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Research Article
Analysis of Trends in Immunization Coverage Inequalities Among Children Aged 12–23 Months in Guinea: Data from Demographic and Health Surveys in 2005, 2012, and 2018
Niouma Nestor Leno*
,
Abdoulaye Maciré Camara,
Daniel William Athanase Leno,
Kadio Jean-Jacques Olivier Kadio,
Moussa Fanta Keita,
Sékou Solano,
Iya Condé,
Sékou Sidate Sylla,
Serge Manitu Mayaka
Issue:
Volume 12, Issue 6, December 2024
Pages:
178-188
Received:
28 September 2024
Accepted:
18 October 2024
Published:
13 November 2024
Abstract: Background: The aim of this study was to describe trends in inequalities in full immunization of children aged 12 to 23 months and to identify associated socioeconomic factors. Methods: A secondary analysis was carried out using data from three Demographic and Health Surveys (DHS) conducted in 2005, 2012 and 2018 in the Republic of Guinea. The concentration, or Lorenz curve, and associated index were used to measure inequalities over time. Multivariate logistic regression was employed to identify socioeconomic factors associated with full vaccination of children aged 12 to 23 months. Results: The study found a strongly positive overall concentration index (CI > 0.5) for complete vaccination of children aged 12 to 23 months, indicating inequalities in favor of wealthier households. This inequality decreased in 2012 but increased again in 2018. Children from wealthy families were nearly twice as likely to be fully vaccinated compared to children from very poor families (adjusted OR 1.79, 95% CI: 1.38 - 2.32). Conclusion: This study revealed significant inequalities favoring wealthy families in the use of immunization services by children aged 12 to 23 months in Guinea. It also underscores the need for planning and implementing strategies to reduce these inequalities in access to and use of immunization services.
Abstract: Background: The aim of this study was to describe trends in inequalities in full immunization of children aged 12 to 23 months and to identify associated socioeconomic factors. Methods: A secondary analysis was carried out using data from three Demographic and Health Surveys (DHS) conducted in 2005, 2012 and 2018 in the Republic of Guinea. The conc...
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Methodology Article
Achieving Healthcare Value through Care Plan Accountability
John Rezen*
Issue:
Volume 12, Issue 6, December 2024
Pages:
189-193
Received:
19 September 2024
Accepted:
30 October 2024
Published:
29 November 2024
Abstract: U.S. medical costs continue to outpace the GDP despite the introduction of multiple accountable care efforts established to reduce unnecessary expenditures. These increasing costs have a negative impact on patients who are experiencing increased out-of-pocket expenses as well as employers who must shoulder a large part of the healthcare cost burden. While there are multiple societal factors contributing to the rising medical costs, our healthcare system can play a more effective role in addressing this problem. This role begins with fundamental changes to our reimbursement systems placing an emphasis on individual plans of care and adding greater accountability through free market controls. A comprehensive plan of care lays out the roles of care plan participants across medical, social, and behavioral services with a corresponding budget covering all the services provided as well as the expected outcomes from each service. An initial free market control is patient authority to accept or reject the plan of care with a corresponding financial responsibility for compliance in care plan execution. The elements of provider accountability include a public provider performance reporting system across quality, costs and patient satisfaction factors as well as a reimbursement system that incentivizes effective care planning and execution. This shift in focus from incremental care to care planning and execution combined with the institution of pro-competitive and financial accountability measures is expected to bring greater value to healthcare by improving patient outcomes while reducing medical costs.
Abstract: U.S. medical costs continue to outpace the GDP despite the introduction of multiple accountable care efforts established to reduce unnecessary expenditures. These increasing costs have a negative impact on patients who are experiencing increased out-of-pocket expenses as well as employers who must shoulder a large part of the healthcare cost burden...
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Research Article
Challenges of Community Health Nurses During Postnatal Home Visitation in Selected Districts of the Ashanti Region, Ghana
Yvonne Agyeman-Duah*,
Million Bimerew
Issue:
Volume 12, Issue 6, December 2024
Pages:
194-200
Received:
31 October 2024
Accepted:
18 November 2024
Published:
29 November 2024
Abstract: Introduction: Efforts have been made to improve maternal and child health care globally, with a focus on promoting postnatal care for mothers and babies. In spite of the known significance of postnatal visits for enhancing maternal and child health care, concerns still exist regarding maternal and infant health care in the Ashanti Region and Ghana as a whole. The study aimed to explore and describe the challenges experienced by community health nurses that may have an impact on postnatal home visitation in selected districts of the Ashanti Region, Ghana. Method: Qualitative research method was used to collect data. Semi-structured interviews were conducted using 15 CHNs. Data were analysed using a thematic content analysis approach. Results: Two main themes and six categories emerged from the overall analysis of the data from the CHNs. One theme emerged based on the objective of the study and the other theme emerged based on the analysis of the responses of the participants. Themes emerged include: challenges of postnatal home visitation and preparation for and responsibilities during postnatal visits. Conclusion: The study concludes that postnatal home visits face significant challenges due to institutional limitations, socio-cultural barriers, and mother-related issues, which can hinder effective care. Additionally, community health nurses (CHNs) strive to provide essential services through preparation, skills application, and ongoing education.
Abstract: Introduction: Efforts have been made to improve maternal and child health care globally, with a focus on promoting postnatal care for mothers and babies. In spite of the known significance of postnatal visits for enhancing maternal and child health care, concerns still exist regarding maternal and infant health care in the Ashanti Region and Ghana ...
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Research Article
Early Discontinuation of Implanon and Its Determinants Among Women Who Ever Used Implanon: A Cross-Sectional Study in Oromia Region of Ethiopia
Damitu Gudina Defa,
Legesse Tadesse Wodajo*
Issue:
Volume 12, Issue 6, December 2024
Pages:
201-211
Received:
29 October 2024
Accepted:
15 November 2024
Published:
3 December 2024
Abstract: Introduction: Contraceptive utilization reduces maternal mortality and improves child survival. The reasons for ineffective practices need proper exploration. However, in the study area, information on the level of early Implanon discontinuation and contributing factors is scarce. Objective: To assess early Implanon discontinuation and associated factors among women seeking Implanon removal services in public health facilities in Asalla Town, Oromia Region, Ethiopia, 2021. Methods and materials: A facility-based cross-sectional study was conducted from March 27, 2021, to April 27, 2021, among 388 Implanon user women. They were selected by using a systematic random sampling technique. The data were collected by a structured questionnaire using a face-to-face interviewer and entered Epi Info version 7 and exported to SPSS version 21 for analysis. Then the early Implanon discontinuation and related factors were analyzed using logistic regression. Factors that have significant association declared using p values less than 5% with 95%. Results: A total of 388 participants responded to the questionnaires, for a response rate of 100%. Among the users of Implanon, 318 (83.7%) discontinued treatment early. Husband educational level (primary) (adjusted OR=0.06 (95% CI: 0.01-0.56), no husband (adjusted OR=0.06 (95% CI: 0.01-0.41), women who needed to go abroad (adjusted OR, 0.09: 95% CI(0.02-0.39)), age (25-29 years) (adjusted OR=0.15 (95% CI: 0.03-0.86) and number of children (adjusted OR=0.04 (95% CI: 0.02-0.78)) were significantly associated with Implanon discontinuation. Conclusion and recommendation: The early Implanon discontinuation rate in this study was very high (83.7%). Having educated partner and more number of children (4-5) were more likely to continue the LARCs, while having no husband and a need to go oversea had less drive than husband objection towards early removal among the study group. The age between 25-29 years were related with more sustained use of LARCs to the expected period than those in 15-19. Effort should be made to address women's health and fertility in the programs to increase the continuation rate of Implanon use.
Abstract: Introduction: Contraceptive utilization reduces maternal mortality and improves child survival. The reasons for ineffective practices need proper exploration. However, in the study area, information on the level of early Implanon discontinuation and contributing factors is scarce. Objective: To assess early Implanon discontinuation and associated f...
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Research Article
The Impact of Quarrying Activities on Air Quality and Public Health: A Case Study in Warwickshire
Issue:
Volume 12, Issue 6, December 2024
Pages:
212-218
Received:
21 October 2024
Accepted:
7 November 2024
Published:
10 December 2024
Abstract: Poor air quality is well-documented for its links to health issues such as asthma, cancer, and autoimmune diseases, posing particularly high risks to children and vulnerable populations. This study utilizes a mixed-methods approach to evaluate the air pollution levels that school students and local residents are currently exposed to, along with the potential impact of a proposed 220-acre sand and gravel quarry, which would increase heavy goods vehicle (HGV) traffic near the community. Monitoring was conducted in multiple locations, including the village High Street, a 250-student primary school, a private residence opposite the school, and 350 meters from an active quarry site. Results indicate that levels of particulate matter (PM10 and PM2.5) frequently exceeded both national and WHO safety thresholds, particularly during peak traffic hours, which exacerbated the decline in air quality. If the new quarry is approved, air pollution levels are expected to further increase due to intensified HGV traffic and additional emissions from quarry activities, raising serious concerns about potential health impacts on local residents. For over twenty years, planning officers, regulatory bodies, and developers have relied predominantly on desktop modelling to assess the health risks associated with quarry activities, often using outdated and limited data that fail to capture the current conditions and real-world risks. Authorities maintain that there is "no evidence" of health risks for residents near quarries, a claim based on the absence of direct scientific studies rather than conclusive safety. This research underscores the urgent need for robust, ground-level data to inform decision-making and safeguard public health, particularly given the increased exposure risks to children attending school within the impact zone. The study’s findings strongly suggest that new quarrying activities could significantly compromise local air quality and increase health risks, highlighting the inadequacies of current regulatory assessments.
Abstract: Poor air quality is well-documented for its links to health issues such as asthma, cancer, and autoimmune diseases, posing particularly high risks to children and vulnerable populations. This study utilizes a mixed-methods approach to evaluate the air pollution levels that school students and local residents are currently exposed to, along with the...
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