RESUMO
Objective: This survey determined the utilisation of eye care services and associated factors among adults in the Ashanti region of Ghana. Design: A population-based cross-sectional descriptive study Method: Data for this study was collected from 1615 randomly selected individuals in the Ashanti region of Ghana, using a structured, pretested interviewer-guided questionnaire. Information regarding the accessibility and determinants of, and barriers to, eye care services was based on self-reports, using the WHO Eye Care Services Assessment Questionnaire. Inferential analyses were performed using the chi-square test for statistical significance, set at p=0.05.Setting: Ashanti Region, Ghana Participants: One thousand six hundred and fifteen randomly selected adults Results: Public eye care facilities were used by 58.2% of the participants for their last eye exam. Of the participants, 47.0% had travelled less than five kilometres for their last eye exam. Waiting time and service cost were participants' most frequently cited challenges in seeking care. No need felt (40.1%), self-medication (37.7%) and cost (22.2%) were the most frequently mentioned barriers to seeking ophthalmic services. Conclusion: The major challenges encountered in seeking eye care services were waiting time and cost of service. Major barriers to ophthalmic services utilisation were no need felt, self-medication and cost. Factors such as cost, lack of felt need and self-medication, which serve as barriers to utilising eye care services, should be addressed by stakeholders through eye health education and promotion
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Humanos , Soluções Oftálmicas , Transtornos da Visão , Estudos Transversais , Automedicação , Serviços de Assistência DomiciliarRESUMO
Introduction: Households' satisfaction is an important and commonly used indicator for measuring quality in health care. Anamelioration of primary health care services at the level of households, by utilising community health workers, has led to a good healthcare system in many countries, such as Brazil. In South Africa, little is known about the satisfaction of households (HH) regarding the healthcare services they receive from ward-based outreach teams (WBOTs). A study was undertaken to determine this phenomenon. Methods: The study used a cross-sectional study design. Tshwane district had established 39 ward-based outreach teams at the time of the study and households were conveniently selected. Hence the study population was estimated to be 3 600. Using 99% confidence level and 5% confidence interval, the sample size was 660, and oversampled to 765 since all households present during the data collection were willing to be included in the survey. Data collected was captured on Microsoft Excel and analysed using SAS, version 9.2. Results: Interviews were held with members of the families, who were willing to participate. Participants' ages ranged from 18 to 110, mean age 53.1years (SD = 19.7). The study participants included more females (74.0%), and 45.2% were single. The majority (89.8%) were unemployed. Overall satisfaction was seen in 692 participants (90.7%). Outcome of satisfaction according to sex (91.9%), age (90.7%) and employment (90.8%) was not statistically significant with p-value < 0.05.Conclusions: The findings of households' satisfaction regarding the healthcare services rendered by the ward-based outreach team in Tshwane district, Pretoria, South Africa showed a high level of satisfaction from the households. This high level of satisfaction was referred to as excellent and was not associated with sex, age or employment status. A recommendation is made to all stakeholders that the ward-based outreach team programme cover all municipal wards in the country in order to raise the level of households' satisfaction with the healthcare system
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Agentes Comunitários de Saúde , Características da Família , Serviços de Saúde , Serviços de Assistência Domiciliar , Satisfação do Paciente , Qualidade da Assistência à Saúde , África do SulRESUMO
health concerns in Cameroon. Its treatment is frequently initiated at home, most often with street drugs. The home management of malaria cases entails the prescription of Artemisinin-based combination (ACTs) as first-line therapy for treatment of uncomplicated malaria after having confirmed the malaria case using rapid diagnostic tests. But induced adverse reactions of this therapy are not well known in Cameroon. Thus, a prospective, observational, cohort study of adverse events associated with ACTs was conducted from January 2013 to November 2013 in the health district of Mfou. Children under 5 years receiving ACTs for malaria treatment at home were enrolled. Suspected ADRs and other clinical events were recorded. Data were managed and analysed using Epi Info version 3.5.3 and Statistical Package for Social Sciences, statistical software version 20. Of the 479 children investigated, 56.8% (n=272/479) were males, the age group 25-59 months (49.5%; n=237/479) was most represented, 27.1% (n=130/479) had experienced one form of ADRs, male children (56.2%; n=73/130) and the age group 25-59 months (50.8%; n=66/130) were most affected. No significant association was found between age, sex and incidence of adverse ACTs reactions. The main experienced ACTs reactions were tiredness (43.1%; n=56/130) followed by lack of appetite (24.6%; n=32/130). The incidence ACTs ARDs was found to be relatively low and tolerable. Home management of malaria cases using ACTs should be encouraged and community members should be trained to improve the recognizing and reporting of adverse effects
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Artemisininas , Camarões , Pré-Escolar , Gerenciamento Clínico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Serviços de Assistência Domiciliar , Lactente , Malária/terapiaRESUMO
"Aims: The aim of this study was to determine the prevalence of microalbuminuria (MA) in patients with type 2 diabetes mellitus (T2DM) and to identify the associated risk factors. Settings and Design: The study was a prospective; descriptive; cross-sectional study carried out in the medical outpatient department of the Central Hospital; Warri from March to August 2014 after approval by the hospital's health and ethics committee. Materials and Methods: Two hundred T2DM aged 45-80 years were randomly selected for the study after obtaining their informed consent. Three-morning urine samples collected at 1-month interval were tested for MA using the ""MICRAL test"" strip. A fasting blood sample was also drawn after 10-12 h overnight fasting for plasma glucose; hemoglobin A1c (HbA1c); lipid profile; and serum creatinine investigations. MA was diagnosed if the urinary albumin excretion ratio was between 30 and 300 mg/24 h from two separate urine samples. Statistical Analysis Used: Data was analyzed using Statistical Package for Social Sciences version 16. Differences at P 0.05 were considered significant. Results: The prevalence of MA was 58. The mean age; duration of T2DM; systolic blood pressure; fasting blood glucose; HbA1c level; serum creatinine of type 2 diabetes with MA were significantly higher when compared to T2DM patients without MA while the mean diastolic blood pressure body mass index and age did not differ significantly between the two groups. Conclusions: The overall prevalence of the MA among type 2 diabetes visiting a medical outpatient clinic in Central Hospital; Warri were high and similar to that reported in other studies."
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Albuminúria , Diabetes Mellitus , Serviços de Assistência Domiciliar , PrevalênciaRESUMO
The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland; Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised; at varying degrees of formality; to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting); we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost; our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact; our findings detail a compelling convergence among CHBC; improved HIV health practices; and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing; (2) the challenges of task-shifting agendas; above all comprehensive support of community health workers/care supporters; and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies; especially with respect to health services decentralisation; in Swaziland and similarly profiled settings
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Antirretrovirais , Cuidadores , Essuatíni , Infecções por HIV , Serviços de Assistência Domiciliar , Cooperação do PacienteRESUMO
The purpose of this paper is to bring to the attention of the AIDS research community the existence of an oral history project known as the Memories of AIDS Project. The project focused on HIV/AIDS support group members; non-governmental organisation (NGO) workers and home-based carers in the Umgungundlovu (Pietermaritzburg) District Municipality; South Africa. The project was carried out by the Sinomlando Centre for Oral History and Memory Work; a research and community development centre of the University of KwaZulu-Natal; over a period of three years (2011-2013). Sixty-five individual oral history interviews of 1 to 4 hours duration and 11 focus group sessions were recorded; transcribed and translated from isiZulu into eng when necessary. The life stories of community workers and support group members documented in the interviews show; on the part of the informants; a remarkable degree of agency and assertiveness in matters of sexuality; gender relations and religious beliefs. They found innovative ways of navigating through the conflicting claims of biomedicine; Christianity and African traditional religion. As much as the epidemic caused grief and suffering; it opened the door to new knowledge and new opportunities
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Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Serviços de Assistência Domiciliar , Estigma Social , África do SulRESUMO
Road traffic injuries are major public health problems and a leading cause of death and injury around the world. Approximately 1.2 million people are killed each year in road crashes worldwide; with up to 50 million more injured. Over 95 of these deaths and injuries occur in the low- and middle-income countries of the world. The aim of this study is to evaluate the impact of the use of seat-belts in reducing the severity of injuries from road traffic crashes and to determine the compliance and awareness of the importance of the use of seat-belts among Nigerian motorists. Patients and Methods: The injury patterns and outcome of care in 140 patients who were seen at the emergency department of our tertiary hospital were evaluated. Initial care and resuscitation was carried out on all patients using the advanced trauma life support protocol. Results: A total of 81 (57) patients used seat-belts; while 59 (42.1) did not. Nineteen (13.6) patients died as a result of their injuries; 4 (21.1) of these had used seat-belts; while 15 (79) had not ( P = 0.001). The mortality rate of 79 for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists. for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists
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Acidentes , Serviços de Assistência Domiciliar , Hospitais , Veículos Automotores , Veículos Off-Road , Pacientes , Saúde Pública , Cintos de Segurança , UniversidadesRESUMO
Background: For many AIDS patients in low income countries such as African countries (Tanzania); hospital care is not always affordable or accessible and home-based care services rarely exist as a solution for meeting needs of PLWHA. Objective: To assess the knowledge; attitude and practice of home based care among family care givers for PLWHA. Setting: Study was conducted at Ukonga ward in Ilala District; Dar es Salaam with family care givers who accepted to participate in the study. Methods: A cross sectional descriptive study design was used: Convenience sampling wasused in recruiting the family care givers who had ever provided or were at that time providing care to PLWHA at Ukonga ward. Results: 103 Family Care givers participated in this study; 73(71) were female and 30(29) were male. The mean age of participants was 38 years. The study revealed that 17believed that they were knowledgeable; 65(63) had inadequate knowledge and 21( 20) had no knowledge whatsoever of HBC for PLWHA.. The relationship of believed knowledge and hospital re-admission of PLWHA was not statistically supported (P 0.001; P) reported that home is a better place than hospital in caring for PLWHA; and the relationship with hospitalre-admission was not signifi cance supported (P=0.2629); 55(53) reported to have had goodpractice of Home-Based Care for their patients. The relationship of poor practice of Home Based Care and hospital re-admission of PLWHA was statistically not supported (P=0.61762). Conclusions and recommendation: The study highlighted that majority of family care givers believed they had inadequate knowledge; had a good attitude and practice of the HBC provision. Therefore HBC Training is important for family members who are taking care of their relatives living with HIV/AIDS and further studies should be conducted in order to explore reasons as to why there is prevalence of hospital re-admission among PLWHA in developing countries like Tanzania
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Atitude , Infecções por HIV , Serviços de Assistência DomiciliarRESUMO
The article outlines the findings of a study designed to explore the working relationship between home-based caregivers and clinic nurses at locations in two informal settlements in Johannesburg; South Africa. By considering the views and experiences of both sponsored and unsponsored caregivers; the research focused on how degrees of informality affect this relationship. The nurse/caregiver relationship represents a primary interface between the formal and informal health sectors and is an important part of the country's primary healthcare system. Despite the attention given to linking home-based care (HBC) with the formal health system; very little research has examined the functionality of this link at the ground level. Through a number of qualitative; semi-structured interviews with nurses; home-based caregivers; and staff from the Department of Health; information was collected to better understand what systems are in place to facilitate the relationship between clinics and HBC organisations; and whether these systems are helping to create the desired results. Do the formal and informal health sectors complement and strengthen or do they distract and damage each other? By examining the influence of degrees of informality; the research also lends insight into how this distinction plays a role in healthcare provision. For instance; how does state support impact the link between the formal and informal health sectors and the ultimate quality of care? And what steps can be taken to improve the health system in this regard; as a whole? The findings point to a number of problems and challenges with integrating HBC into the formal health sector. Degrees of informality are found to have a profound impact on the work of home-based caregivers in some respects; but a surprising lack of impact in others. These issues need to be confronted in order to improve the existing system and; ultimately; health outcomes in South Africa
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Atenção à Saúde , Setor de Assistência à Saúde , Serviços de Assistência Domiciliar , Atenção Primária à Saúde , Pesquisa QualitativaRESUMO
Primary health care involves a sustained partnership between patients and providers that addresses the majority of a population's health needs over time. Patients' perception of satisfaction is an aspect of healthcare quality that is being increasingly recognised for its importance. The objective of this study was to investigate the factors contributing to patients' satisfaction with and their rating of the quality of care in Extension II Clinic in Gaborone; Botswana. of them were displeased with this aspect. A total of 36.9 Method: This was a cross-sectional study in which 360 systematically selected participants completed five-point Likert scale self-administered questionnaires. Results: Overall; participants were quite satisfied (mean score = 3.75) with the services provided by the different service providers. The participants indicated that overall; the quality of care of the health care facility was good (mean score = 3.45). The pharmacy received the highest satisfaction level with a mean rating of 4.1. Thirty-eight per cent of the participants rated the services provided by the doctors as best despite giving the highest quality ratings with a mean of 3.9 to the pharmacy compared to mean ratings of 3.4 for the doctors. The participants' greatest displeasure was with the time spent at the facility; as 63.9 was most pleased with information given to them as a factor of importance. Conclusion: The participants were quite satisfied with the services provided as well as the quality of care provided by the different service providers of the health care facility. There is; however; a need for interventions in terms of time spent at the facility; which would promote good customer-focused service delivery
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Gestão da Qualidade Total , Atenção à Saúde , Instalações de Saúde , Serviços de Assistência Domiciliar , Satisfação do Paciente , Percepção , Assistência Farmacêutica , Relações Médico-Paciente , Atenção Primária à SaúdeRESUMO
Prevalence of HIV infection in Botswana is among the highest in the world; at 23.9 of 15 - 49-year-olds. Most HIV testing is conducted in voluntary counselling and testing centres or medical settings. Improved access to testing is urgently needed. This qualitative study assessed and documented community perceptions about the concept of door-to-door HIV counselling and rapid testing in two of the highest-prevalence districts of Botswana. Community members associated many positive benefits with home-based; door-to-door HIV testing; including convenience; confidentiality; capacity to increase the number of people tested; and opportunities to increase knowledge of HIV transmission; prevention and care through provision of correct information to households. Community members also saw the intervention as increasing opportunities to engage and influence family members and to role model positive behaviours. Participants also perceived social risks and dangers associated with home-based testing including the potential for conflict; coercion; stigma; and psychological distress within households. Community members emphasised the need for individual and community preparation; including procedures to protect confidentiality; provisions for psychological and social support; and links to appropriate services for HIV-positive persons
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HIV , Aconselhamento , Serviços de Assistência Domiciliar , Adesão à Medicação , Percepção , Testes Sorológicos , Estigma SocialRESUMO
According to existing literature; ancillary health care workers (AHCWs) often do not meet the health care needs of patients with physical disabilities (physically disabled patients) in a home-based environment; because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term; home-based care in the northern suburbs of Johannesburg and; based on results; to offer recommendations for the training of AHCWs. Qualitative; exploratory; descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted; where participants had to answer the questions (1)'What are your health care needs?' and (2) 'How should these be met?' Data saturation was ensured; after which Tesch's method of data analysis was followed. Three categories of health care needs were identified (1) physical health care needs; (2) interpersonal relationship needs and (3) social needs; and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs. From the themes; recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient's individual needs; and should use knowledge and critical thinking skills to ensure a patient-centred care setting
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Pessoas com Deficiência , Necessidades e Demandas de Serviços de Saúde , Serviços de Assistência Domiciliar/educaçãoRESUMO
To more effectively address individuals' and couples' sexual and reproductive health needs, innovative service delivery strategies are being explored. These strategies are logistically and ethically complicated, considering prevailing gender inequalities in many contexts. We conducted an exploratory study to assess the acceptability of couples' home-based sexual health services in Malawi. We collected qualitative data from six focus group discussions and 10 husband-wife indepth interviews to gain a more thorough understanding of how gender norms influence acceptability of couples' sexual health services. Findings reveal that women are expected to defer to their husbands and may avoid conflict through covert contraceptive use and non-disclosure of HIV status. Many men felt that accessing sexual health services is stigmatizing, causing some to avoid services or to rely on informal information sources. Gender norms and attitudes toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples' sexual health services (Afr J Reprod Health 2010; 14[4]: 63-73)
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Anticoncepção , Características da Família , Identidade de Gênero , Serviços de Assistência Domiciliar , Malaui , Serviços de Saúde Reprodutiva , Medicina ReprodutivaRESUMO
Background: Vitiligo is an acquired pigmentary disease characterized by loss of the pigment producing cells (melanocytes) of the skin; hair and mucous membranes (lips and genitalia); with subsequent development of white patches. The aim of this study was to evaluate the epidemiological pattern of vitiligo in Port Harcourt; south-south Nigeria. Methods: This was a prospective study of 82 cases of vitiligo seen in the dermatological clinic of the University of Port Harcourt Teaching Hospital (UPTH); Port Harcourt; Nigeria from May 2005 to April 2009. All ages were included in this study. Data was analysed using the SPSS version 15. Descriptive statistics in the form of the frequency and percentage were used. Chi square was used to test relationship between variables. P0.05 was considered statistically significant. Results: There were a total of 1;652 dermatological disorders during the study period. Eighty two patients had vitiligo giving a prevalence of 4.96. There were more females 45(54.9) than males 37(45.1) giving male: female ratio of 0.8:1. Vitiligo is commoner from the age of 20 years to 30 years (32.9). The head and neck region was the most common site of onset of the lesion and accounted for 28of cases. Generalized vitiligo [29(35.4)] was the most frequently found pattern of distribution. Positive family history was found in 6 cases (7.3). Eighteen (22.0) patients suffered from other diseases such as thyroid dysfunction [8(9.8)]; anaemia [4(4.9)]; atopic dermatitis [2(2.4)]; diabetes mellitus [1(1.2)]; anxiety disorder [1(1.2)]; collagen vascular disease [1(1.2)] and oligomenorrhoea [1(1.2)]. Conclusion: The pattern of vitiligo seen is similar to that reported from other parts of the world. There is also need to look for associated disorder in any case of vitiligo
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Serviços de Assistência Domiciliar , Sinais e Sintomas , Vitiligo/epidemiologiaRESUMO
HIV/AIDS has been found to be a challenging disease to humanity; its challenge spin-offs falling especially on to the caregivers of those infected and affected by the virus. This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care (CHBC) programme in Botswana. The study was qualitative in design and explorative in nature; involving 82 primary caregivers in focus group discussions; and 5 CHBC nurses in individual interviews. Caregivers were found challenged by lack of community networks support; inadequate sanitary and care packages; poor shelter compromising privacy; inadequate income and food for their clients; inadequate care motivation as their volunteerism does not attract any payment; inadequate health personnel to offer psychosocial support like counselling; and an unconducive caring environment generally. Putting in place policies to redress caregivers' poverty; helping caregivers start income-generating projects; increasing community assistance and caregiving facilities are recommended as factors to address caregiver challenges
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HIV , Síndrome da Imunodeficiência Adquirida , Serviços de Assistência Domiciliar , Pacientes , Qualidade da Assistência à Saúde , Assistência TerminalRESUMO
Background: Diarrhoea often starts at home. Early and appropriate treatment by caregivers will go a long way towards reducing the morbidity and mortality from diarrhoea. Aim: To document how acute diarrhoea is managed at home by caregivers and to determine the appropriateness of such treatment. Methods: A prospective study of children less than 5 years with diarrhoea attending the Diarrhoea Training Unit (DTU) and Children Emergency Ward (CHEW) of the University of Port Harcourt Teaching Hospital (UPTH) was conducted using a structured questionnaire administered to the caregivers. Results: A total number of 250 children were recruited for the study. Twenty-four (9.6) children had blood in stool (dysentery) while 226(90.4) had acute watery diarrhoea. Thirty-six (14.4) gave oral rehydration therapy (ORT) as the only home treatment; 60 (24.0) gave both drugs and ORT; while 151 (60.4) gave drugs alone and 3 (1.2) children received no treatment. The drugs given included antibiotics in 188 (89.1); adsorbents in 53 (25.1); antiemetic in 12 (5.7); antispasmodic in 8 (3.8); antihelminthics in 7 (3.3); and antacid in 6 (2.8). None of the cases with blood in the stool (dysentery) received the appropriate antibiotics. Parental education and social class did not seem to have an effect on the appropriateness of the care given to these children. Conclusion: Diarrhoea management at home is inadequate in terms of low utilization of oral rehydration therapy; inappropriate adminis- tration of antibiotics for cases with bloody stool; and unnecessary use of antibiotics/antidiarrhoeals for acute watery diarrhoea
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Cuidadores , Diarreia , Serviços de Assistência DomiciliarRESUMO
Background:One of the key interventions proposed under the Roll back malaria initiative is improvement of case management of malaria at the home and community levels to reduce malaria burden. This study was conducted to determine the practice and determinants of Home Management of Malaria (HMM) among care givers of children below 5 years old in an urban community in Lagos State; Nigeria. Mehods: This was a cross-sectional study conducted in 2007. A multi-stage sampling method was used to select the 340 respondents who participated in this study. Data was collected using interviewer administered questionnaires and analysed with Epi-info software. A care giver was included in the study if he/she takes care of a child/ children less than 5 years old. Results: The commonest treatment practice by caregivers for their young children with malaria was home treatment with antimalarial drugs [51.5]. HMM was not significantly determined by care givers' age nor educational level. Most children were treated with chloroquine and only a few [4.2] of the children were treated with the recommended drug [ACT]. Overall; only 1.24received adequate treatment. Conclusion: Few respondents correctly practice HMM. There is need to educate care givers of young children on the proper management of malaria at home
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Antimaláricos , Cuidadores , Criança , Serviços de Assistência Domiciliar , Lactente , Malária , População UrbanaRESUMO
Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urbancommunities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. Objective: The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. Design: A household longitudinal study was conducted in Nyando district; Kenya in 2004-2006 adopting both qualitative and quantitative approaches. Subjects: A total of 927 mothers/caregivers of under-fives participated in the study. Main outcome measures: Perceived causes of childhood diarrhoea; action taken during diarrhea; fluid intake; recognition of signs of dehydration; feeding during convalescence; adherence to treatment and advice. Results: Majority of the respondents 807(87.1) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524(55.6); contaminated food 508(54.9); bad eye 464 (50.0); false teeth 423(45.6) and breast milk 331(35.8). More than 70of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour; rice water and selected herbs as anti-diarrheal agents. During illness; 239(27.8) of the children were reported not to have drunk any fluids at all; 487(52.5) drunk much less and only 93(10.0) were reported to have drunk more than usual. A significant 831(89.6) withheld milk including breast milk with the notion that it enhanced diarrhea. Conclusion: Based on these findings; there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and miscon- ceptions and facilitate positive change in the household practice on management of diarrhea among under-fives
Assuntos
Criança , Diarreia , Serviços de Assistência Domiciliar , Lactente , Sinais e SintomasRESUMO
This study examines clinical waste disposal and handling in the context of a community home-based care (CHBC) programme in Kanye; southern Botswana . This qualitative study involved 10 focus group discussions with a total of 82 HIV/AIDS primary caregivers in Kanye; one-to-one interviews with the five nurses supervising the programme; and participant observation. Numerous aspects of clinical or healthcare waste management were found to be hazardous and challenging to the home-based caregivers in the Kanye CHBC programme; namely: lack of any clear policies for clinical waste management; unhygienic waste handling and disposal by home-based caregivers; including burning and burying the healthcare wastes; and the absence of pre-treatment methods; inadequate transportation facilities to ferry the waste to clinics and then to appropriate disposal sites; stigma and discrimination associated with the physical removal of clinical waste from homes or clinics; poor storage of the healthcare waste at clinics; lack of incinerators for burning clinical waste; and a high risk of contagion to individuals and the environment at all stages of managing the clinical waste