scholarly journals Implementation of a neonatal hepatitis B immunization program in rural Karenni State, Myanmar: A mixed-methods study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261470
Author(s):  
T. Hugh Guan ◽  
Hnin Nandar Htut ◽  
Colleen M. Davison ◽  
Shruti Sebastian ◽  
Susan Andrea Bartels ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Health Care Facilities ◽  
Mixed Methods Study ◽  
Rural Setting ◽  
Health Concern ◽  
Neonatal Hepatitis ◽  
Immunization Program ◽  
Birth Dose

Background Hepatitis B infection is a major health concern in Myanmar. Hepatitis B birth dose vaccination to prevent mother-to-child transmission is not universal, especially in births outside of health care facilities. Little is documented about delivery of immunization programs in rural Myanmar or in conflict-affected regions. To address this gap, this study describes the implementation of a novel community delivered neonatal hepatitis B immunization program in rural Karenni State, Myanmar. Methods A mixed-methods study assessed the effectiveness and feasibility of hepatitis B birth dose immunization program. 1000 pregnant women were screened for hepatitis B virus (HBV) infection using point of care testing. Neonates of HBV positive mothers were immunized with a three dose HBV vaccine schedule at birth, 1, and 6 months of age. HBV testing was completed for children at 9 months to assess for infection. Descriptive statistics were collected including demographic data of mothers, neonatal vaccination schedule completion, and child HBV positivity at 9 months. Qualitative data examining barriers to implementation were collected through semi-structured interviews, participant-observation, and analysis of program documents. Themes were codified and mapped onto the Consolidated Framework for Implementation Research. Results 46 pregnant women tested HBV positive leading to 40 live births. 39 women-child dyads were followed until the 9-month age mark. With the exception of two neonates who received their birth dose past 24 hours, all children received their vaccines on time. None of the 39 children tested positive for HBV at nine months. Themes regarding barriers included adaptability of the program to the rural setting, friction with other stakeholders and not meeting all needs of the community. Identified strengths included good communication and leadership within the implementing ethnic health organization. Conclusion A community delivered neonatal HBV vaccination program by ethnic health organizations is feasible and effective in rural Myanmar.

scholarly journals Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study

2021 ◽  
Vol 15 (2) ◽  
pp. 155798832110060
Author(s):  
Patrice Ngangue ◽  
Middle Fleurantin ◽  
Rheda Adekpedjou ◽  
Leonel Philibert ◽  
Marie-Pierre Gagnon
Keyword(s):  
Mixed Methods ◽  
Pregnant Women ◽  
Male Involvement ◽  
Mixed Methods Study ◽  
Mother To Child Transmission ◽  
Male Partners ◽  
Hiv Status ◽  
Child Transmission ◽  
Factors Associated ◽  
Mother To Child

This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.

scholarly journals Arresting Vertical Transmission of Hepatitis B Virus (AVERT-HBV) in the Democratic Republic of the Congo

2021 ◽  
Author(s):  
Peyton Thompson ◽  
Camille E. Morgan ◽  
Patrick Ngimbi ◽  
Kashamuka Mwandagalirwa ◽  
Noro Ravelomanana ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Democratic Republic ◽  
Sub Saharan Africa ◽  
Pmtct Program ◽  
B Virus ◽  
Birth Dose ◽  
Republic Of The Congo ◽  
Dose Vaccine

Background: Hepatitis B virus (HBV) remains endemic throughout sub-Saharan Africa despite the widespread availability of effective vaccines. We evaluated the feasibility of adding HBV testing and treatment of pregnant women and birth-dose vaccination of HBV-exposed infants to the HIV prevention of MTCT (PMTCT) program infrastructure in the Democratic Republic of the Congo (DRC), where HBV treatment and birth-dose vaccination programs are not established. Methods: As part of the HIV PMTCT program at two maternity centers in Kinshasa, DRC, pregnant women were screened for HBV at routine prenatal care registration. Pregnant women with high viral load and/or HBeAg positivity were offered tenofovir disoproxil fumarate (TDF). HBV-exposed infants received a birth-dose of HBV vaccine within 24 hours of life. The primary endpoint was the feasibility and acceptability of the study. Results: Of 4,016 women screened, 109 (2.7%) were HBsAg-positive. Ten of 91 (11.1%) women evaluated had high-risk disease. Of 88 infants, 60 (68.2%) received a birth-dose vaccine; of these, 46 (76.7%) received a timely birth-dose. No cases of HBV MTCT were observed in our cohort. There were no serious adverse events associated with TDF nor with birth-dose vaccine. The study procedures were highly acceptable (>80%) among mothers. Conclusions: Adding HBV screening and treatment of pregnant women and infant birth-dose vaccination to existing HIV PMTCT platforms is feasible in countries like the DRC. Birth-dose vaccination against HBV integrated within the current Expanded Programme on Immunization (EPI) and HIV PMTCT program could accelerate progress toward HBV elimination in Africa.

scholarly journals Introduction of birth dose of hepatitis B virus vaccine to the immunization program in Ethiopia: an economic evaluation

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Solomon Tessema Memirie ◽  
Hailemichael Desalegn ◽  
Mulugeta Naizgi ◽  
Mulat Nigus ◽  
Lisanu Taddesse ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Virus Vaccine ◽  
Immunization Program ◽  
B Virus ◽  
Birth Dose ◽  
Hepatitis B Virus Vaccine

The Effect of Telephone Support on Depressive Symptoms Among HIV-Infected Pregnant Women in Thailand: An Embedded Mixed Methods Study

2013 ◽  
Vol 24 (5) ◽  
pp. e13-e24 ◽  
Author(s):  
Ratchneewan Ross ◽  
Wilaiphan Sawatphanit ◽  
Tatirat Suwansujarid ◽  
Andrea W. Stidham ◽  
Barbara L. Drew ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mixed Methods ◽  
Pregnant Women ◽  
Mixed Methods Study ◽  
Telephone Support

scholarly journals Comparing perspectives of family caregivers and healthcare professionals regarding caregiver burden in dementia care: results of a mixed methods study in a rural setting

2019 ◽  
Vol 49 (2) ◽  
pp. 199-207
Author(s):  
Simon Krutter ◽  
Dagmar Schaffler-Schaden ◽  
Roland Essl-Maurer ◽  
Laura Wurm ◽  
Alexander Seymer ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Mixed Methods Study ◽  
Rural Setting ◽  
Disruptive Behaviour ◽  
Cross Sectional Survey ◽  
Psychosocial Burden

Abstract Background Persons with dementia (PwD) need support to remain in their own homes as long as possible. Family caregivers, homecare nurses and general practitioners (GPs) play an important role in providing this support, particularly in rural settings. Assessing caregiver burden is important to prevent adverse health effects among this population. This study analysed perceived burden and needs of family caregivers of PwD in rural areas from the perspectives of healthcare professionals and family caregivers. Methods This was a sequential explanatory mixed methods study that used both questionnaires and semi-structured interviews. Questionnaires measuring caregiver burden, quality of life and nursing needs were distributed to the caregivers; health professionals received questionnaires with adjusted items for each group. Additionally, in-depth qualitative interviews were carried out with eight family caregivers. Results The cross-sectional survey population included GPs (n = 50), homecare nurses (n = 140) and family caregivers (n = 113). Healthcare professionals similarly assessed the psychosocial burden and stress caused by behavioural disturbances as most relevant. Psychological stress, social burden and disruptive behaviour (in that order) were regarded as the most important factors from the caregivers’ perspective. It was found that 31% of caregivers reported permanent or frequent caregiver overload. Eight themes related to caregiver burden emerged from the subsequent interviews with caregivers. Conclusions Professional support at home on an hourly basis was found to be highly relevant to prevent social isolation and compensate for lack of leisure among caregivers of PwD. Improvement of interprofessional dementia-related education is needed to ensure high-quality primary care.

scholarly journals Advice given by community members to pregnant women: a mixed methods study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Bianca A. Verma ◽  
Lauren P. Nichols ◽  
Melissa A. Plegue ◽  
Michelle H. Moniz ◽  
Manisha Rai ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Pregnant Women ◽  
Mixed Methods Study ◽  
Community Members

scholarly journals Understanding the Use of Smartphone Apps for Health Information Among Pregnant Chinese Women: Mixed Methods Study (Preprint)

2018 ◽  
Author(s):  
Na Wang ◽  
Zequn Deng ◽  
Li Ming Wen ◽  
Yan Ding ◽  
Gengsheng He
Keyword(s):  
Mixed Methods ◽  
Pregnant Women ◽  
Health Information ◽  
Fetal Development ◽  
Chinese Women ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Smartphone Apps ◽  
Lifestyle Modifications ◽  
Maternity Hospitals

BACKGROUND Hospital-based health promotion resources to assist pregnant women in adopting a healthy lifestyle and optimizing gestational weight gain are important, but with limited effects. Increasingly, women are using mobile apps to access health information during the antenatal period. OBJECTIVE The aims of the study were to investigate app-usage by Chinese women during pregnancy and to gain a better understanding of their views and attitudes toward apps containing health information. METHODS A mixed methods study design was applied. Study participants were recruited from 2 maternity hospitals in Shanghai, China, between March and July 2018. A self-administered Web-based survey was conducted with 535 pregnant Chinese women on their sources of health information and reasons for using apps during pregnancy. A total of 4 semistructured focus groups were also conducted with the pregnant women (n=28). RESULTS The use of pregnancy-related apps and the internet was common among the respondents. Almost half of the women had used pregnancy-related apps. Specifically, the use of apps for health information declined as pregnancy progressed from 70% (35/50) in the first trimester to 41.3% (143/346) in the third trimester. The main reason for using an app was to monitor fetal development (436/535, 81.5%), followed by learning about nutrition and recording diet in pregnancy (140/535, 26.2%). The women found that the apps were useful and convenient and can support lifestyle modifications during pregnancy. However, some apps also contained misinformation or incorrect information that could cause anxiety as reported by the participants. Many women expressed the need for developing an app containing evidence-based, well-informed, and tailored health information to support them during pregnancy. CONCLUSIONS The study suggests that apps were widely used by many Chinese women during pregnancy to monitor fetal development, to obtain diet and physical activity information, and to track their body changes. The women highly appreciated the evidence-based information, expert opinions, and tailored advice available on apps. Smartphone apps have the potential to deliver health information for pregnant women.

scholarly journals Unmet needs in occupational health: prevention and management of viral hepatitis in healthcare workers in Ho Chi Minh City, Vietnam: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052668
Author(s):  
Tran Nguyen ◽  
Trang Pham ◽  
Hong K Tang ◽  
Loc Phan ◽  
Gary Mize ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Healthcare Workers ◽  
Hepatitis B Surface Antigen ◽  
Mixed Methods Study ◽  
Ho Chi Minh City ◽  
Clinical Activity ◽  
Depth Interviews

ObjectivesVietnam is an endemic area for hepatitis B virus and hepatitis C virus infection (HBV-HCV), yet its largest city, Ho Chi Minh City (HCMC), has no comprehensive policy to educate, screen, treat and protect healthcare workers (HCWs) from viral hepatitis. We conducted a mixed-methods study to document HBV-HCV infection rates, risk factors, local barriers and opportunities for providing education, screening and medical care for HCWs.DesignThis mixed-methods study involved an HBV and HCV serological evaluation, knowledge, attitude and practice survey about viral hepatitis and many in-depth interviews. Descriptive statistics and thematic content analysis using inductive and deductive approaches were used.SettingHCMC, Vietnam.ParticipantsHCWs at risk of viral hepatitis exposure at three hospitals in HCMC.ResultsOf the 210 invited HCWs, 203 were enrolled. Of the 203 HCWs enrolled, 20 were hepatitis B surface antigen-positive, 1 was anti-hepatitis C antibody (anti-HCV Ab)-positive, 57 were anti-hepatitis B core Ab-positive and 152 had adequate anti-hepatitis B surface Ab (anti-HBs Ab) titre (≥10IU/mL). Only 50% of the infected HCWs reported always using gloves during a clinical activity involving handling of blood or bodily fluid. Approximately 50% of HCWs were still not vaccinated against HBV following 1 year of employment. In-depth interviews revealed two major concerns for most interviewees: the need for financial support for HBV-HCV screening and treatment in HCWs and the need for specific HBV-HCV guidelines to be independently developed.ConclusionsThe high HBV infection rate in HCWs coupled with inadequate preventive occupational practices among the population in HCMC highlight the urgent needs to establish formal policy and rigorous education, screening, vaccination and treatment programmes to protect HCWs from HBV acquisition or to manage those living with chronic HBV in Vietnam.

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