scholarly journals Deaths From Surgical Conditions In Malawi A Randomised Cross-sectional Nationwide Household Survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

scholarly journals Deaths from surgical conditions in malawi A randomised cross-sectional nationwide household survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

scholarly journals DEATHS FROM SURGICAL CONDITIONS IN MALAWI A Randomised Cross-sectional Nationwide Household Survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

scholarly journals Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlos Varela ◽  
Sven Young ◽  
Reinou S. Groen ◽  
Leonard Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Health Care ◽  
Health Facility ◽  
Scale Up ◽  
Surgical Care ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Middle Income ◽  
Surgical Conditions

Abstract Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. Methods The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. Results The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. Conclusion In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.

scholarly journals Factors Affecting Home Delivery among Women Living in Remote Areas of Rural Zambia: A Cross-Sectional, Mixed-Methods Analysis

2021 ◽  
pp. 1-13
Author(s):  
Ireen Chola Mwape Musonda
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Rural Areas ◽  
Home Delivery ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Home Deliveries ◽  
At Home

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.

scholarly journals Factors Influencing Utilization of Ultrasound Scan Services among Pregnant Mothers at Ndejje Health Center IV, Wakiso District

2020 ◽  
Author(s):  
◽  
Angella Nakimera
Keyword(s):  
Health Facility ◽  
Waiting Time ◽  
Health Centre ◽  
Ultrasound Scan ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Study Results ◽  
To Receive ◽  
Pregnant Mothers

Abstract Background: A study was carried out to identify the factors influencing the utilization of ultrasound scan services among pregnant mothers at Ndejje Health Centre IV, Wakiso District. Methodology: The study design was descriptive and cross-sectional and it employed both quantitative and qualitative data collection methods. A sample size of 30 respondents was selected using a simple random sampling procedure. An interview guide was used to collect data. Results: The study revealed various factors influencing the utilization of ultrasound scan services among pregnant mothers. For example, although all 30 (100%) had ever heard about ultrasound scan services, most 20 (66.7%) had ever used ultrasound scan services once 10 (50%) and 12 (60%) used the services in the 3rd trimester due to factors including 20 (66.7%) of ultrasound scan services, 21 (70%) having fears about using ultrasound scan services including 14 (66.7%) fear that the scan would identify bad conditions on the baby, 18 (60%) lacked partner support. The study results also revealed that respondents faced various health facility factors which influenced the utilization of ultrasound scan services. For example, most 20 (66.7%) respondents reported that Ndejje Health Centre IV was not equipped to provide ultrasound scan services due to 12 (60%) frequent breakdown and poor maintenance of equipment which led to 18 (60%) ultrasound scan services not being readily available, 12 (60%) long waiting time to receive services as most waited more than 2 hours to receive services. Conclusion and recommendations: Respondents faced various and health facility-related factors which influenced their utilization of ultrasound scan services. The key recommendations included ready availability of services through regular and timely maintenance of equipment, improving efficiency, and reducing waiting time as well as improved health education of mothers about the importance of using the services.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

scholarly journals Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Ayodeji M. Adebayo ◽  
Michael C. Asuzu
Keyword(s):  
Health Facility ◽  
Low Income ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Access To Health Services ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Community Based ◽  
Cross Sectional ◽  
North West

Background: Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities.Aim: To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria.Settings: A low-income community in Ibadan North West Local Government Area of Oyo State.Methods:A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents’ sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05.Results: The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90%had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF.Conclusion: The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation.

scholarly journals Effect of Income Level and Perception of Susceptibility and Severity of COVID-19 on Stay-at-Home Preventive Behavior in a Group of Older Adults in Mexico City

2020 ◽  
Vol 17 (20) ◽  
pp. 7418 ◽  
Author(s):  
Maria Esther Irigoyen-Camacho ◽  
Maria Consuelo Velazquez-Alva ◽  
Marco Antonio Zepeda-Zepeda ◽  
Maria Fernanda Cabrer-Rosales ◽  
Irina Lazarevich ◽  
...  
Keyword(s):  
Older Adults ◽  
Mexico City ◽  
Low Income ◽  
Income Level ◽  
Cross Sectional Study ◽  
Total Effect ◽  
Preventive Behavior ◽  
Cross Sectional ◽  
Perceived Severity ◽  
At Home

Early information on public health behaviors adopted to prevent the spread of coronavirus (COVID-19) may be useful in controlling the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission. The objective of this study was to assess the role of income level (IL) and the perception of older adults, regarding COVID-19 susceptibility and severity, on adopting stay-at-home preventive behavior during the first week of the outbreak in Mexico. Participants in this cross-sectional study were urban community dwellers, aged ≥ 65 years from Mexico City. A total of 380 interviews were conducted over the phone. The mean respondent age was 72.9 years, and 76.1% were women. Over half (54.2%) of the participants perceived their susceptibility to COVID-19 as very low or low. Similarly, 33.4% perceived COVID-19 severity as being very low or low, and 57.6% had decided to stay at home: this behavior was associated with IL (β = 1.05, p < 0.001), and its total effect was partially mediated (15.1%) by perceived severity. Educational attainment was also associated with staying at home (β = 0.10, p = 0.018) and its total effect was partially mediated (15.0%) by perceived susceptibility. Interventions aimed at low income and less educated older adults should be developed to improve preventive behaviors in this vulnerable group during the COVID-19 pandemic.

scholarly journals Using Android and Open Data Kit Technology in Data Management for Research in Resource-Limited Settings in the Niger Delta Region of Nigeria: Cross-Sectional Household Survey (Preprint)

2017 ◽  
Author(s):  
Omosivie Maduka ◽  
Godwin Akpan ◽  
Sylvester Maleghemi
Keyword(s):  
Data Collection ◽  
Data Management ◽  
Mobile Devices ◽  
Niger Delta ◽  
Open Data ◽  
Household Survey ◽  
Data Capture ◽  
Cross Sectional ◽  
Niger Delta Region ◽  
Open Data Kit

BACKGROUND Data collection in Sub-Saharan Africa has traditionally been paper-based. However, the popularization of Android mobile devices and data capture software has brought paperless data management within reach. We used Open Data Kit (ODK) technology on Android mobile devices during a household survey in the Niger Delta region of Nigeria. OBJECTIVE The aim of this study was to describe the pros and cons of deploying ODK for data management. METHODS A descriptive cross-sectional household survey was carried out by 6 data collectors between April and May 2016. Data were obtained from 1706 persons in 601 households across 6 communities in 3 states in the Niger Delta. The use of Android mobile devices and ODK technology involved form building, testing, collection, aggregation, and download for data analysis. The median duration for data collection per household and per individual was 25.7 and 9.3 min, respectively. RESULTS Data entries per device ranged from 33 (33/1706, 1.93%) to 482 (482/1706, 28.25%) individuals between 9 (9/601, 1.5%) and 122 (122/601, 20.3%) households. The most entries (470) were made by data collector 5. Only 2 respondents had data entry errors (2/1706, 0.12%). However, 73 (73/601, 12.1%) households had inaccurate date and time entries for when data collection started and ended. The cost of deploying ODK was estimated at US $206.7 in comparison with the estimated cost of US $466.7 for paper-based data management. CONCLUSIONS We found the use of mobile data capture technology to be efficient and cost-effective. As Internet services improve in Africa, we advocate their use as effective tools for health information management.

scholarly journals Factors Influencing Antenatal Care Utilization in the East Akim Municipality of Ghana

2020 ◽  
Author(s):  
Richard Dickson Amoako ◽  
Innocent Kwau Doku ◽  
Juliana Yartey Enos
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
First Trimester ◽  
Socioeconomic Background ◽  
Care Utilization ◽  
Reproductive Health Services ◽  
African Countries ◽  
Cross Sectional ◽  
Unintended Pregnancies ◽  
Factors Influencing

Abstract Background Maternal and neonatal mortality rates continue to be high in sub-Saharan African countries, including Ghana. Timely and regular antenatal care (ANC) during pregnancy are essential for early identification and management of potential risk factors associated with poor pregnancy outcomes. The purpose of this study was to investigate the uptake of ANC services in the East Akim Municipality of Ghana and identify factors influencing ANC utilization. Methods A cross-sectional study which employed stratified sampling methodology to select 310 women in their reproductive ages (15–49 years) in East Akim Municipality was conducted. A structured questionnaire was used to examine the determinants of ANC utilization among respondents. Data was managed using Microsoft Excel 2016 and analysed using Stata version 14. Descriptive, bivariate and multivariable logistic regression analyses were performed. Results ANC attendance, at least once during pregnancy, was almost universal (98.4%) with 83.5% making 4 + visits. However, only 58% of respondents made early ANC visits in the first trimester and 61% attended all regularly scheduled visits. Employment status, distance to health facility and pregnancy intention were significantly associated with regular ANC attendance. Self-employed women were 2.4 times more likely to attend ANC regularly (AOR: 2.42, 95%CI :1.20–4.88) than the unemployed; those who lived < 5 km to a health facility were 3.2 times more likely to attend ANC regularly than those who lived > 10 km (AOR: 3.24, 95%CI: 1.20, 8.72); and women with intended pregnancies were 2.5 times more likely to attend all ANC scheduled visits than those with unintended pregnancies (AOR: 2.46, 95%CI: 1.32, 4.57). Conclusion Although ANC utilization in East Akim Municipality is high, socioeconomically disadvantaged women who were unemployed; lived more than 10 km from a health facility; and those with unintended pregnancies did not attend ANC early and regularly. Interventions to ensure equitable access to quality reproductive health services at the community level for all women, irrespective of their socioeconomic background, is needed to improve timely and regular ANC utilization. These include strengthening of community-based health centers, provision of ANC through outreach services to poor women in remote, hard-to-reach locations and improvements in the socioeconomic conditions in which people live.

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