scholarly journals A Model for the Creation of a Predictive Healthcare Coverage Map in Yemen

2020 ◽  
Author(s):  
Mark Suprenant ◽  
Anuraag Gopaluni ◽  
Meredith Dyson ◽  
Fauzia Shafique ◽  
Muhammad Zaman
Keyword(s):  
Health Care ◽  
Social Services ◽  
Health Care Facilities ◽  
Diarrheal Diseases ◽  
Children Under Five ◽  
Under Five ◽  
Number Of Children ◽  
Conflict Settings ◽  
Significant Difference ◽  
Coverage Map

Abstract IntroductionThe ongoing war in Yemen continues to pose challenges for health care workers in the country. The fighting has destroyed public infrastructure including primary and secondary health care facilities, hindered the movement of people, food, fuel, medical supplies, and information, and restricted access to and availability of social services including safe drinking water and sanitation. This has led to the increase in the spread of diarrheal diseases, including cholera, which, despite the efficacy of zinc and oral rehydration salt solutions to treat the resulting dehydration, remains one of greatest sources of mortality in children under five years old. In contexts such as Yemen, Health Management Information Systems and Surveillance Systems are weak and unreliable to begin with, with conflict and linked disruption of social services these systems are further weakened making monitoring of the situation and evidence-based planning and implementation even more difficult. Without information on the total number of children suffering from these diseases, it is difficult for health officials and aid organizations to make policy level decisions, inform annual and humanitarian response plans, set targets, mobilize resources, order supplies, deploy resources (human and supplies) and monitor based on needs, leading to poor quality decisions. These reasons, coupled with lack of access, security, and financial and human resources make it even more important in conflict settings, than in non-conflict settings, to know where it is best to invest. This manuscript looks at the development of a computational model designed to draw upon available health data and supplement it with additional sources and acceptable assumptions to provide some of the missing data via health access chart to better inform decision making on the above-mentioned policies. This chart is designed to show what percentage of the total estimated sick population is receiving medical assistance without the need for health workers to place themselves in the way of any additional harm.MethodsA Markov model, which is a probabilistic model that shows how a population moves between different states overtime, was created based on an analysis of Yemen clinical register data from the Ministry of Public Health collected through a third party hired for monitoring purposes covering the period of May through September of 2018. The model was designed with four states for children to transition between over a weekly basis. The probability that a child transitioned from the Sick state to the In-treatment state during any given week was a time varying function based on the average precipitation recorded monthly for 115 years and the state of the roads and bridges during that week as assessed by the World Food Program. The model examined the number of children treated, incidence rate, mortality rate, treatment efficacy and treatment mortality. Once validated, the model was run for 2019 to provide the weekly estimated coverage of children being treated for diarrheal diseases throughout all of Yemen. ResultsThe model was able to recreate the observed trends in treatment on the ground with no significant difference between model output and provided validation data for all metrics. When combined with infrastructure data, the curve of best fit created for the precipitation values depicted a seasonal increase in the number of estimated new diarrheal cases in children under five and a resulting decreasing in the number receiving treatment. This combination has led predictions for the percent coverage to range between an average weekly minimum of 1.73% around the 28th week of the year to a weekly maximum weekly coverage of just over 5% around the new year. ConclusionThe model created and presented in this manuscript shows a seasonal trend in the spread of diarrheal disease in children under five living in Yemen. Despite the assistance of aid organizations in attending to those in need, during the mid-year rains up to 98% are unable to receive medical aid. The coverage map indicates that community outreach or other types of assistance where aid proactively goes out to those in need should be scaled up during and just prior to these periods. This would serve to offset the decrease in the number receiving treatment by lessening the prohibitive travel burden on families during these times.

scholarly journals A Predictive Model for Healthcare Coverage in Yemen

2020 ◽  
Author(s):  
Mark Suprenant ◽  
Anuraag Gopaluni ◽  
Meredith Dyson ◽  
Najwa Al-Dheeb ◽  
Fauzia Shafique ◽  
...  
Keyword(s):  
Diarrheal Disease ◽  
Local Health ◽  
Diarrheal Diseases ◽  
Children Under Five ◽  
Under Five ◽  
Number Of Children ◽  
Treatment Services ◽  
Health Authorities ◽  
Healthcare Coverage ◽  
Receive Treatment

Abstract Introduction: The ongoing war in Yemen continues to pose challenges for healthcare coverage in the country especially with regards to critical gaps in information systems needed for planning and delivering health services. Restricted access to social services including safe drinking water and sanitation systems have likely led to an increase in the spread of diarrheal diseases which remains one of greatest sources of mortality in children under five years old. To overcome morbidity and mortality from diarrheal diseases among children in the context of severe information shortages, a predictive model is needed to determine the burden of diarrheal disease on Yemeni children and their ability to reach curative health services through an estimate of healthcare coverage. This will allow for national and local health authorities and humanitarian partners to make better informed decisions for planning and providing health care services. Methods: A probabilistic Markov model was developed based on an analysis of Yemen’s health facilities’ clinical register data provided by UNICEF. The model combines this health system data with environmental and conflict-related factors such as the destruction of infrastructure (roads and health facilities) to fill in gaps in population-level data on the burden of diarrheal diseases on children under five, and the coverage rate of the under-five sick population with treatment services at primary care facilities. The model also provides estimates of the incidence rate, and treatment outcomes including treatment efficacy and mortality rate. Results: By using alternatives to traditional healthcare data, the model was able to recreate the observed trends in treatment with no significant difference compared to provided validation data. Once validated, the model was used to predict the percent of sick children with diarrhea who were able to reach, and thus receive, treatment services (coverage rate) for 2019 which ranged between an average weekly minimum of 1.73% around the 28th week of the year to a weekly maximum coverage of just over 5% around the new year. These predictions can be translated into policy decisions such as when increased efforts are needed to reach children and what type of service delivery modalities may be the most effective.Conclusion: The model developed and presented in this manuscript shows a seasonal trend in the spread of diarrheal disease in children under five living in Yemen through a novel incorporation of weather, infrastructure and conflict parameters in the model. Our model also provides new information on the number of children seeking treatment and how this is influenced by the ongoing conflict. Despite the work of the national and local health authorities with the support of aid organizations, during the mid-year rains up to 98% of children with diarrhea are unable to receive treatment services. Thus, it is recommended that community outreach or other delivery modalities through which services are delivered in closer proximity to those in need should be scaled up prior to and during these periods. This would serve to increase number of children able to receive treatment by lessening the prohibitive travel burden, or access constraint, on families during these times.

scholarly journals TERAPI AKTIVITAS KELOMPOK TERHADAP KUALITAS HIDUP PENGARUH LANSIA

2021 ◽  
Vol 16 (3) ◽  
pp. 586-592
Author(s):  
Juliandi ◽  
Cecep Tribowo
Keyword(s):  
Quality Of Life ◽  
Social Services ◽  
Intervention Group ◽  
The Elderly ◽  
Control Group ◽  
P Value ◽  
Children Under Five ◽  
Under Five ◽  
Significant Difference

Group therapy is a method of treatment that is carried out when a patient is met in a certain time frame with personnel who meet certain requirements. The quality of life is closely related to the environment where the elderly live. The elderly generally live with their families, but not a few elderly people live in nursing homes. There is a significant difference in the quality of life of the elderly in the UPT Social Services for the elderly and children under five in Binjai area between before and after giving group activity therapy in the intervention group with a p value of 0.008.There was no significant difference in the quality of life of the elderly in the UPT Social Services for the elderly and children under five in Binjai area between before and after giving group activity therapy to the control group with a p value of 0.317.There was a significant difference in the quality of life of the elderly in the UPT Social Services for the elderly and children under five in Binjai area between the intervention group and the control group with a p value of 0.043.

The Preparedness of Primary Health Care Network in terms of Emergency Risk Communication: A Study in Iran

2021 ◽  
pp. 1-10
Author(s):  
Zeinab Bagheri ◽  
Tahereh Dehdari ◽  
Masoud Lotfizadeh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Risk Communication ◽  
Health Care Facilities ◽  
Effective Response ◽  
Care Network ◽  
Primary Health ◽  
Significant Difference ◽  
Health Care Network ◽  
Control And Prevention

Abstract Objective: Emergency Risk Communication (ERC) is known as 1 of the important components of an effective response to public health emergencies. In this study, we aimed to investigate the preparedness of the Primary Health Care Network (PHCN) of Iran in terms of the ERC. Methods: This study was conducted in 136 Primary Health Care Facilities (PHCFs) affilated to Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Iran. Data in terms of ERC were collected using a checklist developed by the Center of Disease Control and Prevention (CDC). Results: The findings of the study revealed that 65.9% of the PHCFs had low preparedness in terms of the ERC, 33.3% had a moderate level and 0.8% had high preparedness in this regard. There was a significant difference between the level of ERC and the history of crisis in the past year, PHCF type, and the education level of the responsible employees in the crisis unit in the PHCF. Conclusions: The results showed that the PHCFs studied need to increase their capacity and capability in the field of ERC. Further efforts to provide ERC components may increase the preparedness of PHCN in Iran in terms of the ERC.

Prevalence of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated From Clinical Samples in Illorin Metropolis, Kwara State Nigeria

2021 ◽  
Vol 6 (2) ◽  
pp. 1-7
Author(s):  
Eze EM
Keyword(s):  
Escherichia Coli ◽  
Health Care ◽  
Health Care Facilities ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Significant Difference

Background: This study investigated the prevalence of extended spectrum beta-lactamase producing enterobacteriaceae in Illorin metropolis using standard methods. The prevalence of ESBLs is increasingly being reported worldwide, and it varies according to geographic location and is directly linked to the use and misuse of antibiotics extended spectrum lactamases (ESBLs) are a major challenge in hospitalized patients worldwide and cause epidemic outbreaks in health care facilities, spreading in the community leading to various infections. Objectives: Screen for the extended spectrum β-lactamase producing Enterobacteriaceae and also determine the prevalence of ESBL producing Enterobacteriaceae in relation to gender, age and sample source. Methods: One hundred and sixty eight samples collected from routine clinical specimen such as high vagina swabs, urine, urethra swabs and wound swabs and sputum from October to December 2018 were studied. Fifty two enterobacteriaceae were isolated using spread plate method on macConkey and Cystein lactose electrolyte deficient media. The organisms were Klebsiella pneumoniae, Escherichia coli, Salmonella sp, Shigella sp, and Proteus sp. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer standardized disc diffusion method. The antibiotics used were ceftazidine (30ug), cefuroxime (30ug), gentamicin (10ug), ciprofloxacin (5ug), ofloxacin 5ug, amoxicillin/clavulanate 30ug, nitrofurantoin 30ug and ampicillin 10ug. Ceftazidime showed a susceptibility percentage of 84.6%,, cefuroxime 61.5%, gentamicin 71.2% ciprofloxacin 46.2%, ofloxacin 51.9%, augmentin 61.5%, nitrofurantoin 71.2% and ampicillin, 44.2% with a significant difference (P< 0.05).Extended spectrum beta-lactamase ESBL, production by clinical and laboratory standards institute (CLSI) methods showed that 15(28.9%) of isolates belonging to the genera Escherichia, Klebsiella and Proteus expressed ESBL production. The order of ESBL production by the isolates were Escherichia coli 9 (17.3%), Klebsiella pneumonia 5(9.3%) and Proteus 1(1.9%). Thus, attention needs to be given by health care personnel’s to ESBL producing organisms in order to reduce the spread.

scholarly journals Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa

2020 ◽  
Vol 17 (20) ◽  
pp. 7580
Author(s):  
Perpetua Modjadji ◽  
Josephine Mashishi
Keyword(s):  
South Africa ◽  
Birth Weight ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
School Education ◽  
Limpopo Province ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five

Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.

Marketing Social Services in Health Care Facilities

1981 ◽  
Vol 6 (3) ◽  
pp. 13-20 ◽  
Author(s):  
Gary Rosenberg ◽  
Andrew Weissman
Keyword(s):  
Health Care ◽  
Social Services ◽  
Health Care Facilities ◽  
Marketing Social ◽  
Care Facilities

scholarly journals Maternal Characteristics Determine Stunting in Children of Less than Five Years of Age Results from a National Probabilistic Survey

2008 ◽  
Vol 1 ◽  
pp. CMPed.S1019 ◽  
Author(s):  
Teresa Shamah-Levy ◽  
Lucia Cuevas Nasu ◽  
Hortensia Moreno-Macias ◽  
Eric Monterrubio-Flores ◽  
Marco Antonio Avila-Arcos
Keyword(s):  
Social Services ◽  
Maternal Nutrition ◽  
Marginal Effect ◽  
Sociodemographic Characteristics ◽  
Maternal Height ◽  
Nutrition Survey ◽  
Maternal Characteristics ◽  
Children Under Five ◽  
Under Five ◽  
Mother And Child

Background Maternal nutrition and some variables are the main determining factors of birthweight and delayed intrauterine growth of children. Objective To explore the association between the mothers’ biological and sociodemographic characteristics, and the anthropometry status in children under five years of age. Design The population consisted of a sub-sample of 1,047 mother-and-child selected pairs from the probabilistic National Nutrition Survey, carried out in Mexico. Mother-and-child pairs included mothers aged 12 to 49 years, with children under five years of age. Data on sociodemographic characteristics, obstetric history, 24-hour recall dietary intake, and the women and children's anthropometry were collected. The association between maternal characteristics and children's anthropometry status was assessed using multiple logistic regression models. Result Nearly 16.7% of the children <5y of age were stunted (13.5% ≤ 2y and 18.8% > 2y). The height/age of the children was severely affected by maternal height and birth order. In addition, the interaction between socioeconomic level and maternal schooling had a marginal effect (p = 0.09) in the ≤2y group. On the other hand, whether the family received social services and the interaction between maternal height and a dichotomy urbanism variable were significant (p = 0.05) and (p < 0.01) respectively in >2y group. Conclusion Some biological and socioeconomic characteristics among mothers have a negative effect on their children's attained size, especially in the period between 2 and 5 years of age.

A Study on Diarrheal Diseases in Children Under Five Years of Age

1992 ◽  
Vol 12 (5) ◽  
pp. 459-462 ◽  
Author(s):  
Mohammad Hussain Qadri ◽  
Mohammad Ali Al-Ghamdi ◽  
Abu Yousf Musharaf ◽  
Mohammad Imdad Haq
Keyword(s):  
Diarrheal Diseases ◽  
Children Under Five ◽  
Under Five
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