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Background: Improving the quality of life is a major goal in the provision of health. The study aimed to identify level of quality of life and associated factors with it among pregnant and mothers of under five children in the Kwango district of the Democratic Republic of the Congo.
Methods: A total of 1,333 pregnant women and mother of under five children age. In the total of 719 pregnant women and mother of under five children in the Kenge area and 614 in the Boko area, were selected for the study in 2017. As primary outcome, EuroQol 5Dimension was measured with respect to mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each domain was subdivided into three categories 1) no problem, 2) some problem and 3) problem if of these questions answered that there was a problem, they were defined as problematic. Descriptive statistics, chi-square test and logistic regression analysis was performed to analyze whether general and medical service-related characteristics affect quality of life.
Result: In total, 302 (22.7%) individuals reported to have at least one problem. Education, income level, perceived quality of hospital services, hospital services utilization and post-partum problem were significantly associated quality of life.
Conclusion: Official Development Assistance (ODA) projects in the Democratic Republic of Congo are required not only for the maternal health projects but also policies to raise education and income in order to improve the quality of life related to women’s health.
Background: Despite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015?the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Antenatal care (ANC) service is a cost-effective intervention for reducing the maternal mortality ratio in low-income countries. This study aimed to identify the intervention effect of the maternal and child health care (MCH) project on the use of four or more (4+ ) ANC services.
Methods: The MCH project was implemented using the three delays model in Kenge city by the Ministry of Public Health (MoPH) of the DRC with technical assistance from Korea International Cooperation Agency (KOICA) and the Yonsei Global Health Center from 2014 to 2017. Furthermore, Boko city was selected as the control group. A baseline and an endline survey were conducted in order to evaluate the effectiveness of this project. We interviewed 602 and 719 participants in Kenge, and 150 and 614 participants in Boko in the baseline and endline surveys, respectively. We interviewed married reproductive-aged women (19?45 years old) in both cities annually. The study instruments were developed based on the UNICEF Multiple Indicator Cluster Surveys. This study used the homogeneity test and the
binary logistic regression difference-in-differences method of analysis.
Results: The odds of reproductive-aged women’s 4+ ANC service utilization at the intervention site increased 2.280 times from the baseline (OR: 2.280, 95% CI: 1.332?3.902, p = .003) as compared to the control site.
Conclusions: This study showed that the KOICA MCH project effectively increased the 4+ ANC utilization by reproductive-aged women in Kenge. As the 4+ ANC services are expected to reduce maternal deaths, this project might have contributed to reducing maternal mortality in Kenge. In the future, we expect these findings to inform MCH policies of the MoPH in the DRC.
Objectives: The purpose of study was to evaluate the effects of maternal and child health capacity building training
programme for health workers on knowledge, attitude, practice, and confidence in Kwango, Democratic Republic of
Congo. Methods: Total participants were 369 health workers on 6 topics. 6 topics of maternal and child health care
training sessions were conducted to evaluate the changes in knowledge, attitude, practice, and confidence of health
workers through the questionnaires in pre-and post- training. Analysis were used in paired t-test, independent t-test
and ANOVA by SPSS 24.0. Results: Knowledge, attitude, practice, and confidence were significantly different between
pre-and post-training of health workers. In all training, knowledge, attitudes, practice and confidence score were
increased. According to the position, there were the positive change of score in pre-and post-training from A2 nurses
in essential newborn care, medical doctors in management of medicine and A3 nurses in emergency obstetric and
neonatal care. Conclusions: To provide the improved maternal and child healthcare service and raise the level of
maternal and child health in developing countries, the capacity building of health workers should be supported and
continued.
Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention.
Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health
problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study
design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed
using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were
performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal
care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156?4.174], p=.016); within 7 days
(OR=1.972, 95% CI: [1.102?3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082?4.172], p=.029) among reproductive
health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with
postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038?
3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060?3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192?3.366],
p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote
health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand
washing, prevention of malaria. (Afr J Reprod Health 2019; 23[3]: 30-41).
This study aimed to evaluate the effectiveness of a school-based mental health education
program in preventing adolescent suicide attempts in an impoverished urban area in Peru, as part of
an Official Development Assistance project by the Korea International Cooperation Agency. The
PRECEDE-PROCEED model informed the effectiveness study. In this intervention, the participants
were first to fifth grade students in public secondary schools. The pre-post intervention survey was
conducted with a stratified random sampling method. A sample of 768 and 738 students in
experimental and control groups was analyzed comparatively, using chi-squared tests and logistic
regression. This study found that the program had a positive effect on adolescent mental healthrelated risk behaviors and suicide attempts in the experimental group compared to the control group.
Thus, the intervention may have helped prevent the increase in mental health-related risk behaviors
and suicide attempts. Further, parental affection, when included in the intervention, had a significant
effect on suicide attempts. As such, the involvement of parental affection in the intervention might be
effective in preventing suicide attempts. To enhance the effectiveness of interventions aiming to
prevent adolescent suicide, the participation and attention of parents, as well as adolescents, must be
encouraged. Further, to maintain the effectiveness of the intervention and expand coverage to other
schools in the neighborhood, a strategy for project sustainability is needed, particularly with regards
to capacity-building in schools and communities.
Human immunodeficiency virus (HIV) testing is important to HIV prevention, treatment, and care. We aimed to assess the role of sociodemographic, behavioral factors and HIV knowledge on HIV testing among people aged 15-49 years in Nepal. The 2011 Nepal Demographic and Health Survey data was used for secondary data analysis. Herein, 9843 women and 3017 men who had experienced coitus were included. The respondents were asked if they underwent HIV testing and received the test results in their lifetime. Chi-square test and multivariate logistic regression analysis were applied at 5% level of significance. Adjusted odds ratios and 95% confidence intervals were computed separately for women and men. Of the total, 18.0% of men and 7.4% of women had been tested for HIV in their lifetime. As compared to the age of 15 to 24 years, males aged 25 to 29 years were more likely to report, whereas females aged 35 to 49 years were less likely to report HIV testing. Lower caste groups had more likelihood of reporting HIV testing than the other caste in both sexes. The odds of being tested for HIV were significantly higher among those who had higher education in both sexes. There was significant positive association between HIV testing and economic status in males whereas this association was reverse among females. The male respondents who spent more than one month away from home in the last 12 months were 1.68 times more likely to have been tested for HIV in their lifetime. Having multiple sexual partners was associated with higher odds of testing for HIV in both sexes. Having comprehensive HIV knowledge was independently associated with the reporting of higher odds of HIV testing in females. Promotion of HIV testing should consider sociodemographic factors, sexual behavior, and imparting comprehensive HIV knowledge.
Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization.
Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data.
Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation.
Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014.
Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.
Objectives: The aim of this study is to analyze the effects of mental health projects of KOICA-Yonsei school health
promotion project in Peru. Methods: The project was implemented in Comas and Callao, Lima, Peru from 2014 to 2017
by KOICA-Yonsei School Health project team. The intervention and control schools were four and two, respectively.
Difference in differences and logistic regression analysis were performed using the results of Baseline and Endline
surveys conducted in 2014 and 2017. Mental health indicators were used for the evaluation of the project in the study.
Results: The Difference in Differences analysis showed that the proportion of depression, suicidal thought, being in
fight and physical abuse was reduced by 11%, 7.3%, 6.9% and 4.1%, respectively. The logistic regression analysis
revealed that there was significant improvement in physical abuse and alcohol consumption. There was significant
reduction in being in the fight, intimidation in last 30 days, physical abuse by friends and alcohol consuming in last
30 days in both intervention and control group. However, the proportion of reduction was higher in the intervention
group. Conclusions: The school mental promotion project could be useful intervention for students to improve mental
health status. Therefore, it is necessary to develop and implement integrated programs to improve school mental health.
본 연구는 농촌지역 주민의 커뮤니티케어 요구도와 교통환경을 조사하여 커뮤니티케어 도입에 필요한 기본 정보를 제공하는 것을 목적으로 수행되었다.
본 연구의 대상은 강원도 한 농촌지역에 거주하는 65세 이상 경로당을 이용하는 노인이다. 조사지역의 특징을 알기 위하여 해당 지역의 버스노선과 커뮤니티케어 시설을 조사하였으며, 65세이상 경로당 이용 노인대상 커뮤니티케어 요구도 조사를 하였다. 조사지역은 강원도 원주시 흥업면이며, 흥업면에 위치한 31개 경로당 중 22개 경로당에서 조사가 진행되었다. 2018년 10월 중 조사지역에 직접 방문해 경로당 이용 노인 117명을 대상으로 설문조사 하였다.
커뮤니티케어 서비스 요구도는 예방접종과 치료서비스의 요구도가 가장 높았지만, 지역에 따른 요구도는 달랐다. 이에 지역 및 개인 맞춤형 커뮤니티케어 서비스가 필요한 것으로 나타났다. 또한, 서비스 제공기관이 많은 흥업면 사무소를 기점으로 버스노선을 조사한 결과 버스노선이 적고, 배차간격이 길어 서비스 이용이 힘든 것으로 나타났다.
결론적으로 농촌지역의 커뮤니티케어 사업을 실행하기 위해서는 지역 및 개인 맞춤 서비스를 구축해야 할 것이다. 이를 위해 기존 지역시설을 사용해 지역주민이 이용 가능한 서비스 개발을 하여 지속 가능한 사회보장제도로 만들어야 할 것이다.
