Appropriateness of Care for Common Childhood Infections at Low-Level Private Health Facilities in a Rural District in Western Uganda

In Uganda, >50% of sick children receive treatment from primary level-private health facilities (HF). We assessed the appropriateness of care for common infections in under-five-year-old children and explored perspectives of healthcare workers (HCW) and policymakers on the quality of healthcare at low-level private health facilities (LLPHF) in western Uganda. This was a mixed-methods parallel convergent study. Employing multistage consecutive sampling, we selected 110 HF and observed HCW conduct 777 consultations of children with pneumonia, malaria, diarrhea or neonatal infections. We purposively selected 30 HCW and 8 policymakers for in-depth interviews. Care was considered appropriate if assessment, diagnosis, and treatment were correct. We used univariable and multivariable logistic regression analyses for quantitative data and deductive thematic analysis for qualitative data. The proportion of appropriate care was 11% for pneumonia, 14% for malaria, 8% for diarrhea, and 0% for neonatal infections. Children with danger signs were more likely to receive appropriate care. Children with diarrhea or ability to feed orally were likely to receive inappropriate care. Qualitative data confirmed care given as often inappropriate, due to failure to follow guidelines. Overall, sick children with common infections were inappropriately managed at LLPHF. Technical support and provision of clinical guidelines should be increased to LLPHF.

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Global Financial Crisis and Philanthropy: Malaysian Case

Cosmopolitan Civil Societies An Interdisciplinary Journal ◽

10.5130/ccs.v7i2.4442 ◽

2015 ◽

Vol 7 (2) ◽

pp. 19-31 ◽

Cited By ~ 1

Author(s):

Janice Lay Hui Nga

Keyword(s):

Financial Crisis ◽

Mixed Method ◽

Qualitative Data ◽

Global Financial Crisis ◽

Secondary Data ◽

Civil Society Organisations ◽

The Global Financial Crisis ◽

The Impact ◽

To Receive ◽

Method Approach

This paper investigates the issue of the global financial crisis and its impacts on philanthropy and civil society organisations (CSOs) in Malaysia. CSOs are popularly known as non-governmental organisations (NGOs) in Malaysia. Financial crisis has caused NGOs in many countries to receive less funding. This situation may threaten and discourage voluntary works. Undoubtedly, these beneficial contributions from the NGOs are needful services to the society. This paper examines the impact of financial crisis through the lens of NGOs and philanthropy activities in Malaysia. It utilises primary and secondary data, employs a mixed method approach, and uses quantitative and qualitative data. While there are many influencing factors in this development, this paper presents several significant aspects in the Malaysian context, including the style and nature of giving, culture, religion, and political pressure. This study attempts to seek potential solutions, pathways and possible approaches beneficial to NGOs and philanthropy activities for their sustainability in facing the financial crisis and its consequences. Experiences and lessons learnt in Malaysia may well be useful and applicable to some extent in other countries.

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Gambaran Profil Psikologis Psychopathy Symptoms pada Tahanan Wanita Kasus Korupsi di Lapas Wanita Kelas IIA Sukamiskin Bandung

MANASA ◽

10.25170/manasa.v10i2.1976 ◽

2021 ◽

Vol 10 (2) ◽

pp. 98-106

Author(s):

Medwin Wisnu Prabowo

Keyword(s):

Marital Relationships ◽

Middle Level ◽

Work Setting ◽

Female Inmates ◽

Short Term ◽

Good Relationship ◽

Low Level ◽

The Law ◽

To Receive ◽

Harmonious Family

There are many crimes that happened in this era, which one of them is corruption. Corruption has become a major phenomenon for each country in this world. Even more, it is not only male who doing the corruption, but female also. They were get some money to satisfy themselves although they have to break the law. This phenomenon has attracted researcher to study the female inmates who was doing corruption, and its relation to psychopathic symptom. Three female inmates in Sukamiskin Penitentiary Institute Class IIA – Bandung, who were convicted based on corruption cases, were chosen as subjects of this study. The result showed that all of three female inmates have a tendency to become a Psychopath, but in the low level to middle level tendencies. The three dominant Psychopathic Symptoms that found: pathological lying, lack of remorse or guilt, and short-term marital relationships. It can be summarized and recommended that among 3 subjects need to receive a counseling and/or psychoeducation so they will be more honest in their work setting, and to educate them that its important to have a good relationship to build a harmonious family.

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Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda

Malaria Journal ◽

10.1186/s12936-015-1020-9 ◽

2016 ◽

Vol 15 (1) ◽

Cited By ~ 18

Author(s):

Robin Altaras ◽

Anthony Nuwa ◽

Bosco Agaba ◽

Elizabeth Streat ◽

James K. Tibenderana ◽

...

Keyword(s):

Qualitative Study ◽

Rural Health ◽

Health Workers ◽

Rapid Test ◽

Health Facilities ◽

Test Results ◽

Western Uganda

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Dihydroartemisinin-piperaquine chemoprevention and malaria incidence after severe flooding: evaluation of a pragmatic intervention in rural Uganda

Clinical Infectious Diseases ◽

10.1093/cid/ciab781 ◽

2021 ◽

Author(s):

Ross M Boyce ◽

Brandon D Hollingsworth ◽

Emma Baguma ◽

Erin Xu ◽

Varun Goel ◽

...

Keyword(s):

Malaria Incidence ◽

Mitigation Measures ◽

Older Children ◽

Post Intervention ◽

Rapid Diagnostic Test Result ◽

Western Uganda ◽

And Control ◽

The Impact ◽

To Receive ◽

Severe Flooding

Abstract Background Malaria epidemics are a well-described phenomenon after extreme precipitation and flooding, which account for nearly half of global disasters over the past two decades. Yet few studies have examined mitigation measures to prevent post-flood malaria epidemics. Methods We conducted an evaluation of a malaria chemoprevention program implemented in response to severe flooding in western Uganda. Children ≤12 years of age from one village were eligible to receive 3 monthly rounds of dihydroartemisinin-piperaquine (DP). Two neighboring villages served as controls. Malaria cases were defined as individuals with a positive rapid diagnostic test result as recorded in health center registers. We performed a difference-in-differences analysis to estimate changes in the incidence and test positivity of malaria between intervention and control villages. Results A total of 554 children received at least one round of chemoprevention with 75% participating in at least two rounds. Compared to control villages, we estimated a 53.4% reduction (aRR 0.47, 95% CI 0.34 – 0.62, p<.01) in malaria incidence and a 30% decrease in the test positivity rate (aRR=0.70, CI 0.50 - 0.97, p=0.03) in the intervention village in the six months post-intervention. The impact was greatest among children receiving the intervention, but decreased incidence was also observed in older children and adults (aRR=0.57, CI 0.38-0.84, p<.01). Conclusions Three rounds of chemoprevention with DP delivered under pragmatic conditions reduced the incidence of malaria after severe flooding in western Uganda. These findings provide a proof-of-concept for the use of malaria chemoprevention to reduce excess disease burden associated with severe flooding.

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Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

10.21203/rs.3.rs-128061/v1 ◽

2020 ◽

Author(s):

Richard Mugambe ◽

Habib Yakubu ◽

Solomon Wafula ◽

Tonny Ssekamatte ◽

Simon Kasasa ◽

...

Keyword(s):

Health Facility ◽

Rural Areas ◽

Health Workers ◽

Public Health Facility ◽

Facility Delivery ◽

Health Facilities ◽

Public Facility ◽

Cross Sectional ◽

Western Uganda ◽

Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

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Right to Treatment

Landmark Cases in Forensic Psychiatry ◽

10.1093/med/9780190914424.003.0009 ◽

2019 ◽

pp. 75-78

Author(s):

Bipin Subedi

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Civil Commitment ◽

Insanity Defense ◽

Health Treatment ◽

Appropriate Care ◽

To Receive

Chapter 8 focuses on cases that involve the rights of individuals to receive adequate mental health treatment while involuntarily hospitalized either through civil commitment or insanity defense proceedings. These cases set the stage, many years ago, for environmental and clinical expectations of appropriate care. The cases in this chapter are Rouse v. Cameron, Wyatt v. Stickney, and Youngberg v. Romeo. Cases involving a right to treatment for prisoners are included in Chapter 25.

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Right to Treatment

Landmark Cases in Forensic Psychiatry ◽

10.1093/med/9780199344659.003.0008 ◽

2014 ◽

pp. 51-53

Author(s):

Bipin Subedi

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Civil Commitment ◽

Insanity Defense ◽

Health Treatment ◽

Appropriate Care ◽

To Receive

Chapter 8 focuses on cases that involve the rights of individuals to receive adequate mental health treatment while involuntarily hospitalized through either civil commitment or insanity defense proceedings. These cases set the stage, many years ago, for environmental and clinical expectations of appropriate care. The cases in this chapter are Rouse v. Cameron, Wyatt v. Stickney, and Youngberg v. Romeo. Cases involving a right to treatment for prisoners are included in chapter 26.

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Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

BMC Public Health ◽

10.1186/s12889-020-09859-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Nicholas Kwikiriza Magambo ◽

Francis Bajunirwe ◽

Fred Bagenda

Keyword(s):

Health Facility ◽

Urban Areas ◽

Health Workers ◽

Geographic Location ◽

Health Facilities ◽

Urban Setting ◽

World Health ◽

Program Performance ◽

Immunization Program ◽

Western Uganda

Abstract Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

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The relative impact of patient and institutional rurality on lung cancer disparities.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e20052 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e20052-e20052

Author(s):

Meredith Ray ◽

Nicholas Ryan Faris ◽

Anna Derrick ◽

Matthew Smeltzer ◽

Raymond U. Osarogiagbon

Keyword(s):

Lung Cancer ◽

Clinical Stage ◽

Care Patient ◽

Patient Level ◽

Appropriate Care ◽

Chi Squared ◽

Cox Proportional Hazard Regression ◽

Nsclc Patients ◽

Cancer Network ◽

To Receive

e20052 Background: We quantified variation in stage specific, guideline concordant treatment and examined the interaction with rurality and overall survival (OS). Methods: We used tumor registry data for non-small cell lung cancer (NSCLC) patients at 5 institutions in the Mississippi Delta from 2011-2017, including patient demographics, clinical stage, treatment, and OS. We defined rurality by Rural-Urban Commuting Area codes, hospital and patient zip codes; based stage-stratified treatment on National Comprehensive Cancer Network guidelines; used Chi-squared and ANOVA F-tests to assess differences across institutions and logistic regression to assess associations between appropriate care, patient- and institution-level rurality. We used Log-rank tests to examine differences in OS and Cox proportional hazard regression to calculate hazard ratios (HR). Results: 6,259 patients were identified across 2 rural (n = 1255, 20%) and 3 metropolitan (metro) institutions (n = 5004, 80%). There were significant demographic and clinical differences between institutions: proportion of African-Americans (range: 6-37%, p < 0.001), uninsured (3-18%, p < 0.001), patient rurality (17-99%, p < 0.001), ‘no treatment’ rates (17-31%, p < 0.001). Metro patients or those treated at metro institutions were more likely to receive guideline-concordant treatment (odds ratio: 1.34, 95% CI [1.20 - 1.49]; 1.45 [1.28 - 1.65], respectively) than their rural counterparts and had improved OS (HR: 0.89; 95% CI [0.84 - 0.95]; 0.68 [0.63 - 0.72], respectively). They were also less likely to receive ‘no treatment’ (0.62 [0.55 - 0.71], p < 0.001; 0.51 [0.49 - 0.66], p < 0.001, respectively). Among patients with proper care, there were no patient-level rurality based OS differences (p = 0.2203) but those treated at metro institutions had better OS (p < 0.001). When stage-stratified, only advanced-stage patients treated at metro institutions had better survival (p < 0.001), no other differences in OS were detected for early or late-stage patients. Conclusions: Institution-level rurality had greater influence than patient-level rurality on receipt of guideline concordant care and OS. Appropriate care eliminated patient-level rurality OS disparities.

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