Ability and willingness to pay for family planning services in low resource settings: evidence from an operational research

Objective: This paper establishes levels and patterns of ability and willingness to pay (AWTP) for contraceptives, and associated factors. Study design: A three-stage cluster and stratified sampling was applied in selection of enumeration areas, households and individuals in a baseline survey for a 5-year Family planning programme. Multivariable linear and modified Poisson regressions are used to establish factors associated with AWTP. Results: Ability to pay was higher among men (84%) than women (52%). A high proportion of women (96%) and men (82%) were able to pay at least Ug Shs 1000 ($0.27) for FP services while 93% of women and 83% of men who had never used FP services will in future be able to pay for FP services costed at least Shs 2000 ($0.55). The factors independently associated with AWTP were lower age group (<25 years), residence in urban areas, attainment of higher education level, and higher wealth quintiles. Conclusion: AWTP for FP services varied by different measures. Setting the cost of FP services at Shs 1000 ($0.27) will attract almost all women (96%) and most of men (82%). Key determinants of low AWTP include residence in poor regions, being from rural areas and lack of/low education. Implications statement: Private providers should institute price discrimination for FP services by region, gender and socio-economic levels. More economic empowerment for disadvantaged populations is needed if the country is to realise higher contraceptive uptake. More support for total market approach for FP services needed

Evaluation of the repeated exposure of hexaflumuron on liver and spleen tissues and its mutagenicity ability in male albino rat

Background: Hexaflumuron (HFM) is an insect growth regulator (IGR); it is highly effective against a wide range of pests. Aim of the work: Due to the lack of toxicological assessments of this insecticide especially the formulation type, the objective of the present study was aimed to investigate the toxicological effects of repeated exposure of HFM formulation on adult albino rats. Materials and methods: Three groups were administered daily by gavage for (28 days) at dose of 11, 4, and 2.5 mg/kg b.wt respectively. In addition to control group. Results: The results of acute toxicity indicated HFM exhibited moderate to some extent high toxicity toward the treated rats. Slight tremors and bleeding from nose were observed. The repeated exposure results revealed the high and middle doses exhibited methemoglobinemia. Also, the HFM treatment led to increase in AST and ALT levels. The urea and creatinine levels were not significantly increased except the level of creatinine in high dose. According to the histopathological findings the middle and low doses of HFM revealed greater injurious in liver and spleen tissues than induced by high dose. HFM induced a statistically significant increase in the micronucleus (MN) frequency in a dose-dependent manner compared with a negative control group. Conclusion: So, it is obvious the middle and low doses induced damage in the liver and spleen organs while the high dose induced damage in blood, bone marrow, and kidney organs

Effect of a worksite wellness programme on the physical work capacity profile of workers in an electricity supply company

The aim of this study was to determine the effect of a worksite wellness programme on the physical work capacity profile of workers. Male workers who did not meet the minimum physical ability task requirement based on an assessment of ten essential physical abilities for their job were selected for this study. Twelve workers in the experimental group participated in a 24-month worksite wellness programme and 62 were in the control group. Pre- and post-tests determined if their physical work capacity profile met the minimum physical ability task requirements of their job. There was no practically significant (d = 0.8) difference between the two groups before the start of the programme after controlling for age; gender; motivation to change and initial physical work capacity profile differences. The results showed that workers whose physical work capacity profile did not meet the minimum physical ability task requirement of their job; were practically significantly (.......... = 4.25) more likely to improve their physical work capacity profile through the 24-month worksite wellness programme to a level were they met the minimum physical ability task requirement of the job; than those receiving no intervention. The study found that the cases were poorly reported. The follow up system at the local level between local government officials and the farmers was not efficient for the prevention of agrichemical poisonings. The contributory factors were insufficient information and training; the incorrect use of personal protective equipment; the lack of safety of the agri-chemical store; and the absence of a monitoring system on the majority of farms. This study demonstrated that the notification of agricultural chemical poisoning was applied in a fragmentary manner between the different governmental levels and departments

Evaluation of the Capacity to Appropriately Diagnose and Treat Malaria at Rural Health Centers in Kabarole District; Western Uganda

Setting: Malaria has remained the leading cause of morbidity; responsible for 47of the total causes of ill health at the outpatient department; in Kabarole District for over ten years. In Uganda; the malaria treatment policy changed the first-line treatment from chroloquine and sulfadoxine/pyrimethamine (SP) to artemisinin-based combination therapies in 2005; necessitating building new technical and infrastructural capacities. Objective: This study evaluated the status of the capacities and practices to appropriately manage malaria in a rural setting following the new guidelines.Methods: A stratified random sample of 16 heath facilities was selected from public and private not for profit health centres. We used a pre-tested interviewer-administered questionnaire to interview 26 health workers; and observation checklists to assess essential equipment; supplies; anti-malarial medicines; human resources and treatment practices. Data analysis was done with Epi-Info soft ware. Procedure observations made were coded according to the emergent themes and frequencies calculated. Results: More than 75of the respondents had little knowledge on basic facts about malaria and 54did not know the new malaria treatment policy. Over 50health workers did not understand the rationale for intermittent preventive treatment and 65had never had refresher training about malaria management. At least 65mentioned AL as the first-line anti-malarial treatment and 73mentioned parental quinine as a drug of choice for complicated malaria. Over 80health facilities had experienced stock-outs of artemether/lumefantrine (AL) and SP within the 3 months prior to the study. Only one health centre had 80of the minimum required staff. Malaria treatment policy guidelines lacked in 86health facilities; microscopes in 50; while 100lacked insecticide-treated bed nets. All clinicians spent inadequate time i.e. less than (10-19 minutes) with malaria patients; 82never conducted physical examination; 92never checked for anemia and 67never weighed patients. Conclusion: The district has very low capacity to manage malaria correctly according to the guidelines. The study recommends regular refresher training of health workers on malaria policy and additional support to health facilities to improve their capacity to manage malaria