The scenario of childhood blindness and its remedy in Nepal

Childhood blindness represents one of the most common disabling and for children. There are approximately 1.4 million blind children worldwide and two-thirds live in the developing countries like Nepal. In Nepal more than 80% of the causes of childhood blindness are preventable. The main causes of blindness are diseases related to cornea, retina, lens optic nerve, refractive errors, amblyopia and hereditary. Most of the cases of unilateral childhood blindness are due to corneal causes. To decrease the burden of blindness, awareness program about various ocular diseases, nutritional blindness, ocular trauma, refractive errors, strabismus and amblyopia should be provided to the community health workers and parents. School screening programs and free eye camps should be conducted and motivate the community for regular eye checkup and follow up. Eye services should reach to rural areas and for poor socio-economic condition. Eye health education should focus on proper nutrition of children and harmful effects of traditional eye medicines. The objective of this study was to investigate the magnitude of childhood blindness in Nepal along with their possible causes. Similarly, this study is aimed to highlight the best possible modalities for the remedy of childhood blindness in the developing countries like Nepal.

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Health Workers’ Perspectives on Infrastructure to Support Maternal Health Services in Rural Areas of Vietnam

Asia Pacific Journal of Health Management ◽

10.24083/apjhm.v12i2.81 ◽

2017 ◽

Vol 12 (2) ◽

pp. 55-61

Author(s):

Thi Hoai Thu Nguyen ◽

Fiona McDonald ◽

Andrew Wilson

Keyword(s):

Primary Care ◽

Developing Countries ◽

Maternal Health ◽

Health Services ◽

Rural Areas ◽

Health Workers ◽

Maternal Health Services ◽

District Health ◽

Health Centres ◽

The Impact

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.

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A study on training frontline health workers for prevention, early recognition and treatment or transfer of women with post-partum haemorrhage using mamanatalie

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184145 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4156

Author(s):

Nikhita B. Vadvadgi ◽

Nageshu Shailaja ◽

Lingegowda Krishna ◽

Kirtan Krishna

Keyword(s):

Rural Areas ◽

Health Workers ◽

Early Recognition ◽

Post Partum ◽

Skill Assessment ◽

Knowledge And Skills ◽

Skill Test ◽

Frontline Health Workers ◽

Post Partum Haemorrhage

Background: The objective of the present study was to train frontline health workers (FHW) on prevention, early recognition and treatment/transfer of women with post-partum haemorrhage using mamanatalie and to compare their pre-training and post training knowledge and skills, and to reassess the knowledge and skills of the trainees after six months.Methods: Training of 159 FHW belonging to the nine Primary Health Centres (PHC) of Kuppam constituency was conducted using mamanatalie. Pre and post training knowledge and skill assessment were compared using questionnaires and the mamanatalie. Reassessment of knowledge and skill was done after six months.Results: Among 159 participants 93% scored more, 3% scored same and 4% scored lesser in post training when compared to pre-training test. In the follow up knowledge assessment after six months 73 trainees were lost for follow up, among the remaining, 8% scored more, 16% scored same and 76% scored less when compared to the post training test. However, the follow up scores were higher than the pre-training scores. In the skill test, 82% scored more than 80%. Four trainees were lost for follow up skill assessment, among the remaining, 16% scored more, 23% scored same and 61% scored less when compared to the initial skill test scoresConclusions: The training increased knowledge, skill and confidence among the trainees. It has the potential to lead to improved clinical outcomes, especially in the rural areas. Revision sessions may help in better retention of knowledge and skill.

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M-phone impact on practical training: role of m-phone as part of the educative method for training local health workers of rural areas of developing countries

Health and Technology ◽

10.1007/s12553-013-0073-4 ◽

2014 ◽

Vol 4 (3) ◽

pp. 289-294 ◽

Cited By ~ 6

Author(s):

Livia Bellina ◽

Giovanni Azzolina ◽

Ilenia Nucatola ◽

Annalisa Maggio ◽

Francesco Consiglio ◽

...

Keyword(s):

Developing Countries ◽

Rural Areas ◽

Health Workers ◽

Practical Training ◽

Local Health

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The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i1.5858 ◽

1970 ◽

Vol 4 (1) ◽

pp. 90-95 ◽

Cited By ~ 5

Author(s):

S KC Rai ◽

HB Thapa ◽

MK Sharma ◽

K Dhakhwa ◽

R Karki

Keyword(s):

Refractive Error ◽

Rural Areas ◽

Refractive Errors ◽

Age Group ◽

Pediatric Ophthalmology ◽

Statistical Software ◽

Childhood Blindness ◽

Number Of Children ◽

Urban And Rural Areas ◽

Uncorrected Refractive Error

Introduction: Uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To describe the patterns of refractive errors among children attending the outpatient clinic at the Department of Pediatric Ophthalmology, Lumbini Eye Institute, Bhairahawa, Nepal. Subjects and methods: Records of 133 children with refractive errors aged 5 - 15 years from both the urban and rural areas of Nepal and the adjacent territory of India attending the hospital between September and November 2010 were examined for patterns of refractive errors. The SPSS statistical software was used to perform data analysis. Results: The commonest type of refractive error among the children was astigmatism (47 %) followed by myopia (34 %) and hyperopia (15 %). The refractive error was more prevalent among children of both the genders of age group 11-15 years as compared to their younger counterparts (RR = 1.22, 95 % CI = 0.66 – 2.25). The refractive error was more common (70 %) in the rural than the urban children (26 %). The rural females had a higher (38 %) prevalence of myopia than urban females (18 %). Among the children with refractive errors, only 57 % were using spectacles at the initial presentation. Conclusions: Astigmatism is the commonest type of refractive error among the children of age 5 - 15 years followed by hypermetropia and myopia. Refractive error remains uncorrected in a significant number of children. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5858 NEPJOPH 2012; 4(1): 90-95

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Robust E-Health Communication Architecture for Rural Communities in Developing Countries

Engineering, Technology & Applied Science Research ◽

10.48084/etasr.45 ◽

2012 ◽

Vol 2 (3) ◽

pp. 237-240

Author(s):

F. E. Idachaba ◽

E. M. Idachaba

Keyword(s):

Developing Countries ◽

Rural Communities ◽

Rural Areas ◽

Urban Areas ◽

Health Workers ◽

Low Cost ◽

Healthcare Delivery ◽

Communication Architecture ◽

Quality Healthcare ◽

Communication Devices

The lack of access to quality healthcare and the lack of sufficient manpower, especially doctors, in rural areas is a major healthcare challenge faced by dwellers in rural communities in most developing countries. The intervention of governments, which range from the introduction of training programs aimed at producing health workers from schools of health technology and nursing to the recalling and deployment of retired nurses to rural areas, has still not been able to generate the desired improvement in healthcare delivery, as outbreaks of epidemics are still being reported in such areas. This work presents an E-Health architecture which utilizes low cost sensors and communication devices to link the doctors in the urban areas with the patients in rural areas enabling doctors-patients interaction. The system enables accurate and timely diagnosis of the patients and facilitates proper treatment plans. It also incorporates an epidemic alert which enables the tracking of diseases and the early detection and control of epidemics.

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An Intelligent Computer-Assisted Instruction System Designed for Rural Health Workers in Developing Countries

Methods of Information in Medicine ◽

10.1055/s-0038-1634870 ◽

1992 ◽

Vol 31 (03) ◽

pp. 193-203 ◽

Cited By ~ 1

Author(s):

B. Auvert ◽

V. Gilbos ◽

F. Andrianiriana ◽

W. E. Bertrand ◽

X. Emmanuelli ◽

...

Keyword(s):

Developing Countries ◽

Decision Support ◽

Rural Health ◽

Health Workers ◽

Computer Assisted Instruction ◽

Computer Assisted ◽

Instruction System ◽

Knowledge Based ◽

Assisted Instruction ◽

Intelligent Computer

Abstract:This paper describes an intelligent computer-assisted instruction system that was designed for rural health workers in developing countries. This system, called Consult-EAO, includes an expert module and a coaching module. The expert module, which is derived from the knowledge-based decision support system Tropicaid, covers most of medical practice in developing countries. It allows for the creation of outpatient simulations without the help of a teacher. The student may practice his knowledge by solving problems with these simulations. The system gives some initial facts and controls the simulation during the session by guiding the student toward the most efficient decisions. All student answers are analyzed and, if necessary, criticized. The messages are adapted to the situation due to the pedagogical rules of the coaching module. This system runs on PC-compatible computer.

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Intraocular tuberculosis, a challenge in diagnosis and treatment

Latin American Journal of Ophthalmology ◽

10.25259/lajo_17_2019 ◽

2020 ◽

Vol 3 ◽

pp. 4

Author(s):

Martina Larroude ◽

Gustavo Ariel Budmann

Keyword(s):

Developing Countries ◽

Clinical Signs ◽

Steady Increase ◽

Ocular Tuberculosis ◽

Industrial Countries ◽

Choroidal Granuloma ◽

History Of ◽

And Migration ◽

Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

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The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study

BMC Family Practice ◽

10.1186/s12875-021-01471-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ingmar Schäfer ◽

Heike Hansen ◽

Agata Menzel ◽

Marion Eisele ◽

Daniel Tajdar ◽

...

Keyword(s):

Primary Care ◽

Observational Study ◽

Rural Areas ◽

Longitudinal Observational Study ◽

Multivariable Analyses ◽

Gastrointestinal Complaints ◽

Urban And Rural Areas ◽

Quota Sampling ◽

Primary Care Practices

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.

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Adrenoleukodystrophy Newborn Screening in California Since 2016: Programmatic Outcomes and Follow-Up

International Journal of Neonatal Screening ◽

10.3390/ijns7020022 ◽

2021 ◽

Vol 7 (2) ◽

pp. 22

Author(s):

Jamie Matteson ◽

Stanley Sciortino ◽

Lisa Feuchtbaum ◽

Tracey Bishop ◽

Richard S. Olney ◽

...

Keyword(s):

Newborn Screening ◽

Program Implementation ◽

Screening Program ◽

Birth Prevalence ◽

Variant Of Uncertain Significance ◽

Implementation Challenges ◽

Screening Programs ◽

Uncertain Significance ◽

Long Term Follow Up

X-linked adrenoleukodystrophy (ALD) is a recent addition to the Recommended Uniform Screening Panel, prompting many states to begin screening newborns for the disorder. We provide California’s experience with ALD newborn screening, highlighting the clinical and epidemiological outcomes observed as well as program implementation challenges. In this retrospective cohort study, we examine ALD newborn screening results and clinical outcomes for 1,854,631 newborns whose specimens were received by the California Genetic Disease Screening Program from 16 February 2016 through 15 February 2020. In the first four years of ALD newborn screening in California, 355 newborns screened positive for ALD, including 147 (41%) with an ABCD1 variant of uncertain significance (VUS) and 95 males diagnosed with ALD. After modifying cutoffs, we observed an ALD birth prevalence of 1 in 14,397 males. Long-term follow-up identified 14 males with signs of adrenal involvement. This study adds to a growing body of literature reporting on outcomes of newborn screening for ALD and offering a glimpse of what other large newborn screening programs can expect when adding ALD to their screening panel.

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Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

Dubai Medical Journal ◽

10.1159/000512521 ◽

2021 ◽

pp. 1-7

Author(s):

Salam Chettian Kandi ◽

Hayat Ahmad Khan

Keyword(s):

Visual Acuity ◽

Visual Field ◽

United Arab Emirates ◽

Refractive Error ◽

Screening Program ◽

Low Vision ◽

Refractive Errors ◽

Vision Screening ◽

Screening Programs ◽

School Based

Introduction: Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of <6/18 to 3/60 or having visual field loss to <20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of <3/60 or corresponding visual field of <10°. Purpose: To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. Methods: An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. Results: 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (n = 340) had impaired vision with 20.9% (n = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. Conclusion: A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, n = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (n = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.

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