scholarly journals Effect of Mobile Phone Reminders and Recalls on Missed Immunisations among Infants in Two Health Facilities in Abakaliki, Nigeria

Author(s):  
N. C. Eze ◽  
B. N. Azuogu ◽  
I. L. Okoronkwo

Background: Missed immunisation (MI) may contribute to low immunisation coverage in diverse settings, especially developing countries. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing missed immunisations in Abakaliki. Materials and Methods: This is a quasi-experimental study conducted among caregivers of infants in rural health facilities in Abakaliki. Mile-Four and St. Vincent hospitals located in Ebonyi and Izzi Local Government Areas (LGA) respectively in Ebonyi State were selected purposively. Mile-Four was assigned intervention group and St. Vincent as control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was recruited during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data was collected using a questionnaire, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA). Results: A greater proportion of respondents in the intervention group (8.3%) missed vaccination at the 6th and 10th weeks when compared with the 4.1% and 6.9% for the above mentioned weeks respectively in the control group. In the control group, a greater proportion (22.1%) missed vaccination than the intervention group (8.9%) at the 14th week, a difference in the proportion that was significant (p=0.04). Relative to female caregivers, male caregivers are 6.2 times more likely to miss immunisation in the intervention group. They are 2.3 times more likely to miss immunisation than the female ones in the control group. Those at older age (≥30 years) are 1.2 times more likely to miss immunisation than those of younger age group.                                                                                              Conclusion: Mobile phone reminders and recall has proven effective in reducing childhood missed immunisations and non-compliance in Abakaliki. Implementation of immunisation reminders and recall systems is therefore recommended in immunisation clinics in developing countries especially in Nigeria for immunisation timeliness and completion.

Author(s):  
Byamukama Topher ◽  
Keraka M. Margaret ◽  
Gitonga Eliphas

Background: Immunization is one of the most cost-effective public health interventions to reduce child mortality and morbidity associated with infectious diseases. The objective of this study was to determine the perceptions of caregivers on immunization in Ntungamo district.Methods: Quasi-experimental study was used with health centres assigned to intervention and control groups. Purposive sampling was used to select the two counties where the study was done. Proportional sampling was done to get study samples from each health facility, while systematic sampling was done to get study participants. A total of 787 children from twelve health facilities provided the study sample. A post intervention evaluation was conducted to determine the effect of these interventions. Association of variables was tested using Mann Whitney U-test and Chi-square.Results: On benefits, most caregivers in the intervention group (85.3%) and in the control group (54.3%) regarded immunization as very highly and moderately beneficial to their children respectively. On risks, most caregivers in the intervention group (85.5%) and control group (43.1%) regarded the risk factor associated with immunization as very low and moderate respectively. From hypothesis testing, there was a significant difference on the perceived benefits and risks of immunization between the intervention and control group.Conclusions: Most caregivers in the intervention and control group regarded immunization as very highly beneficial and moderately to their children respectively. Most of the caregivers in the intervention and control group regarded the risk factor associated with immunization as very low and moderate respectively. 


2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Abdelmoneim E.M. Kheir ◽  
Amna M.A. Mustafa ◽  
Awatif A. Osman

Infection of the umbilical cord remains high in developing countries with subsequent increase in neonatal mortality rates. This may be due to the practice of applying potentially harmful substances to the freshly cut cord. The aim of this study was to assess the impact of umbilical cord care with 4% chlorhexidine on the rate of omphalitis and separation time among newborns in Khartoum State. This was a quasi-experimental research design that was carried out in the main maternity hospitals of Khartoum state between February and August 2012. One hundred mothers and their respective babies were selected by convenience sampling and were divided equally into intervention and control groups. The tools used for data collection were a questionnaire and an observational checklist. The data were analyzed using Statistical Package for Social Sciences version 17 for descriptive and inferential statistics. Umbilical cord training was effective in enhancing mothers’ knowledge and skills in the intervention group. The result showed that the omphalitis rate was reduced significantly in the intervention group; also the intervention group had a shorter separation time (mean=5.02) compared to the control group (mean=7.24). In conclusion, the application of 4% chlorhexidine on the freshly cut umbilical cord stump, significantly reduces omphalitis rate. This inexpensive and simple intervention can save a significant number of newborn lives in developing countries.


2019 ◽  
Vol 17 (3) ◽  
pp. 331-335
Author(s):  
Babu Ram Pokhrel ◽  
Chiranjivi Adhikari

Background: Almost seven percent of disease burden is due to genetic disorders and birth defects and they are associated to genetic as well as environmental factors. Prevention of such problems by making aware and increasing knowledge level with the help of health education during adolescence is cost-effective among others. In this context, current study proposed whether mini-lecture and/or poster is/are effective in changing adolescents’ knowledge regarding genetic disorders and birth defects.Methods: Mini-lectures followed by posters on genetic disorders and birth defects were used for intervention group, whereas for control, only mini-lectures based on health promotion were delivered by trained personnel in nine through 12 grade students of conveniently selected two public schools of Kaski district using quasi-experimental design. Knowledge was assessed using a pretested inventory at baseline, after two weeks of mini-lectures and two more weeks after poster for intervention group, whereas, only at baseline and two weeks after mini-lectures for control. Statistical analysis was carried out to compare the intervention group of 133 students with that of control group of 154. Results: Mean knowledge increments among control and intervention groups were 0.20 and 0.68 points respectively after mini-lecture. An addition of 0.84 points gained after the poster, yielding overall increment of 1.52 in intervention group. Inferential analysis showed that effect of control was not effective (p=0.60), whereas mini-lecture (p=0.032), poster (p=0.008) and both mini-lecture and poster (p<0.001) were effective.Conclusions: The mini-lecture and/or poster for grade nine through 12 are effective methods and media for bringing about changes in knowledge of adolescents regarding genetic disorders and birth defects. Keywords: Genetic disorder and birth defect; health education; intervention; knowledge; nepal.


Author(s):  
N. C. Eze ◽  
C. N. Onwasigwe

Background: Immunisation drop-out rate measures the effectiveness of the immunisation programme. When drop-outs exceed 10 percent it indicates a problem of utilisation of services. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing pentavalent vaccination drop-outs in Abakaliki. Materials and Methods: This is a quasi-experimental study among caregivers of infants in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Izzi and Ebonyi Local Government Areas (LGA) of Ebonyi State were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire forms, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria.            Results: The mean age of respondents were 26.6 ±4.9 years and 27.1±4.2 years in the intervention and control groups respectively. Thirty five point seven percent (35.7%) of infants dropped out of pentavalent vaccinnation 3 in pre-intervention phase when compared with 5.5% post-intervention. This difference in their proportions was found statistically significant (p<0.01).  In the control group, 47.7% dropped out of pentavalent vaccination 3 at the beginning of the study when compared with 22.1% at the end of the study, a difference that was statistically significant (p=0.02). Out of 145 infants who received pentavalent vaccines 1 in both groups, 137 (94.5%) infants received pentavalent vaccines 3 in the intervention group while 113 (77.9%) infants received pentavalent vaccines 3 in the control group. Far distance to health facility predicted immunisation drop-out in the control group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility. No predictor was found in the intervention group. Conclusion: Mobile phone reminders and recall has proven very effective in reducing pentavalent vaccines drop-out rate in Abakaliki. Implementation of immunisation reminders and recall systems are therefore recommended in immunisation clinics in developing countries especially in Nigeria for improved immunisation coverage in order to achieve Sustainable Developmental Goal 3 (SDG 3).


Crisis ◽  
2016 ◽  
Vol 37 (6) ◽  
pp. 415-426 ◽  
Author(s):  
Yik-Wa Law ◽  
Paul S. F. Yip ◽  
Carmen C. S. Lai ◽  
Chi Leung Kwok ◽  
Paul W. C. Wong ◽  
...  

Abstract. Background: Studies have shown that postdischarge care for self-harm patients is effective in reducing repeated suicidal behaviors. Little is known about whether volunteer support can help reduce self-harm repetition and improve psychosocial well-being. Aim: This study investigated the efficacy of volunteer support in preventing repetition of self-harm. Method: This study used a quasi-experimental design by assigning self-harm patients admitted to the emergency departments to an intervention group with volunteer support and treatment as usual (TAU) for 9 months and to a control group of TAU. Outcome measures include repetition of self-harm, suicidal ideation, hopelessness, and level of depressive and anxiety symptoms. Results: A total of 74 cases were recruited (38 participants; 36 controls). There were no significant differences in age, gender, and clinical condition between the two groups at the baseline. The intervention group showed significant improvements in hopelessness and depressive symptoms. However, the number of cases of suicide ideation and of repetition of self-harm episodes was similar for both groups at the postintervention period. Conclusion: Postdischarge care provided by volunteers showed significant improvement in hopelessness and depression. Volunteers have been commonly involved in suicide prevention services. Further research using rigorous methods is recommended for improving service quality in the long term.


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Wawan Kurniawan

ABSTRAK  Latar belakang: Demam Berdarah Dengue (DBD) disebabkan oleh virus Dengue dapat menyebabkan kematian. Pencegahan DBD yang dianggap paling tepat adalah Pemberantasan Sarang Nyamuk (PSN). Penelitian ini bertujuan untuk mengetahui pengaruh pelatihan pengendalian vektor Demam Berdarah pada siswa sekolah dasar terhadap Maya Index di Majalengka. Metode: Penelitian ini menggunakan desain quasi experiment (pretest-posttest control group design). Sebanyak 4 sekolah terpilih sebagai kelompok intervensi dan 4 sekolah lainnya sebagai kontrol. Subyek penelitian adalah siswa kelas IV-VI yang terdiri dari 171 siswa pada kelompok intervensi dan 163 pada kelompok kontrol. Instrumen yang digunakan adalah formulir pemantauan jentik berkala. Hasil: Jumlah rumah dengan kategori Maya Index tinggi berkurang dari 27,5% menjadi 9,4%. Terjadi penurunan angka BRI kategori tinggi pada kelompok intervensi dari 20,5% menjadi 1,8%. Pada kelompok kontrol tidak terjadi penurunan angka BRI kategori tinggi (22,1%), sebaliknya terjadi penurunan kategori rendah dari 34,4% menjadi 3,7%. Tidak terjadi penurunan angka HRI pada kelompok intervensi maupun kontrol. Kesimpulan: Pelatihan pengendalian vektor Demam Berdarah dapat menurunkan nilai BRI dan Maya Index, tetapi tidak berpengaruh terhadap nilai HRI. Tidak adanya perubahan nilai HRI menunjukkan bahwa kebersihan dan sanitasi lingkungan merupakan faktor yang berpengaruh terhadap probabilitas kejadian demam berdarah. Kata Kunci : Demam Berdarah, Maya Index, pelatihan, pengendalian vektor   ABSTRACT Background: Dengue Hemorrhagic Fever (DHF) caused by Dengue virus could cause death. The most appropriate prevention of Dengue is eradication of mosquito nests (PSN). This study aims to determine the effect of Dengue vector control training on elementary students towards Maya Index in Majalengka. Method: This study used quasi-experimental design (pretest-posttest control group design). A total of 4 schools were selected as intervention groups and 4 other schools as controls. The subjects were students in grades IV-VI consisting of 171 students in the intervention group and 163 in the control group. The instrument used was periodic larva monitoring form. Results: The number of houses with a high Maya Index category in the intervention group decreased from 27.5% to 9.4%. There was a decrease in the high BRI category in the intervention group from 20.5% to 1.8%. In the control group, there was no decrease in the high BRI category (22.1%), on the contrary, there was a decrease in the low category from 34.4% to 3.7%. There was no decrease in HRI rates both of intervention or control groups. Conclusion: Dengue Fever vector control training could decrease the value of BRI and Maya Index, but does not affect the value of HRI. The absence of changes in HRI  indicate that environmental hygiene and sanitation are factors that influence the probability of dengue fever occurrence. Keywords: Dengue Hemorrhagic Fever, Maya Index, training, vector control


2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 119-120
Author(s):  
N. Østerås ◽  
E. Aas ◽  
T. Moseng ◽  
L. Van Bodegom-Vos ◽  
K. Dziedzic ◽  
...  

Background:To improve quality of care for patients with hip and knee osteoarthritis (OA), a structured model for integrated OA care was developed based on international treatment recommendations. A previous analysis of a cluster RCT (cRCT) showed that compared to usual care, the intervention group reported higher quality of care and greater satisfaction with care. Also, more patients were treated according to international guidelines and fulfilled recommendations for physical activity at the 6-month follow-up.Objectives:To assess the cost-utility of a structured model for hip or knee OA care.Methods:A cRCT with stepped-wedge cohort design was conducted in 6 Norwegian municipalities (clusters) in 2015-17. The OA care model was implemented in one cluster at the time by switching from “usual care” to the structured model. The implementation of the model was facilitated by interactive workshops for general practitioners (GPs) and physiotherapists (PTs) with an update on OA treatment recommendations. The GPs explained the OA diagnosis and treatment alternatives, provided pharmacological treatment when appropriate, and suggested referral to physiotherapy. The PT-led patient OA education programme was group-based and lasted 3 hours followed by an 8–12-week individually tailored resistance exercise programme with twice weekly 1-hour supervised group sessions (5–10 patients per PT). An optional 10-hours Healthy Eating Program was available. Participants were ≥45 years with symptomatic hip or knee OA.Costs were measured from the healthcare perspective and collected from several sources. Patients self-reported visits in primary healthcare at 3, 6, 9 and 12 months. Secondary healthcare visits and joint surgery data were extracted from the Norwegian Patient Register. The health outcome, quality-adjusted life-year (QALY), was estimated based on the EQ-5D-5L scores at baseline, 3, 6, 9 and 12 months. The result of the cost-utility analysis was reported using the incremental cost-effectiveness ratio (ICER), defined as the incremental costs relative to incremental QALYs (QALYs gained). Based on Norwegian guidelines, the threshold is €27500. Sensitivity analyses were performed using bootstrapping to assess the robustness of reported results and presented in a cost-effectiveness plane (Figure 1).Results:The 393 patients’ mean age was 63 years (SD 9.6) and 74% were women. 109 patients were recruited during control periods (control group), and 284 patients were recruited during interventions periods (intervention group). Only the intervention group had a significant increase in EQ-5D-5L utility scores from baseline to 12 months follow-up (mean change 0.03; 95% CI 0.01, 0.05) with QALYs gained: 0.02 (95% CI -0.08, 0.12). The structured OA model cost approx. €301 p.p. with an additional €50 for the Healthy Eating Program. Total 12 months healthcare cost p.p. was €1281 in the intervention and €3147 in the control group, resulting in an incremental cost of -€1866 (95% CI -3147, -584) p.p. Costs related to surgical procedures had the largest impact on total healthcare costs in both groups. During the 12-months follow-up period, 5% (n=14) in the intervention compared to 12% (n=13) in the control group underwent joint surgery; resulting in a mean surgical procedure cost of €553 p.p. in the intervention as compared to €1624 p.p. in the control group. The ICER was -€93300, indicating that the OA care model resulted in QALYs gained and cost-savings. At a threshold of €27500, it is 99% likely that the OA care model is a cost-effective alternative.Conclusion:The results of the cost-utility analysis show that implementing a structured model for OA care in primary healthcare based on international guidelines is highly likely a cost-effective alternative compared to usual care for people with hip and knee OA. More studies are needed to confirm this finding, but this study results indicate that implementing structured OA care models in primary healthcare may be beneficial for the individual as well as for the society.Disclosure of Interests:None declared


Author(s):  
Leticia Borfe ◽  
Caroline Brand ◽  
Letícia Schneiders ◽  
Jorge Mota ◽  
Claudia Cavaglieri ◽  
...  

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.


2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.


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