scholarly journals Missed Opportunities in Tuberculosis Investigation and Associated Factors at Public Health Facilities in Uganda 

2020 ◽  
Author(s):  
Keith Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baluku ◽  
...  
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional Survey ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Public Health Facilities ◽  
Factors Associated

Abstract BackgroundThe incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. A recent national TB prevalence survey revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). The objective of this study was to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda.MethodsA facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation using STATA 14.ResultsTwo hundred forty seven presumptive TB patients were recruited into this study exiting at antiretroviral therapy (ART) clinics (n=132) or general outpatient clinics (n=115) at public health facilities. Majority of participants were females (161/247, 65.2%) and the mean +SD age was 35.1 + 11.5 years. Sputum and/or CXR were not requested from 138 (55.9%) patients with symptoms suggestive of TB disease. Patients who did not inform health workers about TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio: 1.68, 95%CI; 1.36-2.08, P<0.001). Conclusion; A large proportion of patients with symptoms suggestive of TB did not have sputum and/ or CXR requested for investigation. Patients who did not inform health workers about their TB related symptoms were more likely to miss having sputum and/ or CXR requested. We recommend studies to explore barriers and facilitators of disclosure of TB symptoms to enable formulation of effective interventions to empower people to improve likelihood of disclosing TB related symptoms.

scholarly journals Missed opportunities in tuberculosis investigation and associated factors at public health facilities in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keith Twirire Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baruch Baluku ◽  
...  
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Prevalence Ratio ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Public Health Facilities ◽  
Factors Associated

Abstract Background The incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. The population-based survey on the prevalence of TB in Uganda revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). This study aimed to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda. Methods A facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to the World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB diagnosis were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation. Results Two hundred forty-seven (247) patients with presumptive TB exiting at antiretroviral therapy (ART) clinics (n = 132) or general outpatient clinics (n = 115) at public health facilities were recruited into this study. Majority of participants were female (161/247, 65.2%) with a mean + SD age of 35.1 + 11.5 years. Overall, 138 (55.9%) patients with symptoms suggestive of TB disease did not have sputum and/or CXR examinations. Patients who did not inform health workers about their TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio (aPR): 1.68, 95%CI; 1.36–2.08, P < 0.001). However, patients who reported duration of cough of 2 weeks or more were less likely to be missed for TB screening (aPR; 0.69, 95%CI; 0.56–0.86, p < 0.001). Conclusion There are substantial missed opportunities for TB diagnosis in Wakiso District. While it is important that patients should be empowered to report symptoms, health workers need to proactively implement the WHO TB symptom screen tool and complete the subsequent steps in the TB diagnostic cascade.

scholarly journals Current situation of health workers' knowledge and practice on safe motherhood at public health facilities of Ninh Binh province in 2019

2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Phạm Văn Dậu ◽  
Phạm Cẩm Kỳ ◽  
Bùi Thị Hương
Keyword(s):  
Public Health ◽  
Health Workers ◽  
Blood Pressure Measurement ◽  
Health Facilities ◽  
Safe Motherhood ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Danger Signs ◽  
Breast Examination

Objective: To assess knowledge and practices on safe motherhood of mothers giving birth at public health facilities of Ninh Binh province in 2019. Subjects: Health workers working at public health facilities of the province. Rearch method: Descriptive cross-sectional survey. Results:When asked about the danger signs of mothers after giving birth that need to be monitored, the highest percentage is prolonged bleeding (94.3%), the lowest is prolonged abdominal pain (70.7%). In full body examination, the percentage of health workers who  practiced correctly was found the lowest for cardiopulmonary examination (49.0%), breast examination (58.0%), and the highest for blood pressure measurement (91.7%). Conclusion: The rate of health workers having correct knowledge on safe motherhood was not high. The rate of health workers having correct practice on prenatal check-up steps and asking steps ranged from 68.2% to 94.3%.

scholarly journals Assessment of the Midwives Knowledge on Utilization of Partograph in Management of Labour in Public Health Facilities in Tharaka Nithi County

2021 ◽  
Vol 11 (12) ◽  
pp. 167-175
Author(s):  
Mwari P.S ◽  
Gitonga LK ◽  
Mukhwana E.S
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
World Health ◽  
Management Tool ◽  
Labor Management ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Maternal Deaths ◽  
Public Health Facilities ◽  
Obstetric Labor Complications

The World Health Organization (WHO) has recommended Partograph as a labor management tool due to its impact in reducing obstetric labor complications and maternal deaths over the years. This labor management tool is inexpensive and appropriate for use in low-resource settings, particularly in developing countries. Despite the fact that many African countries, including Ethiopia, Kenya, and Nigeria, have adopted the Partograph in labor management, there is little information on midwives' knowledge on the use of the tool in labor management. Understanding of how to use a Partograph is essential for reducing complications and maternal deaths. The purpose of this study was to determine midwives' knowledge on using the Partograph in labor management. The study adopted a cross sectional survey design. 45 midwives were randomly selected from 16 public health facilities in Tharaka Nithi County. Questionnaires were used to collect data. Focused Group Discussions were also conducted with 77 postnatal mothers who gave birth in the 16 health facilities. The collected data was analyzed using descriptive statistics (means, frequencies, and percentages) and Chi-Square tests. Thematic analysis was used to examine qualitative data. Results showed that 74% of midwives had used Partograph in labor monitoring, while 26% had never used the tool. 60% of the midwives had received Partograph training. Despite not having been trained, some midwives were using the Partograph. Findings revealed inconsistencies in the use of Partograph in labor management. A large proportion of midwives deviated from the WHO's recommended use of Partograph in the first stage of labor. The study recommended that the Tharaka Nithi County government, through the Ministry of Health, invest in Partograph utilization in-service training programs to provide nurses and midwives working in the maternity wing the necessary knowledge and skills for proper Partograph utilization. There is also a need for policy changes in institutions to ensure that nurses use of the Partograph as a strategy for reducing maternal mortality rates, improving motherhood, and labor management in the County. Key words: Partograph; labour management; public health facilities.

scholarly journals KNOWLEDGE AND PRACTICE ON SAFE MOTHERHOOD OF MOTHERS GIVING BIRTH AT PUBLIC HEALTH FACILITIES OF NINH BINH PROVINCE IN 2019

2020 ◽  
Vol 62 (1) ◽  
Author(s):  
Văn Dậu Phạm ◽  
Cầm Kỳ Phạm ◽  
Thị Hương Bùi
Keyword(s):  
Public Health ◽  
Antenatal Care ◽  
Health Facilities ◽  
Safe Motherhood ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Survey Results ◽  
Knowledge And Practice

Objective: To assess knowledge and practice on safe motherhood of mothers giving birth at public health facilities of Ninh Binh province in 2019. Subjects: Mothers giving birth at public health facilities in the province. Rearch method: Descriptive cross-sectional survey. Results: The percentage of mothers who understood correctly about safe motherhood was 38,4%; 97,5% of mothers answered that it was necessary to have health check-up before pregnancy; 86,1% of mothers reported necessity to be vaccinated before becoming pregnant; 60,2% of mothers had correct knowledge that antenatal care needs ultrasound check, blood test and urine test; 19,5% of mothers performed antenatal care 3 times or less, 80,5% of mothers performed antenatal care more than 4 times. Conclusion: The rate of mothers with correct and full knowledge of safe motherhood was very low, the rate of those who had at least 4 times of antenatal care during their pregnancy was quite high.

Women and Continuous Labour Support in Public Health Facilities in Nigeria

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Olabisi Fatimo Ibitoye ◽  
Deliwe R Phetlhu
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Public Hospitals ◽  
World Health ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Childbirth Experience ◽  
Health Organization ◽  
The Right

Childbirth is a multifaceted process that is influenced by several factors resulting in an unsatisfactory or satisfactory childbirth experience. Continuous labour support (CLS) has been identified as a positive contributor to a satisfactory birthing experience, and consequently positive maternal health outcomes. The World Health Organization recommended the right of a pregnant woman to have a companion of her choice during labour, but CLS practice remains a mirage in Nigerian hospitals. This descriptive cross-sectional study explores the perceptions, attitudes and preferences of 368 randomly selected women regarding CLS in public hospitals in South West Nigeria. Data were collected using a pretested questionnaire developed from the literature review and analysed with descriptive and inferential statistics using SPSS Version 20. The findings revealed that the participants perceived support from midwives during labour as inadequate but that they were satisfied with professional care at birth. The participants perceived the inclusion of a familiar person for support as beneficial and expressed positive disposition to the introduction of persons from their social network for labour support in public health facilities. The preference for husbands and mothers as labour support persons was higher among the study participants.

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