BMC Public Health, Volume 18, Article number: 303 (2018)
https://doi.org/10.1186/s12889-018-5208-0
Published: 02 March 2018
Frontiers in Public Health | www.frontiersin.org 1 June 2017 | Volume 5 | Article 127
The authors conduct an integrated survey of Antimicrobial Resistant Organisms (AMR) in drinking water, wastewater and surface water in three settings in Bangladesh: rural households, rural poultry farms, and urban food markets. Results show that untreated water discharged from rural households, poul...try farms and urban markets are major contributors to surface water pollution and antibiotic resistant bacteria genes, calling for increased surveillance and monitoring.
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Cutaneous leishmaniasis (CL) is a neglected infectious endemic disease that is transmitted through the bite of a vector insect (sandfly) of the Lutzomyia genus,typical of rural geographical territories, and causes disfiguring skin ulcers and disabilities. It is estimated that CL affects between 600 ...000 and 1 000 000 people a year around the world, mainly in the America s, the Mediterranean basin, the Middle East and Central Asia. Eighteen of the 21 countries that make up the Latin American (LA) region are considered endemic areas for this neglected tropical disease. Colombia is one of the countries that reports the majority of global cases with 6161 in 2020 and has the second highest number of cases in the Americas, after Brazil.
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People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. Th...is case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.
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Follow-up care is crucial but challenging for disease management particularly in rural areas with limited healthcare resources and clinical capacity, yet few studies have been conducted from the perspective of rural primary care physicians (PCPs). We assessed the frequency of follow-up care delivere...d by rural PCPs for hypertension and type 2 diabetes – the two most common long-term conditions.
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The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family hom...es. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families.
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Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among... high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
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Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
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Similar to other parts of the world, the prevalence of type 2 diabetes mellitus (T2DM) in the Asia-Pacific Region has rapidly increased during the last few decades. The purposes of this pilot study were to determine the feasibility and the effects of a capacity building program for Village Health Vo...lunteers (VHVs) to support self-management in a T2DM high risk population from a rural subdistrict in Northeast Thailand. Both quantitative and qualitative data were collected using surveys, focus group discussions, and in-depth interviews. Data were analyzed and used to develop a 12-week capacity building program for VHVs. This program was then implemented on 60 subjects at high risk of T2DM in the selected community. According to the paired t-test and Wilcoxon-signed rank test, VHVs had higher scores on knowledge and self-efficacy of T2DM prevention after a 12 week intervention (p =.03 and p =.02, respectively). Study participants at risk for T2DM also had a significant increase in T2DM knowledge and self-management (p <.001). Implementation of the capacity building program for VHVs in Northeast Thailand was feasible. The key successes were strong community bonding, community empowerment, and support from family and public health nurses. Effects of the program should be examined with those in other Asia-Pacific countries.
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Rural Women Peace Link (RWPL) is a grassroots women-led organization
working in rural areas in the west of Kenya to promote local women’s
involvement in peace building, governance and development.
Guidelines for State Health Society and District Health Society