scholarly journals Improvement of Early Antenatal Care Initiation

2018 ◽  
Vol 5 ◽  
pp. 233339281876148
Author(s):  
Tippawan Liabsuetrakul ◽  
Nurlisa Oumudee ◽  
Masuenah Armeeroh ◽  
Niamina Nima ◽  
Nurosanah Duerahing
Keyword(s):  
Antenatal Care ◽  
Intervention Study ◽  
Intervention Group ◽  
Local Health ◽  
Middle Income ◽  
Counseling Intervention ◽  
Middle Income Countries ◽  
Almost All ◽  
Study Intervention ◽  
Training Modules

Background: Although antenatal care (ANC) coverage has been increasing in low- and middle-income countries, the adherence to the ANC initiation standards at gestational age <12 weeks was inadequate including Thailand. The study aimed to improve the rate of early ANC initiation by training the existing local health volunteers (LHVs) in 3 southernmost provinces of Thailand. Methods: A clustered nonrandomized intervention study was conducted from November 2012 to February 2014. One district of each province was selected to be the study intervention districts for that province. A total of 124 LHVs in the intervention districts participated in the knowledge–counseling intervention. It was organized as half-day workshop using 2 training modules each comprising a 30-minute lecture followed by counseling practice in pairs for 1 hour. Outcome was the rate of early ANC initiation among women giving birth, and its association with intervention, meeting an LHV, and months after training was analyzed. Results: Of 6677 women, 3178 and 3499 women were in the control and intervention groups, respectively. Rates of early ANC were significantly improved after the intervention (adjusted odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.17-1.43, P < .001) and meeting an LHV (adjusted OR: 2.06, 95% CI: 1.86-2.29, P < .001), but lower at 6 months after training (adjusted OR: 0.76, 95% CI: 0.60-0.96, P = .002). Almost all women (99.7%) in the intervention group who met an LHV reported that they were encouraged to attend early ANC. Conclusion: Training LHVs in communities by knowledge–counseling intervention significantly improved early ANC initiation, but the magnitude of change was still limited.

scholarly journals Using pictorial action instructions to build a basic humanitarian engineering project

2019 ◽  
Vol 14 (1) ◽  
pp. 60-70
Author(s):  
Kathleen Paco Cadman ◽  
Du Feng
Keyword(s):  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Low Literacy ◽  
Engineering Project ◽  
Middle Income ◽  
Middle Income Countries ◽  
Humanitarian Engineering ◽  
Engineering Projects ◽  
Low And Middle Income

Humanitarian engineering projects mitigate environmental hazards disproportionately affecting health in low- and middle-income countries. However, widespread literacy deficits can create barriers in training low-literacy adults to construct these projects, indicating a need for literacy-adapted training materials. A randomized control trial in rural Guatemala tested the usability of pictorial action instructions, compared to demonstration-only methods, in training low-literacy adults (N = 60; n = 30 per group) to construct a solar bottle bulb. Fourteen days after the training, participants individually constructed the solar bottle bulb. The intervention group received pictorial action instructions to guide them, and the control group completed construction based on memory. Usability was evaluated by measuring the effectiveness and efficiency of construction, as well as user satisfaction and self-efficacy levels. Effectiveness and self-efficacy were significantly better among those in the intervention group compared to the control group. Considering this, the findings support the use of pictorial action instructions in training low-literacy adults to construct humanitarian engineering projects. This method may allow more individuals in rural regions of low- and middle-income countries to successfully construct their own humanitarian engineering projects in a way that is sustainable and scalable. Further research is needed to test these instructions in different settings, on a larger scale, as well as to test the long-term effects of using pictorial action instructions. 

scholarly journals Generating Evidence From Contextual Clinical Research in Low- to Middle Income Countries: A Roadmap Based on Theory of Change

2021 ◽  
Vol 9 ◽  
Author(s):  
Babar S. Hasan ◽  
Muneera A. Rasheed ◽  
Asra Wahid ◽  
Raman Krishna Kumar ◽  
Liesl Zuhlke
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Change ◽  
Health Priorities ◽  
Global Health Research ◽  
Local Health ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ministries

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low and Middle-Income Countries (LMICs). If diagnosed and managed in a timely manner, as in high-income countries (HICs), most children lead a healthy life and achieve adulthood. However, children with CHD in LMICs have limited care available with subsequent impact on survival. The large disparity in global health research focus on this complex disease makes it a solid paradigm to shape the debate. Despite many challenges, an essential aspect of improving research in LMICs is the realization and ownership of the problem around paucity of local evidence by patients, health care providers, academic centers, and governments in these countries. We have created a theory of change model to address these challenges at a micro- (individual patient or physician or institutions delivering health care) and a macro- (government and health ministries) level, presenting suggested solutions for these complex problems. All stakeholders in the society, from government bodies, health ministries, and systems, to frontline healthcare workers and patients, need to be invested in addressing the local health problems and significantly increase data to define and improve the gaps in care in LMICs. Moreover, interventions can be designed for a more collaborative and effective HIC-LMIC and LMIC-LMIC partnership to increase resources, capacity building, and representation for long-term productivity.

The impact of COVID-19 on oncologists: Experience from Egyptian physicians.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13514-e13514
Author(s):  
Abeid Mohamed Athman Omar ◽  
Marwa Ramadan ◽  
Yomna Khamis ◽  
Abdelsalam A. Ismail
Keyword(s):  
Family Support ◽  
Occupational Safety ◽  
Family Members ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Burnout Rate ◽  
Almost All ◽  
The Impact

e13514 Background: The unprecedented emergence of coronavirus disease (COVID-19) has disrupted the patients' and physicians' daily activities, including cancer care. However, little is known on how COVID-19 has impacted oncologists from low and middle-income countries. Methods: We conducted a cross-sectional survey among eighty-eight practicing oncologists in Alexandria governorate, Egypt. An electronic, anonymized self-reporting survey was distributed in February 2020 to collect information on occupational safety measures, the prevalence of COVID-19 among respondents, workload, and family support during the pandemic Results: Out of 88 contacted oncologists, 75% completed the survey (n=66). Nearly half (45%) of respondents were residents, 36% were specialists, and 18% were consultants. The mean age of respondents was 34.79 years (SD ±10.42). More than half of the respondents were not comfortable managing cancer patients during the pandemic (56%) and did not feel well-protected at the workplace (58%). However, most (79%) had managed a cancer patient with COVID-19 more than once. Furthermore, almost all participants (98%) have worked with an infected colleague. Nevertheless, to more than half (54%), it made no difference working with a colleague who was previously infected. Most physicians (79%) felt overwhelmed with workload than the pre-pandemic period. Despite being COVID-19 negative, nearly half reported their family members had reduced contact with them due to the fear of being infected. In contrast, 24% are now getting more family support, whereas 27% are experiencing the same contact level as before the COVID-19 era. Physicians lacking family support had a significantly higher burnout rate than those who had family support (p=0.038). However, the burnout rate was similar regardless of doctors' rank, or treating COVID-19 patients, or feeling protected at work. The majority of the participants (75%) had experienced COVID-19 like symptoms, and one third (n=21) were confirmed COVID-19 infected: residents - 52%, specialists - 33%, and consultants - 14%. Nevertheless, we found no association between the rank and being infected with COVID-19 (p=0.632). Most participants thought they were infected at the hospital (38% by patients; 24% by colleagues), and 14% by family members. However, there was no significant association between being infected and feeling protected at work (p=0.823). Most of the infected physicians (61%) received moral support from both the family and colleagues, and 33% received family support only. There was no association between burnout rate and being COVID-19 infected (p=0.719). Conclusions: One-third of the oncologists were COVID-19 positive. Besides, most oncologists feel overwhelmed with workload and experience more burnout than before the COVID-19 era, and it worsens if one lacks family support.

scholarly journals SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yingying Hu ◽  
Rui Huang ◽  
Bishwajit Ghose ◽  
Shangfeng Tang
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Maternal Healthcare ◽  
Middle Income ◽  
Modern Contraception ◽  
Middle Income Countries ◽  
Delivery Services ◽  
Meta Analyses

Abstract Background The objectives of this study were to 1) measure the percentage of women who received SMS-based family planning communication, and 2) its association with modern contraception and maternal healthcare services among mothers. In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning and reproductive health. However, little is known regarding the role of SMS-based family planning communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings. Methods Cross-sectional data on 94,675 mothers (15–49 years) were collected from the latest Demographic and Health Surveys in 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic maternal healthcare services (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses. Results The coverage of SMS-based family planning communication for the pooled sample was 5.4% (95%CI = 3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI = 3.38, 8.70) compared with Asia (5.23, 95%CI = 1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI = 11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI = 1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI = 1.95, 2.83). The strength of the association was highest for Senegal (OR = 4.70, 95%CI = 1.14, 7.33) and lowest for Burundi (OR = 1.5; 95%CI = 1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery. Conclusion Although positively associated with using facility delivery services, receiving SMS on family planning does not appear to affect modern contraceptive use and other components of maternal healthcare services such as timely and adequate utilisation of antenatal care.

scholarly journals Inferring antenatal care visit timing in low- and middle-income countries: Methods to inform potential maternal vaccine coverage

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237718
Author(s):  
Ranju Baral ◽  
Jessica Fleming ◽  
Sadaf Khan ◽  
Deborah Higgins ◽  
Nathaniel Hendrix ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Vaccine Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Low And Middle Income

scholarly journals Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jessica L. Watterson ◽  
Julia Walsh ◽  
Isheeta Madeka
Keyword(s):  
Systematic Review ◽  
Behavior Change ◽  
Antenatal Care ◽  
Postnatal Care ◽  
Health Workers ◽  
Review Of The Literature ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Mobile health (mHealth) technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients’, caretakers’, or health workers’ behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC), postnatal care (PNC), and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%,n=8) and most were conducted in African countries (80%,n=8). All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

scholarly journals Distributing development assistance for health: simulating the implications of 11 criteria

2017 ◽  
Vol 12 (2) ◽  
pp. 245-263
Author(s):  
Trygve Ottersen ◽  
Suerie Moon ◽  
John-Arne Røttingen
Keyword(s):  
Low Income ◽  
Economic Transition ◽  
Development Assistance ◽  
National Income ◽  
Low Income Countries ◽  
Economic Downturn ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Almost All

AbstractAfter years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.

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