Reducing New Ileostomy Readmissions in a Rural Health Care Setting

Adolescent health demands specific attention because adolescents have the lowest levels of health-care coverage of any age-group globally. The main objective as addressed in this article was to explore the lived experience of adolescent mothers and the services provided to them by community health assistants (CHAs) in rural Zambia. Because the number of adolescent mothers in rural Zambia is so high, it is even more critical to describe the lived experiences of health care among these young women with particular emphasis on primary health care as delivered by CHAs in rural Zambia. We used a mixed-methods design to address our research questions. Data were collected from nine focus groups, which were conducted with young mothers from four provinces and 10 districts ( n = 60). To support our effort to better understand the delivery of maternal and child health care in rural Zambia, key informant interviews were conducted with adolescent mothers ( n = 12). We also conducted surveys ( n = 44) and one-on-one interviews ( n = 22) with CHAs. To the best of our knowledge, this is the largest study focused on the intersection of adolescents, maternal child health, and CHA delivery of care in Zambia. The results of our study suggest opportunities for change to operational practices within the rural health-care setting and the need to develop structured and age-appropriate services that focus on adolescents. This work addresses the gap in research for adolescents in health care in rural Zambia and brings attention to the unique health-care needs of adolescent mothers within the rural health-care setting.

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Use of Xpert MTB/RIF for the Identification of TB and Drug Resistance Among Smear-Negative and Re-Treatment Cases in Rural Areas of Ethiopia

The Open Microbiology Journal ◽

10.2174/1874285801913010188 ◽

2019 ◽

Vol 13 (1) ◽

pp. 188-192 ◽

Cited By ~ 1

Author(s):

Mesfin Worku ◽

Mulualem Agonafir ◽

Mubarek A. Yassin ◽

Mohammed A. Yassin ◽

Daniel G. Datiko ◽

...

Keyword(s):

Health Care ◽

Drug Resistance ◽

Rural Health ◽

Rural Health Care ◽

Care Setting ◽

Sputum Sample ◽

Health Centre ◽

Health Care Setting ◽

Southern Ethiopia ◽

Additional Tool

Introduction: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide. A key contributor to this burden is poor diagnosis as only 60% of new pulmonary tuberculosis (TB) cases in Africa are ever detected. Therefore, this study aimed to assess the feasibility of Xpert MTB/RIF test implementation in the region, and the performance of the assay to increase case detection on the selected rural health care setting. Objective: To assess the feasibility of Xpert MTB/RIF test implementation in the rural health care setting in Southern Ethiopia. Methods: Two Xpert MTB/RIF machines were brought in 2012 through TB REACH project. It was placed at Yirgalem hospital and at Aletawondo health centre. The instruments were installed after formal training was provided to laboratory technologists for three days. We collected sputum sample from participants who repeatedly had negative smear microscopy and those who had not responded to first-line anti-TB drugs. Result: Of the total participants tested, 1828 have valid result (MTB-, MTB+/RIF-, MTB+/RIF+, MTB+/RIF Indeterminate). From the participants with valid results, 217 (11.9%) were Xpert-positive of which were 165 (9.0%) RIF-negative, 6 (0.3%) RIF-indeterminate and 46 (2.5%) RIF-positive. Among TB suspects with previous treatment history and positive by Xpert, RIF resistance was detected in 10 (2.2%). From the new TB suspects with positive Xpert, RIF resistance was detected in 29 (2.7%). All cases identified were linked with TB/MDR-TB treatment centers. Conclusion: Xpert provides an additional tool for the diagnosis of TB and drug resistance, with almost 12% of new and retreatment cases obtaining information that is useful for clinical management. To enhance its efficient utilisation, operational challenges should be minimized particularly in relation to availing robust alternative power source.

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