scholarly journals Situation of menstrual management facilities in schools of peri-urban areas of Nepal: WASH, privacy, and healthcare

2021 ◽  
Author(s):  
Sadhana Shrestha ◽  
Salina Shrestha ◽  
Yuri Ito ◽  
Yuka Kobayashi ◽  
Kei Nishida ◽  
...  
Keyword(s):  
Urban Schools ◽  
Urban Areas ◽  
Middle Income ◽  
Running Water ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
The Past ◽  
Sanitation And Hygiene ◽  
Sanitary Pads ◽  
Water Provision

Abstract Menstrual management (MM) facilities in schools are neglected in low- and middle-income countries. We examined the existing MM facilities, identified the deficient, and collected students' ideas in peri-urban schools of Nepal. The schools had basic MM facilities including water sanitation and hygiene (WASH) infrastructures, gender-segregated toilet facilities with taps, dustbins and running water, provision of emergency sanitary pads, etc. Out of 71 students who reported soiling of dresses with menstrual blood as a common problem, 27% went home and did not return in such situation instead of washing off at school. Forty-six per cent of students used washable absorbents, but washing and drying facilities were lacking, and students adapted by using disposable pads at school and washable at home. Out of 126 students, 106 took days off during menstruation in the past three months with an average of 2.6 days by one student. Sixty-one per cent gave the reason as pain and 39% tiredness for taking days off. Healthcare facilities were lacking in schools, hence, lack of these facilities in schools might be contributing to absenteeism. The traditionally advocated list of MM facilities for schools, largely involving WASH facilities, should be updated, including newly identified factors which were also suggested by students.

scholarly journals Water, sanitation, and hygiene (WASH) in healthcare facilities of 14 low- and middle-income countries: to what extent is WASH implemented and what are the ‘drivers’ of improvement in their service levels?

2021 ◽  
Author(s):  
Laura Kmentt ◽  
Ryan Cronk ◽  
James Benjamin Tidwell ◽  
Elliott Rogers
Keyword(s):  
Prevention And Control ◽  
Infection Prevention And Control ◽  
Middle Income ◽  
Service Levels ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Sanitation And Hygiene ◽  
Increased Risk ◽  
And Control ◽  
Low And Middle Income

Abstract Prevention and control of healthcare-associated infections through the provision of water, sanitation, and hygiene (WASH) in healthcare facilities (HCF) is inadequate in low- and middle-income countries (LMICs), resulting in high patient morbidity and mortality, additional costs, and increased risk of antibiotic resistance. There is little evidence describing factors leading to improved WASH conditions in LMICs. We aim to identify the extent to which WASH is implemented in HCFs in LMICs and understand the ‘drivers’ of improvement in their service levels. WASH service levels in 14 LMICs were descriptively analysed, and potential drivers of service-level differences were explored using univariable and multivariable mixed-model logistic regression analyses. Descriptive analysis showed a lack of adequate water quality, sanitation, hand, and environmental hygiene, and waste disposal. We found that the presence of infection prevention and control protocols (IPCPs), having an IPC/WASH focal person at the facility, and conducting WASH training for staff were associated with higher levels of WASH services. This study demonstrates a lack of basic WASH services in HCF in LMICs. We show that there are potential interventions, such as implementing IPCPs, identifying WASH leaders in HCF, and conducting training that may lead to service improvements.

scholarly journals Spatial accessibility assessment to healthcare facilities: urban and rural areas

2021 ◽  
Vol 301 ◽  
pp. 02004
Author(s):  
Inna Čábelková ◽  
Zhanna Gardanova ◽  
Eduard Neimatov ◽  
Vladimir Esaulov
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Spatial Accessibility ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Large Pressure ◽  
Urban And Rural Areas ◽  
Social And Cultural Factors ◽  
Political Economic

This research concentrates on the spatial accessibility assessment to healthcare facilities. Specifically, in doing so it compares the situation in urban and rural areas. In many countries, health inequalities continue to be a major public health challenge. Furthermore, there is also urbanization that occurs when people move from rural areas to urban areas. It leads to an increase in urban population and the extent of urban areas. Driven by population growth, many cities in low and middle-income countries are growing at record rates which puts large pressure on the healthcare system and facilities. Our research demonstrates that due to many political, economic, social and cultural factors, the current inequalities in health care between regions, urban and rural areas and different age and income groups are increasing. Thence, there is a pressing need for the improvement of the healthcare in the lagged regions and areas using such means as the advanced technologies, analysis of data, as well as targeted funding and assistance to those who need it the most.

scholarly journals What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries

2018 ◽  
Vol 3 (3) ◽  
pp. e000648 ◽  
Author(s):  
Maha Bouzid ◽  
Oliver Cumming ◽  
Paul R Hunter
Keyword(s):  
Patient Satisfaction ◽  
Low Income ◽  
Maternal Health Services ◽  
Care Seeking ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Patient Dissatisfaction ◽  
Middle Income Countries ◽  
Sanitation And Hygiene ◽  
Care Seeking Behaviour

Patient satisfaction with healthcare has clear implications on service use and health outcomes. Barriers to care seeking are complex and multiple and delays in seeking care are associated with significant morbidity and mortality. We sought to assess the relationship between water, sanitation and hygiene (WASH) provision in healthcare facilities (HCF) and patient satisfaction/care seeking behaviour in low-income and middle-income countries. Pubmed and Medline Ovid were searched using a combination of search terms. 984 papers were retrieved and only 21 had a WASH component warranting inclusion. WASH was not identified as a driver of patient satisfaction but poor WASH provision was associated with significant patient dissatisfaction with infrastructure and quality of care. However, this dissatisfaction was not sufficient to stop patients from seeking care in these poorly served facilities. With specific regard to maternal health services, poor WASH provision was the reason for women choosing home delivery, although providers’ attitudes and interpersonal behaviours were the main drivers of patient dissatisfaction with maternal health services. Patient satisfaction was mainly assessed via questionnaires and studies reported a high risk of courtesy bias, potentially leading to an overestimation of patient satisfaction. Patient satisfaction was also found to be significantly affected by expectation, which was strongly influenced by patients’ socioeconomic status and education. This systematic review also highlighted a paucity of research to describe and evaluate interventions to improve WASH conditions in HCF in low-income setting with a high burden of healthcare-associated infections. Our review suggests that improving WASH conditions will decrease patience dissatisfaction, which may increase care seeking behaviour and improve health outcomes but that more rigorous research is needed.

Problems and Practice of Management on Menstruation by Adolescents Girls of Basic Schools of Chitwan, Nepal

2020 ◽  
Vol 8 ◽  
pp. 85-94
Author(s):  
Sudha Ghimire
Keyword(s):  
Current Practice ◽  
Quantitative Information ◽  
Community Schools ◽  
Mixed Method Research ◽  
Participatory Action ◽  
Group Discussions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Field Notes ◽  
Sanitary Pads

Managing menstruation in a hygienic way is a challenge in most of the low and middle-income countries (LMIC) including Nepal, where normal and natural physiological process of menstruation is considered as girls’ problem which is viewed as sinful, unholy and matter of shame. This paper explores the current practice and existing difficulties that adolescents girls encounter hygienic management of menstruation (MHM) especially during school days. The study was conducted on five purposively selected community schools of Chitwan district. The study adopted Participatory Action Research (PAR) as an approach, that is encapsulated with mixed method research design. For qualitative information observation, focus group discussions (FGD) and field notes were used, whereas for quantitative data self-administrative questionnaires were used. Quantitative information was collected from 205 girls students who were present at schools on the day of data collection. The finding shows that majority of the girls (93.7%) who encounter hygienic management of menstruation were of 10-14 years old age, whereas nearly one third of them were (29%) from grade eight. Similarly, among the total 205 girls, only 79 girls have already started their menstruation; among those who have started menstruation majority (78%) had heard about menstruation form their mothers. Likewise, 35% girls used homemade cotton pads and 40.5% of them changed pad three times a day. During FGD, adolescents girls shared that lack of water and soap in toilets, stress and lack of concentration during menstruation are the major difficulties which they encounter during days of menstruation. They suggested the concerned authorities to manage pad bank, make soap and water available, and develop skills for proper disposing of used sanitary pads for MHM at schools. 

scholarly journals Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2571
Author(s):  
Laura Rossouw ◽  
Hana Ross
Keyword(s):  
Decomposition Methods ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Menstrual Health ◽  
Women And Girls ◽  
Sanitary Pads ◽  
Unequal Access

Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.

scholarly journals Obesities: A New Peer-Reviewed Open-Access Interdisciplinary Journal Fostering Research on Multifactorial Obesity and Associated Cardiometabolic Disorders

Obesities ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 26-28
Author(s):  
Bruno Guigas
Keyword(s):  
Open Access ◽  
Industrialized Countries ◽  
Obesity Prevalence ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Urban Transition ◽  
Cardiometabolic Disorders ◽  
Interdisciplinary Journal ◽  
Low And Middle Income

Obesity prevalence has increased continuously over the past 50 years, a dramatic worldwide expansion not only limited to industrialized countries but also observed in a large number of low- and middle-income countries experiencing rapid rural–urban transition [...]

scholarly journals Tobacco Control in Low- and Middle-Income Countries: Changing the Present to Help the Future

2018 ◽  
Vol 13 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Bethany Hipple Walters ◽  
Ionela Petrea ◽  
Harry Lando
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Second Hand Smoke ◽  
Vulnerable Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Past ◽  
Second Hand Smoke Exposure ◽  
Health Organization ◽  
Low And Middle Income

While the global smoking rate has dropped in the past 30 years (from 41.2% of men in 1980 to 31.1% in 2012 and from 10.6% of women in 1980 to 6.2% in 2012), the number of tobacco smokers has increased due to population growth (Ng et al., 2014). This tobacco use and second-hand smoke exposure continue to harm people worldwide. Those harmed are often vulnerable: children, those living in low- and middle-income countries (LMICs), those with existing diseases, etc. As noted by the World Health Organization (WHO), nearly 80% of those who smoke live in a LMIC (World Health Organization, 2017). Furthermore, it is often those who are more socio-economically disadvantaged or less educated in LMICs that are exposed to second-hand smoke at home and work (Nazar, Lee, Arora, & Millett, 2015).

Zoonotic pathogens in urban animals: Enough research to protect the health of the urban population?

2020 ◽  
Vol 21 (1) ◽  
pp. 50-60
Author(s):  
Johanna Lindahl ◽  
Ulf Magnusson
Keyword(s):  
Urban Areas ◽  
Data Extraction ◽  
Gastrointestinal Parasites ◽  
Host Animal ◽  
Middle Income ◽  
Zoonotic Pathogens ◽  
Middle Income Countries ◽  
Common Category ◽  
Gastrointestinal Bacteria ◽  
Tropical Cities

AbstractWith more than half of the global population living in cities, the urban areas are also teeming with animals, including peridomestic wildlife, pets, and livestock. Urban animals may carry zoonotic pathogens, and crowded conditions in cities can increase the risk for the human population. We used a systematic approach to screen two publication databases as well as gray literature, and quantified the studies conducted on zoonoses in urban animals with respect to the geographic distribution, the host animal and pathogens. Out of 876 references found, 93 were included into final data extraction. Few studies were from the rapidly expanding cities in low- and middle-income countries where urban livestock-keeping is far more prominent than in high-income countries. Most studies were performed in peridomestic wildlife and pets, less in livestock. The most common category of pathogens studied were gastrointestinal parasites followed by gastrointestinal bacteria, whereas studies on some other zoonoses internationally recognized as critical for public health were few or absent. In conclusion, to mitigate the risks of emergence of zoonoses from urban animals this review highlights the research gaps on zoonoses, particularly in livestock in rapidly growing tropical cities and a more comprehensive inclusion of pathogens prioritized by WHO and OIE.

scholarly journals Global Burden of Stroke

2018 ◽  
Vol 38 (02) ◽  
pp. 208-211 ◽  
Author(s):  
Mira Katan ◽  
Andreas Luft
Keyword(s):  
Hemorrhagic Stroke ◽  
Middle Income ◽  
Stroke Incidence ◽  
Middle Income Countries ◽  
The Past ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Incidence And Mortality ◽  
Geographical Regions ◽  
Life Years Lost

AbstractStroke is the second leading cause of death and a major cause of disability worldwide. Its incidence is increasing because the population ages. In addition, more young people are affected by stroke in low- and middle-income countries. Ischemic stroke is more frequent but hemorrhagic stroke is responsible for more deaths and disability-adjusted life-years lost. Incidence and mortality of stroke differ between countries, geographical regions, and ethnic groups. In high-income countries mainly, improvements in prevention, acute treatment, and neurorehabilitation have led to a substantial decrease in the burden of stroke over the past 30 years. This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe.

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