Safe Arrivals: Responding to the Local Context in a Training Program for Birth Attendants in Cambodia

2014 ◽  
Vol 4 (2) ◽  
pp. 77-85
Author(s):  
Lois V. McKellar ◽  
Kevin Taylor

The World Health Organization (WHO) recommends that every woman should have a skilled birth attendant (SBA) attend her birth; however, until this ideal is met, traditional birth attendants (TBA) continue to provide care to women, particularly in rural areas of countries such as Cambodia. The lack of congruence between an ideal and reality has caused difficulty for policy makers and governments. In 2007, The 2h Project, an Australian-based, nongovernment organization in partnership with a local Cambodian organization, “Smile of World,” commenced the “Safe Arrivals” project, providing annual training for SBAs and TBAs in the rural provinces of Cambodia. Following implementation of this project, feedback was collected through a questionnaire undertaken by interviews with participants. This was part of a quality assurance process to further develop training in line with WHO recommendations and to consider the cultural context and respond to local knowledge. Over a 2-year period, 240 birth attendants were interviewed regarding their role and practice. Specifically, through the responses to the questionnaires, several cultural practices were identified that have informed training focus and resource development. More broadly, it was evident that TBAs remain a valuable resource for women, acknowledging their social and cultural role in childbirth.

2021 ◽  
pp. 097275312199850
Author(s):  
Vivek Podder ◽  
Raghuram Nagarathna ◽  
Akshay Anand ◽  
Patil S. Suchitra ◽  
Amit Kumar Singh ◽  
...  

Rationale: India has a high prevalence of noncommunicable diseases (NCDs), which can be lowered by regular physical activity. To understand this association, recent population data is required which is representative of all the states and union territories of the country. Objective: We aimed to investigate the patterns of physical activity in India, stratified by zones, body mass index (BMI), urban, rural areas, and gender. Method: We present the analysis of physical activity status from the data collected during the phase 1 of a pan-India study. This ( Niyantrita Madhumeha Bharata 2017) was a multicenter pan-India cluster sampled trial with dual objectives. A survey to identify all individuals at a high risk for diabetes, using a validated instrument called the Indian Diabetes Risk Score (IDRS), was followed by a two-armed randomized yoga-based lifestyle intervention for the primary prevention of diabetes. The physical activity was scored as per IDRS (vigorous exercise or strenuous at work = 0, moderate exercise at home/work = 10, mild exercise at home/work = 20, no exercise = 30). This was done in a selected cluster using a mobile application. A weighted prevalence was calculated based on the nonresponse rate and design weight. Results: We analyzed the data from 2,33,805 individuals; the mean age was 41.4 years (SD 13.4). Of these, 50.6% were females and 49.4% were males; 45.8% were from rural areas and 54% from urban areas. The BMI was 24.7 ± 4.6 kg/m 2 . Briefly, 20% were physically inactive and 57% of the people were either inactive or mildly active. 21.2% of females were found physically inactive, whereas 19.2% of males were inactive. Individuals living in urban localities were proportionately more inactive (21.7% vs. 18.8%) or mildly active (38.9% vs. 34.8%) than the rural people. Individuals from the central (29.6%) and south zones (28.6%) of the country were also relatively inactive, in contrast to those from the northwest zone (14.2%). The known diabetics were found to be physically inactive (28.3% vs. 19.8%) when compared with those unaware of their diabetic status. Conclusion: 20% and 37% of the population in India are not active or mildly active, respectively, and thus 57% of the surveyed population do not meet the physical activity regimen recommended by the World Health Organization. This puts a large Indian population at risk of developing various NCDs, which are being increasingly reported to be vulnerable to COVID-19 infections. India needs to adopt the four strategic objectives recommended by the World Health Organization for reducing the prevalence of physical inactivity.


2010 ◽  
Vol 138 (3-4) ◽  
pp. 225-229
Author(s):  
Gorica Sbutega-Milosevic ◽  
Zorica Djordjevic ◽  
Zoran Marmut ◽  
Boban Mugosa

Introduction. Combating nutritional deficiencies of micronutrients, such as iodine, represents a priority task of health care organizations. In 2003, the World Health Organization (WHO) published the publication: Global Prevalence of Iodine Deficiency Disorders (IDD), according to which some 2,2 billion people live in areas poor in naturally occurring iodine. Approximately 13% of the world population suffer from goitre - one of the IDD. The recommended iodine content in table salt is 20-40 mg/kg, which should satisfy the daily iodine requirements of an adult. Objective. The authors sought to ascertain whether iodization of table salt in Montenegro was carried out in accordance with the existing legislature. An assessment was also carried out of the attitudes and habits of the population regarding the use of salt in nutrition and the level of awareness in relation to the relevance of table salt iodization. Methods. The research was carried out in 2004 and was sponsored by UNICEF. A sample of 594 homes from the municipalities of Bar and Podgorica was chosen: 354 homes from urban and 240 from rural areas. The participants completed a questionnaire related to the daily use and intake of salt, as well as their understanding of the relevance of table salt iodization. Iodine content was tested in 15 samples of table salt at production level, 170 samples at retail level and 126 samples taken from domestic use. Results. The analysis of table salt samples showed an optimal iodine level in 73.3% of samples from production, in 81.2% from retail, and in 73.0% from domestic use. A lower level of iodine was found in 8.8% retail samples and 15.1% samples from home use. A greater concentration of iodine was found in 26.7% production, 10.0% retail and 11.9% samples from domestic use. Conclusion. Although the application of the WHO programme has led to an improvement in iodization of table salt in Montenegro, both at production and retail levels, this still falls short of the standards recommended by WHO to combat IDD. The levels of iodine in table salt in domestic use also fail to comply with the WHO criteria for elimination of IDD.


Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.


1980 ◽  
Vol 209 (1174) ◽  
pp. 159-163

The purchase of drugs employs an increasingly large part of the health budget of many Third World countries. Like health care expenditure as a whole, drug spending is heavily biased in favour of urban hospitals, often for expensive proprietary drugs that offer little benefit over cheaper preparations. As a result, because limited funds are available, vaccines and drugs for prevention and primary care are sometimes unavailable, especially in rural areas. The World Health Organization and many individual countries have responded to the problem of drug costs by creating a limited list of drugs considered essential for health care needs. Other methods of curtailing spending on drugs have included tendering for supplies and the establishment of plants to manufacture and formulate drugs. Controls of this type meet enormous resistance from doctors and pharmaceutical manufacturers, but are vital for the implementation of policies for appropriate health care.


2021 ◽  
pp. 106648072110524
Author(s):  
Maria Sajan ◽  
Kriti Kakar ◽  
Umair Majid

The effects of suicide are both widespread and long-lasting in the lives of those closest to the deceased. According to the World Health Organization (WHO), suicide is the third leading cause of death in adolescents. Some research has shown that families who lose someone to suicide are at a higher risk of complicated grief compared to those bereaving from other types of losses. These risks may be emphasized given the socio-cultural context surrounding suicide that may problematize the grieving process. In this review, we analyzed 58 qualitative studies describing the experiences of family who lost someone to suicide. We discuss how negative social interactions due to cultural views towards suicide impacted their grieving process. We provide an integrative interpretation of the experiences of family who lost someone to suicide across the following themes: social withdrawal, family communication approaches, role change, cultural attitudes, the role of professional support, interactions with health care providers, and interactions with religious institutions. We examine these findings using the Assumptive World Theory which proposes that humans seek preservation of their reality by using their perceptions of the past to establish expectations for the future. We find that suicide loss is an experience that challenges people's assumptive worlds; suicide loss can be an unexpected trauma that can have a “shock effect” on the assumptive worlds of the bereaved. The assumptive worlds of relatives grieving suicide loss face unique challenges compared to other forms of bereavement because of ambiguity in social norms surrounding suicide that influence interactions.


2015 ◽  
Vol 20 (1) ◽  
Author(s):  
Wilmar Torres-López ◽  
Inés Restrepo-Tarquino ◽  
Charlotte Patterson ◽  
John Gowing ◽  
Isabel Dominguez Rivera

<p>Globally, access to improved water sources is lower in rural areas compared to urban areas. Furthermore, in rural areas many people use water from individual systems they have developed with their investments, often without external support. This phenomenon has been called Self-supply. Self-supply ranges from simple to complex systems and different water sources. Water quality varies, from achieving World Health Organization (WHO) standards (0 CFU/100 ml) to systems that provide water posing high risks to human health. While most studies in Self-supply have been developed in Africa, little is known in Latin America and the Caribbean (LAC). This research explores Self-supply in a rural microcatchment in Colombia (LAC). Data was collected through household and drinking water surveys and analysed. Results showed that 40% of households used Self-supply systems taking water from springs and brooks. Thermotolerant Coliforms were below 50 CFU/100 ml, both in dry and rainy season, and between 5 to 7% of samples achieved the WHO standard. These results suggest that Self-supply has potential to offer safe drinking water, provided improvements on source protection and institutional support. Therefore, Self-supply could contribute to address “unfinished business”, including ensuring access for the hardest-to-reach people, as stated in the post-2015 development agenda.</p>


2010 ◽  
Vol 7 (3) ◽  
pp. 71-74 ◽  
Author(s):  
E. A. Sorketti ◽  
N. Z. Zuraida ◽  
M. H. Habil

The importance of traditional healing in low- and middle-income countries cannot be under estimated. It is generally perceived as part of the prevailing belief system and traditional healers are often seen as the primary agents for psychosocial problems in these countries; estimates of their service share range from 45% to 60% (World Health Organization, 1992). The World Health Organization (2000) estimated that 80% of people living in rural areas in low- and middle-income countries depend on traditional medicine for their health needs.


2020 ◽  
Author(s):  
Chandra Shekhar Azad Kashyap ◽  
Swati Singh

&lt;p&gt;India is one of the fastest economic growing and second-largest country by population. More than 75% people are living in rural areas and engage with agricultural activities for livelihood. A significant portion of the revenue comes from agriculture which cause ignorance in follow the guideline to get more yield. The supply of good quality food and drinking water are the necessity for economic and social health welfare of urban and rural population. In this study, we have observed that the groundwater quality is being degrading due to improper implementation of the rules and regulation. Twenty three groundwater sample were analyze for arsenic and trace elements contamination. The arsenic content in groundwater ranging from 10 to 780 &amp;#181;g/L, which is far above the levels for drinking water standards prescribed by World Health Organization (WHO). For identify the provable source of the contamination, four soil sample were analyzed and observed arsenic content ranging from 110 to 190 mg/kg. Rice is the staple food and ultimately cultivating the paddy crop on more over 80% of the agricultural land. The Paddy crop requires a large amount of water, ultimately maintain the waterlogging condition in the agricultural field. This waterlogging condition is providing a long time to get dissolution of the arsenic bearing minerals present in the soil. This study concluded that the traditional practicing of continuous growing paddy crop in the same field leading to groundwater contamination. The crops cycling could be a better option for reducing the contamination at a local scale.&lt;/p&gt;


2016 ◽  
Vol 18 (4) ◽  
pp. 509-522 ◽  
Author(s):  
Reema Gill

The human resources for health (HRH), especially nurses, constitute an important part of health systems. It is difficult to ascertain comprehensive information on the availability of health workers globally due to irregular reporting of data from the countries. However, experts have proposed minimum thresholds for achieving certain health-related Millennium Development Goals (MDGs). These thresholds have been used as yardsticks by others for determining HRH shortages in their nations. As per the minimum threshold developed by the World Health Organization (WHO), not enough health workers are available in India, especially in the rural areas. The nurse to population ratio in India is even lower than some of the other developing countries in Asia. Various factors, such as low professional and socio-economic status, gender issues, lack of political will on part of the government and unregulated private sector, have led to scarcity of nurses in numbers as well as qualitatively in India. To overcome the dismal working and social conditions, many Indian nurses are migrating to developed nations, further exacerbating the nursing shortages in the country. Inclusive planning, adequate financing and political commitment on the part of all stakeholders are required for overcoming the shortage of health personnel existing in India.


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