Knowledge of Family Planning and Access to Sexual and Reproductive Health Services by Immigrant Youth in Hillbrow, South Africa: A Cross-sectional Study.

Background: For countries to achieve the Sustainable Development Goals (SDGs) especially SDG3.7- universal access to Sexual and Reproductive Health (SRH) care services including information and education for family planning, immigrant youth must be ensured access to SRH services. This study examines the determinants of knowledge about family planning (KFP) and access to SRH services by sexually active immigrant youth in Hillbrow, South Africa.Methods: This cross-sectional study of 467 immigrant youth aged 18-34 years used a multistage-sampling technique. Data were collected using interviewer-administered questionnaires on socio-demographic, migration, KFP and access to SRH services from government health facilities. Unadjusted and adjusted logistic regression models were used to determine levels of KFP and access to SRH services among 437 sexually active youth. Results: The main sources of information on SRH issues were radio/television (38.7%) and friends (22.8%). Over half of the respondents have adequate KFP, while two out of five indicated a lack of access to SRH services from government health facilities. In the adjusted models, the determinants of having KFP were being a female (AOR= 3.85, CI: 2.33–6.35, belonging to the age groups 25–29 years (AOR=2.13, CI: 1.12–4.04; and 30–34 years (AOR=3.88, CI: 2.00–7.53); belonging to the middle and rich wealth index (AOR=1.84, CI: 1.05–3.20) and (AOR=2.61 (1.34–5.08) respectively. Not having received information about family planning (AOR=0.16, CI=0.09–0.28) and not using a contraceptive at the time of the survey (AOR=0.36, CI: 0.18–0.70) were associated with reduced odds of KFP. The determinants of having access to government health facility for SRH services were being a female (AOR=2.95, CI: 1.87–4.65), being 30–34 years of age (AOR=1.91, CI: 1.08–3.39), and not having received information about family planning (AOR=0.44, CI=0.27–0.73). Conclusion: Majority of the survey respondents lack access to information about family and SRH services provided by government health facilities, which resulted in them depending on unreliable sources of information about SRH issues. There is a need to advocate for universal access to SRH services, inclusive of immigrant youth in South Africa, to curb negative SRH outcomes and to achieve SDG 3.7.

Minimum Dietary Diversity and Associated Factors Among Pregnant Women Attending Antenatal Care in Government Health Facilities of Soro District, Hadiya Zone, Southern Ethiopia

Background: Dietary diversity is a good proxy indicator for micronutrient adequacy in pregnant women. Despite some improvements in dietary intake among pregnant mothers, achieving the minimum dietary diversity among them is still a great challenge in Ethiopia. There are no enough studies done on minimum dietary diversity among pregnant women and factors identified were more of local based. Therefore this study determined the prevalence of minimum dietary diversity and its associated factors among pregnant women attending antenatal care in government health facilities of Soro district, Hadiya Zone, Southern Ethiopia.Methods: This is the facility based study conducted in government health facilities of Soro district, Hadiya Zone from Oct. 2020-Jan 2021. Cross sectional study design was undertaken by using systematic sampling on 422 pregnant women attending antenatal care. Both bivariate and multivariable logistic regression analysis were used to assess the association of independent variables with outcome variable.Result: From the total of the 422 study subjects, 416 pregnant women attending antenatal care were participated in the study and making the response rate 98.6 percent. The overall prevalence of pregnant mothers who have met the minimum dietary diversity was only 7.9%. Maternal educational status being grade nine above, eating meal more than three times per day and women being currently not married were factors found to be significantly associated with minimum dietary diversity among pregnant mothers attending antenatal care in government health facilities.Conclusion: The prevalence of the minimum dietary diversity among pregnant women attending ANC in public health facilities of Soro district was very low and far from national and international recommendations to enhance the maternal food diversity. Inter sectoral collaboration is very important to enhance the minimum dietary diversity during pregnancy and should be worked intensively and in an integrated manner.

SOSIALISASI PENCEGAHAN STUNTING MELALUI PENYULUHAN DAN PEMBERIAN MAKANAN TAMBAHAN KEPADA IBU HAMIL

ABSTRAKMasalah stunting menjadi isu penting yang harus diselesaikan secara bersama-sama. Faktor kemiskinan dan pengetahuan yang rendah menjadi faktor utama yang harus dihadapi untuk pencegahan stunting. Pencegahan stunting harus dilakukan sedini mungkin, sejak janin masih di dalam kandungan. Periode 1000 hari pertama anak harus diselamatkan. Untuk menekan jumlah stunting harus ada kerjasama antara pemerintah, dinas kesehatan, dinas sosial dan masyarakat luas. Salah satu cara menekan stunting adalah dengan peningkatan kesadaran stunting melalui sosialisasi dan pendampingan. Pengabdian dilaksanakan oleh tim KKN kelompok 24 yang berkerjasama dengan fakultas teknologi dan industri Pangan Universitas Slamet Riyadi Surakarta serta pemerintah Kelurahan Semanggi. Kelurahan Semanggi kecamatan pasar Kliwon termasuk salah satu Desa dengan angkat stunting tinggi. Pelaksanaan kegiatan dimulai dari FGD. Hasil FGD menunjukkan bahwa bahnya masyarajat Desa Semanggi masih memiliki pengetahuan dan kesadaran yang rendah terhadap penanggulangan bahya stunting. Untuk itu Tim KKN Kelompok 24 memulai kegiatan dengan pendataan dengan tujuan mendapatkan data terbaru jumlah ibu hamil di Kelurahan Semanggi, Hasil pendataan menunjukkan bahwa terdapat 55 ibu hamil yang 34 diantaranya termasuk dalam program keluarga miskin (GAKIN). Setelah pendataan dilanjutkan dengan penyusunan materi, pembuatan video penyuluhan, proses penyuluhan dan terahir evaluasi dan pemberian makanan tambahan untuk ibu hamil. Hasil penyuluhan menunjukkan bahwa ibu hamil menjadi lebih memahami bahaya stunting dan terjadi peningkatan upaya pencegahan dari diri sendiri. Kata Kunci: pencegahan stunting; pemberian makanan tambahan (PMT) ABSTRACTThe problem of stunting is an important issue that must be solved together. Poverty and low knowledge are the main factors that must be faced for stunting prevention.Prevention of stunting must be done as early as possible, since the fetus is still in the womb. The period of the first 1000 days of the child must be saved. To reduce the number of stunting, there must be cooperation between the government, health services, social services and the wider community. One way to suppress stunting is to increase awareness of stunting through socialization and mentoring. The service is carried out by a group of 24 KKN team in collaboration with the Faculty of Technology and Food Industry, Slamet Riyadi University, Surakarta and the Semanggi Village government.Semanggi Village, Pasar Kliwon Subdistrict, is one of the villages with high stunting rates. The implementation of activities starts from the FGD. The results of the FGD showed that the people of Semanggi Village still had low knowledge and awareness of stunting prevention. For this reason, the KKN Group 24 Team started activities with data collection with the aim of getting the latest data on the number of pregnant women in Semanggi Village. After data collection, it was continued with the preparation of materials, making counseling videos, the counseling process and finally evaluating and providing additional food for pregnant women. The results of the counseling showed that pregnant women became more aware of the dangers of stunting and there was an increase in self-prevention efforts. Keywords: stunting prevention; supplementary feeding

Cross-sectional assessment of government health center needs to implement long-acting reversible contraception services in rural Rwanda

Background There is unmet need for family planning in Rwanda. We previously developed an evidence-based couples’ family planning counseling (C)FPC program in the capital city that combines: (1) fertility goal-based family planning counseling with a focus on long-acting reversible contraceptive (LARC) for couples wishing to delay pregnancy; (2) health center capacity building for provision of LARC methods, and (3) LARC promotion by community health workers (CHW) trained in community-based provision of oral and injectable contraception. From 2015 to 2016, this service was integrated into eight government health centers in Kigali, reaching 6072 clients and resulting in 5743 LARC insertions. Methods From May to July 2016, we conducted cross-sectional health center needs assessments in 30 rural health centers using surveys, key informant interviews, logbook extraction, and structured observations. The assessment focused on the infrastructure, materials, and human resources needed for LARC demand creation and provision. Results Few nurses had received training in LARC insertion [41% implant, 27% intrauterine device (IUD)]. All health centers reported working with CHW, but none trained in LARC promotion. Health centers had limited numbers of IUDs (median 10), implants (median 39), functional gynecological exam tables (median 2), and lamps for viewing the cervix (median 0). Many did not have backup power supplies (40%). Most health centers reported no funding partners for family planning assistance (60%). Per national guidelines, couples’ voluntary HIV counseling and testing (CVCT) was provided at the first antenatal visit at all clinics, reaching over 80% of pregnant women and their partners. However, only 10% of health centers had integrated family planning and HIV services. Conclusions To successfully implement (C)FPC and LARC services in rural health centers across Rwanda, material and human resource capacity for LARC provision will need to be greatly strengthened through equipment (gynecological exam tables, sterilization capacity, lamps, and backup power supplies), provider trainings and follow-up supervision, and new funding partnerships. Simultaneously, awareness of LARC methods will need to be increased among couples through education and promotion to ensure that demand and supply scale up together. The potential for integrating (C)FPC with ongoing CVCT in antenatal clinics is unique in Africa and should be pursued.

FUNGSI RAGAM BAHASA PENJUAL IKAN DI PASAR OKA LAMAWALANG, KECAMATAN LARANTUKA, KABUPATEN FLORES TIMUR

This article describes the diversity of languages ​​formed by the development of society in various aspects of life which includes various social activities, such as trade, government, health, education, and religion. The variety of languages ​​has functions such as the variety of languages ​​used by fish sellers in Oka market, Lamawalang, Larantuka District, East Flores Regency which grows and develops especially among speakers of the fish seller community. This variety of languages ​​can be found when fish sellers offer their fish to buyers where there is language contact, between Indonesian and local languages. The functions of various languages ​​used by fish sellers in the Oka Lamawalang market, Larantuka District, East Flores Regency with the Oka Lamawalang dialect include (1) instrumental (directive) functions, such as seducing, convincing, and asking, (2) interactional or interaction functions, such as asking , forms of interaction in the form of rejection and forms of agreement interaction, (3) representational or representational (declarative) functions such as showing and expressing, (4) personal functions, such as joy and disappointment.

Urbanization and Health Conditions in Nigeria: Dealing with the Urban Health Challenges

Health concerns arising from urbanization requires serious commitment to revamp the Nigerian health sector. In that regards, this study sought to investigate the influence of urbanization and health expenditure on life expectancy and mortality rates in Nigeria from 1981 to 2020. The fully modified ordinary least squares (FMOLS) technique was used to ascertain the influence of urbanization and government health expenditure on life expectancy and mortality rates in Nigeria. From the result of FMOLS, it was observed that urbanization exerts a positive and significant effect on life expectancy; but exerts a negative and significant effect on mortality rates. Moreover, government health expenditure generated a negative and significant effect on life expectancy, but a positive and significant effect on adult mortality. As such, the 15% recommended by the World Health Organization should be given a top priority in order to alleviate the country out of the menace of health tourism that has bedevilled the country over the years.

Development of Government Health System in Sri Lanka during Last Three Decades

Aims: Several aspects are associated with the health system. Development in each aspect in health sector is required parallel to the growth of the population of patients. This study was carried out with the intention of investigating the development in physical resources, human resources, and funds allocation for government health system in Sri Lanka. Methodology: This study considered the development within the period from 1987 to 2019. Necessary data were collected from the annual reports of central bank of Sri Lanka. Data for physical resources, human resources, patients, and expenditures were gathered. Parallel developments of these aspects were analyzed by using descriptive and confirmatory techniques: Pearson’ correlation and canonical correlation. Apart from that some graphical techniques and summary measures were also used in the analysis. Results: Number of both in-patients and out-patients has rapidly increased during this period, while expenditure on the health system also has exponentially grown. However, percentage of GDP allocated for health system has remained almost same. There can be seen a reasonable development in both human resources and physical resources. Conclusion: Even though, health system has been developed to a greater extent, developments in some aspects are not parallel to the development in other aspects. However, further development is needed to meet the growing demand for health services due to increasing population of patients.

How West African countries prioritize health

Background The goal of Universal Health Coverage (UHC) is to ensure that everyone is able to obtain the health services they need without suffering financial hardship. UHC remains a mirage if government health expenditure is not improved. Health priority refers to general government health expenditure as a percentage of general government expenditure. It indicates the priority of the government to spend on healthcare from its domestic public resources. Our study aimed to assess health priorities in the Economic Community of West African States (ECOWAS) using the health priority index from the WHO’s Global Health Expenditure Database. Method We extracted and analysed data on health priority in the WHO’s Global Health Expenditure Database across the 15 members of the ECOWAS (Benin, Burkina Faso, Cabo Verde, Cote d'Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo) from 2010 to 2018 to assess how these countries prioritize health. The data are presented using descriptive statistics. Results Our findings revealed that no West African country beats the cutoff of a minimum of 15% health priority index. Ghana (8.43%), Carbo Verde (8.29%), and Burkina Faso (7.60%) were the top three countries with the highest average health priority index, while Guinea (3.05%), Liberia (3.46%), and Guinea-Bissau (3.56%) had the lowest average health priority in the West African region within the period of our analysis (2010 to 2018). Conclusion Our study reiterates the need for West African governments and other relevant stakeholders to prioritize health in their political agenda towards achieving UHC.

Conspiracy Theorists and Con Men

This chapter discusses the 1930s through the 1960s, an anomalous period of American history in which the people’s confidence in major national institutions was at its peak. Most people trusted government health regulators, the medical establishment, and pharmaceutical companies to do the right thing. Consequently, medical freedom of choice activism occurred mainly on society’s margins, voiced by peddlers of fraudulent products and right-wing cranks. The most persistent and cantankerous promoter of medical freedom during this period was the National Health Federation (NHF), the publisher of “Health Freedom News.” This organization, founded by manufacturers of dietary supplements and quack medical devices, resisted FDA regulation of alternative treatments, as well as the fluoridation of municipal water supplies. Although the NHF sometimes exemplified paranoid, Red-Scare politics, it also employed more conventional libertarian arguments of the sort that infused medical freedom rhetoric in other periods of American history.

Outpatient cardiovascular diseases and diabetes medicines dispensing in the population with government health insurance in Syria between 2018 and 2019: a retrospective analysis

Background Low- and middle-income countries bear the highest burden of non-communicable diseases (NCDs) mortality and morbidity. Syria has undergone an epidemiological transition from infectious diseases to NCDs in the past decades. Despite the high prevalence of cardiovascular diseases (CVDs) and diabetes in Syria, little is known about medicines utilization or prescriptions for these diseases. The aims of this study are to present the patterns and rates of dispensing medicines used for CVDs and diabetes among patients with government health insurance in Syria and examine age, sex, and regional variation in the dispensing of these medicines. Methods Outpatient data from June 2018 to May 2019 on dispensed medicines for 81,314 adults with government health insurance were obtained. The dispensing rate was expressed as the number of defined daily doses (DDDs) per 1000 beneficiaries per day (DID). The DID is a measurement that is used in drug utilization research to control for differences or changes in population size between or within countries. The number of DIDs was adjusted according to beneficiaries’ sex, age, and governorate. Results Beneficiaries received 302.09 DIDs of CVDs medicines and 35.66 DIDs of diabetes medicines, including 0.96 DID of insulin (2.99% of the total of diabetes medicines). CVDs and diabetes medicine dispensing rates were low during the study period and included very low rates of insulin dispensing compared to the dispensing rates of these medicines in other countries in East Mediterranean Region or in Europe. We found lower dispensing rates of CVDs medicines among female beneficiaries (249.59 DIDs) than male beneficiaries (388.80 DIDs). Similarly, the dispensing rates of diabetes medicines among female beneficiaries (29.42 DIDs) were lower than those among male beneficiaries (45.98 DIDs). In addition, there were lower rates of CVDs and diabetes medicines and very low to no dispensing of insulin in some governorates that were partly controlled by the Syrian government compared to other governorates that were completely or mostly controlled by the Syrian government. Conclusions Additional efforts are needed to raise awareness about the prevention and management of CVDs and diabetes especially among females in Syria and consider cultural issues that might influence access to healthcare services. There is a crucial need to address the political and geographical challenges caused by the conflict which have limited access to CVDs and diabetes medicines in some regions in Syria.