Advances in Public Health
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Investigating the Effect of Prompt Treatment on Malaria Prevalence in Children Aged below Five Years in Zambia: A Nested Case-Control Study in a Cross-Sectional Survey

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Advances in Public Health publishes original research articles, review articles, and clinical studies in all areas of public health.

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Research Article

Evaluation of Cancer Patient Satisfaction: A Transversal Study in Radiotherapy Department, Hassan II University Hospital, Fez, Morocco

Patient satisfaction is an important quality outcome indicator of health care in the hospital setting. Patients are nowadays care-partners with caregivers. This relation is practically important for patients presenting chronic diseases, especially cancer. The aim of this study is to evaluate cancer patient satisfaction, treated at the Department of Radiotherapy in Hassan II University Hospital, and to study the different components of this satisfaction. A prospective transversal study was conducted between December 2016 and January 2017. Data was collected by three investigators based on structured interviews, a validated, anonymous and a standardized questionnaire. During this period, we have included 230 patients: 159 women (69.1%), 71 men (30.9%) and the sex ratio (women/men) was 2.23. Half of the investigated patients have never been schooled (52.61%). The majority had urban origin (71.3%) and 90% of patients declared being satisfied with the care at Radiotherapy department. 93.48% of cases recommended Radiotherapy department to other patients and 95.65% will want to continue their treatment at this department. Reception conditions were judged as favorable in 92.14%. Satisfaction rates regarding the availability of medical and paramedics, health-care workers were 86.52% and 83.9%, respectively. The quality of medical and paramedical care was judged as excellent or good in 78% cases. However, 44.34% of patients complained about the complexity of administrative formalities. 60.87% of cases judged that the waiting time was too long, whereas 31.4% of patients claimed that care-quality of their pain was insufficient or bad. The majority of patients declared being very satisfied or at least satisfied with different care services. For items that were judged as less satisfactory, some recommendations will be taken especially at the level of pain’s and palliative care as well as the organization of patients’ circuit inside the department. The satisfaction’s variations can be attributed to personally patients factors as well as systemic ones at the level of the hospital. Assessing and understanding these factors are essential in developing appropriate measures to improve patient satisfaction.

Research Article

Hygiene and Sanitation Practices and the Risk of Morbidity among Children 6–23 Months of Age in Kumbungu District, Ghana

Background. Poor hygiene and sanitation (WASH) practices are characterised by the manifestation of disease and infections, notably diarrhoea and respiratory tract infections (RTIs) among children. This study aimed to assess the influence of WASH practices on the occurrence of diarrhoea and RTIs among children 6–23 months of age. Methods. An analytical cross-sectional study design was conducted in June 2017. Systematic random sampling technique was used to select 300 mothers/caregivers with children aged 6–23 months from 9 communities in the Kumbungu District. We assessed the WASH practices, socio-demographic characteristics of the households and the occurrence of diarrhoea and RTIs among the children with a semi-structured questionnaire. The Hygiene Improvement Framework observational guide was adapted for household sanitation. Backward binary multiple logistic regression was used to determine the WASH practices that significantly predicted morbidity. Results. About 53% and 55.3% of the children reportedly experienced diarrhoea and RTIs, respectively, two weeks before the survey. Caregiver handwashing with soap after defecation [OR = 0.32 (95% C.I: 0.19, 0.52)] and before feeding [OR = 0.50 (95% C.I: 0.30, 0.84)] as well as washing the child’s hands with or without soap before feeding [OR = 0.21 (95% C.I: 0.04, 1.01)] were associated with lower odds of diarrhoea morbidity. The main determinants of RTI morbidity included caregiver handwashing with or without soap after defecation [OR = 0.29 (95% C.I: 0.10, 0.81)] and washing of the child’s hands with soap before feeding [OR = 0.60 (95% C.I: 0.37, 0.99)] However, we found no association between household sanitation and diarrhoea as well as RTI among the children. Conclusion. About a half each of the children had diarrhoea and RTI 2 weeks before the survey. The results emphasise the need for urgent targeting of handwashing and waste disposal programmes to avert the high burden of diarrhoea and RTIs among children.

Research Article

Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia

Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.

Research Article

Time Interval for Diagnosis of Tuberculosis and Related Expenditure in Selected Health Centers in Addis Ababa, Ethiopia

Background. Tuberculosis (TB) has continued to be a major health problem globally, in spite of the efforts to improve the diagnosis, treatment, and prevention. It affects millions of people each year and stands as the second cause of death due to infectious disease in the world. Early case finding and timely initiation of treatment is essential to ensure effective control of the disease as late diagnosis and treatment can aggravate the disease and result in poor outcomes and increase chances of transmission. Although TB services are supposed to be provided free of charge, TB affected families incur different types of costs in the process of seeking care, which might include health and nonhealth related costs. TB programs need to identify the underlying factors for delay and related expenditure for TB related services, in order to devise an effective strategy to reduce them. Therefore, the study aimed to assess the time interval between developing TB symptom until patients start anti-TB treatment and associated cost incurred by patients and families. Methods. This cross-sectional study was conducted among pulmonary TB patients who are bacteriologically confirmed, whose age is above 15 years and diagnosed at health centres in Addis Ababa. Results. The median time interval between onset of symptom and commencement of treatment was 4 weeks (IQR: 3, 6). Most patients with TB symptoms visited several health facilities before the final diagnosis was confirmed, the median number of visits being two, and only 48.8% were diagnosed on their first visit. Hence, they spent a lot of their limited resource in search of getting the right diagnosis. The total combined expenditure for all the visits was estimated to be median (IQR) 172.65 birrs (12, 671). Two variables were found to show statistically significant association with higher expenditure. Respondents who have good level of knowledge about TB are less likely to spend more than the median expenditure almost by a fifth compared to those with limited knowledge on TB, (adjusted odds ratio (AOR) = 0.2, with 95% confidence interval (CI): 0.06, 0.84). Patients who visited public hospitals were almost three times and those who visited private health facilities almost four times more likely to pay more than the median total expenditure, compared to those who visited health centre, AOR (95% CI) = 2.8 (1.53, 5.19) and AOR (CI) of 3.86 (1.06, 14.03), respectively. Conclusion. Patients with TB symptoms visit several health facilities till they are diagnosed, the median duration from onset of symptom till commencement of TB treatment being 4 weeks. It was noted that they face major expenses in the process of navigation to the right care. Two variables had statistically significant association with high pre-diagnosis expenditure, where patients with good level of knowledge about TB are less likely to spend more than the median, while patients who visited public hospitals or private health facilities had very high expenses. Improved public awareness about TB, minimizing service charges and other related fees, and further improvement in increasing access to services could reduce the length of time and expense for TB patients and their families. It is recommended to build capacity of health service providers to update them on programmatic approaches and latest diagnostic algorithm. It is important to strengthen public private partnership for TB services.

Research Article

Drivers of Food Choice among Pastoral/Agro-Pastoral Community in Somali Regional State, Eastern Ethiopia

Background. Although nutritional problems are among the Ethiopian government’s priorities, the progress of nutritional indicators in the pastoral/agro-pastoral community is below the national figure. This could be because of poor food choice decisions, which remains poorly understood. Therefore, this study aimed to explore the drivers of food choice among the pastoral/agro-pastoral community of Somali Regional State, Eastern Ethiopia. Materials and Methods. A qualitative study was conducted among 16 Focused Group Discussions (FGDs) and six Key Informant Interviews (KIIs) from May 7 to 27, 2018. Participants were selected purposefully. Native speakers of Somali language, who had previous qualitative data collection experience, collected the data. The overall collected data were cleaned, coded, sorted, categorized, and analyzed line-by-line. Content analysis was used to drive the key themes and sub-themes. Results. The study found that the commonest food item usually consumed by the community was porridge (“Shurow”), which is made from wheat or corn flour. The porridge is sometimes mixed with milk or butter. Besides, they consume boiled bean, wheat or sorghum (“Garaw”) that is mixed with oil or sugar. However, the consumption of fruits and vegetables was rare and seasonal. These all indicate that their feeding habit was monotonous with poor food choice decisions. The reported driving factors of food choice included drought, income, cost, availability and quality of foods, market access, familiarity with new foods, knowledge of nutritious foods, and health status of individuals. Conclusions. The food choice of the community was poor in the study area. Therefore, the health and agricultural sectors should work together to improve the feeding habits of this community by improving their knowledge and the availability of nutritious foods.

Research Article

The Role of Quality Improvement Process in Improving the Culture of Information among Health Staff in Ghana

Background. Over the past decades, knowledge and understanding have grown regarding the role that health information systems play in improving global health. Even so, using data to make evidence-informed decisions is still weak in most low- and middle-income countries. People do not always act on what they are told to do but act on sharing what is important and valued in an organization. Shared principles related to information systems are alluded to as a pre-existing culture of data collection or “culture of information” without specifying how these values originate and sustain themselves. They work in an organizational environment, which ultimately impacts them through organizational directives, principles, and practices. The objective of the study was to determines the role of quality improvement process in improving culture of information among health staff in Ghana, particularly in the Ejisu Juaben Health Service over time. Methods. A quasi-non-experimental pre- and post-intervention study was conducted in 26 health facilities in the Ejisu Juaben municipal health service of Ghana. The study involved assessment of perceived culture of information of staff coupled with training of 141 core staff selected from 26 facilities who were involved in data collection and use of information through application of data quality improvement training module over a twelve-month period. Results. Overall perceived promotion of culture of information improved from 71 percent in the baseline to 81 percent in the endline. Test-retest analysis suggested that the mean levels of the indices measuring promotion of a perceived culture of information, was significantly higher in endline compared to the situation in baseline. Conclusions. The study concluded that the improvement in staff perceived culture of information improved significantly overtime and this might have been contributed by the application and adoption of quality improvement training.

Advances in Public Health
 Journal metrics
Acceptance rate7%
Submission to final decision60 days
Acceptance to publication64 days
CiteScore-
Impact Factor-
 Submit

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