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Mar 2020 DOI 10.14302/issn.2641-4538.jphi-20-3261
Dzinamarira TafadzwaCorresponding author
Department of Public Health, Mount Kenya University Rwanda, Kigali, Rwanda
Efforts to control the Human Immunodeficiency Virus epidemic in Rwanda have seen remarkable success over the years. Effective antiretroviral therapy has played great role in improving longevity among people living with HIV/AIDS (PLWH). While this is the case, there are various nutritional challenges, which are often faced, among PLWH. Guided by the Rwanda country guidelines for nutritional management for PLWH and WHO recommendations, this study aimed to explore the perspectives of health care providers (HCPs) working with PLWH on nutritional challenges faced by their clients in Kigali, Rwanda. We conducted a qualitative study using in-depth interviews to collect data. A non-probability purposive sampling was employed to recruit HCPs. Data analysis was based on the naturalistic paradigm. We followed the hybrid approach in conducting thematic analysis. Three themes were identified. First, HCPs had good knowledge on nutritional requirements for PLWH. They demonstrated good communication skills and adequate counseling skills that were necessary for addressing concerns on nutrition from their clients. Secondly, it emerged that HCPs perceived a lack of resources to be the major challenge faced in nutritional management of their clients. From theme three, it emerged that, from HCPs experiences, food insecurity and lack of feeding supplements were the main causes of malnutrition among PLWH in Kigali, Rwanda. From the HCPs perspective, there is a need to improve healthcare institutions capacity to manage nutritional challenges faced by PLWH. To achieve this, policy makers need to channel adequate resources for this cause.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author
Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Aug 2022 DOI 10.14302/issn.2641-4538.jphi-22-4245
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
This study investigated the healthcare provider’s knowledge and attitudes towards induced abortion in Rwanda. A total of 152 healthcare providers from six public hospitals in Kigali city participated in this study. Questionnaires were used to record data on demographics, level of knowledge and attitudes towards abortion law then be cleaned, coded and entered into Excel sheet. Then all data were exported into SPSS version 22 for final cleaning and analysis. The study findings revealed that 54.6% were female, 56.0% were single, and 73% participants said that they attended formal training on abortion care. The study findings revealed that 23.70% healthcare providers had poor knowledge towards legal abortion law, and 57.20% had positive attitude with regards to induced abortion law. The findings revealed that religion and formal training on abortion care were among the factors which were strongly influencing attitudes of health care providers towards induced abortion where protestants were unlikely to have positive attitude with regards to induced abortion (AOR=0.277; 95% CI=0.027-0.377; P=<0.001) compared to participants belonged to catholic religion and participants who were not trained were unlikely to have positive attitude with regards to induced abortion (AOR=0.696; 95% CI=0.056-0.721; P=0.048) compared to trained respondents. It concludes that marital status, category of caregiver, religion, formal training on abortion and level of knowledge were the main risk factors of level of attitude towards induced abortion. More training about induced abortion are highly needed among health care providers to increase related knowledge as well as to eliminate negative attitude towards induced abortion.
Nov 2021 DOI 10.14302/issn.2641-4538.jphi-21-4001
Bartholomew KathleenCorresponding author
United States
The lived experiences of thousands of health care providers demonstrates an inconguence in values while giving us a tremendous amount of information - if we listen. At every level behaviors are compromised in a structure when the values of the providers are not aligned with the system. Over time, statistics as well as disease become so normalized that the status quo dominates perceptions and inhibits action. The United States will continue to have mediocre to poor outcomes unless the ethical foundation of the system is fundamentally altered to profit on wellness. “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” Buckminster Fuller 1
Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526
Bekele AnbessaCorresponding author
Pharmacy School, Health Institute, Jimma University, Ethiopia
Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.
Mar 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3231
Patel NaiyaCorresponding author
University of Louisville, Department of Health management and Policy
Health services research is a multidisciplinary field which involves policy makers, health care providers, as well as quality outcomes professionals of the health services provided in an organizational setting to name some. Using qualitative research methodology to get insights of both the provider and patient experience down the pipeline can help strengthen what is lacking. Bridging the gap of translation research by not just surveys 1 might be an appropriate research methodology, however, inclusion of case studies, ethnographies might help stakeholders in the field, to visualize in depth phenomenon occurring in health services research field. Telly medicine, commercial digital health status trackr might be some of the inetrventions to improvise health care services, however, knowing what are the actual needs at individual level might efficiently help in redistribution of resources or policy laws. Recruiting for clinical trials through story telling communication technology2,3, might help in recruitment for novel drug therapies to explore possibilities, however, exploring the barriers to enroll for the clinical trials, or why the drug might work effectively in some cultural population and why not on others, can only be efficiently explored through qualitative research methodologies.
Feb 2019 DOI 10.14302/issn.2574-612X.ijpr-18-2564
Patel PritteshCorresponding author
C. G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Bardoli
The widely held belief that emotional and psychological processes affect our physical health, mental health and general well-being are central to a holistic view of the individual, and as such, it is a useful foundational concept in integrative medicine. The purpose of this paper is to review substantial amounts of the latest research and recent findings on this issue to enable us to throw some light on how inhibitory factors to emotional expression and experience can endanger our health, both physically and psychologically including our general wellbeing. In addition, the connection between repression of emotion and certain mental disorders like depression and scientifically proven healthy ways to manage issues bordering on emotion was outlined. The information contained in this paper is just as important to health care providers and also to the patients they deal with