Search results for: health belief

Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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Authors: Sumaiya Amir Khan, Shayma Al-Sharif, Samiha Mazher, Neha Intikhab Khan

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This research paper aims to evaluate the effectiveness of sleep-tracking AI applications in smart-watches. It focuses on comparing the sleep analyses of two different smartwatch brands, Samsung and Fitbit, and measuring sleep at three different stages – REM (Rapid-Eye-Movement), NREM (Non-Rapid-Eye-Movement), and deep sleep. The methodology involves the participation of different users and analyzing their sleep data. The results reveal that although light sleep is the longest stage, deep sleep is higher than average in the participants. The study also suggests that light sleep is not uniform, and getting higher levels of deep sleep can prevent debilitating health conditions. Based on the findings, it is recommended that individuals should aim to achieve higher levels of deep sleep to maintain good health. Overall, this research contributes to the growing literature on the effectiveness of sleep-tracking AI applications and their potential to improve sleep quality.

Keywords: sleep tracking, lifestyle, accuracy, health, AI, AI features, ML

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Authors: Kenza Maher, Yahya Zakaria, Noora S. Al-Jaidah

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Temperature is a critical parameter for lithium-ion battery performance, life, and safety. In this study, four commercially available 18650 lithium-ion cells from four different manufacturers are subjected to accelerated cycle aging for up to 500 cycles at two different temperatures (25°C and 45°C). The cells are also calendar-aged at the same temperatures in both charged and discharged states for 6 months to investigate the effect of aging and temperature on capacity fade and state of health. The results showed that all battery cells demonstrated good cyclability and had a good state of health at both temperatures. However, the capacity loss and state of health of these cells are found to be dependent on the cell chemistry and aging conditions, including temperature. Specifically, the capacity loss is found to be higher at the higher aging temperature, indicating the significant impact of temperature on the aging of lithium-ion batteries.

Keywords: lithium-ion battery, aging mechanisms, cycle aging, calendar aging.

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Authors: Beatriz Mella Lira, Karla Yohannessen, Robin Hickman

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The aim of the paper is recognising inequalities through the self-assessment of health-related factors, in the context of daily mobilities in Santiago de Chile. Human capabilities will be used as the theoretical basis for the recognition and assessment of these factors regarding the functioning (what people are currently able to do) and capabilities (what people want to achieve and what is valuable for them), reflecting differences across social groups and among types of transport users. The self-assessment of health-related factors considers perceptions of stress, physical effort, proximity to other transport users, pollution, safety, and comfort. The types of transport users are classified as: private (cars, taxis, colectivos, motos), public (buses and metro) and active (bicycles and walking). The methodology follows a capability-based questionnaire, which was applied in different areas of Santiago de Chile, considering concepts extracted from the human capabilities list. The self-assessment of these health-related factors examines the context of peoples’ mobilities for performing their daily activities, considering socioeconomic differences as income, age, gender, disabilities, residence location and primary mode choice. The paper uses Relative Importance Index (RII) for weighting the relative influence or valuation of the factors. The respondents were asked to rate the importance of each factor on a scale from 1 to 5, in an ascending order of importance. The results suggest that these health-related factors impact not just the perceptions of users, but their well-being and their propensity for achieving their capabilities and the things they value in life. The paper is focused on the development of an applicable approach, measuring factors that should be included in transport project appraisal, as a more comprehensive and complementary method.

Keywords: active transport, health, human capabilities, Santiago de Chile, transport inequalities, transportation planning, urban planning

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Authors: A. Nazilah

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Floods are classified among sudden onset phenomenon and the highest natural disasters happen in Malaysia. Floods have a negative impact on mental health. Measuring the psychopathology symptoms among flood victims is an important step for intervention and treatment. However, there is a gap of a valid, reliable and an efficient instrument to measure flood victims' mental health, especially in Malaysia. This study aims to replicate the earlier studies of developing e-Psychological Instrument for Flood Victims (e-PIFV). The e-PIFV is a digital self-report inventory that has 84 items with 4 dimension scales namely stress, anxiety, depression, and trauma. Two replicated studies have been done to validate the instrument using expert judgment method. Results showed that content coefficient validity for each sub-scale of the instrument ranging from moderate to very strong validity. In study I, coefficient values of stress was 0.7, anxiety was 0.9, depression was 1.0, trauma was 0.6 and overall was 0.8. In study II, the coefficient values for two subscales and overall scale were increased. The coefficient value of stress was 0.8, anxiety was 0.9, depression was 1.0, trauma was 0.8 and overall was 0.9. This study supports the theoretical framework and provides practical implication in the field of clinical psychology and flood management.

Keywords: developing e-psychological instrument, content validity, instrument, mental health management, flood victims, psychopathology, validity

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Authors: Minna Pikkarainen, Yueqiang Xu

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The integration of digital technology with existing healthcare processes has been painfully slow, a huge gap exists between the fields of strictly regulated official medical care and the quickly moving field of health and wellness technology. We claim that the promises of preventive healthcare can only be fulfilled when this gap is closed – health care and self-care becomes seamless continuum “correct information, in the correct hands, at the correct time allowing individuals and professionals to make better decisions” what we call connected health approach. Currently, the issues related to security, privacy, consumer consent and data sharing are hindering the implementation of this new paradigm of healthcare. This could be solved by following MyData principles stating that: Individuals should have the right and practical means to manage their data and privacy. MyData infrastructure enables decentralized management of personal data, improves interoperability, makes it easier for companies to comply with tightening data protection regulations, and allows individuals to change service providers without proprietary data lock-ins. This paper tackles today’s unprecedented challenges of enabling and stimulating multiple healthcare data providers and stakeholders to have more active participation in the digital health ecosystem. First, the paper systematically proposes the MyData approach for healthcare and preventive health data ecosystem. In this research, the work is targeted for health and wellness ecosystems. Each ecosystem consists of key actors, such as 1) individual (citizen or professional controlling/using the services) i.e. data subject, 2) services providing personal data (e.g. startups providing data collection apps or data collection devices), 3) health and wellness services utilizing aforementioned data and 4) services authorizing the access to this data under individual’s provided explicit consent. Second, the research extends the existing four archetypes of orchestrator-driven healthcare data business models for the healthcare industry and proposes the fifth type of healthcare data model, the MyData Blockchain Platform. This new architecture is developed by the Action Design Research approach, which is a prominent research methodology in the information system domain. The key novelty of the paper is to expand the health data value chain architecture and design from centralization and pseudo-decentralization to full decentralization, enabled by blockchain, thus the MyData blockchain platform. The study not only broadens the healthcare informatics literature but also contributes to the theoretical development of digital healthcare and blockchain research domains with a systemic approach.

Keywords: blockchain, health data, platform, action design

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Authors: Adaobi Anakwe, Wilson Majee, Kari White, Rhonda BeLue

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Background: Black men in the U.S. have overall poorer health, are more likely to experience unintended pregnancies, and have pregnancies (with their partner) at younger ages than other racial/ethnic groups. These factors increase the likelihood that pregnancies among Black fathers will occur at suboptimal paternal health. Although several community-based programs exist to support low-income Black fathers’ involvement with their families, little is known about the sexual and reproductive health, and family planning needs of fathers enrolled in these programs. The objective of this study was to quantitatively examine the relationship between Black fathers’ fertility desires and pregnancy prevention strategies and qualitatively explore the nuances of this relationship. Methods: A concurrent mixed-methods approach was used to survey 36 and interview 13 Black fathers from low-income backgrounds, who were participating in a community-based fatherhood program in a Midwestern urban area. Fathers in this study were ≥18 years old with at least one child. Differences between groups were compared using Fisher’s Exact tests and thematic analyses to examine the relationship between participants' fertility desires and reproductive planning practices. Results: Participants had a median age of 33 years, and 72% were non-residential biological parents. About 40% of men desired pregnancy, and 69% reported they or their partner always used contraception. In bivariate analysis, participants’ fertility desires were not associated with pregnancy prevention (p=0.251). Although most interview participants desired pregnancies, several factors contributed to their ability to plan for a pregnancy. Men felt that using contraception to prevent pregnancies was dependent on navigating trust with a partner. Health before pregnancy and financial stability were also important. Overall, participants thought that using an adult mindset, in which they considered the consequences of unprotected sex, was key to family planning. Conclusion: Black fathers may not desire pregnancy and consider a variety of factors, but this does not always result in active pregnancy prevention/contraceptive use. Community-based organizations already working with Black fathers can be leveraged to increase reproductive health awareness and facilitate reproductive planning for fathers.

Keywords: reproductive planning, reproductive health, preconception health, Black fathers, fertility desires, pregnancy

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Authors: Job Bapyibi Guyson, Bangripa Kefas

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The advent of social media has no doubt provided platforms that facilitate the spread of fake news. The devastating impact of this does not only end with the prevalence of rumours and propaganda but also poses potential impact on individuals’ mental well-being. Therefore, this study on examining the impact of fake news on the mental health of residents in Jos metropolis among others interrogates the impact of exposure to fake news on residents' mental health. Anchored on the Cultivation Theory, the study adopted quantitative method and surveyed two the opinions of hundred (200) social media users in Jos metropolis using purposive sampling technique. The findings reveal that a significant majority of respondents perceive fake news as highly prevalent on social media, with associated feelings of anxiety and stress. The majority of the respondents express confidence in identifying fake news, though a notable proportion lacks such confidence. Strategies for managing the mental impact of encountering fake news include ignoring it, fact checking, discussing with others, reporting to platforms, and seeking professional support. Based on these insights, recommendations were proposed to address the challenges posed by fake news. These include promoting media literacy, integrating fact-checking tools, adjusting algorithms and fostering digital well-being features among others.

Keywords: fake news, mental health, social media, impact

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Authors: Diana Peninger

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Over 10% of couples in the U.S. have infertility problems, with roughly 40% traceable to the male partner. Yet, little attention has been given to improving men’s contribution to the conception process. One solution that is showing promise in increasing conception rates for IVF and other assisted reproductive technology treatments is a first-of-its-kind semen collection that has been engineered to mitigate sperm damage caused by traditional collection methods. Patients are able to collect semen at home and deliver to clinics within 48 hours for use in fertility analysis and treatment, with less stress and improved specimen viability. This abstract will share these findings along with expert insight and tips to help attendees understand the key role sperm collection plays in addressing and treating reproductive issues, while helping to improve patient outcomes and success. Our research was to determine if male reproductive outcomes can be increased by improving sperm specimen health with a focus on technology. We utilized a redesigned semen collection cup (patented as the Device for Improved Semen Collection/DISC—U.S. Patent 6864046 – known commercially as a ProteX) that met a series of physiological parameters. Previous research demonstrated significant improvement in semen perimeters (motility forward, progression, viability, and longevity) and overall sperm biochemistry when the DISC is used for collection. Animal studies have also shown dramatic increases in pregnancy rates. Our current study compares samples collected in the DISC, next-generation DISC (DISCng), and a standard specimen cup (SSC), dry, with the 1 mL measured amount of media and media in excess ( 5mL). Both human and animal testing will be included. With sperm counts declining at alarming rates due to environmental, lifestyle, and other health factors, accurate evaluations of sperm health are critical to understanding reproductive health, origins, and treatments of infertility. An increase in the health of the sperm as measured by extensive semen parameter analysis and improved semen parameters stable for 48 hours, expanding the processing time from 1 hour to 48 hours were also demonstrated.

Keywords: reprodutive, sperm, male, infertility

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Authors: Benjamin Mugisha Bugingo

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Healthcare staffhas been considered as asignificant pillar to the health care system. However, the contest of human resources for health in terms of the turnover of health workers in Uganda has been more distinct in the latest years. The objective of the paper, therefore, were to investigate the influence Role Human resource management functions in on employeeperformance of professional health workers in public district hospitals in Kampala. The study objectives were: to establish the effect of performance management function, financialincentives, non-financial incentives, participation, and involvement in the decision-making on the employee performance of professional health workers in public district hospitals in Kampala. The study was devised in the social exchange theory and the equity theory. This study adopted a descriptive research design using quantitative approaches. The study used a cross-sectional research design with a mixed-methods approach. With a population of 402 individuals, the study considered a sample of 252 respondents, including doctors, nurses, midwives, pharmacists, and dentists from 3 district hospitals. The study instruments entailed a questionnaire as a quantitative data collection tool and interviews and focus group discussions as qualitative data gathering tools. To analyze quantitative data, descriptive statistics were used to assess the perceived status of Human resource management functions and the magnitude of intentions to stay, and inferential statistics were used to show the effect of predictors on the outcome variable by plotting a multiple linear regression. Qualitative data were analyzed in themes and reported in narrative and verbatim quotes and were used to complement descriptive findings for a better understanding of the magnitude of the study variables. The findings of this study showed a significant and positive effect of performance management function, financialincentives, non-financial incentives, and participation and involvement in decision-making on employee performance of professional health workers in public district hospitals in Kampala. This study is expected to be a major contributor for the improvement of the health system in the country and other similar settings as it has provided the insights for strategic orientation in the area of human resources for health, especially for enhanced employee performance in relation with the integrated human resource management approach

Keywords: human resource functions, employee performance, employee wellness, profecial workers

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Authors: E. Bennion, A. Acharya, S. Barnes, D. Ferrell, S. Luckett-Cole, G. Mower, J. Nelson, Y. Nguyen

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Objective: This study aimed to evaluate the validity of a firearm injury query in the Early Notification of Community-based Epidemics syndromic surveillance system. Syndromic surveillance data are used at the Utah Department of Health for early detection of and rapid response to unusually high rates of violence and injury, among other health outcomes. The query of interest was defined by the Centers for Disease Control and Prevention and used chief complaint and discharge diagnosis codes to capture initial emergency department encounters for firearm injury of all intents. Design: Two epidemiologists manually reviewed electronic health records of emergency department visits captured by the query from April-May 2020, compared results, and sent conflicting determinations to two arbiters. Results: Of the 85 unique records captured, 67 were deemed probable, 19 were ruled out, and two were undetermined, resulting in a positive predictive value of 75.3%. Common reasons for false positives included non-initial encounters and misleading keywords. Conclusion: Improving the validity of syndromic surveillance data would better inform outbreak response decisions made by state and local health departments. The firearm injury definition could be refined to exclude non-initial encounters by negating words such as “last month,” “last week,” and “aftercare”; and to exclude non-firearm injury by negating words such as “pellet gun,” “air gun,” “nail gun,” “bullet bike,” and “exit wound” when a firearm is not mentioned.

Keywords: evaluation, health information system, firearm injury, syndromic surveillance

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Authors: Goodness Thandi Ntuli

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The cultural practice of ubuntombi (virginity) among the Zulus is not easily understood from the outside of its cultural context. The empirical study that was conducted through the interviews and focus group discussions about the retrieval of ubuntombi as a cultural practice within the Zulu cultural community indicated that there is a particular cultural identity and difference that can be unearthed from this cultural practice. Being explored from the postcolonial feminist perspective, this cultural identity and difference is discerned in the way in which a Zulu young woman known as intombi (virgin) exercises her power and authority over her own sexuality. Taking full control of her own sexuality from the cultural viewpoint enables her not only to exercise her uniqueness in the midst of multiculturalism and pluralism but also to assert her cultural identity of being intombi. The assertion of the Zulu young woman’s cultural identity does not only empower her to stand on her life principles but also empowers her to lift herself up from the margins of the patriarchal society that otherwise would have kept her on the periphery. She views this as an opportunity for self-development and enhancement through educational opportunities that will enable her to secure a future with financial independence. The underlying belief is that once she has been educationally successful, she would secure a better job opportunity that will enable her to be self-sufficient and not to rely on any male provision for her sustenance. In this, she stands better chances of not being victimized by social patriarchal influences that generally keep women at the bottom of the socio-economic and political ladder. Consequently, ubuntombi (virginity) as a Zulu heritage and cultural identity becomes instrumental in the empowerment of the young women who choose this cultural practice as their adopted lifestyle. In addition, it is the kind of self-empowerment with the intrinsic motivation that works with the innate ability to resist any distraction from an individual’s set goals. It is thus concluded that this kind of motivation is a rare characteristic of the achievers in life. Once these young women adhere to their specified life principles, nothing can stop them from achieving the dreams of their hearts. This includes socio-economic autonomy that will ensure their liberation and emancipation as women in the midst of social and patriarchal challenges that militate against them in the hostile communities of their residence. Another hidden achievement would be to turn around the perception of being viewed as the “other”; instead, they will have to be viewed differently. Their difference lies in the turning around of the archaic kind of cultural practice into a modern tool of self-development and enhancement in contemporary society.

Keywords: cultural, difference, identity, postcolonial, ubuntombi, zulus

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Authors: Ismail Becenen

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Air pollution, a consequence of urbanization brought about by modern life, is as global as it is local and regional. Because of the adverse effects of air pollution on human health, air quality is given importance all over the world. According to the decision of the World Health Organization, clean air is the basic necessity for human health and well-being. It poses a very high risk especially for heart diseases and stroke cases. In this study, the positive effects of natural gas usage on air pollution in cities are explained by using literature scans and air pollution measurement values. Natural gas is cleaner than other types of fuel. It contains less sulfur and organic sulfur compounds. When natural gas burns, it does not leave ashes, it does not cause problems in the rubbish mountains. It's a clean fuel, it easily burns and shines. It is a burning gas that is easy and efficient. In addition, there is not a toxic effect for people in case of inhalation. As a result, the use of natural gas needs to be widespread to reduce air pollution around the world in order to provide a healthier life for people and the environment.

Keywords: natural gas, air pollution, sulfur dioxide, particulate matter, energy

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Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: David Onen

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Staff exchanges amongst different work organizations are a growing international phenomenon. In higher education in particular, it is not only the staff participating on international exchange programs, but their students as well. The practice of exchanging staff is premised on the belief that participating members of staff would not only get the chance to network with colleagues from partner institutions but also gain the opportunity for knowledge sharing and skills development. As a result, it would not only benefit the participating individual staff but their institutions too. However, in practice, staff exchange programs everywhere are not all ‘a bed of roses’. In fact, some of the programs seem to be laden with unapparent source of trouble or danger for the participating staff. This paper is a report on an on-going study investigating the experiences of members of academic staff of Makerere University in Uganda who have ever participated on international staff exchange programs. The study is aimed at documenting individual experiences in order to stimulate, not only a debate, but practical ways of enriching the experiences of staff who engage on well-meant international staff exchange programs. The study has employed an exploratory survey research design in which self-administered questionnaire and interview guide are being used to collect data from university academic staff respondents selected through snow-ball and purposive sampling techniques. Data have been analysed with the use of appropriate descriptive and inferential statistics as well as content analysis techniques. Preliminary study findings reveal that the majority of the respondents (95.5%) were, to a large extent, fully satisfied with their participation on the staff exchange programs. Many attested to gaining new experience (97%), networking (75%), gaining new knowledge (94%), acquiring new skills (88%), and therefore bringing to their institutions something ‘new’ and ‘beneficial’. However, a reasonably large percentage (57%) of the participants too expressed dissatisfaction in the institutional support that Makerere University gave them during their participation on the exchange programs. Some respondents reported about the ‘unfriendly welcome’ they received upon returning ‘home’ because colleagues detested how they were chosen to participate on such programs. The researcher thus concluded that international staff exchange programs are truly beneficial to both the participating staff and their institutions though with pitfalls. The researcher thus recommended for mutual and preferably equal engagement of the participating institutions on staff exchange programs if such programs are to benefit both the participating staff and institutions. Besides, exchange programs require clear terms of cooperation including on how staff are selected, facilitated and what are expected of the sending and host institutions as well as the concerned staff.

Keywords: gains, exchange programs, higher education, pitfalls

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Authors: Srushti R. Joshi, Ujjwal Rakesh, Spoorthi Sripad

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The rapid advancement of remote sensing technologies has revolutionized plant health monitoring, offering valuable insights for precision agriculture and environmental management. This paper presents a comprehensive comparative analysis between the widely employed normalized difference vegetation index (NDVI) and state-of-the-art hyperspectral sensors in the context of plant health assessment. The study aims to elucidate the weigh ups of spectral resolution. Employing a diverse range of vegetative environments, the research utilizes simulated datasets to evaluate the performance of NDVI and hyperspectral sensors in detecting subtle variations indicative of plant stress, disease, and overall vitality. Through meticulous data analysis and statistical validation, this study highlights the superior performance of hyperspectral sensors across the parameters used.

Keywords: normalized difference vegetation index, hyperspectral sensor, spectral resolution, infrared

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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Authors: Susilo Susilo

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In the process of foreign language acquisition, L2 exposure has been evidently assumed efficient for learners to help increase their proficiency. However, to get enough L2 exposure in the context of learning English as a foreign language is not as easy as that of the first language learning context. Therefore, beyond the classroom L2 exposure is helpful for EFL learners to achieve the language tasks. Alongside the rapid development of technology and media, English as a foreign language is virtually used in the social media of almost all regions, affecting the faces of Teaching English as a Foreign Language (TEFL). This different face of TEFL unavoidably intrigues teachers to treat their students differently in the classroom in order that they can put more effort in maximizing beyond-the-class learning to help improve their in-class achievements. The study aims to investigate: 1) EFL teachers’ teaching skills and beliefs about students’ out-of-class activities in different L2 exposure environments, and 2) the effect on EFL teachers’ teaching skills and beliefs about students’ out-of-class activities of different L2 exposure environments. This is a survey for 80 EFL teachers from Senior High Schools in three regions of two provinces in Indonesia. A questionnaire using a four-point Likert scale was distributed to the respondents to elicit data. The questionnaires were developed by reffering to the constructs of teaching skills (i.e. teaching preparation, teaching action, and teaching evaluation) and beliefs about out-of-class learning (i.e. setting, process and atmosphere), which have been taken from some expert definitions. The internal consistencies for those constructs were examined by using Cronbach Alpha. The data of the study were analyzed by using SPSS program, i.e. descriptive statistics and independent sample t-test. The standard for determining the significance was p < .05. The results revealed that: 1) teaching skills performed by the teachers of English as a foreign language in different exposure environments showed various focus of teaching skills, 2) the teachers showed various ways of beliefs about students’ out-of-class activities in different exposure environments, 3) there was a significant difference in the scores for NNESTs’ teaching skills in urban regions (M=34.5500, SD=4.24838) and those in rural schools (M=24.9500, SD=2.42794) conditions; t (78)=12.408, p = 0.000; and 4) there was a significant difference in the scores for NNESTs’ beliefs about students’ out-of-class activities in urban schools (M=36.9250, SD=6.17434) and those in rural regions (M=29.4250, SD=4.56793) conditions; t (78)=6.176, p = 0.000. These results suggest that different L2 exposure environments really do have effects on teachers’ teaching skills and beliefs about their students’ out-of-class learning.

Keywords: belief about EFL out-of-class learning, L2 exposure environment, teachers of English as a foreign language, teaching skills

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Authors: Aryan Sood, Shruti Pathak, Dipanshu Chaudhary, Shreyanshi, Yogesh Pal

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In this comprehensive meta-analysis, the study delves into the widespread issue of body shaming, revealing its pervasive impact on various aspects of human life and its profound implications for mental health. The paper first explores the origins of body shaming, including societal norms, media influences, and interpersonal dynamics. It highlights the various forms it takes and its detrimental effects on self-esteem, body image, and psychological well-being. Particularly among adolescents and teenagers in today's social media-driven world, the pressure to conform to idealized beauty standards is significant, leading to negative consequences for their development and health. The research emphasizes the long-lasting mental health effects of body shaming, including depression, body dysmorphia, low self-esteem, and eating disorders. The study also discusses the emergence of body positivity movements as a means to challenge societal norms and promote inclusivity and empathy. Furthermore, the research addresses body shaming in the workplace and presents strategies to combat it, stressing the importance of awareness campaigns, education, and policy changes. In conclusion, the study underscores the critical need for a culture of acceptance and support, the promotion of positive body image, and efforts to mitigate the severe mental health toll that body shaming takes on individuals and communities. Overall, this research provides a comprehensive overview of body shaming, its root causes, and its far-reaching impacts on mental health and well-being. It highlights the urgency of addressing this issue in various contexts, from adolescence to the workplace, and offers solutions, such as awareness campaigns and societal changes, to foster a more inclusive and empathetic future.

Keywords: body shaming, mental health, age, gender, societal norms, appearance-based discrimination, cyberbullying, self-esteem, social media, depression, acceptance

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Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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Authors: Therese Besnard

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Internationally in early childhood education (ECE), the great majority of teachers are women. Some groups believe that a greater male teacher presence in ECE would be beneficial for children, specifically for boys as it could offer a positive male model. It is a common belief that children would benefit from being exposed to both male and female models. Some believe that women are naturally better suited to offer quality care to young children comparatively to men. Some authors bring forth that after equivalent training, differences in the educational practices are purely individual and do not depend on the teacher’s gender. Others believe that a greater male presence in ECE would increase the risk of pedophilia or child abuse. The few scientific studies in this area suggest that differences could exist between male and female ECE teacher, in particular when it comes to play which is the mainstay of the ECE educational program. Male teachers describe themselves as being more playful and having a greater tendency to initiate physical and turbulent play comparatively to female teachers, who describe themselves as favoring games that are calmer and focused on social interaction. Observed directly, male teachers appear more actively engaged in play with children and propose more motor play than female teachers. Furthermore children who have both male and female teachers for one year show less behavior difficulties when compared to children with only female teachers. Despite a variety of viewpoints we don’t know if the educational practices of male ECE teachers, (emotional support, classroom organization or instructional support) are different than the educational practices of female teachers and if these practices are linked with children’s adaptation. This study compares the educational practices of 37 ECE teachers (57 % male) and analyses the link with children' social adaptation (n=221). Educational practices were assessed through observational measurements with the Classroom Assessment Scoring System (CLASS) in a natural class environment. Child social adaptation was assessed with the Social Competence and Behavior Evaluation (SCBE). Observational data reveals no differences between men's and women's scale of the CLASS. Results using Multilevel models analyses suggest that the ability to propose good classroom organization and give good instructional support are linked with better child' social adaptation, and that is always true for men and women teachers. The results are discussed on the basis of their potential impact on future educational interventions.

Keywords: child social adaptation, early childhood education, educational practices, men teacher

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Authors: Sk Ajim Ali

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The present study is an attempt to overview on the major environmental and health impacts due to hazardous waste generation and poor management. In present scenario, not only hazardous waste, but as a common term ‘Waste’ is one of the acceptable and thinkable environmental issues. With excessive increasing population, industrialization and standardization of human’s life style heap in extra waste generation which is directly or indirectly related with hazardous waste generation. Urbanization and population growth are solely responsible for establishing industrial sector and generating various Hazardous Waste (HW) and concomitantly poor management practice arising adverse effect on environment and human health. As compare to other Indian state, West Bengal is not too much former in HW generation. West Bengal makes a rank of 7th in HW generation followed by Maharashtra, Gujarat, Tamil Nadu, U.P, Punjab and Andhra Pradesh. During the last 30 years, the industrial sectors in W.B have quadrupled in size, during 1995 there were only 440 HW generating Units in West Bengal which produced 129826 MTA hazardous waste but in 2011, it rose up into 609 units and it produced about 259777 MTA hazardous waste. So, the notable thing is that during a 15 year interval there increased 169 waste generating units but it produced about 129951 MTA of hazardous waste. Major chemical industries are the main sources of HW and causes of adverse effect on the environment and human health. HW from industrial sectors contains heavy metals, cyanides, pesticides, complex aromatic compounds (i.e. PCB) and other chemical which are toxic, flammable, reactive, and corrosive and have explosive properties which highly affect the surrounding environment and human health in and around he disposal sites. The main objective of present study is to highlight on the sources and components of hazardous waste in West Bengal and impacts of improper HW management on health and environment. This study is carried out based on a secondary source of data and qualitative method of research. The secondary data has been collected annual report of WBPCB, WHO’s report, research paper, article, books and so on. It has been found that excessive HW generation from various sources and communities has serious health hazards that lead to the spreading of infectious disease and environmental change.

Keywords: environmental impacts, existing HW generation and management practice, hazardous waste (HW), health impacts, recommendation and planning

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Authors: Juliet Sorensen, Anna Maitland

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Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.

Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Jianzhou Ni, Hua Fan

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It has been determined that supervisor support has a major influence on postgraduate students' academic emotions and is considered a method of successfully anticipating postgraduates' good psychological well-being levels. As a result, by assessing the mediating influence upon academic emotions for contemporary postgraduates in China, this study investigated the tight reciprocal relationship between psychological empowerment and positive mental well-being among postgraduates. To that end, a help enables a theoretical analysis of role clarity, academic emotion, and positive psychological health was developed, and its validity and reliability were demonstrated for the first time using the normalized postgrad relationship with supervisor scale, academic emotion scale, and positive mental scale, as well as questionnaire data from Chinese postgraduate students. This study used the cross-lagged (ARCL) panel model data to longitudinally measure 798 valid data from two survey questions polls taken in 2019 (T1) and 2021 (T2) to investigate the link between supervisor support and positive graduate student mental well-being in a bidirectional relationship of influence. The study discovered that mentor assistance could have a considerable beneficial impact on graduate students' academic emotions and, as a result, indirectly help learners attain positive mental health development. This verifies the theoretical premise that academic emotions partially mediate the effect of mentor support on positive mental health development and argues for the coexistence of the two. The outcomes of this study can help researchers gain a better knowledge of the dynamic interplay among three different research variables: supervisor support, academic emotions, and positive mental health, as well as fill gaps in previous research. In this regard, the study indicated that mentor assistance directly stimulates students' academic drive and assists graduate students in developing good academic emotions, which contributes to the development of positive mental health. However, given the restricted measurement time in this study's cross-lagged panel data and the potential effect of moderating effects other than academic mood on graduate students' good mental health, the results of this study need to be more fully understood and validated.

Keywords: supervisor support, academic emotions, positive mental health, interaction effects, longitudinal cross-lagged measurements

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Authors: Saba Nuzhat

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The present ethnographic study examines how domestic violence and authoritative knowledge affect the reproductive health of females; in terms of contraceptive behavior and induced abortion. This qualitative study has been conducted by collecting in depth informal interviews and case studies of 12 female respondents living in an urban slum of Keraniganj, located Dhaka city. The study depicts how multivariable factors are linked to a woman’s ability to contracept and make abortion decisions in a cultural context where being a wife infers to submission, limited mobility, sexual availability, and restricted autonomy on her own reproduction health. This study shows how violence is being normalized and socially acceptable, every time women do not adhere to go through expected gender roles. The study primarily explores the subjective experiences and perceptions of the females about contraceptive behavior as well as abortions from a medical anthropological perspective. A number of salient examples are highlighted into this paper where women who go through abortion or adopt various measures of contraceptives get highly influenced by authoritative knowledge or under the pressure of male dominance. The lack of female autonomy or prevalence of domestic violence challenges the gender equality of Bangladeshi society and female sovereignty in accessing sexual or reproductive rights. This paper remarks the significance of medical anthropological research that helps to understand the intricate interrelationship between authoritative knowledge and male dominance with female reproductive health in order to reduce women’s risk of experiencing domestic violence and to promote reproductive health autonomy for themselves for espousing contraceptive behaviors and abortion decisions.

Keywords: abortion, authoritative knowledge, contraception, domestic violence, reproductive health

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Authors: Arefeh Arabaninezhad, Ali Fakher

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Since the deterministic analysis methods fail to take system uncertainties into account, probabilistic and non-probabilistic methods are suggested. Geotechnical analyses are used to determine the stress and deformation caused by construction; accordingly, many input variables which depend on ground behavior are required for geotechnical analyses. The Random Set approach is an applicable reliability analysis method when comprehensive sources of information are not available. Using Random Set method, with relatively small number of simulations compared to fully probabilistic methods, smooth extremes on system responses are obtained. Therefore random set approach has been proposed for reliability analysis in geotechnical problems. In the present study, the application of random set method in reliability analysis of deep excavations is investigated through three deep excavation projects which were monitored during the excavating process. A finite element code is utilized for numerical modeling. Two expected ranges, from different sources of information, are established for each input variable, and a specific probability assignment is defined for each range. To determine the most influential input variables and subsequently reducing the number of required finite element calculations, sensitivity analysis is carried out. Input data for finite element model are obtained by combining the upper and lower bounds of the input variables. The relevant probability share of each finite element calculation is determined considering the probability assigned to input variables present in these combinations. Horizontal displacement of the top point of excavation is considered as the main response of the system. The result of reliability analysis for each intended deep excavation is presented by constructing the Belief and Plausibility distribution function (i.e. lower and upper bounds) of system response obtained from deterministic finite element calculations. To evaluate the quality of input variables as well as applied reliability analysis method, the range of displacements extracted from models has been compared to the in situ measurements and good agreement is observed. The comparison also showed that Random Set Finite Element Method applies to estimate the horizontal displacement of the top point of deep excavation. Finally, the probability of failure or unsatisfactory performance of the system is evaluated by comparing the threshold displacement with reliability analysis results.

Keywords: deep excavation, random set finite element method, reliability analysis, uncertainty

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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