scholarly journals Clinical Assessment of Integrated Management of Childhood Illnesses (Imci) Given by Professionals Trained Between 2012 and 2015 in Colombia: A Cross-Sectional Study

2021 ◽  
Author(s):  
Jovana Alexandra Ocampo Cañas ◽  
Andrés Mauricio García Sierra ◽  
Yaira Yohanna Pardo Mora ◽  
Diana Sofía Rios Oliveros ◽  
Álvaro José Ayala Galvis ◽  
...  
Keyword(s):  
Infant Mortality ◽  
General Practitioners ◽  
Integrated Management ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Correct Evaluation ◽  
Cross Sectional ◽  
Danger Signs ◽  
Childhood Illnesses ◽  
Basic Care

Abstract Background In Colombia, official statistics indicate that infant mortality by 2020 would reach 7.22 per thousand live births. Prevalent and preventable diseases represent 70% of total infant mortality, so strategies such as Integrated Management of Childhood Illnesses (IMCI) are still relevant for the country. This research seeks to establish whether the professionals trained in IMCI between 2011 and 2015 apply the strategy in the prevention and care of children under 5 years of age. Methods A cross-sectional study was carried out in general practitioners, nurses and pediatricians who had some level of training in the IMCI strategy between 2012 and 2015. A survey based on the basic competences established in the framework of the IMCI strategy was used: evaluate, classify, and treat and, in addition, the basic care registry component was incorporated. Results Skills in the IMCI Strategy were observed in 259 consultations for children. 229 children were between 2 months and 5 years old, 30 children were between 0 and 2 months old (84.4% vs 11.6%, respectively). 51.4% of the evaluations were carried out in the Public Health Service Provider Institutions (HPIs) compared to 48.6% (126/259) in the private HPI. In children from 0 to 2 months, 92% of general practitioners, 82.58% of nurses, and 59.39% of pediatricians correctly assessed danger signs. In children from 2 months to 5 years, the health professional who best evaluated the danger signs was the pediatrician with a 70% correct evaluation, followed by nurses and general practitioners with a 65% correct evaluation. Conclusions Pediatricians were shown to perform better on the IMCI strategy in children 2 to 5 years of age. However, in the 0–2-month age group, general practitioners and nurses outperformed pediatricians on the IMCI strategy

scholarly journals Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji
Keyword(s):  
Pregnant Women ◽  
Knowledge Score ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Obstetric Emergencies ◽  
Level Of Knowledge

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

scholarly journals Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Kersting ◽  
Lena Zimmer ◽  
Anika Thielmann ◽  
Birgitta Weltermann
Keyword(s):  
Regression Model ◽  
General Practitioners ◽  
Chronic Stress ◽  
Medical Records ◽  
High Strain ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Work Related

Abstract Background The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. Methods This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. Results Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. Conclusions This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

scholarly journals Predictors of Health Seeking Behaviours for Common Childhood Illnesses in Poor Resource Settings in Zambia, A Community Cross Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Golden Apuleni ◽  
Choolwe Jacobs ◽  
Patrick Musonda
Keyword(s):  
Health Care ◽  
Marital Status ◽  
Cross Sectional Study ◽  
Education Level ◽  
Child Health Services ◽  
Sectional Study ◽  
Health Seeking ◽  
Cross Sectional ◽  
Seek Health Care ◽  
Childhood Illnesses

Background: Developing countries, including Zambia, account for larger share of child morbidities and mortalities due to common childhood illnesses. Studies on wider determinants of behaviour pertaining to treatment seeking for childhood febrile illnesses in poor resource settings are limited. This study investigated health seeking behaviours of mothers in poor resource settings of Zambia and identified associated factors.Methods: Secondary data from a community cross sectional study design from the Health for the Poorest Population (HPP) Project was analysed between March and May 2019. Data was collected between May and August, 2013. It was collected by means of administering a structured questionnaire from the mothers of under-five children. The survey took place in Samfya and Chiengi of Luapula province while in Northern Province, Luwingu and Mungwi were settled for. A total of 1 653 mothers of under 5 years who had an episode of diarrhoea, malaria, pneumonia or a combination of any of them not more than 14 days before the interview were included in the study. A sample size was arrived at using A Lot Quality Assurance Sampling (LQAS) method. In order to determine the associations between respondent's demographic characteristics and health seeking behaviour, chi square test of independence was carried out. Multivariable logistic regression was also done to identify predictors of health seeking behaviours for common childhood illnesses in children aged &lt;5 years old in poor resource settings.Results: Among the mothers interviewed, 64.6% were married while 35.4% were unmarried. Their mean age was 32 years. Mothers who took their sick children to the health facilities for the purpose of seeking health care for their child for either of the illnesses accounted for 75.2%, [95% CI: 0.62–0.96], while 24.8% did not seek health care for their sick child. Factors typically associated with health seeking behaviours were mothers' marital status [aOR = 0.74; 95% CI: 0.58–0.94], and mothers ‘education level [aOR = 1.47; 95% CI: 1.13–1.92].Conclusion: It was established in this study that health care seeking behaviours for these common childhood illnesses in poor resource settings was relatively high and could be predicted by mother's education level and mothers' marital status. Integrating interventions targeted at increasing utilisation of maternal and child health services with basic education to women and moral support counselling to families may potentially maximise health seeking behaviours in marginalised communities.

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