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Saito A, Kondo M. Continuum of care for maternal and child health and child undernutrition in Angola. BMC Public Health 2024; 24:680. [PMID: 38439029 PMCID: PMC10910721 DOI: 10.1186/s12889-024-18144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/17/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Continuum of care (CoC) for maternal and child health provides opportunities for mothers and children to improve their nutritional status, but many children remain undernourished in Angola. This study aimed to assess the achievement level of CoC and examine the association between the CoC achievement level and child nutritional status. METHODS We used nationally representative data from the Angola 2015-2016 Multiple Indicator and Health Survey. Completion of CoC was defined as achieving at least four antenatal care visits (4 + ANC), delivery with a skilled birth attendant (SBA), child vaccination at birth, child postnatal check within 2 months (PNC), and a series of child vaccinations at 2, 4, 6, 9 and 15 months of child age. We included under 5 years old children who were eligible for child vaccination questionnaires and their mothers. The difference in CoC achievement level among different nutritional status were presented using the Kaplan-Meier method and examined using the Log-Lank test. Additionally, the multivariable logistic regression analysis examined the associations between child nutritional status and CoC achievement levels. RESULTS The prevalence of child stunting, underweight and wasting was 48.3%, 23.2% and 5.9% respectively. The overall CoC completion level was 1.2%. The level of achieving CoC of mother-child pairs was 62.8% for 4 + ANC, 42.2% for SBA, 23.0% for child vaccination at birth, and 6.7% for PNC, and it continued to decline over 15 months. The Log-Lank test showed that there were significant differences in the CoC achievement level between children with no stunting and those with stunting (p < 0.001), those with no underweight and those with underweight (p < 0.001), those with no wasting and those with wasting (p = 0.003), and those with malnutrition and those with a normal nutritional status (p < 0.001). Achieving 4 + ANC (CoC1), 4 + ANC and SBA (CoC 2), and 4 + ANC, SBA, and child vaccination at birth (CoC 3) were associated with reduction in child stunting and underweight. CONCLUSIONS The completion of CoC is low in Angola and many children miss their opportunity of nutritional intervention. According to our result, improving care utilization and its continuity could improve child nutritional status.
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Affiliation(s)
- Akiko Saito
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058577, Japan.
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058577, Japan
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Ntakwinja M, Werth A, Borazjani A, Iglesia C, Williams KJ, Mukwege D. Pelvic floor symptoms among premenopausal women with pelvic organ prolapse in the Democratic Republic of the Congo. Int Urogynecol J 2024; 35:103-108. [PMID: 37897521 DOI: 10.1007/s00192-023-05670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/26/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Most of the literature on pelvic organ prolapse (POP) has been generated from postmenopausal patients in high-income countries. In the Democratic Republic of the Congo (DRC), a significant proportion of patients who present for surgical management of POP are premenopausal. Little is known about the impact of POP on pelvic floor symptoms in this population. The objective was to describe pelvic floor symptoms and sexual function among premenopausal patients presenting for POP surgery in DRC. METHODS We performed a prospective cohort study of symptomatic premenopausal patients undergoing fertility-sparing POP surgery at a large referral hospital in the DRC. Pelvic floor symptoms were evaluated with the Pelvic Floor Distress Inventory Questionnaire and sexual function with the Pelvic organ prolapse/urinary Incontinence Sexual Questionnaire. Data are presented as means with standard deviations or counts with percentages. RESULTS A total of 107 patients were recruited between April 2019 and December 2021. All had either stage III (95.3%) or stage IV (4.7%) prolapse. Ages were 34.2 ± 6.7 years; 78.5% were married. A majority of patients experienced low abdominal pain (82.2%), heaviness or dullness (95.3%), and bulging or protrusion of the prolapse (92.5%). Almost two-thirds of patients reported no longer being sexually active, and 80% stated that they were not sexually active because of POP. Of the 37 sexually active patients (34.6%), nearly all reported significant sexual impairment because of the prolapse, with only 4 reporting no sexual impairment. CONCLUSIONS This study represents one of the largest prospective series of patients with premenopausal POP. Our results highlight the severity of pelvic floor symptoms and the negative effects on sexual function among this patient population with POP.
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Affiliation(s)
- Mukanire Ntakwinja
- Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo
- Evangelical University in Africa, Bukavu, Democratic Republic of the Congo
| | - Adrienne Werth
- Global Innovations for Reproductive Health & Life, Chicago, IL, USA.
- Hartford Healthcare, Hartford, CT, USA.
| | - Ali Borazjani
- Global Innovations for Reproductive Health & Life, Chicago, IL, USA
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Cheryl Iglesia
- Departments of Obstetrics & Gynecology and Urology, MedStar Heath, Georgetown University School of Medicine, Washington, DC, USA
| | | | - Denis Mukwege
- Panzi General Referral Hospital, Bukavu, Democratic Republic of the Congo
- Evangelical University in Africa, Bukavu, Democratic Republic of the Congo
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Punyadasa DH, Kumarapeli V, Senaratne W. Development of a risk prediction model to predict the risk of hospitalization due to exacerbated asthma among adult asthma patients in a lower middle-income country. BMC Pulm Med 2023; 23:491. [PMID: 38057750 DOI: 10.1186/s12890-023-02773-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/18/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Asthma patients experience higher rates of hospitalizations due to exacerbations leaving a considerable clinical and economic burden on the healthcare system. The use of a simple, risk prediction tool offers a low-cost mechanism to identify these high-risk asthma patients for specialized care. The study aimed to develop and validate a risk prediction model to identify high-risk asthma patients for hospitalization due to exacerbations. METHODS Hospital-based, case-control study was carried out among 466 asthma patients aged ≥ 20 years recruited from four tertiary care hospitals in a district of Sri Lanka to identify risk factors for asthma-related hospitalizations. Patients (n = 116) hospitalized due to an exacerbation with respiratory rate > 30/min, pulse rate > 120 bpm, O2 saturation (on air) < 90% on admission, selected consecutively from medical wards; controls (n = 350;1:3 ratio) randomly selected from asthma/medical clinics. Data was collected via a pre-tested Interviewer-Administered Questionnaire (IAQ). Logistic Regression (LR) analyses were performed to develop the model with consensus from an expert panel. A second case-control study was carried out to assess the criterion validity of the new model recruiting 158 cases and 101 controls from the same hospitals. Data was collected using an IAQ based on the newly developed risk prediction model. RESULTS The developed model consisted of ten predictors with an Area Under the Curve (AUC) of 0.83 (95% CI: 0.78 to 0.88, P < 0.001), sensitivity 69.0%, specificity 86.1%, positive predictive value (PPV) 88.6%, negative predictive value (NPV) 63.9%. Positive and negative likelihood ratios were 4.9 and 0.3, respectively. CONCLUSIONS The newly developed model was proven valid to identify adult asthma patients who are at risk of hospitalization due to exacerbations. It is recommended as a simple, low-cost tool for identifying and prioritizing high-risk asthma patients for specialized care.
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Affiliation(s)
| | - Vindya Kumarapeli
- Directorate of Non-Communicable Diseases, Ministry of Health, Colombo, Sri Lanka
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Rozumenko A, Kliuchka V, Rozumenko V, Daschakovskiy A, Fedorenko Z. Glioblastoma management in a lower middle-income country: Nationwide study of compliance with standard care protocols and survival outcomes in Ukraine. Neurooncol Pract 2023; 10:352-359. [PMID: 37457220 PMCID: PMC10346393 DOI: 10.1093/nop/npac094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background The effective treatment of high-grade gliomas is a complex problem that requires ubiquitous implementation of sophisticated therapy protocols. The present study aimed to perform population-based analysis of glioblastoma management in lower-middle-income countries. Methods The National Cancer Registry of Ukraine was screened for the records of adult patients with primary glioblastomas diagnosed in 2015-2019. Survival analysis was performed using Kaplan-Meier method and a multivariable Cox model. Results A total of 2973 adult patients with histologically confirmed glioblastoma were included in the study. Mean age of patients was 55.6 ± 11.4 years, males slightly prevailed-1541 (51.8%) cases. The completed clinical protocol including surgery followed by chemoradiotherapy was applied only in 658 (19.0%) patients. The minority of patients 743 (25.0%) were treated at the academic medical centers, where patients were more likely to receive combined treatment 70.1% compared with 57.9% (P = .0001) at the community hospitals. The overall median survival was 10.6 ± 0.2 months, and the 2-year survival rate was 17%. The number of utilized treatment modalities contributed to better survival rates and was associated with lower hazard ratio: Protocol with 2 modalities - 0.62 (P = .0001), 3 modalities - 0.48 (P = .0001). Conclusions The management of glioblastoma in lower-middle-income countries is characterized by insufficient availability of treatment in academic medical centers and low rates of advanced therapy application. Survival analysis showed similar prognostic risk factors and outcomes compared with high-income countries.
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Affiliation(s)
- Artem Rozumenko
- Department of Neuro-Oncology and Paediatric Neurosurgery, Romodanov Neurosurgery Institute, 32, Platona Maiborody Street, Kyiv 04050, Ukraine
| | - Valentyn Kliuchka
- Department of Neuro-Oncology and Paediatric Neurosurgery, Romodanov Neurosurgery Institute, 32, Platona Maiborody Street, Kyiv 04050, Ukraine
| | - Volodymir Rozumenko
- Department of Neuro-Oncology and Paediatric Neurosurgery, Romodanov Neurosurgery Institute, 32, Platona Maiborody Street, Kyiv 04050, Ukraine
| | - Andriy Daschakovskiy
- Department of Neuro-Oncology and Paediatric Neurosurgery, Romodanov Neurosurgery Institute, 32, Platona Maiborody Street, Kyiv 04050, Ukraine
| | - Zoja Fedorenko
- National Cancer Registry of Ukraine, National Cancer Institute, 33/43, Lomonosova Street, Kyiv 03022, Ukraine
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Mizukami A, Trinh MT, Hoang TP, Shibanuma A, Ong KIC, Jimba M. Determinants of health-related quality of life among patients with systemic lupus erythematosus in Hanoi, Vietnam. BMC Rheumatol 2023; 7:16. [PMID: 37344898 DOI: 10.1186/s41927-023-00339-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which impacts patients' lives. Many studies in high-income countries have focused on their health-related quality of life (HRQoL). However, evidence of awareness of SLE and HRQoL in low- and middle-income countries is lacking. Therefore, this study aimed to identify the determinants of HRQoL of SLE patients in Vietnam, a lower-middle income country. METHODS This cross-sectional study was conducted at the National Hospital of Dermatology and Venereology in 2019. A pre-tested structured questionnaire was used to collect data. It consisted of Short Form-36 to assess HRQoL which comprised physical and mental component summaries, Multidimensional Scale of Perceived Social Support, Satisfaction with Life Scale, and Mental Adjustment to SLE. Multiple linear regression was used to identify the determinants of HRQoL. RESULTS One hundred thirty four patients with SLE participated in this study. The majority of the patients were women (n = 126, 94.0%). The mean age of all participants was 37.9 years old (standard deviation [SD] 12.5). Of 134 participants, 104 (77.6%) were married. Older patients were more likely to have a lower score of mental component summary (B=-0.45, 95% CI -0.73, -0.17). Patients with more children were more likely to have a lower score of physical component summary (B=-5.14, 95% CI -9.27, -1.00). Patients who felt more helplessness or hopelessness were more likely to have lower scores of physical and mental component summaries (B=-1.85, 95% CI -2.80, -0.90; B=-1.69, 95% CI -2.57, -0.81). Also, patients who felt more anxious were more likely to have a lower score of mental component summary (B=-1.04, 95% CI -1.77, -0.32). Patients who were more satisfied with their lives were more likely to have higher scores of physical and mental component summaries (B = 1.07, 95% CI 0.50, 1.64; B = 1.08, 95% CI 0.55, 1.61). CONCLUSION Factors associated with lower HRQoL in Vietnam were feelings of helplessness or hopelessness, and burdens of parenting roles. However, social support can contribute to a higher HRQoL, such as information support, self-support groups, and daycare services provided at the community level.
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Affiliation(s)
- Aya Mizukami
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Hashmi M, Taqi A, Memon MI, Ali SM, Khaskheli S, Sheharyar M, Hayat M, Shiekh M, Kodippily C, Gamage D, Dondorp AM, Haniffa R, Beane A. A national survey of critical care services in hospitals accredited for training in a lower-middle income country: Pakistan. J Crit Care 2020; 60:273-278. [PMID: 32942162 PMCID: PMC7441021 DOI: 10.1016/j.jcrc.2020.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE To describe the extent and variation of critical care services in Pakistan. MATERIALS AND METHODS A cross-sectional survey was conducted in all intensive care units (ICUs) recognised for postgraduate training to determine administration, infrastructure, equipment, staffing, and training. RESULTS There were 151 hospitals recognised for training, providing 2166 ICU beds and 1473 ventilators. Regional distribution of ICU beds per 100,000 population ranged from 1.0 in Sindh to none in Gilgit Baltistan (median 0.7). A senior clinician trained in critical care was available in 19 (12.1%) of units. One-to-one nurse-to-bed ratio during the day was available in 84 (53.5%) of units, dropping to 75 (47.8%) at night. Availability of 1:1 nursing also varied between provinces, ranging from 56.5% in Punjab compared to 0% in Azad Jamu Kashmir. Similarly, there was disparity in the availability of ventilators between provinces. All ICUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (electronic monitoring and infusion pumps). CONCLUSION Pakistan, a lower middle-income country, has an established network of critical care facilities with access to basic equipment, but inequalities in its distribution. Investment in critical care training for doctors and nurses is needed.
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Affiliation(s)
- Madiha Hashmi
- Ziauddin University, 4/B, Saharah-e-Ghalib, Block 6, Clifton Karachi, 7500, Sindh, Pakistan
| | - Arshad Taqi
- Kaul Associates, 14 AbuBaker Block, New Garden Town, Lahore, Punjab, Pakistan
| | - Muhammad I Memon
- Pakistan Institute of Medical Sciences, Ibn-e-Sina Road, G-8/3, Islamabad, Islamabad Capital Territory, Pakistan
| | - Syed Muneeb Ali
- Pakistan Institute of Medical Sciences, Ibn-e-Sina Road, G-8/3, Islamabad, Islamabad Capital Territory, Pakistan
| | - Saleh Khaskheli
- People's University of Medical & Health Sciences for Women, Nawabshah, Shaheed Benazirabad, 67480, Sindh, Pakistan
| | - Muhammad Sheharyar
- Lady Reading Hospital, Soekarno Road, Peshawar, Khyber Pakhtunkhwa 25000, Pakistan
| | - Muhammad Hayat
- North West General Hospital, Sector A-3, Phase 5, Hayatabad, Peshawar, Khyber Pakhtunkhwa 25100, Pakistan
| | - Mohiuddin Shiekh
- South East Asian Research in Criticalcare and Health, Remedial Centre Hospital, D-9, Block-I, North Nazimabad, Karachi 74700, Pakistan
| | - Chamira Kodippily
- Network for Improving Critical Care Systems and Training, 2nd floor, YMBA Building, Colombo 08, Sri Lanka
| | - Dilanthi Gamage
- Network for Improving Critical Care Systems and Training, 2nd floor, YMBA Building, Colombo 08, Sri Lanka
| | - Arjen M Dondorp
- Department of Malaria and Critical Illness, Mahidol Oxford Tropical Medicine Research Unit, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand
| | - Rashan Haniffa
- Network for Improving Critical Care Systems and Training, 2nd floor, YMBA Building, Colombo 08, Sri Lanka; Department of Malaria and Critical Illness, Mahidol Oxford Tropical Medicine Research Unit, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand; Bloomsbury Institute for Intensive Care Medicine, Division of Medicine, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Abi Beane
- Network for Improving Critical Care Systems and Training, 2nd floor, YMBA Building, Colombo 08, Sri Lanka; Department of Malaria and Critical Illness, Mahidol Oxford Tropical Medicine Research Unit, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand; Amsterdam Institute for Global Health and Development, University of Amsterdam, Paasheuvelweg 25, 1105, BP, Amsterdam, Netherlands.
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Giang HTN, Bechtold-Dalla Pozza S, Tran HT, Ulrich S. Stillbirth and preterm birth and associated factors in one of the largest cities in central Vietnam. Acta Paediatr 2019; 108:630-636. [PMID: 30098081 DOI: 10.1111/apa.14534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/03/2018] [Accepted: 08/06/2018] [Indexed: 11/28/2022]
Abstract
AIM Little is known about the rate of stillbirths, preterm births and associated risk factors in resource-limited settings like Vietnam. This study reports those rates for Da Nang, which is one of the largest cities in central Vietnam. METHODS Data on 20 762 births including stillbirths and preterm births and associated risk factors were prospectively collected from health facilities from April 2015 to March 2016. RESULTS The data represented 85% of the total births in Da Nang during the study period, and a stillbirth rate of 9.7 per 1000 live births was recorded. The preterm rate for live births was just under 5%. Independent factors associated with an increased risk of stillbirth and preterm births were mothers aged 35 plus, working as farmers, living in the provinces and a history of abortion. Mothers under 20 years with previous preterm births faced a higher risk of another preterm birth. CONCLUSION The stillbirth and premature birth rates in Da Nang were higher than rates in high-income countries. Developing registration programmes in Vietnam will provide improved data that will enable researchers and policymakers to identify strategies to reduce the number of stillbirths and premature births.
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Affiliation(s)
- Hoang Thi Nam Giang
- Center for International Health; Ludwig-Maximilians-University; Munich Germany
- The Faculty of Medicine and Pharmacy; The University of Da Nang; Da Nang Vietnam
| | - Susanne Bechtold-Dalla Pozza
- Center for International Health; Ludwig-Maximilians-University; Munich Germany
- Pediatric Endocrinology and Diabetology; University Children's Hospital; Ludwig-Maximilians-University; Munich Germany
| | - Hoang Thi Tran
- The Faculty of Medicine and Pharmacy; The University of Da Nang; Da Nang Vietnam
- Da Nang Hospital for Women and Children; Da Nang Vietnam
- Da Nang University of Medical Technology and Pharmacy; Da Nang Vietnam
| | - Sarah Ulrich
- Center for International Health; Ludwig-Maximilians-University; Munich Germany
- Department of Pediatric Cardiology and Intensive Care Medicine; Ludwig-Maximilians-University; Munich Germany
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Beckvid-Henriksson G, Nguyen TH, Kilhed J, Nordström A, Svensson S, Tran TTH, Van Der Ploeg I, Sundberg CJ. Implementation and assessment of diverse strategies for physical activity promotion in Vietnam-A case report. J Sport Health Sci 2018; 7:42-49. [PMID: 30356450 PMCID: PMC6180528 DOI: 10.1016/j.jshs.2017.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/14/2017] [Accepted: 09/30/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Regular physical activity (PA) has documented effects in prevention and treatment of many non-communicable diseases (NCDs). Physical inactivity is recognized as the fourth leading risk factor for premature death, worldwide. Despite these facts, physical inactivity is increasing, not only in high-income, but also in middle- and low-income countries. To address this negative trend, evidence-based methods to increase PA are needed. The purpose of this paper is to describe the implementation and assessment of 4 strategies designed to increase PA in Vietnam. METHODS Four strategies were used: i) introduction and evaluation of an education and training program on the Swedish method of Physical Activity on Prescription (PAP) among health care professionals, ii) translation of the PAP evidence-based handbook, Physical Activity in the Prevention and Treatment of Disease (called FYSS in Swedish) into Vietnamese, iii) launch of a mass-media campaign to promote PA, and iv) advocacy to support development of PA guidelines in Vietnam. RESULTS The evaluation indicated that the participating health care professionals had a positive attitude to PAP. However, they also reported uncertainty in prescribing PA. FYSS was translated and disseminated successfully to health care professionals. A mass-media campaign identified the beneficial effects of PA to health care professionals, journalists, policy makers, and the public. Last, the process of developing national guidelines on PA was initiated. CONCLUSION This project led to enhanced awareness and appreciation of PA in the prevention and treatment of NCDs among health care professionals as well as initiation of national PA guidelines. Important lessons also were learned in the presentation of PAP, which will be considered when designing similar projects in the future.
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Affiliation(s)
- Gabriella Beckvid-Henriksson
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm 17177, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge 14183, Sweden
| | | | - Julia Kilhed
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm 17177, Sweden
| | - Agnes Nordström
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm 17177, Sweden
| | - Sofie Svensson
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm 17177, Sweden
| | - Thi Thanh Huong Tran
- Department of Ethics & Social Medicine, Hanoi Medical University, Hà Nội 100000, Vietnam
| | | | - Carl Johan Sundberg
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm 17177, Sweden
- Unit for Bioentrepreneurship, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm 17177, Sweden
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Haniffa R, De Silva AP, Iddagoda S, Batawalage H, De Silva ST, Mahipala PG, Dondorp A, de Keizer N, Jayasinghe S. A cross-sectional survey of critical care services in Sri Lanka: a lower middle-income country. J Crit Care 2014; 29:764-8. [PMID: 24929445 DOI: 10.1016/j.jcrc.2014.04.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/17/2014] [Accepted: 04/24/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the extent and variation of critical care services in Sri Lanka as a first step towards the development of a nationwide critical care unit (CCU) registry. MATERIALS AND METHODS A cross-sectional survey was conducted in all state CCUs by telephone or by visits to determine administration, infrastructure, equipment, staffing, and overall patient outcomes. RESULTS There were 99 CCUs with 2.5 CCU beds per 100000 population and 13 CCU beds per 1 000 hospital beds. The median number of beds per CCU was 5. The overall admissions were 194 per 100000 population per year. The overall bed turnover was 76.5 per unit per year, with CCU mortality being 17%. Most CCUs were headed by an anesthetist. There were a total of 790 doctors (1.6 per bed), 1,989 nurses (3.9 per bed), and 626 health care assistants (1.2 per bed). Majority (87.9%) had 1:1 nurse-to-patient ratio, although few (11.4%) nurses had received formal intensive care unit training. All CCUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (such as electronic monitoring and infusion pumps). CONCLUSION Sri Lanka, a lower middle-income country has an extensive network of critical care facilities but with inequalities in its distribution and facilities.
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