scholarly journals Testing the effect of an integrated-intervention to promote access to sexual and reproductive healthcare and rights among women with disabilities in Ghana: a quasi-experimental study protocol

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
John Kuumuori Ganle ◽  
Charlotte Ofori ◽  
Samuel Dery
Keyword(s):  
Health Facility ◽  
Control Group ◽  
Local Health ◽  
Sexually Active ◽  
Individual Level ◽  
The Third ◽  
Health Facility Level ◽  
Quasi Experimental ◽  
Facility Level ◽  
The Individual

Abstract Background There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15–49 years in Ghana. Methods A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12 months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for confounders. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services. Trial registration Name of the registry: Pan African Clinical Trials Registry (PACTR). Trial ID: 14591. Date of registration: 02/01/2020. URL of trial registry record: https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=14591

scholarly journals Testing The Effect of an Integrated-Intervention To Promote Access to Sexual and Reproductive Healthcare and Rights Among Women With Disabilities In Ghana: A Quasi-Experimental Study Protocol

2021 ◽  
Author(s):  
John K. Ganle ◽  
Charlotte Ofori ◽  
Samuel Dery
Keyword(s):  
Health Facility ◽  
Control Group ◽  
Local Health ◽  
Sexually Active ◽  
Individual Level ◽  
The Third ◽  
Health Facility Level ◽  
Quasi Experimental ◽  
Facility Level ◽  
The Individual

Abstract Background: There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15-49years in Ghana. Methods: A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for effect modifiers. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion: Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services.

scholarly journals Peranan Pelatihan Learning Organization pada Perubahan Individu dan Institusi: Pengalaman Kabupaten Cianjur

2008 ◽  
Vol 2 (6) ◽  
pp. 273
Author(s):  
Ede Surya Darmawan
Keyword(s):  
Learning Organization ◽  
Control Group ◽  
Institutional Changes ◽  
Problem Analysis ◽  
Group Level ◽  
Post Intervention ◽  
Team Members ◽  
Individual Level ◽  
Quasi Experimental ◽  
The Individual

Dalam rangka mendukung peningkatan kapasitas aparat pemerintah daerah dalam melaksanakan peran dan fungsi setelah penerapan kebijakan desentralisasi, Unit Desentralisasi Departemen Kesehatan telah menyusun beberapa rencana strategis yang bertujuan mengantisipasi transisi desentralisasi, diantaranya adalah membangun organisasi pembelajar. Melihat bagaimana peranan pelatihan berpengaruh pada perubahan individu dan institusi pada lingkungan birokrasi yang lebih ketat pada tingkat pemerintah daerah. Penelitian ini adalah sebuah penelitian quasi-eksperimental dengan pre- dan post- intervensi, pengukuran yang berulang kali, dan kontrol yang tidak merata. Kelompok pertama akan menerima pelatihan SLLO (Xa) dan pendampingan (Xb). Kelompok kedua hanya akan berfungsi sebagai kelompok pengontrol. Penelitian ini menemukan: (1) Pelatihan LO efektif untuk meningkatkan pengetahuan, dan pemahaman peserta dalam perspektif kerja, masalah, keinginan mempebaiki diri dan menyebarkan kepada teman kerja. (2) Perubahan tingkat individu meliputi; keinginan memperbaiki perilaku kerja; keterbukaan dan kesiapan pencatatan perilaku; kesediaan menyediakan waktu; lebih banyak mempergunakan analisis penyebab masalah; lebih banyak dialog dan tidak terjebak dengan gejala; keinginan dan upaya menyebarkan LO dalam seminar dan pelatihan. (3) Bentuk perubahan kelompok dan institusi belum terlihat, berupa upaya untuk menyampaikan informasi pelatihan LO kepada peserta lintas sektor yang lebih luas. (4) Pengaruh lingkungan birokrasi pemerintah tingkat kabupaten mengakibatkan; perubahan individu berpengaruh pada perubahan kelompok sedikit; komunikasi membutuhkan waktu banyak; Sulit melakukan dialog antar anggota tim. Pada tingkat kecamatan keadaan berubah lebih baik; Perubahan individu yang berpengaruh pada perubahan kelompok lebih banyak; komunikasi antar anggota lebih cepat; dialog lebih mudah .Kata kunci : Pelatihan pembelajaran organisasi , perubahan individu dan institusiAbstractIn order to support local government capacity to implement their role and capacity after the implementation of decentralization policy, The Decentralization Unit of Ministry of Health RI has developed several strategic plans which directed to anticipate decentralization transition, such as learning organization. To objective of this study is to understand the effect of training program on individual and institutional changes in a more strict bureocratic environment. This study is a quasi-experimental study with pre and post intervention study design, several times measurements, and unequally distributed control. The first group receive SLLO training (Xa) and assistance (Xb). The second group is a control group. The study result show that: (1) the LO training is efective to increase knowledge and understanding of the trainees on job perspective, problem solving, self improvement need and distribution to group member (2) The individual level changes include the need to job behavioral improvement, the openness and readiness to record behaviour, more problem analysis, more dialogue and not trapped in surface symptoms, want and need to distribute LO in seminar and training (3) the group and institutional changes has not been seen yet (4) only small effect of individual changes to group level changes, communication needs plenty of time, difficult to conduct dialogue among team members. In sub-district level situation has chenged to a better situation, more effect of individual level cahnges to group level changes, faster communication between group members and easier dialogue.Keywords: Learning organization training, individual and institutional changes

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Effect of the Leisure Activities on the Level of Psychological stress among the elderly during the Coronavirus Outbreak

2021 ◽  
Vol 9 (1) ◽  
pp. 70-78
Author(s):  
Ayed Zureigat ◽  
Osama Abdel Fattah
Keyword(s):  
Psychological Stress ◽  
Healthy Aging ◽  
Leisure Activities ◽  
The Elderly ◽  
Control Group ◽  
Face To Face ◽  
Quasi Experimental ◽  
Physical Abilities ◽  
The Individual ◽  
Experimental Group

Background: It is well known that advancing age is accompanied by many negative feelings due to the feeling of loneliness and psychological emptiness, which leads to the individual feeling that society does not need him due to his weak physical abilities and thus this, will negatively affect healthy aging. Objective: The study aimed to investigate the effect of the leisure activities on the psychological stress among the elderly during Coronavirus (COVID-19) Outbreak. Design: To achieve this, we used the quasi-experimental approach on a sample consisting of 54, with the average age of (65.4±2.3) years. Divided into two groups 27 as a control group and 27 as the experimental group and this sample was purposively selected. Because of the home quarantine and to reduce face-to-face interaction, we used a questionnaire to measure the psychological stress level by using the Google form. The study tool consisted of 7 paragraphs associated with depression and 6 paragraphs associated with anxiety, finally 6 paragraphs associated with aggression. Before applying the experiment, the psychological stress was measured among the study sample, and then the leisure activities program was sent to the experimental group by the WhatsApp application. The researchers used means, standard deviations, paired and independent sample t-test by using SPSS version 24 with a confidence level of 95% (p<0.05). Results: The results of the study have shown that the level of the psychological stress among both groups came with a high average in the pre-measurement, as well as the anxiety domain that were the most affected in a positive way through leisure activities practicing. Additionally, there were statistically significant differences between the pre and post measurement among experiment group and favor of the post measurement. Conclusion: the leisure activities practicing among the elderly have contributed positively to reducing the level of psychological stress represented by depression, anxiety.

scholarly journals Determinants of Multimethod Contraceptive Use in a Sample of Adolescent Women Diagnosed with Psychological Disorders

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Delia L. Lang ◽  
Jessica M. Sales ◽  
Laura F. Salazar ◽  
Ralph J. DiClemente ◽  
Richard A. Crosby ◽  
...  
Keyword(s):  
Contraceptive Use ◽  
Psychological Disorders ◽  
Sexually Active ◽  
Individual Level ◽  
Adolescent Women ◽  
Multiple Partners ◽  
Concurrent Use ◽  
The Individual ◽  
Targeted Messages ◽  
Environmental Level

Objective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders.Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use.Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use.Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.

scholarly journals Voluntary Language Switching in the Context of Bilingual Aphasia

2020 ◽  
Vol 10 (9) ◽  
pp. 141
Author(s):  
Nicholas Grunden ◽  
Giorgio Piazza ◽  
Carmen García-Sánchez ◽  
Marco Calabria
Keyword(s):  
Group Performance ◽  
Ecological Validity ◽  
Control Group ◽  
Control Mechanisms ◽  
Reactive Control ◽  
Language Switching ◽  
Individual Level ◽  
Language Control ◽  
Bilingual Aphasia ◽  
The Individual

As studies of bilingual language control (BLC) seek to explore the underpinnings of bilinguals’ abilities to juggle two languages, different types of language switching tasks have been used to uncover switching and mixing effects and thereby reveal what proactive and reactive control mechanisms are involved in language switching. Voluntary language switching tasks, where a bilingual participant can switch freely between their languages while naming, are being utilized more often due to their greater ecological validity compared to cued switching paradigms. Because this type of task had not yet been applied to language switching in bilingual patients, our study sought to explore voluntary switching in bilinguals with aphasia (BWAs) as well as in healthy bilinguals. In Experiment 1, we replicated previously reported results of switch costs and mixing benefits within our own bilingual population of Catalan-Spanish bilinguals. With Experiment 2, we compared both the performances of BWAs as a group and as individuals against control group performance. Results illustrated a complex picture of language control abilities, indicating varying degrees of association and dissociation between factors of BLC. Given the diversity of impairments in BWAs’ language control mechanisms, we highlight the need to examine BLC at the individual level and through the lens of theoretical cognitive control frameworks in order to further parse out how bilinguals regulate their language switching.

A systematic review of vaccine availability at the national, district, and health facility level in the WHO African Region

2020 ◽  
Vol 19 (7) ◽  
pp. 639-651
Author(s):  
Chinwe Juliana Iwu ◽  
Ntombehle Ngcobo ◽  
Anelisa Jaca ◽  
Alison Wiyeh ◽  
Elizabeth Pienaar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Facility ◽  
African Region ◽  
Health Facility Level ◽  
Facility Level ◽  
Vaccine Availability

Definiteness in written Swedish by Finnish-speaking immersion pupils at the end of immersion

2018 ◽  
Vol 6 (1) ◽  
pp. 57-84
Author(s):  
Eeva-Liisa Nyqvist
Keyword(s):  
Control Group ◽  
Group Level ◽  
Individual Level ◽  
Definite Form ◽  
Spontaneous Writing ◽  
Acquisition Order ◽  
The Individual ◽  
The Right ◽  
Better Than

Abstract There are two primary goals for this study – first, to analyse definiteness and article use in spontaneous writing in Swedish by 15-year-old Finnish immersion students (n = 162) and secondly, to compare their performance with that of non-immersion students at the same age (n = 67). Analyses at the group level show that immersion students usually perform significantly better than the control group, but they also reveal similar problems to what L2-Swedish non-immersion students have demonstrated in previous studies, such as omission of indefinite articles and difficulty in choosing the right definite form of the noun. Still, these inaccuracies occurred less often in the data from the immersion students. The studied constructions also show at the group level an acquisition order similar to that reported in previous studies, explainable by different aspects of complexity and cross-linguistic influence. Analyses on the individual level, however, show different acquisition orders depending on the criteria being used.

scholarly journals Baseline results of the first malaria indicator survey in Iran at the health facility level

2011 ◽  
Vol 10 (1) ◽  
pp. 319 ◽  
Author(s):  
Ahmad Raiesi ◽  
Fatemeh Nikpour ◽  
Alireza Ansari-Moghaddam ◽  
Mansoor Ranjbar ◽  
Fatemeh Rakhshani ◽  
...  
Keyword(s):  
Health Facility ◽  
Malaria Indicator Survey ◽  
Health Facility Level ◽  
Facility Level

scholarly journals Factors influencing treatment outcomes in tuberculosis patients in Limpopo Province, South Africa, from 2006 to 2010: A retrospective study

Curationis ◽  
2014 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammed M. Gafar ◽  
Norman Z. Nyazema ◽  
Yoswa M. Dambisya
Keyword(s):  
South Africa ◽  
Treatment Outcomes ◽  
Health Facility ◽  
Treatment Regimen ◽  
Diagnostic Category ◽  
Limpopo Province ◽  
World Health ◽  
Factors Influencing ◽  
Health Facility Level ◽  
Facility Level

Background: South Africa has a high burden of tuberculosis (TB), with high human immunodeficiency virus (HIV)-TB co-infection rates and the emergence of multidrugresistant TB.Objectives: To describe treatment outcomes and factors influencing outcomes amongst pulmonary TB (PTB) patients in the Limpopo Province.Method: A retrospective review was conducted of data on the provincial electronic TB register (ETR.net) for the years 2006 to 2010 (inclusive), and a random sample of 1200 records was selected for further analysis. The Chi square test was used to examine the influence of age, gender, health facility level, diagnostic category and treatment regimen on treatment outcomes.Results: Overall 90 617 (54.6% male) PTB patients were registered between 2006 and 2010. Of the sampled 1200 TB cases, 72.6% were in persons aged 22 to 55 years and 86.2% were new cases. The TB mortality rate was 13.6% (much higher than the World Health Organization target of 3%), whilst the default rate was 9.8%. There was a strong association between age (P < 0.001), diagnostic category (P < 0.001), treatment regimen (P < 0.001), and health facility level (P < 0.001) and treatment outcome. Those aged 22–55, and 56–74 years were more likely to die (P < 0.05). Poor treatment outcomes were also associated with initial treatment failure, receiving treatment at hospital and treatment regimen II.Conclusion: The poor TB treatment outcomes in Limpopo, characterised by a high mortality and default rates, call for strengthening of the TB control programme, which should include integration of HIV and/or AIDS and TB services. 

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