East African journal of public health最新文献

{"title":"Influence of political culture on service provision in Kenyan rural health facilities.","authors":"Collins Ogutu Miruka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the overall implications for an enhanced health system administrative capacity that not only takes account of global and regional developments, but that is also seen as legitimate domestically and is well equipped theoretically to deliver quality health care services in Kenyan rural health facilities.</p><p><strong>Methods: </strong>The study used public hospitals as test cases. A field study was undertaken in western Kenya where four institutions were identified as research sites. In all the sites, a survey questionnaire was administered to both the community of health service providers as well as service users.</p><p><strong>Results: </strong>The study found that health care service reforms must begin at a more fundamental level rather than just organizational development, human resource development and capacity building.</p><p><strong>Conclusions: </strong>The paper concludes by re-emphasizing the need to minimize the traditional tensions between the political and the public administration interface and the need to ensure that health care reforms are embedded or at least reflect the political choice and social structure of Kenyans in general.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"128-31"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31036127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undernutrition of orphans and vulnerable children: a comparison of cash transfer beneficiaries and non beneficiaries in Korogocho slums, Nairobi.","authors":"A B Wakoli,&nbsp;G A Ettyang,&nbsp;A S Lakati","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence and associated factors for undernutrition among the beneficiaries of Kenya Cash Transfer Program compared to non-beneficiaries in Korogocho, Nairobi. Optimal nutrition reduces the prevalence of undernutrition and contributes to improved child survival and development.</p><p><strong>Methods: </strong>A comparative descriptive cross-sectional study design in which a total of 336 children were sampled from the two groups each consisting 168 children. A questionnaire was administered to caregivers. A Food Frequency Questionnaire and a 24 Hour Recall sought information on foods consumed. Anthropometric measurements were taken based on standard procedures. Wasting, underweight and stunting were determined based on a z-score of > or = -2 or < -2 SD. A chi-square test was used to test significance associations of wasting, underweight and stunting with other variables.</p><p><strong>Results: </strong>A majority (89.3%) and (73.8%) of the principal caregivers were females among the beneficiaries and non-beneficiaries respectively. Among the beneficiaries, prevalence of wasting was 6%, underweight 6% and stunting 32.7%. Among non-beneficiaries, undernutrition was higher with wasting 9.5%, underweight 17.9% and stunting 37.5%. There was a significant difference (chi2 = 11.351, df = 1, p = 0.001) for underweight among the beneficiaries and non-beneficiaries. Nutrient inadequacies were high in vitamin A, folate and zinc in both beneficiaries and non-beneficiaries. In beneficiaries, undernutrition was significantly (p < 0.05) associated with number of children aged 6-59 months in the household, cash transfer used on food, carbohydrate intake, protein intake and frequency of breastfeeding. Among non-beneficiaries, undernutrition was significantly (p < 0.05) associated with number of household members, number of children 6-59 months in the household and income spent on food.</p><p><strong>Conclusions: </strong>There was improved nutritional status among the beneficiaries compared to non-beneficiaries. However, there is need of training beneficiaries on the best use of the cash transfers and educating them on consumption of adequate food to improve nutrient intake and eventually their nutritional status.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"132-8"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31036128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and determinants of condom use in Uganda.","authors":"Zaake De Coninck,&nbsp;Gaetano Marrone","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Condom use is an integral indicator of risky sexual behaviour and, as a result, is a potential predictor of future HIV infection rates. Consequently, documenting trends in condom use and exploring the factors associated with their utilisation are important for broadening the information base for the design of HIV intervention programmes. This paper aims to document Uganda's nationwide trends in condom use from 1995 to 2006 and seeks to understand some of the socio-demographic variables that may be associated with their use, using Uganda Demographic Health Surveys (UDHS).</p><p><strong>Method: </strong>Data from the Uganda Demographic Health Surveys (UDHS) conducted in 1995, 2000/2001 and 2006 were analysed. Sociodemographic variables as well as 'Year of the survey' were selected to assess their interaction with condom use. Multivariate regression analyses were performed. Odds Ratios and Confidence Intervals were computed.</p><p><strong>Results: </strong>Certain socio-demographic factors such as being male and living in an urban setting are significantly associated with an increased likelihood of using condoms than others. All results indicate a far greater increase in condom use between 1995 and 2000/2001 compared to the rate of increase in condom use from 2000/2001 to 2006.</p><p><strong>Conclusion: </strong>Policies need to address the lowered use of condoms amongst women and rural populations. The wane in increase in condom use between 2000/2001 and 2006 may be the result of interrupted distribution of condoms between 2004 and 2006. However, this may also be due to the large-scale influx of antiretrovirals (starting in 2004) which may be lowering the anxiety associated with the social construct of HIV/AIDS. Policy makers are urged to intensify condom use campaigns.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"105-11"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31033995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors contributing to non-adherence to diabetes treatment among diabetic patients attending clinic in Mwanza city.","authors":"Francis Fedrick,&nbsp;M Justin-Temu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Non-adherence to the diabetes treatment regimen is possibly the most common reason for poor health outcomes among people with diabetes. The rates of non-adherence to diabetes regimen tasks are highly variable, but have significant consequences on diabetes outcomes and the effectiveness of treatments.</p><p><strong>Objective: </strong>The aim of this study was to determine the proportion (magnitude) of non-adherence and its contributing factors among diabetic patients attending clinics in Mwanza city. Specifically the study determined the relationship between non-adherence and various variables which are; alcohol use, knowledge on diabetes, its treatment and complication, travel distance to reach the clinic by patients and medication side effects.</p><p><strong>Results: </strong>A total of 272 diabetic patients attending two diabetes clinics in Mwanza city were interviewed. Of the respondents, 118 (43.4%) were males. Their mean age was 51.22 (14.97 standard deviation). Among all respondents, 255 (93.8%) scored High level of knowledge on Diabetes and its treatment as compared with those with low knowledge making it not a significant contributor to non-adherence. Of the 272 patients, 77 (28.3%) reported non-adherent. Alcohol use, medication side effects and distance travelled to reach the clinic were the significant contributors to non-adherence (p = 0.001).</p><p><strong>Conclusion: </strong>Factors which were found contributing to non-adherence to diabetes treatment include: alcohol use, medication side effects and few clinics located far from most of patient. For improving adherence, availability of information with patients' perspectives about patients' expectations, needs and experiences in taking medication and about what might help them to become and remain adherent should be maintained.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"90-5"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31035199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and determinants of condom use in Uganda.","authors":"Wakoli Ab, Ettyang Ga, Lakati As","doi":"10.4314/EAJPH.V9I3","DOIUrl":"https://doi.org/10.4314/EAJPH.V9I3","url":null,"abstract":"Background: Condom use is an integral indicator of risky sexual behaviour and, as a result, is a potential predictor of future HIV infection rates. Consequently, documenting trends in condom use and exploring the factors associated with their utilisation are important for broadening the information base for the design of HIV intervention programmes. This paper aims to document Uganda’s nationwide trends in condom use from 1995 to 2006 and seeks to understand some of the socio-demographic variables that may be associated with their use, using Uganda Demographic Health Surveys (UDHS). Method: Data from the Uganda Demographic Health Surveys (UDHS) conducted in 1995, 2000/2001 and 2006 were analysed. Sociodemographic variables as well as ‘Year of the survey’ were selected to assess their interaction with condom use. Multivariate regression analyses were performed. Odds Ratios and Confidence Intervals were computed. Results: Certain socio-demographic factors such as being male and living in an urban setting are significantly associated with an increased likelihood of using condoms than others. All results indicate a far greater increase in condom use between 1995 and 2000/2001 compared to the rate of increase in condom use from 2000/2001 to 2006. Conclusion : Policies need to address the lowered use of condoms amongst women and rural populations. The wane in increase in condom use between 2000/2001 and 2006 may be the result of interrupted distribution of condoms between 2004 and 2006. However, this may also be due to the large-scale influx of antiretrovirals (starting in 2004) which may be lowering the anxiety associated with the social construct of HIV/AIDS. Policy makers are urged to intensify condom use campaigns. Keywords : Antiretroviral, ARV, condom, DHS, HIV, PEPFAR, sexual behaviour, disinhibition, inhibition, Uganda","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 1","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70511332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some determinants of factors associated with HIV/AIDS risk behaviours among University of Dodoma students in Tanzania.","authors":"I Abbas,&nbsp;R R J Akarro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The paper examines whether variables of HIV/AIDS related knowledge, attitude and beliefs of Dodoma University students (UDOM) can predict practices which risk HIV infection. A pre-designed questionnaire was administered in a sample of 547 (539 students and 8 staff members). Since variables involved were many and in many cases highly correlated and unobservable, data were analyzed using factor analysis. Multiple regression analysis were used to analyze factor scores obtained from factor analysis. Based on responses of students to practice questions, two factors emerged and were labeled as sex with high risk persons and common risk sexual behavior. The common predictors in the Multiple Linear Regression (MLR) for sex with high risk persons score (R2 = 5.1%, p < 0.001, F = 4.873) and sex under the influence of alcohol (p < 0.001) respectively both had significant contribution from gender, knowledge on transmission through sexual contact, beliefs about HIV/AIDS and attitudes toward VCT testing. The MLR for common risk sexual behavior score (R2 = 5.4%, p < 0.001, F = 5.147) and sex without condom (p < 0.001) respectively both had significant contributions from gender and attitudes toward condom use. Knowledge on transmission through sexual contact, beliefs about HIV/AIDS and attitudes toward VCT testing and condom use appeared to be common determinants of HIV/AIDS risk behaviors among students.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"112-7"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31033996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between anaemia and infections (HIV, malaria and hookworm) among children admitted at Muhimbili National Hospital.","authors":"A S Magesa,&nbsp;P M Magesa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Anaemia is the major cause of morbidity and mortality in paediatric age with much aetiology. The magnitude of childhood anaemia has been inadequately studied at Muhimbili National Hospital (MNH). The study was aimed at determining the frequency of anaemia and associated infections in patients admitted in general paediatric wards at MNH in Dar es Salaam.</p><p><strong>Methods: </strong></p><p><strong>Study design: </strong>This was a descriptive cross-sectional study.</p><p><strong>Study setting: </strong>This was conducted at MNH in general paediatric wards from 20th August, 2009 to 15th December, 2009.</p><p><strong>Subjects: </strong>Patients, aged 1-84 months, consecutively admitted were recruited in the study. After informed verbal consent from the guardian or parent was obtained, information on demographic and clinical characteristics was collected from the parent or guardian. Physical examination and laboratory tests on blood ; stool samples for hookworm screening; blood slides for malaria parasites; Human Immunodeficiency Virus (HIV) screening; and blood peripheral smears were done on all subjects. Additional information was taken from medical files. Data management: The prevalence of anemia was determined as a percentage of all paediatric patients recruited during the time of data collection. All information was recorded using questionnaires and analysis was done using SPSS version 13.0. A p value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 315 children were assessed. The frequency of anaemia was 79.4%. This is much higher than the WHO prevalence of 67.6% in Africa for anaemia to be taken as a disease of public health importance. The proportion of malaria was 7.9%, HIV seropositive was 10.2% and hookworm was 1.0% of all admissions. There was an increased risk of anaemia in patients with HIV seropositive and or malaria although this was not statistically significant (RR > 1.0, p > 0.05).</p><p><strong>Conclusion: </strong>Anaemia in paediatric patients admitted at MNH is a disease of high public health importance in Dar es Salaam and may well carry a high burden in the rest of the country. Other risk factors of anaemia should be investigated with a goal of reducing the burden of anaemia.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 3","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31033992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation of delivery services in Zaria, northern Nigeria: factors affecting choice of place of delivery.","authors":"Sa'adatu Talatu Sule,&nbsp;Sa'adatu Lafia Baba","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To determine the effect of companionship during labour and delivery, and the preferred delivery position, on the choice of place of delivery among women in Zaria, with a view to providing more acceptable services.</p><p><strong>Methods: </strong>315 consenting women attending the antenatal clinic at primary health facility in Zaria were interviewed.</p><p><strong>Results: </strong>62.24% of the women had their last delivery at home. Reasons for not wanting to deliver in health facility included the fact that it was too expensive (48.19%), concern that a companion would not be allowed to stay with them during labour and delivery (12.05%), unfriendly healthcare providers (10.84%), and concern about not being allowed to deliver in their preferred position (4.82%).</p><p><strong>Conclusion: </strong>Women in Zaria value social support and freedom to decide the position to adopt during labour and delivery. Healthcare providers and policy makers need to be sensitive to such needs that affect uptake of services.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 2","pages":"80-4"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31039750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation of delivery services in Zaria, northern Nigeria: factors affecting choice of place of delivery.","authors":"S. Sule, Sa'adatu Lafia Baba","doi":"10.4314/EAJPH.V9I2","DOIUrl":"https://doi.org/10.4314/EAJPH.V9I2","url":null,"abstract":"AIM\u0000To determine the effect of companionship during labour and delivery, and the preferred delivery position, on the choice of place of delivery among women in Zaria, with a view to providing more acceptable services.\u0000\u0000\u0000METHODS\u0000315 consenting women attending the antenatal clinic at primary health facility in Zaria were interviewed.\u0000\u0000\u0000RESULTS\u000062.24% of the women had their last delivery at home. Reasons for not wanting to deliver in health facility included the fact that it was too expensive (48.19%), concern that a companion would not be allowed to stay with them during labour and delivery (12.05%), unfriendly healthcare providers (10.84%), and concern about not being allowed to deliver in their preferred position (4.82%).\u0000\u0000\u0000CONCLUSION\u0000Women in Zaria value social support and freedom to decide the position to adopt during labour and delivery. Healthcare providers and policy makers need to be sensitive to such needs that affect uptake of services.","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 2 1","pages":"80-4"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70511257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of extended spectrum beta (b)-lactamases in multi-drug resistant Escherichia coli isolated from a clinical setting in Jimma University Specialized Hospital, Jimma, southwest Ethiopia.","authors":"Yohannes Mulualem,&nbsp;Tesfaye Kasa,&nbsp;Zeleke Mekonnen,&nbsp;Sultan Suleman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Resistance to antibiotics has grave consequences leading to treatment failure and increased health care costs. This public health risk has become a global problem with some countries like Ethiopia seriously affected. Members of the family enterobacteriaceae, including E. coli, are among the most important human pathogens accounting for the majority of bacterial strains isolated from clinical patient samples. Moreover, there is insufficient data regarding Extended-spectrum Beta-lactamase (ESBL) prevalence among Escherichia coli strains from Ethiopia. Thus, the objective was to determine the production of ESBL among clinical isolates and assess the in vitro susceptibility of the E. coli to the routinely used selected antibiotics.</p><p><strong>Methods: </strong>We collected a total of 359 clinical specimens (56 urine, 116 sputum, 72 stool and 15 wound swabs) from in- and outpatients at Jimma University Specialised Hospital, Jimma zone, southwest Ethiopia.</p><p><strong>Results: </strong>E. coli was isolated from 67 (18.66%) clinical specimens, of which 24 (36%) isolates were ESBL producers. The resistance pattern to the tested antibiotics was: penicillin (97%), amoxacillin and ampicillin (86.6% each), tetracycline (73.1%), amoxacillin-clavulanate (70.1%), co-trimoxazole (56.7%), chloramphenicol (35.8%), ciprofloxacine (20.9%), norfloxacine (16.4%), cefotaxime (9%), ceftazidime (6%), gentamicin (3%). All the isolates tested showed resistance to two or more drugs, and were considered to be multi-drug resistant.</p><p><strong>Conclusion: </strong>A higher rate (46%) of ESBL production and multi-drug resistance was seen among isolates from inpatients as compared to outpatients (33%) at the hospital.</p>","PeriodicalId":87601,"journal":{"name":"East African journal of public health","volume":"9 2","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31039746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}