Family Planning Unmet Need; Determinant Factors and Strategy Design through Health Management Approach and Fishbone Analysis in Riau Province, Indonesia

The high number of unmet needs for Family Planning (FP) in Indonesia has an effect on birth spacing and the number of parities so that there is a high risk of maternal and infant mortality. Based on data from the Family-Program Performance and Accountability Survey (PPAS) from the National Population and Family Planning Board (NPFPB) in 2019, 51% of Fertile Age Women (FAW) were not willing to use FP. This study aims to describe the determinant factors and strategies to reduce the incidence of unmet needs for FP. The method used was a quantitative descriptive study conducted in July-September 2021. The data collection technique analyzed the program performance and accountability survey report data from NPFPB in 2019 (secondary data). The result was that the determinant factors of the unmet need for FP include: age 30-49 years (60.1%), parity having 6 or more children (73.6%), reasons for fertility (32.89%), being against using (7.9%), lack of knowledge about 8 modern FP tools/methods (15.5%), reasons for FP tools/methods (34.65%). Meanwhile, the majority of information on FP was obtained through television (91.9%), direct information through midwives/nurses (77.5%). The strategy to reduce the number of unmet need for FP was through a health management approach with five stages, namely: 1. Assessment to identify the number of Fertile Age Couple (FAC) unmet need for FP, demographic characteristics, and reasons for not using contraceptive tools/methods: 2. Mapping step, case mapping per region, 3. Planning, service planning process, 4. action, service delivery based on planning, 5. Evaluation monitoring stage, monitoring process, and activity evaluation. Six management elements are used for fishbone analysis, namely: man, money, method, material, machine, and market. It requires a high commitment to all stakeholders so that the implementation of the strategy can be realized.

Developing Education Media of Health Protocol utilizing Live Coloring using Augmented Reality Technology

The objective of the present study is to produce a learning media product of health protocol implementation to children entitled "Awas Ada Virus Corona". This media utilized R&D method and took several steps, namely preliminary research and data collection, research planning, product development, expert validation, product revision and final product. Feasibility testing is carried out by media experts by examining the multimedia construction domain consist of 3 aspects, namely guidance and information, program performance as well as systematic, aesthetic, and design aspects. Furthermore, a filled questionnaire by media experts was used to collect the data needed. Meanwhile, the descriptive statistic was used to analyzed the data gathered. The result of the present study is an application that can be used by children entitled " Awas Ada Virus Corona " as an educational media in implementing 3M of health protocol, namely wearing masks, washing hands, and maintaining a safe distance. The addition of Augmented reality technology with a live coloring feature is added in this application in reading markers to increase children's attractiveness. This augmented reality technology is applied in order to avoid the children only focus on gadgets, so children feel happy in using the familiar media and still interacting with the environment.

Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance

The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%. Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance

Enhanced Surveillance in a Digital Health Landscape: The Role of the Near-Real Time Right to Care Knowledge Centre within South Africa’s APACE HIV Program

Introduction: Right to Care (RTC), through support from the United States Agency for International Development (USAID) implements innovations that improve data accessibility and utilization for improved program performance and patient outcomes for large scale HIV care and treatment programs. Frequent and accessible data, coupled with changes to business practices to use that data, allow for targeted and timely HIV program interventions that impact patient outcomes in Ehlanzeni district, Mpumalanga, South Africa.Methods: In South Africa, within the USAID Accelerating Program Achievements to Control the Epidemic (APACE) program, the Knowledge Centre (KC) – an interoperable automated data warehouse and visualization near real-time solution - allow for rapid daily assessment of over- and under-performance cross-sectionally. The authors established the impact of the KC intervention for 29 USAID-selected Siyenza facilities, before the KC intervention (Dec 2018 to Feb 2019) compared to HIV outcomes during the KC intervention (March 2019 to May 2019), stratified by facility classification as included or not included in the Siyenza program using both non-parametric and parametric methodologies.Results: Average facility ART initiations increased by 16% from a monthly average of 54 new initiations pre-Siyenza to 62 new ART initiations during Siyenza; retention increased to a net retention in care ratio of 1.15 indicating that patients labelled as lost to care were brought back. An independent-samples t-test indicated that the net retention in care scores were significantly higher for Siyenza facilities (M =.379, SD =.808) compared to non-Siyenza facilities (M=-.061, SD =1.016), t(208) = 2.224, p < 0.027, d = .445 during the Siyenza period. A significant difference was noted between the means with a 62.3% chance that the Siyenza facilities have a higher observed mean than the non-Siyenza facilities during the intervention period. Results indicate that Siyenza facilities maintain cohort growth, while non-Siyenza facilities continued to lose patients. Conclusion: The accessibility and utilization of near to real-time interoperable data within HIV programs allowed for rapid responses to program performance, needs and improved patient outcomes. Daily data review meetings facilitated precision programming and contributed to the behavior change necessary to institute routine data use for decision making and evaluations within programs.