Addressing malnutrition among children in routine care: how is the Integrated Management of Childhood Illnesses strategy implemented at health centre level in Burundi?

Background: Antenatal care (ANC) services are the gateway for integrated management of several conditions that adversely affect the mother and foetus. More stillbirths than neonatal deaths in South Africa are a reflection of poor quality ANC services. Aim: The primary aim of this study was to explore the reasons for late booking, and also to determine pregnant women’s knowledge, perceptions and attitude towards antenatal care services they receive in Mthatha area in Eastern Cape, South Africa. Setting: This was a qualitative study, conducted at Mbekweni Health Centre in the King Sabata Dalindyebo (KSD) subdistrict municipality of the Eastern Cape Province. Methods: This qualitative study consisted of selected pregnant women who presented after 19 weeks of gestation at Mbekweni Health Centre. Data were collected through two different methods, namely, semi-structured interviews and focus group discussions were used until saturation of the themes were reached. The interviews were transcribed verbatim and thematic analyses were undertaken. Results: Twenty women participated in the study. They were diverse in terms of age 18–41 years, gravidity 1–6 and time of ANC booking 20–28 weeks. The interviews identified a variety of personal, service and organisational reasons for late ANC booking. The themes identified for late ANC bookings were: health care system related issues, socio-economic factors, women’s perceptions and knowledge, and failure of family planning services. Conclusions: Women’s beliefs, knowledge and perceptions regarding antenatal services outweigh the perceived benefit of early ANC visit. The majority of women had lack of knowledge of contraception, early signs of pregnancy, purpose, timing and benefits of ANC visit.

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Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment.

10.21203/rs.2.19785/v2 ◽

2020 ◽

Author(s):

Paul BIZIMANA ◽

Katja POLMAN ◽

Giuseppina ORTU ◽

Meryam KRIT ◽

Frédéric NSABIYUMVA ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Health Centre ◽

Health Information System ◽

Routine Data ◽

Direct Smear ◽

Incidence Data ◽

Intestinal Schistosomiasis ◽

The Impact ◽

Health Centre Level

Abstract Background : Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school-based surveys with Kato-Katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods : From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts between 2011 and 2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, prevalence data on intestinal schistosomiasis based on Kato-Katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Findings : In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β 2014 =-0.826, p=0.010) and 2015 (β 2015 =-1.294, p<0.001) and for the five-year period (β=-0.286, p<0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β=-0.087, p=0.219). In most of the 45 sanitary districts, the low prevalences based on Kato-Katz in schoolchildren were confirmed by low incidence rates based on direct smear in the health centres. Conclusions : National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the Point-of-care Circulating Cathodic Antigen assay are desirable. Keywords : Direct smear, Health centre, Mass drug administration, Monitoring, Praziquantel, Routine data, Schistosomiasis, Burundi

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Traditional Beliefs and Practices among post-partum women attending Postpartum clinic, at Bukulula Health Centre IV Kalungu district

10.51168/sjhrafrica.v2i6.26 ◽

2021 ◽

Author(s):

◽

Irene Nakibuuka

Keyword(s):

Postpartum Period ◽

Post Partum ◽

Health Centre ◽

Structured Interview ◽

Routine Care ◽

Nutritional Deficiencies ◽

Postpartum Women ◽

Traditional Beliefs ◽

Maternal Deaths ◽

Beliefs And Practices

Background: Maternal deaths in the postpartum period contribute greatly to the global burden of maternal mortality especially in developing countries where 99% of these maternal deaths occur. Almost 40% of women develop serious illness after birth, and close to 50% of maternal deaths occur after delivery. Other problems encountered during the postpartum period include anemia, nutritional deficiencies, infection, family violence, and emotional problems most of which are associated with the mothers’ traditional beliefs and practices. Some of these beliefs and practices used are beneficial to their health, some are non-beneficial but harmless whereas others are harmful and greatly contribute to maternal morbidity and mortality. Methodology: This was a qualitative descriptive study that was conducted among ten purposively selected postpartum women attending a postpartum clinic at Bukulula health center IV. Data was collected through in-depth face-to-face interviews using a semi-structured interview guide and an audio recorder to track the proceedings of each interview. Data were analyzed based on emerging themes, following transcription of the interviews. Results: Three themes emerged from the study and these were; dietary precautions, behavioral precautions and hygiene, and physical warmth. Conclusion and recommendation: Some of the traditional beliefs and practices held by postpartum women are beneficial and can be incorporated into routine care provided whereas others are harmful and need to be restructured.

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