scholarly journals The Effect of COVID-19 on Routine HIV Care Services from Health Facilities in Northwest Ethiopia

2021 ◽  
Vol Volume 13 ◽  
pp. 1159-1168
Author(s):  
Asmamaw Adugna ◽  
Jember Azanaw ◽  
Mequannent Sharew Melaku
Keyword(s):  
Northwest Ethiopia ◽  
Health Facilities ◽  
Hiv Care ◽  
Care Services

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: an application of K-means clustering algorithm

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Milka Bochere Gesicho ◽  
Martin Chieng Were ◽  
Ankica Babic
Keyword(s):  
Clustering Algorithm ◽  
Distinct Pattern ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Hiv Care ◽  
Care Providers ◽  
Homogeneous Groups ◽  
Reporting Requirements ◽  
Low Middle Income Countries ◽  
Over Time

Abstract Background The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV-indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. The aim of this study is to conduct a comprehensive assessment of the reporting status for HIV-indicators, from the time of DHIS2 implementation, using Kenya as a case study. Methods A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 and 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness facility reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters. Results Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups. Conclusions The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.

scholarly journals Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniela C. Rodríguez ◽  
Diwakar Mohan ◽  
Caroline Mackenzie ◽  
Jess Wilhelm ◽  
Ezinne Eze-Ajoku ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Service Delivery ◽  
Health Systems ◽  
Local Level ◽  
Health Facilities ◽  
Government Support ◽  
Hiv Care ◽  
Local Context ◽  
Mixed Methods Evaluation ◽  
The Us

Abstract Background In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)). Methods We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society. Results We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders. Conclusions This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.

scholarly journals Engaging the ‘Missing Men’ in the HIV Treatment Cascade: Creating a Tailored Intervention to Improve Men’s Uptake of HIV Care Services in Rural South Africa: A Study Protocol

2021 ◽  
Vol 18 (7) ◽  
pp. 3709
Author(s):  
Oluwafemi Adeagbo ◽  
Kammila Naidoo
Keyword(s):  
South Africa ◽  
Health Outcomes ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Treatment Cascade ◽  
Hiv Care Cascade ◽  
Care Services ◽  
The Social ◽  
Hiv Treatment Cascade ◽  
Male Specific

Men, especially young men, have been consistently missing from the HIV care cascade, leading to poor health outcomes in men and ongoing transmission of HIV in young women in South Africa. Although these men may not be missing for the same reasons across the cascade and may need different interventions, early work has shown similar trends in men’s low uptake of HIV care services and suggested that the social costs of testing and accessing care are extremely high for men, particularly in South Africa. Interventions and data collection have hitherto, by and large, focused on men in relation to HIV prevention in women and have not approached the problem through the male lens. Using the participatory method, the overall aim of this study is to improve health outcomes in men and women through formative work to co-create male-specific interventions in an HIV-hyper endemic setting in rural KwaZulu-Natal, South Africa.

Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

scholarly journals The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana

2018 ◽  
Vol 3 (4) ◽  
pp. e000786 ◽  
Author(s):  
Akira Shibanuma ◽  
Francis Yeji ◽  
Sumiyo Okawa ◽  
Emmanuel Mahama ◽  
Kimiyo Kikuchi ◽  
...  
Keyword(s):  
Child Health ◽  
Continuum Of Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Newborn And Child Health ◽  
Care Services ◽  
Women And Children ◽  
And Child Health ◽  
The Continuum

IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.

Cross-sectional study of the quality of neonatal care services in Armenia

2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Quality Assessment ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Neonatal Deaths ◽  
Live Births ◽  
Care Services

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

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