Providers’ perspectives of socio-cultural and health service challenges related to postpartum family planning in Alexandria, Egypt

Background Postpartum family planning (PPFP) focuses on prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth. Adoption of family planning during the postpartum period in Egypt faces unique challenges. This study aimed to explore the socio-cultural and health service challenges related to PPFP in Alexandria, Egypt, from perspectives of family planning providers working in public settings. Methods Three focus group discussions were conducted in the period from May to July 2017. It included 32 family planning physicians working in the family health centers and maternal and child health centers in Alexandria for 3 years or more. A discussion guide was prepared. Analysis of data was done using thematic data analysis using a deductive approach. Results The working experience of participants ranged from 3 to 30 years. The most frequently reported reasons for unmet need for PPFP were cultural norms about the contraceptive effects of lactation and inaccurate knowledge of women about the conditions for appropriate use of the lactation amenorrhea as a contraceptive method. The most commonly cited challenge related to the quality of service was the inadequate health education services about PPFP. Lack of training and supervision of community health workers was one of the underlying causes of the perceived inadequacy of the service. Conclusions Mass media campaigns advocating for family planning are urgently needed with full support from the government. Improvement of health education services is a must. Redistribution of family planning providers with an increase in the staff members is highly recommended.

ASSESSMENT OF PATIENT’S SATISFACTION OF NURSING CARE PROVIDED BY CLINICAL DEPARTMENTS IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL IN 2019

Background: The quality of nursing care plays an important role in overall quality of medical care. Nurses and midwives perform care well, contributing to making patients feel secure, confident, cooperative, and increasing treatment efficiency and patient satisfaction. Objective: To assess the patient’s satisfaction with nursing care provided by clinical departments in Hue University of Medicine and Pharmacy Hospital in 2019. Subject and method: A cross-sectional study on 600 inpatients at Hue University of Medicine and Pharmacy Hospital. Results: The general proportion of patient statisfaction was 71.4%%. Patients were satisfied more with mental health services (77.8%), nursing care skills (75.5%) and the relationship with nurses (70.2%), consulting health education services (73.6%). Patient were less satisfied with hospital hygiene (61.5%). Conclusion: overall, more patient show enthusiasm with the medical care provided by nurse (71.4%). However, the patient’s satisfaction with hospital hygiene stood at only 61.5%. Keywords: Quality of nursingcare, nurse, midwife

Patients’ Perception Towards Health Education Services Received at the Enhanced Primary Healthcare Facilities: A Qualitative Exploration

Background: The present Malaysian healthcare system is burdened with increasing cases of non-communicable diseases (NCDs) and its risk factors. Health care providers (HCPs) have to provide both treatment and health education to ensure optimal outcome. Health education is a vital component in addressing and managing chronic diseases. This study intends to explore patient’s perspective on health education services received from HCPs, focusing at the secondary triage in government primary healthcare facilities. Methods: This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach. Results: A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs. Conclusion: Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients’ attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.

Experiences of men’s involvement in antenatal education services in the rural Eastern Highlands Province of Papua New Guinea: a descriptive qualitative study.

Background: Appropriate antenatal education services that increase men’s involvement in pregnancy and childbirth is crucial for improving maternal and child health outcomes. However, in Papua New Guinea (PNG), men’s involvement in antenatal education services remains inadequate. This study aimed to describe experiences of men’s involvement in antenatal education services and identify factors that facilitate or restrict their involvement. Methods: A qualitative study was conducted among 17 men who have attended antenatal care (ANC) and involved in antenatal education sessions with their wives. Semi-structured and face-to-face interviews were employed to obtain detailed descriptions of men’s experiences and their perception of antenatal health education services, including factors that influenced their involvement. Data is generated from interviews. The findings are informed by the thematic analysis. Results: Three key themes that emerged were: (1) perception of ANC as women’s domain, (2) knowledge of antenatal education services, and (3) accessing of antenatal education services. Factors influencing men’s involvement were: strict gender roles, being responsible for pregnancy and spousal communication. Lack of knowledge, dissatisfaction with antenatal services, and lack of capacity to involve men were other reasons further observed. Conclusion: This study found negative perceptions; poor maternal knowledge and socio-cultural norms, inadequate information dissemination and poor men-friendly services influenced men’s involvement. Suggestions to strengthen men’s involvement require gender-inclusive and culturally appropriate antenatal education programs.

Awareness and satisfaction of mothers of under six children residing in the urban field practice area of Burdwan Medical College and Hospital regarding the services rendered by Anganwadi centers: a cross sectional study

Background: Integrated child development services (ICDS) is the foremost symbol of India’s commitment to her children. The present study was done to assess the awareness of mothers of under six children residing in the urban field practice area regarding the services rendered by the Anganwadi Centres (AWC), to find out the satisfaction of mothers of under six children regarding quality of care received and to ascertain the availability of infrastructure and logistics of AWCs catering to the urban field practice area.Methods: A cross-sectional descriptive study was done at Alamganj, Purba Bardhaman, from October 2015 to December 2015 among mothers of under six children and AWCs located there. Mothers were interviewed, with the use of a predesigned and pretested schedule for assessing awareness and satisfaction of beneficiaries and predesigned, pretested check lists for infrastructure and logistics availability. The study was done after getting ethical approval. Data were analysed by SPSS 20.Results: Out of 3 AWCs 2 were pucca and 1 kutcha-pucca with poor sanitary facility. All the mothers were within 19-30 years age group. Immunization, nutrition and health education services were known to 98.2% mother. Only 57.1% and 48.2% mothers were aware of PSE and health check-up respectively. 73.3% mother preferred cooked food and rest raw food, 78.6% mothers were satisfied with amount of food and 71.4% were satisfied with quality. Bad taste and improper cooking were main reason behind non-acceptability.Conclusions: Findings of the study were better than earlier studies but still there were much scope for improvement in infrastructure, training and supervision.

Utilization pattern of child health care services in the rural area of Surendranagar district: a community based cross sectional study

Background: Infant and child mortality continues to be a major public health problem all over the country. Despite the existence of national programmes for improving child health in India, child mortality and morbidity continue to be high. Utilization of child health care services is poor in the rural areas, causing significant impact on the health causing increased morbidity and mortality.Methods: It was a Community based Cross-sectional study carried out in the rural area of Surendranagar district through oral questionnaire method which was pre-designed and pretested. Data on demography, history of colostrum, initiation of breastfeeding, prelacteal feeds, exclusive breastfeeding, introduction of complementary feeding, immunization, respiratory infections etc. were collected, compiled and analyzed by applying appropriate tests using SPSS.Results: Out of 154 participants, 43.51% were offered breastfeeding within one hour of birth. Association was observed between initiation of breastfeeding, exclusive breastfeeding, time of introduction of complementary foods and duration of breastfeeding and utilization of health education services. Educational level of mothers and immunization status of the children had a significant statistical association. The overall prevalence of ARI was 31.82% & of Diarrhoea was 39.61%.Conclusions: A positive association was observed between nutritional status and utilization of nutritional services. Significant impact of health education services given during the antenatal period was observed on initiation of breastfeeding as well as exclusive breastfeeding. Although child services in India have been created, strengthened and expanded over the years, their performance in terms of utilization particularly in rural area is still limited.

Avoiding Unwarranted Segregation of Students With Behavioral Needs: Lessons Learned

Title II of the Americans With Disabilities Act of 1990 requires that state and local agencies refrain from the discrimination of individuals with disabilities by providing them with services in the most integrated setting appropriate. Despite this mandate, state and local education agencies across the country engage in practices that could be characterized as providing unwarranted segregation and unequal education practices. One such example is a U.S. Department of Justice investigation of the Georgia Network for Educational and Therapeutic Services. The Department of Justice issued guidelines for appropriate program modifications, including proper evaluation procedures, appropriate entrance and exit standards, effective behavioral and mental health education services, and equal education and extracurricular opportunities. Implications for practitioners, in light of these suggested guidelines, are detailed.

Liposarcoma: experience in a tropical setting

<p><strong>Background:</strong> Virchow in 1860 described liposarcoma which arise from fat cells. It is a common soft tissue sarcoma found commonly in the limbs and retroperitoneum.</p><p><strong>Objectives:</strong> This study is an attempt to highlight the biographic indices, pattern, and challenges of management and outcomes of liposarcoma in a tropical setting and proffer solutions for improved outcome.</p><p><strong>Methods:</strong> Patients who presented to the University of Calabar Teaching Hospital from 2000-2014 with histologic diagnosis of liposarcoma were studied. This was compared with total soft tissue sarcoma and total malignancy seen during the same study period.</p><p><strong>Results:</strong> The 17 patients seen in the study period comprised 10 males and 7 females (M: F = 1.4:1) and their ages ranged from 37-70 years (mean 51 years). They accounted for 21.8% of soft tissue sarcoma and 0.9% of total malignancy. The commonest site involved was the lower limb 8(47%), while the abdomen ranked second 5(29%) with the retroperitoneum the commonest abdominal location. Pleomorphic liposarcoma was the commonest 8(47%) histologic type followed by myxoid 7(41%). The outcomes were generally poor with one hospital mortality. Sociocultural beliefs, ignorance and poverty were issues highlighted.</p><p><strong>Conclusions:</strong> Early presentation and diagnosis and treatment is advocated for improved outcome. Establishment of support groups in oncology will further provide health education services and compliment financing of treatment in view of the enormous cost of services and drugs.</p>