The socioeconomic impact of rural-origin graduates working as healthcare professionals in South Africa

Background: Studies documenting the socioeconomic impact of education leading to employment of rural youth, specifically in the healthcare professions, are lacking. The Umthombo Youth Development Foundation (UYDF) is an NGO that provides financial support for rural students to train as healthcare professionals (HCPs) as a way of addressing staff shortages at rural hospitals. The aim of this study was to understand the social and economic impact on individuals and their families of qualifying as an HCP and being employed at a rural district hospital. Methodology: A mixed methodology was used to collect data from 40 graduates at eight district hospitals in rural KwaZulu-Natal province. The research tools had qualitative and quantitative questions, with additional data being extracted from the UYDF database. The qualitative data were analysed thematically, with STATA software being used for the quantitative analysis. Results: The findings indicate that graduate household assets increased significantly, as did their socioeconomic circumstances, compared with before they qualified as HCPs. Graduates attached high value to education that led to their employment, which provided them with money to afford assets. Having a permanent job and regular income also transformed their families' lives, as they were able to care for their siblings and extended family members. Conclusions: Training rural youth for employment in scarce skills that leads to employment, such as a career in the health sciences, boosts their socioeconomic circumstances and that of their families. This contributes to the staffing of rural hospitals, job creation and the economic development of the country

Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

Background. Exclusive breastfeeding is rarely practised in most rural areas of developing countries. Poor breastfeeding practices may stem from negative attitudes or poor knowledge about the value of breastfeeding. Objective. To determine breastfeeding knowledge and practices among mothers of infants younger than 2 years in a rural area of the Limpopo province, South Africa (SA). Methods. A cross-sectional questionnaire-based survey was conducted among 360 women with children younger than 2 years from the Ha-Khakhu area in the Vhembe district, SA. Snowballing was used to select 360 participants. Results. The mean age of the respondents was 29.3 (8.1) years (range 18 - 45 years). The majority (75%) of the respondents agreed that infants should be breastfed up to the age of 6 months. Two-thirds of the respondents initiated breastfeeding within an hour of giving birth. During the time of data collection, 83% of the respondents were still breastfeeding, while 17% had stopped. The majority of the respondents (75.8%) agreed that complementary feeding should start at the age of 6 months. Conclusion. The respondents' breastfeeding practices did not correspond to their high level of knowledge about breastfeeding. It is recommended that health education initiatives be intensified to promote breastfeeding

The prevalence pattern of locomotor disability and its impact on mobility, self-care, and interpersonal skills in rural areas of Jodhpur district

Context: Impact of disability is deleterious, affecting an individual's every aspect. Majority of disabled reside in rural areas of developing countries. Moreover, different types of disability add to its wide spectrum. All these make it a major health issue. Aims: The aim of this study was to note the prevalence rate and pattern of locomotor disability in a rural population of Jodhpur District and to observe its impact on mobility, self-care, and interpersonal skills of disabled. Settings: This study was carried out in rural field practice area of the Community and Family Medicine Department of tertiary care setup. Design: This was a cross-sectional study. Materials and Methods: House-to-house survey for a sample size of 1656 was conducted by a team of trained doctors, therapists, and anganwadi workers for identification of locomotor disability applying a pretested survey questionnaire. Statistical Analysis: SPSS version 22 was used for descriptive analysis of variables (frequency distribution), and the Chi-squared test was used for the association of sociodemographic factors with performance qualifier score. Results: The prevalence rate of 2.08% for locomotor disability (male = 57% and female = 43%) was noted, with 31% from 40 to 60 years, 49% were illiterate, and 60% were from lower class. The main etiologies were cerebrovascular accident (25%) and cerebral palsy (23%). About 80% faced some difficulties in mobility domain, 57% in self-care, and 63% in interpersonal skills. Statistically significant association was seen for self-care domain with education level (P = 0.04) and for interpersonal skill domain with age groups and diagnosis (P = 0.022 andP = 0.035, respectively). Conclusion: The overall prevalence of locomotor disability in rural Jodhpur was 2.08%, higher for males and higher from 40 to 60 years. Most disabled were illiterate and were from low socioeconomic status. Self-care, mobility, and interpersonal skills were primarily affected and require proper intervention

Prevalence of tobacco use in selected Johannesburg suburbs

Background. Tobacco smoking is estimated to kill more than 44 000 South Africans every year. Studies have shown that since the introduction of tobacco control measures, national smoking prevalence has declined in South Africa (SA). Objective. To determine the prevalence of tobacco smoking over a 7-year period in five impoverished neighbourhoods in Johannesburg, SA.Methods. Data were collected through the annual administration of a prestructured questionnaire to one adult respondent in preselected dwellings from 2006 to 2012. Information was collected on socioeconomic status, smoking practices and health status.Results. Over the 7-year period of the analysis, smoking levels remained unchanged. The proportion of households with one or more smokers varied significantly across the five study neighbourhoods. Approximately 20% of households in Hillbrow and as many as 77% in Riverlea had a member who smoked.Conclusions. Despite a national downward trend in smoking levels, tobacco use remains high and persistent in certain vulnerable communities, requiring scaled-up action to reduce the risk of a range of tobacco-related diseases

Comparing influenza positivity rates by real-time rt-pcr, elisa and viral culture methods in Cote d'Ivoire, West Africa, in 2009

Detection of circulating influenza strains is a key public health concern especially in limited-resource settings where diagnosis capabilities remain a challenge. As part of multi-site surveillance in Cote d'Ivoire during the 2009 influenza A(H1N1) pandemic; we had the opportunity to test respiratory specimens collected from patients with acute respiratory illness (ARI). We analyzed and compared the percentage of specimens testing positive using three laboratory methods (rtRT-PCR; ELISA; viral culture). From January to October 2009; 1;356 respiratory specimens were collected from patients with acute respiratory illness and shipped at the WHO NIC (Institut Pasteur) Cote d'Ivoire; and 453 (33) tested positive for influenza by one or more laboratory methods. The proportion of positive influenza tests did not differ by the sex or age of the patient or presenting symptoms; but did differ depending on the timing and site of specimen collection. Of the 453 positive specimens; 424 (93.6) were detected by PCR; 199 (43.9) by ELISA and 40 (8.8) by viral culture. While seasonal influenza A(H1N1) virus strains were prominent; only four 2009 pandemic influenza A(H1N1) cases were detected. Use of molecular biology method (rtRT-PCR) increased sensitivity and diagnosis capabilities. Among all three methods used; rRT-PCR was the most sensitive and rapid method. More capacity building is still required for viral culture. Need to collect denominator data in order to have an accurate estimate of the burden of influenza. There was delayed introduction of pandemic influenza A(H1N1)2009 in Cote d'Ivoire

Migration and Sexual Behaviour among Youth in Nairobi's Slum Areas

Migration remains an important event in the urbanization process. However; research evidence indicates that migration is associated with negative outcomes. For migrant youth; migration often coincides with leaving home and divesting of parental authority and controls. This study investigates migration as a determinant of risky sexual behaviours and the factors influencing the timing of first sex among migrant youth. We used data collected between 2006 and 2008 from youth aged 12-22 years living in two slums in Nairobi. We use Cox proportional hazards model for timing of first sex among migrants and logistic regression for determinants of risky sexual behaviour. Migration is important for number of sexual partners but not for sexual debut. The risk of initiating first sex soon after in-migration is higher for youth with problem behaviour. Among adolescents in Nairobi's slums; migration is not associated with a higher risk of engaging in risky sexual behaviour. However; youth with problem behaviour face a higher risk of initiating sex soon after migration

Determinants of Undernutrition among Primary School Children Residing in Slum Areas of a Nigerian City

Background: Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria; characterized by widespread poverty and inequitable distribution of wealth. Objective: This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors; and the nutritional status of children residing in a typical urban slum. Materials and Methods: A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified; multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Results: Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (?2 = 66.69; P = 0.000). Conclusion: This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition

Low Levels of some Nutritional Parameters of Pregnant Women in a Rural Community of South East Nigeria: Implications for the Attainment of the Millennium Developmental Goal

In developing countries; under nutrition is common; and this plays a crucial role in the pathogenesis of malaria and anemia. Indeed it has been associated with adverse pregnancy outcomes. Unfortunately; published evidence concerning the situation is lacking. Objectives: To evaluate some nutritional function indices of pregnant women in a rural Nigerian community. Subjects and Methods: This is a cross sectional study involving of 171 pregnant women from a rural area in South-eastern Nigeria. They included 72 and 99 women in their second and third trimesters respectively. The control group was of 60 women; matched in age; parity and socioeconomic conditions; non-pregnant; non-menstruating and non lactating apparently healthy women. The parameters measured by standard methods included serum iron; total proteins; albumin; globulin; packed cell volume and hemoglobin. Results: The results obtained from control group; second and third trimesters; recorded as Mean (SEM) were 134.60(3.12) ?g/L; 101.20(4.48) ?g/L and 91.87(3.42) ?g/L respectively for iron; 69.12(0.80) g/L; 63.60(0.71) g/L and 57.74(0.75) g/L for total proteins; 42.95(0.92) g/L; 35.74(1.00) g/L and 35.26(0.64) g/L for albumin; 26.77(1.00) g/L; 27.78(1.07) g/L and 22.93(0.88) g/L for globulin; 32.80(0.36); 27.92(0.37) and 27.73(0.34) for packed cell volume; and 11.25(0.11) g/L; 9.59(0.13) g/L and 9.57(0.14) g/L for hemoglobin respectively. These results showed that all the parameters decreased significantly in pregnancy (P0.001) except globulin that did not show immediate; significant decrease. Conclusion: There is a general decrease in the nutrition parameters studied among the pregnant women from our study area; indicating under-nutrition. Urgent measures should be taken to improve the nutritional status of rural dwellers especially the antioxidant micronutrients

The Prevalence of Substance Use and its Associations amongst Students Attending High School in Mitchells Plain; Cape Town

Purpose: In South Africa; there has been an increase in illicit drug trafficking and consumption and associated problems since the 1990s. Mitchells Plain in Cape Town is seen as a community battling with crime; gangsterism; unemployment; overcrowding; substance abuse and poverty. This study evaluated the actual prevalence of substance abuse amongst high school students in this community and factors associated with substance use. In particular; the study evaluated the use of tik (crystal methamphetamine); a relatively new drug. Method: A cross-sectional study was performed amongst 12 secondary schools in Mitchells Plain; Grade 8 and Grade 11 classes were randomly selected to produce a sample of 438 learners. The students completed an anonymous questionnaire that contained enquiries on substance use; demographic and school performance details; and personal and sexual risks. Results: Lifetime and annual prevalence rates were: alcohol (50.6/41.0); tobacco smoking (49.7/36.2); cannabis (32.1/21.1); crystal methamphetamine (9.2/4.6); ecstasy (4.4/2.7); mandrax (2.1/0.9); solvents (3.0/0.9) and cocaine (0.9/0.9). Illicit substance use was significantly associated with age (OR 1.6; CI 1.2-2.2); substance use by other members of the household (OR 2.8; CI 1.2-6.3); carrying a knife (OR 10.9; CI 4.2-28.8); attempted suicide (OR 3.7; CI 1.4-9.5) and higher sexual risk (OR 1.6; CI 1.2-2.3). Conclusion: The prevalence of substance use amongst adolescent students attending high schools in Mitchells Plain; Cape Town; is high for all substances relative to national and international figures. Government officials; educators and health care workers are alerted to the need for more comprehensive interventions to prevent and treat substance abuse in this and similar communities

Adult Patients Presenting with Undescended Testis in Awareness-Poor Region

Objectives The majority of patients with undescended testis present during childhood with minimal complications owing to straightforward treatment with excellent postoperative outcome. This paper reports the mode of presentation; challenges and outcome of management of adult patients with undescended testis. Methods. This prospective study included consecutive cases of adult patients managed with undescended testis from January 2004 to December 2008 in Evbuomore; Nigeria. Results Eighteen adults with a mean age of 38.3 years (range 19-61) were managed during the period. Ten (55.5) had bilateral; 5 (27.8) right and 3 (16.7) left lesions. Awareness was poor as they presented due to infertility in 8 (44.4); associated hernia 5 (27.8); wife/self discovery 4 (22.2) and accidental discovery by a health worker 1 (5.6); with 9 men (50) presenting between 30 and 40 years of age. On inguinal exploration; only 3 (10.7) patients had viable but significantly reduced testicular volume; 17 (60.7) were atrophic/fibrotic while in 8 (28.6) the vas deferens ended blindly in the inguinal canal with no viable testicular tissue. Apart from three patients who had children before presentation; infertility persisted even after treatment despite adequate hormone profiles and satisfactory sexual performance. Counseling of spouses was a major challenge; with 8 couples adopting children and three marriages ending in separation. conclusion: Management of adults with undescended testis was challenging due to irreversible complications; psychological effects and poor outcome of treatment which shows the importance of awareness programs that will result in childhood presentation

Social and Economic Consequences of HIV and AIDS on Children: Case Study of a High-Density Community in Harare; Zimbabwe

We present results from a household-based survey that was conducted in Mabvuku; a high-density community in Zimbabwe. The objective of the study was to improve understanding of social and economic consequences of HIV and AIDS on children. Children affected by HIV and AIDS (CABA) formed the treatment group while those not affected by HIV and AIDS (non-CABA) were the control group. We found that many of the differences in the socio-economic indicators that we studied between CABA and non-CABA were not significant. Therefore our results indicate a gloomy scenario for all the children. These results are consistent with existing literature which indicates that the impact of HIV and AIDS is exacerbated by poverty. Based on evidence from this paper; we conclude that programmes and interventions targeted at children should encompass both CABA and non-CABA within a framework of sustained commitment to improving the lives of these children. We hope that our findings will be used in the formulation of interventions and strategies to improve the situation of children affected by HIV and AIDS and/or living in impoverished communities

Circumventing or Superimposing Poverty on the African Child? The Almajiri Syndrome in Northern Nigeria

This paper discusses the nature and problems associated with street begging by children as it exists today in virtually all states of Northern Nigeria. It contends that this practice in the area is antithetical to human capital development because of its proclivity to deprivation and abuse of children; inducing poverty and further exacerbating underdevelopment of the North. It suggests a sincere commitment by the northern state governments to funding education; a synergy between Qur'anic schools and Universal Basic Education; endorsement and domestication of the 2003 Child's Rights Act by states of the north and the banning of itinerant scholars; migration of children and begging in the north as ways of eradicating begging among children in the region

Factors which may influence immunization coverage among the under-five children in an urban poor population in Uganda

A total of 341 mothers; with at least one child aged under 5 years were interviewed in Katanga Valley (KV)-Kampala to assess some factors which may influence urban poor mothers to take their children for immunization. By analyzing factors which influenced mothers to take their children for at least one dose of vaccine against at least one of the six immunizable diseases (measles; tuberculosis; polio; diphteria; pertussis and tetanus) in Uganda and taking care of the ages of the children and the number of vaccine doses the children had received; we were able to establish that the mother's highest level of education attained; marital status; employment status and knowledge in immunization may be significant factors which influence immunization coverage in KV urban poor population. [abstract terminated]

Assessment of nutrition status among children under five years in a Kampala slum area

This report presents the findings of a community diagnosis which was made in Kibuli slum area; Kakungulu zone; Kampala district between the 1st and 2nd of April 1992 by a group of fourth year medical students

COVID-19 related knowledge, attitudes, practices and needs of households in informal settlements in Nairobi, Kenya

Objective: Urban slums are at high risk of COVID-19 transmission due to the lack of basic housing, water, and sanitation, and overcrowding. No systematic surveys of slum households' experiences exist to date. Methods: A mobile phone knowledge, attitudes, and practices survey was conducted March 30- 31, 2020. Participants were sampled from two study cohorts across five urban slums in Nairobi, Kenya. Findings: 2,009 individuals (63% female) participated. Knowledge of fever and cough as COVID-19 symptoms was high, but only 42% listed difficulty breathing. Most (83%) knew anyone could be infected; younger participants had lower perceived risk. High risk groups were correctly identified (the elderly - 64%; those with weak immune systems - 40%) however, 20% incorrectly stated children.Handwashing and using hand sanitizer were known prevention methods, though not having a personal water source (37%) and hand sanitizer being too expensive (53%) were barriers.Social distancing measures were challenging as 61% said this would risk income.A third worried about losing income, only 26% were concerned about infecting others if themselves sick. Government TV ads and short message service (SMS) were the most common sources of COVID-19 information and considered trustworthy (by >95%) but were less likely to reach less educated households. Conclusion: Knowledge of COVID-19 is high; significant challenges for behavior change campaigns to reach everyone with contextually appropriate guidance remain. Government communication channels should continue with additional efforts to reach less educated households.A strategy is necessary to facilitate social distancing, handwashing and targeted distributions of cash and food