Search results for: poor health

Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

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Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

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Authors: Veronica Ramirez

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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.

Keywords: health, household service worker, overseas, wellness

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Authors: Perpetua Modjadji, Sphiwe Madiba

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Background: The growth patterns of children are good nutritional indicators of their nutritional status, health, and socioeconomic level. However, the maternal factors and the belief system of the society affect the growth of children promoting undernutrition. This study determined the influence of maternal factors on growth patterns of schoolchildren in a rural site. Methods: A convergent mixed method study was conducted among 508 schoolchildren and their mothers in Dikgale Health and Demographic Surveillance System Site, South Africa. Multistage sampling was used to select schools (purposive) and learners (random), who were paired with their mothers. Anthropometry was measured and socio-demographic, obstetrical, household information, maternal influence on children’s nutrition, and growth were assessed using an interviewer administered questionnaire (quantitative). The influence of the cultural beliefs and practices of mothers on the nutrition and growth of their children was explored using focus group discussions (qualitative). Narratives of mothers were used to best understand growth patterns of schoolchildren (mixed method). Data were analyzed using STATA 14 (quantitative) and Nvivo 11 (qualitative). Quantitative and qualitative data were merged for integrated mixed method analysis using a joint display analysis. Results: Mean age of children was 10 ± 2 years, ranging from 6 to 15 years. Substantial percentages of thinness (25%), underweight (24%), and stunting (22%) were observed among the children. Mothers had a mean age of 37 ± 7 years, and 75% were overweight or obese. A depressed socio-economic status indicated by a higher rate of unemployment with no income (82.3%), and dependency on social grants (86.8%) was observed. Determinants of poor growth patterns were child’s age and gender, maternal age, height and BMI, access to water supply, and refrigerator use. The narratives of mothers suggested that the children in most of their households were exposed to poverty and the inadequate intake of quality food. Conclusion: Poor growth patterns were observed among schoolchildren while their mothers were overweight or obese. Child’s gender, school grade, maternal body mass index, and access to water were the main determinants. Congruence was observed between most qualitative themes and quantitative constructs. A need for a multi sectoral approach considering an evidence based and feasible nutrition programs for schoolchildren, especially those in rural settings and educating mothers, cannot be over-emphasized.

Keywords: growth patterns, maternal factors, rural context, schoolchildren, South Africa

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Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna

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Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.

Keywords: city health plan, health system, rapid assessment, urban mission

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Authors: Motahare Aali, Fatemeh Tajik

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Here, we investigate the sensitivity the Casimir force and consequently dynamical actuation of a three-layer microswitch to some ambient conditions. In fact, we have considered the effect of optical properties on the stable operation of the microswitch for both good (e.g. metals) and poor conductors via a three layer Casimir oscillator. Indeed, gold (Au) has been chosen as a good conductor which is widely used for Casimir force measurements, and highly doped conductive silicon carbide (SiC) has been considered as a poor conductor which is a promising material for device operating under harsh environments. Also, the intervening stratum is considered ethanol or water. It is also supposed that the microswitches are frictionless and autonomous. Using reduction factor diagrams and bifurcation curves, it has been shown how performance of the microswitches is sensitive to temperature and intervening stratum, moreover it is investigated how the conductivity of the components can affect this sensitivity.

Keywords: Casimir force, optical properties, Lifshitz theory, dielectric function

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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Authors: Olayinka Ariba, Abe Oudshoorn, Steve Rolfe, Carrie Anne Marshall, Deanna Befus, Jason Gilliland, Miranda Crockett, Susana Caxaj, Sarah McLean, Amy Van Berkum, Natasha Thuemler

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Background: Secure housing is a platform for health and well-being. Those who struggle with housing stability have complex life and health histories and often require some support services such as the provision of permanent supportive housing. Poor access to supportive resources creates an exacerbation of chronic homelessness, particularly affecting individuals who need immediate access to mental health and addiction supports. This paper presents the first phase of a three-part study examining how on-site support impacts housing stability for recently-re-housed persons. Method: This study utilized a community-based participatory research methodology. Twenty in-depth interviews were conducted with permanent supportive housing residents from a single-site dwelling. Interpretative description analysis was used to draw common themes and understand the experiences and challenges of housing support. Results: Three interconnected themes were identified: 1) Available and timely supports; 2) Affordability; and 3) Community, but with independence as desired. These interconnected components are helping residents transition from homelessness or long-term mental health inpatient care to live in the community. Despite some participant concerns about resident conflicts, staff availability, and affordability, this has been a welcome and successful move for most. Conclusion: Supportive housing is essential for successful tenancies as a platform for health and well-being among Canada’s most vulnerable and, from the perspective of persons recently re-housed, permanent supportive housing is a worthwhile investment.

Keywords: homelessness, supportive housing, rehoused, housing stability

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Authors: Abubakar-Zagoon Adams, Emmanuel Intsiful, Haruna Zagoon-Sayeed

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Within the Ghanaian context, the promotion of Technical and Vocational Education and Training (TVET) has been faced with many obstacles which are of great concern to national development. One of the obstacles that have been identified as having some negative impact on TVET promotion is the poor public perception of TVET. Poor public perception, as identified in the sub-sectors report in a number of Ghana Education Service reports, has received little attention in both research and the government’s effort to address the poor performance of the TVET sub-sector. This study investigated TVET stakeholders in the Ayawaso-West Municipality in the Greater Accra Region of Ghana to ascertain knowledge of technical and vocational education in Ghana. This study explored parents’ and students’ views and knowledge about technical and vocational education. The study adopted an exploratory research design and a qualitative research approach. Thirty-six (36) participants were selected by employing a purposive sampling technique. Twelve (ten parents and two school personnel) out of the total sample were engaged in key informant interviews, whereas three focus group discussions were conducted with students, eight in each group. The study found that the public has fair knowledge (positive) about TVET, and the other side of the coin knows that TVET is only meant for school dropouts, underprivileged students, and weak academic students. The study recommended that the government should intensify public education on TVET, deliberate investment should be made in TVET infrastructure, as well as proper regulation of the sub-sector.

Keywords: public perception, TVET promotion, socioeconomic, self-employment

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Authors: Isabela Thomas Mkude

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This research was done to assess how the community is involved in waste management activities and their willingness to pay for services. Mnadani and Madukani are among the old wards in Dodoma urban. These two areas are similar and face numerous environmental problems, poor solid waste management practices being among them. People realize problems because they live with them daily but the study advice that the only way to stay off problems is to find appropriate measures. The findings recognized some problems that led to poor community involvement solid waste management the study areas. Lack of community education on how to deal with solid wastes, poor responsibility of ward leaders in issues concerning the environment and in active participation of communities in environmental meeting are among other major problems found during the research. The research also revealed that there is low willingness to pay for waste collection among communities and financial problems that make environmental committee inactive; that leading to a poor disposal and unavailable collection facilities in urban area. Although the municipal improves disposal activities by increasing amount of waste to be disposed off by 11% in three years, the amount of waste that collected is also increasing by 41% each day. It is advised that some corrective measures need to be put in place so that the communities are well involved in managing solid wastes as the best way to attain achievement in keeping the urban free from solid waste. Environmental education dissemination to the communities is needed so that they become responsible and dedicated citizen on the environment. There should be some incentives from government to the wards local government and CBOs so that they can practically implement solid waste management programs and to attract formation of more groups and motivate the present groups. Capacity building programs to the ward leaders need to be given priority so that leaders are well organized and able to plan, coordinate and cooperate with various governmental institutions, and NGOs responsible for development and environmental management.

Keywords: solid waste, waste management, public involvement, rapid urbanized region

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Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Long-term survivorship in colorectal cancer (CRC) is increasing as mortality decreases, leading to increased focus on patient-reported outcomes such as quality of life (QoL). CRC patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment CRC patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 6,272 total participants (mean = 392, 58% male) with a mean age of 60.6 years. The European Organisation for Research and Treatment of Cancer QLQ-C30 was the most common measure of QoL (n=14, 82.3%). Most studies (n=15, 88.2%) found that emotional distress correlated with poor global QoL. This was most commonly measured with the Hospital Anxiety & Depression Scale (n=11, 64.7%). Other psychosocial factors associated with QoL were lack of social support, body image, and financial difficulties. Clinicopathologic determinants included presence of stoma and metastasis. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment CRC patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: colorectal cancer, cancer surgery, quality of life, oncology, social determinants

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Authors: Njoroge Margaret W., Johnson Deborah

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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

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Authors: Beatrice Adeoye

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Background: One of the health challenges developing countries face is air pollution from indoor and outdoor activities. Smoke as a result of cooking, burning wastes and power generators litter the air space on a continual basis due to poverty and governance challenges. The short and long term implications of these actions are enormous and studies have attributed smoke as one of the leading preventable risk factors contributing to global burden of respiratory infections. Design/Methods: The issue at hand therefore includes an exploration of the existing policy frameworks regarding smoke, adherence to international conventions and practices, and more importantly the activities of the government in addressing these issues. Aside this, an understanding of the implications of smoke on peoples’ health and well-being also become crucial. Consequently, this article seeks to interrogate the effect of smoke on the health and well-being of Nigerians and the activities of the policy makers in addressing these challenges. Results (Main Argument): This study reviewed both primary and secondary data on poverty, smoke emission and attendant health risks coupled with existing policies on smoke and air pollution in the country. For instance, over 69% of Nigerians are poor, ranking third in the world; 2.9 billion people live in homes using wood, coal or dung as their primary cooking fuel; equally, 50.6% of Nigerians has no access to regular electricity supply. Further, sustainable policy regarding smoke emission is lacking in the country. This work further submitted that continued low standard of living as a result of governance challenges coupled with a lack of sustainable policy have aggravated the health risks related to smoke in the country. Conclusions: The implication on the health of the children, mothers and vulnerable groups for the future of the country is enormous and may continue if not addressed. Urgent attention therefore needs to be focused on this area considering what this portends for the nation now and in the future.

Keywords: air pollution, indoor, outdoor, respiratory infections

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Authors: Eman Shady, Ray Langsten

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In Egypt, girls have traditionally been educationally disadvantaged. This disadvantage, however, has been focused on the failure to enter school. Increasingly it is recognized that girls who ever-enroll are at least as likely to complete primary and secondary education as boys. Still the belief persists that girls, especially those from poor families, will be disadvantaged in terms of school expenditures and the transitions to secondary and higher education. We use data from the 2005-06 Egypt Household Education Survey to examine expenditures on tutoring during the final year of preparatory school, and the transition to specific tracks of secondary education. Tests during the last year of preparatory largely determine a student’s educational future. Results show that girls, even girls from poor families, are not disadvantaged in terms of expenditures, whether for tutoring, fees or general expenses. Moreover, girls are more likely than boys to advance to general secondary education, the track that leads to higher education.

Keywords: gender, tutoring, track, Egypt

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Authors: Victor Oluwaseyi Olowonisi

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The paper aimed at presenting an overview on the concept of e-learning as it relates to higher education and how it provides opportunities for students, instructors and the government in developing the educational sector. It also touched on the benefits and challenges attached to e-learning as a new medium of reaching more students especially in the Nigerian context. The opportunities attributed to e-learning in the paper includes breaking boundaries barriers, reaching a larger number of students, provision of jobs for ICT experts, etc. In contrary, poor power supply, cost of implementation, poor computer literacy, technophobia (fear of technology), computer crime and system failure were some of the challenges of e-learning discussed in the paper. The paper proffered that the government can help the people gain more from e-learning through its financing. Also, it was stated that instructors/lecturers and students need to undergo training on computer application in order for e-learning to be more effective in developing higher education in Nigeria.

Keywords: e-learning, education, higher education, increasing literacy

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Authors: Bintou Jobe

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The construction sector, both in the United Kingdom (UK) and developing Anglophone West African countries, specifically The Gambia, is facing significant health and safety challenges. While the UK has established legislation and regulations to support Occupational Health and Safety (OHS) in the industry, the same level of support is lacking in developing countries. The significance of this review is to assess the extent and effectiveness of OHS legislation and regulatory reform in the construction industry, with a focus on understanding the challenges faced by both the UK and developing Anglophone West African countries. It aims to highlight the benefits of implementing an OHS management system, specifically ISO 45001. This study uses a literature review approach, synthesizing publications from the past decade and identifying common themes and best practices related to Occupational Health and Safety in the construction industry. Findings were analysed, compared, and conclusions and recommendations were drawn after developing research questions and addressing them. This comprehensive review of the literature allows for a detailed understanding of the challenges faced by the industry in both contexts. The findings of the study indicate that while the UK has established robust health and safety legislation, many UK construction companies have not fully met the standards outlined in ISO 45001. These challenges faced by the UK include poor data management, inadequate communication of best practices, insufficient training, and a lack of safety culture mirroring those observed in the developing Anglophone countries. Therefore, compliance with OHS management systems has been shown to yield benefits, including injury prevention and centralized health and safety documentation. In conclusion, the effectiveness of OHS legislation for developing Anglophone West African countries should consider the positive impact experienced by the UK. The implementation of ISO 45001 can serve as a benchmark standard and potentially inform recommendations for developing countries. The selection criteria for literature include search keywords and phrases, such as occupational health and safety challenges, The Gambia, developing countries management systems, ISO 45001, and impact and effectiveness of OHS legislation. The literature was sourced from Google Scholar, the UK Health and Safety Executive websites, and Google Advanced Search.

Keywords: ISO 45001, developing countries, occupational health and safety, UK

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Authors: Muhammad Tahir Riaz, Khalid Mehmood, Ahmad Waseem Akhtar, Tariq Abbas, Sadaqat Ali, Muhammad Altaf

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Livestock sector contributes around 55.9 and 11.8% to agriculture and GDP respectively, according to economic survey of Pakistan 2013-2014. The goats population has been estimated about 66.6 million (M). Parasitic infestation is a major health problem in goats causing loss in body weight, poor body condition, low birth weights, and difficulty in kidding. Keeping in view the utilization of these animals in the country, a pilot epidemiological survey was conducted to find out the major parasitic problems of goats in and around Derawar fort area, Cholistan. Data regarding 662 fecal samples of goats was collected from 25 tobas of Cholistan during June 2012 to June 2013. All the fecal samples were examined through Direct Smear Method and Salt Flotation Technique for the presence of helminth eggs. External parasites were taken from the various components of the carcass of goat and were conserved in 70% alcohol in hygienic, properly enclosed glass jars that were tagged thoroughly. The collected date was analyzed statistically by Chi-square test to find out the prevalence in goats. Out of 662 goats, 261 (39.42%) were found positive for parasites. 233 (35.20%) goats were found positive for gastrointestinal parasites while 28 (4.23%) were positive for external parasites including ticks 20 (3.02%) and mange 8 (1.21%). The higher prevalence of parasites in the study area may be due to pasture grazing, poor management and lack of extension work. In this regards proper management and control measures should be adopted to minimize the Parasitic Problems.

Keywords: Cholistan, goats, parasite, surveillance

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Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

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Authors: Theresia F. Mrema, Innocent Semali

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Food insecurity to pregnant women seriously impedes efforts to reduce maternal mortality in resource poor countries. This study was carried out to assess determinants food insecurity among pregnant women in urban areas. A cross sectional study design was used to collect data for the period of two weeks. A structured questionnaire with both closed and open ended questions was used to interview a total of 225 randomly selected pregnant women who attend the three randomly selected antenatal care clinics in Temeke Municipal council. The food insecurity was measured using a modified version of the USDA’s core food security module which consists of 15questions. Logistic regression analysis was used to obtain strength of association between dependent and independent variables. Among 225 pregnant women attending antenatal care (ANC) interviewed 55.1% were food insecure. Food insecurity declined with increasing household wealth, it was also significantly low among those with less than three children compared with having more. Low level of food insecurity was associated with having Secondary education (Adjusted OR=0.24; 95%CI, 0.12–0.48), College Education (OR=0.156; 95%CI, 0.05-0.46), paid employment (OR=0.322; 95%CI, 0.11-0.96) and high income (OR=0.031; 95%CI, 0.01–0.07). Also, having head of the household with secondary education (OR=0.51; 95%CI, 0.07-0.32) college education (OR=0.04; 95%CI, 0.01-0.13) and paid employment (OR=0.225; 95%CI, 0.12-0.42). Food insecurity is a significant problem among pregnant women in Temeke Municipal which might significantly affect health of the pregnant woman and foetus due to higher maternal malnutrition which increases risk of miscarriage, maternal and infant mortality, and poor pregnancy outcomes. The study suggests a multi-sectoral approach in order to address this problem.

Keywords: food security, nutrition, pregnant women, urban settings

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Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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Authors: Tuji Jemal Ahmed, Hussen Beker Yusuf

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Food safety is a major concern worldwide, with microbial contamination being one of the leading causes of foodborne illnesses. In Ethiopia, drinking water and untreated groundwater are a primary source of microbial contamination, leading to significant health risks. East Hararghe, Oromia, is one of the regions in Ethiopia that has been affected by this problem. This paper provides an overview of the impact of untreated groundwater on human health in Haramaya Rural District, East Hararghe and highlights the urgent need for sustained efforts to address the water sanitation supply problem. The use of untreated groundwater for drinking and household purposes in Haramaya Rural District, East Hararghe is prevalent, leading to high rates of waterborne illnesses such as diarrhea, typhoid fever, and cholera. The impact of these illnesses on human health is significant, resulting in significant morbidity and mortality, especially among vulnerable populations such as children and the elderly. In addition to the direct health impacts, waterborne illnesses also have indirect impacts on human health, such as reduced productivity and increased healthcare costs. Groundwater sources are susceptible to microbial contamination due to the infiltration of surface water, human and animal waste, and agricultural runoff. In Haramaya Rural District, East Hararghe, poor water management practices, inadequate sanitation facilities, and limited access to clean water sources contribute to the prevalence of untreated groundwater as a primary source of drinking water. These underlying causes of microbial contamination highlight the need for improved water sanitation infrastructure, including better access to safe drinking water sources and the implementation of effective treatment methods. The paper emphasizes the need for regular water quality monitoring, especially for untreated groundwater sources, to ensure safe drinking water for the population. The implementation of effective preventive measures, such as the use of effective disinfectants, proper waste disposal methods, and regular water quality monitoring, is crucial to reducing the risk of contamination and improving public health outcomes in the region. Community education and awareness-raising campaigns can also play a critical role in promoting safe water practices and reducing the risk of contamination. These campaigns can include educating the population on the importance of boiling water before drinking, the use of water filters, and proper sanitation practices. In conclusion, the use of untreated groundwater as a primary source of drinking water in East Hararghe, Oromia, Ethiopia, has significant impacts on human health, leading to widespread waterborne illnesses and posing a significant threat to public health. Sustained efforts are urgently needed to address the root causes of contamination, such as poor sanitation and hygiene practices, improper waste management, and the water sanitation supply problem, including the implementation of effective preventive measures and community-based education programs, ultimately improving public health outcomes in the region. A comprehensive approach that involves community-based water management systems, point-of-use water treatment methods, and awareness-raising campaigns can contribute to reducing the incidence of microbial contamination in the region.

Keywords: food safety, health risks, microbial contamination, untreated groundwater

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Authors: Martin S. Mulyadi

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This research investigates the corporate governance disclosure behavior of Indonesian corporations with type II agency problems. The primary cause of the 1990s Asian financial crisis has been attributed to poor corporate governance practices in Indonesia. Most importantly, these poor practices were commonly found in family-owned and government-owned corporations. There are a lot of publicly listed family-owned and government-owned corporations in Indonesia. Agency theory refers to these corporations as corporations with type II agency problems. This research employs agency theory to analyzes corporate governance practice and disclosures in such settings and found that government-owned corporations perform better than family-owned corporations.

Keywords: corporate governance, corporate disclosures, agency theory, type II agency problems

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Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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Authors: Anna Guitart Atienza, Ana Fernández del Río, Madhav Nekkar, Jelena Ljubicic, África Periáñez, Eura Shin, Lauren Bellhouse

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The use of digital devices in healthcare or mobile health (mHealth) has increased in recent years due to the advances in digital technology, making it possible to nudge healthy behaviors through individual interventions. In addition, mHealth is becoming essential in poor-resource settings due to the widespread use of smartphones in areas where access to professional healthcare is limited. In this work, we evaluate mHealth interventions in low-income countries with a focus on causal inference. Counterfactuals estimation and other causal computations are key to determining intervention success and assisting in empirical decision-making. Our main purpose is to personalize treatment recommendations and triage patients at the individual level in order to maximize the entire intervention's impact on the desired outcome. For this study, collected data includes mHealth individual logs from front-line healthcare workers, electronic health records (EHR), and external variables data such as environmental, demographic, and geolocation information.

Keywords: causal inference, mHealth, intervention, personalization

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Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Olayemi Bakre

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The majoritant of the South African rural populace are directly or indirectly engaged in agricultural practices for a livelihood. However, impediments such as the climate change and inadequacy of governmental support has undermined the once thriving subsistence farming communities of South Africa. Furthermore, the poor leadership in hydrology, coupled with lack of depths in skills to facilitate the understanding and acceptance of groundwater from national level to local governance has made it near impossible for subsistence farmers to optimally benefit from the groundwater beneath their feet. The 2012 drought experienced in South Africa paralysed the farming activities across several subsistence farming communities across the KwaZulu-Natal Province. To revamp subsistence farming, a variety of interventions and strategies such as the Resource Poor Farmers (RPF) and Water Allocation Reforms (WAR) have been launched by the Department of Water and Sanitation (DWS) as an agendum to galvanising the defunct subsistence farming communities of KwaZulu-Natal as well as other subsistence farming communities across South Africa. Despite the enormous resources expended on the subsistence farming communities whom often fall under the Historically Disadvantaged Individuals (HDI); indicators such as the unsustainable farming practices, poor crop yield, pitiable living condition as well as the poor standard of living, are evidential to the claim that these afore cited interventions and a host of other similar strategies indicates that these initiatives have not yield the desired result. Thus, this paper seeks to suggest practicable interventions aimed at salvaging the vulnerability of subsistence farmers within the province understudy. The study pursued a qualitative approach as the view of experts on ground water and similarly related fields from the DWS were solicited as an agendum to obtaining in-depth perspective into the current study. Some of the core challenges undermining the sustainability and growth of subsistence farming in the area of study were - inadequacy of experts (engineers, scientist, researchers) in ground water; water shortages; lack of political will as well as lack of coordination among stakeholders. As an agendum to optimising the ground water usage for subsistence farming, this paper advocates the strengthening of geohydrological skills, development of technical training capacity, interactive participation among stakeholders as well as the initiation of Participatory Action Research as an agenda to optimising the available ground water in KwaZulu-Natal which is intended to orchestrate a sustainable and viable subsistence farming practice within the province.

Keywords: subsistence farming, ground water optimisation, resource poor farmers, and water allocation reforms, hydrology

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Authors: Mohamed M. Diab, Koura G. Mohamed, A. Balbaa, Radwan Sh. Ahamed

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Background: Chronic mechanical low back pain (CMLBP) is the most common complaint of the working-age population. Mechanical low back pain is often a chronic, dull, aching pain of varying intensity that affects the lower spine. In the current proposal the hip rotation-CMLBP relationship is based on that limited hip motion will be compensated by motion in the lumbopelvic region and this increase force translates to the lumbar spine. The purpose of this study was to investigate if there a relationship between chronic mechanical low back pain (CMLBP) and hip medial and lateral rotation (peak torque and Range of motion (ROM) in patients with CMLBP. Methods: Sixty patients with CMLBP diagnosed by an orthopedist participated in the current study after signing a consent form. Their mean of age was (23.76±2.39) years, mean of weight (71.8±12.7) (Kg), mean of height (169.65±7.49) (Cm) and mean of BMI (25.5±3.86) (Kg/m2). Visual Analogue Scale (VAS) was used to assess pain. Fluid Filled Inclinometer was used to measure Hip rotation ROM (medial and lateral). Isokinetic Dynamometer was used to measure peak torque of hip rotators muscles (medial and lateral), concentric peak torque with tow Isokinetic speeds (60ᵒ/sec and 180ᵒ/sec) was selected to measure peak torque. Results: The results of this study demonstrated that there is poor relationship between pain and hip external rotation ROM, also there is poor relation between pain and hip internal rotation ROM. There is poor relation between pain and hip internal rotators peak torque and hip external rotators peak torque in both speeds. Conclusion: Depending on the current study it is not recommended to give an importance to hip rotation in treating Chronic Mechanical Low Back Pain.

Keywords: hip rotation ROM, hip rotators strength, low back pain, chronic mechanical

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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