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Sample records for mtwara rural district

  1. Effectiveness of community based Safe Motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania.

    Science.gov (United States)

    Mushi, Declare; Mpembeni, Rose; Jahn, Albrecht

    2010-04-01

    In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  2. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

    Directory of Open Access Journals (Sweden)

    Jahn Albrecht

    2010-04-01

    Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  3. Modeling Student Performance in Mathematics Using Binary Logistic Regression at Selected Secondary Schools a Case Study of Mtwara Municipality and Ilemela District

    Science.gov (United States)

    Mabula, Salyungu

    2015-01-01

    This study investigated the performance of secondary school students in Mathematics at the Selected Secondary Schools in Mtwara Municipality and Ilemela District by Absenteeism, Conduct, Type of School and Gender as explanatory Factors. The data used in the study was collected from documented records of 250 form three students with 1:1 gender…

  4. The forgotten 'coastal forests' of Mtwara, Tanzania: a biologically ...

    African Journals Online (AJOL)

    ... of Mtwara, Tanzania: a biologically impoverished and yet important ecosystem. ... and endemism values in these forests, and high levels of forest disturbance. ... of modest biological importance within the context of the Eastern Arc Mountains ...

  5. Quality Improvement for Maternal and Newborn Health in Mtwara ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Maternal and newborn health outcomes in southern Tanzania's Mtwara region are poor ... rates were similar when comparing home births with health facility births. ... and newborn health care services, better care-seeking, and improved health ...

  6. Assistive Technology Service Delivery in Rural School Districts

    Science.gov (United States)

    Ault, Melinda Jones; Bausch, Margaret E.; Mclaren, Elizabeth M.

    2013-01-01

    Little is known about the implementation of assistive technology (AT) services for students in rural areas. This study investigated the AT service delivery in 10 rural districts across six states. The results indicated that students use AT across functional areas, but considerably fewer number of devices than do those not living in rural areas. AT…

  7. Youth Involvement In Rural Development Activities In Ogba District ...

    African Journals Online (AJOL)

    . This is because they are major stakeholders in the development process. This study investigates youth involvement in rural development activities in Ogba district of Rivers state, Nigeria. Data was collected from 120 randomly selected youths ...

  8. Managing Smallness: Promising Fiscal Practices for Rural School District Administrators.

    Science.gov (United States)

    Freitas, Deborah Inman

    Based on a mail survey of over 100 rural school administrators in 34 states, this handbook outlines common problems and successful strategies in the financial management of rural, small school districts. Major problems are related to revenue and cash flow, increasing expenditures, providing quality education programs, and staffing to handle the…

  9. Rural Poultry Production in Ondo South Senatorial District Area of ...

    African Journals Online (AJOL)

    Rural Poultry Production in Ondo South Senatorial District Area of Ondo State, Nigeria. ... African Journal of Livestock Extension ... The need to obtain baseline information on rural poultry with respect to their population and the production potentials of the indigenous chicken under the village conditions in Ondo Area formed ...

  10. Rural Districts Left Behind? Rural Districts and the Challenges of Administering the Elementary and Secondary Education Act

    Science.gov (United States)

    Yettick, Holly; Baker, Robin; Wickersham, Mary; Hupfeld, Kelly

    2014-01-01

    The purpose of this study was to inform the upcoming and overdue reauthorization of the Elementary and Secondary Education Act (ESEA) by exploring whether rural school districts face disadvantages as they attempt to follow the law's provisions and, if so, if the law's rural-specific section ameliorates these disadvantages. The research drew upon…

  11. Rural district hospitals - essential cogs in the district health system - and primary healthcare re-engineering.

    Science.gov (United States)

    le Roux, K W D P; Couper, I

    2015-06-01

    The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

  12. Does Urbanization Affect Rural Poverty? Evidence from Indian Districts

    OpenAIRE

    Calì, Massimiliano; Menon, Carlo

    2013-01-01

    Although a high rate of urbanization and a high incidence of rural poverty are two distinct features of many developing countries, there is little knowledge of the effects of the former on the latter. Using a large sample of Indian districts from the 1983-1999 period, the authors find that urbanization has a substantial and systematic poverty-reducing effect in the surrounding rural areas....

  13. The maintenance of competence of rural district hospital medical ...

    African Journals Online (AJOL)

    District hospital doctors are likely to have educational needs covering surgery, emergency and trauma, in-patient as well as out-patient care at primary service level, an understanding of the rural context and role of other health workers, public-health skills, and teamwork. Given such a broad curriculum, some prioritisation ...

  14. The Impact of Tourism on Rural Development: The Kwabre District ...

    African Journals Online (AJOL)

    This paper assesses the traditional craft-based tourism industry in the Kwbre District of Ghana . It investigates specific crafts namely adinkra making, kente weaving and wood carving with the view to highlight their potentials for harness and use as the basis for the development of rural tourism-based economies. The paper ...

  15. Leading Change for the Implementation of Common Core State Standards in Rural School Districts

    Science.gov (United States)

    Lopez, Paul; Wise, Donald

    2015-01-01

    Rural school districts across the nation, with their limited resources, face daunting challenges posed by the implementation of the Common Core State Standards. This article presents a recent study of 13 rural school districts in the Central Valley of California and how these districts are responding to those challenges. A total of 352 teachers…

  16. Social marketing in a rural African district.

    Science.gov (United States)

    Kipp, W; Kabwa, P; Mwesigye, B

    1992-01-01

    21 focus group discussions were held in 5 locations of Kabarole district, Uganda, with 200 male and female participants to assess the demand for and acceptability of condoms in the region. The discussions were also held to obtain information related to the design of products and motivational materials, and included people believed to engage in high-risk sex, lower-risk members of the general population, and shop owners. Condoms and condom use are strongly desired within this population, with participants expressing interest in high-quality products of uniform size which are continuously available at convenient outlets. Moreover, shop and pharmacy owners were more than willing to display subtle messages about condoms and advertise their availability. The main barriers to use were low female acceptance, unavailability, societal attitudes, high cost, and the inability to buy condoms at night when shops are closed. Feedback led to the development of the logo of a man holding a spear and a shield and the adoption of the brand name Engabu, Rutooro terminology for a wooden shield. Comparatively stronger, yet sensitive, brown condoms were eventually packaged in dark brown wrappings in groups of 5. Vendors are offered the packets of 5 condoms for US$0.06, which they are expected t sell at US$0.08; owners expressed the preference for slot-box distribution containers. In addition, people in the sales network were all trained so they could explain proper condom use to clients. A post-study assessment found people content with the product and its presentation, so the social marketing program was officially launched in September, 1992. Condoms were sold heavily in the 1st few weeks of the program despite the lack of media and newspaper coverage per national government condom policy. Knowledge of the availability of condoms will instead be spread through counseling and health education sessions, seminars, and informal talks.

  17. Equity for Rural School Districts: The Final Report of the Countryside Council's School Finance Task Force.

    Science.gov (United States)

    Wiener, Steve

    Soaring values of agricultural land have created inequities in funding between urban and rural school districts in Minnesota. The state's Foundation Aid to school districts is formulated so that districts of high property valuation receive less Foundation Aid than those districts with low property valuation. In recent years inflation has had…

  18. Children Education Investment of Rural Families in Hechuan District of Chongqing Municipality

    Institute of Scientific and Technical Information of China (English)

    Xiaoling SONG; Dan YANG; Xiaohong SONG

    2015-01-01

    Taking 20 relative poor families in Hechuan District of Chongqing Municipality as survey samples,taking 275 households of rural families selected by stratified sampling method as research objects,and taking family education investment behavior of this rural area as research content,this paper studied current situations of rural family education investment behavior in Hechuan District,difference in investment behavior and related influence factors. It is intended to provide references for family education investment of rural areas in Hechuan District and even Chongqing Municipality,and promote development of rural education undertaking in China.

  19. Spontaneous adverse drug reaction reporting in rural districts of Mozambique.

    Science.gov (United States)

    Sevene, Esperança; Mariano, Alda; Mehta, Ushma; Machai, Maria; Dodoo, Alexander; Vilardell, David; Patel, Sam; Barnes, Karen; Carné, Xavier

    2008-01-01

    The roll out of various public health programmes involving mass administration of medicines calls for the deployment of responsive pharmacovigilance systems to permit identification of signals of rare or even common adverse reactions. In developing countries in Africa, these systems are mostly absent and their performance under any circumstance is difficult to predict given the known shortage of human, financial and technical resources. Nevertheless, the importance of such systems in all countries is not in doubt, and research to identify problems, with the aim of offering pragmatic solutions, is urgently needed. To examine the impact of training and monitoring of healthcare workers, making supervisory visits and the availability of telecommunication and transport facilities on the implementation of a pharmacovigilance system in Mozambique. This was a descriptive study enumerating the lessons learnt and challenges faced in implementing a spontaneous reporting system in two rural districts of Mozambique - Namaacha and Matutuíne - where remote location, poor telecommunication services and a low level of education of health professionals are ongoing challenges. A 'yellow card' system for spontaneous reporting of adverse drug reactions (ADRs) was instituted following training of health workers in the selected districts. Thirty-five health professionals (3 medical doctors, 2 technicians, 24 nurses, 4 basic healthcare agents and 2 pharmacy agents) in these districts were trained to diagnose, treat and report ADRs to all medicines using a standardized yellow card system. There were routine site visits to identify and clarify any problems in filling in and sending the forms. One focal person was identified in each district to facilitate communication between the health professionals and the National Pharmacovigilance Unit (NPU). The report form was assessed for quality and causality. The availability of telecommunications and transport was assessed. Fourteen months after

  20. The Poor Little Rich District: The Effects of Suburbanization on a Rural School and Community

    Science.gov (United States)

    Howley, Aimee; Carnes, Marilyn; Eldridge, Anita; Huber, Donna; Lado, Longun Moses; Kotler, Ruth; Turner, Maryalice

    2005-01-01

    Contextualized in relationship to other case studies about rural districts that have experienced population growth and decline as well as in relationship to the small sociological literature on "boom towns," this study considered the dynamics that seem to be interfering with one previously rural and now suburbanizing district's ability to address…

  1. Estimating the Efficiency of Michigan's Rural and Urban Public School Districts

    Science.gov (United States)

    Maranowski, Rita

    2012-01-01

    This study examined student achievement in Michigan public school districts to determine if rural school districts are demonstrating greater financial efficiency by producing higher levels of student achievement than school districts in other geographic locations with similar socioeconomics. Three models were developed using multiple regression…

  2. Mobility and Access for Off-Road Rural Farmers in West-Akim District

    African Journals Online (AJOL)

    Mobility and Access for Off-Road Rural. Farmers in West-Akim District. Esther Yeboah Da11so-Wired11. Abstract. The study is on the rural transportation problem in Ghana and its consequences on the rural people, especially those who live in off road villages (villages that do not have access to regular transportation ...

  3. The Forgotten ‘Coastal Forests' of Mtwara, Tanzania: A Biologically Impoverished and Yet Important Ecosystem

    DEFF Research Database (Denmark)

    Wegner, Guilia; Howell, Kim M.; Davenport, Tim R.

    2009-01-01

    Biodiversity surveys and the compilation of indigenous knowledge were conducted in eight previously unstudied proposed and already gazetted Forest Reserves of Mtwara Region, south-eastern Tanzania, from April to August of 2005. The results indicate relatively low biodiversity and endemism values ......-term availability of timber and non-timber resources and water and soil regulation services from these forests. The development and implementation of effective natural resource management is therefore urgently needed in this area....

  4. Vaccination perceptions of school employees in a rural school district.

    Science.gov (United States)

    Macintosh, Janelle; Luthy, Karlen E; Beckstrand, Renea L; Eden, Lacey M; Orton, Jennifer

    2014-08-20

    There continues to be a need for increases in adult vaccination rates, especially among those working in environments which may easily become communicable disease outbreak centers, such as school employees in the school environment. The purpose of this study was to evaluate why rural Utah school employees were non-compliant with the influenza and measles, mumps, and rubella (MMR) vaccines, as well as to identify their views on mandatory vaccination policies. A questionnaire was distributed to all school employees in a rural Utah school district. Data analysis included frequencies and measures of central tendency and dispersion for quantitative items and theme identification for qualitative items. Only 51% of school employees were adequately vaccinated for influenza. Reasons for noncompliance with the influenza vaccine included inconvenience, lack of perceived need, and questionable vaccine efficacy. There were 39.3% school employees who had not received an MMR during adulthood, which was commonly attributed to lack of knowledge regarding the need for this vaccine. Almost half (45.7%) of school employees believed a mandatory vaccination policy should be instituted, although 24.2% of school employees were opposed to mandatory adult vaccination policies. Reasons for opposing vaccination mandates included violation of personal choice, lack of perceived vaccination safety and efficacy, lack of perceived need for adult vaccines, and vaccine cost. Suboptimal vaccination rates of school employees may negatively affect the health and well-being of individuals in the school environment. School employees report a variety of beliefs regarding the influenza and MMR vaccines. While over half of school employees support mandatory vaccination policies for adults working in the school environment, those opposing such a policy report concerns regarding violation of personal choice. Public health officials and school administrators should coordinate efforts to increase vaccination

  5. Health worker attrition at a rural district hospital in Rwanda: a need ...

    African Journals Online (AJOL)

    Health worker attrition at a rural district hospital in Rwanda: a need for improved placement and retention strategies. Jackline Odhiambo, Felix Cyamatare Rwabukwisi, Christian Rusangwa, Vincent Rusanganwa, Lisa Ruth Hirschhorn, Evrard Nahimana, Patient Ngamije, Bethany Lynn Hedt-Gauthier ...

  6. A survey of rural poultry management in the West Mamprusi District ...

    African Journals Online (AJOL)

    Une enquête sur l'exploitation de volaille rurale dans le District de West Mamprusi et le District de Ga Rural du Ghana Résumé Quatre - vingt - seize ... La majorité de personnes interrogées étaient officiellement sans instruction (46 %) ou ne sont pas allées au-delà de l'école primaire (78 %). Les volailles étaient largement ...

  7. Effectiveness of a Home-Based Counselling Strategy on Neonatal Care and Survival: A Cluster-Randomised Trial in Six Districts of Rural Southern Tanzania.

    Directory of Open Access Journals (Sweden)

    Claudia Hanson

    2015-09-01

    Full Text Available We report a cluster-randomised trial of a home-based counselling strategy, designed for large-scale implementation, in a population of 1.2 million people in rural southern Tanzania. We hypothesised that the strategy would improve neonatal survival by around 15%.In 2010 we trained 824 female volunteers to make three home visits to women and their families during pregnancy and two visits to them in the first few days of the infant's life in 65 wards, selected randomly from all 132 wards in six districts in Mtwara and Lindi regions, constituting typical rural areas in Southern Tanzania. The remaining wards were comparison areas. Participants were not blinded to the intervention. The primary analysis was an intention-to-treat analysis comparing the neonatal mortality (day 0-27 per 1,000 live births in intervention and comparison wards based on a representative survey in 185,000 households in 2013 with a response rate of 90%. We included 24,381 and 23,307 live births between July 2010 and June 2013 and 7,823 and 7,555 live births in the last year in intervention and comparison wards, respectively. We also compared changes in neonatal mortality and newborn care practices in intervention and comparison wards using baseline census data from 2007 including 225,000 households and 22,243 births in five of the six intervention districts. Amongst the 7,823 women with a live birth in the year prior to survey in intervention wards, 59% and 41% received at least one volunteer visit during pregnancy and postpartum, respectively. Neonatal mortality reduced from 35.0 to 30.5 deaths per 1,000 live births between 2007 and 2013 in the five districts, respectively. There was no evidence of an impact of the intervention on neonatal survival (odds ratio [OR] 1.1, 95% confidence interval [CI] 0.9-1.2, p = 0.339. Newborn care practices reported by mothers were better in intervention than in comparison wards, including immediate breastfeeding (42% of 7,287 versus 35% of 7

  8. Primary Immunization Status In Rural Block Of Kanpur District

    Directory of Open Access Journals (Sweden)

    S K Kaushal

    2009-06-01

    Full Text Available Research question: What is the status of primary immunization of children in the age group of 12-23 month Objective: To assess the status of Primary immunization in age group of 12 to 23 month Children, To compare the primary immunization in intensive and twilight villages, To study the influence of socialfactors affecting immunization & Tofind out reasons for immunization default Study design: cross sectional study Setting and participants: rural block of.Kanpur District and mothers ofchildren in age group of 12-23 months. Study period: July to December 2005 Sample size: 280 mothers of study group children. Study variable: Immunization status, socialfactors, vaccine, reasons for immunization default Results : 32.85% of children were fully immunized. Highest (92.85% covered antigen were found as OPV-1 and lowest (41.78% covered antigen as DPT-3.Literacy and joint family had positive impact on immunization status. The main reasons were observed for immunization default as ignorance (about need/place/person/time and distance factor. Conclusion : Quantity1 wise coverage was quite satisfactory. High dropout rate due to ignorance and distance factors should be taken into

  9. Perceived quality of healthcare delivery in a rural District of Ghana ...

    African Journals Online (AJOL)

    Objective: The study aimed at finding out clients' perceptions of the quality of healthcare delivery at the district level in rural Ghana, using the Komenda-Edina- Eguafo-Abrem District as a case study. Design: 803 patients were purposively selected and interviewed after visits to health facilities using a pretested questionnaire, ...

  10. An evaluation of the District Health Information System in rural South ...

    African Journals Online (AJOL)

    An evaluation of the District Health Information System in rural South Africa. ... Design and subjects. Semi-structured key informant interviews were conducted with clinic managers, supervisors and district information staff. ... of the data collection and collation process but little analysis, interpretation or utilisation of data.

  11. Level of Rural Development in Burdwan and Murshidabad Districts, West Bengal: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Syfujjaman Tarafder

    2016-06-01

    Full Text Available The key purpose of this research is to examine the level of attainment of rural development in the two districts—Burdwan and Murshidabad. The reasons for selecting these two districts stems from the fact that majority of the population of these two districts dwell in rural areas. The concept of rural development is comprehensive. It includes economic development of rural people through the development of productive sectors and employment associated with rural infrastructural development as well human development. Therefore, rural development includes in its domain all the aspects of human development of the rural people. The present Central as well as State Governments have undertaken different policies and plans to bring about positive changes amidst the rural people. In most cases, however, the policies and plans fail to achieve the desired level of changes in the rural areas (Desai, 1991. Although in fewer isolated cases, some success has been achieved, but overall development remains to be reached. This research, based mainly on secondary data aims to investigate the scale of progress in the two districts —Burdwan and Murshidabad of West Bengal, India, in the areas embracing social correlates of rural poverty, basic infrastructure facilities, standard of living and quality of life. The data are analysed with the help of statistical and cartographical analysis.

  12. Options for rural electrification in Arua District, Uganda

    International Nuclear Information System (INIS)

    Onzia, Joseph; Núñez Bosch, Osvaldo Manuel

    2015-01-01

    This study proposed a power generation system suitable for rural area application. The electrification options were proposed for secondary schools, health centres, households and trading centre loads using solar PV system, diesel fired generators, biogas co-fired diesel generators and grid extension. The study is based on simulation, modeling and optimization of renewable energy system. Designs for the options considered were based on the electricity demand and environmental conditions of Arua district. From the designs, capital costs for each option were determined. This was used in carrying out simulations in HOMER computer program to come up with the most cost effective options. Sensitivity analysis was carried out to determine the effects of variation in costs such as diesel price and capital cost of solar PV system.Based on simulation results, it has been found that the trading centre, with 500 kW of electrical demand, must be electrified using the grid extension. The breakeven grid distance is 75.1 km. Grid extension become cost effective compared to diesel generators and solar PV system within this distance. The load at household level ranges from as low as 16 W to 5 kW. For 103 W peak load, the most cost effective option was solar PV system. The second best option was biogas co-fired diesel generator. For schools and health centres with load of up to 15 kW, biogas co-fired generator is the best compared to the total cost of 18 kW diesel fired generator which is higher. Therefore, where biogas cannot be generated, diesel generators should be used. Based on the amount of pollutants produced, a biogas co-fired diesel generator is the best option. (full text)

  13. Analysis of the role of strategic products in sustainable rural livelihoods (Case study: saffron production in the Roshtkhar rural district

    Directory of Open Access Journals (Sweden)

    Sadegh Asghari Lafmejani

    2017-09-01

    Full Text Available Saffron is the most expensive agricultural and pharmaceutical product in the world. It is significant for several reasons such as having high water productivity compared to other crops. It is providing rural employment and preventing their migration, having high medicinal and spice values, ease of maintenance and transportation. Most importantly, it is producing a high revenue compared to other agricultural products. On this basis, due to the suitability of some parts of Iran to saffron production and the role of this product in the livelihood of rural households, assessment of the sustenance impacts of saffron production in the active villages seems absolutely necessary. Therefore, the aim of the present study is to assess the status of saffron production and its role in the livelihood of rural households of the Roshtkhar Rural District. This research was done based on a descriptive-analytic approach. In this regard, the role of saffron cultivation in 355 households living in 13 villages with over 100 households in the study rural district was investigated. To this goal, after conducting documentary studies and initial field visits, a wide range of measures proportional to the circumstances of the study villages were adopted. Then, data collection was performed based on the selected indices and questionnaires were distributed to be filled by villagers and households... To analyze the data, the relevant statistical and spatial analyses were done through the application of Expert choice, SPSS, and ArcGIS software packages. The research findings indicated that the annual revenues derived from saffron production in 43.9% of the households under study were more than they obtained from other sources of income. Through the analysis of the study data, it can be concluded that saffron production has a significant effect on the improvement of the residents’ livelihood in the Roshtkhar Rural District and this fact has reinforced the households

  14. A practice model for rural district nursing success in end-of-life advocacy care.

    Science.gov (United States)

    Reed, Frances M; Fitzgerald, Les; Bish, Melanie R

    2017-08-24

    The development of a practice model for rural district nursing successful end-of-life advocacy care. Resources to help people live well in the end stages of life in rural areas can be limited and difficult to access. District nurse advocacy may promote end-of-life choice for people living at home in rural Australia. The lack of evidence available internationally to inform practice in this context was addressed by exploratory study. A pragmatic mixed method study approved by the University Faculty Ethics Committee and conducted from March 2014 to August 2015 was used to explore the successful end-of-life advocacy of 98 rural Australian district nurses. The findings and results were integrated then compared with theory in this article to develop concepts for a practice model. The model illustrates rural district nurse advocacy success based on respect for the rights and values of people. Advocacy action is motivated by the emotional responses of nurses to the end-of-life vulnerability people experience. The combination of willing investment in relationships, knowing the rural people and resources, and feeling supported, together enables district nurses to develop therapeutic emotional intelligence. This skill promotes moral agency in reflection and advocacy action to overcome emotional and ethical care challenges of access and choice using holistic assessment, communication, organisation of resources and empowering support for the self-determination of person-centred end-of-life goals. Recommendations are proposed from the theoretical concepts in the model. Testing the model in practice is recommended to gain the perceptions of a broader range of rural people both giving and receiving end-of-life-care. A model developed by gathering and comparing district nursing experiences and understanding using mixed methods and existing theory offers evidence for practice of a philosophy of successful person-centred advocacy care in a field of nursing that lacks specific

  15. The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania.

    Science.gov (United States)

    Pfeiffer, Constanze; Kleeb, Matthis; Mbelwa, Alice; Ahorlu, Collins

    2014-05-01

    Social media form part of the rapid worldwide digital development that is re-shaping the life of many young people. While the use of social media by youths is increasingly researched in the North, studies about youth in the South are missing. It therefore remains unclear how social media can be included in interventions that aim at informing young people in many countries of the global South about sexual and reproductive health. This paper presents findings of a mixed-methods study of young people's user behaviour on the internet and specifically of social media as a platform for sexual health promotion in Tanzania. The study used questionnaires with 60 adolescents and in-depth interviews with eight students aged 15 to 19 years in Dar es Salaam, and in Mtwara, Southern Tanzania. Findings show that youth in Dar es Salaam and Mtwara access the internet mainly through mobile phones. Facebook is by far the most popular internet site. Adolescents highlighted their interest in reproductive and sexual health messages and updates being delivered through humorous posts, links and clips, as well as by youth role models like music stars and actors that are entertaining and reflect up-to-date trends of modern youth culture. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. Developing district health systems in the rural Transvaal

    African Journals Online (AJOL)

    Close attention needs to be given to district- level health management, the ..... pilot efforts to inrroduce village-level healrh committees. A detailed proposal from ... authorities and the divided interests that have resulted from years of fragmented ...

  17. Supervision of Special Education Instruction in Rural Public School Districts: A Grounded Theory

    OpenAIRE

    Bays, Debora Ann

    2001-01-01

    The grounded theory presented in this study describes how the supervision of special education instruction occurs in public elementary schools in rural settings. Grounded theory methodology (Strauss & Corbin, 1998) was employed in this study. Nine elementary schools in three rural districts in the state of Virginia participated in the study. Interview data were collected from 34 participants, including special and general education teachers, principals, and directors of special education. Obs...

  18. The influence of housing characteristics on rural migrants’ living condition in Beijing Fengtai District

    Directory of Open Access Journals (Sweden)

    Liu Wen Tao

    2015-08-01

    Full Text Available The study analyzes the influence of housing characteristics on rural migrants’ living condition in Beijing Fengtai District, China. The researcher will identify rural migrants in Beijing, examine their housing characteristics (housing crowding, housing privacy and housing facility and the influence on their living condition. Also, some suggestions are given to improve their housing characteristics and living condition. The government should revise the migrant housing policy and hukou management. Also, the rural migrants should try to increase their education level and social skills. For the occupation, the local government should give the rural migrants more job opportunity. These issues are analyzed in relation to local government attitudes toward the rural migrants. The analysis is based on data collected from two types of interviews: rural migrants and management interviews which examine the rural migrants’ housing and managerial aspects of this research, respectively. It is also supported by the utilization of secondary data. The findings of the study indicate that the rural migrants’ housing characteristics (housing crowding, housing privacy and housing facility highly influence their living condition in Beijing Fengtai District. Therefore, the local government should give some assistance to this group people in the big cities. This paper reports on the findings of a study to seek acknowledged definitions of the terms Project and Project Management. The study was based on a conventional review and analysis of the definitions from a series of texts.

  19. Using a Strategic Plan to Promote Technology in Rural School Districts.

    Science.gov (United States)

    VanSciver, James H.

    1994-01-01

    About six years ago, a rural Delaware school district formed a community/staff long-range planning committee to craft a strategic plan that would identify school system values and reallocate resources. As vision and mission statements emerged, technology evolved as a major value, with three goals related to funding and accessibility. Collaborative…

  20. Review of final-year medical students' rural attachment at district ...

    African Journals Online (AJOL)

    2013-11-15

    Nov 15, 2013 ... This paper presents the first phase of an ongoing quality ... a rural district hospital can provide unique learning opportunities for students if the ..... Peabody C, Block A, Jain S. Multi-disciplinary service learning: a medico-legal.

  1. Improving Immunization Coverage in a Rural School District in Pierce County, Washington

    Science.gov (United States)

    Peterson, Robin M.; Cook, Carolyn; Yerxa, Mary E.; Marshall, James H.; Pulos, Elizabeth; Rollosson, Matthew P.

    2012-01-01

    Washington State has some of the highest percentages of school immunization exemptions in the country. We compared school immunization records in a rural school district in Pierce County, Washington, to immunization records in the state immunization information system (IIS) and parent-held records. Correcting school immunization records resulted…

  2. Media Magic: Automating a K-12 Library Program in a Rural District.

    Science.gov (United States)

    Adams, Helen

    1994-01-01

    Describes the automation process in a library resources center in a small rural school district. Topics discussed include long-range planning; retrospective conversion for an online catalog; library automation software vendors; finances; training; time savings; CD-ROM products; telecomputing; computer literacy skills; professional development…

  3. Postpartum care attendance at a rural district hospital in Zambia

    NARCIS (Netherlands)

    J. Lagro (Joep); A. Liche (Agnes); J. Mumba (John); R. Ntebeka (Ruth); J. van Roosmalen (Jos)

    2006-01-01

    textabstractPostpartum care is an important tool in both preventive and promotive maternal health care. We studied the postpartum care attendance rate in 540 women who delivered at a district hospital in Zambia. Forty-two percent of the women attended postpartum care within six weeks of delivery.

  4. Leadership Strategies for Maintaining Success in a Rural School District

    Science.gov (United States)

    Freeman, Greta G.; Randolph, Ivan

    2013-01-01

    Success in a PK-12 educational environment begins at the top with school leadership. Due to economic problems, poverty and added responsibilities, leaders in rural communities throughout the United States face sensitive and distinctive challenges. Based on research and years of administrative experience as school and school system leaders, the…

  5. Management of appendix mass in a Nigerian rural district | Umunna ...

    African Journals Online (AJOL)

    Background: The traditional management of an appendix mass is conservative, followed by interval appendicectomy. Interval appendicectomy is now controversial. Aim: To present an experience with the management of appendix mass among a rural people in Nigeria. Methods: Patients presenting with appendix masses ...

  6. Non-governmental organisations and rural poverty reduction strategies in Zimbabwe: A case of Binga rural district

    Directory of Open Access Journals (Sweden)

    Stephen Mago

    2015-09-01

    Full Text Available The purpose of this paper is to evaluate the effectiveness of strategies implemented by Non-governmental organisation (NGOs for poverty alleviation in Zimbabwe with specific reference to Zimbabwe’s Binga Rural District. The qulitative research methodology was employed in the article. Data were collected using questionnaires and interviews. Findings indicated that NGOs do not adequately fulfil the needs of the poor due to ineffective strategies that they implement. There is insufficient understanding of the livelihoods of the poor in Binga, hence the need for participatory development approaches. Deepening and widening poverty in the rural areas that are currently served by NGOs is an indicator that their poverty alleviation strategies are inadequate and ineffective to deal with poverty in these rural areas. The paper recommends a policy shift by both NGOs and the government to improve the poverty reduction strategies used by NGOs.

  7. Factors affecting the initial literacy development of urban and rural learners in the Iganga district, Uganda

    Directory of Open Access Journals (Sweden)

    Banda, Felix

    2005-12-01

    Full Text Available The initial motivation for the study was data from the Ministry of Education in Uganda that suggests that in terms of academic performance, urban learners continually outperform rural schools at primary and secondary school levels (Ministry of Education 2002. At present all government examinations are written in English. However, the language in education policy in Uganda differentially stipulates the use English as medium of instruction in urban schools and the use of the mother tongue in rural schools (cf. Kyeyune 2004. Other factors which mitigate against rural learners’ successful academic performance are untrained educators, poor infrastructure and school management practices in rural schools, poverty, lack of supportive academic discourse practices, and a general lack of enthusiasm among rural parents (most of whom have very little formal education for their children’s education. Using data from observations of selected urban and rural homes and schools in The Iganga district and field notes in the form of diary entries, the study draws on New Literacy Studies (NLS particularly the notion of literacy as social practice (Street 2001; Gee 2000; Baynham 2000, 2001, to explore the differential effect of urban and rural-based acculturation processes on the initial literacy development of learners. Finally, since 88% of Ugandans live in rural areas (Uganda Bureau of Statistics 2002, the pedagogical implications for primary schools are discussed and suggestions are made on how to establish an inclusive education system.

  8. Analysis of factors affecting rural people's attitudes towards rural tourism: the case of Doroodzan District of the Marvdasht County

    Directory of Open Access Journals (Sweden)

    Madineh Khosrowjerdi

    2016-11-01

    Full Text Available Although different governments place a lot of interest in developing rural tourism targets and a lot of budgets are spend in this respect, less attention is paid to study the attitudes of the host communities towards tourism.  Thus, the aim of this study was to analyze the factors that can affect the attitudes of rural people towards rural tourism in the Doroodzan District of the Marvdasht County. The research was conducted in 2015.  The survey research method was used for this purpose and data were collected using a pre-designed questionnaire. The research sample included 250 villagers that were selected using Kerjcie and Morgan Sampling Table and the Random Sampling Technique. The Face validity of the questionnaire was verified by the expert faculty members and the staff of the Rural Development Management Department of the Yasouj University, and its reliability was also verified by calculating Cronbach's Alpha reliability coefficient (from 0.61 to 0.86 that was obtained from a pilot study.  The results of the Path Analysis showed that value of tourism is the most effective factor for predicting the respondents' attitudes towards rural tourism. Next to that there are other variables such as income from tourism and observation that have had the most effect on the respondents' attitudes. Finally, it is recommended that the means of mass media such as local radio and television broadcast services prepare programs and campaigns about rural tourism and related topics in order to improve the attitudes of the rural people towards rural tourism.

  9. Factors Associated with Contraceptive Use among Women of Reproductive Age in Rural Districts of Burkina Faso.

    Science.gov (United States)

    Wulifan, Joseph K; Mazalale, Jacob; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Hamadou, Saidou; Haidara, Ousmane; De Allegri, Manuela

    2017-01-01

    Given the current low contraceptive use and corresponding high levels of unwanted pregnancies leading to induced abortions and poor maternal health outcomes among rural populations, a detailed understanding of the factors that limit contraceptive use is essential. Our study investigated household and health facility factors that influence contraceptive use decisions among rural women in rural Burkina Faso. We collected data on fertile non-pregnant women in 24 rural districts in 2014. Of 8,657 women, 1,098 used a modern contraceptive. Women having a living son, a child younger than one year, and household wealth were more likely to use modern contraceptives. Women in polygamous marriages and women living at least 5 kilometers from a health facility were less likely to use contraception. We conclude that modern contraceptive use remains weak, hence, programs aiming to encourage contraceptive use must address barriers at both the health facility and the household level.

  10. Acute admissions to medical departments. A comparison between an urban and a rural district

    DEFF Research Database (Denmark)

    Hilsted, J C; Evald, T; Elbrønd, R

    1995-01-01

    of admissions for social reasons was 13 percent to the city hospital versus 3 percent to the district hospital. Relevant alternatives to hospitalization seemed to exist in 50 percent of the admissions to the city hospital versus only 3 percent to the district hospital. Since patients admitted for social reasons...... block hospital beds for a longer time period than those admitted for other reasons, these differences may to some extent explain why length of hospital stay is longer in city hospitals than in rural ones....

  11. The role of cooperatives in sustaining the livelihoods of rural communities: The case of rural cooperatives in Shurugwi District, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Smart Mhembwe

    2017-04-01

    Full Text Available The main focus of the research was to analyse the role of cooperatives in sustaining the livelihoods of local rural communities in Shurugwi District in Zimbabwe. Descriptive survey design was used in this mixed method approach to the study. A questionnaire, interviews and observation methods were employed as the main research instruments. Purposive sampling technique was adopted and data were collected from government officials and from members of the six cooperatives in Shurugwi District. A total of 50 research participants were involved in the study. It was found that cooperatives were established as a strategy to sustain livelihoods of rural communities. With the adoption of cooperatives, people in the rural communities managed to generate employment, boost food production, empower the marginalised, especially women, and promote social cohesion and integration, thereby improving their livelihoods and reducing poverty. Most cooperatives face a number of challenges that include lack of financial support, poor management and lack of management skills, and lack of competitive markets to sell their produce. The study recommends that the government and the banking sector render financial support to cooperatives in rural communities to allow them to expand and diversify their business operations; constant training on leadership and management skills is provided to cooperatives’ members. There is also a need for cooperatives, especially those in the agricultural sector, to form some producer associations so as to easily market their produce. Lastly, the study recommends that future research should focus on investigating issues that hinder the growth of the cooperative movement in rural communities of Zimbabwe. It is hoped that policy-makers, the academia and communities would benefit from the study.

  12. Emergence of the notion of retirement in rural China. The case of rural districts of Shanghai.

    Science.gov (United States)

    Shih-Jiunn, Shi

    2008-10-01

    Since the outset of the reform process in 1978, rural China has been undergoing fundamental changes in the relationships between the state, society and individuals. Social policy, including pension policy for rural residents, is an essential factor in this transformation process which has influenced the life chances of many peasants. This paper deals with the relationship between social policy and individual life courses in the case of Shanghai's rural pension policy. It integrates the theoretical insights from life course research to emphasise the close relationship between the state welfare and the institutionalisation of the life course. By analysing biographical interviews conducted in rural Shanghai, this article has identified the changing nature of welfare mix in rural old-age security as well as the emergence of the notion of retirement among the peasants in rural Shanghai. The introduction of the innovative rural pension policy has given rise to the rudimentary emergence of a modern life course, in the contour of a temporal partition between work and retirement. However, diverse local subsidies and individual household situations have led to different perceptions and biographical orientations of the peasants with respect to their old-age security and retirement.

  13. Barriers to quality patient care in rural district hospitals

    Directory of Open Access Journals (Sweden)

    Johanna E. Eygelaar

    2012-05-01

    Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot study. The validity, specifically construct and content validity, were assured by means of an extensive literature review, pilot study and use of experts. Ethics approval was obtained from the relevant stakeholders. Results showed that 272 participants (97% disagreed that provision of staff was adequate, with staff above 40 years of age more likely to disagree (p = <0.01. A statistically significant association was shown between availability of doctors and staff not being able to cope with emergencies (p = <0.01. Most participants (n =212; 76% indicated that they were not receiving continuing education, with the registered nurses more likely to disagree (χ² test, p = 0.02. Participants in both hospital types A (n = 131; 82% and B (n = 108; 91% also disagreed that provision of equipment and consumables was adequate. The research showed that inadequacies relating to human resources, professional development, consumables and equipment influenced the quality of patient care. Urgent attention should be given to the problems identified to ensure quality of patient care in rural hospitals.

  14. Biomass District Heat System for Interior Rural Alaska Villages

    Energy Technology Data Exchange (ETDEWEB)

    Wall, William A.; Parker, Charles R.

    2014-09-01

    Alaska Village Initiatives (AVI) from the outset of the project had a goal of developing an integrated village approach to biomass in Rural Alaskan villages. A successful biomass project had to be ecologically, socially/culturally and economically viable and sustainable. Although many agencies were supportive of biomass programs in villages none had the capacity to deal effectively with developing all of the tools necessary to build a complete integrated program. AVI had a sharp learning curve as well. By the end of the project with all the completed tasks, AVI developed the tools and understanding to connect all of the dots of an integrated village based program. These included initially developing a feasibility model that created the capacity to optimize a biomass system in a village. AVI intent was to develop all aspects or components of a fully integrated biomass program for a village. This meant understand the forest resource and developing a sustainable harvest system that included the “right sized” harvest equipment for the scale of the project. Developing a training program for harvesting and managing the forest for regeneration. Making sure the type, quality, and delivery system matched the needs of the type of boiler or boilers to be installed. AVI intended for each biomass program to be of the scale that would create jobs and a sustainable business.

  15. Prevalence of Low Calorie Intake by Rural Families in Palpa District of Nepal

    Directory of Open Access Journals (Sweden)

    Madhusudhan Ghimire

    2013-12-01

    Full Text Available Background: Healthy population is indispensable for national development. Adequate food intake by people is the key determinant to keep up their health. Malnutrition nevertheless remains pervasive in developing countries, undermining people’s health, productivity, and often their survival. Food insecurity and hunger remain persistent in Nepal. Prevalence of low calories intake by rural family is widespread throughout the country population. Mainly marginalized communities, ethnic group with poor economic status, traditional societies and lower cast people are exposed to food defi cit. Objective: to investigate the prevalence of low calories intake by rural families and its associated determinants in Palpa district. Materials and methods: The cross-sectional study was designed to achieve objective of the research. A random sample of 339 families was selected from rural areas (DUMRE, DAMKADA, GORKHEKOT and TELGHA villages of this district. Data were analyzed by using the SPSS software for Windows (version 16.0. Results: The existence of inadequate food calorie intake among rural families was most common. Most of them were malnourished. Conclusion: low calorie intake by ethnic group was considerably higher than other groups in community.

  16. Prevalence of diabetes mellitus in rural adults of District Peshawar

    International Nuclear Information System (INIS)

    Akhtar, T.; Hussain, I.; Ahmad, I.

    2011-01-01

    Background: In Pakistan, approximately 8 million people have diabetes mellitus, making it the fourth leading country in the list of world diabetic patients. Objectives: To measure the prevalence of diabetes mellitus and its associated risk factors in a rural community of Peshawar. Study type, settings: A cross-sectional study conducted in PMRC model research community village of Budhni. Subjects and Methods: All adults over the age of 40 years residing in the specific village were selected for the study. During door to door visit, consent was taken from all the subjects and they were informed that a fasting blood sugar level would be checked a day or two later. All those who consented were interviewed according to pre-designed proforma and their height, weight and blood pressure were recorded using standard methods. Fasting blood samples were drawn the next day and sent to PMRC research laboratory where they were checked using Microlab 200 Merck. Data was analyzed using Epi Info version 6.0. According to American Diabetic Association criteria, fasting blood sugar level of >126 mg/dl was diagnosed. Results: Estimated population of adults > 40 years in the village is 1249 individuals. Nine hundred nine (72.7%) consented to participate in the study. A total of 345 subjects were screened for diabetes using fasting blood sugar as the proxy indicator. Eighty one (23.4%) had blood sugar over 126 mg/dl and were therefore, diagnosed to be diabetic. Of these 81 cases 46(56.8%) were known diabetics while, 35(43.2%) were newly diagnosed. Majority (39) were between 51-60 years, followed by 29 between 40-50 years and remaining 13 subjects were above 60 years of age. Among the 46 known diabetics, 42(91.3%) were non insulin dependent and only 4(8.7%) were insulin dependent. The duration of diabetes was between 1-5 years in 26(57%) cases who were known diabetic's. Those individuals who were not sure about their exact duration of diabetes were 9(19%). Cases with a family history of

  17. Cognitive potential and its predictors in children from a rural district of pakistan

    International Nuclear Information System (INIS)

    Gilani, I.

    2017-01-01

    Effective interventions are available to reduce cognitive deficit currently estimated to affect more than 200 million children under 5 years of age in developing countries. However, developing world's investment is negligible in this regard mainly because of non-existent global indicators to monitor progress with respect to the childhood cognitive development. Intelligence Quotient (IQ) or Full Scale Intelligence Quotient (FSIQ) is an indicator of the cognitive development. This study was designed to assess cognitive potential of 6-7 years old children from a rural district of Pakistan by calculating their FSIQ. Predictors of the FSIQ were also determined. Method: This cross-sectional research was carried out in 40 rural Union Councils (UCs) of 2 sub-districts in district Rawalpindi utilizing simple random sampling technique. Wechsler Pre-school and Primary Scale of Intelligence (WPPSI-IV) was administered to 6-7 years old children (n=300) for measuring their FSIQ. Results: FSIQ of rural Pakistani children, relative to the normative sample, was found to be in the category of low-average. Findings of multiple regression analysis concluded grade/class of the child as the most influential predictor of the FSIQ followed by the level of mother's and then father's education. Conclusion: FSIQ of the rural Pakistani children, relative to the normative sample, was found to be in the category of low-average. Predictors of the FSIQ, seen in this research, were school grades and non-educated parents of the children warranting future research on the contribution of environmental influences to the variability in cognitive potential. (author)

  18. What keeps health professionals working in rural district hospitals in South Africa?

    Directory of Open Access Journals (Sweden)

    Louis S. Jenkins

    2015-06-01

    Full Text Available Background: The theme of the 2014 Southern African Rural Health Conference was ‘Building resilience in facing rural realities’. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. Conference workshop: The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, ‘What is it that keeps you going to work every day?’ Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Results: Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Conclusion: Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported.

  19. Women's perceptions of homebirths in two rural medical districts in Burkina Faso: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sombie Issiaka

    2011-01-01

    Full Text Available Abstract Background In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. The situation increases the risk of death for both mother and child and has severe maternal complications. The purpose of this study was to describe women's perceptions of homebirths in the medical districts of Ouargaye and Diapaga. Methods A qualitative approach was used to gather information. This information was collected by using focus group discussions and individual interviews with 30 women. All the interviews were tape recorded and managed by using QSR NVIVO 2.0, qualitative data management software. Results The findings show that homebirths are frequent because of prohibitive distance to health facilities, fast labour and easy labour, financial constraints, lack of decision making power to reach health facilities. Conclusion The study echoes the need for policy makers to make health facilities easily available to rural inhabitants to forestall maternal and child deaths in the two districts.

  20. Linking agricultural food production and rural tourism in the Kazbegi district – A qualitative study

    Directory of Open Access Journals (Sweden)

    S. Hüller

    2017-03-01

    Full Text Available As in many transition countries, also in Georgia rural urban migration as well as migration from the agricultural sector takes place. This also applies to the Kazbegi district, a mountainous region in the Greater Caucasus of Georgia. The main activity in the district is subsistence farming, while only a few agricultural producers are commercially active. As the region offers beautiful nature, during the last decade tourism has been on the rise, while a dwindling interest in the agricultural sector can be observed. However, the growth in tourism also provides opportunities for small-scale agricultural producers to increase their income by marketing their surplus production to the local tourism sector and thereby improving their livelihoods. In turn, an increase in local agri-food products offered might have a positive effect on the tourism sector. Thus, establishing linkages of agricultural food production and rural tourism might contribute to the economic development of the district and even counteract migration to the capital and from the agricultural sector. Through a qualitative study, we aim at identifying local agri-food products suitable for being marketed to the tourism sector and efficient marketing options. In order to do so, we analyze local agri-food chains. Exploratory interviews, focus group discussions and expert interviews provide data for a qualitative content analysis. First results show that food products which require little technological equipment for processing and do not underlie strict food safety standards, like for example honey, seem to be adequate to tap marketing potentials with regard to rural tourism.

  1. A study on rural women entrepreneurship in Vempalli Mandal, Kadapa District, A.P. India

    Directory of Open Access Journals (Sweden)

    Vijaya Bharathi

    2013-01-01

    Full Text Available The present study aims to show that in order to improve the status of women entrepreneurship in all spheres of Indian life, the government will need to take an initiative in providing an increased pace of awareness and become meaningful providers of needed training programs especially aimed at strengthening rural women entrepreneurs. It also aims at exploring the present status of women entrepreneurs regarding their socio economic backgrounds, problems faced by them in seeking to create new ventures, motivational factors and the availability of finance for them in Vempalli Mandal, YSR District.

  2. A Study on Nutritional Status of Rural School going Children in Kavre District.

    Science.gov (United States)

    Mansur, D I; Haque, M K; Sharma, K; Mehta, D K; Shakya, R

    2015-01-01

    Background Childhood is a time of active growth in terms of physical size, mental, emotional and psychological development. Normal growth is dependent on adequate nutrition and encompasses major transformations from birth to adulthood. Nutrition is a focal point for health and well being; and has special significance in countries with disadvantages in socioeconomic and hygienic standards. Objective The objective of the present study was to assess the nutritional status in terms of prevalence of underweight, stunting and thinness among rural school going children. Method The present study was cross-sectional study, conducted on 438 rural school going children (169 male and 259 female) with the age group 4-16 years, during the period from April 2014 to July 2014. Age was recorded in year; height and weight were measured in centimeter and kilogram respectively. BMI was calculated by using standard equation. Result The present study concluded that the nutritional status in terms of prevalence of underweight, stunting and thinness were found to be 30.85%, 24.54% and 10.05% respectively among rural school going children of Kavre district. It was revealed that 37.87% was underweight, 29.59% was stunted and 11.25% was thinness among male children whereas in female children, 26.27% was underweight, 21.24% was stunted and 9.27% was thinness. Hence, high prevalence of underweight, stunting and thinness were observed in male than in female children. Conclusion The present study has successfully documented the nutritional status in terms of prevalence of underweight, stunting and thinness among the rural school going children of Kavre district. The results of the present study will be useful for policy makers in their endeavor to formulate various developmental and health care programs.

  3. The Effects of Saffron Economic Stability of Rural Residents in the Darbeghazi District City of Nishabur

    Directory of Open Access Journals (Sweden)

    Seyed Amir Mohamad Alavizade

    2016-08-01

    Full Text Available Agricultural sustainability is undoubtedly one of the most important parts of sustainable development. The main source of income for the residents of villages of the Khorasan Razavi province is based on agricultural and horticultural products especially sale of saffron. In this regard the turquoise shades of the flowers of this plant encompass all of the fields in Nishabur and they have been much welcomed by farmers in this city. In this study, the cultivation of saffron in creating economic stability of the rural district Derbghazi in the central part of the city of Nishabur city will be examined. The research method in this paper is based on library, documentary, field and analytical – descriptive studies. In this context and in order to determine the economic stability of rural areas, the Morris Davis model has been used. This model contains three matrices that separately calculate and analyze the economic indicators. The statistical population under study consists of more than one hundred households from the rural villages in the Derbghazi rural district and the sample population studied consists of 308 households based on the Cochran formula. The results of the Morris Davis model indicate that among ten villages that were studied, Behroudi, Jilo, Khojan and Norouazabad have low economic stability, and Rouhabad, Haghiye, Shadmiyane, Karizak plus the villages of Jafarabad garden and Karizak Sabbah have average economic stability. In the end and based on the results of the research study some recommendations are presented in order to maintain employment in the region and support the farmers who are cultivating saffron to encourage the till of saffron and help the economic stability of the residents of the villages that were studied.

  4. A cost-effective evaluation of biomass district heating in rural communities

    International Nuclear Information System (INIS)

    Hendricks, Aaron M.; Wagner, John E.; Volk, Timothy A.; Newman, David H.; Brown, Tristan R.

    2016-01-01

    Highlights: • Develop a cost-effective model using secondary data examining delivering heat through Biomass District Heating (BDH). • Eight of ten rural villages studied could cost-effectively deliver heat through BDH below the 2013 price of heating oil. • 80% of the annual cost of BDH was attributable to capital expenses. • Erratic fuel oil prices substantially impact future feasibility. • Village level feasibility is highly-influenced by the presence of large heat demanders. - Abstract: The economic feasibility of Biomass District Heating (BDH) networks in rural villages is largely unknown. A cost-effective evaluation tool is developed to examine the feasibility of BDH in rural communities using secondary data sources. The approach is unique in that it accounts for all the major capital expenses: energy center, distribution network, and energy transfer stations, as well as biomass procurement. BDH would deliver heat below #2 fuel oil in eight of the ten rural study villages examined, saving nearly $500,000 per year in heating expenses while demanding less than 5% of the forest residues sustainably available regionally. Capital costs comprised over 80% of total costs, illuminating the importance of reaching a sufficient heat density. Reducing capital costs by 1% lowers total cost by $93,000 per year. Extending capital payment period length five years or lowering interest rates has the next highest influence decreasing delivered heat price 0.49% and 0.35% for each 1% change, respectively. This highlights that specific building heat is a strong determinant of feasibility given the relative influence of high-demanding users on the overall village heat-density. Finally, we use a stochastic analysis projecting future #2 fuel oil prices, incorporating historical variability, to determine the probability of future BDH feasibility. Although future oil prices drop below the BDH feasibility threshold, the villages retain a 22–53% probability of feasibility after

  5. Psychosocial assessment of lathyrism patients in rural Estie district of South Gondar, northern Ethiopia.

    Science.gov (United States)

    Getahun, H; Haimanot, R T

    1998-01-01

    Three hundred and thirty three patients in the lathyrism endemic rural Estie district of Northern Ethiopia were interviewed and examined to assess the psychosocial impacts of neurolathyrism. The majority of the affected were in the age group of 11-20 years (43%) followed by 21-30 years (29%). Males were more affected than females (4.8:1). Peak occurrences of neurolathyrism was observed at time of mobilization of the population in villagization and land diversification schemes. Females were affected to lesser extent and at an earlier age than males. Neurolathyrism affected matrimony among the rural farming population where marriage is considered as the most significant social achievement of any young member of the society. Divorce rate due to paralysis was 28%. It also influenced the choice of occupation among the afflicted rural people. Many males went into ecclesiastical professions. A significant number of males also took up occupations which traditionally were considered to be exclusively for women like basketry and embroidery. More females, not withstanding their age, were engaged in cattle-keeping. During the study, the rural communities were made aware of the association of neurolathyrism and consumptions of grass pea seed. It is believed that this step will enable communities to use home-based detoxifying methods and resort to alternate crops during times of food shortage.

  6. A program to enhance k-12 science education in ten rural New York school districts.

    Science.gov (United States)

    Goodell, E; Visco, R; Pollock, P

    1999-04-01

    The Rural Partnership for Science Education, designed by educators and scientists in 1991 with funding from the National Institutes of Health, works in two rural New York State counties with students and their teachers from kindergarten through grade 12 to improve pre-college science education. The Partnership is an alliance among ten rural New York school districts and several New York State institutions (e.g., a regional academic medical center; the New York Academy of Sciences; and others), and has activities that involve around 4,800 students and 240 teachers each year. The authors describe the program's activities (e.g., summer workshops for teachers; science exploration camps for elementary and middle-school students; enrichment activities for high school students). A certified science education specialist directs classroom demonstrations throughout the academic year to support teachers' efforts to integrate hands-on activities into the science curriculum. A variety of evaluations over the years provides strong evidence of the program's effectiveness in promoting students' and teachers' interest in science. The long-term goal of the Partnership is to inspire more rural students to work hard, learn science, and enter the medical professions.

  7. Precontrol observations on lymphatic filariasis & geo-helminthiases in two coastal districts of rural Orrisa.

    Science.gov (United States)

    Chhotray, G P; Ranjit, M R; Khuntia, H K; Acharya, A S

    2005-11-01

    Lymphatic filariasis (LF) is a major public health problem in India, accounting for 40 per cent of the global burden. The World Health Organization has launched a global programme to eliminate LF by 2020 and India is a signatory to it. Orissa, an eastern Indian State has long been known to be endemic for LF. Prior to implementation of mass drug administration programme it is important to collect baseline data on filariasis and geo-helminthiases in the State. The present cross-sectional survey was therefore carried out between February and December 2001 to obtain baseline information on both LF and geo-helminthiases before application of the control measures. The study was carried out in rural areas of Puri and Ganjam districts in two phases. In phase I, the distribution of microfilaraemia in two district was mapped out in randomly selected primary health centres (PHCs), and 12 microfilaraemic villages were identified in each district by cluster analysis for the phase II study. In phase II, detailed clinical and parasitological survey for LF and geo-helminthiases was carried out following the standard procedures. Wuchereria bancrofti was found to be widely prevalent in Puri district with certain pockets of Brugia malayi while W. bancrofti was the only species in Ganjam district. The microfilaraemia (Mf) rate was found to be 9.5 and 11.1 per cent; and circulating filarial antigenaemia (CFA) was 16.8 and 17.8 per cent in Puri and Ganjam respectively. The geometric mean intensity (GMI) of Mf per ml of blood among positive individuals was 387 in Puri and 454 in Ganjam. The overall disease rate in Puri was 7.9 and 8.9 per cent in Ganjam. The prevalence of chronic manifestations was found to be significantly higher (PGanjam; and the heavy infection was found to be significantly higher (PGanjam compared to Puri district. The present study identified LF and geo-helminthiases as widely distributed health problem in rural areas of coastal Orissa which warrants intervention

  8. Making basic health care accessible to rural communities: a case study of Kiang West district in rural Gambia.

    Science.gov (United States)

    Sanneh, Edward Saja; Hu, Allen H; Njai, Modou; Ceesay, Omar Malleh; Manjang, Buba

    2014-01-01

    This study focuses on lack of access to basic health care, which is one of the hindrances to the development of the poor, and subjects them to the poverty penalty. It also focuses on contributing to the Bottom of the Pyramid in a general sense, in addition to meeting the health needs of communities where people live on less than $1 a day. Strengthened multistakeholder responses and better-targeted, low-cost prevention, and care strategies within health systems are suggested to address the health burdens of poverty-stricken communities. In this study, a multistakeholder model which includes the government, World Health Organization, United Nations Children Emergency Fund, and the Medical Research Council was created to highlight the collaborative approach in rural Gambia. The result shows infant immunization and antenatal care coverage were greatly improved which contributes to the reduction in mortality. This case study also finds that strategies addressing health problems in rural communities are required to achieve 'Millennium Development Goals'. In particular, actual community visits to satellite villages within a district (area of study) are extremely vital to making health care accessible. © 2013 Wiley Periodicals, Inc.

  9. Mental health in primary health care in a rural district of Cambodia: a situational analysis.

    Science.gov (United States)

    Olofsson, Sofia; Sebastian, Miguel San; Jegannathan, Bhoomikumar

    2018-01-01

    While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia. A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia. Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present. There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia

  10. Domestic and environmental factors of chikungunya-affected families in Thiruvananthapuram (Rural district of Kerala, India

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    T S Anish

    2011-01-01

    Full Text Available Background: The world is experiencing a pandemic of chikungunya which has swept across Indian Ocean and the Indian subcontinent. Kerala the southernmost state of India was affected by the chikungunya epidemic twice, first in 2006 and then in 2007. Kerala has got geography and climate which are highly favorable for the breeding of Aedes albopictus, the suspected vector. Aim: The aim of the study was to highlight the various domestic and environmental factors of the families affected by chikungunya in 2007 in Thiruvananthapuram district (rural of Kerala. Settings and design: This is a cross-sectional survey conducted in Thiruvananthapuram (rural district during November 2007. Materials and Methods : Samples were selected from field area under three Primary Health Centers. These areas represent the three terrains of the district namely the highland, midland, and lowland. The sample size was estimated to be 134 houses from each study area. The field area of health workers was selected as clusters and six subcenters from each primary health center were randomly selected (lot method. Results and Conclusions: The proportion of population affected by chikungunya fever is 39.9% (38.9-40.9%. The investigators observed water holding containers in the peri-domestic area of 95.6% of the houses. According to regression (binary logistic analysis, the area of residence [adjusted odds ratio (OR = 8.01 (6.06-14.60], residing in a non-remote area [adjusted OR=0.25 (0.16-0.38], perceived mosquito menace [adjusted OR=3.07 (2.31-4.64], and containers/tires outside the house [adjusted OR=5.61 (2.74-27.58] were the independent predictors of the occurrence of chikungunya in households.

  11. Why Rural Community Day Secondary Schools Students' Performance in Physical Science Examinations Is Poor in Lilongwe Rural West Education District in Malawi

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    Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael

    2015-01-01

    A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from schools'…

  12. Rural Districts between Urbanization and Land Abandonment: Undermining Long-Term Changes in Mediterranean Landscapes

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    Ilaria Zambon

    2018-04-01

    Full Text Available The present study investigates changes in the rural landscapes of a Mediterranean country (Greece over a long time period (1970–2015 encompassing economic expansions and recessions. Using a spatial distribution of 5 basic agricultural land-use classes (arable land, garden crop, vineyards, tree crop and fallow land derived from official statistics at 6 years (1970, 1979, 1988, 1997, 2006, 2015, a quantitative analysis based on correlation and multivariate techniques was carried out to identify recent changes in the Greek agricultural landscape at prefectural level during different economic waves. Empirical results evidenced both intuitive and counter-intuitive landscape transformations, including: (i a progressive, spatially-homogeneous reduction of cropland; (ii a (more or less rapid decrease in the surface of high-input crops, including arable land, horticulture and vineyards; (iii a parallel increase in the surface of tree crops, especially olive; (iv a spatially-heterogeneous decrease of fallow land concentrated in metropolitan and tourism districts, especially in the last decade; and, finally, (v increasingly diversified landscapes in rural, accessible areas close to the sea coast. Based on a correlation analysis with background socioeconomic indicators, our findings reflect the multiple impacts of urbanization and land abandonment on the composition and diversity of rural landscapes. Changes in agricultural land-use were moulded by multiple drivers depending on latent transformations in rural systems and inherent conflicts with expanding urban regions. Together with market conditions and the Common Agricultural Policy subsidy regime, social contexts and the economic cycle are important when identifying long-term changes in agricultural landscapes, especially in transitional socio-ecological systems.

  13. School District Personnel Selection Practices: Exploring the Effects of Demographic Factors on Rural Values within a Person-Organization Fit Model.

    Science.gov (United States)

    Little, Paula S.; Miller, Stephen K.

    A study examined the extent to which demographic factors predict rural values in Kentucky public school district hiring officials. Among the demographic factors considered were school district metropolitan classification, school district size, community racial composition, decision makers' position in the organizational hierarchy, and decision…

  14. Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors.

    Science.gov (United States)

    Sadeghian, Afsaneh; Damghanian, Maryam; Shariati, Mohammad

    2012-01-01

    Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures (8.0% vs. 10.1%). Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates.

  15. The hydrochemistry of groundwater in rural communities within the Tema District, Ghana.

    Science.gov (United States)

    Fianko, Joseph Richmond; Nartey, Vincent K; Donkor, Augustine

    2010-09-01

    A detailed study has been carried out on groundwater in rural communities in the Tema District of the Greater Accra region of Ghana to establish the hydrochemistry and identify the various sources of contaminants as well assess the physical and chemical quality of the groundwater to ascertain their wholesomeness and the health impacts of the groundwater on the communities. The groundwater was found to vary considerably in terms of chemical and physical properties. Generally, the water was mildly acidic (pH 4.3-7.4), brackish to fresh, and undersaturated with respect to gypsum and halite. The majority of groundwater clustered toward Ca-Mg-SO(4) and Na-Cl facies. About 70% of boreholes sampled have elevated levels of NO(3)(-) -N, Cl(-), and SO(4)(2-) emanating from anthropogenic activities.

  16. Rural-Urban Differences in Household Treatment-Seeking Behaviour for Suspected Malaria in Children at Bata District, Equatorial Guinea.

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    Maria Romay-Barja

    Full Text Available Malaria remains a major cause of morbidity and mortality among children under five years old in Equatorial Guinea. However, little is known about the community management of malaria and treatment-seeking patterns. We aimed to assess symptoms of children with reported malaria and treatment-seeking behaviour of their caretakers in rural and urban areas in the Bata District.A cross-sectional study was conducted in the district of Bata and 440 houses were selected from 18 rural villages and 26 urban neighbourhoods. Differences between rural and urban caregivers and children with reported malaria were assessed through the chi-squared test for independence of categorical variables and the t-Student or the non-parametric Mann-Whitney test for normally or not-normally distributed continuous variables, respectively.Differences between rural and urban households were observed in caregiver treatment-seeking patterns. Fever was the main symptom associated with malaria in both areas. Malaria was treated first at home, particularly in rural areas. The second step was to seek treatment outside the home, mainly at hospital and Health Centre for rural households and at hospital and private clinic for urban ones. Artemether monotherapy was the antimalarial treatment prescribed most often. Households waited for more than 24 hours before seeking treatment outside and delays were longest in rural areas. The total cost of treatment was higher in urban than in rural areas in Bata.The delays in seeking treatment, the type of malaria therapy received and the cost of treatment are the principal problems found in Bata District. Important steps for reducing malaria morbidity and mortality in this area are to provide sufficient supplies of effective antimalarial drugs and to improve malaria treatment skills in households and in both public and private sectors.

  17. Self Medication: Predictors and Practices among Rural Population of Nellikuppam Village, Kancheepuram District, Tamil Nadu

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    Kalaivani Annadurai

    2017-01-01

    Full Text Available Background: Inappropriate self medication is one of the leading causes of growing antibiotic resistance in developing nations which poses a major public health threat worldwide and assessment of self medication practices is essential for better understanding of the problem. Aim and Objectives: To find out the predictors of self medication use among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. To assess the self medication practices among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. Material and Methods: This was a descriptive cross sectional study conducted among 335 adult households with six months recall period in Nellikuppam village of Tamil Nadu during May to October, 2014 using a pretested semi-structured questionnaire. Results: Prevalence of self medication among adult rural population was 53.43% and only half of the study population opined that it was harmful. Pharmacists (72.06% were the major source of drug information on self medication. Paracetomol (84.91% was the commonest drug used for self medication. Major predictors were perception of illness as minor ailment and unavailability of doctors in their locality. Nearly half of the current self medication users (47.49% were in the idea of practicing self medication in the future. Conclusion: This study results implies the need for proper enforcement of legal measures towards the restriction of over the counter medicine and creating awareness among general population on adverse reaction of self medication.

  18. Predictors of knowledge towards malaria of rural tribal communities in Dhalai District of Tripura, India.

    Science.gov (United States)

    Kumar, S; Debbarma, A

    2013-10-01

    Reduction of malarial morbidity and mortality is one of the top public health priorities in Tripura and the Country. To achieve these targets it is imperative to have active community participation to control malaria. Community participation in turn depends on people's knowledge and attitude towards the disease. This study was conducted to examine the factors that predict the knowledge of rural tribal communities in Dhalai district of Tripura towards malaria. This community based epidemiological cross-sectional descriptive study was carried out in Dhalai district of Tripura. A pre-tested structured questionnaire collecting socio-demographic and malaria-related KAP information was administered to the 216 adult respondents from a representative sample of households. As a whole, there were 147(68.1%) illiterate respondents. Out of them, 89(41.2%) persons were male and 58(26.9%) were female. Correct knowledge about the cause of malaria was 2.77 times higher in males than females and 11.53 times higher in literate tribal people than in illiterate. Correct knowledge about the symptoms fever, chills, and rigors of malaria were also higher in male sex and in literate tribal people. Use of smoke as preventive measure was very high among the respondents. Common predictors of correct knowledge about etiology and clinical features of malaria were in male Tripuri and Reang community. Use of smoke for killing of adult mosquito was predicted by illiteracy. Promotion of literacy and participation in health education are vital component in terms of knowledge and practice.

  19. Energy aspects of city districts and rural townships; Energieaspekte staedtischer und laendlicher Siedlungen. Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Ott, W.; Arend, M.; Philippen, D. [Econcept AG, Zuerich (Switzerland); Gilgen, K.; Beaujean, K. [Hochschule fuer Technik Rapperswil, Institut fuer Raumentwicklung, Rapperswil (Switzerland); Schneider, S. [Planungsbuero Jud AG, Zuerich (Switzerland)

    2008-01-15

    This illustrated final report for the Swiss Federal Office of Energy (SFOE) presents the results of a project concerning the energy consumption of various residential districts in cities and in rural townships. The analysis examines the consumption of primary energy by residential buildings, their supply and disposal infrastructures and that of traffic induced by settlements. Also, grey energy: consumption for the construction, renovation and demolition of buildings and infrastructures as well as the consumption of primary energy for the production and disposal of individual motor vehicle traffic and public transport is reviewed. Four Swiss case studies are dealt with including largely homogenous residential districts in Effretikon, Oetwil am See, Uster and the City of Zurich. The results of the analyses made are presented in graphical form. The authors quote the great potential for the reduction of the consumption of settlement-dependent primary energy that lies in the fields of energy-efficiency of buildings, mobility and power consumption. The report is rounded off with a comprehensive appendix.

  20. An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

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    Marsh Kevin

    2010-10-01

    Full Text Available Abstract Background Most of the global neonatal deaths occur in developing nations, mostly in rural homes. Many of the newborns who receive formal medical care are treated in rural district hospitals and other peripheral health centres. However there are no published studies demonstrating trends in neonatal admissions and outcome in rural health care facilities in resource poor regions. Such information is critical in planning public health interventions. In this study we therefore aimed at describing the pattern of neonatal admissions to a Kenyan rural district hospital and their outcome over a 19 year period, examining clinical indicators of inpatient neonatal mortality and also trends in utilization of a rural hospital for deliveries. Methods Prospectively collected data on neonates is compared to non-neonatal paediatric (≤ 5 years old admissions and deliveries' in the maternity unit at Kilifi District Hospital from January 1st 1990 up to December 31st 2008, to document the pattern of neonatal admissions, deliveries and changes in inpatient deaths. Trends were examined using time series models with likelihood ratios utilised to identify indicators of inpatient neonatal death. Results The proportion of neonatal admissions of the total paediatric ≤ 5 years admissions significantly increased from 11% in 1990 to 20% by 2008 (trend 0.83 (95% confidence interval 0.45 -1.21. Most of the increase in burden was from neonates born in hospital and very young neonates aged 7 mmol/l predicted inpatient neonatal death with a sensitivity of 81% and a specificity of 68%. Conclusions There is clear evidence of increasing burden in neonatal admissions at a rural district hospital in contrast to reducing numbers of non-neonatal paediatrics' admissions aged ≤ 5years. Though the inpatient case fatality for all admissions aged ≤ 5 years declined significantly, neonates now comprise close to 60% of all inpatient deaths. Simple indicators may identify

  1. Alcohol consumption and household expenditure on alcohol in a rural district in Vietnam

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    Peter Allebeck

    2013-01-01

    Full Text Available Introduction: Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. Aim: This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. Methods: A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females aged 18–60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. Results: The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women. The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Conclusion: Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in

  2. Alcohol consumption and household expenditure on alcohol in a rural district in Vietnam.

    Science.gov (United States)

    Giang, Kim Bao; Van Minh, Hoang; Allebeck, Peter

    2013-01-28

    Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females) aged 18-60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women). The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women) occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in the alcohol policy debate.

  3. Prevalence of canine gastrointestinal helminths in urban Lusaka and rural Katete Districts of Zambia.

    Science.gov (United States)

    Bwalya, Eugene C; Nalubamba, King S; Hankanga, C; Namangala, B

    2011-07-01

    Faecal samples were collected from January 2010 through September 2010 to determine the prevalence of gastrointestinal (GI) helminths infestation in dogs in urban Lusaka and rural Katete Districts of Zambia. A total of 452 faecal samples (n=160 Katete, n=292 Lusaka) were examined by faecal flotation for the presence of helminth eggs and 82.5% of dogs were positive for GI helminths in Katete compared to 76% for Lusaka. Positive results with the presence of at least one parasite corresponded to 72.9% Ancylostoma caninum, 11% Toxocara canis, 4.8% Toxascaris leonina, 2.4% Dipylidium caninum, 0.7% Taeniidae and 0.3% T. vulpis, species for Lusaka while Katete recorded 70.6% A. caninum, 18.1% T. vulpis, 11.1% T. canis, 13.1% D. caninum, 3.8% T. leonina, and 0.6% Taeniidae. Except for T. vulpis and D. caninum (pcaninum showed significant difference in prevalence by age category. The study also showed the presence of zoonotic intestinal helminths A. caninum, T. canis and D. caninum. The study highlights that there was no significant difference in spectrum and prevalence of GI helminths between urban and rural areas in Zambia. It further brings to light the importance of educating owners of dogs on the importance of regular deworming of dogs and control of ectoparasites in order to minimise the risk that these dogs pose to them and the public. © 2011 Elsevier B.V. All rights reserved.

  4. Investigation of Factors Affecting Fuel Consumption of Rural Households in Central District of Zahedan County

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    Maryam Sharifzadeh

    2014-08-01

    Full Text Available Domestic fuel forms a significant part of the total energy demand and providing adequate and sustainable fuel is considered as a pivotal foundation for development. This survey study aims at investigating domestic fuel consumption patterns of rural areas in central district of Zahedan County, Eastern Iran. The sample was consisted of 250 household heads resided in rural areas with more than 25 households. The validity of questionnaire was confirmed by a panel of experts and its reliability was measured by using a pilot study. Findings revealed that, only 43 percent (n=102 household revealed an efficient energy use behavior. The efficient energy consumers were significantly different with respect to their education level, age, income, and the other household characteristics. Results from the structural equation modeling which was used to confirm adequacy of the reasoned action model of fuel consumption behavior, showed that 0.24 percent of fuel consumption behavior was determined by attitude, intention and subjective norms towards fuel consumption. The paper presented applied suggestions regarding fuel consumption with special consideration on health and ecosystem and indoor sanitation issues.

  5. Motivation of human resources for health: a case study at rural district level in Tanzania.

    Science.gov (United States)

    Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie

    2012-01-01

    An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Bacterial pathogen spectrum of acute diarrheal outpatients in an urbanized rural district in Southwest China

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    Yongming Zhou

    2018-05-01

    Full Text Available Objectives: To conduct a one-year pathogen surveillance of acute diarrheal disease based on outpatient clinics in township hospitals in rural Hongta District of Yunnan Province, China. Methods: Fecal specimens of acute diarrhea cases and relevant epidemiological information were collected. Salmonella, Shigella, Vibrio, Aeromonas, Plesiomonas shigelloides and diarrheogenic Escherichia coli (DEC were examined. Results: Among the 797 stool specimens sampled, 198 samples (24.8% were positive in pathogen isolation, and 223 strains were isolated. The order of isolation rates from high to low were DEC, Aeromonas, P. shigelloides, Salmonella, Shigella and Vibrio. The overall positive rate in middle school students and preschool children was relatively high; while the overall positive rate of less than 1-year-old infants and above 55 years olds was relatively low. The isolates were analyzed by pulsed-field gel electrophoresis (PFGE. Some cases had the same or very close onset time, and the isolates had similar PFGE patterns, suggesting a possible outbreak once occurred but was not detected by the current infectious disease reporting system. Conclusions: Pathogen infection and transmission in rapidly urbanized rural areas is a serious issue. There is a great need for a more sensitive and accurate mode of monitoring, reporting and outbreak identification of diarrheal disease. Keywords: Diarrheal disease, Diarrheogenic pathogen, Molecular typing, Surveillance, Bacterial pathogen

  7. Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District.

    Science.gov (United States)

    Kubio, Chrysantus; Tierney, Geraldine; Quaye, Theophilus; Nabilisi, James Wewoli; Ziemah, Callistus; Zagbeeb, Sr Mary; Shaw, Sandra; Murphy, William G

    2012-10-01

    Blood transfusion in rural sub-Saharan Africa presents special challenges. Transfusions are primarily given for emergencies--life-threatening blood loss or anemia; blood is usually collected from family or replacement donors; and facilities to store an adequate reserve in a hospital bank are constrained. We report the everyday and organizational practices in a medium-sized district hospital in Northern Ghana. Information and data on blood transfusion practices at West Gonja Hospital, Damongo, were available from the laboratory reports, from day books and workbooks, and from direct observation in the following four areas: blood collection and blood donors; blood donation testing; blood storage and logistics; and clinical transfusion practice, adverse events, and follow-up. The hospital serves a rural community of 86,000. In 2009, a total of 719 units of whole blood were collected, a rate of 8.36 units per 1000 population. All donors were family or replacement donors. Positivity rates for infectious disease markers were 7.5% (64/853) for hepatitis B surface antigen, 6.1% (50/819) for hepatitis C virus, 3.9% (33/846) for human immunodeficiency virus, and 4.7% (22/468) for syphilis. Supply of laboratory materials was sometimes problematic, especially for temperature-critical materials. Difficulties in sample labeling, storage of blood and laboratory supplies, and disposal of waste were also incurred by operational, material, and financial constraints. Follow-up for outcomes of transfusion is not currently feasible. The operational, demographic, and financial environment pertaining in a rural hospital in Northern Ghana differs substantially from that in which much of current blood transfusion practice and technology evolved. Considerable effort and innovation will be needed to address successfully the challenges posed. © 2012 American Association of Blood Banks.

  8. High prescription of antimicrobials in a rural district hospital in India

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    Alvarez-Uria G

    2014-06-01

    Full Text Available Background: The World Health Organization (WHO recommends surveillance of antibiotic use as part of the strategy to fight against antimicrobial resistance. However, there is little information about the antibiotic consumption in developing countries, especially in rural areas. Objective: The objective of this study was to describe the antimicrobial consumption in a rural hospital in India Methods: The study was performed in a district hospital situated in Anantapur, Andhra Pradesh. In accordance with WHO recommendations, we used the defined daily dose (DDD methodology to measure the antibiotic use during one year (from 1st August 2011 to 1st August 2012. The antibiotic use was measured using DDDs/100 admissions and DDDs/100 patient-days for inpatients, and DDDs/100 visits for outpatients. Results: During the study period, there were 15,735 admissions and 250,611 outpatient visits. Antibiotics were prescribed for 86% of inpatients and 12.5% of outpatients. Outpatient prescriptions accounted for 2/3 of the overall antibiotic consumption. For inpatients, the total antibiotic use was 222 DDDs/ 100 patient-days, 693 DDDs/ 100 admissions and the mean number of antibiotics prescribed was 1.8. For outpatients, the total antibiotic use was 86 DDDs/ 100 outpatient visits and the mean number of antibiotics prescribed was 1.2. The most common antibiotics prescribed were aminopenicillins and 3rd generation cephalosporins for inpatients, and tetracyclines and quinolones for outpatients. In a sample of patients with diarrhoea or upper respiratory tract infections (URTI, the proportion of patients who received antibiotics was 84% (95% confidence interval [CI], 67-93 and 52% (95% CI, 43-62, respectively. Conclusion: In this rural setting, the use of antimicrobials was extremely high, even in conditions with a predominantly viral aetiology such as diarrhoea or URTI.

  9. Prevalence of refractive error and visual impairment among rural school-age children of Goro District, Gurage Zone, Ethiopia.

    Science.gov (United States)

    Kedir, Jafer; Girma, Abonesh

    2014-10-01

    Refractive error is one of the major causes of blindness and visual impairment in children; but community based studies are scarce especially in rural parts of Ethiopia. So, this study aims to assess the prevalence of refractive error and its magnitude as a cause of visual impairment among school-age children of rural community. This community-based cross-sectional descriptive study was conducted from March 1 to April 30, 2009 in rural villages of Goro district of Gurage Zone, found south west of Addis Ababa, the capital of Ethiopia. A multistage cluster sampling method was used with simple random selection of representative villages in the district. Chi-Square and t-tests were used in the data analysis. A total of 570 school-age children (age 7-15) were evaluated, 54% boys and 46% girls. The prevalence of refractive error was 3.5% (myopia 2.6% and hyperopia 0.9%). Refractive error was the major cause of visual impairment accounting for 54% of all causes in the study group. No child was found wearing corrective spectacles during the study period. Refractive error was the commonest cause of visual impairment in children of the district, but no measures were taken to reduce the burden in the community. So, large scale community level screening for refractive error should be conducted and integrated with regular school eye screening programs. Effective strategies need to be devised to provide low cost corrective spectacles in the rural community.

  10. An assessment of the compliance with good pharmacy practice in an urban and rural district in Sri Lanka.

    Science.gov (United States)

    Wijesinghe, P R; Jayakody, R L; De A Seneviratne, R

    2007-02-01

    To evaluate the compliance of private pharmacies to good pharmacy practice (GPP) in an urban and rural district in Sri Lanka and identify deficiencies with a view to improving supply of safe and effective drugs to consumers. Lot quality assurance sampling (LQAS) method was used to determine the number of pharmacies that need to be studied and the threshold limit of defective elements. An inspection of 20 pharmacies in the urban and all 18 pharmacies in the rural district was carried out using a structured checklist. Compliance to seven subsystems of GPP was studied. Storage of drugs, maintenance of cold chain, dispensing and documentation were comprehensively substandard in both districts. Individual items of supervision in registration, physical environment and order of the pharmacy were also found to be substandard in both districts. This study shows that the LQAS method can be used to identify inadequate pharmacy services in the community as a whole. There was poor compliance to GPP by the private pharmacies in both districts. There are concerns about the quality of drugs and the safety of private pharmacy services to the community. Some of the deficiencies could be easily corrected by educating the pharmacists and authorised officers, and more effective and streamlined supervision.

  11. The organized contadi. Administration and territoriality of "rural communities" in four districts of Lombardy (1210-1250 ca

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    Paolo Gabriele Nobili

    2013-01-01

    Full Text Available The paper deals with the evolution in the administrations of four Contadi in central and eastern cities of Lombardy (Bergamo, Brescia, Lodi and Mantova. It begins by examining the estate surveys that in the whole area start from the first two decades of the thirteenth century. These surveys will become instruments of knowledge of local territories. In addition it considers the legislation with which the city was seeking to build an active territoriality of the communities in the district. The district is also divided by cities into smaller administrative entities: the rural communities.

  12. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

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    Ogwang Simon

    2012-03-01

    Full Text Available Abstract Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5% of sub-counties, 21/42 (50.0% parishes and 32/212 (15.1% villages (clusters, were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54 and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14. Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community

  13. Level of males participation during perinatal period in rural areas of district layyah

    International Nuclear Information System (INIS)

    Ishtiaq, M.; Khalid, R.

    2016-01-01

    Background: Although pregnancy is not a disease but life partner and other family members must realize distress and fatigue caused by the pregnancy to pregnant women. Husbands play a very important role in ensuring healthy pregnancy outcomes. Males are mainly responsible in taking decision regarding health seeking of pregnant women in rural areas of Pakistan. This study aimed to explore the level of males participation during perinatal period and to assess their knowledge about danger signs of perinatal period in rural areas of District Layyah, South Punjab. Methods: A community based cross sectional study on pregnant women and their husbands was undertaken in one union council (UC) of district Layyah. 369 couples were selected using proportionate simple random sampling technique. Three hundred and thirty-five agreed and filled the complete questionnaire. Couples having pregnancy or delivery during last one year were included in the study. Women who were divorced, separated or living away from their spouses were excluded. Structured interviewer administered questionnaire adopted from a Nigerian study was translated into Urdu and used to collect data via home visiting. Ethical approval was taken from IRB and written informed consent from the participants. Data was entered and analysed in SPSS V.16. Results: Males level of participation in domestic chores was 326 out of 335 (97.31) and their overall level of knowledge regarding danger signs of pregnancy was 135 out of 335 (40.30 percentage).Economic status (Chi square 6.23, p-value 0.045) and husband educated more than wife (Chi square 10.20, p-value 0.006) were significantly associated with level of knowledge regarding danger signs of pregnancy. Whereas, parity was (Fisher exact test 8.07, p-value 0.017) significantly associated with level of males participation in domestic chores. Conclusion: Husbands have high level of participation in domestic chores but moderate level of knowledge regarding danger signs of

  14. Emergency obstetric care in a rural district of Burundi: What are the surgical needs?

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    E De Plecker

    Full Text Available In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC, we assessed the a characteristics of women at risk of, or with an obstetric complication and their types b the number and type of obstetric surgical procedures and anaesthesia performed c human resource cadres who performed surgery and anaesthesia and d hospital exit outcomes.A retrospective analysis of EmOC data (2011 and 2012.A total of 6084 women were referred for EmOC of whom 2534(42% underwent a major surgical procedure while 1345(22% required a minor procedure (36% women did not require any surgical procedure. All cases with uterine rupture(73 and extra-uterine pregnancy(10 and the majority with pre-uterine rupture and foetal distress required major surgery. The two most prevalent conditions requiring a minor surgical procedure were abortions (61% and normal delivery (34%. A total of 2544 major procedures were performed on 2534 admitted individuals. Of these, 1650(65% required spinal and 578(23% required general anaesthesia; 2341(92% procedures were performed by 'general practitioners with surgical skills' and in 2451(96% cases, anaesthesia was provided by nurses. Of 2534 hospital admissions related to major procedures, 2467(97% were discharged, 21(0.8% were referred to tertiary care and 2(0.1% died.Overall, the obstetric surgical volume in rural Burundi is high with nearly six out of ten referrals requiring surgical intervention. Nonetheless, good quality care could be achieved by trained, non-specialist staff. The post-2015 development agenda needs to take this into consideration if it is to make progress towards reducing maternal mortality in Africa.

  15. Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-05-25

    In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs' experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs' ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs' ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA's self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs' ability to deliver services. Programmes aimed at integrating

  16. Perceptions of water access in the context of climate change by rural households in the Seke and Murewa districts, Zimbabwe

    OpenAIRE

    Mudombi, Shakespear; Muchie, Mammo

    2013-01-01

    The objective of the study was to assess perceptions of rural household heads with regard to various aspects of water access and climate change, and to evaluate whether there were significant differences in perceptions of respondents from female-headed and male-headed households. The study is based on a cross-sectional survey of 300 respondents conducted in the Seke and Murewa districts of Zimbabwe in 2011. The analysis included mainly descriptive statistics. The majority of both female-heade...

  17. Difficulties in accessing and availing of public health care systems among rural population in Chittoor District, Andhra Pradesh

    OpenAIRE

    Geetha Lakshmi Sreerama; Sai Varun Matavalum; Paraiveedu Arumugam Chandresekharan; Veronica Thunga

    2015-01-01

    Context: Despite policies to make health care accessible to all, it is not universally accessible. Frequent evaluation of barriers to accessibility of health care services paves path for improvement. Hence, present study is undertaken to evaluate the factors and public health policies influencing health care access to rural people in Chittoor District, Andhra Pradesh, which can be interpolated for other regions. Aims: To assess knowledge, perceptions, availing of public health care services, ...

  18. Demographic and financial characteristics of school districts with low and high à la Carte sales in rural Kansas Public Schools.

    Science.gov (United States)

    Nollen, Nicole L; Kimminau, Kim S; Nazir, Niaman

    2011-06-01

    Reducing à la carte items in schools-foods and beverages sold outside the reimbursable meals program-can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  19. Harvesting and consumption of fuel and timber wood in rural area of district tank, pakistan

    International Nuclear Information System (INIS)

    Badshah, L.; Hussain, F.; Burni, T.

    2014-01-01

    The study revealed that 90% of the rural people with different age group of District Tank, Pakistan depended upon firewood for catering. The total annual wood consumption for fueling by brick brewers, food sellers and domestic utilization was 18371 metric tons in this remote region. The saw machines also convert 13650 metric tons of timber wood yearly into logs and boards of various grades. The total wood consumption exceeds the quantity of wood harvested by tree fellers, farmers and wood sellers. Therefore the balance of over 13000 metric tons is sourced from neighboring forest of Tehsil Kulachi and Dera Ismail Khan. The quantity of wood removed and consumed for various purposes did not show a significant difference at (0.05) among the six locations. However student t-test showed significant difference existed in the mean annual removal and consumption of wood in the area. The study also enumerated Acacia nilotica, Tamarix aphylla, and Sueda fruticosa as the best and preferred fuel species. While Acacia nilotica, Prosopis farcta and Dalbergia sisso as the frequently used timber species in the region. The criterion of firewood and lumber consumption was very conventional like durability in blaze and opposed to termite. Consequently, it is recommended scientific vegetation conservation strategies meant at improved burning of fuel wood and maximized used of timber products as a complimentary efforts to enforced tree planting for conservation of plant resources. (author)

  20. [Research of the Stormwater Runoff and Pollution Characteristics in Rural Area of Yuhang District, Hangzhou].

    Science.gov (United States)

    Duan, Sheng-hui; Zhao, Yu; Shan, Bao-qing; Tang, Wen-zhong; Zhang, Wen-qiang; Zhang, Shu-zhen; Lang, Chao

    2015-10-01

    In order to investigate the pollution characteristics of stormwater runoff in the southern developed rural region, the runoff samples were collected from four different underlying surfaces during three storm events in Caoqiao and Pujia Tou, which are two typical villages and are located in Yuhang District of Hangzhou. The content of nutrition (nitrogen and phosphorus) and heavy metals (Mn, Cu, Zn, Ni, Cr, Cd, As, Pb) in the simples were analyzed, and the difference of EMC ( event mean concentration) and pollution load of the contaminants in the runoff on different underlying surfaces were compared. The results showed that the EMC of TSS, COD, NH4(+)-N, TP and TN were 16.19, 21.01, 0.74, 1.39 and 2.39 mg x L(-1) in the Caoqiao, respectively; as to Pujia Tou, they were 3.10, 15.69, 0.90, 0.78 and 3.58 mg x L(-1), respectively. The content of heavy metals was all lower than the national surface water quality of two type water in the runoff. Compared with the quality standards for surface water, the EMC of TP was 9 times and 3. 5 times higher and TN was 1. 8 times and 1. 2 times higher in two areas. Besides, the pollution loads of TSS and COD were the highest in farmland.

  1. Prevalence of psychosocial problems among adolescents in rural areas of District Muzaffarnagar, Uttar Pradesh

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    Vaibhav Jain

    2014-10-01

    Full Text Available Introduction: Adolescence is a period of transition between childhood and adulthood. It is a phase of life marked by special attributes including rapid physical growth and development; physical, social and psychological maturity. Aims & Objectives: The present cross sectional study was conducted to assess the prevalence of psychosocial problems among adolescents in a rural area of District Muzaffarnagar. Materials & Methods: The study subjects were 210 adolescent girls and boys (10-19 years old selected using multistage random sampling technique. The subjects were interviewed & detailed information was collected on a structured and pre-tested questionnaire after taking consent from the subject/ parents. The clinical diagnosis was generated as per the criteria laid down in ICD-10. The data was entered in Epi Info statistical software package Version 3.4.3 and suitable statistical methods were applied. Results: The overall prevalence of psychosocial problems amongst adolescent was found to be 41.43%. Most of them had conduct disorder (40.51% males & 35.88% females followed by depression (30.38% males & 26.72% females. Conclusions: There are significant psychosocial problems amongst the adolescents. So, enough emphasis should be given to this component of adolescent health and thus it is recommended that a holistic approach to the underlying causes of psychosocial problems of adolescents should be undertaken.

  2. Prevalence of psychosocial problems among adolescents in rural areas of District Muzaffarnagar, Uttar Pradesh

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    Vaibhav Jain

    2014-09-01

    Full Text Available Introduction: Adolescence is a period of transition between childhood and adulthood. It is a phase of life marked by special attributes including rapid physical growth and development; physical, social and psychological maturity. Aims & Objectives: The present cross sectional study was conducted to assess the prevalence of psychosocial problems among adolescents in a rural area of District Muzaffarnagar. Materials & Methods: The study subjects were 210 adolescent girls and boys (10-19 years old selected using multistage random sampling technique. The subjects were interviewed & detailed information was collected on a structured and pre-tested questionnaire after taking consent from the subject/ parents. The clinical diagnosis was generated as per the criteria laid down in ICD-10. The data was entered in Epi Info statistical software package Version 3.4.3 and suitable statistical methods were applied. Results: The overall prevalence of psychosocial problems amongst adolescent was found to be 41.43%. Most of them had conduct disorder (40.51% males & 35.88% females followed by depression (30.38% males & 26.72% females. Conclusions: There are significant psychosocial problems amongst the adolescents. So, enough emphasis should be given to this component of adolescent health and thus it is recommended that a holistic approach to the underlying causes of psychosocial problems of adolescents should be undertaken.

  3. Modelling seasonal farm labour demand: What can we learn from rural Kakamega district, western Kenya?

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    Vincent Canwat

    2012-09-01

    Full Text Available Seasonality of agricultural activities causes fluctuation in the quantity of labour consumed by these activities, and yet many rural labour studies in developing countries still treat labour demand in agriculture as if it is the same across different farm operations. To unearth the amount of information hidden by this aggregated analysis, labour demand for specific farm operations was estimated based on data collected from Kakamega District. This analysis shows that increasing household size increases labour demand for planting, weeding and harvesting. Increasing the share of elderly household members has a negligible effect on labour demand for farm activities except for land preparation, with which it is positively related. Participation of primary school-going children in farm activities is the highest in planting and harvesting. Participation in off-farm employment seems to increase labour demand only during peak seasons. The area planted appears to have an insignificant effect on labour demand for land preparation. Planting sugar cane appears to reduce labour demand for weeding and primary processing, but planting tea increases labour demand for planting. Mechanising land preparation only reduces labour demand for land preparation, but it seems to be offset by other labour-intensive farm operations. The distance from water source is positively related to labour demand for land preparation, but the distance to the market is negatively related to labour demand for weeding and harvesting. These observations point to the need for supporting and investing in technological and organisational innovations in agriculture.

  4. Religiously Motivated Travel and Rural Tourism in Vhembe District of South Africa

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    Gyekye Agyapong

    2014-01-01

    Full Text Available The study investigated the socio-economic impact of religious tourism (UAAC gathering on the local tourism industry and on surrounding rural communities in Vhembe District Municipality (VDM of South Africa. Questionnaires were used to collect data on pilgrims (visitors, businesses, and residents during, and immediately after the event. Statistical techniques were used to analyse the data to gain insight into the data as basis for answering the research questions posed in this study. The results revealed that majority of the pilgrims to the UAAC gathering were from the host province of Limpopo. Also, most pilgrims travel to the pilgrimage site solely for religious reasons. Another significant finding is that the average spending per pilgrim by pilgrims from the rest of South Africa is larger than their Limpopo and foreign pilgrim counterparts. Furthermore, the results showed that while businesses were positive about the pilgrimage’s contribution to increased sales from their businesses, they at the same time opined that the event does not generate any additional employment. This could be because out of every R100 of pilgrims spending only R2.16 remains in the local economy through leakages. Finally an important finding of the study is overall consensus among residents that the annual pilgrimage gathering promotes morality, improved socialization as well as a sense of feeling good and proud of their community.

  5. The physical and aesthetic quality of ground water in rural areas of Lahore district

    International Nuclear Information System (INIS)

    Salik, M.; Mahmood, K.; Sadiq, M.

    2009-01-01

    Physical and aesthetic parameters of drinking water include total dissolved solids, electrical conductivity (EC), taste, odour, colour and turbidity, Although these parameters are not considered to be harmful for health, but they do effect the look and taste of the water, and may cause it to be undrinkable by some people. Addressing these water quality problems is therefore important and all have relatively simple solutions. A study was conducted in twenty villages of Lahore district to, assess the physical and aesthetic quality of ground water. It was observed that in rural area ground water is used for domestic and drinking purpose. Therefore, tube wells water samples were twenty villages were collected, Bore depths .ranged from 60 to 380 feet. Three water samples were collected from each of twenty villages and were analyzed for total dissolved solids, electrical conductivity (EC), taste, odour, colour and turbidity, Analysis showed that regarding colour, odour and taste all, water samples were fit. Considering World Health Organization permissible limit for turbidity (5 Nephlometric Turbidity Unit) all the water samples were fit. Regarding total dissolved solids, 33.3 % water samples were unfit while, 64.7 % were fit considering the WHO criteria (1000 mill). Regarding pH. 7.5 % of water samples were unfit for drinking and only 25 % water samples fall within safe limit. Considering all the parameters, 10 samples (16.6 %) were fit and remaining 50 samples were unfit out of total 60 water samples. (author)

  6. Sustainability of donor-funded rural water supply and sanitation projects in Mbire district, Zimbabwe

    Science.gov (United States)

    Kwangware, Johnson; Mayo, Aloyce; Hoko, Zvikomborero

    The sustainability of donor-funded rural water supply and sanitation projects was assessed in Mbire district, Zimbabwe in terms of level of community participation, quality of implementation and reliability of the systems. The study was carried out through questionnaires, focus group discussions, interviews and field observations. The results show that the quality of implementation of the projects was deemed to be good and participation of the communities in project ideas initiation and choice of technology was found to be very low. Reliability of the systems was found to be very high with 97% of the boreholes in all the three wards studied being functional. Financial management mechanisms were very poor because water consumers were not willing to pay for operation and maintenance. The projects were classified as potentially sustainable with sustainability index between 5.00 and 6.67. Poor financial management mechanisms for effective borehole maintenance, poor quality of construction and lack of community participation in project planning were found to be potential threats to the sustainability of the projects. Future projects should establish the need for the service and should thus be demand driven to ensure effective participation of the water consumers and enhance project's potential for sustainability.

  7. Access to and Usage of Information among Rural Communities: a Case Study of Kilosa District Morogoro Region in Tanzania

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    Wulystan Pius Mtega

    2012-05-01

    Full Text Available The study investigated how rural communities in Kilosa District of Morogoro region in Tanzania accessed and used information. Specifically the study identified the information needs of rural people; determined the factors influencing the choice of information sources; and the appropriateness of the information sources basing on usefulness and preference. Three divisions were involved in the study area, choice of the study area was based on the availability of multiple information sources/channels information seekers could consulted. Simple random sampling technique was employed in selecting villages to be investigated and respondents to be interviewed. Findings showed that almost all people needed information of all types. Most of the information needed related to day to day problems. Information was accessed mainly through radio, television sets, newspapers and magazines, and also through cell phones and face to face communication. Choice of information sources was influenced by the respondents’ level of education, income, sex, age, occupation and distance from the information seeker’s residence to the information sources. Findings showed further that people accessed and used information for solving day to day problems and for leisure purposes. The study recommends that it is important to have frequent rural information needs assessments before providing information services to rural areas. Information providers should repackage information in appropriate forms suitable for rural communities. Moreover, radio and television stations should have enough rural related programmes which should be broadcasted during appropriate time.

  8. Underperformance of Planning for Peri-Urban Rural Sustainable Development: The Case of Mentougou District in Beijing

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    Jing Lin

    2016-08-01

    Full Text Available As the basic cell of social structures and spatial units, rural settlement is now experiencing profound changes through the rapid urbanization process underway in China, particularly in peri-urban areas which serve as the main platform and battlefield for urban–rural integration in China’s latest round of new urbanization. Therefore, how to achieve better planning for rural settlement in peri-urban areas is becoming a pressing and paramount research agenda. This paper attempts to explore the possible reasons for the underperformance of planning practice for rural settlement in peri-urban areas of China by taking the Mentougou district of Beijing as a case study. Following a quick and comprehensive review of planning in Mentougou district, a systematic and critical evaluation is then conducted accordingly. It shows that the plans generally play a positive role in development orientation and implementation. Yet, there is still a lot of room for improvement, particularly in the following aspects: (1 lack of initiative and innovation at the local level; (2 lack of long-term vision and consistent implementation; (3 lack of rationale-oriented approach; (4 lack of scientific and in-depth research; (5 lack of multi-stakeholder participation. As a way forward, this paper thus proposes a revised planning scheme for local practice, including classification of typologies and the customized planning design for each typology. At last, this paper calls for more in-depth scientific research on some key topics in the planning field, domestically and internationally.

  9. Factors affecting choice of financial services among rural consumers: Emerging experiences from Gicumbi District, northern Province in Rwanda

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    Edward Mutandwa

    2015-11-01

    Full Text Available Enhancement of financial inclusivity of rural communities is often recognised as a key strategy for achieving economic development in third world countries. The main objective of this study was to examine the factors that influence consumers’ choice of a rural bank in Gicumbi district of Rwanda. Data was collected using structured questionnaires and analysed using a binary probit regression model and non-parametric procedures. Most consumers were aware of Popular Bank of Rwanda (BPR and Umurenge SACCO through radio advertisements, social networks and community meetings. Accessibility, interest rates and quality of services influenced choice of a given financial intermediary. Moreover, the decision to open a rural bank account was significantly influenced by education and farm size (p<0.1. These results indicate the need for financial managers to consider these findings for successful marketing campaigns.

  10. Age-dependent decline and association with stunting of Giardia duodenalis infection among schoolchildren in rural Huye district, Rwanda.

    Science.gov (United States)

    Heimer, Jakob; Staudacher, Olga; Steiner, Florian; Kayonga, Yvette; Havugimana, Jean Marie; Musemakweri, Andre; Harms, Gundel; Gahutu, Jean-Bosco; Mockenhaupt, Frank P

    2015-05-01

    Giardia duodenalis infection is highly prevalent and a cause of underweight in pre-school children in rural Rwanda. The present study aimed at assessing the age-pattern of Giardia infection and its manifestation in older children, i.e., during school age. Stool samples were collected from 622 schoolchildren at two schools in the Huye district of southern Rwanda (rural, 301; urban, 321) and subjected to G. duodenalis specific PCR assays. Clinical and anthropometric data, socio-economic status and factors potentially associated with G. duodenalis infection were assessed. Of the 622 children (mean age, 10.4 years), 35.7% were infected with G. duodenalis (rural, 43.9%; urban, 28.0%; PRwanda, G. duodenalis prevalence among children declined throughout school-age. The data suggest that while lacking overt clinical manifestation at high endemicity, G. duodenalis infection is a common cause of stunting in schoolchildren. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Factors Influencing Teacher Job Satisfaction and Their Alignment with Current District Practices in a Rural School District

    Science.gov (United States)

    Wallace, Taneal Marie

    2010-01-01

    School districts' decisions across the country are influencing the satisfaction level of teachers, in both positive and negative ways. With statistics reporting as high as fifty percent of teachers leaving the profession in the first five years of experience (Ingersoll, 2003), determining the reasons for teacher dissatisfaction are important in…

  12. Assessment of drinking water quality and rural household water treatment in Balaka District, Malawi

    Science.gov (United States)

    Mkwate, Raphael C.; Chidya, Russel C. G.; Wanda, Elijah M. M.

    2017-08-01

    Access to drinking water from unsafe sources is widespread amongst communities in rural areas such as Balaka District in Malawi. This situation puts many individuals and communities at risk of waterborne diseases despite some households adopting household water treatment to improve the quality of the water. However, there still remains data gaps regarding the quality of drinking water from such sources and the household water treatment methods used to improve public health. This study was, therefore, conducted to help bridge the knowledge gap by evaluating drinking water quality and adoption rate of household water treatment and storage (HWTS) practices in Nkaya, Balaka District. Water samples were collected from eleven systematically selected sites and analyzed for physico-chemical and microbiological parameters: pH, TDS, electrical conductivity (EC), turbidity, F-, Cl-, NO3-, Na, K, Fe, Faecal Coliform (FC) and Faecal Streptococcus (FS) bacteria using standard methods. The mean results were compared to the World Health Organization (WHO) and Malawi Bureau of Standards (MBS) (MS 733:2005) to ascertain the water quality for drinking purposes. A total of 204 randomly selected households were interviewed to determine their access to drinking water, water quality perception and HWTS among others. The majority of households (72%, n = 83) in Njerenje accessed water from shallow wells and rivers whilst in Phimbi boreholes were commonly used. Several households (>95%, n = 204) were observed to be practicing HWST techniques by boiling or chlorination and water storage in closed containers. The levels of pH (7.10-7.64), F- (0.89-1.46 mg/L), Cl- (5.45-89.84 mg/L), NO3- (0-0.16 mg/L), Na (20-490 mg/L), K (2.40-14 mg/L) and Fe (0.10-0.40 mg/L) for most sites were within the standard limits. The EC (358-2220 μS/cm), turbidity (0.54-14.60 NTU), FC (0-56 cfu/100 mL) and FS (0-120 cfu/100 mL) - mainly in shallow wells, were found to be above the WHO and MBS water quality

  13. Examining the relationship between school district size and science achievement in Texas including rural school administrator perceptions of challenges and solutions

    Science.gov (United States)

    Mann, Matthew James

    Rural and small schools have almost one-third of all public school enrollment in America, yet typically have the fewest financial and research based resources. Educational models have been developed with either the urban or suburban school in mind, and the rural school is often left with no other alternative except this paradigm. Rural based educational resources are rare and the ability to access these resources for rural school districts almost non-existent. Federal and state based education agencies provide some rural educational based programs, but have had virtually no success in answering rural school issues. With federal and state interest in science initiatives, the challenge that rural schools face weigh in. To align with that focus, this study examined Texas middle school student achievement in science and its relationship with school district enrollment size. This study involved a sequential transformative mixed methodology with the quantitative phase driving the second qualitative portion. The quantitative research was a non-experimental causal-comparative study conducted to determine whether there is a significant difference between student achievement on the 2010 Texas Assessment of Knowledge and Skills 8 th grade science results and school district enrollment size. The school districts were distributed into four categories by size including: a) small districts (32-550); b) medium districts (551-1500); c) large districts (1501-6000); and d) mega-sized districts (6001-202,773). A one-way analysis of variance (ANOVA) was conducted to compare the district averages from the 2010 TAKS 8th grade science assessment results and the four district enrollment groups. The second phase of the study was qualitative utilizing constructivism and critical theory to identify the issues facing rural and small school administrators concerning science based curriculum and development. These themes and issues were sought through a case study method and through use of semi

  14. Treatment choices for fevers in children under-five years in a rural Ghanaian district

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    Gyapong Margaret

    2010-06-01

    Full Text Available Abstract Background Health care demand studies help to examine the behaviour of individuals and households during illnesses. Few of existing health care demand studies examine the choice of treatment services for childhood illnesses. Besides, in their analyses, many of the existing studies compare alternative treatment options to a single option, usually self-medication. This study aims at examining the factors that influence the choices that caregivers of children under-five years make regarding treatment of fevers due to malaria and pneumonia in a rural setting. The study also examines how the choice of alternative treatment options compare with each other. Methods The study uses data from a 2006 household socio-economic survey and health and demographic surveillance covering caregivers of 529 children under-five years of age in the Dangme West District and applies a multinomial probit technique to model the choice of treatment services for fevers in under-fives in rural Ghana. Four health care options are considered: self-medication, over-the-counter providers, public providers and private providers. Results The findings indicate that longer travel, waiting and treatment times encourage people to use self-medication and over-the-counter providers compared to public and private providers. Caregivers with health insurance coverage also use care from public providers compared to over-the-counter or private providers. Caregivers with higher incomes use public and private providers over self-medication while higher treatment charges and longer times at public facilities encourage caregivers to resort to private providers. Besides, caregivers of female under-fives use self-care while caregivers of male under-fives use public providers instead of self-care, implying gender disparity in the choice of treatment. Conclusions The results of this study imply that efforts at curbing under-five mortality due to malaria and pneumonia need to take into

  15. Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

    Directory of Open Access Journals (Sweden)

    Kathryn Schnippel

    Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

  16. Dietary patterns and household food insecurity in rural populations of Kilosa district, Tanzania.

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    Julius Edward Ntwenya

    Full Text Available Few studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community.Three hundred and seven (307 randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February-May and post harvest season (September-October in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score.Four food consumption patterns namely (I Meat and milk; (II Pulses, legumes, nuts and cooking oils; (III fish (and other sea foods, roots and tubers; (IV Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I Fruits, cooking oils, fats, roots and tubers (II Eggs, meat, milk and milk products (III Fish, other sea foods, vegetables, roots and tubers and (IV Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest-seasons, respectively (P = 0.01. Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity.Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at alleviating household food insecurity could

  17. Monthly food insecurity assessment in rural mkushi district, Zambia: a longitudinal analysis

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    Muzi Na

    2017-03-01

    Full Text Available Abstract Background Perception-based scales are widely used for household food insecurity (HFI assessment but were only recently added in national surveys. The frequency of assessments needed to characterize dynamics in HFI over time is largely unknown. The study aims to examine longitudinal changes in monthly reported HFI at both population- and household-level. Methods A total of 157 households in rural Mkushi District whose children were enrolled in the non-intervened arm of an efficacy trial of biofortified maize were included in the analysis. HFI was assessed by a validated 8-item perception-based Likert scale on a monthly basis from October 2012 to March 2013 (6 visits, characterizing mostly the lean season. An HFI index was created by summing scores over the Likert scale, with a possible range of 0–32. The Wilcoxon matched signed-ranks test was used to compare distribution of HFI index between visits. A random effect model was fit to quantify the sources of variance in indices at household level. Results The median [IQR] HFI index was 4.5 [2, 8], 5 [1, 8], 4 [1, 7], 4 [1, 6], 3 [1, 7] and 4 [1, 6] at the six monthly visits, respectively. HFI index was significantly higher in visit 1 and 2 than visit 3–6 and on average the index decreased by 0.25 points per visit. Within- and between-household variance in the index were 10.6 and 8.8, respectively. Conclusions The small change in mean monthly HFI index over a single lean season indicated that a seasonal HFI measure may be sufficient for monitoring purposes at population level. Yet, higher variation within households suggests that repeated assessments may be required to avoid risk of misclassification at household level and to target households with the greatest risk of food insecurity.

  18. Situation of Environmental Health of Rural Communities in Palpa District of Nepal

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    Moushami Ghimire

    2013-12-01

    Full Text Available Background: Sanitation  refers to create and  maintain  hygienic conditions, through services such as garbage collection and its proper disposal, wastewater disposal, consumption of safe drinking water, housing condition and its surrounding, an act or process of making sanitary,  the promotion of hygiene and prevention of disease. Human being is a social animal and being a part of society, factors affecting the society also affect human and his surroundings. The study is concerned to demographic variables and environmental practices in rural communities. Objectives: To find out environmental situation and observe an impact of demographic variables on environmental factors. Materials and methods: A cross-sectional study was followed to conduct the study in palpa district of Nepal at 2012. Three hundred thirty nine households were selected through simple random procedure. Semi-structure interview schedule was used to collect information. Data were analyzed using software SPSS for windows version 16.0.  Results: Most of the families were faithful to ethnic group. Practices of refuse and excreta disposable had unsatisfactory where percentages of throwing refuse and open field defecation was 39.2 and 9.1 respectively. 77.6% households were consumed tap water. Most of the households (53.4% did not have proper drainage system around their houses. Conclusion: Family type and caste of households were strongly associated with practice related to excreta disposal, drainage system and refuse disposable. Improper sanitation could be main threat to public health promotion and disease prevention in study areas.

  19. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

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    Irene O. Chiringa

    2016-05-01

    Full Text Available Background: Medical male circumcision (MMC has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose: The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods: The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results: Socioculturally, circumcised men are viewed as worthless (37%, shameful (30% and are tainted as promiscuous (20%, psychological factors reported were infection and delayed healing (39%, being ashamed and dehumanised (58%, stigmatised and discriminated (40.2% and fear of having an erection during treatment period (89.7% whilst socio-economic factors were not having time, as it will take their time from work (58% and complications may arise leading to spending money on treatment (84%. Conclusion: Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services. Keywords: Factors, Low uptake, Medical Male Circumcision (MMC

  20. Human Visceral Leishmaniasis: a Serological Survey in Rural Areas of Dashti District of Bushehr Province, Southern Iran

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    Mohammad Gorgipoor

    2017-04-01

    Full Text Available Background: Visceral leishmaniasis (VL or kala-azar is a parasitic disease caused by the species of Leishmania donovani complex. Mediterranean type of the disease is endemic in some parts of Iran and more than 95% of cases were reported in children up to 12 years of age. This study was performed to determine the seroprevalence of VL in the rural areas of the Dashti district from Bushehr province.Materials and Methods: In this cross-sectional study, a randomized cluster sampling method was used for the collection of blood samples from children up to 12 years old from rural areas of Dashti district. Before sampling; a questionnaire was filled out for each case. All the collected blood samples were examined after the serum separating by Direct Agglutination Test (DAT for detection of anti-Leishmania infantum antibodies. The cutoff titers of ≥1: 3200 with specific clinical features were supposed to be considered as VL.Results: Altogether, 24 out of 1221 (1.96% blood samples showed titers between 1:800 and 1:1600 which considered as suspicious cases. None of the suspicious cases had a history of kala-azar. None of 1221 collected blood samples showed anti Leishmania infantum (L. infantum at titer ≥1:3200.Conclusion: This study confirms the circulation of L. infantum in Dashti district and highlights the sporadic pattern of VL in the studied areas which necessitates the surveillance system to be monitored by health authorities.

  1. Challenges faced by professional nurses when implementing the Expanded Programme on Immunisation at rural clinics in Capricorn District, Limpopo

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    Tebogo M. Mothiba

    2016-05-01

    Full Text Available Background: Immunisation is the cornerstone of primary healthcare. Apart from the provision of safe water, immunisation remains the most cost-effective public health intervention currently available. Immunisation prevents infectious conditions that are debilitating, fatal and have the potential to cause huge public health burdens, both financially and socially, in South Africa. Aim: To determine the challenges faced by professional nurses when implementing the Expanded Programme on Immunisation (EPI at rural clinics in Capricorn District, Limpopo Province, South Africa. Setting: The study was conducted in selected primary healthcare clinics of Capricorn District, Limpopo Province. Methods: A qualitative explorative descriptive contextual research design was used to gather data related to the challenges faced by professional nurses when implementing EPI at rural clinics in Capricorn District. Results: The findings revealed that professional nurses had knowledge of the programme, but that they experienced several challenges during implementation of EPI that included staff shortages and problems related to maintenance of the vaccines’ potency. Conclusions: The Department of Health as well as the nursing administration should monitor policies and guidelines, and especially maintenance of a cold chain for vaccines, to ensure that they are practised throughout Limpopo Province. The problem of staff shortages also needs to be addressed so that the EPI can achieve its targeted objectives. Keywords: Professional nurse, knowledge, EPI-SA, immunisation

  2. Knowledge, attitude and practice of private practitioners regarding tb-dots in a rural district of Sindh, Pakistan

    International Nuclear Information System (INIS)

    Ahmed, M.; Fatmi, Z.; Ali, S.; Ahmed, S.; Ara, N.

    2009-01-01

    Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural area of Sindh, Pakistan. This survey was conducted in January 2007 at Thatta, a rural district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and management through DOTS. Survey data was analysed through SPSS version 11.05 software. On average, five TB suspects per month were seen by each PP. Only 14% of PPs advised sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over 40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs (85%) did not follow the treatment through sputum microscopy and instead relied on clinical improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance to the TB treatment and none of PPs were following the retrieval of default cases. A gross lack of PPs knowledge and right practice regarding TB diagnosis and management through DOTS was identified and needed to be addressed through providing DOTS training. (author)

  3. Nursing Personnel Planning for Rural Hospitals in Burdwan District, West Bengal, India, Using Workload Indicators of Staffing Needs

    Science.gov (United States)

    Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil

    2014-01-01

    ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199

  4. Perinatal mental health care in a rural African district, Uganda: a qualitative study of barriers, facilitators and needs.

    Science.gov (United States)

    Nakku, Juliet E M; Okello, Elialilia S; Kizza, Dorothy; Honikman, Simone; Ssebunnya, Joshua; Ndyanabangi, Sheila; Hanlon, Charlotte; Kigozi, Fred

    2016-07-22

    Perinatal mental illness is a common and important public health problem, especially in low and middle-income countries (LMICs). This study aims to explore the barriers and facilitators, as well as perceptions about the feasibility and acceptability of plans to deliver perinatal mental health care in primary care settings in a low income, rural district in Uganda. Six focus group discussions comprising separate groups of pregnant and postpartum women and village health teams as well as eight key informant interviews were conducted in the local language using a topic guide. Transcribed data were translated into English, analyzed, and coded. Key themes were identified using a thematic analysis approach. Participants perceived that there was an important unmet need for perinatal mental health care in the district. There was evidence of significant gaps in knowledge about mental health problems as well as negative attitudes amongst mothers and health care providers towards sufferers. Poverty and inability to afford transport to services, poor partner support and stigma were thought to add to the difficulties of perinatal women accessing care. There was an awareness of the need for interventions to respond to this neglected public health problem and a willingness of both community- and facility-based health care providers to provide care for mothers with mental health problems if equipped to do so by adequate training. This study highlights the acceptability and relevance of perinatal mental health care in a rural, low-income country community. It also underscores some of the key barriers and potential facilitators to delivery of such care in primary care settings. The results of this study have implications for mental health service planning and development for perinatal populations in Uganda and will be useful in informing the development of integrated maternal mental health care in this rural district and in similar settings in other low and middle income countries.

  5. Role Of Gram Panchayat In Rural Development A Study Of Mathura District Uttar Pradesh

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    Suman Kumari

    2015-08-01

    Full Text Available The Panchayats are expected to play an important role in rural development in India particularly after independence. Plan documents of both the central and state governments and various committees have emphasized the importance of these bodies in the policy. Sustainable and inclusive growth of overall rural development of Panchayat Raj Institutions. Empowering rural population to participate in rural development programs for improving their quality of life. Providing rural infrastructure and socio-economic growth opportunities for the poor people in rural areas. Accountable and efficient functions of Panchayat Raj Institutions. Providing opportunity for rural livelihood. Development of rural areas has a bearing on improved agricultural production and related economic activities availability of natural and financial resources and their development improvement of service delivery - paving way for improved human development. The department is striving hard to improve the livelihood of the rural populace and to inculcate awareness in the economic social and political spheres through effective implementation of decentralized administration and implementation of programmes decided particularly by the rural populace.

  6. Understanding the strategies employed to cope with increased numbers of AIDS-orphaned children in families in rural settings: a case of Mbeya Rural District, Tanzania.

    Science.gov (United States)

    Fauk, Nelsensius Klau; Mwakinyali, Silivano Edson; Putra, Sukma; Mwanri, Lillian

    2017-02-07

    The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome (AIDS)-orphaned children (Adoptive families) for coping with and mitigating the impact of AIDS in Mbeya Rural District, Tanzania. High numbers of AIDS-orphaned children aged below 18 years in Mbeya Region have led to increasing the burden of families caring for them. Understanding the coping strategies and impact mitigation activities employed by adoptive families is important in order to develop programmes to help them. This study employed a qualitative method for data collection (one-on-one in-depth interviews). The respondents included 12 male and 8 female heads of families that provide essential care for AIDS-orphaned children in Mbeya Rural District in Tanzania. The framework approach was used to analyse the data that were collected from 15 July to 15 August 2010. The study findings revealed that adoptive families faced several challenges including financial constraints due to increased needs for basic essentials such as health care expenses, school fees and food. Further impacts on adoptive families included shortage of work opportunities and limited time to address these challenges. To mitigate these challenges, adoptive families employed a range of coping strategies including selling family assets and renting out parts of cultivable land for extra cash. Task reallocation which involved the AIDS-orphaned children entering the labour force was also employed as a strategy to mitigate challenges and involved de-enrolling of children from schools so they could take part in income-generating activities in order to earn supplementary family income. The creation of additional income-generating activities such as poultry farming were other coping mechanisms employed, and these received support from both non-governmental organisations (NGOs) and governmental organisations, including the Isangati Agricultural Development Organization (local

  7. Interaction between Rural People’s Basic Needs and Forest Products: A Case Study of the Katha District of Myanmar

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    Zar Chi Hlaing

    2017-01-01

    Full Text Available The understanding of interaction between rural people and forest products is one of the challenges faced while balancing forest product utilization with forest conservation in Myanmar. This study aims to contribute an effort to such challenges by analyzing the interaction of rural households with forest products in Myanmar. Data were collected using face-to-face questionnaire interviews with 218 households and conducting a rapid tree inventory across 132 circular random plots in selected rural communities around four townships of the Katha District. The empirical results indicate that the 95% of rural households were entirely dependent on forest products. The survey documented 13 main forest products and 54 tree species, which were primarily used for household consumption. Low-income households compared with medium- and high-income households with low educational level (p<0.05 and a small agricultural land area (p<0.05 were found to be more forest-dependent households. Illegal logging, mining, fuel-wood collection, slash-and-burn agriculture, and the establishment of forest plantations were reported as the main causes of forest products depletion. Findings from this study, although at a microlevel, can be used by the Myanmar Forestry Department as baseline information to improve community-based forest management activities.

  8. Experiences of nurses working in a rural primary health-care setting in Mopani district, Limpopo Province

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    MP Mohale

    2008-09-01

    Full Text Available Professional nurses working in rural, primary health-care settings are experiencing burnout due to serious shortages of personnel. This is exacerbated by the brain drain of nurses leaving the country. Rural settings are resource constrained in terms of personnel and equipment. This results in dissatisfaction among nurses due to the unbearable working conditions which result in stress and frustration. A qualitative, explorative, descriptive study was conducted to explore and describe the experiences of nurses working in a rural primary health-care setting in the greater Letaba sub district in Limpopo Province. Purposive sampling was used to identify the participants. Data was collected in the form of in-depth interviews. The study revealed that nurses working in primary health-care settings were experiencing emotional and physical strain as a result of the shortage of human resources. It was recommended that policies that meet the health-care needs of rural communities be developed, and that strategies to retain professional nurses in primary health-care settings be formulated.

  9. Inter-linkage between Hinterlands and Service Centers of Bima and Darbang VDCs in Myagdi District: A Rural Development Perspective

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    Beg Prasad Garbuja

    2015-12-01

    Full Text Available This study focuses on exploring the status and contribution of inter- linkage relationship between service center and rural hinterland. The study was conducted in Bima and Darbang Village Development Committees (VDCs of Myagdi district. This paper has used rural development perspective. The respondents were from 63 sample households including producers, consumers and service providers selected by using probability and non probability sampling methods. The primary data were collected through survey questionnaire, key informant interview, participant observation and focus group discussion whereas secondary data were generated from published and unpublished books, articles, journals, profile of VDCs and DDC. The study has revealed with various types of linkage between service center and rural hinterland i.e. service delivery, spatial or physical, administrative, economic, technological, financial and socio-cultural, educational and health service linkage. The study also highlighted productive role of remittance, international experience and adaptation of modern agriculture technology that has been positively affecting socio-economic life of the rural people. Further, joint efforts of public and private sectors’ and local stakeholders’ can be applied for developing and promoting service delivery opportunities and marketing facilities to the local people. The finding of the study has very strong implications to the local stakeholders for formulation of short run and long run local development plan in a similar situation.

  10. Factors Influencing Participation of Rural Women in Zimbabwes 2013 Constitution Referendum A Case Study Of Ward 22 Gutu District

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    Barbra Ncube

    2015-08-01

    Full Text Available Abstract Participation is the cornerstone of citizen engagement. In constitution making and other public policy formulation processes public participation typically involves preparing the public to participate through civic education and public information campaigns as well as consulting the public on issues such as how the process should take place and the contents of the constitution itself. This study sought to examine the factors that influence womens participation in constitution making processes specifically relating to voting in the constitution referendum in the case of rural women residing in ward 22 of Gutu district of Zimbabwe. Gutu District is the third largest district in Masvingo province. Ward 22 is located in the communal region of Gutu central. The people of ward 22 largely depend on subsistence farming and market gardening for their livelihoods. The objectives of the study were to ascertain to what extent media campaign and publicity efforts by womens civic groups and public interaction through public meetings and hearings were able to influence the participation of Zimbabwean women in the 2013 referendum in ward 22 Gutu district. Over and above these objectives the study sought to document the experiences and views of rural Zimbabwean women on the constitution making process. This study adopted a descriptive case study research design. Samples of 108 women from Ward 22 Gutu District were conveniently selected to participate in this study. Data was collected using a structured interview guide and questionnaires which were administered to the respondents. A focused group discussion was also carried out to verify the information gathered through these instruments. Findings and conclusions were derived by means of detailed comparative and inductive analysis of data. Descriptive statistics were employed in the presentation of the findings. Amongst the major findings are that rural women in ward 22 in Gutu district were in actual

  11. Improving the Small Rural or Remote School: The Role of the District

    Science.gov (United States)

    Clarke, Simon; Wildy, Helen

    2011-01-01

    There is a robust body of work highlighting distinctive challenges encountered by leaders of small schools in pursuit of school improvement but this work has focused on the school as the unit of change and neglects the role of the district. As the district potentially influences what principals know and how they use their knowledge, this article…

  12. Trends and Determinants of Rural Poverty: A Logistic Regression Analysis of Selected Districts of Punjab

    OpenAIRE

    Amara Amjad Hashmi; Maqbool H. Sial; Maaida Hussain Hashmi

    2008-01-01

    Poverty is widespread in the rural areas, where the people are in a state of human deprivation with regard to incomes, clothing, housing, health care, education, sanitary facilities and human rights. Nearly 61 percent of the country’s populations live in rural areas. In Pakistan poverty has been increased in rural areas and is higher than urban areas. Of the total rural population 65 percent are directly or indirectly linked with agriculture sector. In Pakistan more than 44.8 percent people g...

  13. Association between Childhood Diarrhoeal Incidence and Climatic Factors in Urban and Rural Settings in the Health District of Mbour, Senegal

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    Sokhna Thiam

    2017-09-01

    Full Text Available We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011–2014. Climatic data (i.e., daily temperature, night temperature and rainfall for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health–climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming.

  14. Association between Childhood Diarrhoeal Incidence and Climatic Factors in Urban and Rural Settings in the Health District of Mbour, Senegal.

    Science.gov (United States)

    Thiam, Sokhna; Diène, Aminata N; Sy, Ibrahima; Winkler, Mirko S; Schindler, Christian; Ndione, Jacques A; Faye, Ousmane; Vounatsou, Penelope; Utzinger, Jürg; Cissé, Guéladio

    2017-09-12

    We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011-2014). Climatic data (i.e., daily temperature, night temperature and rainfall) for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health-climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming.

  15. Dental Caries and Their Treatment Needs in 3-5 Year Old Preschool Children in a Rural District of India

    Science.gov (United States)

    Gupta, Devanand; Momin, Rizwan K; Mathur, Ayush; Srinivas, Kavuri Teja; Jain, Ankita; Dommaraju, Neelima; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

    2015-01-01

    Background: Dental problems in the preschool children are neglected by their parents as the deciduous teeth are going to shed off, and hence considered to be of no importance and more of economic burden if attended to them. Aims: This study was to determine the caries prevalence in preschool children (3-5-year-old) of rural Moradabad district, to analyze the specific pattern of dental caries experience in this population and to assess the treatment needs among them. Material and Methods: Children within the age group of 3-5 years attending Anganwadi centers of rural Moradabad district were included in the study. Caries diagnosis was based on decayed, extracted, filled surface (defs) and the treatment needs were recorded using World Health Organization (WHO) oral health assessment form 1997. Results: Out of 1,500 children examined, 48.7% males and 52.6% females did not require any treatment. The mean decayed, extracted, filled teeth (deft) value was found to be significantly high in 5-year-old participants when compared to 3-year-old participants (P caries arresting sealant care, extraction, crown bridge element, pulp care, and space maintainer. Conclusion: The most common pattern was pit and fissure, then maxillary anterior pattern, posterior proximal pattern, and posterior buccal lingual smooth surface pattern. The mean deft value was higher in males as compared to females. There is a greater need for oral health education among parents and teachers. PMID:25973401

  16. Mobility and Access for Off-Road Rural Farmers in West-Akim District

    African Journals Online (AJOL)

    The study is on the rural transportation problem in Ghana and its consequences on the rural people, especially those who live in off road villages (villages that do not have access to regular transportation systems). The study specifically discusses the failure of the existing road transport network to provide sufficient services ...

  17. Family Size and Rural Poverty -in the Kwahu South District in Ghana ...

    African Journals Online (AJOL)

    Rural Poverty is one of the greatest social problems confronting the world today. The problem is more pronounced in the developing countries. Ghana is no exception to this global problem of rural poverty. Ghana as a nation has adopted a lot of measures to address poverty. From the early 1980's to 2002, the country has ...

  18. Rural Industrial Entrepreneurship - The Case of Bardhaman District in West Bengal

    NARCIS (Netherlands)

    Dutta, S.

    2004-01-01

    For a living, most of the rural people in developing countries are primarily dependent on agriculture. If the farmers, who have investible surplus generated from agriculture, are interested in non-farm entrepreneurship then rural economy can find an industrial route of development. With this

  19. Urban-rural disparities in the nutritional status of school adolescent girls in the Mizan district, south-western Ethiopia.

    Science.gov (United States)

    Berheto, Tezera M; Mikitie, Wondafrash K; Argaw, Alemayehu

    2015-01-01

    Malnutrition that occurs during adolescence has important consequences for the future growth and development of the individual, particularly in girls in developing countries. Besides limiting growth, adolescent malnutrition has important consequences for society. Despite this, there is a lack of information on the nutritional status of adolescent girls in Ethiopia. This study was therefore performed to help redress this lack of data and to provide information for future improvements by health planners and policy makers. A comparative cross-sectional study design was employed to determine the urban-rural disparity in nutritional status of adolescent school girls in the Mizan district in south-western Ethiopia. A two-stage sampling procedure was used to randomly select 622 adolescent girls, 311 each from urban and rural locations. Trained field workers used structured questionnaires to obtain the desired information from the respondents. Anthropometric measurements of height and weight were collected using standard procedures and appropriate quality control measures. Height-for-age Z-scores and body mass index (BMI)-for-age Z-scores were generated using AnthroPlus software. The independent sample t-test and χ2 test were used to determine statistical significance. There were no significant differences in the ages or physical activities of the two populations of girls studied. Consumption of cereal, vegetables, sweets, sugars, fats, meat, and eggs was similar between the two groups, although slight differences were found with regard to legumes, milk, and fruit consumption. No significant differences were found in the prevalence of mild underweight girls and overweight girls in the urban and rural groups (26.5% vs 22.3% and 7.5% vs 5.2%, respectively). Significant stunting was, however, present in the rural population (40.9% vs. 17.8% in the urban group). Although overall lower than the reference data provided by WHO, the mean BMI-for-age Z-scores and height-for-age Z

  20. The forecast scenario of rural territories infrastructure development (on the example of the Volga federal district

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    Valery Nikolaevich Zekin

    2014-06-01

    Full Text Available The authors’ point of view at the forecast of rural territories infrastructure development in Permskiy krai, Udmurtia and Kirovskaya Oblast by considering of innovative technology implementation is given in this paper. The improvement of rural people life conditions has been planned on the basis of this research. The indexes for life quality of rural people assessment were determined. The main ways for their increasing were defined. An important role in this process belongs to the small innovative enterprises, which develop new technologies and forward them to rural enterprises. It reduces risks because of their implementation and promotes the sustainable development of rural territories. It is planned that on the basis of the authors’ method of innovations application, the subsidized regions using their potential will sell their products on the external market of countries accessed to WTO and thereby will provide population with employment and increase its standard of living.

  1. Identification of a threshold for biomass exposure index for chronic bronchitis in rural women of Mysore district, Karnataka, India

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    P A Mahesh

    2013-01-01

    Full Text Available Background & objectives: Exposure to air pollution due to combustion of biomass fuels remains one of the significant risk factors for chronic respiratory diseases such as chronic bronchitis. There is a need to identify the minimum threshold level of biomass index that is significantly associated with chronic bronchitis. This study was undertaken to identify a threshold for biomass exposure index in a rural women population in Mysore district, south India. Methods: A cross-sectional survey was conducted in a representative population of Mysore and Nanjangud taluks. Eight villages each from Mysore and Nanjangud were randomly selected based on the list of villages from census 2001. A house-to-house survey was carried out by trained field workers using the Burden of Obstructive Diseases questionnaire, which evaluated the biomass smoke exposure and chronic bronchitis. All the women aged above 30 yr were included in the study. Results: A total of 2011 women from Mysore and 1942 women from Nanjangud participated in the study. All women were non-smoking and used biomass fuels as the primary fuel for cooking. A threshold of biomass fuel exposure of 60 was identified on multivariate analysis in Mysore district after adjusting for age, passive smoking and working in a occupational exposure to dust, as the minimum required for a significant association with chronic bronchitis. One in every 20 women in Mysore district exposed to biomass fuel exposure index of 110 or more developed chronic bronchitis. Interpretation & conclusions: The minimum threshold of biomass exposure index of 60 is necessary to have a significant risk of developing chronic bronchitis in women. The number needed to harm to develop chronic bronchitis reduces with increasing biomass exposure index and women residing in rural Nanjangud have a higher risk for developing chronic bronchitis as compared to women in Mysore.

  2. Identification of a threshold for biomass exposure index for chronic bronchitis in rural women of Mysore district, Karnataka, India.

    Science.gov (United States)

    Mahesh, P A; Jayaraj, B S; Prabhakar, A K; Chaya, S K; Vijaysimha, R

    2013-01-01

    Exposure to air pollution due to combustion of biomass fuels remains one of the significant risk factors for chronic respiratory diseases such as chronic bronchitis. There is a need to identify the minimum threshold level of biomass index that is significantly associated with chronic bronchitis. This study was undertaken to identify a threshold for biomass exposure index in a rural women population in Mysore district, south India. A cross-sectional survey was conducted in a representative population of Mysore and Nanjangud taluks. Eight villages each from Mysore and Nanjangud were randomly selected based on the list of villages from census 2001. A house-to-house survey was carried out by trained field workers using the Burden of Obstructive Diseases questionnaire, which evaluated the biomass smoke exposure and chronic bronchitis. All the women aged above 30 yr were included in the study. A total of 2011 women from Mysore and 1942 women from Nanjangud participated in the study. All women were non-smoking and used biomass fuels as the primary fuel for cooking. A threshold of biomass fuel exposure of 60 was identified on multivariate analysis in Mysore district after adjusting for age, passive smoking and working in a occupational exposure to dust, as the minimum required for a significant association with chronic bronchitis. One in every 20 women in Mysore district exposed to biomass fuel exposure index of 110 or more developed chronic bronchitis. The minimum threshold of biomass exposure index of 60 is necessary to have a significant risk of developing chronic bronchitis in women. The number needed to harm to develop chronic bronchitis reduces with increasing biomass exposure index and women residing in rural Nanjangud have a higher risk for developing chronic bronchitis as compared to women in Mysore.

  3. Flooding and poverty: Two interrelated social problems impacting rural development in Tsholotsho district of Matabeleland North province in Zimbabwe

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    Ernest Dube

    2018-03-01

    Full Text Available Flooding and poverty are the two social problems that have coexisted within the rural communities of Tsholotsho district. As a result, both problems have negatively affected and disrupted the everyday pattern of lives of people living in the district. This study sought to highlight how the two problems combine to impact human societies. The objectives that the study sought to fulfil were to establish the impact of flooding on the development of rural communities, to analyse how poverty manifests itself in rural communities, to analyse the relationship that exists between flooding and poverty and to suggest ways for dealing with the two problems. A qualitative research approach, using interviews and observations, was used to gather data from the research participants. The study findings were that flooding impeded development through shifting of human populations, destruction of crops, shelter and livestock. Floods also affected human capital through causing injuries to members of the community. Poverty manifested itself in three ways – as a development barrier, a vulnerability amplifier and a non-discriminatory agent. The study further found that a strong relationship exists between flooding and poverty because of the fact that flooding causes or worsens poverty, whereas poverty increases flood vulnerability. The study concluded that the poor need government assistance to reconstruct shelter destroyed by floods. Furthermore, programs aimed at improving livelihoods of the poor are an indispensable imperative. This study informs policymakers and offers a methodological significance to development and disaster practitioners. It also adds to the body of literature on flooding and poverty.

  4. Prevalence of anemia and associated factors in children living in urban and rural settings from Bata District, Equatorial Guinea, 2013.

    Science.gov (United States)

    Ncogo, Policarpo; Romay-Barja, Maria; Benito, Agustin; Aparicio, Pilar; Nseng, Gloria; Berzosa, Pedro; Santana-Morales, Maria A; Riloha, Matilde; Valladares, Basilio; Herrador, Zaida

    2017-01-01

    Anemia in children under 5 years of age is a global public health problem. According to the World Health Organization the current rate of anemia among preschool aged children in Equatorial Guinea is 66%. No information is available above this age. The cross-sectional Prevamal Survey was conducted in 2013 aimed at providing baseline data on malaria prevalence in children aged 2 months-15 years old. Sampling was carried out with the use of a multistage, stratified cluster strategy in the district of Bata, Equatorial Guinea. The χ2 test and adjusted Poisson regression models were applied to assess the association between social-demographic and economic factors, malaria and anemia. A total of 1436 children were tested, out of which 1,421 children (99%) were tested for anemia. Over 85% were anemic; out of them, 284 (24%), 815 (67%) and 111 (9%) children had mild, moderate and severe anemia, respectively. Severe anemia was more frequent among children aged 2-12 months old and those living in rural sites. About 47% tested positive for malaria via a rapid diagnostic test (RDT). This rate was significantly higher in rural villages (66%; panemia and malaria was higher in rural settings (panemia in urban areas displayed a heterogeneity and complexity that differed from the rural environment: in urban neighbourhoods, children with concomitant malaria infection were more likely to be anemic (adjusted prevalence rate (aPR):1.19; CI 95%: 1.12-1.28). Moreover, the prevalence of anemia was higher in children aged above 13 months compared to younger children (pchildren' parents being employees (aPR: 0.86, 95% CI: 0.76-0.96) or self-employed (aPR: 0.86, 95% CI: 0.76-0.97) vs. working in agriculture and/or fishing negatively associated with anemia among urban children. This marked urban-rural variation indicates the importance of targeting specific areas or districts. Strategies aimed at reducing malaria are clearly paramount in this country. Prevention and treatment of other factors

  5. Prevalence of anemia and associated factors in children living in urban and rural settings from Bata District, Equatorial Guinea, 2013.

    Directory of Open Access Journals (Sweden)

    Policarpo Ncogo

    Full Text Available Anemia in children under 5 years of age is a global public health problem. According to the World Health Organization the current rate of anemia among preschool aged children in Equatorial Guinea is 66%. No information is available above this age. The cross-sectional Prevamal Survey was conducted in 2013 aimed at providing baseline data on malaria prevalence in children aged 2 months-15 years old. Sampling was carried out with the use of a multistage, stratified cluster strategy in the district of Bata, Equatorial Guinea. The χ2 test and adjusted Poisson regression models were applied to assess the association between social-demographic and economic factors, malaria and anemia. A total of 1436 children were tested, out of which 1,421 children (99% were tested for anemia. Over 85% were anemic; out of them, 284 (24%, 815 (67% and 111 (9% children had mild, moderate and severe anemia, respectively. Severe anemia was more frequent among children aged 2-12 months old and those living in rural sites. About 47% tested positive for malaria via a rapid diagnostic test (RDT. This rate was significantly higher in rural villages (66%; p<0.001. The prevalence of anemia and malaria was higher in rural settings (p<0.001. On the other hand, anemia in urban areas displayed a heterogeneity and complexity that differed from the rural environment: in urban neighbourhoods, children with concomitant malaria infection were more likely to be anemic (adjusted prevalence rate (aPR:1.19; CI 95%: 1.12-1.28. Moreover, the prevalence of anemia was higher in children aged above 13 months compared to younger children (p<0.005. Belonging to the poorest wealth tertile were positively (aPR: 1.14, 95% CI: 1.05-1.24 and children' parents being employees (aPR: 0.86, 95% CI: 0.76-0.96 or self-employed (aPR: 0.86, 95% CI: 0.76-0.97 vs. working in agriculture and/or fishing negatively associated with anemia among urban children. This marked urban-rural variation indicates the

  6. Characteristics of Poverty in Rural Communities of Gold Mining District Area West Sumbawa

    OpenAIRE

    Ibrahim, Ibrahim; Baiquni, Muhammad; Ritohardoyo, Su; Setiadi, Setiadi

    2016-01-01

    The research is conducted in rural areas of gold mining with the aim to find out the characteristics of poverty in the rural area of gold mining in West Sumbawa regency. The survey method is used in this study, focusing on the rural mining area. Sample of respondents are 167 households, selected by purposive sampling from four villages, which are determined based on the first ma slope. The data analysis uses cross tabulation and frequency tables. The results showes that the poverty rate in th...

  7. Determinants of smoking and chewing habits among rural school children in Bankura district of West Bengal, India

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    Naba Kumar Das

    2013-01-01

    Full Text Available Objectives The present study was undertaken to assess the prevalence of smoking and chewing habits and causes of addiction among the school children of rural areas.Methods This cross-sectional study was conducted in four secondary schools from rural areas of Bankura District, West Bengal during August 2012 to September 2012. Total 1674 students studying in 5th to 10th standard (age group of 10-15 years were enrolled in the present study. A self-administered questionnaire was applied for data collection.Results The study showed that 18.45%, 27.95% and 67.56% of the students were smokers, chewer and non-addicted, respectively. Considerable number of boys were addicted with smoking (boys 32.3% vs. 4.33girls % and chewing habits (boys 43.53% vs 12.15girls %. In case of boys, these habits were increased with advancement of ages. Students were more attracted to bidi and tobacco with pan-masala among different types of smoking and chewing agents. The most familiar reasons for tobacco user were: influenced by friends (22.88%, influenced by family members (16.32% and stress relief (10.88%. Conclusion This study indicated that smoking and chewing habits among school children in rural areas is looming public health issue. Adverse health effect of tobacco use may be incorporated in school secondary curriculum to change the attraction with tobacco among the young generation.

  8. Exclusive Breast Feeding-Knowledge In Different Groups Of Women In Rural And Urban Areas Of Lucknow District

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    Ahmed Naim

    2013-06-01

    Full Text Available A cross-sectional study on S6 females was conducted in the rural and urban areas of Lucknow district of Uttar Pradesh to assess the knowledge of females about exclusive breast-feeding. Knowledge from adolescent girls, married and lactating women was assessed by a pre­tested questionnaire for biosocial correlates (such as marital status,educational status, medium of education, working status, socio-economics status and family size, sources of information, time of initation of breast-feeding and the best method of feeding a baby <4 months of age. Only 9.8% in urban and 13.3% in rural areas had complete knowledge of Exclusive breast-feeding. Educated females had more knowledge in both urban and rural areas of initiating breast-feeding within 1 hr of delivery as compared to un-educated females. The study highlights the needs for continuing medical education and for including knowledge about Exclusive breast-feeding in school curriculum of adolescent girls.

  9. Rural and urban transit district benchmarking : effectiveness and efficiency guidance document.

    Science.gov (United States)

    2011-05-01

    Rural and urban transit systems have sought ways to compare performance across agencies, : identifying successful service delivery strategies and applying these concepts to achieve : successful results within their agency. Benchmarking is a method us...

  10. Preventing the preventable through effective surveillance: the case of diphtheria in a rural district of Maharashtra, India.

    Science.gov (United States)

    Phalkey, Revati K; Bhosale, Rajesh V; Joshi, Abhijeet P; Wakchoure, Sushil S; Tambe, Muralidhar P; Awate, Pradip; Marx, Michael

    2013-04-08

    Epidemic diphtheria is still poorly understood and continues to challenge both developing and developed countries. In the backdrop of poor immunization coverage, non-existent adult boosters, weak case based surveillance and persistence of multiple foci, there is a heightened risk of re-emergence of the disease in epidemic forms in India. Investigating each outbreak to understand the epidemiology of the disease and its current status in the country is therefore necessary. Dhule a predominantly tribal and rural district in Northern Maharashtra has consistently recorded low vaccination coverages alongside sporaidic cases of diphtheria over the last years. This study reports the findings of an onsite survey conducted to assess a recent outbreak of diphtheria in Dhule district and the response mounted to it. Secondary data regarding outbreak detection and response were obtained from the district surveillance office. Clinical data were extracted from hospital records of eleven lab confirmed cases including one death case. Frequency distributions were calculated for each identified clinical and non- clinical variable using Microsoft™ Excel® 2010. Our findings suggest a shift in the median age of disease to adolescents (10-15 years) without gender differences. Two cases (18%) reported disease despite immunization. Clinical symptoms included cough (82%), fever (73%), and throat congestion (64%). About 64% and 36% of the 11 confirmed cases presented with a well defined pseudomembrane and a tonsillar patch respectively. Drug resistance was observed in all three culture positive cases. One death occurred despite the administration of Anti-Diphtheric Serum in a partially immunized case (CFR 9%). Genotyping and toxigenicity of strain was not possible due to specimen contamination during transport as testing facilities were unavailable in the district. The outbreak raises several concerns regarding the epidemiology of diphtheria in Dhule. The reason for shift in the median

  11. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

    Science.gov (United States)

    Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

    Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

  12. Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa

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    Ennion L

    2016-10-01

    Full Text Available Liezel Ennion, Anthea Rhoda Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa Background: Major lower limb amputations result in a significant sense of loss, psychological stress, and decrease in function and overall quality of life for the amputee. The holistic, patient-centered prosthetic rehabilitation of an amputee requires input from a team of dedicated health professionals from different disciplines commonly referred to as a multidisciplinary team (MDT. MDT rehabilitation is considered crucial in the reintegration of the amputee into the community, as well as for providing psychological support after limb loss. Multidisciplinary and interdisciplinary rehabilitation has been proven to be more successful than therapy provided by individual therapists in a number of different populations, regardless of the population studied. However, in most developing countries, there is a significant lack of multidisciplinary rehabilitation.Aim: To explore the roles and challenges of the members of the MDT involved in trans-tibial amputation rehabilitation in a rural community in South Africa (SA.Design: An explorative sequential qualitative descriptive study.Setting: A rural district in the KwaZulu Natal province in SA.Participants: Nine prosthetic users, three surgeons, three traditional healers, 17 therapists, four prosthetists, and four community health workers.Instruments for data collection: Semistructured interviews and focus group discussions.Results: The roles of the members of the MDT were clarified, and various members of the MDT highlighted specific challenges relating to their experiences and roles in the rehabilitation team. Lack of interdisciplinary rehabilitation and communication among team members, as well as lack of resources, and patient education negatively impact the rehabilitation of trans-tibial amputees.Conclusion: Aiming to address the limited resources

  13. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

    Science.gov (United States)

    Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

    2016-01-01

    Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

  14. A comparative study on nutritional status and body composition of urban and rural schoolchildren from Brandsen district (Argentina).

    Science.gov (United States)

    Cesani, Maria Florencia; Garraza, Mariela; Bergel Sanchís, María Laura; Luis, María Antonia; Torres, María Fernanda; Quintero, Fabián Aníbal; Oyhenart, Evelia Edith

    2013-01-01

    The purpose of this study was to analyze whether nutritional status and body composition varies according to the environment of residence (urban or rural) of children in the Brandsen district (Argentina). Weight, height, arm circumference and tricipital and subscapular skinfolds were performed in 1368 schoolchildren aged 3 to 14. NHANES III reference was used to estimate nutritional status -underweight, stunting, wasting, overweight, and obesity- and to evaluate body composition -deficit and excess of adipose (DA, EA) and muscular (DM, EM) tissues of the arm-. Central fat distribution (CFD) was estimated using the subscapular-tricipital index. A structured questionnaire was implemented to evaluate socio-environmental characteristics. Nutritional categories based on body size and body composition were compared between urban and rural areas of residence using Chi-squared tests (χ2). The results indicated for the total sample: 1.1% underweight, 6.9% stunting, 0.4% wasting, 12.1% overweight, 9.7% obesity, 22.0% DM, 2.5% EM, 0.1% DA, 17.6% EA, and 8.5% CFD. Significant differences between urban and rural areas were found only for CFD. The socio-environmental analysis showed that while access to public services and housing quality was significantly better in the urban area, a considerable number of city households lived under deficient conditions, lacked health insurance and had low socioeconomic level. Fifty-three percent of the undernourished children had DM without urban-rural significant differences, and none of them showed DA. In the overweight plus obesity group, 62.8% presented EA, 6.4% EM, 4.7% DM, and 22.8% CFD. The highest percentages of DM and CFD were recorded in rural areas (p = 0.00). We conclude that the child population shows the "double burden" of malnutrition. The environment of residence does not promote any differentiation in the nutritional status. Nevertheless, the increment of central adiposity and, in some cases of muscle deficit in rural

  15. A comparative study on nutritional status and body composition of urban and rural schoolchildren from Brandsen district (Argentina.

    Directory of Open Access Journals (Sweden)

    Maria Florencia Cesani

    Full Text Available The purpose of this study was to analyze whether nutritional status and body composition varies according to the environment of residence (urban or rural of children in the Brandsen district (Argentina. Weight, height, arm circumference and tricipital and subscapular skinfolds were performed in 1368 schoolchildren aged 3 to 14. NHANES III reference was used to estimate nutritional status -underweight, stunting, wasting, overweight, and obesity- and to evaluate body composition -deficit and excess of adipose (DA, EA and muscular (DM, EM tissues of the arm-. Central fat distribution (CFD was estimated using the subscapular-tricipital index. A structured questionnaire was implemented to evaluate socio-environmental characteristics. Nutritional categories based on body size and body composition were compared between urban and rural areas of residence using Chi-squared tests (χ2. The results indicated for the total sample: 1.1% underweight, 6.9% stunting, 0.4% wasting, 12.1% overweight, 9.7% obesity, 22.0% DM, 2.5% EM, 0.1% DA, 17.6% EA, and 8.5% CFD. Significant differences between urban and rural areas were found only for CFD. The socio-environmental analysis showed that while access to public services and housing quality was significantly better in the urban area, a considerable number of city households lived under deficient conditions, lacked health insurance and had low socioeconomic level. Fifty-three percent of the undernourished children had DM without urban-rural significant differences, and none of them showed DA. In the overweight plus obesity group, 62.8% presented EA, 6.4% EM, 4.7% DM, and 22.8% CFD. The highest percentages of DM and CFD were recorded in rural areas (p = 0.00. We conclude that the child population shows the "double burden" of malnutrition. The environment of residence does not promote any differentiation in the nutritional status. Nevertheless, the increment of central adiposity and, in some cases of muscle deficit in

  16. Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda : FRESH AIR methodology for sub-Saharan Africa

    NARCIS (Netherlands)

    van Gemert, Frederik

    2017-01-01

    Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda: FRESH AIR methodology for sub-Saharan Africa Worldwide, tobacco smoking is the most common encountered risk factor for chronic obstructive pulmonary disease (COPD). However, in many low and middle-income

  17. Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

    Science.gov (United States)

    Schoevers, Johan; Jenkins, Louis

    2015-04-21

    Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

  18. Characteristics of Poverty in Rural Communities of Gold Mining District Area West Sumbawa

    Directory of Open Access Journals (Sweden)

    Ibrahim Ibrahim

    2016-06-01

    Full Text Available The research is conducted in rural areas of gold mining with the aim to find out the characteristics of poverty in the rural area of gold mining in West Sumbawa regency. The survey method is used in this study, focusing on the rural mining area. Sample of respondents are 167 households, selected by purposive sampling from four villages, which are determined based on the first ma slope. The data analysis uses cross tabulation and frequency tables. The results showes that the poverty rate in the research area is still low. The results of the combined value of the characteristic size of the hilly topography of poverty are 84 per cent and 83.7 per cent flat topography caused by low levels of income, quality of houses, agricultural land ownership, livestock ownership, ownership of valuables

  19. Assessment of the Ehlanzeni District health transport and logistics function: Enhancing rural healthcare delivery systems

    CSIR Research Space (South Africa)

    Mashiri, MAM

    2009-07-01

    Full Text Available This paper seeks to establish a baseline against which to assess the impacts of the ‘Ehlanzeni District Health Transport Function’ for the district’s healthcare service delivery output, and by extension, health and welfare outcomes. The main...

  20. Maternal health care initiatives: Causes of morbidities and mortalities in two rural districts of Upper West Region, Ghana.

    Directory of Open Access Journals (Sweden)

    Joshua Sumankuuro

    Full Text Available Maternal and neonatal morbidities and mortalities have received much attention over the years in sub-Saharan Africa; yet addressing them remains a profound challenge, no more so than in the nation of Ghana. This study focuses on finding explanations to the conditions which lead to maternal and neonatal morbidities and mortalities in rural Ghana, particularly the Upper West Region.Mixed methods approach was adopted to investigate the medical and non-medical causes of maternal and neonatal morbidities and mortalities in two rural districts of the Upper West Region of Ghana. Survey questionnaires, in-depth interviews and focus group discussions were employed to collect data from: a 80 expectant mothers (who were in their second and third trimesters, excluding those in their ninth month, b 240 community residents and c 13 healthcare providers (2 district directors of health services, 8 heads of health facilities and 3 nurses.Morbidity and mortality during pregnancy is attributed to direct causes such urinary tract infection (48%, hypertensive disorders (4%, mental health conditions (7%, nausea (4% and indirect related sicknesses such as anaemia (11%, malaria, HIV/AIDS, oedema and hepatitis B (26%. Socioeconomic and cultural factors are identified as significant underlying causes of these complications and to morbidity and mortality during labour and the postnatal period. Birth asphyxia and traditional beliefs and practices were major causes of neonatal deaths.These findings provide focused targets and open a window of opportunity for the community-based health services run by Ghana Health Service to intensify health education and promotion programmes directed at reducing risky economic activities and other cultural beliefs and practices affecting maternal and neonatal morbidity and mortality.

  1. Assessment of knowledge on sexually transmitted infections and sexual risk behaviour in two rural districts of Bhutan.

    Science.gov (United States)

    Norbu, Kunzang; Mukhia, Sontosh; Tshokey

    2013-12-06

    The incidence of STI is high and increasing in Bhutan. Poor understanding of risky sexual behavior could be a cause. Comprehensive community surveys have not been previously done. This study was conducted to assess local knowledge on STIs and sexual risk behaviour in two rural districts of Bhutan: Gasa and Zhemgang. The study population included residents aged 15-49 years in the two districts. Health Assistants (HAs) visited all households to distribute questionnaires assessing understanding of knowledge on STIs and risk behaviour. Questionnaires were scored and analyzed. The average score was 61.6%. Respondents had highest knowledge about prevention and lowest about disease and complications. There was a positive correlation between level of education and knowledge on STI (P sexual behavior with 31.2% having sexual relationships with non-regular partners and 10.9% had extramarital sexual contacts. Regular use of condoms with non-regular partners was 49.1%. The most common reason for not using condom was unavailability during the sexual encounter. The study showed that despite increasing knowledge there was no reduction in risky sexual behaviour (p > 0.05). The study population had variable understanding of STIs and their complications. One in three persons practiced risky sexual behaviour, higher in men. Condom use was low. There was no reduction of risky sexual behaviour with increasing level of knowledge indicating that increasing level of knowledge does not necessarily reduce risky sexual behaviour.

  2. Districts on the Edge: The Impact of Urban Sprawl on a Rural Community.

    Science.gov (United States)

    Theobald, Paul

    1988-01-01

    Portrays the controversy surrounding schools and education in a rural community experiencing both an influx of urban and suburban newcomers and the effects of urban sprawl. Reports on surveys of student educational attitudes, household information, and outside activities, and on interviews with teachers, school administrators, and residents.…

  3. Adverse social, nutrition and health conditions in rural districts of the ...

    African Journals Online (AJOL)

    2010-08-25

    Aug 25, 2010 ... Results: Households in OR Tambo had less access to services (tap water 3%, toilets 33%), compared to Umkhanyakude (tap water 50%, toilets 82%) and .... Tambo 28%) or casual employees (Umkhanyakude 17%; Zululand. 2%; OR Tambo 20%). ..... and enable the rural poor to enter the formal job market.

  4. Audit of antenatal care in a rural district of KZN, South Africa

    African Journals Online (AJOL)

    pregnant women received three doses of tetanus toxoid vaccination before delivery. Conclusion: The ... combat AIDS, malaria and other diseases).1 The detection of high-risk ... services provided in rural KZN against the set national standards at the ... immunisation (a total of 3 doses) is given to prevent neonatal tetanus:.

  5. at advanced level in rural secondary schoolş in Makonde District in ...

    African Journals Online (AJOL)

    Variations in the Geography 'A' level results for both the Physical and Human Geography components have been noticed in both ... It cantherefore be concluded that the variations in the results for Advanced level Geography in rural secondary schools ..... not problem-solving approaches yet diversification of teaching and ...

  6. Rural environment study for water from different sources in cluster of villages in Mehsana district of Gujarat.

    Science.gov (United States)

    Khatri, Nitasha; Tyagi, Sanjiv; Rawtani, Deepak

    2017-12-07

    Water pollution and water scarcity are major environmental issues in rural and urban areas. They lead to decline in the quality of water, especially drinking water. Proper qualitative assessment of water is thus necessary to ensure that the water consumed is potable. This study aims to analyze the physicochemical parameters in different sources of water in rural areas and assess the quality of water through a classification system based on BIS and CPCB standards. The classification method has defined water quality in six categories, viz., A, B, C, D, E, and F depending on the levels of physicochemical parameters in the water samples. The proposed classification system was applied to nine villages in Kadi Taluka, Mehsana district of Gujarat. The water samples were collected from borewells, lakes, Narmada Canal, and sewerage systems and were analyzed as per APHA and IS methods. It was observed that most of the physicochemical parameters of Narmada Canal and borewell water fell under class A, thus making them most suitable for drinking. Further, a health camp conducted at Karannagar village, Mehsana revealed no incidents of any waterborne diseases. However, there were certain incidents of kidney stones and joint pain in few villages due to high levels of TDS. Toxic metal analysis in all the water sources revealed low to undetectable concentration of toxic metals such as lead, arsenic, mercury, and cadmium in all the water sources. It is also recommended that the regular treatment of the Narmada Canal water be continued to maintain its excellent quality.

  7. An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

    Science.gov (United States)

    Kaplan, Julika Ayla; Kandodo, Jonathan; Sclafani, Joseph; Raine, Susan; Blumenthal-Barby, Jennifer; Norris, Alison; Norris-Turner, Abigail; Chemey, Elly; Beckham, John Michael; Khan, Zara; Chunda, Reginald

    2017-06-19

    Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre's catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. This study assessed whether women's limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi

  8. Improving paediatric and neonatal care in rural district hospitals in the highlands of Papua New Guinea: a quality improvement approach.

    Science.gov (United States)

    Sa'avu, Martin; Duke, Trevor; Matai, Sens

    2014-05-01

    In developing countries such as Papua New Guinea (PNG), district hospitals play a vital role in clinical care, training health-care workers, implementing immunization and other public health programmes and providing necessary data on disease burdens and outcomes. Pneumonia and neonatal conditions are a major cause of child admission and death in hospitals throughout PNG. Oxygen therapy is an essential component of the management of pneumonia and neonatal conditions, but facilities for oxygen and care of the sick newborn are often inadequate, especially in district hospitals. Improving this area may be a vehicle for improving overall quality of care. A qualitative study of five rural district hospitals in the highlands provinces of Papua New Guinea was undertaken. A structured survey instrument was used by a paediatrician and a biomedical technician to assess the quality of paediatric care, the case-mix and outcomes, resources for delivery of good-quality care for children with pneumonia and neonatal illnesses, existing oxygen systems and equipment, drugs and consumables, infection-control facilities and the reliability of the electricity supply to each hospital. A floor plan was drawn up for the installation of the oxygen concentrators and a plan for improving care of sick neonates, and a process of addressing other priorities was begun. In remote parts of PNG, many district hospitals are run by under-resourced non-government organizations. Most hospitals had general wards in which both adults and children were managed together. Paediatric case-loads ranged between 232 and 840 patients per year with overall case-fatality rates (CFR) of 3-6% and up to 15% among sick neonates. Pneumonia accounts for 28-37% of admissions with a CFR of up to 8%. There were no supervisory visits by paediatricians, and little or no continuing professional development of staff. Essential drugs were mostly available, but basic equipment for the care of sick neonates was often absent or

  9. Assessing the gap between the acute trauma workload and the capacity of a single rural health district in South Africa. What are the implications for systems planning?

    Science.gov (United States)

    Clarke, D L; Aldous, C; Thomson, S R

    2014-06-01

    This study focuses on a single rural health district in South Africa, and attempts to establish the burden of disease and to review the capacity of the district hospitals to deal with this load. Ethical approval to undertake this study was obtained from both the University of Kwa-Zulu Natal and the Department of Health. The audit was performed over a 6-month period in the four district hospitals of rural Sisonke District. There were four components to this audit. 1. Information on the hospital incidence of acute trauma in Sisonke was also sourced from the epidemiology unit of the Department of Health in Pietermaritzburg 2. Each of the district hospitals was visited and the medical manager was interviewed. The medical manager was asked to complete the World Health Organization's Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. (SAT). 3. The operative registers were reviewed to determine the number of index cases for trauma. This information was used to determine the unmet need of acute trauma in the district. 4. Each hospital was classified according to the Trauma Society of South Africa (TSSA) guidelines for levels of trauma care. The annual incidence of trauma in the Sisonke District is estimated to be 1,590 per 100,000 population. Although there appeared to be adequate infrastructure in the district hospitals, the SAT revealed significant deficits in terms of capacity of staff to adequately treat and triage acute trauma patients. There is a significant unmet need for trauma care in Sisonke. The four district hospitals can best be classified as Level IV centers of trauma care. There is a significant burden of trauma in the Sisonke District, yet the capacity to deal with this burden is inadequate. Although the physical infrastructure is adequate, the deficits relate to human resources. The strategic choices are between enhancing the district hospitals' capacity to deal with acute trauma, or deciding to bypass them completely and

  10. Assessment of arsenic, fluoride, bacteria, and other contaminants in drinking water sources for rural communities of Kasur and other districts in Punjab, Pakistan.

    Science.gov (United States)

    Arshad, Nasima; Imran, Saiqa

    2017-01-01

    High levels of arsenic contamination in drinking water of two villages, Badarpur and Ibrahimabad of district Kasur, central Punjab, Pakistan is reported first time in present studies. Groundwater quality situation was found to be impaired when samples of different rural areas of district Kasur were monitored according to Pakistan Standards and Quality Control Authority (PSQCA) for all significant water quality constituents and analyzed for trace elements, physico-chemical, and microbiological parameters. Out of 35water sources, 97 % were found unsafe and only 3 % of the sources were within safe limits. High concentrations of arsenic, fluoride, and bacteria were found in 91, 74, and 77 % sources of drinking water, respectively. Very high concentrations of arsenic ranging 58-3800 μg/L were found in the water samples obtained from Badarpur and Ibrahimabad. A decrease in water contamination was observed with increase in source depth. The health issues like arsenicosis and skeletal/dental flourosis were observed in the residents of the monitored areas. Drinking water quality conditions of some rural areas of northen and southern districts of Punjab was also analyzed and compared with Kasur district. High levels of nitrates were found in the samples of Islamabad and Rawalpindi, while high levels of arsenic, iron, fluoride, and TDS were found in Bahawalpur district. Graphical abstract ᅟ.

  11. Health impact on women using solid cooking fuels in rural area of Cuttack district, Odisha

    Directory of Open Access Journals (Sweden)

    Ipsa Mohapatra

    2018-01-01

    Full Text Available Background: Around 3 billion people use solid fuels (biomass and coal for cooking and heating, and this number is expected to grow until at least 2030. Around 73.7% of households in rural Odisha use wood for cooking. This current study is an attempt to evaluate the impact of solid cooking fuels on health of rural women in age group of 20–40 years and to study the relationship between the duration of exposure to cooking fuels and various health problems. Materials and Methods: This cross-sectional study was carried out in a village which is under the field practice area of the rural health and training centre, under Department of Community Medicine, Kalinga Institute of Medical Sciences. Universal sampling technique was adopted for sample selection. Chi-square test was used to find the association between cooking fuel usage and self-reported symptoms. Results: Dry cough was the most common presenting symptom (15.03%, followed by eye and nose irritation present in nearly 12% each among the study participants. Headache, dry cough, and hypertension (HT was found to associated with number of cooking years and was also found to be statistically significant (P = 0.03, 0.02 and 0.0065, respectively. Discussion: Our study clearly indicated that the exposure to biomass fuel smoke is significantly associated with the prevalence of symptoms of headache, dry cough, and HT. Further research is required for improving information on dose-response relationships between indoor air pollution and various health effects. Conclusion: The morbidities were increased with increase in duration of cooking . Knowledge related to health effects of cooking fuels seems to be poor among the participants.

  12. Monitoring the referral system through benchmarking in rural Niger: an evaluation of the functional relation between health centres and the district hospital

    Directory of Open Access Journals (Sweden)

    Miyé Hamidou

    2006-04-01

    Full Text Available Abstract Background The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger. Methods Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and characteristics of curative referrals in rural Niger. Compliance of referral was monitored as well. Need was matched against actual referral in 11 rural districts. The referral patterns were registered so as to get an idea on the types of pathology referred. Results The referral rate benchmark was set at 2.5 % of patients consulting at the health centre for curative reasons. Niger's rural districts have a referral rate of less than half this benchmark. Acceptability of referrals is low for the population and is adding to the deficient referral system in Niger. Mortality because of under-referral is highest among young children. Conclusion Referral patterns show that the present programme approach to deliver health care leaves a large amount of unmet need for which only comprehensive first and second line health services can provide a proper answer. On the other hand, the benchmark suggests that well functioning health centres can take care of the vast majority of problems patients present with.

  13. CT scanning in stroke patients: meeting the challenge in the remote and rural district general hospital.

    Science.gov (United States)

    Todd, A W; Anderson, E M

    2009-05-01

    National audit data allow crude comparison between centres and indicate that most Scottish hospitals fail to meet current guidelines for CT scanning of the brain in stroke patients. This study identifies some of the reasons for delay in performing CT scans in a largely rural population. This audit study assesses the delays from onset of symptoms, time of admission and request received to CT scan in stroke patients for three different in-patient groups as well as those managed in the community. The reasons for delay in CT scanning varied between different patient groups but for one group of in-patients, changes in booking procedure and introduction of a second CT scanner increased the proportion scanned within 48 hours of request from 65% to 96%. Further developments including the introduction of Saturday and Sunday routine CT scanning, radiologist reporting from home and additional CT scanners placed in remote hospitals may be expected to improve these figures further. Target times of three hours from onset of symptoms to scan to allow thrombolysis may however be impossible to meet for all stroke patients in rural areas.

  14. Sociodemographic drivers of multiple sexual partnerships among women in three rural districts of Tanzania

    Directory of Open Access Journals (Sweden)

    Exavery A

    2015-04-01

    Full Text Available Amon Exavery,1 Almamy Malick Kanté,1–3 Kassimu Tani,1 Ahmed Hingora,1 James F Phillips2 1Ifakara Health Institute, Dar es Salaam, Tanzania; 2Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA; 3Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland Background: This study examines prevalence and correlates of multiple sexual partnerships (MSP among women aged 15+ years in Rufiji, Kilombero, and Ulanga districts of Tanzania. Materials and methods: Data were collected in a cross-sectional household survey in Rufiji, Kilombero, and Ulanga districts in Tanzania in 2011. From the survey, a total of 2,643 sexually active women ages 15+ years were selected for this analysis. While the chi-square test was used for testing association between MSP and each of the independent variables, logistic regression was used for multivariate analysis. Results: Number of sexual partners reported ranged from 1 to 7, with 7.8% of the women reporting multiple sexual partners (2+ in the past year. MSP was more likely among both ever married women (adjusted odds ratio [AOR] =3.83, 95% confidence interval [CI] 1.40–10.49 and single women (AOR =6.13, 95% CI 2.45–15.34 than currently married women. There was an interaction between marital status and education, whereby MSP was 85% less likely among single women with secondary or higher education compared to married women with no education (AOR =0.15, 95% CI 0.03–0.61. Furthermore, women aged 40+ years were 56% less likely compared to the youngest women (<20 years to report MSP (AOR =0.44, 95% CI 0.24–0.80. The odds of MSP among Muslim women was 1.56 times as high as that for Christians women (AOR =1.56, 95% CI 1.11–2.21. Ndengereko women were 67% less likely to report MSP compared to Pogoro women (AOR =0.33, 95% CI 0.18–0.59. Conclusion: Eight percent of the women aged 15+ in Rufiji, Kilombero, and Ulanga

  15. Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso.

    Science.gov (United States)

    Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali

    2017-07-12

    The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at

  16. Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique.

    Science.gov (United States)

    Nhampossa, Tacilta; Sigaúque, Betuel; Machevo, Sónia; Macete, Eusebio; Alonso, Pedro; Bassat, Quique; Menéndez, Clara; Fumadó, Victoria

    2013-09-01

    To describe the burden, clinical characteristics and prognostic factors of severe malnutrition in children under the age of 5 years. Retrospective study of hospital-based data systematically collected from January 2001 to December 2010. Rural Mozambican district hospital. All children aged malnutrition. During the 10-year long study surveillance, 274 813 children belonging to Manhiça’s Demographic Surveillance System were seen at out-patient clinics, almost half of whom (47 %) presented with some indication of malnutrition and 6% (17 188/274 813) with severe malnutrition. Of these, only 15% (2522/17 188) were eventually admitted. Case fatality rate of severe malnutrition was 7% (162/2274). Bacteraemia, hypoglycaemia, oral candidiasis, prostration, oedema, pallor and acute diarrhoea were independently associated with an increased risk of in-hospital mortality, while malaria parasitaemia and breast-feeding were independently associated with a lower risk of a poor outcome. Overall minimum communitybased incidence rate was 15 cases per 1000 child-years at risk and children aged 12–23 months had the highest incidence. Severe malnutrition among admitted children in this Mozambican setting was common but frequently went undetected, despite being associated with a high risk of death. Measures to improve its recognition by clinicians responsible for the first evaluation of patients at the out-patient level are urgently needed so as to improve their likelihood of survival. Together with this, the rapid management of complications such as hypoglycaemia and concomitant co-infections such as bacteraemia, acute diarrhoea, oral candidiasis and HIV/AIDS may contribute to reverse the intolerable toll that malnutrition poses in the health of children in rural African settings.

  17. Prevalence of Diabetic Retinopathy and its Associated Factors in a Rural Area of Villupuram District of Tamil Nadu, India.

    Science.gov (United States)

    Nadarajan, Balasubramanian; Saya, Ganesh Kumar; Krishna, Ramesh Babu; Lakshminarayanan, Subitha

    2017-07-01

    There is limited information on prevalence of Diabetic Retinopathy (DR) among diabetic subjects and its associated factors in a rural setting in developing countries including India. The information will be useful for initiating early screening strategies for this group in the community. To assess the prevalence and certain associated factors of DR among diabetic subjects in a rural area of Tamil Nadu, India. This cross-sectional study was conducted among 105 Type 2 diabetic subjects in Pakkam and Mandagapattu sub-center area of Kondur Primary Health Center in Villupuram district of Tamil Nadu, India. Data on associated factors which include sociodemographic factors, duration of disease, family history, and frequency of blood test, treatment regularity, hypertension, visual acuity and cataract were collected. Detailed eye examination including visual acuity, direct ophthalmoscope and Non Mydriatic Fundus Camera was done. Data was analysed by univariate analysis and described in proportion or percentages. The mean age of the study population was 56.69 years. About 47 (44.8%) of the subjects were more than 60 years of age followed by 44 subjects (41.9%) in age group 45-59 years. Fundus examination in at least one eye was seen in 83 people (79.0%). Prevalence of DR in any eye and both the eye was 32.53% (27/83) and 31.58% (24/76) respectively. Severity of DR was moderate (51.9%) followed by mild (44.4%) and severe (3.7%). DR prevalence was more among >60 years age group (p=0.032) and lesser education level (p=0.057). There was no association of DR with duration of disease, family history of diabetes, treatment regularity, presence of hypertension, visual acuity and cataract (p>0.05). The prevalence of DR was inferred to be high and further larger follow up studies will explore the role of associated factors and its quantification in the causation of DR.

  18. Prevalence and incidence of neurological disorders among adult Ugandans in rural and urban Mukono district; a cross-sectional study.

    Science.gov (United States)

    Kaddumukasa, Mark; Mugenyi, Leviticus; Kaddumukasa, Martin N; Ddumba, Edward; Devereaux, Michael; Furlan, Anthony; Sajatovic, Martha; Katabira, Elly

    2016-11-17

    The burden of neurological diseases is increasing in developing countries. However, there is a prominent scarcity of literature on the incidence of neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the prevalence and incidence of neurological diseases in this setting to serve as a baseline for planning and care for neurological disorders in Uganda. The study was conducted within rural and urban Mukono district, east of Kampala city of Uganda, central region. Over a period of six months, a cross sectional survey was conducted and screening was performed using a standardized questionnaire. All subjects with neurological symptoms and signs were reviewed by a team of neurologists and neurological diagnoses made. Of the 3000 study subjects, 50.3% (1510/3000) were from the rural setting. Out of the participants screened, 67.4% were female, with a median age of 33 years. Among the 98 subjects with confirmed neurological disorders, the frequency of diseases was as follows; peripheral neuropathy (46.2%), chronic headaches (26.4%), and epilepsy (8.5%), followed by pain syndromes (7.5%), stroke (6.6%) and tremors/Parkinson disease (3.8%). The crude prevalence rates of these disorders (95% CI) were 14.3% (8.5-24.1); 13.3% (7.7-22.8); 33.7% (23.9-47.4) for stroke, epilepsy and peripheral neuropathy respectively. Peripheral neuropathy followed by chronic headaches had the highest estimated incidence/1000 years. Stroke had an estimated incidence of 3.6 new cases with 95% CI of (2.1-6.1)/1000 years. Peripheral neuropathy, chronic headaches and epilepsy disorders are major causes of morbidity in Sub-Saharan settings. There is an urgent need of more robust and powered studies to determine the incidence of these diseases.

  19. Measles in vaccinated children 1.5 to 3 years of age in rural community of district peshawar, pakistan

    International Nuclear Information System (INIS)

    Khan, A.; Ullah, O.; Ahmad, I.

    2015-01-01

    In many developing countries measles is a leading cause of childhood morbidity and mortality. Despite of vaccination thousands of children have been infected by measles virus during last couple of years in Pakistan. The objective of this study was to determine the measles vaccination coverage rate and frequency of measles among vaccinated children of age 1.5-3 years in rural community of district Peshawar. Methods: The cross-sectional study was carried out among 385 children aged 1.5-3 year of rural community of Peshawar. After taking informed consent from parents/guardians a predesigned questionnaire was filled. Evidence of vaccination and measles history was taken by vaccination card, doctor prescription and parent/guardian recall. Data was gathered and analysed by using SPSS-16. Results: Of the 385 children, 361 (93.7%) were vaccinated against measles at 9 month. It was found that 27 (7.48%) vaccinated children had measles history of which 23 (6.74%) were infected after 9 month vaccination. One hundred and ninety-two (49.8%) children were vaccinated both at 9 and 15 months, and 14 (7.29%) dual vaccinated children had a measles history, 9 among them (4.68%) were infected after taking both measles doses. Conclusion: The occurrence of measles among vaccinated children and low coverage rate of second dose of measles vaccine raises many questions about vaccination program and its efficacy. Further studies are needed to evaluate the influence of other predisposing factors like vaccine quality, manufacturer, supply, cold chain, handling, nutritional status of children and technical approach, on measles vaccine efficacy. (author)

  20. A Review of a Successful Unsubsidized Market-Based Rural Solar Development Initiative in Laikipia District, Central Kenya

    Directory of Open Access Journals (Sweden)

    O. Wambuguh

    2013-10-01

    Full Text Available The development of renewable energy technologies (RETs in many areas far from grid-based electricity have primarily involved solar photovoltaics (SPVs which tap solar radiation to provide heat, light, hot water, electricity, and cooling for homes, businesses, and industry. A study on RETs took place in the Wiyumiririe Location of Laikipia District (north-central Kenya, a rich agricultural region. To explore this solar initiative in such a remote part of the country, a purposive randomized convenience sample of 246 households was selected and landowner interviews conducted, followed by field visits and observations. Although more than half of the households visited had SPV installations, solar energy was found to contribute only 18% of household estimated total energy needs; most residents still primarily relying on traditional energy sources. Several types of solar panels of different capacities and costs were utilized. Many landowners had at least one or two rooms using solar energy for household lighting, for appliance charging and to power radio and television. Almost all respondents appreciated that solar energy was clean renewable energy that greatly improved household living conditions; gave them some prestige; was easy to use and maintain; and was available year around. Although such significant benefits were associated with SPVs, only about 40% of residents interviewed were somehow satisfied with its development. Respondents expressed specific developmental initiatives that were closely associated with the availability of solar energy. Nevertheless, a number of challenges were raised associated with SPVs primarily investment capital and equipment costs and maintenance. As solutions to capital building will not solely rely on subsidies or individual farmer inputs, strategies must be found to mobilize the essential and tested tools for success including sustainable capital generation, building local institutions and capacities that

  1. The concept of cluster- villages as planning tool in the rural districts of Denmark

    DEFF Research Database (Denmark)

    Laursen, Lea Louise Holst; Møller, Jørgen

    on economies of scale, or the decentralised model based on proximity. In the developments and debate relating to these matters, strategic and visionary planning is back in the municipal arena as the only tool capable of handling the many different challenges facing the municipalities. Mellem disse...... and uses each other’s strengths, as well as developing the individual village in addition to the specific potentials of that village. In recent years, rural Denmark has been undergoing a sweeping and very noticeable process of adjustment, Development in municipal service provision plays a particular...... to forskellige positioner ser vi en ny mulighed for landsbyudvikling, som vi kalder Clustervillages. In order to investigate the potentials and possibilities of the cluster-village concept the paper will seek to unfold the concept strategically; looking into the benefits of such concept. Further, the paper seeks...

  2. Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

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    Shilpa Bawankule

    2010-07-01

    Full Text Available Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD and quantitative (Interview methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days. Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India.

  3. Changing trends in the prevalence of blindness and visual impairment in a rural district of India: Systematic observations over a decade

    Directory of Open Access Journals (Sweden)

    Rohit C Khanna

    2012-01-01

    Full Text Available Context : Globally, limited data are available on changing trends of blindness from a single region. Aims : To report the changing trends in the prevalence of blindness, visual impairment (VI, and visual outcomes of cataract surgery in a rural district of Andhra Pradesh, India, over period of one decade. Settings and Design : Rural setting; cross-sectional study. Materials and Methods : Using a validated Rapid Assessment of Cataract Surgical Services (RACSS method, population-based, cross-sectional survey was done in a rural district in the state of Andhra Pradesh, India. Two-stage sampling procedure was used to select participants ≥50 years of age. Further, a comparative analysis was done with participants ≥50 years from the previously concluded Andhra Pradesh Eye Disease Study (APEDS study, who belonged to the same district. Statistical Analysis : Done using 11 th version of Stata. Results : Using RACSS, 2160/2300 (93.9% participants were examined as compared with the APEDS dataset (n=521. Age and sex adjusted prevalence of blindness in RACSS and APEDS was 8% (95% CI, 6.9-9.1% and 11% (95% CI, 8.3-13.7%, while that of VI was 13.6% (95% CI, 12.2-15.1% and 40.3% (95% CI, 36.1-44.5%, respectively. Cataract was the major cause of blindness in both the studies. There was a significant reduction in blindness following cataract surgery as observed through RACSS (17.3%; 95% CI, 13.5-21.8% compared with APEDS (34%; 95% CI, 20.9-49.3%. Conclusion : There was a significant reduction in prevalence of blindness and VI in this rural district of India over a decade.

  4. Assessment of Nutrition Profile of Pregnant Women in Rural Area (Mymensingh District of Bangladesh

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    M. Shafiur Rahman

    2012-07-01

    Full Text Available Malnutrition is the most common nutritional disorders in the developing countries like Bangladesh. The most vulnerable groups of population to malnutrition are under-5 children, pregnant women and lactating mother. This study makes an attempt to investigate the nutritional status of pregnant women and to correlate different factors with pregnancy. The cross-sectional study was followed to determine nutritional status by anthropometric and biochemical assessment as well as clinical appearance. The obtaining result of all assessments was compared with standard data (NCHS & UNHCR/WFP. A total of 380 pregnant women were randomly selected from health care centers (governments and non-governments in the Mymensingh district of Bangladesh from early June 2007 to January 2008. The result of research showed that 30.52% severely malnourished, 36.57% moderately malnourished, and 23.15% well nourished and 9.73% were overnourished by calculating weight gain during different stages of pregnancy. By using Mid-Upper Arm Circumference (MUAC 28.94%, 35%, 25.26% and 10.78% pregnant women were found severely malnourished, moderately malnourished, well nourished and overnourished respectively. It observed that the prevalence of nutritional status to pregnant women were found 29.69% severely malnourished, 34.39% moderately malnourished, 26.36% well nourished and 9.56% over nourished by observing the clinical appearance. In average it showed that 29.71% were severely malnourished, 35.32% were moderately malnourished, 24.92% were well nourished and 10.02% were overnourished. By estimating hemoglobin (Hb level during pregnancy it obtained that 5.52% severely anemic, 61.84% moderately anemic, 18.15% mildly anemic and 14.47% pregnant women were nonanemic. In my study, 12.63 % pregnant women were under 18 years old while 50% were severely malnourished and 30.4% were malnourished. It found that the primary education levels were 16.57% and total monthly family incomes of 16

  5. Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study.

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    Shah, Rajani; Rehfuess, Eva A; Paudel, Deepak; Maskey, Mahesh K; Delius, Maria

    2018-06-20

    Giving birth assisted by skilled care in a health facility plays a vital role in preventing maternal deaths. In Nepal, delivery services are free and a cash incentive is provided to women giving birth at a health facility. Nevertheless, about half of women still deliver at home. This study explores socio-cultural and health service-related barriers to and facilitators of institutional delivery. Six village development committees in hill and plain areas were selected in Chitwan district. We conducted a total of 10 focus group discussions and 12 in-depth-interviews with relevant stakeholder groups, including mothers, husbands, mothers-in-law, traditional birth attendants, female community health volunteers, health service providers and district health managers. Data were analyzed inductively using thematic analysis. Three main themes played a role in deciding the place of delivery, i.e. socio-cultural norms and values; access to birthing facilities; and perceptions regarding the quality of health services. Factors encouraging an institutional delivery included complications during labour, supportive husbands and mothers-in-law, the availability of an ambulance, having birthing centres nearby, locally sufficient financial incentives and/or material incentives, the 24-h availability of midwives and friendly health service providers. Socio-cultural barriers to institutional deliveries were deeply held beliefs about childbirth being a normal life event, the wish to be cared for by family members, greater freedom of movement at home, a warm environment, the possibility to obtain appropriate "hot" foods, and shyness of young women and their position in the family hierarchy. Accessibility and quality of health services also presented barriers, including lack of road and transportation, insufficient financial incentives, poor infrastructure and equipment at birthing centres and the young age and perceived incompetence of midwives. Despite much progress in recent years, this

  6. The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital

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    Maitland Kathryn

    2008-02-01

    Full Text Available Abstract Background Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic area in coastal Kenya. Methods We recruited all children with and without seizures, aged 0–13 years and admitted to Kilifi District hospital over 2 years from 1st December 2004 to 30th November 2006. Only incident admissions from a defined area were included. Patients with epilepsy were excluded. The population denominator, the number of children in the community on 30th November 2005 (study midpoint, was modelled from a census data. Results Seizures were reported in 900/4,921(18.3% incident admissions and at least 98 had status epilepticus. The incidence of acute seizures in children 0–13 years was 425 (95%CI 386, 466 per 100,000/year and was 879 (95%CI 795, 968 per 100,000/year in children Conclusion There is a high incidence of acute seizures in children living in this malaria endemic area of Kenya. The most important causes are diseases that are preventable with available public health programs.

  7. Costs and consequences of a cash transfer for hospital births in a rural district of Uttar Pradesh, India.

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    Coffey, Diane

    2014-08-01

    The Janani Suraksha Yojana, India's "safe motherhood program," is a conditional cash transfer to encourage women to give birth in health facilities. Despite the program's apparent success in increasing facility-based births, quantitative evaluations have not found corresponding improvements in health outcomes. This study analyses original qualitative data collected between January, 2012 and November, 2013 in a rural district in Uttar Pradesh to address the question of why the program has not improved health outcomes. It finds that health service providers are focused on capturing economic rents associated with the program, and provide an extremely poor quality care. Further, the program does not ultimately provide beneficiaries a large net monetary transfer at the time of birth. Based on a detailed accounting of the monetary costs of hospital and home deliveries, this study finds that the value of the transfer to beneficiaries is small due to costs associated with hospital births. Finally, this study also documents important emotional and psychological costs to women of delivering in the hospital. These findings suggest the need for a substantial rethinking of the program, paying careful attention to incentivizing health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Prevalence of osteoarthritis of knee joint among adult population in a rural area of Kanchipuram District, Tamil Nadu.

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    Venkatachalam, Jayaseelan; Natesan, Murugan; Eswaran, Muthurajesh; Johnson, Abel K Samuel; Bharath, V; Singh, Zile

    2018-01-01

    Osteoarthritis (OA) is one of the most common degenerative disorders among the elderly population; although aging is the most important cause, research has shown that it is a complex disease with many etiologies. It is not an inevitable part of aging but rather the result of a combination of factors, many of which can be modified or prevented. The objective of this study was to assess the burden and determinants of OA knee among the adult population. A community-based, cross-sectional study among 1986 adult persons living in a rural area in Kanchipuram district, Tamil Nadu, South India, was interviewed and examined from January 2014 to December 2014. Data collection was done by the postgraduates, trained health workers under the supervision of principal investigator. Written and informed consent was obtained before data collection. OA was diagnosed using the criteria laid down by the American College of Rheumatology, and it was validated and tested in the study area. A total of 1986 adult respondents were interviewed out of which 27.1% had OA of knee. Age more than 50 years, female gender, tobacco usage, illiteracy, lower socioeconomic class, positive family history of OA, diabetes, and hypertension were found to be associated with OA knee (P < 0.05). The burden of osteoarthritis knee was high in this region. Hence, effective preventive strategy has to be taken to minimize this burden.

  9. Perceptions of water access in the context of climate change by rural households in the Seke and Murewa districts, Zimbabwe

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    Shakespear Mudombi

    2013-09-01

    Full Text Available The objective of the study was to assess perceptions of rural household heads with regard to various aspects of water access and climate change, and to evaluate whether there were significant differences in perceptions of respondents from female-headed and male-headed households. The study is based on a cross-sectional survey of 300 respondents conducted in the Seke and Murewa districts of Zimbabwe in 2011. The analysis included mainly descriptive statistics. The majority of both female-headed and male-headed households relied on rainfall for their crops, rivers were cited as the main water source for their livestock and protected wells supplied water for household use. Households experienced water shortages, which were attributed mainly to reduced rainfall. The general perception was that there would be less water available in future, with a greater proportion of female-headed than male-headed households perceiving such difficulties. However, very few respondents indicated that they would consider emigrating, although female-headed households were more likely to consider emigrating than male-headed households. A considerable number of respondents indicated that they did not have any means to overcome the water shortages. This highlights the need for interventions such as training and empowerment of individuals with regard to sustainable water use and management.

  10. Vertical integration of local fuel producers into rural district heating systems – Climate impact and production costs

    International Nuclear Information System (INIS)

    Kimming, M.; Sundberg, C.; Nordberg, Å.; Hansson, P.-A.

    2015-01-01

    Farmers can use their own agricultural biomass residues for heat production in small-scale systems, enabling synergies between the district heating (DH) sector and agriculture. The barriers to entry into the Swedish heat market were extremely high as long as heat distribution were considered natural monopoly, but were recently lowered due to the introduction of a regulated third party access (TPA) system in the DH sector. This study assesses the potential impact on greenhouse gas emissions and cost-based heat price in the DH sector when farmers vertically integrate into the heat supply chain and introduce more local and agricultural crops and residues into the fuel mix. Four scenarios with various degree of farmer integration, were assessed using life cycle assessment (LCA) methodology, and by analysis of the heat production costs. The results show that full integration of local farm and forest owners in the value chain can reduce greenhouse gas emissions and lower production costs/heat price, if there is an incentive to utilise local and agricultural fuels. The results imply that farmer participation in the DH sector should be encouraged by e.g. EU rural development programmes. - Highlights: • Five DH production systems based on different fuels and ownership were analysed. • Lower GHG emissions were obtained when farmers integrate fully into the DH chain. • Lower heat price was obtained by full vertical integration of farmers. • Salix and straw-based production resulted in the lowest GHG and heat price

  11. Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

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    David Kiima

    2012-05-01

    Full Text Available Association between common mental disorders (CMDs, equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population, were studied. The Clinical Interview Schedule-Revised (CIS-R was used to determine the prevalence of common mental disorders (CMDs. Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health.

  12. Psychosocial implications of tubal ligation in a rural health district: A phenomenological study

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    Lutala Prosper M

    2011-12-01

    Full Text Available Abstract Background Tubal ligation is the most popular family planning method worldwide. While its benefits, such as effectiveness in protecting against pregnancies, minimal need for long-term follow-up and low side-effects profile are well documented, it has many reported complications. However, to date, these complications have not been described by residents in Congo. Therefore, the study aimed at exploring the experience of women who had undergone tubal ligation, focusing on perceptions of physical, psychological and contextual experiences of participants. Methods This qualitative study used a semi-structured questionnaire in a phenomenological paradigm to collect data. Fifteen participants were purposefully selected among sterilized women who had a ligation procedure performed, were aged between 30 and 40 years, and were living within the catchment area of the district hospital. Data were collected by two registered nurses, tape-recorded, and transcribed verbatim. Reading and re-reading cut and paste techniques, and integration were used to establish codes, categories, themes, and description. Results Diverse and sometimes opposite changes in somatic symptoms, psychological symptoms, productivity, ecological relationships, doctor-client relationships, ethical issues, and change of life style were the major problem domains. Conclusions Clients reported conflicting experiences in several areas of their lives after tubal sterilization. Management, including awareness of the particular features of the client, is needed to decrease the likelihood of psychosocial morbidity and/or to select clients in need of sterilization.

  13. Prevalence of lower urinary tract symptoms among men in a rural district of Western Turkey

    International Nuclear Information System (INIS)

    Unsal, A.; Ayranci, U.; Tozun, M.

    2010-01-01

    Objectives: The aim was to determine the prevalence of lower urinary tract symptoms (LUTS) in men aged 40 years or older, as well as to compare characteristics of patients with and without LUTS. Methodology: The paper is a cross-sectional survey conducted on men with LUTS in a district of western Turkey between November 1 and December 31. The questionnaire was filled in by a face to face method, and consisted of the men's socio-demographic characteristics, LUTS related characteristics, and the questions pertaining to international prostate symptom score (IPSS). Results: The prevalence of LUTS was 51.5%. The comparative analyses between patients who had and those who did not have LUTS showed that patients in settlement area Kaymaz, those aged 70 and over, those with primary school education and below, those who were married, those who had recurrent UTI, those who were using medicines continuously, those with a history of previous surgery, those with family history of LUTS had a higher prevalence of LUTS. Conclusion: In conclusion the number of the respondents having LUTS was common among men in this region of Turkey. (author)

  14. Prevalence of dental caries and treatment needs in the rural child population of Nainital District, Uttaranchal

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    Grewal H

    2009-01-01

    Full Text Available Dental caries is a rapidly emerging oral health problem amongst the children of India. Its incidence in different states varies between 31 and 89%. This study was undertaken with a twin objective of assessing the prevalence of dental caries in parts of Uttaranchal state and designing the interventional strategies with a view to attend the oral health care needs of children. A total of 722 school children in the age range of 7-12 years of Nainital district were examined using WHO (1997 criteria. An overall caries prevalence of 77.7% was recorded, which is 67.26% in the age group of 7-9 years and 80.86% in 10-12 years with DMFT+deft of 1.97 and 2.61, respectively. It was observed that there were greater treatment needs in older age group. Another significant finding of the study was that the 59.96% required restorative treatment out of the various dental treatment needs evaluated.

  15. An Epidemiological Study of Animal Bites and Envenomings in a Rural District of Tamilnadu, India

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    Venkatesan M

    2014-12-01

    Full Text Available Aim: To find out the period prevalence of animal bites and envenomings, its epidemiological risk factors and treatment seeking behaviour. Materials and methods: The present cross sectional study was conducted in the 34 villages of the field practising areas of the Rural Health Training Centre, Thiruvenainallur. Considering the prevalence of bites as 7.4%, and taking 5 members in each household with a non response of 10% the number households studied were 4150 covering a population of 18865 which was calculated using an Open EPI version (2.3 software package. Sampling frame of households was prepared and systemic random sampling method was used to select households from each village. Trained medical interns and social workers collected information on bites in the preceding one year. Data was entered and analyzed in Epi_info (3.4.3 software. Results: In this study, information of 12947 adults was included and the overall period prevalence of bites was 81.8/1000 population. The most common bite is dog bite (22.3 followed by scorpion (22.1 and centipede (17.8 per 1000 population. The dog bites are significantly higher among males, people below the poverty line, farmers and laborers. There is significantly increased risk of snake bites among people working in agriculture fields. Only 35% of the dog bite victims washed their wound with soap and water and 28% applied irritants such as ash, ink, calotropis milk etc. over the wounds. Anti-rabies vaccination was given in 60% of the dog bite victims and life saving measure of Rabies Immunoglobulins (RIGS was given in only in 6.2%. Almost half of the bitten victims of scorpion and centipede follow traditional methods of treatment. Conclusions: Considering the high prevalence of different bites and treatment seeking behavior indicates there is a lack of awareness regarding all forms of bites in the rural community. The existing program of rabies control has to be strengthened and community awareness about

  16. The influence of father's child feeding knowledge and practices on children's dietary diversity: a study in urban and rural districts of Northern Ethiopia, 2013.

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    Bilal, Selamawit M; Dinant, GeertJan; Blanco, Roman; Crutzen, Rik; Mulugeta, Afework; Spigt, Mark

    2016-07-01

    Infant and young child feeding has been recognised as an essential element to improve growth of children, especially in developing countries where malnutrition among children and its dire consequences are very prevalent. However, little attention has been paid on the influence of fathers on child feeding practices, although fathers are very important in raising well-adjusted, happy and successful children. Therefore, this study aimed to assess the influence of fathers' child feeding knowledge and practice on children's dietary diversity. A community-based comparative cross-sectional study was conducted among 850 eligible urban and rural households with children of 6-23 months. The father and mother of the child were interviewed on children's dietary diversity and fathers' knowledge and practice of child feeding. Nearly half (46%) of the children in the rural district did not meet the minimum dietary diversity, and in the urban district, the rate was even worse (72%). Grains were the common food group given to the children in both districts, whereas flesh food was the least commonly consumed food group. Additionally, low vitamin A-rich food and other fruit and vegetable consumption seem to be a problem in both districts. Almost all dimensions of fathers' knowledge and practice were significantly related to children's minimum dietary diversity; especially, fathers' knowledge of food groups was an important predictor (P-value child feeding, especially about food groups, are recommended to improve children's dietary diversity in the study communities. © 2014 John Wiley & Sons Ltd.

  17. Asymptomatic Bacteriuria in Pregnant Women from Rural Area of Latur District of Maharashtra, India

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    Jyoti Jojan

    2017-07-01

    Full Text Available Background: Bacteriuria is a significant cause of morbidity in pregnant women affecting both mother and fetus. Institution of rational antibiotic treatment on the basis of screening helps to reduce further morbidity. Aim and Objectives: To find out the prevalence of urinary tract infections in asymptomatic pregnant women and to study the antimicrobial susceptibility pattern of the isolated bacteria to guide the treatment. Materials and Methods: A total of 100 mid-stream urine samples from Asymptomatic Antenatal Care (ANC cases were screened for significant bacteriuria by using standard procedures. The bacterial isolates were subjected to antimicrobial susceptibility studies. Results: Significant bacteriuria was found positive in 23% cases. It was more common in the age group 18 to 25 years (91.30%, and during 2nd trimester (47.82%. S. aureus (82.60% was found to be themost common uropathogen. Imipenem and meropenem (82.60% each were found to be most effective antimicrobial agents. Conclusion: The results indicate that there is a notable increase in the prevalence of uropathogens resistant to multiple antimicrobial agents in rural areas also. The results also emphasize the importance of screening for significant bacteriuria in asymptomatic pregnant women.

  18. Locomotor problems among rural elderly population in a District of Aligarh, North India.

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    Maroof, Mohd; Ahmad, Anees; Khalique, Najam; Ansari, M Athar

    2017-01-01

    Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

  19. Perceptions of rural women about contraceptive usage in district Khushab, Punjab.

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    Tabassum, Aqeela; Manj, Yasir Nawaz; Gunjial, Tahira Rehman; Nazir, Salma

    2016-12-01

    To identify the perceptions of rural women about modern contraceptive methods and to ascertain the psycho-social and economic attitude of women about family planning methods. This cross-sectional study was conducted at the University of Sargodha, Sargodha, Pakistan, from December 2014 to March 2015, and comprised married women. The sample was selected using multistage sampling technique through Fitzgibbon table. They were interviewed regarding use of family planning methods. . SPSS 16 was used for data analysis. Of the 500 women, 358(71.6%) were never-users and 142(28.4%) were past-users of family planning methods. Moreover, 52(14.5%) of never-users did not know about a single modern contraceptive method. Of the past-users, 43(30.3%) knew about 1-3 methods and 99(69.7%) about 4 or more methods. Furthermore, 153(30.6%) respondents graded condoms as good, 261(55.2%) agreed that family planning helped in improving one's standard of living to a great extent while 453(90.6%) indicated that family planning methods were not expensive. Besides, 366(71.2%) respondents believed that using contraceptive method caused infertility. Dissatisfaction with methods, method failure, bad experiences with side effects, privacy concerns and different myths associated to the methods were strongly related to the non-usage of modern contraceptive methods.

  20. [Ecological risk assessment of rural-urban ecotone based on landscape pattern: A case study in Daiyue District of Tai' an City, Shandong Province of East China].

    Science.gov (United States)

    Shi, Hao-Peng; Yu, Kai-Qin; Feng, Yong-jun

    2013-03-01

    Based on the remote sensing data in 2000, 2005, and 2010, this paper analyzed the variation trends of the land use type and landscape pattern in Daiyue District of Tai' an City from 2000 to 2010. The ecological risk index was built, that of the District was re-sampled and spatially interpolated, and the spatiotemporal pattern of the ecological risk in the rural-urban ecotone of the District was analyzed. In 2000-2010, the main variation trend of the land use type in the District was the shift from natural landscape to artificial landscape. The intensity of human disturbance was larger in cultivated land, garden plot, and forestland than in other landscape types, while the human disturbance in water area was smaller. The ecological loss degree of cultivated land and water area decreased somewhat, while that of the other land use types presented an increasing trend. The ecological risk distribution in the District was discrete in 2000 and 2010, but most centralized in 2005. The ecological risk of each ecological risk sub-area had an increasing trend in 2000-2005, but was in adverse in 2005-2010. In 2000-2010, the ecological risk of the District was mainly at medium level. Spatially, the distribution of the ecological risk in the District had an obvious differentiation, with an overall diffusive increasing from forestland as the center to the surrounding areas. In the District, the ecological risk was mainly at medium and higher levels, the area with lower ecological risk had an obvious dynamic change, while that with the lowest and highest ecological risk had less change.

  1. Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study.

    Science.gov (United States)

    Arroz, Jorge A H; Candrinho, Baltazar; Mendis, Chandana; Varela, Pablo; Pinto, João; Martins, Maria do Rosário O

    2018-02-05

    In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.

  2. Emerging issues on the sustainability of the community based rural water resources management approach in Zimbabwe: A case study of Gwanda District

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    Thulani Dube

    2012-12-01

    Full Text Available Although there is considerable on-going debate about the suitability and sustainability of community based water resources management (CBWRM in Africa as a water provision strategy, evidence shows that this approach has gone a long way in promoting access to clean water amongst rural African communities. CBWRM provides an alternative approach to water provision for rural communities. This paper examines how the strategy has been operationalised in Gwanda District in Zimbabwe. The paper examines the experiences of rural communities in using CBWRM. Data was collected using focus group discussions, key informant in-depth interviews and a survey of 685 households in Gwanda district across five wards. The findings of this study are that 67% of the surveyed rural communities in Gwanda depended on community managed water resources mostly in the form of boreholes and protected wells. High rates of nun-functional sources were reported at 60-70% in most wards. Several system weaknesses were noted in the current CBWRM set-up including a depletion of committee memberships, inadequate community resources, limited agency and government support. This paper makes several recommendations on strengthening the capacity of CBWRM in Zimbabwe and Africa.

  3. Menstrual hygiene – A salient hazard in rural schools: A case of Masvingo district of Zimbabwe

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    Everson Ndlovu

    2016-01-01

    Full Text Available Active participation of the girl child in development is hampered by Menstrual Hygiene Management (MHM challenges. MHM is an important gender issue and a critical component in holistic human development. It affects about 25% of the global population aged between 15 and 49 years. Water, sanitation and hygiene (WASH interventions in schools have not prioritised MHM, thus exposing girls and the entire school community to health related hazards. The study explored knowledge, attitudes and community practices, and investigated the impact of religious and cultural beliefs on MHM and how they impact on the girl child in Masvingo district. The survey was largely qualitative and employed methodologies of document analysis, Focus Group Discussions (FGD and structured interviews. Participants included four churches, 13 NGOs, eight government departments and 40 women. Findings revealed deeply embedded power relations, a culture of silence around MHM, noninvolvement of men in MHM issues, limited availability in terms of information, and a girl unfriendly infrastructure, and limited access to menstrual hygiene products due to poverty and poor management and disposal practices. Resultant effects ranged from poor class participation, lack of concentration and constrained interactions with peers and teachers, low self-esteem, anxiety and the general feeling of being discriminated against. Results confirmed the need for increased awareness initiatives on MHM in a bid to tackle inherent religious and cultural beliefs that are a barrier to effective holistic implementation of WASH interventions that empower women and girls. Lobbying government to provide an appropriate policy framework, education and training, construction of girl friendly sanitary facilities, exploring and capitalisation of local production of Reusable Menstrual Pads (RUMPS, more research targeting children living with disabilities, those living in refugee and makeshift camps and Orphans and

  4. A STUDY ON MORBIDITY PROFILE AMONG ELDERLY PERSONS IN A RURAL AREA OF KOZHIKODE DISTRICT

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    Hassan Koya Kalathingal

    2016-11-01

    Full Text Available BACKGROUND World population is aging, which is a concern of 21 st century because of advances in medical sciences and improved social conditions. In developing countries like India where aging occurs rapidly due to the phase of demographic transition characterised by rapid fertility decline and increase in life expectancy. In India for the year 2010, the estimates are 8% of total population are above the age of 60 years and is likely to rise to 19% by 2050. Aging is a time of multiple illness and general disability. Old age diseases are not always curable, but only treatable, implying a strain on financial as well as physical health infrastructure resources, both at the macro and micro levels. MATERIALS AND METHODS A cross-sectional study was done in 2016 in Atholi Panchayath of Kozhikode, which is situated in North Kerala. Elderly people with 60 years and above were included in the study. A sample size of 324 was calculated and cluster sampling method was done for selection of study subjects. Data was collected using a semi-structured questionnaire after getting ethical clearance and was analysed using SPSS software. RESULTS Among the 324 subjects participated in the study, 163 (50.3% were males and 161 (49.67% were females. Mean age of the study subjects were 68.11 yrs. (range 60-94. Majority of the respondents were in the age group of 60-64 years (39.2%. Most common morbidities among the respondents were musculoskeletal disorders (57.4% followed by vision problems (41.7%, gastric problems (39.2%, diabetes (31.5% and hypertension (30.7%. CONCLUSION In our country, proportion of elderly is consistently increasing and there is need to focus on their health needs. A multilevel approach including age friendly health infrastructure development, social security measures, residential care homes, free treatment, etc. are required to manage geriatric morbidity among rural population.

  5. The use of antenatal care in two rural districts of Upper West Region, Ghana.

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    Joshua Sumankuuro

    Full Text Available Despite decades of implementation of maternity healthcare programmes, including a focus on increasing the use of antenatal care (ANC and concomitant birth preparedness and complication readiness (BPCR, the uptake of ANC continues to be below expectations in many developing countries. This has attendant implications for maternal and infant morbidity and mortality rates. Known barriers to ANC use include cost, distance to health care services and forces of various socio-cultural beliefs and practices. As part of a larger study on BPCR in rural Ghana, this paper reflects on the use of ANC in the study areas from rights-based and maternal engagement theoretical perspectives, with a focus on the barriers to ANC use.Mixed methods approach was adopted to collect data from 8 study communities from individual in-depth interviews with 80 expectant mothers and 13 health care professionals, and 24 focus groups comprising 240 community members. The qualitative data followed a thematic analytical method, while the quantitative data was analysed using descriptive statistics.The average number of ANC visits were 3.34±1.292, and the majority of expectant mothers (71.3% enrolled for ANC at the 8th week or later, with the longest delay recorded at the 6th month of gestation. Traditional norms significantly influenced this delay. Likewise, overall use of ANC during pregnancy was shaped by cultural factors related to perceptions of pregnancy, gender-based roles and responsibilities and concerns that ANC would result in an overweighed baby and culturally inappropriate delivery at a health care facility.Greater understanding of the sociocultural barriers to ANC is essential if proposed changes in community-specific health education programs are to facilitate early commencement and increased use of ANC.

  6. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia.

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    Heemelaar, Steffie; Habets, Nicole; Makukula, Ziche; van Roosmalen, Jos; van den Akker, Thomas

    2015-03-01

    To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. A prospective implementation study in a second-level hospital in rural Zambia. Included were all pregnant women who delivered in hospital during May and June 2012. Data regarding antenatal visits and HIV testing were collected by two investigators using a standardised form. Of 401 women who delivered in hospital, sufficient antenatal data could be retrieved for 322 (80.3%) women. Of these 322 women, 301 (93.5%) had attended antenatal care (ANC) at least once. At the time of discharge after delivery in hospital, 171 (53.1%) had an unclear HIV status because their negative test result was more than 3 months ago or of an unknown date, or because they had not been tested at all during pregnancy or delivery. An updated HIV status was present for 151 (46.9%) women: 25 (7.8%) were HIV positive and 126 (39.1%) had tested negative within the last 3 months. In this last group, 79 (24.5%) had been tested twice or more during pregnancy. During the study period, none of the women was tested during admission for delivery. Despite high ANC coverage, opportunities for repeat HIV testing were missed in almost half of all women who delivered in this hospital in a high-prevalence HIV setting. © 2014 John Wiley & Sons Ltd.

  7. Is 'Opt-Out HIV Testing' a real option among pregnant women in rural districts in Kenya?

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    Wamalwa David

    2011-03-01

    Full Text Available Abstract Background An 'opt-out' policy of routine HIV counseling and testing (HCT is being implemented across sub-Saharan Africa to expand prevention of mother-to-child transmission (PMTCT. Although the underlying assumption is that pregnant women in rural Africa are able to voluntarily consent to HIV testing, little is known about the reality and whether 'opt-out' HCT leads to higher completion rates of PMTCT. Factors associated with consent to HIV testing under the 'opt-out' approach were investigated through a large cross-sectional study in Kenya. Methods Observations during HIV pre-test information sessions were followed by a cross-sectional survey of 900 pregnant women in three public district hospitals carrying out PMTCT in the Busia district. Women on their first antenatal care (ANC visit during the current pregnancy were interviewed after giving blood for HIV testing but before learning their test results. Descriptive statistics and multivariate regression analysis were performed. Results Of the 900 women participating, 97% tested for HIV. Lack of testing kits was the only reason for women not being tested, i.e. nobody declined HIV testing. Despite the fact that 96% had more than four earlier pregnancies and 37% had been tested for HIV at ANC previously, only 17% of the women surveyed knew that testing was optional. Only 20% of those surveyed felt they could make an informed decision to decline HIV testing. Making an informed decision to decline HIV testing was associated with knowing that testing was optional (OR = 5.44, 95%CI 3.44-8.59, not having a stable relationship with the child's father (OR = 1.76, 95%CI 1.02-3.03, and not having discussed HIV testing with a partner before the ANC visit (OR = 2.64 95%CI 1.79-3.86. Conclusion High coverage of HIV testing appears to be achieved at the cost of pregnant women not understanding that testing is optional. Good quality HIV pre-test information is central to ensure that pregnant women

  8. Prevalence of Untreated Surgical Conditions in Rural Rwanda: A Population-Based Cross-sectional Study in Burera District.

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    Maine, Rebecca G; Linden, Allison F; Riviello, Robert; Kamanzi, Emmanuel; Mody, Gita N; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel M; Mpunga, Tharcisse; Meara, John G; Hedt-Gauthier, Bethany L

    2017-12-20

    In low- and middle-income countries, community-level surgical epidemiology is largely undefined. Accurate community-level surgical epidemiology is necessary for surgical health systems planning. To determine the prevalence of surgical conditions in Burera District, Northern Province, Rwanda. A cross-sectional study with a 2-stage cluster sample design (at village and household level) was carried out in Burera District in March and May 2012. A team of surgeons randomly sampled 30 villages with probability proportionate to village population size, then sampled 23 households within each village. All available household members were examined. The presence of 10 index surgical conditions (injuries/wounds, hernias/hydroceles, breast masses, neck masses, obstetric fistulas, undescended testes, hypospadias, hydrocephalus, cleft lip/palate, and clubfoot) was determined by physical examination. Prevalence was estimated overall and for each condition. Multivariable logistic regression was performed to identify factors associated with surgical conditions, accounting for the complex survey design. Of the 2165 examined individuals, 1215 (56.2%) were female. The prevalence of any surgical condition among all examined individuals was 12% (95% CI, 9.2-14.9%). Half of conditions were hernias/hydroceles (49.6%), and 44% were injuries/wounds. In multivariable analysis, children 5 years or younger had twice the odds of having a surgical condition compared with married individuals 21 to 35 years of age (reference group) (odds ratio [OR], 2.2; 95% CI, 1.26-4.04; P = .01). The oldest group, people older than 50 years, also had twice the odds of having a surgical condition compared with the reference group (married, aged >50 years: OR, 2.3; 95% CI, 1.28-4.23; P = .01; unmarried, aged >50 years: OR, 2.38; 95% CI, 1.02-5.52; P = .06). Unmarried individuals 21 to 35 years of age and unmarried individuals aged 36 to 50 years had higher odds of a surgical condition compared with the

  9. Birth preparedness and complication readiness among rural women of reproductive age in Abeshige district, Guraghe zone, SNNPR, Ethiopia

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    Zepre K

    2016-12-01

    Full Text Available Kebebush Zepre,1 Mirgissa Kaba2 1Guraghe Zone Health Department, Wolkite, SNNPR, 2School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Background: Birth preparedness and complication readiness (BPCR is a strategy that helps women to consider all available maternal health care services during pregnancy and prepare for potential complications. Federal Ministry of Health in Ethiopia has taken steps to roll out the strategy at community level. Yet, women in rural communities still do not make use of available services to avoid complications in connection to pregnancy and delivery. Objective: This study aims to assess the current BPCR practice and determine associated factors among rural women of reproductive age in Abeshige district, Guraghe zone, SNNPR, Ethiopia. Methods: A community-based cross-sectional study was carried out from February to March 2015. A total of 454 women were randomly selected and interviewed using pretested structured questionnaires, while opinion leaders, health extension workers, and selected women in the community were engaged in in-depth interviews and focus group discussions, using checklists prepared to guide the interviews. Data from different sources were analyzed, triangulated, and interpreted to respond to the objectives. Results: Thirty-seven percent of the respondents were found to have prepared for birth and its complications. BPCR was higher among women who lived within a 1-hour walk from a health center (adjusted odds ratio [AOR] =3.51, 95% confidence interval [CI]: 1.78, 36.79 and who were aware of the danger signs of pregnancy (AOR =1.72, 95% CI: 1.78, 2.94 and postpartum complications (AOR =2.32, 95% CI: 1.32, 4.21. A major source of information was found to be health extension workers and one-to-five women networks (AOR =2.81, 95% CI: 1.34, 6.21 and (AOR =2.52, 95% CI: 1.17, 5.54, respectively. Qualitative finding revealed that lack of transportation and concern over cost of services

  10. Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem.

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    Inthanomchanh Vongphoumy

    Full Text Available The Lao PDR (Laos is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high.Two cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months.Thirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014.Incidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this important public

  11. Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem.

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    Vongphoumy, Inthanomchanh; Phongmany, Panom; Sydala, Sengdao; Prasith, Nouda; Reintjes, Ralf; Blessmann, Joerg

    2015-01-01

    The Lao PDR (Laos) is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high. Two cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months. Thirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014. Incidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this important public health problem in

  12. Screening of hepatitis B and C among people visiting general practice clinics in rural district of Sindh, Pakistan

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    Kumar, A.; Lalani, S.; Afridi, A.A.K.; Khuwaja, A.K.

    2010-01-01

    Background: Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex. Methods: This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect the required information. Chi-squared test and univariate analysis was calculated to assess the difference in HB and HC proportion by age groups and sex. Results: One-fourth of reports were positive for at least one entity whereas 8% and 17% of reviewed reports of adults (>18 years and above) were screened positive for HB and HC respectively. Positive screened tests were higher among older age group compared to young age group (HB: older age group=56.6% vs. younger age group=43.4%; OR=1.07) and (HC: older age group=58.3% vs. younger age group=41.7%; OR=1.08). In the same way, positive screened tests were higher among men compared to women (HB: men=67.0% vs. women=33.0%; OR=1.2) and (HC: men=62.0% vs. women=38.0%; OR=1.3). Conclusion: A large proportion of people were screened positive for HB and HC in this study. Prevention and screening are suggested at larger scale for urgent planning and implementation of intervention strategies in this regard. Further research is also recommended to explore this important health issue at large scale. (author)

  13. Association of socio‐demographic factors with overweight and obesity among rural school going adolescents in Rohtak district, Haryana

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    BM Vashisht

    2018-01-01

    Full Text Available Introduction Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low‐income and middle‐income countries. Childhood obesity is associated with higher chances of premature deaths and disabilities in adulthood. It is also evident that nearly 75% of the obese adolescents remain obese as adults thus increasing the risk of Non Communicable Diseases (NCDs. Aim and Objectives To study the prevalence and associated socio‐demographic factors of overweight and obesity among rural school going adolescents. Material and Methods The present study was conducted in Lakhanmajra block of Rohtak district over a period of one year from July 2016 to June 2017. 750 students from six co‐ educational government senior secondary schools were included in the study. Data were collected using pre‐designed, pre‐tested, semi structured interview schedule. Collected data were analyzed using SPSS version 20.0. Results Prevalence of overweight and obesity was 6.7% and 1.1% respectively. Maximum prevalence of obesity/overweight was found in the age group 13‐14 years (11.2%. Obesity/overweight was more prevalent in males (9.4% in comparison to females (3.4%. 14.3% of the study subjects belonging to three generation family, 11.7% belonging to joint and 4.5% belonging to the nuclear families were found to obese/ overweight. 11% and 5.1% of the study subjects with 6‐10 family members and 5 and less than five family members were obese/ overweight. Conclusion Childhood obesity continues in adult life and thus gives rise to diabetes and cardiovascular diseases. Thus it is the need of the hour to address this problem and to devise programs and strategies to prevent overweight/obesity among children and adolescents because today’s children are future of the nation.

  14. Implementing intimate partner violence care in a rural sub-district of South Africa: a qualitative evaluation

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    Kate Rees

    2014-09-01

    Full Text Available Background: Despite a high burden of disease, in South Africa, intimate partner violence (IPV is known to be poorly recognised and managed. To address this gap, an innovative intersectoral model for the delivery of comprehensive IPV care was piloted in a rural sub-district. Objective: To evaluate the initiative from the perspectives of women using the service, service providers, and managers. Design: A qualitative evaluation was conducted. Service users were interviewed, focus groups were conducted amongst health care workers (HCW, and a focus group and interviews were conducted with the intersectoral implementation team to explore their experiences of the intervention. A thematic analysis approach was used, triangulating the various sources of data. Results: During the pilot, 75 women received the intervention. Study participants described their experience as overwhelmingly positive, with some experiencing improvements in their home lives. Significant access barriers included unaffordable indirect costs, fear of loss of confidentiality, and fear of children being removed from the home. For HCW, barriers to inquiry about IPV included its normalisation in this community, poor understanding of the complexities of living with violence and frustration in managing a difficult emotional problem. Health system constraints affected continuity of care, privacy, and integration of the intervention into routine functioning, and the process of intersectoral action was hindered by the formation of alliances. Contextual factors, for example, high levels of alcohol misuse and socio-economic disempowerment, highlighted the need for a multifaceted approach to addressing IPV. Conclusions: This evaluation draws attention to the need to take a systems approach and focus on contextual factors when implementing complex interventions. The results will be used to inform decisions about instituting appropriate IPV care in the rest of the province. In addition, there is

  15. Routine implementation costs of larviciding with Bacillus thuringiensis israelensis against malaria vectors in a district in rural Burkina Faso.

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    Dambach, Peter; Schleicher, Michael; Stahl, Hans-Christian; Traoré, Issouf; Becker, Norbert; Kaiser, Achim; Sié, Ali; Sauerborn, Rainer

    2016-07-22

    The key tools in malaria control are early diagnosis and treatment of cases as well as vector control. Current strategies for malaria vector control in sub-Saharan Africa are largely based on long-lasting insecticide-treated nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). An additional tool in the fight against malaria vectors, larval source management (LSM), has not been used in sub-Saharan Africa on a wider scale since the abandonment of environmental spraying of DDT. Increasing concerns about limitations of LLINs and IRS and encouraging results from large larvicide-based LSM trials make a strong case for using biological larviciding as a complementary tool to existing control measures. Arguments that are often quoted against such a combined approach are the alleged high implementation costs of LSM. This study makes the first step to test this argument. The implementation costs of larval source management based on Bacillus thuringiensis israelensis (Bti) (strain AM65-52) spraying under different implementation scenarios were analysed in a rural health district in Burkina Faso. The analysis draws on detailed cost data gathered during a large-scale LSM intervention between 2013 and 2015. All 127 villages in the study setup were assigned to two treatment arms and one control group. Treatment either implied exhaustive spraying of all available water collections or targeted spraying of the 50 % most productive larval sources via remote-sensing derived and entomologically validated risk maps. Based on the cost reports from both intervention arms, the per capita programme costs were calculated under the assumption of covering the whole district with either intervention scenario. Cost calculations have been generalized by providing an adaptable cost formula. In addition, this study assesses the sensitivity of per capita programme costs with respect to changes in the underlying cost components. The average annual per capita costs of

  16. Assesment on Reproductive Performance and Hormonal Studies in Rural Women Beedi Rollers in Jagitial District of Telangana State

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    Vanitha Baluka

    2017-10-01

    Full Text Available Beedi manufacturing is the second largest industry in India. It provides employment to millions of women mostly from the poor socioeconomic class. In North region of Telangana, beedi rolling is a major occupation for illiterate women in many villages. It may affect due to the inhalation of unfiltered tobacco dust and volatile and toxic components of tobacco. Biomonitoring of women beedi rollers and their reproductive performance assessment is necessary to take prevention/control the reproduction failure and carcinogen effect on cervical system. Continuous exposed to unfiltered tobacco dust may have systemic effect and lead to many disorders including hormone defects and reproductive health problems. Although studies have been carried out on beedi industry workers and tobacco smoke exposed people at national and international level, no such studies were carried out on women beedi rollers living in rural areas in Telangana State. Hence, this investigation is attempted to understand the study is find to association with hormonal levels and reproductive outcome in rural women beedi rollers of reproductive age in North Telangana. Statistical analysis was done for the obtained results to find the significance between the two groups for the reproductive outcome and Hormonal Studies. Total 50 women (married who are exposed minimum 6-10 years to the unfiltered tobacco dust beedi rollers in the age group of 25 to 45 years from villages of Jagitial district were enrolled for this study. 50 equal numbers of women in the same age group belonging to the same socio economic status and not exposed occupationally to chemical and physical agents was selected for comparison (control group. Estroidal, Progesterone the T3, T4 and TSH levels were measured found significantly T3, T4 levels were low in the beedi rollers, compared the controls. TSH levels were found to be higher in the beedi rollers. Estroidal and progesterone levels were obtained non

  17. Knowledge and Attitude of Married Women in the Reproductive Age Group Regarding Emergency Contraception in Selected Rural Areas of Udupi District

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    Preethi Fernandes

    2014-01-01

    Full Text Available Background: Unwanted pregnancy is still a major problem in the modern world despite the widely available contraception services. This study was conducted to determine the knowledge and attitude of married women in the reproductive age group regarding emergency contraception in selected rural areas of Udupi district, India. Material and Methods: The study group comprised of 350 married women in the reproductive age group residing in rural areas of Udupi district, India. A structured questionnaire and an attitude scale were used to assess the knowledge and the attitude. Results: Majority, 69.1% of the married women belonged to Hindu religion, 46.9% had an educational qualification of 10th standard and below. About 13.1% of the married women had undergone abortion. Nearly 96.9% of the married women had heard about emergency contraceptives and only 2% of the married women had used emergency contraceptive pills. About 63.7% out of 339 married women had got information about emergency contraceptive pills from health personnel and about 77.7% from television. Majority 84% had poor knowledge on emergency contraception. About 99.7% had favourable attitude on the use of emergency contraceptives. There was a significant association between knowledge scores and selected variable like education, knowledge and the attitude scores had a correlation. Conclusion: The study identifies the knowledge and attitude of the rural married women regarding emergency contraception, hence to help them to plan future pregnancies and prevent any unwanted or unintended pregnancies.

  18. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda-a cross sectional study.

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    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham; Clarke, Sîan E; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip; Mbonye, Anthony K

    2016-07-15

    Private facilities are the first place of care seeking for many sick children. Involving these facilities in child health interventions may provide opportunities to improve child welfare. The objective of this study was to assess the potential of rural and urban private facilities in diagnostic capabilities, operations and human resource in the management of malaria, pneumonia and diarrhoea. A survey was conducted in pharmacies, private clinics and drug shops in Mukono district in October 2014. An assessment was done on availability of diagnostic equipment for malaria, record keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis was done. A total of 241 private facilities were assessed with only 47 (19.5 %) being in rural areas. Compared to urban areas, rural private facilities were more likely to be drug shops (OR 2.80; 95 % CI 1.23-7.11), less likely to be registered (OR 0.31; 95 % CI 0.16-0.60), not have trained clinicians, less likely to have people with tertiary education (OR 0.34; 95 % CI 0.17-0.66) and less likely to have zinc tablets (OR 0.38; 95 % CI 0.19-0.78). In both urban and rural areas, there was low usage of stock cards and patient registers. About half of the facilities in both rural and urban areas attended to at least one sick child in the week prior to the interview. There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health interventions need to build capacity of private facilities with special focus on rural areas where child mortality is higher and capacity of facilities lower.

  19. An investigation into the level of empowerment of rural women in the Zululand district of KwaZulu-Natal province of South Africa.

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    Bhengu, B R

    2010-06-01

    The aim of the study was to evaluate the outcome of the empowerment of rural women in relation to gender issues, power, and communication within the Zululand District of KwaZulu-Natal in SouthAfrica after implementation of a four-year Primary Health Care project in partnership with the Provincial Department of Health, and two Schools of Nursing at the University of KwaZulu-Natal and McMaster University in Canada. This project is based on substantial evidence which reveals that rural women are being neglected to the extent that these women have missed out on opportunities for development. The reasons for this disempowerment of women, particularly rural women, are thought to be due to the feminisation of poverty, as well as female submission, educational deprivation, privacy of domestic violence, exploitation, domination by men and cultural oppression (patriarchy). A qualitative research approach was used. Focus group discussion was utilised as the data collection technique, and this was also applied during the collection of baseline data. An interview guide covered issues of concern in the communities and households, including what the women would, or had done about these, how they engaged in decision-making in their families, how they handled situations when there was a difference of opinion, and their awareness of, and ability to claim their rights, including control of their lives. The data was collected from six clinics, from groups of six to ten women in the predominantly rural Zululand District of KwaZulu-Natal. The project has revealed improvement in the women's realisation of their rights, albeit limited, in communication, self-confidence, and reliance, including partnerships between Primary Health Care Nurses and women's groups. The formation of women's groups facilitated community development and participation in their own health, socio-economic and emotional development. The project suggests that such groups be encouraged and allowed to network for

  20. Prevalence of dental fluorosis among primary school children in rural areas of Chidambaram taluk, Cuddalore district, Tamil Nadu, India

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    Saravanan S

    2008-01-01

    Full Text Available Background: Fluorosis is one of the common but major emerging areas of research in the tropics. It is considered endemic in 17 states of India. However, the Cuddalore district of Tamil Nadu is categorised as a fluorosis non-endemic area. But clinical cases of dental fluorosis were reported in the field practice area of Department of Community Medicine, Rajah Muthiah Medical College, Annamalai University, Chidambaram. Since dental fluorosis has been described as a biomarker of exposure to fluoride, we assessed the prevalence and severity of dental fluorosis among primary school children in the service area. Materials and Methods: Children studying in six primary schools of six villages in the field practice area of Rural Health Centre of Faculty of Medicine, Annamalai University, Chidambaram, were surveyed. Every child was clinically examined at the school by calibrated examiners with Dean′s fluorosis index recommended by WHO (1997. Chi-square test, Chi-square trend test and Spearman′s rank correlation coefficient test were used for statistical analysis. Results: Five hundred and twenty-five 5- to 12-year-old school children (255 boys and 270 girls were surveyed. The overall dental fluorosis prevalence was found to be 31.4% in our study sample. Dental fluorosis increased with age P < 0.001, whereas gender difference was not statistically significant. Aesthetically objectionable dental fluorosis was found in 2.1% of the sample. Villages Senjicherry, Keezhaperambai and Kanagarapattu revealed a community fluorosis index (CFI score of 0.43, 0.54 and 0.54 with 5.6%, 4.8% and 1.4% of objectionable dental fluorosis, respectively. Correlation between water fluoride content and CFI values in four villages was noted to be positively significant. Conclusion: Three out of six villages studied were in ′borderline′ public health significance (CFI score 0.4-0.6. A well-designed epidemiological investigation can be undertaken to evaluate the risk factors

  1. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts

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    Wang Hong

    2011-01-01

    Full Text Available Abstract Background One of the key functions of health insurance is to provide financial protection against high costs of health care, yet evidence of such protection from developing countries has been inconsistent. The current study uses the case of Ghana to contribute to the evidence pool about insurance's financial protection effects. It evaluates the impact of the country's National Health Insurance Scheme on households' out-of-pocket spending and catastrophic health expenditure. Methods We use data from a household survey conducted in two rural districts, Nkoranza and Offinso, in 2007, two years after the initiation of the Ghana National Health Insurance Scheme. To address the skewness of health expenditure data, the absolute amount of out-of-pocket spending is estimated using a two-part model. We also conduct a probit estimate of the likelihood of catastrophic health expenditures, defined at different thresholds relative to household income and non-food consumption expenditure. The analysis controls for chronic and self-assessed health conditions, which typically drive adverse selection in insurance. Results At the time of the survey, insurance coverage was 35 percent. Although the benefit package of insurance is generous, insured people still incurred out-of-pocket payment for care from informal sources and for uncovered drugs and tests at health facilities. Nevertheless, they paid significantly less than the uninsured. Insurance has been shown to have a protective effect against the financial burden of health care, reducing significantly the likelihood of incurring catastrophic payment. The effect is particularly remarkable among the poorest quintile of the sample. Conclusions Findings from this study confirm the positive financial protection effect of health insurance in Ghana. The effect is stronger among the poor group than among general population. The results are encouraging for many low income countries who are considering a

  2. Assessment of the impacts of pit latrines on groundwater quality in rural areas: A case study from Marondera district, Zimbabwe

    Science.gov (United States)

    Dzwairo, Bloodless; Hoko, Zvikomborero; Love, David; Guzha, Edward

    In resource-poor and low-population-density areas, on-site sanitation is preferred to off-site sanitation and groundwater is the main source of water for domestic uses. Groundwater pollution potential from on-site sanitation in such areas conflicts with Integrated Water Resources Management (IWRM) principles that advocate for sustainable use of water resources. Given the widespread use of groundwater for domestic purposes in rural areas, maintaining groundwater quality is a critical livelihood intervention. This study assessed impacts of pit latrines on groundwater quality in Kamangira village, Marondera district, Zimbabwe. Groundwater samples from 14 monitoring boreholes and 3 shallow wells were analysed during 6 sampling campaigns, from February 2005 to May 2005. Parameters analysed were total and faecal coliforms, NH4+-N, NO3--N, conductivity, turbidity and pH, both for boreholes and shallow wells. Total and faecal coliforms both ranged 0-TNTC (too-numerous-to-count), 78% of results meeting the 0 CFU/100 ml WHO guidelines value. NH4+-N range was 0-2.0 mg/l, with 99% of results falling below the 1.5 mg/l WHO recommended value. NO3--N range was 0.0-6.7 mg/l, within 10 mg/l WHO guidelines value. The range for conductivity values was 46-370 μS/cm while the pH range was 6.8-7.9. There are no WHO guideline values for these two parameters. Turbidity ranged from 1 NTU to 45 NTU, 59% of results meeting the 5 NTU WHO guidelines limit. Depth from the ground surface to the water table for the period February 2005 to May 2005 was determined for all sampling points using a tape measure. The drop in water table averaged from 1.1 m to 1.9 m and these values were obtained by subtracting water table elevations from absolute ground surface elevation. Soil from the monitoring boreholes was classified as sandy. The soil infiltration layer was taken as the layer between the pit latrine bottom and the water table. It averaged from 1.3 m to 1.7 m above the water table for two latrines

  3. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda

    DEFF Research Database (Denmark)

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham

    2016-01-01

    keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis...... was done. RESULTS: A total of 241 private facilities were assessed with only 47 (19.5 %) being in rural areas. Compared to urban areas, rural private facilities were more likely to be drug shops (OR 2.80; 95 % CI 1.23-7.11), less likely to be registered (OR 0.31; 95 % CI 0.16-0.60), not have trained...... attended to at least one sick child in the week prior to the interview. CONCLUSION: There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health...

  4. Going places, staying home : rural-urban connections and the significance of land in Buhera district, Zimbabwe

    NARCIS (Netherlands)

    Andersson, J.A.

    2002-01-01

    This book consists of four articles containing detailed ethnographic studies of people who are commonly known as migrant workers.Conventional studies on rural-urban migration and urbanisation have often examined such people in either rural or urban social situations,analysing respectively the

  5. "It is not possible for me to have diabetes"-community perceptions on diabetes and its risk factors in Rural Purworejo District, Central Java, Indonesia.

    Science.gov (United States)

    Pujilestari, Cahya Utamie; Ng, Nawi; Hakimi, Mohammad; Eriksson, Malin

    2014-06-12

    Accumulating evidence suggests that negative perceptions towards diabetes can limit the management and prevention of the disease. The negative perceptions towards diabetes are prevalent in many different settings, especially among rural communities. Few qualitative studies have been performed to understand how the community views diabetes and its associated risk factors. This study aimed to explore general community perceptions of diabetes and its risk factors in rural Indonesia. A total of 68 participants were recruited to 12 focus group discussions (FGDs) comprised of different age groups and sexes. The FGDs were conducted in six villages in rural Purworejo District, Central Java, Indonesia, from 2011 to 2012. All FGDs were recorded and transcribed. Qualitative content analysis was performed to describe and analyse how the rural community perceived diabetes and its risk factors. Diabetes was perceived as a visible and scary sugar disease, and the affected individuals themselves were blamed for getting the disease. Recognised as 'sugar' or 'sweet-pee' disease with terrifying effects, diabetes was believed to be a disease with no cure. The participants seemed to have an unrealistic optimism with regards to the diabetes risk factors. They believed that diabetes would not affect them, only others, and that having family members with diabetes was necessary for one to develop diabetes. Our findings demonstrate that rural communities have negative perceptions about diabetes and at the same time individuals have unrealistic optimism about their own risk factors. Understanding how such communities perceive diabetes and its risk factors is important for planning prevention strategies. Health messages need to be tailored to health-related behaviours and the local culture's concepts of diseases and risk factors.

  6. Assessment of Compliance to Treatment of Diabetes and Hypertension amongst Previously Diagnosed Patients from Rural Community of Raigad District of Maharashtra.

    Science.gov (United States)

    Kakumani, Kiranmayi Venkata; Waingankar, Prasad

    2016-12-01

    Substantial burden of diabetes and hypertension is on rise in India, leading to a twin epidemic. India, being a rural country, has unique problems regarding the treatment compliance which is a serious risk for morbidity and mortality. To assess the compliance to treatment of hypertension and diabetes amongst the diagnosed patients from rural area and to study reasons of non-compliance and knowledge and attitude. Community based, cross sectional, observational study conducted in the rural communities of Tara and Barapada villages of Raigad district of Maharashtra. Survey was conducted covering population of 2115 across 360 families, 250 at Barapada and 110 at Tara. All the cases of diabetes and hypertension diagnosed for more than one year were included. A structured and pre-tested questionnaire was administered including details on demography, medical documentation, treatment details and factors assessing the compliance, knowledge and attitude towards the diseases. When reviewed the treatment adherence pattern based on documentary evidence and interview of the patient, on history of taking medication strictly since the detection illness, it was found that more than 70% of the Diabetics and more than 75% of the Hypertensive have discontinued the treatment in between. The most common reasons of non-compliance is the lack of sufficient motivation for treatment adherence as many mentioned (61.4% diabetics, 55.8% hypertensives) difficulty to remember to take daily medication due to work or forgetfulness. This is followed by lack of money (50%diabetics, 55.8% hypertensives) and living far away from doctor in city (43% diabetics and 46% hypertensives). The study findings are only tip of iceberg and the non-adherence to the treatment of diabetes and hypertension in rural population is at alarmingly high. Illiteracy, lack of faith in treatment and motivation, unawareness and self-neglect as well as financial constraints and lack of specialist care in rural area is playing

  7. Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district

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    Dhar V

    2007-06-01

    Full Text Available High prevalence of dental diseases has been recorded in Rajasthan, however, not much work has been done to ascertain the prevalence of dental diseases in Udaipur district. This study was conducted among 1,587 government school children of Udaipur district in the age group of 5-14 years for recording the prevalence of gingival diseases, fluorosis and malocclusion. Gingivitis was found in 84.37% of children, malocclusion in 36.42% and fluorosis in 36.36%.

  8. Anti-malarial drug safety information obtained through routine monitoring in a rural district of South-Western Senegal

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    Brasseur Philippe

    2012-12-01

    Full Text Available Abstract Background Knowing the safety profile of anti-malarial treatments in routine use is essential; millions of patients receive now artemisinin combination therapy (ACT annually, but the return on information through current systems is as yet inadequate. Cohort event monitoring (CEM is a WHO (World Health Organization-recommended practice; testing its performance and feasibility in routine practice in malaria-endemic is important. Methods A nine-year CEM-based study of the safety of artesunate-amodiaquine (ASAQ at five peripheral health facilities in a rural district of South-western Senegal. Staff (nurses, health workers were trained to collect actively and systematically information on the patient, treatment and events on a purposely designed questionnaire. The occurrence and severity of events was collected before, during and after treatment up to 28 days in order to generate information on all adverse events (AEs as well as treatment-emerging signs/symptoms (TESS. Laboratory tests (haematology, liver and renal was planned for at least 10% of cases. Results During 2001–2009, 3,708 parasitologically-confirmed malaria cases (mean age = 16.0 ± 12.7 years were enrolled (26% and 52% of all and parasitologically-confirmed ASAQ treatments, respectively. Treatment was supervised in 96% of cases. Products changed over time: 49% were a loose combination of individually-packaged products (available 2001–03, 42% co-blistered products (2004–09 and 9% a fixed-dose co-formulation (2006–09; dosing was age-based for 42%, weight-based for 58%. AS and AQ were correctly dosed in 97% and 82% of cases with the loose and 93% and 86% with the fixed combination, but only 50% and 42% with the co-blistered product. Thirty-three per cent (33% of patients had at least one sign/symptom pre-treatment, 12% had at least one AE and 9% a TESS (total events 3,914, 1,144 and 693, respectively. AEs overestimated TESS by 1.2-2 fold (average 1.7. Changes in

  9. Drawing a Link—Women’s Empowerment and Mahatma Gandhi National Rural Employment Guarantee Act: A Study Conducted in the Goalpara District, Assam

    Directory of Open Access Journals (Sweden)

    Dr Manisha Bhattacharyya

    2016-03-01

    Full Text Available This article reports on an empirical research that examined the extent of economic empowerment gained by women engaged in Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA in the district of Goalpara, Assam. The key objective of the MGNREGA is to provide social security to rural households by guaranteeing 100 days of paid employment in public works within a year. Based on nine variables (education, land ownership, ownership of other assets, control over income contributed by a woman to her family, control over the income of the family, savings, access to credit, social participation, cash income earned from income generating activities and calculated using empowerment index, the research compared the magnitude of women’s empowerment before and after getting involved in MGNREGA. The findings suggest that while MGNREGA is an important leap to ensuring economic empowerment to rural women, but the scheme has not been implemented properly in the district—women and men not getting 100 days of employment, irregular mode of payment, very slow progress and poor quality in public works.

  10. Exploring the condom gap: is supply or demand the limiting factor - condom access and use in an urban and a rural setting in Kilifi district, Kenya.

    Science.gov (United States)

    Papo, Jacqueline K; Bauni, Evasius K; Sanders, Eduard J; Brocklehurst, Peter; Jaffe, Harold W

    2011-01-14

    to explore the extent of the condom gap, investigating the relative roles of supply-side and demand-side factors in determining condom use. GPS mapping of condom outlets, and population-based survey. an urban and a rural site were selected within the Epidemiological and Demographic Surveillance Site in Kilifi district, Kenya. Potential condom outlets (n = 281) were mapped and surveyed, and questionnaires on condom access and use (n = 630) were administered to a random sample of men and women aged 15-49. Multivariate logistic regression was performed to assess the relative roles of supply-side and demand-side barriers on condom use. the median straight-line distance to free condoms was 18-fold higher in the rural versus urban site. Among sexually active respondents, 42% had ever used a condom, and 23% had used a condom over the past 12 months, with lower levels among rural versus urban respondents (P supply-side or demand-side barriers, compared with individuals experiencing both types of barriers. Despite low levels of usage and the presence of supply-side and demand-side barriers, reported unmet need for condoms was low. there is an urgent need for renewed condom promotion efforts aimed at building demand, in addition to improving physical access, in resource-limited settings with generalized HIV epidemics in sub-Saharan Africa. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  11. Impact of chronic respiratory symptoms in a rural area of sub-Saharan Africa: an in-depth qualitative study in the Masindi district of Uganda.

    Science.gov (United States)

    van Gemert, Frederik; Chavannes, Niels; Nabadda, Nahid; Luzige, Simon; Kirenga, Bruce; Eggermont, Celeste; de Jong, Corina; van der Molen, Thys

    2013-09-01

    Chronic obstructive pulmonary disease (COPD), once regarded as a disease of developed countries, is now recognised as a common disease in low- and middle-income countries. No studies have been performed to examine how the community in resource poor settings of a rural area in sub-Saharan Africa lives with chronic respiratory symptoms. To explore beliefs and attitudes concerning health (particularly respiratory illnesses), use of biomass fuels, tobacco smoking, and the use of health services. A qualitative study was undertaken in a rural area of Masindi district in Uganda, using focus group discussions with 10-15 members of the community in 10 randomly selected villages. Respiratory symptoms were common among men, women, and children. In several communities respiratory symptoms were stigmatised and often associated with tuberculosis. Almost all the households used firewood for cooking and the majority cooked indoors without any ventilation. The extent of exposure to tobacco and biomass fuel smoke was largely determined by their cultural tradition and gender, tribal origin and socioeconomic factors. Many people were unaware of the damage to respiratory health caused by these risk factors, notably the disproportionate effect of biomass smoke in women and children. The knowledge of chronic respiratory diseases, particularly COPD, is poor in the rural community in sub-Saharan Africa. The lack of knowledge has created different beliefs and attitudes concerning respiratory symptoms. Few people are aware of the relation between smoke and respiratory health, leading to extensive exposure to mostly biomass-related smoke.

  12. Analysis of Food Poverty of Rural Women in Villages of Central district of Boyer-Ahmad County

    Directory of Open Access Journals (Sweden)

    2014-10-01

    Full Text Available The findings revealed that about 31 percent of women were below and 69% were above the food poverty line. Comparison of averages of some variables including education status, employment (head of household, income, banking facilities such as credit and loans, property and assets, savings, economic skills, economic participation, government supports, husband's attitude, self-confidence, self-esteem, physical and mental healths showed that there are significant differences between poor and non-poor rural women. The discriminant analysis indicated that variables like husband attitude, self-confidence, and self-essteem correctly classified about 87.7 percent of rural women as poor or non-poor. Due to the husband's attitude had a significant role in differentiation of the two groups, the social and cultural education of rural men are recommended. Furthermore, the supporting sterategies that includes the distribution of food commodities, unemployment insurance and pensions, medical insurance and development of educational services for rural women is suggested.

  13. Predictors and consequences of rural clients' satisfaction level in the district public-private mixed health system of Bangladesh

    NARCIS (Netherlands)

    Roy, Ashim; van der Weijden, Trudy; de Vries, Nanne

    2017-01-01

    Background: We investigated predictors of the rural clients' satisfaction level (CSL), and interlinks between perceived specific service quality (PSSQ), perceived utility value (PUV), CSL, and clients' reactions (CR) towards current and future utilization of providers and facilities in the

  14. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

    Science.gov (United States)

    Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

    2014-01-01

    As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease

  15. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results: 1 Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2 Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3 Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4 Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5 Information and research: Data that can be used for planning and management (including population and epidemiological

  16. Lifestyle Patterns and Prevalence of Overweight and Obesity among Rural School Children of Age 6 to 9 Years of District Una, Himachal Pradesh

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    Shilpa Choudhary

    2017-01-01

    Full Text Available BACKGROUND: Many studies have reported prevalence of overweight and obesity in children and adolescents from urban areas as well as of underweight or malnutrition from rural areas. With changing lifestyles everywhere, a need was felt to study the prevalence of overweight and obesity among rural children also. METHODOLOGY: Present cross-sectional study was planned involving 210 school children (103 boys and 107 girls of age 6-9 years from various private schools of district Una, Himachal Pradesh, India. IOTF (International Obesity Task Force cutoffs for BMI were used. Information about lifestyle, eating habits, physical activity and socio-economic status was collected through well designed questionnaire, which was filled by the parents of the children. The population studied mostly belonged to lower and upper middle class. SPSS version 17.0 was used to analyze the data. RESULTS: Overweight and obesity among children was found to be 14.8%. Time spent in physical activity has reduced greatly; also there was increased sedentary lifestyle among rural children. 93.5% of overweight and obese children were considered fine (according to their weight by their parents. The children, who did not have their food timely, ate less frequently and ate junk food more than 3-times a week, were found to be more overweight and obese. CONCLUSION: Percentage of overweight and obese children (14.8% seen in the study has provided evidence that it is not only the urban population or the higher socioeconomic class groups that are affected with the lifestyle related problems but changing lifestyle has affected rural children also.

  17. Public accountability needs to be enforced -a case study of the governance arrangements and accountability practices in a rural health district in Ghana.

    Science.gov (United States)

    Van Belle, Sara; Mayhew, Susannah H

    2016-10-12

    Improving public accountability is currently high on the global agenda. At the same time, the organisation of health services in low- and middle-income countries is taking place in fragmented institutional landscapes. State and non-state actors are involved in increasingly complex governance arrangements. This often leads to coordination problems, confusion of roles and responsibilities and possibly accountability gaps. This study aimed at assessing the governance arrangements and the accountability practices of key health actors at the level of a Ghanaian health district with the aim to understand how far public accountability is achieved. We adopted the case study design as it allows for in-depth analysis of the governance arrangements and accountability relations between actors, their formal policies and actual accountability practices towards the public and towards stakeholders. Data were collected at a rural health district using in-depth interviews, observation and document review. In the analysis, we used a four-step sequence: identification of the key actors and their relationships, description of the multi-level governance arrangements, identification of the actual accountability relations and practices between all actors and finally appraisal of the public accountability practices, which we define as those practices that ensure direct accountability towards the public. In this rural health district with few (international) non-governmental organisations and private sector providers, accountability linkages towards management and partners in health programmes were found to be strong. Direct accountability towards the public, however, was woefully underdeveloped. This study shows that in settings where there is a small number of actors involved in organising health care, and where the state actors are underfunded, the intense interaction can lead to a web of relations that favours collaboration between partners in health service delivery, but fails public

  18. Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia.

    Science.gov (United States)

    Ir, Por; Horemans, Dirk; Souk, Narin; Van Damme, Wim

    2010-01-07

    In many developing countries, the maternal mortality ratio remains high with huge poor-rich inequalities. Programmes aimed at improving maternal health and preventing maternal mortality often fail to reach poor women. Vouchers in health and Health Equity Funds (HEFs) constitute a financial mechanism to improve access to priority health services for the poor. We assess their effectiveness in improving access to skilled birth attendants for poor women in three rural health districts in Cambodia and draw lessons for further improvement and scaling-up. Data on utilisation of voucher and HEF schemes and on deliveries in public health facilities between 2006 and 2008 were extracted from the available database, reports and the routine health information system. Qualitative data were collected through focus group discussions and key informant interviews. We examined the trend of facility deliveries between 2006 and 2008 in the three health districts and compared this with the situation in other rural districts without voucher and HEF schemes. An operational analysis of the voucher scheme was carried out to assess its effectiveness at different stages of operation. Facility deliveries increased sharply from 16.3% of the expected number of births in 2006 to 44.9% in 2008 after the introduction of voucher and HEF schemes, not only for voucher and HEF beneficiaries, but also for self-paid deliveries. The increase was much more substantial than in comparable districts lacking voucher and HEF schemes. In 2008, voucher and HEF beneficiaries accounted for 40.6% of the expected number of births among the poor. We also outline several limitations of the voucher scheme. Vouchers plus HEFs, if carefully designed and implemented, have a strong potential for reducing financial barriers and hence improving access to skilled birth attendants for poor women. To achieve their full potential, vouchers and HEFs require other interventions to ensure the supply of sufficient quality maternity

  19. Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia

    Directory of Open Access Journals (Sweden)

    Souk Narin

    2010-01-01

    Full Text Available Abstract Background In many developing countries, the maternal mortality ratio remains high with huge poor-rich inequalities. Programmes aimed at improving maternal health and preventing maternal mortality often fail to reach poor women. Vouchers in health and Health Equity Funds (HEFs constitute a financial mechanism to improve access to priority health services for the poor. We assess their effectiveness in improving access to skilled birth attendants for poor women in three rural health districts in Cambodia and draw lessons for further improvement and scaling-up. Methods Data on utilisation of voucher and HEF schemes and on deliveries in public health facilities between 2006 and 2008 were extracted from the available database, reports and the routine health information system. Qualitative data were collected through focus group discussions and key informant interviews. We examined the trend of facility deliveries between 2006 and 2008 in the three health districts and compared this with the situation in other rural districts without voucher and HEF schemes. An operational analysis of the voucher scheme was carried out to assess its effectiveness at different stages of operation. Results Facility deliveries increased sharply from 16.3% of the expected number of births in 2006 to 44.9% in 2008 after the introduction of voucher and HEF schemes, not only for voucher and HEF beneficiaries, but also for self-paid deliveries. The increase was much more substantial than in comparable districts lacking voucher and HEF schemes. In 2008, voucher and HEF beneficiaries accounted for 40.6% of the expected number of births among the poor. We also outline several limitations of the voucher scheme. Conclusions Vouchers plus HEFs, if carefully designed and implemented, have a strong potential for reducing financial barriers and hence improving access to skilled birth attendants for poor women. To achieve their full potential, vouchers and HEFs require other

  20. An investigation into the level of empowerment of rural women in the Zululand district of KwaZulu-Natal province of South Africa

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    B.R. Bhengu

    2010-09-01

    Full Text Available The aim of the study was to evaluate the outcome of the empowerment of rural women in relation to gender issues, power, and communication within the Zululand District of KwaZulu-Natal in South Africa after implementation of a four-year Primary Health Care project in partnership with the Provincial Department of Health, and two Schools of Nursing at the University of KwaZulu-Natal and McMaster University in Canada. This project is based on substantial evidence which reveals that rural women are being neglected to the extent that these women have missed out on opportunities for development. The reasons for this disempowerment of women, particularly rural women, are thought to be due to the feminisation of poverty, as well as female submission, educational deprivation, privacy of domestic violence, exploitation, domination by men and cultural oppression (patriarchy. A qualitative research approach was used. Focus group discussion was utilised as the data collection technique, and this was also applied during the collection of baseline data. An interview guide covered issues of concern in the communities and households, including what the women would, or had done about these, how they engaged in decision-making in their families, how they handled situations when there was a difference of opinion, and their awareness of, and ability to claim their rights, including control of their lives. The data was collected from six clinics, from groups of six to ten women in the predominantly rural Zululand District of KwaZulu-Natal. The project has revealed improvement in the women’s realisation of their rights, albeit limited, in communication, self-confidence, and reliance, including partnerships between Primary Health Care Nurses and women’s groups. The formation of women’s groups facilitated community development and participation in their own health, socio-economic and emotional development. The project suggests that such groups be encouraged and

  1. Power imbalance and consumerism in the doctor-patient relationship: health care providers' experiences of patient encounters in a rural district in India.

    Science.gov (United States)

    Fochsen, Grethe; Deshpande, Kirti; Thorson, Anna

    2006-11-01

    The aim of this study is to explore health care providers' experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor's dominance. A patient-centered approach, acknowledging patients' own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

  2. [Funding of a free healthcare campaign in a rural district of Cameroon: optimizing the role of civil society in sub-Saharan Africa].

    Science.gov (United States)

    Keugoung, B; Fouelifack Ymele, F; Dongtsa Mabou, J; Nangue, C; Ngouadjio Kougoum, P; Takoudjou, L; Hercot, D; Meli, J

    2013-05-01

    Financial barriers represent a major obstacle to access to health care in sub-Saharan Africa and thus to the implementation of the Bamako Initiative. We describe an experience in which a civil society organization financed a free healthcare campaign in a rural health district in Cameroon. In all, 2,073 patients received free consultations, laboratory tests, and drugs. Adults older than 40 years accounted for 55.7% of all patients. The most frequent diseases were: osteoarticular conditions (24.1%), malaria (20.8%), and intestinal parasitosis (12.5%). In health systems financed mainly by cost recovery, some population needs remain uncovered by health services. There is a need to involve and reinforce the role of civil society in health system financing. It can help to pool more funds and improve the management of health resources to increase financial access to health care for poor people.

  3. Effectiveness of an integrated intervention in the control of endo- and ectoparasites of pigs kept by smallholder farmers in Mbeya rural and Mbozi districts, Tanzania

    DEFF Research Database (Denmark)

    Kabululu, Mwemezi Lutakyawa; Ngowi, Helena Aminiel; Kimera, Sharadhuli Iddi

    2018-01-01

    This study was conducted to evaluate effectiveness of an integrated management intervention in the control of endo- and ectoparasites of pigs kept by smallholder farmers in Mbeya Rural and Mbozi districts of southern highlands of Tanzania. A repeated cross-sectional group randomization design...... and ectoparasites, but no effect on sero-prevalence of PC. The reported ineffectiveness of the intervention against PC is probably an underestimation because serology is not able to provide quantitative data. It may also be a result of reduced compliance as this was a field study. Nevertheless, further studies...... was used to measure intervention effect by comparing changes from baseline values of prevalence and faecal egg counts between the two groups. No significant difference (p > 0.05) was observed between the two groups, in changes from baseline of sero-prevalence of PC. The intervention significantly reduced...

  4. Limited Access to AP Courses for Students in Smaller and More Isolated Rural School Districts. National Issue Brief Number 80

    Science.gov (United States)

    Gagnon, Douglas J.; Mattingly, Marybeth J.

    2015-01-01

    This brief assesses trends in access to, enrollment in, and success in Advanced Placement (AP) coursework in relation to school district poverty, racial composition, and urbanicity. It uses data merged from the 2011-2012 Civil Rights Data Collection (CRDC), the 2012 Small Area Income and Poverty Estimates (SAIPE), and the 2010 Decennial U.S.…

  5. Rural Navajo Students in Kayenta Unified School District's Special Education Programs: The Effects of Home Location and Language.

    Science.gov (United States)

    Heimbecker, Connie; Bradley-Wilkinson, Evangeline; Nelson, Bernita; Smith, Jody; Whitehair, Marsha; Begay, Mary H.; Bradley, Brian; Gamble, Armanda; McCarty, Nellie; Medina, Catherine; Nelson, Jacob; Pettigrew, Bobbie; Sealander, Karen; Snyder, Maria; White, Sherri; Redsteer, Denise; Prater, Greg

    In Kayenta Unified School District (KUSD) on the Navajo Reservation, 92 percent of students come from homes where Navajo is the primary language, but many students entering school are not fluent in either English or Navajo. A survey of 23 educators examined the effects of language and culture on the likelihood that a student would be placed in…

  6. Unmet Needs of Family Planning Among Women: A Cross-Sectional Study in a Rural Area of Kanchipuram District, Tamil Nadu, South India.

    Science.gov (United States)

    Vishnu Prasad, R; Venkatachalam, J; Singh, Zile

    2016-10-01

    Global contraceptive usage was 63.3 % in 2010 which was 9 % more than that in 1990. NFHS-III 2005-2006 revealed that the contraceptive prevalence rate was 56 % while in the past decade it was 48 %. In India, female sterilization is the most commonly preferred method of contraception accounting for 76 %, while in Tamil Nadu it was 90 %. Thus, this study aims at measuring the prevalence of unmet needs of family planning and its determinants in a rural area of Kancheepuram district, Tamil Nadu. The study was carried out as a community-based cross-sectional study in Chunambed panchayat, a rural area in Kanchipuram District, Tamil Nadu, India, among 505 women of age group 15-49 years. Cluster random sampling was done to select the households to include in the study. In every household, all the available and eligible women were explained about the study and recruited after obtaining informed consent. Chi-square test was applied for finding the difference in proportion, and p value <0.05 was considered statistically significant. The prevalence of unmet need for family planning in our study population was nearly 31 %; it was even more for younger age groups and for the women whose family size was less. 51.7 % of the participants were currently using a contraceptive measure and very few of their partners used contraception. Government health facilities were the major source of contraceptive service and majority of our participants were well aware about the various contraceptive methods. Unmet needs of family planning were high in our study population, and the knowledge about the contraceptive use and family planning was found to be fairly adequate.

  7. EVALUATION OF THE QUALITY OF EDUCATION FOR SUSTAINABLE DEVELOPMENT ON THE EXAMPLE OF RURAL SETTLEMENTS OF DAKHADAYEVSKY DISTRICT OF THE REPUBLIC OF DAGESTAN

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    G. M. Abdurakhmanov

    2015-01-01

    Full Text Available Aim. Analysis of the quality of environmental education for sustainable development on the example of educational institutions of villages of Dakhadayevsky district in Dagestan. Methods. The basis for research is the results of the surveys and testing among the schoolchildren of 5-11 grades and teachers of rural settlements of Dakhadayevsky District. The research is conducted using a special surveys designed at the faculty of ecology and geography of Dagestan State University. Statistical analysis was based on the general principles of statistics and carried out with the use of Statistica and Excel application packages. Results. The obtained data clearly reflect the situation of environmental education in Russian schools: unbalanced presentation of separate sections in the content of education. As follows from the results, the content of environmental education in schools is dominated by the knowledge gained in the course of learning biology and to a much lesser rate of geography. Analysis of the results showed that in schools the ecological knowledge is gained insufficiently. The comparative analysis of individual components of environmental training of pupils of the region showed varying results in different populations. Conclusions. The pro-file of environmental training for primary school students is analyzed, considering Russian educational standards. An attempt was made to explain these results and make recommendations to improve the learning environment.

  8. A study of malnutrition and associated risk factors among children of age 06-59 months in rural area of Jabalpur district, Madhya Pradesh

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    Nandini Shukla

    2018-03-01

    Full Text Available Background: “Malnutrition is a silent emergency”. Malnutrition is not only an important cause of childhood mortality and morbidity, but also leads to permanent impairment of both physical and mental growth of those who survive. Aims & Objectives: To determine the prevalence of malnutrition and association with various risk factors among children of age 06-59 months in rural area of Jabalpur district Madhya Pradesh. Material and Methods: Study was conducted among 517 children of age group 06-59 months in two randomly selected blocks of Jabalpur District.  Multistage random sampling technique was used. Predesigned questionnaire was used to collect data and anthropometric measurements were done. Data analysis was done using Epi Info™ 7.1.5 and SPSS 20.0 (free trial version. Result: The prevalence of underweight, stunting and wasting were found to be 35.8%, 41.4% and 19.7% respectively while the prevalence of obese and overweight was 2.7% & 5.6% respectively. Children born with low birth weight, having higher birth order, more number of siblings, those with incomplete immunization status and inappropriate feeding practices were associated with malnutrition. Conclusion: The present study demonstrates the multiple risk factors for childhood malnutrition requiring multisectoral approach to fight against this silent killer.

  9. Place Attachment and Place Disruption: The Perceptions of Selected Adults and High School Students on a Rural School District Reorganization.

    Science.gov (United States)

    Wieland, Regi Leann

    2001-01-01

    Interviews with adult residents and high school students in two rural Kansas communities that had consolidated their high schools found that adults in the community that lost its high school had more negative reactions and feelings of loss than adults in the community that retained its high school. Student reactions were generally positive.…

  10. The Impact an Integrated Workforce of a Rural Southwestern School District Has in the Making of a Blue Ribbon School

    Science.gov (United States)

    Goolsby, Annie J.

    2013-01-01

    This study utilized a contemporary approach to qualitative research, the descriptive survey design, to discover whether a diverse workforce was a major influence in producing a rural Blue Ribbon School. The population represented the school systems of a county located in the West South Central region of the United States. In this study, the terms…

  11. The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital

    NARCIS (Netherlands)

    Idro, Richard; Gwer, Samson; Kahindi, Michael; Gatakaa, Hellen; Kazungu, Tony; Ndiritu, Moses; Maitland, Kathryn; Neville, Brian G. R.; Kager, Piet A.; Newton, Charles R. J. C.

    2008-01-01

    BACKGROUND: Acute seizures are a common cause of paediatric admissions to hospitals in resource poor countries and a risk factor for neurological and cognitive impairment and epilepsy. We determined the incidence, aetiological factors and the immediate outcome of seizures in a rural malaria endemic

  12. Prevalence of goiter and urinary iodine status in six-twelve-year-old rural primary school children of Bharuch district, Gujarat, India

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    Haresh Rameshkumar Chandwani

    2012-01-01

    Full Text Available Background: Iodine deficiency disorder (IDD creates major public health problems in India, including Gujarat. The Bharuch district is a known iodine deficiency endemic area. This study was conducted to estimate the prevalence of goiter in primary school children; to determine the median urinary iodine concentration; to assess the level of iodine in salt samples at the household and retail shop levels; and to study the profile of salt sold at retail shops. Methods: This study was carried out by using the 30-cluster survey method in the primary schools of the rural areas in Bharuch district. A total of 70 students, including five boys and five girls from the first to seventh classes, who were present in class on the day of the visit were selected randomly for goiter examination from each village. Urine samples were collected from one boy and one girl from each class in each cluster. From each community, a maximum of two boys and two girls from each standard in the same age group were examined and also salt samples were tested from their households. From each village, one retail shop was visited and the salt purchased from those shops was immediately tested for iodine with spot kits. Results: We found a goiter prevalence of 23.2% (grade 1 - 17.4% and grade 2 - 5.8%. As the age increased, the goiter prevalence decreased except in nine-year-olds. The median urinary iodine excretion level was 110 μg/L. An Iodine level > 15 ppm was found in 93% of the salt samples tested at the household level. Conclusion: The present study showed moderate goiter prevalence in primary school children in the Bharuch district of Gujarat and an inadequate iodine content of salt at some household levels.

  13. THE DISPERSION OF AGRICULTURAL AND RURAL DEVELOPMENT EU FUNDS ON A REGIONAL AND DISTRICT LEVEL IN HUNGARY

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    Horvath Peter

    2015-07-01

    Full Text Available A national objective was realised when Hungary joined the European Union based on the preliminary result of the referendum. Naturally, there were pros and cons about the accession and there were those who refused the European integration. Still the emotion was stronger that came from the future EU membership and the hope in terms of the agriculture that with the opportunities offered by the EU both the Hungarian agriculture and countryside would follow a development course. Because of the accession a lot of support forms as well as the EU institutions became available but considering the impacts there were no clear positions. Obviously, today we know what kind of objective, positive changes were brought by the accession for example in terms of infrastructural and machine supply, broadened market possibilities and income growth. Still we also experience the objective disadvantages such as the stronger competition and the mass expansion of multinational food-processing and trading companies. The scientific measurement and judgement of the developmental changes which are difficult to measure is still a subject of debate. We have done the concentration analysis for two budget periods 2004-2006 and 2007-2013 respectively. Between 2004-2006 the regional concentration is more balanced year by year than the district. In the district values even in this period we can already experience the fact that very few farmers receive a big amount of support. Between 2007-2013 there are no sharp differences in the case of concentration neither in the region nor in the district. The Lorenz curve shows a classic concentration distribution in the Southern Great Plain Region every year. The course of Lorenz curves is supported by the value of the concentration ratio which is the total share of the support of the three players receiving the biggest funds since the indicator has been hovering around the 10% average value in the region since 2006 while in the district we

  14. Socio-personal correlates of participation in livelihood activities among rural youth in Jabalpur district of Madhya pradesh, India

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    VC Umunnakwe

    2015-06-01

    Full Text Available The increasing realization of the negative political, social and economic consequences stemming from the precariousness of youth’s livelihoods, underscores the need to understand their livelihood activities, which is a requisite for curbing social ills and reducing rural poverty. The paper examined the participation of rural youth in livelihood activities, their socio-personal characteristics, the relationship between their socio-personal characteristics and their participation in livelihood activities as well as the interrelationships among their socio-personal characteristics. Multi-stage random sampling was used to collect data from 247 respondents through interview schedule. Frequency counts and percentages were used to present data while Pearson product moment correction (PPMC was used to test relationships. The results revealed that majority of the respondents were from other backward caste (66%, married (72.10%, belonged to joint (57.90% and medium (50.60% size families as well as families that were self-employed in agriculture (59.50%. Higher percentages of the respondents and their fathers were educated up to higher school and above. Huge majority (75.71% of the respondents participated in cereal production while more than half of the respondents were involved in pulse production (56.28% and petty trading (53.44%. Marital status; fathers’ educational attainment; family type and family size had significant relationship with participation in livelihood activities. Inter-correlations among socio-personal characteristics showed that caste was related to marital status and educational attainment. It is concluded that socio-personal attributes of rural youth are related to their participation in livelihood activities. The study recommends that socio-personal variables of present study be considered by rural development policy makers when undertaking programmes aimed at enhancing rural youth’s livelihoods.

  15. Assessment of factors which affect multiple uses of water sources at household level in rural Zimbabwe - A case study of Marondera, Murehwa and Uzumba Maramba Pfungwe districts

    Science.gov (United States)

    Katsi, Luckson; Siwadi, Japson; Guzha, Edward; Makoni, Fungai S.; Smits, Stef

    Water with all its multiple uses plays a pivotal role in the sustenance of rural livelihoods, especially the poor. As such, the provision of water which go beyond domestic to include water for small-scale productive uses should be encouraged to enhance peoples’ livelihood options by making significant contribution to household income, food security, improved nutrition and health. All these multiple benefits, if combined can assist in the fight against hunger and poverty. This study was conducted in Mashonaland East province, covering Marondera, Murehwa and Uzumba Maramba Pfungwe districts in Zimbabwe for the period December 2005-May 2006 to assess factors which affect multiple uses of water sources at household level. Participatory Rural Appraisal tools such as discussions, observations and interviews were used for data collection. The survey found that people indeed require water for productive purposes apart from domestic uses, which are often given top priority. The study found out that multiple uses of water sources at household level can be affected by segmentation of water services into domestic and productive water supply schemes, technology and system design, water quality and quantity and distance to water sources among other factors. The study recommends that water service providers to be able to provide appropriate, efficient and sustainable services, they should understand and appreciate that people’s water needs are integrated and are part and parcel of their multifaceted livelihood strategies.

  16. Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

    Science.gov (United States)

    Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

    2016-10-07

    Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving

  17. Nitrate in drinking water and vegetables: intake and risk assessment in rural and urban areas of Nagpur and Bhandara districts of India.

    Science.gov (United States)

    Taneja, Pinky; Labhasetwar, Pawan; Nagarnaik, Pranav

    2017-06-06

    The study focuses on the estimation of health risk from nitrate present in the drinking water and vegetables in Nagpur and Bhandara districts in the state of Maharashtra, India. Drinking water samples from 77 locations from the rural as well as urban areas and 22 varieties of vegetable were collected and analyzed for the presence of nitrate for a period of 1 year (two seasons). The daily intake of nitrate from these water and vegetable samples was then computed and compared with standard acceptable intake levels to assess the associated health risk. The mean nitrate concentration of 59 drinking water samples exceeded the Bureau of Indian Standards limit of 45 mg/L in drinking water. The rural and urban areas were found to have mean nitrate concentration in drinking water as 45.69 ± 2.08 and 22.53 ± 1.97 mg/L, respectively. The estimated daily intake of drinking water samples from 55 study sites had nitrate concentration far below the safety margin indicating serious health risk. The sanitation survey conducted in 12 households reported contaminated source with positive E. coli count in 20 samples as the major factor of health risk. The average nitrate concentration was maximum in beetroot (1349.38 mg/kg) followed by spinach (1288.75 mg/kg) and amaranthus (1007.64 mg/kg). Among the samples, four varieties of the vegetables exceeded the acceptable daily intake (ADI) with an assumption of 0.5 kg consumption of vegetables for an average of a 60-kg individual. Therefore, irrigation of these locally grown vegetables should be monitored periodically for nitrogen accumulation by the crop above the ADI limit. The application of nitrogenous fertilizers should also be minimized in the rural areas to help protect the nitrate contamination in groundwater sources.

  18. Contribution of draft cattle to rural livelihoods in a district of southeastern Uganda endemic for bovine parasitic diseases: an economic evaluation.

    Science.gov (United States)

    Okello, Walter O; Muhanguzi, Dennis; MacLeod, Ewan T; Welburn, Susan C; Waiswa, Charles; Shaw, Alexandra P

    2015-11-05

    A study was conducted in Tororo District in eastern Uganda to assess the socio-economic contribution of draft cattle to rural livelihoods. The aim of the study was to empirically quantify the economic value of draft cattle thus contributing to understanding the impact of endemic parasitic diseases of cattle on livestock productivity and subsequently household income, labor and food security. A total of 205 draft cattle keeping households (n = 205) were randomly selected and structured household questionnaires were administered, focusing on work oxen use, productivity, inputs and outputs. The data obtained was analyzed using standard statistical methods and used to calculate the gross margin from the draft cattle enterprise. Secondary data were obtained from focus group discussions and key informant interviews and these were analyzed using Bayesian methods. The study showed that, apart from being labor saving, the use of animal traction is highly profitable with the gross margin per year from the use of draft cattle amounting to 245 United States dollars per work oxen owning household. The cash obtained from hiring out draft animals was equivalent to nearly a quarter of the average local household's monetary receipts. It also revealed that endemic bovine parasitic diseases such as trypanosomiasis and tick-borne diseases reduced draft cattle output by 20.9 % and potential household income from the use of draft oxen by 32.2 %. The presence of endemic cattle diseases in rural Uganda is adversely affecting the productivity of draft cattle, which in turn affects household income, labor and ultimately food security. This study highlights the contribution of draft cattle to rural livelihoods, thus increasing the expected impact of cost-effective control strategies of endemic production limiting livestock diseases in Uganda.

  19. Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia.

    Science.gov (United States)

    Bogale, Tesfahun Yonas; Bala, Elazar Tadesse; Tadesse, Minyahil; Asamoah, Benedict Oppong

    2018-05-24

    Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was - 1.1 (±1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.

  20. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

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    Kibballi Madhukeshwar Akshaya

    Full Text Available Birth preparedness and complication readiness (BPCR is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25% under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%, childbirth (45.7%, and postnatal (17.4% period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions.To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs of Dakshina Kannada district, Karnataka, India.A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation and recently delivered (in the last 6 months women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR.Proportion, Odds ratio, and adjusted Odds ratio (adj OR for optimal BPCR

  1. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

    Science.gov (United States)

    Akshaya, Kibballi Madhukeshwar; Shivalli, Siddharudha

    2017-01-01

    Birth preparedness and complication readiness (BPCR) is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25%) under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%), childbirth (45.7%), and postnatal (17.4%) period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions. To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs) of Dakshina Kannada district, Karnataka, India. A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation) and recently delivered (in the last 6 months) women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six) was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR. Proportion, Odds ratio, and adjusted Odds ratio (adj OR) for optimal BPCR practice. A

  2. Characterization of Dairy Production Systems and Analysis of Milk Promotion Strategies in Rural and Urban Areas in Niger: Case of the Urban Community of Niamey and Rural District of Filingue

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    A. R. Boukari

    2007-01-01

    Full Text Available Livestock breeding and particularly milk production play a major role in poverty alleviation and economic growth. The present study aimed at characterizing the production systems and opening avenues for milk production in a (suburban [urban community of Niamey (UCN] and in a rural environment [rural district of Filingue (RDF] in Niger. In UCN, surveys were carried out in 35 dairy sites randomly selected among the 150 already indexed within a radius of 50 km from the capital. Out of these, 12 sites were selected allowing the questionnaire to be administered to 169 heads of household. In RDF, 49 heads of household, located in five villages within 75 km of Filingue, were surveyed. Results showed that in UCN, breeders owned few dairy cows (five on average, i.e. 28% of the bovine herd, which produced in all seasons 7 to 10 L/household/day; they marketed fresh milk more often than in RDF because they had access to dairy transformation units. In RDF, they owned more cows (ten on average, i.e. 52% of the bovine herd, which produced only during the rainy season and the cold dry season (between 0 to 10 and 10 to 20 L/household/ day according to 66 and 20% of the persons surveyed, respectively; dairy products were transformed more often before sale (melted butter, curdled milk, cheese. The innovations observed in the surveyed breeders were related to changes in herd management. The constraints to dairy production development in the urban area concerned in particular production and preservation of good-quality fresh milk all the way to transforming units or consumers, while in the rural area, it concerned the lack of avenues. In urban areas, it is essential to organize the supply of food inputs, evening collection of milk and to popularize technical topics and innovating practices.

  3. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

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    Mihiretu Alemayehu Arba

    Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

  4. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

    Science.gov (United States)

    Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

    2016-01-01

    The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. The use of institutional delivery service is low in the study

  5. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania.

    Science.gov (United States)

    Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; McHomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne

    2008-01-07

    The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. The costs of implementing ACT are substantial. Although drug purchases

  6. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania

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    Abdulla Salim

    2008-01-01

    Full Text Available Abstract Background The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT. However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Methods Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. Results The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita, which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD. In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. Conclusion The costs of

  7. Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso

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    Maurice Yé

    2016-01-01

    Full Text Available Background: One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design: A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results: Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]. Most health workers (95 and 96% expressed a preference for financial incentives (95% CI: [66.64; 85.36] and team-based incentives (95% CI: [67.78; 86.22], respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions: The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.

  8. Determinants of infant and young child feeding practices by mothers in two rural districts of Sindh, Pakistan: a cross-sectional survey.

    Science.gov (United States)

    Khan, Gul Nawaz; Ariff, Shabina; Khan, Ubaidullah; Habib, Atif; Umer, Muhammad; Suhag, Zamir; Hussain, Imtiaz; Bhatti, Zaid; Ullah, Asmat; Turab, Ali; Khan, Ali Ahmad; Garzon, Alba Cecilia; Khan, Mohammad Imran; Soofi, Sajid

    2017-01-01

    Infant and young child feeding (IYCF) practices during the first two years of life are important for the growth and development of a child. The aim of this study was to assess IYCF practices and its associated factors in two rural districts of Pakistan. A cross-sectional study was conducted in two rural districts of Sindh province, Pakistan as part of a stunting prevention project between May and August 2014. A standard questionnaire on IYCF practices recommended by World Health Organization was used to collect information from 2013 mothers who had a child aged between 0 and 23 months. Only 49% of mothers initiated breastfeeding within one hour of birth. Thirty-seven percent of mothers exclusively breastfed their infants for six months. Seventy-percent mothers introduced complementary feeding at 6-8 months of age. Eighty-two percent of mothers continued breastfeeding for at least one year and 75% for at least two years of age. IYCF practices were not significantly different for boys and girls in the study area. Being an employed mother (AOR 2.14; 95% CI 1.02, 4.51) was positively associated with the early initiation of breastfeeding. Children who were born at a health facility (AOR 0.65; 95% CI 0.50, 0.84) and were aged six to eleven months (AOR 0.70; 95% CI 0.54, 0.90) were less likely to be have an early initiation of breastfeeding. Mothers aged 25 to 29 years (AOR 1.83; 95% CI 1.05, 3.18), being literate (AOR 1.79; 95% CI 1.15, 2.78), and higher income (AOR 10.6; 95% CI 4.40, 25.30) were more likely to have an improved dietary diversity. Being an employed mother (AOR 2.18; 95% CI 1.77, 4.03) and higher income were more likely to have minimum acceptable diet (AOR 9.7; 95% CI 4.33, 21.71). IYCF practices were below the acceptable level and associated with maternal age, maternal illiteracy, unemployment, and poor household wealth status. Emphasis should be given to improve maternal literacy and reduction in poverty to improve IYCF practices.

  9. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: three public policy implications.

    Science.gov (United States)

    Lyimo, Frida S; Beran, Tanya N

    2012-01-10

    Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Less than one quarter (22.6%) of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03) and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10) were significantly associated with screening uptake. Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of the disease must include specific information on how to prevent it

  10. Disclosure, stigma of HIV positive child and access to early infant diagnosis in the rural communities of OR Tambo District, South Africa: a qualitative exploration of maternal perspective.

    Science.gov (United States)

    Adeniyi, Vincent Oladele; Thomson, Elza; Ter Goon, Daniel; Ajayi, Idowu Anthony

    2015-08-26

    Despite the overwhelming evidence confirming the morbidity and mortality benefits of early initiation of highly active anti-retroviral therapy (HAART) in HIV-infected infants, some children are still disadvantaged from gaining access to care. The understanding of the maternal perspective on early infant HIV diagnosis and prompt initiation of HAART has not been adequately explored, especially in the rural communities of South Africa. This study explores the perspectives of mothers of HIV-exposed infants with regard to early infant diagnosis (EID) through a lens of social and structural barriers to accessing primary healthcare in OR Tambo district, Eastern Cape Province, South Africa. In this qualitative study, we conducted semi-structured interviews at two primary healthcare centres in the King Sabata Dalindyebo Municipality of the OR Tambo district, South Africa. Twenty-four purposive sample of mothers of HIV-exposed infants took part in the study. Interviews were tape-recorded, transcribed and field notes were obtained. The findings were triangulated with two focus group discussions in order to enrich and validate the qualitative data. Thematic content analysis was employed to analyse the data. The participants have fairly good knowledge of mother-to-child transmission of HIV and the risks during pregnancy, delivery and breastfeeding. The majority of participants were confident of the protection offered by anti-retroviral drugs provided during pregnancy, however, lack knowledge of optimal time for early infant diagnosis of HIV. Reasons for not accessing EID included fear of finding out that their child is HIV positive, feelings of guilt and/or shame and embarrassment with respect to raising an HIV infected infant. Personal experiences of HIV diagnosis and HAART were associated with participants' attitudes and beliefs toward care-seeking behaviours. Stigma resulting from their own disclosure to others reduced their likelihood of recommending EID to other members of

  11. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: Three public policy implications

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    Lyimo Frida S

    2012-01-01

    Full Text Available Abstract Background Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. Methods A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Results Less than one quarter (22.6% of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03 and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10 were significantly associated with screening uptake. Conclusions Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of

  12. Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan.

    Science.gov (United States)

    Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher

    2013-07-05

    Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition - the main targets of the strategy. The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities' survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies

  13. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka

    DEFF Research Database (Denmark)

    Wickramasinghe, Kanchana; Steele, Paul; Dawson, Andrew

    2009-01-01

    pesticides and possibly by improving case management in primary care hospitals. Additional research is needed to assess if increasing infrastructure and staff at peripheral hospitals could reduce the overall cost to the government, optimize case management and reduce pressure on secondary services....... prospectively collected over a one-month period from one general hospital (2005) and five peripheral hospitals (2006) in the Anuradhapura district. Data on transfers to secondary- and tertiary-level facilities were obtained for a 6-month period from 30 peripheral hospitals. The cost of the inputs in United...... States dollars (US$), using 2005 figures, was derived from hospital accounts. FINDINGS: The average total cost of treating a self-poisoned patient at the general hospital was US$ 31.83, with ward staff input and drugs being the highest expenditure category and only US$ 0.19 of this sum related to capital...

  14. Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan

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    Nousheen Akber Pradhan

    2013-07-01

    Full Text Available Background: Integrated management of childhood illnesses (IMCI strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition – the main targets of the strategy. Objective: The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC facilities in Matiari district, Sindh, Pakistan. Design: An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs with stakeholders which included planners and policy makers at a provincial level (n=5, implementers and managers at a district level (n=3, and IMCI-trained physicians posted at PHC facilities (n=8. Quantitative part included PHC facility survey (n=16 utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. Results: The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities’ survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all

  15. Cost to government health-care services of treating acute self-poisonings in a rural district in Sri Lanka

    DEFF Research Database (Denmark)

    Wickramasinghe, Kanchana; Steele, Paul; Dawson, Andrew

    2009-01-01

    States dollars (US$), using 2005 figures, was derived from hospital accounts. FINDINGS: The average total cost of treating a self-poisoned patient at the general hospital was US$ 31.83, with ward staff input and drugs being the highest expenditure category and only US$ 0.19 of this sum related to capital...... pesticides and possibly by improving case management in primary care hospitals. Additional research is needed to assess if increasing infrastructure and staff at peripheral hospitals could reduce the overall cost to the government, optimize case management and reduce pressure on secondary services.......OBJECTIVE: To estimate the direct financial costs to the Sri Lanka Ministry of Health of treating patients after self-poisoning, particularly from pesticides, in a single district. METHODS: Data on staff, drug, laboratory and other inputs for each patient admitted for self-poisoning were...

  16. Adaptation measures to sustain indigenous practices and the use of indigenous knowledge systems to adapt to climate change in Mutoko rural district of Zimbabwe

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    Shingirai S. Mugambiwa

    2018-04-01

    Full Text Available This article examines adaptation measures used to sustain indigenous practices and the use of indigenous knowledge systems (IKS to adapt to climate change in Mutoko rural district of Zimbabwe. Community-based adaptation is able to reduce the vulnerability as well as improve the resilience of the local people to climatic variability and change. Subsistence farmers have always adopted adaptive strategies to some of these changes over the years. As such, the adoption of indigenous practices will significantly help rural community members to adapt to climate change. This study employed a qualitative method and an exploratory design, and the results are derived from 30 purposively selected in-depth interviews. The study discovered that there are numerous measures used to adapt to climate change and subsequently to sustain indigenous practices. The study also found that the community no longer grows maize in large quantities, having shifted to millet and sorghum in order to adapt to climate change. The community also provided various strategies to adapt to climate change. These strategies include mulching, creating large storage houses for produce and creating temporary walls on riverbanks in order to store water when the rivers dry up. This study concludes that climate change adaptation measures employed by the community have significantly helped them to sustain their indigenous practices in many ways. Also, the use of IKS, through activities such as crop type change from maize to traditional millet and sorghum (which facilitates traditional lifestyle and activities, re-establishes the community’s indigenous practices since they are made to observe the practices of yesteryear.

  17. Assessment of Diarrheal Disease Prevalence and Associated Risk Factors in Children of 6-59 Months Old at Adama District Rural Kebeles, Eastern Ethiopia, January/2015.

    Science.gov (United States)

    Regassa, Wakigari; Lemma, Seblewengel

    2016-11-01

    Diarrheal disease is the commonchildhood illness and a leading killer of children aged under 5 years, especially in developing countries like Ethiopia. The aim of this study was to assess the prevalence of diarrheal disease and associated risk factors among children of 6-59 months old at Adama district rural kebeles, Eastern Ethiopia. Community based cross sectional study design was conducted in January/2015. Descriptive method was used to describe study variables quantitatively and explanatory method to identify the effect of determinant factors on diarrheal disease occurrence. A single population proportion sample size formula was applied. Random sampling procedure was used by lottery method to select five kebeles and 442 house-holds. Data was collected by using pretested, structured questionnaires through interview and observational checklist by trained data collectors. Double entry was made to epi-info 3.5.3 and & transferred to SPSS20 for analysis. The two weeks' period prevalence of diarrheal disease in children aged 6 to59 months was 14.7%; 95%CI [11.5-18.1]. mother/caregiver who did not practice hand washing during the critical time was the only factor identified to be significantly associated with AOR=2.2; 95%CI [1.0-4.7] for the child hood diarrheal disease occurrence at Adama distict rural kebeles. Diarrheal disease prevalence is changed by child's caregiver hand washing practice during critical time. Health education for child's caregiver on hand washing practice during critical time is an important intervention for the prevention of diarrheal disease prevalence among children.

  18. Use of Lot quality assurance sampling surveys to evaluate community health worker performance in rural Zambia: a case of Luangwa district.

    Science.gov (United States)

    Mwanza, Moses; Zulu, Japhet; Topp, Stephanie M; Musonda, Patrick; Mutale, Wilbroad; Chilengi, Roma

    2017-04-17

    The Better Health Outcomes through Mentoring and Assessment (BHOMA) project is a cluster randomized controlled trial aimed at reducing age-standardized mortality rates in three rural districts through involvement of Community Health Workers (CHWs), Traditional Birth Attendants (TBAs), and Neighborhood Health Committees (NHCs). CHWs conduct quarterly surveys on all households using a questionnaire that captures key health events occurring within their catchment population. In order to validate contact with households, we utilize the Lot Quality Assurance Sampling (LQAS) methodology. In this study, we report experiences of applying the LQAS approach to monitor performance of CHWs in Luangwa District. Between April 2011 and December 2013, seven health facilities in Luangwa district were enrolled into the BHOMA project. The health facility catchment areas were divided into 33 geographic zones. Quality assurance was performed each quarter by randomly selecting zones representing about 90% of enrolled catchment areas from which 19 households per zone where also randomly identified. The surveys were conducted by CHW supervisors who had been trained on using the LQAS questionnaire. Information collected included household identity number (ID), whether the CHW visited the household, duration of the most recent visit, and what health information was discussed during the CHW visit. The threshold for success was set at 75% household outreach by CHWs in each zone. There are 4,616 total households in the 33 zones. This yielded a target of 32,212 household visits by community health workers during the 7 survey rounds. Based on the set cutoff point for passing the surveys (at least 75% households confirmed as visited), only one team of CHWs at Luangwa high school failed to reach the target during round 1 of the surveys; all the teams otherwise registered successful visits in all the surveys. We have employed the LQAS methodology for assurance that quarterly surveys were

  19. Psychological distress and quality of life: rationale and protocol of a prospective cohort study in a rural district in Bangaladesh

    Science.gov (United States)

    Uddin, Mohammed Nazim; Bhar, Sunil; Al Mahmud, Abdullah; Islam, Fakir M Amirul

    2017-01-01

    Introduction A significant proportion of the global burden of disease has been attributed to mental and behavioural disorders. People with mental disorders (MDs) have lower levels of health-related quality of life than those without MDs. Several studies have shown that in low-resource countries, a range of social determinants including poor health literacy is critical in the epidemiological transition of disease outcome. There is a lack of evidence of MDs literacy, the prevalence and risk factors of common mental health conditions, or any validated instruments to measure psychological distress or evaluate the quality of life in rural areas of Bangladesh. Aims The aims of this study are: (1) report the awareness, knowledge, attitudes and practice (KAP) of MDs; (2) estimate the prevalence of and risk factors for psychological distress; (3) measure association of psychological distress and other socio-demographic factors with quality of life and (4) test the feasibility to use Kessler 10-item (K10) and WHO Quality Of Life-BREF (WHOQOL-BREF) questionnaires in rural Bangladesh for measuring psychological distress and quality of life. Methods and analysis A sample of 1500 adults aged 18–59 years and 1200 older adults aged 60–90 years will be interviewed from a multistage cluster random sample. Each participant will go through a face-to-face interview to assess their awareness and KAP of MDs. Information about the participant’s sociodemographic and socioeconomic status will be collected along with the psychological distress (K10) and quality of life (WHOQOL-BREF) questionnaires. Internal consistency, validity, reliability and item discrimination of K10 and WHOQOL-BREF instruments will be determined by using Rasch analysis and regression techniques. Ethics and dissemination Human Ethics Approval was received from the Swinburne University of Technology Human Ethics Committee. Results of this research will be disseminated via scientific forums including peer

  20. Predictors of successful early infant diagnosis of HIV in a rural district hospital in Zambézia, Mozambique.

    Science.gov (United States)

    Cook, Rebecca E; Ciampa, Philip J; Sidat, Mohsin; Blevins, Meridith; Burlison, Janeen; Davidson, Mario A; Arroz, Jorge A; Vergara, Alfredo E; Vermund, Sten H; Moon, Troy D

    2011-04-01

    A key challenge inhibiting the timely initiation of pediatric antiretroviral treatment is the loss to follow-up of mothers and their infants between the time of mothers' HIV diagnoses in pregnancy and return after delivery for early infant diagnosis of HIV. We sought to identify barriers to follow-up of HIV-exposed infants in rural Zambézia Province, Mozambique. We determined follow-up rates for early infant diagnosis and age at first test in a retrospective cohort of 443 HIV-infected mothers and their infants. Multivariable logistic regression models were used to identify factors associated with successful follow-up. Of the 443 mother-infant pairs, 217 (49%) mothers enrolled in the adult HIV care clinic, and only 110 (25%) infants were brought for early infant diagnosis. The predictors of follow-up for early infant diagnosis were larger household size (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.09-1.53), independent maternal source of income (OR, 10.8; 95% CI, 3.42-34.0), greater distance from the hospital (OR, 2.14; 95% CI, 1.01-4.51), and maternal receipt of antiretroviral therapy (OR, 3.15; 95% CI, 1.02-9.73). The median age at first test among 105 infants was 5 months (interquartile range, 2-7); 16% of the tested infants were infected. Three of four HIV-infected women in rural Mozambique did not bring their children for early infant HIV diagnosis. Maternal receipt of antiretroviral therapy has favorable implications for maternal health that will increase the likelihood of early infant diagnosis. We are working with local health authorities to improve the linkage of HIV-infected women to HIV care to maximize early infant diagnosis and care.

  1. Amyotrophic lateral sclerosis, rural environment and agricultural work in the Local Health District of Ferrara, Italy, in the years 1964-1998.

    Science.gov (United States)

    Govoni, Vittorio; Granieri, Enrico; Fallica, Elisa; Casetta, Ilaria

    2005-11-01

    Previous epidemiological surveys, both analytic and descriptive, in the Local Health District (LHD) of Ferrara, northern Italy, have indicated that rural residence and agricultural work might constitute risk factors for Amyotrophic Lateral Sclerosis (ALS). The present investigation is a demographic survey in the LHD of Ferrara in the years 1964-1998 which aimed to verify whether the level of urbanization and agricultural activities might influence the risk of ALS. Based on the data obtained in a recent incidence study in the LHD of Ferrara which reported a mean annual crude incidence rate of ALS in the years 1964-1998 of 1.63 per 100,000 population (95 % CI 1.31-2.00), it was possible to compare the number of observed ALS cases and the number of expected ALS cases according to the level of urbanization and usual occupation on the basis of the residential and occupational pattern identified in the population of the LHD of Ferrara in the study period under the assumption of a homogeneous distribution of ALS. The present survey identified four different levels of urbanization in the LHD of Ferrara in the study period and for none of them was a difference between the number of observed and expected ALS cases found. Also in the most rural of the four identified levels of urbanization (small villages with an average population in the study period lower than 1,000 inhabitants and scattered houses in the countryside) no difference was found between observed and expected number of ALS cases (observed ALS cases 16, 95% Poisson CI 9.1-25.9, expected ALS cases 18.3). Based on the occupational pattern identified in the population of the LHD of Ferrara in the study period the number of incident cases of ALS whose usual occupation was in agricultural work exceeded the expected number (observed ALS cases 22, 95% Poisson CI 13.8-32.3, expected ALS cases 6.0). The present findings indicate that rural residence itself does not influence the risk of ALS while agricultural activities

  2. Access to comprehensive emergency obstetric and newborn care facilities in three rural districts of Sindh province, Pakistan.

    Science.gov (United States)

    Ansari, Muhammad Shahid; Manzoor, Rabia; Siddiqui, Nasim; Ahmed, Ahsan Maqbool

    2015-11-25

    Pakistan's maternal and child health indicators remain unacceptably high, with a maternal mortality ratio of 276 per 100,000 live births and a neonatal mortality rate of 55 per 1,000 live births. Provision of basic and comprehensive emergency obstetric and newborn care is mandated by the government; however, coverage, access, and utilisation levels remain unsatisfactory, with the situation in Sindh province being amongst the worst in the country. This study attempted to assess access to comprehensive emergency obstetric and newborn care (C-EmONC) facilities and barriers hampering access in Sindh. One public sector hospital in each of three districts in Sindh province providing C-EmONC services were selected for a facility exit survey. A cross-sectional household survey and focus group discussions were conducted in the catchment population of these hospitals. Overall, 82% and 96% of those who utilised a public or private C-EmONC facility, respectively, incurred out-of-pocket expenditure. As expected, those living more than 5 km from the facility reported higher mean expenditure than those living within 5 km of the facility. More than half of the respondents (55%) among public sector users and the majority (71%) of private sector users could not afford travel costs. More than one third (35%) of public sector users and about two thirds (64%) of private sector users who could not afford travel costs took loans. The proportion of respondents who took loans was higher among those living more than 5 km of the health facility compared to those living within a 5 km distance. The majority of respondents (70%) in the community survey chose to go to a private sector C-EmONC facility. In addition to poverty, in terms of sociocultural access, religious and ethnic discrimination and the poor attitude of facility staff were amongst the most important barriers to accessing a C-EmONC facility. C-EmONC facilities in both the public and private sectors may simply not be accessible and

  3. An evaluation of the utilisation of reproductive and child health services provided by government to the rural community of Anand District, Gujrat.

    Science.gov (United States)

    Bhanderi, D J; Mukherjee, S M; Gohel, Manisha K; Christian, D S

    2009-01-01

    A multi-indicator thirty cluster survey was conducted during February- March 2008 in the rural areas of Anand district of Gujrat state to assess the utilization of the reproductive and child health services provided through government sector. In each selected village minimum 40 households were visited till total eight children in age group 12-23 months, at least two antenatal mothers in last trimester and five mothers who delivered in last year were studied. A total of 555 children of age less than three years & 1481 women in reproductive age group were included in the study. 74.8% of the children had institutional delivery. Birth registration was almost 100%. Immunization coverage was 84.5%. Registration of children and pregnant mothers under Mamta Abhiyan(MA) were 91% and 84 % respectively. Only 53% children were brought to Mamta Diwas Kendra regularly. Vitamin A coverage to children was 76.9%. Tetanus toxoid coverage of pregnant women was 85.1%, while Iron tablets were provided to 48.3% women. 43% of the postnatal mothers had no post-partum visit. Utilization of government schemes among postnatal women was 9% to 20%.

  4. Locus of health control as a predictor of diet in pregnant women residing in a small town and rural setting in Małopolska district.

    Science.gov (United States)

    Gacek, Maria

    2013-01-01

    The locus of health control is one of the individual characteristics determining the diet of an individual. The aim of this study was to analyse the consumption frequency of selected food products depending on the locus of health control in a group of pregnant women residing in a small town and rural setting in Małopolska district. The study was conducted in a group of 300 pregnant women from Małopolska region, who were between 20 and 40 years of age (29.02 +/- 6.33). The consumption frequency of food products was examined with a prepared questionnaire, in a 7-item scale (from 7 points--several times a day to 1 point--never). The locus of health control was determined with the MHLC scale developed by K.A. Wallston et al., and adapted by Z. Juczyński. The relationship between the MHLC scale and the frequency of consumption of various products was estimated on the basis of Spearman's coefficients of rank correlation and the Mann-Whitney U test, using Statistica 10.0 software. Higher level of internal control (MHLC-I) was associated with significant increase in the consumption frequency of orange and red vegetables (p locus of health control (MHLC-C) was associated with significantly reduced frequency of consuming whole grains (p control made more rational nutritional choices significantly more frequently than those with the external control.

  5. Assessment of oral health status and periodontal treatment needs among rural, semi-urban, urban, and metropolitan population of Gurgaon District, Haryana State

    Directory of Open Access Journals (Sweden)

    Harpreet Singh Grover

    2016-01-01

    Full Text Available Background: Role of various etiologic factors in periodontal disease has been investigated by means of epidemiologic surveys and clinical studies. The community periodontal index of treatment needs (CPITN provides a picture of the public health requirements in the periodontal field, which is essential for national oral health policy-making and specific interventions. Materials and Methods: This study was conducted on 4000 individuals among rural, semi-urban, and metro population of Gurgaon District, Haryana State, to find out the oral health status and periodontal treatment needs (TNs using CPITN index. Results: An inference was drawn from the results that among 4000 participants from all the four population groups' maximum, i.e., 63.80% of individuals needed TN2 whereas 18.20% of individuals needed TN3 and 18.10% of individuals needed TN1. Conclusion: It can be concluded with a word of hope and a word of warning. Hope lies in the fact that the measurement of periodontal diseases by epidemiological study of this condition is improving and receiving wide spread attention. The warning lies in the varied nature of the condition which goes to make up periodontal disease and perplexing ways in which these conditions blend. In addition to dental practitioner, periodontist and public health workers must devote more time and effort toward controlling periodontal disease than they seem to be devoting at present.

  6. Comparison of frequency of hepatitis B and hepatitis C in pregnant women in urban and rural area of district Swat

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    Khattak, S.T.; Marwat, M.A.

    2009-01-01

    This retrospective analytical study was carried out to observe the frequency of Hepatitis B and Hepatitis C among the pregnant women of Swat. The study was carried out from January 2008 to December 2008. It was a retrospective study based on review of records of pregnant women admitted to Labour Room of Obstetrics/Gynaecology Unit, Saidu Teaching Hospital, Swat. Patients were screened for Hepatitis B and C by Immuno Chromatographic Technique (ICT) device. The findings were recorded on proforma and analysed. Those found positive on screening test were confirmed by ELISA. Total number of patients screened was 5607. The frequency of Hepatitis B and C (Combined) was 223 (3.98%), out of which 77 (1.37%) were HBsAg positive, 141 (2.52%) were anti HCV positive and 5 (0.09%) were both HBsAg and anti HCV positive. The frequency of Hepatitis B amongst age groups 14-19 , 20-29, 30-39 and 40-49 years were 2/77, 33/77, 40/77, and 2/77) respectively. The frequency of Hepatitis C amongst age groups 14-19, 20-29,30-39 and 40-49 years was 4/141, 59/141, 67/141 and 11/141 respectively. The frequency of Hepatitis B and C in multigravida was 41/77, 67/141, in grand multigravida it was 20/77, 43/141 and in primigravida it was 16/77, 31/141 respectively. The frequency of Hepatitis B and Hepatitis C amongst urban and rural population was 32 (39.02%) and 50 (60.98%); and 40 (27.40%) and 106 (72.60%) respectively. The frequency of Hepatitis B and C (Combined) in urban, rural population were 72 (31.58 %) and 156 (68.15 %) respectively. HBsAg and HCV was common infections in pregnant women of Swat. Therefore, every pregnant woman undergoing delivery and/or any other surgical procedure must be screened for Hepatitis B and Hepatitis C. (author)

  7. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention

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    Cousens Simon

    2010-03-01

    Full Text Available Abstract Background In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Methods Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. Results The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Conclusions Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care

  8. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention.

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    Magoma, Moke; Requejo, Jennifer; Campbell, Oona M R; Cousens, Simon; Filippi, Veronique

    2010-03-19

    In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of

  9. Social Motivation And Peoples Participation In Development Of Rural Development In District Of West Of Nias Province North Sumatra

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    Sismudjito

    2015-08-01

    Full Text Available Poverty is the problem of social related to the development. Some of the province in Indonesia which is North Sumatera consisting of 8 cities and 25 districts. Most of the populated shows a number poverty are still relatively high. According to the Susenas in North Sumatera Province particulary West of Nias is the county that classified as having a number of high poverty and decrease in the number of poverty was only 1 each year. To that local governments West of Nias make the implementation of the building area shaped participative which stems from the social motivation sociated in the West of Nias. In this study formulated to the problem is the social motivation and community participation is a factor objectify the construction of underdevelopment area.This research using a combination of a quantitative approach and qualitative approach by the combined method. This method can be done in together turns even combined with starting from the framework exploration then inditifity and classifying data with sourched from the questionnaires development and depth interviews. In this research also used technique of population and research sample. Management of the data could be done by 3 statistics techniques 1 Product Moment Correlation 2 Partial Correlation 3 Analysis of the line.The result of research suggests that through the work of social motivation and community participation can positive affect towards underdeveloped area. The level of community participation appears through an increase participation degrees towards the development of underdeveloped area. The working of community participation could a achieved development in its area with shows a sense of empathy from members of society So it can be concluded that the high participation facilitate the realization of the development of underdeveloped area.

  10. Description of a Mass Poisoning in a Rural District in Mozambique: The First Documented Bongkrekic Acid Poisoning in Africa.

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    Gudo, Eduardo Samo; Cook, Kyla; Kasper, Amelia M; Vergara, Alfredo; Salomão, Cristolde; Oliveira, Fernanda; Ismael, Hamida; Saeze, Cristovão; Mosse, Carla; Fernandes, Quinhas; Viegas, Sofia Omar; Baltazar, Cynthia S; Doyle, Timothy J; Yard, Ellen; Steck, Alaina; Serret, Mayda; Falconer, Travis M; Kern, Sara E; Brzezinski, Jennifer L; Turner, James A; Boyd, Brian L; Jani, Ilesh V

    2018-04-17

    On 9 January 2015, in a rural town in Mozambique, >230 persons became sick and 75 died of an illness linked to drinking pombe, a traditional alcoholic beverage. An investigation was conducted to identify case patients and determine the cause of the outbreak. A case patient was defined as any resident of Chitima who developed any new or unexplained neurologic, gastrointestinal, or cardiovascular symptom from 9 January at 6:00 am through 12 January at 11:59 pm. We conducted medical record reviews, healthcare worker and community surveys, anthropologic and toxicologic investigations of local medicinal plants and commercial pesticides, and laboratory testing of the suspect and control pombe. We identified 234 case patients; 75 (32%) died and 159 recovered. Overall, 61% of case patients were female (n = 142), and ages ranged from 1 to 87 years (median, 30 years). Signs and symptoms included abdominal pain, diarrhea, vomiting, and generalized malaise. Death was preceded by psychomotor agitation and abnormal posturing. The median interval from pombe consumption to symptom onset was 16 hours. Toxic levels of bongkrekic acid (BA) were detected in the suspect pombe but not the control pombe. Burkholderia gladioli pathovar cocovenenans, the bacteria that produces BA, was detected in the flour used to make the pombe. We report for the first time an outbreak of a highly lethal illness linked to BA, a deadly food-borne toxin in Africa. Given that no previous outbreaks have been recognized outside Asia, our investigation suggests that BA might be an unrecognized cause of toxic outbreaks globally.

  11. Prevalence of hypertension and its association with dietary practices in a rural area of Ranchi district of Jharkhand

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    Chandramani Kumar

    2014-12-01

    Full Text Available Background: Hypertension is a major public health problem affecting people across the globe. Rapid change in life style and dietary practices are important factors for increasing prevalence of hypertension. High salt consumption, fat intake and low consumption of dietary fibres are important modifiable risk factors of hypertension. Aims & Objectives: 1 To determine the prevalence of hypertension in community under study. 2 To describe the association of dietary practices and hypertension in community. Materials and Methods: A descriptive cross sectional study in one of the rural field practice area (Ormanjhi of RIMS, Ranchi was done. Sample size was determined using nMaster 2.0 software. Total 500 people were included in the study. Cluster sampling method was adopted to draw the sample. Subjects 20 years and above from both sex were eligible for the study. Pre-tested semi structured questionnaire were used for data collection. Template was generated in MS excel and data analysis was done using SPSS 13 software. Results: Prevalence of hypertension in the present study was found to be 19.8%. Mean systolic and diastolic blood pressure was found to be 122.83 mm of Hg (SD – 15.83 and 79.24 mm of Hg (SD - 8.73 respectively. Prevalence of hypertension was higher among male (22.8% than female (16.5% although this difference was statistically not significant (p – value = 0.075. Prevalence of hypertension was more among non-vegetarians (23.9% compared to vegetarians (8.3%. Added salt intake was found to be significantly associated with hypertension (p - value = 0.023. Conclusions: Prevalence of hypertension was more among male population. Higher prevalence of hypertension was found among subjects with non-vegetarian diet and high salt in their diet.

  12. Exploration of ethno-medicinal knowledge among rural communities of Pearl Valley; Rawalakot, District Poonch Azad Jammu and Kashmir.

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    Humaira Shaheen

    Full Text Available Medicinal plants are the basic source of health care in the Pearl Valley District Poonch, Azad Jammu, and Kashmir. The basic aim of present study was to record information about the use of plants in herbal preparation and quantification of recorded data.The research was conducted with the null hypothesis that there was no differential distribution of knowledge among the communities between genders and among different age groups in the study area and across cultural medicinal uses of the plants are similar. To check these hypotheses information about medicinal plants was collected from 46 laypeople and 18 herbalists by using an open ended and semistructured questionnaire. Different ethnobotanical indices were calculated in order to quantify the knowledge on the medicinal plants reported in the study.Our study recorded 136 species of medicinal plants belonging to 45 families with Asteraceae (14 species as the dominant family of the area. Decoction (26 species, juice and powder (24 species each were most common methods of preparation. Spearman's correlation analysis showed that age and gender had the significant effect on both numbers of mentioned species and different uses. A number of known medicinal plants and the number of different uses (H: 38.51; p < 0.001 differ significantly as indicated by Kruskal-Wallis tests. These results showed that the knowledge about the plant varies among different age groups, which were the first hypothesis of the present study. The highest use values (UVs were reported for Berberis lyceum and Ajuga bracteosa (1.13 each followed by Abies pindrow (1.03. Highest informant consensus factor (ICF values were recorded for digestive system diseases (ICF = 0.90 and muscular and skeletal system diseases (ICF = 0.89. The value of Jaccarad index ranged from 6.11 to 32.97 with an average value of 19.84, percentage of similarity was highest between study area and Pir Lasura National Park (34.62%.High similarity might be due to

  13. Assessing Family Planning Service Quality And User Experiences In Social Franchising Programme - Case Studies From Two Rural Districts In Pakistan.

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    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Awan, Muhammad Ali

    2018-01-01

    Studies have documented the impact of quality family planning services on improved contraceptive uptake and continuation, however, relatively little is known about their quality of service provision especially in the context of social franchising. This study examined the quality of clinical services and user experiences among two models in franchised service providers in rural Pakistan. This facility-based assessment was carried out during May-June 2015 at the 20 randomly selected social franchise providers from Chakwal and Faisalabad. In our case, a franchise health facility was a private clinic (mostly) run by a single provider, supported by an assistant. Within the selected health facilities, a total 39 user-provider interactions were observed and same users were interviewed separately. Most of the health facilities were in the private sector. Comparatively, service providers at Greenstar Social Marketing/Population Services International (GSM/PSI) model franchised facilities had higher number of rooms and staff employed, with more providers' ownership. Quality of service indices showed high scores for both Marie Stopes Society (MSS) and GSM/PSI franchised providers. MSS franchised providers demonstrated comparative edge in terms of clinical governance, better method mix and they were more user-focused, while PSI providers offered broader range of non-FP services. Quality of counselling services were similar among both models. Service providers performed well on all indicators of interpersonal care however overall low scores were noted in technical care. For both models, service providers attained an average score of 6.7 (out of the maximum value of 8) on waste disposal mechanism, supplies 12.5 (out of the maximum value of 15), user-centred facility 2.7 (out of the maximum value of 4), and clinical governance 6.5 (out of the maximum value of 11) and respecting clients' privacy. The exit interviews yielded high user satisfaction in both service models. The

  14. Health care decision making autonomy of women from rural districts of Southern Ethiopia: a community based cross-sectional study.

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    Alemayehu, Mihiretu; Meskele, Mengistu

    2017-01-01

    Millions of women have little health care decision making autonomy in many cultures and tribes. African women are often perceived to have little participation in health care decisions. However, little has been investigated to identify factors contributing to decision making autonomy. Hence, it is important to obtain information on the contributing factors of decision making autonomy and disparities across different socio-cultural contexts. A cross-sectional study was conducted in Wolaita and Dawro zones, Southern Ethiopia from February to March 2015. A total of 967 women were selected through multistage sampling. A survey was administered face-to-face through an interview format. EpiData v1.4.4.0 and SPSS version 20 were used to enter and analyze data, respectively. Proportions and means were used to describe the study population. Variables with P -value autonomy, while 40.9% of study participants' health care decisions were made by their husbands. The husband's education (adjusted odds ratio [AOR] =1.91 [1.10, 3.32]), wealth index (AOR =0.62 [0.42, 0.92]), age (AOR =2.42 [1.35, 4.32] and AOR =7 [3.45, 14.22]), family size (AOR =0.53 [0.33, 0.85] and AOR =0.42 [0.23, 0.75]), and occupation (AOR =1.66 [1.14, 2.41]), were predictors of health care decision making autonomy. Even though every woman has the right to participate in her own health care decision making, more than two fifths of them have no role in making health care decisions about their own health. Husbands play a major role in making health care decisions about their wives. A comprehensive strategy needs to be implemented in order to empower women, as well as to challenge the traditional male dominance. Special attention has to be given to women living in rural areas in order to reduce their dependency through education and income generating activities.

  15. Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia

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    Noramira Nozmi

    2018-04-01

    Full Text Available Little is known on the knowledge, attitudes and preventive practices (KAP of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%, unacceptable attitudes (90.3% and unacceptable preventive practices (69.1% on leptospirosis, and only 29.7% knew “rat-urine disease” as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (p-values < 0.05. As for attitudes, ethnicity, income and education type were significantly associated (p-values < 0.05. Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%. Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR = 0.39, 95% confidence interval (CI = 0.222–0.680 and preventive practices (AOR = 1.81, 95% CI = 1.204–2.734. Ethnicity (AOR = 0.40, 95% CI = 0.239–0.665, income (AOR = 1.58, 95% CI = 1.041–2.385 and education type (AOR = 3.69, 95% CI = 1.237–10.986 were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613–7.264 was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.

  16. Health care decision making autonomy of women from rural districts of Southern Ethiopia: a community based cross-sectional study

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    Alemayehu M

    2017-04-01

    decisions about their own health. Husbands play a major role in making health care decisions about their wives. A comprehensive strategy needs to be implemented in order to empower women, as well as to challenge the traditional male dominance. Special attention has to be given to women living in rural areas in order to reduce their dependency through education and income generating activities. Keywords: decision making, women’s autonomy, health care decision, women’s empowerment, Wolaita, Dawro, Southern Ethiopia

  17. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania

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    Dillip Angel

    2008-09-01

    Full Text Available Abstract Background Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions. Methods We conducted community-based treatment-seeking surveys including 226 recent fever episodes in 2004 and 2005. The local Demographic Surveillance System provided additional household information. A census of drug retailers and health facilities provided data on availability and location of treatment sources. Results After intensive health education, the biomedical concept of malaria has largely been adopted by the community. 87.5% (78.2–93.8 of the fever cases in children and 80.7% (68.1–90.0 in adults were treated with one of the recommended antimalarials (at the time SP, amodiaquine or quinine. However, only 22.5% (13.9–33.2 of the children and 10.5% (4.0–21.5 of the adults received prompt and appropriate antimalarial treatment. Health facility attendance increased the odds of receiving an antimalarial (OR = 7.7 but did not have an influence on correct dosage. The exemption system for under-fives in public health facilities was not functioning and drug expenditures for children were as high in health facilities as with private retailers. Conclusion A clear preference for modern medicine was reflected in the frequent use of antimalarials. Yet, quality of case-management was far from satisfactory as was the functioning of the exemption mechanism for the main risk group. Private drug retailers played a central role by complementing existing formal health

  18. “The problem is ours, it is not CRAIDS’ ”. Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia

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    Walsh Aisling

    2012-11-01

    Full Text Available Abstract Background While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18 and district stakeholders (n= 10 in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6 in 2011. Results Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers’ skills levels had reduced. Conclusions Whilst the World Bank espoused the idea of sustainability in their plans, it remained

  19. Self-reported health and health care use in an ageing population in the Agincourt sub-district of rural South Africa

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    Benjamin Clark

    2013-01-01

    Full Text Available Background: South Africa is experiencing a demographic and epidemiological transition with an increase in population aged 50 years and older and rising prevalence of non-communicable diseases. This, coupled with high HIV and tuberculosis prevalence, puts an already weak health service under greater strain. Objective: To measure self-reported chronic health conditions and chronic disease risk factors, including smoking and alcohol use, and to establish their association with health care use in a rural South African population aged 50 years or older. Methods: The Study on Global Ageing and Adult Health (SAGE, in collaboration with the INDEPTH Network and the World Health Organization, was implemented in the Agincourt sub-district in rural northeast South Africa where there is a long-standing health and socio-demographic surveillance system. Household-based interviews were conducted in a random sample of people aged 50 years and older. The interview included questions on self-reported health and health care use, and some physical measurements, including blood pressure and anthropometry. Results: Four hundred and twenty-five individuals aged 50 years or older participated in the study. Musculoskeletal pain was the most prevalent self-reported condition (41.7%; 95% Confidence Interval [CI] 37.0–46.6 followed by hypertension (31.2%; 95% CI 26.8–35.9 and diabetes (6.1%; 95% CI 4.1–8.9. All self-reported conditions were significantly associated with low self-reported functionality and quality of life, 57% of participants had hypertension, including 44% of those who reported normal blood pressure. A large waist circumference and current alcohol consumption were associated with high risk of hypertension in men, whereas in women, old age, high waist–hip ratio, and less than 6 years of formal education were associated with high risk of hypertension. Only 45% of all participants reported accessing health care in the last 12 months. Those who reported

  20. Community knowledge, perceptions and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region

    Science.gov (United States)

    Nsagha, Dickson Shey; Bissek, Anne-Cécile Zoung-Kanyi; Njamnshi, Theophilus Ngeh; Njih, Irine Ngani-Nformi; Pluschke, Gerd; Njamnshi, Alfred Kongnyu

    2018-01-01

    Background Although leprosy is one of the oldest diseases known to humanity, it remains largely misunderstood. Misconceptions about leprosy lead to stigma towards people with the disease. This study aimed at exploring the knowledge, perceptions and attitudes regarding leprosy in rural Cameroon. Methods We carried out a cross-sectional community survey of 233 respondents aged 15–75 years, free from leprosy, and living in two rural health districts of the South-west Region of Cameroon. A questionnaire designed to evaluate knowledge, perceptions and attitudes about leprosy was used. Binary logistic regression was used to determine independent predictors of negative attitudes. Results About 82% of respondents had heard about, and 64.4% knew someone with leprosy. Information on leprosy was mainly from community volunteers (40.6%), friends (38.0%), and the media (24%). Only 19.7% of respondents knew the cause of leprosy, and a considerable proportion linked it to a spell (25.3%), unclean blood (15.5%) and heredity (14.6%). About 72% knew that leprosy is curable and 86.3% would advise medical treatment. Attitudes towards leprosy patients were generally negative. Only 42% would shake hands, 32.6% would share the same plate, and 28.3% and 27% respectively, would allow their child to play or marry a person with leprosy. Furthermore, only 33.9% approved of participation of leprosy patients, and 42.9% of their employment. Independent predictors of negative attitudes were: the belief that leprosy is a curse; is caused by a germ; and having seen a leprosy patient. The negative attitudes were dampened by: the beliefs that leprosy is a punishment, is hereditary and is due to poor personal hygiene. Conclusion An awareness intervention using community volunteers and the media, with information on the cause of leprosy, its clinical manifestations and curability, and sensitization messages correcting the misconceptions and beliefs regarding leprosy, could improve the community

  1. Effectiveness of community service models for increasing routine immunization coverage at primary healthcare facilities in a rural district of Pakistan: a quasi-experimental study

    International Nuclear Information System (INIS)

    Ali, Z.; Pongpanich, S.; Kumar, R.

    2015-01-01

    Background: In Pakistan Routine Immunization coverage has been reported to be significantly low due to multiple factors that results in high number of deaths in children under 5. This study was conducted to assess the effectiveness of integrating Community Services to improve Routine immunization coverage in rural district of Pakistan. Methods: A quasi-experimental study with control and intervention arms was conducted in government Basic Health units catchment population of Panjgur by interviewing household head/Fathers. Total 234 household head including fathers were interviewed during this baseline survey. Community service model was used for to increase routine immunization coverage at catchment area of Basic Health unit (BHU) in intervention group while routine services were given in control BHU. Results: 230 parents completed the questionnaire during the end line after three months of intervention. There were no significant differences found between two groups at baseline but after the intervention, there was statistically significance difference (<0.05) between both groups knowledge and practices regarding routine immunization. Moreover, there was no statistically significant difference in control group reported (>0.05) after the intervention period. Overall immunization status after intervention where fully immunization status in intervention group after intervention was 88.8% as compared to control group after intervention was 13.6% for partial immunization status in intervention group after intervention was 11.1% as compared to control group after intervention was 81.1 for the Non-Immunization status in intervention group after intervention was 0% as compared to control group after intervention was 5.1%. Conclusions: Community Service Model has significantly improved the Knowledge and Practices among households/parents of children under 5 in the intervention arm. (author)

  2. Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study

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    Engelsmann Barbara

    2008-12-01

    Full Text Available Abstract Background Prevention of Mother-to-Child Transmission of HIV (PMTCT is among the key HIV prevention strategies in Zimbabwe. A decrease in use of antenatal care (ANC services with an increase in home deliveries is affecting the coverage of PMTCT interventions in a context of accelerated economic crisis. The main objective was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs in family and child health services through their participation in PMTCT programmes in Zimbabwe. Methods A community based cross-sectional survey was undertaken using multistage cluster sampling in two rural districts through interviews and focus group discussions among women who delivered at home with a TBA, those who had an institutional delivery and TBAs. Results 45% of TBAs interviewed knew the principles of PMTCT and 8% delivered a woman with known HIV-positive status in previous year. Of the complete package of PMTCT services, more than 75% of TBAs agreed to participate in most activities with the exception of performing a blood test (17%, accompanying new-borns to closest health centre to receive medication (15% and assisting health centres in documentation of the link ANC-PMTCT services (18%. Women who delivered at home were less likely to have received more than one ANC service or have had contact with a health centre compared to women who delivered in a health centre (91.0% vs 72.6%; P Conclusion Although the long-term goal of ANC service delivery in Zimbabwe remains the provision of skilled delivery attendance, PMTCT programmes will benefit from complementary approaches to prevent missed opportunities. TBAs are willing to expand their scope of work regarding activities related to PMTCT. There is a need to reinforce their knowledge on MTCT prevention measures and better integrate them into the health system.

  3. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

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    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-03-06

    A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

  4. Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study

    Science.gov (United States)

    Perez, Freddy; Aung, Khin Devi; Ndoro, Theresa; Engelsmann, Barbara; Dabis, François

    2008-01-01

    Background Prevention of Mother-to-Child Transmission of HIV (PMTCT) is among the key HIV prevention strategies in Zimbabwe. A decrease in use of antenatal care (ANC) services with an increase in home deliveries is affecting the coverage of PMTCT interventions in a context of accelerated economic crisis. The main objective was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs) in family and child health services through their participation in PMTCT programmes in Zimbabwe. Methods A community based cross-sectional survey was undertaken using multistage cluster sampling in two rural districts through interviews and focus group discussions among women who delivered at home with a TBA, those who had an institutional delivery and TBAs. Results 45% of TBAs interviewed knew the principles of PMTCT and 8% delivered a woman with known HIV-positive status in previous year. Of the complete package of PMTCT services, more than 75% of TBAs agreed to participate in most activities with the exception of performing a blood test (17%), accompanying new-borns to closest health centre to receive medication (15%) and assisting health centres in documentation of the link ANC-PMTCT services (18%). Women who delivered at home were less likely to have received more than one ANC service or have had contact with a health centre compared to women who delivered in a health centre (91.0% vs 72.6%; P attendance, PMTCT programmes will benefit from complementary approaches to prevent missed opportunities. TBAs are willing to expand their scope of work regarding activities related to PMTCT. There is a need to reinforce their knowledge on MTCT prevention measures and better integrate them into the health system. PMID:19061506

  5. Banning traditional birth attendants from conducting deliveries: experiences and effects of the ban in a rural district of Kazungula in Zambia.

    Science.gov (United States)

    Cheelo, Chilala; Nzala, Selestine; Zulu, Joseph M

    2016-10-21

    In 2010 the government of the republic of Zambia stopped training traditional birth attendants and forbade them from conducting home deliveries as they were viewed as contributing to maternal mortality. This study explored positive and negative maternal health related experiences and effects of the ban in a rural district of Kazungula. This was a phenomenological study and data were collected through focus group discussions as well as in-depth interviews with trained traditional birth attendants (tTBAs) and key informant interviews with six female traditional leaders that were selected one from each of the six zones. All 22 trained tTBAs from three clinic catchment areas were included in the study. Content analysis was used to analyse the data after coding it using NVIVO 8 software. Home deliveries have continued despite the community and tTBAs being aware of the ban. The ban has had both negative and positive effects on the community. Positive effects include early detection and management of pregnancy complications, enhanced HIV/AIDS prevention and better management of post-natal conditions, reduced criticisms of tTBAs from the community in case of birth complications, and quick response at health facilities in case of an emergency. Negatives effects of the ban include increased work load on the part of health workers, high cost for lodging at health facilities and traveling to health facilities, as well as tTBAs feeling neglected, loss of respect and recognition by the community. Countries should design their approach to banning tTBAs differently depending on contextual factors. Further, it is important to consider adopting a step wise approach when implementing the ban as the process of banning tTBAs may trigger several negative effects.

  6. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy.

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    Njenga, Sammy M; Mwandawiro, Charles S; Muniu, Erastus; Mwanje, Mariam T; Haji, Fatma M; Bockarie, Moses J

    2011-09-14

    Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities.

  7. Impact of health education on knowledge and practices about menstruation among adolescent school girls of rural part of district Ambala, Haryana

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    A Arora

    2013-12-01

    Full Text Available Background: This study was undertaken to assess the impact of health education on knowledge regarding menstruation, misconceptions related to it as the prevalence of RTI is still very high in India.  Aims: To study the existing level of status of hygiene, knowledge and practices regarding menstruation among adolescent school girls and to assess the change in their knowledge level and practices after health education. Materials A community-based pre and post interventional study was conducted among 200 adolescents’ girls of class IX and X of rural part of district Ambala. Multistage random sampling technique was used to draw the representative sample. A pre-tested questionnaire was administered and later health education regarding menstruation and healthy menstrual practices was imparted to the girls. Post-test was done after 3 months to assess the impact of health education. Pre- and post-intervention, data were compared using the paired t test, z test for proportions, chi-squared test for paired proportions. Difference between Proportions of the pre-post data and its 95% confidence interval has been calculated of the findings. SPSS for Windows software version 20 (IBM, Chicago, USA have been used for data analysis. The level of significance has been considered at p value 0.05 while in the post-test preceding health education, significant improvements were observed in their practices. Conclusion: Overall significant improvement was found in knowledge and practices regarding menstruation among adolescent school girls.

  8. Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

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    Atif Riaz

    2015-05-01

    Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

  9. Gender differences, routes of transmission, socio-demographic characteristics and prevalence of HIV related infections of adults and children in an HIV cohort from a rural district of India

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    Gerardo Alvarez-Uria

    2012-02-01

    Full Text Available Despite 67% of HIV infected people in India are rural residents, the epidemiology of HIV in rural areas is not well known. This is an observational cohort study of 11,040 HIV infected people living in a rural district of India. The prevalence of hepatitis B, hepatitis C and syphilis of HIV infected patients were compared to the seroprevalence in 16,641 blood donors from the same area. The age of diagnosis in adults was below 35 years in 70% of cases and 56% were illiterate. One third of women were widows and only 3.6% of adults had a permanent job. Women were diagnosed at earlier age, had lower level of education, had poorer employment conditions and depended more on their relatives than men. In a survey performed to a subgroup of patients, 81% of women referred to have acquired HIV from their spouse, whereas 51% of men acquired HIV from commercial sex. Patients with HIV had significantly higher prevalence of hepatitis B, hepatitis C and syphilis than blood donors. Seroprevalence of HIV-2, hepatitis C and toxoplasmosis were low compared to other sites. Six percent were children (<15 years and almost half of them had lost one or both of their parents. The study shows the poor socio-economical situation and the high level of illiteracy of people living with HIV in rural India, especially women. Future health programmes of HIV in India should take into account the particularities of the HIV epidemic in rural areas.

  10. Gender differences, routes of transmission, socio-demographic characteristics and prevalence of HIV related infections of adults and children in an HIV cohort from a rural district of India.

    Science.gov (United States)

    Alvarez-Uria, Gerardo; Midde, Manoranjan; Pakam, Raghavakalyam; Naik, Praveen Kumar

    2012-01-02

    Despite 67% of HIV infected people in India are rural residents, the epidemiology of HIV in rural areas is not well known. This is an observational cohort study of 11,040 HIV infected people living in a rural district of India. The prevalence of hepatitis B, hepatitis C and syphilis of HIV infected patients were compared to the seroprevalence in 16,641 blood donors from the same area. The age of diagnosis in adults was below 35 years in 70% of cases and 56% were illiterate. One third of women were widows and only 3.6% of adults had a permanent job. Women were diagnosed at earlier age, had lower level of education, had poorer employment conditions and depended more on their relatives than men. In a survey performed to a subgroup of patients, 81% of women referred to have acquired HIV from their spouse, whereas 51% of men acquired HIV from commercial sex. Patients with HIV had significantly higher prevalence of hepatitis B, hepatitis C and syphilis than blood donors. Seroprevalence of HIV-2, hepatitis C and toxoplasmosis were low compared to other sites. Six percent were children (illiteracy of people living with HIV in rural India, especially women. Future health programmes of HIV in India should take into account the particularities of the HIV epidemic in rural areas.

  11. Knowledge, attitude and practice of family planning methods among the rural females of Bagbahara block Mahasamund district in Chhattishgarh State, India

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    Mohammad Jawed Quereishi

    2017-01-01

    Full Text Available Background If many women in Chhattisgarh are not using family planning, it is not due to a lack of knowledge. Knowledge of contraception is nearly universal; 98 percent of currently married women know at least one modern family planning method. Women are most familiar with female sterilization (97 percent, followed by male sterilization (86 percent, the pill (68 percent, the condom (55 percent, and the IUD (40 percent. About two out of every five women (43 percent have knowledge of at least one traditional method. Yet only 45 percent of married women in Chhattisgarh are currently using some method of contraception, about the same as in Madhya Pradesh (44 percent but less than the national average (48 percent. Contraceptive prevalence in Chhattisgarh is considerably higher in urban areas (59 percent than in rural areas (42 percent. Objectives To assess the knowledge, attitude and practice of family planning methods, and factors that could affect their use, among the rural females of reproductive age group (15-49 years. Methods A total of 326 females of reproductive age group (15-49years from the rural areas of Bagbahara block of Mahasamund district in Chhattisgarh state were selected randomly and interviewed with the help of semi-structured interview schedule, which consists of demographic data, questions related to knowledge, attitude and practice of different contraceptive methods and factors affecting the use of these methods. Results Most of the respondents (79% were aware of at least one contraceptive method. The most common source of information on contraception was Health staffs (46%, followed by ASHA (Mitanin workers (42.5%, media (7.5% and relatives/friends (4%. Knowledge of non-contraceptive benefits of family planning methods was claimed by only 19% of the respondents, while knowledge about various adverse effects was reported by 32% of the respondents. About 62% of respondents showed favourable attitude towards family planning methods

  12. Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon -- data from the STRATALL ANRS 12110/ESTHER trial.

    Science.gov (United States)

    Ndziessi, Gilbert; Cohen, Julien; Kouanfack, Charles; Boyer, Sylvie; Moatti, Jean-Paul; Marcellin, Fabienne; Laurent, Christian; Spire, Bruno; Delaporte, Eric; Carrieri, Maria Patrizia

    2013-01-01

    The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n=459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have "never," "sometimes," or "nearly always" used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI]=1.30 [1.17-1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, pART initiation fosters resumption of sexual activity in patients who are inactive before starting treatment; unsafe sexual behaviors remain less frequent in this population than in patients who are already sexually active before starting ART. Risk reduction programs should be reinforced among PLWHA in the context of ART scaling-up.

  13. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District.

    Science.gov (United States)

    Vyagusa, Dismas B; Mubyazi, Godfrey M; Masatu, Melchiory

    2013-10-14

    Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs' inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal

  14. Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme

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    Simiyu Chrispinus

    2011-10-01

    Full Text Available Abstract Background Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care for many fevers is a local medicine retailer, such as a pharmacy or chemist. The role of the medicine retailer as an important distribution point for malaria medicines has been recognized and several different strategies have been used to improve the services that these retailers provide. Despite these efforts, many mothers still purchase ineffective drugs because they are less expensive than effective artemisinin combination therapy (ACT. One strategy that is being piloted in several countries is an international subsidy targeted at anti-malarials supplied through the retail sector. The goal of this strategy is to make ACT as affordable as ineffective alternatives. The programme, called the Affordable Medicines Facility - malaria was rolled out in Kenya in August 2010. Methods In December 2010, the affordability and accessibility of malaria medicines in a rural district in Kenya were evaluated using a complete census of all public and private facilities, chemists, pharmacists, and other malaria medicine retailers within the Webuye Demographic Surveillance Area. Availability, types, and prices of anti-malarials were assessed. There are 13 public or mission facilities and 97 medicine retailers (registered and unregistered. Results The average distance from a home to the nearest public health facility is 2 km, but the average distance to the nearest medicine retailer is half that. Quinine is the most frequently stocked anti-malarial (61% of retailers. More medicine retailers stocked sulphadoxine-pyramethamine (SP; 57% than ACT (44%. Eleven percent of retailers stocked AMFm subsidized artemether-lumefantrine (AL. No retailers had chloroquine in stock and only five were selling artemisinin

  15. Analysis of the effects of change in cropping pattern due to drought on saffron production in rural areas of the Zebarkhan district villages

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    Hamdollah Sojasi Qidari

    2017-04-01

    Full Text Available Selection of a given cropping pattern can have serious results on the farmers’ life and rural society because of the multi dimensionality of agriculture. However, in many cases, farmers are inclined to change the cropping pattern because of changes in natural situations, changes in demand and consumption, etc. One of the most important and effective factors of change cropping pattern amongst Iranian farmers in recent years is the drought problem. One of the more current cultural method changes in the Khorasan region is inclination to saffron cultivation that can have various economic, social and environmental effects. Thus, this research paid attention to the investigation of changes from cultivation method from drought to the economic, social and environmental dimensions of saffron production amongst the villagers of the Zebarkhan district of the Khorasan Razavi province. Analytical-description methodology was used for this purpose. Data collection was done using the library- field methodology with researcher’s questionnaire whose narrative is 0.78 according to Cronbach's alpha method. Therefore, by using the Cochran formula with the intended level of 0.05, 142 farmers have been selected by available sampling method that have changed their cropping pattern to saffron production because of water shortages and drought. Then, their ideas were analyzed considering cases of economic, social and environmental effects of cropping pattern change to saffron production. The results showed meaningful changes in all research indices except for increase of cultivation surface area. Moreover, the most important changes of cropping pattern and switching over to saffron production have been identified using the Shannon entropy weighing method. In addition, the shown the revealed with continuation of differences of the changes in cropping pattern of saffron between the various villages were analyzed by using the multi-index TOPSIS. Finally, it was shown

  16. Council Districts

    Data.gov (United States)

    Town of Cary, North Carolina — View the location of the Town of Cary’s four Town Council districts.Please note that one district, District A, is split into two geo-spatial areas. One area is in...

  17. Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

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    Wilbroad Mutale

    Full Text Available INTRODUCTION: There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. METHODOLOGY: The Better Health Outcome through Mentoring and Assessment (BHOMA project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. RESULTS: Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58% and highest in Luangwa district (77%. Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively. Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02. Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04 and service readiness (coeff 0.54, p = 0.03. CONCLUSION: The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service

  18. Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

    Science.gov (United States)

    Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-01-01

    There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could

  19. Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

    Science.gov (United States)

    Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-01-01

    Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery

  20. Leveraging community health worker system to map a mountainous rural district in low resource setting: a low-cost approach to expand use of geographic information systems for public health.

    Science.gov (United States)

    Munyaneza, Fabien; Hirschhorn, Lisa R; Amoroso, Cheryl L; Nyirazinyoye, Laetitia; Birru, Ermyas; Mugunga, Jean Claude; Murekatete, Rachel M; Ntaganira, Joseph

    2014-12-06

    Geographic Information Systems (GIS) have become an important tool in monitoring and improving health services, particularly at local levels. However, GIS data are often unavailable in rural settings and village-level mapping is resource-intensive. This study describes the use of community health workers' (CHW) supervisors to map villages in a mountainous rural district of Northern Rwanda and subsequent use of these data to map village-level variability in safe water availability. We developed a low literacy and skills-focused training in the local language (Kinyarwanda) to train 86 CHW Supervisors and 25 nurses in charge of community health at the health center (HC) and health post (HP) levels to collect the geographic coordinates of the villages using Global Positioning Systems (GPS). Data were validated through meetings with key stakeholders at the sub-district and district levels and joined using ArcMap 10 Geo-processing tools. Costs were calculated using program budgets and activities' records, and compared with the estimated costs of mapping using a separate, trained GIS team. To demonstrate the usefulness of this work, we mapped drinking water sources (DWS) from data collected by CHW supervisors from the chief of the village. DWSs were categorized as safe versus unsafe using World Health Organization definitions. Following training, each CHW Supervisor spent five days collecting data on the villages in their coverage area. Over 12 months, the CHW supervisors mapped the district's 573 villages using 12 shared GPS devices. Sector maps were produced and distributed to local officials. The cost of mapping using CHW supervisors was $29,692, about two times less than the estimated cost of mapping using a trained and dedicated GIS team ($60,112). The availability of local mapping was able to rapidly identify village-level disparities in DWS, with lower access in populations living near to lakes and wetlands (p villages even in mountainous rural areas. These data

  1. Rural Depopulation Pattern at Yogyakarta Special Province (DIY

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    M Baiquni

    2004-01-01

    This paper is based on a secondary data research i.e. statistical data at rural levels in Yogyakarta, thematics maps and other documents. Statistical methodes and map pattern analysis are employed to analysis data. The result of this research are as follows: a the rural depopulation in DIY can be found in 189 rural areas of 393 rural areas (48.09%; b the spatial distribution of the rural depopulation are in Gunung Kidul District (80 rural areas, Kulon Progo District (59 rural areas Sleman District (33 rural areas, and Bantul District (17 rural areas; c the rural depopulation in Yogyakarta at least related to six factors whih have been identified as out – migration, local resources, carrying capacity, geographycal location or accessibility, rural infrastructure, and service availability.

  2. A renewable energy policy concept for the rural district of Schmalkalden-Meiningen - Assessment of potential and modelling calculations; Potentiale und Modellrechnungen zur Nutzung erneuerbarer Energien im Landkreis Schmalkalden-Meiningen

    Energy Technology Data Exchange (ETDEWEB)

    Krah, N. [Fachhochschule Schmalkalden (Germany). Fachbereich Maschinenbau

    2001-06-01

    The publication is based on previous studies, facts, information, analyses and project results. Using this available reservoir of information, the author examines the potentials and demonstrates that the rural district of Schmalkalden-Meiningen meets all requirements and owns all means to put into place an energy policy that focuses on the use of renewable energy sources and the relevant technologies. The aspects examined are: increasing the energy efficiency; rational use of energy and development of environmentally sound energy supply; use of renewable energy sources; reducing greenhouse gas emissions. (orig./CB) [German] Die Veroeffentlichung baut auf fruehere Untersuchungen, Fakten, Daten, Erkenntnisse und Projekten auf. Unter Verwendung dieser Quellen wird ein Energiekonzept fuer den Landkreis Schmalkalden-Meiningen erarbeitet, das die Nutzung erneuerbarer Energien in den Vordergrund stellt und zeigt, dass der Landkreis alle Voraussetzungen besitzt, um die folgenden Potentiale nutzbar zu machen oder auszubauen: Energieeinsparmoeglichkeiten; rationelle, umweltfreundliche Energieversorgung; Anwendung erneuerbarer Energien; Reduzierung der Schadstoffemissionen. (orig./CB)

  3. Adaptive management of forest fires in periurban areas in the Federal District, Brazil: A case study from the Urubu Valley rural community

    Science.gov (United States)

    Gabriel Constantino Zacharias; Renata Marson Teixeira de Andrade

    2013-01-01

    In a climate change scenario, where global warming increases the critical period of drought, the risk of wildfire is expected to increase. In the Federal District (DF) - Brazil, wildfire in periruban areas have economic, financial, environmental and public health significance, however it is poorly studied. Thus, one wonders if the DF is prepared to deal with the higher...

  4. Smallholder Information Sources and Communication Pathways for Cashew Production and Marketing in Tanzania: An Ex-Post Study in Tandahimba and Lindi Rural Districts, Southern Tanzania

    Science.gov (United States)

    Nyambo, Brigitte; Ligate, Elly

    2013-01-01

    Purpose: To identify and review production and marketing information sources and flows for smallholder cashew (Anacardium occidentale L.) growers in Tanzania and recommend systems improvements for better technology uptake. Design/methodology/approach: Two-stage purposive samples were drawn. First, two districts in the main cashew producing areas,…

  5. Circles of Culture and Cognition: A Sociocognitive Study of Collaboration within and among Academic Groups of Teachers in a Rural School District

    Science.gov (United States)

    Baker, Linda L.

    2011-01-01

    This ethnographic case study examined the roles of district and school macro-culture and teacher sub-group micro-culture in influencing the nature and extent of teachers' professional collaboration. Informed by the sociocognitive theory that learning is rooted in social relationships and develops through interpersonal discourse and activity, the…

  6. Kericho CLinic-based ART Diagnostic Evaluation (CLADE: design, accrual, and baseline characteristics of a randomized controlled trial conducted in predominately rural, district-level, HIV clinics of Kenya.

    Directory of Open Access Journals (Sweden)

    Fredrick K Sawe

    Full Text Available Prospective clinical trial data regarding routine HIV-1 viral load (VL monitoring of antiretroviral therapy (ART in non-research clinics of Sub-Saharan Africa are needed for policy makers.CLinic-based ART Diagnostic Evaluation (CLADE is a randomized, controlled trial (RCT evaluating feasibility, superiority, and cost-effectiveness of routine VL vs. standard of care (clinical and immunological monitoring in adults initiating dual nucleoside reverse transcriptase inhibitor (NRTI+non-NRTI ART. Participants were randomized (1:1 at 7 predominately rural, non-research, district-level clinics of western Kenya. Descriptive statistics present accrual patterns and baseline cohort characteristics.Over 15 months, 820 adults enrolled at 7 sites with 86-152 enrolled per site. Monthly site enrollment ranged from 2-92 participants. Full (100% informed consent compliance was independently documented. Half (49.9% had HIV diagnosed through voluntary counseling and testing. Study arms were similar: mostly females (57.6% aged 37.6 (SD = 9.0 years with low CD4 (166 [SD = 106] cells/m3. Notable proportions had WHO Stage III or IV disease (28.7%, BMI <18.5 kg/m2 (23.1%, and a history of tuberculosis (5.6% or were receiving tuberculosis treatment (8.2% at ART initiation. In the routine VL arm, 407/409 (99.5% received baseline VL (234,577 SD = 151,055 copies/ml. All participants received lamivudine; 49.8% started zidovudine followed by 38.4% stavudine and 11.8% tenofovir; and, 64.4% received nevirapine as nNRTI (35.6% efavirenz.A RCT can be enrolled successfully in rural, non-research, resource limited, district-level clinics in western Kenya. Many adults presenting for ART have advanced HIV/AIDS, emphasizing the importance of universal HIV testing and linkage-to-care campaigns.ClinicalTrials.gov NCT01791556.

  7. Impact of chronic respiratory symptoms in a rural area of sub-Saharan Africa : an in-depth qualitative study in the Masindi district of Uganda

    NARCIS (Netherlands)

    van Gemert, Frederik; Chavannes, Niels; Nabadda, Nahid; Luzige, Simon; Kirenga, Bruce; Eggermont, Celeste; de Jong, Corina; van der Molen, Thys

    Background: Chronic obstructive pulmonary disease (COPD), once regarded as a disease of developed countries, is now recognised as a common disease in low- and middle-income countries. No studies have been performed to examine how the community in resource-poor settings of a rural area in sub-Saharan

  8. Self-reported health problems, health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal.

    Science.gov (United States)

    Kshetri, Dan B B; Smith, William C S

    2011-06-01

    The study aimed to identify the felt common health problems, utilisation of health services and unmet needs of urban and rural elderly people of Bhaktapur district, Nepal. It was a cross sectional population study of people aged 60 years or more where 204 respondents were interviewed in 2009. The common felt problems were pain and swelling of joints (65.7%), indigestion (63.7%), excessive tiredness (38.2%) and hypertension (35.8%). Pain and swelling of joints (72.5%) and back pain (40.4%) were higher in rural elderly population whereas indigestion (67.6%) and hypertension (37.85%) were higher in urban population. Pain and swelling of joints (66.7%) and indigestion (69.6%) were higher in males, and hypertension (50.0%), back pain (38.2%) and chronic bronchitis/asthma (39.2%) were higher in females. The unmet needs varied between different health problems. In general women had more unmet needs than men, where 80 unmet needs were identified for the 102 men compared with 105 for the 102 women, and these unmet needs increased dramatically with age. This approach yields new insights into the health care needs of the elderly and will be helpful to health care planners.

  9. Supply chain solutions to improve the distribution of antiretroviral drugs (ARVs) to clinics in rural areas: A case study of the QwaQwa district

    OpenAIRE

    Mokheseng, Mamolise; Horn, Gideon S.; Klopper, Aileen G.

    2017-01-01

    This article serves as a case study based on research that was performed in the QwaQwa district in the Free State Province where the distribution of ARVs to the regional Manapo hospital, as well as between the hospital and its peripheral clinics, was interrupted and inconsistent due to problems in the supply chain. An unreliable and interrupted ARV supply chain creates the risk of virus reactivation and eventual patient mortality. The objectives of the study were to explore the problems e...

  10. An improved model for provision of rural community-based health rehabilitation services in Vhembe District, Limpopo Province of South Africa

    Directory of Open Access Journals (Sweden)

    Rudzani E. Luruli

    2016-03-01

    Full Text Available Background: In 1991, Riakona Community Rehabilitation Programme initiated community-based rehabilitation (CBR in the Vhembe District of Limpopo Province. Subsequently, the South African government adopted the programme. Aim: The aim of the study was to suggest an improvement in the model of providing CBR services. Setting: The study was conducted in six rehabilitation centres located in hospitals in the Vhembe District in Limpopo Province of South Africa. Method: A mixed-mode research design with qualitative and quantitative elements was used to conduct the study. Content analysis, the chi-square test for Goodness of Fit and the Kruskal–Wallis and Mann–Whitney non-parametric tests were conducted. Results: The key determinants of client satisfaction with the services that the community rehabilitation workers rendered included provision of assistive devices and the adoption of a holistic approach to their work. Overall, satisfaction per domain for each one of the five domains of satisfaction scored less than 90%. More than 80% of clients were satisfied with empathy (83% and assurance (80% domains. Tangibles, reliability and responsiveness domains had scores of 78%, 72% and 67%, respectively. These results, together with the reasoning map of conceptual framework description, were used as the building blocks of the CBR model. Conclusion: The improved CBR model is useful for putting the programme into practice. This is particularly so for the CBR managers in the districts of the Limpopo Province. Keywords: client satisfaction, disability, community-based rehabilitation, community rehabilitation worker

  11. Cross-sectional study of malnutrition and associated factors among school aged children in rural and urban settings of Fogera and Libo Kemkem districts, Ethiopia.

    Science.gov (United States)

    Herrador, Zaida; Sordo, Luis; Gadisa, Endalamaw; Moreno, Javier; Nieto, Javier; Benito, Agustín; Aseffa, Abraham; Cañavate, Carmen; Custodio, Estefania

    2014-01-01

    Little information is available on malnutrition-related factors among school-aged children ≥5 years in Ethiopia. This study describes the prevalence of stunting and thinness and their related factors in Libo Kemkem and Fogera, Amhara Regional State and assesses differences between urban and rural areas. In this cross-sectional study, anthropometrics and individual and household characteristics data were collected from 886 children. Height-for-age z-score for stunting and body-mass-index-for-age z-score for thinness were computed. Dietary data were collected through a 24-hour recall. Bivariate and backward stepwise multivariable statistical methods were employed to assess malnutrition-associated factors in rural and urban communities. The prevalence of stunting among school-aged children was 42.7% in rural areas and 29.2% in urban areas, while the corresponding figures for thinness were 21.6% and 20.8%. Age differences were significant in both strata. In the rural setting, fever in the previous 2 weeks (OR: 1.62; 95% CI: 1.23-2.32), consumption of food from animal sources (OR: 0.51; 95% CI: 0.29-0.91) and consumption of the family's own cattle products (OR: 0.50; 95% CI: 0.27-0.93), among others factors were significantly associated with stunting, while in the urban setting, only age (OR: 4.62; 95% CI: 2.09-10.21) and years of schooling of the person in charge of food preparation were significant (OR: 0.88; 95% CI: 0.79-0.97). Thinness was statistically associated with number of children living in the house (OR: 1.28; 95% CI: 1.03-1.60) and family rice cultivation (OR: 0.64; 95% CI: 0.41-0.99) in the rural setting, and with consumption of food from animal sources (OR: 0.26; 95% CI: 0.10-0.67) and literacy of head of household (OR: 0.24; 95% CI: 0.09-0.65) in the urban setting. The prevalence of stunting was significantly higher in rural areas, whereas no significant differences were observed for thinness. Various factors were associated with one or both types of

  12. Women and Land Ownership Rights in Kilimanjaro: A Tension between Women Land Ownership Rights and Culture: A case of Moshi Rural District Tanzania

    OpenAIRE

    Asantemungu, Raphael Ernest

    2011-01-01

    Despite the efforts and strategies geared towards women in realizing property rights in terms of empowerment, participation and decision making in the global context today many African societies are still characterized by social economic and political inequalities between men and women. This situation is worse in Tanzania rural areas where women land rights are violated as result of culture being regarded as a daily routine that provide the basis and ways in which land is owned and distribute...

  13. The provision of Primary Health Care in two rural districts of the Eastern Cape Province with particular reference to human resources and accessibility

    Directory of Open Access Journals (Sweden)

    M. Thipanyana

    1998-09-01

    Full Text Available The provision of Primary Health Care Services (PHC is still a problem in developing countries like South Africa. In other countries, one finds enough human resources whilst in other countries there may be enough material resources. A both qualitative and quantitative research was conducted at Mqanduli and part of the Eastern Elliotdale districts in the Eastern Cape Province with the aim of investigating the provision of Primary health Care Services, reference was made to the availability of human resources and accessibility of PHC services.

  14. Flood Damage Assessment in Pearl River Delta Rural Area Application in Huashan Town, Huadu District,Guanghzou during the 2017 5.7 Heavy Rain Storm

    Science.gov (United States)

    Wang, X.

    2017-12-01

    The Pearl River Delta (PRD) in China, the summer rain storm occurs frequently, the flood damage is very serious. Damage assessment is the basis of scientific decision-making in disaster mitigation. All approaches of flood damage analysis contain uncertainties due to the inaccuracies and generalisations used, the lack of data aggravates this problem, making methods very rough. This study presents a detailed flood damage assessment framework in Pearl River Delta rural area, using 2017 "5.7" heavy rain storm event to simulate the process and estimate the flood loss in resident building and property, agriculture production. The framework integrates four modules,1) utilize the remote sensing and statistical yearbook and so on to construct the disaster bearing bodies GIS database; 2) using hydraulics model to simulate the flood extent and depth spatial distribution;3)through field investigation to obtain the flood loss data for all kinds of hazard-affected body, using statistical analysis method to get the damage curves;4)Integrate flood scenarios, disaster bearing bodies GIS database and damage curves to calculate the flood loss estimation value. Using this methodology, in the 2017 "5.7" heavy rain storm event, Huashan Town flood damage loss is underestimate compared with the government report, because of not considering the damage of water conservancy facilities. But the disaster loss value on the spatial distribution is consistent with actual situation. In terms of aggregated values in the whole town, the model is capable of obtaining figures that are within the same order of magnitude. This study produce a flood damage assessment framework taking into account the regional characteristics of PRD rural area, provide a template for future practice. This study only considers the current impacts, the framework should be improved by taking into account socio-economic and climatic changes, as well as implementing adaptation measures to be applied to assess the potential

  15. Towards sustainable sanitation management: Establishing the costs and willingness to pay for emptying and transporting sludge in rural districts with high rates of access to latrines.

    Science.gov (United States)

    Balasubramanya, Soumya; Evans, Barbara; Hardy, Richard; Ahmed, Rizwan; Habib, Ahasan; Asad, N S M; Rahman, Mominur; Hasan, M; Dey, Digbijoy; Fletcher, Louise; Camargo-Valero, Miller Alonso; Chaitanya Rao, Krishna; Fernando, Sudarshana

    2017-01-01

    Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood. In this paper we calculate the actual cost of sludge management from onsite latrines, and identify the contributions that latrine owners are willing to make to finance the costs. A spreadsheet-based model is used to identify a cost-effective transport option, and to calculate the cost per household. Then a double-bound contingent valuation method is used to elicit from pit-latrine owners their willingness-to-pay to have sludge transported away. This methodology is employed for the case of a rural subdistrict in Bangladesh called Bhaluka, a unit of administration at which sludge management services are being piloted by the Government of Bangladesh. The typical sludge accumulation rate in Bhaluka is calculated at 0.11 liters/person/day and a typical latrine will need to be emptied approximately once every 3 to 4 years. The costs of emptying and transport are high; approximately USD 13 per emptying event (circa 14% of average monthly income); household contributions could cover around 47% of this cost. However, if costs were spread over time, the service would cost USD 4 per year per household, or USD 0.31 per month per household-comparable to current expenditures of rural households on telecommunications. This is one of few research papers that brings the costs of waste management together with financing of that cost, to provide evidence for an implementable solution. This framework can be used to identify cost effective sludge management options and private contributions towards that cost in other

  16. Exploring the Viability of Solar Photovoltaic for Rural Water Supply in Ghana: A Case Study of Agotime-Ziope District of the Volta Region

    OpenAIRE

    Dzokoto, Seth Theodore Kwasi

    2017-01-01

    Availability of good drinking water is a key factor for health and quality of life. In urban locations of Ghana, water from large rivers is abstracted and treated before it is supplied to the urban people by the use of the grid. However access to potable water is difficult in rural communities of the country because these locations are remote from the grid (or they experience unreliable power supply) and water infrastructure. They are however endowed with abundant sunshine (5-8 hours per day ...

  17. Effect of gender and nutritional status on academic achievement and cognitive function among primary school children in a rural district in Malaysia.

    Science.gov (United States)

    Hamid, Jan J M; Amal, Mitra K; Hasmiza, H; Pim, C D; Ng, L O; Wan, Manan W M

    2011-08-01

    The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function. Two hundred and forty-nine children, seven to nine years of age, were recruited by systematic sampling from six primary schools in a rural area in Malaysia. Cognitive function was assessed by using Raven's Coloured Progressive Matrices (R-CPM). Academic performance of the children was recorded from their school final examination results in four subjects including Malay language, English, Mathematics, and Science. Birth weight was recorded from the birth certificate, and nutritional status was determined by weight-for-age z score and height-for-age z score. Girls had a significantly higher score in all the academic tests, but a lower cognitive score compared to boys. Nutritional status was found to be correlated significantly with academic performance. Academic and cognitive function scores were also found to be correlated significantly with birth weight, parents' education, and family income. In a multivariate analysis, gender remained the significant predictor of academic function, and iron status and haemoglobin were the significant predictors of cognitive function, after controlling for other variables. The study showed that girls performed better academically than boys in rural Malaysia. Nutritional status, parents' education and family income could be additional modifiable factors to improve academic performance of the children. More attention is needed to improve academic achievements of boys at their early school years.

  18. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

    Directory of Open Access Journals (Sweden)

    Mubyazi Godfrey M

    2012-02-01

    Full Text Available Abstract Background Since its introduction in the national antenatal care (ANC system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment

  19. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

    Science.gov (United States)

    2012-01-01

    Background Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water

  20. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts.

    Science.gov (United States)

    Mubyazi, Godfrey M; Bloch, Paul; Byskov, Jens; Magnussen, Pascal; Bygbjerg, Ib C; Hansen, Kristian S

    2012-02-18

    Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water, electricity and cups for

  1. Verbal Autopsies in Rural Tanzania

    African Journals Online (AJOL)

    Maternal mortality rates in rural Tanzania are high. In preparation for the introduction of an intervention to reduce maternal deaths by distribution of misoprostol and erythromycin to women living in rural Rorya District, Mara Region, Tanzania, we conducted a limited verbal autopsy by surveying family members of women ...

  2. Frequency and determinants of malnutrition in children aged between 6 to 59 months in district Tharparkar, a rural area of Sindh.

    Science.gov (United States)

    Ahsan, Shahid; Mansoori, Naveed; Mohiuddin, Syed Maqsood; Mubeen, Syed Muhammad; Saleem, Rubab; Irfanullah, Muhammad

    2017-09-01

    To assess the nutritional status of children living in Tharparkar. This cross-sectional study was conducted in four villages of Tharparkar district of Sindh, Pakistan, in 2014, and comprised children aged between 6 and 59 months. Data was collected from mothers and anthropometry of children was done using standard techniques. Nutritional status was assessed by using age- and sex-specific World Health Organisation standard charts for underweight, stunting and wasting. Data was analysed using SPSS 16. Of the 304 children assessed, 117(38.5%) were stunted, 58(19.1 %) were wasted and 101(33.2 %) were underweight with no gender discrimination. Under-nutrition was particularly observed in the second year of life. Statistically significant factors associated with stunting were illiteracy of mother, family size of >5 members, pregnancy>4 times, child mortality in last 6 months, absence of breastfeeding and no history of child vaccination(pdiscrimination.

  3. Factors Associated with Awareness, Attitudes and Practices Regarding Common Eye Diseases in the General Population in a Rural District in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES.

    Directory of Open Access Journals (Sweden)

    Fakir M Amirul Islam

    Full Text Available To assess the awareness, attitudes, and practices associated with common eye diseases and eye care utilization in a rural district of Bangladesh.Data were collected using a multilevel cluster random sampling technique from 3104 adults aged ≥30 years from the Banshgram union with a questionnaire assessing the awareness, attitudes and practice about diabetes and common eye diseases, educational attainment, socio-economic status, and medical history.Participants were aged between 30 and 89 years with a mean (SD age of 51 (12 years and 65% were female. The majority of participants had heard of cataracts (90%, trachoma (86% and Pterygium (84%, yet only 4% had heard of diabetic retinopathy (DR, 7% of glaucoma and 8% of Age-related macular degeneration (AMD. However, 58% of participants did not know vision loss could be prevented. Factors associated with lower awareness regarding common eye diseases were increasing age, lack of formal schooling, and lower socio-economic status. A lower proportion (57% of people with no schooling compared to those who had attained at least secondary school certificate education (72% reported that they knew that vision loss could be prevented (p<0.001. Overall 51% of people had heard of at least six (67% out of nine items relating to awareness of common eye diseases. This included 41% of participants aged 65 years or older compared to 61% of those aged 30-35 years (p<0.001. Only 4% had an eye check at least once a year and higher education and better SES were associated with higher frequency of eye checks.In rural Bangladesh awareness of cataract, trachoma and pterygium was good but limited in relation to the potentially blinding conditions of glaucoma, DR, and AMD. The results show a large gap between public awareness and treatment practices about common eye diseases. Public health promotion should be designed to address these knowledge gaps.

  4. Towards sustainable sanitation management: Establishing the costs and willingness to pay for emptying and transporting sludge in rural districts with high rates of access to latrines.

    Directory of Open Access Journals (Sweden)

    Soumya Balasubramanya

    Full Text Available Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood.In this paper we calculate the actual cost of sludge management from onsite latrines, and identify the contributions that latrine owners are willing to make to finance the costs. A spreadsheet-based model is used to identify a cost-effective transport option, and to calculate the cost per household. Then a double-bound contingent valuation method is used to elicit from pit-latrine owners their willingness-to-pay to have sludge transported away. This methodology is employed for the case of a rural subdistrict in Bangladesh called Bhaluka, a unit of administration at which sludge management services are being piloted by the Government of Bangladesh.The typical sludge accumulation rate in Bhaluka is calculated at 0.11 liters/person/day and a typical latrine will need to be emptied approximately once every 3 to 4 years. The costs of emptying and transport are high; approximately USD 13 per emptying event (circa 14% of average monthly income; household contributions could cover around 47% of this cost. However, if costs were spread over time, the service would cost USD 4 per year per household, or USD 0.31 per month per household-comparable to current expenditures of rural households on telecommunications.This is one of few research papers that brings the costs of waste management together with financing of that cost, to provide evidence for an implementable solution. This framework can be used to identify cost effective sludge management options and private contributions towards that cost

  5. Survived infancy but still vulnerable: spatial-temporal trends and risk factors for child mortality in the Agincourt rural sub-district, South Africa, 1992-2007

    Directory of Open Access Journals (Sweden)

    Benn Sartorius

    2011-05-01

    Full Text Available Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns within the study site between 1992 and 2007, and to produce all-cause and cause-specific mortality maps to identify high risk areas. Demographic, maternal, paternal and fertility-related factors, household mortality experience, distance to health care facility and socio-economic status were among the examined risk factors. The analysis was carried out by fitting a Bayesian discrete time Bernoulli survival geostatistical model using Markov chain Monte Carlo simulation. Bayesian kriging was used to produce mortality risk maps. Significant temporal increase in child mortality was observed due to the HIV epidemic. A distinct spatial risk pattern was observed with higher risk areas being concentrated in poorer settlements on the eastern part of the study area, largely inhabited by former Mozambican refugees. The major risk factors for childhood mortality, following multivariate adjustment, were mother’s death (especially when due to HIV and tuberculosis, greater number of children under 5 years living in the same household and winter season. This study demonstrates the use of Bayesian geostatistical models for accurately quantifying risk factors and producing maps of child mortality risk in a health and demographic surveillance system. According to the space-time analysis, the southeast and upper central regions of the site appear to have the highest mortality risk. The results inform policies to address health inequalities in the Agincourt sub-district and to

  6. Factors Associated with Awareness, Attitudes and Practices Regarding Common Eye Diseases in the General Population in a Rural District in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES).

    Science.gov (United States)

    Islam, Fakir M Amirul; Chakrabarti, Rahul; Islam, Silvia Z; Finger, Robert P; Critchley, Christine

    2015-01-01

    To assess the awareness, attitudes, and practices associated with common eye diseases and eye care utilization in a rural district of Bangladesh. Data were collected using a multilevel cluster random sampling technique from 3104 adults aged ≥30 years from the Banshgram union with a questionnaire assessing the awareness, attitudes and practice about diabetes and common eye diseases, educational attainment, socio-economic status, and medical history. Participants were aged between 30 and 89 years with a mean (SD) age of 51 (12) years and 65% were female. The majority of participants had heard of cataracts (90%), trachoma (86%) and Pterygium (84%), yet only 4% had heard of diabetic retinopathy (DR), 7% of glaucoma and 8% of Age-related macular degeneration (AMD). However, 58% of participants did not know vision loss could be prevented. Factors associated with lower awareness regarding common eye diseases were increasing age, lack of formal schooling, and lower socio-economic status. A lower proportion (57%) of people with no schooling compared to those who had attained at least secondary school certificate education (72%) reported that they knew that vision loss could be prevented (pBangladesh awareness of cataract, trachoma and pterygium was good but limited in relation to the potentially blinding conditions of glaucoma, DR, and AMD. The results show a large gap between public awareness and treatment practices about common eye diseases. Public health promotion should be designed to address these knowledge gaps.

  7. Health-related quality of life of elderly living in the rural community and homes for the elderly in a district of India. Application of the short form 36 (SF-36) health survey questionnaire.

    Science.gov (United States)

    Varma, G R; Kusuma, Y S; Babu, B V

    2010-08-01

    The present investigation aimed to assess the health-related QoL (HRQoL) of elderly people living in two settings: (i) rural community and (ii) homes for the elderly in a district of South India. The data are drawn from elderly (>60 years of age) sampled from both settings. The short form 36-item health survey (SF-36) was administered to all respondents. The average scores for several domains, including total physical health, total mental health and overall health (total SF-36 score) were around 50, which can be interpreted as a moderate level of health-related QoL. Residents living in a home for the elderly scored better in all domains except for role-physical and role-emotional. Though univariate analysis revealed some associations between characteristics of elderly SF-36 scores, the multiple regression analysis indicated that working status yields a significant but negative coefficient for total SF-36 score among community dwelling elderly. The elderly report that their lives are better when they are staying in homes for the elderly. Hence, despite the socio-economic conditions, provision of a better and conducive environment by setting up more charity-based homes for the elderly may be one of the options for relative betterment of the QoL of the elderly, particularly those who are socially and economically deprived. Finally, the study warrants the need of normative values of SF-36 for various population groups in India.

  8. A cross-sectional study of correlation of body image anxiety with social phobia and their association with depression in the adolescents from a rural area of Sangli district in India

    Directory of Open Access Journals (Sweden)

    Vivek Baliram Waghachavare

    2014-01-01

    Full Text Available Background: Prevailing socio-cultural influences lead females to desire a thin body and males a muscular body, especially in adolescents. This results in body image anxiety which may lead to social phobia. Together they can develop depression. The aim was to study the correlation of body image anxiety with social phobia and their association with depression, among adolescents. Methods: This was a cross-sectional study conducted in randomly selected colleges from a rural area of Sangli district Maharashtra, India. Stratified random sampling technique used with sample size 805. Pretested self-administered questionnaire used. Percentage, Chi-square test, binary logistic regression model was used to estimate odds ratio (OR and its 95% confidence intervals. Results: Of 997 study subjects body image anxiety, social phobia and depression were observed in 232 (23.3%, 193 (19.4% and 326 (32.7% participants, respectively. Binary logistic regression showed that body image anxiety (OR = 1.849 [1.22, 2.804]; P = 0.004 and social phobia (OR = 4.575 [2.952-7.09]; P < 0.001 were significant predictors for depression. Conclusions: Body image anxiety and social phobia are linked with the development of depression. This impresses the need for timely counseling and education among adolescents.

  9. Factors Associated with Awareness, Attitudes and Practices Regarding Common Eye Diseases in the General Population in a Rural District in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES)

    Science.gov (United States)

    Islam, Fakir M. Amirul; Chakrabarti, Rahul; Islam, Silvia Z.; Finger, Robert P.; Critchley, Christine

    2015-01-01

    Background To assess the awareness, attitudes, and practices associated with common eye diseases and eye care utilization in a rural district of Bangladesh. Methods Data were collected using a multilevel cluster random sampling technique from 3104 adults aged ≥30 years from the Banshgram union with a questionnaire assessing the awareness, attitudes and practice about diabetes and common eye diseases, educational attainment, socio-economic status, and medical history. Results Participants were aged between 30 and 89 years with a mean (SD) age of 51 (12) years and 65% were female. The majority of participants had heard of cataracts (90%), trachoma (86%) and Pterygium (84%), yet only 4% had heard of diabetic retinopathy (DR), 7% of glaucoma and 8% of Age-related macular degeneration (AMD). However, 58% of participants did not know vision loss could be prevented. Factors associated with lower awareness regarding common eye diseases were increasing age, lack of formal schooling, and lower socio-economic status. A lower proportion (57%) of people with no schooling compared to those who had attained at least secondary school certificate education (72%) reported that they knew that vision loss could be prevented (pBangladesh awareness of cataract, trachoma and pterygium was good but limited in relation to the potentially blinding conditions of glaucoma, DR, and AMD. The results show a large gap between public awareness and treatment practices about common eye diseases. Public health promotion should be designed to address these knowledge gaps. PMID:26200458

  10. Fisheries Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Fisheries districts data layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset...

  11. Warden Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — This dataset is a representation overlay of warden (areas of responsibility). The Vermont Warden Districts layer is part of a dataset that contains administrative...

  12. Forestry Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Forestry Districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This is a layer file which...

  13. Wastewater Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Wastewater districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...

  14. Wildlife Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Wildlife Districts layer is part of a larger dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature...

  15. Park Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Parks Districts layer is part of a dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature classes for...

  16. Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors

    Directory of Open Access Journals (Sweden)

    Mohammad Afzal Mahmood

    2018-01-01

    Full Text Available Background. Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Method. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records’ review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. Findings. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. Conclusion. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.

  17. Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors.

    Science.gov (United States)

    Mahmood, Mohammad Afzal; Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien; Wahabi, Hayfaa A

    2018-01-01

    Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.

  18. Supply chain solutions to improve the distribution of antiretroviral drugs (ARVs to clinics in rural areas: A case study of the QwaQwa district

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    Mamolise Mokheseng

    2017-10-01

    Full Text Available This article serves as a case study based on research that was performed in the QwaQwa district in the Free State Province where the distribution of ARVs to the regional Manapo hospital, as well as between the hospital and its peripheral clinics, was interrupted and inconsistent due to problems in the supply chain. An unreliable and interrupted ARV supply chain creates the risk of virus reactivation and eventual patient mortality. The objectives of the study were to explore the problems experienced with the ARV distribution practices at the Manapo hospital, and to recommend ways in which the distribution of ARVs can be improved so that patients can receive an uninterrupted supply. The nature of the topic researched dictated the use of mainly the quantitative research method. The main problems identified include: Wrong and no uniform practice of ordering stock by the hospital and the clinics; lack of reliable, structured transportation from the depot to the hospital; as well as poor inventory management and poor overall communication. Recommendations to address the problems include: Implementing a supply chain planning and design process; improving inventory management and warehousing practices; implementing more effective and reliable distribution and transportation processes; as well as improving supply chain coordination and overall communication.

  19. The oral health knowledge and oral hygiene practices among primary school children age 5-17 years in a rural area of Uasin Gishu district, Kenya.

    Science.gov (United States)

    Okemwa, K A; Gatongi, P M; Rotich, J K

    2010-06-01

    To determine the oral health knowledge and oral hygiene practices among school children in the study region This was a descriptive cross-sectional study carried out among primary school going children in Kapsaret Educational division, Uasin-Gishu District, Kenya. A researcher administered questionnaire was used to determine the oral health knowledge and practices in a random sample of 401 students in the period March to June 2002. 92% of the students claimed they brushed their teeth. About 48% brushed at least twice daily. More students (59.1%) reported using the chewing stick compared to those using commercial toothbrushes (p = 0.000).Female students brushed more frequently than their male counterparts (p = 0.000, chi2 = 24.65). 39.9% of the students knew the cause of tooth decay, 48.2% could state at least one method of prevention, while 16.5% knew the importance of teeth. Use of toothpaste was reported by 38.9% of the students. Less than half of the students knew the causes of tooth decay and how to prevent it. Only about half of the students brushed their teeth twice daily with the chewing stick being more frequently used. There is need to increase the oral health knowledge through well Planned school based oral health education programmes in the primary schools. This would hopefully lead to improvement on the oral hygiene practices.

  20. Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP at a district health centre in rural Senegal

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    Vaillant Michel

    2008-11-01

    Full Text Available Abstract Background Intermittent preventive treatment with sulphadoxine-pyrimethamine (SP is recommended for reducing the risk of malaria in pregnancy and its consequences on mothers and babies (IPTp-SP. Indicators of implementation and effects of IPTp-SP were collected in a rural clinic in Southern Senegal. Methods Women seen routinely at the antenatal clinic (ANC of a rural dispensary during 2000–2007. Deployment of IPTp-SP started in January 2004. Inspection of antenatal and outpatient clinic registries of the corresponding period. Results Between 1st January 2000 and 30th April 2007, 1,781 women of all gravitidities and parities attended the ANC with 965 deliveries (606 and 398 respectively since 1st January 2004, when IPTp-SP was started. 69% of women were seen ≥ 3 times; 95% received at least one dose and 70% two doses of SP (from 61% in 2004 to 86% in 2007. The first visit, first and second dose of SP occurred at a median week 20, 22 and 31. The probability of receiving two doses was > 80% with ≥ 3 antenatal visits and a first dose of SP by week 20. The prevalence of maternal malaria was low and similar pre- (0.7% and during IPTp (0.8%. Effects on of low birth weight (LBW, Unfavourable pregnancy outcomes numbered 72 (7.5% of pregnancies with known outcome, including 30 abortions and 42 later deaths (late foetal deaths, stillbirth, peri-natal of which 13 with one or more malformations (1.35% of all recorded deliveries. Conclusion The implementation of IPTp-SP was high. Early attendance to ANC favours completion of IPTp-SP. The record keeping system in place is amenable to data extraction and linkage. A model was developed that predicts optimal compliance to two SP doses, and could be tested in other settings. Maternal malaria was infrequent and unaffected by IPTp-SP. The risk of LBW was lower during IPT implementation but the difference was non-significant and could have other explanations.

  1. Policy framework for sustainable utilisation of farmland for the Waterberg District Municipality in South Africa

    CSIR Research Space (South Africa)

    Nhemachena, C

    2011-01-01

    Full Text Available This study crafts a policy framework for sustainable utilisation of farmland for the Waterberg District Municipality in South Africa. The district, being predominantly agricultural and rural, faces contention in terms of land allocation...

  2. How do low-birthweight neonates fare 2 years after discharge from a low-technology neonatal care unit in a rural district hospital in Burundi?

    Science.gov (United States)

    van den Boogaard, W; Zuniga, I; Manzi, M; Van den Bergh, R; Lefevre, A; Nanan-N'zeth, K; Duchenne, B; Etienne, W; Juma, N; Ndelema, B; Zachariah, R; Reid, A

    2017-04-01

    As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birthweight neonates (LBW, Rural Burundi between January and December 2012. Of 146 LBW neonates, 23% could not be traced and 4% had died. Of the remaining 107 children (median age = 27 months), at least one developmental impairment was found in 27%, with 8% having at least five impairments. Main impairments included delays in motor development (17%) and in learning and speech (12%). Compared to LBW children (n = 100), very-low-birthweight (VLBW, <1500 g, n = 7) children had a significantly higher risk of impairments (intellectual - P = 0.001), needing constant supervision and creating a household burden (P = 0.009). Of all children (n-107), 18% were acutely malnourished, with a 3½ times higher risk in VLBWs (P = 0.02). Reassuringly, most children were thriving 2 years after discharge. However, malnutrition was prevalent and one in three manifested developmental impairments (particularly VLBWs) echoing the need for support programmes. A considerable proportion of children could not be traced, and this emphasises the need for follow-up systems post-discharge. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  3. Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women's perceptions in two rural districts in Uganda.

    Science.gov (United States)

    Kabagenyi, Allen; Jennings, Larissa; Reid, Alice; Nalwadda, Gorette; Ntozi, James; Atuyambe, Lynn

    2014-03-05

    Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner's use of family planning methods. This study examines men and women's perceptions regarding obstacles to men's support and uptake of modern contraceptives. A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15-54 and women aged 15-49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women's perceptions regarding barriers to men's involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Five themes were identified as rationale for men's limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman's domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women's use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men's meaningful involvement in issues related to fertility regulation. Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men's supportive

  4. Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

    Science.gov (United States)

    Coetzee, L M; Cassim, N; Glencross, D K

    2015-12-16

    The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

  5. Prevalence of Malnutrition and Relationship with Scholastic Performance among Primary and Secondary School Children in Two Select Private Schools in Bangalore Rural District (India).

    Science.gov (United States)

    Rashmi, M R; Shweta, B M; Fathima, Farah Naaz; Agrawal, Twinkle; Shah, Moulik; Sequeira, Randell

    2015-01-01

    Malnutrition is a serious problem among children in developing countries. In India; a school meal program is in place to combat malnutrition, but only in government schools. This study is an attempt to assess the prevalence of malnutrition in primary and secondary school children in private schools and to also assess the relationship between malnutrition and academic performance. All 582 students from class 1-7 from two select schools in rural Bangalore, India were included in the study. Information on age of study subjects were collected from school records. Height and weight measurements were taken. BMI was calculated. Children were clinically examined for pallor. Data on height, weight and BMI was transformed into WHO 2007 Z scores and then was categorized as -2 SD, > 2 SD. Mathematics and English scores of the previous two class tests were taken, average scores were calculated. Statistical tests used were Chi square test, Odd's ratio, Chi square for trend. A total of 582 students participated in this study. Males were 54% (315) and females were 46% (267). One hundred and fifty-nine (27%) of the children had pallor, 81 (20%) had under nutrition, 38 (7%) had stunting, 197 (34%) had thinness and 5 (1%) were found to be obese. Positive relationship was found between weight for ageZscores and English as well as Maths; Height for age Z scores with English. Hence we conclude that the prevalence of malnutrition is high among children in private schools also; and the nutritional status of the children is strongly associated with their academic performance.

  6. Prevalence of bovine tuberculosis and risk factor assessment in cattle in rural livestock areas of Govuro District in the Southeast of Mozambique.

    Directory of Open Access Journals (Sweden)

    Ivânia Moiane

    Full Text Available BACKGROUND: Bovine tuberculosis (bTB, caused by Mycobacterium bovis, is an infectious disease of cattle that also affects other domestic animals, free-ranging and farmed wildlife, and also humans. In Mozambique, scattered surveys have reported a wide variation of bTB prevalence rates in cattle from different regions. Due to direct economic repercussions on livestock and indirect consequences for human health and wildlife, knowing the prevalence rates of the disease is essential to define an effective control strategy. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted in Govuro district to determine bTB prevalence in cattle and identify associated risk factors. A representative sample of the cattle population was defined, stratified by livestock areas (n = 14. A total of 1136 cattle from 289 farmers were tested using the single comparative intradermal tuberculin test. The overall apparent prevalence was estimated at 39.6% (95% CI 36.8-42.5 using a diagnostic threshold cut-off according to the World Organization for Animal Health. bTB reactors were found in 13 livestock areas, with prevalence rates ranging from 8.1 to 65.8%. Age was the main risk factor; animals older than 4 years were more likely to be positive reactors (OR = 3.2, 95% CI: 2.2-4.7. Landim local breed showed a lower prevalence than crossbred animals (Landim × Brahman (OR = 0.6, 95% CI: 0.4-0.8. CONCLUSIONS/SIGNIFICANCE: The findings reveal an urgent need for intervention with effective, area-based, control measures in order to reduce bTB prevalence and prevent its spread to the human population. In addition to the high prevalence, population habits in Govuro, particularly the consumption of raw milk, clearly may potentiate the transmission to humans. Thus, further studies on human tuberculosis and the molecular characterization of the predominant strain lineages that cause bTB in cattle and humans are urgently required to evaluate the impact on human health in

  7. Study on Sand Flies as a Vector(s of Cutaneous Leishmaniasis by Nested PCR in Rural Areas of Damghan District, Semnan Province

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    Y. Rasi

    2012-01-01

    Full Text Available Introduction & Objective: Cutaneous Leishmaniasis is caused by obligatory intracellular parasite of genus Lieshmania. The disease is reported from more than half of Iran's provinces. Various species of sand flies are vector of the disease. Determination of vectors and gaining knowledge about them are important for devising of control program. Materials & Methods: This survey was performed as a cross-sectional study in order to determine the vector(s of cutaneous leishmaniasis in Damghan district during 2008-2009. Sand flies were collected from indoors and outdoors by sticky traps twice in month from April to November. Head and last abdominal segments of the samples were removed and mounted in a drop of Puri’s medium and identified. The rest of the sand flies' bodies was subjected to DNA extraction for molecular detection of Leishmania parasite by Nested PCR using specific primers of minicircle kinetoplast DNAResults: Totally, 6110 sand flies in 8 species were collected. P. papatasi had high density (46.7%. Examination of 280 female sand flies by Nested PCR showed that 28 sand flies (10%include 24 specimens P.papatasi (85.7% and 4 specimens P.caucasicus(14.3%were found naturally infected with L.major. The highest rate of infected sandflies were observed in rodents burrow (42.9%. Maximum rate of sand fly infection was in September (89.3%. Conclusion: With respect to high density of P.papatasi and isolation of L.major from it, this species was the main vector of the disease. Detection of L.major from P.caucasicus shows that this species was the secondary vector in rodent burrow. The highest rate of sand leis infected was in September, so personal protection in this month is very important and necessary. Regarding to the high density of vectors and high infection rate of them taking actions to decrease the sand fly abundance and prevention of human biting are suggested.(Sci J Hamadan Univ Med Sci 2012;18(4:47-52

  8. Indoor air quality due to secondhand smoke: Signals from selected hospitality locations in rural and urban areas of Bangalore and Dharwad districts in Karnataka, India.

    Science.gov (United States)

    Travers, Mark J; Nayak, Nayanatara S; Annigeri, Vinod B; Billava, N Narayan

    2015-01-01

    Tobacco smoke has compounds that are known as human carcinogens. With every breath of secondhand smoke we inhale thousands of chemicals. The Government of India in the interest of public health has enacted the Cigarette and Other Tobacco Products Act (COTPA), 2003, which bans smoking in all the public places including hotels and restaurants. The purpose of this study was to observe and record air pollution in smoke free and smoke observed locations and thereby find out whether the owners/managers of hotels, restaurants, and bars comply with rules of COTPA. The objectives of the study were to measure and compare the level of particulate air pollution from secondhand smoke (PM2.5) in smoking and nonsmoking venues. The study was conducted from September 2009 to March 2010 in Karnataka, India following a nonrandom sample of 79 locations, which included restaurants, bars, cafes, hotels, and tea stalls in two districts. The concentration of PM2.5 was measured using a TSI SidePak AM510 Personal Aerosol Monitor. In Karnataka out of the 79 hospitality locations, smoking was observed in 58% places and only 28% had displayed the required "No Smoking" signage. Places where indoor smoking was observed had high levels of air pollution with average 135 PM2.5, which were 3.1 times higher than the average 43 PM2.5 in smoke-free locations and 14 times higher than the World Health Organization (WHO) target air quality guideline for PM2.5. The average PM2.5 levels in different locations ranged from 11 to 417 μg/m(3) and was lower in the case of apparently compliant designated smoking area (DSR). The patrons and the workers in the hospitality sector continue to be exposed to secondhand smoke despite the enactment of COTPA, which bans smoking in public places. This situation demands stringent measures for effective implementation of the Smoke Free Act and negative response to smoking among civil society.

  9. Discussing implications of fast depleting rural ponds on the globally threatened wetland winter migratory bird in Haryana: a Case Study of Nigdu village pond in Karnal District

    Directory of Open Access Journals (Sweden)

    Rohtash Chand Gupta

    2013-05-01

    Full Text Available The Nigdu-Sarovar is located in Nilokheri block in Karnal district in Haryana (29°50′N 76°55′E. The duration of observations span over seven years (September, 2005 to March, 2012. The recording of wetland winter visitor birds during 2005-08 in winter season included atleast 58 species of birds belonging to 10 orders and 18 families. It is important to mention that 29 species of wetland birds were winter migratory, 17 residents, 9 local migratory and three species of wetland birds like Lesser-whistling Duck Dendrocygna javanica, Pheasant-tailed Jacana Hydrophasianus chirurgus and Blue-cheeked Bee-eater Merops persicus were summer migratory. The special features of 2005-06 winter was the huge populations of birds like Northern Shoveller Anas clypeata, Northern Pintail Anas acuta, Common Teal Anas crecca, Spot-billed Duck Anas poecilorhynchus, Common Pochard Aythya ferina, Bar-headed Goose Anser indicus, Greylag Goose Anser anser, Gadwall Anas strepera, Great Cormorant Phalacrocorax carbo, Mallard Anas platyrhynchos and Common Redshank Tringa totanus etc.In successive years, the scenario was more or less a substantial one depicting stability with respect to diversity of birds, number of birds upto the year of 2008. The popular birds included Painted Stork Mycteria leucocephala, Openbill Stork Anastomus oscitans, White-necked Stork Ciconia episcopus, Black-necked Stork Ephippiorhynchus asiaticus, Eurasian Spoonbill Platalea leucorodia, Spotted Greenshank Tringa guttifer and Kentish Plover Charadrius alexandrines. The sharp decline in winter migratory birds at “Nigdu-Sarovar” started in the year of 2008 when the pond was leased out for FISH-FARMING as per the policies of Govt. of Haryana. Fish Farming based deepening of the pond by excavation of bottom resulting in total decimation of rooted, floating, submerged and ejecting plants along with its subsidiary fauna, Zooplanktons, phytoplankton etc. The age old structural regime of the pond

  10. "Once the government employs you, it forgets you": Health workers' and managers' perspectives on factors influencing working conditions for provision of maternal health care services in a rural district of Tanzania.

    Science.gov (United States)

    Mkoka, Dickson Ally; Mahiti, Gladys Reuben; Kiwara, Angwara; Mwangu, Mughwira; Goicolea, Isabel; Hurtig, Anna-Karin

    2015-09-14

    In many developing countries, health workforce crisis is one of the predominant challenges affecting the health care systems' function of providing quality services, including maternal care. The challenge is related to how these countries establish conducive working conditions that attract and retain health workers into the health care sector and enable them to perform effectively and efficiently to improve health services particularly in rural settings. This study explored the perspectives of health workers and managers on factors influencing working conditions for providing maternal health care services in rural Tanzania. The researchers took a broad approach to understand the status of the current working conditions through a governance lens and brought into context the role of government and its decentralized organs in handling health workers in order to improve their performance and retention. In-depth interviews were conducted with 22 informants (15 health workers, 5 members of Council Health Management Team and 2 informants from the District Executive Director's office). An interview guide was used with questions pertaining to informants' perspective on provision of maternal health care service, working environment, living conditions, handling of staff's financial claims, avenue for sharing concerns, opportunities for training and career progression. Probing questions on how these issues affect the health workers' role of providing maternal health care were employed. Document reviews and observations of health facilities were conducted to supplement the data. The interviews were analysed using a qualitative content analysis approach. Overall, health workers felt abandoned and lost within an unsupportive system they serve. Difficult working and living environments that affect health workers' role of providing maternal health care services were dominant concerns raised from interviews with both health workers and managers. Existence of a bureaucratic and

  11. Comparative evaluation of energy-related aspects in urban and in rural districts - Case study in the Canton of Neuchatel, Switzerland; Analyse comparative des aspects energetiques de quartiers urbains et ruraux. Etude de cas dans le canton de Neuchatel. Rapport final

    Energy Technology Data Exchange (ETDEWEB)

    Perret, L.; Vuilleumier, R.; Bonhote, P. [Planair SA, La Sagne (Switzerland); Rey, E. [Bauart Architectes et Urbanistes SA, Neuchatel (Switzerland)

    2007-07-01

    The project aims at identifying the energy impact of various current ways of regional planning through a case study of eight districts in the canton of Neuchatel. The districts reveal the trends of planning in an urban centre, and in incorporated (suburb) or unincorporated territory. Thus, the influence of the distance to the centre of the agglomeration named 'centrality' has been studied. The energy expenditure for the buildings' construction phase (buildings, roads, networks) and utilization phase (heating, electricity, water, waste, networks) has been taken into account as well as the mobility. The energy investments have been evaluated by the method SNARC. The energy expenditure for operation and mobility has been evaluated based on questionnaires addressed to the inhabitants. As a result, the variable 'centrality' has only a weak role on the life cycle analysis (LCA) per inhabitant. In our case, the LCA for incorporated districts (suburb) and unincorporated districts are similar. With a LCA per square meter, the impact is completely similar and no correlation with the variable 'centrality' has been noticed. As the households are larger per inhabitants when the district is located in a suburban zone, the LCA per square meter remains stable. On the contrary, if the LCA is determined per household, the LCA is perfectly correlated with the variable 'centrality'. Thus, a household in the centre of Neuchatel consumes twice less energy resources than a household in Val-of-Ruz (rural area). The study highlights also the critical impacts of a LCA on a district scale. Finally, this study gives recommendations based on the energy and demographic prospects in order to respond to the objective of a 2000 watts society. (author)

  12. Promoting, Guiding, and Surviving Change in School Districts.

    Science.gov (United States)

    Deal, Terrence E.; Nutt, Samuel C.

    Compiled for school administrators who must initiate or respond to external mandate for change, this guide draws on the experiences of 10 rural school districts that participated in the federally funded Experimental Schools (ES) program for perspectives that can be used in the successful management of change efforts in school districts. Organized…

  13. Rural district of Harz tests electricity supply of the future. Exploiting potential of renewable energies with virtual power plants, load management and electronic market platforms; Landkreis Harz erprobt Stromversorgung der Zukunft. Mit virtuellem Kraftwerk, Lastmanagement und elektronischer Marktplattform erneuerbare Potenziale ausschoepfen

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, Uwe

    2012-07-01

    Regions with a large proportion of renewable energies offer particularly good prerequisites for testing out future decentralised supply systems. In the rural district of Harz, one of six model regions in the German government's E-Energy programme, more than 20 partners from various sectors of the electricity industry have developed technologies and business models for smart grids. Four municipal utility companies and two distribution network operators were involved in their implementation. The four-year RegModHarz research project, which is funded by the German Federal Ministry for the Environment, will be completed at the beginning of 2013. (orig.)

  14. Managing Ebola from rural to urban slum settings: experiences from ...

    African Journals Online (AJOL)

    The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas. Methods: Detailed records of the outbreak presentation, cases, and outcomes were reviewed and analyzed. Each outbreak ...

  15. Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh.

    Science.gov (United States)

    Mukherjee, Saradiya; Singh, Aditya

    2018-02-05

    One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, i.e. , all direct and indirect expenditure. The study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households' maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern. Results revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households

  16. Interactive Instructional Television: Education for Rural Areas.

    Science.gov (United States)

    Anagal, Judy; And Others

    The Rural Special Education Project is a federally funded partnership between Kayenta Unified School District and Northern Arizona University's (NAU) Center for Excellence in Education that aims to prepare well qualified special education teachers to work in rural and reservation schools. The participants are Native American residents working…

  17. Coconut processing technologies for rural transformation – Case study on coconut water vinegar

    OpenAIRE

    6. Seeja Thomachan, Deepu Mathew and Habeeburrahman P. V.

    2010-01-01

    The role of coconut based technologies in social development of rural India is described based on the influence of coconut vinegar technology in the rural women of Malappuram district, Kerala state, India

  18. District heating

    International Nuclear Information System (INIS)

    Hansen, L.

    1993-01-01

    The environmental risks and uncertainties of a high-energy future are disturbing and give rise to several reservations concerning the use of fossil fuels. A number of technologies will help to reduce atmospheric pollution. In Denmark special importance is attached to the following: Energy conservation. Efficient energy conversion. Renewable energy sources. District heating, combined production of heat and power. Many agree that district heating (DH), produced by the traditional heat-only plant, and combined heat and power (CHP) have enormous potential when considering thermal efficiency and lowered environmental impacts: The basic technology of each is proven, it would be relatively simple to satisfy a substantial part of the energy demand, and their high efficiencies mean reduced pollution including greenhouse gas emissions. This is especially important in high population density areas - the obviously preferred sites for such energy generation. Compared with individual heating DH can provide a community with an operationally efficient and most often also an economically competitive heat supply. This is particularly true under the circumstances where the DH system is supplied from CHP plants. Their use results in very substantial improvements in overall efficiency. Further environmental improvements arise from the reduced air pollution obtainable in reasonably large CHP plants equipped with flue gas cleaning to remove particles, sulphur dioxide, and nitrogen acids. As a consequence of these considerations, DH plays an important role in fulfilling the space and water heating demand in many countries. This is especially the case in Denmark where this technology is utilised to a very great extent. Indeed, DH is one of the reasons why Denmark has relatively good air quality in the cities. (au)

  19. Rural Alaska Mentoring Project (RAMP)

    Science.gov (United States)

    Cash, Terry

    2011-01-01

    For over two years the National Dropout Prevention Center (NDPC) at Clemson University has been supporting the Lower Kuskokwim School District (LKSD) in NW Alaska with their efforts to reduce high school dropout in 23 remote Yup'ik Eskimo villages. The Rural Alaska Mentoring Project (RAMP) provides school-based E-mentoring services to 164…

  20. 7 CFR 1900.3 - State, district, and county office employees.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false State, district, and county office employees. 1900.3 Section 1900.3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

  1. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh

    Science.gov (United States)

    Iqbal, Afrin; Hoque, D. M. Emdadul; Moinuddin, Md.; Zaman, Sojib Bin; Rahman, Qazi Sadeq-ur; Begum, Tahmina; Chowdhury, Atique Iqbal; Haider, Rafiqul; Arifeen, Shams El; Kissoon, Niranjan; Larson, Charles P.

    2017-01-01

    Introduction Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled ‘Interrupting Pathways to Sepsis Initiative’ (IPSI) introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics. Materials and Method Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite ‘Program Coaches’, facilitating triage and rapid transfer of patients through ‘Welcoming Persons’ and enabling rapid treatment through ‘Task Shifting’ from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department. Results From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of

  2. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh.

    Directory of Open Access Journals (Sweden)

    Ahmed Ehsanur Rahman

    Full Text Available Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled 'Interrupting Pathways to Sepsis Initiative' (IPSI introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics.Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite 'Program Coaches', facilitating triage and rapid transfer of patients through 'Welcoming Persons' and enabling rapid treatment through 'Task Shifting' from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department.From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of which 82% were admitted. More neonates (30

  3. Differences in Food and Beverage Marketing Policies and Practices in US School Districts, by Demographic Characteristics of School Districts, 2012

    Science.gov (United States)

    Michael, Shannon; Brener, Nancy D.; Coffield, Edward; Kingsley, Beverly S.; Zytnick, Deena; Blanck, Heidi

    2016-01-01

    Introduction Foods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students’ exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics. Methods We analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students. Results Most practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. Conclusion Preliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement. PMID:27978408

  4. Differences in Food and Beverage Marketing Policies and Practices in US School Districts, by Demographic Characteristics of School Districts, 2012.

    Science.gov (United States)

    Merlo, Caitlin L; Michael, Shannon; Brener, Nancy D; Coffield, Edward; Kingsley, Beverly S; Zytnick, Deena; Blanck, Heidi

    2016-12-15

    Foods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students' exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics. We analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students. Most practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. Preliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement.

  5. Rural Airports

    Data.gov (United States)

    Department of Transportation — The Rural Airports database is the list of rural airports compiled annually by BTS for the Treasury Department/IRS. It is used by airlines to assist in establishing...

  6. STROKE IN RURAL SOUTH AFRICA - CONTRIBUTING TO THE ...

    African Journals Online (AJOL)

    cerebrovascular accident (CVA) in a rural South African population. Design. ... part of a community-based prospective study examining the burden of disease, in ... to support district health development. .... Community-based work looking at ...

  7. Private Water Districts

    Data.gov (United States)

    California Natural Resource Agency — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...

  8. Lieutenant Chief Warden Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — This dataset is a representation overlay of Lieutenant Chief Warden Districts (areas of responsibility). The Vermont Lieutenant Chief Warden Districts layer is part...

  9. District heating in Switzerland

    International Nuclear Information System (INIS)

    Herzog, F.

    1991-01-01

    District heating has been used in Switzerland for more than 50 years. Its share of the heat market is less than 3% today. An analysis of the use of district heating in various European countries shows that a high share of district heating in the heat market is always dependent on ideal conditions for its use. Market prospects and possible future developments in the use of district heating in Switzerland are described in this paper. The main Swiss producers and distributors of district heating are members of the Association of District Heating Producers and Distributors. This association supports the installation of district heating facilities where ecological, energetical and economic aspects indicate that district heating would be a good solution. (author) 2 tabs., 6 refs

  10. California Political Districts

    Data.gov (United States)

    California Natural Resource Agency — This is a series of district layers pertaining to California'spolitical districts, that are derived from the California State Senateand State Assembly information....

  11. State Water Districts

    Data.gov (United States)

    California Natural Resource Agency — State Water Project District boundaries are areas where state contracts provide water to the district in California. This database is designed as a regions polygon...

  12. National Register Historic Districts

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — The National Register Historic District layer is a shape file showing the boundaries of Historic Districts that are listed on the National Register of Historic Places.

  13. Zero Energy Districts

    Energy Technology Data Exchange (ETDEWEB)

    Polly, Benjamin J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-05-04

    This presentation shows how NREL is approaching Zero Energy Districts, including key opportunities, design strategies, and master planning concepts. The presentation also covers URBANopt, an advanced analytical platform for district that is being developed by NREL.

  14. District nurse training

    OpenAIRE

    Elliott, Arnold; Freeling, Paul; Owen, John

    1980-01-01

    Training for district nursing is being reviewed. By 1981 district nurses will have a new administrative structure, a new curriculum, and a new examination. Training for nursing, like that for general practice, is to become mandatory. The history of the development of district nurse training is briefly described.

  15. District nursing in Dominica

    NARCIS (Netherlands)

    Kolkman, PME; Luteijn, AJ; Nasiiro, RS; Bruney, [No Value; Smith, RJA; Meyboom-de Jong, B

    1998-01-01

    District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the

  16. Instructional Technology for Rural Schools: Access and Acquisition

    Science.gov (United States)

    Sundeen, Todd H.; Sundeen, Darrelanne M.

    2013-01-01

    Integrating instructional technology into all classrooms has the potential to transform modern education and student learning. However, access to technology is not equally available to all districts or schools. Decreased funding and budgetary restraints have had a direct impact on technology acquisition in many rural school districts. One of the…

  17. Provision of Information to Rural Communities in Bama Local ...

    African Journals Online (AJOL)

    Provision of Information to Rural Communities in Bama Local Government Area of Borno State, Nigeria. Y Aliyu, E Camble ... findings of the study showed that rural people in the Soye district have identifiable information needs mainly in the areas of agriculture, health, government programmes and small scale industries.

  18. Delivering Online Professional Development in Mathematics to Rural Educators

    Science.gov (United States)

    Cady, Jo; Rearden, Kristin

    2009-01-01

    Rural school districts struggle to attract, retain, and support highly qualified mathematics teachers. A series of four online professional development courses in the form of integrated mathematics content and pedagogy courses was designed to meet the professional development needs of rural middle school mathematics teachers. Changes in teachers'…

  19. The Role of Rural Communities in the Postsecondary Preparation of Low-Income Students

    Science.gov (United States)

    Alleman, Nathan F.; Holly, L. Neal

    2014-01-01

    In the past decade, rural education has been critiqued for contributing to brain drain and social stratification that saps the human, social, and economic resources of rural communities. This article, based on an investigation of six small rural school districts in the same state, offers an alternative view of the role of community groups and…

  20. A Curriculum Infusion Approach to Preservice Rural Teacher Preparation: Strategies and Resources.

    Science.gov (United States)

    Sarachan-Deily, Ann Beth; And Others

    Collaborative strategies were used by The College of Saint Rose (CSR) and 15 rural school districts in upstate New York to implement preservice teacher training and programming to better meet the needs of handicapped learners in rural settings. Through meetings and questionnaires, rural administrative teams identified relevant skills and issues…

  1. Building Special Education Teacher Capacity in Rural Schools: Impact of a Grow Your Own Program

    Science.gov (United States)

    Sutton, Joe P.; Bausmith, Shirley C.; O'Connor, Dava M.; Pae, Holly A.; Payne, John R.

    2014-01-01

    Rural education has a legacy of unique challenges, with highest priority needs in the South. Chief among these challenges are the conditions of poverty associated with many rural districts and the education of students with disabilities. Compared with their urban and suburban counterparts, rural teachers experience higher rates of turnover, and…

  2. Trees in the small city retail business district: comparing resident and visitor perceptions

    Science.gov (United States)

    Kathleen L. Wolf

    2005-01-01

    Many small cities and towns are located near resource lands, and their central business districts serve both residents and visitors. Such quasi-rural retail centers face competitive challenges from regional shopping malls, online purchasing, and big box discount retailers. District merchants must strategically enhance their market...

  3. A study of prevalence of sexually transmitted infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district, Mahrashtra , India

    Directory of Open Access Journals (Sweden)

    Parmar Mehul Tribhovandas

    2013-07-01

    Full Text Available Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial & response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC, District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Community based interventional study, conducted among representative group of 415 women of reproductive age groups, by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Statistical Analysis Z-test Results Of the surveyed women (415, prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4% followed by Burning Micturition (24.7%, Vulval itching (17.3%, Lower abdominal pain (13% & Genital ulcer (8.6%. Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion: Syndromic Rx & health education can definitely reduce STIs.

  4. A study of prevalence of Sexually Transmitted Infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district

    Directory of Open Access Journals (Sweden)

    Vibha V. Gosalia

    2013-05-01

    Full Text Available Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial& response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC, District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Present Community based interventional study was conducted among representative group of 415 women of reproductive age groups who were selected by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs was significantly reduced. Statistical Analysis Z test Results Of the surveyed women (415, prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4% followed by Burning Micturition (24.7%, Vulval itching (17.3%, Lower abdominal pain (13% & Genital ulcer (8.6%. Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion Syndromic Rx & health education can definitely reduce STIs.

  5. A study of prevalence of sexually transmitted infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district, Mahrashtra , India

    Directory of Open Access Journals (Sweden)

    Parmar Mehul Tribhovandas

    2013-01-01

    Full Text Available Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial & response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC, District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Communitybasedinterventionalstudy,conductedamongrepresentativegroupof415womenof reproductive age groups, by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs has statistically significantly reduced Statistical Analysis Z-test Results Of the surveyed women (415, prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4% followed by Burning Micturition (24.7%, Vulval itching (17.3%, Lower abdominal pain (13% & Genital ulcer (8.6%. Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion: Syndromic Rx & health education can definitely reduce STIs.

  6. Perceptions of Crisis Management in a K-12 School District

    Science.gov (United States)

    Tucker, Joy

    2012-01-01

    This multiple-case qualitative study was conducted to examine the perceptions of community members, students, and staff regarding school crisis management following a 2006 tornado and 2010 bus accident in a small rural school district in Missouri. Online surveys were collected from 66 participants, and 10 follow-up interviews were completed with…

  7. Farming systems and food security in Kwale District, Kenya

    NARCIS (Netherlands)

    Oosten, van C.

    1989-01-01

    This study examines agricultural production and off-farm employment among the rural population in Kwale District Kenya. Research was carried out in two villages, located in different agro-ecological zones: Kibandaongo, in the low-potential livestock-millet zone, inhabited by the Duruma; and Bongwe,

  8. District heating in Italy

    International Nuclear Information System (INIS)

    Sacchi, E.

    1998-01-01

    The legislative act establishing the electric monopoly virtually shut out the district heating associated with electricity cogeneration, while other laws, issued to counteract the effects of oil shocks, allowed municipal utilities to do so. Thus, district heating has experienced some development, though well below its possibilities. The article analyses the reasons for this lagging, reports district heating data and projects its forecasts against the Kyoto Protocol objectives [it

  9. Tourism potential value assessment model for rural-mountain and boundary contact areas. Case study: Cluj County, the district of Ciceu and the balneal area of Bacău County (Romania

    Directory of Open Access Journals (Sweden)

    Bianca Sorina RĂCĂŞAN

    2016-11-01

    Full Text Available This paper aimed to develop a specific assessment method focused on the tourism potential of the rural-mountain and boundary contact areas. Once elaborated, the model was employed within three appropriate territories of Cluj, Bistrița and Bacău counties (Romania, who’s investigated administrative units, were repeatedly ranked into hierarchical order according to the different tourist categories, invested with numerical values. In order to reach its goals, several objectives were assigned, from awarding the components of the primary and secondary tourism supply certain scores, proposing scales and calculating values, to comparing the results and identifying best rated tourism potential categories, units and areas. With respect to the research methodology, the most commonly used methods dealt with observation, analysis and synthesis along with comparison, cartographical, statistical and mathematical techniques. Therefore, main results regarded both proposal and testing the evaluation model, highlighting values and ranging territorial units in concordance with the tourist attractiveness power.

  10. [Impact of rural land market on farm household's behavior of soil & water conservation and its regional difference: A case study of Xingguo, Shangrao, and Yujiang County in Jiangxi province ecologically vulnerable districts].

    Science.gov (United States)

    Zhong, Tai-Yang; Huang, Xian-jin

    2006-02-01

    The paper analyzed the farm households' decision-making progress of soil & water conservation and its two-stage conceptual model. It also discussed the impacts of rural land market on the farm households' behavior of soil & water conservation. Given that, the article established models for the relations between the land market and soil & water conservation, and the models' parameters were estimated with Heckman's two-stage approach by using the farm household questionnaires in Xingguo, Shangrao and Yujiang counties of Jiangxi province. The paper analyzed the impact o f rural land market on farm household's behavior of soil & water conservation and its regional difference with the result of model estimation. The results show that the perception of soil & water loss and the tax & fee on the farm land have significant influence upon the soil and water conservation from the view of the population; however, because of different social and economic condition, and soil & water loss, there are differences of the influence among the three sample counties. These differences go as follows in detail: In Xingguo County, the rent-in land area and its cost have remarkable effect on the farm households' soil & water conservation behavior; In Yujiang County, the rent-in land area, rent-in cost and rent-out land area remarkably influence the farm households' behavior of soil and water conservation, with the influence of the rent-in land area being greater than Xingguo County; In Shangrao County, only rent-out land area has significant influence on the behaviors of soil & water conservation; In all samples, Xingguo County and Yujiang County samples, the rent-out income has no significant influence on the farm household's decision-making behavior soil and water conservation. Finally, the paper put forward some suggestions on how to bring the soil & water loss under control and use land resource in sustainable ways.

  11. Nankana West District of Ghana

    African Journals Online (AJOL)

    Agribotix GCS 077

    Local governments in Ghana play very important roles with actors in the ... Metropolitan, Municipal and District Chief Executives (MMDCEs), the .... District Budget Officer, District Finance Officer, Presiding Member, members of the Works Sub-.

  12. Rural Aging

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... Transportation to medical appointments, grocery shopping, and other essential and leisure activities Housing quality and affordability, including ...

  13. Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania.

    Science.gov (United States)

    Ishengoma, Deus S; Kamugisha, Mathias L; Rutta, Acleus S M; Kagaruki, Gibson B; Kilale, Andrew M; Kahwa, Amos; Kamugisha, Erasmus; Baraka, Vito; Mandara, Celine I; Materu, Godlisten S; Massaga, Julius J; Magesa, Stephen M; Lemnge, Martha M; Mboera, Leonard E G

    2017-01-23

    Roll-out and implementation of antiretroviral therapy (ART) necessitated many countries in Sub-Saharan Africa to strengthen their national health laboratory systems (NHLSs) to provide high quality HIV diagnostic and supportive services. This study was conducted to assess the performance of health laboratories in provision of HIV diagnostic and supportive services in eight districts (from four regions of Iringa, Mtwara, Tabora and Tanga), after nine years of implementation of HIV/AIDS care and treatment plan in Tanzania. In this cross-sectional study, checklists and observations were utilized to collect information from health facilities (HFs) with care and treatment centres (CTCs) for HIV/AIDS patients; on availability of laboratories, CTCs, laboratory personnel, equipment and reagents. A checklist was also used to collect information on implementation of quality assurance (QA) systems at all levels of the NHLS in the study areas. The four regions had 354 HFs (13 hospitals, 41 Health Centres (HCs) and 300 dispensaries); whereby all hospitals had laboratories and 11 had CTCs while 97.5 and 61.0% of HCs had both laboratories and CTCs, respectively. Of the dispensaries, 36.0 and 15.0% had laboratories and CTCs (mainly in urban areas). Thirty nine HFs (12 hospitals, 21 HCs and six dispensaries) were assessed and 56.4% were located in urban areas. The assessed HFs had 199 laboratory staff of different cadres (laboratory assistants = 35.7%; technicians =32.7%; attendants = 22.6%; and others = 9.1%); with >61% of the staff and 72.3% of the technicians working in urban areas. All laboratories were using rapid diagnostic tests for HIV testing. Over 74% of the laboratories were performing internal quality control and 51.4% were participating in external QA programmes. Regional and district laboratories had all key equipment and harmonization was maintained for Fluorescence-Activated Cell Sorting (FACS) machines. Most of the biochemical (58.0%) and haematological

  14. Early loss to follow-up of recently diagnosed HIV-infected adults from routine pre-ART care in a rural district hospital in Kenya: a cohort study.

    Science.gov (United States)

    Hassan, Amin S; Fielding, Katherine L; Thuo, Nahashon M; Nabwera, Helen M; Sanders, Eduard J; Berkley, James A

    2012-01-01

    To determine the rate and predictors of early loss to follow-up (LTFU) for recently diagnosed HIV-infected, antiretroviral therapy (ART)-ineligible adults in rural Kenya. Prospective cohort study. Clients registering for HIV care between July 2008 and August 2009 were followed up for 6 months. Baseline data were used to assess predictors of pre-ART LTFU (not returning for care within 2 months of a scheduled appointment), LTFU before the second visit and LTFU after the second visit. Logistic regression was used to determine factors associated with LTFU before the second visit, while Cox regression was used to assess predictors of time to LTFU and LTFU after the second visit. Of 530 eligible clients, 178 (33.6%) were LTFU from pre-ART care (11.1/100 person-months). Of these, 96 (53.9%) were LTFU before the second visit. Distance (>5 km vs. ART LTFU. Distance and marital status were independently associated with LTFU before the second visit, while distance, education status and seasonality showed weak evidence of predicting LTFU after the second visit. HIV disease severity did not predict pre-ART LTFU. A third of recently diagnosed HIV-infected, ART-ineligible clients were LTFU within 6 months of registration. Predictors of LTFU among ART-ineligible clients are different from those among clients on ART. These findings warrant consideration of an enhanced pre-ART care package aimed at improving retention and timely ART initiation. © 2011 Blackwell Publishing Ltd.

  15. Improving Tanzanian childbirth service quality.

    Science.gov (United States)

    Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

    2018-04-16

    Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

  16. Planning for rural energy system: Part 2

    International Nuclear Information System (INIS)

    Devadas, V.

    2001-01-01

    This paper discusses the central importance of energy inputs in development, and presents the complex interactions within subsystems that contribute a Rural Energy System. This paper also brings about the importance of the primary data for realistic renewable energy planning at the micro level in a given rural system. Factors that render secondary data somewhat inadequate for such applications are discussed. The differences between energy related data from secondary and primary sources in respect of representative villages in Kanyakumari District of Tamil Nadu, India, are detailed. A rural system model for computing the output from various components of a rural system is also presented. This projection is made by making use of a set of technical coefficients, which relate the inputs to the outputs from individual segments of the rural production system. While some of the technical coefficients are developed based on previously published data, a large number have been quantified on the basis of careful survey. The usefulness of the model is discussed. The paper also presents a Linear Programming Model for optimum resource allocation in a rural system. The objective function of the Linear Programming Model is maximizing the revenue of the rural system where in optimum resource allocation is made subject to a number of energy and non-energy related relevant constraints. The model also quantifies the major yields as well as the byproducts of different sectors of the rural economic system. (Author)

  17. Evaluación de la sustentabilidad de la actividad agrícola de tres localidades campesinas en Pahuatlán, Puebla / Sustainability assessment of the agricultural activity of three rural districts in Pahuatlán, Puebla

    Directory of Open Access Journals (Sweden)

    Rosalía Castelán Vega

    2014-08-01

    Full Text Available A pesar del consenso mundial para lograr la sustentabilidad aún no existe un acuerdo en la forma de cuantificarla para tomar decisiones prácticas que encaucen el desarrollo sustentable. En el caso de su evaluación en agroecosistemas se requiere transformar aspectos complejos en otros más claros, que permitan detectar tendencias a nivel de sistema, denominados índices. En la presente investigación se evaluó la sustentabilidad en los agroecosistemas de tres localidades del municipio de Pahuatlán, Puebla, mediante la estimación del índice de desarrollo sustentable (s3. Se realizó un estudio descriptivo longitudinal de campo del año 2009 al 2012, sobre una población total conformada por 506 agroecosistemas ubicados en las localidades de San Pablito, Xilepa y Tlalcruz, pertenecientes al municipio de Pahuatlán, Puebla. De esta población total se tomó una muestra estratificada de 288 agroecosistemas y a sus productores, a quienes se les aplicó un cuestionario socioeconómico estructurado para medir las tres dimensiones del Desarrollo Sustentable (ambiental, económica y social. Los resultados obtenidos demostraron que Xilepa y Tlalcruz se encuentran en un nivel crítico de sustentabilidad al presentar valores de 0.34 y 0.40, respectivamente, y San Pablito con un nivel inestable de 0.52. La dimensión ambiental presentó la mayor limitación para la sustentabilidad de estas localidades. Estos resultados indican que es necesario diseñar y ejecutar planes y programas de desarrollo rural, que permitan promover y mejorar la sustentabilidad de estas localidades para asegurar su permanencia en el tiempo e incrementar su calidad de vida.

  18. Solid Waste Management Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The Solid waste management districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This dataset...

  19. District nursing is vital.

    Science.gov (United States)

    Bliss, Julie

    2016-08-03

    Queen's Nursing Institute chief executive Crystal Oldman has welcomed the RCN congress resolution urging RCN council to lobby for all district nurses to have a specialist practice qualification. This provides the ideal route for future talent and must be supported.

  20. Floodplain District Permit

    Data.gov (United States)

    Montgomery County of Maryland — The purpose of a Floodplain District Permit (FPDP) is to control floodplain development in order to protect persons and property from danger and destruction and to...

  1. 115th Congressional Districts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This layer depicts the 115th Congressional Districts for the United States, with attributes listing the elected officials for the 115th Congress. Elected to a...

  2. Allegheny County Council Districts

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset portrays the boundaries of the County Council Districts in Allegheny County. The dataset is based on municipal boundaries and City of Pittsburgh ward...

  3. ACT250 Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The ACT 250 Districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...

  4. NM Property Tax Districts

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...

  5. NM School District Boundaries

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The dataset represents the boundaries of all public school districts in the state of New Mexico. The source for the data layer is the New Mexico Public Education...

  6. Groundwater Managment Districts

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset outlines the location of the five Groundwater Management Districts in Kansas. GMDs are locally formed and elected boards for regional groundwater...

  7. [The gene pool of the Belgorod oblast population: changes in the endogamy indices of district populations with time].

    Science.gov (United States)

    Churnosov, M I; Sorokina, I N; Balanovskaia, E V

    2008-08-01

    Changes in the endogamy indices of district populations of the Central Chernozem region of Russia during the past 100 years were studied. The size of an elementary population in this region increased from that of a rural municipality in the mid-20th century to that of an administrative district in the late 20th century.

  8. Environmental resources reduce income inequality and the prevalence, depth and severity of poverty in rural Nepal

    DEFF Research Database (Denmark)

    Chhetri, Bir Bahadur Khanal; Larsen, Helle Overgaard; Smith-Hall, Carsten

    2015-01-01

    This paper investigates the economic importance of environmental income to rural households in Nepal and how environmental income influences poverty and inequality measures. Qualitative contextual information was collected from two village development committees in middle Gorkha District followed...

  9. Impact of maize storage on rural household food security in Northern ...

    African Journals Online (AJOL)

    Seugnet

    security in Northern Kwazulu-Natal1 ... incidence of hunger is high among rural South African .... FARMERS IN THREE STUDY DISTRICTS OF NORTHERN KWAZULU-NATAL, 1999 (N = 134) ... Three goats equaled one head of cattle. Calves ...

  10. Rural Households

    DEFF Research Database (Denmark)

    Bruun, Ole

    2013-01-01

    dependency on state institutions under the Vietnamese transition to a market society. It discusses present poverty definitions and measures by comparing survey data with the formal economic categorization of rural households. Both the overall characteristics of rural society and qualitative data indicate...... that the reforms have set in motion a process by which a mix of new opportunities and increasing pressures creates new winners and losers. Second, the chapter draws attention to the nature of interactions between households, local communities and the Vietnamese state. This shows both potentials and limitations...

  11. What variables should be considered in allocating Primary health care Pharmaceutical budgets to districts in Uganda?

    Science.gov (United States)

    Mujasi, Paschal N; Puig-Junoy, Jaume

    2015-01-01

    A key policy question for the government of Uganda is how to equitably allocate primary health care pharmaceutical budgets to districts. This paper seeks to identify variables influencing current primary health care pharmaceutical expenditure and their usefulness in allocating prospective pharmaceutical budgets to districts. This was a cross sectional, retrospective observational study using secondary administrative data. We collected data on the value of pharmaceuticals procured by primary health care facilities in each district from National Medical Stores for the financial year 2011/2012. The dependent variable was expressed as per capita district pharmaceutical expenditure. By reviewing literature we identified 26 potential explanatory variables. They include supply, need and demand, and health system organization variables that may influence the demand and supply of health services and the corresponding pharmaceutical expenditure. We collected secondary data for these variables for all the districts in Uganda (n = 112). We performed econometric analysis to estimate parameters of various regression models. There is a significant correlation between per capita district pharmaceutical expenditure and total district population, rural poverty, access to drinking water and outpatient department (OPD) per capita utilisation.(P Uganda (Adjusted R(2) = 0.528). All variables in the model are significant (p Uganda are: district outpatient department attendance per capita, total district population, total number of government health facilities in the district and the district human poverty index.

  12. District Energy Windsor

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This paper presents a summary of how District Energy Windsor operates. It includes a system site map and reasons why it is advantageous to get connected to a district heating system. District Energy Windsor is a division of the Windsor Utilities Commission. It was developed in 1996 and was the first in North America to supply both heating and cooling requirements. It supplies nearly 2 million square feet of heating and cooling for Windsor's city centre. The district energy system produces hot water or chilled water at a central plant. Energy is then piped out to buildings in the area, including the Art Gallery of Windsor, the Royal Bank Business Centre, the Windsor Justice Facility, the Windsor Casino, and Northwind Windsor. The energy, which is transferred through heat exchangers, is used for space heating, domestic hot water heating, and air conditioning. The 8 reasons for getting connected are: (1) less management costs, (2) lower energy costs, (3) lower level of risk management, (4) stable energy rates, (5) better use of building space, (6) reliable service, (7) reduced expansion costs, and (8) a cleaner environment. District heating improves air quality through reduced carbon dioxide and nitrogen oxide emissions. In addition, fuel delivery and storage are eliminated. figs.

  13. District heating in Flensburg

    Energy Technology Data Exchange (ETDEWEB)

    Prinz, W.

    1981-01-01

    The majority of our population, but also of our authorities, are still skeptical or even disapproving towards district heating. The reasons of this negative attitude are partly psychological - e.g. the individualism of the Swiss and their dislike for too centralised structures and ''forced connections'' - but also the existence of finished gas supply networks and the fear of considerable pre-investments and torn streets over years. The following article - held as a speech on the information meeting ''District heating and the possible contribution of nuclear energy'' organised by the Swiss Association for Atomic Energy in Bern shows a practical problem solving at the example of the district heating in Flensburg and deals with these questions.

  14. The consumption of alcohol among men in rural Sarawak

    OpenAIRE

    Amit, Noh

    2017-01-01

    This research examined sociocultural factors associated with alcohol use among men in rural Sarawak, Malaysia. A mixed methods design was used to explore the phenomenon of alcohol use among young men in rural villages in Kuching and Samarahan Districts, Sarawak. A questionnaire (161 participants), semi structured individual interviews (50 participants), and eight focus group discussions (46 participants) were conducted with men from Iban, Bidayuh, and Malay ethnicities, aged 18-30 years. ...

  15. Dimensions Of Basic School Dropouts In Rural Ghana: The Case Of ...

    African Journals Online (AJOL)

    The objective of this paper was to investigate the various dimensions of basic school dropouts in rural Ghana using the Asutifi district as a case study. The analysis of data (both quantitative and qualitative) gathered from several stakeholders of basic education in the district, revealed that the causes of school dropout were ...

  16. Impact of the introduction of a colposcopy service in a rural South ...

    African Journals Online (AJOL)

    Objective. To describe the establishment of a colposcopy service at a district hospital in a rural sub-district of the Western Cape, South Africa, and assess its impact on colposcopy uptake. Design. A retrospective double-group cohort study using a laboratory database of cervical cytology results, clinical records and ...

  17. A Description of an Inclusion Model That Is Working in a Rural Area.

    Science.gov (United States)

    Dreisbach, Melanie; And Others

    This paper describes an inclusion program at the Kayenta Unified School District (KUSD), located on the Navajo Reservation in northeastern Arizona. KUSD is a rural school district with approximately 2,800 students enrolled in 4 schools (primary, intermediate, middle, and high schools). Virtually all students are Navajo, with 88 percent of students…

  18. Empowerment Zones and Enterprise Districts - MDC_CommunityDevelopmentDistrict

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Community Development Districts (CDDs) are special taxing districts or local units of special-purpose government. A CDD may charge separate non-ad valorem special...

  19. Anemia and intestinal parasite infection in school children in rural Vietnam

    NARCIS (Netherlands)

    Thi, Le H.; Brouwer, I.D.; Verhoef, H.; Khan, N.C.; Kok, F.J.

    2007-01-01

    Objectives: This study hypothesized that besides iron deficiency, intestinal parasites infection is also a determinant of anemia in schoolchildren in rural Vietnam. Methods: 400 primary schoolchildren from 20 primary schools in Tam Nong district, a poor rural area in Vietnam, were randomly selected

  20. Blind Spots: Small Rural Communities and High Turnover in the Superintendency

    Science.gov (United States)

    Kamrath, Barry; Brunner, C. Cryss

    2014-01-01

    This article examines high superintendency turnover through rural community members' perceptions of such attrition in their districts. Findings indicate that community members perceived high turnover as negative and believed that turnover was created by financial pressures, rural community resistance to educational trends, and bias against…

  1. Creating Highly Qualified Teachers: Maximizing University Resources to Provide Professional Development in Rural Areas

    Science.gov (United States)

    Mollenkopf, Dawn L.

    2009-01-01

    The "highly qualified teacher" requirement of No Child Left Behind has put pressure on rural school districts to recruit and retain highly qualified regular and special education teachers. If necessary, they may utilize uncertified, rural teachers with provisional certification; however, these teachers may find completing the necessary…

  2. [Fresno County Library Rural Literacy Outreach Program. Final Performance Report, 1988-1989.

    Science.gov (United States)

    Walling, Joyce

    The Library Rural Literacy Outreach Program targeted to ten rural communities in the Fresno County, California, Free Library district is reported. The sites were chosen based on inquiries from volunteers in those communities and support for the program by the branch library staff. Goals of the program were to provide literacy services to adult…

  3. Investigating GEAR-Up College Readiness Program's Influence on Postsecondary Decisions of Rural Hispanic Youth

    Science.gov (United States)

    Boydstun, Kelli Dawn

    2016-01-01

    This qualitative case study investigated how the GEAR-Up college readiness program influenced the postsecondary decisions of Hispanic students who participated in the GEAR-Up program for the recommended six-year period in a rural school district in Texas. It was not known how long-term participation in the GEAR-Up program at a rural school…

  4. Modelling the impact of rural migration on tropical deforestation in South-West Ethiopia

    NARCIS (Netherlands)

    Van Rompaey, Anton; Debonne, N.; Vanmaercke, Matthias

    2016-01-01

    A major driver of tropical deforestation is rural frontier migration. In this paper an attempt is made to formally describe the human-environment interactions that are manifested in a forested system experiencing a large influx of rural migrants. The Guraferda district in South-West Ethiopia was

  5. Leading Education Innovations in Rural Schools: Reflections from i3 Grantees

    Science.gov (United States)

    Fox, Tom; Friedrich, Linda; Harmon, Hobart; McKithen, Clarissa; Phillips, Andie; Savell, Susan; Schaefer, Victoria; Silva, Mihiri

    2017-01-01

    The Investing in Innovation (i3) Improving Rural Achievement Community, a professional learning community of grantees under the US Department of Education's i3 program, created this document to share knowledge and experiences related to working in rural districts across the United States. Grounded in field-based experiences and lessons, it serves…

  6. Factors affecting school completion by the girl child in Binga Rural ...

    African Journals Online (AJOL)

    Despite the plausible increase in the enrolment rate of girls, progress in education among rural girls at global, regional and local level has been impeded by high influx of school dropouts. The objectives of the study were to assess factors that prohibit girls from completing their formal education in Binga rural district in ...

  7. Interim district energy implementation

    Energy Technology Data Exchange (ETDEWEB)

    Fearnley, R.; Susak, W. [City of Vancouver, BC (Canada); Johnstone, I. [BCG Services Inc., Vancouver, BC (Canada)

    2001-07-01

    The concept of district energy was introduced in the City of North Vancouver, a city of 45,000, in 1997. A preliminary study was completed in 1997, followed by a tour of some district energy facilities in Finland in the same year. In 1999 a large district energy study was completed by a consultant. The study indicated the need for an investment of $15 million to implement district heating in the City. Lack of sufficient financial resources and immediately connectable heat load, the project was considered a non-starter. Some of the other factors leading to shelving the project included no current significant pricing advantages over competing energy sources and no current opportunity for cogeneration, given the low price that BC Hydro is willing to pay for independently produced power. The project, although shelved for the moment, has not been discarded. Planning and exploration are continuing, aided by the City's commitment to energy efficiency and conservation, its long term planning horizon and its significant influence over the development of some prime real estate.

  8. Jordan Lake Watershed Protection District

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — Polygon representing the area of the Jordan Lake Watershed Protection District. The Watershed Protection District (PDF) is a sensitive area of land that drains to...

  9. New Mexico State Forestry Districts

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This dataset contains boundaries of the New Mexico Forestry Districts, plus the names of the district offices. It is in a vector digital structure digitized from a...

  10. District health information system assessment: a case study in iran.

    Science.gov (United States)

    Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab

    2013-03-01

    Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.

  11. STUDIES OF ADVERSE DRUG REACTION PROFILE OF ANTISNAKE VENOM AT DISTRICT GENERAL HOSPITAL

    OpenAIRE

    Mulchand Shende *, Sneha Gawali , Kanchan Bhongade , Vivek Bhuskade , Abhijit Nandgaonkar

    2017-01-01

    Snake bite is a common predominant problem of the rural and periurban areas, neglected and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. This study aimed to investigate of the adverse drug reaction profile of anti-snake venom (ASV) in a district general hospital. An observational study was conducted in hospital for six months. A total number of 142 indoor case papers of snake bite from October 2016 to April 2017 were...

  12. District Consolidation: Rivals Coming Together

    Science.gov (United States)

    Mart, Dan

    2011-01-01

    District consolidation is a highly emotional process. One key to success is sticking to the facts. In Iowa, school districts facing financial difficulties or enrollment concerns do not have to move directly to consolidation. In many cases, districts begin by developing sharing agreements. These sharing agreements may start with simple sharing of…

  13. 7 CFR 917.14 - District.

    Science.gov (United States)

    2010-01-01

    ... District. (g) Contra Costa District includes and consists of Contra Costa County. (h) Santa Clara District... Ventura County. (l) Stockton District includes and consists of San Joaquin County, Amador County...

  14. Medicaid and Rural Health

    Science.gov (United States)

    ... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...

  15. Approach to malaria in rural hospitals

    Directory of Open Access Journals (Sweden)

    Jency Maria Koshy

    2014-01-01

    Full Text Available Malaria is one of the most common parasitic infections in the developing countries. In Rural India, most patients would be treated by primary and secondary care physicians. This article is aimed at providing a feasible approach to the cases of malaria in mission hospitals and other rural hospitals taking into account all the resource limitations. A study done over one year on patients detected to have malaria at Jiwan Jyoti Christian Hospital in Sonbhadra district has helped the authors to identify the various challenges faced by doctors working in the rural hospitals. The article has looked at the various complications associated with malaria and their management. It has also stressed upon the increasing incidence of chloroquine resistance.

  16. Biomass universal district heating systems

    Science.gov (United States)

    Soltero, Victor Manuel; Rodríguez-Artacho, Salvador; Velázquez, Ramón; Chacartegui, Ricardo

    2017-11-01

    In mild climate regions Directive 27/2012 EU application for developing sustainable district heating networks in consolidated urban nucleus is a challenge. In Spain most of the municipalities above 5,000 inhabitants have a reliable natural gas network and individual heating systems at homes. In this work a new heating network paradigm is proposed, the biomass universal heating network in rural areas. This model involves all the economic, legal and technical aspects and interactions between the different agents of the systems: provider company, individual and collective end-users and local and regional administration. The continental region in Spain has 588 municipalities with a population above 1,500 inhabitants close to forest biomass with renewable use. In many of these cases the regulation identifies the ownership of the forest resources use. The universal heating networks are a great opportunity for energy saving of 2,000 GWh, avoiding 2.7 million tons of CO2 emissions and with a global annual savings for end users of 61.8 million of euros. The presented model is easily extrapolated to other small municipalities in Europe. The real application of the model is presented for three municipalities in different locations of Spain where Universal Heating Networks are under development. The analysis show the interest of the integrated model for the three cases with different structural agents and relationships between them. The use of sustainable forest resources, extracted and managed by local companies, strengths circular economy in the region with a potential global economic impact above 200 M€.

  17. In the way of clean and safe drinking water : exploring limitations to improvement of the water supply in Bagamoyo District, Tanzania

    OpenAIRE

    Bemspång, Josefina; Segerström, Rebecka

    2009-01-01

    Bagamoyo District, in the Pwani region in Tanzania, supplies a large part of Tanzania'sbiggest city, Dar es Salaam, with water. At the same time many people in rural villages in thedistrict do not have access to clean and safe water. This thesis aims to explore what limitationsthere are to improvement of the rural water supply in Bagamoyo District. Specific attention ispaid to the organizational structure of the water sector and how roles and responsibilities aredivided, defined and communica...

  18. Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau (ESTHER) substudy].

    Science.gov (United States)

    Suzan-Monti, M; Blanche, J; Boyer, S; Kouanfack, C; Delaporte, E; Bonono, R-C; Carrieri, P M; Protopopescu, C; Laurent, C; Spire, B

    2015-05-01

    The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon. Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes. Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02). Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation

  19. VII international district heating conference

    International Nuclear Information System (INIS)

    1988-01-01

    The proceedings of the 7th International District Heating Conference contain the full texts of the 89 presented papers of which 11 fall under the INIS Subject Scope. The conference met in seven sessions and dealt with the following problem areas: design and optimization of systems of district heating, integration of the power system and the district heating systems, cooperation of nuclear and fossil burning sources in district heating systems, the use of specific nuclear power plants for heating purposes, questions of the control of systems of district heating, the development of components of heating networks, the reliability and design of heat supply pipes. (Z.M.)

  20. Perceptions of drought among rural farmers in the Savelugu district ...

    African Journals Online (AJOL)

    Drought is one of the most constraining climate extremes to livelihoods particularly in ... and interpretation of environmental phenomena have an immense influence on people's ..... The smoke is said to dissipate rain-clouds, resulting in.

  1. Gender equality in rural development and agricultural extension in ...

    African Journals Online (AJOL)

    ... (implementation, access to and control of resources) of women in maleheaded households, female-headed households and male-headed households in rural development and agricultural extension was the focus of this study. The district was purposively selected based on crop and livestock farming systems of the zone.

  2. Irrigation and Rural Welfare: Implications of Schistosomiasis among ...

    African Journals Online (AJOL)

    This paper examines the effects of the prevalence of urinary schistosomiasis infection on the socio-economic health of irrigation farmers in the rural districts of Kazaure Area, Northern Nigeria. It first reviews some general consideration of irrigation environment and schistosomiasis, its major associated health problem.

  3. Cigarette smoking and use of smokeless tobacco in Moshi rural ...

    African Journals Online (AJOL)

    Cigarette smoking and use of smokeless tobacco in Moshi rural district of Kilimanjaro region, northern Tanzania. KS Mnyika, E Klouman, K-I Klepp. Abstract. No Abstract. East African Journal of Public Health Vol. 3 (1) April 2006: 24-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

  4. ICTs in rural education: Let the game begin

    CSIR Research Space (South Africa)

    Botha, Adele

    2015-12-01

    Full Text Available Over a period of three years, 255 teachers at 26 schools in Cofimvaba, which lies in the very rural Nciba district of the Eastern Cape Province, South Africa, have been using mobile tablets in their classrooms to support teaching and learning...

  5. Factors impacting on organisational learning in three rural health ...

    African Journals Online (AJOL)

    a relatively new concept in the healthcare system.1. A learning ... challenges to those working in a rural setting because of the distance from academic ... ness to change entire routines and standard operating procedures embedded in ... priorities for an intervention to create learning organisations of district hospitals and ...

  6. Adolescent alcohol use in rural South African high schools | Onya ...

    African Journals Online (AJOL)

    Objective: To examine psychosocial correlates of lifetime alcohol use among adolescents in rural South African high schools. Method: Questionnaires were administered to 1600 students from 20 randomly selected high schools in the Mankweng district within Limpopo province. Self-report data on alcohol use, demographic, ...

  7. A Rural Special Education Teacher Training Program: Successful Adaptations.

    Science.gov (United States)

    Prater, Greg; And Others

    The Rural Special Education Program (RSEP), a partnership between Northern Arizona University (NAU) and Kayenta Unified School District (KUSD), provides training for preservice special education teachers to work with Native American students and their families. To date, the program has provided training for 63 preservice special education…

  8. Menopausal challenges as perceived by women in rural villages of ...

    African Journals Online (AJOL)

    The study explored the challenges of menopause as perceived by participants in rural villages of Vhembe District. A cross-sectional study involved a sample of 500 women between the ages of 40 years and above. A structured questionnaire was used to collect data and was analysed descriptively. The results indicated that ...

  9. The increasing burden of tuberculosis in rural South Africa - impact ...

    African Journals Online (AJOL)

    Objective. To determine the impact of the HIV epidemic on tuberculosis caseload in rural South Africa. Setting. Hlabisa health district, Kwazulu-Natal. Methods. Demographic and clinical data were extracted from the tuberculosis database for the period, May 1991 June 1995. The attributable fraction of HIV-infected ...

  10. Users' perspectives on decentralized rural water services in Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2015-01-01

    This article examines the impact of decentralization reforms on improving access to domestic water supply in the rural districts of Kondoa and Kongwa, Tanzania, using a users' and a gender perspective. The article addresses the question whether and to what extent the delivery of gender-sensitive

  11. Factors Impacting on Organisational Learning in Three Rural Health ...

    African Journals Online (AJOL)

    ... assessment of hospital leadership as being supportive of learning were significant predictors of attendance among doctors. Conclusions: Despite severe staff shortages in these rural districts, at facilities where there was a perception of leadership and teamwork the professional staff generally attended learning sessions.

  12. Personnel Recruitment and Retention in Rural America: A Growing Problem.

    Science.gov (United States)

    Helge, Doris I.; Marrs, Lawrence W.

    1982-01-01

    The article presents successful strategies based on A. Maslow's hierarchy for recruiting special education personnel for rural school systems. Techniques for selling a district to prospective teachers and administrators are discussed and suggestions for integrating newcomers are covered. (Author/SB)

  13. Unregulated Autonomy: Uncredentialed Educational Interpreters in Rural Schools.

    Science.gov (United States)

    Fitzmaurice, Stephen

    2017-01-01

    Although many rural Deaf and Hard of Hearing students attend public schools most of the day and use the services of educational interpreters to gain access to the school environment, little information exists on what interpreters are doing in rural school systems in the absence of credentialing requirements. The researcher used ethnographic interviews and field observations of three educational interpreters with no certification or professional assessment to explore how uncredentialed interpreters were enacting their role in a rural high school. The findings indicate that uncredentialed interpreters in rural settings perform four major functions during their school day: preparing the environment, staff, and materials; interpreting a variety of content; interacting with numerous stakeholders; and directly instructing Deaf and Hard of Hearing students. Generally, educational interpreters in rural districts operate with unregulated autonomy, a situation that warrants further research and a national standard for all educational interpreters.

  14. Rape in Rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Nowsher Ali

    2015-03-01

    Full Text Available Background: Rape is one of the silent brutal sexual offences in Bangladesh. Despite strong laws against it, the evil of rape continues to rise. Increasing trend of the silent cruel sexual offence (rape represents a major psychopath sexual disorder and public health problem and progress of the country. Objective: The aim of the study was to determine the pattern of alleged rape victims in a rural district of Bangladesh with the ultimate aim to create public awareness about the brutal crime. Materials and method: This retrospective study was carried out on 330 sexually assailed alleged rape victims’ report forms, who reported at Faridpur Medical College, Bangladesh from 2007 to 2011 for medical examination. Results: Among the study subjects maximum number (70.0% of alleged rape cases were under the age of 20 years. More than two-thirds (64.60% of the assailants were known to the victims, most of the incidents (64.20% occurred in the victims’ houses and nearby places. The study also revealed that minimum number of victims (14.20% reported within 24 hours for medical examination. Almost one fourth of the alleged rape cases were gang rape and no positive finding in favour of sexual intercourse was found in about three fourth (72.40% of cases. Conclusion: Public awareness about rape would be effective to report in due time with preserving the evidence of crime and modern techniques like DNA diagnosis may be of help to detect the assailant.

  15. Spatial Recognition of the Urban-Rural Fringe of Beijing Using DMSP/OLS Nighttime Light Data

    Directory of Open Access Journals (Sweden)

    Yuli Yang

    2017-11-01

    Full Text Available Spatial identification of the urban-rural fringes is very significant for deeply understanding the development processes and regulations of urban space and guiding urban spatial development in the future. Traditionally, urban-rural fringe areas are identified using statistical analysis methods that consider indexes from single or multiple factors, such as population densities, the ratio of building land, the proportion of the non-agricultural population, and economic levels. However, these methods have limitations, for example, the statistical data are not continuous, the statistical standards are not uniform, the data is seldom available in real time, and it is difficult to avoid issues on the statistical effects from edges of administrative regions or express the internal differences of these areas. This paper proposes a convenient approach to identify the urban-rural fringe using nighttime light data of DMSP/OLS images. First, a light characteristics–combined value model was built in ArcGIS 10.3, and the combined characteristics of light intensity and the degree of light intensity fluctuation are analyzed in the urban, urban-rural fringe, and rural areas. Then, the Python programming language was used to extract the breakpoints of the characteristic combination values of the nighttime light data in 360 directions taking Tian An Men as the center. Finally, the range of the urban-rural fringe area is identified. The results show that the urban-rural fringe of Beijing is mainly located in the annular band around Tian An Men. The average inner radius is 19 km, and the outer radius is 26 km. The urban-rural fringe includes the outer portions of the four city center districts, which are the Chaoyang District, Haidian District, Fengtai District, and Shijingshan District and the part area border with Daxing District, Tongzhou District, Changping District, Mentougou District, Shunyi District, and Fangshan District. The area of the urban-rural fringe

  16. What Is Rural? Revised

    Science.gov (United States)

    US Department of Agriculture, 2016

    2016-01-01

    Many people have definitions for the term rural, but seldom are these rural definitions in agreement. For some, rural is a subjective state of mind. For others, rural is an objective quantitative measure. In this brief report the United States Department of Agriculture presents the following information along with helpful links for the reader: (1)…

  17. How Small School Districts Can Organize to Afford Their Small Schools

    Science.gov (United States)

    Burton, Christine

    2010-01-01

    While the research continues to mount on the benefits of school downsizing and decentralizing efforts in urban areas, there exists a paradox for small school Administrators who continue to struggle against forces of consolidation. Small schools in rural and suburban districts have fought for their existence against the pressures of consolidation…

  18. The Epidemiology of District Surgery in Malawi: a Two Year Study of ...

    African Journals Online (AJOL)

    Background: The true surgical requirement of a rural African population is also not precisely known. Methods: Data gathered over a 2-year period from 1993 to 1995 on surgical and anaesthetic activities in 18 District Hospitals in Malawi are presented. Results: Theatre records showed that 45,032 operations were carried out ...

  19. Prospecting for Groundwater in the Bawku West District of the Upper ...

    African Journals Online (AJOL)

    An integrated approach involving the Electromagnetic (EM) and Vertical electrical sounding (VES) survey methods, has been used to locate potential drilling sites to find groundwater for twenty (20) rural communities in the Bawku West District of the Upper East Region of Ghana. The EM method involved the use of the ...

  20. Mixing methodology, nursing theory and research design for a practice model of district nursing advocacy.

    Science.gov (United States)

    Reed, Frances M; Fitzgerald, Les; Rae, Melanie

    2016-01-01

    To highlight philosophical and theoretical considerations for planning a mixed methods research design that can inform a practice model to guide rural district nursing end of life care. Conceptual models of nursing in the community are general and lack guidance for rural district nursing care. A combination of pragmatism and nurse agency theory can provide a framework for ethical considerations in mixed methods research in the private world of rural district end of life care. Reflection on experience gathered in a two-stage qualitative research phase, involving rural district nurses who use advocacy successfully, can inform a quantitative phase for testing and complementing the data. Ongoing data analysis and integration result in generalisable inferences to achieve the research objective. Mixed methods research that creatively combines philosophical and theoretical elements to guide design in the particular ethical situation of community end of life care can be used to explore an emerging field of interest and test the findings for evidence to guide quality nursing practice. Combining philosophy and nursing theory to guide mixed methods research design increases the opportunity for sound research outcomes that can inform a nursing model of care.

  1. Perceptions of Organizational Culture of a Multi-Campus Community College District: Mixed Methods in Concert

    Science.gov (United States)

    Kuster Dale, Kimberly

    2012-01-01

    This concurrent, mixed-methods case study analyzed perceptions of current and preferred organizational culture within a rural, multi-campus community college district. This phenomenon was examined by analyzing and comparing data collected by surveying all full-time employees utilizing the Organizational Culture Assessment Instrument (OCAI) and…

  2. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  3. District heating from Forsmark

    International Nuclear Information System (INIS)

    1980-11-01

    The district heating system of Greater Stockholm must be based on other energy sources than oil. Two alternatives are assessed, namely heat from Forsmark or a coal fueled plant in the region of Stockholm. Forsmark 3 can produce both electricity and heat from the year 1988 on. The capacity can be increased by coal fueled blocks. For low electricity use, 115 TWh in the year 1990, the Forsmark alternative will be profitable. The alternative will be profitable. The alternative with a fossile fuelled plant will be profitable when planning for high consumption of electricity, 125 TWh. The Forsmark alternative means high investments and the introduction of new techniques. (G.B.)

  4. The coming vitality of rural places

    Directory of Open Access Journals (Sweden)

    Craig B. HOWLEY

    2013-04-01

    Full Text Available ABSTRACTIn many parts of the world, whether “developing” or “developed,” the concept of a rural sort of education is largely ignored by national ministries. The United States is just one notable example of silence at the bureaucratic center, despite scholarly interest in provincial universities. The future may change the “terms of engagement,” however, and this essay considers the leadership of rural schools and communities from the vantage of the daunting, but clearly visible, challenges of the future. The challenges described in the essay relate to a variety of visible, perhaps even familiar, economic, environmental, political, and cultural threats confronting life in the coming century. Though increasingly important and relevant to education, these threats are not a common part of discussions in education policy. The essay explains why, and why the threats are important to rural villages and districts. Discussion concludes with five rurally appropriate shifts of thinking that might help rural citizens and subjects around the world engage the challenges and counter the threats.

  5. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

  6. IMMUNIZATION COVERAGE IN ETAWAH: A BORDER DISTRICT OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    C M Singh

    2012-06-01

    Full Text Available Research question: What is the coverage of immunization among children of 12-23 months age group in rural Etawah (a border District of Uttar Pradesh? Objectives: 1. To assess the immunization coverage among 12-23 months age group children in rural Etawah. 2. To study the association of different socio-demographic factors with utilization of immunization services. Study Design: A community based cross sectional study. Setting: The present study was conducted in Saifai Block of District Etawah. Participants: Two hundred and ten children of 12-23 months were included in the study. Results: The percentage of completely immunized children was found to be 40%. The present study revealed that approximately 79.0% children were immunized against BCG, while the corresponding figure for measles vaccination was just 42.4%. Drop-out rate for complete immunization was 48.1%. Conclusion: Overall coverage of immunization services among children aged 12-23 months was lower than the national figures for rural Etawah. Literacy status of parents was significantly associated with the percentage of fully immunized children and the drop-out rate was also found to be higher among children of illiterate mothers. So there is need and scope of more focused Information, education and communication efforts towards parents regarding immunization services.

  7. IMMUNIZATION COVERAGE IN ETAWAH: A BORDER DISTRICT OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    C M Singh

    2012-07-01

    Full Text Available Research question: What is the coverage of immunization among children of 12-23 months age group in rural Etawah (a border District of Uttar Pradesh? Objectives: 1. To assess the immunization coverage among 12-23 months age group children in rural Etawah. 2. To study the association of different socio-demographic factors with utilization of immunization services. Study Design: A community based cross sectional study. Setting: The present study was conducted in Saifai Block of District Etawah. Participants: Two hundred and ten children of 12-23 months were included in the study. Results: The percentage of completely immunized children was found to be 40%. The present study revealed that approximately 79.0% children were immunized against BCG, while the corresponding figure for measles vaccination was just 42.4%. Drop-out rate for complete immunization was 48.1%. Conclusion: Overall coverage of immunization services among children aged 12-23 months was lower than the national figures for rural Etawah. Literacy status of parents was significantly associated with the percentage of fully immunized children and the drop-out rate was also found to be higher among children of illiterate mothers. So there is need and scope of more focused Information, education and communication efforts towards parents regarding immunization services.

  8. The Streltsovskoye uranium district

    International Nuclear Information System (INIS)

    Ischukova, L.P.

    1997-01-01

    This paper describes the geology of the Streltsovskoye uranium district located in south-eastern Zabaikalie region, Chita Province, Siberia, Russia. This district hosts Russia's only currently active uranium production centre. The uranium ore was discovered from 1963 to 1967 by drilling below fluorite veins which had minor associated uranium mineralization and radioactive anomalies. The uranium occurs as large scale vein stockwork deposits of hydrothermal origin within a volcano-tectonic caldera formed by continental volcanism of Late Mesozoic age. Rocks occurring in the caldera include basalt and trachydacite, overlain by rhyolite, and with associated interbedded sediments. The ore bodies occur in steeply dipping faults, with the greatest concentrations located where faults along the margins of the caldera intersect steeply dipping, cross cutting, northeasterly and northwesterly striking faults. The Streltsovskoye caldera extends over an area of 150 km 2 and is underlain by a large batholith. The 19 identified uranium deposits occurred in structural features that cut through the caldera sequence and extend into the basement rocks. The caldera has a maximum thickness of 1400 metres. Details of several deposits are given, including descriptions of mineralization and associated alteration. (author). 10 figs

  9. "Reforms Looked Really Good on Paper": Rural Food Service Responses to the Healthy, Hunger-Free Kids Act of 2010

    Science.gov (United States)

    Cornish, Disa; Askelson, Natoshia; Golembiewski, Elizabeth

    2016-01-01

    Background: The Healthy, Hunger-Free Kids Act of 2010 (HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing…

  10. Management of district hospitals--exploring success.

    Science.gov (United States)

    Couper, Ian D; Hugo, Jannie F M

    2005-01-01

    The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world. A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-functioning district hospitals in two districts in South Africa. Thirteen themes were identified, integrated into three clusters, namely 'Teams working together for a purpose', 'Foundational framework and values' and 'Health Service and the community'. Teamwork and teams was a dominant theme. Teams working together are held together by the cement of good relationships and are enhanced by purposeful meetings. Unity is grown through solving difficult problems together and commitment to serving the community guides commitment towards each other, and towards patients and staff. Open communication and sharing lots of information between people and teams is the way in which these things happen. The structure and systems that have developed over years form the basis for teamwork. The different management structures and processes are developed with a view to supporting service and teamwork. A long history of committed people who hand over the baton when they leave creates a stable context. The health service and community theme cluster describes how integration in the community and community services is important for these managers. There is also a focus on involving community representatives in the hospital development and governance. Capacity building for staff is seen in the same spirit of serving people and thus serving staff, all aimed at reaching out to people in need in the community. The three clusters and thirteen themes and the relationships between them are described in detail through diagrams and narrative in the article. Much can be learned from the experience of these managers. The key issue is the development of a team in the hospital, a team with a unified vision of giving

  11. A Tale of Two Districts

    Science.gov (United States)

    Simon, Mark

    2012-01-01

    These days, everyone seems to be wringing their hands about how to construct new evaluation systems that will make teachers better. This unnecessary angst has led to crazy experiments in reform that have embraced churn for the sake of churn, put school districts at risk, and demoralized many of the most talented teachers. A few school districts,…

  12. Redesigning the District Operating System

    Science.gov (United States)

    Hodas, Steven

    2015-01-01

    In this paper, we look at the inner workings of a school district through the lens of the "district operating system (DOS)," a set of interlocking mutually-reinforcing modules that includes functions like procurement, contracting, data and IT policy, the general counsel's office, human resources, and the systems for employee and family…

  13. Suburban District Leadership Does Matter

    Science.gov (United States)

    Thompson, Eustace; France, Roxanne Garcia

    2015-01-01

    The increased demand for educational reform and accountability has resulted in a renewed focus on the relationship between building leaders and district leaders, particularly on how district leaders can support principals to ensure the academic success of students. The No Child Left Behind Act of 2001 (NCLB) and Race to the Top (RttT) legislations…

  14. Nuclear district heating

    International Nuclear Information System (INIS)

    Ricateau, P.

    1976-01-01

    An economic study of nuclear district heating is concerned with: heat production, its transmission towards the area to be served and the distribution management towards the consumers. Foreign and French assessments show that the high cost of now existing techniques of hot water transport defines the competing limit distance between the site and township to be below some fifty kilometers for the most important townships (provided that the fuel price remain stationary). All studies converge towards the choice of a high transport temperature as soon as the distance is of some twenty kilometers. As for fossile energy saving, some new possibilities appear with process heat reactors; either PWR of about 1000MWth for large townships, or pool-type reactors of about 100MWth when a combination with an industrial steam supply occurs [fr

  15. VT Data - Overlay District 20170710, South Burlington

    Data.gov (United States)

    Vermont Center for Geographic Information — Overlay data for the City of South Burlington included in this data:Flood Plain Overlay DistrictTraffic Overlay DistrictInterstate Highway Overlay DistrictScenic...

  16. VT Data - Overlay District 20170419, Colchester

    Data.gov (United States)

    Vermont Center for Geographic Information — The following Overlay Districts are included in the data:General Development Four Commercial DistrictGeneral Development Four Openspace DistrictShoreland...

  17. Rural tourism – return to the farm perspective

    DEFF Research Database (Denmark)

    Nielsen, Niels Christian; Nissen, Kathrine Aae; Just, Flemming

    2010-01-01

    on innovation, i.e. development of new tourism products, preferably based on natural, human and social resources found within the rural district. However, in an ongoing study, carried out for the Danish Food Industry Agency, we shift focus (back) towards the development potential for farms wanting to diversify......Several studies have pointed to tourism as a tool for economic development and a means for keeping the population in rural areas. Typically areas suffering from decline in agriculture and general socio-economic trends. The general view seems to be that, many rural areas are inevitably moving...... towards a post-productive state, and that a possible adaption is diversification of economic activity and “multifunctional land use”, with tourism and recreation among the functions. In the tourism and rural (sociology) literature, the community perspective has been dominant, along with a focus...

  18. Rural Health Concerns

    Science.gov (United States)

    People in rural areas face some different health issues than people who live in towns and cities. Getting health care can ... long distances to get routine checkups and screenings. Rural areas often have fewer doctors and dentists, and ...

  19. Medicare and Rural Health

    Science.gov (United States)

    ... community has a significant impact on the local economy. In rural areas, Medicare reimbursement is a critical source of that healthcare spending, particularly since the higher percentage of elderly population in rural areas mean that Medicare accounts for ...

  20. VT Data - Overlay District 20070306, Marlboro

    Data.gov (United States)

    Vermont Center for Geographic Information — Cartographic version of overlay district (surface water buffer), Marlboro, Vermont. Base zoning districts are in a separate shapefile. Data were originally created...