scholarly journals Health Facility-based Counselling and Community Outreach are Associated with Maternal Dietary Practices in a Cross-sectional Study from Tanzania

2021 ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Community Health Worker ◽  
Children's Health ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Access To Health

Abstract Background: Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania.Methods: Data come from a two-stage, randomized baseline survey among 5,000 female primary caregivers prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression.Results: A third of the sample (34.1 percent) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0 percent). 68.0 percent had never had a community health worker (CHW) speak to them about their children’s health and 9.4 percent had participated in a women’s group. Only 8.0 percent of mothers ate more than usual during pregnancy and 7.1 percent ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95 percent CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving ANC and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 hours. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 hours. Conclusions: Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals Health facility-based counselling and community outreach are associated with maternal dietary practices in a cross-sectional study from Tanzania

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Cross Sectional ◽  
Access To Health

Abstract Background Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania. Methods Data come from a cross-sectional baseline survey among 5000 female primary caregivers who were randomly selected via two-stage sampling, prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression. Results A third of the sample (34.1%) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0%). 68.0% had never had a community health worker (CHW) speak to them about their children’s health and 9.4% had participated in a women’s group. Only 8.0% of mothers ate more than usual during pregnancy and 7.1% ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95% CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving antenatal care (ANC) and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 h. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 h. Conclusions Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

2019 ◽  
Author(s):  
Brian Wahl ◽  
Susanna Lehtimaki ◽  
Stefan Germann ◽  
Nina Schwalbe
Keyword(s):  
Health Services ◽  
Community Health ◽  
Low Income ◽  
Urban Areas ◽  
Access To Health Services ◽  
Middle Income ◽  
Urban Settings ◽  
Middle Income Countries ◽  
Access To Health ◽  
Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

Gambaran Epidemiologi Hipertensi di Puskesmas Gamping I

2017 ◽  
Vol 19 (1) ◽  
pp. 43-50
Author(s):  
Sekti Riyantina ◽  
Th Ninuk Sri Hartini ◽  
Idi Setiyobroto
Keyword(s):  
Population Density ◽  
Health Services ◽  
Community Health ◽  
Health Center ◽  
Access To Health Care ◽  
Community Health Center ◽  
Communicable Diseases ◽  
Access To Health Services ◽  
Access To Health ◽  
Gender Education

Background : Epidemiological transition stems from a change where a decline in the prevalence of communicable diseases and non- communicable diseases (NCDs) have increased. Report in 2011 there was one billion people worldwide suffer from hypertension and in Indonesia the figure reached 31.7%. Objective : The purpose of this study was to determine the epidemiological of hypertension Gamping I Community Health Center and determine the proportion of hypertension according to age, sex, occupation, education, socio-economic, geographic, demographic and access to health services. Method : The research design was a retrospective cohort. This research was conducted in Gamping I Community Health Center in November 2016. Population and sample in this study were all patients with hypertension in Gamping I Community Health Center in 2013, 2014 and 2015. The independent variables in this study were age, gender, education, employment, social, cultural, demographic population density, geographic and ease of access to health services. While the dependent variable is the proportion of hypertension. Data analysis was performed using Chi Square to know know the proportions of age, gender, education, employment, social, economic, population density, geography, access to health services with hypertension in 2013, 2014 and 2015. Result : Based on the analysis proves the young elderly, women, housewife, secondary education, non-poor families, low-lying area, population density and access to health care were likely to have hypertension with percentages respectively 33%, 66.7%, 44.9%, 70.1%, 76.7% , 71.9%, 37.9% and 82.9%.   Keywords: Hypertension, Epidemiology

scholarly journals Treatment Supporters and Their Impact on Treatment Outcomes In Routine Tuberculosis Program Conditions In District Rawalpindi, Pakistan

2013 ◽  
Vol 14 (1) ◽  
pp. 40-46
Author(s):  
Munawar Hussain Soomro ◽  
Ejaz Qadeer ◽  
Muhammad Amir Khan ◽  
Odd Morkve
Keyword(s):  
Community Health ◽  
Treatment Outcomes ◽  
Family Member ◽  
Health Worker ◽  
Health Facility ◽  
Community Health Worker ◽  
Treatment Success ◽  
Sputum Smear ◽  
Lady Health Worker ◽  
Community Volunteer

Background: Tuberculosis (TB) is a major cause of mortality and is affecting millions of people in third world countries. In DOTS patients are monitored facility based and treatment supporter based; by these two ways patients  are observed for the treatment. The aim of the study was to explore the role of treatment supporters and their impact on the treatment outcomes. Material and Method: The study was a cross-sectional survey within routine TB control program operational context. All sputum smear positive TB patients diagnosed, registered in public sector, urban and rural diagnostic centre during year 2008 with available outcomes were included in the study. Data was collected during August- October 2010 from 15 health facilities of 451 patients. Results: The majority of the patients (89.6%) were provided with treatment supporters. In 404 (89.6%) cases in which treatment supporters were provided, 203 (50.2%) were lady health worker, 46 (11.4%) were community health worker and health facility worker, and 155 (38.4%) were family member and community volunteer. 384 (85.1%) were categorized as “treatment success”, 31 (6.9%), as “transferred out”, 17 (3.8%), as “dead”, 16 (3.5%) as “defaulted” and three (0.7%) as “treatment failure”. The treatment success rates in patients supervised by lady health worker, community health worker and health facility worker, and family member and community volunteer was 93.1%, 89.1% and 73.5%, respectively. Conclusions: We found a significantly higher treatment success (93.1%) in patients supervised by lady health workers compared to other types of treatment support. The overall treatment success rate was 85.1%.DOI: http://dx.doi.org/10.3329/jom.v14i1.14535 J MEDICINE 2013; 14 : 40-46 

scholarly journals Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis

2021 ◽  
Vol 15 (2) ◽  
pp. e0008989
Author(s):  
Luisa Rubiano ◽  
Neal D. E. Alexander ◽  
Ruth Mabel Castillo ◽  
Álvaro José Martínez ◽  
Jonny Alejandro García Luna ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Cutaneous Leishmaniasis ◽  
Mobile Application ◽  
Health Workers ◽  
Prediction Rule ◽  
Case Detection ◽  
Access To Health Services ◽  
Community Health Volunteers ◽  
Access To Health

Background Detection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce. Methods We adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician. Results The application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel. Conclusions Translating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the use of mHealth tools for NTD research and healthcare.

scholarly journals Nonclinical Sexual Health Support for HIV, Viral Hepatitis, and Other Sexually Transmitted Infections in Gay, Bisexual, and Other Men Who Have Sex With Men: Protocol for a European Community Health Worker Online Survey (ECHOES)

10.2196/15012 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e15012
Author(s):  
Nigel Sherriff ◽  
Jorg Huber ◽  
Nick McGlynn ◽  
Carrie Llewellyn ◽  
Alex Pollard ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Community Health ◽  
Sexually Transmitted Infections ◽  
Health Worker ◽  
Community Health Worker ◽  
Online Survey ◽  
Sexually Transmitted ◽  
Sex With Men

Background The term “community health worker” (CHW) can apply to a wide range of individuals providing health services and support for diverse populations. Very little is known about the role of CHWs in Europe working in nonclinical settings who promote sexual health and prevent HIV and other sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (MSM). Objective This paper describes the development and piloting of the first European Community Health Worker Online Survey (ECHOES) as part of the broader European Union-funded ESTICOM (European Surveys and Trainings to Improve MSM Community Health) project. The questionnaire aimed to assess the knowledge, attitudes, and practices of CHWs providing sexual health services to gay, bisexual, and other MSM in European settings. Methods ECHOES comprises three superordinate domains divided into 10 subsections with 175 items (routed) based on a scoping exercise and literature review, online prepiloting, and Europe-wide consultation. Additional piloting and cognitive debriefing interviews with stakeholders were conducted to identify comprehension issues and improve the clarity, intelligibility, accessibility, and acceptability of the survey. Psychometric properties, including internal consistency of the standardized scales used as part of the survey were examined. The final survey was available to 33 countries in 16 languages. Results Recruitment closed on January 31, 2018. Data from 1035 CHWs were available for analysis after application of the exclusion criteria. The findings of the ECHOES survey and the wider ESTICOM project, are now available from the ESTICOM website and/or by contacting the first author. Conclusions The findings of this survey will help characterize, for the first time, the diverse role of CHWs who provide sexual health services to gay, bisexual, and other MSM in Europe. Importantly, the data will be used to inform the content and design of a dedicated training program for CHWs as part of the larger ESTICOM project and provide recommendations for MSM-specific strategies to improve sexual health in general and to reduce the incidence and prevalence of HIV, viral hepatitis, and other STIs in particular. International Registered Report Identifier (IRRID) RR1-10.2196/15012

scholarly journals Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Md. Mizanur Rahman ◽  
Md. Rashedul Islam ◽  
Md. Shafiur Rahman ◽  
Fahima Hossain ◽  
Ashraful Alam ◽  
...  
Keyword(s):  
Health Services ◽  
Multilevel Analysis ◽  
Health Facility ◽  
Financial Burden ◽  
Safety Net ◽  
Access To Health Services ◽  
Financing System ◽  
Access To Health ◽  
Out Of Pocket Payments ◽  
Nationally Representative

Abstract Background Ensuring access to health services for all is the main goal of universal health coverage (UHC) plan. Out-of-pocket (OOP) payment still remains the main source of funding for healthcare in Bangladesh. The association between barriers to accessing healthcare and over-reliance on OOP payments has not been explored in Bangladesh using nationally representative household survey data. This study is a novel attempt to examine the burden of OOP payment and forgone healthcare in Bangladesh, and further explores the inequalities in catastrophic health expenditures (CHE) and forgone healthcare at the national and sub-national levels. Methods This study used data from the most recent nationally representative cross-sectional survey, Bangladesh Household Income and Expenditure Survey, conducted in 2016–17 (N = 39,124). In order to identify potential determinants of CHE and forgone healthcare, multilevel Poisson regression was used. Inequalities in CHE and forgone healthcare were measured using the slope index of inequality. Results Around 25% of individuals incurred CHE and 14% of the population had forgone healthcare for any reasons. The most common reasons for forgone healthcare were treatment cost (17%), followed by none to accompany or need for permission (5%), and distance to health facility (3%). Multilevel analysis indicated that financial burden and forgone care was higher among households with older populations or chronic illness, and those who utilize either public or private health facilities. Household consumption quintile had a linear negative association with forgone care and positive association with CHE. Conclusion This study calls for incorporation of social safety net in health financing system, increase health facility, and gives priority to the disadvantaged population to ensure access to health services for all.

Letter to the Editor

PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 776-776
Author(s):  
H. L. Kafka
Keyword(s):  
Public Health ◽  
Health Services ◽  
Access To Care ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Public Health Nurses ◽  
Highly Qualified ◽  
Public Health Services ◽  
The Public

There is no need for highly qualified, highly paid personnel like public health nurses and health assistants to monitor access to care and to encourage the use of the services. Lesser trained, but well known persons in the community, such as a community health worker, would be better received by the community and, therefore, would do a better job. It may be possible in some areas to use volunteers. A study using such a group of people in a well-defined area would certainly help to establish this kind of health worker as a permanent institution in the public health services.

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