Urban-rural differences in health service-related factors associated with male involvement in family planning services in Abia State, Southeastern Nigeria

Objective: To identify and compare the health service-related factors associated with male involvement in family planning services among the rural and urban areas in Abia State, Nigeria. Design: A community-based cross-sectional study. Setting: Twelve communities (six urban and six rural) in Abia State, Nigeria Participants: Five hundred and eighty-eight (588) men aged 15-59 years and resident in the study area 6 months before the study were recruited. Main outcome measure: Male involvement in family planning services Results: The mean ages of the respondents were 41.8±8.0 years and 43.1±8.0 years in the urban and rural areas, respectively. Active male involvement in family planning services was significantly higher in urban areas (62.6%, 95%CI: 56.8%-68.1%) compared to the rural areas (47.6%, 95%CI: 41.5%-53.2%. p<0.001). The predictors of male involvement included gender preference of healthcare workers (aOR=1.75, 95%CI:1.01-3.03) and attitude of the healthcare workers (aOR=2.07, 95%CI:1.17-3.67) among the urban participants, compared to occupational status of the respondents (aOR=2.50, 95% CI: 1.16-5.56) and the availability of male-friendly clinics (aOR=2.27, 95%CI:1.25-4.15) among the rural participants. Conclusion: Health service-related factors associated with male involvement varied between the urban and rural settings. Stakeholders should target addressing health service-related factors by types of settlement while designing family planning programs targeting men

The effect of beliefs about breast cancer on stage and delay to presentation: results from a prospective study in urban South Africa

Background: The disparity in breast cancer survival in Africa is often linked to poor education and awareness leading to late diagnosis and subsequent reduced survival. This study was designed to explore the relationship of attitudes and beliefs held regarding breast cancer to the stage and delay to diagnosis in South Africa. This study provies an epidemiological analysis of the spectrum of disease and outcomes of primary amputation for diabetic foot sepsis in a regional rural hospital.Methods: Women attending an open-access breast unit over 14 months with newly-diagnosed breast cancer answered a survey regarding their fears and beliefs of breast cancer care. Questions addressed demographic, socioeconomic and educational factors linked to delay, and documented time taken to care. Odds ratio with 95% confidence intervals were calculated to identify factors associated with advanced stage at presentation and delay greater than six months. Results: Of the 233 participants the median (IQR) age was 56 years (46­65). The most common stage at presentation was Stage 3 (55%), with 30.5% presenting with T4 tumour at presentation. Most women believed cancer could be beaten (90.0%), and their families would support them (92.8%). They disagreed that cancer was a curse (93.8%), punishment (90.5%) or that alternative therapies or traditional healing would cure their cancer (75.3% and 85.5% respectively). On univariate analysis, age under 45 years and transport difficulties predicted advanced stage at presentation. No socio-economic factors or beliefs increased the risk of delay to presentation. Conclusion: Participants' beliefs about their new breast cancer were most commonly appropriate, and showed a low level of fatalism, in contrast to other studies in Africa. Whilst raising awareness may be important, efforts to increase awareness alone may not directly prevent the likelihood of late or advanced diagnosis in this population

The role of support groups in linking and retaining newly diagnosed clients in HIV care in a peri-urban location in South Africa

Although South Africa has the largest number of people on antiretroviral therapy (ART) in the world, many HIV clients drop out of care immediately after HIV diagnosis. This qualitative study explored the perceptions and experiences of newly diagnosed clients on the role support groups play in linking and retaining newly diagnosed clients in HIV care in Mbandazayo peri-urban location. The data were analysed using the thematic content analysis approach. Data revealed four mechanisms through which support groups appeared to link and retain newly diagnosed clients in the HIV care continuum. First, support groups were a formal link between newly diagnosed clients and health facilities. Second, support groups mitigated the effects of both felt and enacted stigma, thereby facilitating acceptance of HIV diagnosis among newly diagnosed clients. Third, support groups were an advocacy and networking tool for newly diagnosed clients to make their health related needs, challenges, and concerns known to local health clinics, thereby forging and maintaining a close relationship with their local health facilities. Last, support groups were spaces within the community where practical needs of newly diagnosed clients are met, which in turn help in retaining them within support groups, and facilitate their linkage and retention in the HIV continuum of care in Mbandazayo. Our findings suggest that HIV support groups are critical in enhancing linkages and retention of newly diagnosed clients in HIV care. With the introduction of universal test and treat (UTT) in South Africa, our findings suggest that support groups can play a significant role in retaining HIV care clients who are diagnosed and immediately enrolled on ART

A Cross-Sectional Study of Socioeconomic Status and Cardiovascular Disease Risk among Participants in the Prospective Urban Rural Epidemiological (PURE) Study

Background. Cardiovascular diseases (CVDs) are a challenge to populations and health systems worldwide. It is projected that by 2020 about a third of all deaths globally will be caused by CVDs; and that they will become the single leading cause of death by 2030. Empirical evidence suggests that there is socioeconomic patterning in the distribution and prevalence of risk factors for CVD; but the exact nature of this relationship in South Africa remains unclear. Objective. To examine the association between socioeconomic status (SES) and risk factors for CVD in a cohort of adult South Africans living in rural and urban communities.Method. This was a cross-sectional analytical study of baseline data on a population-based cohort of 1 976 SA men and women aged 35 - 70 years who were part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study.Results. We found a complex association between SES and CVD risk factors; its pattern differing between urban and rural participants. Marital status showed the most consistent association with CVD risk in both groups: widowed participants living in urban communities were more likely to be hypertensive as well as diabetic; while single participants in both locations were more likely to use alcohol and tobacco products. Level of education was the only SES variable that had no significant association with any CVD risk factor in either study group. All measured SES variables were significantly different between urban and rural participants (p0.05); with diabetes; obesity and alcohol use significantly more prevalent in urban than in rural participants (p0.05) while hypertension and tobacco use were not (p?0.05). Conclusions. In this cohort of South Africans; there were significant associations between SES and CVD risk; with marked differences in these associations between rural and urban locations. These findings highlight the need to consider SES and area of residence when designing interventions for CVD prevention and control

Saúde, estilo de vida e urbanização em Moçambique: problemas e perspectivas / Health, Lifestyle and urbanization in Mozambique: problems and perspectives

A irreversibilidade do processo de urbanização da população mundial está a atingir Moçambique de uma forma abrupta com múltiplas consequências para a saúde e bem, estar. Entre outros, o aumento da mecanização, o tempo de televisão, o uso do automóvel e o recurso a alimentação artificial, está a transformar, em poucos anos, uma população activa em pessoas sedentárias sujeitas à poluição e níveis de ansiedade até então desconhecidos. Os estudos disponíveis demonstram de forma clara uma enorme redução dos espaços para a recreação activa e uma concomitante redução do dispêndio energético por actividade física habitual. Como consequência, os dados epidemiológicos indicam um aumento, nas cidades, da obesidade, hipertensão e diabetes em adultos. Por seu turno, as crianças em idade escolar estão a conhecer um crescimento em todos os factores de risco de doença cardiovascular e uma redução do seu nível de desenvolvimento motor. A falta de planeamento no crescimento urbano está a ter consequências catastróficas na saúde da população urbana. Neste quadro, a denominada transição epidemiológica acontece sob a forma de acumulação, dado que a população continua muito permissiva a doenças transmissíveis e sofre agora a acumulação de um grupo de patologias associadas ao sedentarismo e desiquilíbrio nutricional.

The process of urbanization of the world population is reaching Mozambique rather abruptly with multiple consequences for the health and well-being. Increased mechanization, screen time, car use and use of fast food are causing, in a short time period, a dramatic changing in lifestyle. Population is reducing their activity levels, that used to be high, the stress levels are increasing as well as the environmental pollution. The available studies demonstrate a huge reduction of spaces for active recreation and a concomitant reduction of energy expenditure for physical activity. As a consequence, epidemiological data indicate an increase in the prevalence of obesity, hypertension and diabetes in adults. In turn, studies are demonstrating that the school aged children are increasing prevalence in all risk factors for cardiovascular disease and a reduction in their level of motor development. Lack of urban planning on urban growth seems to cause disastrous consequences on the health of the urban population. Thus, the so-called epidemiological transition are happening in the form of accumulation since the population remains very permissive to transmissible diseases adding to them an increased in the sedentary lifestyle and nutritional imbalance related diseases.

La faune anophelienne dans une agglomeration urbaine de Kinshasa (R.D.C) en 1994-1995

Les auteurs ont effectue des captures des moustiques adultes dans les collectivites peripheriques de la zone de Ndjili (Kinshasa). Les resultats demontrent l'existence d'une cohabitation entre les Culicides et les anophelines. Dans ce dernier groupe; A. gambiae s.l. represente 99;2 pour cent de la population anophelienne. Les collectivites marecageuses et maraicheres abritent plus de moustiques que les autres. Les femelles sont moins nombreuses que les males (31;8 pour cent) mais les sex-ratios les plus importants observes dans les collectivites montrent la dynamique des femelles d'anopheles

Cout des traitements des urethrites masculines en milieu urbain au Cameroun en 1992

Une etude a ete menee dans les grands centres urbains du Cameroun pour essayer d'evaluer le cout des traitements prescrits dans les urethrites masculines. Il ressort d'abord de cette etude que l'utilisation des preservatifs est devenue monnaie courante au Cameroun. Ensuite; la standardisation du prix de ces traitements a permis de reduire nettement les depenses des malades. Cela a ete finalement un grand succes pour les autorites sanitaires du Cameroun

Sante et environnement urbain

Le phenomene d'urbanisation est d'autant plus marquant en Afrique Noire que le continent; depuis le temps lointain des villes des routes transahariennes et du Ghana; etait reste a l'ecart du processus d'urbanisation que connaissaient l'Europe et dans une moindre mesure l'Amerique et l'Asie. Le passage en quelques decennies de villes moyennes a des villes millionnaires pose des problemes aigus de sante publique. Or; Une recherche sur les relations entre urbanisation et sante en Afrique Noire requiert le concours de specialistes tant des sciences sociales que des sciences biomedicales. Cet article presente succintement quelques traits specifiques des problemes de sante dans des villes d'Afrique Noire

The men's family planning Kap in peri-urban Kampala; Uganda 1989

This paper presents results of family planning Kap study which was done in september; 1989 on men in a peri-urban area in Uganda. Men's opposition to family planning was not as widespread as it populary believed. Men would encourage women to participate in decision making about family size and share responsability in women's health. The problem appeared to be the lack of communication between couples/partners which if it was available; men's consent for family planning use would be favourable

An evaluation of nutrition within an urban health care programme; Malawi

With respect to growth monitoring; nearly all mothers appeared to have a high level of awareness of the main concepts; the importance of growth monitoring and meaningful interpretation of the growth chart. The main area of weakness identified was the appropriate age of introduction of weaning foods. Appropriate weaning and age of introduction were significantly associated with nutritional status. The structural aspects of the primary health care programme illustrated the excellent implementation strategy used throughout its development

L'assainissement a Brazzaville

Le present rapport a pour but d'exposer de facon simple; l'etat d'assainissement tel qu'il est actuellement vecu dans la capitale congolaise et; de preciser quelques grandes lignes du projet d'assainissement de la ville de Brazzaville. Ce rapport technique essaie donc d'analyser sommairement les risques que presente pour la sante de la population; la proliferation des immondices a Brazzaville. Aussi a-t-il l'intention de sensibiliser les responsables communaux sur les possibilites existant en matiere de traitement des immondices et des eaux usees afin d'ameliorer le cadre de vie du Brazzavillois

Faune anophelienne endophile au niveau de la communaute de Niamey en saison seche

L'auteur a effectue en decembre 1993 et en janvier 1994 une enquete entomologique dans la communaute urbaine de Niamey; departement de Tillaberi en Republique du Niger. L'enquete a montre la persistance en saison seche des vecteurs du paludisme; principalement An. gambiae S.I au niveau de la ville de Niamey. Sur l'ensemble des anopheles endophiles captures puis identifies An. gambiae s.I nili avec 82;06 pour cent de l'ensemble des anopheles femelles; An. nili avec 5;79 pour cent et An. rufipes avec 11;59 pour cent. Les densites anopheliennes au niveau des quartiers varient en fonction de leur position par rapport au fleuve Niger et a l'existence de l'affleurement de la nappe phreatique qui traverse la ville

A survey to identify existing practices by health workers in the obstetrical units of the district health facilities in relation to breast feeding

Objective of the study was to identify existing practices within the obstetrical units of the health facilities in the Kumasi District including Komfo Anokye Teaching Hospital (KATH) which enhance or prevent successful breast feeding among mothers. Specifically to find (1) health workers practices in the antenatal clinics; (2) practices in the delivery units and (3) practice in the postnatal wards. The survey clearly showed that existing practices within the health facilities in the district do to some extent discourage successful breast feeding. This is due to inadequate preparation antenatally and also lack of facilities to promote rooming-in especially in KATH. The smaller facilities do practice rooming-in. However; first contact of mother with baby is delayed