ORCID Profile
0000-0002-5792-7785
Current Organisations
Torrens University Australia
,
University of Queensland
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Publisher: Springer Science and Business Media LLC
Date: 02-11-2016
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: 25-07-2022
DOI: 10.1371/JOURNAL.PONE.0264462
Abstract: Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as barriers to access to HIV care services among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals. They were recruited using the snowball s ling technique. The study information sheets were initially posted on information boards in healthcare facilities. Potential participants who contacted to confirm their participation were recruited for an interview and then asked for help to distribute the information sheets to their eligible colleagues who might be willing to participate. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional medicines, a well-known cultural practice in Belu, was a barrier to access to HIV care services among PLHIV. The influence of family in determining the use of traditional medicines for HIV treatment, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of relatives, neighbours, and friends, were also significant barriers to PLHIV’s access to HIV care services. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family, and community members to increase their knowledge of the service, ART and its function, and to support and improve access to HIV care services especially ART by PLHIV.
Publisher: Springer Science and Business Media LLC
Date: 17-03-2020
DOI: 10.1186/S12884-020-02859-2
Abstract: Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can enhance an understanding of the mechanisms underlying relationships between stressors and stress outcomes. This study used the stress process model framework to explore the causal mechanisms underlying antenatal depression in Gondar, Ethiopia. Questionnaires, using an Online Data collection Kit (ODK) tool were administered face-to-face in 916 pregnant women in their second and third trimesters. Pregnant women were included from six randomly selected urban districts in Gondar, Ethiopia during June and August 2018. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depression. A Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effect of stressors and mediators of antenatal depression. Sixty-three participants (6.9%) reported symptoms of depression. Of these, 16 (4.7%) and 47 (8.1%) were in their second and third trimesters, respectively. The SEM demonstrated several direct effects on antenatal depression scores including unplanned pregnancy (standardized β = 0.15), having a history of common mental health disorder (standardized β = 0.18) and fear of giving birth to the current pregnancy (standardized β = 0.29), all of which were associated with a higher depression score. Adequate food access for the last 3 months (standardized β = − 0.11) was associated with decreased depression score. Social support (β = − 0.21), marital agreement (β = − 0.28), and partner support (β = −.18) appeared to partially mediate the link between the identified stressors and the risk of antenatal depression. Both direct and indirect effects contributed to higher antenatal depression score in Ethiopian women. The three psychosocial resources namely marital agreement, social and partner support, mediated reduced antenatal depression scores. Early screening of antenatal depression and enhancing the three psychosocial resources would help to improve maternal resilience.
Publisher: Public Library of Science (PLoS)
Date: 06-05-2021
DOI: 10.1371/JOURNAL.PONE.0251274
Abstract: Caring for children with a disability can cause a range of psychological and socioeconomic challenges for parents and caregivers, such as anxiety, depression, inability to find affordable and appropriate childcare, loss of income and expenses related to disability specific treatment. As part of a study exploring the impacts of childhood disability on mothers or female caregivers and families, and the copy strategies they used, this paper describes strategies employed by mothers or female caregivers to cope with challenges associated with childhood disability within their family in Belu district, Indonesia. A qualitative approach using one-on-one in-depth interviews was used to collect data from participants (n = 22) who were recruited using a combination of purposive and snowball s ling techniques. Interviews were recorded, transcribed verbatim and imported to NVivo 12 for analysis. A qualitative framework analysis was used to guide data analysis. The conceptual framework of coping strategies guided the conceptualisation and discussion of the findings. The findings showed that active psychological coping strategies, including cognitive or acceptance strategies, knowledge of both health condition and socio-academic related development of children with a disability, and family relationship and support, were used by the participants to cope with psychological challenges facing them. Self-reliance and religious/spiritual coping strategies were also utilised. Sociocultural strategies, such as social withdrawal or disengagement, professional support and culture-based support, were used by the participants to cope with social impacts, stigma, and discrimination associated with childhood disability. Participants also reported using financial strategies such as selling of family assets to cope with the economic challenges. The findings indicate the need for programs and interventions that address the needs of mothers and female caregivers and their families, to assist with effectively managing the significant challenges they face when caring for a child with a disability. Further studies are needed, with a larger number of participants and the inclusion of fathers or male caregivers, in order to better understand the broader coping experience of childhood disability impacts within families.
Publisher: MDPI AG
Date: 09-04-2021
Abstract: Background: Emigration to Australia by people from Africa has grown steadily in the past two decades, with skilled migration an increasingly significant component of migration streams. Challenges to resettlement in Australia by African migrants have been identified, including difficulties securing employment, experiences of racism, discrimination and social isolation. These challenges can negatively impact resettlement outcomes, including health and wellbeing. There has been limited research that has examined protective and resilience factors that help highly skilled African migrants mitigate the aforementioned challenges in Australia. This paper discusses how in idual and community resilience factors supported successful resettlement Africans in Australia. The paper is contextualised within a larger study which sought to investigate how belonging and identity inform Afrodiasporic experiences of Africans in Australia. Methods: A qualitative inquiry was conducted with twenty-seven (n = 27) skilled African migrants based in South Australia, using face-to-face semi-structured interviews. Participants were not directly questioned about ‘resilience,’ but were encouraged to reflect critically on how they navigated the transition to living in Australia, and to identify factors that facilitated a successful resettlement. Results: The study findings revealed a mixture of settlement experiences for participants. Resettlement challenges were observed as barriers to fully meeting expectations of emigration. However, there were significant protective factors reported that supported resilience, including participants’ capacities for excellence and willingness to work hard the social capital vested in community and family support networks and African religious and cultural values and traditions. Many participants emphasised their pride in their contributions to Australian society as well as their desire to contribute to changing narratives of what it means to be African in Australia. Conclusions: The findings demonstrate that despite challenges, skilled African migrants’ resilience, ambition and determination were significant enablers to a healthy resettlement in Australia, contributing effectively to social, economic and cultural expectations, and subsequently meeting most of their own migration intentions. These findings suggest that resilience factors identified in the study are key elements of integration.
Publisher: MDPI AG
Date: 30-05-2022
Abstract: Human Immunodeficiency Virus (HIV) infection adds a significant burden to women in Low- and Middle-Income Countries (LMICs), often leading to severe detrimental impact, not only on themselves, but also on their families and communities. Given that more than half of all people living with HIV globally are females (53%), this review seeks to understand the psychological and social impact of HIV infection on Women Living with HIV (WLHIV) and their families in LMICs in Asia, and the interrelationships between one impact and another. A systematic review was conducted to find literature using the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Research articles included in this review were selected based on the following inclusion criteria: conducted in LMICs in Asia, published in English language between 1 January 2004 and 31 December 2021, had full text available, involved WLHIV (married and unmarried) and explored the psychological and social impacts of HIV on these women and their families. Critical appraisal tools developed by Joanna Briggs Institute (JBI) were used to assess the methodological quality of the studies, and thematic narrative synthesis was used to analyse the findings. A total of 17 articles met the inclusion criteria. The review showed that HIV has a range of negative psychological consequences on WLHIV, such as stress, fear, worry, anxiety and depression, as well as social impacts on the women and their families, including stigma, discrimination and family separation. The findings indicate the need for targeted interventions—specific to WLHIV—that address the psychological challenges, stigma and discrimination these women and their families face. These interventions should also incorporate education and sustainable support structures for WLHIV and their families.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Science and Education Publishing Co., Ltd.
Date: 31-01-2013
DOI: 10.12691/AJIDM-1-1-2
Publisher: Rural and Remote Health
Date: 19-11-2020
DOI: 10.22605/RRH5694
Publisher: MDPI AG
Date: 03-11-2021
Abstract: Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball s ling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.
Publisher: Emerald
Date: 15-06-2012
DOI: 10.1108/17479891211250021
Abstract: The purpose of this paper is to describe the application of empowerment and the role that it plays in fostering community participation, community integration and in enabling a healthy re‐settlement of culturally and linguistically erse migrants who have recently arrived in Australia from Sub Saharan Africa. The paper's approach is a discussion expressing the views of authors supported by the relevant literature drawn from a wide range of sources on migration, settlement, health, social, environment, cultural and public health issues. The African community and its peak organisation, the African Communities Council of South Australia is presented and various empowerment strategies used by the council are discussed as a healthy model for empowering new settlers in the new environment. The first part of the paper describes the migration of African migrants in South Australia and sets the scenario describing the current state of these migrants including opportunities and challenges they face in the new environment. The second part describes theories and contexts of community empowerment, relationship between community empowerment and a healthy settlement and the relevance and implications of community empowerment. The third part draws the above context and the empowerment strategy is specifically related to the African Community in South Australia. The empowerment strategy in this case represents a wide range of interventions aimed to equip new African migrants to a successful and a healthy resettlement and integration in South Australia. By addressing a wide range of settlement challenges and issues, the strategy employs concepts of empowerment that have been used in public health in general, health promotion, health education, communications, community engagement and community development. The paper highlights challenges and opportunities for new migrants in the new environment and argues that community empowerment is an important enabling tool for a healthy settlement, particularly for people with refugee backgrounds. The paper also acknowledges that the community development approach has assisted the target group and has improved their ability to overcome challenges associated with settlement through capacity building, social capital and community connectivity.
Publisher: Medknow
Date: 2015
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: MDPI AG
Date: 04-01-2023
Abstract: Poor household dietary ersity has been linked to malnutrition in in iduals, households, and cumulatively in populations. High rates of malnutrition among Khmer ethnic children aged five years and younger have been reported in Tri Ton district, Vietnam. This paper aims to further investigate household dietary ersity and associated factors among Khmer ethnic minority populations in Vietnam. A cross sectional study was conducted from October 2018 to April 2019 in Tri Ton District, An Giang Province. By employing a multistage s ling technique, a total of 402 (99.8% response rate) participants were interviewed to measure household dietary ersity using a structured and validated questionnaire developed by FAO. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with household dietary ersity. The results showed that the prevalence of low, medium and high dietary ersity scores were 21.4%, 70.4% and 8.2%, respectively. Male-headed households, literacy level, household income, exposure to mass media on nutrition and health information, and frequency of eating were positively associated with household dietary ersity (p 0.05). However, owning a vegetable and rice farm was not statistically related to households’ dietary ersification. The paper concludes that the magnitude of household ersified dietary intakes was essentially low to medium in participants’ households. These findings have provided evidence to inform the development of the National Nutrition Strategy—2021–2030 in Vietnam, to be revised in 2045. This national strategy proposes appropriate interventions, programs and policies to improve socioeconomic status in ethnic groups and in mountainous areas to enhance populations’ health and well-being including controlling childhood malnutrition. In order to improve population health and wellbeing in Tri Ton District, further actions to address effective dietary practices including strengthening nutrition and health communication about the need to improve household dietary ersity to high levels are recommended.
Publisher: Oxford University Press (OUP)
Date: 12-2001
Abstract: Iron deficiency anaemia is highly endemic in rural areas of Tanzania and in many developing countries. Its prevention among school children requires greater dissemination of knowledge of anaemia among children, teachers, parents and the general community. Associated improvements in the hygienic status of domestic and school environments are also often required. One-hundred-and-thirty-one anaemic children, 90 parents and 76 teachers were interviewed to ascertain their understanding of anaemia. Most children and parents had little knowledge of the symptoms, causes and prevention of anaemia. In addition to their iron-deficient diets, more than half of the children went to school without something to eat at breakfast and during school hours. However, parents and teachers were willing to work together to provide meals for the children. Poor sanitation in the children's homes and in schools was a little recognized factor which could pose a serious risk of anaemia. In addition, inadequate sanitation facilities and poor quality of physical environment prevailed both in the children's homes and in schools. The findings suggest the need for the establishment of a health-promoting schools network to provide a comprehensive framework for health promotion in schools as well as in homes in Tanzania and in other developing countries. Schools can be an ideal setting to positively influence a community's health status. Partnerships among teachers, parents and the wider community are required to identify, prioritize and ameliorate health problems.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2010
DOI: 10.1007/S00284-010-9820-1
Abstract: In South Australia serotyping and phage typing are employed for routine Salmonella surveillance. Molecular techniques such as Multiple-locus variable number tandem repeat analysis (MLVA) are increasingly utilized to aid outbreak investigations. During 2007 three Salmonella enterica serovar Typhimurium outbreaks involving phage types DT9, DT29, and DT44 were investigated. Human, food and environmental isolates were also typed by MLVA. In the DT9 outbreak cluster MLVA demonstrated distinct groupings that corresponded to epidemiological differences in time, place, and descriptive information on potential transmission mechanisms. In contrast, the human and food isolates of both the DT29 and DT44 clusters had identical MLVA profiles for all but one case. These data correlated with the epidemiology suggesting that these isolates were closely related and probably a single agent. These findings illustrate that phage typing and MLVA can provide different but complementary information for epidemiological investigations of Salmonella outbreaks.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
Publisher: Cold Spring Harbor Laboratory
Date: 11-05-2022
DOI: 10.1101/2022.05.09.22274877
Abstract: Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among HIV-positive mothers who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in HIV-positive mothers with CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (n=23) who were recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnosis stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemma in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support HIV-positive mothers and their CLHIV. Future large-scale studies involving HIV-positive mothers with CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
Publisher: MDPI AG
Date: 05-02-2021
Abstract: This paper was part of a large study that explored suicide among African youths in South Australia. The paper reports perspectives about alcohol and other drugs (AOD) use and mental health among African migrant and refugee youths in South Australia. The study employed a qualitative inquiry, conducting 23 in idual interviews and one focus group discussion with eight participants. An acculturative stress model informed data analysis, interpretation and the discussion of the findings that form the current paper. African migrant and refugee youths revealed challenging stressors, including related to cultural, socioeconomic, living conditions, and pre- and post-migration factors that contributed to mental health problems and the use of AOD in their new country. The traumatic loss of family members and social disruption experienced in their countries of origin were expressed as part of factors leading to migration to Australia. While in Australia, African migrant and refugee youths experienced substantial stressors related to inadequate socioeconomic and cultural support, discrimination, poverty, and unemployment. Participants believed that differences in cultural perspectives about AOD use that existed in Africa and Australia also shaped the experiences of social stressors. Additionally, participants believed that these cultural differences and the identified stressors determined AOD use and mental health problems. The findings highlight the need to understand these social and cultural contexts to improve mental health services and help reduce the use of AOD, which, when problematic, can influence the health and integration experiences of these populations.
Publisher: Emerald
Date: 10-2003
DOI: 10.1108/09654280310499073
Abstract: Describes the development of a management plan for prevention of falls and reduction of falls injuries for older and frail people in the community, nursing homes and acute care settings in Whyalla, South Australia. Falls among the elderly have been described as the most common causes of injury and hospital admissions for trauma in Australia. Prevention and control of injury is one of the five National Health Policy Priority Areas in Australia. As a response to the national initiative, and a felt need, the South Australian Centre for Rural and Remote Health was commissioned by the local health service to develop a plan that would address falls prevention in the older people in Whyalla. The plan was developed in consultation with the key stakeholders. An evidence‐based plan that uses messages from the scientific literature but modified to account for stakeholders’ feedback on what is feasible in practice, is considered a good ex le of best practice. Furthermore, the alignment of literature review alongside stakeholders’ consultation provides higher chances of the plan being adopted locally.
Publisher: Public Library of Science (PLoS)
Date: 04-11-2020
Publisher: Public Library of Science (PLoS)
Date: 10-01-2020
Publisher: Public Library of Science (PLoS)
Date: 05-06-2017
Publisher: Springer Science and Business Media LLC
Date: 07-02-2017
Publisher: Springer Science and Business Media LLC
Date: 13-11-2020
DOI: 10.1186/S12889-020-09724-Z
Abstract: There has been a recent focus on resettlement of migrants and refugee in rural settings in Australia and elsewhere. Rural resettlement is seen as an opportunity to revitalise rural communities, to fill the needs of employers in these areas, and to provide a welcoming community within which new arrivals can integrate and settle. However, challenges to rural resettlement have been identified including difficulties securing employment, discrimination and social isolation. These challenges can affect resettlement outcomes including health and wellbeing, though relatively little research has examined these links. In this paper we explored experiences of people from refugee background settling in a rural Australian town, examining interconnections between social determinants of health (SDH) and integration. Face-to-face interviews were conducted with 44 participants from Southeast Asia and Africa in a rural setting in South Australia, covering experiences of resettlement and impacts on health and wellbeing. Participants were recruited through existing connections within the community and snowball s ling. Audio recorded data were transcribed verbatim and analysed using framework thematic analysis. The study findings revealed a mixture of settlement experiences for participants across a range of elements of SDH and integration. A sense of safety and some elements of social connectedness and support were key enablers for integration and health and wellbeing, with main challenges including limitations in employment opportunities, mismatched education provision, experiences of discrimination and constrained access to services. Challenges experienced by refugees resettled in rural areas can affect integration, health and wellbeing and subsequent onward migration intentions. Attention to broader socioeconomic, cultural and environmental conditions, alongside tailored settlement support policies and practices for in idual rural resettlement sites, is required to support integration and health and wellbeing.
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: Springer Science and Business Media LLC
Date: 27-06-2015
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: Springer Science and Business Media LLC
Date: 04-02-2020
DOI: 10.1186/S12889-020-8293-9
Abstract: Women of childbearing age are at high risk of developing depression and antenatal depression is one of the most common mood disorders. Antenatal depression is also associated with a number of poor maternal and infant outcomes, however, there remains a lack of focus on mental issues in antenatal care, particularly in lower income countries. This systematic review of reviews provides useful evidence regarding the burden of antenatal depression which may provide guidance for health policy development and planning. We searched CINAHL(EBSCO), MEDLINE (via Ovid), PsycINFO, Emcare, PubMed, Psychiatry Online, and Scopus databases for systematic reviews that based on observational studies that were published in between January 1st, 2007 and August 31st, 2018. We used the Assessment of Multiple Systematic Reviews (AMSTAR) checklist scores to assess the quality of the included reviews. We applied vote counting and narrative review to summarize the prevalence of antenatal depression and its associated factors, while statistical pooling was conducted for estimating the association of antenatal depression with low birth weight and preterm birth. This systematic review of reviews was registered on PROSPERO with protocol number CRD42018116267. We have included ten reviews (306 studies with 877,246 participants) on antenatal depression prevalence and six reviews (39 studies with 75,451 participants) conducted to identify the effect of antenatal depression on preterm and low birth weight. Globally, we found that antenatal depression prevalence ranged from 15 to 65%. We identified the following prominent risk factors based on their degree of influence: Current or previous exposure to different forms of abuse and violence (six reviews and 73 studies) lack of social and/or partner support (four reviews and 47 studies) personal or family history of any common mental disorder (three reviews and 34 studies). The risk of low birth weight and preterm birth was 1.49 (95%CI: 1.32, 1.68 I 2 = 0.0%) and 1.40 (95%CI: 1.16, 1.69 I 2 = 35.2%) times higher among infants born from depressed mothers. Globally, antenatal depression prevalence was high and could be considered a common mental disorder during pregnancy. Though the association between antenatal depression and adverse birth outcomes appeared to be modest, its absolute impact would be significant in lower-income countries with a high prevalence of antenatal depression and poor access to quality mental health services.
Publisher: Science and Education Publishing Co., Ltd.
Date: 16-02-2014
DOI: 10.12691/AJEID-2-1-9
Publisher: Springer Science and Business Media LLC
Date: 14-03-2017
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: 06-09-2019
Publisher: Springer Science and Business Media LLC
Date: 31-05-2016
Publisher: Oxford University Press (OUP)
Date: 17-04-2018
Publisher: Springer Science and Business Media LLC
Date: 08-02-2021
DOI: 10.1186/S12884-020-03535-1
Abstract: Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries. PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I 2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.
Publisher: Hindawi Limited
Date: 07-2019
DOI: 10.1155/2019/6045726
Abstract: The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball s ling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria ’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive in iduals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria , their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.
Publisher: MDPI AG
Date: 29-01-2023
Abstract: Refugee resettlement significantly contributes to Australia’s migration programs, with recent policy directives prioritising rural resettlement. As a result, the cultural ersity of populations of several Australian rural towns has substantially expanded. Newcomers may encounter challenges becoming part of closed social networks and accessing the resources they need for a healthy life in resettlement. However, there are also benefits that stem from positive integration for newcomers and for receiving populations. As part of a larger study, which aimed to explore facilitators and barriers to successful resettlement in a rural setting, the objective of this paper was to show how social ties were important for participants’ health, both facilitating access to resources, including health services, and connecting people to health-promoting living conditions. In-depth in idual interviews with 44 participants from refugee communities originally from Africa and South-East Asia, settled in a rural South Australian town, were conducted. Participants were invited to the study through snowball s ling via known connections between the researchers and key people within the communities. Interview transcripts were analysed using framework thematic analysis. The findings demonstrate how participants drew on connections within their cultural communities, reflecting collectivist cultural values. These social ties were key to enabling access to resources for health. These included emotional resources, such as a sense of belonging, as well as physical and practical resources, including food, housing, and/or accessing services. Several participants were also working towards a career in the health industry. Populations from refugee communities in rural towns are growing, not only with the continuation of new arrivals to these towns, but also as the settled populations expand their families and communities. Effective health service provision in these locations needs to serve these growing communities, and there is scope for services to tap into community networks to assist with this.
Publisher: American Medical Association (AMA)
Date: 03-2022
Publisher: Springer Science and Business Media LLC
Date: 05-05-2021
DOI: 10.1186/S13033-021-00466-Y
Abstract: Qualitative studies evaluating maternal mental health services are lacking in Ethiopia, and the available evidence targets severe mental illnesses in the general population. We conducted a qualitative study to explore barriers to, enablers of, or opportunities for perinatal depression health services implementations in Ethiopia. We conducted a total of 13 face to face interviews with mental and maternal health service administrators from different levels of the Ethiopian healthcare system. We interviewed in Amharic (a local language), transcribed and translated into English, and imported into NVivo. We analysed the translated interviews inductively using thematic framework analysis. The study identified: (i) health administrators’ low literacy about perinatal depression as in idual level barriers (ii) community low awareness, health-seeking behaviours and cultural norms about perinatal depression as socio-cultural level barriers (iii) lack of government capacity, readiness, and priority of screening and managing perinatal depression as organisational level barriers and (iv) lack of mental health policy, strategies, and healthcare systems as structural level barriers of perinatal mental health implementation in Ethiopia. The introduction of the new Mental Health Gap Action Programme (mhGap), health professionals’ commitment, and simplicity of screening programs were identified enablers of, or opportunities for, perinatal mental health service implementation. This qualitative inquiry identified important barriers and potential opportunities that could be used to address perinatal depression in Ethiopia. Building the capacity of policy makers and planners, strengthening the mental healthcare system and governance should be a priority issue for an effective integration of maternal mental health care with the routine maternal health services in Ethiopia.
Publisher: Cold Spring Harbor Laboratory
Date: 03-10-2023
Publisher: Public Library of Science (PLoS)
Date: 20-01-2017
Publisher: Bangladesh Journals Online (JOL)
Date: 11-06-2013
DOI: 10.3329/SEAJPH.V2I1.15266
Abstract: Nonmedical expectations of the service seekers is an integral component of care that must be given due respect by the healthcare providers in delivering health services. This paper presents findings of a qualitative study conducted exploring the many dimensions of health systems responsiveness (HSR) in relation to family planning (FP) services provided by the government public health sector of Sri Lanka. Clients visiting the government FP clinics in Colombo district were interviewed using a semi structured moderator guide. Interviews covered three core domains of HSR including (i) clinic environment, (ii) ease of access to services and (iii) clients choice. Content analysis was carried out identifying themes around the domains. In relation to domain clinic environment, three subthemes were identified. These included (i) expectations from a free service, (ii) disorganization and (iii) sanitary facilities. Similarly, five subthemes emerged under the domain ease of access to services, namely, (i) outreach clinics, (ii) domiciliary services, (iii) social networking at MCH clinics, (iv) poly clinic/combined clinic setting and (v) working clients. In relation to the domain clients choice three subthemes emerged including, (i) service provider selecting the method, (ii) selecting the service provider and (iii) selecting the clinic. The findings emphasize that the healthcare providers must be enlightened on nonmedical aspects of service delivery and HSR must be taken into consideration in delivering FP services.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 54-59 DOI: 0.3329/seajph.v2i1.15266
Publisher: Springer Science and Business Media LLC
Date: 23-04-2021
DOI: 10.1186/S12889-021-10679-Y
Abstract: People from ethnically erse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, particularly as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia. This paper reports on HSD in ethnically erse communities in South Australia and impacts on health and wellbeing. Interviews and focus groups were conducted with 10 in iduals living with HIV from ethnically erse backgrounds, 14 ethnically erse community leaders, and 50 service providers. Data were analysed thematically. Findings indicated that HIV is a highly stigmatised condition in ethnically erse communities due to fear of moral judgment and social isolation, and was experienced at the intersections of gender, sexual orientation, religion, culture, and immigration status. Experiences of HSD were damaging to health and wellbeing through non-disclosure, reduced social support, delayed testing, service access barriers, impacts on treatment adherence, and directly to mental health. Actions addressing the impacts of HSD on people from ethnically erse backgrounds are crucial.
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Springer Science and Business Media LLC
Date: 27-02-2017
DOI: 10.1007/S10903-017-0557-9
Abstract: This study aimed to explore determinants of increased suicide deaths among African youth in South Australia. The paper reports on the intersectionality between intergenerational conflicts and fatal suicides in the target population. The study employed a qualitative inquiry approach, studying 31 young people in the African community in Adelaide. Intergenerational conflicts were identified as pervasive, with negative implications for the affected in iduals, their families, and the entire African community. These led to turmoil in the community, youth isolation, reduced social interactions, stress and fatal suicides. Intergenerational conflicts and the increased number of suicide deaths were identified as a significant, emerging public health issue within the African community in South Australia. A need to re-orient resources to develop and implement programs to address mental health problems and provide high quality, informed and culturally responsive services that support the community were identified as a priority.
Publisher: Cold Spring Harbor Laboratory
Date: 25-09-2023
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: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17137
Abstract: Background The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball s ling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers low perceptions of the relevance of available HIV and AIDS services and limited access to these services and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants’ economic situation and in iduals’ household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.
Publisher: Cold Spring Harbor Laboratory
Date: 16-04-2022
DOI: 10.1101/2022.04.16.22273930
Abstract: HIV infection adds a significant burden to women in low- and middle-income countries (LMICs), often leading to severe detrimental impact, not only on themselves, but also on their families and communities. Given that more than half of all people living with HIV globally are females (53%), this review seeks to understand the impact of HIV infection on women living with HIV (WLHIV) and their families in LMICs, and the interrelationships between one impact and another. A systematic review was conducted to find literature using the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Research articles were included if they met the following inclusion criteria: conducted in LMICs, published in English language between January 1 st 1990 and October 31 st 2021, had full text available, involved WLHIV (married and unmarried), and focused on the impact of HIV on these women and their families. Critical appraisal tools developed by Joanna Briggs Institute (JBI) were used to assess the methodological quality of the studies and thematic narrative synthesis was used to analyse the findings. A total of 22 articles met the inclusion criteria. The review showed that HIV has a range of negative consequences on WLHIV and their families including: (i) psychological impact, (ii) poor physical health and intimate partner violence, (iii) social impact, and (iv) economic impact. The findings indicate the need for targeted interventions, specific to WLHIV, that address the inequity and discrimination they face. These interventions should also incorporate education and sustainable support structures for WLHIV and their families.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 06-2008
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: Elsevier BV
Date: 05-2021
Publisher: Springer Science and Business Media LLC
Date: 10-06-2020
DOI: 10.1186/S12889-020-09040-6
Abstract: In Ethiopia, stigmatising attitudes towards people living with HIV have reduced over time. This is mainly due to improved HIV knowledge and the expansion of access to HIV care and support services. However, HIV stigma and discrimination remain a key challenge and have negative impacts on access to and utilisation of HIV services including nutritional programs in the HIV care setting. A small number of studies have examined the experience of stigma related to nutritional programs, but this is limited. This study explored HIV status disclosure and experience of stigma related to a nutritional program in HIV care settings in Ethiopia and impacts on nutritional program utilisation. As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff working in the nutritional program in three hospitals in the Tigray region of Northern Ethiopia. Framework thematic analysis was employed to analyse the data and NVivo 11 was used to analyse the qualitative interview data. This study is presented based on the consolidated criteria for reporting of qualitative research (COREQ). The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional program in terms of improving weight and overall health status, adults and caregivers of children living with HIV revealed experiences of stigma and discrimination that were lified by enrolment to the nutritional program and concerns about unwanted disclosure of positive HIV status. This was due to: a) transporting, consuming and disposing of the nutritional support (Plumpynut/sup) itself, which is associated with HIV in the broader community b) required increased frequency of visits to HIV services for those enrolled in the nutritional program and associated greater likelihood of being seen there. There was evidence of concerns about HIV-related stigma and discrimination among in iduals enrolled in this program and their family members, which in turn negatively affected the utilisation of the nutritional program and the HIV service more broadly. Stigma and discrimination are a source of health inequity and undermine access to the nutritional program and other HIV services. Nutritional programs in HIV care should include strategies to take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of facilitating social inclusion to mitigate stigma and improve utilisation.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14140
Abstract: Objectives The aims of the present study were to: (1) identify trends in bariatric surgery in South Australia (SA) from 2001 to 2013 and (2) compare public and private hospitals, and so discuss the implications of these trends as they relate to equity in access to bariatric procedures and public system healthcare expenditure. Methods An analysis of retrospective data of all bariatric procedures in public and private hospitals in SA was conducted using all SA public and private hospital administrative records between 2001 and 2013. Results Of all procedures conducted in SA, 22.6% were revisions or reversals. The number of revisions or reversals conducted in SA has increased at a rate higher than weight loss procedures (6.4- vs 3.8-fold increase). An increasing proportion of public surgeries are revisions or reversals of weight loss procedures that occurred outside of the SA public system (interstate or in the private system). Conclusion Further investigation is necessary to identify the pathways patients navigate to access bariatric surgery, the utilisation of public services following private procedures and why rates of revisions or reversals of bariatric procedures are increasing in SA. What is known about the topic? Rates of bariatric surgery are increasing internationally as a treatment for obesity. What does this paper add? Trends in bariatric procedures in SA have not been published. We have identified that: (1) rates of bariatric revisions or reversals in SA far surpass the rate at which bariatric weight loss procedures are increasing (2) rates of revisions or reversals are increasing in public hospitals and (3) an increasing number of the revision or reversal procedures in public hospitals are for weight loss procedures that have occurred outside the public system. What are the implications for practitioners? The data have implications for practitioners caring for patients interested in undergoing bariatric surgery for the treatment of obesity. The data suggest that rates of revisions or reversals are increasing in public hospitals, which suggests that further information is needed regarding the effectiveness of weight loss procedures and the implications of revision or reversal increases on waiting times for patients seeking weight loss treatment in a system with limited resources.
Publisher: Elsevier BV
Date: 03-1999
DOI: 10.1016/S0277-9536(98)00382-7
Abstract: This study compares age at enrolment in Primary School with a range of nutritional measures for 8-9 year old and 12-13 year old children in Ghana (n = 1566) and Tanzania (n = 1390). The results show that short stature (height-for-age z-score), but not other nutritional variables (weight-for-age and weight-for-height z-scores and haemoglobin concentration), is strongly associated with late enrolment. This relationship holds for both age group, sexes and countries, and is independent of socio-economic status in Tanzania (where this parameter was assessed). The relationship between stature and age-appropriate grade becomes less marked with progression through school, which is compatible with a higher drop out rate for more stunted children. These results suggest an important role for health in education that stunted children enrol later in school and are more likely to drop out earlier.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2016
Publisher: Diva Enterprises Private Limited
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 26-03-2021
DOI: 10.1186/S12884-021-03733-5
Abstract: Approximately one-third of pregnant and postnatal women in Ethiopia experience depression posing a substantial health burden for these women and their families. Although associations between postnatal depression and worse infant health have been observed, there have been no studies to date assessing the causal effects of perinatal depression on infant health in Ethiopia. We applied longitudinal data and recently developed causal inference methods that reduce the risk of bias to estimate associations between perinatal depression and infant diarrhea, Acute Respiratory Infection (ARI), and malnutrition in Gondar Town, Ethiopia. A cohort of 866 mother-infant dyads were followed from infant birth for 6 months and the cumulative incidence of ARI, diarrhea, and malnutrition were assessed. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the presence of maternal depression, the Integrated Management of Newborn and Childhood Illnesses (IMNCI) guidelines were used to identify infant ARI and diarrhea, and the mid upper arm circumference (MUAC) was used to identify infant malnutrition. The risk difference (RD) due to maternal depression for each outcome was estimated using targeted maximum likelihood estimation (TMLE), a doubly robust causal inference method used to reduce bias in observational studies. The cumulative incidence of diarrhea, ARI and malnutrition during 6-month follow-up was 17.0% (95%CI: 14.5, 19.6), 21.6% (95%CI: 18.89, 24.49), and 14.4% (95%CI: 12.2, 16.9), respectively. There was no association between antenatal depression and ARI (RD = − 1.3% 95%CI: − 21.0, 18.5), diarrhea (RD = 0.8% 95%CI: − 9.2, 10.9), or malnutrition (RD = -7.3% 95%CI: − 22.0, 21.8). Similarly, postnatal depression was not associated with diarrhea (RD = -2.4% 95%CI: − 9.6, 4.9), ARI (RD = − 3.2% 95%CI: − 12.4, 5.9), or malnutrition (RD = 0.9% 95%CI: − 7.6, 9.5). There was no evidence for an association between perinatal depression and the risk of infant diarrhea, ARI, and malnutrition amongst women in Gondar Town. Previous reports suggesting increased risks resulting from maternal depression may be due to unobserved confounding.
Publisher: MDPI AG
Date: 19-01-2020
Abstract: It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball s ling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. In idual moral judgement associating HIV status with amoral behaviours and participants’ negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.
Publisher: Informa UK Limited
Date: 12-2012
Publisher: Public Library of Science (PLoS)
Date: 13-07-2023
DOI: 10.1371/JOURNAL.PONE.0280087
Abstract: Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyakarta and Belu, Indonesia, this paper describes their in-depth views and experiences of the influence of HIV on their QoL. Ninety-two participants were recruited using the snowball s ling technique. Data were collected using in-depth interviews. In addition, the World Health Organisation Quality of Life questionnaire (WHOQOL–HIV BREF) was also distributed to each of them to fill out prior to the interviews. Chi-Square analysis was used to analyse data from the survey and a framework analysis was applied to guide qualitative data analysis. The findings reported several factors affecting the QoL of the participants. These included (i) environmental factors, such as living in rural areas, the unavailability of HIV care services and public transport, and long-distance travel to healthcare facilities (ii) personal beliefs associated with HIV (iii) sexual and social relationships and their influence of the QoL of participants and (iv) level of independence and physical health condition following HIV diagnosis. The findings indicate the need for intervention programs that address the availability and accessibility of HIV care services to PLHIV within rural communities and support various physical, psychological, and financial needs of PLHIV. These can be implemented by providing supplements and nutritious food, HIV counselling and door-to-door/community-based ART service delivery to PLHIV, which may increase their engagement in and adherence to the treatment and improve their physical and psychological condition and QoL.
Publisher: MDPI AG
Date: 29-06-2023
Abstract: Introduction: Stunting and anaemia, two severe public health problems, affect a significant number of children under the age of five. To date, the burden of and predictive factors for coexisting forms of stunting and anaemia in childhood have not been well documented in Ethiopia, where both the conditions are endemic. The primary aims of the present study were to: (i) determine the prevalence of co-morbid anaemia and stunting (CAS) (ii) and identify factors associated with these co-morbid conditions among children aged 6–59 months in Ethiopia. Methods: The study was based on data from the Ethiopian Demographic and Health Survey (EDHS 2005–2016). The EDHS was a cross-sectional study that used a two-stage stratified cluster s ling technique to select households. A total weighted s le of 21,172 children aged 6–59 months was included in the current study (EDHS-2005 (n = 3898), EDHS-2011 (n = 8943), and EDHS-2016 (n = 8332)). Children with height-for-age z-scores (HAZ) less than −2 SD were classified as stunted. Anaemia status was measured by haemoglobin level with readings below 11.0 g/deciliter (g/dL) categorized as anaemic. A multilevel mixed-effects logistic regression model was used to identify the factors associated with CAS. The findings from the models were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results: Almost half of the children were males (51.1%) and the majority were from rural areas (89.2%). The prevalence of CAS was 24.4% [95% CI: (23.8–24.9)]. Multivariate analyses revealed that children aged 12–23 months, 24–35 months, and 36–59 months, and children perceived by their mothers to be smaller than normal at birth had higher odds of CAS. The odds of CAS were significantly higher among children born to anaemic mothers [AOR: 1.25, 95% CI: (1.11–1.41)], mothers with very short stature [AOR: 2.04, 95% CI: (1.44–2.91)], children from households which practiced open defecation [AOR: 1.57, 95% CI: (1.27–1.92)], children born to mothers without education [AOR: 3.66, 95% CI: (1.85–7.22)], and those who reside in rural areas [AOR: 1.41, 95% CI: (1.10, 1.82)]. Male children had 19% lower odds of having CAS compared to female children [AOR: 0.81, 95% CI: (0.73–0.91)]. Children born to mothers who had normal body mass index (BMI) [AOR: 0.82, 95%CI: (0.73–0.92)] reported lower odds of CAS. Conclusions: One in four preschool-age children in Ethiopia had co-morbid anaemia and stunting, which is a significant public health problem. Future interventions to reduce CAS in Ethiopia should target those children perceived to be small at birth, anaemic mothers, and mothers with short stature.
Publisher: Informa UK Limited
Date: 10-03-2021
Publisher: MDPI AG
Date: 28-05-2021
Abstract: Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women (waria) in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants (n = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants’ engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants’ living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for waria populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing waria to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of waria in Yogyakarta and other similar settings in Indonesia are recommended.
Publisher: Oxford University Press (OUP)
Date: 11-1999
DOI: 10.1016/S0035-9203(99)90087-1
Abstract: Data on age, height and mid upper-arm circumference (MUAC) from nearly 6000 schoolchildren in Ghana, Tanzania and Malawi (not MUAC) were used to examine their power to predict bodyweight and thus the dosage of praziquantel required to treat schistosomiasis. Height was found to provide a simple and reasonably accurate estimate of weight, and about 75% of children would have been given a dosage of praziquantel within the range normally given using bodyweight at a dosage of 40 mg/kg bodyweight. The upper and lower ranges in dosage did not exceed dosages of praziquantel which have been used before or are currently recommended to treat schistosomiasis. A pole marked with the number of tablets could thus be used as a simple way to determine the dose of praziquantel to treat children in school-based health programmes.
Publisher: Scitechnol Biosoft Pvt. Ltd.
Date: 2016
Publisher: Emerald
Date: 21-09-2015
DOI: 10.1108/IJHRH-10-2014-0028
Abstract: – The purpose of this paper is to identify the potential socio-cultural determinants contributing to inequalities and the susceptibility of the Ojek to Human Immunodeficiency Virus (HIV) infection. – In 2010 a qualitative enquiry was employed to collect data concerning the susceptibility of the Ojek to HIV infection. Both one-on-one open-ended in-depth interviews and focus group discussions were employed. Participants included Ojek (hired motorcycle drivers), religious and community leaders, staff from the HIV/Acquired Immune Deficiency Syndrome (AIDS) Commission of Belu and staff from two HIV/AIDS non-governmental organisations. A thematic analysis and a framework approach were used to analyse the data. – The findings showed four socio-cultural determinants of susceptibility to HIV infection within the Ojek community. These included: first, mobility and migration second, patterns of sexual behaviours, sexual networks and sexual incentives third, cultural norms and social interactions and fourth, the lack of resources, knowledge and awareness of HIV/AIDS. Underpinned by these factors, the main determinant of HIV susceptibility for the Ojek is an in idual’s engagement in sexual intercourse with multiple sex partners, including female commercial sex workers (FCSWs). – There is a need to disseminate HIV/AIDS information and education throughout the Ojek communities, and to engage the general population in the promotion of sexual behavioural change among the Ojek in Belu. Empowerment strategies should also be employed to empower the general community, the Ojek and FCSWs in order to address HIV/AIDS transmission. – This paper provides evidence of the socio-cultural determinants of HIV inequalities within the Ojek community in Indonesia. An understanding of these determinants would enable the planning, implementation and application of a holistic approach addressing the determinants of HIV in Belu and other similar settings. Additionally, knowledge of such determinants would provide an understanding of the role of inter-sectoral collaboration and community participation in tackling the susceptibility to HIV infection within the Ojek community.
Publisher: Public Library of Science (PLoS)
Date: 13-02-2019
Publisher: MDPI AG
Date: 29-07-2020
Abstract: This paper was part of a large study that aimed to explore determinants of increased suicides among African youths in South Australia. As part of this larger study, narratives from participants indicated that identity crisis could be a potential determinant of suicide. This paper reports on how African youths negotiate and form identity in Australia. A qualitative inquiry was undertaken with 31 African youths using a focus group and in idual interviews. Data analysis was guided by a framework for qualitative research. These youths negotiated multiple identities, including those of race, gender, ethnicity and their origin. ‘Freedom and opportunity’, ‘family relationships’, ‘neither belonging here nor there’ and ‘the ability to cope against the paradox of resourcefulness in Australia’ appeared to be important themes in negotiating in idual identities. An opportunity was used to acknowledge privileges available in Australia relative to Africa. However, the extent to which in iduals acted on these opportunities varied, affecting a person’s sense of purpose, identity formation and belonging in Australia. The loss of social networks following migration, and cultural differences between African and Australian societies, shaped the experience of belonging and identity formation. These findings are crucial as they indicate the need for policies and practices that consider experiences of youths as they form their identity in Australia. Further studies with large numbers of participants are needed to explore these issues further among African youths in Australia.
Publisher: SAGE Publications
Date: 21-07-2019
Abstract: The purpose of this paper is to examine the employment experiences of immigrants of African background in the Australian labor market. Drawing on the findings from a qualitative study conducted in South East Queensland, the paper identifies several barriers and challenges faced by Africans to meaningful employment and labor market success. The paper indicates the need to develop targeted policies to eliminate employment discrimination, reduce barriers to meaningful employment for good settlement and successful integration of African immigrants to Australia.
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: Springer Science and Business Media LLC
Date: 22-07-2020
DOI: 10.1186/S12884-020-03092-7
Abstract: Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8% 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8% 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31 95%CI: 1.17–1.48). Malnutrition (1.39 1.21–1.61), non-exclusive breastfeeding (1.55 1.39–1.74), and common infant illnesses (2.55 1.41–4.61) were the main adverse health outcomes identified. One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
Publisher: Public Library of Science (PLoS)
Date: 30-03-2017
Publisher: SAGE Publications
Date: 04-03-2014
Abstract: The ageing and frail migrants who are at the end of life are an increasing share of migrants living in Australia. However, within such populations, information about end-of-life experiences is limited, particularly among Africans. This article provides some insights into the sociocultural end-of-life experiences of Africans in Australia and their interaction with the health services in general and end-of-life care in particular. It provides points for discussion to consider an ethical framework that include Afro-communitarian ethical principles to enhance the capacity of current health services to provide culturally appropriate and ethical care. This article contributes to our knowledge regarding the provision of culturally appropriate and ethical care to African patients and their families by enabling the learning of health service providers to improve the competence of palliative care systems and professionals in Australia. Additionally, it initiates the discussion to highlight the importance of paying sufficient attention to a erse range of factors including the migration history when providing palliative and hospice care for patients from African migrant populations.
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: MDPI AG
Date: 18-05-2023
Abstract: Background: The double burden of malnutrition in sub-Saharan African countries at different levels of economic development was not extensively explored. This study investigated prevalence, trends, and correlates of undernutrition and overnutrition among children under 5 years and women aged 15–49 years in Malawi, Namibia, and Zimbabwe with differing socio- economic status. Methods: Prevalence of underweight, overweight, and obesity were determined and compared across the countries using demographic and health surveys data. Multivariable logistic regression was used to ascertain any relationships between selected demographic and socio-economic variables and overnutrition and undernutrition. Results: An increasing trend in overweight/obesity in children and women was observed across all countries. Zimbabwe had the highest prevalence of overweight/obesity among women (35.13%) and children (5.9%). A decreasing trend in undernutrition among children was observed across all countries, but the prevalence of stunting was still very high compared to the worldwide average level (22%). Malawi had the highest stunting rate (37.1%). Urban residence, maternal age, and household wealth status influenced maternal nutritional status. The likelihood of undernutrition in children was significantly higher with low wealth status, being a boy, and low level of maternal education. Conclusions: Economic development and urbanization can result in nutritional status shifts.
Publisher: MDPI AG
Date: 20-08-2023
Abstract: HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at in idual and social levels. This disruption has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV n = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of ‘biographical reinvention’. Study participants were recruited using the snowball s ling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a ‘reinvented’ biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a ‘reinvented’ biography.
Publisher: Public Library of Science (PLoS)
Date: 15-08-2019
Publisher: Springer Science and Business Media LLC
Date: 28-07-2021
DOI: 10.1186/S41043-021-00256-9
Abstract: In many resource-poor settings, nutritional counselling is one of the key components of nutrition support programmes aiming to improve nutritional and health outcomes amongst people living with HIV. Counselling methods, contents and recommendations that are culturally appropriate, locally tailored and economically affordable are essential to ensure desired health and nutritional outcomes are achieved. However, there is little evidence showing the effectiveness of counselling in nutritional programmes in HIV care, and the extent to which counselling policies and guidelines are translated into practice and utilised by people with HIV suffering from undernutrition. This study aimed to explore these gaps in the Tigray region of Ethiopia. A qualitative study was conducted in Tigray region Ethiopia between May and August 2016. Forty-eight in idual interviews were conducted with 20 undernourished adults living with HIV and 15 caregivers of children living with HIV enrolled in a nutritional programme in three hospitals, as well as 11 health providers, and 2 programme managers. Data analysis was undertaken using the Framework approach and guided by the socio-ecological model. Qualitative data analysis software (QSR NVivo 11) was used to assist data analysis. The study findings are presented using the consolidated criteria for the reporting of qualitative research (COREQ). The study highlighted that nutritional counselling as a key element of the nutritional programme in HIV care varied in scope, content, and length. Whilst the findings clearly demonstrated the acceptability of the nutritional counselling for participants, a range of challenges hindered the application of counselling recommendations in participants’ everyday lives. Identified challenges included the lack of comprehensiveness of the counselling in terms of providing advice about the nutritional support and dietary practice, participants’ poor understanding of multiple issues related to nutrition counselling and the nutrition programme, lack of consistency in the content, duration and mode of delivery of nutritional counselling, inadequate refresher training for providers and the absence of socioeconomic considerations in nutritional programme planning and implementation. Evidence from this study suggests that counselling in nutritional programmes in HIV care was not adequately structured and lacked a holistic and comprehensive approach. Nutritional counselling provided to people living with HIV lacks comprehensiveness, consistency and varies in scope, content and duration. To achieve programme goal of improved nutritional status, counselling guidelines and practices should be structured in a way that takes a holistic view of patient’s life and considers cultural and socioeconomic situations. Additionally, capacity development of nutritional counsellors and health providers is highly recommended to ensure counselling provides assistance to improve the nutritional well-being of people living with HIV.
Publisher: Elsevier BV
Date: 2022
Publisher: Cold Spring Harbor Laboratory
Date: 16-03-2022
DOI: 10.1101/2022.03.15.22272326
Abstract: The number of HIV infection among heterosexual men in Indonesia continues to increase. This paper describes social and environmental factors and the mechanisms through which these factors may have contributed to the transmission of HIV among men in Indonesia. A qualitative design using one-on-one and face-to-face in-depth interviews was employed to collect data from men living with HIV in Yogyakarta and Belu, from June to December 2019. Participants (n=40) were recruited using the snowball s ling technique. The logical model for socio-environmental determinants diagnosis was used to conceptualise the study and discuss the findings. The findings showed that social factors such as peer influence on sex, condom use and injecting drug use were contributing factors for HIV transmission among the participants. Other factors and drivers of HIV transmission included mobility, migration, and the environment the participants lived, worked and interacted, which facilitated their engagement in high-risk behaviours. The findings indicate the need for wide dissemination of information and education about HIV and condoms for men, within communities and migration areas in Indonesia and other similar settings globally in order to increase their understanding of the means of HIV transmission, and condom use for HIV prevention.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Springer Science and Business Media LLC
Date: 30-05-2018
Publisher: Cambridge University Press (CUP)
Date: 06-2001
DOI: 10.1079/PHN2000111
Abstract: To report on the haemoglobin concentrations and prevalence of anaemia in schoolchildren in eight countries in Africa and Asia. Blood s les were collected during surveys of the health of schoolchildren as a part of programmes to develop school-based health services. Rural schools in Ghana, Indonesia, Kenya, Malawi, Mali, Mozambique, Tanzania and Vietnam. Nearly 14 000 children enrolled in basic education in three age ranges (7& ndash years, 12& ndash years and & Auml years) which reflect the new UNICEF/WHO thresholds to define anaemia. Anaemia was found to be a severe public health problem (defined as % anaemic) in five African countries for children aged 7–11 years and in four of the same countries for children aged 12–14 years. Anaemia was not a public health problem in the children studied in the two Asian countries. More boys than girls were anaemic, and children who enrolled late in school were more likely to be anaemic than children who enrolled closer to the correct age. The implications of the four new thresholds defining anaemia for school-age children are examined. Anaemia is a significant problem in schoolchildren in sub-Saharan Africa. School-based health services which provide treatments for simple conditions that cause blood loss, such as worms, followed by multiple micronutrient supplements including iron, have the potential to provide relief from a large burden of anaemia.
Publisher: Canadian Center of Science and Education
Date: 07-05-2017
DOI: 10.5539/GJHS.V9N8P47
Abstract: A qualitative inquiry using in idual interviews explored determinants of unprotected sexual behaviours favouring HIV transmission among Men who Have sex with Men (MSM) in Yogyakarta, Indonesia. The study was conducted in July 2015 with 24 MSM participants recruited using convenience s ling technique. Data were analysed using a qualitative data analysis framework, with the Social Cognitive Theory (SCT) employed as the study conceptual framework. Findings were grouped into a reciprocal triadic relationship involving behavioural, personal (cognitive) and environmental determinants. Behavioural determinants comprised having multiple casual sex partners, engagement in group sex and transactional sex practices. Environmental factors associated with unprotected sexual behaviours included influence of unsafe sex from regular partners and lack of access to HIV-related services. Personal (cognitive) determinants favouring unprotected sexual behaviours identified were lack of knowledge of condom and HIV/AIDS, in iduals’ expectation of pleasurable sexual intercourse, and low self-efficacy to discuss condom use and HIV status with casual sex partners. As effort to address HIV in MSM in Indonesia is still at its infancy, the findings of the current study are insightful and will inform the development of evidence-based programs in addressing HIV/AIDS problem in MSM populations in Yogyakarta and other similar settings.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2014
Publisher: Springer Science and Business Media LLC
Date: 30-01-2018
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: Cold Spring Harbor Laboratory
Date: 03-2022
DOI: 10.1101/2022.02.28.22270871
Abstract: Access to HIV care service or antiretroviral therapy (ART) is essential for the improvement of health outcomes of people living with HIV (PLHIV) and in reducing HIV transmission and HIV-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional treatment and the role of families in determining traditional treatment for their HIV-positive family member as barriers to access to HIV care service or ART among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals recruited using the snowball s ling technique. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional treatment, a well-known cultural practice in Belu, was a barrier to access to HIV care service or ART among PLHIV. The role of family in determining traditional treatment for HIV, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of families, neighbours and friends, were also significant barriers to PLHIV’s access to HIV care service or ART. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family and community members to increase their knowledge on the service, ART and its function, and to support and improve access to ART by PLHIV.
Publisher: SAGE Publications
Date: 06-2018
Abstract: This study aimed to identify factors that influenced the intention of men who have sex with men (MSM) to participate in voluntary counseling and HIV testing (VCT) and in accessing free condoms. A qualitative inquiry using one-on-one in-depth interviews was conducted with MSM participants who were recruited using a purposive s ling technique. Data analysis was guided by a framework analysis for qualitative data by Ritchie and Spencer, and the Theory of Planned Behavior (TPB) framework was used to analyze the data. The findings were grouped into three themes—namely, (a) attitude encompassing knowledge about HIV/AIDS and HIV/AIDS services and the belief about the positive outcomes of the services (b) subjective norms including support from MSM peers and family members and motivation to comply with the support and (c) perceived behavioral control, which is associated with resource availability and having confidence and positive intention to participate in VCT and willingness to access free condoms. Findings indicated that personal, community, and structural factors were predictors to intention to accessing services. Interventions targeting large numbers of MSM population and further studies to understand what needs to be done by nongovernmental organizations and governmental institutions to halt the spread of HIV infections among MSM populations and increase their intention to use HIV/AIDS services are also recommended.
Publisher: Springer Science and Business Media LLC
Date: 06-04-2020
DOI: 10.1186/S12889-020-08505-Y
Abstract: Despite the implementation of the World Health Organisation’s recommended indoor residual spraying (IRS) intervention in the upper west region of Ghana to reduce malaria morbidity and mortality, the uptake of this intervention remains low. This study explores the facilitators and barriers to the acceptability and community uptake of indoor residual spraying in a highly endemic region of Ghana. The health belief model (HBM) and realist evaluation framework were used to inform the study. A qualitative enquiry was conducted between April to October 2016. Data were collected through focus group discussions and semi-structured interviews with program stakeholders including community members, AngloGold Ashanti malaria control (AGA Mal) spray operators, and AGA Mal officials. A total of 101 people participated in the study. Considerable barriers to community acceptance of indoor residual spraying (IRS) were found, including, dislike of spray insecticides, inadequate information, religious and cultural beliefs, perceived low efficacy of IRS, difficulties with packing, unprofessional conduct of IRS spray operators, and other operational barriers to spraying. Facilitators of IRS uptake included a perceived effectiveness of IRS in preventing malaria and reducing mosquito bites, incidental benefits, respect for authority, training and capacity building, and sensitization activities. The numerous barriers to indoor residual spraying acceptance and implications show that acceptance levels could be improved. However, measures are required to address householders’ concerns and streamline operational barriers to increase community uptake of indoor residual spraying.
Publisher: MDPI AG
Date: 16-01-2021
Abstract: The relapse into undernutrition after nutritional recovery among those enrolled in a nutritional program is a common challenge of nutritional programs in HIV care settings, but there is little evidence on the determinants of the relapse. Nutritional programs in HIV care settings in many countries are not well designed to sustain the gains obtained from enrolment in a nutritional program. This study examined relapse into undernutrition and associated factors among people living with HIV in the Tigray region of Ethiopia. The study employed a mixed-methods approach, involving quantitative and qualitative studies. Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed into undernutrition. The mean time to relapse for adults was 68.5 months (95% CI, 67.0–69.9). Various sociodemographic, clinical, and nutritional characteristics were associated with a relapse into undernutrition. A considerable proportion of adults and children relapsed after nutritional recovery. Food insecurity and poor socioeconomic status were a common experience among those enrolled in the nutritional program. Hence, nutritional programs should design strategies to sustain the nutritional gains of those enrolled in the nutritional programs and address the food insecurity which was reported as one of the contributors to relapse into undernutrition among the program participants.
Publisher: Wiley
Date: 02-2002
DOI: 10.1046/J.1365-3156.2002.00843.X
Abstract: Cross-sectional studies of the relationship between helminth infection and cognitive function can be informative in ways that treatment studies cannot. However, interpretation of results of many previous studies has been complicated by the failure to control for many potentially confounding variables. We gave Tanzanian schoolchildren aged 9-14 a battery of 11 cognitive and three educational tests and assessed their level of helminth infection. We also took measurements of an extensive range of potentially confounding or mediating factors such as socioeconomic and educational factors, anthropometric and other biomedical measures. A total of 272 children were moderately or heavily infected with Schistosoma haematobium, hookworm or both helminth species and 117 were uninfected with either species. Multiple regression analyses, controlling for all confounding and mediating variables, revealed that children with a heavy S. haematobium infection had significantly lower scores than uninfected children on two tests of verbal short-term memory and two reaction time tasks. In one of these tests the effect was greatest for children with poor nutritional status. There was no association between infection and educational achievement, nor between moderate infection with either species of helminth and performance on the cognitive tests. We conclude that children with heavy worm burdens and poor nutritional status are most likely to suffer cognitive impairment, and the domains of verbal short-term memory and speed of information processing are those most likely to be affected.
Publisher: Wiley
Date: 12-2001
DOI: 10.1046/J.1365-3156.2001.00806.X
Abstract: This paper presents the results of an evaluation of community perception of two large-scale, government-run, school-based health programmes delivering anthelmintic drugs to primary school children, in Ghana (80 442 children in 577 schools) and Tanzania (110 000 children in 352 schools). Most teachers (96% in Ghana and 98% in Tanzania) were positive about their role in the programme, including administration of anthelmintic drugs, and parents and children fully accepted their taking on this role. The benefits of the programme were apparent to teachers, parents and children in terms of improved health and well-being of the children. Over 90% of parents in both Ghana and Tanzania indicated a willingness to pay for the continuation of drug treatment. The evaluation also highlighted areas that are critical to programme effectiveness, such as communication between schools and parents, the issue of collaboration between the health and education sectors, parents' perception of the importance of helminth infection as a serious and chronic health problem (compared with more acute and life threatening illnesses such as malaria), and who should pay for treatment of side-effects.
Publisher: Springer Science and Business Media LLC
Date: 07-05-2020
DOI: 10.1186/S12978-020-00912-Z
Abstract: Postnatal depression (PND) is the second most common cause of disability and the most common complication after childbirth. Understanding the potential mechanisms by which the stress process can lead to PND is an important step for planning preventive interventions for PND. This study employed a stress process model to explore the possible pathways leading to PND in Gondar Town, Ethiopia. A community-based cohort study was conducted in 916 pregnant women, who were assessed for depression in their second or third trimester of pregnancy and re-assessed two to eight weeks after birth. Women with an Edinburgh Postnatal Depression Scale (EPDS) ≥6 were considered to be depressed. Modified Poisson regression was used to identify the independent predictors of PND. A Generalized Structural Equation Modeling (GSEM) was then used to explore the direct and indirect effects of stressors and their mediators on PND. The prevalence and incidence proportion of PND were 9.27% (95%CI: 7.45, 11.36) and 7.77% (95%CI: 6.04, 9.79), respectively and 2.1% of the women demonstrated symptoms of depression within the study period. PND was independently predicted by having limited postnatal care services, Antenatal Depression (AND) and a Common Mental Disorders (CMD) before pregnancy, (IRR = 1.8 95%CI: 1.0, 3.2), 1.6(95%CI: 1.4, 1.7), and 2.4 (95%CI: 1.4, 4.3) respectively). In SEM, AND (standardized total effect = 0.36) and a CMD before pregnancy (standardized total effect = 0.11) had both a direct and an indirect positive effect on PND scores. Low birth weight (standardized β = 0.32) and self-reported labor complications (standardized β = 0.09) had direct effects only on PND scores. The observed incidence and prevalence of PND in Ethiopia were lower than in previous studies. A CMD before pregnancy and low birth weight (LBW) increased PND scores, and these effects were in part mediated via antenatal depression and labor complications. Early detection and treatment of depression before or during pregnancy could either directly or indirectly reduce the risk of labor complications and PND. Interventions that reduce LBW or improve the uptake of postnatal care might reduce PND incidence.
Publisher: Mark Allen Group
Date: 02-04-2016
DOI: 10.12968/AJMW.2016.10.2.90
Abstract: Malindi District sub-county Kilifi County has some of the poorest social economic indicators in the country. It has a poverty rate of 72%, relatively low levels of literacy, high fertility rates, and a significant proportion of the population is exposed to health risk factors. To explore women's perspectives of elimination of the user fee for accessing maternal health services and to investigate the facilitators and barriers experienced to using these services following the introduction of this policy. A qualitative inquiry was used to obtain the views of the maternal health service users of health service facilities in Malindi District, conducted in sub-county Kilifi County. Twenty-eight women, including those seeking prenatal and postnatal care services at the time of the study, participated in the study. The service users perceived the fee-free maternity services programme to present both opportunities and challenges. The programme was perceived to have lessened the financial burden of seeking skilled care and facilitated the access of skilled care to disadvantaged members of society. However, despite perceived positive outcomes, several participants believed there are challenges affecting the implementation of the programme, including delays in receiving antenatal care and perinatal services, improper cost associated with services in some facilities and lack of essential commodities in the facilities, which forced the users to purchase medicine and supplies to facilitate service provision. The fee-free maternal health service was perceived to improve access to skilled care during pregnancy and birth by the women, irrespective of their socioeconomic status. However, several challenges posed as potential barriers to the sustained perceived increase in service utilisation.
Publisher: Korean Society for Preventive Medicine
Date: 30-09-2017
DOI: 10.3961/JPMPH.17.046
Publisher: MDPI AG
Date: 04-06-2022
Abstract: Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among mothers living with HIV who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in mothers living with HIV who have CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (N = 23) who were recruited using the snowball s ling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnoses of stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemmas in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support mothers living with HIV and their CLHIV. Future large-scale studies involving mothers living with HIV who have CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
Publisher: Public Library of Science (PLoS)
Date: 21-11-2018
Publisher: Emerald
Date: 20-12-2013
Abstract: – The purpose of this paper is to discuss innovative ways of addressing human resources for health (HRH) shortage in the Pacific, supported by a review of the literature and the Pacific Open Learning Health Network (POLHN), a programme created in response to the Pacific's HRH concern. – A systematic search was conducted of English literature between 1990 and 2012. A number of key words, singly and/or in combination, were used to search for articles on ProQuest and PubMed. Original articles were identified and reference lists scrutinised to obtain additional literature. Due to the paucity of information, only narrative review was conducted and themes emerging from the literature identified and critically reviewed. – There is a worldwide HRH shortage and a need to improve the skills of the health workforce to respond to changing population health needs. Continuing education (CE) through use of information technology (IT) is a means to strengthen HRH. POLHN is one ex le of an initiative to improve health worker skills and motivation. Technological change is increasingly common place in society. To make sense of these changes, practitioners can look for common themes in successful technological innovations of interactivity information access, creation or sharing communication and simplicity. To ensure effective regulation of CE and IT there is a need to incorporate qualitative as well as quantitative measures, to prioritise the creation of quality, relevant, and appropriate resources and to facilitate access and active participation by health workers. – The paper highlights the complexity of HRH shortage as a global problem, which demands multiple initiatives to respond to the shortage in the pursuit of skilled, equitable and just delivery of health services and distribution of health service providers. One initiative that has worked elsewhere is professional development of health professionals through the provision of CE using IT. Online learning offers a pathway to address HRH shortage and overcomes challenges posed by distance, limited infrastructure and in small remote communities. POLHN contributes to improved skills and knowledge among health professionals who can, as a result, deliver better health services in a region as geographically dispersed and isolated as the Pacific.
Publisher: Public Library of Science (PLoS)
Date: 27-04-2020
Publisher: Public Library of Science (PLoS)
Date: 17-06-2020
Publisher: Public Library of Science (PLoS)
Date: 15-11-2021
DOI: 10.1371/JOURNAL.PONE.0257906
Abstract: As a part of a larger qualitative study to understand HIV-risk factors and impacts on people living with HIV (PLHIV) (52 women and 40 men) in Belu and Yogyakarta, Indonesia, this paper reports the influences of cultural practices and religious beliefs on sexual relationships and behaviours of participants as contributors for HIV transmission. This study was conducted from June to December 2020. Data collection was conducted using one-one-one in-depth interviews. Participants were recruited using the snowball s ling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that cultural practices in Belu related to the use of bride wealth, managing spousal disputes, marriage, and condom use, influenced spousal relationships and sexual behaviours or practices which contributed to HIV transmission. Javanese cultural practices and expectation of an ‘ideal wife’, Islamic religious beliefs about expected husband-wife relationships, forbidden premarital sex, and the participants’ in idual interpretation of their religious beliefs about condom use spousal sexual relations, also influenced spousal sexual relations and behaviours, which supported HIV transmission among the participants. The findings indicate the need for HIV education programs that address cultural practices and religious beliefs for community members and population groups to enhance their understanding about HIV, condom use, and how cultural practices and religious beliefs play a role in HIV transmission. The findings also indicate the need for involvement of religious leaders in HIV education programs to bring insights to people and help them interpret their religious beliefs in health promoting ways. Future studies that explore different aspects of culture and religion which may contribute to HIV transmission are recommended.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.PSYCHRES.2022.114899
Abstract: Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60% %CI (26.30-43.00), 33.20% %CI (27.70-38.37) and 37.9% %CI (23.5- 52.4) respectively. Significant heterogeneity (I Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
Publisher: MDPI AG
Date: 13-09-2022
Abstract: Migration has always been a feature of human populations, with people migrating and crisscrossing the globe for a wide range of reasons [...]
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.ORCP.2017.04.009
Abstract: To identify: 1. The percentage of bariatric procedures that are revisions 2. What proportion of bariatric revision procedures in public hospitals are for patients whose primary weight loss procedure occurred in a private hospital 3. The age, sex and level of socioeconomic disadvantage of patients needing revisions. An analysis of patient level admission data from the Integrated South Australian Activity Collection (ISAAC) was performed. Data were collected on all revisions for weight loss related procedures at all South Australian public and private hospitals, between 2000-2015 using the ISAAC codes for revision procedures. 12,606 bariatric procedures occurred in hospitals ∼27% of which represent a revision (n=3366). Of these revisions, ∼82% occurred in a private hospital (n=2771), and ∼18% occurred in a public hospital (n=595). Of the 595 revisions in a public hospital, 51% of patients had their original bariatric procedure performed in a private hospital. The majority of patients who had a revision procedure are female (≥82%) with a mean age of ∼45. In iduals from the lowest 2 IRSD quintiles were over-represented for public hospital revisions and primary bariatric procedures. Further investigation is needed to identify: 1. Why 27% of bariatric procedures are revisions 2. Why at least 51% of revisions in public hospitals are on patients whose original primary bariatric procedure was done in a private hospital 3. The impact that revision procedures in public hospitals, particularly for originally private weight loss procedures, is having on public hospital wait times 4. The impact of socioeconomic disadvantage on weight loss procedure outcomes.
Publisher: MDPI AG
Date: 21-02-2020
Abstract: This study explored the migration and food experiences of Afghani women refugees residing in Adelaide, South Australia for 2 years or less. In-depth semi-structured qualitative interviews were conducted with 10 women between May and September 2017. The data were thematically analysed, and the Social Determinants of Health Framework was used to discuss the findings. Five key themes emerged from the data. In the transition country (Iran/Pakistan), respondents experienced (i) trauma, discrimination and exclusion and (ii) familiar food culture, but food stress. In the destination country (Adelaide, Australia) respondents experienced (iii) a sense of precariousness, (iv) unfamiliar food culture and (v) challenges in accessing halal food. Afghani refugees experienced considerable stressors both in the transition and the final destination country but for different reasons. In the transition country, stresses related to the lack of social services and support, discrimination, racism and poverty seemed to have affected their ability to afford food. In Australia stressors pertaining to socioeconomic, housing and employment precariousness, as well as difficulties in accessing halal foods were identified as challenges. Furthermore, food stress in Australia was associated with the cultural appropriateness of food, the complexity of the food system, and the women’s lack of skills and experiences in navigating the food system. With increasing refugee and immigration flows globally, it is necessary to acknowledge how food and social determinants intersect for refugee immigrants to ensure positive health outcomes.
Publisher: Cold Spring Harbor Laboratory
Date: 22-12-2022
DOI: 10.1101/2022.12.21.22283812
Abstract: Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyakarta and Belu, Indonesia, this paper describes their in-depth views and experiences of the influence of HIV on their QoL. 92 participants were recruited using the snowball s ling technique. Data were collected using in-depth interviews. In addition, the World Health Organisation Quality of Life questionnaire (WHOQOL – HIV BREF) was also distributed to each of them to fill out prior to the interviews. Chi-Square analysis was used to analyse data from the survey and qualitative data analysis was guided by a framework analysis. The findings reported several factors affecting the QoL of the participants. These included (i) environmental factors, such as living in rural areas, the unavailability of HIV care services and public transport, and long-distance travel to healthcare facilities (ii) personal beliefs associated with HIV (iii) sexual and social relationships and their influence of the QoL of participants and (iv) level of independence and physical health condition following HIV diagnosis. The findings indicate the need for intervention programs that address the availability and accessibility of HIV care services to PLHIV within rural communities, and support various physical, psychological, and financial needs of PLHIV. These can be implemented through the provision of supplements and nutritious food, HIV counselling and door-to-door/community-based ART service delivery to PLHIV which may increase their engagement in and adherence to the treatment and improve their physical and psychological condition and QoL.
Publisher: Wiley
Date: 05-08-2020
DOI: 10.1111/HEX.13115
Publisher: Cambridge University Press (CUP)
Date: 22-07-2006
DOI: 10.1017/S0950268805004656
Abstract: To estimate the frequency of infectious gastroenteritis across Australia, and to identify risk factors, we conducted a national telephone survey of 6087 randomly selected respondents in 2001–2002. The case definition was three or more loose stools and/or two or more vomits in a 24-hour period in the last 4 weeks, with adjustment to exclude non-infectious causes and symptoms secondary to a respiratory infection. Frequency data were weighted to the Australian population. Multivariate logistic regression was used to assess potential risk factors including season, region, demographic and socioeconomic status. Among contacted in iduals, 67% responded. The case definition applied to 7% of respondents (450/6087) which extrapolates to 17·2 million (95% CI 14·5–19·9 million) cases of gastroenteritis in Australia in one year, or 0·92 (95% CI 0·77–1·06) cases erson per year. In the multivariate model, the odds of having gastroenteritis were increased in summer and in the warmest state, in young children, females, those with higher socioeconomic status and those without health insurance.
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: Public Library of Science (PLoS)
Date: 18-06-2018
Publisher: SAGE Publications
Date: 22-02-2018
Abstract: This study aimed to explore perceived determinants of condom use behaviors among male clients of female commercial sex workers (FCSWs) in Belu and Malaka districts, Indonesia. One-on-one in-depth interviews guided by the Health Belief Model (HBM) were used to collect the data from participants ( n = 42). The Framework analysis for qualitative data was employed to analyze the data. Results demonstrated several factors associated with lack of and inconsistent condom use among the participants. They included self-perceived risk of contracting HIV infection, knowledge of the severity of HIV illness and its impacts, and condom use: its benefits and its influencing factors. Additionally, factors including reduced sexual pleasure and the lack of knowledge of how and where to access condoms were important perceived barriers to condom use among participants. Having seen images of HIV-/AIDS-positive people, knowing friends and relatives suffering from HIV, and knowing FCSWs as a high-risk group for HIV infection were the cues to using condoms among several participants. Likewise, self-efficacy was also associated with condom use behaviors among the participants. The findings indicate the needs for HIV/AIDS interventions that include dissemination of HIV/AIDS knowledge, condom promotion, and improvement in the availability of condoms for both FCSWs and their clients.
Publisher: Cold Spring Harbor Laboratory
Date: 25-02-2022
DOI: 10.1101/2022.02.24.22271452
Abstract: Obesity and overweight are known are public health scourge challenges affecting populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. From May to July 2021, a community-based cross-sectional survey was conducted on a s le of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage s ling followed by systematic random s ling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) were reported to estimate the strength of associations. The overall prevalence of central obesity using waist circumference was 39.01% (15.44% for men and 53.12% for women). Multi-variable binary logistic regression analysis revealed that female sex (AOR=12.93, 95% CI: 6.74-24.79), Age groups: 30-39 years old (AOR=2.8, 95% CI: 1.59-4.94), 40-49 years (AOR=7.66, 95% CI: 3.87-15.15), 50-59 years (AOR=4.65, 95% CI: 2.19-9.89), ≥60 years (AOR=12.67, 95% CI: 5.46-29.39), occupational status like: housewives (AOR=5.21, 95% CI: 1.85-14.62), self-employed workers (AOR=4.63, 95% CI: 1.62-13.24), government rivate/non-government employees (AOR=4.68, 95% CI: 1.47-14.88) and skipping breakfast (AOR=0.46, 95% CI: 0.23-0.9) were significantly associated with central obesity. Abdominal obesity has become an epidemic in towns of southeast Ethiopia, and the prevalence is higher among women. Female sex, older age group, being employed, not skipping breakfast were significantly associated with central obesity.
Publisher: BENTHAM SCIENCE PUBLISHERS
Date: 12-07-2016
Publisher: Emerald
Date: 08-05-2017
DOI: 10.1108/IJHRH-01-2017-0002
Abstract: The purpose of this paper is to explore the socio-economic impacts of AIDS on families caring for AIDS-orphaned children in Mbeya rural district, Tanzania. A qualitative inquiry employing one-on-one in-depth interviews was conducted in 2015. Purposive s ling technique was used to recruit participants ( n =24) comprising 20 heads of families caring for AIDS-orphaned children, two local government staff and two staff from Isangati Agricultural Development Organisation – a non-government organisation. Qualitative data were analysed using thematic and framework approach. Results demonstrated that families caring for AIDS-orphaned children experienced severe socio-economic impacts of the epidemic. Reduction in household savings, increase in living expenses on health care and increased education fees were the identified economic impacts on these families. Social impacts included labour shortage, withdrawal of children from school and increased demand for food. There is a need for urgent responses and for scaling up programmes delivered by organisations, institutions and the government of Tanzania to help families cope with these impacts. This study provides evidence on socio-economic impacts of AIDS on families caring for AIDS-orphaned children in Tanzania. An understanding of these impacts can help governmental and non-governmental institutions and programme planners to address the problem in their policies and develop evidence-based strategies and interventions in responding to the problem in Mbeya and Tanzania. Moreover, responses to reducing the impacts of AIDS on families require a holistic approach that encourages the involvement of all sectors and agents outside of the health sector.
Publisher: Springer Science and Business Media LLC
Date: 12-02-2016
Publisher: Public Library of Science (PLoS)
Date: 16-06-2017
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: Public Library of Science (PLoS)
Date: 13-09-2016
Publisher: MDPI AG
Date: 19-05-2021
Abstract: HIV stigma and discrimination are a major challenge facing people living with HIV (PLHIV) globally. As part of a larger qualitative study with PLHIV in Yogyakarta and Belu, Indonesia, this paper describes the participants’ perceptions about drivers of HIV stigma and discrimination towards them within families, communities and healthcare settings, and highlights issues of HIV stigma as a social process. Participants were recruited using a snowball s ling technique. Data analysis was guided by the framework analysis for qualitative data, and conceptualization and discussion of the study findings were guided by the HIV stigma framework. The findings showed that participants experienced stigma and discrimination across settings, including in families and communities by family and community members, and in healthcare settings by healthcare professionals. The lack of knowledge about HIV, fear of contracting HIV, social and moral perceptions about HIV and PLHIV were perceived facilitators or drivers of stigma and discrimination towards PLHIV. HIV stigma and discrimination were also identified as a process linked to the whole groups of people within families or communities, which occurred within social context in Yogyakarta and Belu. The findings indicate the need for HIV education for family and community members, and healthcare providers to enhance their knowledge of HIV and improve acceptance of PLHIV within families, communities and healthcare settings.
Publisher: BENTHAM SCIENCE PUBLISHERS
Date: 12-07-2016
Publisher: Public Library of Science (PLoS)
Date: 06-05-2021
DOI: 10.1371/JOURNAL.PONE.0250804
Abstract: Drug resistance tuberculosis (DR-TB) patients’ mortality and loss to follow-up (LTF) from treatment and care is a growing worry in Ethiopia. However, little is known about predictors of mortality and LTF among drug-resistant tuberculosis patients in Oromia region, Ethiopia. The current study aimed to identify predictors of mortality and loss to follow-up among drug resistance tuberculosis patients in Oromia Hospitals, Ethiopia. A retrospective follow up study was carried out from 01 November 2012 to 31 December 2017 among DR-TB patients after calculating s le size using single proportion population formula. Mean, median, Frequency tables and bar charts were used to describe patients’ characteristics in the cohort. The Kaplan-Meier curve was used to estimate the probability of death and LTF after the treatment was initiated. The log-rank test was used to compare time to death and time to LTF. The Cox proportional hazard model was used to determine predictors of mortality and LTF after DR-TB diagnosis. The Crude and adjusted Cox proportional hazard ratio was used to measure the strength of association whereas p-value less than 0.05 were used to declare statistically significant predictors. A total of 406 DR-TB patients were followed for 7084 person-months observations. Among the patients, 71 (17.5%) died and 32 (7.9%) were lost to follow up (LTF). The incidence density of death and LTF in the cohort was 9.8 and 4.5 per 1000 person-months, respectively. The median age of the study participants was 28 years (IQR: 27.1, 29.1). The overall cumulative survival probability of patients at the end of 24 months was 77.5% and 84.5% for the mortality and LTF, respectively. The independent predictors of death was chest radiographic findings (AHR = 0.37, 95% CI: 0.17–0.79) and HIV serostatus 2.98 (95% CI: 1.72–5.19). Drug adverse effect (AHR = 6.1 95% CI: 2.5, 14.34) and culture test result (AHR = 0.1 95% CI: 0.1, 0.3) were independent predictors of LTF. This study concluded that drug-resistant tuberculosis mortality and LTF remains high in the study area. Continual support of the integration of TB/HIV service with emphasis and work to identified predictors may help in reducing drug-resistant tuberculosis mortality and LTF.
Publisher: Wiley
Date: 22-09-2016
DOI: 10.1111/HEL.12360
Abstract: To determine the prevalence of Helicobacter pylori infection in the refugee population attending the Migrant Health Service, South Australia, identify demographic factors associated with infection and compare prevalence of infection in refugees with that of the nonrefugee population in Australia. Cross-sectional study conducted between October 2010 and August 2013. Monoclonal stool antigen testing for H. pylori infection is performed as part of a comprehensive health assessment for newly arrived refugees. The s le population included 922 adults and children. Outcome measures were (i) prevalence of H. pylori infection (ii) association between demographic factors such as sex, ethnicity and age, and H. pylori infection. H. pylori infection was detected in 198 (21.5%) participants (95% CI 18.9%-24.3%). The odds of infection were lower in females OR 0.71 (95% CI 0.51-0.98) compared to males. Compared to Middle Eastern participants, the odds of infection were 1.75 (95% CI 1.17-2.62) times higher in African and 1.90 (95% CI 1.10-3.26) times higher in Burmese participants. Infection was not associated with age. H. pylori infection is common among newly arrived refugees. The long latency of infection to development of complications and the availability of testing and relatively effective eradication regimens all add weight to a decision to screen in this population.
Publisher: Frontiers Media SA
Date: 12-05-2021
Abstract: Stigma and discrimination are major challenges facing People Living with HIV/AIDS (PLWHA) globally due to their HIV status. As part of a larger qualitative study in Yogyakarta and Belu, Indonesia, using in-depth interviews with 92 PLWHA (52 women, 40 men) and 20 healthcare providers, this paper describes perspectives and personal experiences of the 20 healthcare providers, relating to HIV stigma and discrimination toward PLWHA in both study settings. The healthcare providers were recruited from healthcare facilities providing HIV-related healthcare services, using a snowball s ling technique. A qualitative framework analysis was used to guide data analysis. Health stigma and discrimination framework guided the conceptualisation and discussion of the findings. The findings presented the views and perspectives of healthcare providers that HIV stigma and discrimination toward PLWHA still occurred within families, communities and healthcare settings. These were reflected in negative labelling, separation of personal belongings, avoidance, denial of treatment and rejection of PLWHA by healthcare providers, family and community members. Some healthcare providers reported that they had personally stigmatised and discriminated against PLWHA. A lack of knowledge about HIV, fear of contracting HIV, personal values, religious thoughts and sociocultural values and norms, were reported as drivers or facilitators behind this HIV-related stigma and discrimination. The findings indicate the importance of continued HIV/AIDS education for families, community members and healthcare providers, to raise awareness and to ensure that healthy and professional support systems are in place for PLWHA. The findings indicate the need to enhance improvement within the healthcare or HIV care system to adequately address the needs of PLWHA, which may facilitate their early initiation of HIV treatment and better treatment adherence and retention to increase Cluster of Differentiation 4 (CD4) count and suppress viral load. Future studies are also needed to explore the role that government and non-government institutions can play in improving health service delivery for people newly diagnosed with HIV and those living with HIV/AIDS.
Publisher: Informa UK Limited
Date: 22-01-2021
DOI: 10.1080/09540121.2020.1716934
Abstract: This study aimed to understand how transgender women living with human immunodeficiency virus (HIV) cope psychologically with the infection. A qualitative inquiry was conducted with 29 participants in Yogyakarta, Indonesia. Participants were recruited using purposive and snowball s ling techniques. Data analysis was guided by the framework analysis for qualitative research. The findings indicated that acceptance of HIV status by an in idual was related to the person's awareness of personal behaviours leading to HIV acquisition. This meaning-making, "a psychological process" helped their attitudes towards thinking positively about life, stopped self-blaming and acted as a mechanism to cope with the challenging circumstances related to HIV infection. Participants' awareness of the importance of friends and families who cared and loved them, the responsibility they had for their families and the willingness to contribute meaningfully to other people living with HIV (PLHIV) were additional supportive attributes that contributed to participants' coping with the HIV stressful situations. The processes of finding the meaning supported participants' commitment to undergo HIV treatment and being involved in activities for self-help, while helping other PLHIV to cope with their situations. The findings indicate the need for sustained counselling to help PLHIV to find positive meanings out of their condition.
Publisher: Public Library of Science (PLoS)
Date: 05-08-2022
DOI: 10.1371/JOURNAL.PONE.0265107
Abstract: Obesity and overweight are known public health problems that affect populations across the world. These conditions have been associated with a wide range of chronic diseases including type 2 diabetes mellitus, cardiovascular disease, and cancers. In Ethiopia, the literature regarding the burden of central (abdominal) obesity is scarce. This study aimed to fill this gap by assessing the prevalence and risk factors associated with central obesity among adults in Ethiopia. From May to July 2021, a community-based cross-sectional survey was conducted on a s le of 694 adults aged ≥18 years in administrative towns of Bale zone, Southeast Ethiopia. Multi-stage s ling followed by systematic random s ling was employed to identify study participants. Waist and hip circumferences were measured using standard protocols. The World Health Organization STEPS wise tool was used to assess risk factors associated with central obesity. Bi-variable and multi-variable binary logistic regression were used to identify factors associated with central obesity. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) have been reported to estimate the strength of associations. The overall prevalence of central obesity using waist circumference was 39.01% [(95% CI: 35.36–42.76 15.44% for men and 53.12% for women)]. Multi-variable binary logistic regression analysis revealed that female sex (AOR = 12.93, 95% CI: 6.74–24.79), Age groups: 30–39 years old (AOR = 2.8, 95% CI: 1.59–4.94), 40–49 years (AOR = 7.66, 95% CI: 3.87–15.15), 50–59 years (AOR = 4.65, 95% CI: 2.19–9.89), ≥60 years (AOR = 12.67, 95% CI: 5.46–29.39), occupational status like: housewives (AOR = 5.21, 95% CI: 1.85–14.62), self-employed workers (AOR = 4.63, 95% CI: 1.62–13.24), government rivate/non-government employees (AOR = 4.68, 95% CI: 1.47–14.88), and skipping breakfast (AOR = 0.46, 95% CI: 0.23–0.9) were significantly associated with central obesity. Abdominal obesity has become an epidemic in Bale Zone’s towns in Southeastern Ethiopia. Female sex, age, being employed were positively associated with central obesity, while skipping breakfast was a protective factor.
Publisher: Public Library of Science (PLoS)
Date: 30-03-2017
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: MDPI AG
Date: 03-07-2020
Abstract: In the original version of our article [...]
Publisher: BMJ Publishing Group Ltd
Date: 07-2017
Publisher: Indonesian Public Health Association
Date: 25-03-2018
Abstract: Backgroud: Many rural mothers did not give appropriate child feeding which impacted to underweight for their children in Konawe Disrict of Southeast Island in Indonesia. This was also related to mother’s poor knowledge about child feeding. Objective: this study aimed to investigate the relationship between rural mothers’ knowledge and their practices of child feeding with underweight in under-5 children in Konawe District, Southeast Sulawesi Province in Indonesia.Methods: The case-control study was conducted in 5 rural areas in Konawe District, Southeast Sulawesi Province. The study involved 400 under five children and their mothers, including 100 of whom were cases and 300 of whom were age-matched contorls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variabels were mother’s knowledge and their child feeding practices. The data analysis used Conditional Logistic regression.Results: poor mothers’ knowledge (odds ratio [OR], 8.9 95% confidene interval [CI], 4.0 to 19.6 p0.001), poor practices of under-5 children feeding (OR, 15.2 95% CI, 5.5-41.7 p0.001) significantly associated with underweight in rural children.Conclusion: Mothers’ knowledge about the availability of nutritious foods determines her child feeding practices. A mother’s level of knowledge about nutritious foods and her practices is related to her educational level and health information sources.
Publisher: Oxford University Press (OUP)
Date: 1998
Abstract: It has been argued that targeting delivery of anthelmintics to school-children by taking advantage of the existing education infrastructure and administrative system can be one of the most cost-effective approaches in minimizing the intensity of infections with both schistosomiasis and major intestinal nematodes in many developing countries. The study was conducted in January 1997, shortly after the completion of the drug intervention programme. This paper provides an analysis of the costs of providing age-targeted treatment of school-children for urinary schistosomiasis using praziquantel and for intestinal nematodes using albendazole as an integral part of the School Health Programme in Tanga Region, Tanzania. The analysis shows that the total financial cost of the intervention programme in 1996 prices was US$54 252.28 (exchange rate: TSH 573 = US$1). Of this amount, the cost of drugs constitutes 80.6%, while the delivery cost appears relatively low, representing just below 20%. Even when the opportunity cost of unpaid days of labour input is included, the cost of drugs still remains the highest cost component of the intervention (55.8%). In the current epidemiological and logistic setting of Tanzania, the financial cost per child treated using praziquantel, which involved prior screening at the school level, was US$0.79, while treatment using albendazole was as low as US$0.23, of which US$0.20 was drug purchase cost. It is concluded that the base cost of delivering a universal, standard, school-based health intervention such as albendazole can be as low as US$0.03 per child tested, but even a very slight increase in the complexity of delivery can have a very significant impact on the cost of intervention.
Publisher: Wiley
Date: 10-1998
DOI: 10.1046/J.1365-3156.1998.00311.X
Abstract: This paper examines children's potential access to school health services by analysing data on the demographic structure, enrolment patterns and reported causes of early school-leaving in 347 schools in Tanga Region, Tanzania served by a school-based health programme. The analysis indicates that net enrolment ratios have risen over the previous 6 years, particularly among children under 10 years. However, in 1994 children were still much older than expected for a basic school population: 81% were adolescents (> or =10 years) and the mean age was 12 years. These data suggest that schools can provide equitable access to health education and school-based health services for a majority of children, even in a low-income country, and that the primary school population is predominantly adolescent and would benefit from health programmes targeted at that age group.
No related grants have been discovered for Lillian Mwanri.