scholarly journals Economic consequences of caesarean section delivery: evidence from a household survey in Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peter Binyaruka ◽  
Amani Thomas Mori
Keyword(s):  
Caesarean Section ◽  
Health Resources ◽  
Household Survey ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Important Indicator ◽  
Normal Delivery ◽  
Public Facilities ◽  
Life Saving

Abstract Background Caesarean section (C-section) delivery is an important indicator of access to life-saving essential obstetric care. Yet, there is limited understanding of the costs of utilising C-section delivery care in sub-Saharan Africa. Thus, we estimated the direct and indirect patient cost of accessing C-section in Tanzania. Methods Cross-sectional survey data of 2012 was used, which covered 3000 households from 11 districts in three regions. We interviewed women who had given births in the last 12 months before the survey to capture their experience of care. We used a regression model to estimate the effect of C-section on costs, while the degree of inequality on C-section coverage was assessed with a concentration index. Results C-section increased the likelihood of paying for health care by 16% compared to normal delivery. The additional cost of C-section compared to normal delivery was 20 USD, but reduced to about 11 USD when restricted to public facilities. Women with C-section delivery spent an extra 2 days at the health facility compared to normal delivery, but this was reduced slightly to 1.9 days in public facilities. The distribution of C-section coverage was significantly in favour of wealthier than poorest women (CI = 0.2052, p < 0.01), and this pro-rich pattern was consistent in rural districts but with unclear pattern in urban districts. Conclusions C-section is a life-saving intervention but is associated with significant economic burden especially among the poor families. More health resources are needed for provision of free maternal care, reduce inequality in access and improve birth outcomes in Tanzania.

scholarly journals Economic Consequences of Caesarean Section Delivery: Evidence From a Household Survey in Tanzania

2021 ◽  
Author(s):  
Peter Binyaruka ◽  
Amani Thomas Mori
Keyword(s):  
Caesarean Section ◽  
Health Resources ◽  
Household Survey ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Important Indicator ◽  
Normal Delivery ◽  
Public Facilities ◽  
Life Saving

Abstract Background: Caesarean section (C-section) delivery is an important indicator of access to life-saving essential obstetric care. Yet, there is limited understanding of the costs of utilising C-section delivery care in sub-Saharan Africa. Thus, we estimated the direct and indirect patient cost of accessing C-section in TanzaniaMethods: Cross-sectional survey data of 2012 was used, which covered 3000 households from 11 districts in three regions. We interviewed women who had given births in the last 12 months before the survey to capture their experience of care. We used a regression model to estimate the effect of C-section on costs, while inequality on C-section coverage and delivery costs were assessed with a concentration index. Results: C-section increased the likelihood of paying for health care by 16% compared to normal delivery. The additional cost of C-section compared to normal delivery was 20 USD, but reduced to about 11 USD when restricted to public facilities. Women with C-section delivery spent an extra 2 days at the health facility compared to normal delivery, but this was reduced slightly to 1.9 days in public facilities. The distribution of C-section coverage was significantly in favour of wealthier than poorest women (CI=0.2052, p<0.01), and this pro-rich pattern was consistent in rural districts but with unclear pattern in urban districts. Conclusions: C-section is a life-saving intervention but is associated with significant economic burden especially among the poor families. More health resources are needed for provision of free maternal care, reduce inequality in access and improve birth outcomes in Tanzania.

scholarly journals Exploring the link between handwashing proxy measures and child diarrhea in 25 countries in sub-Saharan Africa: a cross-sectional study

2017 ◽  
Vol 7 (2) ◽  
pp. 312-322 ◽  
Author(s):  
Mitsuaki Hirai ◽  
Amira Roess ◽  
Cheng Huang ◽  
Jay P. Graham
Keyword(s):  
Fixed Effects ◽  
Prevalence Ratio ◽  
Household Survey ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Important Indicator ◽  
Sub Saharan

Handwashing (HW) with soap is considered the most cost-effective intervention for reducing the risk of child diarrhea, but reliable measurement of HW behaviors is difficult. This study examined the association between proxy HW measures and child diarrhea by analyzing nationally representative household survey data from 25 countries in sub-Saharan Africa (n = 212,492). The main explanatory variable was the HW ladder, representing a varying level of availability of HW materials in the household, and the outcome variable was a 2-week prevalence of child diarrhea. We estimated the prevalence ratio of child diarrhea between children with a basic HW station and without a HW place. Our analysis revealed that availability of water and soap at a HW place was associated with both increased and decreased prevalence ratios: 0.89 (95% CI 0.79–0.99) in Chad, 0.82 (0.69–0.97) in Mauritania, 1.30 (1.02–1.66) in Burkina Faso, and 1.67 (1.20–2.33) in Ghana. After controlling for country-fixed effects, the prevalence ratio was 0.95 (0.92–0.99), suggesting a protective effect of having a HW station with water and soap. Availability of HW resources is an important indicator to prevent child diarrhea, and HW promotion programs should be tailored to the unique context of each country.

scholarly journals Overview of Some Factors Affecting the Durability and Efficacy of LLINs Used by the Communities in South Region of Cameroon, Central Africa

2021 ◽  
Author(s):  
Patrick NTONGA AKONO ◽  
Serge Mbongue ◽  
Odette Ngo Hondt ◽  
Francis Noel Nopowo Takap ◽  
Rachel Ngaha ◽  
...  
Keyword(s):  
Wild Strain ◽  
Central Africa ◽  
Household Survey ◽  
Sub Saharan Africa ◽  
Reference Laboratory ◽  
The Sun ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Awareness Campaigns ◽  
Rural Settings

Abstract Background: Long-lasting insecticidal nets (LLINs) are widely used in sub-Saharan Africa to control the transmission of malaria parasites by Anopheles mosquitoes. However, their operational lifespan depends on numerous factors that are often not considered. This paper investigates on some of the factors likely associated with the rapid breakdown of LLINs efficacy in urban and rural settings of the seaport city of Kribi, South Region of Cameroon. Methods: A cross-sectional survey was conducted in June 2019 including: (i) a household survey using standard questionnaire for brands of LLINs used, their maintenance, and coverage rates in study communities, (ii) assessment of the physical integrity of nets, and (iii) WHO cone bioassays to determine the residual efficacy of the nets against wild strains and susceptible reference laboratory strains of Anopheles gambiae s. l. species. Results: A total of 540 households were surveyed, 235 in Kribi- urban and 305 in Kribi-rural. The overall net coverage rate per sleeping space was 68.82%, irrespectively with a similar trend between Kribi-rural (68.98%) and Kribi-urban (68.62%) (p = 0.929). Of the 1,211 LLINs recorded, 64.73% were Interceptor®, 25.44% were PermaNet®, 4.68% were Olyset Net ; the remainder (05.13%) belonged to Yorkool®, Royal Sentry®, Netto®, Super Net® and Panda Net®. The hole indices were significantly correlated to the frequency of washes in kribi-urban as well as kribi-rural settings (p≤ 10-3). Nets washed with ordinary soap had lower hole indices compared to nets washed with corrosive detergents in the two groups of settings in the study area (p≤ 10-4). Likewise, nets dried under the sun significantly recorded a higher hole indices compared to nets dried in a shaded area (p≤ 0.04) in the two groups of settings. Polyethylene fibers were significantly less degraded than polyester fibers. The bio efficacy results revealed 21.6% - 99.6% mortality rates of the Kisumu strain exposed to LLINs washed more than 20 times and from 0.8% to 76.50% for the wild strain. LLINs washed with ordinary soap significantly retained their lethal properties more than LLINs washed with corrosive detergents (p=10-4). Similarly, LLINs dried in the shade retained their lethal properties more than those spread in the sun.Conclusion: Excessive washes, Corrosive detergents and drying regimes are factors that degrade the toxic effect of insecticide impregnated on LLINs. Awareness campaigns are needed to encourage people to adopt good LLIN maintainance practices.

scholarly journals Suicidal ideation and associated factors among school-going adolescents in rural Ghana

2021 ◽  
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Samuel Kofi Odame
Keyword(s):  
Suicidal Ideation ◽  
Associated Factors ◽  
Attempted Suicide ◽  
Sub Saharan Africa ◽  
Rural Adolescents ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural Ghana ◽  
Sub Saharan

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.

scholarly journals Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 510
Author(s):  
Lauren Périères ◽  
Fabienne Marcellin ◽  
Gora Lo ◽  
Camelia Protopopescu ◽  
El Ba ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Dose Schedule ◽  
World Health Organisation ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hepatitis B Vaccination ◽  
Detailed Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hbv Vaccination

Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.

Evaluation of health system in Iraq from people's point of view: a comparative study of two different eras

2021 ◽  
Vol 4 (2) ◽  
pp. 380-387
Author(s):  
Saad Ahmed Ali Jadoo ◽  
Adil H. Alhusseiny ◽  
Shukr Mahmood Yaseen ◽  
Mustafa Ali Mustafa Al-Samarrai ◽  
Anmar Shukur Mahmood
Keyword(s):  
Health System ◽  
Health Sector ◽  
Health Resources ◽  
Sampling Technique ◽  
Point Of View ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Current Health ◽  
Multi Stage ◽  
Geographical Regions

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001),  and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

scholarly journals Stigmatising Attitudes Towards Co-workers with HIV in the Workplace of a Metropolitan State, Southwestern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Idongesit Godwin Utuk ◽  
Kayode Omoniyi Osungbade ◽  
Taiwo Akinyode Obembe ◽  
David Ayobami Adewole ◽  
Victoria Oluwabunmi Oladoyin
Keyword(s):  
Sampling Technique ◽  
Sub Saharan Africa ◽  
Good Knowledge ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

scholarly journals Prevalence and Correlates of Pregnancy Self-Testing Among Pregnant Women Attending Antenatal Care in Western Kenya

2020 ◽  
Author(s):  
Nina Njeri Nganga ◽  
Julia Dettinger ◽  
John Kinuthia ◽  
Jared Baeten ◽  
Grace John-Stewart ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Western Kenya ◽  
Self Testing ◽  
Sub Saharan ◽  
Exposure Prophylaxis

Abstract In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) attendance. Understanding the characteristics of women who use pregnancy self-tests may facilitate early access to ANC and preventive interventions in pregnancy. We conducted a cross-sectional survey on an ongoing pre-exposure prophylaxis (PrEP) implementation study which enrolled pregnant women to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall in our study population, the prevalence of pregnancy self-testing was 22% and higher among women who were employed, currently in school, had previous pregnancy complications, received services from urban health facilities, and had partners who had at least attended secondary school. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and lack of money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing.

scholarly journals Postpartum quality of life after normal vaginal delivery and caesarean section

2015 ◽  
Vol 2 (2) ◽  
pp. 13-18
Author(s):  
Yogendra Amatya ◽  
Samita Acharya
Keyword(s):  
Quality Of Life ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Family Type ◽  
Normal Vaginal Delivery ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Physical Health Composite Score

Introductions: Caesarean section is rising. The best method of delivery, vaginal or caesarean, for postpartum quality of life in women is a matter of controversy both from professionals’ perspectives and from women’s experience of childbirth. This study analyses quality of life after these two methods of deliveries.Methods: This was a cross-sectional comparative study in postnatal care outpatient department at Patan Hospital. Primipara women with normal delivery and elective caesarean section done in Patan Hospital were enrolled to analyse postpartum quality of life. The SF-12 questionnaire tool at 6 weeks post delivery was used to compare age, ethnicity, education, family type and employment. Data was analysed using ANOVA test for descriptive parameters.Results: There were 468 primipara, age 30-45 years, 94% in 15-30 years77.8% educated, 74.4% in joint family,73.5% housewife. Normal vaginal delivery was 360 (72.6%) and 128 (27.4%) elective caesarean. Vaginal delivery group had average SF score of Physical Health Composite Score of 68.7, Mental Health CompositeScore69.5 and total SF score 67.7. While in caesarean group, it was 64.8,64.1 and 63.4.Conclusions: Normal vaginal delivery had better quality of life resulting in both superior physical as well as mental health.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page:13-18

scholarly journals Strengthening district healthcare in rural Africa: a cross-sectional survey assessing difficulties in pulse oximetry use and handoff practices

2018 ◽  
Vol 6 (1) ◽  
pp. 57
Author(s):  
Herbert G. Masigati ◽  
Grant W. Potter ◽  
Masahiro J. Morikawa ◽  
Rashid S. Mfaume
Keyword(s):  
Pulse Oximetry ◽  
Patient Care ◽  
Point Of Care ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Information Reporting ◽  
Rural Africa ◽  
Sub Saharan ◽  
Developing Settings

Background: Rural hospitals in sub-Saharan Africa suffer from numerous disparities in resources and practices, and subsequently patient care is affected.Methods: In order to assess current practices and opportunities for improvement in pulse oximetry use and patient-care handoffs, a cross-sectional survey was administered to clinicians at a referral level hospital serving a large rural area in Shinyanga, Tanzania.Results: Respondents (n=46) included nurses (50%), medical doctors (48%), and clinical officers (2%). A response rate of 92% was achieved, and 81% of clinicians acknowledged routine difficulties in the use of current devices when obtaining pulse oximetry. Although 83% of respondents reported using a written handoff at shift change, information reporting was inconsistent and rarely included specific management guidance.Conclusions: Further research is needed to elucidate handoff practices in developing settings, but there is a large opportunity for novel point-of-care devices and tools to improve both pulse oximetry use and patient care handoffs in rural Africa.

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