Determinants of Health Service Utilization Among Users of Dokolo Health Centre IV, Dokolo District: A Community Perspective

Introduction: Health services utilization (HSU) is an important health outcome indicator, a surrogate measure of access to healthcare that influences the outcomes of health status and consumer satisfaction. Healthcare is central to community well-being as well as a fundamental aspect of life. Objective: The study sought to assess determinants of health service utilization among users of Dokolo Health Centre IV, Dokolo district. Methods: A cross sectional analytical design, which employed both quantitative and qualitative approaches, was used between January and July, 2020. A total of 396 respondents participated. Data was collected using Semi-structured questionnaires and Focus Group Discussion guide. Analysis was done using SPSS and qualitative data was analyzed verbatim.Results: Only 26.8% of the users were satisfied with services provided in the health facility. Living environments of respondents was the only socio-demographic factor that determined HSU (p = 0.046). Living in urban area was 1.6 times more likely to be a determinant of HSU than living in rural setting [COR=1.571, 95% CI (0.986-2.504)]. The study found that being a female was 1.14 times more likely to utilize health services (COR=1.135, 95% CI (0.741-1.739)). Similarly, majority of the respondents who were peasants, 174(43.9%), utilized health services from the facility as opposed to their formally employed counterparts. Thus, being formally employed was 0.7 times less likely to utilize health services (COR= 0.655, 95% CI (0.29-1.476)). Satisfaction with services (p=0.000), level of satisfaction (p=0.000) and distance to health facility (p=0.033) were enablers of HSU. Being very satisfied was 16 times more likely for one to utilize health services [COR=16, 95% CI (0.000- 0.001)]. Most of the respondents rated the quality of care as poor.Conclusion: Health service utilization remains quite low in many rural health facilities of Uganda.

Lived Experiences of Women Who Underwent Induced Abortion: A qualitative study of Rakai District, Uganda

Background: Induced abortion is one where products of conception are expelled before 28 weeks of gestation. The process can be safe or unsafe. Safe termination of pregnancy is performed by skilled persons using appropriate tools whereas unsafe induced abortion is performed either by persons without the necessary skills or in an environment without the minimum medical standards, or both.Objectives: To explore the lived experiences of women who had induced abortion in Rakai DistrictMethodology: Phenomenological qualitative design was used. Study population was women who underwent induced abortion. 25 women who had induced abortions in past 1-3years were interviewed. Data was collected by in-depth interviews, tape recorded; transcribed verbatim and written in note book.Results: Lived experiences included denial, shame, confusion, fear, anger, anxiety, depression and uncertainty. Participants reported use of local herbs like “ekiwoko” and “majaani”, “etwaata”, “kisuula” and roots of sugar canes, among others, to induce abortion. The processes were mostly traditional, associated with: severe pain, heavy bleeding, and so on. They were life-threatening and horrible. Short- and long-term lived experiences included secondary barrenness, depression, crying-in-privacy and regrets, among others.Conclusion: Health workers and women in child-bearing age need to work together to discuss how to control unplanned pregnancies.

Status of common disease profile and death records among admitted child patients in medical college hospital

Background: The study assesses the common disease profile and death records among admitted child patients at the department of Paediatrics in Northeast Medical College Hospital (NEMCH) of Bangladesh.Methodology: This was an observational study conducted in the department of Paediatrics in Medical College Hospital over a period of three years. The patients of common diseases were hundred in number surveyed through primary questionnaire in respect to their profile, diagnosis and death records. The selected common diseases were ARI, diarrhoea, protein energy malnutrition and febrile convulsion.Results: The numbers of total admitted child patients with common diseases were 10737 for three years with the ratio of 1: 0.93 between the male and female. Out of them neonatal and general patients were 3622 and 7115 respectively. In 2018 child patients were less in numbers other than two years. ARI is more common in the end of year but diarrhoea in same added the beginning of following year. The study also represents the febrile convulsion and malnutrition are more in middle and round the year successively.From 2017 to 2019 the death records of neonate and general at the department of NEMCH are 101 and 84 respectively. Indeed, it is a good sign to reducing the unwanted death in common disease through the consecutive year. A systematic control model is developed to recover from the common diseases associated with hospital admitted child patients’ management.Conclusion: If the medical authority can take advances in preventive measures through health awareness, quality training, safe health care with equipment, facilities and trained-up personnel, then the mortality and morbidity can be reduced suggestively in connection with dynamic National Health Policy and Sustainable Development Goals 2030.

Comparing health risk behaviors of Franklin County youth with their national and statewide counterparts: An ecological study in the state of Kentucky

While national surveillance studies have stratified high school students’ health behavior outcomes, few ecological data sets have been explored, collected, and analyzed on the unique health problems of minority children. An area for which limited data on minority youth has been collected is Franklin County, home of the state capital of Kentucky. In the current study, we use baseline data collected in 2015 from students attending two high schools that were sites for Kentucky State University’s Youth Empowerment Project. We hypothesize that youth who reside in Franklin County would report lower maladjusted behaviors than their national and statewide counterparts in the same year of observation. Data analyses confirm that compared to their national- and state-level counterparts, Franklin County high school students were less likely to report riding with a driver who had been drinking alcohol, engaging in sexual intercourse, drinking alcohol before sexual intercourse, and experiencing non-condom use when engaged in sexual intercourse, forced sexual intercourse, dating violence, cyber bullying, suicidal ideation, and drug use. These findings suggest that Franklin County high school students may be exposed to environmental variables that may be preventive to maladjusted behaviors.

Prevalence of chronic kidney diseases and determinants among TDF users of pregnant and lactating women based on eGFR-cg, and MDRD-4 in hospital setting of north east Amhara, Ethiopia

In recent days, it is common to see increasing incidence of Fanconi, proximal kidney tubular damage and chronic kidney diseases-CKD among high risk populations that drew the clinicians’ attention to monitor closely. Among these risk populations with potential CKD incidence; HIV positive patients who uses TDF as a component of HAART need to be monitored for the incidence of CKD as a toxicity of TDF before initiation and during treatment despite the fact that the current monitoring practice in Ethiopia in most hospitals remain to be poor. Hence this study aimed at measuring the incidence of CKD among high risk segment of HIV positive pregnant and lactating women who uses TDF as part of their HAART treatment. Using a non-proportionate stratified sampling, a total of 111 HIV+ pregnant and lactating women who are on TDF based HAART treatment were enrolled to measure the incidence of CKD based on NKF K/DOQI Classification. Using the Android application of Medicalc GFR-cg, and MDRD-4; the prevalence of stage-2 CKD was 16.2 % (60-89 ml/min) and Stage 5-CKD/Renal Failure who require dialysis were 3.6% (CrCl < 15ml/min/1.72m2) by both method of calculation CrCl (GFR-cg and MDRD-4). Women who were lactating had a relative risk of 0.918 (95% CI lies within 0.845-0.998) of acquiring CKD (P= 0.045). The other associated factors were BMI less than 18.5 (P= 0.004 and adjusted OR of 7.82), WHO clinical stage-1 (P=0.014, odds ratio of 5.4 and 95% CI of 1.24-24.42), baseline CD4 count > 500 (P=0.02), and duration on TDF (> 12 months on treatment) and low haematocrit of 30 had a higher risk of falling into Stage 2 CKD with cohort risk estimate of 4.103 (95 % CI of 1.02, 16.54). The risk estimate of WHO stage 2 to acquire stage-4 CKD was 1.087 (95% CI of 1.002, 1.180) statistically significant (P=0.05.). The prevalence of stage 2 CKD among pregnant and lactating women by GFR-cg method of calculation was higher than MDRD-4 calculation. In this study, MDRD-4 method underestimated stage 2 CKD. Hence it is worth and highly recommended to use GFR-cg method in the baseline and during treatment monitoring of TDF toxicity to the kidney particularly for diagnosing the early stage of CKD.

Toxic effects of plastic on human health and environment : A consequences of health risk assessment in Bangladesh

Plastics are used widely everywhere in our life and without plastic, modern civilization would indeed look very diverse. This study focuses on the toxic effects of plastic on human health and environment and possible consequences of health risk assessment in Bangladesh. Plastics are essential materials in modern civilization, and many products manufactured from plastics and in numerous cases, they promote risks to human health and the environment. Plastics are contained many chemical and hazardous substances such as Bisphenol A (BPA), thalates, antiminitroxide, brominated flame retardants, and poly- fluorinated chemicals etc. which are a serious risk factor for human health and environment. Plastics are being used by Bangladeshi people without knowing the toxic effects of plastic on human health and environment. Different human health problems like irritation in the eye, vision failure, breathing difficulties, respiratory problems, liver dysfunction, cancers, skin diseases, lungs problems, headache, dizziness, birth effect, reproductive, cardiovascular, genotoxic, and gastrointestinal causes for using toxic plastics. Plastics occur serious environment pollution such as soil pollution, water pollution, and air pollution. Application of proper rules and regulations for the production and use of plastics can reduce toxic effects of plastics on human health and environment.

Yoga practices for different blood types based on occi-dental – oriental food habits

Objective: The objective of this paper is to bring the relationship between blood types versus Occidental – Oriental Food Habits (OOFH) along with Yoga practices for better public health and wellness. Methodology: Sample sizes of 50 persons are selected for the study. Clinical blood type classifications and suitable diet combinations, OOFH items are worked out by trial and error method in a laboratory. A Yoga Wellness scoring card or impact card is developed to measure yoga practices.Results: The trial and error method led to innovative development of 10 basic organic food items with 50,000 variations are shown empirically for clinically tested 4 blood groups. Secondly, by using OOFH items, one can maintain a healthy body-mind. Thirdly, yoga wellness card is developed can be used as a health education and communication tool for healthy life style. Lastly, stress related issues are treated with variant juices.Conclusions: The study concludes, that a recommended OOFH diet along with Wellness card helps the individuals to maintain a disease free body-mind of clinically classified of blood types. There is a scope for further research work.

Implementation and evaluation of communication guidelines for the nurses caring for patients diagnosed with tuberculosis

This article focuses on the process of the implementation and evaluation of the guidelines on communication to enhance the communication skills of the nurses who are caring for the patients diagnosed with tuberculosis. This article consists of two sections. The first section deals with the implementation of the communication guidelines and the second section evaluates the implementation and the outcomes of the evaluation of the guidelines. The guideline's document was completed during a two-day training workshop held at the Katutura Health Centre in Namibia.

Sexual health knowledge among secondary school students in Morogoro, Tanzania: half full or full empty?

Background: Sexual health knowledge (SHK) is very crucial as the world is facing HIV/AIDS tragedy, increased cases of sexually transmitted infections (STIs) and unsafe abortions among adolescents. It is obvious that knowledge is an important prevention factor for any disease.Objectives: The study was conducted to assess knowledge and attitude on sexual health among secondary school students in Morogoro Municipality. Specifically the study (I: (i) examined students’ knowledge and attitude on sexual transmitted infections, (ii) analyzed student's awareness on early pregnancy prevention, and; (iii) determined students’ knowledge on issues related to puberty.Methods: The study involved 75 respondents from five secondary schools and 13 key informants through purposive sampling and simple random sampling techniques. Data were collected using a structured questionnaire. Data collected were analyzed using Statistical Package for Social Science (SPSS) ver.12.Results: Findings revealed that 79.8% of the respondents had knowledge on sexually transmitted infections, 86.5% were aware ofmethods of controlling early pregnancies; 83.9% have never used protective gears during sexual intercourses, and 54.7% did not understand a menstruation cycle.Conclusion: The study recommended for provision of sexual health knowledge to students to reduce incidences of early pregnancies and sexually transmitted infections; likewise on the need to use protective gears during sexual intercourses. Knowledge concerning sexual health is vital for all particularly for adolescents, as they are vulnerable to adopt negative behaviors if not guided properly and at the right age.

Results and findings in the socio-economic determinants of adolescent pregnancy in Katutura, Windhoek: Namibia

This study focuses on the results and findings in the study on socio-economic determinants of adolescent pregnancy in Katutura, Windhoek: Namibia.The aim of this study was to analyze and to come forth with results and findings to explore the socio-economic determinants of adolescent pregnancy in Katutura, Windhoek: Namibia.The clinical study was a cross-sectional, descriptive study of three months duration. Semi-structured interviews methods were utilized to collect the data. A random sampling method was use to select the participant. Study population was all pregnant women attending the Katutura antenatal clinic during the time of the study. The study sample of 150 pregnant adolescent were accepted into the study. Inclusion and exclusion criteria were adhered in the selection process. Data analysis; qualitative and quantitative thematically analysis was used to interpret the data.Based on the findings of the study 89% of the pregnant adolescent falls between the ages 17-21 who visited the ante -natal clinic. The majority interviewed represents 65% of the highest-grade completed grade 8-10. 79% of the pregnant adolescents were still living with their parents. The mean age of the first intercourse was 16.5 years. 71% represent their first pregnancy, compare to 29 % who said this was their second pregnancy. 46% plan to give their babies away, to their mothers which represent 84, 7%. 54 % of the pregnant adolescent prefer to take up their parental role, responsibility and accountability compare to the 46 %, shifting their roles to extended families.