scholarly journals Return to Treatment in the Formal Health Care Sector: Evidence from Tanzania

2015 ◽  
Vol 7 (3) ◽  
pp. 29-57 ◽  
Author(s):  
Achyuta Adhvaryu ◽  
Anant Nyshadham
Keyword(s):  
Public Health ◽  
Health Care ◽  
Low Income ◽  
Health Care Sector ◽  
Health Facilities ◽  
Low Income Countries ◽  
Formal Sector ◽  
Health Goal ◽  
Public Health Goal ◽  
Formal Health Care

Improving access to the formal health care sector is a primary public health goal in many low-income countries. But the returns to this access are unclear, given that the quality of care at public health facilities is often considered inadequate. We exploit temporal and geographic variation in the cost of traveling to formal sector health facilities to show that treatment at these facilities improves short-term health outcomes for acutely ill children in Tanzania. Our results suggest that these improvements are driven in part by more timely receipt of and better adherence to antimalarial treatment. (JEL I11, I12, I15, I18, J13, O15)

scholarly journals Women who have sex with women’s experiences with healthcare system in low-income countries: qualitative findings from Dar-es-Salaam, Tanzania

2021 ◽  
Vol 2 (3) ◽  
pp. 142-145
Author(s):  
Happiness P. Saronga ◽  
Jackline V. Mbishi ◽  
Saidah S. Bakar ◽  
Switbert R. Kamazima
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Low Income ◽  
Dar Es Salaam ◽  
Health Facilities ◽  
Low Income Countries ◽  
Care Providers ◽  
Public Health Facilities

Introduction: Women who have sex with women (WSW) have a right to access health care. Many studies have reported lower access to health services by sexual minorities in many parts of the world. This study explored WSW’s experiences in accessing health care in Tanzania with the intention of determining specific issues facing WSW when accessing health care services. Methods: This study was cross-sectional descriptive, and retrospective conduced in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions (FGDs), in-depth interviews (IDIs), observation, and life stories. Data analysis applied thematic analysis. Results: Most WSW receive rightful health services from public and private health providers. However, transgender WSW face stigma, discrimination, and disrespect from some public health facilities. Private health care providers offer trust, privacy and confidentiality to WSW, although at a higher cost of services compared to public health facilities. Conclusion: Negative experiences with care may discourage WSW from seeking care or fully disclosing health concerns to providers limiting the extent of services offered.

Comparison of Various Treatment Modalities of Iron Deficiency Anemia in Pregnancy

2017 ◽  
Vol 1 (1) ◽  
pp. 23-26
Author(s):  
Pramya Nanjundan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Low Income ◽  
Low Income Countries ◽  
Treatment Modalities ◽  
Deficiency Anemia ◽  
Health Goal ◽  
Public Health Goal ◽  
Anemia In Pregnancy ◽  
In Pregnancy

ABSTRACT More than a quarter of the world’s population is anemic, with about one half of the burden from iron deficiency. Iron deficiency anemia occurs when iron deficiency is severe enough to diminish erythropoiesis and cause the development of anemia. The prevention and treatment of iron deficiency is a major public health goal especially in women, children, and individuals from low-income countries. How to cite this article Nanjundan P. Comparison of Various Treatment Modalities of Iron Deficiency Anemia in Pregnancy. World J Anemia 2017;1(1):23-26.

scholarly journals High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi

2020 ◽  
Vol 5 ◽  
pp. 199
Author(s):  
Marah G. Chibwana ◽  
Khuzwayo C. Jere ◽  
Raphael Kamng'ona ◽  
Jonathan Mandolo ◽  
Vincent Katunga-Phiri ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Serum Samples ◽  
Public Health Response ◽  
Response Planning ◽  
Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death.  We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

scholarly journals Evaluation of Health Facilities Capacity for the Management of Severe Preeclampsia and Eclampsia in Bayelsa State, Nigeria

2021 ◽  
pp. 78-86
Author(s):  
O. M. Alabintei ◽  
P. W. Alabrah ◽  
I. J. Abasi
Keyword(s):  
Health Care ◽  
Low Income ◽  
Care Delivery ◽  
Data Entry ◽  
Sampling Technique ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Low Income Countries ◽  
Multi Stage ◽  
Interview Guide

Background: The lack of properly-stocked facilities with basic and essential equipment and supplies as well as clinical guidelines required to successfully manage Pre-eclampsia/eclampsia (PE/E) has been reported in developing, low-income countries. It is necessary to ensure properly stocked health facilities for effective health care delivery. This study set out to assess the capacity of the health facilities in Bayelsa, Nigeria for the management of cases of eclampsia. Methods: A descriptive design was used in the conduct of this research in which 155 workers were recruited. A multi-stage sampling technique was employed to select health facilities for the study. The study instruments included a self-administered structured questionnaire, an interview guide, and an inventory checklist. Data entry, cleaning and analysis were done using the Statistical Package for Social Sciences (SPSS) version 22. Descriptive and inferential statistics were generated using the data. Results: It was found in this study that though MgSO4 was present in one (8.33%) primary and two (66.6%) secondary health facilities visited, no guide on how to administer and monitor the patients was available. The majority of the workforce in the primary health facility were the CHEW/CHO (48%), followed by midwives (16.9%) and then nurses (12.3%).Doctors constituted 7.7% while  pharmacists and pharmacist technicians constituted 6.2% and 9.2% respectively. Conclusion: In conclusion, this study revealed that facilities assessed lacked most of the basic and essential equipment, supplies and drugs, required for the successful management of PE/E. For effective management of cases of eclampsia, it is very essential that there should be a continuous supply of necessary tools, drugs and functioning equipment needed for the management of PE/E in all health care facilities.

scholarly journals High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi

2020 ◽  
Author(s):  
Marah Grace Chibwana ◽  
Khuzwayo Chidiwa Jere ◽  
Raphael kamng'ona ◽  
Jonathan Mandolo ◽  
Vincent Katunga-Phiri ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Serum Samples ◽  
Public Health Response ◽  
Response Planning ◽  
Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

scholarly journals Maternal deaths in developing countries: A preventable tragedy

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Gunnar Kvåle ◽  
Bjørg Evjen Olsen ◽  
Sven Gudmund Hinderaker ◽  
Magnar Ulstein ◽  
Per Bergsjø
Keyword(s):  
Public Health ◽  
Health Care ◽  
Maternal Mortality ◽  
Low Income ◽  
Health Care Systems ◽  
Health Problems ◽  
Low Income Countries ◽  
Public Health Importance ◽  
Maternal Deaths ◽  
Care Systems

The neglected tragedy of persistent high maternal mortality in the low-income countries is described. One of the millennium development goals states that the current number of maternal deaths of around 500,000 per year should be reduced by three quarters by 2015. Since the major causes and avenues for prevention are known, this may seem an achievable goal. It is concluded, however, that unless all stakeholders globally and within individual countries will demonstrate a real commitment to translate policy statements into actions, it is unlikely that the goal will be reached. A substantial increase in the resources for reproductive health care services is needed, and the human resource crises in the health care systems must be urgently addressed. Epidemiologists have an important role to play by designing randomized controlled trials for estimating the effect of different health care systems interventions aimed at reducing maternal mortality and other major health problems in low resource settings. The public health importance of such trials may be greater than the potential benefit of randomized trials for investigating effects of new vaccines and drugs. Within the field of perinatal epidemiology the disparity in public health importance of research conducted in the rich versus the poor world is glaring. Time is overdue for perinatal epidemiologists to turn their attention to the areas of the world where the maternal and perinatal health problems are overwhelming.

scholarly journals Poverty and user fees for public health care in low-income countries: lessons from Uganda and Cambodia

The Lancet ◽  
2006 ◽  
Vol 368 (9554) ◽  
pp. 2253-2257 ◽  
Author(s):  
Bruno Meessen ◽  
Wim Van Damme ◽  
Christine Kirunga Tashobya ◽  
Abdelmajid Tibouti
Keyword(s):  
Public Health ◽  
Health Care ◽  
Low Income ◽  
Public Health Care ◽  
User Fees ◽  
Low Income Countries

scholarly journals High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi

2020 ◽  
Vol 5 ◽  
pp. 199 ◽  
Author(s):  
Marah G. Chibwana ◽  
Khuzwayo C. Jere ◽  
Raphael Kamng'ona ◽  
Jonathan Mandolo ◽  
Vincent Katunga-Phiri ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Serum Samples ◽  
Public Health Response ◽  
Response Planning ◽  
Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death.  We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

scholarly journals Using Prospective Methods to Identify Fieldwork Locations Favourable to Understanding Divergences in Health Care Accessibility

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali
Keyword(s):  
Health Care ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Good Health ◽  
Low Income Countries ◽  
Care Services ◽  
Health Care Accessibility ◽  
Barriers To Health ◽  
Walking Time

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

scholarly journals COVID-19 pandemic: the implications of the natural history, challenges of diagnosis and management for care in sub-Saharan Africa

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lawrence Omo-Aghoja ◽  
Emuesiri Goodies Moke ◽  
Kenneth Kelechi Anachuna ◽  
Adrian Itivere Omogbiya ◽  
Emuesiri Kohworho Umukoro ◽  
...  
Keyword(s):  
Public Health ◽  
Natural History ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Diagnosis And Management ◽  
Severe Acute Respiratory Infection ◽  
Identification Technique ◽  
Sub Saharan ◽  
Policies And Programs

Abstract Background Coronavirus disease (COVID-19) is a severe acute respiratory infection which has afflicted virtually almost all nations of the earth. It is highly transmissible and represents one of the most serious pandemics in recent times, with the capacity to overwhelm any healthcare system and cause morbidity and fatality. Main content The diagnosis of this disease is daunting and challenging as it is dependent on emerging clinical symptomatology that continues to increase and change very rapidly. The definitive test is the very expensive and scarce polymerase chain reaction (PCR) viral identification technique. The management has remained largely supportive and empirical, as there are no officially approved therapeutic agents, vaccines or antiviral medications for the management of the disease. Severe cases often require intensive care facilities and personnel. Yet there is paucity of facilities including the personnel required for diagnosis and treatment of COVID-19 in sub-Saharan Africa (SSA). It is against this backdrop that a review of key published reports on the pandemic in SSA and globally is made, as understanding the natural history of a disease and the documented responses to diagnosis and management is usually a key public health strategy for designing and improving as appropriate, relevant interventions. Lead findings were that responses by most nations of SSA were adhoc, paucity of public health awareness strategies and absence of legislations that would help enforce preventive measures, as well as limited facilities (including personal protective equipment) and institutional capacities to deliver needed interventions. Conclusion COVID-19 is real and has overwhelmed global health care system especially low-income countries of the sub-Sahara such as Nigeria. Suggestions for improvement of healthcare policies and programs to contain the current pandemic and to respond more optimally in case of future pandemics are made herein.

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