scholarly journals Cross-sectional assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amelia Mazzei ◽  
Rosine Ingabire ◽  
Etienne Karita ◽  
Jeannine Mukamuyango ◽  
Julien Nyombayire ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Center ◽  
Rural Health ◽  
Health Centers ◽  
Power Supplies ◽  
Cross Sectional ◽  
Government Health ◽  
Family Planning Counseling ◽  
Rural Health Centers ◽  
Long Acting

Abstract Background There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: (1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; (2) health center capacity building for provision of LARC methods, and (3) LARC promotion by community health workers (CHW) trained in community-based provision of oral and injectable contraception. From 2015 to 2016, this service was integrated into eight government health centers in Kigali, reaching 6072 clients and resulting in 5743 LARC insertions. Methods From May to July 2016, we conducted cross-sectional health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision. Results Few nurses had received training in LARC insertion [41% implant, 27% intrauterine device (IUD)]. All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (median 10), implants (median 39), functional gynecological exam tables (median 2), and lamps for viewing the cervix (median 0). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

Assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

2019 ◽  
Author(s):  
Amelia Mazzei ◽  
Rosine Ingabire ◽  
Etienne Karita ◽  
Jeannine Mukamuyango ◽  
Julien Nyombayire ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Center ◽  
Rural Health ◽  
Health Centers ◽  
Power Supplies ◽  
Government Health ◽  
Family Planning Counseling ◽  
Rural Health Centers ◽  
Long Acting ◽  
Gynecological Exam

Abstract Background. There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: 1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; 2) health center capacity building for provision of LARC methods, and 3) LARC promotion by community health workers (CHW) trained in community-based provision (CBP) of oral and injectable contraception. From 2015-2016, this service was integrated into eight government health centers in Kigali, reaching 6,072 clients and resulting in 5,743 LARC insertions. Methods. From May-July 2016, we conducted health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision.Results. Few nurses had received training in LARC insertion (41% implant, 27% intrauterine device (IUD)). All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (average 16.4), implants (average 56.1), functional gynecological exam tables (average 2.3), and lamps for viewing the cervix (average <1). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions. To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

HUBUNGAN ANTARA PEMAKAIAN ALAT KONTRASEPSI SUNTIK DENGAN GANGGUAN MENSTRUASI PADA AKSEPTOR KB SUNTIK

2018 ◽  
Vol 5 (07) ◽  
pp. 7-13
Author(s):  
Andi St. Umrah ◽  
Andi Kasrida Dahlan
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Health Center ◽  
Quantitative Research ◽  
Health Centers ◽  
Menstrual Disorders ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Injectable Contraceptive ◽  
The Relationship

The purpose of this study was to determine the relationship between the use of the injectable contraceptive menstrual disorders in family planning acceptors syringes in health centers-Bone Bone North Luw.This type of research is quantitative research with cross sectional. The sample in this study are acceptor injections that come to visit at the time of the study in Health Center Bone-bone North Luwu in 2015 as many as 41 people with purposive sampling techniques.The results showed there is a relationship between the use of injectable contraceptive with menstrual disorders on injecting kb acceptor- Health Center Bone Bone North Luwu in 2015, where the value of p = 0.000 <value α: 0:05.For midwives who work in the health center Bone-bone further improve the coverage of family planning acceptors and counseling about the side effects of injections on the acceptors. For acceptors are expected to choose appropriate contraception. Keywords : Contraceptive Injections, Menstrual Disorders

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS PADA IBU HAMIL

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Negative Impact ◽  
Univariate Analysis ◽  
Good Condition ◽  
Health Centers ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>

HUBUNGAN ANTARA UMUR BALITA DAN PENGETAHUAN IBU DENGAN KEJADIAN PNEUMONIA PADA BALITA DI PUSKESMAS CAMBAI TAHUN 2016

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri
Keyword(s):  
Health Center ◽  
Sampling Technique ◽  
Health Centers ◽  
Survey Method ◽  
Maternal Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Workers ◽  
Important Health

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.

scholarly journals Exploring country-wide equitable government health care facility access in Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Dowhaniuk
Keyword(s):  
Health Care ◽  
Random Forest ◽  
Health Center ◽  
Travel Time ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Walking Distance ◽  
Laboratory System ◽  
Government Health ◽  
Sub Saharan

Abstract Background Rural access to health care remains a challenge in Sub-Saharan Africa due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Sub-Saharan Africa often lack equity, leaving disproportionately less health center access for the poorest residents with the highest health care needs. Lack of health care equity in Sub-Saharan Africa has become of increasing concern as countries enter a period of simultaneous high infectious and non-communicable disease burdens, the second of which requires a robust primary care network due to a long continuum of care. Bicycle ownership has been proposed and promoted as one tool to reduce travel-related barriers to health-services among the poor. Methods An accessibility analysis was conducted to identify the proportion of Ugandans within one-hour travel time to government health centers using walking, bicycling, and driving scenarios. Statistically significant clusters of high and low travel time to health centers were calculated using spatial statistics. Random Forest analysis was used to explore the relationship between poverty, population density, health center access in minutes, and time saved in travel to health centers using a bicycle instead of walking. Linear Mixed-Effects Models were then used to validate the performance of the random forest models. Results The percentage of Ugandans within a one-hour walking distance of the nearest health center II is 71.73%, increasing to 90.57% through bicycles. Bicycles increased one-hour access to the nearest health center III from 53.05 to 80.57%, increasing access to the tiered integrated national laboratory system by 27.52 percentage points. Significant clusters of low health center access were associated with areas of high poverty and urbanicity. A strong direct relationship between travel time to health center and poverty exists at all health center levels. Strong disparities between urban and rural populations exist, with rural poor residents facing disproportionately long travel time to health center compared to wealthier urban residents. Conclusions The results of this study highlight how the most vulnerable Ugandans, who are the least likely to afford transportation, experience the highest prohibitive travel distances to health centers. Bicycles appear to be a “pro-poor” tool to increase health access equity.

scholarly journals Integration of Family Planning Counselling to Mass Screening Campaign for Cervical Cancer: Experience from Guinea

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
D. W. A. Leno ◽  
F. D. Diallo ◽  
A. Delamou ◽  
F. D. Komano ◽  
M. Magassouba ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Family Planning ◽  
Mass Screening ◽  
Local Treatment ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Capital Cities ◽  
Long Acting ◽  
Cancer Experience

Aim. To assess feasibility of integrating family planning counselling into mass screening for cervical cancer in Guinea. Methodology. This was a descriptive cross-sectional study conducted over a month in Guinea regional capital cities. The targeted population comprised women aged 15 to 49 years. Nearly 4000 women were expected for the screening campaigns that utilized VIA and VIL methods with confirmation of positive tests through biopsy. A local treatment was immediately performed when the patient was eligible. Results. Overall 5673 women aged 15 to 60 years were received, a surplus of 42% of the expected population. 92.3% of women were aged 15–49 years and 90.1% were 25–49 years. Long-acting methods were the most utilized (89.2% of family planning users). 154 precancerous and cancerous lesions were screened, a global positivity rate of 2.7%. Conclusion. Integration of counselling and family planning services provision during cervical cancer mass screening is a feasible strategy. A cost-effective analysis of this approach would help a better planning of future campaigns and its replication in other contexts.

scholarly journals Relationship with the Regularity of Visits Complications of Hypertension in Patients more than 45 years old

2014 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Wahyu Wijayanto ◽  
Prijono Satyabakti
Keyword(s):  
Health Center ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Excessive Consumption ◽  
Level Of Knowledge ◽  
Cross Tabulation ◽  
Hypertension Knowledge ◽  
The Relationship

  ABSTRACTHypertension being a risk factor for the entrance of various degenerative diseases such as coronary heart disease, stroke and other vascular Penyait. One factor that may increase the risk of hypertension one of them is poor lifestyle such as smoking, excessive consumption of salt in the diet and lack of exercise. This study was conducted to determine the level of knowledge about the relationship with the regularity of visits Complications of Hypertension Hypertension in Patients 45 years of age at the Tembok Dukuh  health center at Surabaya. The study was an observational cross-sectional study design. Sample size were 48 people that hypertensive patients more than 45 years old  who were treated at the Tembok Dukuh  health center. Independent variables, namely knowledge about the complications of hypertension patients and dependent variable is the regularity of visits to theTembok Dukuh health center patients with hypertension  Data analysis using the crosstab tes The results with cross-tabulation (crosstab) can be seen as many as 30 people from 48 respondents have less knowledge and affect the regularity of visits to the Tembok Dukuh health center. The conclusion can be drawn that most hypertensive patients more than 45 years old whose came to Tembok Dukuh  health centers has less knowledge about hypertension complications that result in hypertensive patients regularity of visits decreasedKeyword : hypertension, knowledge, regularity of visits 

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