scholarly journals Unnecessary & Unsafe Injections Replace Disposable by Auto-Disable Syringes

2013 ◽  
Vol 1 (3) ◽  
pp. 67-70
Author(s):  
SL Srivastav
Keyword(s):  
Health Workers ◽  
Pathogen Transmission ◽  
Childhood Mortality ◽  
Medical Sciences ◽  
Vaccine Preventable Diseases ◽  
Life Saving ◽  
Sterile Needle ◽  
Clean Area ◽  
Safe Injection ◽  
Unsafe Injections

Injections are a skin procedure performed with a syringe and needle to introduce a substance for prophylactic, curative, or recreational purpose. Injections can be given intevenously, intramuscularly, intradermally, or subcutaneously. Injections are among the most frequently used medical procedures, with an estimated 12 billion injections administered worldwide.  A large majority (more than 90%) of these injections are administered for curative purpose (for every vaccination, 20 curative injections are administered). Injections have been used effectively for many years in preventive and curative healthcare. In preventive healthcare, injections have been used to administer vaccinations that have had major impact in reducing childhood mortality due to measles and other vaccine preventable diseases. While injections are still necessary today to administer most vaccination, the number of vaccination injections could be reduced through the use of combination vaccines. In curative healthcare, injections have been used to administer such antibiotics as Penicillin, Streptomycin, as well as many other life saving medications. Today, safe and effective alternatives to injected medications are available and most medications used in primary care can be administered orally. Injections are predominantly needed for treatment of severe diseases, mostly in hospital settings. Nevertheless, injections are overused to administer medications in many countries because of an ingrained preference for injections among health workers and patients. A safe injection does no harm to the recipient, does not expose the healthcare worker to any risk, and does not result in waste that is dangerous for the community. To achieve this, an injection needs to be prepared with clean hands in a clean area, using a syringe and a sterile needle. After administration, sharp equipments such as needle need to be discarded in a puncture proof container for appropriate disposal. When these rules are not followed, injections are unsafe and may expose recipients, healthcare workers, or the community to infections. Among unsafe practices, syringe or needle reuse between patients without sterilization is associated with a high risk of blood-borne pathogen transmission. Unsafe injections occur in many parts of the world and more particularly in developing countries where up to 50% of injections are administered with reused syringes and needles. To reduce the overuse of injections, and to assure safe injection practice, multidisciplinary strategies comprising of various elements have been discussed in this article. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8770 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 67-70

scholarly journals Limiting factors for snail’s pace success of immunization

2021 ◽  
Vol 8 (2) ◽  
pp. 248
Author(s):  
Pavitra V. Arunachalmath ◽  
Vijayakumar B. Murteli
Keyword(s):  
Health Workers ◽  
World Health ◽  
Limiting Factors ◽  
Medical Sciences ◽  
Child Illness ◽  
Vaccine Preventable Diseases ◽  
Grass Root ◽  
Health Organization ◽  
Root Health ◽  
Disease Free

Background: The practice of immunization dates back to hundreds of years. Buddhist monks drank snake venom to confer the immunity against snake bite. World Health Organization (WHO) covers broad scope of global activities in order make the globe free of vaccine preventable diseases. Many surveillance activities are going on, in order to fulfill the aim of disease free globe.Methods: Children admitted to the Pediatric ward of Belgavi Institute of Medical Sciences were enrolled and parents/ guardians were enquired about the vaccination the child received and their knowledge about immunization and interpretation was done to find out the reasons for snail’s pace of successful elimination of the vaccine preventable diseases.Results: Out of 630 participants, 364 had partial immunization and 12 (1.9%) were un- immunized. Poor knowledge being the first reason found in 247 (67.9%) children. No visit by the health worker was the 2nd reason found in 220 (60.4%) children and child illness was the third reason in 116 (31.9%) children.Conclusions: In order to increase the rates of immunization in the community, improving the knowledge of community, about the benefits of immunizing their children as well as empowering the grass root health workers in immunizing the children of their locality can help us achieve a nation free of vaccine preventable diseases. 

Letter to the Editor

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 926-927
Author(s):  
Ralph I. Fried
Keyword(s):  
Quality Of Care ◽  
Child Behavior ◽  
Private Practice ◽  
Allied Health ◽  
Health Workers ◽  
Emotional Problems ◽  
Routine Care ◽  
Parental Concerns ◽  
Life Saving

I gratefully accept your invitation to comment on the letter by Dr. Pick on allied health workers in the private practice of pediatrics. I support Dr. Pick in his statement that this would constitute a regression in the quality of care offered to our children. Dr. Charles A. Janeway remarked in 1957 that during his career the practice of pediatrics had reversed itself from 80% life-saving and 20% routine care, to the opposite figures, so that pediatricians have had to deal increasingly with parental concerns about child behavior and emotional problems.

scholarly journals Awareness and acceptance of contraceptives among the mothers of infants attending an immunization session at a field practices area of a tertiary care hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 374
Author(s):  
S. B. Gupta ◽  
Meenakshi Singh ◽  
Atul Kr. Singh ◽  
Huma Khan ◽  
Alpana Saxena
Keyword(s):  
Health Workers ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Contraceptive Measure ◽  
One Year ◽  
Type Of Delivery

Background: India was the first country in the world to have launched a National Programme for Family Planning.Methods: A cross-sectional descriptive study was carried out in the in Vaccination unit of rural field practice area of Shri Ram Murti Smarak institute of Medical Sciences (SRMSIMS) Bareilly (U.P). Objective of the study was to assess knowledge and practice of postpartum contraception and factors affecting the usage of contraceptives in Rural area. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used. A total of 98 females were included. The appropriate statistical analysis was done to present the results.Results: 28.57% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits.Conclusions: Overall usage of postpartum contraception was low there is need to focus at every step to contact of these women with health facility or health workers.

scholarly journals Peripartum Hysterectomy in a Teaching Hospital in India

2013 ◽  
Vol 4 (1) ◽  
pp. 5-9
Author(s):  
Swati Agrawal ◽  
Reena Yadav ◽  
Chitra Raghunandan ◽  
Shilpa Dhingra ◽  
Harvinder Kaur
Keyword(s):  
Tertiary Care ◽  
Hemodynamic Instability ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Maternal Characteristics ◽  
Peripartum Hysterectomy ◽  
Characteristics Method ◽  
Life Saving

Objectives: To find the incidence and clinical implications of peripartum hysterectomy in a tertiary care centre of India. Methods: A retrospective study of all cases of caesarean and postpartum hysterectomy between January 2006 and December 2011. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. Results: The rate of peripartum hysterectomy was 0.47:1000 deliveries. Most were operative deliveries. The main indications were placenta accreta (38.88%), massive atonic PPH (36.11%) and uterine rupture (22.22%). Half the hysterectomies were subtotal while the rest were total. Maternal morbidity was high and there were seven maternal deaths (19.44%). All deaths were in patients brought in a critical condition to the hospital after massive blood loss. Conclusion: Peripartum hysterectomy is potentially a life saving procedure but the mortality and morbidity is high, especially if performed late when the hemodynamic instability has already set in. DOI: http://dx.doi.org/10.3126/ajms.v4i1.6967 Asian Journal of Medical Sciences 4(2013) 5-9

scholarly journals A Feasibility Study to Assess Non-clinical Community Health Workers’ Capacity to use Simplified Protocols and Tools to Treat Severe Acute Malnutrition in Niger State Nigeria

2021 ◽  
Author(s):  
Olatunde Adesoro ◽  
Olusola Oresanya ◽  
Helen Counihan ◽  
Prudence Hamade ◽  
Dare Eguavon ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Full Recovery ◽  
Childhood Mortality ◽  
Acute Malnutrition ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Clinical Community

Abstract Background: Severe acute malnutrition (SAM) is a major determinant of childhood mortality and morbidity. Although integrated community case management (iCCM) of childhood illnesses is a strategy for increasing access to life-saving treatment, malnutrition is not properly addressed in the guidelines. This study aimed to determine whether non-clinical Community Health Workers (called Community-Oriented Resource Persons, CORPs) implementing iCCM could use simplified tools to treat uncomplicated SAM.Methods: The study used a sequential mixed-method design and was conducted between July 2017 and May 2018. Sixty CORPs already providing iCCM services were trained and deployed in their communities with the target of enrolling 290 SAM cases. Competency of CORPs to treat and the treatment outcomes of enrolled children were documented. SAM cases with MUAC of 9cm to < 11.5cm without medical complications were treated for up to 12 weeks. Full recovery was at MUAC≥12.5cm for two consecutive weeks. Supervision and quantitative data capturing were done weekly while qualitative data were collected after the intervention.Results: CORPs scored 93.1% on first assessment and increment of 0.11 (95% CI: 0.05 – 0.18) points per additional supervision conducted. The cure rate from SAM to full recovery, excluding referrals from the denominator in line with the standard for reporting SAM recovery rates, was 73.5% and the median length of treatment was seven weeks. SAM cases enrolled at 9cm to <10.25cm MUAC had 29% less likelihood of recovery compared to those enrolled at 10.25cm to <11.5cm. CORPs were not burdened by the integration of SAM into iCCM and felt motivated by children’s recovery. Operational challenges like bad terrains for supervision, supply chain management and referrals were reported by supervisors, while Government funding was identified as key for sustainability.Conclusion: The study demonstrated that with training and supportive supervision, CORPs in Nigeria can treat SAM among under-fives, and refer complicated cases using simplified protocols as part of an iCCM programme. This approach seemed acceptable to all stakeholders, however, the effect of the extra workload of integrating SAM into iCCM on the quality of care provided by the CORPs should be assessed further.

scholarly journals Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan: evidence from two longitudinal cohort studies 15 years apart

2020 ◽  
Author(s):  
Chelsea L Hansen ◽  
Benjamin JJ McCormick ◽  
Syed Iqbal Azam ◽  
Khalil Ahmed ◽  
Julia M Baker ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Child Health ◽  
Cohort Studies ◽  
Protective Factor ◽  
Health Workers ◽  
Considerable Change ◽  
Childhood Mortality ◽  
Autopsy Study ◽  
Rural Village ◽  
Significant Difference

Abstract Background: Oshikhandass is a rural village in northern Pakistan where a verbal autopsy study from 1989-1991 showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later.Methods: Two prospective open-cohort studies in Oshikhandass from 1989-1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines conducted weekly household surveillance and promoted knowledge on causes and management of diarrhea and pneumonia. Information about household characteristics and socioeconomic status was collected. Hurdle models were constructed to examine putative risk factors for diarrhea and pneumonia.Results: Against a backdrop of considerable change in the socioeconomic status of the community, under-5 mortality, which declined over the course of Study 1 (from 114.3 to 79.5 deaths/1000 live births (LB) between 1989 and 1996), exceeded Sustainable Development Goal 3 by Study 2 (19.8 deaths/ 1000 LB). Reductions in diarrhea prevalence (20.3 to 2.2 days/ Child Year [CY]), incidence (2.1 to 0.5 episodes/ CY), and number of bloody diarrhea episodes (18.6% to 5.2%) seen during Study 1, were sustained in Study 2. Pneumonia incidence was 0.5 episodes /CY in Study 1 and 0.2/CY in Study 2; only 5% of episodes were categorized as severe or very severe in both studies. While no individual factors predicted a statistically significant difference in diarrhea or pneumonia episodes, the combined effect of water, toilet and housing materials was associated with a significant decrease in diarrhea; higher household income was the most protective factor for pneumonia in Study 1. Conclusions: We report a 4-fold decrease in overall childhood mortality, and a 2-fold decrease in childhood morbidity from diarrhea and pneumonia in a remote rural village in Pakistan between 1989-2014. We conclude that significant, sustainable improvements in child health may be achieved through improved socioeconomic status and promoting interactions between locally engaged health workers and the community, but that continued efforts are needed to improve health worker training, supervision, and the rational use of medications.Trial Registration: Not Applicable

scholarly journals Hospital resilience after the 2015 earthquake in Nepal: a qualitative study with hospital staff

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Moitinho de Almeida ◽  
J van Loenhout ◽  
R Singh ◽  
D P Mahara ◽  
D Guha-Sapir ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Workers ◽  
Early Stage ◽  
Community Support ◽  
Hospital Staff ◽  
Task Shifting ◽  
Structured Interviews ◽  
Basic Care ◽  
Individual Resilience ◽  
Life Saving

Abstract Background Research on hospital resilience is scarce and favours top-down approaches, and evidence from the field and operational levels is lacking. The aim of our study was to understand the mechanisms of hospital and individual resilience experienced by staff from a tertiary hospital in Kathmandu, Nepal, after the 2015 Earthquake. Methods We conducted semi-structured interviews with different professionals in May 2018; undertook a deductive thematic analysis of hospital resilience using the framework proposed by Bruneau et al; and used an inductive thematic analysis for individual resilience. Results The earthquake caused different types of burden to the hospital and individuals. Redundancy was mostly influenced by linkages with lower levels of care. Resourcefulness consisted mostly of spontaneous adaptations, with task shifting the most important for human resources. External provision of resources enabled the transfer of part of the burden but precipitated accountability-related challenges. The hospital's robustness depended not only on its physical resistance, but also on the functional capacity to provide life saving care, although routine services were interrupted and quality decreased. The hospital ensured rapidity in providing life saving care to the victims and re-start of routine activities, but recovery to a sense of normality was more conflicting and dependent on the individual. Individual resilience was dictated by safety, a sense of meaningfulness, self and external appreciation, and community support. Conclusions Our study shows the importance of staff experiences to improve hospital resilience. Disaster plans should acknowledge the role of task shifting, and basic care should be taught to all, not just those with clinical functions. Health workers are extremely overwhelmed during disaster response, and disaster plans should engage staff at an early stage to ensure they feel safe and sufficiently supported. Key messages Our work is one of the first to study hospital resilience with field data from qualitative interviews with hospital staff. Hospital resilience strategies should also address individual resilience of hospital staff.

scholarly journals Determinants of Hesitancy to Childhood Immunizations in a Peri -Urban Settlement; A Case Study of Nansana Municipality, Uganda

2021 ◽  
Vol 9 (3) ◽  
pp. 213-226
Author(s):  
Amos Kijjambu
Keyword(s):  
Side Effects ◽  
Health Workers ◽  
Information Provision ◽  
Simple Random Sampling ◽  
Vaccine Safety ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
Immunization Service ◽  
Vaccine Preventable Diseases ◽  
Childhood Immunizations

Vaccine hesitancy to immunization against the childhood vaccine-preventable diseases is increasingly becoming a concern worldwide, which negatively impacts the parents’ willingness to vaccinate their children. The objective of this study was to establish the current prevalence of vaccine hesitancy and the factors that determine parent’s hesitancy to childhood immunizations in Nansana Municipality, Wakiso District, Uganda. This was a cross-sectional mixed methods study, utilizing both qualitative and quantitative approaches. Evaluation of the determinants of vaccine hesitancy was carried out on 344 parents of children under 24 months, using simple random sampling on pre-tested structured questionnaires. Data was analyzed using SPSS 20.0 software. Additionally, 2 focus group discussions with parents were also conducted. Vaccine hesitancy was found to be 27.6%. Education level (AOR=4.9, 95% CI, 2.6 -29.5, p=0.01), belief in vaccine effectiveness (AOR= 0.47, 95% CI, 0.17 – 0.97, p=0.01), health workers attitude (AOR=0.22, 95% CI, 0.06 - 0.86, p=0.03), timing of immunization service clinic (AOR = 3.4, 95% CI, 1.8 – 6.4, p=0.01) and adequate information provision (AOR = 0.64, 95% CI, 0.16 – 0.99, p=0.04), were the factors that were independently determining vaccine hesitancy. The vaccine hesitancy prevalence rate is comparatively similar to previous urban area studies. Despite parents overwhelmingly believing in vaccines protecting their children from vaccine-preventable disease, these same parents, express concerns regarding timing of the clinic and the side effects of vaccines. There is a need to improve on communication and information flow to address the many vaccine safety concerns, such as side effects. Keywords: Childhood, Determinants, Hesitancy, Immunization, Urban.

scholarly journals Equity in the Distribution of Health Resources: A Case Study in Southeast Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Khammarnia ◽  
Hesam Ghiasvand ◽  
Fateme Javadi ◽  
Fatemeh Safdari Adimi
Keyword(s):  
Health Status ◽  
Gini Index ◽  
Health Workers ◽  
Healthcare Providers ◽  
Health Sector ◽  
Health Resources ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional

Background: Equity in the distribution of equipment and resources in the health sector constitutes one of the main dimensions of justice, improving health status and increasing people's satisfaction. Objectives: The current study aimed at determining how health resources and equipment are distributed in the poorest region of Iran. Methods: The current retrospective, cross-sectional study was performed in Sistan and Baluchistan Province, as the poorest region of Iran, in 2020. Data were collected using a standard checklist from all five health centers affiliated to Zahedan University of Medical Sciences (ZAUMS). Excel and STATA software was used for data analysis; the Gini index was also calculated. Results: The Gini index for the distribution of midwives and rural health workers was equitable (0.216 and 0.287, respectively). The distribution of urban healthcare providers, nutrition and psychology counselors, and active beds in ZAUMS were 0.675, 0.545, 0.454, and 0.526, respectively. The distribution of general practitioners, based on the Gini index (0.492), was not fair. Also, the distribution of specialists and nurses was unfair (Gini index: 0.494 and 589, respectively). Conclusions: The distribution of most resources in the poorest region of Iran was not fair. Unfair distribution and disparities can affect population health status in the future. Then, it is suggested that health policymakers and managers pay more attention to deprived regions.

scholarly journals Awareness of sexually transmitted diseases (STDs) among married women of reproductive age group in Barahi, Chiraigaun, India

1970 ◽  
Vol 6 (3) ◽  
pp. 8-14
Author(s):  
S Thapa ◽  
H Hassan
Keyword(s):  
Sexually Transmitted Diseases ◽  
Health Workers ◽  
Effective Means ◽  
Transmitted Disease ◽  
Married Women ◽  
Reproductive Age ◽  
Medical Sciences ◽  
Medical Practitioners ◽  
Sexually Transmitted ◽  
Reproductive Age Group

A survey was conducted using 139 rural married women to know awareness of sexually transmitted diseases (STDs) in Barahi, Chiraigaun, a rural primise in India. About one-fifth of the respondents were aware of STD, of which there was only one female who had heard of STD. Very few people sought for help from medical practitioners and less than one-fifth of the diseased people failed taking medicine regularly. Treatment cost ranged from Rs 10 to 5,000. Mass media like TV was not popular among rural people. Health workers were effective means of propagating knowledge and creating awareness. None of the diseased persons were using condom while 10% of non-diseased respondents used condom. No awareness program on health was conducted in the locality within a year. None of the respondents were able to tell whether STD’s and HIV were same or different. Key words: Sexually transmitted disease (STD); health worker; condom. DOI: 10.3126/jcmsn.v6i3.4068Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.8-14

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