Nationally Representative Household Survey of Surgery and Mortality in Sierra Leone

2013 ◽  
Vol 37 (8) ◽  
pp. 1829-1835 ◽  
Author(s):  
Steve Kwon ◽  
Reinou S. Groen ◽  
Thaim B. Kamara ◽  
Laura D. Cassidy ◽  
Mohamed Samai ◽  
...  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Lahuerta ◽  
Roberta Sutton ◽  
Anthony Mansaray ◽  
Oliver Eleeza ◽  
Brigette Gleason ◽  
...  

Abstract Background Intermittent preventive treatment of malaria in infants (IPTi) with sulfadoxine-pyrimethamine (SP) is a proven strategy to protect infants against malaria. Sierra Leone is the first country to implement IPTi nationwide. IPTi implementation was evaluated in Kambia, one of two initial pilot districts, to assess quality and coverage of IPTi services. Methods This mixed-methods evaluation had two phases, conducted 3 (phase 1) and 15–17 months (phase 2) after IPTi implementation. Methods included: assessments of 18 health facilities (HF), including register data abstraction (phases 1 and 2); a knowledge, attitudes and practices survey with 20 health workers (HWs) in phase 1; second-generation sequencing of SP resistance markers (pre-IPTi and phase 2); and a cluster-sample household survey among caregivers of children aged 3–15 months (phase 2). IPTi and vaccination coverage from the household survey were calculated from child health cards and maternal recall and weighted for the complex sampling design. Interrupted time series analysis using a Poisson regression model was used to assess changes in malaria cases at HF before and after IPTi implementation. Results Most HWs (19/20) interviewed had been trained on IPTi; 16/19 reported feeling well prepared to administer it. Nearly all HFs (17/18 in phase 1; 18/18 in phase 2) had SP for IPTi in stock. The proportion of parasite alleles with dhps K540E mutations increased but remained below the 50% WHO-recommended threshold for IPTi (4.1% pre-IPTi [95%CI 2–7%]; 11% post-IPTi [95%CI 8–15%], p < 0.01). From the household survey, 299/459 (67.4%) children ≥ 10 weeks old received the first dose of IPTi (versus 80.4% for second pentavalent vaccine, given simultaneously); 274/444 (62.5%) children ≥ 14 weeks old received the second IPTi dose (versus 65.4% for third pentavalent vaccine); and 83/217 (36.4%) children ≥ 9 months old received the third IPTi dose (versus 52.2% for first measles vaccine dose). HF register data indicated no change in confirmed malaria cases among infants after IPTi implementation. Conclusions Kambia district was able to scale up IPTi swiftly and provide necessary health systems support. The gaps between IPTi and childhood vaccine coverage need to be further investigated and addressed to optimize the success of the national IPTi programme.


2021 ◽  
pp. jech-2020-216030
Author(s):  
Benjamin J Gray ◽  
Richard G Kyle ◽  
Jiao Song ◽  
Alisha R Davies

BackgroundThe public health response to the SARS-CoV-2 (COVID-19) pandemic has had a detrimental impact on employment and there are concerns the impact may be greatest among the most vulnerable. We examined the characteristics of those who experienced changes in employment status during the early months of the pandemic.MethodsData were collected from a cross-sectional, nationally representative household survey of the working age population (18–64 years) in Wales in May/June 2020 (n=1379). We looked at changes in employment and being placed on furlough since February 2020 across demographics, contract type, job skill level, health status and household factors. χ2 or Fisher’s exact test and multinomial logistic regression models examined associations between demographics, subgroups and employment outcomes.ResultsOf our respondents, 91.0% remained in the same job in May/June 2020 as they were in February 2020, 5.7% were now in a new job and 3.3% experienced unemployment. In addition, 24% of our respondents reported being placed on furlough. Non-permanent contract types, individuals who reported low mental well-being and household financial difficulties were all significant factors in experiencing unemployment. Being placed on ‘furlough’ was more likely in younger (18–29 years) and older (60–64 years) workers, those in lower skilled jobs and from households with less financial security.ConclusionA number of vulnerable population groups were observed to experience detrimental employment outcomes during the initial stage of the COVID-19 pandemic. Targeted support is needed to mitigate against both the direct impacts on employment, and indirect impacts on financial insecurity and health.


AIDS ◽  
2005 ◽  
Vol 19 (14) ◽  
pp. 1525-1534 ◽  
Author(s):  
Audrey E Pettifor ◽  
Helen V Rees ◽  
Immo Kleinschmidt ◽  
Annie E Steffenson ◽  
Catherine MacPhail ◽  
...  

2021 ◽  
Author(s):  
Ronald Carshon-Marsh ◽  
Ashley Aimone ◽  
Rashid Ansumana ◽  
Ibrahim Bob Swaray ◽  
Anteneh Assalif ◽  
...  

Author(s):  
Derek Asuman ◽  
Charles Godfred Ackah ◽  
Frank Agyire-Tettey

AbstractPersons with disabilities face substantial barriers that impede their integration and participation in social and economic activities. Households with disabled members may be vulnerable to poverty due to the extra cost of living with a disability. However, there exists a knowledge gap in the magnitude of the extra cost of disabilities in sub Saharan Africa. Using data from a nationally representative household survey, this paper estimates the extra cost of disabilities in Ghana. The paper further examines the welfare effects of households with persons with disabilities. Based on the standard of living approach, we estimate the extra cost to households with a person with disability to be 26% of annual household consumption expenditures. Adjusting for the extra cost of poverty, the incidence of poverty increases from 38.5 to 52.9% amongst households with a disabled member. Our findings suggest the need to improve the efficiency of support programs to persons with disabilities to mitigate the extra costs of disabilities and reduce their vulnerability to poverty. In addition, enhancing access to economic opportunities and social services for persons with disabilities will be imperative to improve their quality of life and dignity.


2020 ◽  
Vol 5 (7) ◽  
pp. e002732
Author(s):  
Kirsten Schmidt-Hellerau ◽  
Maike Winters ◽  
Padraig Lyons ◽  
Bailah Leigh ◽  
Mohammad B Jalloh ◽  
...  

IntroductionCaring for an Ebola patient is a known risk factor for disease transmission. In Sierra Leone during the outbreak in 2014/2015, isolation of patients in specialised facilities was not always immediately available and caring for a relative at home was sometimes the only alternative. This study sought to assess population-level protective caregiving intentions, to understand how families cared for their sick and to explore perceived barriers and facilitators influencing caregiving behaviours.MethodsData from a nationwide household survey conducted in December 2014 were used to assess intended protective behaviours if caring for a family member with suspected Ebola. Their association with socio-demographic variables, Ebola-specific knowledge and risk perception was analysed using multilevel logistic regression. To put the results into context, semi-structured interviews with caregivers were conducted in Freetown.ResultsEbola-specific knowledge was positively associated with the intention to avoid touching a sick person and their bodily fluids (adjusted OR (AOR) 1.29; 95% CI 1.01 to 1.54) and the intention to take multiple protective measures (AOR 1.38; 95% CI 1.16 to 1.63). Compared with residing in the mostly urban Western Area, respondents from the initial epicentre of the outbreak (Eastern Province) had increased odds to avoid touching a sick person or their body fluids (AOR 4.74; 95% CI 2.55 to 8.81) and to take more than one protective measure (AOR 2.94; 95% CI 1.37 to 6.34). However, interviews revealed that caregivers, who were mostly aware of the risk of transmission and general protective measures, felt constrained by different contextual factors. Withholding care was not seen as an option and there was a perceived lack of practical advice.ConclusionsEbola outbreak responses need to take the sociocultural reality of caregiving and the availability of resources into account, offering adapted and acceptable practical advice. The necessity to care for a loved one when no alternatives exist should not be underestimated.


2018 ◽  
Vol 13 (2) ◽  
pp. 85-95
Author(s):  
Andrew Hashikawa, MD, MS ◽  
Megan Chang, MD ◽  
Alan Sielaff, MD ◽  
Stuart Bradin, DO ◽  
Dianne C. Singer, MPH ◽  
...  

Objective: Children in early learning settings are vulnerable to site-specific emergencies because of physical and developmental limitations. We examined parents’ knowledge of disaster plans in their child’s early learning settings.Methods: In May 2015, we conducted a nationally representative online household survey, including parents of children ages 0-5 years in child care settings. Parents were asked about their center’s disaster plans and key components: evacuation, special needs children, and disaster supplies. Bivariate analyses and logistic regression were conducted to identify factors associated with parental awareness of disaster plans.Results: Overall, 1,413 of 2,550 parents responded (rate = 55 percent). Sample included 1,119 parents of children 0-5 years old, with 24 percent (n = 264) requiring child care. Parents’ reported knowledge of five types of disaster plans: evacuation (66 percent), power outage (63 percent), severe weather (62 percent), lock-down (57 percent), and delayed parent pick-up (57 percent). Only 21 percent reported if plans included all four key components of evacuation (child identification, parent identification, rapid communication, and extra car seats). One-third (36 percent) reported plans accommodating special needs children. Parents’ knowledge of disaster supplies varied: generator (31 percent), radio (42 percent), water (57 percent), food (60 percent), and first aid (82 percent). Parents attending any disaster training events (34 percent) were more likely to be aware of all five types of disaster plans compared with parents who had not attended.Conclusions: Many parents were unaware of disaster plans at their children’s early learning settings. Although few parents attended training events, such participation was associated with higher levels of parental awareness.


2016 ◽  
Vol 47 (1) ◽  
pp. 108-133 ◽  
Author(s):  
Vani S. Kulkarni ◽  
Veena S. Kulkarni ◽  
Raghav Gaiha

India has one of the highest rates of underweight burden, with signs of rising obesity. Coexistence of underweight and overweight persons is symptomatic of the “double burden of malnutrition.” The present study throws new light on the “double burden of malnutrition” among Indian women in the age group 22–49 years. The analysis is based on a nationally representative household survey, India Human Development Survey. Our results indicate the continuing pattern of socioeconomic segregation of underweight and overweight/obese women, with a large concentration of underweight women among the low socioeconomic group and of overweight/obese women among the high socioeconomic group. Further, relative food prices of food items like cereals and vegetables are significantly associated with the risk of being underweight and overweight/obese. Additionally, we find notable rural/urban differences. The relationship between socioeconomic factors and the probability of being underweight and overweight/obese is stronger in urban than in rural areas. Given that the health implications of being underweight and overweight/obese are equally grim, provision of healthy food items at affordable prices and implementation of programs for preventive and curative care of plausible illnesses related to underweight and overweight/obese are imperative.


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