scholarly journals Impact of the Liberian National Community Health Assistant Program on Childhood Illness Treatment in Grand Bassa County, Liberia: A Difference-in-Differences Analysis of Population-Based Data

2021 ◽  
Author(s):  
Emily White ◽  
Savior Mendin ◽  
Featha R. Kolubah ◽  
Robert Karlay ◽  
Ben Grant ◽  
...  
Keyword(s):  
Community Health ◽  
Maternal Education ◽  
Oral Rehydration Therapy ◽  
Household Wealth ◽  
Population Based ◽  
Difference In Differences ◽  
Oral Rehydration ◽  
National Community ◽  
Malaria Rapid Diagnostic Tests ◽  
Health Assistant

Liberia launched its National Community Health Assistant Program in 2016, which seeks to ensure that all people living 5 kilometers or farther from a health facility have access to trained, supplied, supervised, and paid community health workers (CHWs). This study aims to evaluate the impact of the national program following implementation in Grand Bassa County in 2018 using data from population-based surveys. We measured before-to-after changes in childhood treatment from qualified providers in a portion of the county that implemented in a first phase compared to those which had not yet implemented. We also assessed changes in whether children received oral rehydration therapy for diarrhea and malaria rapid diagnostic tests if they had a fever by a qualified provider (facility based or CHW). For these analyses, we used a difference-in-differences approach and adjusted for potential confounding using inverse probability of treatment weighting. We also assessed changes in the source from which care was received and examined changes by key dimensions of equity (distance from health facilities, maternal education, and household wealth). We found that treatment of childhood illness by a qualified provider increased by 60.3 percentage points (95%CI 44.7-76.0) more in intervention than comparison areas. Difference-in-differences for oral rehydration therapy and malaria rapid diagnostic tests were 37.6 (95%CI 19.5-55.8) and 38.5 (95%CI 19.9-57.0) percentage points, respectively. In intervention areas, treatment by a CHW increased from 0 to 81.6% and care from unqualified providers dropped. Increases in treatment by a qualified provider did not vary significantly by household wealth, remoteness, or maternal education. This evaluation found evidence that the Liberian National Community Health Assistant Program has increased access to effective treatment in rural Grand Bassa County. Improvements were approximately equal across three measured dimensions of marginalization.  

scholarly journals Developing the national community health assistant strategy in Zambia: a policy analysis

2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Joseph Mumba Zulu ◽  
John Kinsman ◽  
Charles Michelo ◽  
Anna-Karin Hurtig
Keyword(s):  
Policy Analysis ◽  
Community Health ◽  
National Community ◽  
Health Assistant

scholarly journals From guidelines to local realities: evaluation of oral rehydration therapy and zinc supplementation in Guatemala

2017 ◽  
Vol 41 ◽  
pp. 1 ◽  
Author(s):  
Rachel Hall-Clifford ◽  
Roxanne Amerson
Keyword(s):  
Community Health ◽  
Zinc Supplementation ◽  
Oral Rehydration Therapy ◽  
Essential Medicines ◽  
World Health ◽  
Local Context ◽  
Local Health ◽  
Who Guidelines ◽  
Community Members ◽  
Oral Rehydration

Objective. Diarrhea remains a leading cause of morbidity and mortality for children in low- and middle-income countries throughout the Americas. The World Health Organization (WHO) has developed guidelines on incorporating zinc supplementation (ZS) with traditional oral rehydration therapy (ORT) in order to shorten the duration of diarrheal episodes and to reduce poor health outcomes. Guatemala adopted these guidelines in 2011, but they have not yet been fully implemented at the community level. The objectives of this study were: (1) to co-design an ORT/ZS training program for community members with local health promoters that is appropriate to the local context and (2) to understand how attitudes and behaviors of community members changed after receiving training from the study promoters. Methods. In an observational study, community health promoters in rural Guatemala were trained according to WHO guidelines, and they worked collaboratively with the study team to develop a training curriculum to implement in their community. Community-based surveys, interviews, and focus group discussions were used to assess acceptability, accessibility, and availability of oral rehydration therapy and zinc supplementation. Results. Use of ORT increased from 63% to 95% among community members following training by local health promoters. Satisfaction with the service offered by health promoters increased from 63% to 90% amongst community members trained by the study promoters. However, knowledge and use of zinc supplementation remained low, which was attributable to unavailability of zinc in the study community. Conclusions. Use of trained community health promoters is an effective way to translate WHO guidelines to local contexts and overcome sociocultural barriers to care. However, the health system’s structure must support availability of essential medicines in order to effectively implement those guidelines.

Child mortality levels and survival patterns from Southern Sudan

1990 ◽  
Vol 22 (3) ◽  
pp. 365-372 ◽  
Author(s):  
Eric A. Roth ◽  
K. Balan Kurup
Keyword(s):  
Health Care ◽  
Regression Analysis ◽  
Maternal Education ◽  
Child Survival ◽  
Oral Rehydration Therapy ◽  
Childhood Mortality ◽  
Care Programme ◽  
Southern Sudan ◽  
Oral Rehydration ◽  
Survival Patterns

SummaryData from a 1985 survey in two major population centres in Southern Sudan, Juba and Wau, were analysed in order to assess childhood mortality levels and the effect of UNICEF's health care programme. There are continuing high levels of childhood mortality. Logistic regression analysis shows significant positive associations between child survival and immunization, oral rehydration therapy and maternal education.

scholarly journals Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study

2017 ◽  
Vol 22 (8) ◽  
pp. 1012-1020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Maria Vaikath ◽  
Jan-Walter De Neve ◽  
Thomas J. Bossert ◽  
Sibusiso Sibandze ◽  
...  
Keyword(s):  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study ◽  
National Community

scholarly journals Prevalence and socio-economic determinants of inadequate dietary diversity among adolescent girls and boys in Bangladesh: findings from a nationwide cross-sectional survey

2021 ◽  
Vol 10 ◽  
Author(s):  
Fahmida Akter ◽  
Md Mokbul Hossain ◽  
Abu Ahmed Shamim ◽  
Md Showkat Ali Khan ◽  
Mehedi Hasan ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Maternal Education ◽  
Dietary Diversity ◽  
Household Wealth ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Economic Determinants ◽  
Adolescent Girls And Boys ◽  
Context Specific

Abstract Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.

Maternal Determinants Mediating the Impact of Household Poverty on the Nutritional Status of Children Under 5 Years of Age in Bangladesh

2021 ◽  
pp. 037957212199901
Author(s):  
Probir Kumar Ghosh ◽  
Pritimoy Das ◽  
Doli Rani Goswam ◽  
Ausraful Islam ◽  
Sukanta Chowdhury ◽  
...  
Keyword(s):  
Higher Education ◽  
Nutritional Status ◽  
Maternal Education ◽  
Prevalence Ratio ◽  
Household Wealth ◽  
Population Based ◽  
Maternal Factors ◽  
Household Poverty ◽  
Maternal Determinants ◽  
The Impact

Objectives: We explored the maternal determinants that mediate the effect of household poverty on childhood undernutrition. Methods: We used the population-based Bangladesh Demographic Health Survey data from 2014 for demographic characteristics, child and maternal factors. Results: Of the 7173 under-5 children, 3456 (48.2%) had undernutrition. The prevalence of undernutrition was less common in wealthy households (poorest vs richest: adjusted prevalence ratio [aPR] = 1.37), mothers having history of antenatal care (ANC) visits (no visit vs ≥4 visits: aPR = 1.22), maternal higher education (no education vs higher education: aPR = 1.54), and mothers with good nutritional status (underweight vs healthy: aPR = 1.13). The risk of undernutrition (37.1%) was attributed to household wealth, mediated 55% by maternal factors; of which 20% by maternal education, 21% by ANC visits, and 14% by maternal nutritional status. Conclusions: Our study findings outlined higher maternal education, ≥4 ANC visits and maternal good nutritional status in mediating the impact of household wealth on childhood nutrition.

Evaluation of mothers' knowledge about oral rehydration therapy and sodium concentration in homemade sugar salt solutions

2001 ◽  
Vol 77 (6) ◽  
pp. 481-6
Author(s):  
Lauro Virgílio de Sena ◽  
Helcio de S. Maranhão ◽  
Mauro B. Morais
Keyword(s):  
Oral Rehydration Therapy ◽  
Sodium Concentration ◽  
Salt Solutions ◽  
Oral Rehydration

scholarly journals Issues and Controversies in the Evolution of Oral Rehydration Therapy (ORT)

2021 ◽  
Vol 6 (1) ◽  
pp. 34
Author(s):  
David Nalin
Keyword(s):  
Pediatric Patients ◽  
Oral Rehydration Therapy ◽  
Sodium Balance ◽  
Plain Water ◽  
Oral Glucose ◽  
Oral Rehydration ◽  
Low Sodium ◽  
Current Review ◽  
The Subject ◽  
Rehydration Solution

The original studies demonstrating the efficacy of oral glucose-electrolytes solutions in reducing or eliminating the need for intravenous therapy to correct dehydration caused by acute watery diarrheas (AWD) were focused chiefly on cholera patients. Later research adapted the oral therapy (ORT) methodology for treatment of non-cholera AWDs including for pediatric patients. These adaptations included the 2:1 regimen using 2 parts of the original WHO oral rehydration solution (ORS) formulation followed by 1 part additional plain water, and a “low sodium” packet formulation with similar average electrolyte and glucose concentrations when dissolved in the recommended volume of water. The programmatic desire for a single ORS packet formulation has led to controversy over use of the “low sodium” formulations to treat cholera patients. This is the subject of the current review, with the conclusion that use of the low-sodium ORS to treat cholera patients leads to negative sodium balance, leading to hyponatremia and, in severe cases, particularly in pediatric cholera, to seizures and other complications of sodium depletion. Therefore it is recommended that two separate ORS packet formulations be used, one for cholera therapy and the other for non-cholera pediatric AWD.

Effect of Pokémon GO on incidence of fatal traffic injuries: a population-based quasi-experimental study using the national traffic collisions database in Japan

2017 ◽  
Vol 24 (6) ◽  
pp. 448-450 ◽  
Author(s):  
Sachiko Ono ◽  
Yosuke Ono ◽  
Nobuaki Michihata ◽  
Yusuke Sasabuchi ◽  
Hideo Yasunaga
Keyword(s):  
Experimental Study ◽  
Traffic Accident ◽  
Regression Discontinuity ◽  
Population Based ◽  
National Data ◽  
Difference In Differences ◽  
Quasi Experimental ◽  
Accident Research ◽  
Pokémon Go ◽  
Augmented Reality Game

Pokémon GO (Niantic Labs, released on 22 July 2016 in Japan) is an augmented reality game that gained huge popularity worldwide. Despite concern about Pokémon GO–related traffic collisions, the effect of playing Pokémon GO on the incidence of traffic injuries remains unknown. We performed a population-based quasi-experimental study using national data from the Institute for Traffic Accident Research and Data Analysis, Japan. The outcome was incidence of traffic injuries. Of 127 082 000 people in Japan, 886 fatal traffic injuries were observed between 1 June and 31 August in 2016. Regression discontinuity analysis showed a non-significant change in incidence of fatal traffic injuries after the Pokémon GO release (0.017 deaths per million, 95%CI −0.036 to 0.071). This finding was similar to that obtained from a difference-in-differences analysis. Effect of Pokémon GO on fatal traffic injuries may be negligible.

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