Understanding of and perceptions towards cardiovascular diseases and their risk factors: a qualitative study among residents of urban informal settings in Nairobi

ObjectivesThe study explored the understanding of and perception towards cardiovascular disease (CVD) and risk factors, and how they influence prevention and development of the conditions, care-seeking and adhering to treatment.SettingInformal settlements of Nairobi.ParticipantsNine focus group discussions consisting of between six and eight purposively sampled participants were conducted among healthy individuals aged 20 years or older. A total of 65 participants (41 female) were involved.ResultsPoverty, ignorance and illiteracy promoted behaviours like smoking, (harmful) alcohol consumption, physical inactivity and unhealthy diet, implicated in the development of obesity, diabetes and hypertension. Some respondents could not see the link between behavioural risk factors with diabetes, hypertension and stroke and heart attacks. Contaminated food items consumed by the residents and familial inheritance were factors that caused CVD, whereas emotional stress from constant worry was linked to hypertension, stroke and heart attacks. Few and inadequately equipped public health facilities were hindrances to treatment seeking and adherence to treatment for CVD conditions. Lack of medication in public health facilities was considered to be the single most important barrier to adherence to treatment next to lack of family support among older patients.ConclusionInterventions to prevent and manage CVD in low-resource and urban poor settings should consider perceptions and understanding of risk factors for CVD, and the interrelationships among them while accounting for cultural and contextual issues for example, stigma and disregard for conventional medicine. Programmes should be informed by locally generated evidence on awareness and opportunities for CVD care, coupled with effective risk communication through healthcare providers. Screening for and treatment of CVD must address perceptions such as prohibitive cost of healthcare. Finally, social determinants of disease and health, mainly poverty and illiteracy, which are implicated in addressing CVD in low-resource settings, should be addressed.

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Understanding the antepartum depressive symptoms and its risk factors among the pregnant women visiting public health facilities of Nepal

PLoS ONE ◽

10.1371/journal.pone.0214992 ◽

2019 ◽

Vol 14 (4) ◽

pp. e0214992 ◽

Cited By ~ 3

Author(s):

Deepak Joshi ◽

Santoshi Shrestha ◽

Nipun Shrestha

Keyword(s):

Public Health ◽

Risk Factors ◽

Depressive Symptoms ◽

Pregnant Women ◽

Health Facilities ◽

Public Health Facilities ◽

Antepartum Depressive Symptoms

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Knowledge of neonatal danger signs, care seeking practice and associated factors among postpartum mothers at public health facilities in Ambo town, Central Ethiopia

BMC Research Notes ◽

10.1186/s13104-019-4583-7 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 7

Author(s):

Gizachew Abdissa Bulto ◽

Daniel Belema Fekene ◽

Berhanu Ejara Moti ◽

Getu Alemu Demissie ◽

Keneni Berhanu Daka

Keyword(s):

Public Health ◽

Associated Factors ◽

Health Facilities ◽

Care Seeking ◽

Central Ethiopia ◽

Public Health Facilities ◽

Danger Signs ◽

Postpartum Mothers

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Determinants of delay in care seeking for diarrheal diseases among mothers/caregivers with under-five children in public health facilities of Arba Minch town, southern Ethiopia; 2019

PLoS ONE ◽

10.1371/journal.pone.0228558 ◽

2020 ◽

Vol 15 (2) ◽

pp. e0228558

Author(s):

Alemayehu Fikire ◽

Gistane Ayele ◽

Desta Haftu

Keyword(s):

Public Health ◽

Health Facilities ◽

Southern Ethiopia ◽

Care Seeking ◽

Diarrheal Diseases ◽

Under Five ◽

Public Health Facilities ◽

Under Five Children

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Patient satisfaction on tuberculosis treatment service and adherence to treatment in public health facilities of Sidama zone, South Ethiopia

BMC Health Services Research ◽

10.1186/1472-6963-13-110 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 32

Author(s):

Zekariyas Sahile Nezenega ◽

Yohannes H/Michael Gacho ◽

Tadese Ejigu Tafere

Keyword(s):

Public Health ◽

Patient Satisfaction ◽

Health Facilities ◽

Tuberculosis Treatment ◽

Adherence To Treatment ◽

Treatment Service ◽

Public Health Facilities ◽

South Ethiopia

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Are underprivileged and less empowered women deprived of respectful maternity care: Inequities in childbirth experiences in public health facilities in Pakistan

PLoS ONE ◽

10.1371/journal.pone.0249874 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249874

Author(s):

Waqas Hameed ◽

Mudassir Uddin ◽

Bilal Iqbal Avan

Keyword(s):

Public Health ◽

Risk Factors ◽

Social Support ◽

Health Services ◽

Psychosocial Support ◽

Women's Empowerment ◽

Health Facilities ◽

Women’S Empowerment ◽

System Level ◽

Public Health Facilities

Background Attainment of healthcare in respectful and dignified manner is a fundamental right for every woman regardless of the individual status. However, social exclusion, poor psychosocial support, and demeaning care during childbirth at health facilities are common worldwide, particularly in low- and middle-income countries. We concurrently examined how women with varying socio-demographic characteristics are treated during childbirth, the effect of women’s empowerment on mistreatment, and health services factors that contribute to mistreatment in secondary-level public health facilities in Pakistan. Methods A cross-sectional survey was conducted during August–November 2016 among 783 women who gave birth in six secondary-care public health facilities across four contiguous districts of southern Sindh. Women were recruited in health facilities and later interviewed at home within 42 days of postpartum using a WHO’s framework-guided 43-item structured questionnaire. Means, standard deviation, and average were used to describe characteristics of the participants. Multivariable linear regression was applied using Stata 15.1. Results Women experiencing at least one violation of their right to care by hospital staff during intrapartum care included: ineffective communication (100%); lack of supportive care (99.7%); loss of autonomy (97.5%); failure of meeting professional clinical standards (84.4%); lack of resources (76.3%); verbal abuse (15.2%); physical abuse (14.8%); and discrimination (3.2%). Risk factors of all three dimensions showed significant association with mistreatment: socio-demographic: primigravida and poorer were more mistreated; health services: lesser-education on birth preparedness and postnatal care leads to higher mistreatment; and in terms of women’s empowerment: women who were emotionally and physically abused by family, and those with lack of social support and lesser involvement in joint household decision making with husbands are more likely to be mistreated as compared to their counterparts. The magnitude of relationship between all significant risk factors and mistreatment, in the form of β coefficients, ranged from 0.2 to 5.5 with p-values less than 0.05. Conclusion There are glaring inequalities in terms of the way women are treated during childbirth in public health facilities. Measures of socio-demographic, health services, and women’s empowerment showed a significant independent association with mistreatment during childbirth. At the health system level, there is a need for urgent solutions for more inclusive care to ensure that all women are treated with compassion and dignity, complemented by psychosocial support for those who are emotionally disturbed and lack social support.

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