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Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

ABSTRACT: OBJECTIVE:The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. RESULTS:The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR?=?8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR?=?6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR?=?2.35 (95% CI 1.09, 5.05)]. CONCLUSIONS:The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.

SUBMITTER: Gebru T

PROVIDER: S-EPMC5964917 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

Gebru Teklemichael T Lentiro Kifle K Jemal Abdulewhab A

BMC research notes 20180522 1

<h4>Objective</h4>The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016.<h4>Results</h4>The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts ...[more]

PMID: 29789010

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Project description:BackgroundEthiopia signed the VISION 2020 Global Declaration and launched its eye health program in 2002. Since then, there has been limited systematic and comprehensive evaluation of the progress towards VISION 2020 goals in Ethiopia.ObjectiveTo evaluate Gurage Zone progress towards VISION 2020 targets and process indicators.MethodAn institutional-based cross-sectional study was conducted among all public and private eye health care facilities in the Gurage Zone within the Southern Nations, Nationalities, and People Region of Ethiopia. The evaluation protocol was adopted from the VISION 2020 situational analysis data collection tool. We used this structure to evaluate progress in terms of human resources for eye health, infrastructure, and service delivery at the zonal health office and health facilities. At the time of the study, Gurage Zone had a 1.7 million catchment area population. There were a total of five eye care centers, one of which was established by a non-governmental organization. Three of these facilities were secondary eye care centers with an operating theatre and two facilities were primary eye care centers. At the zonal level, there was no survey data available on the prevalence of blindness.ResultThere was no systemic evaluation of VISION 2020 process indicators. The budget allocation specific to eye health care was less than 0.7% of the total budget of the zonal health office. The human resources for eye health (HReH) in the catchment area were: one ophthalmologist, two cataract surgeons, five optometrists, and 12 ophthalmic nurses, which is below the VISION 2020 targets for HReH. In terms of equipment, neither primary eye care center had a slit lamp biomicroscope, and two of the three secondary eye care centers did not have intraocular pressure measuring equipment. Only one secondary eye care center was providing glaucoma surgical services, and no center provided emergency and elective pediatric surgery. The cataract surgical rate determined by the study was 1967.ConclusionGurage Zone showed significant improvement in terms of cataract surgical rate. But it had not achieved VISION 2020 goals in terms of critical HReH and service delivery. We recommend that the zonal health office carries out a focused and baseline evaluation of eye health care service achievements.

Project description:BACKGROUND:A vicious cycle exists between dental anxiety, oral health behaviors and oral health status. Based on previous research, psychological factors of the Health Belief Model (HBM) are associated with oral health behaviors and oral health, and are likely involved in this cycle. However, little is known about the relationship between HBM factors and dental anxiety of adolescents. The purpose of this cross-sectional study was to investigate the relationship between health belief factors, oral health and dental anxiety based on the constructs of the HBM. METHODS:1207 Grade 2 students from 12 secondary schools in Hong Kong were randomly selected and measured for the decayed, missing and filled permanent teeth (DMFT) index. Data for oral health behaviors, HBM constructs and dental anxiety were collected using questionnaires. The hierarchical entry of explanatory variables into logistic regression models estimating prevalence odds ratios (POR) were analyzed and 95% confidence intervals (95% CI) for DMFT and dental anxiety were generated. Path analysis was used to evaluate the appropriateness of the HBM as predictors for oral health behaviors, DMFT and dental anxiety. RESULTS:Based on the full model analysis, individuals with higher perceived susceptibility of oral diseases (POR: 1.33, 95% CI: 1.14-1.56) or girls or whose mother received higher education level were likelier to have a DMFT?1, while those with higher perceived severity (POR: 1.31, 95%CI: 1.09-1.57), flossing weekly, DMFT?1 or higher general anxiety level statistically increases the possibility of dental anxiety. The results from path analysis indicated that stronger perceived susceptibility, greater severity of oral diseases, less performing of oral health behaviors and a higher score of DMFT were directly related to increased dental anxiety level. Other HBM variables, such as perceived susceptibility, self-efficacy beliefs, cues to action and perceived barriers, might influence dental anxiety through oral health behaviors and caries status. CONCLUSIONS:Clarifying the propositional structures of the HBM may help the future design of theory-based interventions in reducing dental anxiety and preventing dental caries.

Project description:BACKGROUND:In low-income countries it is difficult to obtain complete data that show spatial heterogeneity in the risk of tuberculosis within-and-between smaller administrative units. This may contribute to the partial effectiveness of tuberculosis control programs. The aim of this study was to estimate the spatial risk of tuberculosis distribution in Gurage Zone, Southern Ethiopia using limited spatial datasets. METHODS:A total of 1601 patient data that were retrieved from unit tuberculosis registers were included in the final analyses. The population and geo-location data were obtained from the Central Statistical Agency of Ethiopia. Altitude data were extracted from ASTER Global Digital Elevation Model Version 2. Aggregated datasets from sample of 169(40%), 254(60%) and 338(80%) kebeles were used to estimate the spatial risk of TB distribution in the Gurage Zone by using a geostatistical kriging approach. The best set of input parameters were decided based on the lowest prediction error criteria of the cross-validation technique. ArcGIS 10.2 was used for the spatial data analyses. RESULTS:The best semivariogram models were the Pentaspherical, Rational Quadratic, and K-Bessel for the 40, 60 and 80% spatial datasets, respectively. The predictive accuracies of the models have improved with the true anisotropy, altitude and latitude covariates, the change in detrending pattern from local to global, and the increase in size of spatial dataset. The risk of tuberculosis was estimated to be higher at western, northwest, southwest and southeast parts of the study area, and crossed between high and low at west-central parts. CONCLUSION:This study has underlined that the geostatistical kriging approach can be applied to estimate the spatial risk of tuberculosis distribution in data limited settings. The estimation results may help local public health authorities measure burden of the disease at all locations, identify geographical areas that require more attention, and evaluate the impacts of intervention programs.

Project description:BackgroundEssential newborn care (ENC) is the most vital care, particularly during the first hour of the newborn's life. This study aimed to assess health professionals' knowledge and practice of ENC at public health facilities in the Bench-Sheko Zone, southwest Ethiopia.MethodsA cross-sectional study was conducted among health professionals at selected public health facilities in the Bench-Sheko Zone of southwest Ethiopia. The data were collected using a self-administered, tested, and structured questionnaire. The data collected were entered in Epi info version 7 and analyzed using SPSS version 22. Bivariate and multivariable analyses were performed to determine the association between the dependent and independent variables. Categorical variables were presented in tabulations by frequencies and percentages. Continuous data were summarized by the mean score and standard deviation. Statistical significance was set at a p-value < 0.05.ResultsAmong the 157 respondents, 60 (38.2%) and 97 (61.8%) had good knowledge and good practice of ENC, respectively. The factors associated with good knowledge of ENC were being female (AOR = 0.72, 95% CI [0.48, 0.86]), the availability of on-the-job training (AOR = 2.00, 95% CI [1.01, 3.97]), and interest in working in the delivery room (AOR = 2.5, 95% CI [1.27, 4.94]). Better educational qualification (AOR = 4.12, 95% CI [1.67, 10.18]) and the availability of on-the-job training (AOR = 3.60, 95% CI [1.58, 8.18]) were the factors associated with good practice of ENC.ConclusionKnowledge of essential newborn care among health professionals was very low; however, the practice of essential newborn care was somewhat average compared to other studies in Ethiopia. Being female, the availability of on-the-job training and interest in working in the delivery room were the factors associated with a good knowledge of ENC; while educational qualification and the availability of on-the-job training were the factors associated with a good practice of ENC. Therefore, concerned bodies should consider the provision of refreshment on-the-job training, upgrading the qualification of health professionals, and providing incentives and motivators to improve interest in working in the delivery room.

Project description:Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001). Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities.There is the need to intensify client education and balanced commitment to technical and perceived quality improvement efforts. This will help enhance client confidence in Ghana's healthcare system, stimulate active participation in the national health insurance, increase healthcare utilization and ultimately improve public health outcomes.

Dataset Information

Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

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Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

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