You searched for - Page 117 of 120 - APHRC

NATIONALLY STANDARDIZED CONTINUOUS ASSESSMENT TESTS AT VARIOUS GRADES FOR IMPROVED ACADEMIC ACHIEVEMENT

Quality of education is important and hence mere access to schooling and education is not an end in itself, rather, what matters most is access to quality education. In Kenya, the quality of education is mostly measured by the performance of pupils in their end of primary cycle examinations2. Those who do not perform well are not allowed to transit to secondary school. […]

MINISTRY OF EDUCATION TO REDUCE THE INCIDENCE OF SEXUAL HARASSMENT AND VIOLENCE AMONG GIRLS ATTENDING HIGH SCHOOLS IN KENYA BY 2015

Sexual violence and harassment in schools is a public health problem. It is detrimental to girls’ psychosomatic health; a fact that has been expressed by students, educators, and community officials throughout the last decade. Sexual violence is “…any sexual act, attempted sexual act, unwanted sexual comments or advances, or acts of trafficking women’s sexuality using coercion, threats of harm or physical force, by any person regardless of relationship to the survivor, in any setting, including but not limited to home and work.” […]

CLOSING THE PERFORMANCE GAP IN STUDENT LEARNING OUTCOMES BETWEEN PRIVATE AND PUBLIC SCHOOLS

In developing countries, school enrolment has increased tremendously over the past 10 years. For instance, between 2003 and 2008, primary school enrolment rates in sub-Saharan Africa increased by 18% with a number of countries recording gross enrolment rates above 100%. Despite these gains, learning outcomes have been declining raising fears that children are simply going through the school system with minimal learning. […]

STATUS REPORT ON THE SEXUAL AND REPRODUCTIVE HEALTH OF ADOLESCENTS LIVING IN URBAN SLUMS IN KENYA

Young people face numerous health challenges during their transition to adulthood. These challenges include, among others, limited access to sexual and reproductive health (SRH) information and services. Unmet SRH needs among adolescents may contribute to sexually transmitted infections (STIs), including HIV, and unintended pregnancies. Adolescent pregnancies are associated with several adverse outcomes, such as miscarriage, unsafe abortion, obstructed labor, and other complications, which can result in long-term morbidity and even death. Additionally, poor sexual and reproductive health outcomes can especially impact the status of young women, as they may face stigma from the community as well as diminished educational and employment opportunities. The long-term impacts of unmet SRH are also felt at population level, as high prevalence of HIV and high fertility rates place strains on communities and nations. As the world undergoes rapid urbanization, these strains will be increasingly felt in urban populations. […]

INCIDENCE AND COMPLICATIONS OF UNSAFE ABORTION IN KENYA: KEY FINDINGS OF A NATIONAL STUDY

Unsafe abortion is defined by the World Health Organization (WHO) as a procedure for terminating pregnancy, carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. Under the 2010 Kenyan constitution, abortion may be granted to a pregnant woman or girl, when in the opinion of a trained health professional, she needs emergency treatment or her life or health is in danger. Nevertheless, unsafe abortion remains a leading cause of maternal morbidity and mortality in Kenya. The treatment of complications of unsafe abortion also consumes significant health systems resources. In this report, we document findings from a recent nationwide study of the incidence of induced abortion and severity of complications of unsafe abortion in Kenya. The study was conducted in 2012 among a nationally-representative sample of Levels II to VI public and private health facilities. The Abortion Incidence Complications Methodology (AICM) and the Prospective Morbidity Methodology (PMM) were used as well-established and complementary approaches to estimate abortion incidence and the severity of unsafe abortion complications in Kenya. […]

THE ASSOCIATION OF UNWANTED PREGNANCY AND SOCIAL SUPPORT WITH DEPRESSIVE SYMPTOMS IN PREGNANCY: EVIDENCE FROM RURAL SOUTHWESTERN ETHIOPIA

Depression in pregnancy has adverse health outcomes for mothers and children. The magnitude and risk factors of maternal depression during pregnancy is less known in developing countries. This study examines the association between pregnancy intention, social support and depressive symptoms in pregnancy in Ethiopia.

Data for this study comes from a baseline survey conducted as part of a community- based cohort study that involved 627 pregnant women from a Demographic Surveillance Site (DSS) in Southwestern Ethiopia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during pregnancy. Data on depressive symptoms, pregnancy intention, social support and other explanatory variables were gathered using an interviewer-administered structured questionnaire. The association between independent variables and depressive symptom during pregnancy was assessed using multivariable logistic regression. […]

RISK FACTORS FOR SUBOPTIMAL ANTIRETROVIRAL THERAPY ADHERENCE IN HIV-INFECTED ADOLESCENTS IN GABORONE, BOTSWANA: A PILOT CROSS-SECTIONAL STUDY

Objective:

Little is known about factors associated with suboptimal antiretroviral treatment (ART) adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV)-infected adolescents at the Botswana-Baylor Children’s Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient’s clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (.95%) and virologic suppression (HIV viral load ,400 copies/mL). Multivariate logistic regression analysis was performed to identify independent predictors of ART non-adherence. Results: The overall median (interquartile range) ART adherence was 99% (96.5–100) (N = 82). Seventy-six percent of adolescents had excellent pill count ART adherence levels and 94% achieved virologic suppression. Male adolescents made up 65% of the non-adherent group (P = 0.02). Those who displayed suboptimal ART adherence were more likely to report having ever missed ART doses due to failure to pick up medication at the pharmacy (30.0% versus 9.7%, P = 0.03). In the multivariate logistic regression model, male sex (odds ratio [OR] 3.29, 95% confidence interval [CI] 1.13–9.54; P = 0.03) was the only factor which was independently associated with suboptimal ART adherence. […]

SPATIAL VARIATION OF VOLATILE ORGANIC COMPOUNDS AND CARBON MONOXIDE IN BLANTYRE CITY, MALAWI

This study assessed variations of ambient volatile organic compounds and carbon monoxide (CO) levels in Blantyre City, Malawi. Volatile organic compounds and carbon monoxide measurement was done using the Multi-Gas Monitor between August and December, 2010. Rapid urbanization and lack of standard enforcement on air pollution as well as lack of data on pollutant levels in the city prompted this study. The study focused on methane volatile organic compounds and non-methane volatile compounds besides carbon monoxide. Results of the analysis showed that non-methane volatile compound levels were highest at public bus terminuses with 12.40 ± 0.83 ppm, and lowest for industrial locations (2.16 ± 0.09 ppm). However, all points registered zero (0.00) ppm for methane volatile organic compounds. Similarly, mean levels of carbon monoxide were highest at public bus terminuses with 10.92 ± 0.74 ppm, and lowest for industrial locations (1.11 ± 0.13 ppm). With the exception of Ginnery Corner, all the sampling points had levels of both parameters within the air quality standards. The study revealed a spatial and diurnal variation of the pollutants in all sampling points. It further revealed that the sources of these pollutants are diverse with vehicular emissions being the main source for Masauko Chipembere highway. […]

STATISTICAL MODELING OF SOCIAL RISK FACTORS FOR SEXUALLY TRANSMITTED DISEASES AMONG FEMALE YOUTHS IN NIGERIA

Introduction:

Sexually transmitted diseases (STDs) are preventable, but the social risks factors connected to them are often not understood, particularly by female youths. There has been a dearth of information on the identification of social risk factors influencing STDs among female youths in Nigeria, hence we conducted this study. Methodology: This retrospective cross-sectional study utilized the Nigeria Demographic and Health Survey, 2008. It focused on female youths aged 15-24 (n=7,736) who ever had sexual intercourse. Data was analyzed using Chi-square and logistic regression models. Results: The mean age of the respondents was 20.2±2.5years. More female youths aged between 20 and 24 years contracted STDs in the last 12 months (2.5%) than those between the ages of 15 and 19 months (1.4%). A year prevalence of STDs among female youths in Nigeria was 2.1%. Socio-demographic factors such as age, education, wealth index, marital status, shared toilet, residence, contraceptive use, and total life-time number of sexual partners were found to be associated risk factors for contracting STDs (p<0.05). Controlling for potential confounding variables at the fifth iteration, the identified predictors of contracting STDs were wealth index, total lifetime number of sexual partners, awareness of HIV/AIDS, and shared toilet facility (p<0.05). Conclusions: The data confirmed the considerable impact of wealth index and awareness of HIV/AIDS as important predictors of STDs acquisition. Providing free condoms, along with teaching the importance of abstinence and improving knowledge of HIV/AIDS, can help to reduce the risk of STDs transmission. [...]

PERSPECTIVES ON THE ROLE OF STAKEHOLDERS IN KNOWLEDGE TRANSLATION IN HEALTH POLICY DEVELOPMENT IN UGANDA

Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. […]

NON-ATTENDANCE FOR OUT-PATIENT PHYSIOTHERAPY: EVALUATION PREDICTION AND PHYSIOTHERAPISTS’ PERCEPTION-A CROSS SECTIONAL STUDY

Non-attendance constitutes significant challenge at outpatient physiotherapy clinics. This study sought to estimate the rate of non-attendance for out-patient physiotherapy, to identify patients at risk of missing an appointment using a prediction model and to assess the perceptions of physiotherapists on factors influencing patient’s non-attendance. Materials and Methods: A 3-year retrospective audit of a Nigerian teaching hospital out-patient physiotherapy clinic was carried out. 1069 case charts were reviewed but only 930 were found valid for analysis. Data were gleaned on socio-demographic variables (age, sex, month of appointment and location of residence), referrer and diagnosis. The cross-sectional part of the study involved 60 consenting physiotherapists from selected hospitals from south-west, Nigeria. An adapted questionnaire was used to elicit perceived factors for patients’ non-attendance. Descriptive statistics of percentages were used to summarize data. Inferential statistics of logistic regression was used to obtain the predictive model for non-attendance at 0.05 alpha level. […]

REHABILITATION OF BACK EXTENSOR MUSCLES’ INHIBITION IN PATIENTS WITH LONG-TERM MECHANICAL LOW-BACK PAIN

Long-term mechanical low-back pain (LBP) results in inhibition and atrophy of the deep segmental muscles such as multifidus and overactivity of the longer superficial muscles of the trunk with resultant decreased dynamic activity and increased fatiguibility [1–4]. Long-term mechanical LBP is more difficult to treat [5–7] and treatment outcomes give variable results [8–10] and it consequently results in both physical and psychological deconditionings that trap the patient in a vicious circle characterized with decreased physical performance, exacerbated nociceptive sensations, depression, impaired social functioning, and work disability [11]. […]

PRACTICE, KNOWLEDGE AND PERCEPTIONS OF ANTENATAL CARE SERVICES AMONG PREGNANT WOMEN AND NURSING MOTHERS IN SOUTHWEST NIGERIA

High maternal death in Nigeria is a concern to public health practitioners. Knowledge and perception of antenatal care (ANC) by pregnant women and nursing mothers are important in usage of ANC facilities. This study bridged existing gap in inadequate report of perception and knowledge about ANC services. We conducted cross-sectional study among 460 randomly selected pregnant women and nursing mothers in Okitipupa local government area and used questionnaire to collect data on antenatal issues. ANC Knowledge was measured using point scores. We analyzed the data using descriptive statistics and Chi-square test (α=5.0%). Almost two third of respondents (64.1%) had negative perception about ANC. ANC know-ledge of about 15% was good, 61.1% moderate and 58(12.9%) was low. Age, husbands’ education level, place of ANC ser-vice, sources of information about ANC were significantly associated to knowledge and perceptions of ANC. Knowledge and utilization of ANC were high, but perception was inadequate. […]

RISK FACTORS IN THE TRANSMISSION OF TUBERCULOSIS IN NAIROBI : A DESCRIPTIVE EPIDEMIOLOGICAL STUDY

Tuberculosis is an infectious disease with an estimated 1.45 million deaths every year. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. A descriptive epidemiological study was conducted on 258 patients presenting with pulmonary tuberculosis. Patients’ sputa were collected for laboratory analysis and patients were required to respond to a structured questionnaire on risk factors for transmission. Data among stratified groups were compared using bivariate analysis. Statistical significance was considered at p < 0.05. [...]

FACTORS ASSOCIATED WITH NOT TESTING FOR HIV AND CONSISTENT CONDOM USE AMONG MEN IN SOWETO, SOUTH AFRICA

Besides access to medical male circumcision, HIV testing, access to condoms and consistent condom use are additional strategies men can use to prevent HIV acquisition. We examine male behavior toward testing and condom use. Objective: To determine factors associated with never testing for HIV and consistent condom use among men who never test in Soweto.Methods: A cross-sectional survey in Soweto was conducted in 1539 men aged 18–32 years in 2007. Data were collected on socio-demographic and behavioral characteristics to determine factors associated with not testing and consistent condom use. […]

HUMAN FACTORS AFFECTING THE QUALITY OF ROUTINELY COLLECTED DATA IN SOUTH AFRICA

Evaluations that have looked at the people aspect of the health information system in South Africa have only focused on the availability of human resources and not on competence or other behavioural factors.

Using the Performance of Routine Information System Management (PRISM) tool that assumes relationships between technical, behavioural and organizational determinants of the routine information processes and performance, this paper highlights some behavioural factors affecting the quality of routinely collected data in South Africa.

In the context of monitoring maternal and child health programmes, data were collected from 161 health information personnel in 58 health facilities and 2 district offices from 2 conveniently sampled health districts. A self-administered questionnaire was used to assess confidence and competence levels of routine health information system (RHIS) tasks, problem solving and data quality checking skills, and motivation. […]

HIV/AIDS STIGMA AND UTILIZATION OF VOLUNTARY COUNSELLING AND TESTING IN NIGERIA

Background:

Despite the recognition of stigma as a hindrance to public health treatment and prevention there are gaps in evidence on the relationship between HIV stigma and VCT services utilization in Nigeria. The purpose of this study was to examine a community’s perceptions, feelings and attitudes towards people living with HIV/AIDS and how this is associated with access to utilization of voluntary counselling and treatment in Nigeria. Methods: A cross-sectional random study of Nigerians, using a mixed-method approach was carried out in two distinct ethnic areas of the country. Both quantitative and qualitative methods (mixed-methods) were used to collect data in Osun State (Yoruba ethnic group) in the South-West and Imo State (Igbo ethnic group) in the South East. Multivariate logistic regression was the model used to examine the association of interest. Results: It is shown that Nigerian public attitudes to HIV/AIDS and those infected with the disease are negative. The markers for stigma on the overall stigma index are significant predictors of utilization of voluntary counselling and testing. As the sum of negative feelings increases, there is less likelihood to using voluntary counselling and testing (VCT) and vice versa.

Conclusions:

Current national efforts at addressing the AIDS pandemic can only be successful when the issue of AIDS is de-stigmatized and is made a critical part of those efforts. One way to do this is through well-designed messages that should be posted in the media, community halls, health centers and other public places aimed at humanizing the disease and those affected and infected by it. […]

LEVEL OF AWARENESS OF MAMMOGRAPHY AMONG WOMEN ATTENDING OUTPATIENT CLINICS IN A TEACHING HOSPITAL IN IBADAN, SOUTH-WEST NIGERIA

Background:

Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness. Methods: We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis. Results: The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR = 0.3, 95% CI, 0.12 – 0.73). Also, participation in community breast cancer prevention activities (OR = 3.4, 95% CI, 1.39 – 8.36), and previous clinical breast examination (OR = 2.34, 95% CI, 1.10 – 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about
mammography screening. […]

PATTERN OF MCKENZIE SYNDROMES AND DIRECTIONAL PREFERENCE IN PATIENTS WITH LONG-TERM MECHANICAL LOW- BACK PAIN

Failure of the plenitude of interventions in non-specific mechanical low-back pain (LBP) management is implicated on its heterogeneity. Identifying specific syndromes and subgroups of patients with mechanical LBP has been recognized as a recent development in LBP research. This study aimed to assess the pattern of McKenzie syndromes (MS) and directional preference (DP) of patients who were referred for physical therapy treatment of mechanical LBP. […]

DETERMINING AN ANTHROPOMETRIC SURROGATE MEASURE FOR IDENTIFYING LOW BIRTH WEIGHT BABIES IN UGANDA: A HOSPITAL-BASED CROSS SECTIONAL STUDY

Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. […]

DOES PRE-SURVEY TRAINING IMPACT KNOWLEDGE OF SURVEY ADMINISTRATORS AND SURVEY OUTCOMES IN DEVELOPING COUNTRIES? EVALUATION FINDINGS OF A TRAINING OF TRAINERS WORKSHOP FOR NATIONAL AIDS AND REPRODUCTIVE HEALTH SURVEY-PLUS IN NIGERIA

Although, Nigeria had conducted various national surveys followed by central and state level trainings for survey administrators, prior pre-survey trainings have not been systematically evaluated to assess their impact on knowledge gain and final outcome of the survey. A central training of trainers’ session was organized for master trainers on the conduct of the 2012 National AIDS and Reproductive Health Survey.To evaluate the impact of training on the quality of conduct of a national research survey in the 36 states and the Federal Capital Territory in Nigeria. […]

DIABETES AND PRE-DIABETES AMONG PERSONS AGED 35 TO 60 YEARS IN EASTERN UGANDA: PREVALENCE AND ASSOCIATED FACTORS

Our aim was to estimate the prevalence of abnormal glucose regulation (AGR) (i.e. diabetes and pre-diabetes) and its associated factors among people aged 35-60 years so as to clarify the relevance of targeted screening in rural Africa.

A population-based survey of 1,497 people (786 women and 711 men) aged 35-60 years was conducted in a predominantly rural Demographic Surveillance Site in eastern Uganda. Participants responded to a lifestyle questionnaire, following which their Body Mass Index (BMI) and Blood Pressure (BP) were measured. Fasting plasma glucose (FPG) was measured from capillary blood using On-Call® Plus (Acon) rapid glucose meters, following overnight fasting. AGR was defined as FPG ≥6.1mmol L-1 (World Health Organization (WHO) criteria or ≥5.6mmol L-1 (American Diabetes Association (ADA) criteria. Diabetes was defined as FPG >6.9mmol L-1, or being on diabetes treatment. […]

EXISTENCE AND FUNCTIONALITY OF EMERGENCY OBSTETRIC CARE SERVICES AT DISTRICT LEVEL IN KENYA: THEORETICAL COVERAGE VERSUS REALITY

The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both at national and lower levels of the health system. In a country with a high maternal mortality burden, the implication is that decision makers are unaware of the extent of need for life-saving care and, therefore, where to intervene. The objective of the study was to assess the actual existence and functionality of EmOC services at district level. […]

DRAMATIZING GENDER STEREOTYPES AND VIOLENCE WITHIN THE CONTEXT OF HIV/AIDS IN KENYA

Gender based violence is key among other factors in fanning the spread of the HIV/AIDS pandemic. Focusing on inequitable power relations, the lack of power to negotiate with the male partners, low economic status and inaccessibility to health care information puts women and girls at a much higher risk of contracting HIV/AIDS. This paper looks at the ways in which violence is dramatized based on the existing (mis)conceptions and misunderstandings of gender roles and sexuality within the H television program Siri. We argue that the persisting spread of HIV/AIDS could be partly blamed on the damaging expectations from the society and the gender and sexuality stereotypes that put both men an of contracting and further transmitting HIV/AIDS. The media has however been on the forefront in providing vital health care information on reproductive health, particularly on HIV/AIDS as well as providing forums which people can dialogue on a range of issues related to HIV/AIDS. […]

WOMEN’S LIVES MATTER : PREVENTING UNSAFE ABORTION IN KENYA

In Kenya, unsafe abortion has long been recognized as a leading cause of death and injury to women—deaths and injuries that are preventable. Most abortions result from unintended pregnancies, which, as in most of Africa, continue to be extremely high throughout Kenya.
A new national study undertaken in 2012 assessed the number of abortions annually in Kenya, the extent of unsafe abortion, the characteristics of women who seek abortion-related care in Kenyan health facilities and the quality of care available. In cooperation with the Kenyan Ministry of Health, the study was conducted in a large representative sample of 328 public and private health facilities across the nation, along with a survey of 124 health care professionals who are knowledgeable about issues of access to abortion care. […]