identities from female sex workers’ perspectives. We employed in-depth interviews with a purposely selected 35 female sex workers in Bali, Indonesia. Information from the in-depth interviews was analysed using thematic framework analysis to develop typologies of female sex workers’ experiences on the logic of condom use and its relation to the construction of identity. We identified two main logics for not using condom: the prioritising of financial stability and romantic relationships over condom use. The main logic for using condom was to protect their health in order to improve their future economic security. Embedded within these logics, women chose to practise agency and negotiate meaningful identities consistent with their ideals of being responsible mothers, successful migrant workers and loyal partners. Our study concluded that female sex workers had clear logics for both the use and non-use of condom with their clients, highlighting the rational nature of female sex workers decision making.
Publisher: MDPI AG
Date: 08-04-2021
Abstract: Background: Africa is far behind from achieving the Joint United Nations Program on HIV and AIDS (UNAIDS) 90-90-90 targets. Evidence shows that the participation of HIV patients as peer educators and other community health workers is substantially improving the entire HIV care continuum and subsequently the UNAIDS targets. This review aims to provide the best available evidence on the impact of peer educators and/or community health workers for the three targets in Africa. Methods: We will include cohort and experimental studies published in English between 2003 and 2020. Studies which reported interventions for HIV diagnosis, initiation of ART, or virological suppression will be included for review. Three steps searching will be conducted: (i) initial search across Google Scholar, (ii) full search strategy across five databases: MEDLINE, PubMed, CINAHL, SCOPUS and Web of Science, and (iii) screening titles and abstracts. Data will be extracted using standardized instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and analyzed through narrative synthesis, and meta-analyses and regression. Heterogeneity among quantitative studies will be assessed using Cochran Q test and Higgins I2. Ethics: A formal ethical approval will not be required as primary data will not be collected.
Publisher: BMJ
Date: 12-2021
DOI: 10.1136/BMJGH-2021-007179
Abstract: The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic. We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O’Malley’s methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed. Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings. The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.
Publisher: MDPI AG
Date: 06-01-2020
Abstract: Ethiopia’s performance toward the UNAIDS 90-90-90 targets is low. The present study explored interventions to improve delayed HIV care presentation (first 90), poor retention (second 90) and clinical and immunological failure (third 90). We employed a qualitative approach using in-depth interviews with 10 HIV patients, nine health workers, 11 community advocates and five HIV program managers. Ethical approvals were obtained from Australia and Ethiopia. The following were suggested solutions to improve HIV care and treatment to meet the three 90s: (i) strengthening existing programs including collaboration with religious leaders (ii) implementing new programs such as self-HIV testing, house-to-house HIV testing, community antiretroviral therapy (ART) distribution and teach-test-treat-link strategy (iii) decentralizing and integrating services such as ART in health post and in private clinics, and integrating HIV care services with mental illness and other non-communicable diseases and (iv) filling gaps in legislation in issues related with HIV status disclosure and traditional healing practices. In conclusion, the study suggested important solutions for improving delayed HIV care presentation, attrition, and clinical and immunological failure. A program such as the teach-test-treat-link strategy was found to be a cross-cutting intervention to enhance the three 90s. We recommend further nationwide research before implementing the interventions.
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-044606
Abstract: COVID-19 has caused a global public health crisis affecting most countries, including Ethiopia, in various ways. This study maps the vulnerability to infection, case severity and likelihood of death from COVID-19 in Ethiopia. Thirty-eight potential indicators of vulnerability to COVID-19 infection, case severity and likelihood of death, identified based on a literature review and the availability of nationally representative data at a low geographic scale, were assembled from multiple sources for geospatial analysis. Geospatial analysis techniques were applied to produce maps showing the vulnerability to infection, case severity and likelihood of death in Ethiopia at a spatial resolution of 1 km×1 km. This study showed that vulnerability to COVID-19 infection is likely to be high across most parts of Ethiopia, particularly in the Somali, Afar, Amhara, Oromia and Tigray regions. The number of severe cases of COVID-19 infection requiring hospitalisation and intensive care unit admission is likely to be high across Amhara, most parts of Oromia and some parts of the Southern Nations, Nationalities and Peoples’ Region. The risk of COVID-19-related death is high in the country’s border regions, where public health preparedness for responding to COVID-19 is limited. This study revealed geographical differences in vulnerability to infection, case severity and likelihood of death from COVID-19 in Ethiopia. The study offers maps that can guide the targeted interventions necessary to contain the spread of COVID-19 in Ethiopia.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 04-2022
Publisher: Springer Science and Business Media LLC
Date: 10-2021
DOI: 10.1038/S41591-021-01498-0
Abstract: Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Public Library of Science (PLoS)
Date: 10-10-2022
DOI: 10.1371/JOURNAL.PONE.0275390
Abstract: HIV infection is a major public health concern, with a range of negative impacts on People Living with HIV (PLHIV). A qualitative study in Yogyakarta, Indonesia, using in-depth interviews with 26 Women Living with HIV (WLHIV) was conducted to understand HIV risk factors and impact and their access to HIV care services. This paper describes the self-response of WLHIV towards negative HIV-related experiences facing them and adds to the existing literature which tends to focus on HIV impact only, as opposed to strategies that many WLHIV have used to empower and educate themselves and their family/community. Participants were recruited using the snowball s ling technique. Data analysis was guided by a qualitative data analysis framework. Our study highlighted that WLHIV experienced psychological challenges, stigma and discrimination. However, they demonstrated remarkable self-response and capacity in pursuing effective strategies and support to protect themselves, and educating themselves and others around them to rebuild trust and regain respect and acceptance. Our findings indicate that the needs of WLHIV should be addressed through policy and practice to help them cope with HIV-related psychological and social challenges effectively. Family and community members seem to play an important role in those negative challenges against WLHIV, thus there is also a need for HIV education programs for family and community members to enhance their HIV-health literacy and acceptance of PLHIV.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 09-2020
Publisher: African Journals Online (AJOL)
Date: 19-09-2016
DOI: 10.4314/EJHS.V26I5.3
Abstract: Over the past decade, the magnitude and intensity of disasters have been vividly rising globally due to the forces of nature or man. This study aimed at assessing the perceived knowledge, experiences and training needs of health professionals regarding disasters, their prevention and management in Jimma Zone, Southwest Ethiopia. An institution based cross-sectional survey was conducted on 377 health professionals taken from 9 randomly selected districts out of 18. All health professionals working at health offices, hospitals and health centers were included. Data were collected using a structured questionnaire which was developed by the investigators after reviewing the relevant literature in the field. Data were coded and entered into SPSS 20 software for cleaning and analysis. Descriptive and logistic regression analyses were done. The majority (85.1%) of the participants were able to define the concept of disaster from various perspectives 9.7% did not know about it at all and 5.2% could describe the concept partially or misconceived it. The majority (84.3%) agreed that disaster has direct public health consequences on humans. The main public health consequence of disaster the participants mentioned was environmental pollution (65.8%). Malaria, measles and diarrhoeal diseases accounted for 35.5%, 33.1% and 10.5% of the epidemics, respectively. Only 20.6% of the respondents were trained on disaster related topics in the last two years. The majority felt that they had poor knowledge on early warning indicators of drought (48.0%) and flood (48.0%). Simialry, 50.8%, 47.7%, 51.1% and 42.6% of the participants had poor knowledge on preparedness to drought, preparedness to flood, response to drought, response to flood. On composite scale, they generally perceived to have adequate (29.4%), moderate (32.4%) and poor (38.2%) knowledge about early warning information bout, preparedness for and response to common disasters. A vast majority (92.8%) reported that they need training on disaster preparedness, management and response. A considerable number of professionals had limited understanding about the concept of disaster and response to certain specific disasters. They also had limited opportunities for training, despite their felt needs. Therefore, training should be provided focusing on the specific gaps identified.
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJGH-2021-007328
Abstract: The war in Tigray region of Ethiopia that started in November 2020 and is still ongoing has brought enormous damage to the health system. This analysis provides an assessment of the health system before and during the war. Evidence of damage was compiled from November 2020 to June 2021 from various reports by the interim government of Tigray, and also by international non-governmental organisations. Comparison was made with data from the prewar calendar year. Six months into the war, only 27.5% of hospitals, 17.5% of health centres, 11% of ambulances and none of the 712 health posts were functional. As of June 2021, the population in need of emergency food assistance in Tigray increased from less than one million to over 5.2 million. While the prewar performance of antenatal care, supervised delivery, postnatal care and children vaccination was 94%, 73%, 63% and 73%, respectively, but none of the services were likely to be delivered in the first 90 days of the war. These data indicate a widespread destruction of livelihoods and a collapse of the healthcare system. The widespread use of hunger and rape during the brutal war and the targeting of healthcare facilities seem to be key components of the war. To avert worsening conditions, an immediate intervention is needed to deliver food and supplies and rehabilitate the healthcare delivery system and infrastructure.
Publisher: Springer Science and Business Media LLC
Date: 17-07-2022
Publisher: Elsevier BV
Date: 10-2020
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-043943
Abstract: This study will evaluate the acceptability and effectiveness of a new intervention programme called teach-test-link-trace (TTLT) model in Tigrai, Ethiopia, where peer educators counsel about HIV ( teach ), perform house-to-house HIV testing ( test ) through pinprick HIV testing (H2H) or OraQuick HIV self-testing (HIVST), link HIV-positive patients to HIV care ( link ) and trace lost patients house-to-house ( trace ). The four-arm cluster randomised trial will be conducted in five phases: Phase 1 will assess the acceptability of the TTLT model using a cross-sectional survey among adults aged 18 years irrespective of HIV status in 6909 households from 40 villages (kebeles). Phase 2 will assess effectiveness of the TTLT model through comparing intervention and control groups among HIV negative or unknown HIV status. The intervention groups will receive one of the three home-based interventions provided by peer educators: (1) demonstrate and distribute OraQuick HIV self-testing kits (HIVST), (2) perform pinprick HIV testing (H2H) and (3) offer a choice to either receive HIVST or H2H. The control group will receive the standard care in which nurses counsel and refer eligible household members to nearby health facilities to access existing HIV testing services. The primary outcomes of the interventions are proportion of in iduals who know of their HIV status (first 90), link to HIV care and treatment (second 90) and meet virological suppression (third 90). We will perform process evaluation through qualitative interviews in phase 3 , economic evaluation for cost-effectiveness analysis in phase 4 and a sustainability exit strategy using nominal group technique in phase 5 . We will apply descriptive and inferential statistics for quantitative studies, and thematic framework analysis for qualitative studies. Ethics approval was obtained from the Southern Adelaide Clinical Health Research Ethics Committee (SAC HREC), South Australia, and findings will be disseminated through publications, conference presentations, media release and policy briefs. ACTRN12620000570987p.
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-065318
Abstract: This study aimed to map the national, regional and local prevalence of hypertension and diabetes in Ethiopia. Nationwide cross-sectional survey in Ethiopia combined with georeferenced ecological level data from publicly available sources. 9801 participants aged between 15 and 69 years. Prevalence of hypertension and diabetes were collected using the WHO’s STEPS survey approach. Bayesian model-based geostatistical techniques were used to estimate hypertension and diabetes prevalence at national, regional and pixel levels (1×1 km 2 ) with corresponding 95% credible intervals (95% CrIs). The national prevalence was 19.2% (95% CI: 18.4 to 20.0) for hypertension and 2.8% (95% CI: 2.4 to 3.1) for diabetes. Substantial variation was observed in the prevalence of these diseases at subnational levels, with the highest prevalence of hypertension observed in Addis Ababa (30.6%) and diabetes in Somali region (8.7%). Spatial overlap of high hypertension and diabetes prevalence was observed in some regions such as the Southern Nations, Nationalities and People’s region and Addis Ababa. Population density (number of people/km 2 ) was positively associated with the prevalence of hypertension (β: 0.015 95% CrI: 0.003–0.027) and diabetes (β: 0.046 95% CrI: 0.020–0.069) whereas altitude in kilometres was negatively associated with the prevalence of diabetes (β: –0.374 95% CrI: –0.711 to –0.044). Spatial clustering of hypertension and diabetes was observed at subnational and local levels in Ethiopia, which was significantly associated with population density and altitude. The variation at the subnational level illustrates the need to include environmental drivers in future NCDs burden estimation. Thus, targeted and integrated interventions in high-risk areas might reduce the burden of hypertension and diabetes in Ethiopia.
Publisher: MDPI AG
Date: 28-06-2022
Abstract: We conducted a qualitative study involving African migrants (n = 20) and service providers (n = 10) in South Australia to explore mental health stressors, access to mental health services and how to improve mental health services for African migrant populations. This paper presents the views and experiences of African migrants about the post-migration stressors they faced in resettlement that pose mental health challenges. The participants were recruited using the snowball s ling technique. To align with the COVID-19 pandemic protocol, the data collection was conducted using one-on-one online interviews through Zoom or WhatsApp video calls. Data analysis was guided by the framework analysis. The post-migration stressors, including separation from family members and significant others, especially spouses, imposed significant difficulties on care provision and in managing children’s attitudes and behavior-related troubles at school. African cultural practices involving the community, especially elders in care provision and disciplining children, were not consistent with Australian norms, compounding the mental health stressors for all involved. The African cultural norms, that do not allow young unmarried people to live together, also contributed to child–parent conflicts, enhancing parental mental stressors. Additionally, poor economic conditions and employment-related difficulties were post-migration stressors that the participants faced. The findings indicate the need for policy and intervention programs that address the above challenges. The provision of interventions, including social support such as subsidized or free childcare services, could help leverage their time and scheduled paid employment, creating time for effective parenting and improving their mental health and wellbeing. Future studies exploring what needs to be achieved by government and non-governmental institutions to support enhanced access to social and employment opportunities for the African migrant population are also recommended.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/8504629
Abstract: Background . Tuberculosis remains a major global health problem. It causes ill-health among millions of people each year and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of death worldwide. Purpose . To assess the outcome of tuberculosis treatment and to identify factors associated with tuberculosis treatment outcome. Methods . A five-year retrospective cross-sectional study was employed and data were collected through medical record review. Data were analyzed using SPSS version 16 and binary and multiple logistic regression methods were used. A p value of less than 0.05 was considered as statistically significant in the final model. Results . Out of the 1584 pulmonary TB patients (882 males and 702 females) including all age group, 60.1% had successful outcome and 39.9% had unsuccessful outcome. In the final multivariate logistic model, the odds of unsuccessful treatment outcome was higher among patients of weight category 30–39.9 kg (AOR = 1.51, 95% CI: 1.102–2.065) and smear negative pulmonary TB (AOR = 3.204, 95% CI: 2.277–4.509) and extrapulmonary TB (AOR = 3.175, 95% CI: 2.201–4.581) and retreatment (AOR = 6.733, 95% CI: 3.235–14.013) and HIV positive TB patients (AOR = 1.988, 95% CI: 1.393–2.838) and unknown HIV status TB patients (AOR = 1.506, 95% CI: 1.166–1.945) as compared to their respective comparison groups. Conclusion . In this study, high proportion of unsuccessful treatment outcome was documented. Therefore emphasis has to be given for patients with high risk of unsuccessful TB treatment outcome and targeted interventions should be carried out.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2017
Publisher: Springer Science and Business Media LLC
Date: 20-03-2017
Publisher: Elsevier BV
Date: 08-2023
Publisher: Cold Spring Harbor Laboratory
Date: 24-10-2021
DOI: 10.1101/2021.10.20.21265265
Abstract: Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of educational intervention program on breast cancer knowledge and practice of breast self-examination among young female students of a university in Bangladesh. A quasi-experimental one group (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students in common room setting in dormitories after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar’s tests and paired s led t -tests were performed to investigate the differences between pre- and post-test stages. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational session. The significant differences were measures in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99±1.05 vs. 6.35±1.15 p .001), risk factors (3.35±1.19 vs. 7.56±1.04 p .001), treatment (1.79±0.90 vs. 4.63±0.84 p .001), prevention (3.82±1.32 vs. 7.14±1.03 p .001), screening of breast cancer (1.82±0.55 vs. 3.98±0.71 p .001) and process of breast self-examination (1.57±1.86 vs. 3.94±0.93 p .001). Likewise, a significate percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8% p .001) This study findings confirm that the study population had poor awareness and knowledge at baseline that was improved significantly after educational session. A nationwide reach-out with community-based interventions is recommended for female population in both rural and urban areas.
Publisher: MDPI AG
Date: 29-01-2020
Abstract: Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at in idual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.
Publisher: Springer Science and Business Media LLC
Date: 31-05-2016
Publisher: Walter de Gruyter GmbH
Date: 12-11-2018
Abstract: Teachers perception of child mental health problems and their attitude to school-based mental health services helps in designing early intervention strategies aimed at promoting the service. However, little is known in this regard among primary school teachers in Ethiopia. Therefore, this study assessed perceptions and attitude of primary school teachers to child mental health problem and school-based mental health programs in Jimma town, southwest Ethiopia in 2013. A cross-sectional study design was implemented among 568 primary school teachers in Jimma town, from 1 to 30 October 2013. Perceptions and attitude of teachers to children with mental health problems and school mental health related information were assessed using a structured self- administered questionnaire. About 40% of teachers recognized the list of psychopathology items presented to them as child mental health problems while 54.4% of them rated child mental health problem as severe. Externalizing behaviors were perceived as the most severe problems. Teaching experience and teaching in public schools were significantly associated with the perception of severe type of child mental health problems. About 95% of teachers acknowledged that school-based mental health programs are important but limited availability was reported. Despite the high problem severity ratings, teachers’ perception of the psychopathology as a mental health problem in children was low. There was also a favorable attitude on the importance and the need of school-based child mental health programs. Thus, creating mental health awareness for teachers and establishing school mental health services to intervene in child mental health problem is crucial.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2020
DOI: 10.1038/S41591-020-0807-6
Abstract: A double burden of malnutrition occurs when in iduals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of % in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
Publisher: Pera Publishing
Date: 2014
Publisher: Elsevier BV
Date: 10-2020
Publisher: Hindawi Limited
Date: 30-11-2021
DOI: 10.1155/2021/4443117
Abstract: Background. Ectopic pregnancy is a neglected and challenging gynecologic problem in developing countries including Ethiopia. Objective. The present study is aimed at assessing the prevalence of ectopic pregnancy, its management outcomes, and factors associated with management outcomes in Tigray, North Ethiopia. Methods. We employed a four-year retrospective cross-sectional study from September 2015 to August 2019. We extracted data about all pregnant mothers who were admitted and managed for EPs in Axum, Tigray. Ectopic pregnancy and its outcomes (favorable and unfavorable) were the dependent variables, and age, residence, ethnicity, religion, parity, history of abortion, history of EP, pelvic infections, history of surgical procedures, and use contraceptives were the independent variables. We employed descriptive statistics and bivariate and multivariate logistic regression analyses using SPSS. Ethical clearance was obtained from Axum University, Tigray, Ethiopia. Results. The overall prevalence of ectopic pregnancy was 0.52% of total deliveries, which equates to 1 : 193 deliveries. Surgery for ectopic pregnancy accounts for 7.6% of all gynecological surgeries. Most participants were in the age group 26–30 years and lived in rural areas. Among the different EP implantation sites, most cases (92.4%) occurred in the fallopian tube, followed by 5.1% in the ovary and 2.5% in abdominal EPs. Surgical management (laparotomy) was undertaken for all the 79 women diagnosed with EPs, including laparotomy (100%), salpingo-oophorectomy (17.7%), salpingectomy (73.9%), oophorectomy (3.4%), cornual resection (2.5%), and removal of concepts tissue 2.5. The record reports that intraoperative procedure was correctly managed for 47 (59.5%) women but the condition of EP procedure was ruptured for about two-thirds (63.3%) of the women. Thirty (38%) patients had developed some complications after surgery including anemia ( hemoglobin 10.5 ) ( n = 12 ), fever ( n = 10 ), wound infection ( n = 2 ), and pneumonia ( n = 2 ). Women who were from urban ( AOR = 11.2 , 95% CI: 2.65-47.2) and who had normal hemoglobin at presentation ( AOR = 9.94 , 95% CI: 2.03-48.7) were associated with favorable maternal outcomes. Conclusions. More than one-third of women with ectopic pregnancies had an unfavorable maternal outcome, which was higher among rural residents and anemic mothers. Women living in rural areas and anemia during pregnancy should seek special attention in the management of EPs. We also recommend improving the data management of hospitals in Ethiopia.
Publisher: Public Library of Science (PLoS)
Date: 20-01-2017
Publisher: Elsevier BV
Date: 08-2023
Publisher: Wiley
Date: 05-08-2020
DOI: 10.1111/HEX.13115
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Frontiers Media SA
Date: 26-02-2021
DOI: 10.3389/FPUBH.2021.648009
Abstract: Background: In Australia, telehealth services were used as an alternative method of health care delivery during the COVID-19 pandemic. Through a realist analysis of a survey of health professionals, we have sought to identify the underlying mechanisms that have assisted Australian health services adapt to the physical separation between clinicians and patients. Methods: Using a critical realist ontology and epistemology, we undertook an online survey of health professionals subscribing to the Australian Telehealth Society newsletter. The survey had close- and open-ended questions, constructed to identify contextual changes in the operating environment for telehealth services, and assess the mechanisms which had contributed to these changes. We applied descriptive and McNemar's Chi-square analysis for the close-ended component of the survey, and a reflexive thematic analysis approach for the open-ended questions which were framed within the activity based funding system which had previously limited telehealth services to regional Australia. Results: Of the 91 respondents most (73%) reported a higher volume of telephone-based care since COVID and an increase in use of video consultations (60% of respondents). Respondents felt that the move to provide care using telehealth services had been a “forced adoption” where clinicians began to use telehealth services (often for the first time) to maintain health care. Respondents noted significant changes in managerial and medical culture which supported the legitimisation of telehealth services as a mode of access to care. The support of leaders and the use personal and organisational networks to facilitate the operation of telehealth service were felt to be particularly valuable. Access to, and reliability of, the technology were considered extremely important for services. Respondents also welcomed the increased availability of more human and financial resources. Conclusions: During the pandemic, mechanisms that legitimise practise, build confidence, support relationships and supply resources have fostered the use of telehealth. This ongoing interaction between telehealth services, contexts and mechanisms is complex. The adoption of telehealth access to enable physically separated care, may mark a “new context ” or it could be that once the pandemic passes, previous policies and practises will re-assert themselves and curb support for telehealth-enabled care.
Publisher: Public Library of Science (PLoS)
Date: 18-06-2018
Publisher: BMJ
Date: 08-2018
DOI: 10.1136/BMJOPEN-2017-017413
Abstract: To assess the prevalence, trend and associated factors for immunological failure (IF), and the magnitude of antiretroviral therapy (ART) shift among adults infected with HIV in Southwest Ethiopia. A retrospective cohort study was undertaken using the data from ART clinic at Jimma University Teaching Hospital from 21 June 2003 to 15 March 2015. Retrospective analysis of 4900 HIV-infected adult patient records dating from June 2003 to March 2015 was conducted. The primary outcome was IF defined when cluster for differentiation 4 (CD4) count falls to the baseline (or below) or persistent CD4 levels below 100 cells/mm 3 after 6 months of ART treatment. The analyses included descriptive and inferential statistics. 546 (19.5%) adults had developed clinical failure (CF), 775 (19.7%) adults had developed IF and 1231 (25.1%) had developed either CF or IF or both. The prevalence of IF was consistently high throughout the decade. Age 25 to ≤50 years adjusted OR (AOR 1.5, 9% CI 1.2 to 2.4), being female (AOR 1.8, 95% CI 1.3 to 1.9), late presenter for HIV care (AOR 2.2, 95% CI 1.6 to 2.7) and having baseline CD4 count below 200 cells/mm 3 (AOR 5.5, 95% CI 4.1 to 7.4), and having no history of HIV testing before diagnosis (AOR 0.7, 95% CI 0.5 to 0.9) were the predictors for IF. Only 29 (0.9%) adults infected with HIV were shifted to second-line ART regimen. The magnitude of CF or IF or both was found significant and consistently high throughout the calendar year although ART shift was found minimal. HIV-infected adult patients with IF were early age adults, females, late presenters for HIV care, and those who had low baseline CD4 counts and history of HIV testing before diagnosis.
Publisher: Frontiers Media SA
Date: 10-08-2021
DOI: 10.3389/FPUBH.2021.647315
Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has caused increasing challenges for healthcare professionals globally. However, there is a dearth of information about these challenges in many developing countries, including Bangladesh. This study aims to explore the challenges faced by healthcare professionals (doctors and nurses) during COVID-19 in Bangladesh. Methods: We conducted qualitative research among healthcare professionals of different hospitals and clinics in Khulna and Dhaka city of Bangladesh from May 2020 to August 2020. We conducted 15 in-depth telephone interviews using a snowball s ling technique. We used an in-depth interview guide as data were collected, audiotaped, and transcribed. The data were analyzed both manually and using QDA Miner software as we used thematic analysis for this study. Results: Seven themes emerged from the study. Participants experienced higher workload, psychological distress, shortage of quality personal protective equipment (PPE), social exclusion/stigmatization, lack of incentives, absence of coordination, and proper management during their service. These healthcare professionals faced difficulty coping with these challenges due to situational and organizational factors. They reported of faith in God and mutual support to be the keys to adapt to adversities. Adequate support to address the difficulties faced by healthcare professionals is necessary for an overall improved health outcome during the pandemic. Conclusion: The findings highlight the common challenges faced by healthcare professionals during the COVID-19 outbreak. This implies the need to support adequate safety kits, protocols, and support for both physical and mental health of the healthcare professionals.
Publisher: Elsevier BV
Date: 12-2019
Publisher: OMICS Publishing Group
Date: 2015
Publisher: MDPI AG
Date: 30-11-2022
Abstract: Fistula is roaring in the ongoing war on Tigray. The potential risk factors for fistula in the conflict zone include obstructed labour due to limited or absent maternal care services, a correlation between malnutrition-stunted growth and birth difficulties and trauma, and sexually transmitted infections (STIs) due to conflict-related sexual violence. As a call to action to mitigate the unimaginable suffering that women and girls are facing in the region, concerted international effort is needed to provide treatment, rehabilitation, and re-integration secure peace and stability rebuild the health-care system and ensure perpetrators are held accountable.
Publisher: Springer Science and Business Media LLC
Date: 12-02-2016
Publisher: MDPI AG
Date: 24-08-2021
Abstract: International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball s ling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.
Publisher: Public Library of Science (PLoS)
Date: 16-06-2017
Publisher: Springer Science and Business Media LLC
Date: 22-02-2022
DOI: 10.1186/S12885-022-09311-Y
Abstract: Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar’s tests and paired s led t -tests were performed to investigate the differences between pre- and post-test stages. A total of 400 female university students aged 18-26 years were included in the s le. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15 p 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04 p 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84 p 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03 p 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71 p 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93 p 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8% p 0.001). Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.
Publisher: Frontiers Media SA
Date: 10-03-2021
DOI: 10.3389/FPUBH.2021.623468
Abstract: The present commentary explored the intersecting nature of the COVID-19 and HIV pandemics to identify a shared research agenda using a syndemic approach. The research agenda posits the following questions. Questions around HIV infection, transmission, and diagnosis include: (i) molecular, genetic, clinical, and environmental assessments of COVID-19 in people living with HIV, (ii) alternative options for facility-based HIV testing services such as self- and home-based HIV testing, and (iii) COVID-19 related sexual violence and mental health on HIV transmission and early diagnosis. These and related questions could be assessed using Biopsychosocial and socio-ecological models. Questions around HIV treatment include: (i) the effect of COVID-19 on HIV treatment services, (ii) alternative options for facility-based treatment provision such as community-based antiretroviral therapy groups, and (iii) equitable distribution of treatment and vaccines for COVID-19, if successful. Bickman's logic model and the social determinants of health framework could guide these issues. The impact of stigma, the role of leveraging lessons on sustained intra-behavioral change, the role of medical mistrust and conspiracy beliefs, and the role of digital health on integrated management of HIV care and spectrum of care of COVID-19 need assessment using several frameworks including Goffman's stigma framework, Luhmann's Trust theory, and Gidden's theory of structuration. In conclusion, the potential research agenda of this commentary encompasses a variety of research fields and disciplinary areas—clinicians, laboratory scientists, public health practitioners, health economists, and psychologists—, and suggests several theoretical frameworks to guide examination of complex issues comprehensively.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2014
Publisher: Public Library of Science (PLoS)
Date: 13-09-2016
Publisher: Cold Spring Harbor Laboratory
Date: 26-10-2021
DOI: 10.1101/2021.10.20.21265262
Abstract: Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were s led from female dormitories at the university from January to April 2020. Proportionate stratified random s ling was conducted to calculate the study s le from each dormitory. A pre-tested, semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consists of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics, and data were analyzed using SPSS. Participants aged between 18-26 years and comprised university students of 1 st year (20%), 2 nd year (24%), 3 rd year (22%), 4 th year (21%) and Master’s (14.%). 18% of them had reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher ( p .001) among Master’s students and students with family members who have breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice towards breast self-examination was significantly higher ( p .001) among participants who reported having family member of breast cancer. It is noted that the total knowledge score about breast cancer and practice towards breast self-examination are significantly correlated with each other ( r = 0.54 p .001). About 33% participants had reported that ‘lack of knowledge as the main barrier to practicing breast self-examination followed by ‘I do not have the symptoms’ (22%), and shyness/ uncomfortable feelings (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. This implies the need of promotion and implementation of educational interventions programs that are social and culturally appropriate and suitable for specific age groups.
Publisher: Public Library of Science (PLoS)
Date: 14-09-2016
Publisher: Informa UK Limited
Date: 08-2016
DOI: 10.2147/OPTH.S107619
Publisher: Elsevier BV
Date: 10-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2013
Publisher: Elsevier BV
Date: 12-2022
Publisher: Springer Science and Business Media LLC
Date: 08-01-2021
DOI: 10.1186/S12916-020-01876-4
Abstract: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. We performed an ecological study using VR data ranging from 2000 to 2017, dependent on in idual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Our subnational estimates of HIV mortality revealed significant spatial variation and erging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
Publisher: Springer Science and Business Media LLC
Date: 09-02-2016
Publisher: Elsevier BV
Date: 05-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2016
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/516369
Abstract: Background . Health related quality of life (HRQOL) is an important outcome measure for highly active antiretroviral treatment program. In Ethiopia, studies revealed that there are improved qualities of life among adults living with the viruses taking antiretroviral therapy but there is no explicit data showing gender differences in health related quality of life. Aim . To assess gender differences in HRQOL and its associated factors among people living with HIV and on highly active antiretroviral therapy in public health institutions of Mekelle town, Northern Ethiopia. Methods . A comparative cross-sectional study was conducted among 494 adult people living with HIV taking ART services. Quality of life was measured using WHOQOL-HIV BREF. Result . There was a statistically significant gender difference ( P 0.05 ) in HRQOL among PLHIV on HAART. Females had low score in all HRQOL domains. High perceived stigma was strongly associated with poor psychological quality of domain among both female and male groups with [ AOR = 2.89 ( 1.69,4.96 ) ] and [ AOR = 2.5 ( 1.4,4.4 ) ] , respectively. Conclusion . There was statistically significant gender difference in all quality of life domains. Public health interventions to improve HRQOL of PLHIV should take in to account the physical, psychological, social, environmental, and spiritual health of PLHIV during treatment, care, and support.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Informa UK Limited
Date: 06-2021
DOI: 10.2147/HIV.S310419
Publisher: African Journals Online (AJOL)
Date: 14-07-2016
DOI: 10.4314/EJHS.V26I4.5
Abstract: Skill mix of health professionals, staff acquisition and turnover rate are among the major challenges for the delivery of quality health care. This study assessed the health workforce acquisition, retention, turnover rate and their intention to leave. A cross-sectional survey with quantitative and qualitative data collection methods was conducted in Jimma Zone health institutions. Five years records (September 2009-August 2014) were reviewed to determine the turnover rate. A total of 367 health professionals were included for the quantitative study. For the qualitaive study, all available and relevant health managers and administrative records in the selected health institutions were included. Descriptive and inferential analyses were done for the quantitative study. Thematic analysis was used for the qualitative component. A total of 367 health workers were incorporated for the quantitative study making a response rate of 87%. The overall health workers' satisfaction was neutral (mean 3.3). In five years period, 45.9% staffs had left for a cause 59.4% health professionals intended to leave. Being male (AOR =1.6, 95%CI: 1.001-2.5), not knowing their overall satisfaction (AOR=0.5, 95%CI: 0.2-0.8), below mean score of institutional satisfaction (AOR =1.7, 95%CI: 1.06-2.7) and below mean score of organizational satisfaction (AOR=1.8, 95%CI: 1.08-2.8) were independent predictors for intention to leave. The overall health workers' satisfaction was marginally neutral. A considerable number of staffs had left, and more than half of the current staffs had an intention to leave. Thus, it is recommended that the responsible authorities should design strategies to improve the situation.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2020
DOI: 10.1186/S12939-020-01315-Z
Abstract: While in general a country’s life expectancy increases with national income, some countries “punch above their weight”, while some “punch below their weight” – achieving higher or lower life expectancy than would be predicted by their per capita income. Discovering which conditions or policies contribute to this outcome is critical to improving population health globally. We conducted a mixed-method study which included: analysis of life expectancy relative to income for all countries an expert opinion study and scoping reviews of literature and data to examine factors that may impact on life expectancy relative to income in three countries: Ethiopia, Brazil, and the United States. Punching above or below weight status was calculated using life expectancy at birth and gross domestic product per capita for 2014–2018. The scoping reviews covered the political context and history, social determinants of health, civil society, and political participation in each country. Possible drivers identified for Ethiopia’s extra 3 years life expectancy included community-based health strategies, improving access to safe water, female education and gender empowerment, and the rise of civil society organisations. Brazil punched above its weight by 2 years. Possible drivers identified included socio-political and economic improvements, reduced inequality, female education, health care coverage, civil society, and political participation. The United States’ neoliberal economics and limited social security, market-based healthcare, limited public health regulation, weak social safety net, significant increases in income inequality and lower levels of political participation may have contributed to the country punching 2.9 years below weight. The review highlighted potential structural determinants driving differential performance in population health outcomes cross-nationally. These included greater equity, a more inclusive welfare system, high political participation, strong civil society and access to employment, housing, safe water, a clean environment, and education. We recommend research comparing more countries, and also to examine the processes driving within-country inequities.
Publisher: BMJ
Date: 2022
DOI: 10.1136/BMJOPEN-2020-047205
Abstract: Although some studies have identified various challenges affecting nutritional programmes to effectively tackle undernutrition among people living with HIV, evidence about the characteristics and impacts of these programmes on weight-related nutritional outcomes varies based on country contexts, specific programme goals and the implementation processes. This systematic review sought to synthesise evidence on the characteristics and impact of nutritional programmes on weight-related nutritional outcomes of people living with HIV in sub-Saharan Africa. Systematic review. We searched for primary studies published in the following databases: Web of Science, Medline, Scopus, ScienceDirect, ProQuest and Google Scholar, supplemented by checking reference lists of included papers. Studies published from 2005 to 10 July 2020 and reporting on the weight-related nutritional outcomes of undernourished people enrolled in nutritional programmes in HIV care in sub-Saharan Africa were included. Data were extracted using a data extraction proforma. Weight-related nutritional outcomes of people living with HIV before and after enrolment in a nutritional programme were compared and narratively synthesised. Sixteen studies assessing the impact of nutritional programmes in HIV care on weight-related nutritional outcomes were included. Of these, 13 examined nutritional programmes implemented in health facilities and the remaining three were delivered outside of health facilities. Nutritional recovery (defined differently in the studies) ranged from 13.1% to 67.9%. Overall programme failure rate, which included default after enrolment in a nutritional programme or non-response, ranged from 37.6% to 48.0%. More specifically, non-response to a nutritional programme ranged from 21.0% to 67.4% and default from the programme ranged from 19.0% to 70.6%. Key sociodemographic, clinical and nutritional characteristics that affect nutritional recovery, non-response and default were also identified. Nutritional programmes in HIV care have led to some improvements in weight-related nutritional outcomes among people living with HIV. However, the programmes were characterised by a high magnitude of default and non-response. To improve desired weight-related nutritional outcomes of people living with HIV, a holistic approach that addresses longer-term determinants of undernutrition is needed. CRD42020196827.
Publisher: BMJ Publishing Group Ltd
Date: 07-2017
Publisher: BMJ Publishing Group Ltd
Date: 07-2017
Publisher: Elsevier BV
Date: 09-2015
Publisher: BMJ Publishing Group Ltd
Date: 07-2017
Publisher: Springer Science and Business Media LLC
Date: 02-07-2020
DOI: 10.1038/S41591-020-0972-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-044618
Abstract: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and in iduals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2023
DOI: 10.1186/S12909-023-04065-Y
Abstract: Health, disability, and community services are increasingly transitioning from government-led to participant-led funding models, which intend to increase choice and control for service users. Allied health practitioners, who provide many frontline services within the resultant marketised environment, must adjust their knowledge and skills to meet participants’ expectations. However, future workforce strategies to address allied health student capabilities to provide these services have received limited attention. This study explored shifting understandings and practices related to allied health student placements during the implementation of a participant-led funding model within the Australian disability sector: the National Disability Insurance Scheme (NDIS). Data for this study came from a two-year disability workforce project exploring allied health placements. Service providers, participants, university representatives, disability advocates and students participated in 48 interviews and two focus groups to provide perspectives on allied health workforce and student placements. The findings result from secondary deductive analysis undertaken following project completion that used Gidden’s (1984) Structuration Theory as a conceptual lens to identify structures and actions related to the marketised service environment that influenced how allied health student placements were undertaken. The findings were organised using two Structuration concepts: knowledgeability, and duality of structure. These described how service providers, supervisors and students understood, legitimised and prioritised placement activities, and how these structures influenced and were influenced by the actions of stakeholders across NDIS settings, contexts and time. Initially, existing placement structures were not compatible with new structures emerging in the disrupted NDIS service environment. However, over time, and responding to new knowledgeability of service providers, supervisors and students, placement structures were identified, monitored and adjusted to reflect perspectives of all stakeholders. Participant-led funding invoked structural changes in disability service provision that transformed how stakeholders understood placements and the role of students in service provision. Whilst there were new opportunities for placement, tensions were identified in how learning activities can be enacted within a marketised system in which resources are aligned to participant needs, and structures for workforce development and learning activities are less visible. Further conceptualisation of how student learning and workforce development activities can fit with contemporary funding models is necessary to meet participant, service provider and student needs.
Publisher: MDPI AG
Date: 21-09-2020
Abstract: There is little up-to-date evidence about changes in quality of life following treatment for acute coronary syndrome (ACS) patients. The main aim of this review was to assess the changes in QoL in ACS patients after treatment. We undertook a systematic review and meta-analysis of quantitative studies. The search included studies that described the change of QoL of ACS patients after receiving treatment options such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical therapy (MT). We synthesized findings using content analysis and pooled the estimates using meta-analysis. We used the PRISMA guidelines to select and appraise the studies and report the findings. Twenty-nine (29) articles were included in the review. We found a significant improvement of QoL in ACS patients after receiving treatment. Particularly, the meta-analytic association found that the mean QoL of patients diagnosed with ACS was higher after receiving treatment compared to baseline (overall pooled mean difference = 31.88 95% CI = 31.64–52.11, I2 = 98) with patients on PCI having slightly lower QoL gains (pooled mean difference = 30.22 95% CI = 29.9–30.53, I2 = 0%) compared to those on CABG (pooled mean difference = 34.01 95% CI = 33.66–34.37, I2 = 0%). The review confirmed that QoL of ACS patients improved after receiving treatment therapies although varied by the treatment options and patients’ preferences. This suggests the need to perform further study on the QoL, patient preferences and physicians’ decision to prescription of treatment options.
Location: Ethiopia
No related grants have been discovered for Hailay Gesesew.