scholarly journals Ethics and Methods for Collecting Sensitive Data

Author(s):  
Bachera Aktar ◽  
Rushdia Ahmed ◽  
Raafat Hassan ◽  
Nadia Farnaz ◽  
Pushpita Ray ◽  
...  

During humanitarian emergencies, such as the forced displacement of the Rohingya diaspora, women and adolescent girls become highly vulnerable to sexual and reproductive health (SRH) issues and abuse. Although sensitive in nature, community-driven information is essential for designing and delivering effective community-centric SRH services. This article provides an overview of the theoretical framework and methodologies used to investigate SRH needs, barriers, and challenges in service-delivery and utilization in the Rohingya refugee camps in Cox’s Bazar, Bangladesh. It also offers insights on important methodological and ethical factors to consider while conducting research in a similar context. A concurrent mixed-method study was undertaken in ten randomly selected Rohingya refugee camps between July and November 2018. The design consisted of a cross-sectional household survey of 403 Rohingya adolescent girls and women, along with an assessment of 29 healthcare facilities. The team also completed in-depth interviews with nine adolescent girls, 10 women, nine formal and nine informal healthcare providers, key informant interviews with seven key stakeholders and seven influential community members. Lastly, three focus group discussions were undertaken with a group of 18 Rohingya men. Our theoretical framework drew from the socio-ecological models developed by Karl Blanchet and colleagues (2017) insofar as they considered a multiplicity of related contextual and cross-cutting factors. Building good rapport with community gatekeepers was key in accessing and sustaining the relationship with the various respondents. The data collected through such context-specific research approaches is critical in designing community-centric service-delivery mechanisms, and culturally and gender-sensitive SRH interventions in humanitarian crises.

Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...


BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016217 ◽  
Author(s):  
M Shafiqur Rahman ◽  
Syed Hanifi ◽  
Fatema Khatun ◽  
Mohammad Iqbal ◽  
Sabrina Rasheed ◽  
...  

Background and objectivesmHealth offers a new opportunity to ensure access to qualified healthcare providers. Therefore, to better understand its potential in Bangladesh, it is important to understand how young people use mobile phones for healthcare. Here we examine the knowledge, attitudes and intentions to use mHealth services among young population.DesignPopulation based cross sectional household survey.Setting and participantsA total of 4909 respondents, aged 18 years and above, under the Chakaria Health and Demographic Surveillance System (HDSS) area, were interviewed during the period November 2012 to April 2013.MethodsParticipants younger than 30 years of age were defined as young (or generation Y). To examine the level of knowledge about and intention towards mHealth services in generation Y compared with their older counterparts, the percentage of the respective outcome measure from a 2×2 contingency table and adjusted odds ratio (aOR), which controls for potential confounders such as mobile ownership, sex, education, occupation and socioeconomic status, were estimated. The aOR was estimated using both the Cochran–Mantel–Haenszel approach and multivariable logistic regression models controlling for confounders.ResultsGeneration Y had significantly greater access to mobile phones (50%vs40%) and better knowledge about its use for healthcare (37.8%vs27.5%;aOR 1.6 (95% CI1.3 to 2.0)). Furthermore, the level of knowledge about two existing mHealth services in generation Y was significantly higher compared with their older counterparts, with aOR values of 3.2 (95% CI 2.6 to 5.5) and 1.5 (95% CI 1.1 to 1.8), respectively. Similarly, generation Y showed significantly greater intention towards future use of mHealth services compared with their older counterparts (aOR 1.3 (95% CI 1.1 to 1.4)). The observed associations were not modified by sociodemographic factors.ConclusionThere is a greater potential for mHealth services in the future among young people compared with older age groups. However, given the low overall use of mHealth, appropriate policy measures need to be formulated to enhance availability, access, utilisation and effectiveness of mHealth services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Bukuluki ◽  
Peter Kisaakye ◽  
Maxime Houinato ◽  
Adekemi Ndieli ◽  
Evelyn Letiyo ◽  
...  

Abstract Background Social norms continue to be entrenched in Uganda. Understanding social norms helps to uncover the underlying drivers that influence attitudes and behavior towards contraceptive access and use. This study therefore seeks to investigate the factors that influence the social norm – access to contraception by adolescent girls – in six districts in Uganda. Data and methods: Using data from a community cross-sectional survey in six districts (Amudat, Kaberamaido, Kasese, Moroto, Tororo and Pader) in Uganda, a binary logistic regression model was fitted to examine the variation in individual beliefs and socio-economic and demographic factors on ‘allowing adolescent girls to access contraception in a community’ – we refer to as a social norm. Results Results demonstrate that a higher proportion of respondents hold social norms that inhibit adolescent girls from accessing contraception in the community. After controlling for all variables, the likelihood for adolescent girls to be allowed access to contraception in the community was higher among respondents living in Kaberamaido (OR = 2.58; 95 %CI = 1.23–5.39), Kasese (OR = 2.62; 95 %CI = 1.25–5.47), Pader (OR = 4.35; 95 %CI = 2.15–8.79) and Tororo (OR = 9.44; 95 %CI = 4.59–19.37), those aged 30–34 years likely (OR = 1.73; 95 %CI = 1.03–2.91). However, the likelihood for respondents living in Moroto to agree that adolescent girls are allowed to access contraception was lower (OR = 0.27; 95 %CI = 0.11–0.68) compared to respondents living in Amudat. Respondents who were not formally employed (OR = 0.63; 95 %CI = 0.43–0.91), and those who agreed that withdrawal prevents pregnancy (OR = 0.45; 95 %CI = 0.35–0.57) were less likely to agree that adolescent girls are allowed to access contraception in the community. Respondents who agreed that a girl who is sexually active can use contraception to prevent unwanted pregnancy (OR = 1.84; 95 %CI = 1.33–2.53), unmarried women or girls should have access to contraception (OR = 2.15; 95 %CI = 1.61–2.88), married women or girls should have access to contraception (OR = 1.55; 95 %CI = 0.99–2.39) and women know where to obtain contraception for prevention against pregnancy (OR = 2.35; 95 %CI = 1.19–4.65) were more likely to agree that adolescent girls are allowed to access contraception. Conclusions The findings underscore the need for context specific ASRH programs that take into account the differences in attitudes and social norms that affect access and use of contraception by adolescents.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257401
Author(s):  
Linus Baatiema ◽  
Augustine Tanle ◽  
Eugene Kofuor Maafo Darteh ◽  
Edward Kwabena Ameyaw

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025079 ◽  
Author(s):  
Grace Mhalu ◽  
Jerry Hella ◽  
Francis Mhimbira ◽  
Khadija Said ◽  
Thomas Mosabi ◽  
...  

ObjectiveTo assess pathways and associated costs of seeking care from the onset of symptoms to diagnosis in patients with confirmed and presumptive tuberculosis (TB).DesignCross-sectional study.SettingDistrict hospital in Dar es Salaam, Tanzania.ParticipantsBacteriologically confirmed TB and presumptive TB patients.Primary and secondary outcome measuresWe calculated distance in metres and visualised pathways to healthcare up to five visits for the current episode of sickness. Costs were described by medians and IQRs, with comparisons by gender and poverty status.ResultsOf 100 confirmed and 100 presumptive TB patients, 44% of confirmed patients sought care first at pharmacies after the onset of symptoms, and 42% of presumptive patients did so at hospitals. The median visits made by confirmed patients was 2 (range 1–5) and 2 (range 1–3) by presumptive patients. Patients spent a median of 31% of their monthly household income on health expenditures for all visits. The median total direct costs were higher in confirmed compared with presumptive patients (USD 27.4 [IQR 18.7–48.4] vs USD 19.8 [IQR 13.8–34.0], p=0.02), as were the indirect costs (USD 66.9 [IQR 35.5–150.0] vs USD 46.8 [IQR 20.1–115.3], p<0.001). The indirect costs were higher in men compared with women (USD 64.6 [IQR 31.8–159.1] vs USD 55.6 [IQR 25.1–141.1], p<0.001). The median total distance from patients’ household to healthcare facilities for patients with confirmed and presumptive TB was 2338 m (IQR 1373–4122) and 2009 m (IQR 986–2976) respectively.ConclusionsPatients with confirmed TB have complex pathways and higher costs of care compared with patients with presumptive TB, but the costs of the latter are also substantial. Improving access to healthcare and ensuring integration of different healthcare providers including private, public health practitioners and patients themselves could help in reducing the complex pathways during healthcare seeking and optimal healthcare utilisation.


Author(s):  
Bhakti Hansoti ◽  
Sarah E. Hill ◽  
Madeleine Whalen ◽  
David Stead ◽  
Andy Parrish ◽  
...  

Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare facilities, yet VCT is not routinely implemented in this setting.Methods: We conducted a cross-sectional study that surveyed patients and healthcare providers at a tertiary care ED in the spring and summer of 2016 to ascertain their attitudes to VCT in the ED. We also used two previously validated survey instruments to gather data on patients’ HIV knowledge and providers’ stigma against patients living with HIV, as we anticipated that these may have an impact on providers’ and patients’ attitudes to the provision of HIV testing within the ED, and may offer insights for future intervention development.Results: A total of 104 patients and 26 providers were enrolled in the study. Overall, patients responded more favourably to ED-based HIV testing (92.3%) compared to providers (only 40% responded favourably). When asked about potential barriers to receiving or providing HIV testing, 16.4% of patients and 24% of providers felt that the subject of HIV was too sensitive and 58.7% of patients and 80% of providers indicated that privacy and confidentiality issues would pose major barriers to implementing ED-based HIV testing.Conclusion: This study shows that while ED-based HIV testing is overall highly acceptable to patients, providers seem less willing to provide this service. The survey data also suggest that future development of ED-based testing strategies should take into consideration privacy and confidentiality concerns that may arise within a busy emergency care setting. Furthermore, every effort should be made to tackle HIV stigma among providers to improve overall attitudes towards HIV-positive individuals that present for care in the ED.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028340 ◽  
Author(s):  
Rushdia Ahmed ◽  
Nadia Farnaz ◽  
Bachera Aktar ◽  
Raafat Hassan ◽  
Sharid Bin Shafique ◽  
...  

IntroductionRohingya diaspora are one of the most vulnerable groups seeking refuge in camps of Cox’s Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee camps; however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee camps in Cox’s Bazar, Bangladesh, and similar humanitarian contexts.Methods and analysisA concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee camps and relevant stakeholders providing SRH services to Rohingya population in Cox’s Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data.Ethics and disseminationEthical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.


Author(s):  
Uroosa Farooq Allaqband ◽  
Anjum B. Fazili ◽  
Rohul Jabeen Shah ◽  
Ab. Majid Ganai ◽  
Walied K. Balwan ◽  
...  

Background: Estimates suggest that at least 50% of the world’s injections administered each year are unsafe, particularly in developing countries. Unsafe injection practices put patients and healthcare providers at risk of infectious and non-infectious adverse events, sound knowledge of healthcare providers is vital to break the chain of blood borne diseases transmission caused by unsafe injection practices.Methods: Cross sectional observational questionnaire based study was carried out amongst 152 injection providers of 40 healthcare facilities of two districts of Kashmir valley (one rural and one urban) selected purposively. Results are summarised and presented in the form of tables and chi (x2) test was used for test of association with statistical significance set at p-value of less than 0.05.Results: In this study out of 152 injection providers, majority (81.57%) were in the age range of 21-40 years and 74.3% were females. 43.4% of the participants were FMPHWs, 30.9% were nurses and 13.8% pharmacists. Overall 65.8% and 67.1% of injection providers had correct knowledge regarding WHO definition of safe injection and infections transmitted by unsafe injections respectively. Majority (90.8%) were aware about the biomedical waste management rules.Conclusions: We conclude that over all the knowledge of different aspects of injection safety was good among the participants except the poor knowledge ofpost exposure prophylaxis and disposal of injection related waste despite the use of color coded bags at the sites of waste generation. 


Author(s):  
Arinola Joda ◽  
Oluwaseun Ajetunmobi ◽  
Olubusola Olugbake

Background: Poisons are chemical substances that produce harmful effects on the body. About 0.3 million people die annually from poisoning. Poisons are produced by animals, plants, microorganisms, and food contamination. Poisoning is a global public health problem, especially in children and teenagers and healthcare providers ought to provide protocols for its management. Objectives: The main aim of this study was to document the mode, knowledge of antidotes, and management of poisoning by healthcare providers in selected community pharmacies and hospitals in Lagos state. Methods: This study was a descriptive cross-sectional study. The study data were collected using questionnaires administered to 112 providers in selected community pharmacies and hospitals in Lagos state. The obtained data were collated and analyzed using SPSS version 20.0. Results were presented as frequency tables and charts. Results: A response rate of 85.7% was achieved. The most common mode of poisoning was accidental (89% and 68% among pharmacists and physicians, respectively) and the highest incidence was among children 0-5 years old (41.5% and 48.3% among pharmacists and physicians, respectively). Management was mainly via gastric decontamination with activated charcoal in pharmacies and supportive care in the hospitals. Knowledge and availability of antidotes and management of poisoning were poor. Conclusion: Management of poisoning was generally inadequate and the prominence of a poison control center was recognized. The establishment of poison control centers in healthcare facilities and the organization of updated lectures for healthcare providers will go a long way to improving poisoning management in the state.


2018 ◽  
Author(s):  
Biniyam Sahiledengle

AbstractBackgroundThe stethoscope, which is universally used as a medical device by healthcare providers, is likely to be contaminated by pathogenic microorganisms. And regular cleaning of the diaphragm of the stethoscope with a suitable disinfectant is decisive. However, in the resource constrained setting like many healthcare facilities in Ethiopia healthcare provider’s stethoscope disinfection practice and its associated factors have not been well studied so far. Therefore, this study sought to determine stethoscope disinfection practice and associated factors among the healthcare providers in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional survey was carried out between April and May 2016. For this survey, 576 healthcare providers were included from 21 healthcare facilities in Addis Ababa. A pre-tested structured questionnaire was used for data collection. Descriptive statistics were computed. Binary and multivariable logistic regression analyses were used to identify factors that were significantly associated with stethoscope disinfection after every use.ResultsFive hundred forty six participants were take part in this study, for a response rate of 94.7%. Of these, only 39.7% (95%CI: 35.9, 44.0%) of healthcare providers disinfecting their stethoscope after every use. Physicians were less likely to disinfect there stethoscope compared to nurses (AOR=0.21; 95%CI: 0.09, 0.49). Healthcare providers who had awareness on infection prevention guideline, healthcare providers who had favorable attitude towards infection prevention and participants having safe infection prevention practice have better stethoscope disinfection practice after every use as compared to their counterparts (AOR=1.93; 95%CI: 1.31, 2.82), (AOR=1.73, 95%CI: 1.02, 2.93), and (AOR=3.79, 95%CI: 2.45-5.84), respectively.ConclusionsOnly a small proportion of healthcare providers disinfect their stethoscopes after every use. Factors such as awareness on infection prevention guidelines, favorable attitude towards infection prevention and safe infection prevention practice were the independent predictors of stethoscopes disinfection after every use. Hence, implementation of effective training on stethoscope disinfection along with increasing awareness on infection prevention may improve stethoscope disinfection practice.


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