scholarly journals Experiences of Midwives on Vscan Limited Obstetric Ultrasound Use: A Qualitative Exploratory Study

Author(s):  
Mesele Damte Argaw ◽  
Hailemariam Segni Abawollo ◽  
Zergu Tafesse Tsegaye ◽  
Ismael Ali Beshir ◽  
Heran Demissie ◽  
...  

Abstract Background Ethiopia is a low-income country located in the horn of Africa’s sub-Saharan region, with very high incidences of maternal and neonatal mortality. Quality antenatal care improves perinatal health outcomes. The USAID funded Transform: Primary Health Care Activity in collaboration with the Ministry of Health and GE Healthcare introduced Vscan limited obstetric ultrasound services in 120 health centers in Ethiopia. So far, the experiences and opinions of midwives on their use have not been explored and described within the local context. This study therefore aims to explore and describe the experiences and opinions of midwives on Vscan limited obstetric ultrasound services at health centers within Ethiopia. Methods An exploratory and descriptive qualitative study was conducted in Amhara, Oromia, and Southern Nations, Nationalities and Peoples’ (SNNP) regions of Ethiopia. Twenty-four participants were selected through a purposeful sampling technique. In-depth individual interviews with trained midwives with practical hands-on limited obstetric ultrasound service provision experience were conducted. The thematic analysis was conducted manually. Results The qualitative data analysis on the experiences and opinions of midwives revealed three themes, namely: individual perception of self-efficacy, facilitators, and barriers of limited obstetric ultrasound services. The basic ultrasound training, which was unique in its organization and arrangement, prepared and built the self-efficacy of trainees in executing their expected competencies. Support of health systems and health managers in dedicating space, availing essential supplies, and assigning human resources emerged as facilitators of the initiated limited obstetric ultrasound services, whereas high workload on one or two ultrasound trained midwives, interruption of essential supplies like paper towels, gel, and alternative power sources were identified as barriers for limited ultrasound services. Conclusion This study explored the experiences and opinions of midwives who were trained on the provision of limited obstetric ultrasound services and served the community in health centers in rural parts of Ethiopia. The results of this study revealed the positive impacts of the intervention on the perceived self-efficacy, facilitation, and breaking-down of barriers to obstetric ultrasound services. Before scaling-up limited obstetric ultrasound interventions, health managers should ensure and commit to availing essential supplies (e.g., paper towels, ultrasound gel, and large memory hard discs), arranging private rooms, and training other mid-level health professionals. In addition, improving pregnant women’s literacy on the national schedule for ultrasound scanning services is recommended.

2020 ◽  
Vol 7 (2) ◽  
pp. 79
Author(s):  
Mulyanti Ners ◽  
Brune Indah Yulitasari

<p>Self efficacy is an important factor to improve the quality of life of Schizophrenia caregivers. A caregiver’s quality of life affects treatment process which is an important key in curing Schizophrenia patient. This research aims to investigate the relation of self-efficacy to the quality of life.  This is a quantitative research with cross sectional approach. The research was conducted in the working area of <em>Puskesmas Godean I</em>, i.e. <em>Desa Sidoluhur, Desa Sidoagung, Desa Sidomulyo, </em>and <em>Desa Sidomoyo </em>on August 1 to September 15, 2018. There were 47 participants chosen using consecutive sampling technique. The dependent variable is the quality of life of Schizophrenia caregivers. Meanwhile, the independent variable is self-efficacy. Both variables were measured through questionnaire. The quantitative data was analyzed using chi square test. The characteristics of the research subjects are: female, middle aged, married, low-income earners, senior high school graduates, and have caring experience of more than 5 years. It is found that the self-efficacy of schizophrenia caregivers is in ‘strong’ category. There is a significant relation between the self-efficacy of Schizophrenia caregivers and their quality of life. The quality of life of<strong> </strong>Schizophrenia caregivers is influenced by high level of self-efficacy.</p><p><strong> </strong></p>


2019 ◽  
Vol 9 (1) ◽  
pp. 1-6
Author(s):  
Harfaina Harfaina ◽  
Suharyo Hadisaputro ◽  
Djoko Trihadi Lukmono ◽  
Mateus Sakundarno

Filariasis adalah penyakit infeksi yang disebabkan oleh cacing Wuchereria Bancrofti, Brugia Malayi, dan Brugia Timori yang menyebabkan cairan limfe tidak dapat tersalurkan dengan baik sehingga menyebabkan pembengkakan pada tungkai dan lengan. Meskipun tidak ada penyebab kematian tetapi menyebabakan cacat permanen dan stigma sosial. Eliminasi Filariasis dilakukan dengan Program Pengobatan Massal ke seluruh penduduk di daerah endemis setahun sekali selama 5 tahun. Keberhasilan program ini memerlukan kepatuhan minum obat pencegahan filariasis. Tujuan penelitian ini untuk mengetahui faktor-faktor yang mempengaruhi ketidakpatuhan minum obat sebagai upaya pencegahan filariasis. Penelitian ini Populasi dalam penelitian ini adalah penduduk berusia 15-65 tahun di dua kelurahan endemis yaitu kelurahan kuripan kertoharjo dan kelurahan jenggot selama mei-juli 2018. Sampel dalam penelitian ini 80 kasus dan 80 kontrol dengan teknik cluster random sampling. Variabel yang terbukti berpengaruh yaitu persepsi kerentanan negatif (OR=4,093) 95%CI=1,356-12,350 dan self efficacy negatif (OR=30,298) 95%CI=8,986-102,156. Persepsi kerentanan negatif dan self efficacy negatif merupakan faktor perilaku yang mempengaruhi ketidakpatuhan minum obat pencegahan filariasis. Diharapkan ada penelitian lanjutan tentang ketidakpatuhan minum obat pencegahan filariasis bukan berwujud persepsi tetapi dengan pengukuran faktor lingkungan sosial secara objektif dengan melakukan intervensi berupa perubahan perilaku.   Kata kunci : Filariasis, Ketidakpatuhan, Minum Obat, Mix Method   FACTORS THAT INFLUENCE DRINKING DRUG PREVENTION NON COMPLIANCE OF FILARIASIS IN PEKALONGAN CITY   ABSTRACT Filariasis is an infectious disease caused by worms Wuchereria Bancrofti, Brugia Malayi, and Brugia Timori, adult worm lives and damage reulting in blockage of lymph channels, causing swelling of the legs and arms. Although no cause of death but causes permanent disability and social stigma. Filariasis elimination done with the Mass Treatment Program to the entire population in endemic areas a year for 5 year. Succesfully this program required a medication adherence. The purpose of this study was to determine the factors that influence drug disobedience as an effort to prevent filariasis. This study uses a mix method. The population in this study were residents aged 15-65 years in two endemic villages, namely kuripan kertoharjo and jenggot villages during May-July 2018. Samples in this study were 80 cases and 80 controls with cluster random sampling technique. Variables that proved influential were perceptions of negative vulnerability (OR = 4,093) 95% CI = 1,356-12,350 and negative self efficacy (OR = 30,298) 95% CI = 8,986-102,156. Negative vulnerability perceptions and negative self efficacy are behavioral factors that influence non-compliance with filariasis prevention drugs. It is expected that further research on non-compliance with taking drugs to prevent filariasis is not a form of perception but objective measurement of social environmental factors by intervening in the form of behavior change.   Keywords: Filariasis, Noncompliance, Medication, Mix Method


2017 ◽  
Vol 1 (1) ◽  
pp. 26
Author(s):  
Ade Kartikasari Sebba ◽  
Baning Rahayujati ◽  
Isa Dharmawidjaja

Pneumonia is one of the deadliest diseases for children under five years-old throughout the world. In Indonesia, pneumonia is the second deadliest disease after diarrhea. In 2015-2016, the Coverage of pneumonia case detection on children under five years-old increased from 22.33% to 36.06% but it had not achieved the detection target (-85%). A program evaluation needs to conduct, consequently. The evaluation aims to observe the implementation of pneumonia investigation program on children under five years-old in Sleman in 2016. The evaluation used a descriptive design performed in June-July 2017. The research subject was the program of Upper Respiratory Infection (ISPA, Infeksi Saluran Pernapasan Akut) implemented in community health centers (puskesmas, pusat kesehatan masyarakat). Twenty respondents as the sample were chosen by using the purposive sampling technique. The surveillance evaluation employed the input, activities, and output. The instruments were structural questionnaires and checklist sheets. The analysis result was presented in forms of tabulation and narration. From the input facet, 100% respondents have not had any special trainings related to pneumonia. 55% respondents have interlocking jobs with the longest service time of three years or more (75%). 70% respondents are able to show ARI Soundtimer. There are only 10% respondents holding the media of communication, information, and education (KIE, Komunikasi, Informasi, dan Edukasi) in forms of flipchart and leaflet; while 100% respondents admit that they have no stamp seal of URI. The proses facet displays that 100% respondents do not arrange any plan. The case investigation is only passive (100%). 80% respondents do socialization of case management and only 15% respondents perform a home visit. 100% respondents have not held trainings for responsible people, alert villages, and private midwives. From the output facet, the scope of case investigation is still low (36.06%).The implementation of pneumonia case investigation program on children under five years-old has been well executed but there are still weaknesses. Hence, public health offices (dinas kesehatan) should improve their human resources by arran ging a training program, equalize the use of breath counting tool and make MoU with all health services to report pneumonia cases. Community health centers are recommended to arrange plans, actively attempt to discover pneumonia cases, and train the responsible people, centers for pre-and postnatal health care (posyandu, pos pelayanan terpadu), or midwives related to the subject of pneumonia.


2018 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Abdul Wakhid ◽  
Estri Linda Wijayanti ◽  
Liyanovitasari Liyanovitasari

Background: Self efficacy can optimize the quality of life of clients who undergo the healing process due to chronic diseases. Individuals with higher self-efficacy move their personal and social resources proactively to maintain and improve the quality and length of their lives so that they experience a better quality of life. Objectives: the purpose of this study was to find the correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency. Metode: This type of research was descriptive correlation with cross sectional approach. The samples in this study more 76 people with total sampling technique. The data collection tool for self efficacy was measured by General Self-Efficacy scale, for quality of life with WHOQoL-BREF. Statistical test used Kolmogorov-smirnov. Result: The result showed that self efficacy in patients with chronic kidney disease was mostly in moderate category (53,9%), quality of life in patients with chronic kidney disease was mostly in good category (68,4%). There was a correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency, the result obtained p-value of 0.000 <α (0,05). Suggestion: Patients with chronic kidney disease can maintain good quality of life by helping to generate positive self-esteem and high self efficacy.


Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.


2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.


2021 ◽  
Vol 28 ◽  
pp. 107327482110110
Author(s):  
Grace X. Ma ◽  
Lin Zhu ◽  
Timmy R. Lin ◽  
Yin Tan ◽  
Phuong Do

Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures


2021 ◽  
pp. 097639962097420
Author(s):  
Gaurav Bhattarai ◽  
Binita Subedi

The global economy has been severely paralysed, owing to the unprecedented crisis triggered by the COVID-19 pandemic, and different studies have indicated that the crisis is relatively more maleficent to the lower-income and middle-income economies. Methodologically, this study relied on the review and analysis of the grey literature, media reporting and data published by the Asian Development Bank, United Nations Conference on Trade and Development (UNCTAD), United Nations (UN), World Bank, International Monetary Fund (IMF) among others. The article begins by describing the impact of the pandemic on low-income and middle-income countries, and it discusses how they have responded to the crisis. While discussions have surfaced regarding whether COVID-19 will reverse the process of globalization, what will be its impact on the low-income country like Nepal? The study also highlights that with foreign direct investments speculated to shrink and foreign assistance and remittance taking a hit, how is Nepal struggling to keep its economy afloat? Analysing the new budget that the government unveiled in 2020, this study concludes with a note that instead of effectively implementing the plans and policies directed by the budget, Nepal is unnecessarily engaged in political mess and is needlessly being dragged into the geopolitical complications.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.


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